The recent study by the Human Sciences Research Council (HSRC) has revealed that people living with Human Immunodeficiency Virus (HIV) in KwaZulu-Natal has dropped from 1.99 million in 2017 to 1.98 million in 2022, but, the province still has the second highest HIV prevalence in the country.
The HSRC disclosed this during the Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) for the province on Monday, September 23 2024, at a provincial dialogue held at The Edward Hotel, Durban.
According to the overall principal investigator of the study, Professor Khangelani Zuma the survey found that KwaZulu-Natal had the second-highest HIV prevalence at 16.0% in 2022, a drop from 18.0% in 2017 compared to other provinces.
“This translates to 1,980,000 people living with HIV (PLHIV) in KwaZulu-Natal, which was a decline from 1,990,000 PLHIV in 2017.”
Zuma said in 2022, HIV prevalence in the province was higher among those aged between 25 to 49 years at 31.1%, with both females at 38.4%, and males at 21.5%.
He said the HIV prevalence was also higher among those residing in rural formal or farm areas by 20.0%.
“HIV prevalence peaked at 44.5% among those aged 45-49 years in 2022 from 39.7% in 2017 among those aged 35-39 years, indicating a possibility of continuing infections among older people. HIV prevalence had decreased by 2022 among all age groups younger than 40 years compared to 2017,” he said.
By district, Zuma said in 2022, the HIV prevalence was highest in uMgungundlovu at 19.5%.
He said the data presented focused eight districts within the province specifically, eThekwini, Harry Gwala, King Cetshwayo, Ugu, uMgungundlovu, uThukela, Zululand and uMkhanyakude districts.
He said the districts were identified as priorities in the study protocol.
“Data for Amajuba, uMzinyathi and iLembe are not presented because these districts were not oversampled to allow for reliable estimates.”
Zuma said the Antiretroviral treatment (ART) coverage in KwaZulu-Natal rose to 87.3% in 2022 from 71.2% in 2017.
“The ART coverage estimate translates to an estimated 1,609,000 PLHIV in the province receiving treatment in 2022.”
He said in 2022, ART uptake among adolescents and youth aged between 15 and 24 years, remained significantly lower by 62.8% compared to other age groups.
Zuma said the ART use was also lower among both males by 58.8% and females with 64.0% in the same age groups compared to others.
“ART use was lower among those who reside in urban areas (83.1%), compared to other localities, and these findings were consistent for both males and females in the rural localities (>90%).”
He said the ART use in the province was consistently lower among males compared to females.
“Two exceptions were, firstly, among children aged 0-14 years where ART use among males was 83.5% compared to females (65.9%), and secondly, among rural formal areas, where ART use among males (93.3%) was similar to females (93.6%).”
By district, Zuma said the ART use was lowest in eThekwini at 83.4% and King Cetshwayo at 85.5%.
According to the study, in terms of progress towards the 95-95-95 UN AIDS targets, in KZN, 94.0% of people aged 15 years and older know their HIV status, while 93.4% of those are on ART and 95.3% of those on ART, are virally suppressed.
“Nationally, 89.6% of PLHIV aged 15 years and older were aware of their HIV status, 90.7% of those who knew their HIV status were on ART, and 93.9% of those on ART were virally suppressed,” Zuma said.
Zuma expressed concern that people aged between 25 and 49 years accounted for the majority of HIV in the province at 68.3%.
He said 54.5% of those don’t know their HIV statuses, while 63.5% of them not receiving ART and 66.4% on ART but not virally suppressed.
“However, adolescents and youth aged 15-24 years contribute disproportionately to gaps in treatment, accounting for just 8.5% of all PLHIV, but 28.4% of those unaware of their HIV status, 19.1% of those aware but not on ART and 15.7% of those on ART but not virally suppressed.”
Zuma noted that, in KZN, there was no change in the proportion of adolescents and youth aged between 15 and 24 years who reported having sex before the age of 15 years in 2017 at 8.2% compared to 2022 at 8.6%.
He said the sexual debut before the age of 15 years among adolescents and youth aged 15 and 24 years in 2022 was higher among males at 12.3% than females at 4.8%.
“It was lowest in uMkhanyakude (4.1%) and highest in uMgungundlovu (9.4%) followed by eThekwini (8.8%).”
In addition, the study also revealed concerning trends in sexual behaviour in the province, with about 11.0% of people aged 15 years and older reported having multiple sexual partners in 2022 compared to 9.4% in 2017.
Zuma said condom use with most recent partners has decreased from 44.9% in 2027, to 32.8% in 2022, which was a decrease of 12.1%.
He added that self-reported circumcision in the province climbed from 38.3% in 2017 to 54.6% in 2022.
“In 2022, self-reported male circumcision in the province was lower among those aged 25-49 years (57.6%) and in those residing in rural informal or farm areas (51.5%), and highest among those aged 25-34 years (62.8%),” he said.
