News Roundup [abridged Versions Appear In The Paper Journal]

1 in 4 pregnant women in South Africa has HIV

BMJ 2001; 322 doi: (Published 31 March 2001) Cite this as: BMJ 2001;322:755
  1. Pat Sidley
  1. Johannesburg

    The South African government has released its annual figures on HIV and AIDS, which show a continued increase in the numbers of people contracting the virus. About 4.7 million South Africans now have the virus, compared with 4.2m in 1999.

    Some 24.5% of pregnant women were infected with HIV, according to a survey of 16 548 blood samples in the year 2000. The equivalent figures for 1998 and 1999 were 22.8% and 22.4% respectively.

    The government's claim that the rate of increase in the disease was slowing significantly prompted questioning from several experts in the field. The controversy has arisen from the 1998 figure, which experts believe was as an overestimate.

    The survey is done each October, at state-run antenatal clinics among pregnant women presenting for the first time in that pregnancy. It is anonymous and unlinked. From these figures—largely drawn from African women—the statistics are weighted and then extrapolated to produce an estimate of the country-wide prevalence of the infection.

    Several provinces showed a substantial rise in prevalence, such as Kwa-Zulu Natal, which showed a rate among pregnant women of 36.2%, compared with 32.5% in the previous year. In the Western Cape 8.7% of women at the clinics were HIV positive, but questions have been raised about the adequacy of the samples.

    The most worrying increase was among young women in their late 20s, who showed a prevalence rate of 30.6%. The survey's authors noted that this group of women have consistently shown the highest rates of increase over the years.

    Women aged under 20 showed a much lower prevalence rate (16.1%). This, according to the Treatment Action Campaign's Mark Heywood, may reflect the heightened awareness of HIV and AIDS among the young people of the country and the comparative powerlessness that African women experience when they marry. They find themselves unable to enforce the use of condoms or enforce monogamy if the husband is a migrant worker.