The number of HIV-positive people in South Africa increased 12% in 2002, but the spread of the epidemic may be slowing down, according to a report released by the South African Department of Health yesterday, Reuters/AlertNet reports (Reuters/AlertNet, 9/10). The data are based on a national prenatal survey conducted in October 2002, which gathered HIV and syphilis information from 16,500 pregnant women at 396 state-run prenatal clinics throughout the country. Extrapolations based on a model developed by the national health department estimate that the total number of HIV-positive people in the country grew from 4.74 million in 2001 to 5.3 million in 2002 (Caelers, Cape Argus/IOL, 9/10). The study found that HIV prevalence for pregnant women under age 20 remained stable for the fourth year in a row. According to SAPA/News24, the HIV prevalence among this age group is considered to be the most accurate indicator of whether new infections are on the rise. "These findings support the view that, although the HIV infection rate is high in South Africa, there has been a significant slowing down in the spread of the epidemic and South Africa can be considered to have a slow-developing epidemic," the report said, adding that the country's epidemic had the characteristics of mature HIV epidemics around the world (SAPA/News24, 9/10). Approximately 34.5% of pregnant women ages 25 to 29 in South Africa are HIV-positive, and about 29.5% of pregnant women ages 30 to 34 are HIV-positive (SAPA/News24, 9/10). According to the study, KwaZulu-Natal province had the highest HIV prevalence rate -- 36.5% -- in South Africa, followed by Guateng at 31.6% and Western Cape at 12.4% (Kahn, Business Day, 9/10). The study also found that 90,000 infants contracted HIV from their mothers in 2002, roughly equivalent to 250 cases of vertical HIV transmission each day (Reuters/AlertNet, 9/10).

Advocates Challenge Interpretation
Some AIDS advocates and experts disagree with the government's interpretation of the survey results, South Africa's Star reports (Altenroxel, Star, 9/10). Zackie Achmat, head of South Africa's Treatment Action Campaign, said that the government's response to the survey was not "a fair interpretation or reflection of the scale of the pandemic," adding that the survey "must not mean we should think our prevention work is over or has been done properly." TAC also criticized the delay in the release of the report, which was supposed to have been released in April, SAPA/News24 reports. "The delays not only pose a question mark over the results and the government's interpretation of them, but also unnecessarily delay planning that relies on these statistics," Achmat said (SAPA/News24, 9/10). "It is simply unacceptable in our democratic state that the minister of health [Manto Tshabalala-Msimang] kept this report under wraps for so long. What is more startling is that the minister did not hold a press conference when releasing the report; the department merely issued a press statement. This low-key approach, and the procrastination that preceded it, highlights the appalling lack of urgency with which the minister has responded to the HIV/AIDS pandemic," the Democratic Alliance said in a statement (Democratic Alliance release, 9/9).

Tuberculosis
An international health expert yesterday said that tuberculosis is the number one cause of death among HIV-positive South Africans, Agence France-Presse reports. Patrick Bertrand, regional coordinator of the Massive Effort Campaign, a not-for-profit organization specializing in combining efforts to fight TB, AIDS and malaria, said that HIV-positive people were 10 times more likely to contract TB than people who are HIV-negative. South Africa now has the highest HIV-TB coinfection rate in the world -- more than half of the country's HIV-positive people also have TB, according to Agence France-Presse. However, TB "is an easily treated and curable disease -- the drugs and diagnosis are free and accessible everywhere in the country," Bertrand said during a visit to clinics in a mining community southwest of Johannesburg. An unnamed health care worker at the clinic said that because there is such a strong link between HIV and TB, the two diseases should be treated at the same time, according to Agence France-Presse. "With HIV/AIDS there has been a lot of publicity and we haven't seen a lot of drugs. With TB, there are a lot of drugs and treatment available for free, but there has not been a lot of publicity around it," the health worker said (Hennop, Agence France-Presse, 9/10).

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