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Mpumalanga has recorded the highest HIV prevalence in South Africa, according to the latest findings from the Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI), released by the Human Sciences Research Council (HSRC).
The survey reveals that in 2022, Mpumalanga’s HIV prevalence stood at 17.4%, the highest of any province, equating to approximately 890,000 people living with HIV (PLHIV) in the region.
Professor Khangelani Zuma, the study’s principal investigator, reported that HIV prevalence among adolescents aged 15 to 24 was 7.8%, with males in this age group showing a higher prevalence (9.8%) compared to females (6.3%).
For adults aged 25 to 49, HIV prevalence was notably higher, at 26.4%, with women showing a 31.9% prevalence compared to 19.9% among men.
The survey also highlighted variations by locality, with HIV prevalence being higher in rural formal/farm areas (21.1%) and rural informal areas (18.4%), compared to urban areas (15.5%).
“A particularly concerning trend is the increase in HIV prevalence among individuals aged 45 to 49, which reached 40.8% in 2022. This suggests a potential continuation of new infections, though a notable decline was observed among younger respondents aged 15 to 44,” said Professor Zuma.
The study focused on three priority districts in Mpumalanga: Ehlanzeni, Gert Sibande, and Nkangala. Gert Sibande recorded the highest HIV prevalence (20.5%), followed by Ehlanzeni (16.0%) and Nkangala (13.1%).
The findings also reveal significant progress in antiretroviral treatment (ART) coverage in Mpumalanga, which increased to 81.8% in 2022 from 65.4% in 2017. This means that approximately 630,000 people living with HIV in the province were receiving ART in 2022.
However, ART use varied by age and gender. Among adolescents and youth aged 15 to 24, ART coverage was 56.4%, compared to 83.9% among adults aged 25 to 49. Coverage was particularly low among young males aged 15 to 24, at 54.8%.
By district, ART coverage was lowest in Nkangala (77.9%) and Ehlanzeni (79.4%).
The SABSSM VI survey, conducted between 2022 and 2023, aimed to assess HIV infection, behaviours, and the progress of the national HIV and Aids, STI, and TB Strategic Plan.
The survey highlighted the need for targeted interventions, particularly for adolescent girls and young women, to combat the HIV epidemic by 2030. Professor Zuma also called for a long-term strategy to address the ageing HIV epidemic, suggesting that clinical gaps be addressed by district and locality.
“We also recommend a continued focus on increasing medical male circumcision among males aged 15 and older and promoting public awareness of HIV prevention measures like regular testing, condom use, and Pre-Exposure Prophylaxis (PrEP),” added Zuma.