Durban — KwaZulu-Natal has the second-highest HIV prevalence rate in South Africa at 16.0%, a decrease from 18.0% in 2017.

This translates to about 1.98 million individuals living with HIV in the province.

This emerged from the Sixth South African HIV Prevalence, Incidence and Behaviour Survey (SABSSM VI) released by the Human Sciences Research Council (HSRC) at a provincial dialogue at the Edward Hotel in Durban on Monday.

The survey, led by overall principal investigator of the study, the HSRC’s Professor Khangelani Zuma, highlighted significant age-related disparities, noting that individuals aged 25 to 49 represent a staggering 31.1% prevalence, with women significantly more affected than males.

Rural areas recorded a prevalence of 20.0%.

Despite the decline in overall prevalence, the data indicated a concerning trend: the HIV prevalence among older populations is rising.

The report also noted an increase in antiretroviral treatment (ART) coverage to 87.3%.

Zuma said: “HIV prevalence peaked at 44.5% among those aged 45 to 49 years in 2022 from 39.7% in 2017 among those aged 35 to 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.”

In a statement released by the council, ART coverage in KwaZulu-Natal increased 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.

In 2022, ART use among all PLHIV in the province was lowest among adolescents and youth aged 15 to 24 years (62.8%) compared to other age groups. ART use was also lower among both males (58.8%) and women (64.0%) in this age group compared to other age groups. In addition, 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 women in the rural localities (>90%).

However, the data also put KZN on the right track in reaching the UNAIDS 95–95–95 targets.

It stated that in KZN, 94.0% of PLHIV aged 15 years and older were aware of their HIV status. Some 93.4% of those were on ART and 95.3% of those on ART were virally suppressed.

Nationally, 89.6% of PLHIV aged 15 years and older were aware of their HIV status, 90.7% were on ART, and 93.9% of those on ART were virally suppressed.

The study also revealed that key drivers of the HIV epidemic were sexually active before the age of 15 years, and Zuma noted that in KZN there was no change in the proportion of youth aged 15 to 24 years who reported having sex before the age of 15 in 2017 (8.2%) compared to 2022 (8.6%).

However, sexual activity before the age of 15 among adolescents and youth aged 15 to 24 years in 2022 was higher among males (12.3%) than females (4.8%). It was lowest in uMkhanyakude (4.1%) and highest in uMgungundlovu (9.4%) followed by eThekwini (8.8%).

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