Despite an increase in intergenerational sex amongst female teenagers, despite an increase in the number of multiple partners amongst men age 15-24, despite a decrease in HIV prevention knowledge, the third South African National HIV survey conducted in 2008 showed a promising decline in the number of HIV infections amongst the 15-24 years old.

“HIV prevalence among adults aged 15-49 has declined between 2002 and 2008 in the Western Cape, Gauteng, Northern Cape and the Free State, with the largest decline of 7.9 percentage points in the Western Cape.”

This may well be explained by an increase in condom use:

“The proportion of the population who reported using a condom at their last sexual encounter was particularly high among young people aged 15-24 years: from 57% in 2002 to 87% in 2008 among young males, and from 46% to 73% among young females. This trend was also obvious in condom use among people in the 25-49 age group, where condom use among males aged 25-49 at last sex has nearly doubled, while among females in the same age group it has tripled.”

The survey conducted by by the Human Sciences Research Council (HSRC), in conjunction with the Medical Research Council (MRC) and the Centre for AIDS Development, Research and Evaluation (CADRE), sends a clear message:

Condoms work!

It also hints at a very different kind of HIV prevention intervention as suggested by another observation:

“The good news is that the change in HIV prevalence in children is most likely attributable to the successful implementation of several HIV-prevention interventions,” said Dr Olive Shisana, CEO of the Human Sciences Research Council (HSRC) and one of the two principal investigators of the study. “These interventions are related to addressing HIV in early childhood, particularly programmes to prevent mother-to-child transmission in the Western Cape, where the largest decline of 6 percentage points occurred.”

This is a completely different way of tackling the HIV epidemic with a dramatic shift from prevention to treatment and a focus on addressing sexual behaviours that most contribute to the spread of the epidemic such as multiple partnership and intergenerational sex.

The survey also confirmed that drug users and Men who have Sex with Men (MSM) are amongst those most vulnerable to HIV infection and that specific interventions are needed to reach these groups.

“For the first time, the report provides information on high-risk groups, defined in this study as people who drink excessively, those who take drugs, men who have sex with men and people with disabilities as well as women aged 20-34 and men aged 25-49. More attention should be paid to these categories in the NSP” said Shisana.

Evidences are piling up, action is urgently needed, starting by knowing your status (if the South African can do it and they did – “The percentage of people in the age group 15-49 who reported awareness of their HIV status has doubled from 2005 to 2008”, we can do it too) and by insuring human rights for those most vulnerable.

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