The sexual debut before the age of 15, found to be higher among adolescent males than females, has been identified as one of the key drivers of the HIV epidemic in the Western Cape.
This was revealed when the Human Sciences Research Council (HSRC) released the key findings of the Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) for the Western Cape on Thursday.
The report showed an increase in the proportion of adolescents and youth aged 15–24 years who reported sex before the age of 15 years in 2022 (16.3%) compared with 2017 (14%).
The sexual debut before the age of 15 years among adolescents and youth aged 15–24 in 2022 was higher among males (21.5%) than females (11.3%).
Despite this, the survey found that compared to other provinces, the Western Cape had the lowest HIV prevalence (7.4%) in 2022.
This translates to 540 000 people living with HIV in the Western Cape, which was a decline from 560 000 in 2017.
According to principal investigator of the study, HSRC’s Professor Khangelani Zuma, the survey showed that in 2022, HIV prevalence in the province was higher among those aged 25–49 years (10.8%), for both females (14.6%), and males (5.8%).
Zuma recommended a long-term strategy to care for individuals in an ageing HIV epidemic as well as tailored interventions to address gaps in the clinical cascade.
“HIV prevalence peaked at 12.9% among those aged 35–39 years in 2022 from 23.4% in 2017 within the same age group.
“There was a decrease in HIV prevalence in 2022 among all age groups younger than 30–34 years compared to 2017, apart from the age groups 0–14, 15–19, and those 50 years and older.
The worsening prevalence among those younger than 24 years is deeply concerning as it shows continued new infections from both horizontal and vertical transmissions.
“We also recommend a continued focus on increasing coverage and demand for medical male circumcision among males aged 15 years and older.
We must enhance public awareness and uptake of effective HIV prevention measures, such as regular HIV testing, condoms and PrEP,” said Zuma.
The report further detailed that condom use in the province had declined – 22.1% reported using a condom with their most recent sexual partner in 2022 compared with 26.6% in 2017, representing a 4.5% decline.
Health and Wellness MEC Mireille Wenger said: “We are encouraged by the results showing that in 2022 the Western Cape had the lowest HIV prevalence in the country compared to other provinces. This only strengthens our resolve to continue working towards lowering this rate even further in co-operation with our civil society partners.”
The HSRC conducted its survey in partnership with the US Centers for Disease Control and Prevention (CDC), the South African Medical Research Council (SAMRC), UCT, and the National Institute for Communicable Diseases (NICD).
A provincial results dissemination roadshow, dubbed the Provincial Dialogue, was so far successfully completed in the Eastern Cape, Limpopo, Gauteng North West and Mpumalanga, Free State and KwaZulu-Natal.
The final dialogue will take place in the Northern Cape on September 30.
The HSRC noted that Mpumalanga had the highest HIV prevalence at 17.4% in 2022, which translated to an estimated 890 000 people living with HIV in the province.
KwaZulu-Natal recorded the second-highest HIV prevalence rate at 16% in 2022.
Cape Times