HIV rates among children, adolescents may be decreasing in South Africa

New HIV infections in children aged 2 to 14 years may have decreased by more than 50% in South Africa between 2002 and 2008, according to findings presented at the 17th Conference on Retroviruses and Opportunistic Infections, held in San Francisco.

Thomas Rehle, MD, PhD, of the Human Sciences Research Council in South Africa, said the decrease may be attributed to the availability of antiretroviral therapy.

“ART was a game-changer in this country,” Rehle said. “It is encouraging that there are almost 1 million people on treatment programs in South Africa.”

Although overall prevalence did not change significantly, some changes were seen in specific age groups, he said. Between 2002 and 2008, rates among children aged 2 to 14 years decreased from 5.6% to 2.5%. Between 2005 and 2008, the rate among adolescents aged 15 to 24 years decreased from 10.3% to 8.7%. HIV prevalence increased slightly among individuals older than 25 years, from 15.5% to 16.8%.

“The significant decline among children between 2002 and 2008 is likely due to AZT coverage in the country, which has impacted vertical transmission,” Rehle said, adding that behavioral changes were also observed.

“Though rates of multiple sexual partnerships and intergenerational sex have not changed, condom use and awareness of HIV status increased over the past three years,” he said.

Among individuals aged 15 to 49 years, reported condom use at the last sexual encounter increased from 31.3% in 2002 to 64.8% in 2008.

“Overall, I would say that there are two success stories in these data — the reduction in mortality resulting from ART coverage and the reduction in incidence due to prevention programs,” Rehle said. – by Rob Volansky

For more information:

Rehle T. Trends in HIV prevalence, incidence, and risk behaviors among children, youth and adults in South Africa, 2002 to 2008. Presented at: 17th Conference on Retroviruses and Opportunistic Infections; Feb. 16-19, 2010; San Francisco.