HIV epidemic in South Africa: A comparison of HIV epidemic patterns of two extreme provinces in South Africa
Authors: Zuma Khangelani , Manzini Khanyisile , Mohlabane Neo 
Published: August 2014

Background: South Africa is experiencing one of the worst HIV epidemics, which varies by province and by districts within each province.Objective: To explore and compare HIV trends and patterns between two provinces in South Africa. Method: ‘Know your epidemic’ synthesis suggests that HIV prevalence is rising in older age groups and falling in younger people. Using secondary data analyses of population-based and antenatal care surveillance (ANC) surveys, we explored trends and patterns in HIV prevalence in KwaZulu-Natal and Western Cape.Results: Even though KwaZulu-Natal has the highest HIV prevalence in the country (15.5% compared with 3.8% in the Western Cape), there is considerable recent decline (6%) in HIV prevalence in KwaZulu-Natal, compared with a 2% increase in the Western Cape, based on ANC data, in youth aged 15 to 24 years. These results are consistent with those from a population-based survey where a decline of 0.3% in HIV prevalence in KwaZulu-Natal was observed as compared with an increase of 0.7% in Western Cape youth. Both ANC results and population-based surveys conducted in different years show a decline in HIV prevalence amongst youth in KwaZulu-Natal compared with an increase in the same age group in the Western Cape. HIV infection in this age group is associated with recent infection, thus indicating an increasing epidemic in the Western Cape compared with KwaZulu-Natal.Conclusion: Interventions aimed at curbing infections such as sexual abstinence and condom promotion in this age group need to be implemented extensively in the Western Cape. These should include HIV counseling and testing campaigns. Agtergrond: Suid-Afrika ondervind een van die ergste MIV-epedemies, wat verskil ten opsigte van elke provinsie en distrik en binne elke provinise. Doelstelling: Om MIV-voorkoms en -patrone tussen twee provinises in Suid-Afrika te ondersoek en vergelyk.Metode: ‘Ken jou epidemie’ sintese dui daarop dat die voorkomssyfer van MIV in ouer ouderdomsgroepe styg en daal by jonger mense. Ons het sekondêre data analieses van bevolkingsgebaseerde en swangerskapsorg waarnemingsopnames (ANC) gebruik om neigings en patrone in MIV-voorkoms in Kwa-Zulu Natal en die Wes-Kaap, vas te stel.Resultate: Ofskoon Kwa-Zulu Natal die hoogste voorkoms in Suid-Afrika (15.5% vergelyk met 3.8% in die Wes-Kaap) het, is daar ‘n aansienlike onlangse afname (6%) in die voorkoms van MIV in Kwa-Zulu Natal waargeneem, vergelyk met die 2% verhoging in die Wes-Kaap, gebasseer op ANC data, in jongmense in die ouderdomsgroep 15–24 jaar. Hierdie resultate is konsekwent met dié van die bevolkingsgebaseerde opname, waar ‘n afname van 0.3% in MIV-voorkoms in Kwa-Zulu Natal waargeneem is, vergelyk met ‘n toename van 0.7% in die jeug van die Wes-Kaap. Altwee die ANC-resultate en die bevolkings-gebaseerde opnames wat in verskillende jare uitgevoer is, wys ’n afname in MIV-voorkoms onder die jeug in Kwa-Zuly Natal vergelyk met ’n toename onder dieselfde ouderdomsgroep in die Wes-Kaap. MIV-infeksie onder hierdie ouderdomsgroep word verbind met ’n onlangse infeksie, wat ’n toename van die epidemie in die Wes-Kaap, vergelyk met Kwa-Zulu Natal aandui.Gevolgtrekkings: Ingryping, wat daarop gemik is om infeksies soos seksuele onthouding en die reklame van kondome vir hierdie ouderdomsgroep, behoort wyd in die Wes-Kaap geimplementeer te word. Hierdie behoort voorligtings- en toetsveldtogte in te sluit.