A new study on HIV infection and AIDS in South Africa has shown that children aged 2 to 14 years have an infection rate of 5.6%, leading to worries that South Africa's other epidemic—child abuse—is linked to the spread of HIV.
The Nelson Mandela/HSRC [Human Sciences Research Council] study of HIV and AIDS released last week draws for the first time on a representative sample of the local population including all ages and population groups. The most frequently used survey, done annually by the health department, has always been based on pregnant women reporting to state antenatal clinics. They are almost always African women, sexually active, and unprotected and poor. Other data have been extrapolated from this annual survey.
The new study, based on nearly 9000 participants and using anonymous saliva tests, has also shown that the white population is much more at risk from the virus than previously thought. Some 6.2% were found to carry the virus. Black Africans had the highest prevalence—18.4%.
Investigators are not sure why the prevalence among young children is so high. South Africa has not so far had a problem with reusing needles at clinics. Although abuse of children is common, that is not thought to be the whole explanation because abuse is more common in girls than boys and yet the HIV rate was found to be similar between the sexes. The situation is likely to give rise to more research.
Other areas in which the study showed differing nuances of the spread of the epidemic was in the geographical spread. The conventional wisdom that KwaZulu-Natal is at the epicentre of the epidemic has been shattered with evidence that three other provinces have higher prevalence.
Researchers have suggested that KwaZulu-Natal's antenatal clinics, on which earlier studies were conducted, are largely along lorry drivers' routes. The province has, however, got a much larger rural population than have most other provinces.
In the same week as the HSRC study was announced, the South African Medical Association stated that it will provide 18 pilot sites from which to offer treatment, with the funding likely to come from the Nelson Mandela Foundation.
At the launch of this initiative, Mr Mandela praised Zackie Achmat, the chairman of the Treatment Action Campaign and also an HIV positive activist, who has refused to take antiretroviral treatment until it is available to poor people. His medical condition requires that he take them now as he has been increasingly developing opportunistic infections.