South African National HIV Prevalence, Incidence and Behaviour Survey, 2012

Presenter: Prof LC SimbayiExecutive Director, HAST Programme,

Human Sciences Research Council

Presentation during Botswana NACA’s Satellite on “Are we there yet? Stepping up the Pace through 2012 National HIV Prevalence Surveys: Botswana, Kenya and South Africa” at

the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia Venue: Room 101-102.

Date: Wednesday 28 July 2014Time: 0700-0830

South African National HIV Prevalence, Incidence and Behaviour Survey, 2012

Presenter: Prof LC SimbayiExecutive Director, HAST Programme,

Human Sciences Research Council

Presentation during Botswana NACA’s Satellite on “Are we there yet? Stepping up the Pace through 2012 National HIV Prevalence Surveys: Botswana, Kenya and South Africa” at

the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia Venue: Room 101-102.

Date: Wednesday 28 July 2014Time: 0700-0830

ReferenceReference

• Shisana, O., Rehle, T., Simbayi, L.C., Zuma, K., Jooste, S., Zungu, N., Labadarios, D., Onoya, D., et al. (2014) South African National HIV Prevalence, Incidence and Behaviour Survey,2012. Cape Town, HSRC Press.

BackgroundBackground• This is the fourth national population-based survey,

three similar surveys were conducted by the same team in 2002, 2005 and 2008.

• The study has provided an important gauge of the HIV epidemic of South Africa.

• The results are used to both inform and evaluate important health programmes such as the National Strategic Plan (NSP) on HIV/AIDS, STI and TB, and the National Health Insurance, among others.

• Main HIV survey objectives were:• to estimate national HIV prevalence & HIV

incidence• to measure behavioral,socio-demographic and

health indicators

National HIV Household SurveySouth Africa 2012

National HIV Household SurveySouth Africa 2012

• Survey period: January 2012 – November 2012• All age groups eligible

38,431 interviewed 28,997 tested for HIV

HIV PREVALENCEHIV PREVALENCE

National HIV Household SurveySouth Africa 2012

National HIV Household SurveySouth Africa 2012

• HIV prevalence, total population: 12.2% (2008: 10.6%)

• 6.4 million living with HIV/AIDS

(based on Statistics South Africa’s mid-year

population estimate for 2012: 52.3 million)

HIV prevalence by age and sex, South Africa, 2012

HIV prevalence by age and sex, South Africa, 2012

0-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60+0

5

10

15

20

25

30

35

40

2.4

5.6

17.4

28.4

36

31.6

28

19.7

14.8

9.7

2.4

Males Females

Age group (years)

HIV

prev

alen

ce (%

)

HIV prevalence by sex (15-49 years), South Africa, 2012

HIV prevalence by sex (15-49 years), South Africa, 2012

Males Females Total0

5

10

15

20

25

14.5

23.2

18.8

HIV

pre

vala

nce

(%)

HIV prevalence by province (15-49 years), South Africa, 2012

HIV prevalence by province (15-49 years), South Africa, 2012

KZN MP FS NW EC GP LP NC WC0

5

10

15

20

25

3027.9

21.8 20.4

20.3 19.917.8

13.9

11.9

7.8

HIV

pre

vale

nce

(%)

Trends in HIV prevalence in children, South Africa 2002-2012

Trends in HIV prevalence in children, South Africa 2002-2012

Children (0-4) Children (2-14)0

1

2

3

4

5

63.3

2.51.7 2.4

5.6

3.3

2002 2005 2008 2012

HIV

pre

vale

nce

(%)

Trends in HIV prevalence by age, South Africa 2002-2012

Trends in HIV prevalence by age, South Africa 2002-2012

Youth (15-24 years) Adults( ≥ 25)0

5

10

15

20

25

9.3

15.5

10.3

15.6

8.7

16.8

7.1

19.9

2002 2005 2008 2012

HIV

pre

vale

nce

(%)

HIV INCIDENCEHIV INCIDENCE

Measuring HIV incidence South Africa 2012

Measuring HIV incidence South Africa 2012

• We used two methods:

1. Direct HIV incidence using blood specimens• Multi-assay testing algorithm (N.B. The findings will be presented during HSRC’s satellite in Room 105-106 at 18:30-20:30 this evening)

2. Indirect HIV incidence using a mathematical model• HIV incidence estimation from HIV prevalence data

collected in repeated national population-based surveys (HSRC 2002, 2005, 2008 & 2012)

Modelled HIV incidence rates by age, South Africa 2002-2005,

2005-2008 and 2008-2012

Modelled HIV incidence rates by age, South Africa 2002-2005,

2005-2008 and 2008-2012

15-49 yrs 15-24 yrs0

1

2

3

4

5

2.2

2.8

1.92.3

1.91.5

2002-2005 2005-2008 2008-2012

HIV

Inci

denc

e (/

100p

yar)

MALE CIRCUMCISIONMALE CIRCUMCISION

Trends in self-reported circumcision by type, South Africa 2002-2012

Trends in self-reported circumcision by type, South Africa 2002-2012

2002 2008 20120

5

10

15

20

25

30

35

40

45

50

38.2

40.6

46.5

13.214.6

18.6

24.8 25.2 26.1

Total circumcised Medical Traditional

Perc

enta

ge

BEHAVIOURAL FINDINGSBEHAVIOURAL FINDINGS

Condom use at last sex by age and sex, South Africa 2002-2012Condom use at last sex by age

and sex, South Africa 2002-2012

Males Females Males Females15-24 25-49

0

10

20

30

40

50

60

70

80

90

72.8

55.7

35.329.1

85.2

66.5

44.140.8

67.5

49.8

36.132.7

2002 2005 2008 2012

Cond

om u

se a

t las

t sex

(%)

Multiple sexual partnerships (15-49 years),

South Africa 2002-2012

Multiple sexual partnerships (15-49 years),

South Africa 2002-2012

Male Female0

5

10

15

20

25

17.9

2.9

19.3

3.7

23.1

5.1

2002 2005 2008 2012

Mul

tipl

e pa

rtne

rs (%

)

Correct HIV knowledge among key populations, South Africa 2008 and

2012

Correct HIV knowledge among key populations, South Africa 2008 and

2012

0

10

20

30

4026.9

30.1 31.823.3

33.636.1

27.6 27.222.7

17.725.3 24.7

20082012

Key populations at higher risk of exposure

Corr

ect

know

ledg

e of

HIV

tra

nsm

issi

on a

nd

reje

ction

of m

ajor

mis

conc

epti

ons

(%)

2012 National Average (26.8%)

Sexual debut before age 15 years(15-24 years), South Africa 2002-2012 Sexual debut before age 15 years

(15-24 years), South Africa 2002-2012

2002 2005 2008 201202468

1012141618

13.1 11.9 11.3

16.7

5.35.1 5.9 5

Males Females Total

Sex

befo

re th

e ag

e of

15

year

s (%

)

Age-disparate sexual relationships (15-19 years)

by sex, South Africa 2005-2012

Age-disparate sexual relationships (15-19 years)

by sex, South Africa 2005-2012

2002 2005 2008 20120

5

10

15

20

25

30

35

40

0.32.0 0.7 4.1

29.7

18.5

27.6

33.6

Male Female Total

Year

Part

ner 5

+ ye

ars

olde

r (%

)

Awareness of HIV status among those who tested in the last 12 months, by sex (15 years

and older), South Africa 2005-2012

Awareness of HIV status among those who tested in the last 12 months, by sex (15 years

and older), South Africa 2005-2012

Males Females Total05

101520253035404550

10.213.3 11.9

19.8

28.724.7

36.4

46.341.5

2005 2008 2012

Awar

enes

s of

HIV

sta

tus

(%)

Recommendations Recommendations

• Balance prevention and treatment

• Further strengthen and encourage HCT to address gender disparity

• Encourage consistent condom use

• Target key populations at high risk of HIV

• Encourage monogamy and faithfulness

• Promote HIV prevention in informal settlement

Research CollaboratorsResearch Collaborators

FundersFunders

This research has been supported mainly by the President’s Emergency Plan for AIDS Relief (PEPFAR) through CDC under the terms of Cooperative Agreement Numbers 5U2GPS000570-05 , 3U2GGH00357-02 and U2GPS001328.

The findings and conclusions in the report are

those of the author(s) and do not necessarily

represent the official positions of the

Centers for Disease Control and Prevention

Thank you for your attention