title: New insights into HIV epidemic in South Africa: key findings from the National HIV Prevalence, Incidence and Behaviour Survey, 2012.
abstract: This article presents key findings from the 2012 HIV prevalence, incidence and behaviour survey conducted in South Africa and explores trends in the HIV epidemic. A representative household based survey collected behavioural and biomedical data among people of all ages. Chi-squared test for association and formal trend tests (2002, 2005, 2008 and 2012) were used to test for associations and trends in the HIV epidemic across the four surveys. In 2012 a total of 38 431 respondents were interviewed from 11 079 households; 28 997 (67.5%) of 42 950 eligible individuals provided blood specimens. HIV prevalence was 12.2% [95% CI: 11.4-13.1] in 2012 with prevalence higher among females 14.4% than males 9.9%. Adults aged 25-49 years were most affected, 25.2% [95% CI: 23.2-27.3]. HIV prevalence increased from 10.6% [95%CI: 9.8-11.6] in 2008 to 12.2% [95% CI: 11.4-13.1] in 2012 (p < 0.001). Antiretroviral treatment (ART) exposure doubled from 16.6% in 2008 to 31.2% in 2012 (p < 0.001). HIV incidence in 2012 among persons 2 years and older was 1.07% [95% CI: 0.87-1.27], with the highest incidence among Black African females aged 20-34 years at 4.5%. Sexual debut before 15 years was reported by 10.7% of respondents aged 15-24 years, and was significantly higher among male youth than female (16.7% vs. 5.0% respectively, p < 0.001). Reporting of multiple sexual partners in the previous 12 months increased from 11.5% in 2002 to 18.3% in 2012 (p < 0.001). Condom use at last sex dropped from 45.1% in 2008 to 36.2% in 2012 (p < 0.001). Levels of accurate HIV knowledge about transmission and prevention were low and had decreased between 2008 and 2012 from 31.5% to 26.8%. South Africa is on the right track with scaling up ART. However, there have been worrying increases in most HIV-related risk behaviours. These findings suggest that there is a need to scale up prevention methods that integrate biomedical, behavioural, social and structural prevention interventions to reverse the tide in the fight against HIV.
authors.affiliation: a Human Sciences Research Council , Pretoria , South Africa.|b Statistics Department , University of South Africa , Pretoria , South Africa.
authors.forename: Khangelani
authors.initials: K
authors.lastname: Zuma
authors.affiliation: a Human Sciences Research Council , Pretoria , South Africa.
authors.forename: Olive
authors.initials: O
authors.lastname: Shisana
authors.affiliation: a Human Sciences Research Council , Pretoria , South Africa.|c Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town , Cape Town , South Africa.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Rehle
authors.affiliation: a Human Sciences Research Council , Pretoria , South Africa.|d Department of Psychiatry and Mental Health, University of Cape Town , Cape Town South Africa.
authors.forename: Leickness C
authors.initials: LC
authors.lastname: Simbayi
authors.affiliation: a Human Sciences Research Council , Pretoria , South Africa.
authors.forename: Sean
authors.initials: S
authors.lastname: Jooste
authors.affiliation: a Human Sciences Research Council , Pretoria , South Africa.
authors.forename: Nompumelelo
authors.initials: N
authors.lastname: Zungu
authors.affiliation: a Human Sciences Research Council , Pretoria , South Africa.
authors.forename: Demetre
authors.initials: D
authors.lastname: Labadarios
authors.affiliation: a Human Sciences Research Council , Pretoria , South Africa.
authors.forename: Dorina
authors.initials: D
authors.lastname: Onoya
authors.affiliation: a Human Sciences Research Council , Pretoria , South Africa.
authors.forename: Meredith
authors.initials: M
authors.lastname: Evans
authors.affiliation: a Human Sciences Research Council , Pretoria , South Africa.
authors.forename: Sizulu
authors.initials: S
authors.lastname: Moyo
authors.affiliation: e South African National AIDS Council , Pretoria , South Africa.
authors.forename: Fareed
authors.initials: F
authors.lastname: Abdullah
mesh_terms: D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012725:Sexual Behavior; D012747:Sexual Partners; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: HIV incidence; HIV knowledge; antiretroviral treatment; household survey; sexual behaviour