The North West province has one of the highest HIV prevalence rates in South Africa, according to the latest findings from the Human Sciences Research Council (HSRC). The survey data, released today, highlights significant concerns and ongoing challenges in managing and preventing HIV in the region.

Prevalence Rates and Demographics

The HSRC’s Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) reveals that the HIV prevalence rate in North West was 12.3% in 2022, placing it fifth highest in the country. Among those aged 25 to 49 years, the prevalence rate is notably higher at 20.8%.

Women are disproportionately affected, with HIV prevalence among females in this age group reaching 29.0%, compared to 13.4% among males. The prevalence rate among adolescents and youth is also concerning, with females experiencing an HIV prevalence of 8.3% compared to 3.3% among males.

The survey indicates a peak in HIV prevalence at 31.4% among those aged 40 to 44 years in 2022, although there was a decrease in prevalence among those aged 30 to 39 and 40 to 49 compared to 2017.

Concerns Among Adolescents and Youth

A troubling aspect of the survey is the increase in HIV prevalence among adolescents aged 15 to 19, which rose to 4.5% in 2022 from 3.2% in 2017. This suggests persistent issues in preventing infections within this vulnerable age group.

District-Level Findings

The survey also highlights significant regional disparities:

• Bojanala district has the highest HIV prevalence at 15.4%.
• Ngaka Modiri Molema follows at 12.1%.
• Dr Kenneth Kaunda has the lowest rate at 11.9%.

Antiretroviral Treatment (ART) Coverage

Antiretroviral treatment coverage has improved in the province, increasing from 60.7% in 2017 to 78.9% in 2022. Approximately 324,000 people living with HIV in North West received ART in 2022. Coverage is higher in rural areas compared to urban areas, with notable differences across districts.

Gaps in Treatment and Key Drivers

Despite progress, significant gaps remain:

• A large proportion of people living with HIV aged 25 to 49 are either unaware of their status, not on ART, or not virally suppressed.
• Adolescents and youth aged 15 to 24 contribute disproportionately to these gaps.

Key drivers of HIV transmission include a high rate of sexual activity before age 15 among males and a decline in condom use, which fell to 32.2% in 2022 from 44.7% in 2017.

Recommendations and Next Steps

Professor Khangelani Zuma of the HSRC recommends a long-term strategy to address the ageing HIV epidemic and tailored interventions to close gaps in the clinical cascade. Increased coverage of medical male circumcision and enhanced public awareness of HIV prevention measures, such as regular testing and condom use, are also crucial. The findings underscore the need for continued and focused efforts to tackle HIV in the North West province, with a particular emphasis on addressing the needs of adolescents and women and improving treatment and prevention strategies