Limpopo's HIV Prevalence Declines, Yet Challenges Remain: SABSSM VI Findings

ART coverage in Limpopo has significantly improved, rising from 62.8% in 2017 to 80.8% in 2022.

The Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) for Limpopo, conducted by the Human Sciences Research Council (HSRC), has revealed a notable decrease in the province's HIV prevalence, which fell to 8.9% in 2022 from 10.1% in 2017. This reduction means that approximately 570,000 people are living with HIV (PLHIV) in Limpopo, down from 580,000 in 2017.

HIV Prevalence and Demographics

Despite the overall decline, the survey highlighted that HIV prevalence remains disproportionately high among specific demographics:

Age Group 25-49: Females in this age group recorded an HIV prevalence of 22.3%, compared to 17% among males.

Rural Areas: The prevalence was particularly high in rural formal or farm areas, with 7.4% of individuals infected.

Peak Prevalence: The highest prevalence was observed among those aged 50 to 54, with a rate of 29.4% in 2022, down from 36.9% among those aged 40 to 44 in 2017.

Among the three districts surveyed—Vhembe, Capricorn, and Mopani—Mopani recorded the highest HIV prevalence at 9%.

Antiretroviral Treatment (ART) Coverage

ART coverage in Limpopo has significantly improved, rising from 62.8% in 2017 to 80.8% in 2022. This increase means that an estimated 430,000 PLHIV were receiving treatment in 2022, up from 290,000 in 2017. However, disparities in ART coverage persist:

Gender Disparity: ART coverage was higher among females (84%) than males (73.1%).

Geographical Disparity: Urban areas had lower ART coverage (79.7%) compared to other localities, with Vhembe recording the lowest coverage at 76.4%.

Viral Load Suppression (VLS)

Limpopo's VLS rates also improved, with 77.0% of PLHIV achieving VLS in 2022, up from 60.8% in 2017. However, significant disparities remain:

Gender Disparity: VLS was slightly lower among females (76.6%) compared to males (77.8%).

Rural Disparity: In rural informal or tribal areas, females had a VLS rate of 75.2%, while males achieved 83.9%.

Knowledge of HIV Status

The survey identified a concerning gap in HIV status awareness among those aged 25 to 49:

Unawareness: 65.0% of PLHIV in this age group are unaware of their status.

Treatment Gaps: 63.3% are aware but not on ART, and 65.9% are on ART but not virally suppressed.

Adolescents and youth aged 15 to 24 also contribute significantly to gaps in treatment, despite representing only 4.8% of all PLHIV. This age group accounts for 15% of those unaware of their status, 13.3% of those aware but not on ART, and 11.4% of those on ART but not virally suppressed.

Risk Behaviors and Prevention

Sexual Debut: The percentage of adolescents and youth aged 15 to 24 who reported having sex before age 15 decreased from 13.5% in 2017 to 8.7% in 2022. The rate was higher among males (14%) than females (3.1%).

Multiple Partners: 11.4% of people aged 15 and older reported having multiple sexual partners in 2022, down from 12% in 2017. Males were 3.7 times more likely than females to report multiple partners.

Condom Use: Condom use declined significantly, with only 29.8% of people reporting using a condom with their most recent sexual partner in 2022, down from 41.6% in 2017. Adolescents and youth aged 15 to 24 reported higher consistency in condom use (31.7%) compared to those aged 25 to 49 (19%).

The SABSSM VI survey underscores the progress made in reducing HIV prevalence in Limpopo but also highlights the ongoing challenges in treatment access, awareness, and preventive behaviors. Continued efforts are needed to address these disparities and improve the overall health outcomes for those living with HIV in the province.