The Nelson Mandela Foundation (NMF) commissioned the first national, household sero-prevalence survey of HIV/AIDS in 2002. That study had significant impact nationally, in the sub-region and internationally. The report received widespread attention, has been used to build the capacity of other Southern African Development Community (SADC) countries in implementing similar studies, and has impacted on policy, strategy and practice in the area of HIV/AIDS in South Africa. Statistics South Africa currently uses the 2002 household survey to estimate the magnitude of the HIV/AIDS situation in the country.
Since 2002, significant shifts have occurred and South Africa has made great strides: the roll out of a comprehensive programme for the care and treatment of HIV-infected individuals has begun and investment in mass media campaigns aimed at preventing new infections is at an all-time high. The NMF realised that it was important to assess the extent to which these policies and practices had changed the shape of the pandemic in South Africa by following up on the first survey.
This report on the second national survey of HIV/AIDS reveals a number of key issues, such as:
- South Africans are increasingly being tested to find out their HIV status;
- More people, including older South Africans, are using condoms at higher rates than before; and
- More care and support is being provided to people living with and affected by HIV/AIDS.
The report brings home the reality that the HIV prevalence in South Africa among persons aged 2 years and older at 10.8% translates to 4.8 million people living with HIV/AIDS in 2005. Factors underpinning continued high HIV prevalence are partly illustrated by the finding that half of the respondents in this study who were found to be HIV positive did not think they were at risk of HIV infection. It considers HIV/AIDS stigma, the integration of family planning and HIV/AIDS service, and the existing HIV/AIDS communication campaigns. The findings and recommendations of the report will be invaluable to policy-makers and strategic planners, health and other professionals, the media, researchers and academics.
Product information
List of figures
List of tables
Foreword
Acknowledgements
Contributors
Abbreviations and acronyms
Executive Summary
- Introduction
1.1 Background
1.2 Objectives of this study - Methodology
2.1 Survey design and sampling
2.2 Sample size estimation
2.3 Weighting of the sample
2.4 Ethical considerations
2.5 Questionnaires
2.6 Fieldwork procedures
2.6.1 Recruitment and training of fieldworkers
2.6.2 Community mobilisation
2.6.3 Community and household entry
2.6.4 Pilot study
2.6.5 Main survey
2.6.6 Quality control
2.7 Laboratory procedures
2.7.1 Specimen collection
2.7.2 Specimen tracking
2.7.3 HIV antibody testing
2.7.4 HIV incidence testing
2.8 Data management and analysis - Results
3.1 Assessment of 2005 survey data
3.1.1 Generalisability of the survey results
3.1.2 Response analysis
3.2 National HIV prevalence
3.2.1 Overall HIV prevalence
3.2.2 HIV prevalence among youth aged 1524 years
3.2.3 HIV prevalence among persons aged 1549 years
3.2.4 HIV prevalence in females aged 1549 years compared with the antenatal survey 2004
3.3 National HIV incidence
3.4 Behavioural determinants of HIV/AIDS
3.4.1 Sexual behavioural risks
3.4.2 Substance use
3.4.3 Perceived susceptibility to HIV infection
3.4.4 Knowledge and use of voluntary counselling and testing (VCT)
3.5 Knowledge and attitudes concerning HIV-related issues
3.5.1 Knowledge about HIV/AIDS
3.5.2 Knowledge about anti-retroviral (ARV) therapy
3.5.3 Knowledge of HIV vaccines
3.5.4 Attitudes towards people with HIV/AIDS
3.6 Communication
3.6.1 Introduction
3.6.2 Exposure to mass media
3.6.3 Language
3.6.4 Contribution of media to understanding HIV/AIDS information
3.6.5 Taking HIV/AIDS more seriously
3.6.6 Awareness of HIV/AIDS campaigns and programmes
3.6.7 Utility of HIV/AIDS programmes and campaigns
3.6.8 Other sources of HIV/AIDS information
3.6.9 Interpersonal communication and participation in HIV/AIDS activities
3.6.10 Relationship of activities to taking HIV/AIDS more seriously
3.7 Mental health and HIV/AIDS
3.8 Other contextual factors for HIV/AIDS
3.8.1 Household burden of HIV/AIDS
3.8.2 Orphans
3.8.3 Child-headed households
3.8.4 Risk factors and risk environments for children aged 218 years
3.8.5 Communication and knowledge about HIV/AIDS-related issues
3.9 Structural and political contextual issues
3.9.1 Use of healthcare services
3.9.2 Financing of HIV/AIDS services
3.9.3 Opinion poll of political and structural contextual issues - Conclusions and recommendations
4.1 Conclusions
4.2 Recommendations - Appendices
5.1 HIV prevalence rates, socio-demographic characteristics, coefficient of variation, and design effect
5.2 HIV viral load analysis
5.3 List of supervisors, fieldworkers and field editors
References
