SAfrica says HIV epidemic easing

The HIV infection rate is dropping among young, pregnant women in South Africa but it is on the rise for the country's older women, according to a government study released Thursday.

The 2006 survey showed the rate of infection for the virus that causes AIDS fell among pregnant women under 20 from 15.9 percent in 2005 to 13.7 percent last year, and from 30.6 percent to 28 percent in women aged 20-24.

In the hardest hit 25-29 year-old group, it fell from 39.5 percent to 38.7 percent.

However, the prevalence among women older than 40 increased from 19.8 percent to 21.3 percent in the same time period. And the overall infection rate among pregnant women in the worst-hit province of KwaZulu-Natal was unchanged, at 39.1 percent.

South African Health Minister Manto Tshabalala-Msimang, who has long been criticized for voicing doubts about the safety and effectiveness of AIDS drugs, said the results showed "a statistically significant decrease" in the overall prevalence of HIV-infected pregnant women from 30.2 percent in 2005 to 29.1 percent last year.

"In the last three years, we have been noticing a stabilizing of HIV prevalence in the country. This year we have seen a turning point," she told reporters. "We are quite excited to see this downward trend."

About 33,000 pregnant women took part in the survey - more than double the previous year.

Independent health experts welcomed the drop, but said the statistics may show nothing more than that the epidemic was holding steady, as has been the case for years.

South Africa has an estimated 5.4 million people living with HIV, the second highest after India, which has a much bigger population. Last year, an estimated 950 South Africans died each day from AIDS-related diseases and a further 1,400 were infected each day, according to the Medical Research Council.

David Bourne, epidemiologist at the University of Cape Town, agreed with the minister that the decline was "good news" and that the epidemic was "turning." However, he said the decline in the overall rate of infection to 29.1 percent was not statistically significant, as it fell within the margin of error of the study.

Bourne said the minister was still "in denial" that antiretroviral drugs were working.

"She is using the statistics not scientifically but in a way which suits her agenda. It is not prevention which has caused the change but treatment," he said.

Regardless, the health minister was upbeat.

"It may be a small percentage, but that for us is significant enough because it means those messages (of prevention) around which we have been working for many years are beginning to sink in," she said. "We are beginning to see behavioral changes and that's why we see this decrease."

Tshabalala-Msimang has been the target of international criticism for espousing the use of beetroot, garlic, lemon and the African potato in the fight against AIDS, earning her the nickname "Dr. Beetroot."

Deputy President Phumzile Mlambo-Ngcuka was appointed last year to lead efforts in revamping South Africa's AIDS strategy, effectively sidelining Tshabalala-Msimang, who had been ill but recently resumed her duties.

Bourne said - ironically - the success of the rollout of AIDS drugs made it more difficult to interpret the prevalence statistics. As less people died, prevalence figures may not decline as rapidly as expected and might even rise, he said.

"The older prevalence figures that have been used for the last 15 years are no longer an appropriate way of measuring the epidemic. What we want to know is the new cases," he added.

The government survey gave no information on the number of new infections.

Tshabalala-Msimang said rates had plateaued in recent years and the government, intent on seeing AIDS cases drop, had intensified prevention programs among young people. She said more than 288,000 people were currently on antiretroviral treatment provided by the government.

Aids activist welcomed the decline but questioned whether the government's anti-AIDS campaign was a success.

"The thing that is critical is a decline in the incidence rate of new infections," said Nathan Geffen of the Treatment Action Campaign, which has repeatedly criticized the government for lack of political leadership on AIDS.

The South African government has made reducing the number of new HIV infections one of its main targets, and aims to extend treatment to 80 percent of those with AIDS by 2011.