The Demographic Impact of HIV/AIDS in South Africa


Just over 5 million people out of a total 46 million South Africans were HIV positive in 2004, giving a total population prevalence rate of 11%. This is estimated from the ASSA2002 demographic and AIDS model which is based on a thorough analysis of a range of epidemiological and demographic data including the antenatal surveys up to the year 2002. Compared with previous models, the impact of HIV/AIDS has been revised downwards as better epidemiological data has emerged. The new model also allows for several behaviour and treatment interventions and a plausible pace of implementation is used as the default scenario for future projections. These projections suggest that ART could, even at this late stage, reduce the number of AIDS deaths per year. Without ART we would have expected some 495 000 deaths due to AIDS in 2010, with ART this will be reduced to approximately 380 000 ? a difference of about 100 000 deaths in a year. There is uncertainty about the coverage of the ART roll-out and the number of deaths in 2010 could be anything between 290 000 and 450 000. With the default scenario of the interventions, life expectancy is projected to fall to just under 50 years compared with the previous estimate of 43 years. The life expectancy in 2004 is estimated to be 48.5 years for males and 52.7 years for females and the Infant Mortality Rate is estimated to be 56 per 1000 live births. There are a total of 1.1 million orphans (maternal orphans under the age of 18 years) of which just over 250 000 were newly orphaned in 2004. On the assumptions in the model it is estimated that about 500 000 people were in need of treatment. By October 2004, 19 500 people were receiving ART in the public sector. The distribution of male condoms has increased and reached 302 million by 2003 and in addition 0.19 million female condoms were distributed in that year. Other indicators of prevention are sadly lacking. The proportion of facilities providing PMTCT increased from 20% in 2002 to 52% in 2003 but no information could be obtained on the number of mothers who have received this intervention or the impact that it is having. The Department of Health has reported increases in the number of people being counselled for testing from 412 696 in 2002/3 to 690 537 in 2003/4. The population growth rate has been affected by HIV/AIDS and although falling is not expected to become negative. It is estimated to be about 0.8% in 2004 and is projected to fall still further to around 0.4% in the years beyond 2011. Further developments of the ASSA model are underway to provide provincial estimates and to estimate bounds of uncertainty around key indicators. In the meanwhile, these indicators for 2004 and the projections from 1990 ? 2015 highlight the urgent need to strengthen our efforts to respond to the epidemic and should be used to guide planning the response.
Date: 1 June - Time: 8:30 to 10:30 - Room: 242B
Theme: 9.A. Various topics