Tools currently used to combat the spread were "mismatched" against the group showing the highest incidence rate - young women.
By Latoya Newman
Women in their teens and twenties were bearing the greatest burden of the HIV/Aids pandemic and South Africa's tools to fight the spread of the disease were not doing the job, a health conference in Durban heard on Wednesday.
HIV/Aids expert Salim Abdool Karim said at the fifth Public Health Association of South Africa conference on Wednesday that the disease continued to spread unabated in the country and that it was not the "mythical" disease of poverty.
Karim said the global pandemic showed that sub-Saharan Africa bore the greatest burden of the disease in the world. South Africa had the highest single burden and KwaZulu-Natal was worst affected.
He said the rapid spread was a "complex, multi-layered problem", which required an appreciation of the underlying dynamics.
The main point was that the tools currently used to combat the spread were "mismatched" against the group showing the highest incidence rate - young women.
"The number of new infections presenting in young women is part and parcel of the spread of infection. In the last seven years, teenage girls have come in to pre-natal clinics already showing high prevalence. It's scary when you see two out of 10 come in already having HIV," said Karim.
He said a study conducted in KwaZulu-Natal showed that 30.2 percent of rural women, 59.3 percent of urban women and 59.4 percent of sex workers (from truck stops in the study) were infected. Research showed that close to one in five women would become infected in the coming year.
Karim said the abstinence, behaviour (be faithful), condoms, counselling and testing, and circumcision strategy was not effective in this group. "You have to consider the underlying socio-economic variables. It is difficult to promote abstinence with variables like sex influenced by money, prestige, security and the comfort of having an older partner, for which the majority of young girls were opting. In many incidents, girls are faithful, but often their partners are infected."
Karim said a young girl would have difficulty getting an older man to wear a condom and circumcision only protected men. "So if you look at the toolbox, we do not really have the tools to translate into risk reduction in this group," said Karim.
He dismissed the notion that HIV/Aids was a disease of poverty, saying a study had disproved it. He said a recent study showed that HIV occurred across all employment bands.