This research programme, based in Vulindlela, has revealed that HIV prevalence in pregnant women in this rural community has not changed substantially from 32.4% (95%CI 27.6-37.6) in 2001 to 34.4% (95% CI 29.4-39.2) in 2007 because high HIV-related mortality offsets the high incidence rates, estimated at 8.5% (CI: 4.0-12.9%) per annum in young women under the age of 30 years. Most of the prenatal clinic attendees were younger than 25 years of age; with 56.9% in this age range in 2001, and 63.2% in 2007. In 2007, the age specific prevalence was 36.4% among 20-24 year old women.
The toll of the HIV epidemic on young women makes the need for interventions to protect them from HIV infection imperative. Such interventions need to address risk factors for HIV infection, while simultaneously addressing the social, political, and economic factors that generate vulnerability and perpetuate risk. CAPRISA’s epidemiological studies have enhanced our understanding of the evolving HIV epidemic in South Africa by generating valuable information on HIV acquisition in young women to guide the development of interventions focused on your women.
The pivotal study in this programme is the CAPRISA 007 RHIVA (Reducing HIV in Adolescents) trial, a cluster-randomised controlled trial to assess the impact of a school-based intervention of incentivised behaviour change on HIV incidence in grade 9 and 10 children in 14 Vulindlela schools.