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Despite the many millions of dollars spent on preventing the spread of HIV, the virus that causes AIDS, the disease is continuing to advance in Mozambique.
According to the survey on Indicators of Immunisation, Malaria and HIV/AIDS (IMASIDA), published on Monday by the Ministry of Health, the prevalence of HIV in 2015 among people aged between 15 and 49 was 13.2 per cent.
The previous estimate, from 2009, was a prevalence rate among the same age group of 11.5 per cent. Thus between 2009 and 2015 there was an increase of 14.8 per cent in the proportion of adult Mozambicans who are HIV positive.
By referring to margins of error in the two surveys, it can be claimed that the difference is not “statistically significant”. However, one thing is absolutely certain – the expected decline in HIV prevalence has not materialised.
IMASIDA is based on interviews of 5,283 men and 7,749 women in 7,169 households. The interviews were held between June and December 2015.
The survey shows that women are more vulnerable to HIV infection than men. The HIV prevalence rate among women is 15.4 per cent, while among men it is only 10.1 per cent.
In line with previous surveys, IMASIDA found many more infections in cities than in the countryside. The HIV prevalence rate was 16.8 per cent in Mozambican urban areas, and 11 per cent in rural areas.
The worst hit provinces are in the south of the country. Around a quarter of the adult population of Gaza province is HIV-positive. Some comfort can be taken from the slight decline in the prevalence rate from 25.1 per cent in 2009 to 24.4 per cent in 2015.
But in Maputo province the prevalence has increased, from 19.8 to 22.9 per cent, while in Maputo city it is much the same (16.8 per cent in 2009 and 16.9 per cent in 2015). Alarmingly, Inhambane province has registered an enormous jump in the prevalence rate, from 8.6 to 14.1 per cent.
Sofala is the worst hit province in the centre of the country, where HIV prevalence has risen from 15.5 to 16.3 per cent. Zambezia is not far behind, with a prevalence rate that has risen from 12.6 to 15. 1 per cent.
But the other two central provinces have seen a decline in their prevalence rates. In Manica, the rate has fallen from 15.3 to 13.5 per cent, and in Tete from seven to 5.2 per cent.
The north remains the region least affected by the epidemic – but even here there is an alarming rise in HIV infections. In Cabo Delgado, the prevalence rate jumped from 9.4 per cent in 2009 to 13.8 per cent in 2015. In Niassa, the increase was from 3.7 to 7.8 per cent, while in Nmapula the rate rose from 4.6 to 5.7 per cent.
The worst hit age group is people between 35 and 39 years old. In this group, 17.5 per cent of the men and 23.4 per cent of the women are HIV positive.
Among adolescents and youths aged between 14 and 24, 6.9 per cent are infected – in this age group women are three times more likely than men to be infected. The prevalence rate is 9.8 per cent among women and 3.2 per cent among women.
Shockingly, IMASIDA found that knowledge of how HIV is transmitted and how it can be prevented had declined since 2009. Only 56 per cent of men and 47 per cent of women interviewed in 2015 knew that it is possible to reduce the risk of HIV infection by using condoms, and by limiting sexual relations to one, non-infected partner.
Presenting the results, the lead researcher, Francisco Mbofana, who is also National Director of Public Health, warned that IMASIDA showed that HIV/AIDS remains a public health problem. He urged people not to become complacent about the availability of the life-prolonging anti-retroviral treatment.
The fact that anti-retroviral drugs can keep HIV-positive people alive was no good reason for ignoring basic preventive measures. “High risk behavior is continuing, such as the failure to use condoms and multiple sexual partners”, said Mbofana.
Mbofana also did not believe that circumcision is any panacea for the AIDS epidemic. He pointed out that Tete is the province where the lowest percentage of men are circumcised – yet Tete is also the province with the lowest HIV prevalence rate.
“As we can see, circumcision is not a magic wand to reduce HIV infection”, said Mbofana.
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