Abstract

PIP: This paper discusses the emergence of HIV/AIDS and the extent of the epidemic in KwaZulu-Natal and South Africa. HIV cases were first detected in South Africa in 1985 following the introduction of enzyme-linked immunosorbent assay in the African market. During this time most cases of AIDS were seen in Johannesburg and Cape Town with a few cases in Pretoria and Durban, affecting mostly young White males. 1986 and 1987 showed an early development of the epidemic, but case finding was restricted by laboratory limitations and there were no epidemiological surveys. 1988 showed a rapid progress of the epidemic, with a move away from the earlier predominant involvement of White male homosexuals to a greater involvement of the Black African heterosexual population. In 1989, the pattern changed from predominantly homosexual to heterosexual involvement. Unfortunately, in 1990, with the first national Antenatal Clinic surveillance, HIV infections showed a prevalence rate twice that of the national level in KwaZulu-Natal. 1999 saw a leveling off of the antenatal prevalence, at 33.5%, in KwaZulu-Natal, and this has also been seen in several other provinces, resulting in a national prevalence of 22.4%. Reasons for this higher-than-average HIV prevalence and its significance for the government are discussed.