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The adoption of an HIV/AIDS national strategic plan in South Africa has increased the necessity to monitor trends in the HIV epidemic. The National Department of Health uses antenatal survey results (showing an overall HIV prevalence of 28%) to reinforce those of the previous survey and argue that South Africa may be making some real progress in its response to the HIV epidemic and that the South African HIV epidemic is on a downward trend. While this may or may not be true in order for one to infer a trend in indicators from a sequence of surveys they need to be comparable year on year with one another. Unfortunately this is not the case with the antenatal surveys of the past 2 years. Interpretation of the trend in the antenatal survey data is becoming increasingly difficult as one has not only to allow for possible bias at the young ages (sexually active young women who have had unprotected sex do not represent all young women) but also for the impact of treatment on prevalence levels (on which the report is surprisingly silent). On the face of it analysis of these data appears to be becoming increasingly beyond the skills of the Department of Health and it would serve all if these data were made available to the broader scientific community to analyse and interpret more thoroughly. (excerpt)

Has HIV prevalence peaked in South Africa?--Can the report on the latest antenatal survey be trusted to answer this question?