Surveillance data shows an increasing rate of HIV infections among pregnant women in Mpumalanga, Health Minister Aaron Motsoaledi said on Monday.
Releasing the annual 2011 national antenatal sentinel HIV and syphilis prevalence survey in Pretoria, Motsoaledi said Mpumalanga had shown an increase in estimated HIV prevalence of two percent.
The province had a 34.7 percent prevalence rate in 2009 and the figure has since risen to 36.7 percent, according to the survey compiled by the department of health.
Other increases in prevalence rates were recorded in the Free State, North West, Limpopo and Mpumalanga.
The 2011 survey also showed that KwaZulu-Natal had the highest prevalence rate in the country, followed by Mpumalanga, the Free Sate and North West, with a prevalence greater than 30 percent.
In Limpopo, Gauteng and the Eastern Cape prevalence was between 20 percent and 30 percent. The Northern Cape and the Western Cape were the only provinces with an HIV prevalence below 20 percent.
Gauteng showed a slight decrease from 30.4 percent in 2010 to 28.7 percent in 2011.
Motsoaledi said the highest prevalence by district was in Mpumalanga’s Gert Sibande municipality at 46.1 percent, followed by the KwaZulu-Natal districts of Ugu at 41.7 percent and Mkanyakude at 41.1 percent.
"We have districts [with rates] which are above the national average and that worries us," he said.
The national antenatal HIV prevalence rate was 29.5 percent, and relatively stable with rates of 30.2 percent in 2010 and 29.4 in 2007. The rate in the general population was 17.5 percent.
Motsoaledi said that to start with, there was need for "analytical epidemiological surveys" based on scientific study in the highly-affected areas to understand the factors driving the epidemic.
He believed significant developmental projects in sectors like mining and construction directly contributed to some areas higher HIV prevalence rates.
"In areas where we see new mining operations, news towns, constructions and new people coming in, we expect something like this [higher prevalence rates] to happen. It needs our attention," he said.
He used as an example Limpopo’s Waterberg district, which was expanding because of mining developments and the Medupi power station, and had a prevalence rate of 30.3 percent.
"That is why we launched the biggest HIV campaign there with the Deputy President [Kgalema Motlanthe]."
In 2011, 26 of the country's 52 districts had prevalence rates below the national average. In 2010, there were 28.
Motsoaledi said the lowest prevalence rate was recorded in the Namaqua district, in the Northern Cape, at 6.2 percent.
The study found that no district recorded prevalence below five percent.
A total of 33,446 first time antenatal-care attendees participated in the 2011 survey.
The health department said the number of women participants had enabled conclusive inferences on the HIV and syphilis occurrence at national and provincial level in all the health districts.
The survey used cross-sectional, anonymous testing methods involving blood samples collected for other purposes in selected primary health care facilities.
Regarding syphilis, the study found a 0.1 percent increase in the national prevalence rate.
It was most prevalent in Mpumalanga, at four percent -- up from 2.1 percent in 2010.
Syphilis infections trends would be dropped from future editions of the study in favour of herpes simplex, said Motsoaledi.