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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
Academics Cast Doubt on New AIDS Survey
Tamar Kahn
October 23, 2003
Business Day (South Africa) (10.21.03) - Thursday, October 23,

Two of South Africa's leading HIV/AIDS academics have reacted with skepticism to a study by former health department Director-General Olive Shishana. The study said the epidemic peaked last year with about 4.69 million infected people and has started to level off. It also said the HIV incidence rate among 15- to 49-year-olds had decreased from 4.2 percent in 1997 to 1.7 percent in 2003.

"We were surprised by these findings, but when you look closely it coincides with the introduction of major interventions like condom distribution," said Shishana, executive director of an HIV/AIDS research program at the Human Sciences Research Council. The new study used data from the health department's HIV prevalence surveys of pregnant women from 1990-2001, and from the Nelson Mandela-HSRC HIV/AIDS household survey published last year. The Mandela- HSRC study contradicted previous research by showing HIV prevalence rates were highest in Free State and Guateng, not KwaZulu-Natal and Mpumalanga.

"The Mandela-HSRC study has not been through a peer-review process," said University of Natal epidemiologist professor Quarraisha Abdool Karim. "There are a number of flaws in the study, and in the interpretation and data analysis that have not been addressed... the use of these data to calibrate a new model questions the validity of the model." Professor Rob Dorrington, head of Cape Town University's center for actuarial research, questioned whether the model showed anything more than the researchers' assumptions about future prevalence rates. "The authors assumed the epidemic peaked in 2002 and than that prevalence levels declined. All their 'results' are thus contingent on these heroic assumptions," he said.

The researchers have refused to let other academics examine their data or questionnaires. The study, "Epidemiological and Demographic HIV/AIDS Projections: South Africa," appeared in the African Journal of AIDS Research (2003;2(1):1-8).