What is this study about?

The study reviewed the implementation and findings of serial editions of the antenatal HIV prevalence surveys conducted in South Africa during the period 1990-2022 and discusses how the objectives and methods have changed over time and how the survey can evolve and adapt to the current and future policy and funding environment.  

Why does this matter?

Editions of the antenatal HIV prevalence survey were conducted annually until 2015. They have been published every two to three years since then. Each edition is a nationally representative survey enrolling around 36 000 women from close to 1600 sentinel sites in all 52 districts and nine provinces. The survey is a massive undertaking that brings together national, provincial, district, and facility teams. It is an expensive and logistically challenging exercise that has required additional funding from US government partners in recent years. This review attempts to answer the questions of what role the survey has played in HIV surveillance, whether the survey is necessary given changes to the policy and data landscape in South Africa, and how the survey can be adapted and made more cost-efficient in the future.

How did this study come about?

The NICD team responsible for co-ordinating the conduct of the survey on behalf of the National Department of Health, as well as for data analysis and reporting on the survey, was preparing for the 2024/2025 edition. As part of the preparations, there were discussions on what should or could be changed regarding the objectives and conduct of the survey to make it responsive and relevant to the current policy and funding environment. It was the idea of looking back in order to move forward with greater clarity while being intentional about conducting each edition of the survey.

What was your role in the study?  

I conceived the idea, sourced previous reports for review, reviewed the reports, and drafted the manuscript for review by co-authors.

Why should people read this article?

Programme managers, health care practitioners, researchers, and policymakers should read this report to get a summary of over 30 years’ worth of antenatal HIV prevalence surveys in South Africa and reflect on the progress the country has made in preventing and managing HIV and syphilis infections among pregnant women as well as consider what form or shape the survey should take in the future.

 What impact do you hope this article will have on public health policy and healthcare access?

I hope this article will spur discussion among the survey’s stakeholders. I am looking forward to hearing from stakeholders how they have used the survey findings in the past, what role they see the survey playing in the future, and how they would like to see the survey evolve in the coming years.

Dr Tendesayi Kufa-Chakezha is an Epidemiologist at the Centre for HIV and STIs at the National Institute for Communicable Diseases.

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