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A le ading AIDS expert has warned that key decisions need to be made in South Africa to prevent new HIV infections, as mortality rates are expected to increase.

Speaking today at the country's National AIDS Conference in Durban, Professor Quarraisha Abdool-Karim of the University of Natal, said HIV infection rate in the country remained high.

However, according to statistics from the national health department, HIV trends observed between 1990 and 1998 - began to slow down between 1998 and 2000.

The statistics were taken from government's annual antenatal survey in 2000 and estimated HIV prevalence rate of 24,5% was recorded for women in public antenatal clinics during the month of October 2000. Pregnant women in their late twenties show the highest infection rate at 30,6% whereas survey participants aged 20-24 yielded a point prevalence of 29,1%. However, Abdool-Karim said what was being seen now was an explosive form of HIV transmission in South Africa. For this reason, Abdool-Karim said intensified prevention methods were required to halt the mortality expected to increase in the coming years. She said it was essential to prevent new infections through the programmes such as the prevention of HIV transmission from mother to child, care and treatment with antiretrovirals, social services for families impacted by the death from AIDS, and programmes and social assistance for orphans. She added that addressing gender inequality, and ensuring greater involvement for youth in various programmes was also essential in this regard. Speaking on antiretroviral therapy, Professor Rodney Hoff of the US National Institute of Health (NIH) said research had shown that short courses of antiretrovirals such as AZT and Nevirapine reduced the transmission of HIV from mother to child in developing countries. About vaccines, Hoff said there were new vaccines in the pipeline around the world, with 17 of them entering the pre-phase 1 period in the international setting. However, he said many of them might not prevent HIV infection, citing topical microbicides, including pre-exposure prophylaxis for high-risk groups and post-exposure prophylaxis for discordant couples.

On the part of the NIH, he said it was the institute's goals to offer long-term support for developing countries, with plans in the pipeline to implement programmes for the prevention of HIV in the developing world. In South Africa alone, Hoff said the NHI would continue to address comprehensive research in the country. – BuaNews.

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