Pregnancy and HIV risk behaviours: evidence from four national surveys in South Africa, 2005-2017

Acquisition of HIV among pregnant women has widespread public health implications. Despite improved maternal and child health outcomes including preventing mother-to-child HIV transmission (MTCT), it remains an area of concern. This article describes the demographics, HIV prevalence and related risk behaviours among females aged 15-54 years, who reported being pregnant at the interview. Data were extracted from four South Africa National HIV Prevalence, Incidence, Behaviour and Communication Surveys dated 2005, 2008, 2012 and 2017. The sample sizes were n=4954, n=3046, n=7022 and n=9874, respectively. The analysis showed that pregnancy declined over time from 5.3% to 3.9%. Most pregnancies occurred among Black Africans and Coloureds, single women, youth aged 15-19 years (2005-7.5%; 2008-16.2%), those with a minimum of secondary school level education (2012-7.8%; 2017-5%) and among the unemployed (2005-6.6%; 2008-5.8%). Pregnancies were higher among women with multiple sexual partners and those who did not use a condom at last sex and had no knowledge of MTCT. HIV prevalence was 35.6% in 2005 and 27.2% in 2017; representing a decline over time, but also shows relatively stable HIV prevalence among pregnant women. This suggests a need for tailored sexual and reproductive health (SRH) interventions, focused on risks involving multiple sexual partnerships and unprotected sex, and enhancing MTCT knowledge.