The HSRC's population-based HIV prevalence and incidence survey series: history, impact and the future

As a leading Social Sciences institution in the country, the Human Sciences Research Council (HSRC) has distinguished itself with its contribution to research in the field of HIV and AIDS. Before 2002, South Africa, like many other African countries, had depended on sentinel surveillance among pregnant women attending antenatal clinics to estimate the rates of HIV infections in the country (Chin & Mann 1989). However, using antenatal clinic surveillance data for making national HIV estimates has limitations, the main one being that this type of data excludes women and girls who are not pregnant and males of all ages. Hence, the extrapolation from this data to the general population is known to produce biased HIV estimates. National population- based surveys that include HIV testing are considered to be the 'gold' standard to measure representatively HIV prevalence at a country level, and these surveys were first conducted by the HSRC in South Africa in 2002. Their strength is in the inclusion of a much wider proportion of the population than that included in the antenatal surveys. They thus typically have a better national coverage, even though there is potential for bias introduced by non-response and the exclusion from the sampling frame of population groups at high risk of HIV infection (Boerma et al. 2003).