AIDS in South Africa
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HIV/AIDS in South Africa - Wikipedia, the free encyclopedia
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HIV/AIDS in South Africa
From Wikipedia, the free encyclopedia
HIV/AIDS in South Africa is a prominent health concern; South Africa is believed to have more
people with HIV/AIDS than any other country in the world.
The 2007 UNAIDS report estimated that 5,700,000 South Africans had HIV/AIDS, or just under
12% of South Africa's population of 48 million.[1] In the adult population the rate is 18.5%.[2] The
number of infected is larger than in any other single country in the world. The other top five
countries with the highest HIV/AIDS prevalence are all neighbours of South Africa.
In 2007, only 28% of people in South Africa with advanced HIV/AIDS were receiving antiretroviral treatment (ART). In 2004, 2005 and 2006 the figures were 4%, 15% and 21%
respectively.[3] By 2009, nearly 1 million or about 2% of all adult South Africans were receiving
ART.[4]
In 2010, an estimated 280,000 South Africans died of HIV/AIDS. In the aughts, it is estimated that
between 42% and 47% of all deaths among South Africans were HIV/AIDS deaths. [5] However,
the Death Notification Forms Survey of 2010, which estimates a 93% completion rate, shows that
out of a total of 543,856 deaths nationwide (Appendix C4), only 18,325 deaths were attributed to
HIV/AIDS Diseases (B20-B24, Table 4.5). [6]
Estimated HIV infection in Africa in 2007 shows
high rates of infection in Southern Africa.
Although new infections among mature age groups in South Africa remain high, new infections
among teenagers seem to be on the decline. HIV/AIDS prevalence figures in the 15–19 year age group for 2005, 2006 and 2007 were 16%, 14% and
13% respectively.[7]
Contents
◾ 1 Prevalence
◾ 1.1 By race
◾ 1.2 By gender
◾ 1.3 By pregnant women
◾ 1.4 By age
◾ 1.5 By province
◾ 2 Economic impact
◾ 3 Awareness campaigns
◾ 4 Co-infection with tuberculosis
◾ 5 History of HIV/AIDS in South Africa
◾ 5.1 1985
◾ 5.2 1990
◾ 5.3 1993
◾ 5.4 1995
◾ 5.5 1996
◾ 5.6 1997
◾ 5.7 1999
◾ 5.8 2000
◾ 5.9 2001
◾ 5.10 2002
◾ 6 Demographics
◾ 7 AIDS denialism in South Africa
◾ 7.1 2000
◾ 7.2 2001
◾ 7.3 2003
◾ 7.4 2006
◾ 7.5 2007
◾ 7.6 2013
◾ 8 The role of the media in South Africa's epidemic
◾ 9 See also
◾ 10 References
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◾ 11 Further reading
◾ 12 External links
Prevalence
The Human Sciences Research Council, a South African institution, estimates 10.9% of all South Africans have HIV/AIDS. [8] Additionally, the
Central Intelligence Agency estimates that 310,000 individuals died in South Africa from HIV/AIDS in the year 2009. [2] The rising prevalence rate has
increased from 10.6% in 2008 to 12.2% in 2012. In 2012 alone, the Human Science Research Council (HSRC), reported 470,000 new diagnoses -- or
nearly 1,100 new infections every day. That's 100,000 more than was seen just one year earlier in 2011. Driving these statistics is the decreasing,
rather than increasing, public knowledge about HIV. According the HSRC report, only 26.8% of the 38,000 people surveyed understood how HIV was
transmitted or ways to prevent it. That's down from 30.3% in 2008, with evidence showing that South Africans under 50 are having an increasing
number of sexual partners and lower condom use.
By race
A 2008 study revealed that HIV/AIDS infection in South Africa is distinctly divided along racial lines: 13.6% of black Africans in South Africa are
HIV-positive, whereas only 0.3% of whites living in South Africa have the disease. [9] False traditional beliefs about HIV/AIDS, which contribute to
the spread of the disease, persist in townships due to the lack of education and awareness programmes in these regions. Sexual violence and local
attitudes toward HIV/AIDS have also amplified the epidemic.
By gender
HIV/AIDS is more prevalent among female adults under the age of 40 in nearly all age groups. Roughly 4 in every 5 people with HIV/AIDS aged 20
–24 are women, and only one third of people with HIV/AIDS aged 25–29 are men. Although prevalence is higher among women in general, only 1 in
every 6 HIV/AIDS infected people with multiple sex partners are women.
By pregnant women
HIV prevalence among pregnant women is highest in the populous KwaZulu-Natal province (37%), and lowest in the Western Cape (13%), Northern
Cape (16%) and Limpopo (18%) provinces. In the five other provinces (Eastern Cape, Free State, Gauteng, Mpumalanga and North West) at least 26%
of women attending antenatal clinics in 2006 tested HIV-positive.
The latest HIV data collected at antenatal clinics suggest that HIV infection levels might be levelling off, with HIV prevalence in pregnant women at
30% in 2007, 29% in 2006, and 28% in 2007. The decrease in the percentage of young pregnant women (15–24 years) found to be infected with HIV
also suggests a possible decline in the annual number of new infections. [10]
By age
Between 2005 and 2008, the number of older teenagers with HIV/AIDS has nearly halved. [8] Between 2002 and 2008, prevalence among South
Africans over 20 years old have increased whereas the figure for those under 20 years old have dropped somewhat over the same period. [8]
Condom use is highest among the youth and lowest among old people. More than 80% of men and more than 70% of women under 25 years old use
condoms, and slightly more than half of men and women aged 25–49 claim to use condoms. [8]
More than 30% of young adults and more than 80% of older adults are aware of the dangers posed by HIV/AIDS. Knowledge about HIV/AIDS is
lowest among people older than 50 years—less than two thirds know the truth about the disease. [8]
By province
In 2008, more than half (55%) of all South Africans infected with HIV reside in the KwaZulu-Natal and Gauteng provinces. [11]
Between 2005 and 2008, the total number of people infected with HIV/AIDS have increased in all of South Africa's provinces except KwaZulu-Natal
and Gauteng. Nevertheless, KwaZulu-Natal still has the highest infection rate at 15.5% In the province with the lowest infection rate, the Western
Cape, the total number of people with HIV/AIDS doubled between 2005 and 2008.[8]
Condom use has increased twofold in all provinces between 2002 and 2008. The two provinces where condoms were least used in 2002 were also the
provinces where condoms are least used in 2008, namely the Northern Cape and the Western Cape. [8]
HIV/AIDS prevalence among sexually active South Africans by province are:
◾ KwaZulu-Natal: 25.8%
◾ Mpumalanga: 23.1%
◾ Free State: 18.5%
◾ North West: 17.7%
◾ Gauteng: 15.2%
◾ Eastern Cape: 15.2%
◾ Limpopo: 13.7%
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◾ Northern Cape: 9.2%
◾ Western Cape: 5.3%
Economic impact
The comparison done in 2003 of the results from four forecasting methods predicted the difference between an HIV/AIDS scenario versus a noHIV/AIDS scenario for annual growth rates between 2002 and 2015.[12] According to the study, real growth in GDP would be 0.6 percentage points
lower than if there were no HIV/AIDS, but per-capita growth in GDP would be 0.9 percentage points higher. Growth in population would have been
1.5 percentage points lower, and growth of the labour force would be 1.2 percentage points lower, but the unemployment rate would be 0.9 percentage
points lower as well.
The South African branch of the company Daimler-Chrysler estimated that in 2002 expenses related to HIV/AIDS were equivalent to 4% of all its
salaries in South Africa.[13] A study done in 2000 by South Africa's second largest company, Sasol, indicated that 15% of its local workforce was HIV
positive, of which 11% had AIDS.[14] According to the CEO of South Africa's largest company, SAB Miller, the cost of HIV/AIDS include costs
associated with increased absenteeism, reduced productivity, increased turnover, and healthcare costs. [15]
Awareness campaigns
The four main HIV/AIDS awareness campaigns in South Africa are Khomanani (funded by the government), LoveLife (primarily privately funded),
Soul City (a television drama for adults) and Soul Buddyz (a television series for teenagers). [16] Soul City and Soul Buddyz are the most successful
campaigns although both campaigns experienced a slight loss of effectiveness between 2005 and 2008. Khomanani is the least successful campaign,
although its effectiveness has increased by more than 50% between 2005 and 2008.
The dubious quality of condoms which are distributed is a setback to these efforts. In 2007, the government recalled more than 20 million locally
manufactured condoms which were defective. Some of the contraceptive devices given away at the ANC's centenary celebrations in 2012 failed the
water test conducted by the Treatment Action Campaign. [17]
Co-infection with tuberculosis
In 2007, it was estimated that one third of HIV infected people will develop TB (tuberculosis) in their lifetime. Although not all patients with TB are
tested for HIV, in 2006, some 40% of TB patients were tested for HIV. It has been the government policy since 2002 to cross-check all new cases of
TB for HIV infection.[18]
Although STI prevention is part of the government's HIV/AIDS programmes, as it is in that of most countries, in South Africa HIV/AIDS prevention
is done in conjunction with TB prevention. Most patients who die from HIV-related causes die from TB or similar illnesses. In fact the Health
Department's programme of prevention is called the "National HIV and AIDS and TB Programme". [19] In line with United Nations requirements,
South Africa has also drawn up an "HIV & AIDS and STI Strategic Plan". [20]
History of HIV/AIDS in South Africa
In 1983, AIDS was diagnosed for the first time in two patients in South Africa. [21] The first recorded death owing to AIDS occurred in 1983.[21] By
1986, there were 46 recorded AIDS diagnoses. Estimates from 2000 indicated that 5% of actual infections and only 1% of actual deaths due to AIDS
were reported prior to 1990. Prior to 1990, AIDS was more common among homosexual people. By 1990, less than 1% of South Africans had AIDS.
By 1996, the figure stood at around 3% and by 1999 the figure had reached 10%. [22] AIDS infection started reaching pandemic proportions around
1995.[23]
1985
In 1985, the South African government set up the country’s first AIDS Advisory Group.
1990
In 1990 the first national antenatal survey to test for HIV found that 0.8% of pregnant women were HIV-positive. It was estimated that there were
between 74,000 and 6,500,135 people in South Africa living with HIV. Antenatal surveys have subsequently been carried out annually.
1993
In 1993 the HIV prevalence rate among pregnant women was 4.3%. By 1993 the National Health Department reported that the number of recorded
HIV infections had increased by 60% in the previous two years and the number was expected to double in 1993.
1995
In August 1995, the Department of Health awarded a R14.27 million contract to produce a sequel to the musical, Sarafina, about AIDS that would
reach young people.[24] The project was dogged by controversy, and was finally shelved in 1996. [25]
From 6–10 March 1995, the 7th International Conference for People Living with HIV and AIDS was held in Cape Town, South Africa. [26] The
conference was opened by then-Deputy President Thabo Mbeki. [27]
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1996
In January 1996 it was decided that South Africa's national soccer team, Bafana-Bafana, would contribute to the AIDS Awareness Campaign by
wearing red ribbons to all their public appearances during the African Nations Cup. [28]
On 5 July 1996,[29] South Africa's health minister Nkosazana Zuma spoke at the 11th International Conference on AIDS in Vancouver. She said:
Most people infected with HIV live in Africa, where therapies involving combinations of expensive anti-viral drugs are out of the question. [30]
1997
In February 1997, South African government's Health Department defended its support for the controversial AIDS drug Virodene by stating that "the
`cocktails' that are available [for the treatment of HIV/AIDS] are way beyond the means of most patients [even from developed countries]". [31]
Parliament had previously launched an investigation into the procedural soundness of the clinical trials for the drug. [32]
1999
In 1999 the South African HIV prevention campaign loveLife is founded.
2000
In 2000 the Department of Health outlined a five-year plan to combat AIDS, HIV and STIs. A National AIDS Council (SANAC) was set up to oversee
these developments.
2001
The South African government successfully defended against a legal action brought by transnational pharmaceutical companies in April 2001 of a law
that would allow cheaper locally-produced medicines, including anti-retrovirals, although the government's roll-out of anti-retrovirals remained
generally slow.
In 2001, Right to Care, an NGO dedicated to the prevention and treatment of HIV and associated diseases, was founded. Using USAID's PEPFAR
funding, the organisation expanded rapidly and after ten years (2011) had over 125 000 HIV-positive patients in clinical care.
2002
In 2002 South Africa's High Court ordered the government to make the drug nevirapine available to pregnant women to help prevent mother to child
transmission of HIV, following campaigns by Treatment Action Campaign and others.
Demographics
According to the National HIV and Syphilis Antenatal Sero-prevalence Survey of 2005 [33] and 2007,[34] the percentage of pregnant women with HIV
per year was as follows:
Year:
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Percentage: 0.7
1.7
2.2
4.0
7.6
2011
[35]
10.4 14.2 17.0 22.8 22.4 24.5 24.8 26.5 27.9 29.5 30.2 29.1 28.0 29.3 29.4 30.2 29.5
According to a 2006 study by The South African Department of Health, 13.3% of 9,950 Africans that were included in the poll had HIV. Out of 1,173
whites, 0.6% had HIV.[36] These numbers are confirmed in a 2008 study by the Human Sciences Research Council that found a 13.6% infection rate
among Africans, 1.7% among Coloreds, 0.3% among Indians, and 0.3% among Whites. [37]
In 2007, it was estimated that between 4.9 and 6.6 million of South Africa's 48 million people of all ages were infected with HIV (human
immunodeficiency virus), which is the virus that causes AIDS (acquired immunodeficiency syndrome). [38]
AIDS denialism in South Africa
See also HIV/AIDS denialism in South Africa.
2000
On 9 July 2000, then President Thabo Mbeki opened the International AIDS Conference in Durban with a speech not about HIV or AIDS but about
extreme poverty in Africa. In the speech, he confirmed his belief that immune deficiency is a big problem in Africa but that one can't possibly attribute
all immune deficiency related diseases to a single virus. [39][40]
On 4 September 2000, Thabo Mbeki acknowledged during an interview with Time Magazine (South African edition) that HIV can cause AIDS but
confirmed his opinion that HIV should not be regarded as the sole cause of immune deficiency. He said:
...the notion that immune deficiency is only acquired from a single virus cannot be sustained. Once you say immune deficiency is acquired from
that virus, your response will be anti-retroviral drugs. But if you accept that there can be a variety of reasons ... then you can have a more
comprehensive treatment response.[41][42]
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On 20 September 2000, then President Thabo Mbeki responded to a question in Parliament about his views. He said:
All HIV/AIDS programmes of this government are based on the thesis that HIV causes AIDS. [But...] can a virus cause a syndrome? ... It can't,
because a syndrome is a group of diseases resulting from acquired immune deficiency. Indeed, HIV contributes [to the collapse of the immune
system], but other things contribute as well. [43]
2001
In 2001 the government appointed a panel of scientists, including a number of AIDS denialists, to report back on the issue. The report suggested
alternative treatments for HIV/AIDS, but the South African government responded that unless alternative scientific proof is obtained, it will continue
to base its policy on the idea that the cause of AIDS is HIV. [44]
2003
Despite international drug companies offering free or cheap anti-retroviral drugs, the Health Ministry remained hesitant about providing treatment for
people living with HIV. Only in November 2003 did the government approve a plan to make anti-retroviral treatment publicly available. Prior to 2003,
South Africans with HIV who used the public sector health system could get treatment for opportunistic infections but could not get anti-retrovirals. [36]
2006
The effort to improve treatment of HIV/AIDS was damaged by the attitude of many figures in the government, including President Mbeki. The then
health minister, Manto Tshabalala-Msimang, advocated a diet of garlic, olive oil and lemon to cure the disease. [45] Although many scientists and
political figures called for her removal, she was not removed from office until Mbeki himself was removed from office. [46] These policies led to the
deaths of over 300,000 South Africans.[47]
2007
In August 2007, President Mbeki and Health Minister Tshabalala-Msimang dismissed Deputy Health Minister Nozizwe Madlala-Routledge. MadlalaRoutledge has been widely credited by medical professionals and AIDS activists. [48] Although she was officially dismissed for corruption, it was
widely held that she was dismissed for her more mainstream beliefs about AIDS and its relation with HIV. [49]
2013
The United States announced in March, 2013 that their support to South Africa will be cut in half by 2017 due to the economic crisis and compulsory
budget cuts.[50]
The role of the media in South Africa's epidemic
The South African press took a strong advocacy position during the denialism era under Thabo Mbeki. [51][52] There are numerous examples of
journalists taking the government to task for policy positions and public statements that were seen as irresponsible. [51] Some of these examples include:
attacks on Health Minister Manto Tshabalala-Msimang’s “garlic and potato” approach to treatment, [53] outrage at Mbeki’s statement that he never
knew anyone who had died of AIDS,[54] and coverage of the humiliating 2006 Global AIDS Conference. [55]
It could be claimed that the news media have taken a less aggressive stance since the end of Mbeki’s presidency and the death of Tshabalala Msimang.
The emergence of Jacob Zuma as party and state leader heralded what the press saw as a new era of AIDS treatment. [56] However, this also means that
HIV is afforded less news coverage. A recent study by the HIV/AIDS and the Media Project has shown that the quantity of HIV-related news coverage
has declined dramatically from 2002/3 (what could be considered the pinnacle of government denialism) to the more recent “conflict resolution” phase
under Zuma. Perhaps HIV has fallen into the traditional categories of being impersonal, undramatic, "old" news. [52] The number of health journalists
has also declined considerably.[57]
See also
◾ HIV/AIDS in South African townships
◾ Sexual violence in South Africa
◾ 46664 (concerts)
General:
◾ Health care in South Africa
◾ HIV/AIDS in Africa
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(http://www.int.iol.co.za/index.php?
need-red-herrings). Mg.co.za. 29 September 2003. Retrieved 15 May 2011.
55. ^ "Manto defends AIDS policies" (http://www.mg.co.za/article/2006-08-
set_id=1&click_id=125&art_id=nw20070808223254301C831843) 8
21-manto-defends-aids-policies). Mg.co.za. 21 August 2006. Retrieved
August 2007
50. ^ Madapolitics. "Daunting Outlook for AIDS Crisis in South
15 May 2011.
56. ^ "President heralds new
Africa" (http://madapolitics.wordpress.com/2013/03/14/daunting-outlook-
era" (http://www.unaids.org/en/resources/presscentre/featurestories/2009/november/20091101s
for-the-aids-crisis/). Madapolitics. Retrieved 15 March 2013.
Unaids.org. Retrieved 15 May 2011.
57. ^ Duncan, C (2009). "HIV in the print media: A comparative and
retrospective print media monitoring analysis".
Further reading
◾ Pieter Fourie "The Political Management of HIV and AIDS in South Africa: One burden too many?" Palgrave Macmillan, 2006, ISBN 0-23000667-1
◾ Fassin, Didier "When Bodies Remember: Experiences and Politics of AIDS in South Africa" University of California Press, 2007, ISBN 978-0520-25027-7
External links
◾ AIDSPortal South Africa page – latest research, guidelines and case studies
(http://www.aidsportal.org/overlay_details.aspx?nex=22)
◾ NewsHour: HIV/AIDS and TB in South Africa (http://www.pbs.org/newshour/video/share.html?
Wikimedia Commons has
media related to AIDS in
South Africa.
s=news01p824)
◾ JournAIDS: A resource on HIV for South African media practitioners (http://www.journaids.org)
Retrieved from "http://en.wikipedia.org/w/index.php?title=HIV/AIDS_in_South_Africa&oldid=646394627"
Categories: HIV/AIDS in South Africa HIV/AIDS in Africa
◾ This page was last modified on 9 February 2015, at 20:16.
◾ Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the
Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization.
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HIV/AIDS in South Africa
From Wikipedia, the free encyclopedia
HIV/AIDS in South Africa is a prominent health concern; South Africa is believed to have more
people with HIV/AIDS than any other country in the world.
The 2007 UNAIDS report estimated that 5,700,000 South Africans had HIV/AIDS, or just under
12% of South Africa's population of 48 million.[1] In the adult population the rate is 18.5%.[2] The
number of infected is larger than in any other single country in the world. The other top five
countries with the highest HIV/AIDS prevalence are all neighbours of South Africa.
In 2007, only 28% of people in South Africa with advanced HIV/AIDS were receiving antiretroviral treatment (ART). In 2004, 2005 and 2006 the figures were 4%, 15% and 21%
respectively.[3] By 2009, nearly 1 million or about 2% of all adult South Africans were receiving
ART.[4]
In 2010, an estimated 280,000 South Africans died of HIV/AIDS. In the aughts, it is estimated that
between 42% and 47% of all deaths among South Africans were HIV/AIDS deaths. [5] However,
the Death Notification Forms Survey of 2010, which estimates a 93% completion rate, shows that
out of a total of 543,856 deaths nationwide (Appendix C4), only 18,325 deaths were attributed to
HIV/AIDS Diseases (B20-B24, Table 4.5). [6]
Estimated HIV infection in Africa in 2007 shows
high rates of infection in Southern Africa.
Although new infections among mature age groups in South Africa remain high, new infections
among teenagers seem to be on the decline. HIV/AIDS prevalence figures in the 15–19 year age group for 2005, 2006 and 2007 were 16%, 14% and
13% respectively.[7]
Contents
◾ 1 Prevalence
◾ 1.1 By race
◾ 1.2 By gender
◾ 1.3 By pregnant women
◾ 1.4 By age
◾ 1.5 By province
◾ 2 Economic impact
◾ 3 Awareness campaigns
◾ 4 Co-infection with tuberculosis
◾ 5 History of HIV/AIDS in South Africa
◾ 5.1 1985
◾ 5.2 1990
◾ 5.3 1993
◾ 5.4 1995
◾ 5.5 1996
◾ 5.6 1997
◾ 5.7 1999
◾ 5.8 2000
◾ 5.9 2001
◾ 5.10 2002
◾ 6 Demographics
◾ 7 AIDS denialism in South Africa
◾ 7.1 2000
◾ 7.2 2001
◾ 7.3 2003
◾ 7.4 2006
◾ 7.5 2007
◾ 7.6 2013
◾ 8 The role of the media in South Africa's epidemic
◾ 9 See also
◾ 10 References
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◾ 11 Further reading
◾ 12 External links
Prevalence
The Human Sciences Research Council, a South African institution, estimates 10.9% of all South Africans have HIV/AIDS. [8] Additionally, the
Central Intelligence Agency estimates that 310,000 individuals died in South Africa from HIV/AIDS in the year 2009. [2] The rising prevalence rate has
increased from 10.6% in 2008 to 12.2% in 2012. In 2012 alone, the Human Science Research Council (HSRC), reported 470,000 new diagnoses -- or
nearly 1,100 new infections every day. That's 100,000 more than was seen just one year earlier in 2011. Driving these statistics is the decreasing,
rather than increasing, public knowledge about HIV. According the HSRC report, only 26.8% of the 38,000 people surveyed understood how HIV was
transmitted or ways to prevent it. That's down from 30.3% in 2008, with evidence showing that South Africans under 50 are having an increasing
number of sexual partners and lower condom use.
By race
A 2008 study revealed that HIV/AIDS infection in South Africa is distinctly divided along racial lines: 13.6% of black Africans in South Africa are
HIV-positive, whereas only 0.3% of whites living in South Africa have the disease. [9] False traditional beliefs about HIV/AIDS, which contribute to
the spread of the disease, persist in townships due to the lack of education and awareness programmes in these regions. Sexual violence and local
attitudes toward HIV/AIDS have also amplified the epidemic.
By gender
HIV/AIDS is more prevalent among female adults under the age of 40 in nearly all age groups. Roughly 4 in every 5 people with HIV/AIDS aged 20
–24 are women, and only one third of people with HIV/AIDS aged 25–29 are men. Although prevalence is higher among women in general, only 1 in
every 6 HIV/AIDS infected people with multiple sex partners are women.
By pregnant women
HIV prevalence among pregnant women is highest in the populous KwaZulu-Natal province (37%), and lowest in the Western Cape (13%), Northern
Cape (16%) and Limpopo (18%) provinces. In the five other provinces (Eastern Cape, Free State, Gauteng, Mpumalanga and North West) at least 26%
of women attending antenatal clinics in 2006 tested HIV-positive.
The latest HIV data collected at antenatal clinics suggest that HIV infection levels might be levelling off, with HIV prevalence in pregnant women at
30% in 2007, 29% in 2006, and 28% in 2007. The decrease in the percentage of young pregnant women (15–24 years) found to be infected with HIV
also suggests a possible decline in the annual number of new infections. [10]
By age
Between 2005 and 2008, the number of older teenagers with HIV/AIDS has nearly halved. [8] Between 2002 and 2008, prevalence among South
Africans over 20 years old have increased whereas the figure for those under 20 years old have dropped somewhat over the same period. [8]
Condom use is highest among the youth and lowest among old people. More than 80% of men and more than 70% of women under 25 years old use
condoms, and slightly more than half of men and women aged 25–49 claim to use condoms. [8]
More than 30% of young adults and more than 80% of older adults are aware of the dangers posed by HIV/AIDS. Knowledge about HIV/AIDS is
lowest among people older than 50 years—less than two thirds know the truth about the disease. [8]
By province
In 2008, more than half (55%) of all South Africans infected with HIV reside in the KwaZulu-Natal and Gauteng provinces. [11]
Between 2005 and 2008, the total number of people infected with HIV/AIDS have increased in all of South Africa's provinces except KwaZulu-Natal
and Gauteng. Nevertheless, KwaZulu-Natal still has the highest infection rate at 15.5% In the province with the lowest infection rate, the Western
Cape, the total number of people with HIV/AIDS doubled between 2005 and 2008.[8]
Condom use has increased twofold in all provinces between 2002 and 2008. The two provinces where condoms were least used in 2002 were also the
provinces where condoms are least used in 2008, namely the Northern Cape and the Western Cape. [8]
HIV/AIDS prevalence among sexually active South Africans by province are:
◾ KwaZulu-Natal: 25.8%
◾ Mpumalanga: 23.1%
◾ Free State: 18.5%
◾ North West: 17.7%
◾ Gauteng: 15.2%
◾ Eastern Cape: 15.2%
◾ Limpopo: 13.7%
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◾ Northern Cape: 9.2%
◾ Western Cape: 5.3%
Economic impact
The comparison done in 2003 of the results from four forecasting methods predicted the difference between an HIV/AIDS scenario versus a noHIV/AIDS scenario for annual growth rates between 2002 and 2015.[12] According to the study, real growth in GDP would be 0.6 percentage points
lower than if there were no HIV/AIDS, but per-capita growth in GDP would be 0.9 percentage points higher. Growth in population would have been
1.5 percentage points lower, and growth of the labour force would be 1.2 percentage points lower, but the unemployment rate would be 0.9 percentage
points lower as well.
The South African branch of the company Daimler-Chrysler estimated that in 2002 expenses related to HIV/AIDS were equivalent to 4% of all its
salaries in South Africa.[13] A study done in 2000 by South Africa's second largest company, Sasol, indicated that 15% of its local workforce was HIV
positive, of which 11% had AIDS.[14] According to the CEO of South Africa's largest company, SAB Miller, the cost of HIV/AIDS include costs
associated with increased absenteeism, reduced productivity, increased turnover, and healthcare costs. [15]
Awareness campaigns
The four main HIV/AIDS awareness campaigns in South Africa are Khomanani (funded by the government), LoveLife (primarily privately funded),
Soul City (a television drama for adults) and Soul Buddyz (a television series for teenagers). [16] Soul City and Soul Buddyz are the most successful
campaigns although both campaigns experienced a slight loss of effectiveness between 2005 and 2008. Khomanani is the least successful campaign,
although its effectiveness has increased by more than 50% between 2005 and 2008.
The dubious quality of condoms which are distributed is a setback to these efforts. In 2007, the government recalled more than 20 million locally
manufactured condoms which were defective. Some of the contraceptive devices given away at the ANC's centenary celebrations in 2012 failed the
water test conducted by the Treatment Action Campaign. [17]
Co-infection with tuberculosis
In 2007, it was estimated that one third of HIV infected people will develop TB (tuberculosis) in their lifetime. Although not all patients with TB are
tested for HIV, in 2006, some 40% of TB patients were tested for HIV. It has been the government policy since 2002 to cross-check all new cases of
TB for HIV infection.[18]
Although STI prevention is part of the government's HIV/AIDS programmes, as it is in that of most countries, in South Africa HIV/AIDS prevention
is done in conjunction with TB prevention. Most patients who die from HIV-related causes die from TB or similar illnesses. In fact the Health
Department's programme of prevention is called the "National HIV and AIDS and TB Programme". [19] In line with United Nations requirements,
South Africa has also drawn up an "HIV & AIDS and STI Strategic Plan". [20]
History of HIV/AIDS in South Africa
In 1983, AIDS was diagnosed for the first time in two patients in South Africa. [21] The first recorded death owing to AIDS occurred in 1983.[21] By
1986, there were 46 recorded AIDS diagnoses. Estimates from 2000 indicated that 5% of actual infections and only 1% of actual deaths due to AIDS
were reported prior to 1990. Prior to 1990, AIDS was more common among homosexual people. By 1990, less than 1% of South Africans had AIDS.
By 1996, the figure stood at around 3% and by 1999 the figure had reached 10%. [22] AIDS infection started reaching pandemic proportions around
1995.[23]
1985
In 1985, the South African government set up the country’s first AIDS Advisory Group.
1990
In 1990 the first national antenatal survey to test for HIV found that 0.8% of pregnant women were HIV-positive. It was estimated that there were
between 74,000 and 6,500,135 people in South Africa living with HIV. Antenatal surveys have subsequently been carried out annually.
1993
In 1993 the HIV prevalence rate among pregnant women was 4.3%. By 1993 the National Health Department reported that the number of recorded
HIV infections had increased by 60% in the previous two years and the number was expected to double in 1993.
1995
In August 1995, the Department of Health awarded a R14.27 million contract to produce a sequel to the musical, Sarafina, about AIDS that would
reach young people.[24] The project was dogged by controversy, and was finally shelved in 1996. [25]
From 6–10 March 1995, the 7th International Conference for People Living with HIV and AIDS was held in Cape Town, South Africa. [26] The
conference was opened by then-Deputy President Thabo Mbeki. [27]
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1996
In January 1996 it was decided that South Africa's national soccer team, Bafana-Bafana, would contribute to the AIDS Awareness Campaign by
wearing red ribbons to all their public appearances during the African Nations Cup. [28]
On 5 July 1996,[29] South Africa's health minister Nkosazana Zuma spoke at the 11th International Conference on AIDS in Vancouver. She said:
Most people infected with HIV live in Africa, where therapies involving combinations of expensive anti-viral drugs are out of the question. [30]
1997
In February 1997, South African government's Health Department defended its support for the controversial AIDS drug Virodene by stating that "the
`cocktails' that are available [for the treatment of HIV/AIDS] are way beyond the means of most patients [even from developed countries]". [31]
Parliament had previously launched an investigation into the procedural soundness of the clinical trials for the drug. [32]
1999
In 1999 the South African HIV prevention campaign loveLife is founded.
2000
In 2000 the Department of Health outlined a five-year plan to combat AIDS, HIV and STIs. A National AIDS Council (SANAC) was set up to oversee
these developments.
2001
The South African government successfully defended against a legal action brought by transnational pharmaceutical companies in April 2001 of a law
that would allow cheaper locally-produced medicines, including anti-retrovirals, although the government's roll-out of anti-retrovirals remained
generally slow.
In 2001, Right to Care, an NGO dedicated to the prevention and treatment of HIV and associated diseases, was founded. Using USAID's PEPFAR
funding, the organisation expanded rapidly and after ten years (2011) had over 125 000 HIV-positive patients in clinical care.
2002
In 2002 South Africa's High Court ordered the government to make the drug nevirapine available to pregnant women to help prevent mother to child
transmission of HIV, following campaigns by Treatment Action Campaign and others.
Demographics
According to the National HIV and Syphilis Antenatal Sero-prevalence Survey of 2005 [33] and 2007,[34] the percentage of pregnant women with HIV
per year was as follows:
Year:
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Percentage: 0.7
1.7
2.2
4.0
7.6
2011
[35]
10.4 14.2 17.0 22.8 22.4 24.5 24.8 26.5 27.9 29.5 30.2 29.1 28.0 29.3 29.4 30.2 29.5
According to a 2006 study by The South African Department of Health, 13.3% of 9,950 Africans that were included in the poll had HIV. Out of 1,173
whites, 0.6% had HIV.[36] These numbers are confirmed in a 2008 study by the Human Sciences Research Council that found a 13.6% infection rate
among Africans, 1.7% among Coloreds, 0.3% among Indians, and 0.3% among Whites. [37]
In 2007, it was estimated that between 4.9 and 6.6 million of South Africa's 48 million people of all ages were infected with HIV (human
immunodeficiency virus), which is the virus that causes AIDS (acquired immunodeficiency syndrome). [38]
AIDS denialism in South Africa
See also HIV/AIDS denialism in South Africa.
2000
On 9 July 2000, then President Thabo Mbeki opened the International AIDS Conference in Durban with a speech not about HIV or AIDS but about
extreme poverty in Africa. In the speech, he confirmed his belief that immune deficiency is a big problem in Africa but that one can't possibly attribute
all immune deficiency related diseases to a single virus. [39][40]
On 4 September 2000, Thabo Mbeki acknowledged during an interview with Time Magazine (South African edition) that HIV can cause AIDS but
confirmed his opinion that HIV should not be regarded as the sole cause of immune deficiency. He said:
...the notion that immune deficiency is only acquired from a single virus cannot be sustained. Once you say immune deficiency is acquired from
that virus, your response will be anti-retroviral drugs. But if you accept that there can be a variety of reasons ... then you can have a more
comprehensive treatment response.[41][42]
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On 20 September 2000, then President Thabo Mbeki responded to a question in Parliament about his views. He said:
All HIV/AIDS programmes of this government are based on the thesis that HIV causes AIDS. [But...] can a virus cause a syndrome? ... It can't,
because a syndrome is a group of diseases resulting from acquired immune deficiency. Indeed, HIV contributes [to the collapse of the immune
system], but other things contribute as well. [43]
2001
In 2001 the government appointed a panel of scientists, including a number of AIDS denialists, to report back on the issue. The report suggested
alternative treatments for HIV/AIDS, but the South African government responded that unless alternative scientific proof is obtained, it will continue
to base its policy on the idea that the cause of AIDS is HIV. [44]
2003
Despite international drug companies offering free or cheap anti-retroviral drugs, the Health Ministry remained hesitant about providing treatment for
people living with HIV. Only in November 2003 did the government approve a plan to make anti-retroviral treatment publicly available. Prior to 2003,
South Africans with HIV who used the public sector health system could get treatment for opportunistic infections but could not get anti-retrovirals. [36]
2006
The effort to improve treatment of HIV/AIDS was damaged by the attitude of many figures in the government, including President Mbeki. The then
health minister, Manto Tshabalala-Msimang, advocated a diet of garlic, olive oil and lemon to cure the disease. [45] Although many scientists and
political figures called for her removal, she was not removed from office until Mbeki himself was removed from office. [46] These policies led to the
deaths of over 300,000 South Africans.[47]
2007
In August 2007, President Mbeki and Health Minister Tshabalala-Msimang dismissed Deputy Health Minister Nozizwe Madlala-Routledge. MadlalaRoutledge has been widely credited by medical professionals and AIDS activists. [48] Although she was officially dismissed for corruption, it was
widely held that she was dismissed for her more mainstream beliefs about AIDS and its relation with HIV. [49]
2013
The United States announced in March, 2013 that their support to South Africa will be cut in half by 2017 due to the economic crisis and compulsory
budget cuts.[50]
The role of the media in South Africa's epidemic
The South African press took a strong advocacy position during the denialism era under Thabo Mbeki. [51][52] There are numerous examples of
journalists taking the government to task for policy positions and public statements that were seen as irresponsible. [51] Some of these examples include:
attacks on Health Minister Manto Tshabalala-Msimang’s “garlic and potato” approach to treatment, [53] outrage at Mbeki’s statement that he never
knew anyone who had died of AIDS,[54] and coverage of the humiliating 2006 Global AIDS Conference. [55]
It could be claimed that the news media have taken a less aggressive stance since the end of Mbeki’s presidency and the death of Tshabalala Msimang.
The emergence of Jacob Zuma as party and state leader heralded what the press saw as a new era of AIDS treatment. [56] However, this also means that
HIV is afforded less news coverage. A recent study by the HIV/AIDS and the Media Project has shown that the quantity of HIV-related news coverage
has declined dramatically from 2002/3 (what could be considered the pinnacle of government denialism) to the more recent “conflict resolution” phase
under Zuma. Perhaps HIV has fallen into the traditional categories of being impersonal, undramatic, "old" news. [52] The number of health journalists
has also declined considerably.[57]
See also
◾ HIV/AIDS in South African townships
◾ Sexual violence in South Africa
◾ 46664 (concerts)
General:
◾ Health care in South Africa
◾ HIV/AIDS in Africa
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Further reading
◾ Pieter Fourie "The Political Management of HIV and AIDS in South Africa: One burden too many?" Palgrave Macmillan, 2006, ISBN 0-23000667-1
◾ Fassin, Didier "When Bodies Remember: Experiences and Politics of AIDS in South Africa" University of California Press, 2007, ISBN 978-0520-25027-7
External links
◾ AIDSPortal South Africa page – latest research, guidelines and case studies
(http://www.aidsportal.org/overlay_details.aspx?nex=22)
◾ NewsHour: HIV/AIDS and TB in South Africa (http://www.pbs.org/newshour/video/share.html?
Wikimedia Commons has
media related to AIDS in
South Africa.
s=news01p824)
◾ JournAIDS: A resource on HIV for South African media practitioners (http://www.journaids.org)
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