HIV/AIDS in South Africa

1
HIV/AIDS in South Africa

• Stacy Krull
• Natalie Kunewych
• Lindsey Litwinczuk
• Angela Madias
• Mary Martinovich
• Brian Matyniak

2
Overview of South Africa

• Official Name Republic of South Africa
• Land Area 471,443 sq miles
• Population 43,647,658
• Ethnic Groups Black (75.2) White (13.6)
  Colored (8.6) Indian (2.6)
• Religion primarily Christian (68) Indigenous
  (28.5)

3
Overview of HIV/AIDS in South Africa

• HIV Infected 5.6 million -- more HIV positive
  people than any other country
• (This number includes the approximately 230,000
  children, under 15 years old, that are infected)
• AIDS Deaths 370,000
• 1,000 AIDS deaths occurring every day
• AIDS Orphans 1.1 million

4
Overview of HIV/AIDS in South Africa Continued .
. .

• Among females, HIV prevalence is highest in those
  between 25 and 29 years old
• Among males, the peak is in the group aged 30-39
  years

5
Overview of HIV/AIDS in South Africa Continued .
. .

• Researchers estimate that 10.8 of all South
  Africans over the age of 2 years were living with
  HIV in 2005
• Among those between 15 and 49 years old, the
  estimated HIV prevalence was 16.2 in 2005

6
Commonalities Compared to Brazil, India,
Ukraine, Cambodia, the United States, Haiti, and
Uganda

• Predominantly discovered during the 1980s
• Commonly transmitted via sexual contact,
  intravenous drug use, blood transfusions, and
  mother to child transmission

7
Commonalities Continued

• Globally, women and girls comprise approximately
  50 of the HIV/Aids population
• Affects and kills the most productive members,
  young adults 15-24 years old
• High numbers of orphaned children put strains on
  the traditional family structure
• Often carries a stigma causing discrimination

8
Commonalities Continued

• Conflict found in many of the areas cause unrest
  and displacement leading to poverty and
  helplessness
• Often leads to employment in the sex trade and
  heavy use of drugs
• Typically spreads trailing the travel lines of
  migrants, displaced individuals, and transport
  drivers

9
Commonalities Continued

• Healthcare and drug treatment is almost
  nonexistent in most regions especially for the
  impoverished
• Lack of education and literacy issues cause
  difficulties in communicating the need for
  treatment and behavioral modifications

10

• Social factors that place South Africa at high
  risk for HIV/ Aids
• Social inequalities in income and employment
  status are powerful predictors of HIV infection.
• In many parts of Sub-Saharan Africa, as elsewhere
  in the world, the inequality between men and
  women, and economic deprivation helps to drive
  the epidemic. Women and girls are commonly
  discriminated against in terms of access to
  education, employment, credit, health care, land
  and inheritance.
• Mobility Mass resettlements of populations
  under apartheid, seasonal labor migrations,
  movements along major trade routes and refugees
  fleeing war in other parts of Africa help spread
  infection.
• Sexual violence Linked with common forms of
  social and political violence that have long been
  part of the everyday life of townships and inner
  city areas.

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A Touchy Situation? Racism and the suspicion to
eliminate the African race.

• Epidemics have often been used to enforce racial
  segregation. The bubonic plague of 1900 in
  Capetown was used to justify the mass removal of
  Africans from their homes to the first native
  locations under the first segregationist law,
  passed in 1883 and called, significantly, the
  Public Health Act.
• When AIDS appeared in South Africa it was
  immediately interpreted in racist terms some
  white leaders evoked a supposed African
  promiscuity they denounced the danger that
  infected black people posed to the nation and
  they even publicly rejoiced over the possible
  elimination of black people by the disease as one
  member of parliament did in 1992.

12
So, what is the Common Response to such a problem
as HIV/AIDS?

• Denial!
• It is difficult for anybody- even a state
  leader-to fully comprehend the magnitude of the
  epidemic and its demographic consequences, such
  as the loss of 20 years of life expectancy within
  two decades.
• This is what obvious state president Mbeki was in
  when he denied the link of HIV and AIDS in
  September 2003 by stating Personally, I dont
  know anyone who has died of AIDS. I honestly
  dont.
• The lack of political commitment has contributed
  to the spread of HIV/AIDS.

13
Common Response to HIV/AIDS Continued

• Alongside AIDS denialism and misinformation about
  AIDS treatment, false beliefs about how HIV can
  be transmitted are also a concern. At a trial in
  April 2006, South Africas former
  Deputy-President, Jacob Zuma, stated his belief
  that taking a shower after having sex had reduced
  his chances of contracting HIV. 
• South African President Thabo Mbeki's has
  consistently refused to acknowledge that HIV is
  the cause of AIDS he argues that HIV is just one
  factor among many that might contribute to deaths
  resulting from immunodeficiency, alongside others
  such as poverty and poor nutrition 
• Does HIV Cause AIDS? Can a virus cause a
  syndrome? How? It cant, because a syndrome is a
  group of diseases resulting from acquired immune
  deficiency. Indeed, HIV contributes, but other
  things contribute as well.- African president
  Thabo Mbeki. 

14
Responsibilities include

• Poverty and Social Instability
• High levels of sexual infections
• Low status of women
• High mobility

15
Government Response 2000-2005

• The Operational Plan for Comprehensive care and
  Treatment for People Living with HIV and AIDS
• Prevention
• Treatment
• Care
• Support

16
Government Debate surrounding the Plan

• Costs of the antiretroviral (ARV) drug
• Other treatments needed to be considered
• Change in the Governments attitude towards ARVs
• Pharmaceutical companies agreed to allow low-cost
  generic versions to be produced in South Africa

17
Progress since 2003

• Governments plan aimed to save 381,177 people on
  Government-funded ARVs by 2005-2006
• 85,000 people in the public sector were receiving
  treatment by 2005
• It is estimated by UNAIDS that at least 79 of
  those who needed ARVs were not receiving them at
  the end of 2005
• Treatment was established, meeting the
  Governments 2003 goal, however the number of
  people receiving ARVs failed the initial targets.

18
Health Care Issues

• Overcrowding of under-resourced hospitals
• Due to working conditions patients receive
  inadequate care
• Morale of health professional is low due to poor
  conditions inability to treat people
• Many workers themselves are living with HIV/AIDS
• Lack of specialized training and staff shortages

19
South African Labor Unions

• COSATU demand for adequate care and treatment for
  people living with HIV/AIDS
• Mineworkers were the first group known to be
  vulnerable to the disease
• High levels of mobility, promote the tendency for
  workers to have more than one partner
• Workers risk losing their incomes, partners,
  caregivers, and guardians
• Unions have now made testing, counseling, and
  treatment programs available through their
  workplace.

20
Methods for the Future

• Education and prevention campaigns
• Encourage real behavior change
• HIV awareness
• Government taking firmer stance on treatment
  access

21
Culture

• Highly diverse population with a mixture of
  ethnic backgrounds
• South Africa consists of rural and crowded cities
  with many different dialects
• Difficult to spread AIDS awareness campaigns

22
Culture Continued

• The religion of South Africa is primarily
  Christianity but also includes Muslim, Hindu, and
  Jewish
• South Africa has become the worlds most affected
  region from AIDS
• The people are seeking both traditional African
  healers along with ARV drugs

23
Values

• The stigma surrounding the diagnosis of AIDS is a
  major concern
• In heterosexual AIDS victims in 2005, 57 were
  women and 75 of the total amount are either
  young people or women
• Young people are most severely affected between
  the ages of 15-24

24
Values and Morals

• Many men and women do not want the results from
  the HIV test to be disclosed because of the
  stigma that is placed on them and their family
• Many women are more concerned about the hardships
  their children will face and not their disease

25
Morals and Values

• A conflict has arisen on whether or not the
  partner of the HIV patient should have the right
  to know of the diagnosis
• Women are afraid to tell their partners because
  of fear of abandonment

26
Poverty

• According to the AIDS Law Project in 2006
• 50,000 children need ARV medication and only
  10,000 are receiving them
• The orphans are not
• receiving medication,
• have poor health,
• and no education
• High correlation between extreme poverty and high
  HIV prevalence

27
Gender Inequality

• Many women are unable to negotiate safe sexual
  practices and are involved with men who have many
  partners
• Women are affected by sexual violence and are
  economically and socially subordinate to men
• Women loose their economic stability when they
  are separated from their partners

28
USAID

• Providing 221. 5 million dollars in 2006
• Interventions
• Primary prevention of mother-to-child
  transmission programs and HIV/Aids education
• Secondary increase number of ARV drugs being
  provided with 8 to children
• Tertiary link HIV patients to community
  caregiver that will make home visits and support
  the efforts of a partner organization to train 30
  palliative care providers

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References

• www.cdc.gov/nchstp/od/gap/countries/southern_afric
  a.htm
• www.usaid.gov/locations/sub-saharan_africa/countri
  es/southafrica/
• http//www.avert.org/aidssouthafrica.html
• http//www.avert.org/safricastats.html
• http//www.pubmedcentral.nih.gov/articlerender.fch
  i?artid1125376
• http//www.csa.com/discoveryguides/afraid/review.p
  hp
• http//www.aegis.com/countries/safrica.html
• www.state.gov/documents/organization/61629.pdf
• http//www.aids.org.za/hiv.htm