Who is Infected?
For decades, the prevailing thought among South Africans was that HIV/AIDS was a disease of the poor. Today, HIV is found everywhere, even among the country's rich. Still, there are groups that have been hit by the epidemic harder than others. Let's look at those populations.- Young People – Young people ages 15 to 24 years make up the largest proportion of HIV infected people in South Africa. Of the thousands of new HIV infections each year, 58 percent of those are people younger that the age of 24. So why is this the case? Most believe the most probable causes include:
- profound poverty that limits access to education, good paying jobs, and health care
- young people orphaned by AIDS have no access to HIV education and are powerless to protect themselves from the disease
- Women – Females account for 55 percent of all new infections. Of all the infections in people 15 to 24 years old, 77 percent are women. There are many factors that account for this disproportional infection rate among women:
- South Africa is a patriarchal society, meaning men have social and economic power, making them the decision makers. Sexism against women is a common practice. Because men have the social, political and economic power, women are less able to make decisions that impact their lives, including the use of safer sex methods.
- Women are economically dependent on men. Because men are their only source of income, women feel they must obey their husband’s wishes in order to maintain the relationship. It is difficult for a woman to insist on safer sex and condoms when they fear doing so will cause them to lose their only means of providing for their children. For those who have no source of income at all, prostitution is their means of making a living. And again, because of the male-dominated school of thought, these women have little or no choice regarding safer sex and condom use.
- Gender-based violence is a spin-off of the male-dominated societal norm. Sexual abuse, rape, and domestic violence are common. One study showed that over 1,000 rapes occurred each day. Fear of violence makes women hesitant to insist on condoms. It's common for men to believe women have been unfaithful if they ask for condoms. Asking for a condom can lead to rape, gang rape, or physical violence as a form of punishment for the woman's infidelity. And because women are looked upon as "less worthy people," these practices are common and seldom frowned upon. In fact, 30 percent of South African women say their first sexual experience was forced sex. Economic dependency, sexism, and gender-based oppression has become a deadly combination for the women of South Africa.
- South Africa is a patriarchal society, meaning men have social and economic power, making them the decision makers. Sexism against women is a common practice. Because men have the social, political and economic power, women are less able to make decisions that impact their lives, including the use of safer sex methods.
- Mother-to-Child Transmission – With the advent of HIV medications, HIV transmission from mother to child has decreased to less than three percent in countries like the U.S. Yet, in South Africa, this mode of HIV transmission is very common. By 2005, over 30 percent of all pregnant women were HIV infected. With limited access to medical care before, during and after delivery, mother-to-child transmission occurs in 25 to 30 percent of all pregnancies. After childbirth, breastfeeding contributes to the mother-to-child transmission problem. The lack of commercial formulas and clean water leaves breastfeeding as the only choice for mothers of newborns. Unfortunately, the rate of HIV infection by breastfeeding can be as high as 30 percent.
- Men Who Have Sex with Men (MSM) – Heterosexual transmission is the most common transmission type in South African. However, transmission among MSMs is gaining ground. Estimates place the infection rate among gay men at 33 percent. Since apartheid ended, homosexuality has become more accepted yet many still consider it a taboo. As such, gay men are subject to significant discrimination and stigma. National prevention agencies have been accused by the South African government of omitting gay men from their HIV education targets. The agencies in turn blame the omission on a lack of support from the South African government. The result is that condom use is at best erratic, and for the most part non-existent among gay men.
- Migration – South African men often have to go to where the work is. These men migrate to rural areas to work in mines, farms, and factories. They return home two or three times each year to see their families. Unfortunately, while they are away from home, unsafe sex outside their marriages is quite common. Young men with disposable income far away from home is a recipe for something South African officials call "migration-induced unsafe sex." Since the end of apartheid, this migration problem has gotten worse because travel restrictions have been lifted.
We now know HIV is a huge problem in South Africa. What's being done about the problem? Page three tells us.
