1.7. The HIV and AIDS epidemic and statistics

Why is HIV and AIDS a 'global' epidemic?
* HIV's rapid spread through different parts of the world has led to it being described as a 'global' epidemic. Although the global HIV and AIDS epidemic is not growing anymore, it remains at an unacceptably high level.
* The Joint United Nations Programme on HIV and AIDS (UNAIDS) estimates that, in 2007, there were 33 million people living with HIV across the world. [1]
* Sub-Saharan Africa (African countries south of the Saharan dessert), has more HIV positive people and AIDS deaths than any other part of the world: 67% of all HIV positive people and 72% of all AIDS deaths were in Sub-Saharan Africa in 2007. [2]
* Globally there are around 2 million HIV positive children (younger than 15 years), of whom 90% live in Sub-Saharan Africa.
* UNAIDS states that the percentage of young pregnant women (15-24 year old), who are HIV positive, has reduced since 2000-2001.
* There are still around 2.7 million new infections every year.
The South African epidemic
* South Africa is experiencing the largest HIV and AIDS epidemic in the world - an estimated 5.7 million South Africans are HIV positive in 2009.
* Around 20% of the adults in South Africa (ages 20-64) are HIV positive, as are around 29% of the women visiting antenatal clinics. This means that one in every five adults in South Africa is HIV positive.
* In 2009, it is estimated that there are still around 1400 new HIV infections and around 1000 AIDS deaths every day.
* Around 2.9 million South African have died from AIDS-related illnesses since the start of the epidemic. [3]
* There is currently no cure for HIV. As long as there are more new infections than deaths, the total number of HIV positive people will continue to grow. It is interesting to note that if there are more deaths than new infections, the total number of HIV positive people will reduce. A smaller epidemic might not mean that we are 'winning the battle against new infections', it might mean that we are 'losing the battle against preventing AIDS deaths'.
* South Africa has made progress in the treatment of AIDS sick patients. Around 60% of those in need of antiretroviral treatment were receiving treatment through public and private healthcare facilities by the end of 2008 [4]. More and more pregnant women receive antiretroviral treatment to prevent passing on the virus from mother to child.
* Different provinces in South Africa experience different levels of HIV infections and AIDS related deaths:
- Kwazulu-Natal is experiencing the largest HIV epidemic in the country. Nearly 1.6 million people and almost a third of the adult population are HIV positive. Take-up on treatment has been slow.
- Gauteng has the second largest HIV epidemic with around 1.4 million HIV positive people and one in every five adults. Take-up on treatment is growing rapidly.
- The Eastern Cape epidemic is one of the fastest growing in the country with around 730 000 HIV positive people and one in every five adults. Take-up on treatment has also been extremely slow.
- Other provinces with big mature epidemics (epidemics with stable numbers of new infections and deaths) are the North West (500 000 HIV positive), Mpumalanga (450 000 HIV positive) and the Free State (400 000).
- The epidemic in Limpopo is also relatively big (430 000 HIV positive) and still growing.
- The Western Cape has the smallest HIV prevalence rate (6% of the total population or 300 000 people estimated to be HIV positive). Although the take-up on treatment is the highest, the province is still experiencing a growing epidemic.
- The Northern Cape epidemic is the smallest with around 67 000 people HIV positive. The epidemic in the province is also still growing. [5]
Why is the AIDS epidemic so big in South Africa?
There are several reasons for the HIV and AIDS epidemic killing South Africans:
* There is a lot of risky sexual behaviour in South Africa:
- People don't use a condom every time they have sex.
- Many start having sex when they are very young which increases their chance of becoming infected.
- When HIV positive people have sex with older or younger partners the virus moves from generation to generation
- HIV positive people who don't know their status don't know they are infecting others.
- People change sexual partners often or have more than one sexual partner.
- Some people exchange sex for money or possessions.
* The South African environment makes it easier to get infected through:
- More and more South Africans move to cities where they have several sexual partners making it easier for the virus to spread.
- Poorer South African women may not be able to protect themselves from getting infected due to their low status in the community.
- It's easy for South Africans to travel from place to place so the disease is spread across different areas.
- Sexual violence is very high in South Africa - HIV infection might happen as a result of rape or sexual abuse.
- Some South African women believe men should be knowledgeable in sexual matters so they don't find out about AIDS and HIV. Others might feel pressurised to have children with a partner without knowing their HIV status.
- Some men might believe it is their right to have more than one partner without protecting themselves against infection or infecting others.
How can South Africa achieve a 'Summer for All People'?
The Metropolitan Live the Future scenarios are four different possible situations that may unfold in South Africa until 2025, depending on how we respond to HIV and AIDS. The best case scenario is called the Summer for All People.
Under the Summer scenario, the HIV and AIDS epidemic drops dramatically and all South Africans enjoy life under the African sun. It is the only scenario that succeeds in bringing adult HIV prevalence rates down from 20% to 7% through economic growth, working together and a strong focus on prevention. It predicts that South Africans will respond successfully to the epidemic through:
* Individual behaviour change
- Everyone focuses on prevention of HIV infection.
- Everyone takes personal responsibility for their sexual behaviour and health.
- People change their sexual behaviour.
- South Africans test regularly for HIV so that most people are aware of their HIV status by 2010.
- All South Africans use condoms consistently and correctly.
- South Africans remain faithful to one sexual partner
* Collaboration: Strong leaders in government, the community and business standing together.
* Partnerships: The private sector (business) and the public sector (NGOs and government) form partnerships to tackle specific problems.
YOU DO NOT NEED TO BE ANOTHER HIV STATISTIC! BECOME PART OF SUMMER FOR ALL PEOPLE - KNOW AND/OR MANAGE YOUR HIV STATUS!
Read more about the Live the Future model on:
www.livethefuture.co.za
e-mail the Metropolitan Foundation:
info@livethefuture.co.za
References: [1] UNAIDS, 2008, Report on the Global HIV/AIDS epidemic 2008: Executive Summary [2] UNAIDS, 2008, Report on the Global HIV/AIDS epidemic 2008: Executive Summary [3] Actuarial Society of South Africa, 2006, ASSA2003 (Full) AIDS and Demographic model (projected by Nathea Nicolay) [4] Metropolitan AIDS Risk Consulting, 2009. [5] Nathea Nicolay, Metropolitan, Oct 2008, Summary of provincial HIV and AIDS Statistics for South Africa.
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