As the world commemorates World Aids Day, a new study has found that more and more South Africans are displaying high-risk sexual behaviour and are in denial with regard to HIV/Aids. This is despite considerable public-education efforts about the risks associated with HIV/Aids.
”In fact, high-risk sexual behaviour remains the norm among a large proportion of the South African society,” the latest HIV/Aids risk-assessment study conducted annually by Markinor has found.
Another survey, released on Wednesday, reported that nearly half of South Africans aged 15 and older find nothing wrong with marrying an HIV-positive person and would not have a problem having sex with them.
The Nelson Mandela Foundation-commissioned Second South African HIV Prevalence, Incidence, Behaviour and Communications Survey‘s results ”suggest that South Africans are accepting HIV/Aids as a reality in South Africa and that stigmatisation in society is becoming less of a factor, especially in urban areas” said principal investigator Olive Shisana, CEO of the Human Sciences Research Council, on Wednesday.
The prevalence study found that 90,7% of South Africans polled were willing to care for HIV-positive family members and that 79,8% were against the exclusion of HIV-positive children from schools. Sixty-six percent of those interviewed did not think they were at risk of being infected — because they were faithful to one partner, trusted their partner and always used condoms — but some of these respondents were later found to be HIV-positive in tests conducted as part of the study.
Harsh picture
The Markinor survey, however, paints a much harsher picture of HIV/Aids in South Africa. It focuses on awareness, knowledge, beliefs and opinions and addresses questions such as: ”What do people know about sex and HIV/Aids?” and ”What do people do?”.
A total of 3 500 randomly selected adults — 16 years and older — are interviewed during April and May every year. People in all nine provinces and from all walks of life are included. The results are representative in terms of gender, age, working status, income, language, race and community size, and the findings are weighted and projected to the total adult population.
Markinor divides the sexually active proportion of the population into five groups, based on their sexual behaviour and views on casual sex, condom usage, alcohol and sex and other relevant issues.
Currently 43% of adults fall into the medium-risk and high-risk groups. In 2002, when the project started, these two groups together comprised 37% of the adult South African population.
The medium-risk group demonstrates high promiscuity and usually uses condoms (18%), while the high-risk group demonstrates ignorant behaviour — this group has more males and is younger than the others (25%).
Some of the other findings from the current study are that more than eight in every 10 (81%) adult South Africans are afraid of contracting HIV/Aids, and only four in every 10 (40%) believe they are not at risk of contracting HIV/Aids. A quarter (23%) believes HIV/Aids can be spread by mosquitoes.
Three-quarters (73%) believe there is no cure for Aids and most (87%) agree that everybody, regardless of race, education or gender, is equally threatened by HIV/Aids.
Curing Aids
On the other hand, 14% say they don’t really know how one gets HIV/Aids and a similar proportion (15%) is of the opinion that HIV/Aids is not at all serious; in fact, 8% say it does not exist. A sizable group (16%) believes that HIV/Aids can be cured by Western medicine or doctors; that traditional herbal remedies can protect a person from contracting HIV/Aids (14%); or that HIV/Aids can be cured by traditional healers (12%).
These beliefs are much stronger among the higher-risk groups.
The study also found that the stigma surrounding HIV/Aids is still rife. Even though almost nine in 10 (88%) agree in principle that people with HIV/Aids should be treated like anybody else, 20% say that HIV/Aids victims should be separated from healthy people, isolated and given separate facilities so they can’t infect other people. The same proportion (18%) will avoid a co-worker if they know that she or he has HIV/Aids.
Opinions on HIV/Aids also resonate with views on gender issues. Almost six in every 10 (58%) agree that the submission of women to men in traditional cultures makes women more vulnerable to HIV/Aids. However, a quarter (23%) believes that HIV/Aids is mostly spread by women and more than a third of the high-risk group (36%) believe that this is the case.
Some myths are closely associated with gender issues and 7% believe that sex with a virgin can cure a person of HIV/Aids. Among the high-risk group, this proportion increases to almost two in every 10 (17%).
Communication
These findings emphasise that communication messages should be different for the different risk groups, Markinor said.
Markinor said the findings of the study are in keeping with the recently released United Nations Joint Programme on HIV/Aids report Aids Epidemic Update: December 2005 and demographic projections done by the University of South Africa’s Bureau of Market Research (BMR), from which it is clear that the number of new infections and number of people with full-blown Aids are still on an upward trajectory.
It appears from the BMR projections shown below that at present there are — conservatively estimated — more than 5,2-million HIV-positive people in South Africa, giving rise to an HIV prevalence rate for the total population of about 11%, Markinor said.
Furthermore, by the end of this year, more than two million people would have died Aids-related deaths. This figure could be as high as nine million by 2021, it added.
”There can be no dispute that HIV/Aids is already having a serious impact on the economic and social well-being of South Africans,” said Markinor.
Typical examples of this include the negative effect of HIV/Aids on household incomes and expenditures, the ability of households to save and to remit cash or goods to other households, and food security of many households, as well as the ability to sustain livelihoods. Especially among rural households, HIV and Aids could deepen and widen already high levels of rural poverty.
The impact of HIV/Aids on business will also increase in impact as more South Africans move into full-blown Aids and die because of the disease, it said.
Typical impacts of this nature include that output growth in South Africa could slow down because of the consumer-based impacts of HIV/Aids, while high levels of HIV/Aids will also negatively affect the country’s investment profile and levels of foreign direct investment. Over the long term, HIV/Aids can even give rise to negative economic growth because of the erosion of the human capital and consumer base affected by HIV/Aids.