HIV/AIDSSurveys that we have conducted over the last decade have found increasing numbers of South Africans whose lives are being directly touched by HIV/AIDS.
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Surveys typically throw up a profile of awareness coupled with denial. The typical response to questions about the virus is that HIV/AI
DS poses a serious threat to South African society. However, when the questions focus closer to home, diminishing proportions of South Africans have traditionally thought that HIV/AIDS poses a threat to their community or to them personally. Very few people ever admitted to knowing anyone in their community who is HIV positive.
However, the days of denial are running out. HIV/AIDS has become a reality for many people in the country, and is tragically set to become so for a great many more.
Awareness of AIDS-related illness and death
A recent random sample survey that we conducted in 3 District Councils in KwaZulu-Natal for the Department of Public Works produced shocking results. The survey concentrated on predominantly rural residents and found that one out of every two respondents had heard of someone suffering from full-blown AIDS in their community.
A second question asked whether respondents had heard of anyone who had died of AIDS in their community. Many people try to hide the HIV+ status of those infected with the virus. In addition, deaths are often attributed to the presenting disease such as TB or pneumonia. In other words, there is considerable scope for denial about HIV/AIDS. In this context it was tragic that one in every two respondents - 51% - told us they knew of someone who had died of AIDS in their community.
Regional spread or awareness?
It would appear that KwaZulu-Natal is at the heart of the HIV/AIDS epidemic. A similar survey in the Eastern Cape found far lower proportions of residents who knew HIV/AIDS sufferers or victims. But is this because of the geographic spread of the HI virus, or because KwaZulu-Natal is at the heart of much HIV/AIDS work including awareness raising?
The integration of HIV/AIDS concerns into government development programmes is of vital importance. The epidemic has taken root in rural areas, with far higher proportions of rural residents having heard of AIDS sufferers in their community compared with their urban counterparts. It may be that people with full-blown AIDS are sent to older relatives in rural areas to take care of them. This needs further investigation: if true, it will place greater stress on the already stretched rural infrastructure and household resources.
It is vital that the impact of HIV/AIDS on rural communities is carefully mapped and models for future impact are developed.
With the government about to embark on a sustained rural development strategy, it is vital that we better understand the likely impact of HIV/AIDS on social structures, the economy and so on.
This is particularly true of rural areas, where the household structure is both different from urban areas and already overstretched by poverty. When the costs - financial, emotional and other - of home-based care for AIDS sufferers is added, then we have to wonder what measures can be taken to shore up the household against collapse.