BACKGROUND TO HIV AND AIDS EPIDEMIC IN SOUTH AFRICA

An estimated 5.7 million people were living with HIV and AIDS in South Africa in 2009, more than in any other country. It is believed that in 2008, over 250,000 South Africans died of AIDS. National prevalence is around 11%, with some age groups being particularly affected. Almost one-in-three women aged 25-29, and over a quarter of men aged 30-34, are living with HIV. HIV prevalence among those aged two and older also varies by province with the Western Cape (3.8%) and Northern Cape (5.9%) being least affected, and Mpumalanga (15.4%) and KwaZulu-Natal (15.8%) at the upper end of the scale, followed by Gauteng the province we are operating at as the organization.

The impact of the AIDS epidemic is reflected in the dramatic change in South Africa’s mortality rates. The overall number of annual deaths increased sharply from 1997, when 316,559 people died, to 2006 when 607,184 people died. This rise is not necessarily due solely to HIV and AIDS but it is young adults, the age group most affected by AIDS, who are particularly shouldering the burden of the increasing mortality rate. In 2006, 41% of deaths were attributed to 25-49 year olds, up from 29% in 1997. This is a strong indicator that AIDS is a major, if not the principal; factor in the overall rising number of deaths.

Impact upon children and families

South Africa’s HIV and AIDS epidemic has had a devastating effect on children in a number of ways. There were an estimated 280,000 under-15s living with HIV in 2007, a figure that almost doubled since 2001. HIV in South Africa is transmitted predominantly heterosexually between couples, with mother-to-child transmission being the other main infection route. The national transmission rate of HIV from mother to child is approximately 11%. In most instances the virus was transmitted from the child’s mother. Consequently, the HIV-infected child is born into a family where the virus may have already had a severe impact on health, income, productivity and the ability to care for each other.

The age bracket that AIDS most heavily targets – younger adults – means it is not uncommon for one or more parents to die from AIDS while their offspring are young. The number of premature deaths due to HIV/AIDS has risen significantly over the last decade from 39% to 75% in 2010.
The loss of a parent not only has an immense emotional impact on children but for most families can spell financial hardship. One survey on HIV’s impact on households found that, “80% of the sample would lose more than half their per capita income with the death of the highest income earner, suggesting a lingering and debilitating shock of death.”

It is estimated there are between 1.5 and 3 million AIDS orphans where one or both parents are deceased in South Africa, and it is estimated that the HIV/AIDS epidemic has created half of the country’s orphans. Another estimate puts the proportion of maternal orphans – those who have lost their mother – orphaned by AIDS as over 70%. Orphans may put pressure on older relatives who become their primary care givers; they may have to relocate from their familiar neighborhood; and siblings may be split apart, all of which can harm their development.