Poverty and gender inequality negating anti-HIV/AIDS efforts

Poverty and gender inequality are hampering South Africa's response to the HIV/AIDS epidemic, researchers have found.

World-renowned paediatrician Hoosen Coovadia, Professor of HIV/AIDS Research at the Nelson Mandela Medical School of the University of KwaZulu-Natal (KZN), said high unemployment rates, poverty and lack of access to basic services, such as electricity, running water and housing, had thrown South Africa into a "huge crisis", causing "serious unhappiness" among its population.

Speaking in KwaZulu-Natal at a recent HIV/AIDS forum organised by the HIV/AIDS networking organisation, HIVAN, and the World Council of Religion and Peace (WCRP), Coovadia warned: "As long as we cannot control poverty, we [won't be able to] control the HIV/AIDS pandemic."

If people's basic needs remained unfulfilled they could not mobilise the resources to fight HIV/AIDS, he pointed out.

Coovadia slammed the poor condition of the country's public health facilities, and related an incident where he had sent a HIV-positive woman with cryptococcal meningitis - a life-threatening brain infection caused by a yeast-like fungus - to Addington Hospital, one of KwaZulu-Natal's governmental rollout sites for antiretroviral (ARV) drugs.

The woman was given Panado, an over-the-counter painkiller, and sent home without any attempt by hospital staff to inform her of the ARV programme or include her in it.

He noted that recent statistics released by the national Department of Health, showing that HIV prevalence in South Africa had risen from 26.5 percent in 2002 to 29.5 percent in 2004, also indicated that there was "something terribly wrong with this country's HIV/AIDS programme."

In addition, growing numbers of HIV-positive South Africans would start falling ill from AIDS-related diseases, placing a heavier burden on the public healthcare sector.

Nevertheless, Coovadia acknowledged the country's success in implementing one of the most extensive prevention of mother-to-child transmission (PMTCT) programmes in the world, and enrolling more than 50,000 people in the national treatment plan.

He called on researchers to pay greater attention to the link between HIV/AIDS and gender, and to remember that women were at higher risk of infection.

One in four South African women are raped or suffer domestic violence.

"Women's decisions are circumscribed by social conditions," said Coovadia, remarking that in Southern Africa, "women's rights and freedom to choose are seriously compromised."

According to Cookie Edwards, provincial coordinator of the KZN Network of Violence Against Women, HIV/AIDS and the abuse of women were often regarded as unrelated. "But you cannot separate the two issues," Edwards stressed, noting that sexual domestic violence increased the transmission of HIV.

The forum also heard that the country's fight against HIV/AIDS relied heavily on medical and technical solutions, while largely ignoring social factors, such as behaviour, beliefs, traditions and inter-personal relationships.