Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.

Reuters NewMedia - November 30, 2005
Andrew Quinn

South Africa's second national HIV/AIDS study confirmed that roughly 11 percent of South Africa's 45 million people are infected with the AIDS virus with young women the most at risk.

While the national percentage has not changed significantly since the first study in 2002, it is not good news -- meaning new HIV infections are keeping pace with South Africa's rising AIDS death rate.

"Now is a very critical time to see if we keep at this plateau ... or see a decline in coming years," said Dr. Thomas Rehle, co-principal investigator of the report. "This will be a very critical year to see what is going on."

The survey is among the most comprehensive of any AIDS study done in Africa, involving more than 23,000 people of whom almost 16,000 agreed to be tested for HIV.

Most estimates of African AIDS prevalence are based on studies of pregnant women visiting birth clinics, a limited sample which is then used as the basis for extrapolating broader results for the general population.

Olive Shisana of South Africa's Human Sciences Research Council, chief author of the report, said the 2005 study confirmed earlier estimates putting South Africa's national HIV/AIDS prevalence at 10.8 percent, a slight decline from 11.4 percent estimated in 2002.

She said that while this could show South Africa's epidemic was reaching a plateau, it did not necessarily mean it was slowing. "If you have new infections coming up, and a high mortality rate, it can in fact level off," she said.

AIDS TAX?

A separate business survey on Wednesday found two-thirds of South Africa's mining houses, along with significant numbers of manufacturing and transport firms, said HIV/AIDS was hitting profits, although most put the impact at less than 2.5 percent.

The national HIV report, funded in part by the Nelson Mandela Foundation, contained a raft of policy suggestions for South Africa's government -- among them the controversial notion of a new AIDS tax to help pay for treatment of the sick.

Under domestic and international pressure, South Africa last year launched a public anti-retroviral drug program that now reaches almost 90,000 people. But with hundreds of thousands of South Africans still needing the drugs, costs are a big concern.

Shisana said almost half the employed South Africans questioned in the survey said they would be willing to pay a tax to fight AIDS, and urged the government to consider this step.

"Obviously it is up to the government to decide if this information is useful," she said.

"SUGAR DADDY SYNDROME"

The 2005 report, released ahead of World AIDS Day on Thursday, highlighted the continued tragedies of South Africa's HIV/AIDS crisis.

It found young women aged between 15-24 were up to four times as likely to be infected with HIV than men the same age, thanks to the "Sugar Daddy Syndrome" which sees older, sexually-experienced men seek out younger women as partners.

Using new blood tests to determine how recent HIV infections were, the study found that almost 3 percent of some 16,000 specimens showed infection within the past 180 days -- mostly among young women, but in 0.9 percent of the infections seen in children aged between 2 and 14.

"Could it be sexual abuse? We don't know. Could it be the health system? We don't know," Shisana said, calling for further study of the phenomenon.

Most disturbing, she said, was the low level of risk that most South Africans see from HIV/AIDS more than 10 years into the epidemic. Sixty-six percent of those surveyed felt they were not at risk of infection -- including 51 percent of those who later turned out to be HIV-positive.

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