Sunday Times, South Africa - July 16, 2000 Laurice Taitz
THERE's not one AIDS epidemic ravaging South Africa - it's a number of different epidemics all happening at the same time, scientists say. Professor Salim Abdool Karim, the Director of the Centre for Epidemiological Research at the Medical Research Council, said a number of different strains have been brought into the country as borders have opened up in the wake of political change, and are spreading simultaneously. Karim, who served as chairman of the scientific committee at the 13th International AIDS Conference in Durban this week, said: "We have multiple separate epidemics happening at the same time. "Analysis of the strains found among South Africans found that they are similar to strains found in Malawi, Botswana and even Zambia." Karim, who presented data from his own published research to President Thabo Mbeki's AIDS Advisory Panel last week, said that the "coalescence of multiple separate epidemics" answered Mbeki's question about why the disease had come to blight Africa. Mbeki had asked how AIDS had developed from a disease that infected predominantly homosexual men, intravenous drug users and haemophiliacs in the US in the '80s to one that affected a vast African heterosexual population less than a decade later. Karim said: "This spread of HIV/AIDS was not unique to South Africa." Karim said South Africa's initial epidemic, the first cases of which were reported around 1980, affected the same groups as in the US. But then HIV/AIDS spread to the adult heterosexual population and to infants as a result of transmission from mother to child. "While all socio-economic groups were affected," said Karim, "the poor, marginalised communities were the most affected." He said another way in which the epidemic was different in South Africa to that experienced in the US was that survival times were much shorter, with people infected progressing from HIV to AIDS much more quickly. Other factors included the prevalence of unprotected sex in young people, rape and resistance to condom use. He said a study in a rural KwaZulu-Natal community found that one in four women between the ages of 15 and 49 had reported to a health facility with a sexually transmitted infection. Karim said that top priorities for preventing the spread of further infection in South Africa included the use of Nevirapine to reduce the transmission of infection from mother to child, a comprehensive treatment programme for sexually transmitted diseases and policies that encourage families to stay together despite migrant labour. He said other priorities included the formulation and implementation of policies on safe sex education in schools, condom promotion and anti-retroviral treatment for rape.
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