Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Sunday Times (Johannesburg) - August 24, 2003
Claire Keeton
By last year, about 22 500 members had enrolled for HIV/Aids programmes out of an estimated 450 000 infected by the virus.
This figure is based on an estimated 6% HIV prevalence among the country's seven million medical aid members. An estimated 45 000 members already have full-blown Aids and should be on antiretroviral drugs.
Members do not pay extra to register for most HIV/Aids programmes as the cost is covered by annual premium increases.
"The schemes are paying," confirmed Gary Taylor, the managing director for group services of the largest medical aid administrator, Medscheme.
Dr Leon Regensberg, the clinical director of Aid for AIDS (Afa), said: "We wish beneficiaries would join sooner. The benefit they get from treatment is much greater if they start at the appropriate time, rather than when they are already sick."
Afa, the biggest HIV/Aids management programme in South Africa, controls HIV/Aids medical care for more than 36 medical schemes and several companies.
About two-thirds of the 20 000 people registered with Afa are now on antiretroviral treatment.
In South Africa roughly 90% of medical aids offer some form of antiretroviral therapy and these options are set to expand when this treatment becomes available in the public health care sector.
Denial, fear of discrimination, inadequate information, and cost are reasons for the slow uptake uncovered in a study by the Centre for Actuarial Research (Care) at the University of Cape Town.
The detailed study into "The cover provided for HIV/Aids benefits in medical schemes in 2002" reported that only 0.3% of medical aid beneficiaries were making use of the HIV/Aids programmes.
"People are afraid their confidentiality will not be protected," said Care researcher, Leigh Johnson.
They are scared that their employers will find out their status if they register for HIV/Aids programmes, despite strict regulations protecting their confidentiality.
The cost of antiretrovirals is another concern, as some schemes balance antiretroviral therapy against other treatment, and members could run out of benefits.
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