CHAPTER ONE

INTRODUCTION

According to UNAIDS Report (2004), almost five million people became newly infected with HIV in 2003, the greatest number in any one year since the beginning of the epidemic. At the global level, the number of people living with HIV continues to grow – from 35 million in 2001 to 38 million in 2003. In the same year, AIDS killed almost three million; over 20 million have died since the first cases of AIDS were identified in 1981 (UNAIDS Report, 2004).

The HIV/AIDS epidemic continues to spread, with the majority of infections occurring in sub-Saharan Africa. It is estimated that 25 million people are living with HIV in sub – Saharan Africa. There seems to be stabilization in HIV prevalence rates, but this is mainly due to a rise in AIDS deaths and a continued increase in new infections. UNAIDS Report (2004) states that prevalence is still rising in some countries such as Madagascar and Swaziland and is declining nationwide in Uganda. It is estimated that in 2003, three million people became newly infected and 2.2 million died (75% of the three million AIDS deaths globally that year).

HIV knows no social, gender, age or racial boundaries, but it is accepted that socio-economic circumstances do influence the disease patterns.  HIV thrives in an environment of poverty, rapid urbanisation, violence and destabilisation. Transmission is exacerbated by disparities in resources and patterns of migration from rural to urban areas.  Women particularly are more vulnerable to infection in cultures and economic circumstances where they have little control over their lives.

The prevention of HIV infection remains the most important approach to the control of the epidemic, care and support for the infected and affected is becoming crucial. Therefore, HIV and AIDS and interventions must address prevention, care and support issues. (Development Gateway: 2004)

In South Africa, a survey is conducted annually to establish the prevalence of

HIV infection amongst pregnant woman attending antenatal clinics.

Extrapolating from the 2001 antenatal survey, it is estimated that 4.7 million adults were infected with HIV – 2.65 million women between the ages of 15 and 49, and 2.09 million men in the same age group (Department of Public Service and Administration, 2002).

The impact of the HIV/AIDS epidemic is significant, affecting all spheres of life and all sectors.  It has the potential to reverse many development gains.  The Department of Social Development in the State of South Africa’s Population Report 2000, estimates that:

§  “Life expectancy has dropped from 63 years in 1990 to 56.5 years in 2000;

§  Child mortality has increased from 75 per 1 000 in 1990 to 91 per 1 000 in 2000; and

§  The probability of a 15 year old dying before the age of 60 was 27 per 1 000 in 1990 and has risen to 40 per 1 000 in 2000” (Department of Public Service and Administration, 2002:14).

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