Hiv Aids Situation In South Africa Essay

The HIV/AIDS epidemic has had a annihilating consequence on the South African population. The Human Immunodeficiency Virus ( HIV ) is first transmitted through bodily fluid contact  normally through blood, seeds, vaginal fluid, pre-ejaculate and/or chest milk ( Centre for Disease Control and Prevention 1999 ). Ultimately, HIV advances to Acquired Immunodeficiency Syndrome ( AIDS ) where the status markedly attacks the immune system by increasing the hazard of a assortment of infections caused by bacteriums, parasites and viruses ( Centre for Disease Control and Prevention 1999 ). Typically, the development of AIDS from HIV takes about five to eight old ages, but can be postponed with the assistance of anti-retroviral drugs ( Centre for Disease Control and Prevention 1999 ).

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It can be noted that the disease affects persons at the prime of their life-times. Sexually active work forces and adult females, every bit good as immature kids are affected most by this unwellness because HIV is transmitted through events such as insecure sex, contaminated acerate leafs and/or transmittal from a female parent to her newborn during birth ( Centre for Disease Control and Prevention 1999 ). The coincident nature of this disease makes it a greater menace to economic growing in South Africa  one time one spouse contracts it, the other spouse does excessively. An person is most susceptible to geting the disease from their sexual spouse if that spouse was infected less than a twelvemonth prior.

Clearly so, the disease is impacting the most economically active proportion of the South African population. It is estimated that 5.7 million people or about 12 % of their population is affected by HIV/AIDS ( United Nations Programme on HIV/AIDS 2008 ). When analyzing the HIV prevalence rate for the labour force ( ages 15-49 ), the rate additions to 18 % ( Figure 1 ) ( United Nations Programme on HIV/AIDS 2008 ) ( United Nations Statistics Division 2009 ). The disease is far more prevailing among females between the ages of twenty- five and 29  at a prevalence rate of 32.7 % ; for males the age scope is between 30 and thirty-nine and the prevalence is merely approximately 25.8 % ( Figure 2 ) ( United Nations Programme on HIV/AIDS 2008 ).

The impact of the epidemic can be seen most deeply by the dramatic alteration in South Africas mortality rates. The overall figure of one-year deceases increased aggressively from 1997, when about 316, 559 persons died to about 607, 184 deceases in 2006 ( Figure 3 ) ( Statistics South Africa 2008 ). Obviously, the rise can non needfully be attributed entirely to HIV/AIDS, but what is indispensable here is that immature grownups are shouldering the load of this increased mortality rate ( Figure 4 ). In 2006, 41 % of deceases were associated with 25 to 29 twelvemonth olds ; in 1997 this per centum was approximately 29 % ( Statistics South Africa 2008 ). This is a important marker in reasoning that AIDS is a major factor in the overall lifting figure of deceases.

Clearly so, it is non uncommon for one or more parents to decease when their kids are immature. The figure of premature deceases has risen well: 39 % in 1997 to 75 % in 2009 ( Harrison 2009 ). This indicates that 80 % of the sample population would lose more than half their per capita income with the decease of the highest income earner ( Harrison 2009 ). Therefore, the HIV/AIDS epidemic that started in South Africa in the 1980s has had a negative impact on the wellness position every bit good as the economic development of persons and families.


In South Africa it can be said that their income has increased merely by analyzing their Gross Domestic Product ( GDP ) over the last 30 old ages ( Figure 5 ). As can be noted, GDP has steadily increased over the last 20 old ages ( World Bank 2010 ). South Africa is a state that possibly has the best operational and entrepreneurial environment in Africa  it is considered to besides hold one of the most politically stabile climes in the Sub-saharan African part. Furthermore, it has a really advanced fiscal system  the South African stock exchange ranks among the worlds top ten largest exchanges. 1948 marked the beginning of the Apartheid ; the economic system had been divided into two  a privileged white sector an destitute black 1. The policy was to a great extent criticized and many countenances were placed against South Africa in the 1980s. It was at the terminal of this period, when GDP every bit good as HIV/AIDS began to lift.

Analyzing trade specifically, it is noted that South Africa is the worlds largest manufacturer and exporter of Pt and gold every bit good as of base metals and coal. It is the worlds 4th largest manufacturer of diamonds. Agriculture lone histories for approximately 3.4 % of GDP, whereas services history for approximately 65.1 %. South Africas other chief industries are mining, car assembly, metalworking, machinery, fabrics, Fe and steel, chemicals, and groceries. Their exports history for approximately 30 % of their GDP. South Africas major merchandising spouses include the United Kingdom, the United States, Germany, Italy, Belgium, China and Japan.

South Africas integrating into the planetary economic system became really evident in the 1990s, particularly after the execution of rapid duty liberalisation after 1995, the export orientation of industrial policy and financial restraint through its macro-economic policy, the Growth, Redistribution and Employment Strategy ( GEAR ) in 1996. What has become clear through my research is that integrating of South Africa into the planetary economic system has brought about economic stableness for the state but it has non translated into sustainable economic growing or a decrease in income disparities. High unemployment rates dominate which leaves those from disadvantaged families mostly marginalized. Furthermore, their volatile domestic currency has created much instability in the export market.

This generalised narrative of the South African economic system has been provided to demo that the state has enjoyed increased wealth over the last 15 or so old ages, some of which can be attributed to globalisation. Trade activity, specifically exports is merely one constituent of this kind of globalisation.


In the discourse of wellness, economic activity, specifically trade activity is seldom spoken to. Economists have non yet opened duologue on this kind of subject  this is clear in the modest sum of literature available on the topic. Relationships have been estimated between economic activity and the incidence of HIV in Africa. A notable association comes from Emily Oster  she suggests that a doubling of exports leads to a doubling of infections ( Oster 2009 ). Using national trade openness as a placeholder for traffic flows, grounds suggest that trade is a important and positive forecaster of HIV-infection ( Clark and Vencatachellum 2003 ). It is estimated that 25 % of epidemics spread via trade ( Voigtlander and Voth 2009 ). This implies that the flow of people ensuing from trade might increase the hazard of infection.

Further, much research has indicated that states with higher route densenesss have had stronger relationships between exports and new infections ( Oster 2009 ). This has been proposed to be the mechanism by which exports could impact HIV infections. The premise here is that more exports means more production, hence more hauling is necessary to relocate goods ( Oster 2009 ). Basically, it is the motion of people which is the implicit in consequence. Another major premise that is made in some of the research is that migratory workers ( ex. Teamsters ) have more sex than persons in the general population ( Anarfi 1993 ; Brewer, et Al. 1998 ; Brockerhoff and Biddlecom 1999 ; Lurie, et Al. 2003 ; Orubuloye, Caldwell and Caldwell 1993 ) and they have riskier sex than the mean single ( Orubuloye, Caldwell and Caldwell 1993 ).

The propinquity to a route increases single hazard of HIV infection and the consequence is sensitive to the usage of the route ( Djemai 2009 ). The increased mobility and greater figure of chances to hold sex induced by the presence of better route substructure has shown to increase AIDS ( Djemai 2009 ). This negative consequence of roads undermines the positive effects ; taint is non prevented even though persons have better entree to information and improved contact with rubbers ( Djemai 2009 ). Furthermore, the mechanism driving the relationship between distance to a route and the hazard of infection is shown to be the addition in demand for insouciant sexual spouses which offsets the addition of rubber usage ( Djemai 2009 ). Consequently, the research shows that people choose to expose themselves to the hazard of infection despite holding better entree to self-protective tools ( Djemai 2009 ).

States have been examined and have been grouped into classs harmonizing to knowledge scattering. Kenya and Malawi, based on important relationships between infection and route distance, suggest spacial inequalities in the entree to information about HIV/AIDS ( Djemai 2009 ). Cameroon and Ghana fit into the 2nd class, where route propinquity is non important when the media are controlled for ( Djemai 2009 ). Therefore, the media has an consequence on cognition transportation in some of the states. Last, Ethiopia and Zimbabwe point towards success of scattering cognition about HIV/AIDS even to the most distant locations ( Djemai 2009 ).

Entree to condoms is another subject of involvement that has been given a great sum of coverage in the HIV/AIDS discourse. There are obvious spacial inequalities in the entree to condoms across states which are suggested to ensue from the supply of private and public medical services. Basically, handiness through roads increases the cognition that medical services are available, but use has non been shown to be statistically important ( Robinson, et Al. 2006 ). It is evident that entree to rubbers and to information about the importance of utilizing them has facilitated their usage, but one time once more the empirical grounds does non bespeak anything statistically important ( Robinson, et Al. 2006 ). Likewise, people are showing their penchants towards the set of available preventive steps that are aching their public-service corporation the least. This would therefore mean that persons who are populating closer to roads are utilizing rubbers more, but are besides prosecuting in riskier sexual behaviours ( Kiriga, et Al. 2002 ).

Basically, the research implies that incentives to wellness are excessively low in the Sub-saharan African states that have been analyzed. The cost of altering behaviour in Sub-saharan African states is excessively high. For persons populating in low-income states with life anticipations of no more than 40 or 50 old ages, there is small incentive to put in their wellness and therefore their economic systems ( Oster 2007 ). The United States is a premier illustration of how education runs did work in the mid 1980s, but that is besides because the cost of premature decease was high ( Oster 2007 ).

Last, Oster made a instance for Uganda and concluded that 30 to sixty per centum of the lessening in their HIV prevalence rate in the ninetiess could be attributed to a lessening in export activity ( Oster 2009 ). Oster claims that the decrease could be a consequence of a decrese in java monetary values during that clip ( Oster 2009 ). They are the lone state in Sub-Saharan Africa to hold seen such a diminution in their HIV-infection rates. I think this could be a direct consequence of a lessening in the labour force during that clip period which decreased the figure of persons present in sexual webs, therefore cut downing HIV-transmission. Another proposition could be that there was an eventual impact on the labour force, whereby there were less people because of increased mortality or morbidity, cut downing the figure of persons in the sexual web.

Regardless, the literature environing this country is really much in its babyhood. This sort of dialogueexamining HIV/AIDS from a position that inquiries the unity of economic activity is still fresh in the public wellness sphere.


Throughout all the literature, I was distressed to happen information on the relationship between South African trade activity and their HIV-infection rates. Therefore, to foreground one time once more, the intent of this paper was to analyze the assortment of factors that contribute to high HIV/AIDS prevalence rates with a direct application to the state of affairs in South Africa. To sum up, South Africa has one of the highest prevalence rates every bit good as one of the highest GDP values within Sub-Saharan Africa ( Figure 6 ). Therefore, analyzing it with a closer expression at the structural issues systemic within the state was interesting. Small research focused on South Africa for some curious ground, bring outing the issue with South Africa seemed really absorbing.

To put basis for this treatment, it must be noted that the export market in South Africa preponderantly is labored by low to medium skilled workers ( Outtek 2000 ). These markets are chiefly capital-intensive instead than labour-intensive ( Abt Associates Inc. 2000 ). Due to that fact, capital-intensive markets by and large employ low-skilled workers who, although are roll uping wealth, have low degrees of instruction. Projections from companies confirm that the highest HIV infection degrees are concentrated among low-skilled workers ( Abt Associates Inc. 2000 ). Therefore, an individuals degree of instruction is a determiner of the type of work they do, therefore lending to their likeliness of being infected. In a survey that modeled each sector confirmed what they referred to as a sector gradient  that prevalence rates varied by each sector of the economic system ( Figure 7 ) ( Vass 2005 ). It was found that there were higher prevalence ratios in South Africa in the excavation, conveyance, building, authorities, adjustment and catering sectors ( Vass 2005 ). The fiscal, insurance, concern and communicating sectors had the lowest sum HIV prevalence ratios ( Vass 2005 ).

The sector gradient seeable in South Africa is brooding of a assortment of high hazard factors which are: age, gender, population group, skill degree, and length of employment. There is a concentration of Blacks and adult females in low-skilled work ; White persons are more to a great extent occupied in the high skilled businesss ( Vass 2003 ). These decisions are similar to projections of infection population groups ( United Nations Statistics Division 2009 ).

All of the surveies that have been conducted in South Africa on the labour force and HIV-prevalence have assume that there is a changeless hazard associated with HIV-transmission ; that each person in each accomplishment degree has the same opportunity of acquiring infected with HIV. This coincides with the income and survival consequence discussed below.

We have established that increased exports are hence enabling transmittal of this disease because of the population group that is employed by the sector. Although, this decision can non be quantitatively analyzed through empirical grounds due to restrictions in informations, the statement is still valid. Through figure 8 it can be seen that as exports have increased over the past 15 old ages, so has HIV-prevalence. It is evident through the informations that HIV prevalence seems to plateau, nevertheless as per figure 9, it can be seen that the grownup prevalence rates are still go oning to lift.

The focal point of this paper is chiefly on the labour force ( ages 15-49 ) or the grownups, but what should be analyzed is that prevalence is diminishing for kids and young person. This is consistent with public wellness officials position to this disease  they are focused on instruction and bar runs for young person and kids because they have been proven to be most effectual if information has been accessed before sexual introduction ( Frolich and Vazquez-Alvarez 2009 ).

Due to the fact that low-skilled workers who are occupied by the capital-intensive sectors, which contribute to the exports of the South Africa, have lower degrees of instruction  this must be an of import facet to see in this treatment. However, because it is non the focal point of this paper, I will merely notice on the negative correlativity that is found to be statistically important for instruction degree and HIV-prevalence ( Walque 2009 ).

It has been noted that income and instruction are positively correlated. So why in South Africa are the wealthiest the most affected, but the most educated non? Prosecuting the subject at manus, we are discoursing low-skilled workers who have really small instruction but who do hold income that is comparatively better than some of their educated opposite numbers. Thus we must discourse the relationship between wealth and this disease.

Empirical grounds suggests that wealthier persons are more likely to be infected with HIV every bit good as to prosecute in riskier sexual behaviours than their poorer opposite numbers ( Walque 2009 ). Traditionally it is thought that income and wellness are positively correlated, nevertheless in the instance of the HIV/AIDS epidemic in Africa, things are traveling in the opposite way. Peoples are following hazardous behaviours that cut down their human capital potency as their income additions.

Taking into history the fraction of the population that is expected to prosecute in insecure sex, persons must make up one’s mind whether their first sexual brush should affect the usage of a rubber or non. Those who do non utilize a rubber may contract HIV and non last to see a 2nd brush. Assuming that there is disutility in from utilizing a rubber to get down with ( Agha, et Al. 2002 ), it can be said that some persons volitionally trade-off future public-service corporation for the current public-service corporation gained from insecure sex.

I think a major ground why so many members of the population engage in insecure sex in Africa is what I would mention to as an income consequence. Persons are more likely to prosecute in insecure sex if their income depends non merely on their ain potency for human capital but besides on the aggregative degree of human capital nowadays in the economic system ( Kiriga, et Al. 2002 ). An person may be more likely to prosecute in insecure sex if they know that a big fraction of the population will besides prosecute in insecure sex. Therefore, the negative macroeconomic effects of HIV/AIDS root from this kind of consequence: a big portion of the population participates in insecure sex, which leads to a lower degree of aggregative human capital and hence lower income and ingestion ( Kiriga, et Al. 2002 ). All of this straight leads to greater degrees of induced poorness.

Additionally, a term stemming from evolutionary biological science  a survival consequence can be noted when persons are cognizant that many people are holding insecure sex and they choose to hold safe sex based on this premiss. Persons in this state of affairs would be concerned with protecting themselves from undertaking the disease. I would presume to see the survival consequence in a portion of the population that has greater possible for human capital ( higher income capacity ). However, this is non what we are detecting in South Africa presently, therefore it is safe to believe that South Africa depicts an income consequence.

Part of the ground for this kind of form must be that family wealth correlatives with urban abode, more explicitly as closer propinquity to roads ; HIV-infection is higher in urban countries as a consequence of the route denseness ( Djemai 2009 ). Besides, HIV prevalence is a map of endurance, the wealthier people with HIV are more likely to afford the appropriate medicine, therefore populating longer. Possibly, wealth enables persons to prosecute multiple sexual spouses.

Wealth is frequently associated with mobility, clip and resources to keep coincident relationships ( Gillespie and Greener 2006 )  those that are characterized as an single holding a primary relationship every bit good as a secondary relationship, with the single their holding that secondary relationship with besides holding primary and secondary relationships. This causes an single to knowingly or unwittingly have a big sexual web therefore increasing the hazard of HIV-infection. The economic factor in these relationships is obvious: wealth and societal interaction are linked. Further, wealth increases the figure of chances to prosecute in legion sexual partnerships ( Shelton, Cassell and Adetunji 2005 ).

Furthermore, in South Africa, there is a stronger positive relationship for wealth and HIV position for adult females. Possibly, adult females exhibit this quality because wealth is lending to their mobility and societal position or it might be that adult females are bettering their economic position by holding more than one concurrent relationship. In any instance, it appears that wealth appears to play a disadvantageous function in HIV transmittal. The hypothesis here is that the combined consequence of people being less worried about holding the disease because they know they can afford intervention and holding more persons with the infection in the community is outweighing the disease itself. As these persons are better able to pull off the disease, the cost of geting it is really low.

It can so be concluded that South Africa does demo an addition in HIV/AIDS prevalence as a consequence of increased trade, but merely because the persons employed in the sector are low-skilled workers who have been pushed segregated into this class.


The hereafter of the labour force infected with the disease looks rather black. Macro-economic mold indicates that the labour force growing rate will worsen which will ensue in a smaller labour force in the coming old ages. This will hinder economic growing most decidedly. ING Barings predicts an 18 % diminution in the labour force by 2015 ( Orubuloye, Caldwell and Caldwell 1993 ) and Abt Associates Inc predicts a 21 % diminution when compared to a state of affairs where no AIDS was present ( Abt Associates Inc. 2000 ).

The impact that this could hold on productiveness every bit good as South Africas exports is profound. Sing a big proportion of the sectors that contribute to export activity are sing high degrees of HIV prevalence, it can be assumed that abrasion is high in the labour force. The increased morbidity and mortality creates absenteeism which hinders non merely productiveness but besides creates a farther diminution in skill-level and experience.

An implicit in issue is that the inducement to life to longer has non been addressed in South Africa. It is clear that poorer states have a lower life anticipation even in the absence of HIV/AIDS ( Voigtlander and Voth 2009 ). Many research workers have pointed out that a higher life anticipation increases the likeliness of lasting if persons engage in safe sex, but it does non impact the likeliness of lasting if an single engages in insecure sex ( Voigtlander and Voth 2009 ). Therefore, insecure sex has as higher chance cost. As a consequence, if the overall population is sing a greater life anticipation, more persons will take safe sex. Therefore, the issue here is how should moo and middle-income states addition aggregative life anticipation? The reply to this kind of argument is good beyond the range of this paper, but can be addressed utilizing basic public wellness and community development intercessions.

Besides, what I think might be a solution to this issue is if the South African authorities introduced execution of a free antiretroviral drug program. This would guarantee that HIV prevalence lessenings. The statement here is that persons who are wealthier are able to afford medical intervention they are clearly populating longer than their hapless opposite numbers. Therefore, they are able to populate longer and lend to the labour force and economic productiveness. Even though they are non take parting in safe sex, at least they are populating for greater periods of human capital collection, which increases expected income and lifetime public-service corporation from safe sex. The free antiretroviral drug program would enable all members of the population, rich or hapless to exhibit these features. Therefore, if lifetime public-service corporation is increasing, the chance cost to insecure sex will increase.

In decision, the low accomplishment and instruction degrees within the sectors that are take parting in the export activity of South Africa is lending to the disease  that is the direct association behind why links can be made between exports and HIV-infection. Thus my research hypothesis does stand  addition in exports has lead to an addition in wealth which has contributed to the spreading of HIV/AIDS. Therefore, policy treatments should be focused on the persons who fall within this class. Addressing bar plans geared towards the persons are evidently in the labour force and who are in the low-skilled class seem to be of extreme importance.


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