HIV/AIDS is rising among South Africa's rich and best-educated

Andrew Quinn:

South Africa's AIDS epidemic, often regarded by health workers as a disease of the poor, is in fact spreading quickly among the country's richest and best educated people, researchers said on Tuesday.

The study by the Markinor polling firm and the University of South Africa (UNISA) showed a rapid increase in HIV infections in professional people and those with full-time employment – both key to South Africa's hopes to spur economic development.

'The high risk group is growing, it is getting older and it is getting richer,' said Carel van Aardt, director of UNISA's Bureau of Market Research. 'This could represent a whole new wave of the epidemic.'

The study challenges widespread assumptions about South Africa's HIV/AIDS crisis, which is often described as a disease of the rural poor who lack access to information, treatment and basic health services.

South Africa now has some 5.5 million HIV-positive people out of a total population of some 45 million, giving it an estimated overall prevalence rate of about 11 percent and one of the worst AIDS caseloads in the world.

The new study examined some 3,500 South Africans between the years of 2002-2005, a poll engineered to reflect the country's racial and economic demographics.

Overall, the study identified young people below the age of 30 as being at greatest risk for HIV, as most previous research has done. But it also found infections rising at alarming rates in the rich and better educated – groups not previously singled out as being at risk.

'We are on the eve of a very scary reality unless we start making some changes,' said Tracy Hammond, Markinor's project manager for the study.

Researchers said there were many possible factors behind the spread of HIV among upper levels of society, among them confused government messages about HIV/AIDS, greater disposable income and leisure, and general apathy about safe sex practices.

But whatever the reason, AIDS is certainly climbing the social ladder for both black and white South Africans.

Among South Africa's professionals, for instance, the study found a 34 percent jump in estimated HIV prevalence, rising to 8.3 percent in 2004 from 6.2 percent in 2002.

People with full-time jobs – who in South Africa account for only about half the working population – saw estimated HIV-prevalence rise to 19.2 percent in 2005 from 14.4. percent in 2002, an increase of 36 percent.

Unemployed people, while seeing a bigger percentage jump in HIV prevalence, remained lower in terms of actual prevalence rates with just 18.4 percent estimated infected in 2005 compared with 11 percent in 2002.

In a further piece of alarming news, the study said HIV infection was growing most quickly in those aged between 30-34, threatening people just as their careers take off.

Overall, the richest third of South Africa's population still has a lower estimated HIV-prevalence than the poorest third, at 8.5 percent compared to 23.4 percent.

But the study said new infections were increasing most rapidly in this demographic, rising by 39 percent between 2002-2005 against only a 14 percent increase for their poorest compatriots.

'This time it is not the employees, it is the employers. It is not the people without bank accounts, it is the people who make investments,' Markinor's Hammond said. 'If we thought the AIDS epidemic was having bad economic effects already, this could take us to the crisis point.'

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