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HIV and AIDS

Introduction

An important message to the person finding out that they are infected is that a healthy, continued life is possible (don’t give up!) Studies point to the enormous difference made by nutrition, basic food safety, adequate sleep and a positive attitude. And ARV medication holds out a lifeline.

Farm workers are the most under-serviced labourers in South Africa. Poor access to health care and health-related information is partly due to their remote location of work. The high incidence of poverty and low level of education makes the farm worker even more vulnerable to the impact of HIV and AIDS. And lack of awareness is compounded by high levels of stigma around the issue, a problem because the stigma severely tests and often severs the safety net of support from village and extended family. Workers are scared to test and fear that they might be HIV positive. Unfortunately not knowing your status and not testing will not remedy this situation.

Farmers often don’t know where to turn to in order to help their workers. Losing skilled workers has a significant impact on productivity, but there are also social challenges. How do you deal with a household that is now without an income? And what if there are orphans that are left behind?

TB, cryptococcal meningitis and severe bacterial infections are responsible for most HIV-related deaths, and all three are preventable and treatable – if detected early enough (Van Cutsem, 2020).

International business environment

The third of the global goals agreed to by governments in 2015, the Sustainable Development Goals (SDGs), has to do with health.

Find international updates at www.unaids.org/en.

 

Some role players

  • Africa Centres for Disease Control and Prevention (Africa CDC) – https://africacdc.org
  • The African Comprehensive HIV/AIDS Partnerships (ACHAP) at www.achap.org
  • https://afaid.org – Africa Aid Organisation (AFAID)
  • AIDS Healthcare Foundation – www.aidshealth.org
  • The Global Alliance to End AIDS in Children by 2030 www.childrenandaids.org/global-alliance
  • The Global Fund to fight HIV/AIDS – www.theglobalfund.org
  • For a global database on how HIV/AIDS is viewed (there are restrictions in some countries), see www.hivtravel.org.
  • International AIDS Society (IAS) is “the world’s largest association of HIV professionals”. See www.iasociety.org.
  • Read about the International Labour Organisation’s Programme on HIV/AIDS at www.ilo.org/aids.
  • Men Star Coalition www.menstarcoalition.org The aim of this organisation is “to expand the diagnoses and treatment of HIV infections in men – keys to breaking the cycle of HIV transmission and ultimately ending the AIDS epidemic as a public health threat by 2030”.
  • Population Council – https://popcouncil.org
  • Population Services International (PSI) – www.psi.org
  • Society for AIDS in Africa – www.saafrica.org
  • Southern Africa HIV and AIDS information Dissemination Service (SAfAIDS) is based in Zimbabwe with country offices in South Africa, Swaziland and Zambia – https://safaids.net
  • The Joint United Nations Programme on HIV and AIDS (UNAIDS) – www.unaids.org. Find the latest global statistics here and news on the progress against HIV and AIDS.
  • Unitaid “works with partner organisations to leverage innovation for global health”, https://unitaid.org.
  • USAID through PEPFAR has subsidised the NPOs who do HIV testing, and many of these offer Voluntary Counselling and Testing (VCT) free-of-charge in the rural areas. Visit www.usaid.gov.
  • The World Health Organisation (WHO) – www.who.int

Local business environment

About 7.8 million people, or 13.2% of the population, were living with HIV in South Africa in 2022 (HSRC, 2024). The Western Cape had the lowest prevalence of people living with HIV and Mpumalanga the highest.

Refer to the latest articles listed under the last heading on this page for an update on what is happening in the country.

The subsistence farmer

HIV/AIDS accelerates rural impoverishment and the breakdown of extended family relations that have over many years been the foundation of traditional safety-net mechanisms.

Subsistence agriculture makes for a hard life, particularly in areas that are badly hit by HIV. Put farming and AIDS together, add drought or disease, and you have a diabolical mixture of circumstances. Subsistence farmers typically work in remote areas with poor access to markets and agricultural services. Poverty is widespread. The burden of tending to family members with AIDS-related diseases – and the frequent death of these persons – leads to a decline in production among subsistence households, as human and financial resources are invested in taking care of people rather than crops and animals. Lower production, in turn, causes food insecurity that exacerbates the effects of AIDS – and heightens the likelihood of HIV exposure and infection. A vicious cycle is set in motion.

Because HIV largely affects the population group aged between 15 and 49 years, it is often parents that are lost to the pandemic. As a result, farming skills that would normally be passed from mothers and fathers to their children tend to be lost, with the new generation left ill-equipped to continue with agriculture. In some cases, when AIDS claimed all the adults, children are left to manage households, raise siblings and attempt to produce food. This creates another cycle of lack of formal education, leading to unemployment and children growing up without any parental guidance and love, leading to marginalisation.

Advice to subsistence or small-scale farmers would include:

  1. Grow millet and sorghum. These crops can grow without irrigation – no small matter in an aids-affected household – with little labour or money to spare.
  2. Invest more in the farming of indigenous livestock e.g. Nguni cattle, a local breed that copes better with dry African weather than other breeds and which has greater resistance to ticks and diseases. European breeds need expensive medication and vaccinations, and that they are sometimes unable to survive the South African climate.
  3. Chicken farming, which requires less expertise than cattle breeding, could also prove useful for families struggling to cope with AIDS. In addition, poultry is a cheap source of the protein that is vital in maintaining the immune system of HIV-positive persons for as long as possible.
Adapted from an article in the Mail & Guardian, 7 June 2005
       ***

The stigma, different misconceptions and the fear to die alone if diagnosed with HIV, especially in rural settings, necessitate that a HIV/AIDS policy needs to be built upon trust and confidence amongst all the players/stakeholders. Involvement of all stakeholders in an early stage helps building the necessary team approach. Before starting awareness sessions for the farm workers, the farmer / farm management need to speak to the farm workers, indicating commitment and stipulating assurance that people will not be fired (one of the fears is that they will be fired if tested positive). By implementing an HIV programme the hope is that the workers are more knowledgeable about the importance of a healthy life style.

Source: AgriAid SA. Contact them at 012 320 8455.

Nutrition and food safety

No specific food or nutrient can destroy the virus, but a healthy eating pattern and life style will strengthen the immune system. Good nutrition will help you to fight infections and delay the development of full-blown AIDS. This will improve well being and prolong life.

It seems prudent for all HIV infected individuals to consume an adequate vitamin intake from food, but in those with a poor dietary intake, a multivitamin and mineral supplement should be used.

Food hygiene is important in HIV-positive individuals with poor immune function as they are at an increased risk of food poisoning. Special care should be taken with uncooked products such as eggs, fish, meat and milk products.

Food Safety Precautions

  1. Wash hands thoroughly before handling or eating food. Avoid raw/ unpasteurised milk.
  2. Meat, fish or chicken should always be well cooked.
  3. Avoid raw eggs in uncooked foods e.g. drinks, mayonnaise, etc. Discard cracked eggs.
  4. Do not buy prepared salads with chicken, fish, meat, egg or mayonnaise from the supermarket.
  5. Leftover food should be refrigerated as soon as it has cooled. It should be reheated once and should be hot all the way through.
  6. Wash all fruit and vegetables well.
  7. Store food in a cool, dry place.
  8. Moderate exercise should be encouraged and will assist in the toning or development of muscle.
Source: Dr Marianne E.Visser

National strategy and government contact

South Africa treats more people than any other country with anti-retrovirals, consuming one-quarter of global generics.

The National Development Plan (NDP) set a target of no new HIV infections by the year 2030. Even once this goal has been reached, “there will still be a sizeable number of HIV-positive people requiring treatment, presenting a continuous challenge for the tuberculosis infection rate and the risk of drug-resistant HIV strains developing” (SANAC, 2017). By all indications, the epidemic and its implications for public policy are likely to persist for at least another generation, possibly two.

The National Strategic Plan (NSP) for Human Immunodeficiency Virus (HIV), Tuberculosis (TB) and Sexually Transmitted Infections (STIs) 2023-2028 sets out South Africa’s national strategy.

  • Department of Health www.health.gov.za.
  • Department of Social Development www.dsd.gov.za
  • Department of Higher Education runs HIGHER LIFE which serves students across South Africa’s 26 public universities, 50 technical and vocational training colleges (TVET) and 9 community education and training colleges (CET).
  • Department of Science and Innovation (DSI) www.dst.gov.za
  • South African Health Products Regulatory Authority (SAHPRA) was established in 2018 to replace the Medicines Control Council (MCC). See www.sahpra.org.za.
  • South African National Aids Council (SANAC) officially brings together the government and civil society in the fight against HIV/AIDS. Visit www.sanac.org.za. Find statistics and details of each of the province’s own councils on the website.

Role players

Note: Click to expand the headings below.  To get a free listing on our website like the ones below, visit here for more information or place your order here. Disclaimer: The role player listings are not vetted by this website.

 
Healthi Choices – www.healthichoices.com
Kaelo – www.kaelo.co.za

South African Chamber of Commerce and Industry (SACCI) – https://sacci.org.za

Project Literacy – https://projectliteracy.org.za Project Literacy works with communities in areas like Hiv/AiDS and STDs, TB, social ills affecting orphans etc. It also develops entrepreneurial skills, in the field of hospitality and tourism for example.
University of KwaZulu-Natal Health Economics and HIV/AIDS Research Division (HEARD) – www.heard.org.za
Health Systems Trust – www.hst.org.za
Bureau for Economic Research – www.ber.ac.za Based at Stellenbosch University
The Valley Trust – https://thevalleytrust.org.za
International Organisation for Migration South Africa – https://southafrica.iom.int
National Institute for Communicable Diseases – www.nicd.ac.za
Children of the Dawn – www.childrenofthedawn.org.za

Further reference:

National Aids Helpline – 0800-012-322 www.lifelinesa.co.za

  • Good nutrition is of enormous importance to HIV-positive people. e’Pap is more than 29 times more nutritionally dense than refined maize and is packed with 28 micro and macro nutrients.
  • International Organisation for Migration South Africa works with sectors that traditionally employ a relatively large number of migrant workers including the commercial agriculture sector.
  • Khululeka Grief Support provides training, materials and support for pre-schools and care-givers across a wide region.
  • Employees dismissed on the grounds of HIV who have no resort to legal assistance can seek free legal advice at the HIV and TB helpline operated by Legal Aid SA.
  • Details of Lifeline offices and crisis lines across the country are available on its website.

Voluntary Counselling and Testing (VCT)

  • Numerous clinics and hospitals around the nine provinces do VCT. Lists of these are available on www.lifelinesa.co.za. You can also call the National AIDS Helpline and ask for the nearest voluntary counseling and testing (VCT) centre. The number is 0800-012-322.

 Training and research

  • Read about HIGHER HEALTH, the Higher Education & Training: Health, Wellness and Development Centre. Go to https://higherhealth.ac.za.

Websites and publications

Visit the websites listed earlier on this page.

The following Info Paks are available at www.dalrrd.gov.za, website of the Department of Agriculture, Land Reform and Rural Development (DALRRD).

  • HIV/AIDS and nutrition [Eating the right food can help your immune system to fight infection]
  • HIV/AIDS & STDS: what the farming community ought to know
  • HIV/AIDS and the farming community: Caring for people with AIDS [Basic guidelines to caring for people with HIV and AIDS]
  • HIV/AIDS and the farming community: Know your rights [The rights of a person suffering from HIV and AIDS]
  • HIV/AIDS and the farming community: Staying healthy [Basic guidelines on how to stay healthy when you are HIV positive]

The Code of Best Practice for Sheep Farming in South Africa, available in English and Afrikaans on www.capewools.co.za and www.nwga.co.za, includes coverage of the topic of HIV/Aids.

Find publications like South African National HIV Prevalence, Incidence, Behaviour and Communication Survey by the Human Sciences Research Council (HSRC) at www.hsrcpress.ac.za.

Find details of the Southern African Journal of HIV Medicine at www.sahivsoc.org.

Law L. 2023, October. The Vulnerability of Girls and Young Women to HIV Infection. Southern African Catholic Bishops’ Conference (SACBC). Available at https://cisp.cachefly.net/assets/articles/attachments/91685_bp_575_the_vulnerability_of_girls_and_young_women_to_hiv_infection_by_lois_law.pdf

Find the “Reduce the stigma of AIDS” download under “Hot topics” at www.healthichoices.com/healthichoices/corporate/hot-topics

Impact of HIV & AIDS on agriculture and food security: The case of Limpopo Province in South Africa can be found among the historical documents on www.fanrpan.org.

The HIV/AIDS Emergency – A Guideline for Educators available in four languages (English, Afrikaans, Sesotho, Xhosa). This is available from the Department of Basic Education.

Moyle, D. Speaking Truth to Power. 2015. Johannesburg: Jacana.

Find information on the African Journal of AIDS Research at www.nisc.co.za.

www.aidsmap.com – “HIV and AIDS – sharing knowledge, changing lives”

“Get the facts about sexual health and HIV” , www.beintheknow.org

“The Complete HIV/AIDS Resource” – www.thebody.com

The medical journal The Lancet periodically runs articles about HIV/AIDS. See www.thelancet.com. 

POZ is a magazine for HIV positive people. See www.poz.com.

Epstein, H. 2007. The Invisible Cure: Africa, the West and the Fight against AIDS. New York: Farrar, Straus, and Giroux.

Find the HIV option at www.verywell.com for comprehensive information on the HIV condition.

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