an Eldis Resource

This report summarises the results of a survey of 771 AIDS-affected households in different parts of South Africa.

It documents the impoverishing impact of HIV/AIDS on households and the inordinate burden of caring for AIDS-sick family members. It also documents access to and satisfaction with public services, as well as access to government financial support for AIDS-affected households.

Findings include:

• 2/3 of the poorest households reported loss of income as a consequence of HIV/AIDS
• 22% of all children under 15 years in households included in the survey had lost a parent
• 64% of the AIDS-sick individuals in the survey were female on average 33 years of age
• half of the households in the survey reported having insufficient food at times and that the children in these households often went hungry
• more than 12% of households had sent their children away to live elsewhere, most often with a grandparent or another relative
• the households worst affected by HIV/AIDS are also those most underserved by basic public services such as sanitation and piped water
• more than 40% of households reported that the primary caregiver had taken time off from formal or informal employment or schooling to take care of the AIDS-sick person
• even though all the households in the survey were eligible for at least one form of government grant, fewer than 16% of households were receiving them
• 40% of respondents who used public health services said they were less than happy with these services
• 50% of the households in the survey said that the sick person they were caring for had HIV/AIDS. Most often respondents only mentioned opportunistic infections such as tuberculosis and pneumonia. But where respondents had revealed the AIDS-related cause of their illness, families tended to be supportive
• 80% of those who had been open about their HIV status said that the household had been very supportive
• 35% of those who had revealed their HIV-status reported a supportive response from the community. One in ten reported hostility and rejection

Conclusions:

• poor people in South Africa are the most adversely affected by HIV/AIDS
• the public health service is struggling to satisfy the medical needs of AIDS-sick patients, support to AIDS-affected these households is limited
• available government grants are not getting through
• there is deepening poverty among the already poor
• there is disruption and premature termination of schooling for children, especially girls
• increasing early childhood malnutrition can be observed
• there is increasing strain on extended family networks
• increasing numbers of sick patients are routinely referred to district hospitals. Respondents were substantially less happy with the service received at district hospitals mainly because AIDS-sick patients are only kept in hospital a short time and the lack of appropriate treatment
• terminally ill AIDS patients are generally sent home to die and access to home-based care programs is very limited
• AIDS-affected households are spending up to a third of their income on private medical care
• the lack of AIDS treatments in the public health system together with the lack of home-based care and support is further exacerbated by difficulties in accessing available government grants

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