Wealthy Restrict AIDS Researchers. 20/09/08

Wealthy South Africans are apparently reluctant to allow nurses conducting South Africa’s biggest HIV survey into their homes, leaving researchers in the dark as to how many of them have the virus.

Whites and Indians living in wealthy suburbs are refusing access to staff from the third South African national HIV behaviour and health 2008 survey, conducted by the Human Sciences Research Council, because they think Aids doesn’t affect the rich.

“People say to us: ‘We have no Aids in this community, or in this street. Why don’t you go down the road to that squatter settlement?’” said HSRC senior researcher Shandir Ramlagan.

HSRC chief executive, Dr Olive Shisana, said better access to wealthier residents was needed to ensure the reliability of results for this group.

“We need increased participation of all those with high fences, big security gates, laser beams and dogs in order for us to provide useful information on HIV in the country and also among this well-to-do population,” Shisana said.

The HSRC’s massive door-to-door survey, which began in May, aims to reach 28000 South Africans by December.

The survey consists of an anonymous health and sexual behaviour questionnaire and a finger-prick HIV test, the results of which are not given to the tester and are kept completely anonymous.

So far, 73% of the 8088 people surveyed have agreed to the blood test.

One of the country’s major sources of HIV/Aids statistics is pregnant women using public clinics.

As wealthier women are less likely to use these services, it is difficult to accurately estimate prevalence of the disease among them.

The HSRC did its best to forewarn people about the survey. It contracted registered nurses to perform the research and had them wear uniforms. It also hired a communications company to inform the public via newspapers, posters at police stations and community halls, and pamphlets at homes.

“They say ‘No’ through their intercoms, or even send their domestic staff outside to say they will not take part,” Ramlagan said.

What many rich people don’t realise is that their children, with access to cash and cellphones, have been shown by other studies to engage in risky behaviour that could lead to HIV infection, such as taking drugs and having unsafe sex.

“A lot of kids are afraid that if they talk to the nurse, she will tell their parents. But interviews are confidential and nurses do not take names.

“Even if the child agrees to participate, when the time comes to answer questions, they skip the house and when the nurse comes back, the child is not in,” Ramlagan said.

“This time round, we are not getting as many 12-to 14-year-olds as we could in order to get a comprehensive understanding of the age group.”

For the first time, the door-to-door survey sees nurses testing newborn to two-year-old children for HIV.

But, Shisana said, many parents withheld permission for their children to be tested.

“It is essential that we know how many children in South Africa are infected with HIV in order to plan properly for health and social welfare interventions for the future,” she said.

The HSRC’s previous survey, conducted in 2005, revealed that 10% of those who thought they were at low risk of HIV infection were in fact HIV-positive.

It also showed 60% of adult respondents did not use condoms and eight times more young women (aged 15 to 24) were HIV-positive than young men.

Whites and Indians had the worst participation rate in the 2005 survey, in which more than 16000 people took HIV tests and nearly 25000 answered the questionnaire.

In that survey, 72% of coloureds and 70% of blacks agreed to be tested, compared with 45% of whites and 51% of Indians.

Poor participation by whites and Indians, particularly in the Western Cape, meant the 2005 survey’s findings for that province were unreliable.

Survey ambassador, singer Loyiso Bala, who turns 29 tomorrow, urged people to participate to help paint a true picture of the Aids epidemic.

“I have friends who are really scared of going to take a test,” he said.

“This survey gives us better stats of where South Africans are in general and can help to prevent HIV.”

To demonstrate his support, Bala met the Sunday Times at the Nelson Mandela Foundation in Johannesburg, where Sister Amanda du Plessis took his blood to send into the survey"