The HIV/Aids epidemic in South Africa has become worse, with the situation most dire in Mpumalanga's Gert Sibande district.
Here, long distance truck drivers, as well as migrant workers serving the mining, agriculture and forestry industries are among those blamed for a devastatingly high HIV prevalence rate of 46.1%.
"The existence of the national N17 and other roads connecting Gert Sibande district to other districts and provinces, creates an opportunity for commercial sex work between unemployed women and long distance truck drivers," said TB and HIV expert Dr Eric Khumalo, who has a private practice in Nelspruit.
"This challenge, coupled with the province's underbudgeting and slow implementation of the Mpumalanga Provincial Aids Council (MPAC), is fuelling the high HIV prevalence in that district and the province at large," he said.
Read: Six million South Africans living with HIV/Aids
An even darker picture
But Gert Sibande's figures could be even higher than that. The 46.1% statistics are three years out of date and relate to the 2011 Antenatal Sentinel HIV and Syphilis Prevalence Survey.
The next survey, which relates to 2013 will be released later this year and may paint an even darker picture based on another survey released this week.
The newly released South African National HIV Prevalence, Incidence and Behaviour Survey of 2012 indicates that here has been an increase in infections and decrease in condom use nationally.
The report, by the Human Sciences and Research Council, states that an estimated 6.4 million people had HIV/Aids in 2012.
Unemployed and barely literate
Nearly a million people live in the Gert Sibande district, which borders Gauteng in the west and the Free State and KwaZulu-Natal in the south.
Dr Khumalo said the HIV prevalence rate is exacerbated by the fact that 39% of adults in the region are unemployed and most are barely literate.
Read: SA has highest HIV rate
He said women have little voice in relationship matters, including sexual relations.
There's also a lack of co-operation from government, the community, civil society, private and public doctors in the district, he added.
“The approach needs to be multi-sectoral. Government, the non-profit organisations, doctors from all sectors and the public needs to get involved and work together and act against the identified contributing factors to HIV, not only in Gert Sibande, but the whole country,” he said.
Budget needs to be increased
Not much funding has gone towards addressing the crisis in Gert Sibande. The Gert Sibande district municipality budgeted R1.3 million for HIV programmes for the 2014/2015 financial year.
The provincial government, through the Mpumalanga Provincial Aids Council (MPAC), has a budget of R4.4 million for the entire province.
MPAC chairman and Premier of Mpumalanga, David Mabuza, admitted that the province needs to increase the council's budget.
Read: HIV increasing steadily
Dedicated programmes required
"Currently the province is the second worst-hit after KwaZulu-Natal in terms of HIV statistics, with Gert Sibande district having the most infections at 46%. The municipality's R1.3 million budget to deal with the disease is not enough.
"If you want to fight this kind of battle, you must arm yourself by having dedicated programmes that you must carry out. In order for you to achieve on those programmes, you need reasonable resources to systematically go all out and attack this scourge,” said Mabuza.
He said an increased budget would enable local Aids councils to do their work properly, including mobilising communities to take responsibility for HIV and Aids matters.
These include the basic, like not engaging in unsafe sex, knowing one's status and supporting those who are infected and affected by the virus.
Image: Truck driver from Shutterstock
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