Women are disproportionately affected and infected by the HIV epidemic in South Africa. According to official statistics, an estimated 5.2 million people are living with HIV. The rates of infection among women 15 to 34 years of age are two to four times higher than among men of the same age, and an average of nearly 30 percent of women attending antenatal clinics are HIV infected.
Women are also disproportionately affected by poverty, with more than two-fifths living on less than Rand 500 [USD 67] a month, a higher proportion than men, according to a 2008 population survey. While the government has expanded access to comprehensive HIV services, including the provision of anti-retroviral therapy for AIDS, these services are still largely provided through hospitals. For women living in poor rural communities, the transport costs to these often distant facilities are high relative to their income. Consequently they find it particularly difficult to reach them to begin or maintain their daily treatment under medical supervision.
Rural transportation systems are also frequently unreliable. P, who runs an organisation providing services to women living with HIV in several rural communities, expressed concern to Amnesty International. “If you are living in [a poor rural community] where there isn’t a bus [system], you have to get the one vehicle that moves from the area”, she said. “If you miss that vehicle, there’s nothing, there is no other vehicle [that day].”
Barriers and delays in access to appropriate treatment can severely undermine the health of a person at risk of or living with HIV.
South Africa has had a widely agreed strategy in place since 2007 to tackle the epidemic. In a parliamentary address in October 2009, President Jacob Zuma announced that World AIDS Day 2009 “should be the day on which we start to turn the tide in the battle against AIDS”. He noted that “we are not yet winning the battle” against HIV and AIDS and called on all levels of government to cooperate in implementing the strategy.
This renewed government commitment to combat HIV and AIDS, which is also a Millennium Development Goal, is a positive development. However the government’s reinvigorated efforts must include addressing the particular needs of women, including those living in poor, rural communities. Accessible, affordable and reliable transport is critical in improving access to health services and the government must give deeper recognition to this as a crucial element of the HIV and AIDS response.
Take action! Call on the Ministry of Transport to help increase access to health services for HIV, particularly for women, by improving the regularity and affordability of rural transport systems.
Image caption: A young woman and her aunt walk to the bus stop on their way to hospital in KwaZulu Natal province. Chris de Bode/PANOS.
Read the Memorandum Sent by Amnesty International to the South African Government, August 2009, (AFR 53.008.2009)