The impact from the HIV/AIDS epidemic, with an estimated 42 million cases worldwide, is only beginning to be felt in the lives of individuals, communities and entire nations. In 2003, an estimated five million people were newly infected with HIV, 3.5 million of these cases occurring in sub-Saharan Africa alone. Not surprisingly, the HIV/AIDS epidemic has been cited as being a "developmental crises," expected to negatively impact all major demographic, economic, and social indicators. South Africa has experienced one of the worst HIV/AIDS epidemics in the world, with quickly escalating infection and prevalence rates. While only 1% of women attending antenatal clinics were found to be HIV-positive in 1990, this figure rose to over 22% by the end of 1999. Recent statistics from the first nationally representative study of HIV prevalence in South Africa has found similar alarming rates of HIV in the general population. Saliva-based HIV tests on over 8,800 individuals nationwide found that 11.4%, or 4.5 million of South Africans are currently living with HIV/AIDS. Other sources have estimated that this equates to as many as one in eight adults (15-49) infected with the virus. The high HIV prevalence within the adult population will contribute to an estimated 800,000 AIDS orphans by the year 2005; a figure that could reach as high as 1.95 million by the year 2010. Besides the obvious detrimental psychological effects and stigma associated with losing both parents to HIV/AIDS, the new generation of orphans is also more likely to grow up on the streets. In this environment, the seemingly cyclic relationship between certain social conditions (e.g., abuse, sex work, emotional stability, poverty, lack of education) and increased risk of HIV/AIDS will continue.
The human toll of HIV/AIDS at the individual and familial levels has also been extremely detrimental to the overreaching, macro level processes in South African society. HIV/AIDS is proving to have dire economic consequences. Hospitals, indeed entire health systems, are becoming increasingly overburdened by the disease, with a lack of beds, medication, and even trained personnel who are also succumbing to the disease.
Those most economically active, between the ages of 15-45, are also those with the highest rate of HIV infection (Reddy et al., 2000). In Sub-Saharan Africa, an estimated 6,000 youth, between the ages of 15-24, become infected with the virus everyday (UNAIDS/UNICEF/WHO, 2002). In South Africa, it is estimated that deaths due to AIDS among people in the workforce will soon exceed deaths due to all other causes, wiping out nearly half of the employees in some major companies (Stephenson, 2000).
Although the economic ramifications of HIV/AIDS is apparent, it may also be argued that HIV/AIDS is a disease borne of various forms of impoverishment, disproportionately affecting groups of people worldwide that are inherently more at risk due to compromised positions of social, political, and economic power. This train of thought regarding the link between HIV/AIDS and inequality has been echoed by Peter Piot, the Executive Director of UNAIDS. As eloquently stated in his presentation during the conference on racism in Durban, South Africa (Piot):
"The spread of HIV is linked to racism, poverty, intolerance and inequality because HIV transmission is not only about immediate risk, it is also about underlying vulnerability. And once the epidemic takes hold, the impact of AIDS compounds existing inequality. "
The link between inequality, poverty and HIV/AIDS was brought to the forefront in South Africa when President Thabo Mbeki made his now infamous statement at the opening of the 2000 international Aids conference in Durban (Butler, 2000; Horton, 2000; Jeffery, 2000). In his speech, he declared that AIDS was not caused by the HIV virus, but rather was a disease borne from extreme poverty. Mbeki's assertion