An assessment of the effect of HIV/AIDS policy in combating the spread of the disease within Buffalo City Metropolitan Municipality: Eastern Cape

Due to its rapid spreading, AIDS has been declared a global epidemic. Especially sub-Saharan Africa has been the most affected by the epidemic. South Africa is no exception to the devastating impact of the epidemic. Over the past few years, HIV-prevention initiatives have been underway on a full scale in an effort to combat the destructive powers of the epidemic in the country. These initiatives appear to have adopted a health-belief approach in their strategies to decrease HIV-infections. This approach to HIV-prevention assumes that the desired behavior change, namely increasing safe sexual practices and decreasing high-risk HIV/AIDS behavior, can be achieved through rational decision-making based on knowledge of the disease and its consequences. The findings of the studies on sexual behavior and HIV/AIDS such as KAPB (knowledge, attitudes, practice and beliefs) studies appear to reaffirm the fact that knowledge alone is neither sufficient nor effective in bringing about the appropriate behavior change to combat HIV/AIDS. These studies point towards a high level of knowledge about AIDS in the general population, yet the ever increasing infection rate remains undeterred. The ANC came to power in 1994 after 10 years of National Party inaction with regard to AIDS. The National AIDS plan, endorsed by incoming minister Dr Nkosazana Dlamini-Zuma, was insufficiently informed by the institutional and social realities of South Africa. Like other policy blueprints of this period, it over-estimated the economic, and especially human, resources at the disposal of incoming government. Moreover, this avowedly multi-sect oral HIV/AIDS plan, designated a “presidential lead project”, was situated in a national department of health in the throes of transformation. Because health is in part a provincial prerogative, AIDS was vulnerable to further administrative obstruction in a second tier of bureaucracy from the previous regime. Competing claims on resources in the poorer provinces, the demands of administrative reconfiguration, and very uneven provincial capacity, further undermined implementations. The community of Duncan Village, in Buffalo City was selected because of the high HIV-prevalence in the District and because of the involvement of the Centers for Health Systems Research & Development in the proposed youth center in Duncan Village. Buffalo City is the third highest HIV-prevalence. The study intends to inform HIV-prevention initiatives about impediments to safe sex. Also, its aim is to decrease HIV-infections among the youth in the community. Towards informing the study the study aim and objectives, individual in-depth interviews were conducted with 30 confirmed HIV-positive males and females from various social strata in the community, and who assumedly HIV-negative. The focus group discussions were conducted with the aid of a semi-structured group -discussions schedule. The two forms of data collection served to complement each other and promoted the validity and quality of the data collected. The study design opted for was explorative in nature, as little is currently known about the community-specific obstacles to safe sex. All respondents were purposively sampled. The main findings of the study point towards the need for HIV/AIDS to be viewed in the light of the socio-cultural and socio-economic contexts of sexual behavior. Factors that were identified as influencing sexual behavior, and therefore HIV/AIDS, include the unbalanced power in gender-relations, socio-economic status and perceived self-efficacy, amongst others. Also, there is a need for detailed knowledge about the specific of HIV-prevention and transmission, as well as safe sexual practices. This will serve to address myths and misconceptions about three models of safe sex, namely condom use, sexual abstinence and mutual faithfulness. Overall, the research that HIV/AIDS is a socio-behavioral problem rooted in the sexual practices of individuals. Attempts to successfully change high-risk sexual behaviors should first identify factors that influence the progression of the disease in order to develop community-specific effective HIV-prevention initiatives. To a large extent, this study has identified those factors that influence and limit the options and opportunities that people in Buffalo City have when it comes to practice safe sex. In this community, there are factors that should be taken into account when HIV/AIDS -prevention initiatives are planned and implemented.