‘HIV-AIDS mortality higher in older patients and Older People in South Africa’

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Patients affected by HIV-AIDS at older age with low immunity levels (CD4 cell count) are more likely to die of the condition than the younger ones, according to a latest study done by the city-based national AIDS Research Institute (NARI) and John Hopkins University, Baltimore, USA.

The data presented by them provides information on mortality among 457 HIV-positive individuals in Pune. They participated in an observational study and had free access to non-Antiretroviral drugs, which were advised as per guidelines provided by the National  AIDS Control Organisation (NACO).

The study titled 'Mortality in HIV infected individuals in Pune, India' has been authored by Manisha Ghate, Swapna Deshpande, Shrikanth Tripathy, Sanjay Mehendale and others from NARI, Pune and Robert Bollinger from John Hopkins University. The study has been published in the Indian Journal of Medical Research.

“Mortality was significantly higher in older age group (over 35 years). This finding suggests that age itself is a poor prognostic factor. It was significantly related to low CD4 counts, which highlights bad prognosis in patients with advanced stage of HIV disease,” the study stated.

South Africa is experiencing a rapidly growing and severe HIV/AIDS epidemic. National antenatal clinic data show a rise in seroprevalence from 1 percent in 1990 to 25 percent in 2000 (Karim and Karim, 1999; South Africa Department of Health, 2005). By 2000, 40 percent of adult deaths at ages 15-49 were due to HIV/AIDS (Dorrington, Bourne, Bradshaw, Laubscher, and Timaeus, 2001). This disastrous epidemic has enormous implications for older people. They are at risk of HIV infection and AIDS mortality themselves. In addition, many more older people face the consequences of AIDS-related illness and deaths among their own children and other relatives and of the wider social and economic changes wrought by the epidemic. The rising burden of morbidity and mortality among younger adults is likely to increase the importance of the practical contributions made by older people to their households. In South Africa, these include the contribution the monthly old age pension makes to family incomes as well as older people’s role in caring for grandchildren and other children whose parents are absent (HelpAge International, 2003).

In their international review of AIDS and older people, Knodel, Watkins, and VanLandingham (2003) extensively consider the evidence concerning the sociodemographic impact of AIDS on older people in Africa (Knodel et al., 2003). This paper complements their review by focusing on South Africa. The survival of the apartheid system in South Africa long after decolonization of the rest of the continent and the economic advantages of the country mean that older South Africans live in a very different social, political, and economic environment from older people in other African countries. These distinctions, coupled with a very severe HIV epidemic, suggest that the impact of HIV/AIDS on older people in South Africa may be very different from that in other countries with generalized HIV epidemics.

We begin by describing some of the more important social, demographic, and economic aspects of older people’s lives in South Africa and then discuss the direct and indirect consequences of the HIV epidemic for them. The last section of the paper presents data on the living arrangements of older people in rural KwaZulu-Natal in South Africa and examines their households’ experience of adult mortality, in particular AIDS mortality.

South Africa is experiencing a rapidly growing and severe HIV/AIDS epidemic. National antenatal clinic data show a rise in seroprevalence from 1 percent in 1990 to 25 percent in 2000 (Karim and Karim, 1999; South Africa Department of Health, 2005). By 2000, 40 percent of adult deaths at ages 15-49 were due to HIV/AIDS (Dorrington, Bourne, Bradshaw, Laubscher, and Timaeus, 2001). This disastrous epidemic has enormous implications for older people. They are at risk of HIV infection and AIDS mortality themselves. In addition, many more older people face the consequences of AIDS-related illness and deaths among their own children and other relatives and of the wider social and economic changes wrought by the epidemic. The rising burden of morbidity and mortality among younger adults is likely to increase the importance of the practical contributions made by older people to their households. In South Africa, these include the contribution the monthly old age pension makes to family incomes as well as older people’s role in caring for grandchildren and other children whose parents are absent (HelpAge International, 2003).

In their international review of AIDS and older people, Knodel, Watkins, and VanLandingham (2003) extensively consider the evidence concerning the sociodemographic impact of AIDS on older people in Africa (Knodel et al., 2003). This paper complements their review by focusing on South Africa. The survival of the apartheid system in South Africa long after decolonization of the rest of the continent and the economic advantages of the country mean that older South Africans live in a very different.

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