The Independent, January 31, 2004

Nearly half of all patients in state hospitals are HIV-positive, a secret study for the Health Department has found. This was among the alarming findings in a report entitled “The impact of HIV/AIDS on the health sector”, published last year, but kept under wraps.

The report, leaked to Independent Newspapers, was based on an in-depth study during 2002 under the direction of Dr. Olive Shisana, executive director of the Human Sciences Research Council’s programme on the social aspects of HIV/AIDS.

Some of the report’s findings were discussed at last year’s national AIDS conference, but so far the government has refused to release the full 175-page report.

The research shows the need for massive capacity building in the health sector, where AIDS has begun to consume the bulk of resources. It found that AIDS patients had started “crowding out” other patients from hospitals as the impact of HIV/AIDS increasingly took its toll on health workers and health facilities.

In public hospitals, about 46% of patients were HIV-positive, in line with other countries where the epidemic had progressed, such as Uganda and Thailand.

Altogether, 28% of patients in public and private health care facilities were HIV-positive, with the free State showing the highest levels at nearly 38%. The research was concentrated mainly in Kwa-Zulu-Natal, the Free State, Mpumalanga and the North West. Patients were asked for their consent to be tested and whether they wanted to know the results.

Objectives of the study included ascertaining the scope of HIV/AIDS among health workers and patients in the health care system, and projecting how many would die and what the AIDS patient load on health facilities would be.

“The finding that almost half of the patients admitted to hospital are HIV-infected demonstrates the massive increase in the burden placed on health care facilities,” the report stated, adding that meant almost half of the normal number of beds was no longer available for other patients. By 2007 the trend forecasts a 40%-45% increase of AIDS patients in the health care system, “as more people seek treatment, testing and counseling”.

In addition, people who were HIV positive tended to stay in hospital longer – an average of 13.7 days, compared with 8.2 days for non-HIV patients.

The report also warned the government to train more nurses because up to 16% of health workers were likely to die from AIDS between 2002 and 2007, particularly if they did not get anti-retroviral treatment. Nearly 29% of all deaths of health workers were attributable to AIDS.

More and more health workers infected with the HIV virus are also having to work harder than before to meet the extra demands of AIDS patients, which included counseling for patients and their families.