Summary findings of KZN Integrated HIV/AIDS Project 2006-10, South African Red Cross

· All community interviews acknowledged HIV&AIDs as a problem in their communities; however 26 percent of them reported to be doing nothing on the fight against HIV. None of the communities interviewed in Umzimkulu had mechanisms in place to fight HIV&AIDS as they said that they do not have people trained in the communities to speak about AIDS.

· Stigma and discrimination was a concern in 57 percent of the villages surveyed. Main factors causing stigma and discrimination were lack of education on HIV and its transmission and fear about status disclosure as there not enough support mechanism in place. A total number of 77 stigma and discrimination reports were issued in the 12 months prior to the survey, out of which 44 (57 percent) were followed up and solved with appropriate action.

· Almost all the villages surveyed (86 percent) saw gender-based violence (GBV) as a big problem in their communities. Fuelled by an increased number of orphans and vulnerable children in the communities with no adequate adult protection, drugs and unemployment, 64 percent of the communities had mechanisms in place to tackle GBV. A total number of 19 gender-based violence cases were reported in the 12 months prior to the survey, out of which, 5 ( 26 percent) of them were followed up and solved with appropriate action.

· Four hundred and thirty-four (434) youth in-school were surveyed. Males were found to be more sexual active than females, however males tended to have partners of the same age contrary to females that tended to have partners on average 3.5 years older than them.

· Big variations on condom use amongst in-school youth with non-regular partners were found among districts. While 53 percent of the respondents had had sex with more than one non-regular partner in the last 12 months, only 40 percent used condom at last non-regular sex. Pietermaritzburg district, with most of the population surveyed being urban or semi-urban, had over half of the respondents engaged in multi non-regular partner sexual relationships and less than 20 percent used condom.

· Three percent of all the in-school youth interviewed mentioned that Red Cross was supporting their schools with life skills training and HIV&AIDS education campaigns. Comparing the three groups interviewed by the Behaviour Change Survey, in-school youth are the ones receiving less HIV prevention information despite being in school.

· Data indicated that in-school youth engages in sexual practice at a very young age (15.5 years of age), and despite being exposed to HIV prevention very often, comprehensive knowledge about HIV and correct beliefs about AIDS remains very low (23 percent).

· Despite most of the in-school youth having access to confidential Voluntary Counselling and Testing, only 15 percent went for an HIV test. Of those who went for a test (85 percent), 68 percent went back for their results.

· Two hundred and seventy-five (275) out-of-school youth was interviewed. Of the 275, 76 percent received HIV&AIDS prevention information in the 12 months prior to the survey. However, and despite all the information received, knowledge on prevention methods and correct beliefs about AIDS and stigma and discrimination were very low (under 30 percent) for both indicators. Alarming data was found in Zululand where only 10 percent of the males and 7 percent of the females responded correctly to prevention methods and AIDS beliefs questions.

· Forty-two (42) percent of the youth out-of-school have had sex with more than one non-regular partner within the 12 months prior to the survey. Of those, almost half (45 percent) used condom at last non-regular sex.

· Almost 30 percent of the youth out-of-school had an HIV test within the last year, and of those tested, 85 percent received their results.

· The behaviour change questionnaire also targeted 373 between the ages of 20 to 49. Over 70 percent had had sexual intercourse, and 54 percent of men and 41 of women had had sex with more than one partner in the 12 months prior to the survey. One-third (33 percent) of those having sex with more than one partner did use condom.

· Information about HIV prevention methods amongst the 20-49 years old group was high in all the communities surveyed. However, only 34 percent reported comprehensive knowledge on HIV prevention methods and correct belief about AIDS.

· Seventy-four percent of the people interviewed had access to Voluntary Counselling and Testing within 12 months, however only 43 percent of them went for an HIV test, and out those 89 percent went back to get their results.

· A total of 742 households were randomly selected and data from 4036 household members was collected. The average household size of those household interviewed was 6.9 people per dwelling. Fourteen percent of the households were headed by people over the age of 65, out of whom 66 were women. Only one child was found to be headed a household. On average households were caring for an average of 3.5 children. More than half of the households surveyed did not have a regular source of income.

· Amongst the 63 percent of the households with members on Anti-retroviral treatment (35 percent) and TB treatment (44 percent), adherence to treatment was found high, with 96 percent on the interviewees being adherent over 90 percent to the ARV treatment and 92 percent of the people on TB taking over 90 percent of the treatment.

· Adult/Client Status Index was completed for 501 people on ART/TB treatment, on HBC programmes or members that have seen seriously ill for the last 3 or more months. Overall CSI rating for adults was 0.711, which falls in the highest category, meaning that no major concerns about the interviewees were found.

· Twenty-one percent of the Adult Status Index interviewees were benefiting from Red Cross at the time the interview was conducted. However external assistance from institutions, government and/or organizations was found very erratic, with only 56 percent of all the interviewees receiving support. Access to health services, provided mainly by the Ministry of Health, was the most extended support, received by 33 percent of the people interviewed. Nursing care was the second most expanded service, with Red Cross catering for more than 69 percent of the people surveyed with counselling and weekly household visits.

· Child Status Index was completed for 679 children, out of whom 422 met the criteria of orphans and vulnerable children. CSI rating OVC/Non-OVC ratio was 1.0, which indicates that OVCs overall wellbeing and status does not differ from Non-OVCs. Out of those children identified as OVCs, 26 percent had lost one parent, 13 percent experienced the death of a household member and 13 percent had at least one parent sick in the 6 months prior to the survey.

· Access to education was granted to 73 percent of the children interviewed as they are enrolled and do attend to school regularly. Difference on attendance was found when comparing OVCs and non-OVCs, with non-OVCs attending more regularly to school (21 percent) than OVCs (16 percent). However this figure differs when data is analysed only for children between the ages of 6 to 17. Data from the CSI indicates that 77 percent of the 6 to 17 years old children do go to school regularly, however OVCs go more (79 percent) than Non-OVCs (73 percent). See Table 11.

· Only 11percent of the Child Status Index interviewees were benefiting from Red Cross at the time the interview was conducted. External assistance from institutions, government and/or organizations was found very erratic, with only 36 percent of the OVCs and 32 percent of the children not receiving any type of assistance in the last 12 months. Livelihood support, provided mainly by the Government consisting mainly on grants, was the most extended support, received by 54 percent of the OVCs. Access to education was the second most expanded service, with Red Cross providing for 42 percent of it.

· In general, people interviewed whether through Behaviour Change or Household Survey, continue to remain in denial about AIDS, even when a close friend or relative is dying from AIDS. AIDS continued to remain stigmatized and there is well-founded fear of rejection from family and friends when you are diagnosed with HIV.