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CHAPTER ONE
INTRODUCTION OF THE STUDY
1.1 Introduction and background to the study
There is evidence of a worldwide increase in the HIV epidemic from 8 million in 1990 to
33.3 million at the end of 2009. Approximately 2.6 million were infected with new infections
and 1.8 million AIDS related deaths were recorded in the year 1999 alone (UNAIDS, 2010).
In total, approximately 30 million AIDS related deaths have been recorded since the
beginning of the epidemic (UNAIDS, 2010). However, there has been a steady reduction in
the number of new infections and AIDS related deaths due to the increased number of people
taking antiretroviral drugs (ARVs) (UNAIDS, 2010).
Although, 10% of the world population reside in sub-Saharan Africa, this region has the
highest number of people infected with HIV/AIDS. For example, 68% (22.5 million) of
people infected with the disease on the globe live in this region and its estimated number of
AIDS related deaths is 1.3 million. In sub-Saharan Africa, Southern Africa is the most
severely affected region as one in every five people between the ages of 15-49 years are
living with the HIV virus in three of the countries in this region (UNAIDS, 2010). For
example in Botswana, 24.8% adults were living with HIV at the end of 2009 (Fidzani &
Attah, 1996).
South Africa’s AIDS epidemic remains the largest in the world with an estimated 5.6 million
people living with HIV/AIDS in the year 2009 (UNAIDS 2010). The total number of persons
living with HIV/AIDS in South Africa increased from an estimated 4.10 million in 2001 to
5.24 million by 2010. A study conducted in South Africa on HIV infection in pregnant
women, shows that an estimated 29.4% of pregnant women between the age of 15 and 49
were HIV infected in 2009 while another study estimated that 10.9% of people aged 20 and
above were HIV infected in 2009 (South African Department of Health [DoH]a, 2010).
Furthermore, an estimated 10.5% of the total population was HIV positive in the year 2010
(Rehle, Hallet, Shisana, Pillay-van Wyk, Zuma, Carrara, & Jooste, 2010). Additionally,
among all provinces, Kwa-Zulu Natal (KZN) is the most affected. Recent estimates show that
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