HIV/AIDS prevalence among South African health workers

  • O Shisana Human Sciences Research Council, Cape Town
  • EJ Hall Human Sciences Research Council, Pretoria
  • R Maluleke National School of Public Health, Medical University of Southern Africa, Pretoria
  • J Chauveau National School of Public Health, Medical University of Southern Africa, Pretoria
  • C Schwabe Consultant: Marseille, France

Abstract

Introduction. Studies on HIV prevalence among health workers usually focus on occupational exposure to HIV. Little is known about HIV prevalence in this group. However, it is expected that HIV prevalence among health workers will reflect prevalence in their society.

Objective. To determine HIV prevalence among South African health workers.

Method. A stratified cluster sample was drawn of 5% of health facilities in South Africa (N = 222) representative of the public and private health sectors in South Africa. The sample was designed to obtain a nationwide representative sample of medical professionals and non-professional health workers. A subsample comprising health workers in four provinces was tested for HIV status. The Orasure HIV-1 device in combination with the Vironostika HIV UNI-Form II plus O enzyme-linked immunosorbent assay (ELISA) kits were used to collect oral fluid specimens for HIV testing.

Results. Based on a sample of 721 health workers and a response rate of 82.5% (or 595 respondents), the study found that an estimated 15.7% (95% confidence interval (CI): 12.2 - 19.9%) of health workers employed in the public and private health facilities located in four South African provinces, were living with HIV/AIDS in 2002. Among younger health workers, the risk is much higher. This group (aged 18 - 35 years) had an estimated HIV prevalence of 20% (95% CI: 14.1 - 27.6%). Non-professionals had an HIV prevalence of 20.3%, while professionals had a prevalence of 13.7%.

Conclusion. HIV prevalence among health workers in South Africa is high; this calls for the introduction of antiretroviral programmes targeting them. In addition, there is a need for the development of new policy regarding placement of infected health workers in tuberculosis (TB) wards, coupled with vigorous human resource planning to replace the health workers likely to die from AIDS. Infection control procedures also need to be reviewed.

S Afr Med J 2004; 94: 846-850.
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