One in four people in the country is HIV positive. Southern Africa, which is expected to see similar levels of HIV as were seen earlier in Eastern Africa, is only just beginning to tackle the problem. It has a relatively well developed road system as well as a high level of migrant workers, allowing the disease to spread rapidly. Many men working in the mines have to live most of the year away from home and there is a high use of prostitutes. The end of apartheid may help the spread of HIV because it allows freer movement around the country.
Aids also shows graphically the inequalities in world health.
While in the West, the presence of strong drug combinations has led to HIV becoming virtually a manageable disease, the situation is totally different in developing countries where drug treatments are too expensive. In many places people have no access to voluntary HIV testing and counselling. Even when these services are offered, many do not want to know or acknowledge their HIV status because of the stigma attached to Aids. Uganda was hit early on in the pandemic and has organised huge health campaigns as a result. Other factors influencing the spread of the disease include cultural attitudes to sex and the fact that governments have many other problems which demand urgent attention.