Wall Street Journal Examines How Some HIV-Positive South Africans Skip Treatment To Qualify for Welfare

The Wall Street Journal on Friday examined how some low-income, HIV-positive people in South Africa forego antiretroviral treatment regimens to become sick enough to qualify for a disability grant. Two HIV/AIDS counselors at one of the largest hospitals in Durban, South Africa, estimate that about 30% of their clients choose this tactic for financial support, though there are no reliable statistics, according to the Journal. The disability grant is one of the only forms of welfare available to working-age adults in South Africa, the Journal reports. To qualify for such a grant, a person must be unable to work because of a physical or mental condition and must earn less than $130 per month. The government does not use any specific criteria to decide if an HIV-positive person is disabled but instead leaves the decision up to physicians, who tend to endorse grants for patients whose blood tests show CD4+ T cell counts of 200 or below, the Journal reports. After six months, patients must reapply for an extension, which requires them to prove that they still are sick. Some counselors say that patients with T cell counts that exceed the necessary threshold often pay about $80 to $160 to have someone with a low T cell count take the blood test for them. Suzanne Leclerc-Madlala -- head of the anthropology department at the University of KwaZulu-Natal, who has studied the issue -- said some HIV-positive patients purposely have unprotected sex with people whom they know also are HIV-positive in the weeks before their blood tests with the aim of mixing HIV strains and lowering their T cell counts. The government is working currently on a pilot program that will base disability criteria on a person's functional abilities (Phillips, Wall Street Journal, 4/7).

Life Expectancy in South Africa Drops to 51 Years
In related news, life expectancy in South Africa has dropped to 51 years because of HIV/AIDS, which has a direct impact on the most productive sector of the population, according to South Africa's Business Report. Nathea Nicolay, an HIV/AIDS risk consultant, said life expectancy could be raised to 59 or 60 years by 2025 under the best circumstances and urged businesses to implement HIV/AIDS policy programs to save money in the long run (Moodley, Business Report, 4/7).