AIDS in South Africa: Not Living, Not Dying Alone

“I don’t want to die alone!” This was the cry of the truckers with whom I discussed HIV and AIDS in Johannesburg in November 2004. They are long-distance drivers at KITE, a trans-continental trucking company.

The AIDS/HIV epidemic is a reaction to the reality of the instability and insecurity of forces that seek to serve the market – while neglecting to serve men.

The truckers are lonely and alone on long hauls — and even in the face of the scourge of HIV/AIDS, they would rather risk infection than insulate themselves and die alone.

I asked, “How would you react if you found yourself HIV-positive?” Immanuel immediately responded, “I would shoot myself.”
Herman, young and dashing, with smooth skin and soft brown eyes, said, “I will sleep with as many people as possible — so that I do not die alone.” All of the truckers applauded. I stood astonished.

For these men, HIV/AIDS is not a dissuading threat to the need for the even brief intimacy and security of a sexual encounter. In an industry where men are reduced to subsistence wages, they often lack the means to pay lobola, the bride price.

And even if they are married, they are generally separated for long periods of time, straining monogamy. Under such circumstances, being accountable for acquiring HIV — and then for knowingly infecting other people — is devoid of meaning.

In between routes, these truckers tend to stay in Johannesburg. Their wives usually stay in KwaZulu/Natal, Limpopo or elsewhere. The truckers admit that both they and their wives have local girlfriends and boyfriends.

A weekend getaway to another location — not to mention the transactional sex offered and accepted along the trucking routes — adds more sexual partners to the spread of HIV/AIDS.

Norm spoke up and said, “I have no choice but to sleep around! I drink, then I get drunk — and then I sleep with whoever is available. I have no choice.”

I asked him, “Do you see the sequence of your choices?” “Yes,” he answered. “Do you accept that you might have the choice to control those choices to enhance your life and the lives of those with whom you interact?” “Yes,” he answered again.

However, neither Norm nor any of the other truckers can exercise those choices without the enabling conditions created by the environment in which they act. Indeed, within a month or so of this exchange, Immanuel died.

What kind of calamity is this? It is a reaction to the reality of the instability and insecurity — and ultimately the unsustainability — of forces that seek to serve the market, while neglecting to serve the people within that market.

These truckers should be living in an interconnected, supportive society, rather than leading an existence where they fear dying alone — and thus ease their loneliness through desperate and destructive behaviors.

Hope comes from a harrowing awareness of the precariousness of life, but also from its promise. This recognition must form the new foundation of reality.

According to the worst-case scenario of the latest UNAIDS report, 120 million people stand to become infected with HIV/AIDS in Africa by 2020.

Also, according to a prominent virologist, a vaccine — while having short-term value — could potentially worsen the plight, as apathy to infection might increase along with the incidence and resistance, reigniting the vicious cycle.

In our interdependent world, we make a choice to remain HIV-negative, to take care of ourselves if we are HIV-positive — and to care for one another in such as manner as to contain and to control HIV.

In Africa, the expression ubuntu — meaning that “people are people only through other people” — reveals the relationship between each individual self and the broader society. In combating HIV/AIDS, it is necessary to understand the ways and means of the transfer and transmission of the disease.

It is important to treat HIV-infected persons with anti-retroviral medications — and to help them to take care of themselves and to avoid spreading infections. Aside from the need for vaccines, it is crucial to promote prevention.

Beyond the strategies to ensure sustainable existence or co-existence with this disease, it is vital to value each individual person and his or her life — and to enable each to develop his or her own dignity.

Conditions that allow for the articulation and acceptance of self include healthcare access and support, as well as ensuring food security through specialized care.

Methods to achieve this goal include educational opportunity and support from nursery school through theoretical, practical and technical training, as well as employment placement through public works programs, company recruitment, mentoring and fostering.

When that happens, an enabling environment is established within which individuals — such as the truckers whose dire situation I described above — can see a trajectory of sustainable livelihoods throughout their working lives. Their success, in turn, will have positive follow-on effect on a local, regional and even global basis.

Consequently, both they and their employers need to tackle the task of creating an economy that enhances both the market and the lives of the men and women who work within it.