Abstract

PIP: Miners in South Africa are now more at risk of contracting human immunodeficiency virus (HIV) than of being in a mining accident. Some epidemiologists predict that the mines could be experiencing 12,000-40,000 deaths related to acquired immunodeficiency syndrome (AIDS) by 2010. In 1986, HIV infection among mineworkers was 1/3500. Gencor medical personnel now estimate that 20% of the company's employees are HIV-positive and that 30 workers are dying of AIDS each month. In August 1995, the Chamber of Mines, the World Bank, and the World Health Organization (WHO) held a seminar to discuss the potential impact of the epidemic; it was followed by a workshop, "Research Needs and Priorities for the Management of HIV/AIDS Transmission in the Mining Industry," which was organized by the Epidemiology Unit in Johannesburg. Although the seminar invited no people with HIV, mineworkers, or government representatives, the workshop did; however, no representatives of the National Union of Mineworkers (NUM), or the Chamber of Mines, came. In spite of this, a new, holistic approach to HIV-prevention is emerging in the mining sector. A decade of education has not changed risk behaviors, so more emphasis will be placed on outreach programs to the communities, including the prostitutes, with which the miners interact, and on treatment of sexually transmitted diseases (STDs). The mining sector is in a unique position to fight HIV because it already has an extensive medical infrastructure with the capacity to treat STDs effectively, a unionized workforce to provide a pool of peer educators, and recruitment agencies to extend HIV-prevention into rural areas. Obstacles to effective HIV/AIDS education include discrimination (Workers are tested for HIV without consent, and dismissed, if found to be positive, regardless of union agreements.); a psychological factor that is related to underground work and produces recklessness; poor living conditions; and illiteracy. Many myths remain about the cost of improving social conditions and introducing HIV-prevention programs.