What are you thinking when you do it?

I spent December in South Africa with Nikolai. It was his first visit to SA, and although I was eager for him to see my home country and everything it had to offer, I was all too aware of the many things he'd see which would have him shaking his head and thinking, thank the Lord I live in Britain. Like so many South Africans, I've learned to smooth over the rough edges of my country with a fat dose of pride and optimism. I wanted Nikolai to see the best the country had to offer, although I was gritting my teeth in anticipation of the questions about the insistent poverty, unemployment, crime. But the one question that came up over and over on our trip was not about racism or poverty. It was about health. Specifically, the invisible spectre of HIV. Why was it invisible? Where was it lurking? And why was it still so threatening - why, in more than 10 years of knowing exactly how the disease is transmitted and how to avoid it, why are people still getting it?

According to current statistics available on the Internet, by 2005, approximately 10.8 of all South Africans over the age of 2 were living with HIV. Prevalence differs widely according to racial groups: around 13% of black South Africans carry the virus, whereas 0.6% of white South Africans, 1.9% of coloured South Africans and 1.6% of Indian South Africans carry it. Figures also vary for the different provinces:

Province	Number surveyed	Prevalence %
KwaZulu-Natal	2,729	16.5
Mpumalanga	1,224	15.2
Free State	1,066	12.6
North West	1,056	10.9
Gauteng	2,430	10.8
Eastern Cape	2,428	8.9
Limpopo	1,570	8.0
Northern Cape	1,144	5.4
Western Cape	2,204	1.9
Total	15,851	10.8

(Figures taken from http://www.avert.org/safricastats.htm for 2005)
Around 600,000 people per year die from the virus. That's around 1.2% of our population dying annually of HIV.

Now, Nikolai's unusually well-informed, and he asks questions. He wasn't all that surprised that the disease is not visible among the affluent, educated still-mostly-white suburbs of Cape Town. But out in the rural areas, he asked, do people know how it's spread? Yes, I said, I believe they do.

There's enough information available in every clinic, every hospital, every doctor's surgery, to tell them. Despite the government's attempts to deny the pandemic, there have been the efforts of the Lovelife campaign, and the TAC's drives to increase awareness. You don't need special access to special information to know that HIV is a deadly virus. You don't need to live in a particular suburb or city to know that you can prevent it by using condoms when you have sex. The information is out there. The country is awash in condoms, leaflets, billboards. Why, then, is the disease still spreading so fast?

We didn't meet anyone on the trip that could answer the question. It was only a couple of days after Nik had left, that I was having lunch in a little cafe in Kalk Bay, overlooking the Indian Ocean. The waitress was a cute twenty-something black girl, with funky dreads and a T-shirt with a photo of Nelson Mandela and the logo from the 46664 concert. Under the logo, in big letters, the T-shirt said: "ASK ME ABOUT HIV/Aids".

I pointed at the T-shirt. "Do a lot of people ask you about that?" I said to her. "About HIV and Aids?" She looked at the T-shirt as though she'd just remembered she was wearing it. "No, I think you're the first, you know."
"Why're you wearing it?"
"I used to work for Lovelife, you know," she said. She had a lovely clear husky voice. "We used to talk to people about Aids."
"And do you know anyone that has it?" I asked.
"Oh, yeah, lots," she said.
"Do they know about the disease? I mean, do they know how it's transmitted, and how to stop it from spreading?"
"Oh, yes, people know all about it. The thing is, their attitudes. Even though they know how you get it, they have this attitude that it can't happen to me. And then, a lot of people that have it, they have this idea that they should spread it."

So is that what it is? A combination of knowing the facts plus not caring? Is that enough to infect hundreds of thousands of people? What I want to know is, who are you? Are you having unprotected sex freely, or is someone forcing you? Are you admitting to yourself what's going on? What are you thinking when you do it? If you're reading this, please write and let me know. Cause I'm finding it very difficult to understand.