• HIV infection results in the progressive weakening of the immune system, which makes a person susceptible to a wide variety of infections.
• The virus itself can also lead to various nervous system complications, fever and weight loss.
• Secondary infections due to the lower immunity occur before the development of AIDS itself.
• Secondary infections, termed "AIDS defining conditions" only occur at the end stage of the natural history.
• Diseases associated with HIV infection occur with different frequency in different population groups, and include:
  - Tuberculosis
  - Diarrhoeal diseases
  - Herpes virus infections and
  - Bacterial pneumonia (Steinberg et.al., 1999).

TEENAGERS, YOUNG ADULTS AND STREET CHILDREN

Street children and youth are regarded as being at increased risk for HIV-infection, as they become sexually active at younger ages than adolescents generally, they have more sexual partners, they are more vulnerable to rape, they use condoms more inconsistently than other youth, and drug and alcohol abuse on streets exacerbate HIV-infection risks (Athley, 1991, in Richter & Swart-Kruger, 1995).

Due to the fact that most infections occur among young adults and teenagers and the lag time between infection and AIDS, most deaths occur in the age group 25-49 years, affecting individuals that are in the prime of their lives, breadwinners, parents of dependent children: the mainstay of society. Many affected households will sink into poverty and the burden of the young and aged dependents on the remaining income-earners will increase sharply, as the income per head plummets. By 2013 Gauteng will have half a million children aged 14 or younger, who have lost their mothers to AIDS. The Gauteng economy will feel the impact, although not immediately. About 10-15% of employees are already infected and will be lost in years to come. Most will continue to work, but productivity will be hit by extraordinary absenteeism. Lastly services at hospitals will be challenged, while alternative treatment networks, as well as treatment at schools will have to be developed (Gauteng Provincial Government, 1998).

OCCUPATIONAL EXPOSURE

Injuries with syringe and drip needles are the most common cause of accidental HIV infection to health care workers.

IMPACT ON THE BUILDING INDUSTRY

The effect of AIDS on the building industry could be devastating, due to the large amount of semi-and unskilled workers in this sector. These people seem to be in denial as to the dangers of HIV/AIDS. It is estimated that close to 18% of the country’s workforce will be infected by 2005 (Saturday Star, 2000). If these workers are absent from work, due to HIV/AIDS related illnesses, additional labour would have to be employed. This means higher training costs, medical aids and sick leave. Given that an estimated 220 000 people are currently employed in the building sector, it is possible that 40 000 additional people would have to be required for the same output.

HOUSEHOLD AND COMMUNITY LEVEL IMPACTS

In addition to health care, households will experience psychological trauma and economic impacts through reduced earnings and HIV-related expenses (Steinberg et.al., 1999). Family functions will be disrupted due to the needs of ill members, or the disablement of a key adult. Poor households will often be most vulnerable to HIV/AIDS impacts, plunging them further into poverty. Large numbers of children will become orphans and also suffer psychological trauma. HIV has a higher impact on households than most diseases, because it is a terminal disease, is stigmatised, affects people in their most productive years and often affects more than one household or family member.

ECONOMIC IMPACTS

Firms will face threats to productivity due to absenteeism, higher recruitment, training, employee benefit costs and loss of skills in the workforce. The vulnerability of a business will be determined by the employment of workers at high risk of infection (eg migrants), labour intensity, high levels of employee benefits, dependence on skilled workers who are hard to replace, and dependence on markets and production processes which are affected by HIV and absenteeism (Steinberg et.al., 1999).

IMPACTS ON THE HEALTH SYSTEM

Projections have indicated that AIDS could consume 35-84% of public sector health expenditure in South Africa by 2005. In Gauteng the number of people needing health care will be 92 000-115 000 by 2005 and 174 000-186 000 by 2013 (Steinberg et.al., 1999). The care needs of the individuals also change during the progression of the illness.

Gauteng Provincial Government 1998: AIDS Strategy. AIDS Unit: Marshalltown.

Richter, L.M. & J. Swart-Kruger 1995: AIDS-risk among street children and youth: implications for intervention. South African Journal of Psychology, 25:1, 31-5.

Saturday Star 12/02/2000: Building Industry hit by AIDS.