Military makes headway against HIV/AIDS

Members of the South African military have to undergo mandatory HIV-testing to qualify for deployment on international peace missions, and if found to be infected with the HI virus are denied deployment. HIV-tests are part of the military's routine predeployment health assessments, during which soldiers are tested for a number of chronic diseases. Initially the government decided to exclude HIV-positive soldiers from international deployment, based on the assumption that the disease would develop more quickly in stressful working environments, such as military missions. However, after complaints were made, the government has been requested to revisit the policy. "It is our goal to have HIV-positive soldiers make their own decision if they want to be deployed or not," Brigadier-General Pieter Oelofse of the South African Military Health Service told PlusNews. He commented that in some cases an HIV-infected soldier might be healthier than his HIV-negative colleague, depending on the progression of the disease, and added "This issue a moral challenge for us." According to the South African National Defence Force (SANDF), around 23 percent of its personnel are HIV-positive. The SANDF implemented an AIDS mitigation programme in 2004, with financial support from the US President's Emergency Plan for AIDS Relief (PEPFAR). The intervention provides a range of services to soldiers and their families, including voluntary counselling and testing (VCT), palliative care, and other support services. SANDF noted that 76 percent of soldiers were aware of the AIDS programme, and almost half its employees had received HIV/AIDS education and training; more than 80 percent of soldiers had tested for HIV on either a voluntary or mandatory basis. As a result, Oelofse claimed, members of the military had shown a "significant decrease of overall risk behaviour". Last year the SANDF launched a clinical research initiative, Project Phidisa, which provides antiretroviral treatment (ARV) to HIV-positive soldiers and their dependants at six hospitals, which include both military and public institutions. The three urban research sites are located in Pretoria, Cape Town and Bloemfontein, while the rural sites are situated in Phalaborwa in Limpopo province, Mtubatuba in KwaZulu-Natal province and Umtata in the Eastern Cape province. So far, more than 2,700 SANDF members and their families have undergone CD4-count tests to establish their eligibility for ARVs, and 771 soldiers and their dependants are receiving treatment. "We had members [of the military] with no hope, but through ARVs they have their lives back," Colonel Xolani Currie told IRIN. He added that attitudes to HIV-positive people were changing in the SANDF, as "people begin to see that HIV/AIDS can be treated like any other chronic disease". However, there were concerns over low disclosure rates, drug adherence and data accuracy. "We are still sailing a rough sea," he acknowledged. Eventually the SANDF expects to provide ARV treatment at all of its 65 clinics across the country, and in the near future also plans to establish a laboratory repository and molecular laboratory at one of its military hospitals.