Health workers in Hoedspruit, South Africa, are expressing concerns about the increasing number of young seasonal workers testing positive for HIV. The trend is particularly noticeable during the agricultural recruitment season, which typically begins in October. According to Antoinette Ngwenya, operations manager at Hlokomela Clinic, many of the young people testing positive are from Mpumalanga, a province with one of the highest HIV prevalence rates in the country.
South Africa continues to carry the world's largest HIV burden, with approximately 7.8 million people living with HIV in 2024. Despite significant progress in reducing the epidemic, the country still faces challenges in preventing new infections. The Human Sciences Research Council's latest national household HIV survey found that HIV prevalence across all ages declined from 14% in 2017 to 12.7% in 2022. However, the survey estimated that around 232,400 people acquired HIV in 2022.
Hlokomela Clinic, which serves farm workers, seasonal laborers, and surrounding communities in Hoedspruit, has seen a notable increase in new HIV diagnoses among young people aged between 20 and 35. Ngwenya stated that during the farming season, pre-employment screenings of 200 or 300 people often reveal 15 HIV-positive cases. This trend is concerning, as it feels like a return to the high HIV prevalence rates of 20 years ago.
Unemployment, alcohol, and substance abuse are believed to contribute to the increased vulnerability among young people. Ngwenya emphasized that many young people testing positive come from Mpumalanga, a province with an HIV prevalence of 17.4% in 2022. The province has made progress in treatment, with antiretroviral therapy coverage increasing from 65.4% in 2017 to 81.8% in 2022.
Hlokomela Clinic was established in 2005 in response to research highlighting the critical need for healthcare among farm workers and other vulnerable communities in Hoedspruit. The clinic has made significant progress in reducing the burden of HIV among farm workers, with prevalence declining from 29% in 2008 to 6.3% in 2018. Today, the clinic conducts around 1,700 HIV tests per month and provides treatment to approximately 2,000 people living with HIV.
Kgopotso Manamela, a manager at Hlokomela, highlighted another challenge: getting migrant workers diagnosed with HIV to start or remain on treatment. Some migrant workers, particularly those from neighboring countries like Zimbabwe and Zambia, may resist treatment due to cultural or religious beliefs. Manamela also noted that some people may hide behind their religion or beliefs to avoid taking HIV medication.
The concerns about young workers arriving from Mpumalanga are significant, given the province's high HIV burden. The Human Sciences Research Council's survey found that among young people aged 15 to 24 in Mpumalanga, HIV prevalence was 7.8%. The survey also revealed that prevalence among young men in this age group was 9.8%, compared with 6.3% among young women.
Key points
- Young seasonal workers in Hoedspruit are testing positive for HIV, raising concerns among health workers.
- Mpumalanga has one of the highest HIV prevalence rates in South Africa, with 17.4% of people living with HIV in 2022.
- Hlokomela Clinic has made significant progress in reducing HIV prevalence among farm workers, but faces challenges in treating migrant workers.
