KHOPOTSO: Although there is no scientific research to support the claims, there is intriguing anecdotal evidence to warrant formal research into the matter. The claims are varied, with others going to the extreme of even suggesting that some people are deliberately exposing themselves to HIV for the sole purpose of qualifying for a government social grant. But, those with an interest in South Africa’€™s social security system have differing views on the claim. Marlise Richter is a PhD candidate at Wits University’€™s School of Public Health.

MARLISE RICHTER: I think for someone to deliberately or carelessly contract HIV in order to get a grant is quite unlikely. The person’€™s circumstances must be very dire’€¦ HIV is a dreadful disease. I would strongly doubt that there are masses of people trying to infect themselves in order to get R800 a month.

KHOPOTSO: Dimakatso Moutloatse is a Director responsible for disability and old-age grants in the government’€™s Department of Social Development.  

DIMAKATSO MOUTLOATSE: I haven’€™t come across it in a scientific way that can be supported by research. But there are several anecdotes’€¦ The possibility is there. You can never under-estimate a human mind’€™s issues of survival’€¦ People faced with survival issues and the need for food will do anything possible.        

KHOPOTSO: Richter finds it hard to believe that people might risk HIV infection in order to secure a government grant. But, she is interested in so-called ‘€˜perverse incentives’€™ that undermine the recovery of someone with AIDS.

MARLISE RICHTER: The so-called ‘€˜perverse incentives’€™ arise with people with HIV who have been able to qualify for a disability grant, but are now in fear of losing it when they go on to antiretrovirals’€¦ Some of the terrible decisions that people have to make, what we call ‘€˜The Dreadful Dilemma’€™, are people with HIV might have to choose between going on to antiretrovirals and losing their disability grant or keeping their disability grant, not accessing healthcare and, eventually, dying.    

KHOPOTSO: Government does not have a policy on grants for HIV-infected people. But due to the debilitating nature of the virus, people often become too weak to continue working. For this reason, doctors and social workers may recommend that they receive a temporary disability grant while they start taking antiretrovirals until they get better ‘€“ often for a period of six months to a year.                

DIMAKATSO MOUTLOATSE: The temporary disability grant is a big challenge because people get used to receiving it, especially given the weaknesses within the administrative systems of the Department’€¦ People get temporary disability grants, supposedly for a period of six months, maximum 12 months – but the review doesn’€™t take place soon within those six months or within 12 months. By default, they end up receiving disability grants for three, four, five years and then after that lengthy period of a person being used to receiving the grant, the review sets in and the person is found not to qualify for a disability grant, and has to be lapsed. That’€™s where we have the biggest problems.          

KHOPOTSO: Floyd Mogase from Meadowlands, Soweto, lives with HIV. He has difficulty walking as a result of peripheral neuropathy, a side-effect of one of the ARVs he’€™s taking. For 12 months he received a government temporary grant, but it was suddenly discontinued in March. Through an interpreter, he explains how confused he is about the termination of his grant.

FLOYD MOGASE: What he wants to know is that: Why is it that government is recommending that he takes antiretrovirals, (while) at the same time they terminate his access to a disability grant? The antiretrovirals make him eat a lot. He doesn’€™t look like he’€™s eating a lot, but they make him a lot. He’€™s also trying to highlight other responsibilities he’€™s got, (like) paying for his burial society. He’€™s living with his mother, unemployed and he’€™s also got children to look after.

KHOPOTSO: Floyd re-applied for the grant, but was turned down. He’€™s now been sent a letter saying he can appeal the decision. Richter says people like Floyd, will always need some form of support from the government for as long as they are not well enough to fend for themselves. The Department of Social Development is currently investigating the feasibility of a separate grant for people with chronic illnesses. Richter believes that that could be of help to people such as Floyd.

MARLISE RICHTER: A number of people are losing their disability grants and that might impact on their antiretrovirals. I think it also highlights the fact that we need to look at more creative social assistance mechanisms for supporting people’€¦ Issues like the Basic Income Grant, also the proposed Chronic Illness Grant need to be debated much more widely. And there needs to be much more engagement by government on these issues; that we can see how these people can be supported.