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S. Africans Shun a Remedy for AIDS

Mbeki has said little about AIDS over the past year but previously prompted international rebuke by suggesting that factors other than HIV caused the disease. Conflicting messages on AIDS remain stubbornly common in Africa, even among the most educated. Wangari Maathai, the Kenyan environmentalist who won the Nobel Peace Prize this month, suggested in recent interviews that HIV was crafted by Western scientists as a biological weapon.

Such ideas are dissuading many profoundly sick people from seeking powerful remedies only now becoming available on a wide scale.

Senzeni Tshabalala, 26, chooses to drink a clear potion made of a boiled grain and roots instead of taking AIDS drugs. "I don't believe in anti-retrovirals," she says. (Craig Timberg)

"Mbeki scared a lot of patients," said Francois Venter, a physician who treats people with AIDS with free anti-retrovirals at Johannesburg General Hospital. He estimated that one out of three patients who need the medicine refuse it. "They are just terrified of the side effects."

A program begun nearly two years ago by mining conglomerate Anglo American suggests the extent of the problem.

All 140,000 of the company's employees are eligible for free, easily accessible anti-retroviral treatment. Brian A. Brink, a physician who oversees the program, said 34,000 of those employees are infected with HIV and at least 8,500 have reached the point in their illness that they should be taking anti-retrovirals.

But only about 2,050 have so far taken advantage of the drugs. That means 75 percent of those in need of anti-retrovirals have not sought them. Brink attributes the gap to a combination of the stigma of AIDS, uncertainty about the effectiveness of anti-retrovirals and fear of their side effects.

"There's a lot of denial out there," he said. "I think there's a lot of ignorance."

Tshabalala, however, knows what anti-retrovirals can do. Her estranged husband started taking them in August, and already he has regained nearly all of the weight he had lost. He also has returned to his job as a taxi driver after not working for two years.

Tshabalala has also closely watched the side effects he has displayed. He grew frighteningly crazed and manic the first night after he began taking the medicine, she said, but he returned to normal the next day.

Yet something deeper is driving Tshabalala's reluctance to take anti-retrovirals, something that she struggled to explain.

Just seven months ago, she was a whirl of energy. But now a fatalism has settled over her. She finds herself suddenly and unexpectedly angry at her estranged husband and angrier still at one of his former girlfriends, now dead, who Tshabalala blames for introducing the virus into their family.

Tshabalala has come to regard AIDS, on some level, as the price of living in a world of sin.

"It's all about God," Tshabalala said as she stood outside the home of Radebe, the healer. "It's a punishment."

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