In South Africa, a family and a nation finally face AIDS crisis

ALEXANDRA, South Africa — He was never a big kid, but 14-year-old Vuyani Ngxalaba was starting to look frighteningly skinny. He turned up at soccer practice in a cold sweat, with sores across his hollowing cheeks. His family had little to eat, yet he seemed to vomit constantly.

Ingrid Moloi, a charity worker who ran the soccer team, had seen this illness many times. It had raced through the narrow, mazelike streets of Alexandra Township over the past decade like an unseen tornado.

Three years earlier, it had killed Vuyani's mother, leaving him in the care of four older siblings, none of whom had a steady job.

While the spread of HIV slowed worldwide over the past decade — thanks largely to multibillion-dollar anti-AIDS campaigns that taught people safer sex and made antiretroviral drugs widely available — South Africa was a glaring exception.

South Africa's AIDS epidemic got worse. It was driven, many experts say, by a government policy marked by denial and misinformation that still echoes in overcrowded black townships such as Alexandra, outside Johannesburg, where few people openly discuss a disease that's nearly wiped out entire households.

Now, South Africa is trying to turn it around. Doctors, researchers and AIDS activists cheered in September when two officials left their posts: Thabo Mbeki, the president who questioned the science surrounding AIDS and for several years refused to subsidize antiretroviral drugs; and Manto Tshabalala-Msimang, who as Mbeki's health minister argued that a proper diet, including garlic and beetroot, could fight the disease.

Many think the battle can only be won in places such as Alexandra, a sprawling labyrinth of simple homes and cement-box shacks north of Johannesburg. Unemployment is high, schools are poorly equipped, children are initiated into sex at an early age, and few households have been spared from HIV.

When Vuyani's sister Rosinah learned her brother was HIV-positive, she went to Moloi and brought home a pamphlet for Vuyani, who studied it for several days.

"I started to understand," he said. "I felt bad. It made me think a lot. But as time passed I could see what they were talking about. Being sick was not my fault."

Last year he enrolled in a counseling group where he met other teenagers with HIV.

The messages from community groups and teachers are sinking in. Vuyani, now 16, can recite what he needs to do to avoid getting sicker or spreading the virus: "Don't drink alcohol; don't sleep with a girl without a condom; don't smoke."

At an age when some of his friends have begun sharing tales of sexual conquests, Vuyani said he's holding off and trying to focus on improving his grades. His health has steadily improved. Every three months he goes for a free checkup at a nearby clinic, and recently he felt comfortable enough to tell a few friends from the soccer team that he's HIV-positive.

Their response surprised him.

"They don't treat me differently because of it," he said. "Maybe they don't know how serious it is."