1. IMPACTS OF HIV/AIDS
The impacts of HIV/AIDS on poor rural populations are many and intertwined. The impacts can be felt most dramatically in entrenched poverty, food insecurity and malnutrition, in the reduction of the labour force, and in the loss of essential knowledge that is transmitted from generation to generation. And the impacts are felt disproportionately among women.
What's more, these same consequences of HIV/AIDS - poverty, food insecurity, malnutrition, reduced labour force and loss of knowledge - contribute to making the rural poor more vulnerable to HIV/AIDS infection. This devastating cycle must be broken, and the agricultural sector has a critical role to play.
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Research in Tanzania showed that per capita food consumption in the poorest households decreased by 15 percent when an adult died. A study carried out in Uganda showed that food insecurity and malnutrition were foremost among the immediate problems faced by female-headed, AIDS-affected households.
In addition to household food security, national food production is also affected by the loss of agricultural workers, especially in countries where agriculture forms a large part of the gross domestic product.
HIV/AIDS has direct impacts on nutrition, particularly for people living with HIV/AIDS and for nutritionally vulnerable members in HIV/AIDS-affected households.
People living with HIV face a vicious cycle in which repeated episodes of illness caused by HIV lead to malnutrition, and malnutrition in turn further accelerates the onset of AIDS. HIV damages a person's immune system, and the repeated illness that ensues reduces appetite; moreover, nutrients are lost from vomiting and diarrhoea, and the use of certain medications. Infections also interfere with the body's ability to absorb and use nutrients, which are needed to fight off HIV. This has serious consequences for the poor, who are more likely to be malnourished even before they become infected.
Malnutrition in itself also leads to the suppression of the immune system, giving rise to more frequent illnesses and accelerating the development of AIDS. It may also be associated with increased risk of HIV transmission from mother to child.
The recurring bouts of sickness of those living with HIV places an enormous workload on those who care for them and those who foster orphans. Female-headed and orphan-headed households are most at risk. Moreover, the costs of health care and the labour constraints gradually drain the household of its means to make a living. This further exacerbates poverty, food insecurity, malnutrition and disease. Food-insecure households are more likely to turn to livelihoods that put them at greater risk of infection, such as migration and prostitution.
As HIV is predominantly a sexually transmitted disease, the largest number of people infected are those of reproductive age. Thus, the HIV epidemic not only reduces the total number of people, but the age and sex composition changes, with a population dominated by the elderly and the youth.
The reproductive age group is also the most productive. When a person is sick, the household not only has to manage without his or her labour contribution, but also with the loss of labour from those who have to care for the sick family member.
AIDS is characterized by recurrent periods of sickness, and consequently a recurrent loss of labour. This eventually erodes agricultural production and food security. Much of rural agricultural production is highly labour-dependent. In some agro-ecological zones, labour demands are concentrated in specific and critical periods of the year. In those areas...