HIV/AIDS is an outcome of poverty

In Sub-Saharan Africa, 14 000 people are being infected with HIV daily and 11 000 are dying every day due to HIV/AIDS-related illnesses, according to statistics. In this region, more than 60 percent of the people live below the UN poverty line of US$1 per day.

A long-held belief in the field of HIV infection prevention is that poverty drives the HIV/AIDS pandemic. The World Bank’s 2008 report titled ‘Confronting AIDS’ explained that “widespread poverty and unequal distribution of income that typify underdevelopment appear to stimulate the spread of HIV”.
Similarly, the Joint United Nations Programme on HIV/AIDS (UNAIDS) stated in 2001 that “poverty, underdevelopment, the lack of choices and the inability to determine one’s own destiny fuel the HIV epidemic”.
Poverty includes deprivation, constrained choices, and unfulfilled capabilities, and refers to interrelated features of well-being that impact upon the standard of living and the quality of life.
Many people in Sub-Saharan Africa are in such poverty. They lack not only money, but also assets and skills. Therefore, people strive to get basic needs and mostly indulge in risky behaviours.
In Sub-Saharan Africa, sexual trade is rampant, with extreme poverty compelling most young women to indulge in risky behaviour that can easily bring in money and resources for survival.
Moreover, poverty-driven sex work or sexual transactions carry the risk of unprotected sex. These young women do not bother to use condoms, as in most cases the man is responsible for that since he is the one who pays. Worse still, men are willing to pay exorbitant prices for sex without a condom, which puts women in even greater temptation.
The migration of people in the region also exacerbates the prevalence of HIV/AIDS. Migration is often seen simply as a “flight from poverty”; when there are no opportunities available locally, so people migrate in order to survive in another region or country. People have also run away from civil wars in Sudan and Congo. When these people are displaced, they have no shelter, food or clothes, resulting in most of them indulging in commercial sex work to survive. Others marry local people to secure citizenship in fear of deportation. However, in some cases, migration occurs not because of civil war but because of poverty in their indigenous societies.
Cultural practices like polygamy catalyse the HIV/AIDS pandemic. Moreover, poverty forces most young girls into early marriage that further puts them at risk.
Girls who marry young in Africa are mostly from poor families and have low levels of education. Traditionally, if they marry men outside their village, they must move away, which may cause loneliness and isolation. As these girls assume their new roles as wives and mothers, they also inherit the primary job of a domestic worker. Because the husband has paid a hefty bride price, the girl is also under immediate pressure to prove her fertility.
Girls often embrace their fate and bear children quickly to secure their identity, status and respect as adults. As a result, though these young girls have high total fertility rates they miss the opportunity to be children – to play, develop friendships, bond, become educated, and build social skills. This vicious cycle of poverty is compounded by the HIV/AIDS pandemic that in many cases is an outcome of forced teenage marriages.
Despite limited data obtained so far, an epidemiologist gives a possibility to conclude that, indeed, HIV/AIDS is an outcome of poverty.
“Personally, I believe that unless and until poverty is reduced or alleviated, there will be little progress either with reducing transmission of the virus or an enhanced capacity to cope with its socio-economic consequences. There is a need to take a multi-sectoral approach with a number of capacity-building programmes to combat the scourge.”
Simple answers to the poverty problem do not exist, but at least recognition of the association of poverty and HIV/AIDS existence is a step towards its solution. There is a need for the development of policies and programmes that address the inter-relationships between poverty and the indicators addressed above.
Such activities can make a difference for development outcomes. Programmes that address poverty today will facilitate socio-economic development tomorrow and, as a result, people will not have to indulge in immoral behaviour for survival. If the predictors of poverty are addressed now, then we can assume that Africa will become a pole of development in following decades.
The HIV/AIDS scourge requires our maximum attention if innocent lives are to be spared. The global physical and economical actions are needed to reverse the pandemic. If we do not urgently deal with the predictors of HIV/AIDS in this region, neither the health vision targets nor the Millennium Development Goals (MDG) will be achievable.

 

June 2013
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