Food Insecurity Increases Risk Of HIV Infection

 

Inequalities with respect to gender, socioeconomic status, class, caste, and religion are central to the risks people face. Gender inequity shapes power relations, sexual relations, and access to resources, opportunities, and assets including land. It thus also shapes the relative risks and vulnerabilities that women face. Such socioeconomic vulnerability may lead a woman to exchange sex for food or cash, drastically increasing her risk of becoming infected.

Mobility is another risk factor. Many of the points of intersection between households and services represent conduits for the spread of infection into or out of communities. Migration, an important consequence of unequal socioeconomic development between urban and rural areas, is an important factor in HIV transmission. Consider an agricultural commercialization policy: while any contributions toward reducing poverty and poverty induced migration to find work may reduce exposure to

HIV, additional cash and the stimulus to travel further afield to market produce could result in increased exposure. Hence activities associated with promoting the marketing of agricultural products need to be carefully designed to ensure they play a role in arresting, rather than hastening, the spread of HIV in rural communities.
HIV Infection Impairs Food Security
Many studies in sub-Saharan Africa have shown the vulnerability of subsistence agriculture to the various downstream impacts of HIV. The characteristics of livelihood and farming systems will determine levels and types of vulnerability. Farming systems that exhibit a high degree of seasonality of labor demand, significant specialization by age and sex, high interdependence of labor inputs, increasing returns to scale of labor, and low substitutability of labor for capital tend to be particularly vulnerable. Studies have shown significant and enduring impacts. Labor loss occurs not only as a result of sickness and premature adult death, but also due to reallocation of labor to nurse the ill, and siphoning off of working capital to pay medical bills.

HIV has also profoundly impacted commercial agriculture, and there is increasing evidence of so-called burdenshifting as companies shift the costs being incurred, such as replacement worker costs, paid sick leave, lost wages, and productivity losses, to employees. Agriculture extension is being hit hard too, both in terms of death and sick leave of extension agents, who may be at particular risk due to their mobility, as well as declining time being allocated to extension work by current workers.

As affected households face increased labor shortages, widespread reductions in household incomes and increased cash constraints may also depress labor and nontradable demand in rural communities with high HIV incidence. Reductions in family labor may lead to a shift out of more labor-demanding cash crops. There is some evidence that multiplier effects of this depressed demand could cause reductions in labor demand to the extent that wages also fall, posing serious problems even for poor households not directly affected by HIV and AIDS. For poorer, smallholder households, land and cash may be the primary constraints on rural productivity and livelihoods, not specifically labor. AIDS is likely to progressively decapitalize highly afflicted rural communities, meaning a loss of savings, cattle assets, farming equipment, and other assets.

The impacts of HIV on agriculture and other sources of livelihood are hidden, potentially destructive processes. They are also context-specific, differing by community and by household. The nature and severity of impacts depends on a range of demographic, economic, and sociocultural factors and processes. Impacts may also be revealed in the responses made by people, and these too differ in effectiveness and sustainability. Some may be characterized as ‘coping,’ or demonstrating resilience; others are clearly taken under extreme duress and are not sustainable.
Conclusion
Undernutrition and food insecurity play a pivotal role in the global HIV/AIDS epidemic, affecting both risks of HIV transmission and the subsequent AIDS-related impacts. The response to the HIV/AIDS epidemic thus needs to be comprehensive in focusing on broad-based approaches to prevention, treatment and care, and mitigation, as well as interventions to improve nutritional status and food security globally.

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