Wednesday, 13 August 2008

HIV & AIDS and Poverty and Inequality

HIV: Human Immunodeficiency Virus

AIDS: Acquired Immune Deficiency Syndrome

In the UK, and the rest of the developed world, the prognosis for an HIV positive person is quite good. With the advent of effective Anti Retro Virals (ARVs), someone being diagnosed as being HIV positive now has a good chance of having a normal life span and leading a normal life, side effects from the ARVs and stigma aside and dying with HIV rather than of an AIDS related illness.

This is not the case in the developing world. There, an HIV positive has a greatly reduced life expectancy as they are likely to develop AIDS (where the T-cell level reaches below 200 or a person develops an AIDS related illness) quickly.

The difference isn't only in how individuals suffer from the virus/syndrome, but how many people are infected. Take a look at this top 10 of HIV prevalence:

RankingCountryPrevalence rate (in 15-49 year olds) %
4South Africa18.1

As you can see, all of the top 10 are countries in Sub Saharan Africa (SSA), and for the next part of this topic, I shall attempt to ascertain why this is and what the impact of this is.
As Sub Saharan Africa also contains most of the poorest countries in the world, I was tempted to assume that there was a direct link between these two facts. There are also quite logical reasons as to why this would be the case, as poor people are less likely to be able to afford contraception, less likely to be able afford to go to school to be educated about HIV prevention, and less likely to be healthy enough to not contract the virus when they come into contact with it. However, after some research, I found that this apparently isn't the case. Although when poor people living in SSA come into contact with HIV they are more likely to be susceptible to it, they are also less likely to come into contact with. This is because wealthier people are more likely to move around more and have multiple sex partners. There is apparently evidence to suggest that there is a link between high economic inequality and HIV prevalence (perhaps caused by rich men paying poor women to sleep with them).
Where poverty has the most impact is in the survival rate and provision of care of those with HIV. Poor people in SSA aren't provided for by the state. They can't afford to eat healthily and more often than not the water they have access to is dirty and is likely to make them ill. This means that once a poor person becomes infected with HIV, their immune system is not able to fight the virus and they get sick really quickly. ARVs don't come cheap and there are not many doctors available in most SSA countries, so there is also little care for those with HIV.
Having HIV is likely to impact people's ability to work. There are two reasons for this. Firstly, if they develop full blown AIDS, they are unlikely to be well enough to work. Secondly, if an employer finds out that they are HIV positive they are not likely to employ them, and there are no laws preventing discrimination in the work place to help them.
Most of the people who die of AIDS in SSA are of a productive working age. This is catastrophic for SSA's development. This leaves dependents, both orphans and elderly people behind to fend for themselves. For orphans this means that they are unlikely to be able to go to school because they have to go out to work. This makes it likely that they to will not get the education they need in HIV prevention.

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