Social Problems Chupical Shollah Manuel

HIV is a long term social problem in most underdeveloped countries. This takes us directly beyond the epidemiological aspects of the disease to the social and economic dimensions. Many social studies have revealed that HIV and AIDS is fast becoming a social cancer and it can be understood if one was to assess the social structure and the availability of resources in the society. The most affected persons are those who live in the lower strata of the social stratification due to inequalities that comes with social structure. This paper serves to explain that HIV and AIDS is a social problem of poverty and it also looks at other factors such as religion, promiscuity and child rights which also result in the spread of the disease. It is undisputed to say that poverty is implicated in the prevalence in most developing world. Because these countries are generally poor people are normally forced to engage in activities that end up putting them at the risk of HIV. United Nations (2004) revealed that in South Africa more than 6 million people where living with HIV. The paper also revealed that the majority number who were affected were blacks who are generally poor who have no proper housing facilities, mal-nutritional, lack of safe water. Further research has suggested that Botswana and Zimbabwe have high prevalence of the disease due to the poor conditions which prevails in these countries. In Zimbabwe around 2 million people are said to be contracting the disease and an assessment shows that those who are infected are mainly the poor people as compared with those who stay in low density suburbs. The general consensus is that poor people are pushed into risk behavior such as prostitution where they tend to sell their bodies for money so that they can earn a decent living. Part of the complexity of dealing with the relationship between HIV/AIDS and socioeconomic variables is that the latter can be both determinants and consequences of the epidemic. This dual relationship gives rise to complex causal patterns and feedback loops, which make single causeeffect relationships more difficult to isolate (SSRC, 2004). For example, increased poverty and income inequality fuel the spread of the epidemic. The epidemic, in turn, worsens the economic situation of the household, often leading to increased poverty and inequality. A similar relationship exists between HIV/AIDS and economic growth. At a macroeconomic level, while

HIV/AIDS is believed to slow economic growth, growth is closely related to poverty and availability of resources, variables that, in turn, contribute to shaping the epidemic and determining a country’s ability to respond to it.

In understanding that HIV and AIDS is a social problem of poverty, the dominant issue must be unequivocally the context of widespread extreme poverty. HIV/AIDS then exacerbates the poverty situations of affected families in a downward spiral. Family members of persons with AIDS, older women in particular, will sell off their assets and belongings and expend all of what little money they have in desperate but futile efforts to find a cure for their dying child or children. Young adults with AIDS are unable to earn income and become dependent on their elderly parents and what meager income they have to support them and their offspring. Investigations in Southern Africa have shown that food deprivation is a major issue for affected families, as are expressed material and financial needs for clothes and bedding, schooling expenses for grandchildren and funeral expenses. A major problem is the education of vulnerable children: either through a lack of money to pay for schooling, or because children fall out of the education system because of a lack of money, and end up ill equipped to earn a living one day.

Poverty increases susceptibility to contracting HIV/AIDS through several channels including increased migration to urban areas; limited access to health care, nutrition and other basic services; limited access to education and information, sexual exploitation and gender inequality. Little recent research explores the influence of socio-economic variables on the risk of contracting HIV. Bloom’s (2002) analysis of Cambodian and Vietnamese households is an exception. This study suggests that there are strong correlations between wealth and education on the one hand, and reduced risk for HIV on the other. Wealth and education both appear positively correlated with increased knowledge and behavior.

Because most African countries are experiencing massive boost in urbanization this trend has certainly resulted in increased HIV infections over the years. Research by Bloom (2002) suggested that African countries are largely rural and impoverished which was further worsened by globalization and the desire to find better living standards in urban areas. As a result there is increase rural urban migration since governments are not capable to adequately provide jobs to

the young rural population, which tend to move to urban areas after completing school. This generation of the population has been hard hit by the pandemic due to lack of jobs in urban areas so they end up engaging into sex for their survival. Furthermore, international migration has also increased the prevalence of HIV with people going out of their countries looking for greener pastures. For instance in South Africa mostly economic refugees from Zimbabwe and Mozambique are vulnerable to infection due to their desperate situations which put them into sexual behaviors for a living. Similar dynamics are described in Bachmann and Booysen’s (2002/2004) 18-month longitudinal study of rural and urban households in South Africa’s Free State Province. The baseline study (2001-2002) finds that affected households are poorer than non-affected households, regardless of the poverty measure used. Compared to unaffected households, affected households had lower monthly incomes (mean $130 vs $215) and expenditures ($90 vs $119) and lower proportions of members in employment (11% vs 20%). The incidence, depth and severity of poverty were worse among affected households, particularly among those who experienced illness or death. Some new findings of the follow up studies are the insignificant differences in the impact on rural and urban households (even though the income and expenditure levels of rural households are lower) and the decline in income of unaffected households. The latter phenomenon suggests that the effects of the epidemic are not limited to “infected” households, but are giving rise to deepening poverty in the wider community.

Several International Food Policy Research Institute (IFPRI) publications investigate the causal relationship between good nutrition and HIV prevalence. For example, Gillespie and Kadiyala (2005) affirm that food insecurity and malnutrition may accelerate the spread of HIV, both by increasing people’s exposure to the virus and by increasing the risk of infection following exposure. They draw on a number of previous studies to support this theory, including work carried out by Stillwaggon (2002), which finds falling calorie and protein consumption and increasing inequality to be strongly correlated with HIV prevalence in 44 Sub-Saharan African countries.

Significant research has concentrated on the role of socio-economic variables as consequences. The epidemic’s influence on household living conditions derives in great part from the virus’s specific demographic effects. HIV/AIDS changes the structure of the population; it is distinct from other diseases because it strikes prime-aged adults, the most productive segment of the economy (Barnett and Whiteside, 2002). Thus the breadwinners are falling ill and dying, destroying much-needed skills and depriving children of their parents. Barnett and Clement (2005) point out that the key to the social and economic impact of HIV/AIDS is that it is a slow moving virus: as a result it can affect three human generations. Barnett and Whiteside (2002) further argued that the greatest impact of the epidemic is felt at a household level, where socioeconomic factors combine with socio-cultural and epidemiological variables to influence prevalence (SSRC, 2004). It is the household unit that carries the greatest burden. Since socioeconomic indicators, such as poverty and inequality, are both consequences and

determinants of HIV/AIDS, they can interact with the epidemic at a household level to perpetuate a vicious downward cycle towards greater indigence. Mtika’s (2003) study touches the issue of dependency. In the developed world people generally are able to save and social welfare and public assistance programmes support the needy (children, poor and the elderly). This is not the case in subsistence economies of the developing world, where children and the elderly are heavily dependent on the ‘productive middle generation’ and their transfers (Mtika, 2003; Barnett and Clement, 2005). By striking the middle generation, the HIV/AIDS epidemic is disrupting and eroding intergenerational dependency structures. Once again the poor are disproportionately affected, in that they are less likely to have alternative sources of income, accumulated wealth (assets to sell) and access to health and other welfare services (e.g. pension funds). When young adults fall ill and die, the children and the elderly – who are the most vulnerable household members have no choice but to find ways of taking care of themselves.

Although poverty is the main determinant of HIV and AIDS, there are also other factors that influence the pandemic such as religion, forced sexual contact and sharing of needles by drug addicts. Research has shown that although some countries are impoverished the rate of HIV infection is kept low by their religion practices. For instance, in the Islamic world because of the

sharia law there are very few incidences of commercial sex workers and prostitutes. In countries like Egypt and Algeria women are stoned to death if caught cheating, so these traditional laws and Islamic played a key role in alleviating the spread of HIV. A comparison with Christian countries one would conclude that Christian countries a more liberal hence the high infection rates involved.

To conclude poverty and HIV/AIDS are vast problems in Africa and are linked in a vicious circle. The epidemics and their effects cannot be adequately addressed without reducing poverty. To achieve international development targets, both poverty and the epidemics must be addressed simultaneously. HIV/AIDS cannot be separated from other issues in the developing world, but must be tackled in the context of the multiplicity of societal problems faced by poor communities and families.

REFERENCES

Donahue, J. & Williamson, J. 1999. Community mobilization to mitigate the impact of HIV/AIDS. Displaced Children and Orphans Fund.

Du Guerny, J. 2002. The elderly, HIV/AIDS and sustainable rural development. Food and Agriculture Organization, Sustainable Development Programme. Fylkesnes, K., Brunborg, H. & Msiska, R. 1995. Zambia update: the HIV/AIDS situation – and future demographic impact. Lusaka: Epidemiology and Research Unit, Zambia National

AIDS/STD/TB and Leprosy Programme.

Glynn, J. R., Warndorff, D. K., Fine, P. E. M., Msiska, G. K. & Pönninghaus, J. M. 1997. Interactions between HIV and tuberculosis in a rural area of Malawi. The Socio-Demographic Impact of AIDS in Africa Conference, Durban, February 3-6.

May, J. 2003. Chronic poverty and older people in South Africa. University of Manchester and HelpAge International.