Poverty, Food Insecurity, HIV Vulnerability, and the Impacts of AIDS in Sub- Saharan Africa

Throughout this decade, the prevailing narrative on the links between socioeconomic status and HIV portrays poor individuals and households as being more vulnerable to HIV infection, and least able to cope with the ensuing impacts of AIDS-related disease and death. While early stages of the epidemic in the 1980s and early 1990s were driven by “mobile men with money”, AIDS is now conventionally perceived as a disease of poverty. But is this too simplistic? This brief overview aims to review the current evidence on the upstream and downstream links between poverty, food insecurity, HIV vulnerability, and the impacts of AIDS. The first section focuses on the upstream – that is, whether, and through what pathways, poverty puts people at greater risk of being exposed to the virus. This is followed by an examination of what is known about the downstream (or post-infection) side – how AIDS-related disease, and premature mortality exacerbate or precipitate poverty. While it is hard to decide where to draw the line when discussing vulnerability and impacts – given the interconnectedness of resources, livelihood strategies and the multidimensional responses to shocks and stresses – the focus is very much on poverty, inequality, and food insecurity. Geographically, the predominant concern is with eastern and southern Africa, where the coexistence of (and the interactions between) poverty, food insecurity, HIV, and AIDS are more widespread and more severe than anywhere else.