AIDS and rural
• Access to information
and health services is poorer in rural areas than in cities. Rural people
are less likely to know how to protect themselves against HIV. If they
fall ill, they are also less likely to receive adequate care.
• Rural communities
bear especially heavy burdens, as many HIV-infected urban dwellers tend
to return to their rural communities when they fall ill.
• Studies have
shown that HIV prevalence rates can be unusually high among mobile populations.
HIV/AIDS therefore disproportionately affects the agriculture, transportation
and mining sectors, which rely on large numbers of migrant workers.
• By striking
people in the prime of their working and parenting lives, AIDS hinders
knowledge and expertise from being passed on to subsequent generations.
The effects are particularly harsh in sub-Saharan Africa. A study in
Kenya has shown that only 7% of farming households headed by orphans
have adequate knowledge of agricultural production.
• In Kenya’s
Ministry of Agriculture, an estimated 58% of all staff deaths are caused
by AIDS, while some 16% of staff in Malawi’s Ministry of Agriculture
and Irrigation are living with the disease. Researchers have calculated
that HIV/AIDS is causing the loss of up to 50% of agricultural extension
staff time in sub-Saharan Africa.
• In badly affected
parts of Thailand, one-third of rural families affected by AIDS experienced
a halving of their agriculture output, threatening their food security.
Around 15% had to take their children out of school, and over half the
elderly were left to fend for themselves.
• Rural families
and households hit by the epidemic often are forced to sell productive
assets in order to pay for health care and funerals. Replacing those
assets is very difficult. The price paid can be the long-term development
of rural enterprises and communities.
• More than one-third
of the gross national product of the worst affected African countries
comes from agriculture. Labour-intensive farming systems with a low
level of mechanization and agricultural input are particularly vulnerable
to the epidemic.
• AIDS has killed
around 7 million agricultural workers since 1985 in the 25 worst hit
African countries. It is estimated that the epidemic could claim as
much as 25% of the agricultural labour force in badly affected countries
• In contrast
to other diseases, AIDS kills mostly members of the productive age group—people
aged 15-49 years. AIDS cuts productivity as more people become ill and
as more time has to be devoted to caring for the sick and for funeral
Food security under
• The loss of
assets and productive workers severely affects household capacities
to produce and purchase food. Evidence from Namibia shows widespread
sale and slaughter of livestock to support the sick and provide food
for mourners at funerals. This jeopardizes the livestock industry, as
well as communities’ long-term food security and survival options.
• In badly affected
areas, many households take in sick relatives and foster orphans, which
reduces the amount of food available for each household member. As a
result, nutrition levels tend to drop and people’s health is compromised
Women on the frontline
• Women whose
husbands are migrant workers are especially vulnerable to HIV/AIDS,
as their spouses may have other sexual partners. Similarly, some women
may engage in transactional sex to earn money or other commodities in
times of economic insecurity.
• In rural areas,
as in cities, the epidemic further adds to the already formidable burdens
women bear—as workers, caregivers, educators and mothers. At the same
time, in some countries, their legal, social and political status make
them more vulnerable to HIV/AIDS.
• In some cases,
traditions meant to ensure widows’ access to land might contribute to
the spread of HIV. An example is the custom that obliges a man to marry
his brother’s widow. Unfortunately, initiatives to stop these practices,
while effective in slowing the transmission of HIV, may also leave widows
without access to land and food.
• Studies in
several countries have found that some rural women whose husbands have
died of AIDS have resorted to commercial sex as a means of survival,
because they had no legal rights of inheritance to their husbands’ property.
Meeting the challenges
• Effective prevention,
care and support programmes demand greater insight into the dynamics
of the epidemic in rural areas. Although these are complex issues, a
growing understanding is evolving of better ways to tackle the problems
of AIDS that are specific to rural areas.
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