AIDS and the Ecology of Poverty

Abstract

This book examines the HIV/AIDS epidemic in the social and economic context of poverty and economic crisis in developing and transition countries. It challenges the assumption — implicit in AIDS policy — that differences in sexual behavior are adequate to explain differences in HIV prevalence between populations. Using an epidemiological approach, the book shows how people who are malnourished, burdened with parasites and infectious diseases, and who lack access to medical care are more vulnerable to all diseases. It explains the specific mechanisms by which undernutrition, micronutrient deficiency, malaria, soil-transmitted helminths, schistosomiasis, and other parasitic illnesses increase the risk of HIV transmission and epidemic spread of HIV/AIDS in poor populations. A theme throughout the book is that the sexual transmission of HIV diverts attention from the social and economic context of profound poverty. The distraction of sex is compounded by Western stereotypes of African sexuality, perpetuated through reliance on anecdotal evidence and the construction of a notion of fundamental dissimilarity among peoples of different world regions. The book evaluates current methods in epidemiology and health economics, which do not take account of the interactions among diseases that increase risk of transmission of HIV in poor populations. It criticizes HIV-prevention policies as narrow, shortsighted, and dead-end because they fail to address the economic and social context in which risky behaviors occur. Finally, the book offers pragmatic solutions to social, economic, and biological factors that promote disease transmission, including the spread of HIV.

Infections and inequalities: anemia in AIDS, the disadvantages of poverty

“…drug abuse, they might have concluded that the infection is neither a priority nor a threat to public health [9] . Political leaders, authorities, economists, members of the society and HIV affected people must join efforts to face AIDS epidemic [10] .…”

“…Therefore, authorities will generally reach their aims in matters of fairness more effectively if when focusing their help they take not only poverty indicators into account but also the presence of AIDS in the homes [10] . It is essential that available resources reach the homes of the neediest people through the combination of poverty reduction programs and measures mitigating the impact of HIV/AIDS epidemic.…”

“…Only in South Africa, there are about 5.7 million people living with HIV/AIDS. About 90% of new infections occur in developing countries, where in some cases the disease has already reduced life expectancy by over 10 years. HIV has become generalized in many nations, and in other poor regions in the world, the disease could be about to spread without control [2] .…”

Mono-Causal and Multi-Causal Theories of Disease: How to Think Virally and Socially about the Aetiology of AIDS

“…4 Third, that it is the practice of concurrent sexual partnerships, which is claimed to be more common in southern Africa than in other parts of the world, that explains the difference. The scientific evidence has resolutely rejected the first two of these possible explanations (UNAIDS 1999;Gray et al 2001;Stillwaggon 2006). However, the third, the 'concurrency theory' has gained widespread acceptance and requires closer attention.…”

“…Individuals who already have diminished immune function-due to malnutrition, concurrent exposure to other infections, etc. -spend more time at higher viral loads, thus making them more infectious for more of the time (Stillwaggon 2006).…”