HIVAIDS The Social Economic Impact Interact Worldwide believes

HIV/AIDS The Social & Economic Impact

Interact Worldwide believes in the fundamental right of all human beings to access quality sexual and reproductive health services. We believe that unless people have access to these services they will never be able to lift themselves out of poverty. As such, we provide sexual and reproductive health services in some of the worlds poorest communities and campaign internationally for the right of all people to these services.

HIV/AIDS • HIV: Human Immunodeficiency Virus • AIDS: Acquired Immune Deficiency Syndrome

? How can you get HIV? 1. Through these bodily fluids VAGINAL SECRETION S BLOOD SEMEN BREAST MILK CERVICAL SECRETION S 2. Through these acts: H INFECTED MOTHER: DURING 1. PREGNANCY 2. BIRTH 3. BREAST FEEDING UNPROTECTED PENETRATIVE INTERCOURSE (HOMOSEXUAL OR HETEROSEXUAL) WITH SOMEONE WHO IS INFECTED 1. INJECTION OR TRANSFUSION OF INFECTED BLOOD / BLOOD PRODUCTS 2. SHARING UNSTERALISED NEEDLES WITH SOMEONE WHO IS INFECTED

! HIV Myths 1 1. You cannot catch HIV from kissing. 2. You cannot catch HIV from sitting on a toilet seat 3. You cannot catch HIV from coughing or sneezing 4. You cannot catch HIV from sharing cutlery

! 5. HIV Myths 2 You cannot catch HIV from drinking out of the same glass 6. You cannot catch HIV from holding hands 7. You cannot catch HIV from hugging

Adults and children estimated to be living with HIV as of end 2005 Western & Eastern Europe Central Europe & Central Asia 720 000 North America [570 000 – 890 000] [990 000 – 2. 3 East Asia million] 1. 2 million [650 000 – 1. 8 million] Caribbean 300 000 1. 6 million North Africa & Middle East 870 000 [440 000 – 1. 4 million] 510 000 South & South-East Asia [230 000 – 1. 4 million] Sub-Saharan Africa 7. 4 million Latin America [4. 5 – 11. 0 million] 25. 8 million Oceania [200 000 – 510 000] 1. 8 million [1. 4 – 2. 4 million] [23. 8 – 28. 9 million] 74 000 [45 000 – 120 000] Total: 40. 3 (36. 7 – 45. 3) million

Country Level • • • Swaziland Botswana Lesotho Zimbabwe S. Africa Namibia Zambia Malawi CAR Mozambique 38. 8% 37. 3 28. 9 24. 6 21. 5 21. 3 16. 5 14. 2 13. 5 12. 2 • • • S. Africa 5, 300, 000 India 5, 100, 000 Nigeria 3, 600, 000 Zimbabwe 1, 800, 000 Tanzania 1, 600, 000 Ethiopia 1, 500, 000 Mozamb 1, 300, 000 Kenya 1, 200, 000 DRC 1, 100, 000 USA 950, 000

SUB-SAHARAN AFRICA 25. 8 MILLION INFECTED 66% OF THE PEOPLE WITH HIV LIVE HERE. AIDS HAS LEFT BEHIND OVER 13 MILLION ORPHANS 57% OF THE INFECTED ADULTS ARE WOMEN HERE AIDS IS THE LEADING CAUSE OF DEATH 2. 4 MILLION ESTIMATED DEATHS AT THE END OF 2005 SWAZILAND HAS THE HIGHEST PREVALENCE OF HIV IN THE WORLD. 38. 8% OF THE ADULT POPULATION INFECTED.

Estimated number of adults and children newly infected with HIV during 2005 43 000 Caribbean 30 000 [15 000 – 39 000] [140 000 – 610 000] 270 000 North Africa & Middle East [17 000 – 71 000] Latin America 200 000 Eastern Europe & Central Asia 22 000 North America [15 000 – 120 000] Western & Central Europe [130 000 – 360 000] 67 000 [35 000 – 200 000] Sub-Saharan Africa East Asia 140 000 South [42 000 – 390 000] & South-East Asia 990 000 [480 000 – 2. 4 million] 3. 2 million [2. 8 – 3. 9 million] Total: 4. 9 (4. 3 – 6. 6) million Oceania 8200 [2400 – 25 000]

From “Health Issue” to “Development Crisis” • Destruction of social capital – Knowledge base of society – Production sectors: agriculture, industry • Weakening of institutions - Civil service, judiciary, armed forces, education, health - Inhibition of private sector growth • Wider, deeper poverty

Estimated adult and child deaths from AIDS during 2005 Western & Central Eastern Europe & Central Asia North America 18 000 [9000 – 30 000] Caribbean 24 000 [16 000 – 40 000] Latin America 66 000 [52 000 – 86 000] 12 000 [<15 000] 62 000 [39 000 – 91 000] East Asia 41 000 North Africa & Middle East South [20 000 – 68 000] & South-East Asia 58 000 [25 000 – 145 000] Sub-Saharan Africa 2. 4 million [2. 1 – 2. 7 million] 480 000 [290 000 – 740 000] Oceania 3600 [1700 – 8200] Total: 3. 1 (2. 8 – 3. 6) million

Percentage of 15 -year-old males who will die of HIV/AIDS based on current risk levels

Age in years Projected population structure with and without the AIDS epidemic, Botswana 2020 80 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0 Projected population structure in 2020 Males 140 120 100 80 Females 60 40 20 40 60 Population (thousands) Source: US Census Bureau, World Population Profile 2000 80 100 120 140 Deficits due to AIDS

Women • Women are infected up to 10 times more easily than men • Social and economic factors increase women’s vulnerability • In SSA 75% of 15 -24 years olds infected are women, globally 47% of total infections are in women • Women bear the social and economic burden of the epidemic

Household Impact • In Zambia and South Africa household incomes fall by 66 -80% • In Vietnam one fifth of children in AIDS households had started to work • A study from Uganda shows that 25% of households are providing for an orphan • In Zambia when a mother dies 65% of households break up

Demand & Supply for Education Demand: – The school enrollment rate among orphans was 39% in Central African Republic, two thirds of the national rate of 60% Source: Survey from CAR, UNICEF, 1999 Supply: – Over 30% of all educators in Malawi and Zambia were estimated to be HIV positive in 2000 – In Tanzania 27, 000 teachers will have died by 2020

Bed occupancy required for AIDS patients, Zimbabwe 1990 AIDS beds Non-AIDS beds Source : UNAIDS, 2000

Potential AIDS treatment costs as a percent of the Ministry of Health Budget 70 % of MOH Budget 60 50 40 30 20 10 0 Ethiopia 2014 Kenya 2005 Zimbabwe 2005 Source: Stover & Bollinger, 1999

HIV/AIDS affects rural areas • 69% of the population of the most affected countries lives in rural areas • AIDS affects economic sectors with mobile/ migratory workers (agriculture, mining) • AIDS-related traditional practices are more prevalent in rural areas • AIDS-affected urban dwellers often return to rural areas

HIV/AIDS and food insecurity: deadly Poverty and Inequality New HIV infections Food Insecurity Faster progression HIV to AIDS Malnutrition Risky survival activities Source: Mullins

NAPHAM Malawi “We go to schools to warn youth about the dangers of HIV. We teach about HIV/AIDS stigma and discrimination and after we summarise with a play. And also we go to community outreach. When we go to community outreach we just perform a play. We first find out what problems the community has, and we do a play about their problems, their concerns such as about VCT (voluntary counselling and testing), about HIV/AIDS information in general, positive living, stigma and Discrimination. ” Victoria Kambemba, voluntary youth worker for NAPHAM, performing to a lively crowd at a marketplace to raise awareness of HIV/AIDS.

SOME POSITIVES UGANDA, ZAMBIA, SENEGAL: HIV HAS BEEN KEPT AT PREVALENCE RATES OF 0. 8% THANKS TO VIGOROUS PREVENTION PROGRAMMES UGANDA: HIV PREVALENCE RATES DROPPED TO 7%. GOVERNMENT TALKED OPENLY ABOUT HIV AND IT IS NOW FIRMLY ON THE POLITICAL AGENDA SENEGAL UGANDA ZAMBIA: PREVALENCE AT 16. 5% BUT: URBAN MEN & WOMEN REPORT LESS SEX, FEWER PARTNERS AND A HIGHER RATE OF CONDOM USE

2005: success stories • Zimbabwe: number of new HIV infections has gone down, mainly due to increased use of condoms and fewer partners • Caribbean: Haiti may be turning a corner, particularly in urban areas, due to increased abstention and faithfulness to one partner, however condom use among young people has decreased as has the age of first sex.