HIV/AIDS

The Social & Economic Impact

Interact Worldwide

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?

BREASTMILK

VAGINALSECRETION

SBLOOD

SEMEN

CERVICALSECRETION

S

2. Through these acts:

H

INFECTED MOTHER:DURING1. PREGNANCY2. BIRTH3. BREAST FEEDING

UNPROTECTED PENETRATIVE INTERCOURSE (HOMOSEXUAL OR HETEROSEXUAL) WITH SOMEONE WHO IS INFECTED

1. INJECTION OR TRANSFUSION OF INFECTED BLOOD / BLOOD PRODUCTS2. SHARING UNSTERALISED NEEDLES WITH SOMEONE WHO IS INFECTED

1. Through these bodily fluids

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

! HIV Myths 1

HIV Myths 2

5. 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 Adults and children estimated to be living with HIV as of end 2005with HIV as of end 2005

Total: 40.3 (36.7 – 45.3) million

Western & Central Europe

720 000720 000[570 000 – 890 000][570 000 – 890 000]

North Africa & Middle East510 000510 000

[230 000 – 1.4 million][230 000 – 1.4 million]

Sub-Saharan Africa25.8 million25.8 million

[23.8 – 28.9 million][23.8 – 28.9 million]

Eastern Europe & Central Asia1.6 million 1.6 million

[990 000 – 2.3 million][990 000 – 2.3 million]

South & South-East Asia7.4 million7.4 million[4.5 – 11.0 million][4.5 – 11.0 million]

Oceania74 00074 000

[45 000 – 120 000][45 000 – 120 000]

North America1.2 million1.2 million

[650 000 – 1.8 million][650 000 – 1.8 million]

Caribbean300 000300 000

[200 000 – 510 000][200 000 – 510 000]

Latin America1.8 million1.8 million

[1.4 – 2.4 million][1.4 – 2.4 million]

East Asia870 000870 000

[440 000 – 1.4 million][440 000 – 1.4 million]

Country Level

• Swaziland 38.8%• Botswana 37.3• Lesotho 28.9• Zimbabwe 24.6• S. Africa 21.5• Namibia 21.3• Zambia 16.5• Malawi 14.2• CAR 13.5• Mozambique 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.

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

AIDS HAS LEFT BEHIND OVER 13 MILLION ORPHANS

SWAZILAND HAS THE HIGHEST PREVALENCE OF HIV IN THE WORLD. 38.8% OF THE ADULT POPULATION INFECTED.

Estimated number of adults and childrenEstimated number of adults and childrennewly infected with HIV during 2005newly infected with HIV during 2005

Total: 4.9 (4.3 – 6.6) million

Western & Central Europe22 00022 000

[15 000 – 39 000][15 000 – 39 000]

North Africa & Middle East67 00067 000

[35 000 – 200 000][35 000 – 200 000]

Sub-Saharan Africa3.2 million3.2 million

[2.8 – 3.9 million][2.8 – 3.9 million]

Eastern Europe & Central Asia270 000270 000[140 000 – 610 000][140 000 – 610 000]

East Asia140 000140 000

[42 000 – 390 000][42 000 – 390 000]South & South-East Asia

990 000990 000[480 000 – 2.4 million][480 000 – 2.4 million]

Oceania82008200

[2400 – 25 000][2400 – 25 000]

North America43 00043 000

[15 000 – 120 000][15 000 – 120 000]

Caribbean30 00030 000

[17 000 – 71 000][17 000 – 71 000]

Latin America200 000200 000

[130 000 – 360 000][130 000 – 360 000]

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 Estimated adult and child deaths from AIDS during 2005from AIDS during 2005

Total: 3.1 (2.8 – 3.6) million

Western & Central Europe12 00012 000[<15 000][<15 000]

North Africa & Middle East58 00058 000

[25 000 – 145 000][25 000 – 145 000]

Sub-Saharan Africa2.4 million2.4 million

[2.1 – 2.7 million][2.1 – 2.7 million]

Eastern Europe & Central Asia62 00062 000[39 000 – 91 000][39 000 – 91 000]

East Asia41 00041 000

[20 000 – 68 000][20 000 – 68 000]South & South-East Asia

480 000480 000[290 000 – 740 000][290 000 – 740 000]

Oceania36003600

[1700 – 8200][1700 – 8200]

North America 18 00018 000

[9000 – 30 000][9000 – 30 000]

Caribbean24 00024 000

[16 000 – 40 000][16 000 – 40 000]

Latin America66 00066 000

[52 000 – 86 000][52 000 – 86 000]

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

0

10

20

30

40

50

60

70

80

90

100

Honduras Thailand Cote d'Ivoire Zambia South Africa Zimbabwe Botswana

Series1

Projected population structure with and Projected population structure with and without the AIDS epidemic, Botswana 2020without the AIDS epidemic, Botswana 2020

80757065605550454035302520151050

020406080100120140 0 20 40 60 80 100 120 140

Males Females Deficits due to AIDS

Projected population structure in 2020

Population (thousands)

Ag

e in

yea

rs

Source: US Census Bureau, World Population Profile 2000

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

Non-AIDS bedsNon-AIDS bedsAIDS bedsAIDS beds

1990199019901990 2000200020002000

Source :Source : UNAIDS, 2000 UNAIDS, 2000

Bed occupancy required for AIDS patients, Zimbabwe

Bed occupancy required for AIDS patients, Zimbabwe

Potential AIDS treatment costs as a percent of the Ministry of Health Budget

00

1010

3030

4040

5050

6060

7070% of MOH Budget% of MOH Budget

Ethiopia 2014Ethiopia 2014

2020

Kenya 2005Kenya 2005 Zimbabwe 2005Zimbabwe 2005

Source: Source: Stover & Bollinger, 1999Stover & 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

Poverty and Inequality

New HIV infections

Malnutrition

Faster progression HIV to AIDS

Food Insecurity

Risky survival activities

Source: Mullins

HIV/AIDS and food insecurity: deadly

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 UGANDA: HIV PREVALENCE RATES DROPPED TO 7%. GOVERNMENT TALKED OPENLY ABOUT HIV AND IT IS NOW FIRMLY ON THE POLITICAL AGENDA

SENEGAL: HIV HAS BEEN KEPT AT PREVALENCE RATES OF 0.8% THANKS TO VIGOROUS PREVENTION PROGRAMMES

ZAMBIA: PREVALENCE AT 16.5%BUT: URBAN MEN & WOMEN REPORT LESS SEX, FEWER PARTNERS AND A HIGHER RATE OF CONDOM USE

UGANDA

SENEGAL

ZAMBIA

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.