On the Socioeconomic Impact of the HIV/AIDS Epidemic

The UN General Assembly Special Session on HIV/AIDS met 25–2 7 June 2001 and adopted a Declaration of Commitment on HIV/AIDS. The Declaration, in 103 paragraphs, sets out a comprehensive response strategy for governments and UN agencies, supports establishment of a global HIV/AIDS and health fund, and calls for an annual progress report to be reviewed by the Assembly. As part of the Special Session, four “round tables” were conducted on substantive topics: prevention and care, human rights, socioeconomic impact, and international funding. Round Table 3, Socioeconomic impact of the epidemic and the strengthening of national capacities to combat HIV/AIDS, was led by the United Nations Development Programme. The background document prepared for it is reproduced in full below. It argues that the brunt of the epidemic's impact on human development has been borne by households, communities, and civil society organizations. The emphasis of national and international action has been on prevention and care rather than on counteracting that impact. “Extraordinary efforts” are now required to intensify poverty‐reduction measures, to assist caregivers and orphaned children, to prevent the collapse of public services, and to promote workplace tolerance and flexibility. “While HIV/AIDS must be seen as an emergency of the highest order, steady progress in reducing poverty is still the long‐term and sustainable solution to the health crisis in the developing world. In the long run, prevention and care will only succeed if people and nations can lift themselves out of poverty.” (The Declaration was not much influenced by such arguments. It devotes two paragraphs to socio‐economic impact, both setting diffuse goals: “By 2003, evaluate the economic and social impact of the HIV/AIDS epidemic and develop multisectoral strategies [on poverty alleviation, etc.]” and “By 2003, develop a national legal and policy framework that protects in the workplace the rights and dignity of persons living with and affected by HIV/AIDS.…”) The Millennium Summit referred to in the document was the meeting on the role of the UN in the twenty‐first century held in September 2000 as part of the 55th session of the General Assembly. The Declaration of Commitment on HIV/AIDS and the Round Table 3 document can both be found at http://www.unaids.org/ungass/index.html .     

AIDS and kitchen gardens: insights from a village in Western Kenya

In rural Africa, indigenous farming and natural resource management systems exemplified by kitchen gardens are being reshaped by the HIV/AIDS epidemic and its negative impacts (illness, stigma and mortality, and economic costs) and positive opportunities (organizational responses to the epidemic). Subtle changes in crops and farm techniques can be traced to these diverse influences of HIV+ infection, illness, mortality, widowhood, foster child care, and AIDS support groups, as well as the organizations, ideas, and flow of funding from outside. These findings draw on original field data: a village census, in-depth interviews with gardeners, and group discussions in a village in Bungoma District (in 2005 and 2007). This part of western Kenya is a typical small-farm zone that has faced a moderate HIV/AIDS epidemic since the 1990s, following decades of demographic, environmental, technological, and institutional changes. Implications of this case study for further research on HIV/AIDS and on micro-level population–environment change suggest that households are useful but imperfect analytical units and are best seen as part of complex social networks, shaping connections to markets. These important “mediating institutions” link AIDS as a demographic and economic force with environmental outcomes in cultivated landscapes.     

"But of course he is led by God": pastoral influence on an HIV/AIDS ministry

HIV/AIDS is spreading more rapidly in black communities than any other in the United States, with black women being 23 times more likely to become infected than any other subgroup in the country. Some African-American churches are becoming involved by creating HIV/AIDS ministries that cater to various needs of local populations. Through an examination of deictic markers, this article analyzes ideologies surrounding HIV/AIDS and the pastor's influence on the HIV/AIDS ministry at College Street Baptist Church.     

The long-term effect of childhood poverty

This paper uses variation among siblings to identify the consequences of childhood poverty on both labour and marriage market outcomes. In the labour market, individuals who experienced childhood poverty are found to have lower earnings and lower labour market attachment and to have worse jobs both vertically in terms of low-paying industries and horizontally in terms of job positions. In the marriage market, childhood poverty is found to have negative consequences for the probability of marriage, cohabitation, and having children around the age of 30. The effect sizes are found to exhibit an inverse u-shape in the age of the child, peaking during adolescence. Results on educational choices suggest that the mechanisms behind these results can be that childhood poverty affects the skill formation, networks, and decision making of the child.     

Child labour or school attendance? Evidence from Zambia

In this paper we investigate what affects school attendance and child labour in an LDC, using data for Zambia. Since the data comes from a household survey with information on all household members it allows us to take account of unobserved household effects by introducing household-specific effects in a logit model. The empirical analysis suggests that both economic and sociological variables are important determinants for the choice between school attendance and child labour. In particular, we find some support for the hypothesis that poverty forces households to keep their children away from school. JEL classification: J24, I21, O15 Received May 20, 1996/Accepted January 2, 1997     

Aids and the elderly of thailand: projecting familial impacts

We apply aggregate demographic analysis and computer microsimulation to project the number of older Thais who will lose children to AIDS during their own lifetimes and to assess their involvement with ill children through caregiving and coresidence. Parental bereavements from AIDS are predicted to peak at around 80,000 per year between 2003 and 2007. Despite an HIV prevalence of only 2%, 13% of Thais who were over age 50 as of 1995 are likely to experience the loss of at least one adult child to AIDS, and 12% of them will lose multiple children. The chance of losing an adult child during one's lifetime will be 70% higher than if there were no AIDS epidemic.     

Priorities in Global Assistance for Health,AIDS, and Population

This article makes three points regarding international assistance in health, AIDS, and population. First, despite growing attention in the development policy dialogue, the share of health (broadly considered) in total assistance is actually declining, not increasing, if assistance for the HIV/AIDS crisis is taken out of the picture. Second, interventions financed by international health assistance do not closely correspond to the burden of disease as conventionally calculated. HIV/AIDS receives a share of assistance in excess of its contribution to the global burden of disease, and reasons for this are adduced. Third, despite the emphasis on aligning international assistance to country priorities, a comparison of how health is treated in poverty‐reduction strategies and the nature of health assistance reveals no clear relationship between the two. This suggests that there may be room for improvement in the process of preparing such strategies, the allocation of health assistance, or both.     

Mitigating an elephantine epidemic: gendered space for HIV/AIDS outreach through Namibian conservancies

As the reach of HIV/AIDS continues to devastate communities and create potential pressures on natural resources, conservation organizations have increasingly become involved in education and outreach to address the disease. This paper’s purpose is to investigate how increasing HIV infection rates and AIDS deaths relate to community-based conservation and livelihood strategies in the Caprivi Region of northeastern Namibia, and demonstrate that conservation organizations can play a unique role in combating the disease. As the epidemic is more widespread in the Caprivi than in any other region of the country, local organizations such as Integrated Rural Development and Nature Conservation (IRDNC) are responding to the disease by integrating it into conservation work. IRDNC’s efforts reflect a particular focus on gender, including changes in the way that HIV/AIDS is discussed in local communities, strategies to promote access to testing and care, and bringing to light the experiences of individuals and families struggling with HIV/AIDS. This approach shows that there are benefits to be gained from approaching HIV/AIDS mitigation through familiar, existing structures such as those of community conservancies in Namibia—especially the ability to circumvent heavy local stigma. Using data collected through participant observation and participatory discussions, this paper demonstrates that conservation programs can positively affect people with HIV/AIDS, highlighting the importance of mainstreaming outreach efforts that address the particular localized manifestations of the disease in the context of natural resource management.     

AIDS in China

Most recent official statistics indicate that there was a cumulative total of 133 AIDS cases in mainland China through the end of October 1996 and 5157 people infected with HIV. Official statistics also indicate continuing increases in recent years in the number of people with AIDS and people infected with HIV, and that the incidence of infection is growing in China. HIV has been found to have been transmitted in China through IV drug use, sexual activities, from mother to child, and through transfusions and the use of blood products. Important risk factors for the spread of HIV in China include high population density, a considerable transient population, drug use, prostitution, blood transfusion, the improper sterilization of medical instruments in rural areas, changes in people's sexual attitudes and behaviors, and lack of information on safe sex. The Chinese government reports having taken considerable steps to check the spread of HIV/AIDS and supports communication and education as an essential tool in the fight against the epidemic. Life expectancies in China's provinces and municipalities are listed.     

Child Poverty in Vietnam: Providing Insights Using a Country-Specific and Multidimensional Model

Despite a wide under-prioritization, the issue of child poverty has received increasing attention worldwide over the last decade. The acknowledgement in Vietnam that child-specific poverty measurement is crucial for poverty efforts directed towards children, and the current lack thereof, instigated the development of a Vietnam child poverty approach. This paper proposes a country-specific, multidimensional and outcome-based approach for the measurement of the incidence, depth and severity of child poverty. It does so at the level of the individual child using household survey data. The development of such an approach at the level of the individual child presents an appropriate alternative for or supplement to the widely used monetary poverty approach, allowing for the use of compatible analytical methods. Findings suggest that 37% of all children in Vietnam live in poverty, with the most pressing areas of deprivation being water, sanitation and leisure. We do not find evidence for a gender bias but do observe a large urban–rural divide, regional disparities and large ethnic inequalities. We argue that this tailor-made approach is a valuable new tool for policy makers and analysts in Vietnam as it enables identification and analysis of poor children, their characteristics and most pressing areas of deprivation within the country’s specific social and cultural context.     

中国公民社会组织在生殖健康领域的作用

20世纪80年代后，中国公民社会组织在环保、扶贫、妇女发展、艾滋病防治等领域迅速发展，发挥了积极作用。 随着1994年开罗国际人发大会和1995年北京第四届世界妇女大会的召开，从20世纪90年代初开始，从事与生殖健康相关领域的公民社会组织（简称RH—CSO）不断发展壮大。     

Uncovering the impact of the HIV epidemic on fertility in Sub-Saharan Africa: the case of Malawi

We evaluate the impact of the HIV/AIDS epidemic on the reproductive behaviour for all women in Malawi, HIV-negative and HIV-positive alike, allowing for heterogeneous response depending on age and prior number of births. HIV/AIDS increases the probability that a young woman gives birth to her first child, while it decreases the probability to give birth of older women and of women who have already given birth. The resulting change in the distribution of fertility across age groups is likely to be more demographically and economically important than changes in the total number of children a woman gives birth to.     

Wild foods and household food security responses to AIDS: evidence from South Africa

Wild foods may offer unique benefits to households afflicted by AIDS, providing a nutritious and freely available food source at minimal labour and financial costs. This article presents the results of food security assessments in two rural South African sites. Detailed household dietary recalls from 227 households, combined with qualitative work, explored the association of household AIDS proxies (recent morbidity, mortality and orphan fostering) with household food security and dietary composition. The study found that AIDS-proxy households were significantly more food insecure, and households fostering orphans were both poorer and more food insecure. Wild foods were evident in 40.3% of the 48 h recalls, with significantly greater likelihood of use in households with fostering paternal orphans, and/or with at least one AIDS proxy. Only paternal orphans were significantly associated with likelihood of using wild foods when controlling for household socio-economic status. Qualitative data suggests that households afflicted by AIDS might curtail their use of wild foods due to household labour shortages and stigma. This is unfortunate, as regressions indicate that households using wild foods may be more economically resilient. This may be particularly important for households registering AIDS proxies, due to a demonstrated negative correlation between accumulated household AIDS proxies and household income.     

Using innovation to address HIV, AIDS, and environment links: intervention case studies from Zimbabwe, Uganda, and Malawi

This article presents three cross-cutting intervention case studies that address HIV, AIDS, and natural resources management in an integrated manner through innovative programming in Zimbabwe, Uganda, and Malawi. In Zimbabwe, a religious-based non-governmental group and two community organizations work together to build skills of HIV- and AIDS-vulnerable children in rural areas to meet dietary and income needs, while using natural resources sustainably. In Uganda, various government agencies and NGO actors work together to improve the food security of HIV-affected households at the national, district, sub-district, and village levels. Finally, in Malawi, a conservation organization incorporates HIV and AIDS awareness and programming into its operations and projects. Each case study presents pioneering approaches to simultaneously addressing the pressures on conservation initiatives, food security/agricultural production, income generation/livelihoods, and social and health care systems. They also provide lessons for expanding interventions and partnerships.     

Role of women in schooling and child labour decision: the case of urban boys in India

This paper uses household level data from National Sample Survey Organization (NSSO) of India, the 55th round (1999–2000), to show that for urban male children there exists significant wage incentive for schooling, though school dropout rate and child labour incidence are not so small. The parents’ level of education plays an important role in reducing this tendency; thus establishing the linkage between social and human capital outcomes in the family. We also look at the incidence of harmful and manual occupations among the child labour. Mother’s education now appears as a very important factor in curbing these incidences; supporting earlier findings that women’s empowerment (one important indicator of which would be female educational level) is indeed instrumental in increasing parental awareness.     

Trends in Child Poverty in Hong Kong Immigrant Families

In Hong Kong, child poverty is a serious social problem which may lead to intergenerational poverty, but nevertheless only a few studies have examined this issue, particularly for immigrant families. Using Census data (5 %) from 1981, 1991, 2001, and 2011, we assessed child poverty rates in the past three decades and identified key variables contributing to changes in the risk of child poverty for both immigrant and local families. Our results indicate that child poverty rates in Hong Kong-born families have fluctuated between 14.3 and 15.8 % over the past three decades, while for immigrant families they have increased steadily and substantially from 18.1 % in 1981 to 36.5 % in 2001 and then to 37.5 % in 2011. We show that the increase in immigrant child poverty is associated with changes in the Hong Kong economy that have made it more difficult for such families to adapt to the host society, especially in the 1990s and that this negative effect offset the positive influence of compositional changes among this group of immigrant families in terms of parental education levels and family size. The gap between immigrant and local families in terms of child poverty risk is mainly due to the fact that during the 1990s the negative effect of contextual changes in Hong Kong was cancelled out by the beneficial impact of compositional changes for local families, but not for immigrant families where the latter effect was minimal.     

Social Health Indicators and Economic Growth: Evidence from East Asia and Pacific,Middle East and North Africa,South Asia,and Sub-Saharan Africa

The objective of this study is to empirically investigate a two-way statistical relationship between the social health indicators and economic growth in the context of four major regions of the world i.e., East Asia and Pacific, Middle East and North Africa (MENA), South Asia and Sub-Saharan Africa. To recognize the relationship between the two variables, a time series, co-integration and Granger causality tests have been employed. Aggregate secondary data pertaining to these four regions from 1975 to 2011 on economic growth and social health indicators i.e., infant mortality, child abuse, child poverty, unemployment, weekly wages, health insurance coverage, teenage suicide, teenage drug abuse, high school dropouts, poverty, out-of-pocket health costs, homicides, alcohol related traffic fatalities, food insecurity, income inequality, HIV/AIDS, tuberculosis, basic health units and rural health centers has been used for analysis. This study evaluates four alternative but equally plausible hypotheses, each with different policy implications. These are: (1) social health indicators Granger cause economic growth, (2) economic growth Granger cause social health indicators (the conventional view), (3) There is a bi-directional causality between the two variables and (4) Both variables are causality independent (although highly correlated). The empirical results only moderately support the conventional view that economic growth has significant long run casual effect on social health indicators in East Asia and Pacific, MENA, South Asia and Sub-Saharan Africa. The present study find evident of unidirectional causality running towards economic growth to social health indicators, although, there are some bidirectional causality also exists between the variables. The percentage of unidirectional causality between economic growth and social health indicators is larger than bidirectional or neutrality hypothesis.     

Child Poverty Among Hong Kong Ethnic Minorities

This paper analyzes the data from the Population Census of 2011 to identify the characteristics of poor ethnic minority groups in Hong Kong and the factors that are associated with child poverty among these ethnic minorities. The results show that the child poverty level varies between different ethnic groups and that ethnic minorities from developing nations are likely to have a higher poverty level. In particular, Pakistani children have the highest poverty rate among all ethnic groups. The results also show that Pakistani, Nepalese, and Mixed (Chinese and Asian) nationalities have a higher child poverty rate than that of Chinese individuals who constitute the majority of the Hong Kong population. The main reason for this is that, unlike their Chinese counterparts, some of these ethnic minority households have not benefited from their own human capital or their length of exposure in the local society in Hong Kong. And even if they have benefited, the positive impact of these factors on ethnic minority households was much weaker compared to that of Chinese households. These results suggest that ethnic minorities need to be categorized as a separate group in order to assess their specific needs, and assimilation policies, especially support on Chinese language learning, need to be an integral part of the government’s poverty reduction strategy to reduce child poverty among ethnic minorities.     

The Effect on Elderly Parents in Cambodia of Losing an Adult Child to AIDS

Little systematic quantitative research is available on the parents of adults who become ill and die of AIDS despite their large number and the wide range of adverse consequences. This study, based on survey data from Cambodia, explores economic and social effects on parents in a country characterized by extreme poverty and a substantial AIDS epidemic. Results indicate that parents play a major role during the illness of an adult son or daughter, often sharing living quarters, providing care, and paying for illness‐related expenses. These contributions to the societal response to AIDS come at considerable cost to parents at advanced ages. Multivariate analysis suggests lasting negative consequences for parents’economic well‐being, and the consequences are more substantial if the adult child's death was from AIDS rather than from other causes. The study found little evidence of stigma associated with losing a grown child to AIDS: reactions from local community members are more likely to be sympathetic and supportive than negative. These results underscore the need for organizations dealing with AIDS to recognize the contributions older persons make in coping with the epidemic and to address the burden it imposes on them.     

Stigma and Salvation: Advertising HIV Awareness in New York City: A Case Study

Popular culture representations and negotiations of HIV/AIDS have fluctuated over the last several decades, and awareness of the illness and its causes has grown due to better education and extensive cultural dialogue. The following examines two contemporary HIV/AIDS public health campaigns in the New York City area. Although there have been limited improvements in the portrayals of HIV-positive individuals, advertising focused on HIV awareness still does not directly address prevention. These two campaigns encourage two distinct messages; one that reinforces the stigma attached to HIV/AIDS and one that promises salvation.