Equity and HIV/AIDS

AIDS Treatment and Intrahousehold Resource Allocations: Children's Nutrition and Schooling in Kenya
Thirumurthy H, Zivin JG, Goldstein M: Center for Global Development Working Paper 105, 22 January 2007

The provision of life-saving antiretroviral (ARV) treatment has emerged as a key component of the global response to HIV/AIDS, yet little is known about the impact of this intervention on the welfare of children whose parents receive treatment. In this working paper CGD post-doctoral fellow Harsha Thirumurthy and his co-authors use longitudinal household survey data collected in collaboration with a treatment program in western Kenya to provide the first estimate of the impact of ARV treatment on children’s schooling and nutrition. They find that children's weekly hours of school attendance increase by over 20 percent within six months after treatment is initiated for the adult household member. Young children's short-term nutritional status also improves dramatically. Since the improvements in children’s schooling and nutrition at these critical early ages will affect their socio-economic outcomes in adulthood, the authors argue that the widespread provision of ARV treatment is also likely to generate significant long-run macroeconomic benefits.

Children and AIDS: A stocktaking report
UNAIDS, Unicef, World Health Organization (WHO): January 2007

This report seeks to identify discernible trends through the measurement of new and existing data against a baseline used here for the first time in the areas of preventing mother-to-child transmission of HIV, providing paediatric treatment, preventing infection among adolescents and young people, and protecting and supporting children affected by HIV/AIDS – the ‘Four Ps’. Further, this report reviews progress towards support strategies identified as critical elements of a child-focused response. It seeks to illuminate some of the ways in which Unite for Children, Unite against AIDS has shown relevance and promise, as well as some of the ways it has failed to spur the global, regional and country mobilization required to address the problems facing children affected by AIDS. It will explore how Unite for Children, Unite against AIDS needs to move forward in the next year to achieve its ambitious goals.

Living with AIDS in Uganda: Impacts on banana-farming households in two districts
Beraho MK: Wageningen Academic Publishers

The research in this book was carried out among banana-farming households in the districts of Masaka and Kabarole in Uganda. A gendered livelihood approach was used. The research focused on the identification of critical factors that need to be taken into consideration in the development of relevant policies for HIV/AIDS-affected agriculture-based households or those that are at risk. The book shows that HIV/AIDS causes significant negative effects on the lives of those affected. Their resources are affected due to HIV/AIDS-related labour loss and asset-eroding effects and disinvestment in production and child education. While in the overwhelming majority of the affected cases the effects of AIDS are negative and lead to increased impoverishment and vulnerability, for some households HIV/AIDS-related effects are manageable. It is concluded that a household's socio-economic status and demographic characteristics influence the magnitude of HIV/AIDS-related impacts experienced and capacity to cope. The book also highlights some historically specific social practices, policies, and ideologies that continue to maintain or reproduce distinct forms of inequality, with certain social groups being marginalized and others being privileged. Unless these are redressed, they will continue to aggravate people's vulnerability regardless of the type of shock that they are exposed to or experience.

Why not ‘front-load’ ODA for HIV/AIDS?
Serieux J, McKinley T: UNDP, February 2007

Global funds available to combat HIV/AIDS are estimated to reach about US$ 9 billion in 2007. Although this amount will be only about half of what is needed, it is, nevertheless, substantial. Used effectively, such donor financing could help stem the pandemic’s spread and mitigate its effects. In fact, disbursing the balance of such financing early on - ‘front-loading’ it - should be a priority. But there is considerable resistance to doing so. Why is this the case?

"I don't have options but to persevere." Experiences and practices of care for HIV and diabetes in rural Tanzania: a qualitative study of patients and family caregivers.
Mwangome M; Geubbels E; Klatser P; Dieleman M: Int Jo for Equity in Health 15(1)56, 2016, doi:10.1186/s12939-016-0345-5

The high prevalence of chronic diseases in Tanzania is putting a strain on the already stretched health care services, patients and their families. This study sought to find out how health care for diabetes and HIV is perceived, practiced and experienced by patients and family caregivers, to inform strategies to improve continuity of care. Thirty two in-depth interviews were conducted among 19 patients (10 HIV, 9 diabetes) and 13 family caregivers (6 HIV, 7 diabetes). The innovative care for chronic conditions framework informed the study design. Three major themes emerged; preparedness and practices in care, health care at health facilities and community support in care for HIV and diabetes. In preparedness and practices, HIV patients and caregivers knew more about aspects of HIV than did diabetes patients and caregivers on diabetes aspects. Continued education on care for the conditions was better structured for HIV than diabetes. On care at facilities, HIV and diabetes patients reported that they appreciated familiarity with providers, warm reception, gentle correction of mistakes and privacy during care. HIV services were free of charge at all levels. Costs involved in seeking services resulted in some diabetes patients to not keep appointments. There was limited community support for care of diabetes patients. Community support for HIV care was through community health workers, patient groups, and village leaders. Diabetes and HIV have socio-cultural and economic implications for patients and their families. The HIV programme is successfully using decentralization of health services, task shifting and CHWs to address these implications. For diabetes and NCDs, decentralization and task shifting are also important and, strengthening of community involvement is warranted for continuity of care and patient centeredness in care. While considering differences between HIV and diabetes, the authors show that Tanzania's rich experiences in community involvement in health can be leveraged for care and treatment of diabetes and other NCDs.

$42 billion needed to achieve universal access by 2010, says UNAIDS
Alcorn K: Aidsmap, 26 September 2007

Up to $42 billion will need to be found by 2010 if universal access to HIV treatment, prevention and care is to be achieved in line with the 2005 commitment by G8 governments, UNAIDS said today. UNAIDS’ estimate has been developed ahead of an international meeting to win increased donor commitments to the Global Fund to Fight AIDS, TB and Malaria which started on 26 September 2007 in Berlin. The Fund currently accounts for one-quarter of all international donor expenditure on AIDS.

'Gilead’s plan to cut AIDS drug prices in middle-income countries by two-thirds precedent-setting'
AIDS Healthcare Foundation, 13 July 2006

In mid-July 2006, AIDS Healthcare Foundation (AHF) the largest US-based AIDS organisation with free AIDS treatment clinics in the US, Africa, Asia and Latin America/Caribbean, applauded Gilead Sciences, Inc for its recent decision to cut the prices for its lifesaving antiretroviral AIDS drugs by almost two-thirds in middle-income countries such as Mexico and India.

'Less noisy' female condom proves a hit in Uganda
Plus News: 22 December 2009

Ten months after being re-launched, a new brand of female condom has proven popular among Ugandan women. FC2 was launched in February; the government stopped distributing the original female condom, FC1, in 2007 on the grounds that women had complained it was smelly and noisy during sex. 'The new condom has improved features and will enable women to have a procedure within their control to give them more choices for prevention [of HIV and unwanted pregnancies],' said Vashta Kibirige, the coordinator of the condom unit at the Ministry of Health. The UN Population Fund and the NGO, Programme for Accessible health Communication and Education, are spearheading the re-launch of the female condom, which is still in the sensitisation stage and will become available to the public in 2010. The women questioned said the new condom was less noisy, more comfortable and well lubricated, increasing their sexual pleasure. It also has no smell and can be inserted in the vagina at least eight hours before sex, which the women liked a lot.

'Second line' ARVs too costly for patients, warns MSF
TRALAC: Kimani D (Nationmedia.com)

HIV-positive East Africans – and other people in the developing world on life-saving antiretrovirals may find themselves without effective medicines unless measures are taken to lower the cost of second-generation drugs, Aids activists have warned. According to the international humanitarian organisation Medecins Sans Frontieres (Doctors Without Borders), a growing number of HIV patients on first-line ARVs will inevitably have to move to second-line drugs, which are more expensive and therefore harder to access.

'Side dishes' campaign in Uganda gets people talking
Plus News: 24 March 2010

A national campaign to encourage sexual fidelity in Uganda is reported to have got the country talking. The nine-month-long 'One Love' campaign is in the second of three phases, which uses television and radio ads that highlight AIDS-related deaths from 'eating a side dish' - a euphemism for having a sexual relationship outside marriage. The intention of the second phase is to bring home the effects of infidelity, not just on health, but on the lives of the people they care for most. The first phase - which ended in February - introduced the public to sexual networks, using forum theatre in rural communities and billboards, TV ads and radio spots in towns urging people to 'get off the sexual network'. Previous prevention campaigns have failed to directly address married and cohabiting Ugandans, the most likely group to become HIV infected. Beyond the traditional routes of advertising, the campaign has also employed mobile-phone technology and the social networking site Facebook to engage with younger people in a higher socio-economic group.