6. Vulnerability of Livelihood Systems to AIDS Vulnerable Groups - Orphans, Elderly and Youth Headed Households, Effect on Institutions Community-based, Civil society, Market, State, Global Outcomes Nutrition, Food Security, Education, Community Cohesion, Income Effect on Assets Human, Financial, Social, Natural, Physical, Political Responses Individual, Household, Community Vulnerability to infection HIV Stigma and Discrimination
7. HIV AIDS upstream downstream Food insecurity Malnutrition mid-stream Three stages of vulnerability
8. HIV AIDS prevention mitigation Food insecurity Malnutrition care & treatment HIV strategies
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10. HIV Food insecurity Malnutrition Upstream vulnerability
15. The Vicious Cycle of Malnutrition and HIV Insufficient dietary intake Malabsorption , diarrhea Altered metabolism and nutrient storage Increased HIV replication Hastened disease progression Increased morbidity Increased oxidative stress Immune suppression Nutritional deficiencies Source: Semba and Tang, 1999
16. HIV AIDS Mid-stream vulnerability ART access and adherence STIs (especially HSV-2) Malnutrition Food insecurity (time, resources for care)
17. AIDS Food insecurity Malnutrition Downstream vulnerability
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19. AIDS Food insecurity Malnutrition Downstream vulnerability Depends on quantity, quality and mix of assets at household and community levels, institutional context and processes. AIDS impoverishes (directly and indirectly) Intra-household effects (women, children)
20. More volatile food prices Source: Data from FAO 2009 and IMF 2009. Prices fell as financial crisis and recession developed
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22. How to respond? Agriculture Social protection HIV programs Nutrition/health programs Livelihood/food insecurity HIV & AIDS Malnutrition
23. HIV AIDS prevention mitigation Food insecurity Malnutrition care & treatment HIV strategies
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Notas del editor
Direct measures of poverty, such as the percentage below $1 per day shown here do not seem to show any clear pattern between countries
There is a striking association between income inequality (measured here by the GINI coefficient) and HIV – countries with higher income inequality appear to have higher HIV prevalence rates Similar patterns (slightly less clear) can be seen with other inequality measures such as the decile or quintile ratio There may be many counfounding factors here, such as differences in cultural practice (e.g. male circumcision and religion) Bubble plots such as this probably represent the limits of what can be understood from country level analysis – to find more robust relationships we need to go to regional or household level
Reductions in food intake Appetite loss, mouth sores Effects of food security decline Nutrient malabsorption Diarrhea Malabsorption of fats and vitamins Metabolic alterations Increased energy, protein requirements Oxidative stress.
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