Impact of hunger hastens spread of HIV/AIDS - new study

Southern Africa's recent humanitarian crisis highlighted how the HIV/AIDS epidemic increased people's vulnerability to acute food shortages, leaving them unable to cope. But research presented at last week's international conference on 'HIV/AIDS and Food and Nutrition Security' in Durban, South Africa, found that this was only half the story. A study of smallholder farmers in three rural villages in Malawi's Lilongwe district revealed that hunger was a greater contributing factor to increasing susceptibility to HIV/AIDS, as these communities were engaging in risky sexual practices to survive. Small-scale farmers who rely on subsistence food production to make ends meet are the largest occupational group in Malawi. Faced with three consecutive years of declining food production, this group has become a "dissipating and dying force", study co-author Deborah Fahy-Bryceson told delegates attending the three-day conference, organised by the Washington-based International Food Policy Research Institute (IFPRI). The effects of drought-induced food shortages were causing an "unravelling of their social, economic and cultural way of life" and threatening their existence, she added. During the pre-harvest lean months, smallholder farmers have traditionally relied on 'ganyu' labour - the exchange of their labour for goods or cash from better off households. The study, however, found that ganyu opportunities were increasingly hard to find in rural communities, and women were often forced to venture into the outskirts of the capital, Lilongwe, to work in gardens and factories. According to Bryceson, there was now "a new twist to this traditional practice". Most of the labourers - women and youth - were "increasingly becoming involved in sexual services" in exchange for food and cash. Because women were bringing food home, husbands were forced to turn a blind eye to this new form of coping - the risk of hunger was a far greater priority than the risk of HIV infection. "Villagers are prioritising risk on the basis of perceptions of relative manageability. A sense of powerlessness concerning their vulnerability to HIV/AIDS leads to concentration on the more immediate concern of trying to ensure their day-to-day staple food needs," the study said. Nevertheless, it was important to distinguish this coping strategy as transactional sex, because the women were compelled by circumstances, and did not have a professional interest in safer sex, as was often the case in commercial sex work, Bryceson warned. Their deep-rooted belief systems presented another risk factor. The study found that the prevailing traditional view, which saw condoms as "abnormal", and the widespread Christian discourse on condoms as "immoral", resulted in few villagers admitting to the use of the contraceptive, despite their local availability. For these rural households, "AIDS was not very threatening compared to hunger. In fact, hunger is contributing to AIDS", Bryceson said. With increasing research into the link between food insecurity and HIV/AIDS, there was still a need to focus on how different occupational groups faced the combined threat, rather than coming to general conclusions, she noted. "We still need to be looking into the who, why and how."