Community Responses to HIV/AIDS

This project, which continues UNRISD research on the development aspects of the HIV/AIDS epidemic, studies responses to HIV/AIDS at the community level. In the face of the persistent spread of HIV and the growing AIDS epidemic, the project explores the extent to which community responses provide effective, equitable and sustainable approaches to prevention, treatment and mitigation of impact. It examines (i) how communities are dealing with risk environments, and (ii) how communities are dealing with the impacts of HIV/AIDS, particularly in terms of sustaining production and incomes. The project will examine the effects of social cohesion on community responses, identify how the initiatives and support of civil society and the state affect community responses, and explore the forms of support that enable effective and equitable prevention and care responses to HIV and AIDS. In order to study these issues, the project is commissioning review papers and carrying out focused research. The findings will be used to inform community and state programmes, with the goal of strengthening the political response to the epidemic.

HIV/AIDS is a devastating epidemic. By 2000, nearly 58 million people had been infected and 22 million had died. Each day sees over 15,000 new infections. The epidemic is a development crisis that feeds on and worsens poverty, gender inequity, social insecurity, limited access to health care and education, war, debt, and macroeconomic and social instability.

HIV/AIDS has documented, negative, effects on economic growth that have undermined efforts to widen economic opportunity and inclusion. It deepens poverty and increases inequalities at every level, from household to global, confounding efforts to deal with these problems. Numbers poorly express the losses and costs caused by HIV/AIDS. The most critical—but often least recognized—costs are within households, where HIV/AIDS can lead to complete collapse. At this level, loss of income, diversion of assets to caring, and weakened family and social networking have been shown to divert labour from production to care, leading to falling household production and rising spending, particularly on medical care and funerals. Household members, and particularly women, have to make hard choices about the allocation of their time between production, meeting household needs, child care and care of the sick. These effects are associated with new poverty, widening exclusion and increasing economic inequality.

The responses to this development challenge include prevention of new infection, treatment and care of the ill, and mitigation of the current and future social and economic impacts of the epidemic. Communities intervene across all three of these areas. Important questions arises, however: To what extent have the economic, social and political conditions, and the corresponding state and private sector interventions, supported and enabled these community responses? To what extent do community responses transform risk environments and enable households to respond to impacts in ways that do not undermine their long-term survival? Community action provides an important basis for confronting the epidemic when positively supported by initiatives that reduce risk environments; provide accessible and relevant treatment and care that are of adequate quality; and offer appropriate and consistent support to mitigate impact.

This project is funded by the Royal Minister of Foreign Affairs of Norway and UNRISD core funds. For more information on the project research team and related UNRISD work on health and on HIV/AIDS, please use the links on the right.