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HIV and AIDS

Date of Adoption: June 2006
Policy Serial No: POS 2.5

The Issues

HIV and AIDS are the fastest growing threat to human development in many developing countries; for example, in South Africa 30% of the population is infected with the virus according to recent government estimates.

The epidemic is having a profound impact on infant, child and maternal mortality, morbidity and life expectancy.

Rising morbidity and mortality rates among the economically active segment of the population are distorting labour markets, disrupting production and consumption, eroding public sector capacity and diminishing national wealth.

As HIV infections rise, poverty deepens. Given this, reducing the incidence and prevalence of HIV is a prerequisite for poverty elimination.

At the individual and household level in developing countries, the consequences of the epidemic include ill health; death and grief; stigma and discrimination; mother-to-child transmission; single parent families; orphaned (often HIV positive) children; caring for themselves or cared for by elderly grandparents; increased unemployment; reduced household labour; and declining household incomes and an increased burden of care.

These consequences are compounded by little or no access to testing and counseling, antiretroviral drugs, treatment for opportunistic infections and other support services.

Joint programs with affiliates have provided Oxfam Australia with valuable experience of these issues since 1998.

Women are particularly affected by HIV and AIDS as they are physiologically more vulnerable to infection and less able to negotiate safe sex because of their typically lower status. They have less access to female-controlled prevention methods and appropriate health services. Also, women and children usually assume the role of care-giver for those infected.

Similarly, marginalised groups such as injecting drug users, sex workers and men who have sex with men can experience heightened vulnerability to infection due to harassment, criminalisation, discrimination and social exclusion. This results in little or no access to prevention education, clean injection equipment, condoms, treatment and support services.

Stigma and discrimination are major obstacles to effective HIV and AIDS prevention treatment and care. Fear of discrimination prevents people from acknowledging their HIV status and seeking treatment. People with HIV, or suspected of having it, are often turned away from healthcare services, denied housing or employment, shunned by friends and family, abandoned by their spouse, suffer physical violence and are sometimes even murdered.

The stigma of HIV and AIDS often extends to the next generation, placing an extra burden on children who are trying to deal with the death of their parents while caring for younger siblings.

Global insecurity creates conditions that facilitate the spread of HIV and AIDS, in particular war and armed uprisings, destruction of infrastructure, disruptions to livelihoods and large-scale population movements.

Contributing factors to the spread of HIV under these conditions, as well as those created by natural disasters, include: insecure blood supplies; limited or no access to clean injecting equipment and condoms; the disruption of social norms regulating sexual behaviour; reduced food and income security; increased dependence on sex work; disruptions to health education, treatment and care services; and increased vulnerability of displaced people – especially women and children – to sexual abuse and violence.

The global HIV epidemic, while showing significant regional variation, is still at an early stage. Sub-Saharan Africa is the world's worst-affected region. The virus is spreading rapidly in other regions, however, particularly in South Asia, East Asia and parts of the Pacific.

This spread is facilitated by high population densities, low socio-economic development, high rates of population mobility and official denial.

Oxfam Australia principles

Our view is:

Consequently, we call for:

Appropriate strategies: