Abstract
There has been a systematic imbalance between the treatment and prevention responses to the AIDS pandemic (Horton and Das, 2008). One of the consequences has been a dramatic rise in the number of people receiving antiretroviral therapy in South Africa (3 million), but at the same time there will be 2.5 million new infections this year (Horton and Das, 2008). Approximately two-thirds of people living with HIV live in sub-Saharan Africa, though only 10% of the world’s population lives in this region (Global Health Council, 2009). This startling imbalance, coupled with the continuing rising prevalence in HIV, suggests that HIV prevention efforts have failed. There are a number of reasons for this, but one is that preventive efforts must begin to focus on social, economic, and cultural factors, in addition to individual risk factors. The aim of this chapter is to provide an analysis of some of the intersections between HIV/AIDS, nutrition, agriculture and the school as a platform for the delivery of interventions. This is a huge area, and we will not attempt a comprehensive review but rather argue that a structural focus on the intersections combined with a gendered poverty relief programme promises a long-term and more sustainable approach to the prevention of HIV/AIDS.
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- 1.
The relationship is however a complex one with relatively richer countries in sub-Saharan Africa such as Botswana and South Africa having the highest prevalence figures (Mishra et al., 2007).
- 2.
This case study was detailed in a recent conference paper as an example of the need for convergence between Social Services Provision and Productivity Enhancing Investments in Development Strategies (Gillespie and Drimie, 2008).
References
Ajzen, I. (1985). From intentions to actions: A theory of planned behaviour. In J., Kuhl, and J., Beckmann (Eds.), Action control: From cognition to behaviour. Berlin: Springer-Verlag.
Ajzen, I. (1991). The theory of planned behaviour. Organizational Behavior and Human Decision Processes, 50, 179–211.
Ajzen I., and Fishbein, M. (1980). Understanding attitudes and predicting social behaviour. Englewood Cliffs, New Jersey: Prentice-Hall.
Bennett, J (2003). Review of school feeding projects.
Blankenship, K.M., Friedman, S.R., Dworkin, S., and Mantel, J.E. (2006). Structural interventions: Challenges and opportunities for research. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 83, 59–72.
Bundy, D. (2005). School health and nutrition: Policy and programs. Food and Nutrition Bulletin, 26, Suppl 2, S186–S192.
Campbell, C. (2003). ‘Letting them die’: Why HIV/AIDS intervention programmes fail. Bloomington: Indiana University Press.
Child Health Unit. (1997). An evaluation of South Africa’s Primary School Nutrition Programme. Rondebosch: Health Systems Trust.
Chopra, M. (2003). Equity issues in HIV/AIDS, nutrition and food security in Southern Africa. EQUINET Discussion Paper number 11. Regional Network for Equity in Health in Southern Africa.
Chopra, M. (2004). Food security, rural development and health equity in Southern Africa. EQUINET discussion paper number 22. Regional Network for Equity in Health in Southern Africa.
Coates, T.J., Richter, L., and Caceres, C. (2008). Behavioural strategies to reduce HIV transmission: how to make them work better. Lancet, 372, 669–684.
Cortina, M.A., Kahn, K., Fazel, M., Hlungwani, T., Tollman, S., Bhana, A., Prothow-Stith, D., and Stein, A. (2008). School-based interventions can play a critical role in enhancing children’s development and health in the developing world. Child: care, health and development, 34, 1–3.
De Waal, A., and Whiteside, A. (2003). ‘New Variant Famine’: AIDS and Food Crisis in Southern Africa. The Lancet, 362, 1234–1237.
Del Rosso, J.M., and Marek, T. (1996). Class action: Meeting the nutrition and health needs of school age children in the developing world. Washington: World Bank Human Development Department.
Drimie, S. (2006). “Junior Farmer Field and Life Schools in Swaziland: Lessons Learned Assessment”, United Nations Joint Programme, Swaziland, Mbabane.
Drimie, S., and D. Mullins. (2006). Mainstreaming HIV and AIDS into livelihoods and food security programmes: The experience of CARE Malawi. In: Gillespie SR (editor) (2006) AIDS, Poverty and Hunger: Challenges and Responses. Washington DC: International Food Policy Research Institute.
Eaton, L., Flisher, A.J., and Aarø, L.E. (2003). Unsafe sexual behaviour in South African youth. Social Science & Medicine, 56, 149–165.
Fenton, L. (2004). Preventing HIV/AIDS through poverty reduction: the only sustainable solution. Lancet, 364, 1186–1187.
Gasperini, L. (2006). From agricultural education to education for rural development and food security: All for education and food for all. Retrieved January 15, 2007 from http://www.fao.org/sd/EXdirect/EXre0028.htm
Gillespie, S.R. (Ed.). (2006). AIDS, poverty and hunger: Challenges and responses. Washington DC: International Food Policy Research Institute.
Gillespie, S.R., and Drimie, S. (2008). Agricultural development, social protection and chronic disease: challenges and opportunities during the AIDS epidemic in sub-Saharan Africa. Unpublished paper for the IFPRI/UKZN/NEPAD Conference on the Convergence between Social Services Provision and Productivity Enhancing Investments in Development Strategies: How to Maximize the Impact of Public Expenditure on Agricultural Growth and Poverty Reduction, Pietermaritzburg, South Africa.
Global Health Council (2009). Regional Profiles – Sub-Saharan Africa and Asia. Downloaded from http://www.globalhealth.org/hiv_aids/global_view/profile_asia/, Feruary 19 2009.
Greig, F., and Koopman, C. (2003). Multilevel analysis of women’s empowerment and HIV prevention: quantitative survey results from a preliminary study in Botswana. AIDS and Behavior, 7, 195–208.
Gupta, G.R., Parkhurst, J.O., Ogden, J.A., Aggleton, P., and Mahal, A. (2008). Structural approaches to HIV prevention. Lancet, 372, 764–775.
Hawkes C and Ruel MT (2006) Agriculture and Nutrition Linkages: Old Lessons and New Paradigms. International Food Policy Research Institute, Focus 13. Washington, USA.
Hicks, K.M. (1996). Food security and school feeding programs. Catholic Relief Services School Feeding/Education Guidebook: Background document.
Horton, R., and Das, P. (2008). Putting prevention at the forefront of HIV/AIDS. Lancet, 372, 421–422
Jamison, D., and Leslie, J. (1990). Health and nutrition considerations in education planning: the cost and effectiveness of school-based interventions. Food and Nutrition Bulletin, 12(3), 204–214.
Joffe, H. (1999). Risk and 'the other'. Cambridge: Cambridge University Press.
Link, B.G., and Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health and Social Behaviour, Spec No: 80–94.
Lindegger, G., and Wood, G. (1995). The AIDS crisis: Review of psychological issues and implications, with special reference to the South African situation. South African Journal of Psychology, 25, 1–11.
MacPhail, C., and Campbell, C. (2001). ‘I think condoms are good but, aai, I hate those things’: Condom use among adolescents and young people in a Southern African township. Social Science and Medicine, 52, 1613–1627.
Mahmud, S. (2003). Actually how empowering is microcredit. Developmental Change, 34, 577–605.
Ministry of Agriculture and Co-operatives, the Federation of Swaziland Employers and UNAIDS. (2003). ‘The impact of HIV/AIDS on Agriculture and the Private Sector in Swaziland’. Matsapha, Swaziland: Jubilee Printers.
Mishra, V., Bignami-Van Assche, S., Greener, R., et al. (2007). HIV infection does not disproportionately affect the poorer in sub-Saharan Africa. AIDS, 21 (suppl 7), S5–S16.
Panagides, D., Graciano, R., Atekyereza, P., Gerberg, L., and Chopra, M. (2007). A review of nutrition and food security approaches in HIV and AIDS programmes in Eastern and Southern Africa, Discussion Paper 48, Regional Network for Equity in Health in Southern Africa.
Pieterse, J., and van Wyk, B. (2006). What’s cooking. AIDS review 2005. Centre for the Study of AIDS, University of Pretoria.
Petros, G., Airhihenbuwa, C.O., Simbayi, L., Ramlagan, S., and Brown, B. (2006). HIV/AIDS and ‘othering’ in South Africa: The blame goes on. Culture, Health and Sexuality, 8(1), 67–77.
Pettifor, A.E., Measham, D.M., Rees, H.V., and Padian, N.S. (2004). Sexual power and HIV risk, South Africa. Emerging Infectious Diseases, 10(11), 1996–2004.
Piot, P., Bartos, M., Larson, H., Zewdie, D., and Mane, P. (2008). Coming to terms with complexity: a call for action for HIV prevention. Lancet, 372, 845–859.
Porter, G., and Blaufuss, K. (2002). Children, transport and traffic in Southern Ghana. International workshop on children and traffic, Copehagen: Denmark.
Pronyk, P.M., Hargreaves, J.R., Kim, J.C., Morison, L.A., Phetla, G., Watts, C., Busza, J., and Porter, J.D.H. (2006). Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomized trial. Lancet, 368, 1973–1983.
Psacharopoulos, G., and Woodhall, M. (1985). Education for development: An analysis of investment choices. Washington DC: World Bank
Piwoz, E.G., and Preble, E.A. (2001). HIV/AIDS and Nutrition: A review of the literature and recommendations for nutrition care in Sub-Saharan Africa. Washington, DC: AED Publications.
Rippetoe, P.A., and Rogers, R.W. (1987). Effects of components of protection-motivation theory on adaptive and maladaptive coping with a health threat. Journal of Personality and Social Psychology, 52(2), 596–604.
Rogers, R.W. (1975). A protection motivation theory of fear appeals and attitude change. Journal of Psychology, 91, 93–114.
Rohleder, P. (2007). HIV and the ‘other’. Psychodynamic Practice, 13(4), 401–412.
Rosenstock, I.M. (1974). The health belief model and preventive health behavior. Health Education Monographs, 2, 354–386.
Scrimshaw, N., Taylor, C., and Gordon, J. (1968). Interactions of Nutrition and Infection. World Health Organization, Geneva.
Semba, R.D., and Tang, A.M. (1999). Micronutrients and the pathogenesis of human immunodeficiency virus infection. British Journal of Nutrition, 81, 181–189.
Sontag, S. (1991). Illness as metaphor and AIDS and its metaphors. London: Penguin Books.
Sibanda-Mulder, F. (2004). Assuring food and nutrition security in Africa by 2020. Prioritizing action, strengthening actors, and facilitating partnerships, Kampala, Uganda.
Slater. (2004). The implications of HIV/AIDS for social protection. Overseas Development Institute. Retrieved December 14, 2006 from http://www.sed.manchester.ac.uk/idpm/research/events/february2005/documents/Slater.doc
Save the Children and Oxfam. (2002). HIV and AIDS and Food Security in Southern Africa, December 2002. Oxford: Oxfam
Tomlinson, M. (2007). School feeding in East and Southern Africa: improving food sovereignty or photo opportunity? Regional Network for Equity in Health in Southern Africa. EQUINET discussion paper, No 46.
UNAIDS. (2007). AIDS epidemic update: December 2007. Geneva: Joint United Nations Programme on HIV/AIDS and World Health Organization. Retrieved February 8, 2008 from the World Wide Web: http://www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive/2007/default.asp
UNESCO. EFA Global Monitoring Report 2005. Paris, France: UNESCO, 2005.
Weiser, S.D., Leiter, K., Bangsberg, D.R., Butler, M.L., Percy-de Korte, F., Hlanze, Z., Phaladze, N., Iacopino, V., and Heisler, M. (2007). Food insufficiency is associated with high-risk sexual behavior among women in Botswana and Swaziland. PLoS Medicine, 4(10), e260.
Whiteside, A., Andrade, C., Arrehag, L., Dlamini, S., Ginindza, T., and Parikh, A. (2006). The Socio-Economic Impact of HIV/AIDS in Swaziland, Health Economics and AIDS Research Division (HEARD) of the University of KwaZulu-Natal, Draft Report, June.
World Bank (2006). Repositioning nutrition as central to development: A strategy for large-scale action. Washington: The International Bank for Reconstruction and Development/The World Bank
World Health Organization. (2001). Macroeconomics and health: Investing in health for economic development. Report on the Commission on Macroeconomics and Health. Geneva: World Health Organization.
Yamano, T., and Jayne, T.S., “Measuring the Impacts of Working-Age Adult Mortality on Small-Scale Farm Households in Kenya,” World Development, 32 (1), 91–119.
Zuma, K., Gouws, E., Williams, B., and Lurie, M. (2003). Risk factors for HIV infection among women in Carletonville, South Africa: Migration, demography and sexually transmitted diseases. International Journal of STD and AIDS, 14(12), 814–817.
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Tomlinson, M., Drimie, S., Swartz, L., Rohleder, P. (2009). HIV/AIDS, Nutrition and Structural Interventions in South Africa: A Move in the Right Direction. In: Rohleder, P., Swartz, L., Kalichman, S., Simbayi, L. (eds) HIV/AIDS in South Africa 25 Years On. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0306-8_14
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