HIV, nutrition, food and livelihoods in Sub-Saharan Africa: evidence, debates and reflections for guidance
How can livelihoods and food security strategies play their part more squarely in addressing the HIV epidemic? How can objectives and practice adjust to the changing realities in communities? This report is one output of a review study carried out by IDS and the ODI for the UK DFID. The study focused on the various linkages between HIV, livelihoods, food security and nutrition in high prevalence countries in sub-Saharan Africa. It considers the evidence for the relationship between HIV, poverty, and inequality and assesses the upstream links, midstream interactions and downstream impacts of HIV infection in terms of individuals in the context of a particular environment.
Interrelations between livelihoods and HIV-linked vulnerabilities and resilience include that:
- HIV creates new categories of vulnerable people, less resilient to various livelihood crises and reproduces or reinforces existing livelihood vulnerabilities
- informal livelihoods, mobility, migration, and sex-work based livelihoods all imply specific upstream, midstream and downstream linkages. Downstream linkages are exacerbated by stigma which mediates access to markets, jobs, and social networks.
Recommendations for livelihoods policy and interventions include that:
- policy should incorporate better attention to the role of different kinds of individuals within households and the role of social networks, sexual culture and mobility
- interventions need to be flexible and non-discriminatory, allowing marginalised or disadvantaged people access to resources. Solutions will often need to be creative, providing support options which do not rely on heavy labour
- factoring in how to build the resilience of growing people is central to breaking the back of the epidemic and prevention must systematically be considered.
