You are on page 1of 8

Indian Journal of Millennium Development Studies: An International Journal

Volume 5 Numbers 1-2 January & June, 2010; pp. 139-146


ISSN. 0973-3981

THE ECONOMIC IMPACT OF HIV/AIDS:


A STUDY IN TRIBAL AREAS IN ANDHRA PRADESH
B. Suresh Lal
Assoc. Professor, Department of Economics, University Arts & Science College,
Kakatiya University, Warangal-506001, A.P., India.

ABSTRACT: Community learning processes are crucial to increasing resilience to


HIV/AIDS in Indias remote rural areas. This paper examines the victims social
status, expenditure and income patterns, reasons for spread of disease, how
respondents economic conditions responsible for exposure to this epidemic. It also
examine and focuses psychological and stigma/discrimination in the society. This
study highlights the tribal groups in Khammam district of Andhra Pradesh, India, to
reduce their vulnerability to HIV/AIDS, improve household nutrition and clean up
their environment to reduce opportunistic infections.

INTRODUCTION
Over the second half of the twentieth century and the new millennium, the world has
seen enormous health improvements. However, developing countries have benefited
unequally from health gains, with many, especially in the Indian tribal community,
continuing to experience high mortality. Young Adults and children experience
substantial premature mortality. Within country, poorer tribal groups have considerably
worse health than the better off. Analysis of avoidable mortality highlights the
importance of HIV and AIDS, which represent around 90% of all avoidable mortality in
almost all age/sex groups.
In Andhra Pradesh, home to Indias worst HIV/AIDS epidemic, 15,000 people are
now receiving ARVs, compared to just 200 three years ago, Locals claim it is their
famous hot chilies which fuel the states expansive commercial sex trade. In truth, its
the ordinary twin burdens of poverty and illiteracy. Nature bestows few favors on the
tens of millions who eke out a living from Andhra Pradeshs red soil. Back-breaking
labor in the cotton, tobacco and chili fields pulls in perhaps one US dollar a day. Some
villages survive by crushing rocks in the searing heat, no water spared to damp down
the dust. Summer brings daytime highs of 45 degrees Celsius. Then there are the fields of
despair; fallow roadside plots where poor women loiter at night offering cut-price sex to
the steady stream of truck drivers plying the major trading routes. Uneducated girls who
try their luck in the cities often end up in the same trade.
EPIDEMIOLOGY OF HIV AND AIDS
The HIV stand for Human Immunodeficiency Virus. That means it is a virus that attacks
and destroys the immune system in human beings. The immune system is the bodys
natural defense system to fight off infections and disease. The HIV virus originated in
Africa in the twentieth century and has been able to spread across the world through

140

INDIAN JOURNAL OF MILLENNIUM DEVELOPMENT

the global mobility of people. Today, almost no country has been unaffected by the
human loss and financial costs of treating and preventing the spread of the HIV virus.
The HIV virus belongs to a special class of viruses. Once it has entered the body, it lives in
the white blood cells, using them as food to grow and reproduce. In the process of
reproducing itself, it kills these cells. In particular, it destroys a type of cell that normally
protects us from disease. This cell is called a CD4 cell. A healthy person has between
450 to 1,200 of these cells in each cubic millimeter of blood.
The HIV virus is generally slow to impact on the health of an infected individual.
Some people become sick quickly, but most adults do not develop symptoms for around
10 years. As HIV progressively weakens the immune system, the person infected becomes
vulnerable to a range of illnesses, including pneumonia and tuberculosis. These are
called opportunistic infections. If a person is living with HIV, they are said to be HIV
positive. Because of the slow progression of disease, a person who is living with HIV
may appear perfectly healthy and normal. This fact has helped the virus spread across
the world. Fortunately, the virus cannot survive long outside the human body. It can
only be transmitted in a limited number of ways. Even so, the virus has been remarkably
successful. At the end of 2009, there were 35.8 million people estimated by UNAIDS to
be living with the virus. There were 2.4 million AIDS-related deaths in 2009. To date,
more than 25 million people have already died from HIV and AIDS. When a person
begins developing opportunistic infections because HIV has weakened their immune
system, that person is considered to have AIDS. AIDS is a condition where a person
living with HIV has become seriously ill because their immune system can no longer
defend them effectively against disease. The AIDS stand for Acquired Immunodeficiency
Syndrome. A person with AIDS may die of diseases that would not kill a person with a
healthy immune system. A person with AIDS typically has lost a large number of CD4
cells. The CD4 cell count is 200 cells per cubic millimeter of blood or less, and this is
insufficient to provide the body with protection. As AIDS is signaled by the presence of
opportunistic diseases such as pneumonia, it is necessary to be tested for HIV in order to
confirm their cause. Early confirmation of HIVs presence can lead to sooner use of lifeprolonging medical care. Access to HIV testing is important for treating the virus.
THE STUDY AREA
The Khammam district has been selected for the study on HIV/AIDS. The district is
predominantly by tribal population in the Telangana areas. Khammam is one of the
most affected districts in the Telangana region of Andhra Pradesh, after Hyderabad,
by HIV/AIDS. The main reasons behind this are that majority people have illiteracy,
ignorance, poverty, migration, prostitution etc. We have interviewed 300 sample
respondents in the district from various mandals and villages.
THE DATA ANALYSIS
Social Conditions
The field study data provides the age group of the people in our study area who are
affected by HIV/AIDS. The highest percentage of AIDS affected people are in the age
group of 15-29 yrs. Next follows the age group of 30-39 years with 24% people. It is
surprising to note that about 15% of 0-14 age group of people affected with HIV/AIDS.

THE ECONOMIC IMPACT OF HIV/AIDS: A STUDY

IN

TRIBAL AREAS

IN

ANDHRA

141

The above fifty age group people are seen to be sincere in their lives, might be due to old
generation and have characters.
It is observed that about 40% of the respondents are affected by HIV/AIDS who are
illiterates. About the family system of the respondents. Out of a total three hundred
respondents interviewed about 79% of them are living with nuclear family. Only 21% of
the respondents are living in a joint family system. In India, there is a lot of change
recently among the perceptions of the people. Most of the youth do not want to live with
their parents. The youth of this country becoming day by day undisciplined, uncultured,
and adopting mostly the Western culture.
The study data provide the marital status of the respondents in the study area.
There are about 28% of the people who are unmarried and affected by the HIV/AIDS.
About 72% of the people are married and living with HIV/AIDS. The unmarried may
cause is spreading HIV to others and the married people may spread HIV to their life
partners too. This way it goes on spreading among the people if they do not take proper
care. Most of the surveys reveal that the spread of HIV/AIDS among the females is due to
males only and they fall prey to these diseases with not knowing by them.
The study examines the number of the children of the respondents and the housing
particulars of the respondents in our study area. There are about 28% respondents who
do not have children and are affected by HIV/AIDS. About 48% respondents are having 2
children each though they have AIDS. 14% respondents are having one child each, and
remain having more than 3 children. The house particulars of the respondents. Out of
three hundred respondents about 66% of them are living in the thatched houses, which
show the economic backwardness of these people. About 23% of the respondents are having
pucca houses or houses with tiles and about 11% respondents are having RCC houses.
This indicates that the HIV/AIDS disease can not discriminate rich and the poor.
ECONOMIC IMPACT
Occupation
The field study data shows the particulars of landholdings of the respondents. About
45% of the respondents are having no land at all. These are called as landless agricultural
labourers. Once this infection is identified their life is hanging and have to spend on
medicines, treatment etc. Their landed property, house property, everything becomes
useless for them. About 35% of the respondents are having two acres of land, which is
neither sufficient for their needs nor able to produce anything. 12% respondents are
having 3 to 5 acres of land, about 8% respondents are having 6 to 10 acres of land. The
landlords and the landless are equally important before the HIV/AIDS. Here also no
discrimination between the rich and the poor in evident.
Out of three hundred respondents, about 72% of the people are working in the
agriculture and allied activities and about 28% of the people are working in the private
and government sector, which shows the pitiable condition of the people who are affected
by the HIV/AIDS.
Income and Expenditure Particulars
The response of the respondents provides the data on annual income in the study area.
Majority of them i.e 44%, are below Rs .11000 per annum. Already they are affected

142

INDIAN JOURNAL OF MILLENNIUM DEVELOPMENT

with HIV/AIDS, who require expenses to cure their diseases. This shows a pitiable
condition of the respondents. About 24% of them are getting Rs. 12000 to Rs. 24000 and
22% of the respondents are getting between Rs. 24000 to Rs. 60000 etc. Only 10% of the
respondents are getting more than Rs. 6000 per annum, it is also much less to maintain
their family members and to meet the personal requirements. Though they have land
resources, own houses and living in the villages but the disease makes them
psychologically depressing in the society. The society also keeps them away once they
know that the particular person is affected with HIV/AIDS.
The study explains the expenditure on food items and non-food items is almost
same. About 72% of the respondents are spending on food items between Rs. 3000 to
Rs.6000 per annum, reveals the utter poverty prevails in them. About 18% of them are
spending Rs. 6001 to Rs. 12000 per annum on food items and nonfood items. Only 10% of
the respondents spend more than Rs. 12000 per annum on food and nonfood items, this
shows the life styles and their living habits in the society. It really shows the
backwardness of the people in the area. The food items mostly are rice, vegetables,
milk oil and pulses etc. The nonfood items, we mean expenditure on clothes, shelter
and education to children etc. The people who are affected by HIV/AIDS require nutrition
food but their low income would not permit them to consume. If these dreaded diseases
are not cured and not prevented before the people acquire it, the economy totally in the
country may be disturbed
Work Particulars
The study analyzed the data on working days per year of the respondents. About 25% of
the people are working for 100 days in a year out of 365 days. 49% of the people are able to
work for 100 to 200 days in year, and about 26% of the people are working for 200 to
300 days for their livelihood. As these are mostly unorganized in nature, they may not
get work for the entire days in a year. Moreover, the respondents, who are affected by
HIV/AIDS may not able to work 8 hours a day or 365 days in a year. Due to ill health,
they loose capacity to work. The diseases are mostly prone to youth in the society. On
account of this, the human development is severely affected and production is reduced in
course of time. Many surveys have reported in the news papers by giving warning to the
state governments and the government of India on spreading these diseases in the
economy. It is for the government to prevent such diseases spreading and make sure to
increase GDP and the Human Development Index.
The field data provides the mode of transmission of HIV infection to the respondents.
According to our sample survey, 14% respondents got this infection by the transfusion
of infected blood. At the time of accidents or other medical operations the respondents
may be transfused by infected blood. This shows the importance of blood testing while
under going treatment to have blood of others. Due to this they fall prey to this dreaded
disease. And 44% of the respondents got this infection through sexual intercourse, all
of these respondents are females and they told that they got this infection from their
husbands. Most of the husbands of these females died and some are on the death bed.
This shows the male domination and gender inequalities in the society, over women,
and helplessness of the innocent wives to refuse forcible sexual intercourse by infected
husbands. In addition to this the study shows the pitiable condition of 15% respondents,
who were infected through the parent to child transmission. The mistakes done by the

THE ECONOMIC IMPACT OF HIV/AIDS: A STUDY

IN

TRIBAL AREAS

IN

ANDHRA

143

parents cause curse to their children, 27% respondents infected through unknown factors
may be they knew, even though they dont want to reveal about it. Just they tell that we
dont know how we got this infection .According to our survey most of them are reluctant to
reveal the facts about how they were affected by HIV.
Economic Loss
The field data provides loss of working hours per day and the working days per year by
the respondents due to ill health. The number of working hours lost by the respondents
shows the physical productivity decline in the economy. About 20% of the respondents
lost at least 3 hours per day due to health problems. Once the disease is attacked, the
person is unable to work physically. About 49% of the people have lost 3 to 6 hours a
day and about 26% respondents lost 6 to 9 hours a day. 5% of respondents are not able
to work at all as they lost physical ability. If hundred persons are not able to work at
least one hour a day, the economy put to loss three hundred man hours production per
day. The loss of not only production, in the economy but also monetary income foregone
by the respondents is also taken into account.
A small study by us in the Khammam district reveals that the substantial income is
foregone by the small respondents. If it is applied to the state and the nation, the
income foregone by these HIV/AIDS affected people is considerable. As India is a big
country with huge population we are able to bear the loss but it is not advisable. For
this purpose only we have taken up the economic aspect of this study as to how much is
the loss to the State and country due to these dreaded diseases like HIV/AIDS. The loss of
income by the respondents due to ill health. About 20% of respondents lost the income to
the extent of Rs. 3000 per annum, and about 49% of them lost the income between Rs.
3000 to 6000 per annum. As the health is not permitting them, they are not able to work
and hence no earnings. The loss of annual income due to illhealth in the range of Rs.
6000 to Rs. 12,000 comes about 26%. About five respondents are loosing annual
income to the extent of more than Rs.12000 per annum due to the illhealth. Such is the
income loss to the society and also to the economy. There fore a quick action is necessary to
meet these challenges.
Epidemic Problems
The study explains impact of HIV on the respondents. We have elicited the data on
HIV/AIDS patients as to how they have acquired the diseases and since how many
years they are suffering from these diseases. It is noticed that about 32% of the patients
were suffering for the past one year with AIDS. About 48% of the respondents stated
that they are suffering with this disease for the past 5 years. About 16% of the people
were said to be suffering since 10 years and about 4% of the respondents stated
that they are suffering since more than ten years. It is clearly understood that about
80% of the respondents said to have acquired these diseases recently. This must be due
to inability of the government machinery to control it. These diseases are having
treatment if individual attacked and the voluntary agencies and government officials
try to work hard.
The study depicts the diseases that occur to the people who are affected by HIV/
AIDS. After having attacked by this disease, the patients later subjected to opportunistic
disease like TB, Skin diseases, diarrhoea and other such diseases. Not only this they

144

INDIAN JOURNAL OF MILLENNIUM DEVELOPMENT

are put to mental agony on account of these diseases and become pessimistic in their
life. This situation further depresses the people and ultimately makes them to leave
this world. Out of three hundred respondents about 62% of them are subjected to TB,
about 24% of the respondents are attacked by skin diseases etc. The diarrhoea has been
attacked by 12% respondents in our study area and two per cent respondents received
other disease.
The people are already suffering with HIV/AIDS and these diseases keep them at
low profile in the society. As a result of these diseases people are suffering from reactive
depression is their life. About 54% of the respondents received such a reaction in our
study area. 26% respondents feel with Encephalopathy and about 16% people
faced with Dementia. A four per cent of respondents faced convolutions. Thus the HIV/
AIDS affected people suffer, socially, economically, mentally, physically and also politically.
Some people may get fits also. In a way they are depressed in all means and repent
that this life is waste. This type of situation in the economy is to be avoided and the
government must plan tackling there problems. In fact, the government machinery,
officials, especially health officials do not bother to attend the problems of these people
and the society in put to loss at the end. It is for the intellectuals in the country to frame
plans in such a way that these diseases are tackled at the initial level to increase the
productivity and production in the economy as these persons cause one per cent of GDP to
decline. Due to illhealth, the people are not able to work fully in the day and in a year.
This is loss of human resources to the economy.
Health Facilities
The responses of the respondents provide the data on health facilities, available in the
study area and the treatment regularly taken by the respondents. As a matter of fact
every mandal should consist of one Primary Health Centre (PHC), but they are name
sake and no doctor is available. Only compounder and other staff are not able to meet
the requirements of the patients. For every 5000 population, there should be a
PHC. But no where this is not met and Karimnagar district is no exception. About 23% of
the respondents go to PHC for treatment. There are community health centres
apart from PHCs, about 18% of the respondents go for treatment to these centres.
About 13% Hospitals, This is 6O km away in this mandals. About 32% of the respondents
are not taking any treatment, through the facilities are available, due to social
prestige or due to depression psychologically as to how this diseases attacked them.
The meagre facilities, irresponsible medical officers and staff can not able to eradicate
these diseases.
The study provided the data on increase of expenses by the respondents due to
illhealth. Many of them are incurring huge expenses to their capacity. As most of them
are agricultural labourers and working class, they can not bear the expenses. Whatever
they earn they are seems spend on the medicines to cure the diseases. Almost all the
respondents are incurring expenses on these diseases and incurring debts. Some times
they have to go to different places, distant places also for their treatment incurring
travel expenses and other expenditure. They may also go to people who mesmerize
them through olden methods. All these factors contribute increase in their expenditure
on medicines, traveling etc. and ultimately run in debt. This debt may also be passing
on to the coming generation. Thus, the entire society in the rural areas fall prey to the

THE ECONOMIC IMPACT OF HIV/AIDS: A STUDY

IN

TRIBAL AREAS

IN

ANDHRA

145

money lenders, who extract huge interests, making the already poor people into destitute.
Therefore, the attending of the government is required to save these people from all the
problems.
Stigma/Discrimination
The study shows the family discrimination of the respondents. Out of 300 respondents
about 73% of the respondents are living with their families, and 27% of the respondents
are separated or driven away by their families. This shows the awareness and good
emotional attachments among families, it is one of the causes to be attached to remain
with their families. Especially, the female respondents face much discrimination than
males after having faced these diseases. As most of the males are earning something
they are treated well in the society or in the family but the females are facing problems.
The females are getting such diseases through males or husbands and once the husband
dies, the females are not able to survive an economic aspect and have to transform
themselves as sex workers. This further causes to attract HIV. This activity and attitude
and the living conditions reduce them in to pitiable condition and causing of AIDS to
others in the society. Any way, it is the females who are the victims in the society due to
non-earning and absence of help from both sides among the families once her husband
dies under this circumstances, it is the society or the government to take care of these
people. HIV/AIDS does not contaminate by living together, even though the families
and society are showing discrimination to the HIV/AIDS patients.
CONCLUSION
Over the years, there has been considerable discussion on HIV/AIDS spread in the
world countries in general, and particularly in India. Andhra Pradesh stated to be in
the second position in India. So far as HIV is concerned. The field survey in our study
areas reveal that the HIV/AIDS is ruining and destructions not only lives of the people
but also the entire economy. The micro level study in Khammam district of Andhra
Pradesh on tribal population revealed that the people are fear stricken with these
dreaded diseases and the families have been put to loss economically means the problem
may be manifold at the national level. The illiteracy in the country, poverty,
unemployment, migration, urbanization and globalization lead the country to spread of
these dreaded diseases like HIV/AIDS.
There might be many reasons to mention how the HIV is spreading in the country
but it is true that we are progressing in these aspects. The HIV/AIDS spreading is not
only a problem of deteriorating health problems of individuals in the society, but it is a
problem of human lifes survival. Therefore, the HIV/AIDS affected people need not
fear that they can stand before others that they are strong enough to do anything.
ACKNOWLEDGEMENT
This research is carried out under MRP funded by UGC-SERO, Hyderabad to [BSL]. I
thank research scholars who have helped me for data collection.
REFERENCES
Anderson, R. M.; Garnett, G. P. (2000), Mathematical Models of the Transmission and Control of
Sexually Transmitted Diseases, Sex Transm Dis, 01/11/2000 , Volume 27 issue.

146

INDIAN JOURNAL OF MILLENNIUM DEVELOPMENT

Bill and Melinda Gates Foundation (2002), Grant Highlights. http://www.gatesfoundation.org/


grants/default.htm. April 2002.
Commission on AIDS in Asia (2008), Report: Redefining AIDS in Asia Crafting and Effective
Response, http://data.unaids.org/pub/report/2008/20080326_report_commission_aids_en.pdf
Gangakhedkar, R. R.; Bentley, M. E.; Divekar, A. D.; Gadkari, D.; Mehendale, S. M.; Shepherd,
M. E.; Bollinger, R. C.; Quinn, T. C. (1997), Spread of HIV Infection in Married Monogamous
Women in India. Journal of the American Medical Association.
International Institute for Population Sciences (IIPS), (2000), National Family Health Survey:
Andhra Pradesh Report, 2000 and In: Srinivasan PC, Kanitkar S, Kanitkar T (Eds), (1979),
Child in India. Himalaya, Bombay.
Lal B. Suresh (2009), Tribal Womens Health Conditions: An investigation in Andhra
Pradesh, In Lal B.Suresh (Eds), 2009: Human Development in India, Serial Publication,
New Delhi.
Mehendale, S. M.; Shepherd, M. E.; Divekr, A. D., et al.(1996): Evidence for High Prevalence
and Rapid Transmission of HIV among Individuals Attending STD Clinics in Pune, India.
Indian J. Med Res.
Report on the Global HIV/AIDS epidemic. UN-AIDS/WHO June 2009.
UNAIDS Fast Facts about AIDS, http://www.unaids.org/en/MediaCentre/References/default.asp
UNAIDS Report on the Global AIDS Epidemic, http://www.unaids.org/en/HIV_data/
2006GlobalReport/default.asp.