HIV (human immunodeficiency virus) is a virus that attacks cells that help the body fight infection,

making a person more vulnerable to other infections and diseases.

Acquired immunodeficiency syndrome (AIDS)

HIV/AIDS: a rural issue

Of the 36,1 million people living with HIV/AIDS, an overwhelming 95 percent live
in developing countries. And within those countries, AIDS is becoming a greater
threat in rural areas than in cities. In absolute numbers, more people living with HIV
reside in rural areas. The epidemic is spreading with alarming speed into the remotest
villages, cutting food production and threatening the very life of rural communities.

 Africa accounts for only one tenth of the world's population but nine out of ten
new cases of HIV infection. Eighty three percent of all AIDS deaths are in
Africa, where the disease has killed ten times more people than war.
 In nine countries in sub-Saharan Africa, more than 10 percent of the adult
population is HIV positive. In Botswana, Namibia, Swaziland and Zimbabwe,
20 to 26 percent of the population aged 15-49 is living with HIV or AIDS
(Click here to view map).

But other parts of the world are also hard hit. In India around four million people are
infected with HIV. The incidence of the disease is high in several Caribbean
countries, although the spread of the epidemic in Latin America has been slower than
in other regions and the epidemic is concentrated in urban areas.

A threat to agriculture and household food security

AIDS undermines agricultural systems and affects the nutritional situation and food
security of rural families. As adults fall ill and die, families face declining
productivity as well as loss of knowledge about indigenous farming methods and loss
of assets.

FAO has estimated that in the 25 most-affected African countries, AIDS has killed
seven million agricultural workers since 1985. It could kill 16 million more within the
next 20 years (Click here for more facts and
figures)

In addition, rural communities bear a higher

burden of the cost of HIV/AIDS as many urban p
dwellers and migrant labourers return to their
village of origin when they fall ill. At the same
time, household expenditures rise to meet
Click here for enlarged poster
medical bills and funeral expenses, and while the number of productive family
members decline, the number of dependents grow. These realities endanger both
short-term and long-term household food security.

A threat to women and girls

Biological and social factors make women and girls more vulnerable to HIV/AIDS
than men and boys. Studies have shown that HIV infection rates in young women can
be 3-5 times higher than among young men. Also, some of the traditional mechanisms
to ensure women's access to land in case of widowhood contribute to the spread of
AIDS -- such as the custom that obliges a man to marry his brother's widow. Studies
have shown that a widow who loses access to her husband's property can be forced
into commercial sex as her only means of subsistence.

Women and girls also face the greatest burden of work -- given their traditional
responsibilities for growing much of the food and caring for the sick and dying. In
many hard-hit communities, girls are being withdrawn from school to help lighten the
family load.

The impact of AIDS on farming communities differs from village to village and
country to country. But it is clear that the epidemic is undermining the progress made
in the last 40 years of agricultural and rural development. This poses enormous
challenges to governments, non-governmental organizations and the international
community. The disease is no longer just a health problem -- it has become a major
development issue.
Fact sheet
AIDS is becoming a greater threat in rural
areas than in cities of the developing world, pp
contrary to conventional wisdom. Growing links
between rural and urban areas through trade,
migration and improved transportation
networks have made HIV prevalence rates rise
A 65-year-old Malawian woman with six of
faster in rural areas. This fact sheet summarizes her nine grandchildren, whose parents have
some major findings about this devastating died of AIDS (UNICEF/HQ93-0757/Andrew)
trend, using data for sub-Saharan Africa, home p
to the most-affected countries. The main
conclusions apply to other developing countries
as well.

AIDS is mostly a rural issue

 More than two thirds of the population of the 25 most-affected African

countries live in rural areas.
 Information and health services are less available in rural areas than in cities.
Rural people are therefore less likely to know how to protect themselves from
HIV and, if they fall ill, less likely to get care.
 Costs of HIV/AIDS are largely borne by rural communities as HIV-infected
urban dwellers of rural origin often return to their communities when they fall
ill.
 HIV/AIDS disproportionately affects
economic sectors such as agriculture,
transportation and mining that have large
numbers of mobile or migratory workers.

AIDS undermines the sustainability of

development
pp
 People are dying before they can pass on
knowledge and expertise to the next
generation. A study in Kenya showed that
only 7 percent of agricultural households
headed by orphans had adequate
knowledge of agricultural production.
 In Kenya's Ministry of Agriculture, 58
percent of all staff deaths are caused by
p
 AIDS, and in Malawi's Ministry of Agriculture and Irrigation at least 16
percent of the staff are living with the disease. One study found that up to 50
percent of agricultural extension staff time was lost through HIV/AIDS in sub-
Saharan Africa.
 In the first ten months of 1998, Zambia lost 1 300 teachers to AIDS -- the
equivalent of around two thirds of all new teachers trained annually.
 The sale of productive resources to care for the sick and pay for funerals diverts
funds away from long-term development.

AIDS threatens food security

 The loss of productive members of society is severely affecting household

capacity to produce and buy food.
 Fostering AIDS orphans or hosting and caring for sick relatives reduces the
amount of food available for each household member.
 Evidence from Namibia shows widespread sale and slaughter of livestock to
support the sick and provide food for mourners at funerals. This jeopardizes the
livestock industry and longer-term food security and survival options.

AIDS undermines agriculture because of its toll on the labour force

 AIDS has killed around 7 million agricultural workers since 1985 in the 25
hardest-hit countries in Africa. It could kill 16 million more before 2020.
 More than a third of the gross national product of the most-affected countries
comes from agriculture.
 In contrast to other diseases, AIDS mostly devastates the productive age group
-- people between 15 and 50 years.
 Up to 25 percent of the agricultural labour force could be lost in countries of
sub-Saharan Africa by 2020.
 AIDS reduces productivity as people become ill and die and others spend time
caring for the sick, mourning and attending funerals. The result is severe labour
shortages for both farm and domestic work.
 Labour-intensive farming systems with a
low level of mechanization and
agricultural input are particularly
vulnerable to AIDS.
pp
AIDS affects women disproportionately

 Women whose husbands are migrant

workers are especially vulnerable to
A Zimbabwean woman with AIDS sits on the
ground in her village. She lives with her
mother-in-law, who cares for her.
(UNAIDS/Szulz-Kryzanowski)
 AIDS, as their spouses may have other sexual partners. The women themselves
may engage in commercial sex in periods of economic stress.
 Some of the traditional mechanisms to ensure widows' access to land contribute
to the spread of AIDS -- for example, levirate, the custom that obliges a man to
marry his brother's widow. Unfortunately, initiatives to stop these practices
may leave widows without access to land and food.
 Biological and social factors make women more vulnerable to AIDS, especially
in adolescence and youth. In many places HIV infection has been found to be
three to five times higher in young women than in young men.
 In several countries, studies have found that rural women whose husbands had
died of AIDS were forced to engage in commercial sex to survive because they
had no legal rights to their husband's property.

FOCUS ON SOUTHERN
AFRICA
So how does all of this affect population structures?

We are going to be using Botswana as our focus for how AIDS can affect a
population structure. Spend 2 minutes exploring Botswana on the Google
Map. Make some notes about its human and physical geographies. 

Click here to be taken to some familiar population pyramids structures for

Botswana. 

Task 5 - Take a copy of the population pyramid and bar chart before using
them to respond to the following IGCSE Population exam question:

Explain, using examples, how incidences of disease can affect the

population structure of a country. (7)

This should take you approximately 14 minutes to respond to. 

Structure:

 What is HIV/ AIDS and how is it spread?

 Why is the infection rate so high in Botswana?
 How does this affect birth and death rates?
 How can a high fertility rate contribute towards the spread?
  Cultures and Traditions
 Explain how the 2020 structure is different if AIDS is taken into
consideration.
 Concluding statement
 14 lines / 14 minutes . 

Homework Video:

Watch The AIDS Highway - Africa to the right hand side. Make notes on how
the AIDS virus has been spread along the so called 'AIDS Highway' in
southern Africa. What are the causes and effects? 

Demographics
HIV and Population Decline
High HIV infection rates and mortality cause a different kind of population growth curb than that
shown in this module. In a number of countries, HIV is projected to turn population growth to
decline. HIV has already infected 20% or more of all adults aged 15-49 in Botswana, Lesotho,
Namibia, South Africa, Swaziland, Zambia, and Zimbabwe. This translates to infant HIV
infection. For example, in Zimbabwe, 70% of all deaths under the age of 5 are from AIDS.*

The simulator in this module is based on fixed age-structured mortality rates. It has no
model for increasing mortality rates. So this file is an attempt to include the subject,
though not the simulation.

Below are two superimposed population pyramids for Botswana for 2020. The larger
pyramid is Botswana's projected population without HIV. The smaller pyramid is the
projection with HIV. The year 2000 birthrate in Botswana is 30 per 1000. The deathrate
is 22 per 1000, projected to rise to 36 per 1000 around the year 2010. (For comparison,
the US birthrate is 14 and deathrate 9 per 1000).
Another view of HIV can be seen in this chart. In Zimbabwe, life expectancy at birth is now 38
instead of the 70 it would have been without HIV.