OPINION
Poverty and AIDS: What Really Drives the Epidemic?
HIV thrives on poverty, is spread by poverty and produces poverty in its turn. The relationship isn't simple — if it were, AIDS might not have struck so hard in a relatively prosperous country like South Africa.
Given their limited choices, poor people are ingenious and resourceful. They have to be, in order to survive. But poverty's companions encourage the infection. Very poor people may lack confidence or hope in the future. The pressures under which they live encourage high-risk behaviour, from casual relationships to drug and alcohol abuse and gender violence. Living with HIV and AIDS, they find that lost earnings, lost crops and missing or inadequate care make them weaker and make their poverty deeper. AIDS can push vulnerable families and whole communities into poverty. Children of affected families grow up in a world of diminished opportunities. The cycle intensifies.
Inequality sharpens the impact of poverty, and a mixture of poverty and inequality may be driving the epidemic. A truck driver is not well paid compared to the executives who run his company; but he is rich compared to the people in the villages he drives through. For the woman at a truck stop, a man with a few rand or rupees is wealthy. She knows the risks, but she is desperate for money to feed her family. That may be enough to buy him unprotected sex; and perhaps to doom her and her family as well.
If poor people were given the conditions that are necessary for better health, such as clean water, good food, sanitation, shelter and adequate medical care, if they were armed with literacy and access to information, if they were given voice and space to participate in decisions that affect their lives, they would be better equipped to resist the spread of HIV and AIDS. None of these measures call for huge investments or high technology. But they do require the determination to put poor people first.
