Gillespie 2009 – Seasonality of HIV and hunger in southern Africa

The seasonality of disease, ill-health and hunger were illustrated in multiple contexts in the original IDS conference on seasonality over three decades ago. The subsequent book (Chambers et al. 1981) was published in the same year as the first case of AIDS was reported. Since then, the rapidly accelerating AIDS epidemic of the 1990s and its current state of “hyperendemicity” in southern Africa have affected the levels, intensity and nature of vulnerability of households to livelihood shocks and stresses. The food price crisis of 2008 and the ongoing global financial crisis have further impacted the ability of households, communities, and national governments to achieve food security for large numbers of people in the region. Overlaying these dynamics, various manifestations of climate change are beginning to have an impact — again, with evidence of interactions with other drivers of vulnerability. In this paper, we apply a “seasonal lens” to a decade of work on HIV, food and nutrition security in eastern and southern Africa. We investigate the existence and nature of seasonal dimensions to the HIV-hunger nexus. Following the HIV timeline, we examine whether seasonality in food insecurity and malnutrition can affect an individual’s risk of being infected with HIV; whether seasonality is a major issue for people living with HIV, and whether it affects their ability to access and adhere to treatment. We examine how seasonality plays out with regard to the resilience of households in the face of the downstream impacts of AIDS. In the final section, we briefly review the record of international agencies, governments and other stakeholders in addressing the adverse effects of seasonality – before concluding by showing how a combined response to HIV and hunger can be better adapted to such effects. At the outset we need to state clearly that very few studies in this field explicitly discuss or measure seasonality. Interestingly, most peer-reviewed journal articles that emerge from web searches using keywords of season and  HIV derive from studies undertaken in developed countries where effects are far less common and less serious.

File: Gillespie 2009 - Seasonality of HIV and hunger in southern Africa.pdf