AIDS and the Ecology of Poverty

Abstract

Abstract This book examines the HIV/AIDS epidemic in the social and economic context of poverty and economic crisis in developing and transition countries. It challenges the assumption — implicit in AIDS policy — that differences in sexual behavior are adequate to explain differences in HIV prevalence between populations. Using an epidemiological approach, the book shows how people who are malnourished, burdened with parasites and infectious diseases, and who lack access to medical care are more vulnerable to all diseases. It explains the specific mechanisms by which undernutrition, micronutrient deficiency, malaria, soil-transmitted helminths, schistosomiasis, and other parasitic illnesses increase the risk of HIV transmission and epidemic spread of HIV/AIDS in poor populations. A theme throughout the book is that the sexual transmission of HIV diverts attention from the social and economic context of profound poverty. The distraction of sex is compounded by Western stereotypes of African sexuality, perpetuated through reliance on anecdotal evidence and the construction of a notion of fundamental dissimilarity among peoples of different world regions. The book evaluates current methods in epidemiology and health economics, which do not take account of the interactions among diseases that increase risk of transmission of HIV in poor populations. It criticizes HIV-prevention policies as narrow, shortsighted, and dead-end because they fail to address the economic and social context in which risky behaviors occur. Finally, the book offers pragmatic solutions to social, economic, and biological factors that promote disease transmission, including the spread of HIV.

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