Poverty and the impact of HIV are closely linked, albeit that this link is complex. What improves health? Health is improved by getting out of poverty, having access to clean water, good food, education, sanitation, shelter and preventive care. Where there is poverty and inequality HIV thrives. When someone is poor it is not easy for them to reduce or manage the risks that they need to take in order to survive.
The following are some of the factors that contribute to the links between HIV and poverty:
- Lack of access to education means people have less opportunities to earn a living safely as an adult, they also do not have the same ability to make informed choices (they may not have had any access to information about HIV and how to prevent it).
- Lack of clean water and sanitation makes people more vulnerable to disease and infection. This has a knock on impact on schooling and also ability to live well and fight off infection if they are living with HIV.
- Gender: women are more vulnerable to HIV. They are more likely to be poor and to be subject to rape and sexual violence. They have less economic opportunities and may feel forced into commercial sex work as a route to survive.
- Population mobility: poverty forces people to move to get work and being away from home makes people more vulnerable to risk taking behaviour which increases their vulnerability to HIV.
- Food security: lack of food security will make people more vulnerable to HIV and its impact. They may be forced into risk taking behaviour in order to survive. If they are living with HIV they will be at increased risk of becoming ill without a good balanced diet. Families caring for orphaned children will be less able to do so if they live with low food security and poverty. These children are more at risk in later life if they don’t get access to an education.
- Conflict: war and conflict displaces people and increases the vulnerability of women to sexual violence and rape, therefore increasing their vulnerability to HIV.
- Low social cohesion: Eastern Europe and the Former Soviet Union are examples of where social upheaval has impacted the prevalence of HIV. Unemployment, struggling health and education systems, lack of security and mobile populations result in people being more vulnerable to high-risk behaviours such as intravenous drug use.
- Poor public health facilities: in countries where poverty is prevalent there are often struggling health facilities, which means that there is a lack of both prevention and care facilities and services. Individuals in rural areas particularly struggle with access to adequate health service.
A combination of all these factors increases the vulnerability of individuals, families, communities and nations to HIV.