How do households and communities respond to HIV and AIDS? A study by the UK Institute of Education examined the beliefs and social structures that influence the way people cope, and help others to cope, with HIV.

In the Dominican Republic, weaker children may be segregated from an infected adult family member. When a man dies in India, his wife might have to leave his house or that of his parents, and in Mexico City gay men with HIV often return to their mother for care. Understanding these diverse reactions is crucial in order to develop interventions that reinforce positive rather than negative responses to HIV.

Research was carried out in the Dominican Republic, India, Mexico, Tanzania and Thailand from 1993-4. In spite of the stigma attached to people with HIV, they receive widespread practical and emotional support from household members. However:

• Household and community responses depend strongly on the perceived culpability of infected individuals. It is generally thought more shameful for women to have HIV.
• If a major wage earner dies, financial problems can cause as much stress for households as the stigma and physical symptoms associated with HIV and AIDS.
• When the number of deaths rises sharply, local health care networks suffer. Also, lower levels of emotional support are available for bereaved households.
• A person’s HIV status may be concealed to avoid discrimination. Conversely, when someone falls ill, HIV infection is often wrongly suspected.
• HIV-positive women may not receive the same level of care as men. Women also receive little support in caring for infected relatives and hesitate to ask for help.
• Children’s nutrition and education suffers in households living with HIV, although bereaved children often continue to receive support.
• Although the main routes of HIV transmission are understood, some anxiety exists about the risk of infection through the air, bodily contact and sharing eating utensils.

While non-governmental and community-based organisations can play an important role, they should complement and not substitute for indigenous and local care and support systems. The results of this study suggest that policy-makers can enhance community support mechanisms by:

• providing extra assistance for poor households and communities
• promoting a shared responsibility for caring for people with HIV involving both men and women
• focussing on the needs of HIV-positive women in illness and health
• providing education on the way HIV is transmitted and the responsibilities of both men and women in this respect
• challenging the stereotypes and assumptions that underpin prejudice and stigmatisation.

Source(s):
‘Sex and youth: contextual factors affecting risk for HIV/AIDS. A comparative analysis of multi-site studies in developing countries. Part 2: Community Responses to AIDS’ by P. Aggleton and I. Warwick (1999) Full document.

Funded by: UNAIDS

id21 Research Highlight: 25 January 2001

Further Information:
Peter Aggleton and Ian Warwick
Thomas Coram Research Unit
Institute of Education
University of London
27-28 Woburn Square
London WC1H 0AA
UK

Tel: +44 (0) 20 7612 6957
Fax: +44 (0) 20 7612 6927
Contact the contributor: p.aggleton@ioe.ac.uk

Institute of Education, University of London, UK

Contact the contributor: i.warwick@ioe.ac.uk

Other related links:
Take a look at AIDS Action - a newsletter on AIDS prevention and care from Healthlink Worldwide.

UNDP also has information on HIV/AIDS.

Refer to Family Health International for more research, education and services relating to reproductive health.