Over the last decade, HIV/AIDS has become increasingly associated with malnutrition and household food insecurity in many countries around the world. Life-prolonging medication exists for HIV/AIDS, but access to such medicines and accompanying care is beyond the reach of most people living with the disease. This is especially the case in countries where the rapid increase in HIV/AIDS is creating additional pressures for resource-poor communities. Within this context, a new imperative has emerged: rethinking development strategies and redirecting projects and resources to address the impact of HIV/AIDS on food and livelihood security.
While the need to mitigate the effects of HIV/AIDS is increasingly acknowledged, it is equally important to recognize that food and livelihood security is a key element of prevention. Prevention is usually considered to be the health sector's responsibility and most commonly involves education and the promotion of safer sexual practices. However, food and livelihood insecurity often leads people into behaviours and strategies that increase their risk of infection, such as migration and exchanging sex for cash or food. Improving livelihoods, especially among the most vulnerable groups in society, can provide a concrete way to tackle one of the most fundamental issues behind the spread of HIV.
This pocketbook provides a checklist of questions to provide guidance for incorporating HIV/AIDS considerations into food security and livelihood projects. The pocketbook is drawn from the full document "Incorporating HIV/AIDS considerations into food security and livelihood projects" prepared by FAO's Nutrition Programmes Service. It is intended to be used by people involved in project management and technical support.
HIV/AIDS and nutrition are intimately linked. Poor nutrition can damage the immune system and contribute to the acceleration of full-blown AIDS. In turn, HIV/AIDS itself may lead to malnutrition. HIV weakens the immune system, thus compromising the body's ability to fight infections. As a result, an HIV-positive person may become prone to repeated periods of prolonged illness, which can reduce their appetite and interfere with the body's absorption of nutrients. Infections also increase the body's need for essential nutrients. Many HIV-infected people are unable to meet these additional nutritional requirements and become weak and malnourished.
An adequate, well-balanced diet is therefore an essential component of basic care for people living with HIV/AIDS. Given the lack of medical care and drug treatment in most AIDS-affected developing countries, it is imperative that vigorous efforts to achieve and maintain good nutrition among HIV-infected people are undertaken as a matter of priority.
Not only does HIV/AIDS undermine the ability of individuals and households to feed and care for themselves, it also erodes the capacity of communities and institutions to provide basic services and support for people in need. Groups of people generally requiring special attention include:
The combination of interventions and how they are implemented will differ depending on the stage of the epidemic. The response to an existing HIV/AIDS crisis will be fundamentally different from preparing for a crisis which may arise. This has important implications when considering HIV/AIDS in the project cycle.