Harnessing poverty alleviation to reduce the stigma of HIV in Sub-Saharan Africa

Abstract

Alexander Tsai and colleagues highlight the complex relationship between poverty and HIV stigma in sub-Saharan Africa, and discuss possible ways to break the cycle. Please see later in the article for the Editors' Summary.

Figure 1. Relationships between HIV, disability, and stigma.

HIV infection has adverse health and economic impacts, undermining HIV-infected persons' abilities to maintain their full economic contributions to family and community life and engage in reciprocal exchange. Stigmatization and exclusion from local solidarity networks erodes their food and livelihood security, which in turn undermine their adherence to ART. Non-adherence to ART perpetuates this cycle by further compromising health and economic viability.

Figure 2. Transforming HIV-stigmatizing beliefs through ART-plus.

ART manages the disability incurred through HIV infection, undermining the view of HIV-infected persons as economically inadequate members of the community and permitting them to re-engage in productive activity. Livelihood interventions, such as combined financial literacy and microenterprise management programs, may additionally create new modes of engaging in productive activity, such as new trades or new enterprise development. These financial contributions are welcomed within local solidarity networks, and the norm of reciprocity is upheld.