English language version - Human Development Reports - United ...

The Demographic Impact of HIV and AIDS in Mozambiqueshown a chain of impacts. According to these studies,the curve of infection is followed by the curve of sicknessand death, which in turn determine the thirdcurve – that of the impact (Benett and Whiteside,2002). Individuals, by families and by communities,will feel the impact in different ways.Regardless of the social responsibility of the individual,whether within the household or in otherareas of civic life, the consequences of HIV infectionwill be immediate and severe, varying, however, inaccordance with age and sex. The impact on the individualbegins with his/her awareness of his/her HIVpositivestatus. However, if the individual obtains indue time appropriate counselling on how to organisehis/her life as from that moment, the magnitude ofthe impact may be lessened.In the absence of treatment, the infected individualmay experience periods of illness, which is likelyto reduce productivity and income, and to increaseexpenditures for travel costs, laboratory tests andmedicines. Some individuals may, depending on theirlife style combined with good nutrition and other factors,hold back the disease and may even never experienceit. However, anybody in this state will be facedwith his/her health status and also, very frequently,with the resources he/she possesses.Where there are support systems, or free medicalcare, it is expected that the individual impactsbecome less serious.Access to free antiretroviral treatment, as is currentlybeing called up in Mozambique, impacts onHIV infected individuals in two ways: it improvestheir life expectancy and quality of life; and at thesame time it creates a lifelong dependence on antiretroviralmedicines and the interventions related toit (regular medical check ups, for example).The level of social cohesion, solidarity and experiencesof the past with regard to epidemics or similarscenarios also influence the impacts on the individual.Where the level of tolerance and the balance ofsocial togetherness are high, and also where acceptanceof the disease and community mobilisation aresufficiently strong to provide support to those who aresuffering, then levels of stigma and discrimination willtend to be low, thus minimizing the psychologicalpressure on the individual. The reverse will form thepremise for worsening the consequences on the individual,and it is expected that the effect of these willsurpass the individual dimension, and hit the family ofwhich the individual is a member.The impact of HIV and AIDS on the familyhousehold will be conditioned by a series of factorswhich determine the place of the infected individualwithin the household. If the epidemic mainly affectsproductive adults with a determinant influence inthe household’s economic and social affairs, withsickness or death, the consequences will becomeevident. These impacts will be expressed in thehousehold’s increased poverty, through the loss ofincome and consequent reduction in standards ofnutrition, and evidently by children becomingorphans.When children lose their parents and guardiansat a tender age, this has consequences in severalspheres of their lives. In the economic field, theseconsequences may be reflected in the loss of incometo sustain the household, guaranteeing food, schoolattendance for the children, clothing and housing,among others. In the legal field, the consequenceswill be expressed in the context of inheritance basedon customary systems.These consequences may also be visible asregards the social construction of personality, ininculcating values and norms of civic life, assimilatingwhich depends on individual reference pointsduring childhood. HIV and AIDS also increases longterm insecurity, arising from emotional suffering,deprivation and mourning.Since in most families, the task of caring for sickfamily members is a woman’s task, it is women inparticular who bear the burden of caring for peoplewith HIV or AIDS. When family members receive ART,the task shifts from taking care of a sick person tomaking sure that the children or male family memberstake their medication in the prescribed way andadhere to their treatment.While with illness the household’s economicreserves are called upon to pay for hospital care,with death these reserves are used for the funeral,which in the final analysis reduces the household’sincome. To mitigate the erosion of the householdeconomy arising from the effects of HIV and AIDS,women and children will be called upon to redoubletheir efforts in domestic work. Often this compromisesthe future of the children, particularly the girls,since in the first instance they are called on to interrupttheir schooling.The risks of stigma, isolation and rejection arealways present, depending however on the level ofcohesion and solidarity within the community. The25