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Justin Smith worked as a journalist before joining WFP in 2010. He tweets at @justin_eugene
As we remember all those living with the HIV virus on World AIDS Day, millions of people with the disease are barred by hunger from leading the healthy and productive lives that they could have with treatment. Zambia-born nutritionist Mutinta Humbayi says that by breaking down those barriers, we can help stop a vicious cycle driving the epidemic.
What have we learned about the relationship between HIV and hunger since the epidemic began almost 30 years ago?
We know that hunger is both a cause and consequence of the HIV epidemic. When a person is food insecure, they’re likely to take risks that exposes them to infection. And once you’re infected, you incur a number of illness-related costs. When people have to choose between buying food and buying medication, then HIV can deepen hunger.
What can a food aid agency like WFP do to help break that link?
If you’re living with HIV in a poor country, you have hard choices to make. If you live far away from a clinic, you’ll need transportation and that’s a cost. You also need to be eating more to stay healthy and that’s another cost, which can compete with paying the rent or sending your children to school. All of these can be barriers to treatment. Our job as WFP is to offset those barriers by making sure people have access to enough of the right kinds of food.
Apart from propelling sick people into hunger, what effect does the virus have on food security overall?
Studies in rural communities have shown that when a family has someone infected with the virus, their crop yields can fall by as much as half. People who are sick aren’t just less productive, they need to be cared for. Families also will change crops to grow more of the ones that are easier to cultivate, but that might get a lower price at the market. That can have a big impact on income.
Obviously people who are sick need nutritious food to fight off infections. What other role does nutrition play in treating people with HIV?
When you have an infection, the body mounts a defence mechanism. If you don’t have enough food, you’re going to lose weight. We know that people who are underweight are six times more likely to die from the disease. They can’t absorb food as well and they may not be able to tolerate the side-effects of the anti-retroviral medication if they’re not eating enough.
How have women been affected by the disease?
Slightly more than half of all people living with HIV are women (UNAIDS, 2010). Apart from being anatomically more vulnerable to infection, there’s growing evidence that economic dependence on men can also drive the spread of the disease. It makes them more vulnerable to exploitation, less able to insist on safe-sex practices and less likely to leave violent or dangerous relationships. All of these are risk factors to infection.
What was it like to grow up in Zambia, one of the countries hit hardest by the epidemic?
Growing up in a country with a high HIV prevalence, you’re confronted everyday by the realities of life with HIV. You’d see people on the street and be able to tell just by looking at them that they were sick. I've known a lot of them and I've been to a lot of funerals.
When you go back to Zambia, does it seem like things are getting better or worse?
I think things are getting better. You no longer see people who are visibly sick. And people who are infected no longer have to live with the stigma—particularly women. It used to be that when someone was diagnosed, people were afraid to be around them. But now people understand that it’s a manageable disease and if you receive treatment and proper nutrition, you can be as healthy as the next person.
WFP works in over 50 of the countries hardest hit by the AIDS epidemic to ensure that people infected with the disease get the nutrition they need to stay healthy. That involves feeding people in clinics and making sure their families and support networks have the resources to care for them. Find out more