The demographic and socioeconomic consequences of HIV/AIDS

In South Africa, many circular migrants return to their places of origin when ill. To estimate the contribution the internal migrants have made to excess mortality in a rural sub-district population, we computed AIDS and TB cause-deleted life expectancy and crude death rates by gender and migration status between 1994 and 2006. The annualised crude death rate almost tripled from 5∙39 to 15∙10 per 1000 over the years 1994-2006. This reduced life expectancy from 67∙7 to 47∙0 years. AIDS and TB in returning migrants contributed to 44∙4% of the overall loss in life expectancy with a notable disparity by gender: 62∙3% for males and 34∙2% for females. The contribution of AIDS and TB in returned migrants to the increase in crude death rate was 78∙7% for males and 44∙4% for females. In a typical South African setting dependent on labour migration for rural livelihoods, the contribution of returned migrants, many infected with AIDS and TB, to the burden of disease is high. Returned male migrants are more affected by AIDS and TB than female migrants and non-migrant males and females. Care and referral systems must bridge long distances and span different settlement types to maintain continuity of health care.

Against the background of high HIV infection rates and AIDS-related death in the 1990s, the government of Botswana declared HIV and AIDS a national emergency and committed an aggressive and comprehensive multi-sectoral and multi-level response to fight the epidemic and mitigate its socio-economic impact. One venue of the response has been the provision of free HAART to all eligible citizens through the National ARV Therapy Programme. Introduced in 2002, the programme is now available countrywide, with over 90% of people in need of it accessing it free of charge. This success has, however, been accompanied by many anecdotal accounts of an increase in the prevalence of risky sexual behaviour. Using a combination of quantitative and qualitative data, this paper assesses the perceived association between the availability of HAART and high-risk sexual behaviour in the country. The results show suggest that contrary to the anecdotal accounts people continue practising, and even adopting, safe sex and health-seeking behaviours such as consistent condom use, having one sexual partner, and uptake of voluntary HIV testing. Among other things, the study concludes that increased contact with health systems to receive HAART may actually encourage positive changes in risky sexual behaviours.

HIV risk is shaped as much by the partners we choose as by the sex we have. In the absence of widespread uptake of couples testing, most partnerships lack information about the prospective partners’ sero-status. This paper seeks to determine how effective individuals are at managing this uncertainty. Previous research suggests that individuals use selective partnership formation to select against risky attributes, such as age, mobility, and widowhood. What remains unclear, however, is how accurate people are at selecting sero-negative partners. This paper examines trends in marital partnership formation and sero-sorting over 13 years using census data from a sero-surveillance site in Southwestern Uganda. Taking into account population composition changes over time, this paper finds evidence of intra-group preference among both sero-positives and sero-negatives. This paper provides the first quantitative analysis of sero-sorting and the effectiveness of partnership selection as an HIV prevention strategy.

HIV/AIDS has come to have great important and wholly negative impacts on the population dynamics of most of sub Saharan Africa including Cameroon since the beginning of the 1980s. Any analysis of both short and medium term demographic trends of Cameroon without due consideration of the HIV/AIDS infection factor will be unrealistic. Even though, the estimated HIV/AIDS infection rate of 11.0% was found to be an exaggeration by findings of the 2004 and 2008 Cameroon Demographic and Health Surveys which put the infection rate at 5.5%, the damage of HIV/AIDS infection on life expectancy, population growth rate and numbers, death rates, median age as well as population structure will remain important at least for the short or medium terms. The damaging effects of HIV/AIDS on the demographics of Cameroon is now recognized by many but little efforts have been made to quantify these effects.This paper seeks to measure these impacts using the 2010 population figures of Cameroon estimated from the 2005 population count and information on HIV/AIDS derived from Demographic and Health Surveys
Key words: HIV/AIDS, demographic impacts, life expectancy, population size, population structure

This paper takes a retrospective look at the substantive, theoretical and methodological innovations and contributions of the Malawi/South Africa Journals Project, an archive of over 1200 observational journals from 1999 to the present. The journals provide intensive details of day-to-day rural life in a range of settings, focusing the interactions, interpretations, and challenges that populate informal social networks. The journals provide a longitudinal account of communities, households and individuals coping with the phases of the AIDS epidemic, from the era of highest prevalence, through the expansion of prevention campaigns, to the coming of HIV testing, and, most recently, the rollout of treatment. Using the journals, scholars have been able to identify how ordinary Malawians have negotiated matters of love, risk and death in the face of their knowledge of AIDS, and how local dynamics have shaped the uptake and use of innovations from "outside", ranging from the clinical apparatuses of biomedicine to the "talking technologies" of self-help and support groups. We identify the unique contributions of this extraordinary archive, and consider both its limitations and future directions.