A Cost–Benefit Approach
Chapter 10: HIV and Hunger
Table 9.1 in Chapter 9 informed us that HIV/AIDS is concentrated in SSA. We will see evidence in the next two chapters that hunger, in the form of malnutrition, also has a major presence in SSA. In this chapter we are going to argue that this positive association between HIV and malnutrition in SSA is not an accidental relationship and that understanding this association is crucial for explaining why HIV is highest in SSA. Malnutrition occurs when the nutrients available to a person are insufficient to meet the body’s needs. This nutrient deficiency between what the body needs and receives can be because a person does not receive sufficient nutrients or because, even though the level may be sufficient, the nutrients are not properly absorbed. What the body needs is not constant over time and is itself a function of the extent to which disease is present. One of the many reasons why HIV and malnutrition go hand in hand is that people living with HIV have higher than normal nutrition requirements. Gillespie and Haddad (2002, p. 10) report that people with HIV need up to 50 percent more protein and up to 15 percent more calories than those who are uninfected. THE DIRECT ROLE OF MALNUTRITION IN HIV TRANSMISSION There are two main types of malnutrition: (1) macro-malnutrition exists when there is insufficient protein, energy (carbohydrates) and fat and (2) micro-malnutrition involves a shortage of vitamins (such as A, D and E) and minerals (for example, calcium, sodium and...
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