Poverty and HIV/AIDS in Africa: Specifying the connections

There is an increasing recognition that poverty in Africa is a critical factor in the transmission of HIV/AIDS. To this end, at a macro level some theorists have described HIV/AIDS as one of the diseases of poverty. ‘Diseases of poverty’ are those that primarily affect the poor, and which worsen the toll of poverty. Many if not most countries severely affected by HIV/AIDS are also in the global south and poverty stricken, but this does not necessarily mean poverty leads to HIV infection. In fact, evidence on the relationship between HIV transmission and poverty remains mixed. While some macro and micro studies find a positive relationship between poverty and HIV, others do not. Although efforts have been made to tackle the issue of poverty as a way of dealing with HIV/AIDS, the role played by poverty in HIV/AIDS remains poorly understood. There are several impediments to understanding the poverty and HIV/AIDS nexus. First, researchers who investigate the poverty and HIV relationship have failed to take into account conceptual and theoretical advances in the literature on poverty. In the process they have failed to specify what aspects of poverty might be related to HIV/AIDS. Second, there is little agreement on how poverty should be measured. Choice of the poverty measure is much more than just a technical detail, and is reflective of social concerns and values inherent in debates over poverty. Third, researchers in this area use different definitions of poverty, but different definitions of poverty lead to different measures of poverty, yielding different groups of people. This article evaluates studies in Africa that look at the role played by poverty in HIV/AIDS transmission at both macro and micro level. It examines the conceptual and methodological obstacles that prevent a clear sociological understanding of the poverty–HIV/AIDS behaviour dynamic. In this article we develop a framework for conceptualizing poverty and its relationship to HIV/AIDS. We look to common and well-formulated ideas in the literature on poverty to develop the framework. We suggest material deprivation (relative and absolute), vulnerability and social exclusion as the core ideas in recent advances in the literature on poverty. We then identify possible social, structural and behavioural pathways between these aspects of poverty and link them to HIV/AIDS.