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Socio-Economic Impact of HIV and AIDS in Andhra Pradesh 2004-2005 and 200630 Dec 2006
AIDS has emerged as a serious challenge to the world today. India has 5.206 million people living with HIV and AIDS (PLWHA)(2005), although the overall HIV prevalence rate (among adult population) is low (0.91%).
The study entitled ‘Socio-Economic Impact of HIV and AIDS on Households’ was undertaken by NCAER with support from UNDP and NACO in six HIV highprevalence states in India namely Andhra Pradesh, Karnataka, Maharashtra, Manipur, Nagaland and Tamil Nadu.
Of the six states considered for this study, Andhra Pradesh has recorded the highest prevalence of 2.00 percent among the antenatal clinic attendees and 22.8 percent among STD clinic attendees in 2005. The state accounts for an estimated 10 percent of the HIV and AIDS cases in India. This is a critical period for India’s response to the epidemic and studies of this nature are of importance at this juncture.
Objectives The objective of the study is to analyse the nature and extent of socio-economic impact of HIV and AIDS on the affected individuals and their households and the measures that need to be taken to help the affected families. The focus of the study is on the impact of HIV and AIDS on household income and employment, level and pattern of consumption, savings and borrowings, education of the children, health status including expenditure on treatment of opportunistic infections as well as the stigma and discrimination the affected individuals and their families are subjected to.
Data and methodology A field survey was conducted in the state of Andhra Pradesh during the period October to December 2004. Both HIV and non-HIV (control group ) households were surveyed so as to compare their socio-economic characteristics, pattern of household expenditure, prevalence of morbidity and differences in enrolment and dropout rates of school-going children. The number of HIV households surveyed was 400, comprising 189 rural and 211 urban households. Apart from the state capital city of Hyderabad, the survey covered six more districts, namely East Godavari, Krishna and Guntur from coastal Andhra, Warangal from Telangana region and Chittoor and Cuddapah from Rayalseema, among the HIV high-prevalence districts covering all the three regions of the state.
As suggested by the Andhra Pradesh State AIDS Control Society (APSACS), PLWHA who had been trained by the State AIDS Control Society to do outreach work were selected to canvass the questionnaires from the PLWHA. These persons were trained by NCAER team and were advised to select the sample from a diverse socioxii Socio-Economic Impact of HIV and AIDS in Andhra Pradesh, India economic profile of households.
However, in spite of their best efforts these persons who acted as field investigators could not get access to upper middle class and rich HIV households since the samples were drawn mostly from government general hospitals, TB hospitals, Care and Support homes, drop-in-centres run by NGOs, the Network of Positive People etc.
which mainly cater to poor/low-income households. An attempt was made to select PLWHA from both sexes at different stages of the infection. In households with more than one PLWHA, a maximum of two adult PLWHA, mostly husband and wife, were interviewed.
For every HIV household surveyed in a village/urban block, approximately three non-HIV households belonging to similar economic strata were interviewed. The households were matched first on the basis of broad income category of the HIV household and at the second stage, the occupational group of the head of the household was matched from within each income category.
The household survey was conducted using two sets of structured questionnaires – one each for HIV and non-HIV households. These two questionnaires had some common sections as well as special sections. The reason for conducting the survey was explained and the consent of the interviewee was obtained prior to conducting the interview. Qualitative techniques like case studies and focus group discussions were also conducted to supplement the findings of the survey. The Focus Group Discussion was held at Vijayawada, with the Telugu Network of Positive People. Two case studies were also done.
Profile of the sample More than 60 percent of HIV and non-HIV household heads were in the age group of 20-40 years. About 31 percent of HIV and non-HIV household heads were in the age group of 41-60 years. The level of education of the household heads in the sample was poor with 43 percent illiterates among HIV households and 34 percent illiterate among non-HIV households. However, the level of education of the non-HIV households was slightly better than that of HIV households. No glaring differences were, however, noticed between HIV and non-HIV households regarding availability of basic amenities.
The ownership of assets and other consumer durables in the households also indicated that the economic status of the sample households was low. As regarding ownership of assets like agricultural land and livestock, the HIV households were marginally better than non-HIV households while percentages of households owning house/flat were higher under non-HIV households (68) as compared to HIV households (46) even though both belonged to almost similar economic levels. The percentage of households having consumer durables like fan, television, refrigerator, etc. are almost similar for both HIV and non-HIV households.
Most of the PLWHA were in the age group of 20-40 years with nearly 64 percent of the women between 20-30 years. Nearly 70 percent of the men and 39 percent of women were newly married. Percentage of men separated/ divorced/ abandoned was 6.6, while it was 8.0 for women. Also, 5 percent of men were widowers while 49 percent of women, widows. The sample PLWHA was poorly educated. Nearly 31 percent men and 24 percent women were found to be wage earners while 21 percent men and 15 percent women