DISCUSSION, CONCLUSION AND RECOMME NDATION S

Modell equation

SECfION 3: DISCUSSION, CONCLUSION AND RECOMME NDATION S

Brief discussion of the Findings

In this section I review the findings of data analysis and relate them to the hypothesis stated earlier, in Chapter

2.

These findings are discussed according to their appropriate sections.

Economic Status and HIV knowledge

In Chapter 2 it was hypothesised that low economic status increases the risk of HIV

infection through its associated factors of low education that reduce the likelihood of

having the knowledge necessary to adopt safer sexual behaviours. The results of data

analysis provide support for this argument. As was hypothesised, the non-poor are

more likely to have good knowledge of the means of avoiding HIV infection as

opposed to the poor. The same applied to level of education whereby an increase in the

level of education was associated with an increase in the likelihood of knowing the

means of avoiding AIDS. These results are supported by a multitude of literature both

in Africa and elsewhere (see Chapter 5). The results also indicated that even with

similar levels of education, the poor were l ess likely to have good knowledge of the effective means of avoiding HIV infection. The results do not, however provide reasons for this and as such further research is required to establish the factors at play.

Economic Status and Sexual Behavioural Practices

This section aimed to provide evidence to the hypothesis stated earlier which stated that the poor were less likel y to adopt safer sexual behaviours due to low levels of education and financial dependence on their partners, which reduce their sexual negotiating power. This claim was supported by the results of the data analysis which showed that the non-poor were more likel y to use condoms than the very poor. As with knowledge of the effective means of avoiding HIV infection, the chances of having used a condom during last sexual intercourse improved with an increase in the level of education attained.

The relationship between economic status and sexual behavioural practices is perhaps better reflected by the association between economic status and non-use of condoms as a result of partner's dislike of condoms. Respondents who received money from their partners as well as those who came from households where hunger was a common phenomenon were more likely to not use condoms because their partner's dislike them than those who did not, that is, controlling for level of education and economic status, among other factors.

More interesting were the findings of the regression of non-use of condoms due to low

perceived risk of HIV infection which indicate that knowledge does not always

guarantee the adoption of safer sexual behaviours. This is indicated by the high odds of

not using a condom due to low perceived risk of HIV infection among women who

knew condoms (12.62) and among those who knew that practising safe sex helps to

avoid HIV infection (2.96). Even more interesting about these results is their

demonstration of the intricacy of the poverty and HIV/ AIDS relation whereby it is not

only low economic status that increases susceptibili ty to HIV infection but also high

socio-economic status. While being poor increases susceptibility much more than being

non-poor, the stigmatization of poverty as a disease of poverty, which provides the poor with a false sense of protection from HIV infection, may hinder their adoption of safer sexual behaviours. The increased odds of non-use of condoms due to low perceived risk of HIV infection among the poor as compared

to

the very poor as well as among those who never experience hunger as opposed to those who come from households where hunger is frequent and even among the White population (which has few poor people) as opposed

to

Blacks bear evidence for this.

Conclusion

It is undisputable that HIV/ AIDS and poverty are associated. What needs

to

be understood is the nature of the relationship. Poverty does not cause HIV/ AIDS and HIV/ AIDS does not cause poverty. Instead poverty increases susceptibility

to

HIV infection and HIV/ AIDS deepens poverty. Establishing and explaining this complex relationship formed the main objective of this study. To accomplish this objective two hypotheses were set: hypothesis 1, the hypothesis of increased susceptibility

to

HIV, which states that the poor are more susceptible to HIV infection than the non-poor due firstly

to

low education levels which reduce the chances of knowing the effective means of avoiding HIV infection and secondly through lack of or low sexual negotiation power as a result of financial dependence on their partners. Hypothesis 2, which is the hypothesis of reduced mitigation power, states that the poor are less likely

to

mitigate the various impacts of HIV/ AIDS due a variety of poverty related factors.

Firstly lack of proper nutrition and unsanitary living conditions can lead to a compromised immune system, thus increasing the susceptibility of the poor to opportunistic infections. To fight off infection, HIV infected individuals require treatment and care. However for the poor, their low income levels often imply that they do not afford the cost of treatment and care. Sometimes poor families divert money from other household expenditure to afford the cost of treatment and care.

This can upset household income. Continued ailment may result in loss of

employment which consequently results in loss of household wealth thus deepening

household poverty. Lastly, the coping strategies adopted by the poor to fight off the impacts of HIV/ AIDS such using up of savings or selling asset may increase household poverty even further.

This study has been unable to reject the two hypotheses. Firstly evidence for hypothesis 2 has been provided in Chapter 4 whereby it was shown through a review of current literature on how the vicious poverty- HIV/ AIDS cycle works. From the studies reviewed as well as the case studies provided it became evident how intricately poverty and disease are linked, from stage l(not yet infected) to the final stage (coping with the impacts of disease). During the first stage, it has been shown how insufficient knowledge increases susceptibility to infection. There is common consensus among various scholars that prevention from any disease requires prior knowledge of the risk on infection and of the ways of avoiding HIV infection. However due to their low education and literacy levels as well as low access to media, poor people often lack enough knowledge to enable them to protect themselves from HIV infection. This

then causes them to unconsciously put themselves at a higher risk of HIV infection through continued practise of unsafe sexual behaviours. Furthermore a lack of knowledge becomes a problem for those who are infected but do not yet show signs of infection. Access to infection encourages good health seeking behaviour; therefore lacking knowledge might result in poor health seeking behaviour, thus resulting in infections that go undetected until very late. This then reduces survival time. Survival time is also affected by a lack of resources (treatment and care (both medication and facilities)), which is often a characteristic of poor communities. More disheartening in the poverty and HIV/ AIDS cycle is the lengths that people will go to fight off the impacts of the pandemic such as deliberately acquiring the deadly disease or refusing treatment in order to be eligible for the disability grant so as to live a "happier" life.

In Chapter 6, empirical evidence supporting hypothesis 1 was provided. From the

findings of this section it can be said that poverty and its associated factors, that is, low

education and decreased decision making power, can indeed increase the risk of HIV

infection. Low socio-economic status robs the poor of the knowledge necessary for the

prevention of infection with HIV / AIDS and also increases susceptibility to infection by making the poor more likely to practice unsafe sexual behaviour. However the stereotypes associated with high economic status such as the view of AIDS as a disease of the poor increase susceptibility to infection among the non-poor as they discourage the adoption of safer sexual behaviours. While the results contained in this study do not provide direct evidence of the role of such stereotypes, the increase in the odds of non-use of condoms due to low perceived risk among the educated and those who never experience household hunger hint at this relationship.

The evidence contained in this study has proven how inseparable poverty and disease,

in this case HIV/ AIDS, are. Therefore any efforts to successfully reduce HIV infection

rates should take poverty into consideration just as poverty reduction programmes

aiming at success should take HIV/ AIDS into consideration.