Relationships between poverty and AIDS Illness in South Africa: an investigation of urban and rural households in KwaZulu-Natal

ABSTRACT

The association between poverty and HIV/AIDS in Sub-Saharan Africa remains contested. A better understanding of the relationship between the prevalence of poverty and the disease is essential for addressing prevention, treatment, and care. The present study interrogates this relationship, using a cross-sectional survey of 2477 households in urban and rural KwaZulu-Natal, South Africa. Structural equation modelling was employed to estimate the correlations between poverty and AIDS illness. The analysis revealed a correlation of r_pb = 0.23, denoting that a higher level of household poverty was associated with a higher likelihood of being AIDS-unwell. Post hoc t-test showed that receipt of a disability grant by AIDS-affected households was associated with significantly lower poverty, compared to AIDS-affected households not receiving the grant, t(654) = 3.67, p < .01. Geographic location was found to confound the correlation: the strength of the relationship between poverty and AIDS was decreased to r_pb= 0.15 (p < .001) for the urban and r_pb = 0.16 (p < .001) for the rural sub-population. Findings suggest the importance of two sets of policies: those that address the potential upstream risk of poverty through economic interventions, and those that alleviate the impoverishing effects of AIDS illness for affected households.

KEYWORDS:

• HIV/AIDS
• poverty
• structural equation modelling
• poverty measurement
• verbal autopsy

Acknowledgements

Ethical approval for the study was granted by the Research Ethics Committees of the University of Oxford, the University of Cape Town, the University of KwaZulu-Natal, and the University of the Witwatersrand as well as the Departments of Health and Education from KwaZulu-Natal province. In addition, we would like to acknowledge the important contribution of our entire Young Carers fieldwork team in KwaZulu-Natal and our local NGO partner, Tholulwazi Uzivikele, to this research. Lastly, we would like to thank the children and their families who participated in our study and welcomed us into their homes and communities. All authors have read and approved the final version of this text.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Claude Leon Foundation [10.13039/501100001337] and Economic and Social Research Council [10.13039/501100000269]. The Young Carers study was funded by the Health Economics and HIV and AIDS Research Division (HEARD) at the University of KwaZulu-Natal, the Economic and Social Research Council (UK), the National Research Foundation (SA), the National Department of Social Development (South Africa), the Claude Leon Foundation, and the John Fell Fund. Dr Cluver was supported by funding from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007-2013)/ERC grant agreement no. 313421.