The hidden battle: HIV/AIDS in the household and community

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Abstract
The AIDS epidemic will cause significant increases in illness and death in prime‐age adults, which will manifest itself through negative social, economic and developmental impacts. The epidemics economic impacts at the household level are decreased income, increased health‐care costs, decreased productive capacity and changing expenditure patterns. Three coping strategies are observed: altering household composition; withdrawing savings or selling assets; and receiving assistance from other households. Following death, the impacts break out of the family into the community, primarily through orphaning. In the near future, the sheer number of orphans may overwhelm the capacity of existing community resources to cope. The distribution of the impacts of the AIDS epidemic falls unevenly among the genders. In Africa, women have higher infection rates and bear a disproportionate burden of the care of HIV‐positive people. Orphaned girls are more vulnerable to exploitation.

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