Delivered as part of the satellite session on "Integrating Nutrition Assessment, Counseling and Support (NACS) into HIV Services" at the XIX International AIDS Conference in Washington, DC on July 22, 2012

1. HIV, Food Security & Nutrition
Socioeconomic Impact
Jason Wolfe
USAID Office of HIV/AIDS
AIDS 2012 - Turning the Tide Together

2. HIV & Food Security
HIV exacerbates food insecurity & vulnerability:
• Increased costs
• Reduced labor
• Diminished earnings
• Liquidated assets
• Stressed safety nets

3. Food Security & HIV
Food insecurity & vulnerability exacerbates HIV :
• Inhibited health-seeking behavior
• Reduced access to services
• Limited follow-up and adherence
• Increased opportunistic infections
• Diminished community support

4. Food Security before HIV
Cyclical fluctuations driven by seasonality
moderated by income diversity, assets, food storage, and safety nets

5. Food Security after HIV
increased costs
for food & healthcare
sale of assets
facilitates recovery
reduced labor sale of assets
limits food access limits future productivity
Prolonged downward trajectory
reduced ability to buffer and bounce back from shocks

6. Coping Strategies
• Before the shock: Risk Reduction
– Low risk (low return) income generation activities
– Diversification of income generation activities
– Insurance mechanisms: savings & assets, social ties,
credit access
• After the shock: Loss Management
– Stage 1: Insurance & reversible mechanisms
– Stage 2: Disposal of key productive assets
– Stage 3: Destitution: charity, household breakup,
migration

7. Segmenting by Vulnerability
Food
Vulnerability Security Expenses Income Assets
Low Mild Some lumpsum Fluctuating Consistent
Medium Moderate No lumpsum Fluctuating Fluctuating
High Severe Little/none Little/none None

8. Implications for Support
Vulnerability Strategy Interventions
Low Promotion Income diversification
Medium Protection Savings & asset management
High Provision Consumption support

9. Pathway Approach
promotion
protection restores livelihoods
builds assets
provision
smooths consumption
nutrition support
improves productivity
Sustainable graduation out of extreme vulnerability
with nutrition, food security, and livelihoods support