Mirjam van Donk
The purpose of this paper is to explore HIV/AIDS as an urban development concern, with a particular focus on the link between HIV/AIDS and urban poverty. It demonstrates that HIV/AIDS is not merely a health concern, but in essence a development issue with the potential to undermine the prospect of urban development. The paper concludes with some recommendations on how to conceptualise a coherent and comprehensive approach to HIV/AIDS and urban poverty reduction.
The first section looks at the concentration and manifestation of HIV/AIDS in urban areas. It examines why HIV/AIDS is concentrated in urban areas and which social groups are most vulnerable to HIV infection. In doing this, it highlights factors in the urban context that influence sexual behaviour and may constrain individual choice in sexual behaviour and access to HIV prevention methods. Poverty and inequality, particularly gender inequality, are identified as core factors in enhanced vulnerability to HIV infection. Section 3 discusses the relationship between urban poverty, inequality and HIV/AIDS in a bit more detail. In addition to recognising that urban poverty and inequality can enhance vulnerability to HIV infection, the paper discusses how urban poverty accelerates ill health and death due to HIV/AIDS and negatively affects the coping mechanisms of households affected by HIV/AIDS. But the relationship between poverty and HIV/AIDS is not just unidirectional. In looking at the impacts of HIV/AIDS in urban areas (in section 4), we find that HIV/AIDS has the potential to aggravate poverty by pushing more households into poverty and forcing poor households into deeper impoverishment. At the same time, the epidemic erodes the capacity of public sector institutions to deal with the increasing demand, as public sector personnel is also infected with and affected by HIV/AIDS.