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  • Title: Economic causes and effects of AIDS in South African households.
    Author: Bachmann MO, Booysen FL.
    Journal: AIDS; 2006 Sep 11; 20(14):1861-7. PubMed ID: 16954727.
    Abstract:
    OBJECTIVE: To investigate the magnitude and temporal directionality of associations between illness and death, and income and expenditure, in households affected by HIV/AIDS. DESIGN AND SUBJECTS: A cohort study with repeated measures carried out in 405 households (1913 occupants), known to have HIV-infected occupants and their neighbours, in one rural and one urban area of South Africa. MAIN OUTCOME MEASURES: Monthly adult equivalent income and expenditure. Illness episodes and deaths attributed to HIV/AIDS, tuberculosis and pneumonia. METHODS: Interview surveys of household heads were conducted at baseline and five more times, biannually, providing information on household economics, illnesses and deaths. Regression analyses used marginal structural models and 'before-after' models to analyse changes. RESULTS: In marginal structural models, current or previous AIDS illness was independently associated with 34% [95% confidence intervals (CI) 23-43%] lower monthly expenditure, and current or recent poverty was associated with 1.74 (95% CI 0.94-3.2) times higher odds of an AIDS death. In before-after models, each AIDS death was independently associated with a 23% (95% CI 11-34%) greater expenditure decline over 3 years, and a 100 US dollars higher monthly expenditure at baseline was associated with 0.31 (95% CI 0.13-0.74) times as many AIDS deaths and with 0.41 (95% CI 0.27-0.64) times as many AIDS illness episodes over 3 years. CONCLUSION: AIDS deaths and illnesses predicted declining expenditure and poverty predicted AIDS, suggesting that both welfare and effective treatment are needed.
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