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JOURNAL OF RESEARCH IN NATIONAL DEVELOPMENT VOLUME 5 NO 2, DECEMBER, 2007

HIV / AIDS AND THE SOCIO – ECONOMIC STATUS OF VICTIMS IN OYO STATE

I.A. Odusanya,  T. A. Ayinla, and O.E.  Maku
Department of Economics,  Olabisi Onabanjo University, Ago – Iwoye

Abstract
            Owing to the ferocious spread of HIV / AIDS and the soaring cases of ill – halth and impending death associated with the epidemic in Nigeria, this study assesses the impact of HIV / AIDS on the socio – economic status. Specifically, it examines the effects of the epidemic on the level of imcome, level of productivity, marital status and the work status of the vicitims. It also investigates the relationship existing between HIV / AIDS and the sexual, occupational, the burden of care on the infected individuals. The study vividly reveals that the HIV / AIDS scourge is having its toll on the victims and their respective households. And thus requires an uregent and a better coordinated response to stem its spread.
Keywords: HIV / AIDS, Socio – Economic Status, Victims, Health Care


Introduction
            Human Immunodeficiency Virus / Acquired Immure Deficiency Syndrome (HIV / AIDS) is one of the epidemic diseases tht pose a trheat to good health. Its virus affects the health status of the adults and children, the quality of life components (learning, productivity, life expectancy and mortality rates) also become adversely affected (Armstrong, 1995). It has also spread with ferocious speed. Though, initially considered to be an exclusive medical problem, it has constituted a serious threat to development. It was estimated that 37.8 million people were living with HIV worldwide in 2003 while an estimated 4.8 million people were newly infected with HIV. Similarly, at least 15 percent of children in Sub – Saharan African countries had lost one or both parents to AIDS or associated causes, and because of the possible 10 – year time lag between infection and death, the number of orphans is expected to be on the increase for at least the next decade. By 2010, it is estimated that 20 million children would have lost their parents to AIDS in Sub – Saharan African alone (UNAIDS1, 2004).
            The HIV weakens the immune system of the victim and is followed by AIDS. While the immune system becomes fragile, certain symptoms (like sustained weight loss, chronic fatigue, diarrhoea, deterioration of the central nervous system), generally known as AIDS related complex (ARC) will emerge. The prolonged deterioration of the immune system will give way to opportunisitic diseases (e.g meningitis, tuberculosis, pnemonia and cancer). (Ayorinde, 2002).
            The impact on the household begins as soon as a member of the household starts to suffer from HIV – relate illness. This culminates in loss of income of the patient and astronomical increase in household’s expenditures for medical care, while the members of the household, usually daughters and wives, miss school or work to care for the sick person. Also, deaths result not only in additional expenses for funerals and mourining, but bring about a reduction in the aggregate income of the household due to the permanent loss of income of the dead member of the household (World Bank, 1997).
            The most excruciating and worrisome long – term feature of the HIV / AIDS epidemic is its impact on the life expectancy, which makes HIV / AIDS a terrible catastrophe in the world’s history. This is particularly due to the fact that it hits people hadest in teir most productive years. Additionally, it does not only disrupt the economic and social bases of the households but also those of national economy. More so, the effects vary according to the severity of the AIDS epidemic and the structure of the families and the overall economy (World Bank, 1999).

Following the introduction, the remainder of the paper is structured as follows. Section 2 presents a brief review of related research works on the socio – economic impact of HIV / AIDS on socio – economic behaviour of the victims. Section 3 provides the methodology employed in gathering and analyzing data. Under section 4, we discuss our findings based on the field survey conduected. Section, however, concludes with some policy recommendations.

Literature Review
            The HIV / AIDS scourge is considered to be an epidemic that poses an unthinkable threat to good health. It poses more danger than other common infections and parasitic as well as endemic diseases such as malaria, diarrhoea, tuberculosis and dysentery for it affects mainly the productive age group. (Ainsworth and Over 1994. Aregneyen, 2001).
            Ayorinde (2002) observed that the impact of HIV / AIDS commence once the HIV status of a member of the household is known. This situation will be exacerbated by the resultant discrimination, stigmatization and ostracism infections. The situation will become worse when the infected individual begins to suffer from opportunistic infections. The situation will be exacerbated by the resultant discrimination, stigmatization and ostracism in the society. Some of these HIV / AIDS victims may be forced to wuit teir hobs and even their places of sojourn. Similarly, they may be discriminated against in terms of employment and may result to taking up jobs that are incomparable with their qulifications. There may also be total loss of income accruing to the household, increased medical expenditure and funeral costs, assets may be total loss of income accruing to the household, increased medical expenditure and funeral costs, asets may be sold and huge debts may be incurred while children may be orphaned. Olufemi (2003) also stated that HIV / AIDS pandemic has increased the number of orphans, number of child headed households and single parents, thereby shaping the age and family structure of the household population. These orphans are more likely to be undernourished, less likely to receive immunization or health care, and usually very poor. They often end up on the streets, where they pursue survivual strategies that put them at a great risk of contracting HIV themselves.
            Odumosu (2001) noted that when AIDS patients are being taken care of, greater burden are borne by female members of the household. This affects relationship with non-relatives while neighbours distant themselves from the affected household. While large chunk of household’s resources are spent on the car of the victim, substantial time and energy, which could have been channeled towards some productive activities, are dissipated in caring for the sick. Nicolas, et al (2003) also stated that when the husband or wofe falls victim of AIDS, the ‘not yet ill’ spouse would devote more time to his work and less to the education of the children. The children may even have to work as a result of emergency financial requirements of the family emanating from the huge cost of care of the victim. The high cost of car would lead to deduction of savings and would lower accumulation of capital.
            Foster (1996) noted that three phases exist in the cycle of illness and death from HIV / AIDS. These are the illness phase, the period following immediately after death, and longer – term aftermath phase. The impact of HIV in tehse phases differ in certain respect. However once a household begins to witness the impact in a particular manner, respte is usually difficult for the affected household in consecutive phases of infection. Some studies further revealed that when a family member has AIDS, average income falls by 52 to 67 percent, while expenditures on health care quadrupe (UNICEF and UNAIDS, 1999; Booysen and Bachmann 2002). This is particularly true in relation to the illness phase. During this phase; there will be a reduction in the strength of the infected person, which culminates into a fall in his productivity and that of the household while he will possibly spend more on health care (as a result of increase in expenditures for medical tratment and transport).

Babatimehin and Ajala (2002) postulated that in the next phase (i.e the period following immediately after death), the impact of the loss of a member on the household becomes more intense since the impact experienced in eh first phase will continue while some other devastating effects will emerge. The loss of the member of the household would lead to a monumental rise in the dependency ratio as a result of a lower number of productive family members in relation to higher numbers of unproductive members. It was further stated that the impacts of HIV / AIDS experienced by the affected household in the longer – term aftermath phase have no specific endpoint. This impact varies among various households and cannot be accurately determined. These consequences could be much, irrespective of the initial capacity of the household before the infection of any member of the household.
            The impact of the epidemic on the victims and their household can also be viewed from increased number of orphaned children and elderly in the households with fewer breadwinners to support them. This is specifically caused by the high mortality of prime – aged adults resulting from AIDS (Barnett and Blaikie, 1992; Hunter and Williamson, 1998).
            Ainsworth and Dayton (2001) corroborated this view by stressing that HIV / AIDS epidemic brings about a situation where the elderly often become caregivers for their adult children affected by HIV / AIDS, the guardians of orphaned grand children, and substitute workers for ill or deceased adults in the home and on the farm.
            Hubert and Dresruesse (1999) noted that HIV / AIDS has gone beyond the boundary of the health sector and is now a newly emerged general obstacle to development. They observed tha tteh impact of HIV / AIDS are enormous – socially, politically and economically. In the same vein, its ferocious spread is hinged on some social, economic, political, cultural and behavioural factors. The socio – cultural factors include illiteracy, sexual exploitation prompted by the subordinate role of women, discrimination of people with certain sexual orientations and the conception of discussions of sexulity as a taboo. The economic factors include promotion of prostitution, underdevelopment, migration, urbanization and poverty while the behavioural factors comprise of unprotected sex, multiple sexual partners and mother to child transmission. The major political factors are wars, unrest, expulsion and violence, which reduce access to medical care, favour frequent changes of partmers and unsafe sexual contracts.
Methodology
            The study involves the use of primary data. A structured questionnaire comprising items required to investigate the socio – economic conditions of people living with HIV / AIDS (before and after ailment) was prepared.
            The sample size for this study consists of fifty selected individuals defined as being HIV / AIDS victims from Oyo State. At the same time, the study specifically covered those who have been on the ailment for quite scientifically confirmed as being HIV – positive and identified trhough the support group of people living with HIV / AIDS (PLWHA) constituted the sample for the study. And the questionnaires were personally administered by the researchers.
            The data collected were analysed with the Statistical Package for Social Sciences (SPSS) trhough the use of summary statistics – frequency distribution, simple percentages, pair sample statistics, and difference of mean. The hypotheses were tested with the aid of Chi – square test and T – test.


Research Findings
Characteristics of Respondents:       The Socio – demographic features of respondents in terms of sex, age, and education are shown in table 1

Table 1:          Distribution Characterisitics of Respondents in Relation to Sex, Age and Education

Characteristics

Frequency

Percentage (%)

SEX

 

 

Male

15

30

Female

35

70

TOTAL

50

100

AGE

 

 

Less than 15 years

3

6

15 – 25 years

7

34

25 – 35 years

17

38

35 – 45 years

19

6

55 years and above

3

2

TOTAL

50

100

EDUCATION

 

 

No formal education

4

8

Isamic Education

1

2

Primary

8

16

Secondary

20

40

Post Secondary

17

34

TOTAL

50

100

Source: Researchers Field Survey, 2006.
         

From the table, out of the fifty respondents, fifteen of them, constituting 30%, are male while the remaining 35 respondents are female, which constitute 70%. This shows that prevalence as well as vulnerability to HIV / AIDS is higher for female than male.
            Furthermore, nineteen of the respondents belonged to 35 – 45 years age category with the highest percentage of 38%. This is closely followed by those in the 25 – 35 years (age category) constituting 34% of the respondents while those that are 55 years and above have the least percentage of  2%. It is important to note that, 78% of the respondents are in the age brackets of 25 – 35 years, 35 – 45 years and 45 – 55 years which constitute the working population. It could then be inferred that people who are in the labour force category are most affected by the scourge, with young people between 25 and 45 years being the worst hit.
            Table 1 also shows that 8% of the respondents have no formal education while 16% of them undergone primary education. However, 40% of them had secondary education while only 34% of them had post secondary education. It could be deduced that HIV / AIDS is more prevalent among people that possess secondary and post secondary education than those whose possess primary education.


 

Table 2:          Frequency Distribution of Work Status of Respondent before and after Ailment


Work status

Distribution of respondents before ailment

Distribution of respondents after ailment

Working

32 (64%)

25 (50%)

Unemployed

8 (16%)

16 (32%)

Full Housewife

3 (6%)

3 (6%)

Voluntarily retired

2 (4%)

1 (2%)

Sacked / compulsorily retired

- (0%)

- (0%)

Schooling

5 (10%)

3 (6%)

Dropped out to School

- (0%)

2 (4%)

Employer

- (0%)

- (0%)

Total

50 (100%)

50 (100%)

Source:           Researchers Field Survey, 2006.
           


Table 2 reveals that 64% of the respondents were working before ailment but their population reduced to 50% (i.e 29) as a result of the HIV / AIDS epidemic. Also before the ailment, only 16% of the respondents claimed to be unemployed while the percentage increased significantly to 32% as a result of the ailment. Additionally, of the 4% of the victims dropped out of school after the ailment.


Table 3:          Frequency Distribution of Respondents According to Occupation before and after Ailment


Occupation

Distribution of respondents before ailment

Distribution of respondents after ailment

Single / Never Married

10 (20%)

7 (14%)

Single and Engaged

1 (2%)

2 (4%)

Married

34 (68%)

24 (48%)

Separated

2 (4%)

9 (18%)

Divorced

- (0%)

- (0%)

Widowed

3 (6%)

8(16%)

Total

50 (100%)

50 (100%)

Source:           Research Field Survey, 2006.
           


From table 4, 68% of the respondents claimed to be married before ailment. This percentage however reduced to 48% after the ailment. Moreover, the percentage of respondents who claimed to be separated before the ailment increased from 4% to 18%. Similarly, the number of respondents who are widowed prior to ailment rose from three (i.e 6%) to eight (i.e 16%) after the ailment. Thus, it is quite obvious that HIV / AIDS is reshaping the marital status of victims.


Table 5:          Frequency Distribution of Respondents that are Separated / Divorced on Account of Ailment


Responses

Frequency

Percentage

Yes

7

77.8%

No

2

22.2%

Total

9

100%

Source:           Researchers Field Survey, 2006.
           


Out of the eighteen respondents who are separated / divorced, 77.8% of them did so on account of ailment while the remaining 22.2% were separated / divorced based on factors that are not related to their ailment.


 

Table 6:          Frequency Distribution of Respondents that are Widowed on Account of Ailment


Responses

Frequency

Percentage

Male:   Yes

3

100%

             No

-

0%

            Total

3

100%

Female: Yes

4

80%

              No

1

20%

Total

5

100%

Source:           Researchers Field Survey, 2006.

           


Table 6 shows that three male respondents are widowed and they are all widowed as a result of the scourge. Similarly, five female respondents are widowed, 80% (I.e four) are widowed on account of the ailment. This corroborates the fact that HIV / AIDS constitutes unthinkable disruption to the marital status of the victims in Oyo state.


Table 7:          Frequency Distribution of Respondents based on the Effect of Ailment on tehir Level of Productivity


Responses

Frequency

Percentage

Yes

25

50%

No

25

50%

Total

50

100%

Source: Researchers Field Survey, 2006.
           


Table 7 shows that 50% of the respondents claimed that the ailment was having negative impact on their productivity while the remaining 50% stated that their level of productivity was unaffected b the ailment.


Table 8:          Frequency Distribution of Respondents based on the Monthly Cost Incurred on Care of Ailment


Cost of Care

Frequency

Percentage

Less than N2,000

-

0%

N2,000 – N6,000

9

18%

N6,000 – N10,000

32

64%

N10,000 – N14,000

6

12%

N14,000 – N18,000

3

6%

Total

50

100%

Source:           Researchers Field Survey, 2006.


**Cost of care covers expenses on Anti – retroviral drugs, average transportation fare to and from health facility, drugs on opportunistic infection, diet and consultation.
*Cost of each item was obtained from each respondents and the total were put into ranges.
Table 8 indicated that none of the respondents incurs less than N2,000 on cost of care of ailment while majority of them constituting 64% spend between N6,000 and N10, 000 on care of ailment on monthly basis. This is closely followed by those who expend N2, 000 in taking care of the ailment and they constitute 18% of the respondents.


Table 9:          Frequency Distribution of Respondents based on the Affordability of the Cost of Care


Degree of Affordability

Frequency

Percentage

Very Affordable

3

6%

Affordable

25

50%

Unaffordable

16

32%

Very unaffordable

6

12%

Total

50

100%

Source: Researchers Field Survey, 2006.

           


From the table above, 32% of the respondents (i.e sixteen) claimed that the cost of care was unaffordable while 12% of them considered the cost of care very unaffordable. And only 6% of them considered the cost to be very affordable it thus implies that the victims still require more assistance in relation to the cost of care since 44% still claimed that the cost of care was unaffordable / very unaffordable.


Table 10:        Frequency Distribution of Respondents based on Effect of Cost of Care of Ailment on Other Aspects of Family Care


Responses

Frequency

Percentage

Yes

30

60%

No

20

40%

Total

50

100%

Source: Researchers Field Survey, 2006.


*Otheraspect of family care highlighted were education of children, accommodation, feeding and family business.
            From table 10, 60% of the respondents claimed that the total cost incurred on cost of care per month affect other aspect(s) of family care (i.e education of children, feeding, accommodation and family business). This indicates that the victims require more support and assistance towards reduction in the average cost of care.


Table 11:        Frequency Distribution of Respondents according to Average Monthly Income before Ailment


Level of Income

Frequency

Percentage

Less than N5, 000

7

14%

N5, 000 – N10, 000

11

22%

N10, 000 – N20, 000

12

24%

N20, 000 – N30, 000

9

18%

N30, 000 – N40, 000

-

0%

N40, 000 – N50, 000

2

4%

N50, 000 and above

1

2%

None

8

16%

Total

50

100%

Source: Researchers Field Survey, 2006.



* None – respondents were earning between N5,000 – N10, 000 before the ailment. Also, 24% of the respondents were earning between N10, 000 and N20, 000 while 14% of them were earning less than N5, 000 per month. Also 16% of the respondents received no income while 2% (i.e one) was earning more than N50, 000 per month.


Table 12:        Frequency Distribution of Respondents according to Average Monthly Income before Ailment


Level of Income

Frequency

Percentage

Total loss of income

9

18%

Less than N5, 000

12

24%

N5, 000 – N10, 000

7

14%

N10, 000 – N20, 000

9

18%

N20, 000 – N30, 000

3

6%

N30, 000 – N40, 000

1

2%

N40, 000 – N50, 000

-

0%

N50, 000 and above

1

2%

None

8

16%

Total

50

100%

Source: Researchers Field Survey, 2006.

           


Table 12 reveals that 18% of the respondents lost their income totally as a result of the ailment. Also, the number of respondents earning less than N5, 000 after the ailment is twelve (i.e 24%) as compared with sven (i.e 14%) priop to the ailment. Similarly, the percentage of respondents in the N5, 000 – N10, 000 range fell from 22% (before the ailment) to 14% (after the ailment). Also, the number of respondents earning between N10, 00 – N20, 000 fell from twelve (before the ailment) to nine (after the ailment), while those earning between N20, 000 – N30, 000 fell from 18% to 6%.


Hypothesis 1:             HIV / AIDS epidemic does not affect the income f the victims
Table 12.1:                 Paired Samples Statistics

 

Mean

N

Std. deviation

Std. error mean

Pair Income B      18650.00              50            20480.2668                    2896.3471
1 Income A          10850.0000          50            16641.5542                    2353.4712

Table 12.2                   Paired Samples Test

Paired differences

 

 

 

 

 

Mean

 

 

Std.
Deviation

 

Std.
Error
Mean

95% Confidence
Interval of the
Difference
fhhjfh Lower         Upper

 

 

t

 

 

df

 

Sig. (2 – tailed)

Pair 1 Income B - Income

7800.0000

25870.7541

3658.6771

447.6130

15152.39

2.132

49

.038

Key:     Income B         =          Income before ailment
            Income A         =          Income after ailment           

Table 12.1 shows that the mean income before ailment is N18,650, which is greater than mean income after ailment (i.e N10,850). And the difference between the mean income before and after ailment is N7,800. This is implies that the income of the victims reduced signigicantly as a result of ailment.
            From table 12.2, the paired sample t-test reveals that a significant difference exists between the average monthly income of respondents before and after ailment, with a df = 49 and t – statistic value of 2.132 at p < 0.05. thus, the null hypothesis specifying that HIV / AIDS does not affect the income of the victims is rejected.

Concluding Remarks
            It could be inferred from this study that the HIV / AIDS scourge is no doubt constituting untold hardship to the victims with respect to their work status, occupation and productivity while it reduces the income accruing to the affected individuals and their respective household. The study also corroborates the fact that females are more susceptible to the epidemic than their male counterparts.
            Furthermore, the study shows the burden of the cost of care of ailment is unbearable for the majority of the victims while it also affects other aspects of family care of most of the victims. This is because they had to put up in affordable but very poor accommodation, feed on unbalanced diet and also put an abrupt and inevitable end to the education of their wards (due to inability to pay school fees and the requirement of their assistance in looking after the sick).
            Thus, it becomes an imperative for the government and all other stakeholders to be more active in curtailing the spread of HIV / AIDS. This is quite vital in order to guide against complete erosion of hard – won development over the past decades and for the achievement of objectives specified under the ongoing reforms of the government.

Recommendations
a)         Government should include HIV / AIDS education in the school curriculum while post – secondary school students should be trained as AIDS educators and programme coordinators.
b)         Laws may be enacted to protect victims against stigmatization, ostracism, physical abuse and segregation.
c)         Adequate programmes on voluntary counseling and testing should be put in place while people should be encouraged to ascertain their HIV status.
d)         HIV / AIDS high – rist individuals, like itinerant traders, long distance drivers and commercial sex workers (CSW) should be properly enlightened about the epidemic.
e)         Enlightenment campaigns on HIV / AIDS should be intensified while more emphasis should be laid on its prevention, rather than its control.
f)          In order to reduce the burden of the cost of care on victims, they should be treated at zero cost while they could also be provided with less strenuous jobs. Also, widows and orphans could be paid monthly allowances.
g)         More support groups for people living with HIV / AIDS (PLWHA) should be established by the government, and other stakeholders while the existing ones should be adequately funded. This will provide an avenue for direct and required assistance to the victims and their families.

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