This paper examines the consequences of HIV/AIDS related morbidity and mortality on rural households in South Africa’s Eastern Cape region. The literature suggests a range of both individual and household level factors that serve to differentiate the effects of AIDS illness and death on affected households. Furthermore, the effects of HIV/AIDS are not only differentiated, they are also distributed. The social reciprocity undergirding African livelihoods both ameliorates HIV/AIDS-related livelihood shock and simultaneously serves to transmit these shocks to otherwise unaffected households. The six case studies presented demonstrate the highly differentiated consequences of HIV illness and death on households, and the extent to which these effects are significantly mediated by a range of household level factors. The consequences of HIV/AIDS are shaped by household pre-illness asset levels, care and dependency burdens and finally, the extent to which the household members either acknowledge the illness (enabling them to better engage with treatment options) or alternatively, revert to denial. The consequences of HIV/AIDS are also significantly mediated by infected individuals’ household headship status and resources. In the rural Eastern Cape, the structural context of unemployment, limited prospects for agrarian production and the exclusion of prime age adults from social grants, serves to pattern vulnerability by rendering unemployed, prime-age adults relatively weak economic agents. The empirical material accordingly suggests the effects of the morbidity and mortality particularly of peripheral (i.e. non-household head) and non-resource contributing individuals is relatively limited (at least in the short to medium term). Within a structural context of impoverishment and economic disempowerment, HIV/AIDS therefore does not constitute a homogenous shock to all affected households.
Working Paper 08/232 Centre for Social Science Research, University of Cape Town. 22 pp.