Aids and the Ecology of Poverty

One of my big time commitments here comes from my role as co-president of the International Development Program Student Association (IDPSA) at AU. The beginning of the year is the busiest, as we set the propose and defend the budget to receive university funds and plan out the activities for the year. I really enjoy it though; the IDPSA is known for being really active, productive, and having a good time!

One of our primary activities is the Friday Forum. Eight or nine Fridays of the semester, we bring in a speaker or panel of speakers on a topic we find to be interesting. Most weeks we follow the academic material with happy hour at various locations around town.

Our first Forum was September 23rd, and it was fantastic! Dr. Eileen Stillwaggon, professor at Gettysburg College and author of the newly released Aids and the Ecology of Poverty , gave a presentation on the biological factors that have helped spread the HIV/AIDS crisis in so many poor countries.

While everyone knows that HIV is spread by sexual contact, Stillwaggon challenges the idea that the disease is so much more common in Sub-Saharan Africa (possibly as high as 40% in some countries while less than 1% in the US) because the people there are having what she calls "exotic sex." Evidence suggests that in otherwise-healthy adults, the chance of contracting HIV from a person who has it with one contact is somewhere around 1/500 for women, and maybe half that for men (Please note: No one is suggesting you test this at home.) And if you do the math...? "No one can have that much sex!" she says. (I wish you could see this smiley, unassuming woman who must be older than my mother!) So what's the difference?

This is where she introduces the ecology of poverty. What are all the other conditions that are more than commonplace in Sub-Saharan Africa? Malnutrition, malaria, schistosomiasis, and all sorts of other parasites and worms, to give a short list. None is a problem in developed countries because each is quite cheap to prevent or cure.

And what do these have to do with it? Malnutrition causes a deficiency in any number of micronutrients, which supress immune activity (it's harder for the body to fight off infection) and reduces integrity of the skin and other membranes (extra rips and tears that allow the virus to enter the system are more likely). Malaria, schistosomiasis, and other parasites cause an overactive immune system, which leave it less able to defend against new infections, and they increase susceptibility to other STDs, which also increase the chance of contracting HIV. Parasites also cause malnutrition. All of this DRASTICALLY, DRASTICALLY increases your susceptibility to HIV. And so you get an epidemic.

So yes, people should be encouraged to stay in mutually monogamous relationships when sexually active, and condoms should be available, but these aren't helpful when one partner already has the infection, or when a couple wants to have a baby, or when one partner has no say in the condom-use or fidelity of the relationship. And it seems the policies with this single focus aren't working. Until more of the symptoms of poverty are dealt with, the epidemic will continue to spread, causing further devastation.

Stillwaggon ends on a positive note, however. The good news is that we can see these connections now, and the solutions are out there. Mosquito nets or insecticide can reduce malaria; the treatment for parasites can be just a few cents, as are supplements of the lacking nutrients. All that's needed is funding and political will.

And crusaders like Eileen Stillwaggon.