HIV/AIDS and Women

Man, women have it rough. Here is a list of some of the ways HIV/AIDS affects women more acutely than men, be it through actual physical causes, or through a chain of social and environmental effects.

• women are more likely to report being widowed (due to AIDS), which often reduces their access to food (1)
  
• in families where money is scarce and weighty decisions have to be made whether to spend the resources available on medicine or on food, some married women are unable to do what they think is best because their husbands choose to spend money on themselves or in support of a second family (1)
• women who are widowed or separate from their husbands report having to stretch their resources to feed large extended families, reducing their ability to afford medications (1)
• women have been taught to feed their husbands and children first, so they receive less food than the rest of their family (1)
• when women have sick husbands, they spend 60% less time on agricultural activities (2)
• in rural parts of Africa, widows may have no legal rights to their land or property due to inheritance laws (2)
• one study found that food insecurity and malnutrition are more prevalent in female-headed AIDS affected households (2)
• HIV/AIDS exacerbates nutrient deficiencies in everyone, but this relationships is worse in women due to pregnancy, lactation, menstruation, and heavy workload (2)

(1) = Food insecurity as a barrier to sustained antiretroviral therapy adherence in Uganda (Wiser et al)
(2) = Impact of HIV and aids on household food and nutrition security in Suba district, Kenya (Musita et al)

Both of the articles that I got this information from cited other research that indicates that if nutritional supplements can be given at the beginning of ARV therapy, some of these effects can be avoided. ARVs taken on an empty stomach cause side effects that make it more difficult for patients to obtain food, which in turn makes their side effects worse, which makes it even harder for them to access food etc etc. However, if during the first few months of ARV therapy, nutritional supplements are also added, the ARVs can do their magic without causing severe side effects, which helps patients become more effective at obtaining food, which helps them to take their medicine, which starts a positive cycle instead of a negative one.

I feel like, as the center of the home, frequently responsible for obtaining food for their families and taking care of their sick family members, if you could improve nutrition even just among women with HIV/AIDS that are taking ARVs, a significant difference could be made.

Ok, so let's see if I can verbalize what it is I'm trying to study. I want to study the effects that good nutrition has among HIV positive South African women on ARVs, physically, socially, mentally, and emotionally, and try to pinpoint what barriers are present in South Africa that prevent South African women from accessing the food that they need.