Peter F. Schaefer explains how economics and property rights in African nations combine to facilitate the proliferation of the AIDs virus:
However no one in the US government and few in the anti-AIDS community are dealing with a major issue in the transmission of AIDS called “property stripping.” Since the cure for property stripping is cheap, technically quite easy and would have an enormous secondary impact on economic growth (poverty is a hidden vector of AIDS) it would seem like a sure thing for attention. But it is virtually ignored.
On World AIDS Day two years earlier Dr. Jim Yong Kim – [head of World Health Organization’s HIV Division, Kevin] De Cock’s predecessor – said,“In sub-Saharan Africa almost 60 percent of AIDS sufferers are women [and] in some settings … we are finding … that the number one risk factor for women in becoming infected with HIV is marriage. [And] married women have the highest rates of HIV infection. We have to take on some of the most fundamental and difficult cultural and social issues that are definitely affecting the way this epidemic is spreading. And … if we can take on things like for example, property rights [so] women can inherit the property of their husband if [he] dies, that really reduces the likelihood of them getting into sex work for example. If we can … change laws, change fundamental beliefs and culture by [getting] people the right kinds of prevention messages we will have done a lot not just for HIV AIDS but for issues like gender equity that have been with us forever.”
In the scholarly literature, the traditional practice of the husband’s family inheriting all his property after he dies is called “property stripping.” In normal times, this had some logic; the husband’s family had responsibility for the widow and her children, a brother often taking her as a second wife and so assuming responsibility for his nieces and nephews.
But things have changed. In the time of AIDS, the widow is likely also infected with the HIV virus, though not yet sick since her husband often gets it first and the disease is less advanced in her when her husband dies. So even if her brother-in-law hasn’t died from AIDS himself, he is not willing to marry someone infected with HIV. And often the brother-in-law himself is sick or dead. Nevertheless, the family often still follows custom and seizes her house and farm and so she has no recourse but to turn to menial jobs, begging or prostitution. And since she was infected later, she may have years to spread her illness to her sex partners which are commonly many a day.
[A] Washington Post editorial by Richard Holbrooke . . . noted that increased testing and detection efforts was the “only effective prevention strategies can stop the spread of AIDS.” He goes on to point out that “…monogamous women [are] thrown out of their homes for a disease they got from their husbands.”
Read the entire article, which is another reminder that there are few simple solutions to this terrible disease.
And another reminder that social conditions have a marked influence on health and epidemiology. Given that our spending on health and biomedical research is overwhelmingly directed to acute care or vaccine research and minuscule amounts are directed to public health and preventive medicine, we have a problem, IMO.
Epidemiology is not reducible to single, discrete causal agents. HIV is necessary to cause AIDS in a single person, but its spread across populations requires a host of additional social, cultural, political, and economic factors.