Background: Epidemics of disease are milestones in the history of humanity, nodes in the web of causes and consequences which shape the development of societies. HIV has been with us for long enough to reveal global patterns of distribution which can be linked to currently accepted indicators of social development. Its highest prevalence is found in poor societies, societies in turmoil, among the displaced, the powerless, and the marginalized. The prevalence of HIV is an indicator of uneven or dysfunctional social development.
Discussion: How HIV will affect the development of nations is difficult to predict. A major impact on national macro-economic indicators such as gross national product is unlikely. The most important social and economic effect of the epidemic in developing countries will be an increasing gap between rich and poor, and the feminization of poverty.
PIP: Global patterns of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are consistent with indicators of social development. The highest HIV prevalence is found in poor societies, societies in turmoil, and among the displaced, powerless, and marginalized. AIDS is an indicator of uneven or dysfunctional development, a cause of developmental delays, and a result of inadequacies in the development of health and social services. Factors such as untreated sexually transmitted diseases, the education of women and their level of autonomy to seek medical care, the availability and quality of medical services, large age differences between men and women in sexual partnerships, prostitution as a means of economic survival, and labor migration and refugee movements play key roles in the generation of AIDS epidemics. The impact of HIV on the feminization of poverty and the maldistribution of household wealth is one of the most significant developmental effects. In areas with high HIV prevalence, crop yields and soil fertility are declining, pests and plant diseases are spreading, and starchy crops of low nutritional value are replacing more labor-intensive traditional crops. Finally, AIDS exerts a major impact on the human development index, especially life expectancy at birth.