This study, a joint publication by FAO and UNAIDS, describes how the HIV epidemic is undermining the hard-earned gains of development efforts of the last 40 years.

This book is about the effects of AIDS on women and food security in Côte d'Ivoire, West Africa. AIDS is more than a health problem. Rural households and women in particular have to cope with the lack of labour in agriculture which threatens their food security. For the matrilineal Agni women land ownership appears to be an unexpected burden, rather than a safeguard from poverty. Culture matters, but not in similar ways everywhere. Matrilineal or patrilineal kinship organisation, gender inequality, and norms about sexual relationships very much influence the differences in Agni and migrant women's vulnerability to AIDS. African women are often seen as victims of AIDS. This study shows that women may also use their creativity and social networks to battle and to be resilient against the effects of the illness in their everyday household activities. Using a combination of quantitative statistical data and qualitative methods, this research questions the effectiveness of mainstream AIDS policy and interventions in Côte d'Ivoire. Victimising the poor does not help. Instead, multi-sector policy intervention can mitigate the social effects of AIDS by improving household food security and by changing cultural practices through local leaders who have historical legitimacy and power.

AIDS epidemics continue to threaten the livelihoods of millions of people in sub-Saharan Africa. Three decades after the disease was first recognized, the annual death toll from AIDS exceeds that from wars, famine and floods combined. Yet despite millions of dollars of aid and research, there has previously been little detailed on-the-ground analysis of the multifaceted impacts on rural people. Filling that gap, this book brings together recent evidence of AIDS impacts on rural households, livelihoods, and agricultural practice in sub-Saharan Africa. There is particular emphasis on the role of women in affected households, and on the situation of children. The book is unique in presenting micro-level information collected by original empirical research in a range of African countries, and showing how well-grounded conclusions on trends, impacts and local responses can be applied to the design of HIV-responsive policies and programmes. AIDS impacts are more diverse than we previously thought, and local responses more varied - sometimes innovative, sometimes desperate. The book represents a major contribution to our understanding of the impacts of AIDS in the epidemic's heartland, and how these can be managed at different levels.