Not infected but affected: The burden of AIDS-induced food insecurity among HIV-affected households in Ghana

Providing adequate food and nutrition to a nation is a huge public health undertaking in resource-constrained settings. This becomes more complex when it has to be provided to populations adversely affected by AIDS. AIDS in Ghana - as in sub-Saharan Africa - is one public health problem that has had, and will continue to have a significant impact on the dynamics of “who has access to what and how”. In 2009, the World Food Program assessed food insecurity in Ghana using an indicator that combined household food consumption frequency and dietary diversity, and it was reported that about 5% of Ghanaians were food insecure. An additional 9% were at risk of food insecurity. The problem is worst among HIV-infected individuals or HIV-affected households. A 2011 estimate showed that about 16% of HIV-affected Ghanaian households were food insecure. There is evidence that HIV contributes to food insecurity and vice versa. This chapter commences with a brief description of the concepts and measurements of food insecurity. As part of this, definitions and origins of chronic food insecurity, household food insecurity, and nutrition insecurity are provided. The chapter then presents the burden of food insecurity among the general population, and among HIV-infected, and HIV-affected populations. These are situated within the lived experiences of the Ghanaian HIV-infected and affected person. The chapter further examines the response strategies of individuals and households to the negative impacts of HIV-related food insecurity. The chapter concludes with considerations/recommendations toward addressing the food needs of individuals, households and communities affected by HIV. To achieve this, all state, non-state, and public health actors are enjoined to redouble their intellectual and advocacy efforts at addressing the origins, the burden, the structural risk factors, and social consequences of AIDS-induced food insecurity.