The environmental dimensions of the HIV/AIDS pandemic: a call for scholarship and evidence-based intervention

The HIV/AIDS pandemic has had dramatic influence on the demographic dynamics of many of the world's less economically developed regions. Today, an estimated 33 million individuals are living with HIV, and recent data suggest that, every day, over 6800 persons become HIV-infected and over 5700 persons die from AIDS (UNAIDS 2006). The age profile of HIV infection is well known, with new cases impacting primarily prime-age adults. Sub-Saharan Africa remains the world's most affected region with recent population-based surveys suggesting that adult prevalence rates (age 15-49) reaches as high as 25% in Botswana and over 23% in Lesotho (UNAIDS 2006). Still, HIV/AIDS also impacts children, with over 2 million HIV+ individuals under age 15 in sub-Saharan Africa; And the disease profile now includes many individuals over age 50 due to the positive impact on life expectancy of recent treatment advances (UNAIDS 2006).Of course, HIV/AIDS' impacts at the individual and household levels are difficult to discern from aggregate data although ethnographic research provides insights into nuanced household survival strategies (e.g., Evans 2005; Schatz and Ogunmefun 2007). Such work reveals household efforts to maintain a sense of "normality" in response to the impacts of HIV/AIDS, otherwise known as "the disease" (Bohman et al. 2007).