HIV, Food Security & Nutrition Socioeconomic Impact Jason Wolfe USAID Office of HIV/AIDS

1. HIV, Food Security & Nutrition Socioeconomic Impact Jason Wolfe USAID Office of HIV/AIDS

2. HIV & Food Security HIV exacerbates food insecurity & vulnerability: • Increased costs • Reduced labor • Diminished earnings • Liquidated assets • Stressed safety nets

3. Food Security & HIV Food insecurity & vulnerability exacerbates HIV : • Inhibited health-seeking behavior • Reduced access to services • Limited follow-up and adherence • Increased opportunistic infections • Diminished community support

4. Food Security before HIV Cyclical fluctuations driven by seasonality moderated by income diversity, assets, food storage, and safety nets

5. Food Security after HIV increased costs for food & healthcare sale of assets facilitates recovery sale of assets limits future productivity reduced labor limits food access Prolonged downward trajectory reduced ability to buffer and bounce back from shocks

6. Coping Strategies • Before the shock: Risk Reduction • Low risk (low return) income generation activities • Diversification of income generation activities • Insurance mechanisms: savings & assets, social ties, credit access • After the shock: Loss Management • Stage 1: Insurance & reversible mechanisms • Stage 2: Disposal of key productive assets • Stage 3: Destitution: charity, household breakup, migration

7. Segmenting by Vulnerability

8. Implications for Support

9. Pathway Approach promotion restores livelihoods protection builds assets provision smooths consumption nutrition support improves productivity Sustainable graduation out of extreme vulnerability with nutrition, food security, and livelihoods support