Livelihood Trajectories and HIV and AIDS in SW Uganda - Follow On funding

The overall purpose of this follow-on work is to analyze the trajectories of individuals, households and communities affected by HIV and AIDS and explore the impact of the epidemic in Uganda on demographic structure, agriculture and rural livelihoods over the last 20 years. This work will contribute to building an understanding of the long-term impact of HIV and AIDS and contribute to the design of policies and programmes for impact mitigation. The research will take place in Masaka District, the study area of the Medical Research Council/Uganda Virus Research Institute Research Unit on AIDS in Uganda (MRC/UVRI). In 1991/92 the MRC/UVRI undertook an ethnographic study of 27 households in the General Population Cohort (GPC) (which had been set up in 1989 covering the population of 15 villages). In 2006/07 the ESRC funded research (hereafter called the `Trajectory Study') that included a restudy of those households (Component 1), plus two additional components. Component 2, with 144 households to represent different socio-economic ranks and households both with and without HIV, compared the influence of parental HIV-infection on household resource allocations, particularly those that affect children and documented the livelihood trajectories of individuals and households. Component 3 involved statistical analysis of GPC census and adult medical survey data from baseline (1989/90) through 2004/5 to begin to describe household trajectories in response to HIV-infection over time.

The initial findings of the Trajectory Study caught the attention of staff in the Economic and Social Development Department of the Food and Agriculture Organisation of the United Nations because the study findings offered insights into the affects of the epidemic on rural livelihoods over more than a decade, providing information that had not been available before. Many of the initial studies of rural societies and of the impact of HIV and AIDS that had been carried out were essentially short-term cross-sectional views from which many advocates drew long-range conclusions and generalizations. The Trajectory study findings offered some explanation as to why many of the worst-case scenarios suggested by those projections during the 1990s have not come to pass: national economies have not collapsed, rural communities have not imploded, and agricultural production has not stagnated. The Trajectory study showed that much of the impact has been borne at household level rather than the national level with the affects being absorbed by extended family groups as well as individual household units. The findings showed that the determinants of household vulnerability to HIV and the capacity to resist or recover from the impact of the disease and the trajectories such recovery (or not) take, are more complex than many commentators had expected.

The FAO is providing funding for new fieldwork to explore in more detail the impact of the epidemic on agricultural livelihoods in the GPC field site of the MRC/UVRI. We would like to complement this work by building on the Trajectory study analysis to look in more depth at the impact HIV-related infection and AIDS deaths have had on broader livelihoods in individual households and wider family groups. In addition to continued analysis of the qualitative data collected in the course of the Trajectory study, we wish to begin to carry out the analysis plan, set out in the Final Report of the Trajectory study, and undertake detailed analysis of the new family unit data (categorizing people by kin group) to explore demographic change by family, rather than just physical house unit membership. We plan to improve upon our household and family categorizations and apply the categorization to data from the Rakai Health Sciences Programme cohort as well as begin to share the categorization with other, similar, cohort studies in Africa through a small workshop to be held at the MRC/UVRI field site in Uganda.