HIV/AIDS, nutrition and structural interventions in South Africa: A move in the right direction

There has been a systematic imbalance between the treatment and prevention responses to the AIDS pandemic (Horton and Das, 2008). One of the consequences has been a dramatic rise in the number of people receiving antiretroviral therapy in South Africa (3 million), but at the same time there will be 2.5 million new infections this year (Horton and Das, 2008). Approximately two-thirds of people living with HIV live in sub-Saharan Africa, though only 10% of the world's population lives in this region (Global Health Council, 2009). This startling imbalance, coupled with the continuing rising prevalence in HIV, suggests that HIV prevention efforts have failed. There are a number of reasons for this, but one is that preventive efforts must begin to focus on social, economic, and cultural factors, in addition to individual risk factors. The aim of this chapter is to provide an analysis of some of the intersections between HIV/AIDS, nutrition, agriculture and the school as a platform for the delivery of interventions. This is a huge area, and we will not attempt a comprehensive review but rather argue that a structural focus on the intersections combined with a gendered poverty relief programme promises a long-term and more sustainable approach to the prevention of HIV/AIDS.