ECONOMIC SPILLOVER EFFECTS OF HIV TREATMENT ON RURAL

SOUTH AFRICAN HOUSEHOLDS

Jacob Bor1,2, Frank Tanser1, Marie-Louise Newell1,3, Till Bärnighausen1,2

1Harvard School of Public Health, Harvard University2Africa Centre for Health and Population Studies, University of KwaZulu-Natal

3Institute of Child Health, University College London

HARVARD SCHOOL

OF PUBLIC HEALTH

International AIDS Conference, July 23, 2012, Washington, D.C.

Africa Centre for Health and Population Studies (UKZN)

More than 100,000 people

in over 10,000 households

>4500 adults initiate ART in public sector treatment program

Surveillance data linked with clinical records from HIV treatment program

Community-based population surveillance, 2001-2010

25% of population lives with ART patient

Adapted from Bor, et al (2011) TMIH

2004 2005 2006 2007 2008 2009 20100%

10%

20%

30%

40%

Member of a household or resident in a compound with someone who accessed the programmeMember of a household or resident in a compound with someone who initiated ARTAccessed the programme (date of first CD4 count)Initiated ART

Per

cen

t o

f T

ota

l P

op

ula

tio

n

90% employment recovery

Adapted from Bor, et al (2012) Health Affairs

ART protects household assets

4-2 years pre

2-0 years pre

0-2 years post

2-4 years post

4-6 years post

-0.6

-0.4

-0.2

1.11022302462516E-16

0.2 ART ini-tiation

HIV death

ART initiation or HIV death

Baseline Number of household assets about 6

N (ART initiation)85,338 observa-tions in 18,662 households

N (HIV death)77,762 observa-tions in 16,797 households

Acknowledgments• We thank all the respondents who gave their time to this

research and the staff of the Africa Centre for Health and Population Studies and the Hlabisa HIV Care and Treatment Programme

• Funding− Wellcome Trust (Africa Centre for Health and Population Studies)− National Institutes of Health grants R01 HD058482-01 and

1R01MH083539-01 (Till Bärnighausen, Frank Tanser)− Harvard Global Health Institute (Jacob Bor)