1. HIV, Food Security & Nutrition Socioeconomic Impact Jason Wolfe USAID Office of HIV/AIDS AIDS 2012 - Turning the Tide Together

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

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 Vulnerability Food SecurityExpensesIncomeAssets LowMildSome lumpsumFluctuatingConsistent MediumModerateNo lumpsumFluctuating HighSevereLittle/none None

8. Implications for Support VulnerabilityStrategyInterventions LowPromotionIncome diversification MediumProtectionSavings & asset management HighProvisionConsumption support

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