The African family and AIDS: a current look at the epidemic.

PIP: The magnitude and scope of the HIV/AIDS epidemic are increasing in Africa. In Central and East Africa, the first regions of Africa to identify AIDS as a major problem, HIV infection is not limited to individuals in formerly identified high-risk groups. Infection is instead spreading from such groups to and through the general population. HIV infection is also emerging as a threat in regions of Africa previously thought to be relatively unaffected. As such, the World Health Organization estimates that AIDS will add more than 40% to annual death rates for adults aged 15-49 years in sub-Saharan Africa by the mid-1990s, and will reverse declining trends in both child and adult mortality rates. AIDS in Africa affects entire families and communities. More than any other disease, heterosexually-transmitted AIDS is critically influenced by changing African family patterns and structures. The family in Africa has traditionally been the major structure responsible for caring for individual health and well-being given the dearth of effective government social welfare systems to provide support. The widespread AIDS-related morbidity and mortality, however, are threatening the integrity and viability of African families in many AIDS-affected areas. Moreover, the stigma associated with AIDS often isolates family units as they try to cope with an AIDS-affected family member. This article discusses the relationships between familial economic pressures, women's status, and HIV transmission; describes the direct and indirect effects of AIDS on children in African families; and calls for a community-based approach to combatting AIDS.^ieng