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By : Richard Tomlinson

The background to this paper is the increasing interest in the relationship between housing and municipal services and HIV/AIDS. The purpose of this paper is to clarify what, precisely, one has in mind when thinking that housing and municipal services might prevent HIV infection and associated opportunistic infections. The focus is not on the socioeconomic dimensions but on the modes of transmission associated with specific opportunistic infections. That is, the paper first disputes the relevance of housing and services to HIV prevention, but then demonstrates that housing and municipal services are important for
(a) the prevention of certain opportunistic infections to which people affected by HIV/AIDS are particularly vulnerable, and
(b) for the provision of home-based care. In addition to the medical focus of the paper, there is attention to the empirical backdrop on the relation between housing, municipal services and HIV/AIDS, analysing survey findings regarding among whom and where HIV prevalence is highest, and projections regarding the extent of HIV infections and AIDS based on the World Health Organization clinical staging system. Using Johannesburg as a case study, it is demonstrated that the number of persons having AIDS is smaller than one might expect and also that the number is already declining, which has implications for the provision of home-based care. However, it is also shown that the number of households that lost one or several members is increasing rapidly. In this context, labour force surveys are employed to identify the impacts on specific categories of households. At this stage, a defining unknown is the scale, nature and location of these reconstituted households and what this means for housing policy. Finally, a feature of the research was the extent to which medical practitioners viewed housing as a quixotic sideline within the broader struggle for HIV prevention and the provision of treatment. In sum, the paper provides an argument for incorporating housing and municipal services into both HIV and AIDS prevention and treatment programmes.
Keywords : HIV/AIDS, Opportunistic Infections, Housing, Municipal Services.

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