Parental Presence and the Impact of Antiretroviral Treatment on Household Composition in Khayelitsha

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2012

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University of Cape Town

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AIDS (the Acquired Immune Deficiency Syndrome) is known to affect household structure in Africa, as patients rely on kin (especially mothers) for care and support. Little is known about how highly active antiretroviral treatment (HAART) might reverse these dynamics. We use panel survey data from Khayelitsha (Cape Town) to explore changes in the presence of mothers, fathers, sisters and sexual partners in HAART patient households over time. We show that HAART patients, when they first started treatment (i.e. were sick with AIDS), were more likely to be living with their mothers and in parent-headed households than their counterparts in the general population (that is, a sample of Khayelitsha residents and matched to HAART survey respondents by age, gender and education). Over time, the presence of mothers, fathers and parental household heads drops significantly and the living arrangements of HAART patients become indistinguishable from those in the matched sample in this respect. This is consistent with the hypothesis that parental support is no longer required once HAART restores health, thereby enabling patients to live independent, healthy lives. We also show that over time there is a marked increase in the proportion of HAART patients with sexual partners resident in the household. However, the proportion remains significantly lower than for their counterparts in the general population, and HAART patients are more likely to live in single-person households. This suggests that HIV-positive people continue to suffer from social marginalisation to some extent, even after being stabilised on treatment.
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