Life history analysis of HIV/AIDS-affected households in rice and cassava-based farming communities in Northern Malawi.

The "New Variant Famine" hypothesis proposed that AIDS offers a major challenge to food security in this part of Africa by impairing the functioning of traditional support systems, leading to the collapse of "social immunity". This study explores the changing perceptions of HIV and AIDS and peoples' responses to its impact by eliciting life history narratives of 30 respondents in Northern Malawi. We classified respondents by means of gender, livelihood systems and AIDS impact levels. Respondents reported a range of critical events, recorded in the life histories, that threatened their "social immunity", including deaths, sicknesses, migration, marriages and divorces, and dropping out of school; i.e., a greater range of risks than AIDS alone, that need to be recognised in HIV and AIDS programming. For the respondents who were classified as "AIDS-affected", learning about their seropositive status was found to be an important, and in some cases a positive, turning point in their lives in terms of behavioural changes, such as joining support groups and opening up to discussion of the implications of their status. The emerging social organisations could re-create social capacity and check the downward spiral proposed by the "New Variant Famine" hypothesis. To promote this shift and to confer a higher level of "social immunity", investments in expanding access to voluntary counselling and testing and antiretroviral therapy services, and assistance to community-based organisations would be essential.