Social networks and state grants: sustaining the livelihoods of households affected by HIV and AIDS in KwaZuluNatal, South Africa

The livelihoods of households in rural South Africa depend largely on formal and informal paid work. remittances and social security payments. Agricultural production is far less important than in other parts of sub-Saharan Africa. In addition. a turbulent social and political history has affected the composition, functioning and definition of rural households. This thesis explores in this context how illness caused by HIV, access to antiretroviral therapy (ART) and the death of individuals change the experience of household members and their livelihoods. The study is based on case studies of ten households and adopted a livelihoods conceptual framework. Data were collected both prospectively and retrospectively in a series of indepth interviews supplemented by direct observation. Social capital and state grants were particularly important in mitigating the effects of HIV and AIDS in affected households. Resident and non-resident members of the household provided each other with both valuable financial and material support and physical care. Access to this resource was underpinned by strong norms of obligation to family and generalised reciprocity within households. These findings highlight the importance of family or household-focussed interventions in alleviating the burden of HIV and AIDS. Norms of reciprocity also enabled affected households and individuals with sufficient social capital to secure support from kin outside the household and the wider community. Although many affected households encountered difficulties accessing them. social grants were a major component of their livelihoods. A synergistic relationship existed between receipt of a disability grant and successful ART outcomes. This finding highlights the importance of providing social grants for those who become ill and have no other source of income. Unemployed people on ART should remain entitled to grant support even if they no longer qualify as disabled in order to assist them to continue treatment.