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M94A1821.TXT
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1994-10-24
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Document 1821
DOCN M94A1821
TI The impact of International Monetary Fund and World Bank policies on HIV
transmission in developing countries.
DT 9412
AU Lurie P; Lowe RA; Hintzen P; Center for AIDS Prevention Studies, U of
California, San; Francisco.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):443 (abstract no. PD0380). Unique
Identifier : AIDSLINE ICA10/94370754
AB OBJECTIVE: To describe the impact of the International Monetary Fund and
World Bank lending policy of structural adjustment (SA) on risk factors
for HIV transmission in developing countries. SA programs are a complex
of policies applied primarily to developing countries suffering balance
of payments deficits and that seek to stimulate growth in the private
sector and bolster the export sector. METHODS: We reviewed the
epidemiology of HIV and its risk factors in developing countries as well
as reports on economic development by the World Bank, UNICEF and others.
RESULTS: SA programs require: 1. Reduced government spending on health
and social services; 2. Personal income tax increases; 3. Export
promotion; 4. Currency devaluation; 5. Concessions to foreign investors;
and 6. Increases in the prices of goods and services. The following
social phenomena appear to have been promoted by these policies: 1.
Declining sustainability of rural subsistence economies as economic
activity shifts to the export sector; 2. Increasing poverty and
landlessness, particularly in rural areas, as social services are scaled
back and prices increase; 3. Development of of a transportation
infrastructure to serve the export economy; and 4. Increasing
urbanization. These factors have contributed to the disruption of family
life as rural-dwellers have left rural areas for the city in search of
employment; HIV seroprevalence has become substantial along
transportation routes in many countries. A drug trade has grown up in
many urban centers. Migrant workers from the countryside and in some
cases tourists lured by favorable foreign exchange rates frequent
commercial sex workers, potentially spreading HIV infection. Migrant
workers may introduce HIV into rural areas when they return to visit
family members. Efforts to promote behavioral change or treat HIV
disease are stymied by declining expenditures on health and social
services. DISCUSSION AND CONCLUSIONS: SA programs appear to have
contributed to fundamental changes in the social and economic structures
of many developing countries. These changes may have promoted the
dissemination of HIV in some developing countries.
DE Developing Countries/*ECONOMICS Human HIV
Infections/EPIDEMIOLOGY/*TRANSMISSION *International Agencies Risk
Factors Socioeconomic Factors United Nations MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).