The experiences and livelihood strategies of poor people living with HIV/AIDS in Kolkata, India

The international literature, policy and action up to now have concentratedpredominantly on the prevention and treatment aspects of HIV/AIDS, oftenneglecting the support and care that poor people living with HIV/AIDS (PLHA)require. Internationally, most studies that have focused on the household livelihoodstrategies employed by PLHA have been carried out in rural contexts and very fewhave been carried out in urban contexts, particularly in urban India. The current study addresses this gap by exploring a group of poor PLHAs’ own perceptions of their experience of living with and seeking treatment for HIV/AIDS, the adequacy of the health care services they are able to access and the support programmes for PLHA provided by NGOs and other not-for-profit organisations in the context of Kolkata one of the largest metropolitan cities in India. Semi-structured interviews were carried out with 59 men and women from Kolkata, India, all receiving treatment for HIV/AIDS and some other forms of support. The study reveals that in the case of HIV/AIDS, it is necessary to divide the postsymptomatic phase into pre and post-diagnosis stages, because it emerged that many PLHA had experienced serious delays in obtaining an accurate diagnosis, resulting in the loss of most, if not all, their existing assets, further impoverishing many at an early stage of the illness trajectory, although by the time of the study most were accessing free antiretroviral therapy. Confirming experiences elsewhere, significant differences were found between the ways men and women experience living with their illness on a daily basis. People’s ability to mobilise additional labour assets within their households to ‘earn money in new ways’ and the characteristics of their ‘household relations’ emerged as key explanations of how well households fared during the post-diagnosis phase. The PLHA reported that of the NGO programmes, mental support (in the form of counselling and the opportunity to interact with other PLHA), nutritional support and financial assistance were the most useful forms of support, helping them to live with their illness on an everyday basis and avoid becoming more vulnerable and impoverished. These findings have some policy and practice implications, which are identified.