HIV, the virus that causes AIDS, Acquired Immunodeficiency Syndrome, has become one of the world s most serious health and development challenges, since the first cases were reported in 1981: At the end of 2010, an estimated 34 million people were living with HIV globally, including 3.4 million children less than 15 years. The number of people newly infected in 2010 was 2.7 million. Almost all of those living with HIV (97%) reside in low and middle income countries, particularly in sub-Saharan Africa. Sub-Saharan Africa remained the most affected region in the global AIDS epidemic. This regions accounts more than two third (68%) of people living with HIV. Most children with HIV live in this region. Globally, the annual numbers of people newly infected with HIV continues to decline (Global HIV/AIDS Response progress report, 2011).
Chapter 18.104.22.168, Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: The full range of food insecurity and hunger cannot be captured by any single indicator. Instead, a household s level of food insecurity or hunger must be determined by obtaining information on a variety of specific conditions, experiences, and behaviors that serve as indicators of the varying degrees of severity of the condition (USAID, 1992). Because it is acomplex, multidimensional concept, measuring food insecurity has been an ongoing challenge to researchers and practitioners alike. Until very recently, most household-level measures of food access, such as income and caloric adequacy, have been technically difficult, data-intensive, and costly to collect. The household food insecurity access scale (HFIAS) which is an adaptation of the approach that used to estimate the prevalence of food security in the United States annually. The method is based on the idea that the experience of food insecurity (access) causes predictable reactions and responses that can be captured and quantified through a survey and summarized in a scale (Radimer et al., 1990) Based on this growing body of evidence, FANTA and its partners have identified a set of questions (Household Food Insecurity Access Scale Generic Questions) that have been used in several countries and appear to distinguish the food secure from the insecure households across different cultural contexts. These questions represent apparently universal domains of the household food insecurity (access) experience and can be used to assign households and populations along a continuum of severity, from food secure to severely food insecure (ibid). The questionnaire consists of nine occurrence questions that represent a generally increasing level of severity of food insecurity (access), and nine frequency-of-occurrence questions that are asked as a follow-up to each occurrence question to determine how often the condition occurred. The frequency-of-occurrence question is skipped if the respondent reports that the condition described in the corresponding occurrence question was not experienced in the previous four weeks (30 days). Some of the nine occurrence questions inquire about the respondents perceptions of food vulnerability or stress (e.g., did you worry that your household would not have enough food?) and others ask about the respondents behavioral responses to insecurity (e.g., did you or any household member have to eat fewer meals in a day because there was not enough food?). The questions address the situation of all household members and do not distinguish adults from children or adolescents. All of the occurrence questions ask whether the respondent or other household members either felt a certain way or performed a particular behavior over the previous four weeks (FANTA, 2004 and Coates, 2004). Some field validation studies of this approach to measuring food insecurity (access) more directly, by constructing measures based on households experience of the problem, have demonstrated the feasibility and usefulness of the approach in very different, developing country context(Coates et al., 2003). Generally, the household food insecurity access prevalence (HFIAP) indicator categorizes households into four levels of household food insecurity (access): food secure and mild, moderately and severely food insecure. Households are categorized as increasingly food insecure as they respond affirmatively to more severe conditions and/or experience those conditions more frequently (FANTA, 2007). A food secure household experiences none of the food insecurity (access) conditions, or just experiences worry, but rarely. A mildly food insecure (access) household worries about not having enough food sometimes or often, and/or is unable to eat preferred foods, and/or eats amore monotonous diet than desired and/or some foods considered undesirable, but only rarely. But it does not cut
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