South Africa is classified as an upper middle income country (UMIC) but is one of the most unequal society in the world.
UMkhanyakude, one of its districts, is amongst the most economically deprived in the world. It is the epicentre of the HIV epidemic with a growing problem of drug resistant HIV. The district is affected by severe drought and was declared a drought emergency disaster area in October 2015. The co-location of HIV and drought has made the former and diarrhoeal diseases the two leading causes of death in the district.
We hypothesise that the added shock from drought contributes to HIV-positive individuals prioritising their means of livelihood over their health resulting in poor engagement with care and HIV drug resistance (HIVDR) in the district. By investigating the increased vulnerability created by drought (SDG 13) and poor socioeconomic status (SDG 1), this project seeks to understand the difficult trade-offs HIV-positive individuals face daily between health care utilisation (SDG 3) and pursuit of economic sustenance (SDG 8).