Attempts to analyse the impacts of HIV/AIDS on individuals and households have tended to
consider HIV/AIDS as a distinct and primarily medical issue, unrelated to other processes and
vulnerabilities. Drawing upon a holistic livelihoods and entitlements approach, this mixedmethods
research demonstrates that the impacts of HIV/AIDS must be understood within the
context of multiple, dynamic, and co-existing vulnerabilities and institutional processes which
influence the capability of different individuals and households to both access and mobilise key
livelihood assets. The importance of recognising local perceptions and understandings of
HIV/AIDS is also stressed. Despite HIV prevalence of 43%, few people in Caprivi Region are
aware of their HIV status and continuing stigma and misunderstandings prevent those who are
from disclosure. Under such circumstances, alternative illness narratives exist, providing
‘acceptable’ explanations for illness and death which adversely influence key decisions
regarding treatment and ‘coping’ responses.
Recent socio-cultural change, increased economic heterogeneity and an upsurge in witchcraft
accusations within Caprivi Region are straining traditional familial support structures and safety
nets, resulting in household welfare – particularly provision of care for ill people – becoming an
internal responsibility. Solicited diaries kept by ill people and their main carer provide an
innovative insight into the physical and psychological pressures of long-term care. The
necessity to continue with livelihood activities to maintain food security results in carer fatigue
and stigma against the ill person, particularly if HIV/AIDS is suspected. The increasing
dependency of the ill person not only influences their ability to seek treatment, but also their
ability to undertake expected familial and livelihood roles. This research found that an inability
to ‘see for yourself’ – i.e. be self-sufficient, or contribute to reciprocal support networks results
in stigma, isolation and rejection both within and beyond the household. This research argues
that inequalities and stigma are hampering effective HIV/AIDS prevention and impact
mitigation in the Caprivi Region.