This paper reviews the existing scientific and programmatic evidence, raises WASH issues in the HIV and AIDS context that need further study to build the evidence base, assesses current WASH guidance through a review of national HIV/AIDS guidelines from five African countries, and identifies programmatic implications that home-based care programs and the WASH sectors must consider.
- Diarrheal diseases are the most common opportunistic infections (OIs) experienced by people living with HIV and AIDS (PLHA) in Africa and elsewhere.
- Most of these diarrheal OIs are water borne or water washed and cause significant loss of functional days (missed work and missed school days), loss of income, considerable human suffering, increased burden on caregivers, weakening of general health and eventually death.
- A small but growing body of literature has identified a series of linkages between water, sanitation and hygiene and HIV/AIDS.
- Few programs for PLHA have included a focus on basic water, sanitation, and hygiene (WASH) behavior change or attended to services and products (such as chlorine for household water treatment, sanitary platforms, or soap) critical to the performance of key WASH behaviors.
- Opportunistic infections negatively impact the quality of life of PLHA and can speed the progression to AIDS. Infection frequency is tied to water and sanitation services available to households and the hygiene practices of household members.
- Ensuring proper WASH practices benefits those infected with HIV and AIDS by keeping them stronger, well nourished, and able to contribute to the household; and they will also prevent the caregivers and other household members from contracting water-borne diarrheal diseases.
