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How do teenagers located in the KwaZulu-Natal province of South Africa, the epicentre of the HIV pandemic, give meaning to sexuality? This paper examines teenage black Africans investments in sex and sexuality and the gendered dynamics through which sexuality is articulated. Whilst unequal gender relations of power continue to feature prominently within relationship dynamics fuelling the gendering of HIV, attention to the micro-processes through which relationships are forged remain significant in illustrating the complex connections between love, sex and gender. Drawing on empirical findings with teenagers between the ages of 16 and 17 years old, the paper shows how relationships are conceptualised based on discourses of love. Love is inextricably bound up with sex and when teenagers talk about love and sex they also talk about condom use, multiple sexual partners and gender inequalities. What teenagers were interested in for their sexual relationships was not raised in sex education programmes at school. Implications for addressing teenage constructions of sexuality are discussed in the conclusion. [ABSTRACT FROM AUTHOR]

Globally, in the last 20 years health has improved. In this generally optimistic setting HIV and AIDS accounts for the fastest growing burden of disease. The data show the bulk of this is experienced in Southern Africa. In this region, HIV and AIDS (and tuberculosis [TB]) peaks among young adults. Women carry the greater proportion of infections and provided most of the care. South Africa has the dubious distinction of having the largest number of people living with HIV in the world, 6.4 million. HIV began spreading from about 1990 and today the prevalence among antenatal clinic attendees is 29.5%. A similar situation exists in other nations of the region. It is an expensive disease, requiring more resources than are available, and it is slipping off the global agenda, both in terms of attention and international funding. Those halcyon days of the decade from 2000 to 2010 are over. This paper explores the concept of three transition points: economic, epidemiological and programmatic. The first two have been developed and written about by others. We add a third transition point, namely programmatic, argue this is an important concept, and show how it can become a powerful tool in the response to the epidemic. The economic transition point assesses HIV incidence and mortality of people infected with HIV. Until the number of newly infected people falls below the number of deaths of people living with HIV, the demand for treatment and costs will increase. This is a concern for the health sector, finance ministry and all working in the field of HIV. Once an economic transition occurs the treatment future is predictable and the number of people living with HIV and AIDS decreases. This paper plots two more lines. These are the number of new people from the HIV infected pool initiated on treatment and the number of people from the HIV infected pool requiring treatment. This introduces new transition points on the graph. The first when the number of people initiated on treatment exceeds the number of people needing treatment. The second when the number initiated on treatment exceeds the new infections. That is the theory. When we applied South African data from the ASSA2008 model, we were able to plot transition points marking progress in the national response. We argue these concepts can and should be applied to any country or HIV epidemic. [ABSTRACT FROM PUBLISHER]

Since the end of apartheid, patterns of migration into South Africa have shifted, and South Africa has become a destination for people from across the African continent and beyond - a small but important number of whom are refugees and asylum seekers. While South Africa has a protective, integrative, urban refugee policy, many of these individuals struggle to access the rights to which they are entitled, including healthcare. In addition, many lower-skilled international migrants are unable to legalise their stay in South Africa. As a result, international migrants often become part of the group of 'urban poor,' falling within the periphery of health and social welfare provision and relying on a survivalist livelihood within the informal economy. The health and wellbeing of an individual impact greatly on their ability to maintain a secure livelihood, and this becomes more difficult in the context of an HIV epidemic. This paper presents findings from a case study situated in the City of Johannesburg. The research made use of 1) 2006 survey data on migrant livelihood strategies in Johannesburg, 2) a study investigating non-citizens' access to antiretroviral treatment (ART) in the inner city, which included 3) a set of interviews conducted with migrant ART clients who were working in the city's informal economy. The findings indicate (a) the importance of the informal economy for migrants to Johannesburg; (b) the challenges that non-citizens face in accessing ART in the public sector in South Africa; and (c) the linkages between urban migrants' access to ART and their ability to maintain a survivalist livelihood. The paper argues that upholding people's right to ART for all who need it within South Africa will enable international migrants (including refugees and asylum seekers) to maintain an otherwise fragile survivalist livelihood, and this in turn will assist their self-reliance and integration into urban life. Recommendations are made to ensure that the right to healthcare is upheld for all in South Africa. [ABSTRACT FROM AUTHOR]

This work explores the connections between gender inequality, HIV/AIDS and women's health in the world of work in South Africa. These connections are located within a context of significant reversals in development, specifically declining life expectancy and premature mortality for South Africans - particularly for women. By relying on the existing literature and interviews with 33 key informants, the paper examines the extent to which South African workplaces are recognising women's social and biological vulnerability to HIV. In particular, the paper considers the potential role of the workplace in responding to growing evidence that links gender and health by establishing targeted HIV/AIDS interventions. The findings suggest that the vast majority of company representatives do not recognise women's social and biological vulnerability and related social norms vis-à-vis HIV and AIDS. Importantly, most workplaces are not initiating programmes that specifically address women's or men's health. The author briefly identifies factors that may help explain the current state of knowledge and practice in the realm of HIV and women's health in the workplace, and puts forward suggestions for future research. [ABSTRACT FROM AUTHOR]

In the face of the extreme challenges posed by the South African HIV/AIDS epidemic, collaboration between public and private partners is often called for in an attempt to mobilise additional resources and generate synergies. This paper shows that the ability to successfully use public-private partnerships to address complex challenges, such as an HIV/AIDS epidemic, is influenced by the fabric of society, one important aspect being historical legacies. The first part of the article shows how South Africa's apartheid past affects the ability of public and private partners to collaborate in a response to HIV and AIDS today. It also takes into account how reconciliation and nation-building policies in the immediate post-transformation period have affected the ability to form and sustain partnerships concerning HIV/AIDS issues. The second part of the article analyses more recent developments regarding the information that these hold as to the feasibility of public-private partnerships and whether these continue to be affected by the legacies of the past. Two events with symbolic political value in South Africa, namely the 2010 FIFA World Cup soccer event and the recent changes in government, are systematically examined on the basis of three analytical queries, regarding: the impact of the event on nation-building and transcending cleavages in society; the event's impact on the ability to form public-private partnerships in general; and the role of HIV/AIDS in connection with the event. Conclusions are drawn a propos the influence of historic factors on the ability of South African society to effectively use public-private partnerships in the response to HIV and AIDS, and the continued dynamics and likely future directions of these partnerships. [ABSTRACT FROM AUTHOR]

This paper reports on a post-intervention qualitative evaluation of the pilot intervention of the AmaQhawe Family Project, in South Africa, which is a cartoon-based, manualised intervention delivered to multiple family groups over 10 sessions, aimed at preventing HIV in adolescents through strengthening the adult protective shield. Semi-structured interviews with nine women who had participated in the pilot intervention were used to understand participants' perceptions of how the family-based HIV-prevention programme had assisted in addressing the issues identified in a pre-intervention exploratory study. Analysis of the data was informed by community health psychology and social capital theory. The findings indicate that at an individual level, the women interviewed had experienced an improved sense of empowerment, both as parents and as women. They also reported increased social support for effective parenting. At a collective level, the women reported that the programme had helped them to exert better informal social controls within the community, as well as to increase their social leverage and participation in community organisations. The findings suggest that HIV interventions involving families can strengthen the adult protective shield to facilitate health-enabling social contexts for youth. [ABSTRACT FROM AUTHOR]

This paper presents epidemiological data from ongoing HIV-prevalence surveillance in a large South African manufacturing company located in various provinces, as well as one location in Swaziland. A survey of the workforce in 12 of the manufacturer's business units (BUs) throughout these locations was carried out in 2001-2003, and each was repeated three years later, in 2004-2006. The company is typical of manufacturing in South Africa, in that it is labour-intensive, male-dominated, and has high proportions of semi-skilled and unskilled employees. The surveys were anonymous, cross-sectional and unlinked. The workforce was stratified at the level of analysis by workplace, geographical location, job status (permanent or contract), job skill level, and age group. In 2001/3 a total of 5 177 permanent employees, representing 76% of those on duty at the time, plus 1 966 contract employees were surveyed. In 2004/6, 5 445 permanent employees, representing 81% of those on duty, and 2 688 contract employees were surveyed. HIV prevalence in the 2004/6 survey ranged from 0.9-30.7% throughout the 12 BUs, with a mean of 15.4%, showing an increase from the previous mean of 13% prevalence in the 2001/3 survey of the same locations (p = 0.0001). Differences in HIV prevalence across the BUs were determined by geographical location and the profile of the workforce. Similar proportions of contract employees were found to be HIV-positive in the initial survey and repeat survey (23% and 24.5%, respectively). HIV prevalence was inversely proportionate to permanent employees' job skill level. The 2004/6 data show lowest HIV prevalence in the upper-management category (3.6%) and highest prevalence in the unskilled category (22.6%). HIV prevalence did not increase in the upper- and middle-management categories but increased significantly in the skilled (p = 0.02), semi-skilled (p < 0.001) and unskilled (p < 0.001) job categories. HIV prevalence was similar among contract employees and unskilled permanent employees. Race (not considered in the study) may in part confound these findings. In both surveys, HIV prevalence was highest in the age group 30-39. Prevalence did not increase between surveys in the age group 18-29; however, significant increases occurred in the age groups 30-39 and 40-49 (p < 0.001), and possibly also in the age 50+ category (p = 0.09). [ABSTRACT FROM AUTHOR]

The ongoing damage that the newer forms of HIV denialism are visiting upon our country is evidenced by the recent firing of Nozizwe Madlala-Routtedge, the South African Deputy Minister of Health. It is widely believed that the underlying reason for her dismissal was her support of orthodox HIV treatment and prevention strategies and her disdain for HIV denialism. This paper seeks to understand the origins, spread and metamorphosis of President Thabo Mbeki's HIV denialism in South Africa. Using the theory of cognitive dissonance, I argue that, given the structural beliefs of the African National Congress (ANC) and the pattern of emergence of HIV in the 1980s, a degree of scepticism around the putative science of HIV was probable in ANC circles. On assuming the Presidency in 1999, Mbeki tapped into this scepticism to formulate his initial biological version of HIV denialism, which claimed that 'a virus can't cause a syndrome.' The steady erosion of support for this flagrant HIV denialism, together with the rise of neoliberal thinking in the ANC, would lead to the evolution of this biological denialism into a form of treatment denialism. This ideology argued against the widespread provision and use of antiretroviral treatment. Empirical evidence is presented to demonstrate the extent to which ongoing HIV denial in the general population is continuing to fuel the spread of HIV. [ABSTRACT FROM AUTHOR]