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This paper contextualises counselling within a broader historical formation that links disclosure to healing and deploys confessional technologies to incite disclosure and awareness of the mysterious substance of the self. Foucault's argument that sexuality was the privileged arena for using confessional technologies to ‘produce’ the truth of the self is particularly relevant in light of the diffusion of counselling practices in Africa in the wake of the HIV epidemic, particularly with their emphasis on inciting appropriate sexual behaviour. Examination of the historical assemblage of counselling practices shows how they articulate what the self is, the nature of truth and a politics of language. This paper focuses on the genealogy of four key assumptions that express this confessional reason. These are that: (1) people can be ‘empowered’ to have control on their own lives by working on themselves, (2) secrets untold become pathogens, (3) the ability to heal requires that one first overcome personal illness, (4) the experience of sharing secrets is cathartic and healing. The genealogy intertwines four strands: that of the Unconscious as revealed by Freud and his followers, attempts to treat shell-shocked veterans of World War I, group psychotherapy and participatory research after World War II.El presente artículo contextualiza el asesoramiento dentro de una formación histórica más amplia, que vincula la transparencia con la sanación, utilizando tecnologías confesionales que alientan la transparencia y la conciencia en torno a la misteriosa sustancia del sí mismo. Es particularmente pertinente el argumento de Foucault acerca de que la sexualidad es el espacio privilegiado para el uso de tecnologías confesionales que "producen" la verdad del sí mismo, especialmente a la luz de la difusión de prácticas de asesoramiento en África tras la epidemia del vih y considerando la importancia que las mismas atribuyen al hecho de fomentar un comportamiento sexual apropiado. Un análisis del andamiaje histórico de las prácticas de asesoramiento demuestra cómo articulan lo que es el sí mismo, la naturaleza de la verdad y las políticas del lenguaje. Este artículo se centra en la genealogía de cuatro suposiciones clave que expresan esta razón confesional: (1) al hacer un trabajo personal, las personas pueden ser "empoderadas" para asumir el control de sus propias vidas; (2) los secretos no revelados se convierten en patógenos; (3) la posibilidad de sanar implica primero recuperarse de enfermedades personales; y (4) la experiencia de compartir secretos es catártica y sanadora. Esta genealogía entrelaza cuatro ejes: el de la Inconsciencia trabajada por Freud y sus seguidores; los intentos de tratar a exsoldados aturdidos por el combate de la I Guerra Mundial; la psicoterapia grupal; y la investigación participativa posterior a la II Guerra Mundial.Cet article contextualise le counselling dans une formation historique plus large établissant une correspondance entre le dévoilement et la guérison, et décrit les « technologies confessionnelles » qui incitent au dévoilement et à la prise de conscience de la substance mystérieuse qu’est le soi. L’argument de Foucault selon lequel la sexualité serait l’arène privilégiée pour l’utilisation des technologies confessionnelles pour « produire » la vérité sur le soi est particulièrement pertinent à la lumière de la diffusion des pratiques de counselling en Afrique dans le sillage de l’épidémie de VIH, notamment parce qu’elles mettent particulièrement l’accent sur l’incitation aux comportements sexuels appropriés. L’examen de l’assemblage historique des pratiques de counselling montre comment elles articulent ce qu’est le soi, la nature de la vérité et une politique du langage. Cet article se concentre sur la généalogie de quatre hypothèses clé qui expriment cette raison confessionnelle. Selon ces hypothèses (1) les individus peuvent acquérir une autonomisation (empowerment) pour contrôler leur propre vie en travaillant sur eux-mêmes, (2) le secrets non révélés deviennent des agents pathogènes, (3) la capacité de guérir exige que l’on dépasse d’abord la maladie personnelle et (4) le partage des secrets est cathartique et permet de guérir. La généalogie de ces hypothèses entremêle quatre aspects distincts : l’inconscient, tel que révélé par Freud et ses disciples; les tentatives de traitement des vétérans commotionnés de la 1ère guerre mondiale; la psychologie de groupe et la recherche participative après la 2ème guerre mondiale.

Meaning-making has emerged as a core construct in addressing trauma, loss or crisis. This paper considers how diasporic Black Africans living with HIV, who come from interdependent collectivist cultures where the norm is one of implicit support, extend their meaning-making strategies when faced with a diagnosis of HIV. In this qualitative study, 13 Black African migrants and refugees living with HIV in New Zealand were interviewed and the transcripts analysed. After their diagnosis, participants began a journey of reconceptualising situational and global meaning. They extended their meaning-making strategies to include a community of like others to gain explicit support. Caregivers in host countries must understand the meaning-making processes of HIV-positive Black African migrants in order to provide competent services that lead to good social and health outcomes. All healthcare and social services workers should regularly assess Black African migrants and refugees living with HIV for positive social connectedness as well as medication adherence and more specific health concerns.

Understanding gender in Africa is essential to creating policy and designing interventions to address key reproductive-health issues such as HIV/AIDS and maternal mortality that are particularly pressing for the continent and are strongly related to gender inequality. The addition of questions to capture women's empowerment and autonomy on the MEASURE/Demographic and Health Surveys (DHS) in the late-1990s expanded opportunities to examine the relationship between gender and reproductive health. These questions provide valuable information on trends and individual-level associations between gender inequality and health. Given that women's empowerment, status and autonomy are largely dependent on contextually-specific gender systems, however, supplementary qualitative studies to validate and contextualise these data would strengthen analyses significantly. This paper provides examples of how such mixed-methods work would improve understandings of gender and reproductive health in Africa by validating survey questions, providing insights into how to analyse and interpret DHS data and illuminating the processes and mechanisms behind gendered experiences. Additionally, this work could help improve future survey research on gender and reproductive health.