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This paper analyses the lived experiences of people living with HIV in South Africa through the use of body mapping as a visual research method, by focusing on the physical and symbolic use of the body within the broader context of anthropology and medical anthropology. The study consists of an empirical analysis of the body maps themselves and the accompanied narratives of seven participants, six female and one male participant living with HIV in South Africa. Drawing upon theories and literature on theorising the body in medical anthropology and visual research, this study explores the significance of this practice as a visual research method in understanding the nuanced lived experiences of people living with HIV by highlighting the individuality of the body and emotions; embodied experiences: a bio-cultural approach; and the body politic: social injustice. The results of this study illustrate that body mapping is a unique visual research method, that explores the body as the vehicle in which we exist within the world, while containing a vast amount of layered interpretive and cultural meanings, which are key to understanding the lived experience of people from marginalised groups. [ABSTRACT FROM AUTHOR]

Pentecostalism is the fastest growing form of Christianity in developing countries. Paralleling Pentecostalism's growth has been the HIV/AIDS pandemic. This paper examines how post-apartheid South Africans are responding to the conflicts born of the HIV/AIDS crisis. Fieldwork conducted in 2005 shows that Pentecostals who were not involved in efforts to address HIV/AIDS saw the church's mission as almost exclusively spiritual in nature. Pentecostals who were engaged in HIV/AIDS-related work were more likely to have an integrated worldview and to see the church's mission as relevant to the physical world. Beliefs about removing racism from the church and sin as structural as well as individual were also associated with this integrated worldview. These insights lay the foundation for constructing a Pentecostal social ethic for addressing HIV/AIDS. [ABSTRACT FROM AUTHOR]

This paper emerges out of a larger qualitative study that aimed at mapping barriers to basic education experienced by children and adults in the context of the HIV and AIDS pandemic. The study was undertaken in Richmond district and involved a range of centres of learning (formal and informal) including three high schools, five primary schools, two adult basic education centres, a school for the deaf, two early childhood centres and their communities. The participants in the study were child and adult learners, parents and caregivers, school governing bodies, organizations working in the district, officials from the Departments of Health, Education and Social Welfare and members of a support group for people living with HIV or AIDS. The study attempted to capture the voices of participants and to obtain rich qualitative data through individual interviews and focus group interviews. In addition, various participatory research techniques such as transect walks, vulnerability matrices, ranking exercises, photo-voice and social mapping were used in the focus group interviews. This paper provides an understanding of a theme - that of oppression - that emerged from the data. The findings suggest that oppressions are systematically produced and reproduced in the processes of the everyday lives of learners, their families, teachers and the wider school community in this particular context. The paper juxtaposes Young's (1990) five categories of oppression: exploitation, marginalization, powerlessness, cultural imperialism and violence, with three post-structural constructs: discourse, hegemony and resistance to highlight the complex workings of oppression. These constructs are applied to the data from the study. The paper will provide examples of the forms of oppression and multiple ways in which oppression is played out in different situated spaces. [ABSTRACT FROM AUTHOR]

This paper examines two autobiographical responses to the HIV/AIDS epidemic in South Africa from the perspective of responsibility and rights. The analysis draws on interdisciplinary studies of the epidemic and its effects on South African communities. Memoirs by Edwin Cameron and Sister Abegail Ntleko address challenges in South Africa with regard to attitudes toward and treatment of HIV-infected people. Both writers use their texts to advocate for social and political responsibility and for the rights of those infected. Rian Malan's essays function as a counterpoint, bringing into focus controversial questions about the role of funding and reliable statistics for the epidemic. The topic is relevant in a South African context where antiretroviral treatment was met with skepticism in official political discourse. Representations of responsibilities and rights as well as official responses to the HIV/AIDS epidemic have been additionally reexamined in relation to the COVID-19 pandemic, giving the epidemic renewed relevance. [ABSTRACT FROM AUTHOR]

We have only just begun to understand the long-term impact of living with chronic HIV on health and livelihood after a decade of widespread access to treatment in southern Africa. This paper explores health and well-being, disability, and livelihood dynamics among people living with HIV (PLHIV) in a public healthcare setting in South Africa. We undertook a cross-sectional survey among a cohort of 1042 people on ART and explored associations between socio-demographic characteristics, treatment adherence, measures of disability (functional and activity limitations), livelihood resources (capitals) and outcomes, including food security, and exposure to livelihood shocks. A range of dynamic relationships relevant for decision-makers is evident. Age, gender, and marital status all had significant associations with levels of livelihood capitals and outcomes. Those who had been on ART for longer periods of time also had significantly higher aggregate livelihood capital. This was particularly driven by social and financial capital. Livelihoods are built within specific social and health contexts. Of particular importance is that the resources drawn on to build a livelihood differ significantly between men and women, and that different forms of disability also have gender-specific pathways in influencing livelihood and livelihood outcomes. Our results support the need for a gender-sensitive approach to supporting the well-being and livelihoods of PLHIV. Of equal importance is an approach that considers more comprehensively the new experiences of comorbidities and disabilities that may occur with a long life on ART. [ABSTRACT FROM PUBLISHER]

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To date the international community has tended to direct HIV prevention programmes, treatment, care and supportive services to young adults and children, with little concern about the impact on older people. Since empirical evidence on the socioeconomic impact of HIV/AIDS on households with older persons is lacking, this paper attempts to fill this gap, using data from a household-based survey conducted in Bhambayi, a mixed formal and informal settlement north of eThekwini, KwaZulu-Natal. The findings highlight the links between the uptake of the South African old age pension, poverty and HIV/AIDS in households with older persons. The paper makes recommendations for both government and non-governmental organisations in respect of community-based support systems for such households affected by HIV/AIDS. [ABSTRACT FROM AUTHOR]

It is timely to have this kind of study in South Africa as the country has an increasing number of people living with HIV and AIDS. While an extensive literature has documented factors associated with HIV and AIDS, psychosocial variables associated with the health of persons living with HIV (PLH) have only begun to receive attention recently. The objective of this paper was to explore the views of a group of people living with HIV and AIDS regarding HIV and AIDS and Self-Forgiveness. Theoretical base: To examine the role of self-forgiveness in people living with HIV and AIDS, George Engel's Biopsychosocial Model was adopted. Methods: Individual In-depth Interviews were conducted with 10 purposefully-selected participants in Ekurhuleni. Outcomes: Results showed that self-forgiveness has a huge role in the lives of people living with HIV and AIDS. For instance, it has been found that self-forgiveness leads to acceptance of HIV status, promote infected people to seek medical care, and eventually gain the confidence to disclose to friends and families. Work implications: In conclusion, self-forgiveness has micro, messo and macro implications as it promotes good health of people living with HIV and AIDS; enhance HIV status self-disclosure and adherence to HIV treatment. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper focuses specifically on the needs and concerns of 'very young adolescents' who as defined by the Population Council are young people aged between 10 and 14 years. The title of this paper, 'Where Do We Start?', acknowledges that attitudes towards and knowledge of HIV and AIDS are best looked at in a situated way. We look at classes of sixth-grade students from four quite different cultural contexts within the province of KwaZulu-Natal: a deeply rural school made up of black students; a township school again made up exclusively of black students; and two more urban and affluent schools, one a public school made up primarily of white and Indian students, and one faith-based school which, while made up of various racial and ethnic groups, is predominantly white. The paper maps out ways of using arts-based approaches with young people so that they are positioned in engaging and participatory ways. It is argued that 'one size does not fit all' when it comes to planning HIV and AIDS interventions. [ABSTRACT FROM AUTHOR]

This paper examines young South African school children's understanding of HIV/AIDS. Based on ethnographic work in two schools in Greater Durban, it explores the impact of HIV/AIDS on the ways in which gender and sexuality are articulated against the backdrop of race and class specific contexts. The first part of the paper examines the children's discourses of sex, sexuality and HIV/AIDS. We show that young children's meanings of sex, sexuality and are not straightforward and are actively produced and defined through a range of social processes. These processes shape the extent to which young children experience sexuality within discourses of fear and pleasure. Young children's meanings of HIV/AIDS are explored in the second part of the paper. Here we show how their knowledge of HIV/AIDS is socially structured through class/race and gender and these forms of social relations provide the framing and reference points for children's constructions of meanings around HIV/AIDS. We finish the paper by raising some theoretical and practical/political questions about the implications of what we have found for HIV/AIDS education in South Africa. [ABSTRACT FROM AUTHOR]

In the face of international pressure and local concern regarding the repercussions of the AIDS epidemic for children in South Africa, as well as the review underway of children's legislation in the country, there is much debate regarding social security provision for children in the context of HIV/AIDS. To date, the State's social security response to the impact of AIDS on children has been to focus its attention on the provision of the Foster Child Grant for orphans. Draft Children's legislation introduces additional cash grants, some of which similarly target orphans. However, drawing on a combination of primary research and demographic projections, this paper argues against the provision of grants for orphans as a category of children distinct from other children. It argues that. given the pervasiveness of poverty across South Africa's child population, a social security system that directs interventions on the basis of children's orphanhood mistargets crucial resources; is inequitable; is located in questionable assumptions about children's circumstances; risks further overburdening the child protection system; and is not, as a whole, a cost-efficient way of adequately supporting the largest possible number of poor children who require assistance. The paper argues therefore that the most equitable, accessible and appropriate mechanism for supporting children in the context of the AIDS epidemic would be through the extension to all children of the Child Support Grant mechanism that is currently in place. Progressive implementation of a universal Child Support Grant should be based not on providing grants in the interim to particular categories of children (such as orphans) but rather on drawing more impoverished children -- irrespective of their parental circumstances -- into the social security 'safety net'. [ABSTRACT FROM AUTHOR]

Copyright of Social & Cultural Geography is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Worldwide, researchers routinely study children indirectly through adults who act as proxies for such children. The call for researchers to rather study children directly and adopt less intrusive child-friendly methodologies has become louder. The draw-and-write technique is regarded as a less intrusive child-friendly method of collecting data that can be used for this purpose. This paper reports the findings of a qualitative study that sought to establish the feasibility of the draw-and-write technique in exploring the resilience of children orphaned by AIDS. This study involved a convenience sample of 23 IsiXhosa-speaking orphaned children aged from 13 to 17. The participants were in grades 6 to 10 and they resided in two child and youth care centres in the Eastern Cape province of South Africa. As part of the draw-and-write technique the participants were asked to make drawings of what enabled them to cope with their lives and to write short narratives in which they explained their drawings. Inductive content analysis was used to analyse the data and this process yielded two main themes, namely: personal protective resources and socio-ecological protective resources. The findings show that complex combinations of personal and socio-ecological resilience resources enabled the resilience of the orphaned children. The findings challenge researchers not to be oblivious to alternative child-friendly methods of research such as the draw-and-write technique when young people are the unit of analysis. The findings of this study have implications for research as well as practice in the field of education and psychology. [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]

With 3 million people receiving anti-retroviral therapies (ARV) in South Africa, it has the largest public ARV programme in the world. The implementation of this programme was made possible by the efforts of AIDS advocacy groups that lobbied the government to make ARV available. Chief among these was the Treatment Action Campaign (TAC). The group mobilised South Africans across socio-economic and racial lines against the AIDS denial of key members of the African National Congress (ANC). Through interviews with TAC members and ethnographic accounts of ©current activism, this paper examines song as a method of mobilisation against HIV/AIDS-related injustices. As instrumental components of the liberation struggle, songs have become ubiqioutus within protest action, as demonstrated by the recent hashtag student movements. By utilising similar forms of rights-based activism found in the country's liberation struggle, TAC is able to tap into reservoirs of emotional potential rooted in political struggle. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper, based on a case study of a South African contract cleaning company in Durban, KwaZulu-Natal, adds to the recent literature on the management of the financial impact of the HIV/AIDS pandemic. After situating the research alongside recent contributions that have examined large enterprises, and small, medium and micro enterprises, the paper provides a profile of the company and its predominantly female workforce. The company's management of costs incurred due to HIV/AIDS is critically assessed from the perspective of financial sustainability, using an AIDS Projection Model developed by Matthews (2007). It was found that while continued employment of this workforce is economically sustainable, both from the perspective of the business and the associated provident fund, the costs to employees are far from equitable. The paper therefore recommends the implementation of a holistic HIV/AIDS management programme, including treatment and prevention activities. [ABSTRACT FROM PUBLISHER]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Why and how do issues expire? This paper applies the concept of path dependency to issue-life cycle and argues that the manner in which an issue dies is closely associated with how it comes to life. This paper argues that, on the Access to Medicines issue, the first actors (1) to have called attention to a legal problem, (2) to have capitalised on the HIV/AIDs crisis, and (3) to have used the example of Africa, were also the first to have felt constrained by their own frame in their attempt to (1) look for economical rather than legal solutions, (2) expand the list of medicines covered beyond anti-AIDs drugs, and (3) allow large emerging economies to benefit from a scheme designed by countries without manufacturing capacities. In order to escape an issue in which they felt entrapped, issue-entrepreneurs worked strategically to close the debate in order to better reframe it in other forums. [ABSTRACT FROM AUTHOR]

This paper explores the ways in which young South African school children (aged between seven and eight) in a predominantly white primary school give meanings to HIV/AIDS. Using ethnographic methods and interview data, the analysis of young children's responses shows that their accounts of HIV/AIDS draw from their knowledge of disease more generally and associate it with allergies, fungus, moss as well as contagion. Their knowledge is also intricately connected with their understandings of sex and gender. Within the same age group young children's knowledge of the disease vacillates from inaccurate information to graphic accounts of sex as a transmission route and gendered vulnerability to the disease. The findings of this study suggest that children are active makers of meanings about the disease. They relate HIV/AIDS to disease, to contagion and dirt, and in doing so harness social processes including race, class, sex and gender. Efforts to scale up young children's understanding of the disease in the early years of primary schooling are significant in the light of this study. [ABSTRACT FROM AUTHOR]

Despite their high levels of knowledge about HIV and AIDS, young people ages 15-24 years in South Africa remain disproportionately affected by the epidemic. Young people's continued susceptibility to HIV infection has been consistently linked to intractable higher-risk sexual behaviours. This paper uses multivariate techniques and secondary data from two nationally representative surveys to illuminate individual and socio-structural factors that play a significant role in youths' continued engagement in higher-risk behaviour, despite their high awareness about HIV and AIDS. The findings show that notwithstanding progress in terms of increased condom use and reduced incidence of other sexually transmitted infections, the average age of sexual debut remains low, multiple sexual partnerships are prevalent, and inconsistent condom use is widespread among young people. Factors significantly associated with these risk behaviours occur at the individual and structural levels and include issues of race, gender, poverty and susceptibility to peer pressure. The paper concludes by recommending that future HIV-prevention interventions in South Africa should aim at building resilience among youths by promoting affirmative, supportive interventions that emphasize the potentials of young people. [ABSTRACT FROM AUTHOR]

In addressing the psychosocial effects of the HIV and AIDS pandemic among vulnerable children, the issue of bereavement appears inadequately addressed. Amid the global discourse on children orphaned and made vulnerable by HIV and AIDS, this paper explores how cultural contexts and social environments in South Africa shape children's experience of grief. The argument draws on a number of qualitative studies and uses empirical evidence from an evaluation of a peer-led HIV/AIDS-prevention strategy aimed at providing psychosocial support for 10- to 13-year-old South African children living in resource-poor communities. The paper reveals a central paradox regarding how the intervention's objective of talking about death and eliciting memories of deceased loved ones with young children is confounded by cultural practices located in notions of silence and the need to protect children. The paper acknowledges the 'culture of silence' surrounding death in some African contexts, but concludes that peer-led strategies have the potential to naturally circumvent these cultural taboos, simultaneously creating a much-needed space for young children to cry and talk among themselves, even if remaining silent at home in the presence of adults. [ABSTRACT FROM AUTHOR]

One of the consequences of massive investment in antiretroviral access and other AIDS programmes has been the rapid emergence of large numbers of lay workers in the health systems of developing countries. In South Africa, government estimates are 65,000, mostly HIV/TB care-related lay workers contribute their labour in the public health sector, outnumbering the main front-line primary health care providers and professional nurses. The phenomenon has grown organically and incrementally, playing a wide variety of care-giving, support and advocacy roles. Using South Africa as a case, this paper discusses the different forms, traditions and contradictory orientations taken by lay health work and the system-wide effects of a large lay worker presence. As pressures to regularise and formalise the status of lay health workers grow, important questions are raised as to their place in health systems, and more broadly what they represent as a new intermediary layer between state and citizen. It argues for a research agenda that seeks to better characterise types of lay involvement in the health system, particularly in an era of antiretroviral therapy, and which takes a wider perspective on the meanings of this recent re-emergence of an old concept in health systems heavily affected by HIV/AIDS. [ABSTRACT FROM AUTHOR]

This paper explores the financial and opportunity costs of adult morbidity and mortality for rural South African female pensioners in the era of HIV/AIDS. As mortality rates from HIV/AIDS and other causes escalate, older women are bearing the brunt of caregiving responsibilities for the sick and orphaned. They often use their state-funded non-contributory pensions to support kin during crises. Interviews conducted with 30 women aged 60-75 years in the Medical Research Council/University of the Witwatersrand Unit (Agincourt) study site in northeastern South Africa revealed that, to cover expenses incurred during crises, older women sometimes forgo spending money and time on their personal needs. They are thus negatively affected as individuals, while contributing positively to the household. Despite the additional household income from pensions, many of the study respondents still found it difficult to recover from the financial impact of these crises. [ABSTRACT FROM AUTHOR]

In 1997, at the Davos International Economic Forum, Nelson Mandela stated that “the poor, the vulnerable, the unschooled, the socially marginalized, the women, and the children, those who bear the burden of colonial legacy—these are the sectors of society which bear the burden of AIDS” (Richter, 2001). Nearly a decade later, that statement still holds true, especially in Mr. Mandela's home country. South Africa continues to have one of the world's highest prevalence ratios of HIV infection (UNAIDS, 2002). This paper explores the significance of perceptions, knowledge, practices, and attitudes toward HIV/AIDS in two important groups in South Africa: health care providers based in public health clinics and their patients. This paper will assess the provider-patient interaction from the perspective of members of the South African HIV/AIDS treatment and prevention community. The analysis will examine the results of in-depth interviews and focus group discussions with providers and patients, respectively, in two of South Africa's nine provinces. Between December 2002 and April 2003 in Guateng and KwaZulu-Natal provinces, we conducted (1) in-depth interviews of a spectrum of health care providers at five local public health clinics and (2) focus groups of patients who patronize those clinics. The results show that there are gaps in the HIV/AIDS knowledge of some of the health care providers and that the participants' health beliefs and practices are embedded in the social conditions in which they live and work, which has a ripple effect on their risk behaviors and trumps any intervention messages from their health care providers and larger public health intervention messages. [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]

This paper presents the diverse understandings of HIV/AIDS and people living with HIV (PLHIV) revealed by school managers in a selection of public schools in Gauteng Province, South Africa. Discussions with school managers emerged as part of a larger investigation into the interplay of culture and gender in people's experience of HIV. The respondents from five public schools comprised head teachers, school board members, educators and adult learners. The data were assembled from semi-structured interviews, focus group discussions, comments on rumours and gossip, and informal conversations. Mary Douglas's (1966) analysis of the theory of cultural risk has provided the main approach for explaining the prevailing understandings of HIV and AIDS among the South African educators. Despite good knowledge of HIV and AIDS, the respondents' understanding of the disease and the experiences of PLHIV were commonly drawn from six categories of meaning: biomedical, cultural, religious, witchcraft, race, and eschatology. Social constructs were strong in terms of the ways HIV/AIDS and PLHIV were understood in these South African education workplaces. The findings imply that new strategies are required from the government and agencies that are involved in developing responses to the HIV epidemic, especially in the education sector. [ABSTRACT FROM AUTHOR]

Mother-to-child transmission is a continuing source of new HIV infections in South Africa. The paper posits that insight into the socio-cultural, behavioural, environmental and economic factors that sustain the HIV epidemic is as important as understanding the biological causes of the disease when planning and implementing interventions to prevent and reduce perinatal transmission. Furthermore, understanding the pregnancy intentions of individuals in areas of endemic HIV/AIDS is vital for providing the best care for individuals who are HIV-positive. This paper suggests a model for types of support and interventions that are relative to the intention of HIV-positive women or couples to become pregnant. Included among these are interventions for prevention of unwanted pregnancy, prevention of transmission of HIV, protection of the infant, and protection of the mother. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

HIV/AIDS-related stigma is conceptualised as multi-dimensional, and indices are designed to measure its different dimensions. Findings show that it is uncommon for young adults to have high levels of negative behavioural intentions towards people living with HIV/AIDS, but the majority show some tendencies to discriminate. Expressions of negative judgement (symbolic stigma) and fear of HIV infection (instrumental stigma) are both prevalent. Instrumental stigma is expressed by more respondents and to greater degrees than symbolic stigma. Resource-based stigma, on the other hand, is rare. Understanding of HIV transmission is the most significant (negative) predictor of HIV/AIDS-related stigma, thereby highlighting the importance of HIV/AIDS education campaigns for reducing stigma. The importance of education in general is also indicated by the association of higher levels of education with less instrumental stigma. Symbolic stigma and prejudices towards other groups are also significant (positive) factors predicting negative behavioural intentions and stigmatising attitudes. This suggests that although HIV/AIDS education is necessary for stigma alleviation, it is by no means sufficient. In the case of Cape Town, racial differences are also salient in predicting both the magnitude of HIV/AIDS-related stigma and its determinants. This corroborates the theory of stigma as a complex social process dependent on particular cultural and environmental contexts. It also highlights the necessity of considering cultural and environmental aspects in understanding and addressing stigma. [ABSTRACT FROM AUTHOR]

This paper traces the rise of the HIV pandemic in Zimbabwe and also traces the history of official silence about it. The paper argues that women are a particularly vulnerable group, but are often the most deprived of treatment. The spread of the disease within the Zimbabwean diaspora is also described and it is pointed out how British asylum procedures can discourage bearers of the disease from seeking medical opinion and help. The medical profession within Zimbabwe itself is castigated as not having been ready to take a stand against silence and on behalf of patient choice and empowerment, and the Zimbabwean situation is contrasted with those in Uganda and South Africa. The paper makes a passionate call for engagement nationally, professionally and internationally with the Zimbabwe pandemic. [ABSTRACT FROM AUTHOR]

This paper attempts to analyse historically why stigma and denial around HIV/AIDS is so powerful in South Africa, so powerful that ailing family members can be shunned and evicted. For many observers, the answer lies simply in its being a venereal disease, in its connotation with promiscuity and unregulated sexuality. We argue that this is not an adequate explanation. Pre-colonial African societies were relatively open about sexuality. Though pre-marital and adulterous pregnancy certainly caused social disruption, extra-marital sex per se was not stigmatised. Even the sexual shame introduced (unevenly) by Christianity and its hybridised forms is inadequate in explaining the degree of stigma associated with HIV/AIDS. We extend the discussion by exploring the stigma associated with various forms of pollution and the inevitability of death. The peculiarly interwoven mixture of sexual transgression, pollution and delayed death, we argue, makes HIV/AIDS an extraordinarily powerful generator of stigma. [ABSTRACT FROM AUTHOR]

The diagnosis of AIDS in 1982 in South Africa was followed by a rapid rise in the number of people living with the virus and dying from AIDS-related illnesses. The 2016 report by the Statistics South Africa indicated that about 7.03 million South Africans were infected with HIV/AIDS — the highest rate in the world. Despite the emergence of effective drugs in the mid-1990s, medical treatment remained unavailable in South Africa, particularly in public hospitals. This prompted civil society groups to establish platforms to discuss health policy change in South Africa. Prominent among these was the Treatment Action Campaign (TAC), formed in 1998, which aimed to advocate for improved HIV/AIDS health service delivery. The efforts succeeded in shaping the current HIV/AIDS policy through various initiatives such as the use of constitutional law in legal action against profiteering drug companies. This paper examines the role of civil society, and particularly the TAC engagement with the state in health policy making, and the subsequent implementation of health policy on HIV/AIDS in post-apartheid South Africa. [ABSTRACT FROM AUTHOR]

Collaboration amongst stakeholders remains a central tenet to achieving goals in planning, implementation, monitoring and evaluation of HIV and AIDS prevention and care strategies. This paper describes the experiences of members of a health care team who joined efforts to collaborate and form a community of practice (CoP) in HIV and AIDS. Qualitative, exploratory case study methods were used. Twenty-six participants were interviewed. Transcripts from the interviews were subjected to the thematic framework of data analysis. Based on the analysis, three themes emerged as impacting on collaboration and these were: the understanding and expectations of being a CoP member; professionalism and ethics within the CoP and collaboration in HIV and AIDS care. The key findings were that the understanding and expectations from the CoP varied. Ethical principles including respect, trust and confidentiality were identified as key tenets of collaboration and were expressed in various ways. The expectations of being a CoP member, the ethical principles within the CoP all impacted in differing ways on how they collaborated. The implication of this study suggests that consultation during inception and throughout the process, clarification of roles, transparency and respect are cardinal points in professional relationships. [ABSTRACT FROM AUTHOR]

The Strengths and Difficulties Questionnaire (SDQ) is an internationally recognized tool. This study aims to evaluate the cultural and contextual acceptability, and potential uses of the SDQ amongst Sesotho learners in South Africa. This paper uses reports from ten teachers based on their experience of using the SDQ. Teachers found the SDQ contextually relevant and easy to administer. They felt it assisted them in understanding the challenges learners were facing and to develop better relationships with them. Very few concerns were raised. The lack of referral options for affected learners and their own lack of appropriate skills generated frustration. [ABSTRACT FROM AUTHOR]

Home visiting is a popular component of programs for HIV-affected children in sub-Saharan Africa, but its implementation varies widely. While some home visitors are lay volunteers, other programs invest in more highly trained paraprofessional staff. This paper describes a study investigating whether additional investment in paraprofessional staffing translated into higher quality service delivery in one program context. Beneficiary children and caregivers at sites in KwaZulu-Natal, South Africa were interviewed after 2 years of program enrollment and asked to report about their experiences with home visiting. Analysis focused on intervention exposure, including visit intensity, duration and the kinds of emotional, informational and tangible support provided. Few beneficiaries reported receiving home visits in program models primarily driven by lay volunteers; when visits did occur, they were shorter and more infrequent. Paraprofessional-driven programs not only provided significantly more home visits, but also provided greater interaction with the child, communication on a larger variety of topics, and more tangible support to caregivers. These results suggest that programs that invest in compensation and extensive training for home visitors are better able to serve and retain beneficiaries, and they support a move toward establishing a professional workforce of home visitors to support vulnerable children and families in South Africa. [ABSTRACT FROM PUBLISHER]

South Africa has one of the highest HIV/AIDS prevalence rates in the world. It is estimated that 5.38 million South Africans are living with HIV/AIDS. In addition, new infections among adults aged 15+ were reportedly 316 900 in 2011. New infections among children (0–14 years old) was also high in 2011 at 63 600. This paper examines South Africa's mortality due to HIV/AIDS among the youth (15–34 years old). This age group is of fundamental importance to the economic and social development of the country. However, the challenges of youth development remain vast and incomparable. One of these challenges is the impact of HIV/AIDS on mortality. Life table techniques are used to estimate among others, sex differentials in death rates for the youth population, probability of dying from HIV/AIDS before the age of 35 and life expectancy should HIV/AIDS be eradicated from the population. The study used data from the National Registry of Deaths, as collated by Statistics South Africa from 2001 to 2009. Results show that youth mortality due to HIV/AIDS has remained consistently higher among older youths than in younger ones. By sex, mortality due to this cause has also remained consistent over the period, with mortality due to HIV/AIDS being higher among females than males. Cause-specific mortality rates and proportional mortality ratios reflect the increased mortality of older youth (especially 30–34 years old) and females within the South African population. Probability of dying from HIV/AIDS shows that over the period, fluctuations in likelihood of mortality have occurred, but for both males and females (of all age groups) the chances of dying from this cause decreased in 2007–2009. [ABSTRACT FROM PUBLISHER]

The transport sector is an integral element of southern Africa's economic development. The impact of HIV/AIDS on the region is therefore a major cause for concern. Using a method of triangulation, we used the findings of a comprehensive literature review, a stakeholder questionnaire and a United Nations regional workshop to take stock of the existing evidence linking HIV/AIDS to the transport sector. This paper outlines the strategies used to address HIV/AIDS by a range of stakeholders in the road, maritime, aviation and railway transport sectors. It highlights regional, national, and intervention-specific good practice examples in the field, suggesting key research gaps and putting forward policy recommendations for the region. As a result, national action plans will hopefully be able to benefit from this knowledge-sharing, enhanced regional cooperation and implementation of more effective responses to the epidemic in this critical sector. [ABSTRACT FROM PUBLISHER]

The role of religion in development is often neglected, whether this refers to the faith of intended beneficiaries, provides staff and volunteers with a motivation for involvement in development practice or influences the design and implementation of projects. This paper examines how Islam provides guidance for development practice, with a focus on addressing HIV/AIDS, using a South African case study. The case study highlights important principles on which two Muslim organisations (Islamic Careline and the Muslim AIDS Programme) base their operational methodologies. It shows how Islamic beliefs have influenced their approach to addressing issues related to HIV/AIDS in the South African context, where prevalence rates remain very high, the impact of the epidemic is widely felt and Islam is a minority faith. L'Islam et les pratiques de développement : VIH et sida en Afrique du Sud Le rôle de la religion dans le développement est souvent oublié, qu'elle concerne la foi des bénéficiaires prévus, donne aux membres du personnel et aux volontaires une motivation pour prendre part aux pratiques de développement, ou influence la conception et la mise en œuvre des projets. Cet article examine la manière dont l'Islam donne des conseils pour les pratiques de développement, en se concentrant sur la lutte contre le VIH et le sida, à l'aide d'une étude de cas sud-africaine. Cette étude de cas met en relief des principes importants sur lesquels deux organisations musulmanes (Islamic Careline et le Muslim AIDS Programme) basent leurs méthodologies opérationnelles. Elle montre comment les croyances islamiques ont influencé leur approche pour aborder les questions liées au VIH et au sida dans le contexte sud-africain, où les taux de prévalence restent élevés, l'impact de l'épidémie se fait largement sentir et l'Islam est une foi minoritaire. Islamismo e prática de desenvolvimento: HIV e AIDS na África do Sul O papel da religião no desenvolvimento é frequentemente negligenciado, seja ele referente à fé dos beneficiários pretendidos, proporcione motivação aos funcionários e voluntários para que se envolvam na prática de desenvolvimento ou influencie a criação e implementação de projetos. Este artigo examina como o Islamismo oferece orientação para a prática de desenvolvimento, com enfoque na abordagem do HIV e a AIDS, utilizando um estudo de caso sul-africano. O estudo de caso destaca princípios importantes nos quais duas organizações islâmicas (Islamic Careline e o Programa Muçulmano contra a AIDS) baseiam suas metodologias operacionais. Ele mostra como as crenças islâmicas têm influenciado sua abordagem para tratar de questões relacionadas ao HIV e AIDS no contexto sul-africano, onde as taxas de incidência permanecem muito altas, o impacto da epidemia é amplamente sentido e o Islamismo é uma fé minoritária. Islamismo y desarrollo: VIH y SIDA en Sudáfrica A menudo se pasa por alto el papel de la religión en el desarrollo, trátese de la fe de los beneficiarios, de la motivación del personal y de los voluntarios o de su influencia en el diseño y la implementación de los proyectos. Basado en un estudio de caso de Sudáfrica, este ensayo examina cómo el islamismo orienta la práctica del desarrollo centrándose en la atención al VIH/SIDA. El estudio de caso pone de relieve principios fundamentales sobre los cuales dos organizaciones islámicas (Islamic Careline y el Programa Islámico sobre SIDA) han elaborado sus metodologías de operación. También demuestra cómo la fe islámica se ha utilizado para responder a temas vinculados al VIH/SIDA en Sudáfrica, donde la tasa de prevalencia sigue alta, el impacto de la epidemia se ha generalizado y el islam es una fe minoritaria. [ABSTRACT FROM AUTHOR]

Using the exhibition 'Positive Living: Art and AIDS in South Africa' (Peltz Gallery, London, 2016) as a starting point, this article offers itself as a short history of some key visual strategies developed to raise political consciousness in South Africa and internationally over one of the darkest periods in South Africa's history, 1999-2006, when former President Thabo Mbeki, in denial about the relationship between HIV and AIDS, withheld life-saving treatment from hundreds of thousands of the most vulnerable South African citizens, who were only just emerging from the scourge of apartheid. The article examines the strategies deployed by fine artists engaged in raising awareness and support from the international community in order to put pressure on the South African government, together with visual strategies sometimes assigned as 'craft' or 'therapy', and produced as local and, often, rural community responses to the HIV crisis. 'Positive Living' is concerned to provoke a more comparative debate about the relative values and limitations of different visual strategies as part of a wider commitment to the ways in which visual and material culture (shortcomings notwithstanding) can produce powerful tools for social change. [ABSTRACT FROM AUTHOR]

The extent of the HIV pandemic — particularly in the hardest-hit countries, including South Africa — has prompted a call for greater engagement of all groups, including faith-based organisations (FBOs). Although FBOs are known to play a substantial role in providing care and support to those affected by HIV and AIDS, empirical evidence in regard to their actions in the broader context of stigma is limited. A qualitative, key-informant survey was conducted in South Africa as part of a six-country international study to examine perceptions of how FBOs have contributed to reduction in HIV risk, vulnerability and related impacts. The special emphasis of this paper is the influence of FBOs on stigma and discrimination. In-depth interviews were held with 34 senior-level key informants who act as key decision-makers in the response to HIV and AIDS in South Africa. Secular and faith-based respondents shared their perceptions of the faith-based response, including FBOs' actions in relation to HIV/AIDS stigma and discrimination. Our study revealed that while FBOs were perceived as taking some action to address stigma in South Africa, FBOs were also thought to contribute to HIV/AIDS- discrimination through conflating issues of sexuality and morality, and through associating HIV and AIDS with sin. The interviewees indicated a number of internal and external challenges faced by FBOs to deal effectively with stigma, including lack of information and skills, the difficulty of maintaining confidentiality in health services, and self-stigmatisation which prevents HIV-infected persons from revealing their status. Findings from this study may help both faith-based and secular groups capitalise on the perceived strengths of FBOs as well as to elucidate their perceived weaknesses so that these areas of concern can be further explored and addressed. [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 explores the organisational structures of traditional healers, outlines their explanations of HIV/AIDS, and discusses how they can be integrated with company programmes. The South African Traditional Health Practitioners Act seeks to register, regulate and promote traditional healers, but its ability to do this depends on strong, formalised associations of traditional healers. The different forms of traditional healer groupings in South Africa are described along with the implications that their organisational structure has for knowledge, competition and service standards. Traditional healers' diverse and fluid beliefs about HIV and AIDS are explained together with ways in which cooperation between companies, allopathic medicine and African traditional healing practices could be promoted in workplace responses to HIV/AIDS. It is suggested that such collaboration should focus on 'windows of compatibility' rather than on overall agreement. Moreover, it is argued that any response to HIV/AIDS must be embedded within a wider set of agreements, the most critical being a genuine process of referral between the traditional and allopathic healthcare systems. Companies are in a strong position to initiate such reforms, and this would support the professionalisation of traditional healers as well as help coordinate a wider and more effective response to the HIV epidemic in South Africa. [ABSTRACT FROM AUTHOR]

This paper presents a case study of wellness programme and health policy development based on an HIV/AIDS organisation's Khayelitsha site in the Western Cape Province, South Africa. The study examines the different challenges that the organisation faces in relation to its predominantly low-income staff, donor-driven structure, its limited resources and organisational capacity, and the highly stressful and demanding nature of HIV-related treatment and care. This case study also examines the significant and contentious challenges lying in the organisation's faith-based identity. Research began with a review of civil society organisations' responses to HIV in sub-Saharan Africa, as well as related topics, such as South Africa's public health system, and health-seeking attitudes, beliefs and behaviours in high-risk South African communities. The organisation's health policy was analysed and 'workshopped' with multiple employees. Focus groups were conducted with mid-management and fieldwork staff in the Khayelitsha office, while a comprehensive, anonymous, wellness questionnaire was distributed in order to collect quantitative data. Data acquired from the questionnaire responses and the focus group discussions indicated that wellness programme and health policy development faces its greatest challenges on two fronts, namely due to a critical lack of organisational development and capacity, and a host of practical, social and cultural challenges among the most vulnerable people whom the NGO intends to serve. The study's primary recommendations include: taking its employees' cultural and social norms into consideration; addressing issues related to capacity and organisational development with the major donors; broadening the scope of its health policy to extend beyond issues related to HIV; and examining and clarifying expectations of employee behaviour in light of its identity as a faith-based organisation. The study also issues a secondary list of recommendations for other resource-constrained NGOs that also wish to develop and implement wellness programmes and health policies in their workplace. [ABSTRACT FROM AUTHOR]

This paper explores the gender dimensions of access to highly active antiretroviral therapy (HAART) in South Africa. It shows that women are more vulnerable to HIV infection than men, but that women access HAART in disproportionately large numbers. Regression analysis on data from the South African Demographic and Health Survey suggests that men in general access health services less readily than women. This 'masculinity factor' accounts for most of the difference between men and women when it comes to accessing HAART. Although men were more likely to favor traditional medicine than women, this was not a statistically significant factor, and it appears that visiting a traditional healer is complementary to, rather than a substitute for, accessing HAART. In short, it seems that gendered norms that make it difficult for men to admit weakness and seek medical attention are the main probable cause for the low proportions of men accessing HAART. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue, including the article about human immunodeficiency virus (HIV) and another on acquired immunodeficiency syndrome (AIDS) in South Africa.

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]

The end of apartheid in South Africa has led to political-economic transition, the deregulation of cities, and increased population mobility, with growing numbers of people living and working in sub-standard and 'informal' urban conditions. These processes have created a fertile terrain for the rapid spread of HIV, especially in the province of KwaZulu-Natal. Few studies have considered how the HIV epidemic's outcomes are interacting with other societal processes, such as globalisation and urbanisation, or how these processes collectively converge with place-specific conditions to expose, drive and compound vulnerabilities to HIV and AIDS. This paper links an analysis of the political economy of South Africa's HIV epidemic with findings from an ethnographic case study with street traders in Warwick Junction, the largest trading hub in Durban, KwaZulu-Natal. [ABSTRACT FROM AUTHOR]

This paper shows how two publicly available epidemiological modelling packages, namely the Spectrum AIDS Impact Model and the ASSA2003 AIDS and Demographic Model, predict very different impacts from rolling out highly active antiretroviral treatment (HAART) on new HIV infections. Using South Africa as a case study, it shows that the ASSA2003 model predicts a significant drop in new HIV infections as HAART is rolled out, whereas the Spectrum model assumes that HAART does not have a preventative impact (and in fact generates a small increase in new HIV infections). Users will thus draw different conclusions about the public health benefits of HAART depending on which modelling package they use. Despite being presented as a policy-oriented modelling tool capable of exploring 'what if' questions about the impact of different policy choices, the Spectrum model is illequipped to do so with regard to a HAART rollout. Unlike Spectrum, ASSA2003 is more flexible and its assumptions are clear. Better modelling and more information (including about the relationship between HAART and sexual risk behaviour) is required to develop appropriate public-policy modelling for the HAART era. [ABSTRACT FROM AUTHOR]