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Early in South Africa's HIV/AIDS crisis, entertainment education emerged as a powerful vehicle for communicating health and social messaging to combat the epidemic. Applied theatre now accounts for the majority of arts-based HIV interventions in sub-Saharan Africa, and continues a history of theatre for social change in South Africa in particular. While much has been written about the dramaturgical and communication theories that support such interventions, the role of music, a formidable tool in the applied theatre intervention arsenal, has received considerably less attention within applied arts intervention scholarship. This paper draws from Durkheim's collective effervescence to propose a theoretical approach to music within the creation and maintenance of effervescent assemblies that is being employed by HIV/AIDS interventions to encourage participation in HIV testing. The theoretical model of musical effervescence is situated within ethnographic fieldwork conducted while accompanying an applied HIV/AIDS theatre company on a national tour of South Africa. [ABSTRACT FROM AUTHOR]

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]

Transracial adoption (TRA) has been practised and researched in wealthy industrialized countries for decades, but there is limited literature about this practice in low- and middle-income countries like South Africa, where it is an uncommon and relatively new practice. Transracial adoption is heavily influenced by the context in which it occurs. Particular contextual features make South Africa well placed to showcase a different form of transracial adoption. This paper starts filling in the gap in the international literature by outlining historical, socio-economic and cultural features that influence the practice of transracial adoption and the experiences of transracial adoptive families in South Africa. [ABSTRACT FROM AUTHOR]

Community home-based care (CHBC) is a critical component of non-formal care in communities in Africa that have a high prevalence of HIV and tuberculosis (TB). Community carers consisting primarily of volunteers are critical role players in African healthcare systems and particularly in South Africa’s strategy to fight HIV and AIDS. This paper explores the structural barriers volunteer caregivers need to overcome to provide quality CHBC. The researchers used two focus group discussions with key informants (each with four participants), and semi-structured interviews with six key informants to collect data relating to the meaning of quality CHBC. The data were coded using Tesch’s data analysis technique. A major theme that emerged from the results was “Addressing structural challenges to improve the quality of CHBC”. Subthemes underpinning this theme were: 1) lack of standardised training of volunteer caregivers; 2) the need for a scope of practice, parameters and legal boundaries; 3) lack of monitoring and evaluation (M&E) of CHBC; and 4) the importance of mentoring and supervision in CHBC. CHBC policy should address the need for standardised training programmes for caregivers, so that they are equipped with multiple skills. Furthermore CHBC policy must emphasise mentoring as well as M&E to encourage quality care. Finally, the policy should provide a clear scope of practice for caregivers to regulate their competencies and boundaries. [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]

The care offered to children living with HIV (CLHIV) experiencing HIV-related disability is often challenged by caregiver illness, poverty and poor support structures in and around communities. Since caregiver needs directly influences the care offered to CLHIV this paper aimed to explore the experiences of the caregivers of CLHIV in order to inform an appropriate rehabilitation model in South Africa. A qualitative enquiry using in-depth interviews with 14 caregivers (one male and thirteen females) of CLHIV experiencing disability in a peri-urban setting was conducted. Data were analysed using thematic analysis. Four themes emerged from the interviews: understanding of HIV-related disability and rehabilitation, challengers to care and well-being, enablers to care; and perceived needs of caregivers. The study revealed that caregiver burden is influenced by the availability of resources and social support services. Financial constraints, poor access to rehabilitation and reduced support networks challenged the care offered to CLHIV. The perceived needs of the caregivers in this study included appeals for improved social security, housing, accessible rehabilitation and education. Changes in government policy guiding social support, employment, education and rehabilitation interventions are needed to improve the availability of resources, education, health and well-being of CLHIV and their caregiver's in South Africa. [ABSTRACT FROM AUTHOR]

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Responsive to perceived high risk of HIV infection by sexually active youth, several South African sexual health-promotion campaigns have used media targeting mothers, instructing them on how sex should be talked about with their children to 'risk-proof' them. A Foucauldian approach to the normative apparatus of family-sexuality-risk finds mothers positioned as pivots between 'public' (health, economy, culture) and 'private' (family, childrearing, sex) apparatuses, tasked with appropriately socialising a new generation of sexually responsible, HIV-free citizens. This paper uses a reading of interactive discourse from (racially and gender) mixed groups of parents who, as professionals and postgraduate students in a university context, discussed their own childrearing practices in response to a particular didactic media text about sex-communication. In a way different from traditional media-reception studies, this discourse analytic reading of parents' engagement with risk-expertise examines how mothers especially are persuaded (or not) to adopt particular childrearing practices in the context of an HIV epidemic. Using a Foucauldian argument about subject positioning, this paper examines how the parents positioned themselves in relation to the expertise offered in the stimulus material, as well as how they positioned one another during the group discussions. The analysis explores the partial buy-in to expert Western psychological techniques concerning talking with children about sex openly and often, and how this appropriation is negotiated in contextual family situations that are gendered, raced, classed and acculturated. [ABSTRACT FROM AUTHOR]

HIV has emerged as a highly stigmatizing disease, with a number of negative social representations associated with it. In South Africa, HIV has been the subject of much politicized debate about racist projections of sexual behaviour, and issues of HIV care. This paper uses psychoanalytic theory, particularly the theory of Klein and the concept of the paranoid-schizoid position, to explore how individuals position themselves in relation to others with regard to HIV. In order to protect against threats to the self, negative notions about ourselves are projected onto others who then become at risk for HIV. This is explored in relation to the South African context and the racial politics of HIV. When an individual becomes HIV positive, these notions have to be reincorporated as the individual socially becomes that 'other'. Once again, an 'othering' process may take place as the HIV-positive individual struggles to incorporate these new aspects into their identity. The paper makes use of research and case material to illustrate these processes. [ABSTRACT FROM AUTHOR]

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]

Drawing from data collected during interviews with grade 2 teachers who work in a black working-class township school, this paper explores the meanings that teachers attach to HIV and AIDS education. It is argued that the relationship of many teachers to the subject of HIV and AIDS is inscribed within regulatory forces based on the notion of childhood sexual innocence which uphold and construct a particular version of childhood which is racialized, 'classed' and gendered. Despite the urgency of addressing young children's right to HIV and AIDS education, teaching discourses mobilize a notion of innocence which culminates in fear and anxiety around expressions of sexuality in early childhood. Throughout the paper shows that while teachers' constructions of childhood are formidable, they are not irreversible since teachers point in contradictory ways to young children's sexual agency. The significance of starting early with young children together with the calamitous effects of HIV and AIDS in South Africa indicate that we must begin confronting the HIV and AIDS pandemic and start to develop HIV and AIDS reduction and prevention programmes appropriate to the early years of schooling. The findings reported herein have implications for teachers' work in the development of such programmes. [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]

Young people, particularly adolescent girls and young women, represent a growing proportion of those living with HIV. Edutainment programmes have been widely used throughout the world to "educate" and "entertain" audiences and tackle serious social issues in bold and engaging ways. This paper examines the extent to which an edutainment programme, MTV-Shuga, was reported to influence young people's engagement with sexual and reproductive health (SRH) information in rural KwaZulu-Natal, South Africa. In 2019 we conducted eight community-based screenings of MTV-Shuga episodes followed by 25 individual in-depth interviews and 13 focus group discussions with young people aged between 15 and 30. Interviews were audio recorded and transcribed verbatim. Data analysis was thematic and complemented by constant comparison and deviant case analysis techniques. In this rural and poor setting with a high burden of HIV, young people exhibited high levels of awareness of SRH and HIV but had constrained access to services, and limited ability to engage with parents or guardians on SRH matters. MTV Shuga provided an entertaining guide of ways to navigate the risks that they faced in a way that resonated with them. The findings highlight the importance of enabling young people in rural areas to watch MTV Shuga with peers in a safe space in which discussion of the content is facilitated. There is also value in encouraging parents to watch MTV Shuga as a means of enabling discussions between children and adults in their lives about SRH matters. [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.)

The last 20 years have seen a proliferation of research, spurred by the imperatives of the HIV epidemic and reportedly high rates of gender-based violence, on heterosexual practices in the South African context. Research has focused on how poverty, age and gender within specific cultural contexts shape sexual agency and provide a context for unequal, coercive and violent practices for young women. This paper takes stock of what we currently ‘know’ about heterosex and critically reflects on the political and ideological effects of such research, specifically in the light of young women's agency. A primary concern is that efforts to address gender inequality and the normative gender practices that shape inequitable heterosexual practices may have functioned to reproduce the very discourses that underpin such inequalities. The paper ‘troubles’ the victim–agency binarism as it has been played out in South African research on heterosex, raising concerns about how the research may reproduce gendered, classed and raced othering practices and discourses and bolstered regulatory and disciplinary responses to young women's sexualities. The paper argues for critical, feminist self-reflexivity that should extend to re-thinking methodologies entrenched in frameworks of authority and surveillance. [ABSTRACT FROM AUTHOR]

The HIV response is hampered by many obstacles to progression along the HIV care cascade, with men, in particular, experiencing different forms of disruption. One group of men, whose stories remain untold, are those who have succumbed to HIV-related illness. In this paper, we explore how next-of-kin account for the death of a male relative. We conducted 26 qualitative after-death interviews with family members of male PLHIV who had recently died from HIV in health and demographic surveillance sites in Malawi, Tanzania, Kenya, Uganda, Zimbabwe and South Africa. The next-of-kin expressed frustration about the defiance of their male relative to disclose his HIV status and ask for support, and attributed this to shame, fear and a lack of self-acceptance of HIV diagnosis. Next-of-kin painted a picture of their male relative as rebellious. Some claimed that their deceased relative deliberately ignored instructions received by the health worker. Others described their male relatives as unable to maintain caring relationships that would avail day-to-day treatment partners, and give purpose to their lives. Through these accounts, next-of-kin vocalised the perceived rebellious behaviour of these men, and in the process of doing so neutralised their responsibility for the premature death of their relative. [ABSTRACT FROM AUTHOR]

South African schools are tasked with providing sexuality education through the Life Orientation curriculum as a means of challenging continued high rates of HIV, unwanted pregnancy and gender-based violence. While in theory schools are well positioned to provide appropriate knowledge for reproductive health and navigating sexual challenges within a gender justice framework, research on sexuality education in South African schools indicates that this is not the reality in practice. This paper draws on a growing body of qualitative studies, with both educators and learners in South African schools, to understand the issues undermining the goal of a critical and social justice pedagogy of sexuality in Life Orientation classrooms. We argue that sexuality education has been deployed to regulate and discipline young sexualities, reinforce and perpetuate gender binarisms and heteronormativity, re-establish global northern family values of the nuclear family within a pro-family discourse, and represent continued assumptions of adult authority in a civilising mission over young people. We suggest that the failure to make critical use of Life Orientation is linked to the dominance of 'expert'-based didactic pedagogy, and argue the possibilities of sexuality education as a productive space for young people's active participation and agency in making meaning of gender and sexualities. [ABSTRACT FROM AUTHOR]

The effects of HIV and AIDS have devastated families and communities in South Africa. The scourge has also left many children orphaned in the country. Given the vulnerability of orphaned children, social workers are in the forefront of ensuring that these children are cared for and protected from any harm. Hence, the purpose of this paper was to explore the role of a social worker in issues related to children orphaned by AIDS in their middle childhood. This study was situated within a qualitative research paradigm utilizing purposive, non-probability sampling of 10 participants recruited from Potchefstroom in the Northwest Province of South Africa. A semi-structured interview schedule was employed as a research tool, and in-depth one-on-one interviews were adopted as the method of data collection. A thematic content analysis was used to analyze the data collected during the interviews. The main findings point towards the need to educate children about HIV and AIDS and to empower their caregivers. The primary conclusion drawn from this study is that social workers play various key roles which contribute towards the well-being of orphaned children. Recommendations are posed in relation to social work service providers, government interventions, and future research. [ABSTRACT FROM AUTHOR]

Community health workers deployed around South Africa’s primary health care clinics, supply indispensable support for the world’s largest HIV/AIDS treatment programme. Interviews with these workers illuminated the contribution they make to anti-retroviral treatment (ART) of HIV/AIDS patients and the motivations that sustain their engagement. Their testimony highlights points of stress in the programme and supplies insights into the quality of its implementation. Finally, the paper addresses issues about the sustainability of a programme that depends on a group of workers who are not yet fully incorporated into the public sector. [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.)

South Africa, like other sub-Saharan African countries, is in the midst of the AIDS epidemic. Older women, here defined as aged 60 years and older, while at lower risk of infection than those aged 20–50, are amongst those deeply ‘affected’ by the epidemic. In rural areas, older women, who have always played central roles in social reproduction in South African households and families, bear the brunt of care giving for the sick and dying. For this reason, it is important to explore how these women understand the epidemic. In South Africa, the prominence of traditional healers and medicine alongside biomedicine has led to multiple ways of perceiving, explaining and treating illness. This paper explores the various discourses older women in rural South Africa employ to make sense of the HIV/ AIDS epidemic in their daily lives. The aim is to better understand how these women construct the epidemic and how this knowledge can be used to benefit education and treatment endeavours in similar contexts. This paper draws on interview data collected as part of the Gogo Project conducted in the Medical Research Council (MRC)/Wits Rural Public Health and Health Transitions Research Unit. Sixty women between the ages of 60 and 75 years living in the rural Agincourt sub-district participated in three in-depth, semi-structured interviews. The respondents in this study relied on a variety of discourses to make sense of the HIV/AIDS epidemic. They displayed a high level of knowledge based on biomedical education, however, they expressed ideas, often simultaneously, that seemed to contradict this education. Their ability to employ seemingly contradictory discourses represents the need to place the epidemic within familiar ‘explanatory models’ that are based on these women's life experiences and local knowledge. [ABSTRACT FROM PUBLISHER]

In this article the author discusses the role of the sociologist after half-a-century of studying science. He explores the problem with misconceptions about human immunodeficiency virus (HIV) treatment in South Africa. He provides an overview of the paper "Third Wave of Science Studies," which he and fellow sociologist Rob Evans wrote. He also discusses the new programme called Studies of Expertise and Experience.

This article is a review of the PhD thesis undertaken by Joanna Vearey that explores local government responses to the urban health challenges of migration, informal settlements, and HIV in Johannesburg, South Africa. Urbanisation in South Africa is a result of natural urban growth and (to a lesser extent) in-migration from within the country and across borders. This has led to the development of informal settlements within and on the periphery of urban areas. The highest HIV prevalence nationally is found within urban informal settlements. South African local government has a 'developmental mandate' that calls for government to work with citizens to develop sustainable interventions to address their social, economic, and material needs. Through a mixed-methods approach, four studies were undertaken within inner-city Johannesburg and a peripheral urban informal settlement. Two cross-sectional surveys -- one at a household level and one with migrant antiretroviral clients -- were supplemented with semi-structured interviews with multiple stakeholders involved with urban health and HIV in Johannesburg, and participatory photography and film projects undertaken with urban migrant communities. The findings show that local government requires support in developing and implementing appropriate intersectoral responses to address urban health. Existing urban health frameworks do not deal adequately with the complex health and development challenges identified; it is essential that urban public health practitioners and other development professionals in South Africa engage with the complexities of the urban environment. A revised, participatory approach to urban health -- 'concept mapping' -- is suggested which requires a recommitment to intersectoral action, 'healthy urban governance' and public health advocacy. [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]

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.)

University students form an important constituency in interventions against HIV and AIDS. The majority of university students are between ages 18 and 30 years, which, according to recent surveys, is the age category at the highest risk of HIV infection. Even though there is currently no comprehensive statistical data on the HIV prevalence at South African institutions of higher learning, a number of studies have noted increasing AIDS-related deaths and sicknesses among students. This highlights the need for effective intervention against HIV infections within this community. Condom use remains the most effective intervention against HIV infection within sexually active populations. This paper examines perceptions of public-sector condoms and their impact on condom use among university students, based on the findings of research conducted at three universities in KwaZulu-Natal Province, South Africa. Study findings indicate that public-sector condoms are perceived as ineffective, smelly and even 'infectious' and are widely seen to be of lower status as compared to the commercial brands. These perceptions were found to influence condom use as some students preferred to engage in unprotected sex rather than use public-sector condoms. The paper highlights the need for communication programmes to demystify the misconceptions surrounding public-sector condoms and to provide reassurance of the quality of such condoms. [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 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.)

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 is a summary of some of the key findings of an eighteen-month MilAIDS research project that focused on how militaries in the Southern African countries of Botswana, Swaziland, Tanzania, Zambia and Zimbabwe had coped with the impact of the HIV epidemic since it had been identified amongst the ranks in the 1980s. As a result, there is a single major source for citation, which is 'The enemy within: Southern African militaries' quarter-century battle with HIV and AIDS'. The summary does, however, contain other information related to developments that have emerged since the completion of the larger study, bringing us up to date with the contemporary discourse in the field. The purpose of highlighting some of the elements in the larger study is twofold: to distil its main findings for easier consumption and to draw our attention to salient factors that are considered worthy of replication. A second objective of this brief paper is of course to whet readers' appetite to read the more detailed work referred to above. [ABSTRACT FROM AUTHOR]

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]

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 and AIDS has serious repercussions on psychological, social and physical well-being, and the assessment of Quality of Life (QoL) of people living with HIV and AIDS is essential to gauge how these challenges are met. The WHOQoL-HIV Bref forms part of a suite of instruments developed by the World Health Organisation. The purpose of this paper is to describe the quality of life of a sample of HIV-infected students at a South African university, as well as explain the internal consistency between questions within each of the QoL domains. A descriptive, cross-sectional study design using a quantitative approach was applied. A non-probability, purposive sampling approach was utilized and students enrolled in the antiretroviral therapy or wellness programme were invited to voluntarily participate in this study. The WHOQOL-HIV Bref was self-administered after explanation of the questions by a registered, trained health care professional. A total of 63 students returned completed questionnaires that were included in the analysis. Acceptable to good reliability scores were established for the following domains: Level of Independence; Social Relations; Environment and Spiritual or Personal Beliefs. Assessing QoL in the sample, the lowest score was for “Spirituality” and the highest “Social Relations”. The “Physical” and “Psychological” domain scores for females were significantly lower than the score for males. There was no significant difference between any of the domain scores among participants with CD4 cell counts above or below 350 cells/mm3. In general the performance of this sample is encouraging and it is recommended that the measure be utilized for QoL screening, and further research. The WHOQOL-HIV Bref for students does not contain an academic wellness component which should be added considering the significant effects of HIV on neuropsychological functioning. Also further investigation into the reasons for poor scores obtained in physical and psychological well-being in females should be encouraged. [ABSTRACT FROM PUBLISHER]

This paper is a sequel to a 2004 article that reviewed South Africa’s introduction of new sexual and reproductive health (SRH) and rights laws, policies and programmes, a decade into democracy. Similarly to the previous article, this paper focuses on key areas of women’s SRH: contraception and fertility, abortion, maternal health, HIV, cervical and breast cancer and sexual violence. In the last decade, South Africa has retained and expanded its sexual and reproductive health and rights (SRHR) policies in the areas of abortion, contraception, youth and HIV treatment (with the largest antiretroviral treatment programme in the world). These are positive examples within the SRHR policy arena. These improvements include fewer unsafe abortions, AIDS deaths and vertical HIV transmission, as well as the public provision of a human papillomavirus vaccine to prevent cervical cancer. However, persistent socio-economic inequities and gender inequality continue to profoundly affect South African women’s SRHR. The state shows mixed success over the past two decades in advancing measurable SRH social justice outcomes, and in confronting and ameliorating social norms that undermine SRHR. [ABSTRACT FROM AUTHOR]

In order to achieve optimal benefits of antiretroviral therapy (ART), caregivers of children receiving ART are required to attend routine clinic visits monthly and administer medication to the child as prescribed. Yet, the level of adherence to these behaviours varies considerably in many settings. As a way to achieve optimal adherence in rural KwaZulu-Natal, caregivers are required to attend routine counselling sessions at HIV treatment clinics that are centred on imparting information, motivation, and behavioural skills related to medication administration. According to the information-motivation-behavioural skills model, information related to adherence, motivation, and behavioural skills are necessary and fundamental determinants of adherence to ART. The purpose of the study was to observe and document the content of adherence counselling sessions that caregivers attending rural clinics in KwaZulu Natal receive. We observed 25 adherence counselling sessions, which lasted on average 8.1 minutes. Counselling typically consisted of counsellors recording patient attendance, reporting CD4 count and viral load results to caregivers, emphasising dose times, and asking caregivers to name their medications and dosage amounts. Patients were seldom asked to demonstrate how they measure the medication. They were also not probed for problems regarding treatment, even when an unsuppressed VL was reported to a caregiver. This paper calls attention to the sub-optimal level of counselling provided to patients on ART and the urgent need to standardise and improve the training, support, and debriefing provided to counsellors. [ABSTRACT FROM PUBLISHER]

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This paper reports on Kganya Motsha Adolescent Centre, an adolescent program specifically established to provide voluntary counseling and testing as well as management of HIV-positive young people in Soweto, South Africa. A retrospective cross-sectional analysis, using clinic records of young people accessing services from 2008 to 2012, was conducted. Of the 11,522 who tested, 7689 (67%) were females. The total number of HIV infections was 410, with an HIV prevalence of 3.6% (95% CI 3.2–3.9%). More females (332, 4% vs. 72, 2%;p< 0.0001) were HIV-infected than males. Of those testing HIV positive, 109 (26.5%) had a median CD4 cell count of 491 (IQR 345–686) cells/mm3. Only 12/410 individuals (2.9%) were eligible for antiretroviral treatment and 10 (2.4%) of those successfully received treatment. The program observed that young people testing HIV positive would not return for follow up blood specimens or confirmatory results. Future programs should consider innovative ways of retaining adolescents in care to reduce potential HIV transmissions that could lead to deteriorating health. [ABSTRACT FROM AUTHOR]

Background: Urban informal settlements remain sites of high HIV incidence and prevalence, as well as violence. Increasing attention is paid on how configurations of young men's masculinities shape these practices through exploring how men build respect and identity. In this paper, we explore how young Black South Africans in two urban informal settlements construct respect and a masculine identity. Methods: Data are drawn from three focus groups and 19 in-depth interviews. Results: We suggest that while young men aspire to a 'traditional' masculinity, prioritising economic power and control over the household, we suggest that a youth masculinity emerges which, in lieu of alternative ways to display power, prioritises violence and control over men's sexual partners, men seeking multiple sexual partners and men's violence to other men. This functions as a way of demonstrating masculinity and their position within a public gender order. Discussion: We suggest there are three implications of the findings for working with men on violence and HIV-risk reduction. First, there exist a number of contradictions in men's discourses about masculinity that may provide spaces and opportunities for change. Second, it is important to work on multiple issues at once given the way violence, alcohol use, and sexual risk are interlinked in youth masculinity. Finally, engaging with men's exclusion from the capitalist system may provide an important way to reduce violence. [ABSTRACT FROM AUTHOR]

This paper describes implementation research of an intervention in a complex HIV prevention randomised trial in southern Africa. Researchers collected stories of change attributed by 106 community members to an audio-drama edutainment intervention in 41 sites in Botswana, Namibia and Swaziland. The team analysed themes in the stories following a behaviour change model of conscious knowledge, attitudes, subjective norms, intention to change, agency, discussion and action (CASCADA). Storytellers attributed positive changes to the intervention in the areas of gender violence, multiple sexual partners, transactional and intergenerational sex and condom use. Their stories illustrate each of the steps in the CASCADA behaviour change model. As well as supporting an enabling environment for other interventions in the trial, the audio-drama also helped some participants to make personal changes. Collecting and discussing the stories were encouraging for the trial fieldworkers. Documenting the experiences of participants and framing the analysis of stories in an explicit behaviour change model allowed us to reflect on potential mechanisms and pathways through which the intervention impacts on individuals and communities. It helped in the design of the quantitative instruments to measure intermediate outcomes of the trial. [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]

Community-based care is receiving increasing global attention as a way to support children who are orphaned or vulnerable due to the HIV/AIDS pandemic. Using both qualitative and quantitative methodology, this study assesses community-based responses to the well-being of orphans and vulnerable children (OVC) and compares these responses with the actual mental health of OVC in order to evaluate the South African government’s approach of funding community-based organisations (CBOs) that support and care for OVC. The study results show that the activities of CBOs mainly extend government services and address poverty. Although this should not be seen as insignificant, the paper argues that CBOs give very little attention to the mental health of OVC. [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.)

The objective of this paper was to review current evidence on physical activity for health in order to support the food-based dietary guideline (FBDG) “Be active!”. Physical activity, defined as at least 30 minutes of moderate-intensity physical activity per day for adults, and 60 minutes for children and adolescents, is advised in the FBDG because of the role it plays in maintaining energy balance, improving body composition and promoting general health and well-being. The reviewed outcome measures are changes in physical activity patterns and the reported prevalence of noncommunicable diseases (NCDs) in South Africa. Despite the previous set of FBDGs, no improvements in physical activity, obesity or NCDs have been reported in South Africa. Recent literature emphasises the beneficial effects of physical activity on the reduction of risk factors associated with the prevalence of NCDs. Physical activity has a positive effect on appetite and weight control, insulin sensitivity, dyslipidaemia, hypertension, stress relief and burnout. Barriers that prevent children and adults from participating in regular physical activity have been identified, and recommendations how to overcome these have been made. It has been concluded that South Africans are not sufficiently physically active for their general health status to be improved. It is recommended that methods to promote physical activity at national, provincial, district and local level need to be developed, implemented and sustained. [ABSTRACT FROM AUTHOR]

This paper explores the implications of the disability grant for household members' well-being and adults' success on ART (antiretroviral therapy). It uses case studies based on data from an in-depth qualitative study of 10 households in KwaZulu-Natal. Receipt of the disability grant ensured that the basic needs of the HIV-infected adult could be met by other household members, especially when the grant was received when the person first met the qualifying criteria and in conjunction with ART. Where treatment was effective, HIV-infected adults were able to make substantial contributions to the well-being of other members in addition to the financial support provided by the grant itself. Thus, early access to financial support in conjunction with commencing ART may lead to improved health outcomes and reduce poverty and vulnerability associated with illness in poor households. This synergistic relationship between social welfare and treatment may in turn contribute to greater cost-efficiency. [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.)

The occurrence of high rates of alcohol consumption in a context of high HIV prevalence in South Africa poses a significant health challenge for this country. This paper aims to answer three questions that could further our knowledge regarding the links between alcohol use and HIV infection: (a) 'Are problem drinkers more likely to have multiple concurrent partners than those who are not?'; (b) 'Are condoms applied less effectively and less consistently by problem drinkers compared to those who are not?'; (c) 'Are the female sexual partners of problem drinkers different from those who are not?' Two cross-sectional HIV bio-behavioural surveillance surveys using Respondent-Driven Sampling were conducted in two peri-urban settings on the outskirts of Cape Town, South Africa. Eight hundred and forty-eight men aged 25-55 years who have multiple, concurrent female sexual partners were recruited. Problem drinkers had a score of ≥3 on the CAGE questionnaire. Questions enquired about partner numbers, condom use and partner traits. Multivariate logistic regression models were developed to determine significant associations between outcome variables and problem drinking. Fifty-eight percent of men were problem drinkers. Compared to non-problem drinkers, problem drinkers were significantly more likely to report having any symptom of a STI; not using condoms due to drinking; inconsistent condom use with all partner types; that their most recent once-off partner was unemployed; having met their most recent partner at an alcohol-serving venue; and having had a once-off sexual relationship. Alcohol may fuel once-off sexual encounters, often characterised by transactional sex and women's limited authority to negotiate sex and condom use; factors that can facilitate transmission of HIV. HIV prevention interventions specifically targeting drinkers, the contexts in which problem drinking occurs and multiple sexual partnering are urgently needed. [ABSTRACT FROM AUTHOR]

Responses to the HIV epidemic leading to an increase in the number of residential care facilities for children across sub-Saharan Africa have prompted concerns that large numbers of orphaned children are being placed in institutional care. There is little empirical research into the role that institutions are playing in the provision of care to children affected by HIV in the region. This paper draws on an exploratory study of the provision of residential care for children in the context of the HIV epidemic in South Africa. The analysis characterises the population of children in a small sample of residential care facilities in four provinces, and, after identifying a disproportionate number of HIV-positive children in care, examines the circumstances that led to their admission and the nature of HIV-related interventions in the facilities. The analysis reveals missed opportunities for non-institutional placements for HIV-positive children and identifies important gaps in the HIV prevention, treatment, care, and support interventions within the facilities. The article argues that a global and local preoccupation with orphans as being the children most severely affected by HIV, and as the primary category of children requiring alternative care as a result of the HIV epidemic, may have diverted attention away from the extent to which HIV-positive children populate institutions in South Africa. Furthermore, we suggest that adjustments are required to both decisionmaking regarding placement of HIV-positive children requiring alternative care and the provision of HIV-related interventions in residential facilities in order to ensure an adequate response to children's health and wellbeing. [ABSTRACT FROM AUTHOR]