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Robust advancements in clinical treatment of people living with HIV (PLHIV) have resulted in the current “treatment as prevention” strategy: the inability to transmit the virus when it is undetectable. Nevertheless, disclosure within marital relationships remains important to adhere optimally to treatment and further limit transmission in the era of treat-all. Disclosure, however, can have serious social repercussions, particularly for women. This paper examines gendered disclosure decisions and their social consequences in marital relationships in Tanzania. Drawing from a 9-month ethnographic study in Shinyanga Region, we explore how Sukuma societal values shape disclosure decisions. In-depth interviews with 103 PLHIV and 19 FGDs inform our analysis. We found that societal values regarding gender and marriage significantly influence disclosure decisions in marital relationships. The HIV treat-all approach, with its focus on early treatment initiation preserved health and inability to transmit allowed men and women to carefully weigh the costs and benefits of disclosure to their marital aspirations. The benefits of antiretroviral treatment for social relations are often overlooked in medical interventions. We conclude that to reduce difficult disclosure decisions for PLHIV, emphasising community awareness of HIV treatment as prevention to mitigate the negative impacts of disclosure is needed. [ABSTRACT FROM AUTHOR]

Facing an ever-changing political-economic landscape marked by inequality, joblessness, and xenophobia, migrants in inner city Johannesburg are pushed towards the economic margins, or the 'corner' of life. In this precarious place, structural and everyday violence shape the daily lives and practices of men from various parts of Africa. This article examines how such men work to live up to self and societal expectations of masculinities while attempting to adjust to the socio-economic realities they face. Departing from the crisis in masculinity narrative, we highlight the multiple, creative ways that men navigate precarity. Our arguments are based on an ethnographic study of masculinities and violence, conducted from June 2017 to February 2018 in Johannesburg, South Africa. Drawing on the stories of two migrant men and more broadly from observations undertaken at Uncle Kofi's Corner, a street corner hangout and our main ethnographic site, we show how participants mapped urban space to produce enclaved masculinities. In these enclaves, specific scripts on how to be a man were (re)constructed resulting in multiple and unstable masculinities in a perpetual state of becoming. [ABSTRACT FROM AUTHOR]

In Dar es Salaam, Tanzania, heteronormative presumptions relating to masculinity dictate that men should be engaged in or actively pursuing heterosexual relationships. For many gay men, fears of social rejection, stigma, and legal repercussion combine to prevent them from being open about their sexuality. This article examines social and legal pressures experienced by gay men in Dar es Salaam and the ways they navigate their daily lives to avoid detection and act in instances where they fail to adhere to ascribed norms of masculinity. Our arguments draw on one year of ethnographic research among gay men aged 18 years and above in Dar es Salaam in 2017. Our findings show that gay men are under constant pressure to meet expectations such as having female sexual partners, getting married, and having children, as well as to conform with masculine body styling norms. In trying to navigate between masculine expectations of society and the desire to live freely as men who desire other men, they resort to a range of temporal, spatial and bodily tactics to conceal homosexual practices and identities from family and neighbors. These techniques include socializing, dating, and sometimes marrying women in response to family and societal pressure. They also dress in prescribed ways to conform to heteronormative standards, carefully attending to space and time to identify safe places for being gay, and utilizing mobile phones and social media to build communities of support. [ABSTRACT FROM AUTHOR]

Emily Margaretten, Street Life Under a Roof youth homelessness in South Africa. Urbana 1L: University of Illinois Press (hb US$85-9780252039607; pb US$25--9780252081118). 2015, 213 pp. In Street Life Under a [...]

Introduction Universal test and treat (UTT)—antiretroviral therapy (ART) for all HIV-positive individuals regardless of CD4 count—is the WHO's recommended treatment guideline. UTT has implications for health providers' workload in areas of high HIV prevalence and for understandings of ART and HIV. This article explores health providers' experiences of implementing UTT in Hhohho Region, Eswatini. Methods Between March 2015 and October 2016, in-depth interviews were conducted with health providers implementing UTT. Interviews were transcribed verbatim and translated into English for qualitative content analysis. Results Twenty-five providers from eight facilities were interviewed. Respondents encouraged early ART by promoting its overall health benefits, and the possibility of avoiding disclosure and HIV-related stigma in the community. Some health providers downplayed UTT's preventive benefits to avoid discouraging condom use. Respondents suggested that initiating ART immediately after testing could improve linkage-to-care, but recognized that overly hasty initiation might affect adherence. Viral load testing was seen as a potentially useful tool to monitor clients' response to ART. Conclusions Health providers appropriated stigma to encourage early ART. This suggests an attentiveness to the social burden of HIV/AIDS, but potentially exacerbates discrimination and conflicts with efforts to reduce HIV-related stigma. [ABSTRACT FROM AUTHOR]

As part of the chronic disease paradigm now widely used for HIV in sub-Saharan Africa, antiretroviral treatment programs emphasize self-care. In the informal settlements of Mombasa, Kenya, the management of stress—associated with economic precariousness—plays a significant role in self-care practices and ideologies. Based on ethnographic fieldwork, we examine how local narratives of stress and self-care intertwine with social responsibilities of older HIV-positive people. For older Mombassans, living with ‘chronic’ HIV means living with an unpredictable body, which affects how they are able to care for their kin. The physical reality of living with HIV thus shapes relational networks, making self-care a social practice. While, for some self-care entails managing the body so that its needs are hidden from loved ones, a kind of ‘protective secrecy,’ others enlist the support of their children and grandchildren in managing their body, and in that process subtly redefine generational expectations and responsibilities. [ABSTRACT FROM PUBLISHER]