HIV/AIDS in South Africa 25 Years On: Psychosocial Perspectives

392 Pages·2009·2.16 MB·English

by  Poul Rohleder

HIV/AIDS in South Africa 25 Years On
· · ·
Poul Rohleder Leslie Swartz Seth C. Kalichman
Leickness C. Simbayi
Editors
HIV/AIDS in South Africa
25 Years On
Psychosocial Perspectives
Foreword by Edwin Cameron
1 3
Editors
PoulRohleder LeslieSwartz
DepartmentofPsychology DepartmentofPsychology
AngliaRuskinUniversity StellenboschUniversity
EastRoad PrivateBagX1
Cambridge Matieland
CB11PT 7602
UK SouthAfrica
[email protected] [email protected]
SethC.Kalichman LeicknessC.Simbayi
CenterforHIVInterventionand HumanSciencesResearchCouncil
Prevention 69-83PlainParkBldg,13thFl
UniversityofConnecticut CapeTown
8001SouthAfrica
206HillsideRoad
[email protected]
Storrs,CT06269
Unit1248
USA
[email protected]
ISBN978-1-4419-0305-1 e-ISBN978-1-4419-0306-8
DOI10.1007/978-1-4419-0306-8
SpringerNewYorkDordrechtHeidelbergLondon
LibraryofCongressControlNumber:2009931924
©SpringerScience+BusinessMedia,LLC2009
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Foreword
AIDShasbeenoneofthedefiningchallengesofourtime.OnourcontinentAfrica,
moreso,becauseitsgreatestglobalburdenishere,wherewealthisleastandhuman
systemsfrailest.AndinSouthAfricamostacutely,notjustbecause5or6millionof
usarelivingwithHIVandAIDS,butbecauseofthegrosspoliticalmismanagement
oftheepidemic,rootedinpresidentiallyinstigatedAIDSdenialismintheearlyyears
of this century. Its disabling effects still linger, even as new political purpose is at
lastbringingorderandhopetotheepidemic.
Nocornerofoursocialeffortorinvestment–fromhealthcaretosocialsecurity,
education to the economy, correctional services or the judiciary – escapes AIDS.
Amongstthemanylessonstheepidemichastaughtusisthathealthisonlypartlythe
domainofmedicalscience–everyaspectoflifeissubjectto,andinturninfluences,
AIDS.
Hence, no single approach can begin to secure the proper prevention, contain-
ment,treatmentandcareweneed.Thewords“holistic”and“multi-sectoral”,though
grievouslyover-used,havepracticalmeaning:thatimagination,cohesionandcom-
mitment are what we have to start with. Then we need effective knowledge and
systemsandresources.
Butwealsoneedunderstanding.Todealeffectivelywithanepidemicthatthreat-
ensthelivesofsomanydemandsinsight.Andforthat,wehavetoconfrontcontro-
versy–indelicatelywherenecessary.Italsorequiresustoinnovate,andtoconfound
conventionwisely.
Thisimpressivebookwill,Ihope,helpuswithallofthis.Itbringstogethermany
ofthe“usualsuspects”–thoseauthoritativeexpertsfromourregionwhoseclinical
andanalyticalandacademicworkhasplacedthemattheglobalforefrontofAIDS.
Theircommoninteresthere,reflectedthroughtheirbroadrangeofcollaborators,
isinpsychosocialapproachestotheepidemic.Eachwritesaboutafascinatingand
important aspect. All do so with a view to increasing our understanding, and thus
ourcapacitytodomore.
The contributions are generally of high quality; some are innovative; and most
are of real interest. The emphases differ. Across chapters, there are differences of
opinion.Good.
v
vi Foreword
Thisbookshowshowfarwehavecomeoverthepastquarter-centuryinmoving
togreaterpsychosocialunderstandingofHIV/AIDSinSouthAfrica.Italsotellsus
howfarwestillhavetogo.
Whatisgoodisthatwenowhavebetweenthecoversofonevolumearangeof
authoritativereviewsofwhatweknow–andofwhatwestillneedtolearn.
Theeditorscollectedthesechapterstoprovokedebate.Thebestcomplimentyou
couldreturnwouldbetoreadthechapterscritically,inaspiritofchallenge,response
andfurtherinquiry.
SoIcongratulatethemandtheauthorsonthisimpressivecompendiumofideas,
data, and challenges. This book is quite a landmark in HIV/AIDS scholarship in
SouthAfrica.
Ifithelpsustothinkmoredeeply,andtoworkmoreeffectivelyinthisstilldire
epidemic, it will have been worth the contributors’ effort, and your investment in
buyingit.
EdwinCameron
JusticeoftheConstitutionalC ourto f S outh Africa
March 2009
Acknowledgments
Thecontributorstothisvolumecomefromabroadrangeofdisciplinesandinstitu-
tions, both in South Africa and internationally. We have attempted to put together
a book that reflects a diversity of psychosocial issues and perspectives involved in
approachingtheHIV/AIDSepidemicinSouthAfrica.Wehavetriedtobeasinclu-
siveaspossibleinaddressingvarioustopics,andofcoursethereremainsomeareas
thatwedidnothavethespacetoinclude.Thishasturnedouttobealargevolume,
andwewouldliketothankallthecontributorsforputtingtogethertheirknowledge
andthoughtsintothisbook,forthinkingaboutwhathasbeenlearntandstillneeds
tobelearntaboutHIV/AIDSinSouthAfrica,andfordoingsowithinourdeadlines.
Insomecases,authorshadtoputupwithongoingemailsandsomedifficultrequests
fromtheeditorialteam.Wethankallauthorsfortheircontributions,withoutwhich
thisbookwouldnotbepossible.
We would also like to thank Janis Kritizinger for her meticulous final editing
and formatting of the manuscript and her attention to detail. As our deadline for
submissionwasapproaching,herworkonthemanuscriptwasablessing.
WewouldalsoliketothanktheteamatSpringer,especiallyBillTuckerandIan
Marvinneyfortheirenthusiasmandsupportofthisproject.Aspecialthankyoualso
toJudgeEdwinCameronforhisendorsementofthebookandagreeingtowritethe
Foreword.
Finally we would like to thank our partners and our families for their patience
whileweworkedonthisvolume.
vii
Contents
1 IntroductionandOverview . . . . . . . . . . . . . . . . . . . . . . 1
PoulRohleder,LeslieSwartz,SethC.Kalichman,
andLeicknessC.Simbayi
PartI PsychosocialIssues
2 The Sociocultural Aspects of HIV/AIDS
inSouthAfrica . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
SuzanneLeclerc-Madlala,LeicknessC.Simbayi,
andAllaniseCloete
3 HIVandWomen . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
RachelJewkes
4 MasculinityandHIV/AIDS. . . . . . . . . . . . . . . . . . . . . . 41
GrahamLindeggerandMichaelQuayle
5 HIVandYouth:ABehaviouralPerspective . . . . . . . . . . . . . 55
ArvinBhanaandIngePetersen
6 InfantsandYoungChildrenAffectedbyHIV/AIDS . . . . . . . . 69
LindaRichter,AlanStein,LucieCluver,andJuliadeKadt
7 PovertyandHIVandAIDS . . . . . . . . . . . . . . . . . . . . . 89
OliveShisana,NompumeleloZungu,andSinawePezi
8 HIVandStigmainSouthAfrica . . . . . . . . . . . . . . . . . . . 105
HarrietDeacon,LeanaUys,andRakgadiMohlahlane
PartII PreventionandTreatment
9 ThePoliticsandPsychologyofAIDSDenialism . . . . . . . . . . 123
NicoliNattrassandSethC.Kalichman
10 Local-LevelResponsestoHIV/AIDSinSouthAfrica . . . . . . . 135
KevinKellyandMirjamvanDonk
ix
x Contents
11 SocialMovementsandHIV/AIDSinSouthAfrica . . . . . . . . . 155
ChristopherJ.ColvinandStevenRobins
12 ApproachestoHIVCounsellingandTesting:Strengths
andWeaknesses,andChallengesfortheWayForward . . . . . . 165
HeidivanRooyen,LindaRichter,ThomasJ.Coates,
andMerridyBoettiger
13 VerticaltransmissionofHIV–PregnancyandInfantIssues . . . 183
LorraineSherr
14 HIV/AIDS, Nutrition and Structural Interventions
inSouthAfrica:AMoveintheRightDirection . . . . . . . . . . 205
MarkTomlinson,ScottDrimie,LeslieSwartz,
andPoulRohleder
15 Strengthening Community Responses to AIDS:
PossibilitiesandChallenges . . . . . . . . . . . . . . . . . . . . . 221
CatherineCampbell,YugiNair,SbongileMaimane,
andAndrewGibbs
16 HIV/AIDS,ReligionandSpirituality . . . . . . . . . . . . . . . . 237
YoesrieToefy
PartIII PersonsLivingwithHIV/AIDS
17 ExperiencesofPeopleLivingwithHIV . . . . . . . . . . . . . . . 255
LumkaDanielandCorinneSquire
18 Positive Prevention: HIV Risk Reduction for People
LivingwithHIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . 273
SethC.KalichmanandLeicknessC.Simbayi
PartIV NewDirectionsinHIVResearch
19 HIV/AIDSandPersonswithDisabilities . . . . . . . . . . . . . . 289
PoulRohleder,LeslieSwartz,ArneHenningEide,
andHayleyMacGregor
20 HIV/AidsandthePrisonSystem . . . . . . . . . . . . . . . . . . . 305
LukasMuntinghandChrisTapscott
21 HIVandCircumcision . . . . . . . . . . . . . . . . . . . . . . . . 323
DirkTaljaardandChiweniChimbwete
22 ParticipationinHIVVaccineTrials . . . . . . . . . . . . . . . . . 337
AntheaLesch,ZuhayrKafaar,andAshrafKagee
Contents xi
23 Bridging the Gap Between HIV and Mental Health
ServicesinSouthAfrica . . . . . . . . . . . . . . . . . . . . . . . 353
PamelaY.CollinsandMelvynFreeman
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373