Narratives and Silences in Discussions of AIDS/HIV Amongst Young People in Mpumalanga, South Africa

This paper centres on discussions surrounding people living with HIV and AIDS in Mpumalanga province of South Africa and challenges an accepted hypothesis that a Euro-American understanding of stigma is the main reason for the silence surrounding HIV and AIDS. Through the example of Sipho’s silence above, and narratives of various participants, I examine the choices available to this community in the face of the calamity that is a provincial HIV infection rate of 27.3%3 and the silences that often accompany a diagnosis of HIV/AIDS. I begin by identifying alternative, although not necessarily mutually exclusive, cultural mechanisms, which are in place in Mpumalanga. I look at the role of stigma, whether “felt” or “enacted” (Scambler & Hopkins, 1986) and the internalisation and reproduction of external public criticisms (Goffman 1986). While some stigma does exist, it is important to emphasise that in each model identified, silence plays a major role in the strategy of a people working to protect, restructure, and re-affirm their community. This paper, then, is my attempt to understand each of these mechanisms and reconcile some of those divergent views and discordant voices

AIDS Walks in High Heels

Poster presentation

Narratives and Silences in Discussions of AIDS/HIV Amongst Young People in Mpumalanga, South Africa

This paper centres on discussions surrounding people living with HIV and AIDS in Mpumalanga province of South Africa and challenges an accepted hypothesis that a Euro-American understanding of stigma is the main reason for the silence surrounding HIV and AIDS. Through the example of Sipho’s silence above, and narratives of various participants, I examine the choices available to this community in the face of the calamity that is a provincial HIV infection rate of 27.3%3 and the silences that often accompany a diagnosis of HIV/AIDS. I begin by identifying alternative, although not necessarily mutually exclusive, cultural mechanisms, which are in place in Mpumalanga. I look at the role of stigma, whether “felt” or “enacted” (Scambler & Hopkins, 1986) and the internalisation and reproduction of external public criticisms (Goffman 1986). While some stigma does exist, it is important to emphasise that in each model identified, silence plays a major role in the strategy of a people working to protect, restructure, and re-affirm their community. This paper, then, is my attempt to understand each of these mechanisms and reconcile some of those divergent views and discordant voices

A Few Good Men in a World of Gangsters: Discourses of Respectability and Risk amongst Student Teachers in the Western Cape, South Africa

This paper considers the concurrent discourses of risk and respectability which are prominent in South  Africa’s Western Cape region and asks how one becomes a ‘respectable’ man in a community which values strong masculine role models and in which there are endemic levels of violence. Through a process of risk ‘mapping’ we explore the means through which a group of young male student teachers consciously ‘locate’ risk in their built environment. We look at the strategies these young men use to negotiate risk in their lives, and the close connection between risk and respectability which they articulate on an ongoing basis.Keywords: discourse; male, risk, respectability, violence, masculinity

Between the Clinic and the Community: Temporality and Patterns of ART Adherence in the Western Cape Province, South Africa

In an ethnographic study conducted over thirty months in South Africa’s Western Cape Province ending in 2012, we explored ART adherence amongst almost 200 patients attending three clinics. This setting contained significant political, structural, economic and socio-cultural barriers to the uptake of, and adherence to, treatment. Such barriers certainly impacted patient drug use and the labelling of clients as ‘adherent’ or ‘non-adherent’. Yet, as our fieldwork developed, it became apparent that these labels also bore little relationship to the amount and regularity of drug consumption outside the clinic. Indeed, the people that we knew moved through these labels in ways that could not simply be explained by brute socio-economic circumstances, poor understanding of the functions of the drugs, or varying levels of family and community support, which themselves often changed over time. This paper presents four on-going ‘patterns of adherence’, which are clearly discernible in the communities in which we worked. Each pattern is demonstrated through the life of an ‘index patient’ whose case is seen to be representative of the range of experiences and practices observed under the terms ‘adherent’ and ‘non-adherent’. We argue that such terms are deeply contextual and, crucially, temporally situated. The complex intertwining of political, economic, socio-cultural, gender, and biological factors that constitute the lives of participants exists in time and we call for a focus on evolving lives in relationship to changing health systems that can follow (and respond to) such developments to better deliver both information and services

Globalization and Health: developing the journal to advance the field

Founded in 2005, Globalization and Health was the first open access global health journal. The journal has since expanded the field, and its influence, with the number of downloaded papers rising 17-fold, to over 4 million. Its ground-breaking papers, leading authors -including a Nobel Prize winner- and an impact factor of 2.25 place it among the top global health journals in the world. To mark the ten years since the journal’s founding, we, members of the current editorial board, undertook a review of the journal’s progress over the last decade. Through the application of an inductive thematic analysis, we systematically identified themes of research published in the journal from 2005 to 2014. We identify key areas the journal has promoted and consider these in the context of an existing framework, identify current gaps in global health research and highlight areas we, as a journal, would like to see strengthened

AIDS Walks in High Heels

Poster presentation

AIDS Walks in High Heels

Poster presentation