Problematising the discourse of 'Post-AIDS'

This paper reflects on the meanings of ‘post-AIDS’ in the Global North and Global South. I bring together a range of contemporary arguments to suggest that the notion of ‘post-AIDS’ is, at best, misplaced, not least because its starting point remains a biotechnical one. Drawing on aspects of the sub-Saharan African experience, this essay suggests that, despite significant shifts in access to antiretroviral therapy (ART), HIV continues to be fundamentally shaped by economic determinants and social and cultural practices. In this essay, I question the certainty of the discourse of (Western biomedical) ‘positive progress’ (Johnson et al. 2015), which underpins the ‘post-AIDS’ narrative, and suggest that living with HIV and AIDS in our contemporary global context is a life lived with ongoing complexity, stigma and chronicity. I suggest that HIV in the Global North shares many characteristics with HIV in the Global South, yet differs in significant ways, not least in the fact that a resource-rich context generates an environment where health and social care support is possible, and, mostly, usual. In both contexts, however, the experience of living with a highly stigmatized illness with no cure in both the Global South and North suggests that this is a point of shared experience

‘There’s no pill to help you deal with the guilt and shame’: Contemporary experiences of HIV in the United Kingdom

© The Author(s) 2017. The experience of living with HIV, in the global north, has changed significantly over the past 20 years. This is largely the result of effective biomedical methods of treatment and prevention. HIV is now widely considered to be a long-term condition like many others – it has been argued that HIV has been ‘normalised’. Drawing on online qualitative survey data, with respondents aged 18–35 years, diagnosed with HIV in the past 5 years, this research explores contemporary subjective experiences of being diagnosed, and living, with HIV in the United Kingdom. The data reveal ambiguous experiences and expectations, as the ‘normative’ status of HIV exists alongside ongoing experiences of fear, shame and stigma – maintaining its status as the most ‘social’ of diseases. In rendering HIV ‘everyday’, the space to articulate (and experience) the ‘difference’ which attaches to the virus has contracted, making it difficult to express ambivalence and fear in the face of a positive, largely biomedical, discourse. In this article, the concepts of normalisation and chronicity provide an analytical framework through which to explore the complexity of the ‘sick role’ and ‘illness work’ in HIV

Abortion: Some insights into power and patriarchy

African Studies Seminar series. Paper presented 20 March 1995As in the rest of the world, abortion in South Africa, is a pressing social proble (2). It is also an issue about which we know and understand very little, in part because the question of abortion has received limited attention in both the popular and academic literature in this country (3). The issue of abortion in South Africa has generally been kept silent. Two reasons can be cited for this. Firstly, the availability and accessibility of abortion have been determined by the medical profession and the State, both historically dominated by white men (4). Secondly, political and women's organisations in South Africa have been both divided and silent on the issue. Reproductive politics has assumed little political profile. Abortion, and indeed "fighting for a woman's right to choose, was not like being part of any other political cause, [because] the issue is not 'malestream' politics" (5). The fight against apartheid has assumed a far greater significance than reproductive politics (6)

Learning design approaches for personalised and non-personalised e-learling systems

Recognizing the powerful role that technology plays in the lives of people, researchers are increasingly focusing on the most effective uses of technology to support learning and teaching. Technology enhanced learning (TEL) has the potential to support and transform students’ learning and allows them to choose when, where and how to learn. This paper describes two different approaches for the design of personalised and non-personalised online learning environments, which have been developed to investigate whether personalised e-learning is more efficient than non-personalised e-learning, and discuss some of the student’s experiences and assessment test results based on experiments conducted so far

'It was like an animal in pain': Institutional thoughtlessness and bereavement in prison

Using the concept of institutional thoughtlessness, this article examines a range of issues embedded within daily prison life which have a detrimental effect upon the lives of those bereaved during a prison sentence. Drawing on in-depth qualitative research undertaken with bereaved prisoners, staff members and volunteers at a male prison in the North of England, the article explores how individual and institutional goals compete, compounding bereavement experiences and the management of grief. Findings demonstrate the tension between the policies and protocols prisons are tasked to follow, and unintended consequences for the individually bereaved. This article illuminates the need for far greater understanding of bereavement in the prison population and explores how a universal life experience can be particularly debilitating within the prison setting with the potential to exacerbate what is often cumulative loss among prisoners

Feeling the benefit : fluctuating illness and the world of welfare

This article explores the experiences of people living with fluctuating long-term conditions, with a particular focus on the UK welfare benefits system. Respondents in this study suggested that this system constitutes a critical barrier to maintaining a positive work-based identity, being characterised by assessment and decision-making processes that are inappropriately focused and inflexibly implemented. Here, we report the findings from a cross sectional online study of people aged 18 to 75+, resident in the UK, with a self-reported diagnosis of lupus, arguably, the archetypal fluctuating condition. We explore some of the key themes respondents living with lupus identified in the context of striving to maintain a sense of themselves as productive and functional citizens. We conclude that there is a critical lack of attention afforded to the experience of fluctuating illness within the State benefits system and offer some strategies for better understanding, and addressing, this issue

From a rare syndrome to a pandemic: applied epidemiology of infectious diseases in Australia

In this thesis, I present four field research projects and a variety of epidemiological activities. I conducted this body of work at the Australian Government Department of Health, Office of Health Protection from April 2019 to October 2020 to meet the competencies required for the Master of Philosophy in Applied Epidemiology (MAE) at The Australian National University. I conducted an acute flaccid paralysis case-series review in children under 15 years of age in Australia from 2000 to 2018. I applied the new case definition for the newly termed acute flaccid myelitis and retrospectively identified 41 cases occurring most consistently from 2010 onwards. The review found that the Australian acute flaccid paralysis surveillance system was well-positioned to actively monitor this newly sustained, albeit rare syndrome in the future. I investigated an outbreak of SARS-CoV-2 among Australian passengers on the Diamond Princess cruise ship, docked in Yokohama, Japan. The outbreak showed how quickly SARS-CoV-2 could spread through a confined and susceptible population and the need for a rapid public health response to minimise onward transmission. In the post-COVID era, cruise ships will need enhanced public health planning and risk mitigation strategies to recommence operations. I evaluated COVID-19 notifications in the National Notifiable Disease Surveillance System in Australia from 22 January to 9 June 2020. I conducted semi-structured interviews with a small selection of stakeholders and analysed data quality at two-week intervals. The evaluation found a high level of representativeness and acceptability to reporting de-identified COVID-19 cases to the surveillance system. However, two-way communication between the Australian Government Department of Health and jurisdictions needed improvement. An agreed minimum dataset for national COVID-19 reporting would reduce the data collection burden on states and territories. My epidemiological study used probabilistic linkage to assess the accuracy of enrolment details in the Australian Immunisation Register. The project explored the methodology behind probabilistic data linkage using a Fellegi-Sunter approach. I matched record pairs on 11 identifiers and incorporated inexact matching and weighting by frequency. The algorithm successfully linked 54% of non-Medicare enrolled infants' vaccination records to their Medicare enrolment record. The majority of non-Medicare enrolled infants, transitioned to Medicare, and within a timeframe that would accurately capture them in the immunisation coverage calculation for one-year-olds. Lastly, I described two teaching components conducted as part of the MAE program, including their teaching rational and my lessons learnt

Invisible in Plain Sight? Grandfathers Caring for Orphaned Grandchildren in Rural Malawi

Millions of orphans, created by parental deaths due to the HIV/AIDS pandemic in sub-Saharan Africa, live with, and are cared for, by grandparents. Little research has considered how grandparents and, in particular, grandfathers, are caring for orphans. Here, we employ the analytical concept of generative grandfathering to analyse rural grandfathers’ roles in orphan care within communities of Zomba District, Southern Malawi. Using an ethnographic approach to investigate orphan care, we engaged children, young people and adults in multiple qualitative research activities, including interviews, focus group discussions, stakeholder and dissemination meetings. The findings suggest that although grandfathers’ contributions to orphan care are on the periphery of research and policy concerned with grandparenting in Malawi and other regions of sub-Saharan Africa, grandfathers are incontrovertibly at the epicentre of their orphaned grandchildren’s everyday lives. Grandfathers are providers for their orphaned grandchildren, they support their formal education, and are integral to the intergenerational transmission of both knowledge and values. However, despite performing myriad caring roles in plain sight of their communities, grandfathers remain largely invisible due to gendered (mis)conceptions of care. This highlights the dilemma of grandfathers as ageing men who find themselves in roles not traditionally associated with hegemonic notions of masculinity in their communities