HIV/AIDS in South Africa 25 Years On: Psychosocial Perspectives PDF
Preview HIV/AIDS in South Africa 25 Years On: Psychosocial Perspectives
Poul Rohleder Leslie Swartz Seth C. Kalichman Leickness Chisamu Simbayi Editors HIV/AIDS in South Africa 25 Years On Psychosocial Perspectives 1 23 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 123 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 Allrightsreserved.Thisworkmaynotbetranslatedorcopiedinwholeorinpartwithoutthewritten permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY10013,USA),exceptforbriefexcerptsinconnectionwithreviewsorscholarlyanalysis.Usein connectionwithanyformofinformationstorageandretrieval,electronicadaptation,computersoftware, orbysimilarordissimilarmethodologynowknownorhereafterdevelopedisforbidden. Theuseinthispublicationoftradenames,trademarks,servicemarks,andsimilarterms,eveniftheyare notidentifiedassuch,isnottobetakenasanexpressionofopinionastowhetherornottheyaresubject toproprietaryrights. Printedonacid-freepaper SpringerispartofSpringerScience+BusinessMedia(www.springer.com) 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 JusticeoftheConstitutionalCourtof SouthAfrica March2009 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
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