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Burden of Tuberculosis in HIV+ Pregnant & Postpartum Women in Cape Town, South Africa
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This paper examines the approaches heterosexual men and women in South Africa use to engage their partners in discussions of HIV and risk factors in their relationships. These strategies entail balancing the risks of infection while managing the challenges of maintaining a relationship. In a context in which there is a great deal of insecurity in relationships it is especially challenging to discuss HIV risks with partners.
Our findings reveal that concerns about children or the desire to have children provided a legitimate basis for discussing HIV risk with partners. The focus of these discussions is on the future for their children. Research in South Africa should attend to men’s and women’s desires to have and to raise children. HIV prevention and treatment programs can capitalise on concerns regarding children, and the future of the family, to engage men and women in discussing mutually acceptable strategies for preventing infection and ensuring safe conception.
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Mabeo is a member of Positive Connection, the only Internet dating forum geared to people with HIV in South Africa, the country with more infections – over 5 million and counting – than any other. I still haven’t found anyone I’ve gotten romantically involved with, but I’m carefully going through the list. AIDS is no longer an automatic killer here. As in the United States, it has become a chronic illness for those with access to antiretroviral drugs.
Up to , South Africans are on treatment, well below the half-million deemed in urgent need of care but far more than a few years ago.
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Looking to the future: South African men and women negotiating HIV risk and relationship intimacy
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Using qualitative methods we did repeat interviewed with 42 HIV-positive men and women in Cape Town and Mthatha resulting in 71 interviews. The most common stigma experiences were gossips and insults where HIV status was used as a tool, but these were often resisted. Many feared the possibility of stigma, but very few had experiences that resulted in discrimination or loss of social status. Stigma experiences were intertwined with other daily conflicts and together created tensions, particularly in gender relations, which interfered with attempts to regain normality.
Evidence of support and resistance to stigma was common, and most encouraging was the evidence of how structural interventions such as de-stigmatizing policies impacted on experiences and transference into active resistance. The study showed the complex and shifting nature of stigma experiences. These differences must be considered when we intensify stigma reduction with context- and gender-specific strategies focussing on those not yet on ARV programmes.
Living with HIV is of daily concern for many South Africans, and the challenges they face include adapting their lives to live with a chronic illness whilst continuing to achieve or meet social expectations including being economically independent, have intimate relationships, assessing risks, protecting others and adhering to treatment. The availability of antiretroviral therapy ART globally has resulted increasingly in perceptions that HIV infection and AIDS are manageable chronic health problems [ 1 — 3 ], but in many countries too few people know their status and are coming forward in time for treatment and HIV stigma remains one of the greatest challenges to service delivery [ 4 , 5 ].