Sex, disease and stigma in South Africa: historical perspectives

Abstract

This paper attempts to analyse historically why stigma and denial around HIV/AIDS is so powerful in South Africa, so powerful that ailing family members can be shunned and evicted. For many observers, the answer lies simply in its being a venereal disease, in its connotation with promiscuity and unregulated sexuality. We argue that this is not an adequate explanation. Pre-colonial African societies were relatively open about sexuality. Though pre-marital and adulterous pregnancy certainly caused social disruption, extra-marital sex per se was not stigmatised. Even the sexual shame introduced (unevenly) by Christianity and its hybridised forms is inadequate in explaining the degree of stigma associated with HIV/AIDS. We extend the discussion by exploring the stigma associated with various forms of pollution and the inevitability of death. The peculiarly interwoven mixture of sexual transgression, pollution and delayed death, we argue, makes HIV/AIDS an extraordinarily powerful generator of stigma.

Microbicide clinical trial adherence: insights for introduction

“…Nevertheless, since most women menstruate at some points in their sexually active lives, the potential menses-related adherence issues must be considered. In sub-Saharan Africa, evidence from multiple cultural contexts suggests that sexual activity tapers during menses [28–30]; thus, in many settings adherence during menses may be a non-issue for coitally dependent methods. For those who have sex during menses, the combination of microbicide gel products and menstrual flow might cause excessive leakage, or make the vagina too lubricated and adherence might drop.…”

The Past, Present, and Future of HIV Prevention: Integrating Behavioral, Biomedical, and Structural Intervention Strategies for the Next Generation of HIV Prevention

“…Framing HIV around sex and drug behaviors facilitates and maintains stigma globally (Dorfman et al 2005, Schneider et al 2006). Being HIV positive provides evidence that one has engaged in illicit social behaviors (MacPhail et al 2008): HIV is perceived as just punishment for such violations in China (Li et al 2007), the United States (Herek et al 2003), South Africa (Delius & Glaser 2005), and Uganda (Bikaako-Kajura et al 2006). Many churches are unwilling to deliver HIV prevention programs because sex and drug behaviors must be discussed, which may be misperceived as endorsement of risky acts (Kaisernetwork.org 2005, McKoy & Petersen 2006).…”

Kuru, AIDS, and Witchcraft: Reconfiguring Culpability in Melanesia and Africa

“…As elsewhere in South Africa, men saw multiple sexual partners as a sign of success, rather than a source of shame (Delius and Glaser 2005;Hunter 2005). However, they were extremely sensitive to the manner in which outsiders attached negative connotations to 'African sexuality'.…”