Abstract
South Africa has one of the most extensive HIV epidemics in the world, and one where the burden of the epidemic is most conspicuously borne by young black women. In the interests of epidemiological pragmatism, its course has until fairly recently been mapped through women’s infections. One consequence of which has been to render men relatively invisible, both as HIV-related health-service users and as agents of sexual risk (Greig et al., 2008). Yet women’s subordinate position in a highly patriarchal society has critically shaped their HIV risk, just as the racial patterning of the epidemic has its roots in the political and economic subordination stemming from colonisation and the era of apartheid. This chapter is largely an account of influences on the lives of African women, who carry the overwhelming burden of infection.
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Notes
- 1.
Under apartheid, schools were racially segregated and differentially resourced. Africans were deliberately under-educated. The ethos underlying black African education was explained by Dr. HF Verwoerd, Minister of Native Affairs, Senate in 1957, when he said “There is no place for [the Bantu] in the European community above the level of certain forms of labour…Until now he has been subjected to a school system which drew him away from his own community and misled him by showing him the green pastures of European society in which he was not allowed to graze.”
References
Campbell, C. (2000). Selling sex in the time of AIDS: the psycho-social context of condom use by southern Africa sex workers. Social Science and Medicine, 50, 479–494.
Casale, D., and Posel, D. (2005). Women and the economy: how far have we come? Agenda, 64, 21–29.
Christofides, N., Muirhead, D., Jewkes, R., Penn-Kekana, L., and Conco, N. (2006). Including post – exposure prophylaxis to prevent HIV/AIDS into post- sexual assault health services in South Africa: costs and cost effectiveness of user preferred approaches to provision. Pretoria: Medical Research Council.
Crush, J., and Ambler, C. (Ed.), (1992). Liquor and labor in Southern Africa Pietermaritzburg: Natal University Press.
Delius, P., and Glaser, C. (2002). Sexual socialisation in South Africa: a historical perspective. African Studies, 61(1), 27–54.
Department of Health (2007). South Africa demographic & health survey 2003. Pretoria: Department of Health.
Department of Health (2008). The national HIV and syphilis prevalence survey, South Africa 2007. Pretoria: National Department of Health.
Dunkle, K.L., Jewkes, R.K., Brown, H.C., Gray, G.E., McIntyre, J.A., and Harlow, S.D. (2004a) Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection. Social Science & Medicine 59, 1581–1592.
Dunkle, K.L., Jewkes, R.K., Brown, H.C., Gray, G.E., McIntyre, J.A., and Harlow, S.D. (2004b). Gender-based violence, relationship power and risk of prevalent HIV infection among women attending antenatal clinics in Soweto, South Africa. The Lancet, 363, 1415–1421.
Dunkle, K.L., Jewkes, R.K., Brown, H.C., Yoshihama, M., Gray, G. E., McIntyre, J. A., et al. (2004c). Prevalence and patterns of gender-based violence and revictimization among women attending antenatal clinics in Soweto, South Africa. American Journal of Epidemiology, 160, 230–239.
Dunkle, K., Jewkes, R.K., Nduna, M., Levin, J., Jama, N., Khuzwayo, N., et al. (2006). Connections between perpetration of partner violence and HIV risk behavior among young men in the rural Eastern Cape province of South Africa. AIDS, 20, 2107–2114.
Dunkle, K., Jewkes, R., Nduna, M., Jama, P.N., Levin, J.B., Sikweyiya, Y., et al. (2007). Transactional sex and economic exchange with partners among young South African men in the rural Eastern Cape: prevalence, predictors, and associations with gender-based violence. Social Science & Medicine, 65(6), 1235–1248.
Epprecht, M. (1993). Domesticity and piety in Colonial Lesotho: the private politics of Basotho Women’s Pious Associations. Journal of Southern African Studies, 19(2), 202–224.
Epprecht, M. (2004). Hungochani: the history of a dissident sexuality in Southern Africa. Montreal/Kingston: McGill-Queen’s University Press.
Epstein, H. (2007) The invisible cure. AIDS in Africa. New York: Farrar, Strauss and Giroux.
Freeman, E.E., Weiss, H.A., Glynn, J.R., Cross, P.L., Whitworth, J.A., and Hayes, R.J. (2006). Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies. AIDS, 20, 73–83.
Gaitskell, D. (1982). ‘Wailing for purity’: prayer unions, African mothers and adolescent daughters, 1912–1940. In S. Marks and R. Rathbone (Ed.), Industrialisation and social change in South Africa: African class formation, culture and consciousness 1870–1930 (pp. 338–357). Harlow: Longman.
Gray, R.H., Wawer, M.J., Brookmeyer, R., Sewankambo, N.K., Serwadda, D., Wabwire-Mangen, F., Lutalo, T., Li, X., van Cott, T., Quinn, T.C., and Rakai Project Team. (2001). Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda. The Lancet, 357(9263), 1149–1153.
Greig, A., Peacock, D., Jewkes, R., and Msimang, S. (2008). Gender and AIDS: time to act. AIDS, Supp2, S35–43.
Hunter, M. (2002). The materiality of everyday sex: thinking beyond ‘prostitution’. African Studies, 61(1), 99–120.
Hunter, M. (2005). Cultural politics & masculinities: multiple-partners in historical perspective in KwaZulu-Natal. In G. Reid and L. Walker (Ed.), Men behaving differently. South African men since 1994. Cape Town: Double Storey Books.
Hunter, M., (2006). Fathers without amandla?. In L. Richter and R. Morrell (Ed.), Baba? fathers and fatherhood in South Africa (pp. 99–107). Pretoria: HSRC.
Interpol (International Criminal Police Organisation (ICPO) – Interpol (1996) International crime statistics. Washington D.C.: Interpol.
Jama, P.N., and Jewkes, R.K. (2002). Walking on two legs: sexual partnerships and condom use among youth in Winterveldt. XIVth International AIDS Conference, Barcelona.
Jewkes, R., Vundule, C., Maforah, F., and Jordaan, E. (2001). Relationship dynamics and adolescent pregnancy in South Africa. Social Science and Medicine, 52(5), 733–744.
Jewkes, R., Penn-Kekana, L., and Rose-Junius, H. (2005). “If they rape me, I can’t blame them”: reflections on the social context of child sexual abuse in South Africa and Namibia. Social Science and Medicine, 61, 1809–1820.
Jewkes, R., Dunkle, K,. Nduna, M., Levin, J., Jama, N., Khuzwayo, N., Koss, M., Puren, A., and Duvvury, N. (2006a). Factors associated with HIV sero-status in young rural South African women: connections between intimate partner violence and HIV. International Journal of Epidemiology, 35(6), 1461–1468.
Jewkes, R.K., Dunkle, K., Koss, M.P., Levin, J., Nduna, M., Jama, P.N., and Sikweyiya, Y. (2006b). Rape perpetration by young, rural South African men: prevalence, patterns and risk factors. Social Science and Medicine, 63, 2949–2961.
Jewkes, R.K., Sikweyiya, Y., Morrell, R., and Dunkle, K. (2008a). Understanding men’s health and use of violence: interface of rape and HIV in South Africa. Pretoria: Medical Research Council.
Jewkes, R., Nduna, M., Levin, J., Jama, N., Dunkle, K., Puren, A., and Duvvury, N. (2008b). Impact of Stepping Stones on HIV, HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. British Medical Journal, 337, a506.
Longmore, L. (1959). The dispossessed. A study of the sex-life of Bantu women in urban areas in and around Johannesburg. London: Tavistock.
Lurie, M.N., Williams, B.G., Zuma, K., Mkaya-Mwamburia, D., Garnette, G.P., Sweat, M.D., Gittelsohn, J., and Abdool Karim, S.S. (2003). Who infects whom? HIV-1 concordance and discordance among migrant and non-migrant couples in South Africa, AIDS, 17, 2245–2252.
Mager, A.K. (1999). Gender and the making of a South African Bantustan. A social history of the Ciskei, 1945–1959. Oxford: James Currey.
Manzini, N. (2001). Sexual initiation and childbearing among adolescent girls in KwaZulu Natal, South Africa. Reproductive Health Matters, 9(17), 44–52.
Marks, S. (2002). An epidemic waiting to happen? the spread of HIV/AIDS in South Africa in social and historical perspective, African Studies, 61(1), 13–26.
Mayer, P. (1961). Townsmen or tribesmen: conservatism and the process of urbanisation in a South African City. Cape Town: Oxford University Press.
Mayer, P., and Mayer, I. (1970). Socialisation by peers; the Youth Organisation of the Red Xhosa. In P. Mayer (Ed.), Socialisation: the approach from social anthropology. London: Tavistock.
Morrell, R. (2001). The times of change: men and masculinity in South Africa. In R. Morrell (Ed.), Changing men in Southern Africa (pp. 3–37). Pietermaritzburg: University of Natal Press.
Nduna, M., and Jama, N. (2000). Stepping Stones preliminary findings. Paper presented at the AIDS in Context.
Ntlabati, P., Kelly, K., and Mankayi, A. (2001). The first time: an oral history of sexual debut in a deep rural area. AIDS in Context Conference, University of the Witwatersrand, Johannesburg.
O’Sullivan, L.F., Harrison, A., Morrell, R., Monroe-Wise, A., and Kubeka, M. (2006). Shifting sexualities: gender dynamics in the primary sexual relationships of young rural South African women and men. Culture, Health and Sexuality, 8(2), 99–113.
Pettifor, A.E., Rees, H.V., Kleinschmidt, I. Steffensen, A.E., MacPhail, C., Hlongwa-Madikizela, L., et al. (2005). Young people’s sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. AIDS, 19, 1525–1534.
Pronyk, P.M., Hargreaves, J.R., Kim, J.C., Morrison, L.A., Phetla, G., Watts, C., et al. (2006). Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial Lancet, 368, 1973–1983.
Reid, G., and Walker, L. (Ed.) (2005). Men behaving differently. South African men since 1994. Cape Town: Double Storey Books.
Schapera, I. (1933). Premarital pregnancy and native opinion. Africa, 6, 59–88.
Selikow, T.A., Zulu, B., and Cedras, E. (2002). The Ingagara, the regte and the cherry: HIV/AIDS and youth culture in contemporary urban townships, Agenda, 53, 22–32.
Shai, P.N., Jewkes, R., Nduna, M., Levin, J., and Dunkle, K. (in press). Factors associated with consistent condom use in young rural South African women. AIDS Care.
Shisana, O., Rehle, T., Simbayi. L.C., Parker, W., Zuma, K., Bhana, A., Connolly, C., Jooste, S., Pillay, V. et al. (2005). South African National HIV prevalence, HIV incidence, behaviour and communication Survey, 2005. Cape Town: HSRC Press.
Statistics South Africa (1996) October Household Survey 1995. Available on: http://www.statssa.gov.za/publications/statsdownload.asp?PPN=P0317&SCH=850. Last accessed 24.1.09
Walker, C. (Ed.) (1990). Women and gender in Southern Africa 1945. London: James Currey.
Wang, S.K., and Rowley, E. (2008). Rape: responses from women and health providers. Geneva: Sexual Violence Research Initiative/World Health Organisation.
Wilson, F. (2006). “On being a father and poor in Southern Africa today”. In L. Richter and R. Morrell (Eds.), Baba? Fathers and Fatherhood in South Africa (pp. 26–37). Pretoria: HSRC.
Wojcicki, J.M. (2002). Commercial sex work or ukuphanda? Sex-for-money exchange in Soweto and Hammanskrall area, South Africa. Culture, Medicine & Psychiatry, 26, 339–370.
Wojcicki, J.M., and Malala, J. (2001). Condom use, power and HIV/AIDS risk: sex-workers bargain for survival in Hillbrow/Joubert Park/Berea, Johannesburg. Social Science & Medicine, 53, 99–121.
Wood, K.M. (2003). An ethnography of sexual health and violence among township youth in South Africa. Unpublished PhD thesis, University of London.
Wood, K., and Jewkes, R. (2001). ‘Dangerous’ love: reflections on violence among Xhosa township youth. In R. Morrell (Ed.), Changing men in Southern Africa (pp. 317–336). Pietermaritzburg: University of Natal Press.
Wood, K., and Jewkes, R. (2006). Blood blockages and scolding nurses: barriers to adolescent contraceptive use in South Africa. Reproductive Health Matters, 14(7), 109–118.
Wood, K., Maforah, F., and Jewkes, R. (1998). ‘He forced me to love him’: putting violence on the adolescent sexual health agenda. Social Science and Medicine, 47, 233–242.
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Many thanks to Robert Morrell for comments on the manuscript.
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Jewkes, R. (2009). HIV and Women. In: Rohleder, P., Swartz, L., Kalichman, S., Simbayi, L. (eds) HIV/AIDS in South Africa 25 Years On. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0306-8_3
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