The political context of AIDS-related stigma and knowledge in a South African township community

Abstract

The purpose of this study was to examine the presentation of AIDS-related stigma and knowledge within the political context of the South African government's response to the AIDS epidemic. It was during the 2000 – 2004 period that key government officials publicly challenged the orthodox views of HIV/AIDS, with the South African president, Thabo Mbeki, actively positing the primary role of poverty and other socio-economic stressors in the progression of the AIDS epidemic. This discursive position had real-time effects for AIDS policy-making and ultimately delayed the implementation of a national antiretroviral (ARV) rollout programme. Consequently this position was criticised by commentators in the media and elsewhere for contributing to an already widespread climate of AIDS stigmatisation and misinformation. To shed more light on these claims we conducted a survey in 2005 in Atteridgeville, a South African township, and compared results with those of a similar survey conducted shortly after ARV medications became available in 2004. Results indicated a reduction in AIDS stigma levels across the 1-year period, and that those participants who endorsed contentious political views (such as those expressed by key government officials) were more likely to have a higher level of AIDS-related stigma than those who disagreed. Nevertheless, this study cautions against drawing a causal relationship between the South African government's position and AIDS-stigmatising attitudes, and suggests that further political and social factors be accounted for in an attempt to gain a fuller understanding of this seemingly complex relationship.

Le but de cette étude fut d'examiner la présentation de stigmatisation et du savoir liés au SIDA dans le contexte politique de la réponse du gouvernement sud-africain vis-à-vis l'épidémie du SIDA. C'était au court de la période 2000 – 2004 où les cadres du gouvernement ont ouvertement défié le point de vue orthodoxe du VIH/SIDA. Le Président sud-africain, Thabo Mbeki, a vivement mis le rôle principal de la pauvreté et d'autres problèmes socio-économiques dans la progression de l'épidémie du SIDA. Cette position discursive a eu des effets en temps réel par rapport à l'élaboration d'une politique et a, au bout de compte, retardé l'exécution du programme national du déploiement des antirétroviraux (ARV). Par conséquence, cette position fut critiquée, par les média et ailleurs, de contribuer au climat de stigmatisation et de désinformation du SIDA déjà répandu. En guise d'élucider ces revendications, nous avons mené une étude en 2005 dans un township sud-africain nommé Atteridgeville. Nous avons comparé les résultats à une étude qui a été faite peu après que les médicaments antirétroviraux furent disponibles en 2004. Ces résultats indiquent une baisse du niveau de stigmatisation du SIDA tout au long d'une année et que les participants qui partageaient le même avis que certains politiciens, avaient plus de chance de montrer un niveau plus élevé de stigmatisation liée au SIDA que ceux qui étaient d'une avis contraire. Néanmoins, cette étude nous averti à ne pas banaliser la relation entre la position du gouvernement sud-africain et les attitudes de stigmatisation du SIDA. Elle suggère que davantage des facteurs politiques et sociaux soient pris en compte pour tenter d'avoir une compréhension profonde de cette relation qui semble complexe.

Keywords:

• HIV/AIDS
• AIDS-related stigma
• South African government
• AIDS debate
• antiretroviral rollout
• Atteridgeville

Mots clés:

• VIH/SIDA
• stigmatisation liée au SIDA
• gouvernement sud-africain
• débat du SIDA
• déploiement des antirétroviraux
• Atteridgeville

Additional information

Notes on contributors

Brian Forsyth

Brian Forsyth is Professor of Pediatrics at Yale University and a Deputy Director of Yale's Center for Interdisciplinary Research on AIDS. Since 2002, Dr Forsyth has collaborated with investigators at the University of Pretoria in conducting the Serithi Project, a multidisciplinary research project focused on addressing the effects of HIV/AIDS on women and children.

Alain Vandormael

Alain Vandormael is an associate fellow of the Department of Sociology at the University of Pretoria. Since 2004 he has been involved with the Serithi project and Yale's Center for Interdisciplinary Research on AIDS (CIRA). His research focuses on the political response of the government and civil society to the AIDS crisis in South Africa.

Trace Kershaw

Trace Kershaw is an Assistant Professor at Yale University School of Public Health. His research focuses on sexual and reproductive health of young couples.

Janis Grobbelaar

Janis Grobbelaar is Professor and Head of the Department of Sociology, University of Pretoria. She has done wide-ranging fieldwork on poverty, development, socio-political transformation, local government, human rights and race and ethnicity in the eastern, western and northern Cape, in the north west, the Free State, Limpopo, Mpumalanga, Gauteng and in Natal. She was seconded to the South Africa Truth and Reconciliation Commission for 2 years and acted as Deputy Provincial Electoral Officer for the Pretoria sub-province on secondment during the 1994 general elections held in Pretoria. She has produced numerous research reports, published a monograph and a number of journal and book articles dealing with South African studies.