Public Secrets and Private Sufferings in the South African AIDS Epidemic

by Jonathan Stadler

Overview

This book tells the story of the HIV epidemic in South Africa, and asks why, after more than three decades, it has not normalised. Despite considerable efforts to prevent infection, and ambitious targets set to end the epidemic by 2030, HIV infections are increasing among young women and treatment uptake and adherence have been uneven. Focusing on the years preceding and following treatment access, this book addresses why an end to AIDS may be misplaced optimism. By examining public discourses and private narratives about infection, illness and death, this work reveals the contradictions between the lived experiences of AIDS suffering on the one hand, and biomedical certainties on the other. Based on long-term ethnographic research in rural villages of the South African lowveld, and within HIV prevention interventions in South Africa more generally, this book offers an intimate perspective on the social and cultural responses to the epidemic.

Product Details

ISBN-13:	9783030694371
Publisher:	Springer-Verlag New York, LLC
Publication date:	04/26/2021
Series:	Social Aspects of HIV , #6
Sold by:	Barnes & Noble
Format:	eBook
File size:	472 KB

About the Author

Jonathan Stadler is Associate Professor at the Department of Anthropology, University of Johannesburg. An anthropologist with almost 20 years of research experience in rural and urban southern Africa, his research interests are epidemics and syndemics, social suffering, sexuality, biotechnologies, clinical trials, and the application of anthropological methods in medical research. Stadler has pursued these themes over the past two decades in several linked long term ethnographic studies in rural (Bushbuckridge) and urban settings (Mombasa, Orange Farm, Soweto, inner-city Johannesburg). He has worked on five large-scale international clinical trials for HIV prevention, and several smaller studies, of innovative biotechnologies. He is co-author of Negotiating Pharmaceutical Uncertainty: Women’s Agency in a South African HIV Prevention Trial (2017 Vanderbilt University Press) and Off-Label: AIDS Review 2012 (Centre for the Study of AIDS, University of Pretoria), and more than 40 peer reviewed articles.

Table of Contents

Chapter 1. Ending AIDS: An “Epidemic of ARVs”.- Chapter 2. Culture and Difference: From Medical Mission to HIV Prevention.- Chapter 3. Truth and Harm: Dangerous Knowledge and Popular Epidemiologies of HIV.- Chapter 4. Intentional Infections: Public Discourses of HIV Spread.- Chapter 5. Revenge and Remembering: Idioms and Accusations of Witchcraft and AIDS.- Chapter 6. Hope and Loss: Illness Narratives from the Margins.- Chapter 7. Death and Dying: Narrating the End of Life.- Chapter 8. Conclusions.

Editorial Reviews

Reviewer: Anna A Helm, BS, MPH (Multnomah County)
Description: This cultural history of the AIDS epidemic in Brushbuckridge, South Africa, explores the impact of the almost exclusive focus on medical treatment as the solution to HIV spread and the pharmaceuticalization of the epidemic and the resulting lack of attention to the social and economic contexts of the infection and consequent death. It then discusses the emergence of an "AIDS industry" that includes university research centers, NGOs, and community organizations that provide palliative care and HIV prevention and community development projects, all of which provide employment. It also discusses the availability of ART, the consequences of its availability, and the community perceptions of both ART and HIV.
Purpose: The purpose is to explore whether the almost exclusive focus on a pharmaceutical solution to the HIV epidemic might have made HIV invisible and seem irrelevant, allowing the structural forces and inequities that are fundamental to understanding and preventing the spread of HIV to be ignored.
Audience: Those working in public health, health promotion, social work, and international development, as well as teachers, students, and administrators of relevant programs will find this book very interesting. Funding entities and those monitoring implementation of HIV-related programs also will find it useful.
Features: The author traces the history of medicine in the area, from missionary medicine to current models, and describes how some of those early perceptions have carried over into current ideologies of HIV prevention. The book discusses the place rumor and witchcraft played in the epidemic and how they impacted relationships and perceptions of death and dying from HIV.
Assessment: As an exploration of the cultural history of the HIV epidemic in a specific geographical area, this book points out how essential it is that local culture and social norms be recognized and taken into account when health promotion programs are being developed or medical care offered, whether for an HIV epidemic or a COVID-19 pandemic.

Doody's Review Service

In his brilliant and timely contribution, Public Secrets and Private Sufferings in the South African AIDS Epidemic, Jonathan Stadler proves that medical anthropology has a unique ability to dig below, to challenge and complicate the powerful yet often homogenising discourses of public health and biomedical science. … This book is highly recommended … . Public health scholars and practitioners, students of development studies, policymakers and anyone interested in understanding our complex country will find this a valuable and engaging read.” (Andrew Hartnack, Anthropology Southern Africa, May 6, 2022)

From the Publisher