‘Sometimes it is not about men’: Gendered and generational discourses of caregiving HIV transmission in a rural South African setting

摘要

In this paper, we examine a prominent interpretation of HIV risk in a ruralSouth African setting experiencing a severe HIV epidemic well into olderages: the discourse of caregiving HIV transmission. By caregivingtransmission, we refer to HIV infection resulting from caring for familymembers who are living with HIV and may be sick with AIDS-relatedillnesses. We draw on individual life history and community focus groupinterviews with men and women aged 40–80+, as well as interviewswith health workers providing HIV counselling and testing services atlocal health facilities in their communities. We illustrate the social andstrategic role caregiving HIV transmission discourses play in re-signifyingHIV as a sexless infection for older women, thereby promoting HIVtesting as well as blameless acceptance of an HIV diagnosis. We furtherhighlight the role of rural health workers who serve as medicalepistemic bricoleurs, vernacularising global HIV counselling andprevention messages by blending ideas of gender, generation, and locallived experiences and practices so that they resonate with communitynorms, values and understandings. Our study highlights the genderedand generational complexities and challenges experienced by ruralSouth Africans aging in a community over-burdened by an HIV epidemicand AIDS-related mortality.