‘Sometimes it is not about men’: gendered and generational discourses of caregiving HIV transmission in a rural South African setting.
Date
2022-12
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Abstract
In this paper, we examine a prominent interpretation of HIV risk in a rural South African
setting experiencing a severe HIV epidemic well into older ages: the discourse of caregiving
HIV transmission. By caregiving transmission, we refer to HIV infection resulting from caring
for family members who are living with HIV and may be sick with AIDS-related illnesses. We
draw on individual life history and community focus group interviews with men and women
ages 40-84, as well as interviews with health workers providing HIV counselling and testing
services at local health facilities in their communities. We illustrate the social and strategic role
caregiving HIV transmission discourse plays in re-signifying HIV as a sexless infection for older
women, thereby promoting HIV testing as well as blameless acceptance of an HIV diagnosis.
We further highlight the role of rural health workers who serve as medical epistemic bricoleurs,
vernacularizing global HIV counselling and prevention messages by blending ideas of gender,
generation, and local lived experiences and practices so that they resonate with community norms,
values, and understandings. Our study highlights the gendered and generational complexities and
challenges experienced by rural South Africans aging in a community over-burdened by an HIV
epidemic and AIDS-related mortality.
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Keywords
Caregiving; HIV transmission; older women; rural South Africa