Abstract
The introduction sets the context and frames the research concern. It highlights the rationale for a focus on human immunodeficiency virus (HIV) in black South African women as a problem of public health and social justice. It offers a broad sketch of relevant debates in policy and in the extant literature, and then locates the work within the lacuna. It articulates the aims and scope of the work, and briefly discusses the theoretical framework used to conceptualise and investigate the research problem: Amartya Sen’s capabilities approach. The final part of the introduction offers a thumbnail sketch of the chapters to come.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
Health science publications typically seek the latest available data. Robust data from low- and middle-income countries (LMIC) settings are not always available, however. Publications cited in this work are those that specifically track, analyse and offer comparative data on key trends in particular population groups in these settings (such as women generally, African women, or young women aged 15–24). These publications may be several years old and still constitute the latest data. Additionally, the key (high-quality) reports cited and released in South Africa, such as the South African National HIV Prevalence , Incidence and Behaviour and Survey and the National Burden of Disease Study for South Africa, are released typically only every 3–5 years. With other works (e.g. on health equity or gender), I am highlighting significant foundational texts or reports, rather than the latest publication dealing with the subject matter. The dearth of data in LMICs, a theme emerging from the Millennium Development Goals (MDGs) that is reaffirmed in this work, has important ethical and equity dimensions: the lack of and poor-quality data in LMICs raise questions concerning who is counted, and thus whose health and lives matter.
- 2.
Race is a social construct . Today, prominent scientists agree that the biological basis of race is so weak as to require cessation in using racial categories in genetics research: ‘Racial categories are weak proxies for genetic diversity and need to be phased out’ (see Gannon, 2016, p. 1). I employ the racial categories here in the South African context, which were socially constructed, had a highly deleterious impact on people’s life chances and experiences for decades (and which continues for many), and are still in use in data collection, in order for redress to occur (see Gutto, 2002; Habib & Bentley, 2008). These are African or black, coloured, white and Asian.
- 3.
The award-winning author, film director and activist Tsitsi Dangarembga created a short film (17 minutes) that powerfully engages the struggles of a rural Zimbabwean woman seeking to care for a vulnerable AIDS (acquired immune deficiency syndrome) orphan, Tabitha, during the Zimbabwean economic crisis. The film underscores the essential role of family and community in sharing the burden of caring for their most vulnerable members, while highlighting the political determinants of health. The Sharing Day can be seen here: http://tve.org/film/the-sharing-day/.
- 4.
Jong-wook (2003), former director general of the World Health Organization (WHO) (2003–2006), first sought to connect the global ‘Health for All’ campaign to the international HIV epidemic and to WHO’s health equity agenda. Before his death, Jong-wook wrote that the most urgent objectives for WHO included the health-related MDGs and the ‘3 by 5’ targets for HIV/AIDS treatment, which aimed to make essential HIV medication accessible to 3 million people, mainly in the poorest countries, by the end of 2005.
References
Alma-Ata Declaration. (1978). Retrieved October 19, 2017, from http://www.who.int/publications/almaata_declaration_en.pdf
Anand, S., Peter, F., & Sen, A. (Eds.). (2004). Public Health, Ethics, and Equity. Oxford: Oxford University Press.
Bartley, M. (2017). Health Inequality: An Introduction to Concepts, Theories and Methods (2nd ed.). Cambridge: Polity.
Bilchitz, D. (2006). The right to health. In S. Woolman & M. Bishop (Eds.), Constitutional Law of South Africa (2nd ed.). Cape Town: Juta Press, Chapter 56A.
Bilchitz, D. (2008). Poverty and Fundamental Rights: The Justification and Enforcement of Socio-Economic Rights. Oxford: Oxford University Press.
Black, D., Morris, J., Smith, C., & Townsend, P. (1980). Inequalities in Health: Report of a Research Working Group. London: Department of Health and Social Security.
Braveman, P. (2006). Health disparities and health equity: Concepts and measurement. Annual Review of Public Health, 27, 167–194.
Braveman, P., & Gruskin, S. (2003). Defining equity in health. Journal of Epidemiology and Community Health, 57(4), 254–258.
Buchmann, E., Mnyani, C., Frank, K., Chersich, M., & McIntyre, J. (2015). Declining maternal mortality in the face of persistently high HIV prevalence in a middle-income country. BJOG, 122(2), 220–227.
Burton, R. (2013). Maternal health: There is cause for optimism. South African Medical Journal, 103(8), 520–521.
Butler, J. (2004). Undoing Gender. New York: Routledge.
CDC. (2017a). Selected National HIV Prevention and Care Outcomes in the United States. [online]. Atlanta: CDC. Retrieved January 15, 2018 from https://www.cdc.gov/hiv/pdf/library/factsheets/cdc-hiv-national-hiv-care-outcomes.pdf
CDC. (2017b). HIV Among Women. [online]. Atlanta: CDC. Retrieved January 15, 2018, from http://www.cdc.gov/hiv/group/gender/women/
CDC. (2018). HIV and AIDS in the United States by Geographic Distribution [online]. Atlanta: CDC. Retrieved January 15, 2018, from https://www.cdc.gov/hiv/statistics/overview/geographicdistribution.html
Connell, R. (1987). Gender and Power: Society, the Person and Sexual Politics. Stanford: Stanford University Press.
Connell, R. (1995). Masculinities. Berkeley: University of California Press.
Coovadia, H., Jewkes, R., Barron, P., Sanders, D., & McIntyre, D. (2009). The health and health system of South Africa: Historical roots of current public health challenges. Lancet, 374(9692), 817–834.
Correa, S., Petchesky, R., & Parker, R. (2008). Sexuality, Health and Human Rights. New York: Routledge.
Dahlgren, G., & Whitehead, M. (1992). Policies and Strategies to Promote Equity in Health. Copenhagen: World Health Organization Regional Office for Europe.
Daniels, N. (1981). Health care needs and distributive justice. Philosophy and Public Affairs, 10(2), 146–179.
Daniels, N. (2008). Just Health: Meeting Health Needs Fairly. Cambridge: Cambridge University Press.
Diderichsen, F., Evans, T., & Whitehead, M. (2001). The social disparities in health. In T. Evans, M. Whitehead, F. Diderichsen, A. Bhuiya, & M. Wirth (Eds.), Challenging Inequities to Health: From Ethics to Action (pp. 12–23). Oxford: Oxford University Press.
Evans, T., Whitehead, M., Diderichsen, F., Bhuiya, A., & Wirth, M. (Eds.). (2001). Challenging Inequities to Health: From Ethics to Action. Oxford: Oxford University Press.
Farmer, P. (1992). AIDS & Accusation, Haiti and the Geography of Blame. Berkeley: University of California Press.
Frenk, J., & Moon, S. (2013). Governance challenges in global health. New England Journal of Medicine, 368, 936–942.
Fried, L., Piot, P., Spencer, H., & Parker, R. (2012). The changing landscape of global public health. Global Public Health, 7(Suppl. 1), S1–S4.
Galvão, J. (2005). Brazil and access to HIV/AIDS drugs: A question of human rights and public health. American Journal of Public Health, 95(7), 1110–1115.
Gannon, M. (2016, February 5). Race is a social construct scientists argue. Scientific American. Retrieved October 25, 2017, from https://www.scientificamerican.com/article/race-is-a-social-construct-scientists-argue/
Giddens, A. (1984). The Constitution of Society. Cambridge: Polity Press.
Goffman, E. (1963). Stigma: Notes on the Management of Spoiled Identity. Englewood Cliffs: Prentice-Hall.
Government of South Africa. (1996). The Constitution of the Republic of South Africa, Act No. 108 of 1996. Cape Town: South Africa.
Government of South Africa. (2015b). Saving Mothers 2011–2013: Sixth Report on the Confidential Enquiries into Maternal Deaths in South Africa. Pretoria: National Department of Health.
Gruskin, S., Mills, E., & Tarantola, D. (2007). History, principles, and practice of health and human rights. Lancet, 370(9585), 449–455.
Gupta, G., Parkhurst, J., Ogden, J., Aggleton, P., & Mahal, A. (2008). Structural approaches to HIV prevention. Lancet, 372, 764–775.
Gutto, S. (2002). Equality and Non-discrimination in South Africa: The Political Economy of Law. Wynberg: David Philip Publishers.
Habib, A., & Bentley, K. (2008). Racial Redress and Citizenship in South Africa. Cape Town: HSRC Press.
Heywood, M. (2003). Preventing mother-to-child HIV transmission in South Africa: Background, strategies and outcomes of the Treatment Action Campaign case against the Minister of Health. South African Journal of Human Rights, 19, 278–280.
Heywood, M. (2009). South Africa’s Treatment Action Campaign: Combining law and social mobilization to realize the right to health. Journal of Human Rights Practice, 1(1), 14–36.
Hogan, M., Foreman, K., Naghavi, M., Ahn, S., Wang, M., Makela, S., et al. (2010). Maternal mortality for 181 countries, 1980–2008: A systematic analysis of progress towards Millennium Development Goal 5. Lancet, 375(9726), 1609–1623.
Human Sciences Research Council. (2015). The People Living with HIV Stigma Index: South Africa 2014. Pretoria: HSRC, South African National AIDS Council, and UNAIDS.
Jewkes, R., Flood, M., & Lang, J. (2015). From work with men and boys to changes of social norms and reduction of inequities in gender relations: A conceptual shift in prevention of violence against women and girls. Lancet, 385, 1580–1589.
Jewkes, R., Levin, J., & Penn-Kekana, L. (2002). Risk factors for domestic violence: Findings from a South African cross-sectional study. Social Science & Medicine, 55, 1603–1617.
Jewkes, R., Martin, L., & Penn-Kekana, L. (2002). Correspondence: The virgin cleansing myth: Cases of child rape are not exotic. Lancet, 359, 711.
Jewkes, R., Penn-Kekana, L., & Rose-Junius, H. (2005). “If they rape me, I can’t blame them”: Reflections on gender in the social context of rape in South Africa and Namibia. Social Science & Medicine, 61, 1809–1820.
Jong-wook, L. (2003). Global health improvement and WHO: Shaping the future. Lancet, 362, 2083–2088.
Kleinman, A. (2004). Ethics and experience: An anthropological approach to health equity. In P. Anand, F. Peter, & A. Sen (Eds.), Public Health, Ethics, and Equity (pp. 269–282). Oxford: Oxford University Press.
Koivusalo, M. (2010). The state of health in all policies (HiAP) in the European Union: Potential and pitfalls. Journal of Epidemiology and Community Health, 64(6), 500–503.
Kontis, V., Bennett, J., Mathers, C., Guangquan, L., Foreman, K., & Ezzati, M. (2017). Future life expectancy in 35 industrialised countries: Projections with a Bayesian model ensemble. Lancet, 389(10076), 1323–1335.
Koplan, J., Bond, T., Merson, M., Reddy, K., Henry, M., Sewankambo, N., et al. (2009). Towards a common definition of global health. Lancet, 373, 1993–1995.
Lancet Editorial. (2014). Women, children, and adolescents: The post-2015 agenda. Lancet, 384, 1159.
Lawn, J., Rohde, J., Rifkin, S., Were, M., Vinod, P., & Chopra, M. (2008). Alma-Ata: Rebirth and revision Alma-Ata 30 years on: Revolutionary, relevant, and time to revitalize. Lancet, 372, 917–927.
Leclerc-Madlala, S. (2008a). Age-disparate and intergenerational sex in Southern Africa: The dynamics of hypervulnerability. AIDS, 22(Suppl. 4), S17–S25.
Leclerc-Madlala, S. (2008b). Intergenerational/age-disparate sex and young women’s vulnerability in Southern Africa. In UNAIDS Technical Meeting on Young Women in HIV Hyper-Endemic Countries of Southern Africa. Muldersdrift, South Africa: UNAIDS.
Leppo, K., Ollla, E., Pena, S., Wismar, M., & Cook, S. (2013). Health in All Policies: Seizing Opportunities, Implementing Policies. Helsinki: Finland Ministry of Social Affairs and Health.
Lima, N. (2007). Public health and social ideas in modern Brazil. American Journal of Public Health, 97, 1168–1177.
Link, B., & Phelan, J. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363–385.
MacNaughton, G., Haigh, F., McGill, M., Koutsioumpas, K., & Sprague, C. (2015). The impact of human rights on universalizing health care in Vermont, USA. Health & Human Rights Journal, 17(2), 83–95.
Mann, J. (1997). Medicine and public health, ethics and human rights. The Hastings Centre Report, 27(3), 6–13.
Marins, J., Jamal, L., Chen, S., Marilisa, B., Hudes, E., Barbosa, A., et al. (2003). Dramatic improvement in survival among adult Brazilian AIDS patients. AIDS, 17, 1675–1682.
Marmot, M. (1998). Improvement of social environment to improve health. Lancet, 351, 57–60.
Marmot, M. (2015). The Health Gap: The Challenge of an Unequal World. London: Bloomsbury.
Marmot, M., & Shipley, M. (2006). Do socioeconomic differences in mortality persist after retirement? 25 year follow up of civil servants from the first Whitehall study. British Medical Journal, 313, 1177–1180.
Merson, M., Black, R., & Mills, A. (2011). Global Health: Diseases, Programs, Systems and Policies (3rd ed.). Burlington: Jones & Bartlett.
Meyersfeld, B. (2003). Reconceptualizing domestic violence in international law. Albany Law Review, 67, 371–426.
Meyersfeld, B. (2008). Domestic violence, health and international law. Emory International Law Review, 22, 61–112.
Moynihan, C. (1998). Theories in health care and research: Theories of masculinity. BMJ, 317, 1072–1075.
Msemburi, W., Pillay-van Wyk, V., Dorrington, R., Neethling, I., Nannan, N., Groenewald, P., et al. (2016). Second National Burden of Disease Study for South Africa: Cause-of-Death Profile for South Africa, 1997–2012. Cape Town: South African Medical Research Council.
Nattrass, N. (2004). The Moral Economy of AIDS in South Africa. Cambridge: Cambridge University Press.
Nussbaum, M. (2000). Women and Human Development: The Capabilities Approach. Cambridge: Cambridge University Press.
Nussbaum, M. (2003). Capabilities as fundamental entitlements: Sen and social justice. Feminist Economics, 9(2–3), 33–59.
Nussbaum, M. (2011). Creating Capabilities. Cambridge: Harvard University Press.
Peter, F. (2004). Health equity and social justice. In S. Anand, F. Peter, & A. Sen (Eds.), Public Health, Ethics, and Equity (pp. 93–106). Oxford: Oxford University Press.
Pogge, T. (2004). Relational conceptions of justice: Responsibilities for health outcomes. In S. Anand, F. Peter, & A. Sen (Eds.), Public Health, Ethics, and Equity (pp. 135–161). Oxford: Oxford University Press.
Rawls, J. (1971). A Theory of Justice. Cambridge, MA: Harvard University Press.
Rawls, J. (1993). Political Liberalism. New York: Columbia University Press.
Robeyns, I. (2003). Capability ethics. In H. LaFollette & I. Persson (Eds.), The Blackwell Guide to Ethical Theory (2nd ed.). New York: Blackwell.
Rosenberg, T. (2001). Drug companies are vincible. The AIDS crisis is solvable. The New York Times Magazine.
Ruger, J. (2004a). Health and social justice. Lancet, 364, 1075–1080.
Ruger, J. (2004b). Ethics of the social determinants of health. Lancet, 364, 1092–1097.
Ruger, J. (2006). Ethics and governance of global health inequalities. Journal of Epidemiological and Community Health, 60, 998–1003.
Ruger, J. (2010). Health and Social Justice. Oxford: Oxford University Press.
Sen, A. (1992). Inequality Re-Examined. Cambridge: Harvard University Press.
Sen, A. (1999). Development as Freedom. New York: Random House.
Sen, A. (2002). Why health equity? Health Economics, 11, 659–666.
Sen, A. (2011). The Idea of Justice. Cambridge: Harvard University Press.
Sen, G., Östlin, P., & George, A. (2007). Unequal, unfair, ineffective and inefficient gender inequity in health: Why it exists and how we can change it. In Report of the Women and Gender Equity Knowledge Network of the Commission on Social Determinants of Health, Final Report to the Commission on Social Determinants of Health. Geneva: WHO.
Sewell, W. (1992). A theory of structure: Duality, agency and transformation. The American Journal of Sociology, 98(1), 1–29.
Shisana, O., Rehle, T., Simbayi, L., Parker, W., Zuma, K., Bhana, A., et al. (2005). South African National HIV Prevalence, Incidence and Communication Survey. Cape Town: HSRC Press.
Shisana, O., Rehle, T., Simbayi, L., Zuma, K., Jooste, S., Pillay-van Wyk, V., et al. (2009). South African National HIV Prevalence, Incidence and Communication Survey, 2008. A Turning Tide Among Teenagers? Cape Town: HSRC Press.
Shisana, O., Rehle, T., Simbayi, L., Zuma, K., Jooste, S., Zungu, N., et al. (2014). South African National HIV Prevalence, Incidence and Behaviour Survey, 2012. Cape Town: HSRC Press.
Smith, K., Bambra, C., & Hill, S. (Eds.). (2015). Health Inequalities: Critical Perspectives. Oxford: Oxford University Press.
Solar, O., & Irwin, A. (2007). A conceptual framework for action on the social determinants of health. Discussion paper for the Commission on Social Determinants of Health (April). Geneva: WHO.
South African National AIDS Council (SANAC). (2014). Progress Report on the National Strategic Plan for HIV, TB and STIs 2012–2016. Pretoria: South African National AIDS Council.
Sprague, C. (2009). Cui Bono: A Capabilities Approach to Understanding HIV 1192 Prevention and Treatment for Pregnant Women and Children in South Africa. 1193 Doctoral thesis, University of the Witwatersrand.
Sprague, C., & Brown, S. (2016). Introduction: Local and global HIV aging demographics and research. In R. DeMarco & M. Brennan-Ing (Eds.), HIV and Aging (pp. 1–10). Basel: S. Karger.
Sprague, C., Scanlon, M., & Pantalone, D. W. (2017b). Qualitative methods to advance research on health inequities among previously incarcerated women living with HIV in Alabama. Health Education & Behavior, 44(5), 716–727.
Sprague, C., & Woolman, S. (2006). Moral luck: Exploiting South Africa’s policy environment for an effective national antiretroviral treatment programme. South African Journal on Human Rights, 22(3), 337–379.
Stats SA. (2016). Mid-Year Population Estimates 2016, Statistical Release P0302. Pretoria: Statistics South Africa.
Stern, D. (2013). Intersubjectivity. In E. Person, A. Cooper, & G. Gabbard (Eds.), The American Psychiatric Publishing Text—Book of Psychoanalysis (pp. 77–92). Arlington, TX: American Psychiatric Publishing.
Stuart, E., & Woodroffe, J. (2016). Leaving no-one behind: Can the sustainable development goals succeed where the millennium development goals lacked? Gender and Development, 24(1), 69–81.
Teixeira, P. (2003). Universal access to AIDS medicines: The Brazilian experience. Divulgaçao em Saúde para Debate, 27, 184–191.
UNAIDS. (2013). HIV and Aging: Special Supplement to the UNAIDS Report on the Global AIDS Epidemic 2013. Geneva: UNAIDS.
UNAIDS. (2014a). 90-90-90: An Ambitious Treatment Target to Help End the AIDS Epidemic. Geneva: UNAIDS.
UNAIDS. (2014b). The Gap Report. Geneva: UNAIDS.
UNAIDS. (2016a). UNAIDS 2016 Estimates. [online]. Geneva: UNAIDS. Retrieved February 8, 2017, from http://www.unaids.org/en/resources/documents/2016/HIV_estimates_with_uncertainty_bounds_1990-2015
UNAIDS. (2016b). UNAIDS 2016 Guidance: HIV Prevention Among Adolescent Girls and Young Women. Putting HIV Prevention Among Adolescent Girls and Young Women on the Fast-Track and Engaging Men and Boys. [online]. Geneva: UNAIDS. Retrieved February 8, 2017, from http://www.unaids.org/sites/default/files/media_asset/UNAIDS_HIV_prevention_among_adolescent_girls_and_young_women.pdf
UNAIDS. (2016c). Global AIDS Update 2016. Geneva: UNAIDS.
UN Office of the Special Adviser on Gender Issues and the Advancement of Women. (2001). Important concepts underlying gender mainstreaming: Concepts and definitions. Retrieved June 16, 2017, from http://www.un.org/womenwatch/osagi/conceptsandefinitions.htm
Vearey, J. (2010). The persistent urban challenges of migration and informal settlements in the context of HIV. Doctoral thesis, University of the Witwatersrand, Johannesburg, South Africa.
Venkatapuram, S. (2011). Health Justice. Cambridge: Polity Press.
Walensky, R., Paltiel, A., & Losina, E. (2006). The survival benefits of AIDS treatment in the United States. Journal of Infectious Diseases, 194(1), 11–19.
Whitehead, M. (1990). The Concepts and Principles of Equity in Health. Copenhagen: WHO Regional Office for Europe.
Whitehead, M. (1992). The concepts and principles of equity in health. International Journal of Health Services, 22(3), 429–435.
Wikler, D. (2004). Personal and social responsibility for health. In S. Anand, F. Peter, & A. Sen (Eds.), Public Health, Ethics, and Equity (pp. 109–134). Oxford: Oxford University Press.
Woolman, S. (2008). Constitutional Law of South Africa (2nd ed.). Cape Town: Juta Press.
Woolman, S., & Sprague, C. (2015). Nowhere to run, nowhere to hide: The absence of public policy as to how health care professionals should address intimate partner violence constitutes a breach of the rights to health and bodily integrity under the South African Constitution. Cardozo Journal of Law & Gender, 22(1), 29–74.
WHO. (1988). WHO: From Small Beginnings, Interview with Dr Szeming Sze. World Health Forum, 9, 29–34. Retrieved October 19, 2017, from http://apps.who.int/iris/bitstream/10665/46414/1/WHF_1988_9_1_p29-34.pdf
WHO. (2010). A Conceptual Framework for Action on the Social Determinants of Health. Discussion Paper 2: Debates, Policy and Practice. Geneva: WHO. Retrieved June 10, 2017, from http://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf
WHO (2014a). Women’s health. Fact sheet number 334 (September). Retrieved May 30, 2017, from http://www.who.int/mediacentre/factsheets/fs334/en/
WHO. (2014b). World Health Statistics, 2014. Geneva: WHO.
Yang, L. H., Kleinman, A., Link, B. G., Phelan, J. C., Lee, S., & Good, B. (2007). Culture and stigma: Adding moral experience to stigma theory. Social Science & Medicine, 64(7), 1524–1535.
Author information
Authors and Affiliations
Copyright information
© 2018 The Author(s)
About this chapter
Cite this chapter
Sprague, C. (2018). Introduction. In: Gender and HIV in South Africa. Global Research in Gender, Sexuality and Health. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-137-55997-5_1
Download citation
DOI: https://doi.org/10.1057/978-1-137-55997-5_1
Published:
Publisher Name: Palgrave Macmillan, London
Print ISBN: 978-1-137-55996-8
Online ISBN: 978-1-137-55997-5
eBook Packages: Social SciencesSocial Sciences (R0)