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  • Title: Prevention implications of AIDS discourses among South African women.
    Author: Strebel A.
    Journal: AIDS Educ Prev; 1996 Aug; 8(4):352-74. PubMed ID: 8874652.
    Abstract:
    Social constructionist and feminist analyses have done much to extend the understanding of AIDS beyond the biomedical to include social accounts of the constitution of AIDS knowledge and meanings. However, these frameworks have not translated easily into realistic responses to the paradox of women being seen as responsible for HIV prevention, while they lack the power to implement safe sex behavior. This study explores the range and interplay of discursive themes which South African women drew on regarding AIDS and identifies constraints and opportunities for realistic prevention. The research involved 14 focus group discussions with women. Two main interpretative repertoires regarding AIDS were identified from the texts: one concerning the medicalization and the other the stigmatization of the disease. Although these representations were not unchallenged, the pervasive sense was of denial of own risk, fear, and fatalism. However, the analysis highlighted the complexity of issues to be faced in developing effective prevention initiatives. In African countries, where women lack social status and access to economic resources, gendered power relations can increase their vulnerability to acquired immunodeficiency syndrome (AIDS). To further understanding of how South African women experience AIDS, 14 focus groups with a total of 95 participants were conducted. Two main AIDS-related themes emerged: medicalization and stigmatization. Women spoke of AIDS as a grave, infectious, and incurable epidemic. This medical discourse served to reinforce an image of medical professionals as experts with the power to develop preventive strategies for the general population. Notable was a lack of reference to traditional conceptions of health and illness -- a phenomenon that further distanced AIDS from the realm of common experience. Also evident was an association of AIDS with sexual promiscuity and a tendency to stigmatize its victims. AIDS was perceived as a traumatic, shameful event that would lead infected persons to withdraw from traditional sources of social support. High levels of fear of AIDS resulted in increased denial of risk and fatalism about any potential for curbing the epidemic. Most participants did not consider themselves or their partners at risk; AIDS was viewed as a disease that affects prostitutes, injecting drug users, homosexuals, and Whites. Charges of racial discrimination were prominent in the discussions, and past government campaigns to curb South Africa's Black population fostered suspicion of condom use promotion.
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