TY - JOUR
T1 - ‘Taking care’ in the age of AIDS
T2 - older rural South Africans’ strategies for surviving the HIV epidemic
AU - Angotti, Nicole
AU - Mojola, Sanyu A.
AU - Schatz, Enid
AU - Williams, Jill R.
AU - Gómez-Olivé, F. Xavier
N1 - Funding Information:
This work was supported by the US National Institute on Aging–HIV after 40 in rural South Africa: Aging in the Context of an HIV Epidemic [R01 AG049634] (PI Sanyu Mojola) and Partnership for Social Science AIDS Research in South Africa's Era of ART Rollout [R24 AG032112-05] (PI Jane Menken); the University of Colorado, Innovative Seed Grant, HIV after 40 in rural South Africa (PI Sanyu Mojola); and the William and Flora Hewlett Foundation African Population Research and Training Program [2009-4060] (PI Jane Menken). The MRC/Wits Agincourt Unit is supported by the South African Medical Research Council and the University of the Witwatersrand, as well as the Wellcome Trust, UK [grants 058893/Z/99/A, 069683/Z/02/Z, and 085477/B/08/Z] (PI Stephen Tollman). This work has also benefited from research, administrative, and computing support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development–funded University of Colorado Population Center [P2C HD066613]. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We thank all the respondents who participated in this study. We also thank the Izindaba za Badala field team as well as the people of Agincourt for their long involvement with the AHDSS study. For additional research assistance, we thank Vusimusi G. Dlamini and Laurie Hawkins; for their helpful comments, we thank Mike Bader, Ernesto Castaneda, Vusimusi G. Dlamini, Chodziwadziwa Whiteson Kabudula, Sangeetha Madhavan, Rachel Sullivan Robinson, Randa Serhan, Kirsten Stoebenau, Nina Yamanis, and the anonymous reviewers.
Funding Information:
This work was supported by the US National Institute on Aging – HIV after 40 in rural South Africa: Aging in the Context of an HIV Epidemic [R01 AG049634] (PI Sanyu Mojola) and Partnership for Social Science AIDS Research in South Africa's Era of ART Rollout [R24 AG032112-05] (PI Jane Menken); the University of Colorado, Innovative Seed Grant, HIV after 40 in rural South Africa (PI Sanyu Mojola); and the William and Flora Hewlett Foundation African Population Research and Training Program [2009-4060] (PI Jane Menken). The MRC/Wits Agincourt Unit is supported by the South African Medical Research Council and the University of the Witwatersrand, as well as the Wellcome Trust, UK [grants 058893/Z/99/A, 069683/Z/02/Z, and 085477/B/08/Z] (PI Stephen Tollman). This work has also benefited from research, administrative, and computing support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development–funded University of Colorado Population Center [P2C HD066613]. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/3/4
Y1 - 2018/3/4
N2 - Older adults have been largely overlooked in community studies of HIV in highly endemic African countries. In our rural study site in Mpumalanga Province, South Africa, HIV prevalence among those aged 50 and older is 16.5%, suggesting that older adults are at risk of both acquiring and transmitting HIV. This paper utilises community-based focus-group interviews with older rural South African men and women to better understand the normative environment in which they come to understand and make decisions about their health as they age in an HIV endemic setting. We analyse the dimensions of an inductively emerging theme: ku ti hlayisa (to take care of yourself). For older adults, ‘taking care’ in an age of AIDS represented: (1) an individualised pathway to achieving old-age respectability through the taking up of responsibilities and behaviours that characterise being an older person, (2) a set of gendered norms and strategies for reducing one’s HIV risk, and (3) a shared responsibility for attenuating the impact of the HIV epidemic in the local community. Findings reflect the individual, interdependent and communal ways in which older rural South Africans understand HIV risk and prevention, ways that also map onto current epidemiological thinking for improving HIV-related outcomes in high-prevalence settings.
AB - Older adults have been largely overlooked in community studies of HIV in highly endemic African countries. In our rural study site in Mpumalanga Province, South Africa, HIV prevalence among those aged 50 and older is 16.5%, suggesting that older adults are at risk of both acquiring and transmitting HIV. This paper utilises community-based focus-group interviews with older rural South African men and women to better understand the normative environment in which they come to understand and make decisions about their health as they age in an HIV endemic setting. We analyse the dimensions of an inductively emerging theme: ku ti hlayisa (to take care of yourself). For older adults, ‘taking care’ in an age of AIDS represented: (1) an individualised pathway to achieving old-age respectability through the taking up of responsibilities and behaviours that characterise being an older person, (2) a set of gendered norms and strategies for reducing one’s HIV risk, and (3) a shared responsibility for attenuating the impact of the HIV epidemic in the local community. Findings reflect the individual, interdependent and communal ways in which older rural South Africans understand HIV risk and prevention, ways that also map onto current epidemiological thinking for improving HIV-related outcomes in high-prevalence settings.
KW - Ageing
KW - HIV prevention
KW - community-based focus-group interviews
KW - rural South Africa
KW - ubuntu
UR - http://www.scopus.com/inward/record.url?scp=85025802911&partnerID=8YFLogxK
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U2 - 10.1080/13691058.2017.1340670
DO - 10.1080/13691058.2017.1340670
M3 - Article
C2 - 28741983
AN - SCOPUS:85025802911
SN - 1369-1058
VL - 20
SP - 262
EP - 275
JO - Culture, Health and Sexuality
JF - Culture, Health and Sexuality
IS - 3
ER -