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Living with death in a time of AIDS: A rural South African case study

Wits Institute for Social and Economic Research (WISER), University of the Witwatersrand, South Africa, poseld{at}wiser.wits.ac.za

Kathleen Kahn

MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa

Liz Walker

Wits Institute for Social and Economic Research (WISER), University of the Witwatersrand, South Africa, University of Hull, UK

Aims: To examine how a rural community profoundly affected by escalating rates of largely AIDS-related deaths of young and middle-aged people makes sense of this phenomenon and its impact on their everyday lives. Methods: Data were collected in Agincourt subdistrict, Limpopo Province. Twelve focus groups were constituted according to age and gender and met three times (a total of 36 focus-group discussions [FGDs]). The FGDs explored sequentially people's expectations of their lives in the ``new'' South Africa, their interpretations of the acceleration of death amongst the young and middle-aged, and their understandings of HIV/AIDS. Discussions were recorded, fully transcribed, and thematically analysed. Results: Respondents acknowledged escalating death rates in their community, yet few referred directly to HIV/AIDS as the cause. Rather, respondents focused on the social and cultural causes of death, including the erosion of cultural norms and traditions such as cultural taboos on sex. There are many competing versions of what HIV/AIDS is, what causes it and how it is spread, ranging from scientific explanations to conspiracy theories. Findings highlight the relationship between AIDS and other traditional diseases with some respondents suggesting that AIDS is a new form of other longstanding illnesses. Conclusions: This study points to the centrality of cultural explanations in understanding ``bad death'' (AIDS death) in the Agincourt area. Physical illness is understood to be a symptom of ``cultural damage''. Implications of this for public health practice and research are outlined.

Key Words: Culture • death • generation • HIV/AIDS illness • indigenous health beliefs • public health • rural • sex • South Africa

Scandinavian Journal of Public Health, Vol. 35, No. 69 suppl, 138-146 (2007)
DOI: 10.1080/14034950701356443


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