1. Living with HIV
- Labour force participation of people on antiretroviral therapy
- Gender, sexuality and discrimination
- The changing nature of stigma
- Interactions between traditional and biomedical healing systems
2. Drivers of African HIV epidemics
- Social, economic and cultural drivers of the Southern African hyperepidemic
- Male circumcision: policy and practice
3. Political Economy of AIDS
Health Economics and AIDS Research Division (HEARD)
ASRU is currently collaborating with HEARD at the University of KwaZulu-Natal on the fifth wave of the Cape Area Panel Study of young adults in Cape Town. HEARD is funding the survey and sponsoring graduate students to work on socio-economic corellates of HIV infection in the hyperepidemic countries of Southern Africa.
Institute for Development Studies, University of Sussex
Elizabeth Mills (ASRU), Dr Hayley MacGregor (Institude for Development Studies) and Nondumiso Hwlele (Bambanani Women’s Group) worked together to update a series of Body-maps through a project entitled ‘Mapping Change and Continuity: Living with HIV as a Chronic Illness in South Africa’. A set of new narratives were collected in 2008 in order to explore key issues around chronic illness, including gender, biomedicine, psycho-social support and health citizenship. Outcomes of this project include a contribution to the ‘Assembling Bodies’ Exhibition at the Museum of Archaeology and Anthropology, University of Cambridge, and two academic papers jointly published by IDS and ASRU. Visit this website to learn more about the Institute of Development Studies.
- MacGregor, H. & Mills, E. (2009) Mapping Change and Continuity: Living with HIV as a Chronic Illness in South Africa.
University of Cambridge, United Kingdom
In collaboration IDS and the University of Cambridge, a series of Body-maps (created 2003) and new narratives (collected in 2008) were exhibited at the Museum of Archaeology and Anthropology. Visit this website to learn more about the exhibition.
University of Penambuco, Brazil
Elizabeth Mills is collaborating with the Department of Social Development at the University of Penambuco on a comparative project that seeks to explore similarities and differences in civil society and national government’s leadership on HIV treatment, prevention and care.
Grassroots Soccer is an international organisation that seeks to promote HIV education and awareness through soccer. ASRU provides technical advice through the Grassroots Soccer Advisory Board. Visit this website to learn more about Grassroots Soccer.
Research Projects in greater detail
In South Africa, HIV infection is closely correlated with gender, race and class. These intersections are explored through a series of research projects undertaken by scholars and researchers in ASRU.
Research themes within this programme include
- Gendered health seeking behaviour
- Gender and therapeutic citizenship
- Women’s experiences of poverty
- Government, civil society and individual responses to poverty
- Stigma and gender
- Sexual and reproductive health
Stigma has been identified as a key barrier to disclosure, testing and treatment. The introduction of HAART was, in part, promoted as a means to reducing HIV-related stigma as associations of HIV with death would be transformed to highlight hope and the potential for living a long life on HAART. ASRU conducts both qualitative and quantitative research on a stigmatising behaviours and attitudes. Quantitative data is drawn from two longitudinal survey conducted in Khayelitsha. One survey is conducted with a group of HIV-positive people on HAART, and the control survey is conducted with a matched-sample from the general population living in Khayelitsha. The two surveys facilitate comparative and longitudinal analysis on a range of issues, including stigma, employment patterns, sexual behaviour, disclosure and health seeking behaviour. Research themes within this programme include
- Expression and effect of stigma
- Voluntary counselling and testing
- Spatiality and stigma
- Political denial, stigma and disclosure
- Stigma and body-image
South Africa has a rich history of medical pluralism, and therefore researchers need to understand individual and societal responses to HIV across traditional and biomedical healing systems. Given the massive scale of HIV in South Africa, and the importance of supporting both the medical and psycho-social components of health, it is important to engage constructively and collaboratively with both traditional and medical health practitioners. Research on medical pluralism extends to critical engagement on untested remedies that are promoted by quacks who pose as medical experts. This is particularly salient given the history of political equivocation and denial in South Africa and the negative interactions between antiretroviral treatment and untested medicines. Research themes within this programme include:
- Evaluation of collaborative interventions between traditional healers and medical doctors
- Gender, witchcraft and health seeking behaviour
- Science and risk
- Conceptions of illness and healing strategies
A quarter century into the AIDS epidemic, 'AIDS leadership' is increasingly recognised as crucial to sustaining and improving national AIDS responses.However, the notion is difficult to define and the ingredients of good leadership are even more difficult to identify. This is a difficult question to address for three reasons: 1) the qualities of leadership itself are hard to pin down; 2) what is required for successful leadership is highly context-specific (and political); and 3) the challenges imposed on leaders at all levels of society by the AIDS epidemic are multi-facetted and require interventions with regard to both prevention and treatment. In order to get analytical and empirical purchase on this problem, we have largely focused on the specific issue of highly active antiretroviral treatment (HAART) and harness comparative international analysis and detailed case studies of good and bad leadership in this regard. Important research output in this programme include:
- The impact of government leadership on access to ARVs: Nattrass (2008) Government leadership and ARV provision in developing countries.
- Evidence for 'leadership' as a key determinant of HAART and MTCTP coverage: Schwardmann (2008) A cross-country analysis of the determinants of antiretroviral drug coverage; Nattrass (2008) Are country reputations for good and bad leadership on AIDS deserved? An exploratory quantitative analysis.
- Comparative studies of the politics of AIDS leadership: Mauchline (2008) Official government justifications and public ARV provision: a comparison of Brazil, Thailand and South Africa; Grebe (2009) Leaders, networks and coalitions in the AIDS response: A comparison of Uganda and South Africa.
While cross-country analyses and case studies indicate the huge impact of different government approaches on outcomes, it is also becoming clear that civil society mobilisation is a key driver of government leadership. We capture the importance of both government and civil society leadership by defining 'AIDS leadership' as as the mobilisation of broad coalitions for cooperative collective action that involves a broad range of societal actors. An important emerging insight is that the factors affecting the opportunities for such coalitions vary substantially between countries.
Research themes within this programme include:
- Theoretical approaches to civil society leadership on AIDS: Grebe (2008) Networks of influence: A theoretical review and proposed approach to AIDS treatment activism.
- AIDS activism and the politics of AIDS in Africa: Nattrass (2007) Mortal Combat: AIDS denialism and the struggle for antiretrovirals in South Africa; Grebe (2008) Transnational networks of influence in South African AIDS treatment activism; Grebe (2009) Leaders, networks and coalitions in the AIDS response: A comparison of Uganda and South Africa; Mackintosh (2009) The politicisation of HIV/AIDS in South Africa: Responses of the Treatment Action Campaign and South African government, 1994-2004 - A literature review.
- Statistical evidence for a relationship between civil society mobilisation and effective AIDS responses (in progress).