Skip to main content
Log in

Dual Taboos: Sexuality and Women with Severe Mental Illness in South Africa. Perceptions of Mental Health Care Providers

  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

The AIDS epidemic in South Africa is among the fastest growing in the world. While much of the population is at risk for infection, marginalized groups such as women with severe mental illness (SMI) are often neglected in prevention efforts. A qualitative study of mental health care providers' perceptions of HIV risk and sexuality among women with SMI was conducted in four provinces of South Africa. Semistructured qualitative interviews explored providers' views on the impact of mental illness on sexuality and reproductive health for women with SMI. Providers described their perceptions of the role of psychiatric symptoms in sexual behavior, the kinds of sexual behavior engaged in, and the quality of sexual relationships for women with SMI. Providers prioritized family planning and prevention of pregnancy for women with SMI over HIV prevention. The findings suggest that mental health care providers' ambivalence about sexual expression in women with SMI may be a barrier to complete care as well as effective HIV prevention for this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Bernard, H. R. (1995). Research methods in anthropology: Qualitative and quantitative approaches. Walnut Creek, CA: AltaMira Press.

    Google Scholar 

  • Block, P. (1997). Biology, culture, and cognitive disability: 20th century professional discourse in Brazil and the United States, Unpublished doctoral dissertation. Durham, NC: Duke University.

    Google Scholar 

  • Buckley, P. F. (1999). Sexuality and serious mental illness. Amsterdam: Harwood Academic.

    Google Scholar 

  • Chapman, A. R., and Rubinstein, L. S. (1998). Human rights and health: The legacy of Apartheid. New York: American Association for the Advancement of Science.

    Google Scholar 

  • Dartnall, E., Modiba, P., Porteus, K., and Lee, T. (1999). Is deinstitutionalization appropriate? Johannesburg, South Africa: Mental Health Programme, Centre for Health Policy, University of the Witswatersrand.

    Google Scholar 

  • Department of Health (1999). National HIV seroprevalence survey of women attending public antenatal clinics in South Africa, summary report. Health Systems Research & Epidemiology, Feb.

  • Dikotter, F. (1998). Imperfect conceptions: Medical knowledge, birth defects and eugenics in China. NewYork: Columbia University Press.

    Google Scholar 

  • Foster, D., and Swartz, S. (1997). Introduction: Policy considerations. In D. Foster, M. Freeman, and Y. Pillay (Eds.), Mental health policy issues for South Africa (pp. 1-22). Pinelands 7430, South Africa: Medical Association of South Africa Multimedia Publications.

    Google Scholar 

  • Freeman, M., and Pillay, Y. (1997). Mental health policy-Plans and funding. In D. Foster, M. Freeman, and Y. Pillay (Eds.), Mental health policy issues for South Africa (pp. 32-53). Pinelands 7430, South Africa: Medical Association of South Africa Multimedia Publications.

    Google Scholar 

  • Gould, S. J. (1981). The mismeasure of man. New York: W. W. Norton.

    Google Scholar 

  • Jeter, J. (2000). Mbeki vs. AIDS experts. Washington Post Foreign Service, May 16, p. A01.

  • Kevles, D. J. (1995). In the name of eugenics: Genetics and the uses of human heredity. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Larson, E. J. (1996). Sex, race, and science: Eugenics in the Deep South. Baltimore: Johns Hopkins University Press.

    Google Scholar 

  • Marais, H. (2000). To the edge: AIDS review. Pretoria: University of Pretoria.

    Google Scholar 

  • Maxwell, J. (1996). Qualitative research design: An interactive approach. Thousand Oaks, CA: Sage.

    Google Scholar 

  • McKinnon, K. A., Cournos, F., Sugden, R., Guido, J. R., and Herman, R. (1996). The relative contributions of psychiatric symptoms and AIDS knowledge to HIV risk behaviors among people with severe mental illness. Journal of Clinical Psychiatry, 57, 506-513.

    Google Scholar 

  • Mossman, D., Perlin, M. L., and Dorfman, D. A. (1997). Sex on the wards: Conundra for clinicians. Journal of the American Academy of Psychiatry and the Law, 25, 441-460.

    Google Scholar 

  • Omer-Cooper, J. D. (1999). South Africa-Recent history. In Europa Publications Staff (Eds.), Africa south of the Sahara: 1999, 28th ed. (pp. 974-991). London: Europa.

    Google Scholar 

  • Stefan, S. (1995). “Dancing in the sky without a parachute”: Sex and love in institutional settings. In C. Sundram (Ed.), Choice and responsibility (pp. 219-243). Albany, NY: New York Commission on Quality of Care for the Mentally Disabled.

    Google Scholar 

  • Swartz, S. (1995a). Colonizing the insane: Causes of insanity in the Cape, 1891-1920. History of the Human Sciences, 8, 39-57.

    Google Scholar 

  • Swartz, S. (1995b).The black insane in the Cape, 1891-1920. Journal of Southern African Studies, 21, 399-415.

    Google Scholar 

  • Swartz, S. (1999). “Work of mercy and necessity”: British rule and psychiatric practice in the Cape. International Journal of Mental Health, 28, 72-90.

    Google Scholar 

  • Weinberg, J. K. (1988). Autonomy as a different voice: Women, disabilities, and decisions. In M. Fine and A. Asch (Eds.), Women with disabilities: Essays in psychology, culture, and politics (pp. 269-295). Philadelphia: Temple University Press.

    Google Scholar 

  • Welch, S. J., Clements, G. W., and Moreau, M. E. (1999). Developing and implementing a policy for consensual sex between inpatients. In P. F. Buckley (Ed.), Sexuality and serious mental illness (pp. 75-109). Amsterdam: Harwood Academic.

    Google Scholar 

  • Wood, K., Maforah, F., and Jewkes,R. (1998).”Heforcedmeto love him”: Putting violence on adolescent sexual health agendas. Social Science and Medicine, 47, 233-242.

    Google Scholar 

  • Wyatt, G. E. (1997). Stolen women: Reclaiming our sexuality, taking back our lives. New York: J.Wiley Press.

    Google Scholar 

  • UNAIDS (2000). Report on the global HIV/AIDS epidemic. Geneva: Joint United Nations Programme on HIV/AIDS, June.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Collins, P.Y. Dual Taboos: Sexuality and Women with Severe Mental Illness in South Africa. Perceptions of Mental Health Care Providers. AIDS Behav 5, 151–161 (2001). https://doi.org/10.1023/A:1011331028450

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1011331028450

Navigation