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.
Similar content being viewed by others
REFERENCES
Bernard, H. R. (1995). Research methods in anthropology: Qualitative and quantitative approaches. Walnut Creek, CA: AltaMira Press.
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 Biology, culture, and cognitive disability: 20th century professional discourse in Brazil and the United States, Unpublished doctoral dissertation.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.
Buckley, P. F. (1999). Sexuality and serious mental illness. Amsterdam: Harwood Academic.
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.
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.
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.
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.
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.
Gould, S. J. (1981). The mismeasure of man. New York: W. W. Norton.
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.
Larson, E. J. (1996). Sex, race, and science: Eugenics in the Deep South. Baltimore: Johns Hopkins University Press.
Marais, H. (2000). To the edge: AIDS review. Pretoria: University of Pretoria.
Maxwell, J. (1996). Qualitative research design: An interactive approach. Thousand Oaks, CA: Sage.
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.
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.
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.
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.
Swartz, S. (1995a). Colonizing the insane: Causes of insanity in the Cape, 1891-1920. History of the Human Sciences, 8, 39-57.
Swartz, S. (1995b).The black insane in the Cape, 1891-1920. Journal of Southern African Studies, 21, 399-415.
Swartz, S. (1999). “Work of mercy and necessity”: British rule and psychiatric practice in the Cape. International Journal of Mental Health, 28, 72-90.
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.
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.
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.
Wyatt, G. E. (1997). Stolen women: Reclaiming our sexuality, taking back our lives. New York: J.Wiley Press.
UNAIDS (2000). Report on the global HIV/AIDS epidemic. Geneva: Joint United Nations Programme on HIV/AIDS, June.
Author information
Authors and Affiliations
Rights 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
Issue Date:
DOI: https://doi.org/10.1023/A:1011331028450