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HIV/AIDS in South Africa 25 Years On pp 221–235Cite as

Strengthening Community Responses to AIDS: Possibilities and Challenges

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Abstract

Many AIDS programmes in sub-Saharan Africa have had disappointing results (Gregson et al., 2007), with HIV rates continuing to rise, stigma remaining stubbornly resistant to change, and access and adherence to treatment and support remaining inconsistent. Other interventions have worked well in carefully controlled research conditions, but these have been difficult to scale up in less highly monitored ‘real-world’ settings (Binswanger, 2000; Chopra and Ford, 2005; Greig et al., 2008). One key reason for the less-than-optimal outcome of many programmes is that they fail to resonate with the worldviews and perceived needs and interests of their target groupings, or to take adequate account of the complex social relations into which programmes are inserted (Gruber and Caffrey, 2005; Pfeiffer, 2003). Too many programmes are imposed on communities in ‘top-down’ ways by outside experts. In such settings, target communities are seen as passive recipients of prevention, care and treatment services rather than active participants working in partnership with health professionals to improve their health (Campbell, 2003).

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References

  • Bak, M. (2004). Can development social work change an unfair world? The South African experience. International Social Work, 47(1), 81–94.

    Article  Google Scholar 

  • Barnett, T., and Whiteside. A. (2006). AIDS in the twenty-first century: Disease and globalization. (2nd Ed.) Basingstoke: Palgrave MacMillan.

    Google Scholar 

  • Barron, P., Day, C., and Monticelli, F. (2007). The district health barometer – Year 2006/07.Durban, South Africa: Health Systems Trust.

    Google Scholar 

  • Binswanger, H. (2000). Scaling up HIV/AIDS programs to National coverage. Science, 288, 2173–2176.

    Article  PubMed  CAS  Google Scholar 

  • Campbell, C. (1997). Migrancy, masculine identities and AIDS: The psychosocial context of HIV transmission on the South African gold mines. Social Science and Medicine, 45(2), 273–281.

    Article  PubMed  CAS  Google Scholar 

  • Campbell, C. (2003). ‘Letting Them Die’: Why HIV/AIDS programmes fail. Oxford: James Currey.

    Google Scholar 

  • Campbell, C., and Foulis, C. (2004). Creating contexts for effective home-based care of people living with HIV/AIDS. Curationis, 27(3), 5–14.

    Article  PubMed  CAS  Google Scholar 

  • Campbell, C., and Gibbs, A. (2008a). Facilitating HIV/AIDS ‘Empowerment’ programmes within traditional authority structures: Experiences from Southern Africa. Submitted.

    Google Scholar 

  • Campbell, C., and Gibbs, A. (2008b). Representations of HIV/AIDS management in South African newspapers. African Journal of AIDS Research,7(2), 195–208.

    Article  Google Scholar 

  • Campbell, C., and Nhamo, M. (2008). Community readiness for interventions: a Zimbabwean case study. Submitted.

    Google Scholar 

  • Campbell, C., Nair, Y., and Maimane, S. (2007a). Building contexts that support effective community responses to HIV/AIDS: A South African case study. American Journal of Community Psychology,39, 347–363.

    Article  PubMed  Google Scholar 

  • Campbell, C., Nair, Y., and Maimane, S. (2007b) ‘Dying Twice’: A multi-level model of the roots of AIDS stigma in two South African communities. Journal of Health Psychology,12(3), 403–416.

    Article  PubMed  Google Scholar 

  • Campbell, C., Gibbs, A., Maimane, S., and Nair, Y. (2008a). Hearing community voices: grassroots perceptions of an intervention to support health volunteers in South Africa. SAHARA–Journal of Social Aspects of HIV/AIDS Research Alliance, 5(4), 162–177.

    Article  Google Scholar 

  • Campbell, C., Gibbs, A., Maimane, S., and Nair, Y. (2008b). What do young people want? Mismatches between youth aspirations and participatory HIV/AIDS programmes in South Africa. Submitted.

    Google Scholar 

  • Campbell, C., Gibbs, A., Nair, Y., and Maimane, S. (2008c). Frustrated potential, false promises or complicated possibilities? empowerment and participation amongst female health volunteers in South Africa. Journal of Health Management., Forthcoming.

    Google Scholar 

  • Campbell, C., Nair, Y., Maimane, S., and Sibiya, Z. (2008d). Supporting people with AIDS and their carers in rural South Africa: possibilities and challenges. Health and Place, 14(3), 507–518.

    Article  PubMed  Google Scholar 

  • Campbell, C., Nair, Y., Maimane, S., Sibiya, Z., and Gibbs, A. (2008e). Dissemination as intervention’: building local AIDS competence through the report-back of research findings to a deep rural community in South Africa. Antipode. Accepted for publication.

    Google Scholar 

  • Campbell, C., Gibbs, A., Nair, Y., and Maimane, S. (2009). Youth Participation in the Fight Against AIDS: From policy to practice. Journal of Youth Studies. 12(1), 93–109.

    Google Scholar 

  • Chopra, M., and Ford, N. (2005). Scaling up health promotion interventions in the era of HIV/AIDS: challenges for a rights based approach. Health Promotion International,20, 383–390.

    Article  PubMed  Google Scholar 

  • Coetzee, D., Boulle, A., Hildebrand, K., Asselman, V., Van Cutsem, G., and Goemaere, E. (2004). Promoting adherence to antiretroviral therapy: the experience from a primary care setting in Khayelitsha, South Africa. AIDS, 18, S27–S31.

    Article  PubMed  Google Scholar 

  • Cornish, F., and Ghosh, R. (2007). The necessary contradictions of ‘community-led’ health promotion: A case study of HIV prevention in an Indian red light district. Social Science and Medicine, 64(2), 496–507.

    Article  PubMed  Google Scholar 

  • Evans, P. (1996). Government action, social capital and development: reviewing the evidence on synergy. World Development, 24(6), 1119–1132.

    Article  Google Scholar 

  • Farr, R.M., and Moscovici, S. (1984). Social Representations. Cambridge: Cambridge University Press.

    Google Scholar 

  • Freire, P. (1970). The Pedagogy of the Oppressed. Harmondworth: Penguin.

    Google Scholar 

  • Freire, P. (1973). Education for Critical Consciousness. New York: Continuum.

    Google Scholar 

  • Gregson, S., Adamson, A., Papaya, S., Chimbadzwa, T., Mundondo. J, Nyamukapa, C. et al. (2007). Impact and process evaluation of integrated community and clinic-based HIV-1 control: a cluster-randomised trial in eastern Zimbabwe. PLoS Medicine,4(3), 0545-0555.

    Article  Google Scholar 

  • Greig, A., Peacock, D., Jewkes, R., and Msimang, S. (2008). Gender and AIDS: time to act. AIDS, 22, S35-S43.

    Article  PubMed  Google Scholar 

  • Gruber, J., and Caffrey, M. (2005). HIV/AIDS and community conflict in Nigeria: implications and challenges. Social Science and Medicine, 60(6), 1209–1218.

    Article  PubMed  Google Scholar 

  • Hadley, M., and Maher, D. (2001). Community involvement in tuberculosis control: lessons from other health care programmes. International Journal of Tuberculosis and Lung Disease, 5(5), 489–490.

    Google Scholar 

  • Habermas, J. (1992). Further reflections on the public sphere. In C. Calhoun (Ed.), Habermas and the public sphere. (pp. 421–461). Cambridge, Massachusetts: The MIT Press.

    Google Scholar 

  • Jovchelovitch, S. (2001). Social representations, public life and social construction. In K. Deaux and G. Philogéne (Ed.), Representations of the Social. (pp. 165–182). Oxford: Blackwell.

    Google Scholar 

  • Low-Beer, D., and Stoneburner, R. (2004). AIDS communication through social networks: catalyst for behaviour changes in Uganda. African Journal of AIDS Research, 3(1), 1–13.

    Article  Google Scholar 

  • Maimane, S., Campbell, C., Nair, Y., and Sibiya, Z. (2004). The role of volunteer community health workers in a rural setting. Monduzzi Editore (Ed), Proceedings of the XV International AIDS Conference. Bangkok, 2004.

    Google Scholar 

  • Mqadi, N. (2007). External evaluation of the community responses to HIV/AIDS Project. Durban, South Africa: HIVAN.

    Google Scholar 

  • Nair, Y., and Campbell, C. (2008). Building partnerships to support community-led HIV/AIDS management: a case study from rural South Africa. African Journal of AIDS Research, 7(1), 45–53.

    Article  Google Scholar 

  • Ogden, J., Esim, S., and Grown, C. (2006). Expanding the care continuum for HIV/AIDS: bringing carers into focus. Health Policy and Planning,21(5), 333–342.

    Article  PubMed  Google Scholar 

  • Pfeiffer, J. (2003). International NGOs and primary health care in Mozambique: the need for a new model of collaboration. Social Science and Medicine, 56(4), 725–738.

    Article  PubMed  Google Scholar 

  • Poku, N., and Sandkjaer, B. (2007). Meeting the challenges of scaling up HIV/AIDS treatment in Africa. Development in Practice, 17(2), 279–290.

    Article  Google Scholar 

  • Schneider, H., Hlophe, H., and van Rensberg, D. (2008). Community health workers and the response to HIV/AIDS in South Africa: tensions and prospects. Health Policy and Planning, 23(3), 179–187.

    Article  PubMed  Google Scholar 

  • Seedat, M. (2001). Community Psychology: theory, method and practice – South African and other perspectives. Oxford: Oxford University Press.

    Google Scholar 

  • Segall, M. (2003). District health systems in a neoliberal world: a review of five key areas. International Journal of Health Planning Management, S5–S26.

    Google Scholar 

  • South African Government (2007). HIV and AIDS and STI strategic plan for South Africa, 2007–2011. Pretoria: South African Government.

    Google Scholar 

  • Spivak, G.C. (1988). Can the Subaltern Speak? In C. Nelson and L. Grossberg, (Ed.), Marxism and the interpretation of culture. (pp. 271–313). Urbana: University of Illinois Press.

    Google Scholar 

  • Tawil, O., Verster, A., and O’Reilly, K. (1995). Enabling approaches for HIV/AIDS prevention: can we modify the environment and minimise the risk? AIDS, 9, 1299–1306.

    Article  PubMed  CAS  Google Scholar 

  • UNGASS (2001). UNGASS declaration: Global crisis – global action. UN, New York

    Google Scholar 

  • Van Damme, W., Kober, K., and Laga, M. (2006). The real challenges for scaling up ART in sub-Saharan Africa. AIDS, 20, 653–656.

    Article  PubMed  Google Scholar 

  • van Wyk, B., Strebel, A., Peltzer, K., and Skinner, D. (2006). Community-level behavioural interventions for HIV prevention in Sub-Saharan Africa. Cape Town: HSRC Press.

    Google Scholar 

  • Woolcock, M. (1998). Social capital and economic development: towards a theoretical synthesis and policy framework. Theory and Society, 27, 151–208.

    Article  Google Scholar 

Download references

Acknowledgments

We thank Professor Eleanor Preston-Whyte and Debbie Heustice of HIVAN for enabling this research. Zweni Sibiya was involved in many of our early discussions of this work, and his input to our collective views is gratefully acknowledged. Thanks also to Kerry Scott for insightful comments on the first draft.

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Authors and Affiliations

  1. London School of Economics, University of London, London, UK

    Catherine Campbell

  2. University of KwaZulu-Natal, Natal, South Africa

    Yugi Nair

  3. Centre for HIV/AIDS Networking (HIVAN) at the University of KwaZulu-Natal., Natal, South Africa

    Sbongile Maimane

  4. Health Economics and HIV/AIDS Research Division (HEARD) at the University of KwaZulu-Natal., KwaZulu Natal, South Africa

    Andrew Gibbs

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  1. Catherine Campbell
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  2. Yugi Nair
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  3. Sbongile Maimane
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  4. Andrew Gibbs
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Editors and Affiliations

  1. Revelstoke Road 12, London, SW18 5PD, United Kingdom

    Poul Rohleder

  2. Springer Science + Business Media, Spring St. 233, New York, 10013, New York, USA

    Leslie Swartz

  3. Center for HIV Intervention and, Prevention, University of Connecticut, Hillside Road 206, Storrs, 06269, Connecticut, USA

    Seth C. Kalichman

  4. Plain Park Bldg, 13th Fl 69-83, Cape Town, 8001, South Africa

    Leickness Chisamu Simbayi

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Campbell, C., Nair, Y., Maimane, S., Gibbs, A. (2009). Strengthening Community Responses to AIDS: Possibilities and Challenges. In: Rohleder, P., Swartz, L., Kalichman, S., Simbayi, L. (eds) HIV/AIDS in South Africa 25 Years On. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0306-8_15

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  • DOI: https://doi.org/10.1007/978-1-4419-0306-8_15

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