The Sociocultural Aspects of HIV/AIDS in South Africa

  • Suzanne Leclerc-Madlala
  • Leickness C. Simbayi
  • Allanise Cloete


In 2005 the Commission for Africa noted that ‘Tackling HIV and AIDS requires a holistic response that recognises the wider cultural and social context’ (p. 197). Cultural factors that range from beliefs and values regarding courtship, sexual networking, contraceptive use, perspectives on sexual orientation, explanatory models for disease and misfortune and norms for gender and marital relations have all been shown to be factors in the various ways that HIV/AIDS has impacted on African societies (UNESCO, 2002). Increasingly the centrality of culture is being recognised as important to HIV/AIDS prevention, treatment, care and support. With culture having both positive and negative influences on health behaviour, international donors and policy makers are beginning to acknowledge the need for cultural approaches to the AIDS crisis (Nguyen et al., 2008).


Male Circumcision African Society African Culture Concurrent Partner Young Wife 
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  1. Abdool-Karim, Q., Abdool-Karim, S., Soldan, K., and Zondi, M. (1995). Reducing the risk of HIV infection among South African sex-workers: socioeconomic and gender barriers. American Journal of Public Health, 85(11), 1511–1525.Google Scholar
  2. AIDS Weekly (2001). In Africa, stigma blocks treatment – even talk – of AIDS. Available:
  3. Bagnol, B., and Mariano, E. (2008). Vaginal practices: eroticism and implications for women’s health and condom use in Mozambique. Culture, Health and Sexuality, 10(6), 573–585.PubMedCrossRefGoogle Scholar
  4. Baleta, A. (1999). Concern voiced over ‘dry sex’ practices in South Africa. The Lancet, 352, 1292.CrossRefGoogle Scholar
  5. Beksinska, M.E., Rees, H.V., Kleinschmidt, I., and McIntyre, J. (1999). The practice and prevalence of dry sex among men and women in South Africa: a risk factor for sexually transmitted infections? Sexually Transmitted Infections, 75, 178–180.PubMedCrossRefGoogle Scholar
  6. Byakika-Tusiime, J. (2008). Circumcision and HIV infection: assessment of causality. AIDS and Behaviour, 12(6), 835–841.CrossRefGoogle Scholar
  7. Caldwell, J. C., Caldwell, P., and Quiggin, P. (1994). The social context of AIDS in sub-Saharan Africa. In Orubuloye et al. (Ed.), Sexual networking and AIDS in sub-saharan Africa: Behavioural research and the social context (pp. 129–161). Canberra: Australian National University Printing Service for the Health Transition Centre.Google Scholar
  8. Campbell, T. (1997). How can psychological theory help to promote condom use in sub-Saharan developing countries? Journal of the Royal Society of Health, 117(3), 186–191.PubMedCrossRefGoogle Scholar
  9. Connolly, C., Simbayi, L.C., Shanmugam, R., and Mqeketo, A. (2008). Male circumcision and its relationship to HIV infection in South Africa: Results from a national survey in 2002. South African Medical Journal, 98(10), 789–794.PubMedGoogle Scholar
  10. Department of Health (2007). HIV, AIDS and STIs National strategic plan on for South Africa, 2007–2011. Pretoria: Department of Health.Google Scholar
  11. Eaton, L., Flisher, A.J., and Aarø, L. (2003). Unsafe sexual behaviour in South African youth. Social Science and Medicine, 56, 149–165.PubMedCrossRefGoogle Scholar
  12. Fisher, J.C., Bang, H., and Kapiga, S.H. (2007). The association between HIV infection and alcohol use: A systematic review and meta-analysis of African studies. Sexually Transmitted Diseases, 34, 856–863.PubMedCrossRefGoogle Scholar
  13. Garuba, H., and Raditlhalo, S. (2008). Culture. In N. Shepherd and S. Robins (Ed.), New South African Keywords. Jacana/Johannesburg: Ohio University Press/Athens.Google Scholar
  14. Gorringe T (2004). Furthering Humanity: A Theology of Culture. Aldershot, UK: Ashgate Publishing Ltd.Google Scholar
  15. Grieser, M., Gittelsohn, J., Shankar, A.V., Koppenhaver, T., Legrand, T.K., Marindo, R., Mavhu, W.M., and Hill, K. (2001). Reproductive decision-making and the HIV/AIDS epidemic in Zimbabwe. Journal of Southern African Studies, 27(2), 225–243.CrossRefGoogle Scholar
  16. Halperin, D.T., and Epstein, H. (2007). Why is HIV prevalence so severe in Southern Africa? The role of multiple concurrent partnerships and lack of male circumcision: Implications for AIDS prevention. The Southern African Journal of HIV Medicine, 8(1), 19–25.Google Scholar
  17. Hammond-Tooke, W.D. (Ed.), (1974). The Bantu-Speaking Peoples of Southern Africa. Johannesburg: Routledge & Kegan Paul.Google Scholar
  18. Hopa, M., Simbayi, L.C., and Du Toit, C. (1998). Perceptions on integration on traditional and western healing in the new South Africa. South African Journal of Psychology, 28(1), 8–14.Google Scholar
  19. Jewkes, R., and Abrahams, N. (2000). Violence Against Women in South Africa: Rape and Sexual Coercion.Review Study for Crime Prevention Research Resources Centre. Johannesburg: Medical Research Council.Google Scholar
  20. Johnston, A.G. (2001). Twelve Key Messages on HIV/AIDS, A Briefing Paper to US Ambassadors in Africa. The Policy Project Report prepared for the US Agency for International Development.Google Scholar
  21. Kalichman, S.C., Simbayi, L.C., Kaufman, M., Cain, D., and Jooste, S. (2007). Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: Systematic review of empirical findings. Prevention Science, 8, 141–151.PubMedCrossRefGoogle Scholar
  22. Kalichman, S.C., Simbayi, L.C., Vermaak, R., Jooste, S., and Cain, D. (2008). HIV/AIDS risks among men and women who drink at informal alcohol serving establishments (shebeens) in Cape Town, South Africa. Prevention Science, 9, 55–62.PubMedCrossRefGoogle Scholar
  23. Kiene, S.M, Simbayi, L.C., Abrams, A., Cloete, A., Tennen, H., and Fisher, J.D. (2007) High Rates of Unprotected Sex occurring among HIV-Positive Individuals in a Daily Diary Study in South Africa: The Role of Alcohol Use . JAIDS, 49 (2), 219–226.Google Scholar
  24. Lachenicht, L.G. (1993). A sceptical argument concerning the value of a behavioural solution for AIDS. South African Journal of Psychology, 23(1), 15–20.Google Scholar
  25. Leclerc-Madlala, S. (2002). On the virgin cleansing myth: gendered bodies, AIDS and ethnomedicine. African Journal of AIDS Research, 1, 87–95.CrossRefGoogle Scholar
  26. Leclerc-Madlala, S. (2008). Age-disparate and intergenerational sex in Southern Africa: The dynamics of Hypervulnerability. AIDS, 22, 1–9.CrossRefGoogle Scholar
  27. Lesetedi, G.N. (1999). HIV/AIDS and the status of women in Botswana. In K.R. Hope Sr. (Ed.), AIDS and Development in Africa (pp. 47–57). New York: Haworth Press.Google Scholar
  28. Levin, R.J. (2005). Science Update – wet and dry sex – the impact of cultural influence in modifying vaginal function. Sexual and Relationship Therapy, 20(4), 465–474.CrossRefGoogle Scholar
  29. Louria, D.B., Skurnick, J.H., Palumbo, P., Bogdon, J.D., Rohowsky – Kochan, C., Denny, T.N., and Kennedy, C.A. (2000). HIV heterosexual transmission: A hypothesis about an additional potential determinant. International Journal of Infectious Diseases, 4(2), 110–116.PubMedCrossRefGoogle Scholar
  30. Macphail, C., and Campbell, C. (2001). ‘I think condoms are good but, aai, I hate those things’: condom use among adolescents and young people in a Southern African township. Social Science and Medicine, 52, 1613–1627.PubMedCrossRefGoogle Scholar
  31. Mah, T.L., and Halperin, D.T. (2008). Concurrent sexual partnerships and the HIV epidemic in Africa: evidence to move forward. AIDS and Behaviour. doi: 10.1007/s10461 -008-9433-x.Google Scholar
  32. McKerrow, N. (2000). At Risk Groups. Paper presented at Second Annual HIV/AIDS Conference. Pietermaritzburg, University of KwaZulu-Natal.Google Scholar
  33. Meyer-Weitz, A., Reddy, P., Weijtz, W., van den Borne, B., and Kok, G. (1998). The sociocultural contexts of sexually transmitted diseases in South Africa: Implications for health education programmes. AIDS Care, 10, s39–s55.PubMedCrossRefGoogle Scholar
  34. Morar, N. S., Ramjee, G., Gouws, E., and Wilkinson, D., (2003) Vaginal douching and vaginal substance use among sex workers in Kwazulu-Natal, South Africa. South African Journal of Science, 99, 371–374.Google Scholar
  35. Morojele, N.K., Kachieng, M.A., Mokoko, E., Nkoko, M.A., Parry, C.H.D., Nkowane, A.M., Moshia, K.M., and Saxena, S. (2005). Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Social Science and Medicine, 62, 217–227.PubMedGoogle Scholar
  36. Mzimkulu, K.G., and Simbayi, L.C. (2006). An investigation of perspectives and practices of Xhosa-speaking African traditional healers when managing psychoses. International Journal of Disability, Development and Education, 53(4), 417–431.CrossRefGoogle Scholar
  37. Nielsen, M.F., Resnick, C.A., and Acuda, S.W. (1989). Alcoholism among outpatients of a rural district general hospital in Kenya. British Journal of Addiction, 84, 1343–1351.PubMedCrossRefGoogle Scholar
  38. Nguyen, V.-K., Klot, J. Phillips, A., and Pirkle, C. (2008) Culture, HIV & AIDS: An Annotated Bibliography. Paris: UNESCO.Google Scholar
  39. Nxumalo, M. (1999). Women’s health, sociocultural practices, and HIV/AIDS in Swaziland. In K.R. Hope Sr. (Ed.), AIDS and Development in Africa (pp. 59–68). New York: Haworth Press.Google Scholar
  40. Parry, C.D.H., Myers, B., Morojele, N.K., Flisher, A.J., Bhana, A., Donson, H., and Plüddemann, A. (2004). Trends in adolescent alcohol and other drug use: Findings from three sentinel sites in South Africa (1997–2001). Journal of Adolescence, 27, 429–440.PubMedCrossRefGoogle Scholar
  41. Patta, D. (2008). Teen Drug Abuse. Third Degree Television Programme. E-TV, 01 October 2008.Google Scholar
  42. Pattman, R. (2001). The beer drinkers say I had a nice prostitute, but the church goers talk about things spiritual: learning to be a men at a teachers’ college in Zimbabwe. In R. Morrell (Ed.), Changing Men in Southern Africa (pp. 225–238). Pietermaritzburg: University of Natal Press.Google Scholar
  43. Peltzer, K, Niang, C.I., Muula, A.S., Bowa, K., Okeke, L., Boiro, H., & Chimbwete, C. (2007). Editorial review: male circumcision, gender and HIV prevention in sub-Saharan Africa: a (social science) research agenda, Journal of Social Aspects of HIV/AIDS Research Alliance, 4(3), 658–667.PubMedCrossRefGoogle Scholar
  44. Pettifor, A.E., Measham, D.M., Rees, H.V., and Padian, N.S. (2004). Sexual power and HIV risk, South Africa. Emerging Infectious Diseases, 10(11), 1996–2004.PubMedCrossRefGoogle Scholar
  45. Petros, G., Collins O. A., Simbayi, L.C., Ramlagan, S., and Brown, B. (2006). HIV/AIDS and ‘othering’ in South Africa: The blame goes on. Culture, Health & Sexuality, 8(1), 67–77.CrossRefGoogle Scholar
  46. Qwana, E., Mkaya-Mwamburi, D., Lurie, M., & Mthembu, A. (2001). An analysis of reasons for wanting and not wanting to disclose HIV status. South African AIDS Information Dissemination Service News, 8(3), 5.Google Scholar
  47. Rankin, W.W., Brennan, S., Schell, E., Laviwa, J., & Rankin, S.H. (2005). The stigma of being HIV- positive in Africa. PLoS Medicine, 2(8), e247.PubMedCrossRefGoogle Scholar
  48. Rehle, T., Shisana, O., Pillay, V., Zuma, K., Puren, A., and Parker, W. (2007). National HIV incidence measures—new insights into the South African epidemic. South African Medical Journal, 97(3), 194–199.PubMedGoogle Scholar
  49. SADC (2006). Expert Think Tank Meeting on HIV Prevention in High Prevalence Countries. Meeting Report, May. Gaborone: SADC HIV and AIDS Unit.Google Scholar
  50. Schoepf, B.G. (1995). Culture, sex research and AIDS Prevention in Africa. In H. Brummelhuis and G. Herdt (Ed.), Culture and Sexual Risk: Anthropological Perspectives on AIDS (pp. 29–51). Routledge: Taylor & Francis Group.Google Scholar
  51. Shisana, O., Rehle, T., Simbayi, L.C., Parker, W., Zuma, K., Bhana, A., Connoly, C., Jooste, S., Pillay, V., et al. (2005). South African National HIV Prevalence, HIV Incidence, Behaviour and Communicatioin Survey. Cape Town: HSRC Press.Google Scholar
  52. Shell, R.C.H., and Zeitlin, R. (2000). Positive outcomes: The chances of acquiring HIV/AIDS during school going years in the Eastern Cape, 1990–2000. Social Work Practitioner – Researcher, 12(3), 139–154.Google Scholar
  53. Siyam’kela Project. (2003). Siyam’kela: A Report on the Fieldwork Leading to the Development of HIV/AIDS Stigma Indicators and Guidelines. Prepared by Insideout Research for Policy Project, South Africa; Centre for the study of AIDS, University of Pretoria; United States Agency for International Development; and Chief Directorate: HIV, AIDS & TB, Department of Health. Retrieved September 25, 2006, from
  54. Skinner, D., and Mfecane, S. (2004). Stigma, discrimination and the implications for people living with HIV/AIDS in South Africa. Journal of the Social Aspects of HIV/AIDS Research Alliance, 1(3), 157–164.CrossRefGoogle Scholar
  55. Strydom, H. (2000).The knowledge base of high school pupils in the North West Province on HIV/AIDS. Social Work practitioner – Researcher, 12(3), 195–207.Google Scholar
  56. The Commission for Africa (2005). Our Common Interest: Report of the Commission for Africa. London: The Commission for Africa.Google Scholar
  57. Ulin, P.R. (1992). African women and AIDS: negotiating behavioural change. Social Science and Medicine, 34(1), 63–73.PubMedCrossRefGoogle Scholar
  58. UNAIDS (2006). Collaborating with Traditional Healers for HIV Prevention and Care in Sub-Saharan Africa: Suggestions for Programme Managers and Field Workers. Geneva: UNAIDS.Google Scholar
  59. UNAIDS (2007). AIDS Epidemic Update – December 2007. Geneva: UNAIDS.Google Scholar
  60. UNECA (2008). Securing our Future: Report of the Commission on HIV/AIDS and Governance in Africa. New York: UNECA.Google Scholar
  61. UNESCO/UNAIDS (2002). A Cultural Approach to HIV/AIDS Prevention and Care: Summary of Country Assessments. Division of Cultural Policies, Paris: UNESCO.Google Scholar
  62. Van Dyk, A. (2001). HIV/AIDS Care and Counselling: A Multidisciplinary Approach. Cape Town: Pearson Education.Google Scholar
  63. Varga, C. (1997). Sexual decision making and negotiations in the midst of AIDS: youth in KwaZulu-Natal. Health Transition Review, 7(2), 13–40.Google Scholar
  64. Versteeg, M.F., and Murray, M. (2008). Condom use as part of the wider HIV prevention strategy: experiences from communities in the North West Province, South Africa. Journal of the Social Aspects of HIV/AIDS Research Alliance, 5(2), 83–93.CrossRefGoogle Scholar
  65. Vincent, L. (2008). ‘Boys will be boys’: Traditional Xhosa male circumcision, HIV and sexual socialisation in contemporary South Africa. Culture, Health & Sexuality, 10(5), 431–446.CrossRefGoogle Scholar
  66. Wechsberg, W.M., Luseno, W. K., and Lam, W.K. (2005). Violence against substance-abusing South African sex workers: Intersection with culture and HIV risk, AIDS Care, 17, S55–S64.PubMedCrossRefGoogle Scholar
  67. Westercamp, N., and Bailey, R.C. (2007). Acceptability of male circumcision for prevention of HIV/AIDS in sub-Saharan Africa: A review. AIDS & Behaviour, 11, 341–355.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Suzanne Leclerc-Madlala
    • 1
  • Leickness C. Simbayi
    • 2
  • Allanise Cloete
    • 3
  1. 1.University of KwaZulu-NatalNatalSouth Africa
  2. 2.Stellenbosch UniversityStellenboschSouth Africa
  3. 3.Health Research programme of the Human Sciences Research Council in Cape TownCape TownSouth Africa

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