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Health Outcomes and Social Factors Influencing Women’s HIV Acquisition in Social Context

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Gender and HIV in South Africa

Part of the book series: Global Research in Gender, Sexuality and Health ((GRGSH))

Abstract

This chapter moves from empirical to normative considerations in three parts. Part one considers the magnitude of HIV in black South African women. Despite recent gains, the evidence base indicates that black South African women have high HIV-related premature mortality and lower life expectancy at birth, relative to South African women of other race groups and to women in other settings, internationally. Part two engages with the complex set of factors that underpin high HIV risk and transmission among this population, spanning social and biological factors. It frames the debates concerning women’s constrained agency; and reviews the latest evidence. Taken together, health outcomes and social factors affecting this population paint a stark portrait of HIV’s deleterious long-term effects on black South African women’s health. Part three begins to apply normative considerations of health and social justice to the empirical evidence, concluding that reliance on a single information source in assessing justice in health (such as health outcomes) misleads, thus necessitating engagement with additional bases of information and evidence.

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Notes

  1. 1.

    Led each time by Dr Olive Shisana of the HSRC . For the methodology and other details of the survey, see Shisana et al. (2014).

  2. 2.

    When I refer to the ‘population’ or ‘group’ (a public health convention), I am referring to black or African South African women. When I refer to the ‘study population’ I am referring to the group of women studied in the empirical investigation (design and methods described in Chap. 5, and findings presented in Chap. 6), and described in detail in Box 2.1.

  3. 3.

    The emphasis on the individual in public health control efforts has been criticised by anthropologists and sociologists because it assumes that individuals have full and free agency, and it considers individual behaviour outside of the full composition of social, economic, political and cultural forces that shape behaviour (Gupta et al., 2008; Parkhurst, 2014). All people engage in sexual practices and relationships rooted within social contexts and gender norms situated within larger social systems and institutions that comprise the gendered social order.

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  1. University of Massachusetts, Boston, USA

    Courtenay Sprague

  2. University of the Witwatersrand, Johannesburg, South Africa

    Courtenay Sprague

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Sprague, C. (2018). Health Outcomes and Social Factors Influencing Women’s HIV Acquisition in Social Context. In: Gender and HIV in South Africa. Global Research in Gender, Sexuality and Health. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-137-55997-5_2

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