‘If the doctors see that they don't know how to cure the disease, they say it's AIDS’: How older women in rural South Africa make sense of the HIV/AIDS epidemic

Abstract

South Africa, like other sub-Saharan African countries, is in the midst of the AIDS epidemic. Older women, here defined as aged 60 years and older, while at lower risk of infection than those aged 20-50, are amongst those deeply 'affected' by the epidemic. In rural areas, older women, who have always played central roles in social reproduction in South African households and families, bear the brunt of care giving for the sick and dying. For this reason, it is important to explore how these women understand the epidemic. In South Africa, the prominence of traditional healers and medicine alongside biomedicine has led to multiple ways of perceiving, explaining and treating illness. This paper explores the various discourses older women in rural South Africa employ to make sense of the HIV/ AIDS epidemic in their daily lives. The aim is to better understand how these women construct the epidemic and how this knowledge can be used to benefit education and treatment endeavours in similar contexts. This paper draws on interview data collected as part of the Gogo Project conducted in the Medical Research Council (MRC)/Wits Rural Public Health and Health Transitions Research Unit. Sixty women between the ages of 60 and 75 years living in the rural Agincourt sub-district participated in three in-depth, semi-structured interviews. The respondents in this study relied on a variety of discourses to make sense of the HIV/AIDS epidemic. They displayed a high level of knowledge based on biomedical education, however, they expressed ideas, often simultaneously, that seemed to contradict this education. Their ability to employ seemingly contradictory discourses represents the need to place the epidemic within familiar 'explanatory models' that are based on these women's life experiences and local knowledge.

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