UNAIDS's Technical Support Facility for South Asia (TSF SA), Nepal
Australian and New Zealand Journal of Public Health
Volume 36, Issue 2, page 197,April 2012
HIV/AIDS in South Africa
By Salim Karim and Quarraisha Karim . Published by Cambridge University Press , Cape Town , South Africa , September 2005 , Paperback , 590 pages , plus index , ISBN 9780521147934 , RRP $165.95
This edited volume covers almost all aspects of HIV and AIDS in southern Africa. It has been written by a highly-respected team of South African HIV experts, mostly in the field of biomedical sciences, and provides a thoroughly researched account of the epidemic in the region. The book comprises seven sections and 35 articles, the first of which covers the numbers behind the epidemic; both in terms of evolution and in the current state. Sections following this include: the science of the virus, its structure, diagnosis and spread; HIV risk factors and prevention strategies, focal population groups and the impact of AIDS in all aspects of South African life. The final sections examine treatment of AIDS, the politics of AIDS, mathematical modelling and a discussion on the future of HIV and AIDS in South Africa.
Nelson Mandela's forward to this book is fitting. He hopes and trusts this book is a `call to action'.
This well-edited book should be read by HIV and AIDS policy makers, activists, academics, public health administrators and students who want to understand more about biomedical response to the HIV and AIDS pandemic in South Africa. This book may also be of interest for Australians involved in international health and development issues in general and particularly working on development issues in Africa. Although this book does not challenge or break new grounds of our knowledge about HIV and AIDS in South Africa, this is a timely and much-needed resource which brings a vast array of knowledge together, covering most of the critical issues in one edition.
The language and the information presented is more or less accurate and sensitive to the unique circumstance of HIV and AIDS. However, the authors should have been aware of some of the contemporary usage of terms. For instance, Chapter 14 of the book has been titled `Intravenous Drug Use'. Instead of using this word, the chapter author could have used the words `Injecting Drug Use', or simply `People who Inject Drugs'. For some reason, the 2nd edition of this book omitted Chapter 33 of the first edition, `A litany of errors post 1994' by Nawaal Deane.
To become a definitive textbook for all aspects of HIV and AIDS in South Africa, as claimed by the publisher, the editors should have added additional chapters on social determinants of HIV infection and social, political and structural response to HIV infection in South Africa. While the introductory chapter made an effort to describe "South Africa's response to AIDS epidemic", it lost the analytical rigor as it was attempted to be written from a biomedical perspective.
AIDS response is increasingly analysed as a transnational social movement, based on the premise of health and access to treatment – which are basic human rights. South African HIV and AIDS activists have contributed significantly to this movement.
Similarly, while Section Three attempts to address `HIV risk factors and prevention strategies' and to cover `HIV vulnerability', the authors are preoccupied with individual risk behaviours rather than looking into deeper aspects of structurally derived vulnerability of people who are infected, affected and likely to be affected by HIV/AIDS.
Section Four attempts to develop a discussion on `focal groups for understanding HIV epidemic', covering heterosexual transmission, young people, female sex workers and migrant population, however, the absent discussion of HIV infection among men who are having sex with men is conspicuous.
A comprehensive discussion on HIV epidemic in South Africa needs a detailed analysis on the HIV and AIDS policies, legal, structural and political dimension of the epidemic, preferably analysed and contributed by authors with backgrounds in the social sciences and public health.
South Africa has a complex `law and order' problem and an entrenched epidemic of HIV. Therefore, this book could also have explored this interaction, the interdisciplinary insights on the connections between law and order, human security and the HIV epidemic. An analysis of gender and rights perspective is yet another critical omission.
South Africa has made great strides in the response to HIV epidemic; however, there are numerous challenges to addressing operational obstacles and fully implementing proven strategies. Therefore, a chapter on facing the programmatic (technical support/capacity development) challenges created by the HIV/AIDS epidemic in South Africa would have been appropriate to include.
Overall, this book is a valuable and timely contribution to a growing body of scholarship in the clinical, epidemiological and social contexts of AIDS response in South Africa. If the editors could incorporate a section on social determinants and social context of AIDS response in South Africa in the next edition, the book would provide a more comprehensive understanding about HIV pandemic and the response to contain this pandemic in South Africa and across the globe
Truth resides in every human heart, and one has to search for it there, and to be guided by truth as one sees it. But no one has a right to coerce others to act according to his own view of truth. - Mohandas Gandhi
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