This second edition of the book provides up-to-date information on new drugs, new proven HIV prevention interventions, a new chapter on positive prevention, and current HIV epidemiology. This definitive text covers all aspects of HIV/AIDS in South Africa, from basic science to medicine, sociology, economics and politics. It has been written by a highly respected team of South African HIV/AIDS experts and provides a thoroughly researched account of the epidemic in the region.

South Africa has the world's largest number of people living with HIV. This book offers a history of AIDS activism in South Africa from its origins in gay and anti-apartheid activism to the formation and consolidation of the Treatment Action Campaign (TAC), including its central role in the global HIV treatment access movement.

Few people realize that the familiar HIV/AIDS global statistics are actually estimates. For example, UNAIDS estimated that the Republic of South Africa had 140,000 HIV/AIDS deaths in 1997. However, after tabulating all deaths for 1997, the Republic of South Africa attributed only 6,635 deaths to HIV/AIDS. Such discrepancies are rarely noted. The Republic of South Africa (RSA) stands as the exemplar of these discrepancies, and is reputed to have the world's largest AIDS epidemic with an estimated 5.6 million people living with HIV/AIDS (PLWH) in 2008. Such PLWH estimates, as with the estimates of HIV/AIDS deaths, are highly questionable. The reasons behind these discrepancies are clarified by describing two common misunderstandings of HIV infection that contribute to poor mathematical modeling outcomes. Unfortunately, the health authorities in the Republic of South Africa grant more validity to computer-generated estimates than to their own empirical death counts. The author discusses why these modeled estimates, and the HIV sero-prevalence surveys upon which they are based, are simply implausible. Presented with full references are raw numerical data on: the tabulated number of HIV/AIDS deaths in the RSA; the number of AIDS cases detected by RSA disease surveillance systems; UNAIDS/WHO estimates for AIDS deaths in the RSA; and UNAIDS/WHO estimates for the number of people living with HIV/AIDS in the RSA. The total cumulative HIV/AIDS cases in the United States and Africa are also presented for comparison, and to place the African and RSA data within appropriate epidemiological context. Overall, these data span from 1981 to 2009. Altogether, these data, plus additional information detailing the nature of HIV infection and heterosexual HIV transmission rates, explain why the hyperbolic mathematical estimates and HIV antibody test surveys - the primary sources of HIV/AIDS data in Africa - are simply implausible.

Why are more women than men in South Africa HIV positive? What explains the exponential growth of AIDS in the country? How is HIV/AIDS understood in various cultural belief systems? What can be done about the epidemic? This powerful book -- incorporating evocative photographs and the voices of scholars, practitioners, and victims of the epidemic -- looks at the social, cultural, and historical aspects of HIV/AIDS in South Africa. -- Back cover.

The HIV/AIDS pandemic striking South Africa is of historic proportions. More people are living with AIDS in South Africa than in any other country in the world. Just in the past decade, the life expectancy in South Africa has dropped from 67 to 43 years. The social and economic impact of this disease is hard to overstate. However, what is striking is the paucity of thoughtful, reflective scholarship and writing on the subject. AIDS and South Africa: The Social Expression of a Pandemic addresses the economic, social and cultural impact of HIV/AIDS as it relates to South African society.

HIV/AIDS is a catastrophe globally but nowhere more so than in sub-Saharan Africa, which in 2008 accounted for 67 percent of cases worldwide and 91 percent of new infections. The Institute of Medicine recommends that the United States and African nations move toward a strategy of shared responsibility such that these nations are empowered to take ownership of their HIV/AIDS problem and work to solve it.

In this book, France's leading medical anthropologist takes on one of the most tragic stories of the global AIDS crisis—the failure of the ANC government to stem the tide of the AIDS epidemic in South Africa. Didier Fassin traces the deep roots of the AIDS crisis to apartheid and, before that, to the colonial period. One person in ten is infected with HIV in South Africa, and President Thabo Mbeki has initiated a global controversy by funding questionable medical research, casting doubt on the benefits of preventing mother-to-child transmission, and embracing dissidents who challenge the viral theory of AIDS. Fassin contextualizes Mbeki's position by sensitively exploring issues of race and genocide that surround this controversy. Basing his discussion on vivid ethnographical data collected in the townships of Johannesburg, he passionately demonstrates that the unprecedented epidemiological crisis in South Africa is a demographic catastrophe as well as a human tragedy, one that cannot be understood without reference to the social history of the country, in particular to institutionalized racial inequality as the fundamental principle of government during the past century.

In the years since the end of apartheid, South Africans have enjoyed a progressive constitution, considerable access to social services for the poor and sick, and a booming economy that has made their nation into one of the wealthiest on the continent. At the same time, South Africa experiences extremely unequal income distribution, and its citizens suffer the highest prevalence of HIV in the world. As Archbishop Desmond Tutu has noted, “AIDS is South Africa’s new apartheid.” In Ancestors and Antiretrovirals, Claire Laurier Decoteau backs up Tutu’s assertion with powerful arguments about how this came to pass. Decoteau traces the historical shifts in health policy after apartheid and describes their effects, detailing, in particular, the changing relationship between biomedical and indigenous health care, both at the national and the local level. Decoteau tells this story from the perspective of those living with and dying from AIDS in Johannesburg’s squatter camps. At the same time, she exposes the complex and often contradictory ways that the South African government has failed to balance the demands of neoliberal capital with the considerable health needs of its population.

Much has happened since the first appearance of AIDS in 1981: it has been identified, studied, and occasionally denied. The virus has shifted host populations and spread globally. Medicine, the social sciences, and world governments have joined forces to combat and prevent the disease. And South Africa has emerged as ground zero for the pandemic. The editors of HIV/AIDS in South Africa 25 Years On present the South African crisis as a template for addressing the myriad issues surrounding the epidemic worldwide, as the book brings together a widely scattered body of literature, analyzes psychosocial and sexual aspects contributing to HIV transmission and prevention, and delves into complex intersections of race, gender, class, and politics. Including largely overlooked populations and issues (e.g., prisoners, persons with disabilities, stigma), as well as challenges shaping future research and policy, the contributors approach their topics with rare depth, meticulous research, carefully drawn conclusions, and profound compassion. Among the topics covered: The relationship between HIV and poverty, starting from the question, "Which is the determinant and which is the consequence?" Epidemiology of HIV among women and men: concepts of femininity and masculinity, and gender inequities as they affect HIV risk; gender-specific prevention and intervention strategies. The impact of AIDS on infants and young children: risk and protective factors; care of children by HIV-positive mothers; HIV-infected children. Current prevention and treatment projects, including local-level responses, community-based work, and VCT (voluntary counseling and testing) programs. New directions: promoting circumcision, vaccine trials, "positive prevention." South Africa’s history of AIDS denialism. The urgent lessons in this book apply both globally and locally, making HIV/AIDS in South Africa 25 Years On uniquely instructive and useful for professionals working in HIV/AIDS and global public health.

Current data and trends in morbidity and mortality for the sub-Saharan Region as presented in this new edition reflect the heavy toll that HIV/AIDS has had on health indicators, leading to either a stalling or reversal of the gains made, not just for communicable disorders, but for cancers, as well as mental and neurological disorders.