South Africa News Reports 2005-06

washingtonpost.com
http://www.washingtonpost.com/wp-dyn/articles/A7822-2005Jan13.html

January 14, 2005

1
In South Africa, Stigma Magnifies Pain of AIDS-Many Still See Disease as Fatal, Shameful

by Craig Timberg
Soweto, South Africa - The very moment he learned he had contracted HIV, Sibusiso Mlangeni said he got his first taste of the stigma that comes with it. "You've been messing around," the nurse at the AIDS clinic scolded him. "You are HIV-positive."

The words delivered a wallop of shock and shame for Mlangeni, 28, who had a steady girlfriend and hardly considered himself promiscuous. But the nurse's comment, made one year ago, hinted at what lay ahead as news of the diagnosis spread.

His father, a retired security guard who had badgered Mlangeni about losing too much weight, declared, "You are going to die." His sister, a nurse, asked Mlangeni not to stand near her. Soon he was given his own set of dishes, a crude but common reaction from families under the false impression that HIV can spread through casual contact.

"I had my own special plate," said Mlangeni, a volunteer at a hospice in this sprawling township outside Johannesburg. His bright, ready smile tightened into a grimace as he recalled his feelings of rejection. "I had my own special cup. I had my own special blanket, everything."

Last week, in announcing that his eldest son had died of complications of AIDS, Nelson Mandela urged South Africans to stop treating the disease as a sickness for which "people will go to hell and not to heaven."

The announcement by Mandela, the former president and a national icon, was a highly public attempt to fight the stigma that has accompanied AIDS across South Africa, hampering both testing and timely treatment of the disease, even as it has become the country's top killer, with 1,000 people a day dying from its ravages, according to the United Nations.

The message, like appeals made by other regional leaders in the past few years, was greeted with relief by people suffering from the affliction. Yet many interviewed in recent days said they were still treated as contaminated sinners by neighbors, friends and their own families. Some are ordered to use separate toilets or to wash outside. Others are banished.

A study of 144 HIV patients at two Johannesburg hospitals found that 38 percent had not told a single family member that they had HIV, and 21 percent had not told their sexual partners. One in 10 said diagnosis of the disease was followed by suicidal thoughts. A small number of women reported that their partners beat them after learning of the presence of the infection.

Such violent reactions remain rare, although an AIDS activist was killed outside Cape Town in 2003 after she told a group of men who had gang-raped her that she had HIV. Another woman with AIDS was stoned to death in a township near Durban in 1998. Simple shunning is far more common and deeply hurtful, say those with the virus.

The reaction compounds feelings of terror and self-loathing that can accompany the diagnosis of a disease that many here believe, incorrectly, to be fatal in all cases and contracted exclusively through promiscuous sex.

Although heterosexual contact is the primary means of transmission throughout Africa, researchers say that HIV infection has now reached far beyond those who have multiple sex partners. In South Africa, according to U.N. estimates, one of every five people between 15 and 49 is infected with HIV.

Among the most vulnerable, researchers said, are women with only one sexual partner -- their husbands -- who either have the virus when they marry or acquire it later through an extramarital affair. For these wives to insist on the use of condoms would mean forgoing pregnancy, the cornerstone of marriage according to most African traditions.

Thobi Segabi, a physician at Soweto Hospice, recalled a woman last year who spent four weeks there in increasing misery. Segabi asked whether something was troubling her and learned that years earlier the woman had left her husband abruptly after being told she had HIV.
The husband, who had never been told, visited the hospice soon after and spoke with his wife for the first time about her illness. The woman died the next day. "She had this heavy load that she hadn't released," Segabi recalled. "She was blaming herself."

As AIDS activists try to make the issue more visible and less shameful, T-shirts declaring "HIV Positive" have become a common sight throughout South Africa. Yet physicians, researchers and AIDS activists say the disease remains little understood even after years of public education campaigns.

Among families, an HIV infection is often kept secret. South Africa's newspapers are filled with death notices that refer euphemistically to a "prolonged illness." Pneumonia or tuberculosis, rather than AIDS, is often listed as the cause of death, which, while technically accurate, neglects the overriding point: that HIV led to the lung ailment.

Contrary to popular belief here, AIDS is not necessarily fatal. A small but growing trickle of antiretroviral drugs is reaching those with AIDS in South Africa, allowing dramatically prolonged lives for the few people with access to the medicine. And the government, after years of resistance, is now offering the drugs at some public health clinics.

Yet most of the estimated 5 million South Africans infected with HIV have never even been tested for the virus. Many of those who die of AIDS complications are unfamiliar with the illness and do not appear at hospitals until they are too sick to gain much benefit from potentially life-prolonging drugs, physicians say.

And even those knowledgeable about HIV can find it difficult to tell others. Harry Nyathela, 30, an AIDS activist in Soweto, told a friend soon after the disease was diagnosed in him in 1998. The friend quickly accepted the news but requested that his wife not be told, fearing that she would ban Nyathela from the house. At his family home, Nyathela had to buy his own wash basin. One relative threw out a loaf of bread he had touched. Friends asked him to take home cups after he had used them.
"They did this because they didn't understand," Nyathela said.

For Mlangeni, the rejection he encountered at his father's house grew so painful that he moved out. He and his father had never had an affectionate relationship, Mlangeni said, but he was comfortable in the large, lavish brick home they had shared for 22 years after his parents broke up.

The HIV test changed that. His father virtually stopped speaking to him and locked the outer gate, saying he should no longer visit friends. After three weeks, Mlangeni moved into his mother's one-room shack, because she accepted his sickness unconditionally.
Yet even in new surroundings, Mlangeni was tormented with thoughts of death and regret.

" The minute you sit down, you keep on blaming yourself," he said. "You've got to focus on the plans you had before. . . . You must not lose hope.

Mlangeni is now living with his girlfriend and has found a useful role tending to the hospice building and garden. With the help of sympathetic relatives and religious faith, he has come to accept that he has HIV. When he gets sicker, he said, he hopes to begin taking antiretrovirals.

His relationship with his father, however, appears permanently fractured. After church one day this month, Mlangeni stopped by his old house. His father, outside working in the yard, gave him a perfunctory greeting. Mlangeni went inside for a glass of water. When he came back out, his father had disappeared.

BBC News

8 March 2005

2
Taking Gay Pride to South Africa's black townships

by Alastair Leithead , Cape Town
Black South African society remains unwilling to accept gays.

Despite a decade of democracy and one of the most liberal constitutions in the world, South Africa still has trouble accommodating those who are black and gay.

Watching the recent Gay Pride march through the streets of Cape Town, however, you may have got a different impression. Leading the procession were three open topped cars, and sprawled across their bonnets, Miss Gay Pride's top three transvestites. Two of them were black, and even though South Africa has come a long way, that is something a little unusual.

It is the third year Cape Town has hosted a pride march, but again it was noticeable just how white-dominated the participants were. "Being black and gay is a very different place to being white and gay in Cape Town," said Juanita Jacobs, or JJ as she's known, one of the Pride organisers.

Shebeen crawl
So this year the festival went a step further towards breaking racial barriers. "This year we decided to take Pride into the townships to engender understanding," said JJ. As a young black man I would need to be looking for a wife, making babies, and because I am not fulfilling those roles, society does not know how to deal with me.

"We wanted to bring the white South African Cape Town community and expose them to a section of the gay community they wouldn't usually see." And so on the list of events was a gay shebeen crawl - a trip around some of the more liberal of the small bars that can be found scattered all over the black townships of the Cape Flats, outside the city. Township tours have been laid on for years for tourists keen to see the other side of life outside the beautiful beaches, huge shopping malls and beautiful scenery of the "Mother City".

But this is the first time a tour of gay pubs, or shebeens, has been organised.

Two extremes
" It's exciting, I've never been here before. It's wonderful, it's good, it should - could - happen all the time," said one of the Capetonians on the trip. But it doesn't - while white gay South Africans have been pretty much accepted, certainly in as sexually liberated a city as Cape Town, it is a different story in the black community.

White gays set out to discover the black gay scene
Africa Melane is a presenter on the radio station Cape Talk - he's 27, gay, but did not join the Pride march this year. "I certainly don't make any secrets about my lifestyle, but at the same time I don't stand on top of Table Mountain and shout to the world: 'Hey, this is who I am'," he said.

His family knows, but they have never talked about his sexuality - he says black African culture doesn't accommodate homosexuality. "Tradition, ritual, family is paramount in any African culture out there, so as a young black man I would need to be looking for a wife, making babies, and because I am not fulfilling those roles, society does not know how to deal with me. "You risk not being part of the community, not being part of the family, not being part of society."

Africa Melane has seen two responses - friends becoming introverted, denying it to themselves, and some even committing suicide because of the pressure. Others go to the other extreme as transvestites or transsexuals. And in Nyanga township, some of the regulars were certainly not hiding their sexuality, with one guy bounding into a lavish dance routine.

Discrimination
As the drinks went down, so the social barriers followed suit. The five minibuses continued their three-bar tour with organisers mumbling about making this a regular event. There were also some foreign visitors on the tour and the observation was that there does not seem to be much mixing between black and white in the city - you do not see many black people in the gay bars.

A lot of people don't come out to these areas because of fear - the same fears that fuel racism are the fears that fuel homophobia

Ronnie Ngalo owns one of the shebeens - he explained this was due to economic reasons. "It costs money to get to town on transport, to get into the bars and clubs, to buy drinks," he said. "We get people from the rural areas who come here after being chased away by their family - we create a new family here in the township. "There is still discrimination, our culture suppresses us, but gay people are here to stay."

JJ explained the thinking behind the shebeen crawl: "A lot of people don't come out to these areas because of fear - the same fears that fuel racism are the fears that fuel homophobia and the idea of breaking those fears down and meeting the other half is what this is all about."

A lot of things are changing in South Africa, and fast. Old taboos are being broken and cultural barriers are coming down, but so far few people even in Cape Town can be openly proud of being black and gay.

Gay.com U.K.
http://www.gay.com/news/article.html?2005/05/18/4

May 18, 2005

3
South Africa high court weighs lesbian marriage case

by Ben Townley
A lesbian couple looking to challenge South Africa's ban on same-sex marriage appeared in the country's highest court Tuesday, calling for the law to be amended.

Marie Fourie and Cecilia Bonthuys told the Constitutional Court that a ban on their marriage is discriminatory. Their case was buoyed by a win in the country's Supreme Court of Appeal, which agreed with them last year and ruled that legislation should be adapted to take the issue of sexual diversity into account and not discriminate against lesbian and gay people.

The couple told the country's South African Press Association that they "just want that little white piece of paper. We want it to be legal, legal, legal," Fourie reportedly told the court from the public gallery.

The government is fighting the claim, arguing that marriage should be restricted to heterosexual couples. It says the appeal court ruling goes against what the South African public wants." Same-sex partnerships are a relatively new phenomena," Marumo Moerane, a legal representative from the Department of Home Affairs, reportedly told the court. "We don't know whether single-sex relationships involve the idea of mutual support."

The case has seen widespread support from the country's lesbian and gay community, which demonstrated outside the court on Tuesday.
The court has so far refused to suggest when it will give its verdict.

Women's Project Officer
International Lesbian and Gay Association, Brussels
www.ilga.orglgaworldnews@ilga

2 June 2005

4
New Publication on South African Gay and Lesbian Youth

GALA, an LGBT South African organisation will be launching a publication on South African Lesbian and Gay Youth. Please read below to obtain more information on this positive initiative

On June 11 the Johannesburg-based organisation Gay and Lesbian Archives (GALA) will launch a new publication and traveling exhibit that shares stories of gay and lesbian youth in South Africa, while promoting respect and tolerance in schools.

In Balancing Act: South African Gay and Lesbian Youth Speak Out, twenty-one young South Africans from a wide range of social backgrounds speak candidly about their experiences, hopes and dreams.

Specifically written to be used in schools, the book contains insightful and useful teaching notes relating to the area of Life Orientation. The exhibition based on the book showcases a selection of extracts from 9 stories with photographs. "We created this resource to help address the high levels of discrimination and victimization being faced by gay and lesbian youth in schools," says GALA director Ruth Morgan, "anecdotal evidence tells us that these high levels of abuse result in many youth leaving school before completion."

For many young people in South Africa, coming to terms with their sexual orientation can be a very painful experience. Although guaranteed as a freedom in the national constitution, lack of acceptance by family and society is often a reality. "Sometimes I feel sad and lonely, like my family doesn't love me. But I have to deal with the facts: it's not easy to accept that your child is gay. There are very few parents who would, because of the stigma," says 17 year-old Sandile.

The book explores the lives of gay youth in this country in a manner that challenges stereotypes and prejudices, and provides much needed information to young gay and lesbian people. The book not only focuses on the difficulties faced, but also the positive options and strategies adopted by well-adjusted young people - providing positive role models that readers can relate to as they begin to make their own life choices. It is hoped that the book and accompanying traveling exhibition will play an important role in an ongoing process of human rights-based sexuality education for young South Africans.

Since the experiences described in Balancing Act are related to issues affecting all youth, whatever their orientation, the book and exhibition are relevant to all young people growing up in this country. By producing a positive, life-affirming book and exhibition, GALA hopes to promote much -needed openness on issues of sexual orientation, in the interests of reducing homophobic prejudice.

Established in January 1997, the Gay and Lesbian Archives of South Africa (GALA) is an independent project of the South African History Archive (SAHA) which forms part of the Historical Papers collection based at the William Cullen Library in the University of the Witwatersrand. GALA provides a permanent institutional home for the wide range of historical and archival material relating to gay and lesbian experience in South Africa. It aims to be a source of information to the public and to serve as a catalyst for generating other, previously silenced community histories and personal narratives.

The book was written by Karen Martin and Joanne Bloch, and published by New Africa Education. It is being translated in Xhosa and Afrikaans by the Project for the Study of Alternative Education in South Africa.

For more information about the book or launch event, contact: Ruth Morgan, Director OR Anthony Manion Gay and Lesbian Archives (GALA) morganr@gala.wits.ac.za OR anthonym@library.wits.ac.za http://www.wits.ac.za/gala/ Telephone 011 717 4239/ 1963 Deborah Walter Project Manager/ Editorial Director Soul Beat Africa http://www.comminit.com/africa

SA

September 24, 2005

5
Thousands celebrate Gay Pride

Johannesburg - Several thousand people streamed through the streets of Johannesburg on Saturday in the 16th annual Gay Pride march themed "the right to be, the freedom to express".

On foot or dancing on board buses and trucks, a largely white crowd made its festive way through the city under a blazing sun.
Young women on one truck held placards saying: "Same sex marriage is African", "Viva same sex marriage, viva", "I am a very traditional woman, that's why I support same-sex marriage" and "Equality in marriage is one step to real liberation".

The march began at 16:00 outside the Constitutional Court buildings, the site of a former prison where Nelson Mandela was once held.
In May, the Constitutional Court, South Africa's highest court, began deliberations on same-sex marriage, prompted by the government's appeal against a lower court's landmark ruling that people of the same sex had a legal right to wed.

The Constitutional Court is due to issue its own ruling in the coming months.

South Africa's constitution, adopted two years after the country's first multiracial elections in 1994, explicitly bans all discrimination based on sexual orientation. This clause puts the country at odds with the rest of the continent, where homosexuality is largely taboo and, in some states, harshly punished.

Many African leaders, in particular Zimbabwean President Robert Mugabe, frequently speak out vehemently against gays and lesbians.
Another Gay Pride march takes place each February in Cape Town.

United Press International/BBC

December 1, 2005

6
South African court allows gay marriages

Johannesburg, South Africa - South Africa's highest court has ruled in favor of same-sex marriages banned under current law, reports the BBC.

The Constitutional Court, outlawing discrimination against gays and lesbians, ordered that parliament amend marriage laws to allow same-sex weddings within a year, the report said. The court also said the definition of marriage must be changed from a "union between a man and a woman" to a "union between two persons."

A lawyer for the Lesbian and Gay Equality project said he was disappointed the Constitutional Court did not order the immediate implementation of its ruling.

http://www.int.iol.co.za/index.php?set_id=1&click_id=6&art_id=vn20051205060747478C818569

7
Mass gay weddings planned

December 05, 2005

by Xoliswa Zulu
Gay and lesbian couples will make the most of the landmark ruling by the Constitutional Court that legalises same-sex marriage.

KwaZulu-Natal, the Western Cape and Gauteng have been earmarked to host Africa's first-ever mass gay wedding ceremonies next December to officially celebrate the official sanctioning of these relationships in the country.
The chairperson of the South African Mass Gay and Lesbian Wedding Ceremony, Johann Ludick, said the celebration would be regarded as both ceremonial and official.

"The three planned ceremonies will take place at outdoor venues, such as stadiums, to enable us to accommodate a minimum of 5 000 gay and lesbian couples. The weddings will take place over a period of 72 hours at three selected venues to be announced in February, from a shortlist of nine."

gay.com

21 February, 2006

8
Lesbian murder prompts homophobia fears

The murder of a lesbian in Cape Town has led campaigners in South Africa to warn of a spike in anti-gay feeling in the Rainbow Nation.
Zoliswa Nkonyana, 19, was stabbed and stoned to death in a township just outside the city earlier this month, according to press reports.
Gay rights groups say that the death is likely to be a result of homophobia, but warned that the number of lesbian and gay deaths in the country could be set to rise.

Additionally, lesbians are increasingly subjected to physical abuse, including rape, a women’s rights group told the IRIN news service.
Other gay rights groups, including the Triangle Project, say lesbians are raped as an attempt to cure them of their sexuality and to stop them challenging gender stereotypes.

"Lesbians who mimic men are seen to be challenging male superiority. Rape and violence against lesbians is common,” Dawn Betteridge told IRIN.
“The men who perpetrate such crimes see rape as curative and as an attempt to show women their place in society."

Police are still investigating the murder of Nkonyana, but campaigners say her death has increased fear in what is regarded as Africa’s most liberal country. South Africa was the first country in the world to enshrine protection against discrimination based on sexuality in its constitution, in its post-Apartheid era. It was also the first on the continent – and one of the few in the world, to legalise gay marriage after its Supreme Court ruled a ban on same-sex unions would be unconstitutional.

Cape Times

February 20, 2006

9
Historic march highlights lesbian's killing

by Leanne Raymond
The brutal murder of a young lesbian woman in Khayelitsha two weeks ago took centre stage as 150 Gay Pride supporters strutted their stuff through the streets of Guguletu on Sunday, in the first Gay Pride march to take place in a township.

Organiser of the event Ronnie Ngalo said the murder of Zoliswa Nkonyana, 19, showed the importance of events that increased the awareness of gays and lesbians in the townships. "People believe to be gay is un-African, (but) that is discrimination against us," said Ngalo.

'People believe to be gay is un-African'
He said gays and lesbians were here to stay and people should support and protect them. Police spokesperson, Elliot Sinyangana, said Nkonyana was "stabbed and stoned to death by a mob of young people on February 4". Police were still investigating the reason for her murder, said Sinyangana, and no one has been arrested. "It is difficult because the people involved are not known in that area," said Sinyangana.

Nkonyana was a member of a lesbian soccer club, the Wini Club. According to a Sunday newspaper report, she was with a 17-year-old lesbian friend when another woman began taunting them, saying they "wanted to get raped".

'Nkonyana was killed in sight of her family'
They told the woman they were lesbians and to leave them alone. The woman then fetched "about 20 youngish guys" who began beating them, said Nkonyana's friend, who was too terrified to be named. Nkonyana's friend managed to run away. Nkonyana ran towards her house but the mob threw bricks at her until she was lying on the ground. "But they just carried on," her friend said.

At Sunday's march, a brass band played as the group of dancing people followed Ngalo who was waving the gay pride flag brought from Amsterdam for the city's Pride festival. Treatment Action Campaign representatives and traditional Xhosa women marched along in support of the campaign. Russell Southey, Pride festival director, said Nkonyana's murder highlighted the high level of homophobia in black communities.

"Hopefully marches like this will bring about social change," said Southey. "In white communities... gay people are accepted into society and protected. But in black communities the gay pride cause is extremely relevant. Gay people in black communities need to know they are not alone. Nkonyana was killed in sight of her family, imagine living with that threat."

Southey said the three other lesbian girls photographed by the Sunday newspaper feared for their lives. He said in a previous homophobic murder, two people pictured with the victim in the newspaper were raped. "One has died of Aids," he said. Bulelwa Panda, an organiser, said she was excited about the march, although the turnout was not very good. As they marched past a church, Oscar Mashicila, the church warden, said: "Everyone must respect each other."

QueerDay.com
http://www.queerday.com/

February 22, 2006

10
Taking Gay Pride to SA's townships

Despite a decade of democracy and one of the most liberal constitutions in the world, South Africa still has trouble accommodating those who are black and gay. Watching the recent Gay Pride march through the streets of Cape Town, however, you may have got a different impression.
Leading the procession were three open topped cars, and sprawled across their bonnets, Miss Gay Pride's top three transvestites.
Two of them were black, and even though South Africa has come a long way, that is something a little unusual.

It is the third year Cape Town has hosted a pride march, but again it was noticeable just how white-dominated the participants were.
"Being black and gay is a very different place to being white and gay in Cape Town," said Juanita Jacobs, or JJ as she's known, one of the Pride organisers.

Shebeen crawl
So this year the festival went a step further towards breaking racial barriers. "This year we decided to take Pride into the townships to engender understanding," said JJ. "We wanted to bring the white South African Cape Town community and expose them to a section of the gay community they wouldn't usually see."

And so on the list of events was a gay shebeen crawl - a trip around some of the more liberal of the small bars that can be found scattered all over the black townships of the Cape Flats, outside the city. Township tours have been laid on for years for tourists keen to see the other side of life outside the beautiful beaches, huge shopping malls and beautiful scenery of the " Mother City". But this is the first time a tour of gay pubs, or shebeens, has been organised.

Two extremes
"It's exciting, I've never been here before. It's wonderful, it's good, it should - could - happen all the time," said one of the Capetonians on the trip. But it doesn't - while white gay South Africans have been pretty much accepted, certainly in as sexually liberated a city as Cape Town, it is a different story in the black community.

Africa Melane is a presenter on the radio station Cape Talk - he's 27, gay, but did not join the Pride march this year. "I certainly don't make any secrets about my lifestyle, but at the same time I don't stand on top of Table Mountain and shout to the world: 'Hey, this is who I am'," he said. His family knows, but they have never talked about his sexuality - he says black African culture doesn't accommodate homosexuality.
"Tradition, ritual, family is paramount in any African culture out there, so as a young black man I would need to be looking for a wife, making babies, and because I am not fulfilling those roles, society does not know how to deal with me. "You risk not being part of the community, not being part of the family, not being part of society."

Africa Melane has seen two responses - friends becoming introverted, denying it to themselves, and some even committing suicide because of the pressure. Others go to the other extreme as transvestites or transsexuals. And in Nyanga township, some of the regulars were certainly not hiding their sexuality, with one guy bounding into a lavish dance routine.

Discrimination
As the drinks went down, so the social barriers followed suit. The five minibuses continued their three-bar tour with organisers mumbling about making this a regular event. There were also some foreign visitors on the tour and the observation was that there does not seem to be much mixing between black and white in the city - you do not see many black people in the gay bars.

Ronnie Ngalo owns one of the shebeens - he explained this was due to economic reasons. "It costs money to get to town on transport, to get into the bars and clubs, to buy drinks," he said. "We get people from the rural areas who come here after being chased away by their family - we create a new family here in the township. "There is still discrimination, our culture suppresses us, but gay people are here to stay."

JJ explained the thinking behind the shebeen crawl: "A lot of people don't come out to these areas because of fear - the same fears that fuel racism are the fears that fuel homophobia and the idea of breaking those fears down and meeting the other half is what this is all about."
A lot of things are changing in South Africa, and fast. Old taboos are being broken and cultural barriers are coming down, but so far few people even in Cape Town can be openly proud of being black and gay.

GayWired.com

February 24, 2006

11
Triangle Project Attacks South African Times for Lesbian Endangerment

by Danny McCoy
Cape Town, South Africa – South African gay rights group the Triangle Project is voicing extreme disappointment with Sunday Times for publishing a picture of four lesbians after one of them was beaten to death in an apparent hate crime.

The picture made clear the identity of three friends of 19-year-old Zoliswa Nkonyana. She was beaten to death with bricks and stones in front of her stepfather for being a lesbian by a gang of men outside her home on February 4. A spokesperson for the Triangle Project said they had warned the Times about hate crimes against gay and lesbian people in the traditional township areas, but the picture of Nkonyana along with three members of her lesbian football club was published anyway.

“ Publishing a photo of three lesbians, without their consent, accompanying an article on hate crimes against lesbians is highly irresponsible – especially considering that one of their friends was killed by a mob in their community," said Glenn de Swaart, Triangle Project spokesperson.
Sunday Times editor Mondli Makhanya issued this response: “Our intention was to highlight a crime against the gay community, and it was never our intention to cause further hurt. We're happy to correspond with the gay community on this issue.”

The Triangle Project said it wanted to further convey that Nkonyana's death shows that violent crimes, such as rape or assault on the grounds of sexual orientation, remain a reality in Cape Town. This week the Cape Town Pride Festival kicks off, culminating in the Pride March through the streets of Cape Town.

Gay.Com/PlanetOut.com Network

6 March 2006

12
Human Rights Watch says South Africa must protect lesbians

An international human rights group has urged South Africa to guard against attacks and abuse directed at lesbians.
New York-based Human Rights Watch (HRW) raised concern about the issue on Friday, following news that a 19-year-old lesbian was brutally killed last month by a mob.

The victim, Zoliswa Nkonyana, was walking on February 4th with a lesbian friend in the Khayelitsha township near Cape Town when a group of young men accosted them. The assailants beat Nkonyana with golf clubs, threw bricks at her and stabbed her, according to HRW.
Nkonyana's friend outran the mob and escaped. She remains in hiding and fears for her life, the human rights group said.

"Lesbians in South Africa face abuse and violence simply for not fitting social expectations of how women should look and act," said Jessica Stern, researcher for Human Rights Watch's Lesbian, Gay, Bisexual and Transgender Rights Program.
"Ten years ago, South Africa enacted the world's first constitution to protect against discrimination based on sexual orientation," Stern said in a prepared statement. "Today it's both tragic and telling that Zoliswa Nkonyana still could not be safe in her own neighbourhood."

In several African countries, homosexuality is outlawed or considered "un-African". Last week in Cameroon two men received one-year jail terms for having sex with each other. South Africa, however, is poised to be the first African country to legalise same-sex marriage, after the high court ruled in December that it is unconstitutional to deny civil marriage rights to lesbian and gay couples.

"Zoliswa's murder tragically shows that violence against lesbians continues," Stern said. "The South African government must promote equality and diversity through public education to ensure lesbians' right to security."

13
Gay Sport South Africa – GSSA: one of the largest gay and lesbian networks in South Africa

E-mail: gaysportsa@mweb.co.za.

2006

Johannesburg - Since December 2002, GSSA was founded by a group of participants returning from Sydney Gay Games and has since, grown into one of the largest gay and lesbian networks in South Africa. The network caters specifically for those individuals who have an interest in sport in various capacities, and currently has almost 1500 members nationwide.

The principle was to create a forum for those with a sporting interest, to be able to connect and interact with one another. Despite the collapse of many of the sporting organisation in South Africa over the last few years, it was still perceived that there was an interest in sport or a need for sporting organisation/ bodies/ groups.

The circle works countrywide and in any sporting discipline, attempting to place an individual in touch with an existing organisation/ group should there be one, or attempt to bring together people in a specific area should there appear to be a need there. As a result there are now, for example, sports co-ordinators for various sports in Durban, Cape Town, Port Elizabeth and Bloemfontein (none of these had previously had strong sports groups).

The needs may be various, from social to fitness to competitive to simply wanting a training partner and that is dependant on the individual member and their willingness to take this initiative and make it their own. GSSA retains a co-ordination/ facilitation function amongst its members, encouraging grass roots development but has avoided becoming, itself, an official organisation.

GSSA has also partnered with various organisations in an attempt to spread the word and encourage other people to join the network, and hence making it easier to connect likeminded sporting individuals. With this in mind has resulted in an association with a resurgent TOGS (under the new Chairpersonship of Shane Blakebrough), since TOGS retains the only South African and African membership of the FGG (Federation of Gay Games – holder of the right to the Gay Games).

This allows for the second focus of GSSA, the increased participation of South African LGBTI sporting persons in international events such as the Gay Games, OUTgames or Eurogames. If you have any queries please contact GaryC on gaysportsa@mweb.co.za.

News24.com
http://www.news24.com/News24/Entertainment/Local/0,,2-1225-1242_1895251,00.html

March 10, 2006

14
SA's gay cinema 'going places'--one of the biggest events on South Africa's gay cultural calenda

Johannesburg - For 12 years, the "Out in Africa" film festival has been one of the biggest events on South Africa's gay cultural calendar.
Now, its organisers hope to take "queer cinema" to other African countries, where many gay people still live in fear of being persecuted for their sexuality - much less get a chance to see people like themselves in films. The festival already distributes free DVDs in Namibia, Botswana and Zimbabwe and its organisers plan to add six more African countries to that list by the end of the year.

The organisers get permission from the filmmakers to duplicate movies free of charge; they are then passed on to gay groups in each country for their own mini-festivals or any other use they see fit. Festival director Nodi Murphy said the enthusiasm with which "Out in Africa" has been received in small-town South Africa, where the event is still in its infancy, showed there was definitely a hunger for gay films even in out of the way places. "You go to small communities where people are just thirsting for knowledge, they're thirsting for images of themselves. They're so appreciative. They're ready to celebrate," Murphy told Reuters.

These "satellite festivals" in South Africa initially got off to a slow start when the films were screened in cinemas, where many gay people afraid of revealing their sexuality were too afraid to go, Murphy said. They then decided to work with local gay groups to spread the word about the events and screen the films in places that were less in the public eye - in one case in a hotel owned by a gay-friendly straight man.

Black gays and lesbians
"Out In Africa" currently hosts its premier festivals in Johannesburg and Cape Town but in recent years it has taken its offerings to some of the remotest towns in the country. South Africa's post-apartheid constitution is alone in Africa with its protection of gay rights. But Murphy said outside the main urban centres, where gay clubs and bars flourish, the closet door is still firmly shut for many gay men and lesbians.

She said one year organisers had planned to put up a festival in Soweto, South Africa's biggest black township, but some gay people were afraid of being "outed" to their community. Showing just how real the threat of violence can be, a 19-year old lesbian was last month beaten, stoned and stabbed to death by a gang in the Khayelitsha township near Cape Town.

Murphy said poorer townships also did not have the facilities to screen films. This year they are hoping to change that by bringing township dwellers to the swish suburban malls where most festival-goers hail from. Three thousand free tickets will be given away through gay groups in townships. The recipients will be shuttled to and from the main festivals in Johannesburg and Cape Town.

"I would never despise it but our greatest supporters are white men and then after that white women. We must be representative of South Africa and the gay and lesbian community that we serve and of course there are a great number of black gays and lesbians," Murphy said.
"The truth of the matter is with the economic circumstance that we still have in this country the majority of black people don't have the disposal income necessary to attend a film festival of this kind or of any kind."

365Gay.com Cape Town, South Africa Bureau

April 20, 2006

15
20% Of South African Gay Students Raped

by Mark Levy
Cape Town, South Africa - A study of LGBT teens in South Africa's KwaZulu-Natal province has sent shockwaves throughout the country. Focusing on young people in the municipalities of Pietermaritzburg and Durban researchers found that 20 percent of gay and bisexual teenage males and 19% of lesbian and bisexual female teens had been raped or sexually assaulted.

They also found that one third of all LGBT students had been physically assaulted at school because of their sexuality.
The study was conducted for Out LGBT Well-being and the Durban Lesbian and Gay Health and Community and Health Center.
The researchers found that black and Indian students were more likely to be victimized because of their sexuality than were white students.

"More alarming is the victimization by teachers and principals," said Pietermaritzburg Gay & Lesbian Network convener Anthony Waldhausen. "The network will go out of its way to protect the gay and lesbian community and is looking at ways to provide hope for the many that are victimized."

The study found that homophobia was so severe in the province that many students refused health care because they did not trust medical staff. The researchers noted that this often had the added concern that HIV transmission to the victims was not determined. The situation in the province is so severe the researchers said in their report that almost one in five LGBT students said they had attempted suicide.

South Africa is one of the few countries in the world with equality for gays, lesbians and the transgendered enshrined in its constitution but the report noted that equality has not found its way down to the grassroots of society.

http://www.theglobeandmail.com/

16
Lesotho takes HIV test on the road

by Stephanie Nolen
Maseru, Lesotho - Teams of people will start going door-to-door across Lesotho next month to give everyone over the age of 12 the chance to have an on-the-spot HIV test.

They will approach people at the small stone houses where they live in the mountains, in the industrial zone factories where they stitch Gap sweaters, the churches where they go to mass and the mess halls where soldiers eat.

Lesotho is calling it 'Know Your Status,' an initiative of the government and the World Health Organization. Modelled on mass immunization campaigns such as those for polio, the HIV testing effort will cost $12.5-million (U.S.), most of which has yet to be raised from international donors, and run until the end of next year.

Organizers hope it will resolve one of the stickiest problems of responding to AIDS in Africa: the stigma and fear of the disease, which is still so great that many people don't get tested. Parents won't take sick children for HIV tests, and even doctors and nurses fail to suggest testing for the most obvious AIDS patient, out of a desire to protect "confidentiality" or to avoid the implied shame.

It is estimated that 265,000 people, or one in three adults in Lesotho, are living with HIV-AIDS and 50,000 are already so sick they need antiretroviral treatment. But only 72,000 people have ever been tested for HIV, even though the government has been committed, since 2004, to providing free ARV drugs to those who need them. The Ministry of Health says that just 12 per cent of women and 9 per cent of men know their HIV status.

The Lesotho campaign will rely on HIV tests that produce results in minutes. These are cheap, about $2 a test, and use a finger-prick of blood rather than a syringe, so are more easily administered by lay people. Studies show that a third to half of people don't come back if they must collect their test results days or weeks later.

Community members will be asked to decide themselves how they wish to be tested -- whether, for instance, they want to be tested by residents of the village or by outsiders to preserve confidentiality. Key to the plan is the idea that no one will be offered testing without a full range of counselling, support, prevention and care options being available, whatever each person's diagnosis.

"The brilliance of Know Your Status is what's embedded is that you cannot be more aggressive or proactive about asking people to get tested unless both treatment and prevention are in place," said Jim Yong Kim, the former head of the AIDS directorate at the WHO, now a director for the medical aid agency Partners in Health, who helped pilot the plan.

Lesotho's plan recently won the praise of former U.S. president Bill Clinton, whose charitable foundation is a major player in the world of AIDS care. "I think there needs to be a total rethinking of this testing position in the AIDS community and a real push for this," Mr. Clinton said. He noted that 90 per cent of those believed to be HIV-positive in the developing world do not know their HIV status.

In Africa, where HIV is primarily a disease of heterosexual, married people, and in particular in countries where the prevalence rate is more than 15 per cent of the population, an increasing number of people argue the "human-rights-based approach" to testing is ill-fitting. They say it needs to be replaced with a public-health model in which HIV is treated more like diabetes, just one more disease for which a sick person is routinely screened.

Lesotho's campaign has a public-health ethos, treating HIV like a communicable disease to be tracked down and controlled, but it still makes an exception of HIV by putting heavy emphasis on confidentiality and counselling, because there is such great stigma attached to the illness here. Lesotho's bold plan is not without its critics, who say it looks great on paper, but that it is unrealistic to think that a few months of community education will be enough to erode that pervasive shame.

"You will agree to test and they will tell you the result and they will leave you with no psycho-social support, they will just leave you," predicted Makokoli Nthinya, program officer for an AIDS support organization called Positive Action. "People don't disclose even to the closest, closest person taking care of them because they say, 'When I tell, I will get no support.' The support systems are not adequate." The government says its plan to hire 3,500 new community-health workers, and train thousands of volunteers, will counter this problem. But "then you have people in the mountains with no access to ARVs; they are hours from a clinic or they have no money for transport," Ms. Nthinya worried.

In theory, treatment will be available everywhere before people are tested. But the glacially slow pace of treatment rollout -- just 6,000 people were put on the drugs in the past 18 months -- raises serious questions about how well a decentralized treatment program will run, and suggests that testing will either proceed equally slowly or that HIV-positive people won't have easy access to the drugs.

Conversations with people ostensibly already trained to be "peer educators" in communities outside the capital reveal a vast level of ignorance of HIV transmission, and such pervasive fear that even those who have been tapped to "mobilize" people for testing say they would not themselves take the test.

While the WHO speaks carefully of a "universal offer of testing," the reality is that people in AIDS organizations, clinics and on the streets in Lesotho use the words "routine," "mandatory" and "compulsory" interchangeably. That produces a widespread feeling here that the testing will be, if not forced, then socially obligatory. In a tightly knit culture such as Lesotho's, the "encouragement" of a person of influence such as a chief or a priest -- or even a husband to his wife and children -- can amount to coercion, critics say. "There is this kind of pie-in-the-sky notion that in the name of public health, you can test everyone door-to-door without serious consequences, even violent ones, for the individual," said Rachel Cohen, field co-ordinator for a Médecins sans frontières (Doctors Without Borders) AIDS-treatment program in Lesotho.

". . . But what worries me about so-called universal testing is, what will be the long-term effects on people who get tested and aren't really prepared for their results because they won't get adequate counselling? What will be the consequences for women who test positive and are blamed by their husbands and families, something we hear about on a regular basis here? And what will be the penalties for those who are offered an HIV test and say no? And what will be the penalties for those that are offered an HIV test and say no for whatever reason?"

But the WHO's Loretta Hieber-Girardet said that the plan includes a provision to train "human-rights monitoring groups in every community . . . who will be trained in how to assure informed consent, volunteerism, and guard against any potential coercion." Monitors, like those from an independent electoral commission, will oversee all testing, she said, and this will be enough to ensure that people are not overtly coerced or more subtly pressured. Lesotho hopes this campaign will be a major incentive not only for those who are sick to seek care, she said, but also that those who are positive will take steps not to spread the disease -- although AIDS research has found little proof that knowing their HIV status changes people's sexual practices.
No one with the Ministry of Health was prepared to discuss the once-off nature of this exercise. Everyone will, in theory, be tested for HIV now. But what if they get infected next week? How often will the testing be repeated? And what of the risk of sowing complacency in those who are tested and told they are negative?

Ms. Hieber-Girardet argued that challenges notwithstanding, Know Your Status will have an impact. "In a country like Lesotho, where a third of the population is HIV-positive, not doing anything is not an option," she said.

The New York Times
http://www.nytimes.com/2006/08/06/magazine/06aids.html?_r=1&oref=slogin

August 6, 2006

16a
When a Pill Is Not Enough

by Tina Rosenberg
In the whole AIDS epidemic, no question is more heartbreaking and confounding than this: Why would a mother choose to condemn her baby to death? Mothers with H.I.V., the virus that causes AIDS, pass it along to their newborns at birth 25 to 30 percent of the time, and in poor countries, some half a million babies a year are born with H.I.V. But the rate of transmission can be cut to 14 percent with a simple and cheap program: H.I.V.-positive mothers take a single pill of an antiretroviral called nevirapine when they begin labor, and their newborns are given nevirapine drops. At the Alexandra Health Center and University Clinic in South Africa, pregnant women can get nevirapine free. The antenatal clinic is a complex of low brick buildings on a pretty hospital campus in the middle of the township of Alexandra, a bleak neighborhood on the outskirts of Johannesburg. The clinic has a doctor only on Thursdays, but an advanced midwife and two nurses attend a crowd of patients every day. I had been in South Africa for four days when I visited the clinic, and I had already seen the stigma that AIDS still carries in the country — those dozens of funerals every Saturday in the townships? Oh, say family members, it was asthma, or tuberculosis, or “a long illness.” I thought I understood how powerful denial could be. But I was unprepared for what Pauline Molotsi, a registered nurse at the clinic, told me.

About twice a week, a woman who has tested H.I.V.-positive begins labor at the clinic but refuses to take the nevirapine that might save her baby’s life. “She says, ‘Oh, no, I’m not positive,”’ Molotsi told me. Even though the only person who will know her H.I.V. status is the nurse — who knows already, since she is holding the patient’s chart — the woman won’t take the incriminating pill. “They have not accepted their status,” Molotsi said. “They are still in denial.” In most of the world, the biggest reason so many babies are born with the AIDS virus is that their governments do not offer nevirapine; because of shortages of health-care personnel, in many countries this program, like all AIDS programs, is available only in urban hospitals. But in South Africa, there’s a different problem. Nevirapine is widely available, yet more than 70,000 babies a year are born there with H.I.V. The government can get nevirapine, condoms and AIDS treatment out to the most remote corners of the country — by truck or wheelbarrow, to modern hospitals and to clinics with no electricity. But it cannot penetrate what has become the most difficult terrain in AIDS work: the insides of people’s heads.

A significant minority of women in South Africa refuse to take an AIDS test. It’s not only that they do not want to confront painful facts that could lie buried a while longer. It’s also that being tested can be dangerous. At the Alexandra clinic, I listened to a tall young man named Vernon as he gave pretest group counseling to about two dozen pregnant woman. “Think about your baby before you think about yourself,” he urged them. He assured them the results of their H.I.V. tests would be confidential but encouraged the women to tell their families and partners. “Don’t hide it. Don’t use the phone — tell him face to face. You use the phone, he will hunt you down. Try to prepare him. Some people are very violent. He will beat you. But when he’s alone, he will think about it. If anything happens to you, your family knows you went to tell him your H.I.V. status and never came home.” This speech seemed unlikely to encourage many women to be tested. But it obviously reflected reality. Prudence Mabele, who works for a feminist organization, told me about a woman whose husband greeted her disclosure by pouring a kettle of boiling water over her.

Other women end up infecting their babies through breast feeding because they cannot follow the clinic’s advice to bottle-feed only — tantamount in some areas to announcing you have H.I.V. The very present danger posed by disclosure outweighs the future risk that the baby will get sick. And there are those whose denial is so deep it engulfs them. “Labor is already a stressful environment,” says Macharia Kamau, a Kenyan who is Unicef’s representative in South Africa. “You are pregnant, poor, vulnerable, marginalized, uneducated. At that point, what do you rely on? What your mother told you when you left home? Your cultural beliefs — or this stranger who’s standing there saying, ‘Take this pill?”’

As AIDS passes the quarter-century mark, in several countries the epidemic appears to be declining. South Africa is not one of them. In 1990, South Africa and Thailand both had H.I.V. prevalence rates in adults of less than 1 percent. Today, Thailand’s rate is 1.4 percent. But in South Africa, AIDS exploded in the 1990’s, and now 18.8 percent of adults are infected — and the number is still rising, though very slowly. Last year 300,000 new South Africans were infected with H.I.V. At the Alexandra Health Center, about 60 percent of women test positive. Choose any two 15-year-olds in South Africa; the odds say one of them will get AIDS.

South Africa is not even the worst of it. In Botswana, 24.1 percent of adults have H.I.V., and in tiny Swaziland, a third of all adults do. AIDS rates in southern Africa are far higher than they are anywhere else in the world. No one really knows why. South Africa has astronomical rates of sexual violence — more than a quarter of the time, a young woman’s first sexual experience is coerced — and a strong culture of male entitlement to sex, but so do many other countries. Much of the blame may go to apartheid, which kept male workers in hostels and their families in villages far away. Similar geographical dislocations come from mining, southern Africa’s main industry. Separating families encourages people to maintain ongoing relationships in two places. This is more dangerous than serial monogamous relationships, as H.I.V. is far more contagious when freshly caught.

South Africa’s post-apartheid government, besieged with problems, largely ignored AIDS. As president, Nelson Mandela did not publicly speak in South Africa on AIDS until 1998, more than three years into his term. Then came spectacular irrationality — the government of Thabo Mbeki spent years insisting AIDS was a Western plot, that the drugs were poison, that it was better to use African “cures,” that all those people were dying of something else. Now the public troublemaking of government officials has died down. What has replaced it is not the crusade so badly needed but just an official silence.

In the last few years, however, South Africans have forced their government to begin saving lives despite itself. The country is now spending millions to provide free antiretroviral drugs to AIDS patients, equip maternity clinics with nevirapine and run prevention campaigns. South Africa is successfully pushing services out to its people. But that doesn’t mean people always use them. Mothers sometimes reject nevirapine. People decline AIDS tests. Some sick people refuse to take free antiretrovirals. Some orphans will starve — even though help is available — rather than make the shameful admission that their parents died of AIDS. And of course, millions of people who know better continue to risk their lives every time they have sex.

All over the world, human psychology, local custom and the pressures of poverty are AIDS’s best friends. None of this should be foreign to Americans. We know we should quit smoking. We know we should go have that lump checked out. We know we should give up the French fries. But we don’t. In America, as around the world, a good amount of sickness and death is at least in part self-inflicted. In all aspects of health care, the challenge of providing not just solutions but ones patients will embrace is only now beginning to get attention. We are accustomed to thinking of noncompliance as the patient’s fault. But when a pregnant woman chooses to keep the nevirapine tablet in her pocket, the real failing belongs to the health system, which did not consider what would help her to follow medical advice. Such thinking is always crucial for health professionals but never more so than with AIDS, a disease that is shrouded in the dark and forbidden — sex, drug use, betrayal, rejection, death, rape, the struggles of intimate relationships — and that primarily hits the notoriously irrational young.

But the AIDS establishment has not yet assumed this challenge. “The technology is doing O.K., it’s moving,” says Peter Piot, executive director of the United Nations’ AIDS agency, Unaids. “But we have grossly, grossly neglected the social, cultural and personal stuff that makes it work.”

In a bland corporate research office in a strip mall in the Johannesburg suburbs one day late last spring, American and South African investigators were intently trying to prove Piot wrong. They were sitting behind a two-way mirror, watching five young women from Soweto talk about vaginal gel. The research office, normally employed to assess South Africans’ views on laundry detergent or breakfast cereal, was now the site of a series of focus groups designed to solve one of the biggest problems in AIDS prevention: the failure of the condom.

It is a social failure, not a mechanical one. Condoms prevent AIDS transmission quite well when people use them consistently. But men would rather not, and in Africa men usually call the shots. One of the most chilling findings of AIDS researchers is that marriage can be a risk factor. Studies in Kenya and Zambia found that young, married, monogamous women had higher rates of AIDS infection than sexually active single women of the same age; if condom use is hard for single women to negotiate, it is nearly impossible for married women. Even women who know their husbands are unfaithful cannot demand condoms, for to do so indicates a lack of trust. Husbands can get violent, or accuse the woman of infidelity. Condoms are also not an option for couples who wish to conceive. Women need a method of H.I.V. protection that they can control, that does not impede fertility and that men do not object to. +

It does not exist — yet. But one form of it, a vaginal microbicide, may be available within five years. The Johannesburg focus groups were designed to test three different gels, for use once a day, that may someday contain an ingredient that kills H.I.V. before it can infect the woman. The sessions were run by the International Partnership for Microbicides (I.P.M.), which is based near Washington. I.P.M. scientists realize that creating an effective medicine is just half the battle, and so they are taking a proactive approach to marketing the gel; before the microbicide’s active ingredient has even been invented, researchers have spent years figuring out how to get women in a variety of cultures to use it.

“A microbicide could be marketed as a sexual aid, or as something to make a woman feel more attractive inside and out,” Dr. Zeda Rosenberg, I.P.M.’s C.E.O., told me when I first met her in 2004. She was still puzzling it out when I spoke to her this year in South Africa. “Maybe H.I.V. prevention would be a secondary selling point,” she said. “This could be a lubricant that stops H.I.V. If the product made sex great, they would use it even if there were a trust issue.”

The focus groups were a chance for I.P.M.’s researchers to hear from their target market. Five young women from Soweto, all paid to participate in the study, sat around a table laden with platters of food and chatted in Zulu, Sotho and English about the gels, which they had been using for the last three weeks. The moderator asked whether they would want to use the gels to avoid getting H.I.V. All responded with enthusiasm. “I would recommend it to women who are married but do not trust their husbands,” said a participant. Just as important, they talked about how they handled the issue with their boyfriends. “I didn’t tell my boyfriend, but he noticed something different,” said Dimakatso, a young-looking girl with a ponytail. She explained to him what she was using, and it was no problem.

But most women preferred stealth — and it worked. Some didn’t tell because South Africans don’t normally discuss sex. Others said their boyfriends were superstitious. “He will think I am using something for witchcraft,” said one woman. Overall, the women preferred the gel whose texture was easiest to hide from their sexual partners.

Women’s groups have been talking about a microbicide for more than a decade, since it became obvious that AIDS was developing into a woman’s disease. But the rest of the world wasn’t listening. In the late 1990’s, Rosenberg was senior scientist for H.I.V.-prevention research at the National Institutes of Health. She, along with some others, tried to focus money and research on developing an AIDS-prevention product that women could control. “It was difficult to get people’s attention,” she says. “It was not considered interesting scientifically. It was seen as a product-development issue, not a scientific problem. Scientists in drug and cosmetic companies don’t get papers published.” Research was slow to get moving. Rosenberg left N.I.H. and eventually became C.E.O. of I.P.M. It is one of several organizations working to develop a microbicide.

For a microbicide, the traditional public-health approach — invent it, put it out there and tell people to use it — won’t cut it. Nearly as important as whether it kills H.I.V. is whether a microbicide feels acceptable, whether it can be used discreetly if necessary and how it is packaged and promoted. Dr. Mark Mitchnick, the group’s senior scientific consultant, worked on sunscreens and other products before switching to AIDS prevention. “One thing I learned with sunscreen is that people will often need a second reason to buy,” he says. “You want people to use sunscreen because it protects against melanoma. But people buy it because it prevents wrinkles.”

“The cosmetics industry can get women to use all sorts of topical products they don’t need,” Rosenberg said. Maybe the same tools could be used to make a microbicide popular. “Is there a way to think about it that isn’t H.I.V.? Public health can’t tell us that.”

Every weapon in the fight against AIDS needs to pass these same two tests — it has to work and people have to use it. But particularly in poor countries, where most of these services are by necessity free, AIDS treatments and prevention strategies are usually offered as if marketing were unnecessary. That is especially true for antiretroviral therapy. After all, the logic goes, it’s a lifeline. Surely no one would throw it back.

And when they have access to it, most people don’t. Antiretrovirals are now saving lives all over South Africa. The public-health system has gone from 0 to 175,000 people on antiretrovirals in two years. Add in programs run by businesses and nongovernmental groups like Médicins Sans Frontières, and more than a third of South Africans who need antiretrovirals are now taking them, and the figure continues to rise. Patients who have agreed to start antiretrovirals are very good about taking their medicine, and when they do, few are dying.

But the surprise is that South Africa has indeed had to sell AIDS treatment — and it’s often a hard sell. “People think the health department wants them to be dead,” said Sylvia Maguma, a traditional healer, or sangoma, I met in the township of Bekkersdal. I heard many people say this. It may be a hangover from the apartheid years, when it was literally true, and more recently, the government has spent years criticizing as poisonous the same drugs it is giving out now. Some antiretrovirals do have awful side effects, especially at first. But denial and stigma make things worse. People with AIDS tend not to admit, even to themselves, that they are sick; they seek help only when death is imminent. They start the antiretrovirals too late, and then the rumor spreads: the medicines killed her.

But there is something else at work here: the weight of traditional culture. In the township of Tembisa I met Vusi Ziqubu, a 33-year-old who was dying of AIDS. He could get free antiretroviral treatment at his local clinic. But he preferred the herbal remedies of Grace Mhaula, his sangoma. “He was gone,” said Mhaula of the moment she first saw Ziqubu. “He was frail, smelling of death.” Mhaula gave him a solution of herbs to drink four times a day. When I visited him in his house, he was thin, but looked strong and was up and around.

It is commonly said in South Africa that 80 percent of blacks go to a traditional healer first when they are sick. To South Africa’s poor, the bones of the sangoma are the reassuring and trustworthy medicine their families have used forever. It is the clinic’s fabulous tales of invisible bugs that sound to them like hoodoo. The science of the rich is the magic of the poor, and vice versa. And the sangoma, unlike the nurses at the clinic, can spend time with the patient.

But traditional healers can be a dangerous first stop for people with H.I.V., and not just because they often mean a delay in starting antiretrovirals. Sometimes the consequences are more dire. “I discourage older men from going to young girls to cure AIDS,” said Mhaula, but horrifyingly, some healers do not, spreading the message that sex with a virgin is curative. Many sangomas, Mhaula said, induce diarrhea or vomiting to clean out the illness, which can be debilitating for someone sick with AIDS.

So South African officials have begun to train traditional healers about H.I.V. Training often lasts only a few days, and it varies greatly in quality, but it is nonetheless useful and has reached thousands of sangomas. Mhaula took the training and trained others herself. I met her in April, and I later found out that she died suddenly three weeks after I visited her, of an infection unrelated to AIDS. She was an enormous woman of 53 who greeted me in a muumuu and fuzzy pink slippers. The daughter of two traditional healers, she had been one herself since the late 1970’s. But she also worked in the labs of a multinational drug company for 27 years, and the company paid her college tuition. Arthritis forced her into early retirement, but she was bored at home. At Tembisa’s health clinic, she received training in H.I.V. counseling and caring for the terminally ill. Her own daughter died of AIDS six years ago, and Mhaula was raising her daughter’s child.

Off her patio was a small room — her indumba, or consulting room. The walls were lined with hundreds of glass jars and plastic tubs containing mixtures of herbs. Animal skins and straw mats covered the concrete floor. Hanging from the ceiling were candles, the clothes of her ancestors and beaded necklaces. There was a plate of bones. When her clients (she does not call them patients) visited her, she read the bones. When she was alone, she put on the clothes of her ancestors and called their spirits. There were seven different ancestors that she talked to.

Mhaula walked me through what she did when she recognized symptoms of H.I.V. “I say: ‘Think about it. We live in the modern age. Don’t you think we should go to the clinic? You will be in a safe environment.’ They say, ‘Will you go with me?’ I say, ‘Yes.’ Sometimes they want me to go get their test results. They say, ‘Don’t tell me the results, just give me imbiza”’ — the herbal mixture she makes that she says boosts the immune system. “I say, ‘How are you going to change your behavior?’ They say, ‘I’m not yet ready.’ I tell them: ‘It’s good to have one partner. You must use condoms.”’

Working with traditional healers is hugely important for fighting AIDS in South Africa. But it has a dangerous side. The problem lies in the stack of white tubs that were behind the door of the indumba — Mhaula’s imbiza. She was careful not to call it a cure. It might indeed strengthen the immune system — it has never been tested in clinical trials, so we don’t know. But it cannot be taken with antiretroviral drugs. That meant Vusi Ziqubu had to choose.

“Traditional healing is being manipulated to put forth a political agenda,” says Jonathan Berger, head of policy and research at the AIDS Law Project in Johannesburg. “It’s a way to push the anti-Western-medicine line by appealing to culture and tradition.” When I was in South Africa, a “cure” called the mopane worm was on the front pages of the tabloid papers. Health officials’ embrace of a long line of charlatans has encouraged a thriving industry in such cures. Hundreds of sangomas sell them.

They are very tempting to people fearful of the impersonal clinic. “With us, you don’t have to take it the rest of your life,” Mhaula told me. “And there are no side effects. Patients come in, and they are so afraid, and then I give them the imbiza and I give them some porridge to eat. And it’s all right.”

Imbiza seemed to be helping Ziqubu — for now. But there was another patient taking Mhaula’s imbiza, a close family friend, a mother of three children. She was doing well, Mhaula told me — please come talk to her. Two days later, I came back to meet the woman. But she had already died.

AIDS is a disease of taboos. For its sufferers, psychological comfort, like that provided by traditional healers, is paramount — sometimes more important than even staying alive. But over the next few years, word will spread about the Lazarus effect of antiretroviral drugs. Although logistical and personnel problems will no doubt remain, few people will be able to argue that the drugs are poison, and few will shun them for herbal remedies.

There is also reason for optimism that other weapons in the fight against AIDS will win more public acceptance. Improvements in service will encourage more women to protect their babies. In the Alexandra clinic, the resourceful nurse Pauline Molotsi has hit on a strategy that sometimes helps. If an H.I.V.-positive woman does not want to take the nevirapine, Molotsi thrusts a piece of paper and a pen toward the woman, essentially making her take responsibility for her decision. “Would you really like your baby to have the virus?” she asks. “If you don’t take the pill, you will have to sign.” At Chris Hani Baragwanath Hospital in Soweto, which has an unusually well-financed and -run antenatal clinic, 98 percent of pregnant women agree to be tested for H.I.V. There will always be psychological barriers, but good service can overcome them.

That may not be true with South Africa’s most basic challenge: to bring down AIDS’s astronomical prevalence in the general population. Help could come from the brand-new technology of microbicides, but it could also come from the very old one of circumcision, which may offer some protection from H.I.V. infection. (Clinical studies due to conclude next year may tell how much protection.) That’s the future, though. For the moment, AIDS prevention is entirely a conundrum of psychology and culture — one we know very little about how to solve. The small list of countries that have had some success with prevention includes such dysfunctional places as Haiti, Zimbabwe and Cambodia. Experts can point to some good programs in these countries, but plenty of nations with rising AIDS rates have the same programs. The country that had an early drop in AIDS prevalence, Uganda, probably achieved this because its particular culture of openness brought the disease into the public eye, and the country treated it like World War III.

In South Africa, where AIDS has already exploded through the general population, prevention is an even more overwhelming challenge. One disturbing fact: Surveys show that South Africa’s teenagers know about AIDS and how it is transmitted. They know the behaviors that put people at risk. But they don’t apply this information to themselves. There is no correlation between information and behavior change. Two-thirds of young people who test H.I.V.-positive — in anonymous surveys, so they don’t know it — do not consider themselves at risk for AIDS. Especially for teenagers, the psychology of sexual behavior resides in some deep and mysterious place, apparently shielded from the reach of traditional public-health messages as if by a lead curtain. The question is whether anything can get through.

South Africa is trying to answer that question with a controversial H.I.V./AIDS-prevention program called loveLife, which generally serves youths from 12 to 17. It is as far from the traditional campaigns as it could be. I went to the community hall in Emzinoni, a black township in Mpumalanga province in the country’s east, to hear a dialogue staged by loveLife. Outside, geese ran in the dirt yard next to purple loveLife banners. Inside the auditorium, vibrant music blared and balloons filled the stage. A pop star named Elle sang a song about believing in yourself. A woman in jeans and a pink hat and a man in khaki shorts strode back and forth in front of the crowd, each with a microphone in hand, bantering in Zulu and English with about 500 Emzinoni parents and children, leading them in games and discussions about AIDS. Sithembile Sefako, the woman, and Mnqobi Nyembe, the man, are trainers from loveLife’s national office. They are local versions of a motivational speaker like Tony Robbins, traveling the country holding these events — but the problems they are discussing are not the ones Tony Robbins usually has to confront.

Sefako asked for volunteers for a little play: a university student named Beauty comes back from college to tell her parents she is pregnant and has H.I.V. Afterward, the actors compared their skit to reality. “Our parents scream at you and call you names,” said the young man who played the father. “They say: ‘I’ve seen you walking in the street! I knew you were going to fall pregnant!’ They beat you.”

“We use culture as an excuse,” Sefako said. “They say, ‘I can’t talk to my children, it’s not right.’ We hide behind culture.”

Next Sefako opened a discussion about responsibility for teen sex. A girl in a flowered cap said: “Most guys force us. Then they say if you are going to open a case with the police, we’ll beat you. We’ll come with a group and we’ll kill you.”

“Guys compete,” one boy said. “You say, ‘I’m going to sleep with six girls before Sunday.”’

“Is it true most women are falling pregnant to prove they can bear children?” Sefako asked.

One girl said: “We mustn’t lie. Most fall pregnant because they want the money” — the South African government’s grant of $30 per month per child. “They think, I’ll buy myself sneakers and jeans.”

A man differed: “The reason women fall pregnant is that we see females in the street in a miniskirt.”

“Are you saying young girls are getting raped because of what they wear?” Sefako asked.

“Yes, because of the way they are dressing, they end up in trouble.”

A girl responded: “Then what about someone who rapes a 3-year-old child?”

“A child from 10 upward knows how to sleep with a guy, and she knows the way she is dressing,” the man responded. The crowd hooted.

These unnerving comments contrasted bizarrely with the festive tone of the event. What was most remarkable to participants, however, was not what people were saying but that they were saying anything at all. Nelson Mandela often said that when he told traditional chiefs that he planned to speak out about AIDS and sex, they told him he would lose their support. What passes for communication between parents and children about sex is often just a cryptic warning to girls to “stay away from boys” and to boys, nothing. Yet children whose parents do talk to them about sex abstain longer and are more likely to use condoms. In general, openness is the anti-AIDS — if the sick came out of hiding, it would be easier for their friends and neighbors to accept that they, too, are at risk. That’s one reason loveLife’s principal slogan is “Talk About It.”

By 1997 AIDS was a crisis of biblical proportion in South Africa, with 13 percent of adults infected. The red-ribbon billboards that passed for an AIDS-prevention campaign were failing disastrously, especially with young people. For girls — who tend to have sex with older men — the riskiest age was between 12 and 17. The Kaiser Family Foundation, a health organization based in California, pledged that if South Africans could decide what was needed to prevent the spread of AIDS in young people, the foundation would pay the bill for the first five years.

Kaiser hired Judi Nwokedi to help plan the program. Nwokedi is a charismatic whirlwind who is head of government relations for Motorola in South Africa. A psychologist by training, she worked with sexually abused children and on AIDS projects while in exile in Thailand and Australia. Nwokedi met with AIDS groups, government officials and international experts to forge agreement on the basics. She also commissioned surveys of South Africa’s teenagers. The surveys found that teenagers tuned out the traditional prevention messages and were most receptive to an AIDS campaign that was about more than just AIDS. The teenagers also said their parents didn’t talk to them about sex or relationships — and they desperately wanted that kind of communication and wanted their parents to set limits. Significantly, the study found that poorer girls realized their first sexual encounter would probably be coerced and violent.

The next question was how to reach the children and young people at risk. “The normal way of AIDS or any peer education with young people was to pack them into the church hall or the school hall,” Nwokedi says. “They would have to sit there while someone would stand up there and talk at them. And whatever they told you, you went out and did the exact opposite because you were so angry that they kept you there for five hours. I wanted H.I.V. education to have another dimension — it had to be interactive, engaging, question-and-answer, vibrant debate.”

Under apartheid, young people identified with collective action. Now they were tired of politics, tired of “we.” An expansion of electrical service in the late 1990’s had allowed the number of households with televisions to soar. Young people were tuning into the global popular culture they saw on TV, with a very high level of awareness of brands.

The working title for the campaign had been the National Adolescent Sexual Health Initiative. Nwokedi, consulting with teenagers, public-health leaders and marketing experts, nixed it. “You’re dead before you can even go out to young people,” she said. “They’d call it Nashi as an acronym — that was soooo public health!”

The AIDS-prevention program had to be branded. The closest model was a recent relaunch of Sprite. “Sprite took the brand off the shelf into the communities,” Nwokedi says. “They did basketball, sponsored concerts, sent cool kids onto campus, talked up Sprite in Internet chat rooms. It was very driven by celebrities in the community creating the hype. I was looking at what is tactile about your brand, what experiences you create.”

Instead of a fear-driven, preachy, stodgy Nashi, the AIDS prevention campaign became loveLife — positive, hip and fun, “an aspirational lifestyle brand for young South Africans,” as the group’s literature says. Today loveLife is one of the 15 best-known brands in South Africa. The country is dotted with 1,750 loveLife billboards. Radio call-in shows reach three million young listeners a week. LoveLife has TV spots and TV reality shows, including one that sent attractive young people into the wilderness to compete in AIDS-related games, like using the other sex’s tools of seduction. A Web site (www.lovelife.org.za) and magazines feature not only graphic information about H.I.V. but also fashion, gossip and relationship advice.

There are very few South Africans who lack strong opinions about loveLife. South Africa has other AIDS-themed TV series and media campaigns and many other behavior-change programs. But at $25 million a year, loveLife is the giant, and it attracts most of the controversy. Initially, I was a skeptic. LoveLife struck me as empty cheerleading — telling young people who live in cardboard houses and eat a few handfuls of cornmeal mush each day to look on the bright side, when there is no bright side.

LoveLife started out promising too much, pledging to halve the rate of new H.I.V. infections among young people in five years. More recently, it has suffered management problems. South Africans cluck about the fact that the Global Fund to Fight AIDS, Tuberculosis and Malaria cut off a loveLife grant last year — one of only three grants stopped worldwide. The money was being used to, among other things, build rooms where teenagers could go, known as “chill rooms,” in health clinics. Brad Herbert, who was chief of operations at the Global Fund at the time, told me that the grant was canceled because construction was too slow and expensive, but that there were no charges of impropriety. (The grant arrived six months late, and loveLife officials argue that the delay caused cash-flow and exchange-rate problems.)

But many people also question loveLife’s basics. Virtually every South African adult I met thinks that the messages on loveLife’s billboards — the media most visible to adults — are incomprehensible. Many — like “Get Attitude!”— indeed appear to have nothing to do with AIDS. But loveLife’s leaders argue that the billboards, like all of loveLife’s media, are not there to educate young people but to draw them into the face-to-face programs. They promote loveLife as an exclusive club that you, as a teenager, can join. The celebrity gossip and fashion advice in loveLife magazines is also not a message but a delivery system. “The logic of the brand is to create something larger than life, a sense of belonging,” says Dr. David Harrison, a tall, lanky, white physician who became head of loveLife in 2000. “That creates participation in clinics, schools — people go because they like to be a part of loveLife.”

As Sprite did, loveLife uses kids to recruit their peers. It has programs now in a third of the country’s high schools, a seventh of the nation’s health clinics, 130 community organizations and 16 loveLife centers. All these programs are run by what loveLife calls, with a typical typographical flourish, groundBREAKERs. They are young people between 18 and 25, trained and hired for one year at minimum wage to talk about sex, AIDS and relationships, help run school sports competitions (South Africa’s only public-school sports in most of the country), radio stations and computer workshops. Perhaps most important, they are taught how to motivate young people by sharing their own personal histories. That is crucial, as loveLife’s challenge is not to impart information but to cut through fatalism and denial to get young people to apply the information they already know.

I met Harrison in loveLife’s headquarters in the Johannesburg suburb of Sandton, a pleasant campus of modern buildings with interiors painted in loveLife’s trademark purple and white. He said that loveLife’s research found that what particularly put young people at risk was coerced sex. Other factors were low self-esteem, absence of belief that the future offered any reason to make wiser choices today, peer pressure, lack of parental communication and the popular belief that a girl is not a woman until she has a baby. Poverty, low education and marginalization also led to higher rates of AIDS.

LoveLife cannot do much about those last three. Instead it tries to promote family and society communication and help young people acquire the skills and motivation to resist pressure to have sex, especially unprotected sex. “When I ask young people what made them change, they never say, ‘You gave us information,’ ” Harrison says. “They say: ‘I feel an identity with a new way of life. I can be like my friend whose life has changed.”’

There have been some good recent analyses about how to tinker effectively with teenagers’ heads. A study last year led by Dolores Albarracín of the University of Florida examined evaluations of hundreds of H.I.V.-prevention programs. The group found that threats and fear don’t work. This finding argues against “AIDS kills” messages and also against more sophisticated programs that encourage teenagers to confront how AIDS has ravaged their families. For young people, not surprisingly, one of the most effective arguments for making healthier choices is that their peers are doing the same. Programs that produced the most behavior change combined H.I.V. information, attitude change and training in skills like saying no to sex without a condom.

The most serious criticism is that loveLife is aimed in the wrong direction. “LoveLife is too focused on individual choice,” says Warren Parker, the executive director of Cadre, an AIDS group. “We need community organizing around the issues of sexual violence, gender imbalance.” The question of whether to try to change an individual’s behavior or a society’s culture is a big debate in AIDS work. Certainly in South Africa, both seem necessary.

“To stop the epidemic in the long term we need to tackle sexual violence,” says Piot of Unaids. “But the problem is we still have a crisis. If we’re going to wait till men and women have equality and no one has to sell their body — well, we can’t wait for that.”

LoveLife’s message is the same public-health gospel a Nashi would have used: abstinence, fidelity, condoms. But that message is received very differently if it comes during a five-hour lecture in the church hall than it is if it comes from Sibulele Sibaca, a petite, enthusiastic, energetic 23-year-old from Langa, a township outside of Cape Town. Today she is a corporate social investment manager in Richard Branson’s Virgin Group in South Africa. That, she says, is because of loveLife. When she was 12, her mother died of AIDS. When she was 16, her father followed. “Before I joined loveLife, I had a serious history of self-destruction,” she said by phone from Cape Town. “I saw my life ending up in the township, pregnant, not knowing who the father of my child is.”

She got through high school. A friend told her about loveLife, and she began going to its programs. “I had been engaging in highly risky behavior, but loveLife helped me realize there were things I wanted to achieve in my life, and I couldn’t afford to have sex without a condom,” she said. “The reality is that every young person has a dream, but a lot of us look at our situation and think, Who are we kidding? But the minute someone triggers in your brain that it is possible, you start looking at life in a different way.

“Seeing billboards of a dying person didn’t tell me about me,” Sibaca says. “But when someone says, ‘You have such amazing potential that H.I.V. shouldn’t be a part of it’ — then it wasn’t about H.I.V. It was about me. No one is wagging a finger at me. These were people the same age as me. It wasn’t a celebrity telling me their story living in a million-dollar house. It was another young person from the same township as me.”

She applied to be a groundBREAKER. LoveLife trained her to do motivational speaking and gave her facts and ways to talk about teen pregnancy, peer pressure, H.I.V. and other issues. She went to work in a high school, visiting the same class every day for 21 weeks. I asked her whether she felt it helped anyone. She told me about one girl in her class two years ago, also from Langa. “She was 15 and came to me and said, ‘My boyfriend is pressuring me to have sex without a condom.’ Her fear was that her boyfriend would break up with her if she said no, and she had to hold on to him because he gave her money and clothes that her family could not provide her with. I gave her all the different choices and consequences and said, ‘Are you willing to live with those consequences at age 16?’

“She came to me the next week and said, ‘I’m single.’ She had broken up with her boyfriend. I hugged her and started crying — she saw her fears and was willing to go through with it anyway.” Sibaca saw the young woman again a few months ago. “She was not H.I.V.-positive and not pregnant, and she was going to study law next year.”

This is cheerleading — but it’s not empty cheerleading. LoveLife cannot promise any South African teenager that life will be good. But living on one meal a day is even harder if you have AIDS. It seemed valuable to help young people realize that there were reasons to stay healthy and that the choice is theirs.

In Orange Farm, a forlorn and violent township southwest of Johannesburg, I visited a loveLife center, a complex of buildings that draws kids in with a basketball court, a radio-production facility and a computer workshop — but first, kids have to do AIDS training. LoveLife seemed to be Orange Farm’s only after-school alternative to drinking, gangs and sex. In a mining district in rural Limpopo, I visited several health clinics. Nurses at clinics are famous for simply yelling at kids who come in with gonorrhea or a request for contraception, or threatening to tell their mothers. Now these clinics have loveLife chill rooms manned by groundBREAKERs. They have persuaded nurses not to drive teenagers away and will escort teenagers into their appointments.

I watched groundBREAKERs give talks on H.I.V. in schools and after school. The quality of their programs varied with their skills and the local environment. Some were pretty good. At Serokolo high school in the Limpopo mining town, I watched 23-year-old Tebatso Klass Leswifi run a class through a quiz on H.I.V., with discussion that ranged from whether girls become pregnant because of the country’s child grant to why you would want to know your H.I.V. status. He also works at the local health clinic and helps run a league with 10 basketball teams. The high school’s aerobics team — also coached in part by Leswifi — put on a show to the music of the pop hit “Gloria.” I met a 17-year-old named Princess who said she calls Leswifi every day for some words of wisdom to motivate her to stay in school. In another Limpopo health clinic, however, I watched about 20 bored-looking kids sit through a lecture by groundBREAKERs on H.I.V. and loveLife’s programs. It was done in the rote-memorization style still typical in South Africa’s rural schools, with practically no discussion. Still, I heard too many young people tell me loveLife had changed their lives to dismiss it. The organization seemed a little like a cult — and that’s good. Many young people I met told me that loveLife had saved them in big or little ways, and they said they were on a mission to pass that along to others.

There are strong indications that loveLife does indeed change young people’s behavior. In 2003, the Reproductive Health Research Unit of the University of the Witwatersrand in Johannesburg did a survey of 15- to 24-year-olds. It found that people who had participated in loveLife’s programs were only 60 percent as likely to be infected with H.I.V. as those who had not, and the risk diminished further for those who had participated in more than one program. There was also a strong association between loveLife participation and increased condom use — although there was no statistically significant effect on abstention or partner reduction. Since the study was not a randomized, controlled one, it could not prove that loveLife programs caused the behavior change.

LoveLife has not, of course, produced the promised 50 percent drop in new H.I.V. infections. But loveLife’s face-to-face programs have been working nationwide since only 2002. “It is too early to dismiss this,” says Purnima Mane, the director of policy, evidence and partnerships at Unaids in Geneva. “It can take five or six years to see results.” And last month, the South African government reported that new surveys of pregnant women showed that rates of infection in teenagers are holding steady, while the rates of other age groups are rising. This suggests something is working with teenagers. LoveLife currently reaches around 40 percent of South Africa’s youth with face-to-face programs. That’s a lot, but more would be better — given the scope of the catastrophe, $25 million a year is not that much. There are other programs that take a different but equally sophisticated approach, and it would help if they were broadened as well. Where the likelihood your partner is infected is as high as in South Africa, ordinary success might not be enough.

The thinking behind loveLife — get into their heads — needs to become part of every AIDS program, in South Africa and around the world. Governments are still setting goals of providing “access” to medicines or condoms, but access and accessed are very different things. It will be a complicated and expensive change, because what works in one culture may not work in another. It will also require people to take into account what works. It sounds strange to say it, but this is often not a factor. Across Africa, groups are turning to abstinence-only programs not because they work — they don’t — but because that’s what Washington wants to finance. Rigorous evaluation to show which AIDS programs are effective is also necessary, something that is only an occasional afterthought today. Without attention to the social, psychological and cultural factors surrounding the disease, we are throwing away money and lives. This is the new frontier. Twenty-five years into the epidemic, we now know how to keep people from dying of AIDS. The challenge for the future is to keep them from dying of stigma, denial and silence.

Tina Rosenberg writes editorials for The New York Times. She has written for the magazine about AIDS, malaria and tuberculosis, among other subjects.

BBC News
http://news.bbc.co.uk/go/pr/fr/-/2/hi/africa/4166848.stm

August 22, 2005

17
The interview: Edwin Cameron

Supreme Court judge Edwin Cameron, 52, is the only person in public office in South Africa to acknowledge having HIV/Aids. Here, he talks about going public, the political denial surrounding HIV/Aids and the drugs keeping him alive.

Q: You are still the only prominent public figure in South Africa to have announced having HIV/Aids. Why is that?

A: It's an epidemic that affects so many tens of millions of Africans but it's an epidemic of silence. We are still waiting for a cabinet minister in Africa, for a public figure or even for a soccer star or a singer - we have people with tremendous public following in Africa to come forward and say: "I am now living with HIV and this is how I'm dealing with it".

Q: Why are people reluctant? What has been your experience?

A: I was a gay man who came to terms with being a homosexual about 20 years ago. And not long after I came out. I was infected with HIV. I experienced the diagnosis not only as a terrible shock because it was without my consent or knowledge but I also had this tremendous feeling of shame, a sense of contamination, of defilement. I thought the shame about my HIV diagnosis was because I'd got it as a gay man, and I was wrong. At that very time in Africa, we began to realise - it had been evident for the past few years - this was going to be a mass heterosexual epidemic.

Q: You had to separate the stigma of being a gay man in a country like South Africa from the HIV/Aids stigma?

A: A poor black woman... went onto the radio and she spoke about having HIV - three weeks later, she was killed You're quite right. And I've discovered from dealing with many people over the last 20 years, that heterosexual black women, so different from myself in so many dramatic material ways of life, have experienced the exact same sense of being defiled and contaminated, of unworthiness, when they discover they've got HIV.

Q: How do people consider you?

A: I was known as someone who had an expertise in Aids as a human rights lawyer... so I had a stature within the epidemic as a policymaker. But at the same time I was living this dread secret. I decided to speak out because I'd fallen ill with Aids, it had caught up with me after 12 years. I thought I couldn't live this double-life much longer. And then there was a trigger at the end of 1998 when a poor black woman living in a township in Durban went onto the radio and she spoke about having HIV. And three weeks later, she was killed. I thought if [this woman], without any protection, living in a township, not behind a palisade like I do in my middle-class suburb in Johannesburg, not with the income of a judge, not with the constitutional protection... I thought that I should speak out...

Q: The trappings of your life have protected you from the kind of rage that someone felt against her for declaring her Aids status.

A: I was greeted with this absolute flood of loving approbation from all over Africa. I got letters from all over the world. It was on the main television news and the newspapers. I got back to an office filled with flowers. It was a wonderful response. For someone in my position, there is a great deal of approval for speaking out but people in ordinary jobs, people in ordinary communities are still speaking about a great deal of stigma and discrimination.

Q: You originally considered yourself to be heterosexual. When did you realise you were homosexual?

A: For most people in Africa, homosexuality is a very difficult thing to confront. In South Africa, when I was an adolescent, I knew that I was gay but I suppressed it. I never ever thought I would speak about being gay or ever act it out. But I had a failed marriage and the unhappiness it inflicted on my partner and myself made me realise that I had to come to terms with this... e