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How AIDS KillsBy Bhekisisa MncubeBook Title: Letting Them DieAuthor: Professor Catherine Campbell, London School of Economics &Political SciencePublisher: The International African Institute in association with JamesCarrey, OxfordHow Aids Kills?Letting them Die is about the construction of sexuality by migrant mineworkers, commercialsex workers and young people in the South African mining town of Summertime inJohannesburg. It is a valuable study of the Summertime HIV/AIDS Project, and it reveals whyHIV/Aids intervention programmes often fail.The book is a result of seven years of collaborative research including monitoring andevaluation of a multi-million rands HIV/AIDS campaign based in Summertime, one of the worstaffected mining towns in South Africa. The book highlights the barriers and constraints incontrolling and managing the AIDS pandemic.Summertime is home to 170 000 predominantly black African people. About 70 000 of theseare migrant mineworkers who dig gold for a living. These workers are housed in single-sexhostels, which sometimes have as many as 12 or 18 men in a room - this offers no privacy andscant opportunities for intimate relationships. It is these men, the book suggest that gave birthto a thriving commercial sex trade. It reveals that women find accommodation in informalshack settlements on the mine perimeters from where they sell sex and alcohol to the miners.Some women, the study found also sell sex in the open fields surrounding the mine fence.The Summertime Project sought to limit HIV-transmission through three activities: SexualTransmitted Infection (STI) control; community-led peer education and condom distribution;and, local multi-stakeholder collaborative project management.The book seeks and succeeds in answering the following key questions: • Why do people knowingly engage in sexual behavior that could lead to a slow and painful premature death? • Why do the best intentioned attempts to stem the tide of the epidemic often have so little impact?
The book plays special attention to the phenomenon of sexuality, and the way it is shaped andconstrained by an avalanche of factors. These range from the deepest psychological needs forintimacy and pleasure, to the complex and unequal relationships between women and men,rich and poor.The books central argument is that AIDS is a social problem that is embedded in unevendevelopment, and to address it requires multi-pronged strategies including stakeholdercollaboration. The book suggests that the solution to the AIDS crises lies beyond the bio-medical approach. It says the one vital strategy for reducing HIV-transmission in Summertimeor anywhere in South Africa would be to reduce the social inequalities that undermine the lifechances of so many people. Author, Professor Catherine Campbell maps a link between chronicunemployment, poverty and housing shortages - and how these have become entangled withthe ideas about masculinity, love and sex thus creating an economy of exchange thatperpetuates the transmission of HIV/AIDS.The study found that sexualities are constructed and reconstructed at the intersection of akaleidoscopic array of interlocking multi-level processes, ranging from the intra-psychological tothe macro-social. After conducting many interviews and surveys with the Summertimeresidents in the three categories - mineworkers, commercial sex workers and youth, Campbell,concludes that the driver of the epidemic is linked to the innermost needs for trust andintimacy. These are symbolized by the closeness of the flesh-flesh sex.Several surveys and focus groups conducted with mineworkers and other informants revealedshocking results - these men have high levels of HIV/AIDS awareness, and yet they refuse towear condoms. It is these condom forsaking men who drive the spread of the epidemic. Someminers opined that there is nothing more risky than going underground to dig for gold in returnfor a pittance. In their warped view of reality, the risk posed by AIDS pale into insignificance inrelation to their full-time profession. On the other hand commercial sex workers did not alwaysinsist on condoms because they dont want to alienate their regular clients. Some claimed thatthreats of or real violence was the main driver for their condom forsaking behaviour.The study concludes that in this mining town, AIDS will kill six out of ten young women and fourout of ten young men.Letting them Die is sad book that documents the voices of real people who knowingly engage insexual behaviour that could lead to a slow and painful premature death. It sadly shows thateven the best intentioned programmes such as the Summertime Project are susceptible tofailure unless the government addresses the fundamental causes of inequalities between menand women, and rich and poor among others.