HIV Responsibilization: Stigma, Disclosure, and Care in the Age of 90-90-90

Authors: Brian King*, Pennsylvania State University
Topics: Medical and Health Geography, Cultural and Political Ecology, Development
Keywords: HIV, stigma, responsibility, South Africa, care
Session Type: Paper
Day: 4/6/2019
Start / End Time: 3:05 PM / 4:45 PM
Room: Chairman's Boardroom, Omni, East
Presentation File: No File Uploaded


It was announced in September 2018 that World AIDS Day would mark its thirtieth-year anniversary with the theme “know your status.” In making this declaration, the World Health Organization emphasized that HIV testing is essential for expanding treatment and ensuring that all people living with HIV can lead healthy and productive lives. Importantly, the organization announced that knowing one’s status is crucial to achieving the 90–90–90 targets, which emphasize that by 2020, 90% of all people living with HIV will know their status, receive sustained antiretroviral therapy, and will have viral suppression. Media declarations about the campaign also emphasized that knowing one’s status is “empowering people to make choices about HIV prevention so they can protect themselves and their loved ones.” This messaging reflects a larger theme in the age of expanded antiretroviral therapy: being responsible to one’s own health obligates caring for the health of others. Responsibilization is routinely understood as the transfer of responsibility from external authorities to communities or individuals who are expected to take an active role in resolving their own problems. Key to these developments are the sites through which HIV responsibilization occurs and how responsibility is marshaled as a political act. This paper draws from ongoing research in rural South Africa on the management of HIV within resource constrained environments. Qualitative and quantitative methods conducted from 2012 – 2016 outline the challenges for those living with HIV, particularly when stigma and other needs remain stark even for those intent on knowing their status.

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