‘There is a secret in love’: gender, care and HIV management in South Africa

Abstract

Research within geography and cognate disciplines have worked to demonstrate the important ways care(ing) informs the emotive, bodily and obligatory nature of gendered health. Although acts of care shape gendered health inequalities and possibilities for reconfiguration, scholarly research tends to focus on individual caregiving and receiving relationships within the domestic sphere, eliding more complicated, contradictory and uncomfortable questions of care that emerge in and through the wider social context. South Africa’s HIV/AIDS epidemic provides important opportunities to engage contradictions in care since expanded access to antiretroviral therapy allows women to care for their health with increased confidence. Drawing on qualitative research with women in South Africa, we argue that while new HIV management regimes rework opportunities for women to care for and enhance bodily health and wellbeing, they paradoxically conflict with women’s ability to care for and maintain their gendered selves, generating possibilities for harm, conflict and abuse. New biomedical modes of care mean women are often forced to make contradictory decisions between caring for their health but losing idealized notions of the gendered self, or caring for their gendered self, but undermining their possibilities for health. This article concludes that future geographic research on gender-health-place interactions should extend the practice and politics of care by illuminating how constructions, experiences and enactments of gender, health and disease mediate encounters with care and the institutions that attempt to manage them.