CSA&G to co-host ‘Deadly Medicine: Creating the Master Race’ Exhibition

deadly medincine

The CSA&G, Department of Library Services and the Faculty of Humanities will be hosting a provocative exhibition exploring the Nazi regime’s “science of race” and its implications for medical ethics and social responsibility today.

From 1933 to 1945, Nazi Germany carried out a campaign to “cleanse” German society of people viewed as biological threats to the nation’s “health.” Enlisting the help of physicians and medically trained geneticists, psychiatrists, and anthropologists, the Nazis developed racial health policies that started with the mass sterilization of “hereditarily diseased” persons and ended with the near annihilation of European Jewry. Deadly Medicine: Creating the Master Race traces this history from the early 20th-century international eugenics movement to the Nazi regime’s “science of race.” It also challenges viewers to reflect on the present-day interest in genetic manipulation that promotes the possibility of human perfection.

The exhibition and a series of seminars will run from 4 – 27 September on Level 3 of the Merensky Library on the University of Pretoria’s Hatfield Campus.

This travelling exhibition of the United States Holocaust Memorial Museum has been made possible by The Lerner Foundation and Eric F. and Lore Ross, with additional support from the Lester Robbins and Sheila Johnson Robbins Traveling and Special Exhibitions Fund established in 1990.


Submission from the CSA&G on Draft National Policy on the Prevention and Management of Learner Pregnancy in Schools

The Centre for Sexualities, AIDS and Gender (CSA&G), based at the University of Pretoria (UP), would like to express its wholehearted support for the Draft National Policy on the Prevention and Management of Learner Pregnancy in Schools, circulated for comment, by 31 July 2018.

The CSA&G is a 20-year-old semi-autonomous unit, working under the umbrella of the Humanities Faculty at UP. Using HIV and AIDS as both a lens and a springboard, it seeks to explore, at the university and beyond, themes of: social and community justice; institutional and social transformation; sexual and reproductive health and rights for all; sexual diversity and sexual citizenship; the challenges and dynamics of gender, identity, race and class; personal and social leadership for active citizenship and political accountability; and effective community engagement. It’s mission is: “understanding power, exploring diversity, examining difference and imagining inclusivity”.

When it comes to the question of youth sexualities in general, and teenage pregnancy in particular, we firmly believe in a Comprehensive Sexualities Education (CSE) approach and believe that the evidence[1] supports the view that information, education and supportive engagement on sexualities and gender reduces teenage pregnancies, lowers the incidence of HIV and delays sexual debut. In contrast, the evidence on abstinence-only approaches[2] shows that these disempower young people and in fact do not result in lower risk for HIV, STIs and pregnancy.

The Policy makes a clear case for the role of teachers, informally of course as stigma and unprocessed teacher attitudes are a major barrier to acceptance, but formally through the Life Orientation (LO) curriculum. Evidence[3] suggests that LO fails at a number of levels, in what is taught (teachers omit what makes them uncomfortable), in how it is taught (teachers often moralise) and who it is taught by (LO is not seen as having sufficient importance). The work of McLeod et al[4], who conducted a formal review of LO, shows that there is much that needs improvement. Our recommendation is that an audit of LO in South African schools and ongoing monitoring of LO practices is a critical adjunct to this policy.

The Policy is thin on male involvement in our view. Where girls and young women conceive after sex with young male peers we argue these young people need support and the young men need help to support their partners, if the relationship is ongoing. Where possible families should be able to come together to support fatherhood. Where relationships have ended, or never existed, young men may still wish to be supportive and should receive counselling and support to understand their roles. The LO curriculum is a useful entry point to some of these discussions.

In the case of older men, the question of statutory rape is addressed in the Policy, but where the girl or young woman has conceived after sex with a teacher the Policy should be clearer on legal and disciplinary procedures to sanction the perpetrators. We would also like the Policy to address the question of “informal” reparations, some of a financial nature, which may be adopted by families of the parties involved, to avoid negative repercussions for the perpetrator.

The CSA&G strongly supports the Policy’s approach on stigma, and we argue for intensive programmes to reduce the stigma associated with: teenage sexuality in general; contraceptives, condoms and termination of pregnancy; and pregnancy itself. We believe that many of the “moral anxieties” of parents and communities become focused on young girls, who are expected to be moral gatekeepers. The gendering of morality places an unfair burden on young girls and misses an opportunity to locate teenage pregnancy in a structural analysis.

Finally, we would like to make a case for two forms of media messaging: firstly around positive and affirming stories of teenage parents who succeed and do well, to avoid catastrophisation narratives; and secondly around teenage pregnancy rates, to expose the SA public to the knowledge that these are dropping.


[2] Nathan C. Lo, Anita Lowe and Eran Bendavid. Health Affairs 35, no.5 (2016):856-863

Abstinence Funding Was Not Associated With Reductions In HIV Risk Behavior In Sub-Saharan Africa

[3] Francis, D. Sexuality education in South Africa: Whose values are we teaching? The Canadian journal of human sexuality 22(2):69-76. October 2013

[4] Glover, J. & Macleod, C. (2016). Rolling out comprehensive sexuality education in South Africa: An overview of research conducted on Life Orientation sexuality education. Unpublished policy brief document, Critical Studies in Sexualities and Reproduction, Rhodes University, Grahamstown.

Should people living with HIV assume the main responsibility for being open about HIV?

by Pierre Brouard and Rob Hamilton

In a recent posting on Facebook, an HIV educator living with HIV was highly critical of gay men who are HIV positive, yet who say on gay dating and hook-up sites that they are “HIV negative on PrEP”.  He called them out for “lying” about their status, arguing that being HIV negative on PrEP is not equivalent to having being HIV positive and having an undetectable viral load on ART.

He suggested that making a claim like this in effect denied the other party the right to make an informed decision about whether or not to have sex with the person who was living with HIV, because they “would not have sex with them if they knew they were HIV positive”. Yet he admitted that a person living with HIV who takes antiretroviral treatment as prescribed and has achieved suppression of the virus in their body is safer to have sex with than someone who does not know their current HIV status.

He tacitly acknowledged that the prospect of having sex with an HIV-positive individual was still daunting for some HIV-negative people, because prejudice and stigma persisted. He claimed that stigma could be “stopped” if people living with HIV didn’t “present false information just to get a lay”.

We respect these views, and they may indeed be popular, but suggest they are an interesting starting point for some debates and provocations, which we set out below.

Why do we lie?

As two gay men concerned about HIV – one of whom is living with HIV and has an undetectable viral load, and one of whom is to the best of his knowledge still HIV negative – we thought it useful to look more closely at the meanings and unintended implications of this Facebook post. Firstly, we agree that deliberately misleading someone with a conscious intention to cause them harm is indefensible.

And in an ideal world we would all be honest with each other about everything (including our HIV status). But the truth is that we don’t actually live in an ideal world: the truth is often unpalatable, or it offends some people, and it alienates others. In some circumstances, telling others the truth – such as disclosing one’s HIV-positive status online – elicits a negative response, which can range anywhere from the other person refusing to chat further and blocking all future messages, to harsh judgements and vicious name-calling, through to various unpleasant threats, and in some cases, it can even culminate in physical assault or much worse than that.

While some might argue that only minor consequences follow truth-telling on a hook-up site, any disclosure of one’s HIV-positive status to a complete stranger on an internet site involves an enormous leap of faith, and, in truth, means making oneself vulnerable and taking a major risk which is seldom appreciated or respected by the recipient of the message. In fact, we have seen that it far too often leads to summary and hurtful rejection: the conversation is ended by the other person with no explanation given, and the person who has disclosed their HIV-positive status is blocked from having any further communication with them.

Stigma management

We argue that gay men who are living with HIV might adopt an “HIV negative on PrEP” identity as a self- preservation strategy. Yes, they are not telling the full truth – an act which some might see as lacking integrity – but they are attempting to protect their public identities, and to maintain the integrity of their self-image: a self image which may have taken a battering as a result of relentless hostility from both straight and gay society over nearly four decades of the HIV epidemic. To say that one is “HIV negative on PrEP” is  a less risky way of communicating that one cannot infect another person with HIV, even via unprotected sex , which is true for a person living with HIV who makes sure that they stay “undetectable on ART”. The words might differ, but the effective meaning is the same. Perhaps those of us who are HIV negative need to ask ourselves: why and in what ways we contribute to a society which still stigmatises people with HIV?

Internalised stigma

Furthermore, when people living with HIV express views that imply that people living with HIV should be held to a higher moral standard than others, we argue that this is actually a form of internalised stigma. To require gay men living with HIV to be more consistently honest than other gay men suggests having bought into the idea that gay men living with HIV are in some sense ‘damaged’ goods, and, therefore, that they should be held to a higher set of standards than other gay men!

This is of course unremarkable, since it is inevitable that someone with a “socially spoiled” identity will experience internalised stigma to some degree. We need to remember too that very few of us – whether gay men or lesbians – ever completely divest ourselves of the homophobic beliefs and attitudes that surrounded us and that we all grew up with. This can lead to many forms of self-loathing, self-justification and self-promotion. We think here of ideas of queer fabulosity and exceptionalism as two common examples of this.

Or the comment so often made in conversations between two gay men – and, if we are honest, we need to admit that most of us have indulged in such stereotyping at one time or another: “Well, you know, I’m not like other gay men. They are so promiscuous / shallow / just after sex / not interested in a real relationship / unreliable / judgemental / camp / two faced / materialistic / unattractive / pretentious / etc” (fill in the applicable negative description yourself).

Moral certainty?

Do gay men living with HIV owe their potential partners the “complete truth” about themselves and their HIV status? In an ideal world we would all tell the truth all the time. But in an epidemic which has seen people living with HIV betrayed, attacked and excluded, we suggest that strategies for psychic self-protection, like a claim of being HIV negative on PrEP, need to be understood in more nuanced ways and perhaps judged less harshly. Humans lie all the time, and not just to “get a lay”.

We acknowledge that some might find our ideas controversial, and that they could reinforce the irrational fear in some quarters that people living with HIV are more “unreliable” than others, or that they seek to “deliberately infect” their sexual partners. But what we are trying to do is to unravel apparent moral certainties, to embrace complexity, and to understand these so-called acts of “lying” a little differently.

PrEP as a social signifier

Finally, as PrEP rolls out and it is absorbed into the social imagination and adopted as a “folk” understanding of biomedicine, it will be used increasingly as a social signifier of being HIV negative, of being HIV anxious, of being HIV careful, and perhaps even of being willing to take sexual and other risks. This is normal, and we believe that claims of being HIV negative on PrEP  are not to be railed against and vehemently condemned, but that they need to be understood as yet another example of how humans adapt to new scientific developments and fresh knowledge.

Already tensions are on the rise in queer communities, tensions between the undetectable = uninfectious (U=U) and the HIV-negative-on-PrEP rhetoric. At the recent International AIDS conference in Amsterdam, Nic Holas of the Australian online organisation the Institute of Many pointed to the tension between these two approaches. Some PrEP users remained fearful of and stigmatised people living with HIV, he suggested. They prioritised their new found freedom but ignored the fact that it had only been possible to develop PrEP “after people with AIDS put their bodies on the line”, adding that “in the age of PrEP, people living with HIV must not shy away from taking up space and ensuring [their] voices are heard. It is not enough to end the HIV epidemic with PrEP and leave us isolated, criminalised and stigmatised.”

So what’s the answer?

To reduce stigma, we argue, it is important to acknowledge that stigma is in all of us, and that it might well be wired into the human condition, and be a common feature of all human societies over time.

We need better social science and more comprehensive interventions, which dig down into the subtle and intractable nuances of “othering”. Expecting people living with HIV to do all the “heavy lifting” on online hook-up sites is, we believe, both unfair and unreasonable, and does them a real disservice.

Finally, we need to acknowledge that new tensions inevitably develop as biomedicine evolves. It might be more helpful in a case like this to not respond so quickly, but to rather apply our social science lenses and try to understand what these emerging social meanings and new identities are actually all about.