WORKING PAPER 08/235Title: The influences of AIDS-related morbidity and mortality on change in urban households: An ethnographic studyAuthor(s): Rachel Bray Date of Publication: December 2008 Price: R 5.00 Abstract Drawing on qualitative panel data collected in a poor township on the edge of Cape Town, this paper provides a fine-grained analysis of the residential decision-making of five HIV positive women and some of their children. HIV status and illness are found to add to the pressures exerted by income and asset poverty in ways that further incline women to seek residential security for themselves and their children. The presence of HIV intensifies the mental health implications of pre-existing socio-economic burdens and efforts to respond to these. Much of the resultant mobility cannot therefore be considered AIDSspecific. At the same time, being HIV positive and unwell (or anticipating illhealth) prompts women to organise particular domestic arrangements for themselves and their children. Previously non-resident children are moved from distant relatives to join the urban household, incurring financial and social strain on the domestic group and on infected women in particular. Infected mothers want to live with all their children so that they can nurture them, have opportunity to disclose and familiarise their children with the everyday implications of being positive and on treatment, and to ensure they have the skills to survive on their own should they themselves die. Such moves can be made without raising suspicion of HIV within the family because there is a wellestablished pattern of moving teenagers from the Eastern Cape to schools in Masiphumelele for reasons of improving education. Other factors that act alongside, and often in relation to, women’s HIV status in shaping their residential decision-making include the nature and structure of related rural and urban households, point in the domestic development-cycle of different branches of the family, a woman’s personal relational history and her individual temperament. We found that close connections with a rural home reduced women’s sense of vulnerability but were not always the first port of call for support owing partly to fears around disclosure and (often related) anticipated compromises in their abilities to claim resources from the rural home in future moments of greater need. The mothers in our sample were reticent to disclose to their own mothers and saw the rural maternal home as a 2 possible (but not always preferable) option for their young children but not themselves or their older children. And while siblings living close by were often those to whom women first disclosed their status, the homes of sibs who had resident children of their own were not experienced as available. The ethic of responsibility that exists between siblings includes attention to the moral integrity of individuals and the family, which can conflict with parallel efforts of care and support for those in greatest need. These dynamics appear to partly explain women’s preference to live with their partner and children, or their children only, rather than with members of the wider family. Such decisions are also shaped by the increased importance of sustaining and asserting control over their own and their children’s residence for women who experience their status and illness as tangible evidence that they cannot control their health or longevity. |