HIV/AIDS in South Africa

Submitting Institution

Brunel University

Unit of Assessment

Anthropology and Development Studies

Summary Impact Type


Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

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Summary of the impact

Six million South Africans are currently infected with HIV and two million have died from AIDS- related diseases. Initially seen solely from a medical perspective, there is now recognition of social and cultural factors, such as witchcraft, that have shaped the pandemic. Niehaus's research findings, which have been disseminated beyond the academic domain, form part of a diverse body of social scientific literature on HIV/AIDS in South Africa. Niehaus's work has (i) enhanced cultural understandings; (ii) shaped public debate; (iii) contributed towards the training of health personnel; (iv) assisted the work of legal practitioners; and (v) assisted in the production of cultural artefacts.

Underpinning research

Niehaus (lecturer at Brunel University) has done in-depth, independent, ethnographic research on the HIV/AIDS pandemic in the South African lowveld. He has visited the field site for at least one month each year. Within the larger body of social scientific literature on AIDS, Niehaus's work focuses on rural contexts and on deep cultural meanings. The multi-temporal nature of the fieldwork has provided Niehaus with a unique perspective on the local history of the pandemic. He has worked with the active collaboration of Eliazaar Mohlala and Eric Thobela, two local residents employed as research assistants, and he has collaborated with a number of South African scholars, including Mary Crewe (Centre for the Study of AIDS in Pretoria); Jonathan Stadler (School of Public Health, University of the Witwatersrand) and Frazer McNeill (Department of Anthropology and Archaeology, University of Pretoria).

The research findings have challenged several orthodoxies.

(i) Questioning AIDS Stigma. The central argument has been that in the South African lowveld the stigma of AIDS is due not to its association with promiscuous sexuality but to its association with death. Niehaus suggests that persons living with AIDS are perceived as `dead before dying' and as located in the liminal domain between the categories of `life' and `death' — an outcome of health workers' emphasis on prevention and their portrayal of AIDS as a fatal, untreatable condition.

(ii) Religion and AIDS Stigma. Niehaus suggests that Christian churches, particularly Zionist Congregations, have actively contributed towards stigmatising sick persons by constructing AIDS as a new, deadlier kind of leprosy with all its overtones of divine punishment.

(iii) Gender and AIDS. Niehaus's research has illuminated the gendered nature of AIDS, documenting how sexual violence has facilitated the spread of HIV. He has shown that men are more likely than women to resist biomedical paradigms and to accept conspiracy theories concerning the origin and spread of HIV/AIDS. Men's commitment to political paradigms is due to their location in the public sphere and their traumatic experiences of deindustrialisation. This finding highlights the need for health workers to be sensitive to men's gendered concerns.

(iv) Witchcraft, Culpability and AIDS. Niehaus has argued that a reluctance to test for HIV antibodies relates to the issue of culpability. Accepting that one is HIV-positive often amounts to an acknowledgement that one might have infected sexual partners with a potentially deadly virus. Hence people often respond to HIV/AIDs with silence. Otherwise, they might deflect culpability by claiming that they had been victims of witchcraft. In this sense HIV/AIDS has spawned an increase in witchcraft accusations.

(v) Barriers to HIV Testing and Antiretroviral Treatment. Since 2004, the government has launched a public roll out of HAART (Highly Active Antiretroviral Therapy). Through the use of life histories Niehaus has explored different reasons for the late uptake of testing and treatment, including the issues of poverty, stigma and treatment literacy. He suggests that in an environment characterised by widespread blame, it might be more appropriate to maintain confidentiality than to insist on public confessions.

References to the research

Niehaus, Isak. 2013. `AIDS, Speech and Silence in South Africa'. Anthropology Today 29 (3), 8-12.


Niehaus, Isak. 2013. Witchcraft and a Life in the New South Africa. New York: Cambridge University Press. [Available from Institution: submitted to REF2]


Niehaus, Isak and Fraser McNeill. 2010. Magic: AIDS Review 2009. University of Pretoria: Centre for the Study of AIDS in Africa.

Niehaus, Isak. 2010: `Witchcraft as Sub-Text: Deep Knowledge and the South African Public Sphere'. Social Dynamics 36 (1), 65-77.


Niehaus, Isak. 2009:`Leprosy of a Deadlier Kind: Christian Conceptions of AIDS in the South African Lowveld.' In Felicitas Becker and Wenzel Geissler (eds.) AIDS and Religious Practice in Africa. Leiden: C.J. Brill, 309-332. [Available from Institution: submitted to REF2]


Niehaus, Isak, 2007. `Death Before Dying: Understanding of AIDS Stigma in the South African Lowveld', Journal of Southern African Studies 33 (4), 845-860.


Evidence of Quality of Research
The work has received extremely positive references from academic and non-academic readers and has been published in prestigious academic journals widely used in medical fields. In the period under review Niehaus received small grants from the British Academy (£3,000 in 2007) and also from the Centre for the Study of AIDS at the University of Pretoria (R15,000 in 2009). The publications are regularly cited in academic literature in diverse applied fields — including anthropology, health sciences, development studies, law and African studies — and in different countries — Europe, Africa and the United States. The sources entered received 59 citations on Google Scholar. An official website of the Journal of Southern African Studies lists the essay `Dead Before Dying' as the sixth most regularly cited of all its articles.

Niehaus has received regular invitations to speak to academic forums highly influential in applied fields. Talks have included presentations at conferences entitled `Paradoxes of the Postcolonial Public Sphere', (Johannesburg, 2008); `Making Sense of Health, Illness and Disease', (Oxford, 2010); `Sexuality, AIDS and Religion in Africa' (Oxford, 2011); and at the `AIDS and Silence' panel of the African-European Group for Interdisciplinary Studies (Leipzig, 2009). Niehaus presented the AIDS Forum Lecture hosted by the Centre for the Study of AIDS (Pretoria, 2008); and read papers at departmental seminars the universities of Uppsala, Sweden (2008), Pretoria (2009), the Open University(2009), Cambridge (2010), Manchester (2010), Sussex (2011), Bergen (2013), Bern (2013), London School of Economics (2013), and the London School of Hygiene and Tropical Medicine (2013).

Details of the impact

i) Enhancement of Cultural Understanding. The research findings have been disseminated beyond conventional academic institutions. With Fraser McNeill, Niehaus wrote a review for the Centre for the Study of AIDS in Pretoria, entitled Magic. The Centre distributed 3,500 copies to libraries, organisations, and funders in the AIDS Industry (such as Oxfam). This study can be accessed on internet and has to date registered 2,229 downloads, which is more than any other review published by the Centre. The monograph, Witchcraft and a Life in the New South Africa (2013) is written in popular, accessible language. In June 2013, it was reviewed in the London Review of Books (by Jeremy Harding), and the Times Literary Supplement (by Tanya Luhrmann). Niehaus gave interviews to the English service of South African FM Radio in 2008 and to HBO television in the United States in 2013. The latter show draws over 1 million viewers.

(ii) Shaping of Public Debate. The media have cited Niehaus's argument that in an era of deindustrialisation male sexual violence dramatises the ideal of lost masculine dominance. This suggests that women's empowerment alone is unlikely to curb the spread of HIV, and highlights the need for prevention campaigns to address men's gendered concerns. A colloquium on violence against women and the structural drivers of HIV/AIDS, hosted by the organisation 30/30 in Johannesburg on 11 August 2010, debated Niehaus's work. He is also listed as an expert on the gender and security research hub of the Social Sciences Research Council in New York. The Hub provides researchers, policy shapers, and practitioners with the evidence needed to advance their work and contribute to increasing women's security. An influential research report by the South African AIDS Foundation, entitled `Towards the Development of an Integrated Model for the Effective Provision of Heath Care on Community Level' (2009), refers to Niehaus's arguments on AIDS stigma and on the connections between AIDS and witchcraft.

(iii) Contribution to the training of academic and health personnel. Niehaus' work regularly features in syllabi of courses taught at prominent universities, some with a strong applied element. These include courses in political anthropology at Galway in Ireland; African History at Maryland (US); religion and society in Denmark; and anthropology in Aberdeen and Illinois. A course offered by the Centre for Faculty Development at Emory University in Atlanta called `Viral Cultures' devotes a full week to Niehaus's research on death and dying. Pearson Holdings South Africa recently requested permission from Niehaus to reproduce sections of Magic in the influential volume, HIV and AIDS: Education, Care and Counselling (5th edition). The volume is used as a training manual for nurses and AIDS counsellors.

(iv) Assistance in the Work of Legal Personnel. Niehaus has participated in two influential workshops geared towards empowering legal personnel to deal more effectively with cases involving witchcraft. In August 2010 he worked as an instructor in a course organised by FAHUMA and the United Nations High Commissioner for Refugees. The course examined different means of assisting the victims of witchcraft related violence, and determining their entitlement to refugee protection and human rights. In 2013 he was also a discussant at a workshop entitled `Witchcraft, Spirit Possession and Anthropological Expertise in Legal Contexts' at the London School of Economics. The workshop involved lawyers, social workers and police. Niehaus is currently listed as a specialist on witchcraft by the FAHUMA Refugee for legal AID Network.

In February 2013, Niehaus advised Ian Nichols, the chief lawyer representing the families of 34 deceased miners at the Farlam Commission of Enquiry in South Africa. In 2012, police killed the miners whilst they engaged in a strike near Marikana mine. He wrote a critique of a report submitted by an anthropologist suggesting that the police acted in self-defence. The report contends that the miners had used a potion called intelezi, which they believed rendered them invulnerable, invisible and invincible, should they attack the police. Niehaus disputes the claim on the ground of insufficient evidence, contending that miners simply used intelezi to ensure the success of their wage demands.

(v) Assistance in the Production of Cultural Artefacts. Niehaus contributed two chapters to the catalogue of an exhibition at the Johannesburg Art Gallery called Dungamanzi/Stirring Waters. The innovative exhibition displays items used by Shangaan diviners and healers. The exhibition stood from 2007 to 2013. Niehaus granted an extensive interview on the topic of conspiracy theories and AIDS to HBO Public Television from New York. The programme is to be screened on the popular Vice Show throughout the United States.

Sources to corroborate the impact

(i) Enhancement of Cultural Understanding. For downloads registered by the Centre for the Study of AIDS, see:
On reviews of Niehaus monograph Witchcraft and a Life in the New South Africa (2013) see:§ionId=1809&p=tls

(ii) Shaping of public debate. For citations of Niehaus work in media reports and in government reports see:

(iii) Contribution to the training of academic and health personnel. On the listing of Niehaus research in syllabi for course to academic and health personnel see:

Corroborating evidence of request to cite material in a training manual for nurses and health personnel is available.

(iv) Assistance in the Work of Legal Personnel.

For listing as an expert as by the FAHAMU network see:
Details on course presentations and also details of correspondence with Jim Nichols, lawyer representing families of the deceased miners at the Farlam commission of enquiry in South Africa are available.

v) Assistance in the Production of Cultural Artefacts: On the catalogue for the Johannesburg Art gallery exhibition on Shangaan traditional healers, see:

Correspondence on the production of the HBO television programme is available.