Chlamydia and You

October 27th, 2011 by | Permalink



There are a number of different sexually transmitted diseases out there of course, one of which is Chlamydia. Let’s talk a bit about this particular condition, its origins, and what types of affects it will have on either gender. First of all, Chlamydia is actually one of the more common sexually transmitted diseases, and it is caused by the bacterium Chlamydia trachomatis.

The disease affects two general areas: the eye and genitals. At the moment it is believed that somewhere around one million people in the United States are infected with the disease, and transmission can be performed through vaginal, anal, or even oral sex. Though anal sex is considered safe by many, this is actually a misconception that needs to be corrected. Anal sex can cause bleeding and therefore a serious risk of infection actually exists. That being said, it would be important to practice safe sex, and try to avoid anal sex if you are aware that the other individual is infected with any type of STD.

Symptoms

The symptoms of Chlamydia can differ significantly between men and women, so with that being the case, we will discuss the symptoms commonly found in women first.

Women

Something interesting to note regarding this condition is the fact that in women it often does not show any symptoms. This is true in about 75% of the known Chlamydia cases, and it can in fact sit unnoticed within the system for several years. There is however the chance that it can cause vaginal bleeding, abdominal pain, pain during intercourse, fever, or even frequent urination. If you notice these symptoms within yourself, it would be in your best interest to make sure you seek treatment as quickly as possible.

Men

In men, the condition will behind to provide unusual discharge from the penis along with swollen or even tender testicles. Fever may accompany the condition and if left untreated it could cause epididymitis in the testicles. There is also a chance of course that prostatitis will occur in men which is never a favorable outcome.

While this particular sexually transmitted disease is not fatal, it does cause complications that most people will not want to experience in their lifetime. It is a fact however that a large number of people will be infected by a sexually transmitted disease within their lifetime which makes preventative measures that much more important. Start  memorizing the symptoms today and even speak with your physician regarding the different courses of treatment that you might take when you realize that treatment is your only option. The diagnosis is not the end by any means, but it is certainly a new beginning that you will need to address if you are to live a normal life again.

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Understanding Lymphogranuloma Venereum

October 15th, 2011 by | Permalink

While there are many different types of sexually transmitted diseases in the world, only the more common diseases are usually

covered by awareness campaigns and media documentaries. However, the dynamic nature of the world means that new sexually transmitted diseases are discovered every day or become prominent off and on. One sexually transmitted disease that was considered very rare before the year of 2003 is Lymphogranuloma Venereum. As a result of this sexually transmitted disease becoming more prominent in recent years in even developed countries, it is critical that awareness about it is increased. The following are some basic facts pertaining to Lymphogranuloma Venereum.

Picture of a male with Lymphogranuloma Venereum

Lymphogranuloma Venereum

What is Lymphogranuloma Venereum?

Lymphogranuloma Venereum is a sexually transmitted disease that affects both men and women alike. It is a disease that is caused by the microorganism Chlamydia Trachomatis. Chlamydia Trachomatis is a bacterium that enters the body through some break in the skin or through mucous membranes. Other names of the disease include Climatic bubo, Durand Nicolas Favre disease, Poradenitis inguinale and Strumous bubo. As the name of the sexually transmitted disease suggests, it involves the infection of the lymph nodes. Once a person is infected, the

organism moves down the lymphatic tunnels and multiplies within the mononuclear phagocytes of the lymph nodes.

What are the different stages and clinical manifestations of the disease?

There are primarily three different clinical manifestations of Lymphogranuloma Venereum, namely the inguinal syndrome, the rectal syndrome and the pharyngeal syndrome. As the names suggest, the three manifestations show up in different places of the body with the inguinal syndrome seen in external sex organs i.e. vagina and penis, the rectal syndrome in the anus and the rectum and the pharyngeal syndrome seen in the pharynx and the neck.

The symptoms or the physical manifestations of the sexually transmitted disease vary on the basis of the stage at which the disease is. There are primarily two stages of the disease i.e. the primary and the secondary. The primary stage of the sexually transmitted disease is characterized by a single genital ulcer that is hard to spot for both men and women but more in women. The primary stage symptoms show up between three to twelve days of infection.

The second stage of the disease, although usually seen within 10 to 30 days after the primary stage, can be seen for up to six months. There is a range of clinical symptoms of this kind of infection with visible manifestations being abnormal discharges, pain, swelling and a range of other problems. It is worth noting that as the organism multiplies and the disease progresses, there is significant swelling in lymph nodes which are then called buboes.

How is Lymphogranuloma Venereum cured?

The treatment of this sexually transmitted disease is an amalgamation of different procedures such as antibiotic regime, drainage of buboes through needle aspiration or even incision, dilation of the rectal stricture, and many others. Commonly used antibiotics in the case of Lymphogranuloma Venereum are tetracycline, doxycycline and erythromycin. Untreated Lymphogranuloma Venereum can result in a variety of more complex problems like edema, arthritis, pneumonitis, hepatitis and perihepatitis.

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The Independent Voter Theory – Myth or Reality?

September 27th, 2011 by | Permalink

With the U.S. elections so near, the media is vividly discussing the independent voter. Over the past weeks, news agencies claimed that independent voters were the largest sector of the American electorate, making any candidate who grabs their attention the next American president.

As a result, many are questioning whether independent voters are more powerful than loyal Democrats and Republicans.

The Independent Voter in the US

Independent voters, or those who register themselves as unaffiliated voters, are individuals who aren’t aligned to a political party. This indicates that voters aren’t loyal to a single political party, which means that they don’t usually elect the same party every time.

As a result, rather than voting because of a political ideology or partisanship, they vote based on opinions they have made on the candidates and the way they deal with issues.

The concept of the independent voter has been around in the United States since the early 1950s. In 1952, the number of independent voters reached 22 percent. After that, it continued to fluctuate between 22-37 percent until the late 1980s. In the 1990s, the number of independent voters reached 30 percent and remained that low for two decades.

Are These Voters Real or Myths?

According to political scientists, the independent voter theory is nothing more than a myth. One of the prominent names that have made their opinions known on this topic is senior columnist Alan Abramowitz. Abramowitz claims that independents are actually “closet partisans” who are no different than others voting for Republicans or Democrats. He goes on to say that because of not having party preferences, their turnout rate may be less than 10 percent of the electorate, which is lower than the rest.

To prove his point, Abramowitz used data from the 2008 elections. Of the 33 percent independent voters who participated, only 7 percent didn’t actually have a party preference while the remaining 26 percent showed preference in one of the parties.

91 percent of these leaners, as Abramowitz calls them, chose the Democratic candidate Barack Obama while the rest voted Republican candidate John McCain.

While some of these points are true, Abramowitz may have been too dismissive of the independent voter. Claiming that the majority of such voters are “independent in name alone” has pushed different scholars to use the same data to prove that the decline in pure independents has given birth to more independent partisans.

Opponents of Abramowitz claim that Obama was not elected because of independent voters leaning towards Democrats, but due to the fact that the loyalty of many Democrats has decreased, therefore putting them in the independent segment.

To prove their claims, supporters of the independent voter theory showed that Democratic Party affiliation kept on decreasing over the years. Between 1952 and 1968, the party’s affiliation was 54.9 percent, and then it plunged all the way to 49.7 percent from 1990 to 2008.

Of that percentage, the lion’s share goes to independent Democrats, weak Democrats who lost faith in their party and chose to be neutral rather than completely dedicated.

After going over both sides, it is apparent that independent voters do exist. However, their preference may not affect the results of the election unless it is the same as the overall popular vote.

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Dealing With HIV Infection and AIDS

September 14th, 2011 by | Permalink

 

 

AIDS is easily the most feared sexually transmitted disease in the world. The reason for this is fairly simple in that AIDS has no cure and that, once a person is infected with the virus that causes the disease i.e. HIV, there is no turning back. The stories of people who are HIV positive or suffering from AIDS are fairly well documented in a variety of media ways such as government and non government campaigns, documentaries and even movies like Philadelphia. Such stories and depictions of the suffering that an HIV positive person goes through have resulted in people becoming very wary of the risks. There are only two ways through which a person can avoid the kind of suffering that is a part and parcel of HIV infection and AIDS. The following are some details.
 
Precautionary measures designed to avoid HIV infection and AIDS:
 
There are primarily three categories in which all ways of HIV transmission can be categorized. These are transmission through sexual contact, transmission through body fluids and transmission from mother to child. As there are three routes of transmission, the precautionary measures also need to be categorized into three headings.
 
The best way to prevent HIV infection through sexual contact is to use protection i.e. condoms. Using condoms during sexual contact would prevent the direct transfer of the sexually transmitted disease from an infected person to the uninfected person. As sexual contact is considered to be the primary mode through which the disease spreads, most governments in the world have made sure that the condoms are available easily. Prevention of infection from exposure to body fluids is something that is relevant for healthcare practitioners and the person taking care of a patient. Infection spread through exposure to body fluids can be prevented through the use of protective gear like gloves and masks. The spread of the disease from mother to child, though rare, is difficult for pregnant women to deal with. However, since the infection spreads through breast feeding, avoiding this can prevent the transfer.
 
Suppression techniques used on HIV positive patients:
 
As mentioned above, there is no known cure for an HIV positive person. However, this does not mean that there are no procedures for slowing the growth of the infection or limiting its symptoms. The procedure most successful in limiting the growth of the infection is known as antiretroviral therapy. The problem with this procedure is that it has to be used within 72 hours of exposure to the virus. The principle behind the antiretroviral therapy is that it prevents the initial infection from expanding and taking root in the body. Another problem with this procedure is that the dosage schedule lasts for four weeks and is extremely grueling for the patient. There are many unpleasant side effects to the treatment such as malaise, nausea, vomiting, diarrhea and fatigue. Moreover, there is some success that has been reported from the alternative medical sciences as well. While around 60 percent of HIV positive and AIDS patients use herbal medicines today, there are also some people who rely on acupuncture for symptomatic relief.

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Gonorrhea Information

September 9th, 2011 by | Permalink

A Note on Gonorrhea

One of the most common sexually transmitted diseases in the world is known as gonorrhea. The possible reason for this is the effort of nonprofit organizations and governmental institutions to make people aware about various sexually transmitted diseases. The most critical aspect of a sexually transmitted disease is that a person cannot truly spot or seek treatment unless he or she knows what to look for. This is precisely why most people should know about such common sexually transmitted diseases. The following are some details pertaining to gonorrhea.

What is gonorrhea?

As mentioned above, gonorrhea is a sexually transmitted disease that is particularly well known amongst the masses because of the endeavors of various governmental and nongovernmental organizations. The disease is caused by a bacterium known as Neisseria Gonorrhoeae. Neisseria Gonorrhoeae can particularly grow and multiply in locations where there is warmth and a lot of moisture. As a result of its affinity to such conditions, this bacterium infects reproductive regions of the human body.

What is the process of contracting gonorrhea?

There are four ways that gonorrhea can spread from one person to another. These are contact with four parts of the body, namely mouth, vagina, penis and anus. The reason why this disease is so particularly common amongst the masses is that it does not require ejaculation to spread. This means that a person can get this disease from another sufferer by just physical contact with any of the body parts mentioned above. In addition to these situations, a pregnant mother can also end up giving the disease to her child. Like all types of sexually transmitted diseases, the risks of contracting gonorrhea increase if a person is in the habit of multiple sexual partners. Even so, statistics seem to suggest that the young and African Americans are more susceptible to contracting this disease.

What symptoms are there?

Unfortunately, gonorrhea falls in the category of sexually transmitted diseases that do not have overt or prominent symptoms. This means that, whether the infected person is a man or a woman, it is hard for him or her to realize that infection has occurred. Even so, when symptoms do occur, they occur differently for men and women.

A man suffering from gonorrhea, if he gets symptoms, would feel a burning sensation during the process of urination and may even see abnormal yellow, green or white discharge from the penis. Rarely, the symptoms become more prominent and result in painful and swollen testicles. In women, if symptoms show up, they are a burning sensation during urination, more than normal vaginal discharge and even abnormal vaginal bleeding.

How is gonorrhea treated?

Gonorrhea has the potential to cause infertility in both men and women, which is why it should be treated immediately. The treatment for gonorrhea itself is extremely simple in that proper dosages of antibiotics are required. However, it is worth noting that drug resistant strains of gonorrhea are becoming more widespread, and the treatment of patients with such strains is particularly complex and difficult.

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The Most Deadly STD: AIDS

September 8th, 2011 by | Permalink

The Most Deadly Disease: AIDS

AIDS is a disease that is widely known all over the world primarily because of the way it affects the infected person. There have been enough movies, documentaries and other similar forms of media coverage for the disease and the people suffering from it. Furthermore, there have also been a host of awareness programs undertaken all over the world. However, despite so many media campaigns, many people still do not know a lot about AIDS. In order to rectify this, the following is some critical information pertaining to AIDS.

What is AIDS?

AIDS is a sexually transmitted disease that is deadly because it affects the body’s ability to defend itself. The full form of AIDS is Acquired Immune Deficiency Syndrome and it is caused by the Human Immunodeficiency Virus or, as it is more generally known, HIV. As mentioned earlier, AIDS is a disease where HIV renders the infected person’s immune system almost redundant. This results in the patient becoming susceptible to a variety of external infections and internal tumors that he or she would have otherwise been able to fight off. Therefore, in simple words, AIDS is a disease which destroys the patient’s immunity, leading to him or her contracting all types of diseases. It is worth noting that research and scientific studies have revealed that AIDS originated on the continent of Africa.

How do people get affected from AIDS?

AIDS is a sexually transmitted disease, which means that sexual activities can result in a person contracting the virus from the other person. Although AIDS is counted under the category of sexually transmitted diseases, it can spread in more ways than just sexual activities. Apart from sexual activities, HIV can spread through people sharing needles, blood transfusions and from a pregnant mother to her child. In a nutshell, HIV can spread through direct contact of a mucous membrane or bodily fluids like blood, vaginal fluid, semen, preseminal fluid and breast milk.

What symptoms are there in a person suffering from AIDS?

The primary effect of HIV in a person is partial or complete loss of immunity. This leaves the door open for opportunistic infections. Therefore, the direct and most blatant symptom of AIDS are the person developing multiple diseases in multiple parts of the body that would have otherwise not occurred. The agents of these infections could be virtually all types of microorganisms including fungi, bacteria, viruses and parasites. In fact, people with AIDS are also particularly susceptible to cancers and tumors.

What is the treatment for AIDS?

There is no known treatment for AIDS which is why most media campaigns and doctors suggest that the best foot forward is prevention of the disease. However, if a person is already HIV positive, then there are ways through which the problems can be managed. This procedure is an antiretroviral treatment that is extremely expensive and rare in most countries. Furthermore, the treatment also has its related side effects such as extreme fatigue, diarrhea, malaise and nausea. Also, the regimen that an HIV positive or AIDS patient has to follow under this treatment can be very demanding.

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Herpes Information

September 5th, 2011 by | Permalink

Understanding Genital Herpes and the Relevant Implications

Genital herpes is a disease that most educated people know about throughout the world. The reason for this is simply the widespread nature of the disease. However, apart from the fact that genital herpes is a sexually transmitted disease, most people do not know anything else about the disease. Unfortunately, most sexually transmitted diseases are so sly that knowing about them is the only way that they can be spotted. Hence, the following is some information relevant to genital herpes.

Defining genital herpes

As explained above, genital herpes is a sexually transmitted disease. It is caused by two types of viruses, namely the Herpes Simplex Virus Type 1 (HSV-1) and the Herpes Simplex Virus Type 2 (HSV-2). Of the two, the latter is much more widespread than the former. Genital herpes spreads through sexual contact, whether there is some visual mark on the infected person or not. This means that genital herpes does not need any kind of break from the skin like a sore or rash to spread from one person to another.

Symptoms of genital herpes

Genital herpes, as a disease, is particularly hard to spot because of the way its symptoms show up. As a result of this difficulty, most people with the disease are not even aware of the fact that they have it. Typically, genital herpes shows itself in the form of outbreaks of blisters near the genitals or rectum. These blisters break leaving behind sensitive ulcers or sores which also heal after a period of two to four weeks. Following this outbreak, there may be more outbreaks at a later stage. However, the following outbreaks are usually less severe and do not last as long. The first outbreak, more often than not, shows up in less than two weeks of the person being infected. During this outbreak, some symptoms that can crop up include another set of sores, flu like symptoms like fever, and swelling. It is worth stating that these symptoms are mostly very mild and, hence, are ignored by the infected person. A typical characteristic of genital herpes is that it makes the infected person much more susceptible to the risks of contracting HIV.

Special considerations

Most people think that a person infected with genital herpes would show visible signs. Furthermore, many people also think that unless a person is in the middle of an outbreak, the virus cannot spread. On the contrary, genital herpes is infectious even if the infected person is not currently in the midst of a blister outbreak. In different words, irrespective of whether a person is going through an outbreak, he or she can spread the disease to another person.

Treatment of genital herpes

Unfortunately, there is no known cure for genital herpes. However, there are techniques and procedures that reduce the impact of the disease. For example, a person suffering from genital herpes can take antiviral medication which will result in the outbreaks either being eliminated completely or being shortened. However, the effect is not lasting which means that the person has to stay on medication.

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Understanding Chlamydia

September 5th, 2011 by | Permalink

Sexually transmitted diseases (STD) are reviled and feared, irrespective of the culture, history or social background of an area. The reason for this is simply the kind of damage that such diseases can cause in a person. While the majority of sexually transmitted diseases are easy to diagnose, there are some that are extremely difficult to spot. These types of sexually transmitted diseases can result in the patient being unaware of them till some serious damage has already occurred. Chlamydia is one such disease. Consider the following:

What is Chlamydia?

Chlamydia is one of the more common sexually transmitted diseases. However, as explained above, the real danger of Chlamydia is not the fact that it is common. Instead, it is the fact that it is very hard to spot in the patient. Resultantly, this sexual disease can also be termed as one of the most under-reported diseases in the world. The disease is named after the agent which causes it i.e. a bacterium known as Chlamydia Trachomatis. The disease can affect both men and women and can result in serious repercussions if not treated.

How does a person get Chlamydia?

As is the case with all types of sexually transmitted diseases, Chlamydia can be contracted by an adult through sexual activities like vaginal, oral or anal sex. Furthermore, a pregnant mother can also end up giving the disease to her child. The chances of a person contracting Chlamydia increase with the number of active sexual partners. Resultantly, the more number of lovers a person has, the more susceptible he or she would be to this disease.

What are the symptoms or signs of Chlamydia?

As mentioned earlier, the biggest problem with Chlamydia is that it is hard to spot for a person. This means that people tend to not realize that they are suffering from Chlamydia up until it is too late because there are rarely any overt symptoms. This is also the reason why Chlamydia is often called a ‘silent disease’. Even though there are no overt and prominent symptoms of Chlamydia, there are still some signs that can hint at the disease. For example, women suffering from this disease at an early stage may go through slightly abnormal vaginal discharge or a burning sensation during urination. However, if the disease has moved on to latter stages then some symptoms that may show up include lower abdominal pain, nausea, intercourse related pains, non menstrual bleeding and fever. If the patient is a man then the only symptoms he may have are abnormal penile discharge or a burning sensation during urination.

How is Chlamydia treated?

Chlamydia needs to be diagnosed and treated early because of the damage it can cause silently, especially in women. The disease, if left untreated, can result in failure of the reproductive system and even fatal pregnancies. If detected, Chlamydia can be treated quite easily with antibiotics like azithromycin and doxycycline. It is also worth noting that the contracting of Chlamydia can result in a marked increase in the chances of a person contracting an HIV infection.

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Doxycycline for Treatment of Chlamydia and Other STDs

August 27th, 2011 by | Permalink

Looking to Buy Doxycycline? Click Here.

Doxycycline is an antibiotic drug of the tetracycline family. It is a man-made compound that works by interfering with the ability of bacteria to produce essential proteins. Without these proteins the bacteria cannot grow, multiply and increase in number. Doxycycline therefore stops the spread of the infection and the remaining bacteria are killed by the immune system or eventually die.

Doxycycline for Treating Sexually Transmitted Infections

As a broad-spectrum antibiotic, Doxycycline has a wide variety of applications, from treating bubonic plague, acne, malaria, Lyme disease to Rocky Mountain spotted fever. It is used very effectively for treating some sexually transmitted infections.

It is regularly used in treatinggonorrhea, chlamydia, syphilis, pelvic inflammatory disease, Granuloma inguinale, lymphogranulomavenereum (LGV) andmost variants of urethritis. Each of these infections is bacterium-based, which is where Doxycycline works best.

The drug is not effective for other, non-bacterium-based infections such as HIV, HPV, genital warts or genital herpes. It is however sometimes used to treat the oral symptoms of herpes.

If a patient has an intolerance to penicillin, Doxycycline may be prescribed forprimary or secondary stage syphilis as part of a treatment regimen for the infection. It has proven very effective in this treatment where penicillin cannot be used.

Doxycycline is now one of the primary tools in treating many STIs.As mentioned, infections that are bacteria-based are often treated very effectively with the drug. Specific infections, such as gonorrhoea, chlamydia and LGV.

It is also used to treat other urinary tract infections such as non-specific urethritis. This can occur in men or women and be caused by an STI or something completely different. This infection can cause severe pain and inflammation in women, and discomfort in men when passing water. It is a common infection, but is not necessarily sexually transmitted.

Doxycycline is particularly effective in treating the lymphogranulomavenereum bacteria, which causes genital ulcers. The widespread use of the drug is testament to its effectiveness in treating many types of bacteria while carrying relatively few side-effects.

Form and Dose

Doxycycline is an oral antibiotic mainly taken in pill form. A typical dose for an adult treating a sexually transmitted infection would be an initial dose of 200mg on day one, then 100mg per day for 7 – 14 days. That would typically be 2 x 100mg on day one and 2 x 50mg for the rest of the course.

Side-effects

Most drugs have side-effects and Doxycycline is no different. However, being a stable, man-made compound, they are few and far-between. Potential side-effects include nausea, diarrhea, loss of appetite, rashes, photosensitivity and tooth discoloration.

The drug will still be in the system up to four days after taking the last tablet, so in the rare occasions that someone experiences side-effects, they may continue after the last dose is taken.

On the whole, Doxycycline is known for being well-tolerated in most people which is why it is used so much as a treatment. That, combined with its efficacy against many kinds of bacteria make it an ideal treatment for many ailments.

 

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But where are our moral heroes?

August 14th, 2011 by | Permalink

Introduction

When an article by journalist Emily Wax, first published in the Washington Post in August 2003 (Wax, 2003) was posted shortly afterwards onto the CABA (Children Affected by AIDS) forum list-serve, a flurry of electronic conversation ensued.

Wax’s article – a story of two sets of siblings orphaned by AIDS2 – is an evocative account of some of the potential implications of the death of parents for children in Africa (in this case, in rural Kenya). These children, Wax argues, “are part of the lost generation… A generation that is growing up without parental guidance”, a state she links to the likelihood of unfulfilled potential on the part of the children, and of worsening political instability for the State and continent. She describes, in dramatic terms, the children’s exploitation, abandonment and neglect by relatives; their dropping out of school, their hunger, their isolation – among other things.

Responses from those subscribed to the CABA list ranged from critiques of Wax’s presentation of the situation of AIDS in Africa as one of passivity and hopelessness (Giese, 2003; Monk, 2003; Williamson, 2003), to reiterations thereof (Samson, 2003).  More striking, however, was the string of well-intentioned responses that “pooled  resources”  (Feldman,  2003)  to  ensure  that  the  particular  children documented in Wax’s story would receive school uniforms, books, clothes and food, at least for “the coming semester/term” (Arum, Odhiambo, & Ondiek, 2003). One writer, delighted at the collaborative response, articulated her wish “for a nice little trust fund to be set up that would go directly to a boarding school for all 8 of these  children  to  grow  and  flourish.  To  safely  reach  adulthood  together” (‘Maureen’, 2003).

In one fell hyperspacial swoop, communications across the list-serve encapsulated the issues that had been of concern to us – and others – for some time, and neatly documented themselves in the intransience of type-face and the immediacy of the internet. The media is powerful, through (among other things) it’s spin on stories, it’s ability to communicate the unfamiliar or distant, it’s global reach.  The responses to Wax’s article in the Washington Post illustrate the way in which readers’ interpretation of messages in the print media can prompt well-intentioned but not necessarily appropriate action, in this case to assist children.  Eight orphaned children in Kenya may have their lifetimes altered – possibly with a trust fund that inserts them into entirely different circumstances to those they might even  have  experienced  were  their  parents  living.   However,  the  destitute circumstances of the eight children in the story are not unique. Targeted assistance, in particular of material goods, to these particular children in isolation of others does not take sufficient account of the context of their challenges. In addition, it could put their safety at risk by generating neighbourhood jealousies (Giese, Meintjes, Croke, & Chamberlain, 2003).

Appropriate responses to children in the face the epidemic are critical.  South Africa currently has resident the highest number of HIV-positive individuals of any country in Africa, with an estimated 5 million people living with HIV or AIDS in 2004, of whom roughly 245 000 are likely to be children under the age of 15 (Dorrington,  Bradshaw,  Johnson,  &  Budlender,  2004).  High  levels  of  adult morbidity and mortality do – and will continue to for many years – affect the country’s large child population (estimated at roughly 39% of the total), even with widespread antiretroviral treatment intervention (Authors’ analysis of ‘Community Profiles  2001  Population  Census’).  For  this  reason,  what  is  conveyed  both explicitly and implicitly within media text about the impact of HIV/AIDS on children deserves examination in terms of its impact on public knowledge, policy design and interventions.

Despite  an  extensive  multidisciplinary  literature  examining  discourses  of 3 Most studies analyse media reporting in the global North – in particular Britain, Europe, the United States and Australia – with only a few isolated studies examining reporting on AIDS in the South African/African media. Existing studies of AIDS in the African media generally employ quantitative content analysis methodologies that enable commentary on trends in type, frequency and extent of reporting, prominence given to particular themes, representation of children in media reporting on AIDS.  Existing references to media reporting on children and AIDS are isolated to brief comments as opposed to full analyses.  No researchers have undertaken any in-depth analysis of the particular ways that the media represents children affected by HIV/AIDS.  This paper thus sets out to analyse English-medium South African press reporting on children and HIV/AIDS, in an effort to closely consider the messages being communicated to the local public about the impact of AIDS on children. We examine what is emphasized, and what is omitted, with respect to the effect of HIV/AIDS on children’s lives, and explore some of the implications of patterns found in the reporting.

The relationship between media coverage and public opinion, and the role of media language  and  content  in  shaping  public  attitudes,  discussions,  responses  – including towards HIV/AIDS – has been repeatedly documented and discussed (Beamish, 2002; Hughes & Malila, 1999; Kitzinger, 1993, 1995; Lupton, 1994; Schindlamayr,  2001;  Williams,  1999,  among  others).  Lupton  (1994:9),  for example, concludes that “the way in which the phenomenon of AIDS has been represented in the entertainment and news mass media has played an important role in the development of shared cultural meanings about AIDS”4.

This said, social scientists vary in the degree of agency they accrue to the reader, and thus the extent to which media text is treated as constitutive of social relations and mainstream ideologies (Rapport & Overing, 2000).  As Askew and Wilk (2002) point out, readers are also engaged in producing meaning and hence have the potential to interpret a story in a variety of ways, perhaps resisting or challenging the perspectives of the news writer. Yet she clearly regards the media to have authority in this relationship: “media producers apply a host of strategies main subjects, etc rather than conducting discourse analysis (Finlay, 2003; Kasoma, 2000; Linda, 2000; Mchombu, 2000; Odhiambo, 2000).  Work by Page (2003) and Connelly and McCloud (2003) is an exception to this.  Like analyses of media elsewhere, none of these studies on African media pay more than cursory attention to reporting on children in the context of HIV. Where mention is made, it is with regards to ‘AIDS orphans’ rather than to children infected with HIV.

South African journalist Jo Stein (2002: 16) makes an important point however when she states that it is not media “in and of itself, but in relation to a complex set of social players and historical variables, which determines what issues gain currency as social priorities”. In other words, the nature of the relationship between media coverage and government or public policy is not straightforward. The historical, cultural, political and socio-economic context to the AIDS debate all play a part in shaping media coverage and (the individual andgroup) responses to such coverage.

Of primary concern to our study therefore is the possibility that the South African news  media  plays  an  influential  role  in  creating  or  maintaining  a  general understanding of the way in which AIDS affects children, which in turn may contribute to the nation’s responses in terms of social policy and resource distribution.

Considerable attention has been given by analysts to the nature of the constraints placed upon news-making bodies and their impact on reporting (see Bell, 1991; Lupton, 1994; Stein, 2002). In this respect, it is not our intention to go over ‘old ground’.  Rather,  we begin  by  acknowledging  the  differences  between  what journalists would like to produce and what they are able to, given limits to time, budget, access to (re)sources and literary freedom. The same can be said for editors whose decisions are influenced by the need to sell a product and maintain a particular political position (Stein, 2002). We thus recognise that the nature of the ‘news market’ is critical in allowing more or less space for certain topics, as well as determining the breadth of interpretation of issues raised.

Methods

The analysis that follows is drawn from articles published in the South African press.  A range of English-medium South African newspapers – some of them local, some of them regional and national, including both dailies and weeklies, were systematically monitored over two periods of three months each, from March to May 2002 and again over the same period during 2003.  In addition reporting during the week around World AIDS day in 2002 (1st December) was monitored.

Newspapers included the Business Day, Cape Argus, Cape Times, the Citizen, City Press, Daily News, EP Herald, Independent on Saturday, the Mail & Guardian, the Natal  Witness,  Saturday  Star,  Sowetan,  Sowetan  Sunday  World,  Sunday Independent, Sunday Times, Sunday Tribune, The Star, and the Weekend Argus. Nine of these papers are dailies, eight are produced weekly.

In the 2002 monitoring period, additional English-medium papers that were monitored were the daily papers Business Times, Daily Dispatch, and the Pretoria News. In the 2003 period, The Sunday Sun was monitored in addition to those listed.

The articles were sourced at the time of their publication by the Media Monitoring Project (MMP) and Perinatal HIV Research Unit (PHRU) at the University of Witwatersrand, as part of larger media analysis studies, on children in the case of the former, and HIV/AIDS in the latter. The choices made by the two agencies account for the slightly different – though largely overlapping – sample of papers.

A total of 150 articles were identified as relating to children and HIV/AIDS during the monitoring period. Of these however, 44 included only a tangential reference to children affected by HIV/AIDS. One hundred and fourteen articles have therefore been analysed in detail for the purposes of this paper.

Our analytical approach followed a form of discourse analysis conducted on all articles, columns and editorials touching on issues relating to HIV/AIDS and children that were published during these periods. Analysis focussed on the verbal and linguistic text of the articles rather than accompanying images. A central theme was identified for each article, as well as a series of sub-themes. Both explicit and implicit messaging was considered – via careful examination of metaphor, and other lexical choice, as well as through content included and excluded. We were thus concerned to identify particular and recurring discourses, shared ways of talking and thinking about children and HIV/AIDS.

In this regard, we follow Pennycook’s (1994:128) definition of ‘discourse’ to mean “ways of organising meaning that are often, though not exclusively, realised through language. Discourses are about the creation and limitation of possibilities, they are systems of power/knowledge (pouvoir/savoir) within which we take up subject positions”.

Communication through the print media is a primary means of social exchange around  issues  considered  to  be  of  national  or  local  importance  (such  as HIV/AIDS). In recognising that the production and consumption of text (for the print media) takes place in a specific socio-cultural, political and historical space, we can expect the content and tone of articles to be structured by particular norms and conventions. The anthropologist Dell Hymes (1972 in Rapport and Overing, 2000:118) uses the term ‘speech community’ to refer to those who share rules concerning the conduct and interpretation of speech, and who determine particular ways of proper speaking which its competent members will practise. Thinking about the journalists’ writing on health and social issues in South Africa, as well as their readership, as ‘speech communities’ poses questions related to the rules of ‘proper writing’ about HIV/AIDS and children, and the social processes and power relationships that maintain these rules.

Who features in the reporting?

During the periods monitored, reporting relating to HIV/AIDS and children focused overwhelmingly on orphaned children5, and on existing or ‘necessary’ responses to “the orphan problem”.  HIV-positive children also received some attention, though considerably more limited. Very few news articles during the monitoring periods considered the broader impacts of the epidemic on children. Only two of a total of 114 articles analysed made reference to children living with sick caregivers. An overwhelming majority of the reports focus their attention on the issues as they relate to South Africa: only four articles consider other countries, two Southern Africa in general, and two provide a global perspective.

Although there has been an important shift amongst experts to conceptualising the impact of AIDS on children as being more broad-based than orphaning, articles continued  to use  the outdated  (and  much  maligned)  terminology  of ‘AIDS orphans’. The majority also propagated the popular stereotype of the orphan as the archetypal vulnerable child of the AIDS pandemic (a stereotype that remains similarly widespread in much existing research and reporting by International Agencies and others) (Meintjes & Giese, 2004). References to ‘AIDS orphans’ as, for example, “the innocents who are perhaps the most vulnerable victims of AIDS” (Independent on Saturday, 30.11.2002) are prevalent in articles.

In instances where the issue being reported does not exclusively apply to children who have been orphaned, and is salient to other children, it is common for articles to focus attention on its relevance as a concern regarding orphans.  An article published in the Star, and subsequently in the Daily News (in an edited form) in April 2003 on the difficulties experienced by orphans in accessing the social grants to which they are entitled provides a good example of this trend. The article is an otherwise excellent piece of reporting that stands apart from most of the articles published during the monitoring period for its timely investigation of a critical issue, its provision of evidence, and its consultation with children.  However, the centreing of its argument on orphans – as opposed to poor children in general, to whom  the  majority  of  issues  it  reported  apply  equally  –  resulted  in misunderstandings that revealed themselves in a series of articles that appeared in response. Subsequent related articles called for interventions targeting ‘AIDS orphans’ that would in fact be more appropriately directed at poor children. This is in contrast to patterns noted by studies elsewhere, where references are made largely to HIV-positive children.  This comes as no surprise considering the majority of other studies examine media reporting in countries where ARV treatment is accessible and rates of AIDS-related parental death therefore much lower.

Research illustrates in particular how children’s vulnerabilities can be exacerbated during periods when they are living with sick caregivers or others who are terminally ill, as increased demands are made on the financial and social resources of the household.  While South Africa remains some years away from a peak in orphan numbers, the country is currently home to vast numbers of children whose care is potentially compromised by residence or relationships with sickly adults (Giese et al., 2003). Furthermore, HIV/AIDS does not only impact on those whom it ‘directly’ affects: the same research study illustrates the ways in which whole neighbourhoods face increased demands on ‘informal’ networks of support to provide for those who need help (Giese et al., 2003; Meintjes, Giese, Croke, & Chamberlain, 2003).

Thus, we would argue that while the issue of children orphaned by HIV/AIDS is a critical one, the emphasis placed on this issue by journalists risks obscuring the diversity of additional ways in which children are affected by HIV/AIDS, and stands to divert public knowledge and attention away from other critical points of intervention and support.

Morality, the media, and AIDS

The extent to which poor children in South Africa struggle to access the cash grants to which they are entitled because of administrative and legislative requirements are well documented. See for example, Case, Hosegood & Lund (2003), Clacherty (2001), Giese et al. (2003), Leatt (2004), Rosa, Leatt & Hall (2005) and Rosa & Mpokotho (2004).

Distinctions made through language and imaging are shown to set apart ‘innocent’ and ‘guilty’ victims of HIV, with blamelessness generally being situated within white, middleclass, heterosexual populations.  Researchers argue that through practices of ‘othering’, and the accompanying blame, discourses of AIDS reporting thus  produce  and  –  importantly  –  reproduce  hegemonic  stereotypes,  power relations and notions of deviance (Juhasz, 1990; McAllister & Kitron, 2003; Sacks, 1996;  Treichler,  1988;  Watney,  1989a,  1989b).

Pre-existing  ideologies  and narratives are drawn upon by the media in order to make sense of a (no longer so) new phenomenon (Lupton, 1994). Referring to representations of the epidemic in the USA, McAllister and Kitron (2003:58) note that “AIDS is the disease of the peripheral, the poor, the deviant, the morally ill (and is only newsworthy when it threatens ‘the mainstream’).  For the most part, news coverage [in the New York Times and other prominent US papers] has reinforced these meanings”.  These kinds of reporting practices contribute to binding HIV/AIDS up in moralism in a way that, according to Kistenberg (2003), discourses around other diseases have not.

Discourses of morality are no less present in the South African press reporting on children in the context of HIV/AIDS.  However, with South African reporting on the impact of HIV/AIDS on children centred predominantly on issues broadly relating to orphanhood and to children’s care, the notions of morality and moral deviance communicated by the press take on additional dimensions to those discussed elsewhere. It is to the analysis of these that we now turn.

Innocents discarded: the moral transgressions of ‘the African family’

The theme of children’s innocence lies at the centre of the South African print media’s reporting on children in the context of AIDS. Children, and particularly orphans, are portrayed as blameless victims of a situation beyond their control.

These children are “the innocents … with absolutely nothing to lose” (Independent on Saturday, 30.11.2002b), “helpless victims of a social and medical nightmare”, a “band  of  little  angels”  (Sowetan  Sunday  World, 24.3.2002)  who  “deserve” assistance (Daily News, 3.5.2003).

In all likelihood journalists have good intentions in presenting children this way. By publishing articles that highlight children’s needs, the press stands to provoke empathy, and perhaps action, towards improving children’s lives. Moreover, we know that the consequences of the epidemic for children are multi-faceted and very serious. It is therefore appropriate that the media draws attention to children’s vulnerability. The issue under debate is how this is done; what implicit messages are conveyed to the readership and what impact do these have on general understandings of how South African children and adults are responding to the epidemic.

The discourse of the ‘innocent victim’ is not new in media reporting on children in general (Moeller, 2002), and is briefly noted with respect to discourses regarding HIV-positive children in a number of the analyses of HIV/AIDS reporting around the world (Konick, 2003; Lupton, 1994, 1999, 2003; McAllister & Kitron, 2003; Page, 2003; Sacks, 1996). Along similar lines to others, Lupton notes of reporting in Australia, “the most innocent of all people with HIV/AIDS … are infants and young children, who are commonly positioned as devoid of any blame, shame or guilt for their infection” (Lupton, 1999:38). With ‘innocence’ presented as the foremost characteristic of children affected by AIDS, ‘guilt’ of others is implied, even in the absence of any explicit juxtaposition. And thus paradigms of morality in relation to HIV/AIDS, are reinforced.

In particular, moral judgement is (implicitly or explicitly) directed at caregivers – biological mothers as well as broader kinship and community networks – in press reports during the period monitored.  As noted similarly by Sacks in her study of reporting of women and HIV/AIDS in the press in the USA, pregnant HIV-positive women were commonly framed as irresponsible and uncaring, ‘bad’ mothers for becoming pregnant in the first place, and in the South African situation, even more morally aberrant for risking HIV transmission to their children as a result of subsequent choices.   We see reports such as that in the Cape Times (9.4.2003) which condemn women for being irresponsible towards their unborn – implicitly ‘innocent’ – children.

“Thousands of babies born in South Africa are being put at risk of ‘inheriting’ HIV at birth because of their mothers’ reluctance to have an HIV test … A Johannesburg obstetrician and gynaecologist said studies had shown that nearly half of the pregnant women who declined to be tested were HIV-positive. Concern now was for the babies of untested mothers who had ‘no voice’ and who were at risk”

The article employs emotive language and references an obstetrician’s study (providing it with scientific authority despite a questionable point being made) but fails to take into account women’s contexts in its implicit critique of their choices.

More prominent in the press reports however, was a discourse regarding the loss of morality – frequently framed as a loss of ‘traditional African values’ – specifically related to the provision of care for children.  Critique of absent parents or others identified as having a moral responsibility to take care of children is evident throughout much of the reporting, with their failure to do so a consistent theme.

The emphasis on ‘dumping’ babies depicts poor African mothers (in particular) as people who cannot or will not care for their children. They are described as “desperate” (Pretoria News, 15.4.2003) and “despairing” (Star,16.4.2002), and only cursory reference is made to the contexts of mothers’ decisions to leave their children in the hands of others. At no point in any of the press articles was there any discussion of the complex set of social, economic, health and emotional pressures acting on poor women, nor any reference to the large numbers of women in similar positions who are caring for their children despite the odds stacked against them.

The perceived loss of morality is also referred to directly in many of the articles produced during the monitoring period. It is common for articles to make reference to a time that they claim was different. For example, readers are told that “In the past orphaned children were cared for by uncles or aunts or grandparents” (Mail&Guardian, 17.04.2003) – now, it is implied, this is not the case. Or that “This country used to pride itself in the spirit of ubuntu. Somehow that, like some of the other post ’94 goodwill, has disappeared” (Star, 17.4.2002).  Articles describe a disintegration of ‘traditional African values’ – the notion of ubuntu being central, and in a number of instances join the president’s call for widespread moral regeneration.  Appeals are made for “a moral crusade” (Independent on Saturday, 11.5.2002b) or a “return to traditional Christian family values in our societies”  (Citizen, 20.5.2003)  to  “help  rebuild  a  caring  nation”  (Sowetan, 7.5.2002), and are peppered with references to the requirements of “African tradition and morality” (Sowetan Sunday World, 23.3.2003) and how “vukuzenzele [self reliance] should be rekindled among sections of our society” (Sowetan, 7.5.2002). An article in the Star newspaper (20.4.2002) reporting on the launch of South  Africa’s  Moral  Regeneration  Movement  focuses  its  attention  almost exclusively on the situation of children in the context of AIDS.  South Africans (read black South Africans) are urged to “go back to their roots”, and quoting deputy president Zuma, “revive our social support networks and ‘promote the notion that ‘every child is my child’ which formed a rock on which communities were built’”, in order to ensure that orphaned children are integrated into families. “Family is the key to renewal”, the article’s headline proclaims in bold text. “We need to strengthen the moral fibre of our society, as a matter of priority, by rebuilding the family unit”, the article continues.  Throughout this article and others, discourses of a loss of morality are focussed on the failure specifically of the African family.  In this way, in much of the reporting, morality – and specifically moral transgression – becomes racialised.

Thus, by using evocative language that presents children affected by HIV/AIDS as deserted by traditional structures of family/adult care and by focussing attention on children who are living without adult caregivers, the English-language South African press produces a moral dichotomy not recorded in analyses of media reporting elsewhere: that of the AIDS epidemic in South Africa constituting – and being constituted by – new crises of morality in the form of African families’ failure in their moral responsibility for children, resulting in the forsaking of a generation of ‘innocent’ children who deserve better.  Children are presented as victims of a situation within broader society. Innocent (morally pure) children are again juxtaposed with guilty (morally deviant) adults.  However, in this instance, the cumulative effect of South African press reporting is the implicit directing of blame not only at those who are HIV-positive, but also at those who fail in their perceived moral duties to those who are considered to be innocent victims of the pandemic.

Moral messaging does not end here. Representations of families and communities failing in their moral responsibilities towards children, and of helpless child victims of the pandemic, coalesce in places into apocalyptic conclusions of resultant terror and the demise of society as we know it.  A number of different discourses operate together to communicate a moral panic located in predictions of a South African society out of control.

These metaphors of natural disaster in addition emphasise people other than those referred to in the metaphors as victims of the circumstances, powerless in the face of the onslaught of others. We return to this notion shortly.

Another linguistic technique which achieves similar effect is the application of hyperbole in describing the epidemic.  Though more limited in association than metaphors of natural disaster, the descriptions such as “soaring AIDS deaths” (Independent  on  Saturday,  11.5.2002a),  “mushrooming  orphan  numbers” (Independent on Saturday, 30.11.2002a) and references to the likes of “AIDS orphan explosions” (Independent on Saturday, 11.5.2002a) that were similarly present in some press reports, point again to a situation that is worsening rapidly and exponentially, with negative implications.

Definitions of orphaning applying to estimates and projections generally relate to children who may have experienced the death of either one or both parents.  The majority of children thus enumerated in South Africa will have lost one parent, rather than both.  As has been pointed out elsewhere (Meintjes & Giese, 2004), a lack of clarity regarding the definition of orphaning to which estimates and projections pertain operates to feed incorrect notions of the nature of the tragedy – in this case, to inflate the number of children who are ‘double orphans’ in the popular imagination.

We see then how crises of morality are implicitly located in the predictions of the nature of horror that is anticipated to follow from increasing numbers of AIDS deaths, and concomitantly increasing numbers of orphans in South Africa.  As a result of an absence of care they deserve (the moral failure of ‘the African family’), it is suggested that orphaned children will grow up inadequately socialised. These children, ‘innocent victims’ of circumstances beyond their control at the start, are expected to become morally deviant as they mature in the absence of the care to which  they  are  entitled.  In  representations  in  the  press  reports,  one  moral transgression – the lack of provision of care for children – can be seen to feed another, in the form of the creation of a proportion of young people in society who are without good values and morals.

In these ways, it is repeatedly communicated to readers that the oft-labelled “AIDS orphan crisis” (City Press, 1.12.2002; Star, 30.5.2003, among others) is not simply a crisis for affected children, but perhaps of more concern, a looming crisis for readers themselves. Concomitantly, a dichotomy of belonging and ‘non-belonging’ that  is  again  infused  with  notions  of  morality,  is  communicated:  Moral righteousness is situated with those who ‘belong’, the ‘us’ to which articles refer, the HIV-negative, those not ‘contaminated’ by HIV, while a fate of moral degeneration is placed upon those affected, ‘orphans’ of the epidemic.

Public responses: the heroes of the pandemic

Amidst widespread (if by and large implicit) reference to failure on the part of African families, and to less extensive but nonetheless prevalent predictions of public terror, there are articles which denounce a perceived absence of support for children, and rebuke those identified as responsible. In pointing out that readers live in “a society which largely continues to close its collective eyes to [orphans’] plight” and posing the question “Is this how much we care about our children?” (Daily News, 3.5.2003), or arguing that “something should be done to show [orphans] there are people who care” (Business Day, 2.5.2003; Star, 2.5.2003), South Africans are admonished in the press for not taking sufficient moral responsibility in stepping in where families are failing children. “Where”, readers are asked, “are our moral heroes?” (Sunday Times, 16.3.2003). The contrast between press representations of the African family and representations of those who are documented to be responding to children affected by AIDS is striking. Representations of the first – of kin networks that have failed their children – are juxtaposed with representations of people who have gone way beyond the normal call of duty to assist children.

It is in the main the middle class (and largely the white middle class) who feature in press reports as responding to children affected by HIV/AIDS. Articles heroise these individuals for the self-sacrifice, compromise and risk-taking involved in caring  for  those  who  are  implicitly  not  considered  to  be  their  immediate responsibility.  Thus for example, readers learn of a “Cape Town-born banker … who gave up a successful financial career in London to help raise funds for AIDS orphans in South Africa” (Star, 30.5.2002); or an intrepid doctor who adventures beyond hospital walls and comfort to bring aid to children: “Dr Jana Oosthuizen climbs out of the bright red CitiGolf, … humps a heavy rucksack on her back full of medical paraphernalia and heads for the tin shack that is home to five children orphaned by AIDS’ (Financial Mail, 6.12.2002); an “American doctor” who moved across the world to South Africa to start a hospice for dying children (Argus, 22.3.2002); a South African businessman who reverses his decision to emigrate to Canada, “motivated [by] the spectre of millions of orphans left destitute in the wake of the HIV/AIDS devastation … to tackle what is rapidly evolving into a ‘lost generation’ scenario”  (Natal Witness, 3.5.2003); or an emergency/foster mother  who is described as “one of those amazing people who open their hearts to needy children irrespective of the fact that there isn’t enough room for them all in her 3-bedroomed council house”. In each case, their status as ‘outsiders’ to the specifics of the situation is made clear to readers through reference to where they are from in relation to the children they care for.

It is entirely appropriate that affirmation and praise be directed at those who intervene. For many, personal sacrifices and risks are indeed involved. In addition, far-reaching efforts on the part of South Africans are required in order to adequately address the scale of the epidemic, including its repercussions for children. Reporting on these efforts is fitting. However the cumulative effect of the press texts analysed is to locate the moral high ground in the hands of the (white) middle class – whose actions, it is implied, go far beyond the actions of those who should be responding. Distinctions about who is providing support to children affected by HIV/AIDS are made not only in terms of class but also in terms of race.  Commentary such as  “We commend the Topsy Foundation and gardening guru Keith Kirsten for caring about the HIV-infected or affected black children the government does not want to care for” (Sowetan Sunday World, 24.3.2002) provides an overt example of this trend.

The silence in the press reports with regard to the role that African communities are playing in supporting children affected by HIV/AIDS is striking. That more than 90% of children who are orphaned (as well as many others that are not) live with relatives (Budlender & Meintjes, 2004; Hosegood & Ford, 2003; Meintjes & Giese, 2004) and are not cast out to the streets or left to exist as so-called child- headed households is a fact made explicit in only one article (Sowetan, 8.3.2002) published during the monitoring periods. In a couple of articles, the presence of a grandmother or other relative caring for a child is noted but, as illustrated earlier, by far the most predominant image presented in the press articles is of children resident without adult caregivers, having been ‘discarded’ by those responsible for them.

The creation of binary oppositions is a common strategy in the news media (Askew & Wilk, 2002:5). What is important are the associations that are created by, or reinforced, by these oppositions. In this instance, the oppositional representations bolster an overriding racialisation of morality that runs – whether intentionally or unintentionally – through the reporting on children in the context of HIV/AIDS.

Moral ‘decay’ in African communities is offset by the heroism and self-sacrifice of those who take exceptional moral responsibility, responsibility explicitly presented as ‘beyond the call of duty’.  And while these people’s and organisations’ actions are indeed admirable in many respects, the absence of recognition of the role that poor African kin and communities are playing creates  a skewed picture of the challenges that children and South Africans more broadly face as a result of the AIDS  epidemic.  Indeed,  South  Africa’s  particular  political  history  makes reflections which locate moral virtue in the hands of the white middle-class somewhat alarming.

The co-existence  of  contradictory  images  of children

The language used in these articles presents a third powerful image of children, namely the rare and highly capable hero. Far fewer articles analysed portrayed this picture  of  AIDS-affected  children  as  compared  to  depictions  of  vulnerable, innocent victims or threatening delinquents discussed above. Yet this third image deserves attention because its assertion of (albeit unusual) positive agency on the part of the child appears to contradict the helplessness and negative agency (namely criminality) so prevalent in the majority of press reporting.

Here is a further example of a set of binary oppositions orientated around notions of morality. The difference is that they make implicit reference to what is considered appropriate in childhood rather than what a family ought to be and do for children (although the two are related).

We argue that cultural notions of the developing person are so deeply embedded that writers and readers are unaware of their presence in everyday discourse. For example, reporting like that cited above on Nkosi Johnson shows that children are assumed to be incompetent unless they prove otherwise. Research in modern industrialised  societies  finds  that  competence  is  associated  with  adulthood, meaning that the abilities of children and youth are often overlooked (Hutchby & Moran-Ellis, 1998).   Age specific associations start to matter in relation to children’s relationship with wider social forces. Early childhood is seen as a period of innocence and vulnerability, whereas youth is seen as a period of rebellion (Dimmock, 1997). Writers, probably unconsciously, make reference to one or other of these embedded cultural assumptions relating to age and behaviour, rather than any substantive evidence from children’s lives.

Our first concern is that the absence of critical debate in the articles analysed implies that neither writers nor readers question whether such images reflect reality. In what ways, for example, are children with sick parents acting to support themselves and their families? And what are the limitations placed on children in this position? No discussion around these, nor many other relevant questions, is evident in press reporting.  Secondly, the absence of debate suggests a lack of thinking about the possible implications for social policy and children’s lives of reporting that draws more heavily on culturally situated moral convention than on empirical evidence.

Children as sources

In all 114 articles examined for this study, five directly source the children or young people to whom they refer. The representations of children which transpire as a result are salient for the ways in which they diverge from those which prevail in much of the reporting (and which are described above).

Consider for example, an article in the Mail & Guardian (17.04.2003) which reported  on  children’s  school-based  peer  education  and  HIV/AIDS  support activities in an area of Kenya heavily affected by HIV/AIDS. The journalist observes young children providing nuanced information about HIV/AIDS in response to questions from peers, and performing insightful dramas “full of sly observation of adult behaviour, wit and humour”.  In observing and engaging the children directly, his conclusions about children’s experiences and responses to AIDS  contrast  with  the  dominant  imaging  of  children  as  victims  of  their circumstances.  “While all of these children will have had bitter experience of HIV/AIDS”, he notes, “there is no sense that they have submitted to its tyranny, or that they are helpless in the face of it”. Another article – this time in the Saturday Star (15.3.2003) – reported the situation of a young man and his sister (described in the headline as ‘AIDS orphans’) who face eviction from their house because of bureaucratic glitches accessing their mother’s pension funds after her death. Sidwell Blangwe, the ‘AIDS orphan’ at the centre of the article and its primary source, is presented as articulate, competent and active. “When faced with the threat of losing his home and an end to his younger sister Refiloe’s education, he didn’t become despondent but was spurred into taking action”. Similar imaging is present in a third article about a 13 year old girl who lives with her HIV-positive mother, and who has become a vocal AIDS activist (Daily News, 15.4.2003). “She has not let the tragedies tarnish her zest for life”, the article notes, quoting the young woman’s comment that “I love music, dancing and hanging out with my friends. I dream of becoming a professional model”.

In each of these instances, the positive agency of the children is highlighted alongside their qualities as resilient, capable, responsible human beings. That such contrasting images to those more common in the press – of children as pathetic, helpless victims or irresponsible thugs – are present in the few articles which source children provides good evidence, we would argue, of the value of finding ways to directly engage children in articles about children.

Conclusion

It could be argued that the public rarely examines, let alone deconstructs, the messages within press texts, and that communicating the key message – namely that ‘children are suffering as a result of the AIDS epidemic so we need to act’ – in whatever way possible, should be a priority for South African journalists. And that for this reason, the use of various well-rehearsed news writing strategies, including the use of sensationalism, stereotyping, essentialism, and binary oppositions, is justified. However, as Askew and Wilk (2002) have pointed out, these strategies predispose and guide audiences towards readings which favour existing power structures, and characteristically replicate existing hegemonic discourses.

We argue that these strategies are employed at a cost, both in the public’s knowledge and attitudes around the impact of AIDS, and more importantly, in the lives of children affected by the epidemic. For example, portraying orphans as children without adult or ‘family’ care, or as victims or delinquents, or withoutadequate recognition of the challenges they share with other children also growing up in a time of HIV/AIDS, can lead to inappropriate policy and programme responses. These can include inappropriately targeted responses, the foregrounding of institutional care for orphaned children, and decisions that prioritise protecting the public over meeting children’s needs. If such decisions are informed by images of large numbers of criminal children, we can only expect that interventions will aim to contain, reform and perhaps punish young people (Bray, 2003).

Layer upon layer of moral messaging is present in South African press reporting on children living in the context of AIDS. The cumulative effect of the reporting – at least during the periods monitored by this study – is the communication of a series of moral judgements about who is and who is not performing appropriate roles in relation to children. In this respect, representations in the South African press differ from those documented by studies of the media elsewhere. Discourses of existing moral transgression on the part of African parents and families (read kinship networks) for failing in their moral responsibility towards their children coalesce with discourses of anticipated moral decay amongst (previously innocent) children who lack their due care. The need for moral regeneration amongst South Africans generally (but implicitly black South Africans) is contrasted with an accolade of (usually white) middle class individuals who have gone beyond their moral duty to respond. In each instance, the particular moralism is highly questionable in the light of both empirical evidence and principles of human dignity underlying our constitution.

It is not our intention to suggest that South African journalists and other media workers are deliberately – with negative intent – promoting these kinds of messages. Rather, our aim is to illustrate the ways in which a pervasive discourse around children and family life, language choice by individual journalists, and particular silences in reporting children’s everyday experiences and their responses in the face of these, can operate in tandem to produce a very skewed picture.

Previous research has shown that elements of these discourses can be found in writing by academics and development organisations (Bray, 2003; Meintjes & Giese,  2004).  These  continuities  suggest  that  subtle  but  powerful  social conventions exist that restrict writing on children and family life in the context of AIDS, and that these are unintentionally reinforced by different institutions. In this regard, the media would seem to be missing an opportunity to do what they are best at, namely to be the critical voice against such conventions9. As we have suggested, reporting that consults children directly or research conducted with children would enable the press to better fulfil this role.

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