1. Jonathan Stadler 18 September 2014 Networks of infection in South Africa: Implications for HIV spread

3. Bushbuckridge, South Africa

6. I just woke up one morning thinking ‘who is going to help me?’ I wanted money to buy food and clothes. Then I thought I would go out and ask them [men] for money. I thought no. I cannot go and ask for money without having an affair with that person. If he has got something he can give it to me like a gift. If I hear my mother complaining about something like there is no meat or tea bags, I will go out and ask from my boyfriends to buy what I need

7. ‘go and find a man to help you’

8. I didn’t love him – I just wanted his money. Because if you go out for ku phanda it is not that you love the person – you just want to crook the person. I just told myself I must just go out there and start crooking people.

9. serial monogamy: sequential / serial concurrent partnerships:

10. Focus on social structure How people employ strategies to maximise their social value / social capital Socially marginalised – occupy the peripheries and invest in sexual relationships to acquire ‘social capital’ Sex – without condoms: sharing bodily fluids embodies ‘trust’ – solidifying bonds

11. c b i j a g Male27 (61%) Female17 (39%) k n f e d q s o x y p w z m ee cc bb aa dd jj ll kk qq mm oo hh pp ii rr gg h rt uv sstt nn A sexual network

12. c b j a g k d s y p m ee cc bb aa dd ll kk mm oo hh pp ii h rt uv sstt nn f n e q o z x rr w gg jj qq i 3737 8080 Male Female 3+2Partners Multiple partnerships

13. Male Female ee cc n o z x rr w jj qq gg Nodes

14. Soweto c b j a g k e d s x y p w m ee cc bb aa dd jj ll kk qq mm oo hh pp ii gg h rt uv sstt nn Mozambique Randfontein Tzaneen Phalaborwa Randfontein o i rr n f q z Spatial spread

15. Male6 Female6 c b j a g k d q s y p m ee cc bb aa dd ll kk mm oo hh pp ii h rt uv sstt i f e n o z x rr w nn qq gg jj Suspected AIDS deaths

16. What are the implications for prevention, treatment and care? Sexual networks and HIV spread - behaviour change approaches are unlikely to impact because vulnerability is shaped by position within networks … not by individual behaviour Do women regard themselves at risk of infection when they are not able to see the broader structures of which they are part? Does HIV risk outweigh the social risks faced by young women?

17. Implications … for planning? Structural dimensions – historical processes of segregation, creating rural and urban ghettos

18. Acknowledgements PhD project funders – University of Pretoria Post Graduate Awards – Mellon Fund – Centre for the Study of AIDS in Africa Support from DFID funded STRIVE RPC (REF PO 5244) Friends and acquaintances in Bushbuckridge