Between 1990 and 2005, HIV prevalence rates in South Africa jumped from less than 1% to around 29%. Combining ethnographic, demographic and historical insights, this article addresses the important question posed recently by prominent South Africanist scholars:
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Was Aids in South Africa “an epidemic waiting to happen?”1 To date, responses to this question have forefronted the legacy of apartheid and in doing so challenged cultural models that reify an “African system of sexuality” supposedly characterized by sexual permissiveness (for instance as contained in Caldwell, Caldwell and Quiggin, 1989, for a direct critique see Heald, 1995). In particular, the work of social historians has brought to attention the ways in which racial segregation and male migration fuelled an earlier epidemic of syphilis only partially quelled by the introduction of penicillin in the 1950s; moreover, they note how the forces of urbanization, industrialization, and Christianization have long been argued to have destabilized African family structures (for instance Jochelson, Mthibeli, & Leger, 1991; Horwitz, 2001; Delius & Glaser, 2002; Marks, 2002; Phillips, 2004). These accounts of the social origins of Aids built on earlier groundbreaking work on the political economy of health in South Africa (for instance
Andersson & Marks, 1988; Packard, 1989).