Artykuły w czasopismach na temat „Johannesburg Art Gallery (South Africa)”

The Michaelis Art Library, part of the Reference Division of the Johannesburg Public Library Service, originated with a collection of books purchased for the planned Johannesburg Art Gallery in the 1920s. Temporarily and then permanently housed in the Public Library, the collection became the nucleus of a growing art library, the largest public art library in South Africa. In recent years usage of the library declined as a result of political tensions, but then increased in parallel with a surge of vitality in the arts which heralded the end of apartheid and the emergence of democracy. During 1995 the Michaelis Art Library was due to move into Johannesburg’s central library building.

The Johannesburg Art Gallery opened in 1915. A collection of books intended for the Gallery, but housed elsewhere pending the completion of the building, became the separate Michaelis Art Library; the Gallery gradually formed its own library, for the use of the curators. In 1986 the Gallery Library was accommodated in a new wing. Selection for the Library has reflected the Gallery’s diverse collecting activities. Latterly, the Library has worked closely with the Gallery’s education department, and as a result its resources have been made available to the wider community. In 1994 the Library was given a major art slide collection by the Rand Afrikaans University; in the same year, it received funding for the computerisation of its catalogue, which will be accessible through SABINET. Work is in progress on an index of South African art.

Introduction Universal test and treat (UTT) is a population-based strategy that aims to ensure widespread HIV testing and rapid antiretroviral therapy (ART) for all who have tested positive regardless of CD4 count to decrease HIV incidence and improve health outcomes. Little is known about the specific resources required to implement UTT in correctional facilities for incarcerated people. The primary aim of this study was to describe the resources used to implement UTT and to provide detailed costing to inform UTT scale-up in similar settings. Methods The costing study was a cross-sectional descriptive study conducted in three correctional complexes, Johannesburg Correctional Facility in Johannesburg (>4000 inmates) South Africa, and Brandvlei (~3000 inmates), South Africa and Lusaka Central (~1400 inmates), Zambia. Costing was determined through a survey conducted between September and December 2017 that identified materials and labour used for three separate components of UTT: HIV testing services (HTS), ART initiation, and ART maintenance. Our study participants were staff working in the correctional facilities involved in any activity related to UTT implementation. Unit costs were reported as cost per client served while total costs were reported for all clients seen over a 12-month period. Results The cost of HIV testing services (HTS) per client was $ 92.12 at Brandvlei, $ 73.82 at Johannesburg, and $ 65.15 at Lusaka. The largest cost driver for HIV testing at Brandvlei were staff costs at 55.6% of the total cost, while at Johannesburg (56.5%) and Lusaka (86.6%) supplies were the largest contributor. The cost per client initiated on ART was $917 for Brandvlei, $421.8 for Johannesburg, and $252.1 for Lusaka. The activity cost drivers were adherence counselling at Brandvlei (59%), and at Johannesburg and Lusaka it was the actual ART initiation at 75.6% and 75.8%, respectively. The annual unit cost for ART maintenance was $2,640.6 for Brandvlei, $710 for Johannesburg, and $385.5 for Lusaka. The activity cost drivers for all three facilities were side effect monitoring, and initiation of isoniazid preventive treatment (IPT), cotrimoxazole, and fluconazole, with this comprising 44.7% of the total cost at Brandvlei, 88.9% at Johannesburg, and 50.5% at Lusaka. Conclusion Given the needs of this population, the opportunity to reach inmates at high risk for HIV, and overall national and global 95-95-95 goals, the UTT policies for incarcerated individuals are of vital importance. Our findings provide comparator costing data and highlight key drivers of UTT cost by facility.

Visualizing the discourse in Material Thinking: Conversations between China and South Africa, Chen Qingqing, Feng Jiali, Gu Lin, Liu Liguo, Qi Zhilong, Qing Taimao, Wang Xiaojin and Zhong Biao (China); William Kentridge, Diane Victor, Colbert Mashile, Kristin NG-Yang and Rory Klopper (South Africa), curated by Zhang SiyongDurban Art Gallery, South Africa, 12 September‐10 November 2019

Art has been suggested as a good way to diversify investment portfolios during times of financial uncertainty. The argument is that art exhibits different risk and return characteristics to conventional investments in other asset classes. The new Citadel art price index offered the opportunity to test this theory in the South African context. Moreover, this paper tests whether art prices are efficient. The Citadel index uses the hedonic regression method with observations drawn from the top 100, 50 and 20 artists by sales volume, giving approximately 29 503 total auction observations. The Index consists of quarterly data from the period 2000Q1 to 2013Q3. A vector autoregression of the art price index, Johannesburg stock exchange all-share index, house price index, and South African government bond index were used. Results show that, when there are increased returns on the stock market in a preceding period and wealth increases, there is a change in the Citadel art price index in the same direction. No significant difference was found between the house price index and the art price index, or between the art and government bond price indices. The art market is also found to be inefficient, thereby exacerbating the risk of investing in art. Overall, the South African art market does not offer the opportunity to diversify portfolios dominated by either property, bonds, or shares.

This article will draw upon some of the creative work being done in South Africa from March 2020 through December 2021, during the time of the coronavirus disease 2019 (COVID-19) worldwide pandemic, by artists working across disciplines in education, community, health, and mental health. The authors had been located in Johannesburg, South Africa, in early 2020, when their stay was cut short by the spread of the COVID-19 virus and the worldwide border shutdowns that followed as they were recalled to the USA in March 2020. They have remained in communication and contact with their colleagues in South Africa, and this article is based upon these observations and interactions. This article will describe some of the initiatives and programs developed by artists in the country as well as by the faculty in the Drama for Life program at the University of the Witwatersrand and the Art Therapy program at the University of Johannesburg. These initiatives have been used toward survival and healing in this liminal space of the COVID-19 crises.

The pending graduation of the ten pioneering South African art therapists from the Department of Visual Art (DOVA) at the University of Johannesburg (UJ) is a case for celebration and a long-nurtured dream for many involved in this training. I am not an art therapist and am not familiar enough with the field of practice and literature. I consider myself an artist, art activist, and educator. As the professor in charge of postgraduate studies in our department, as well as a fierce advocate for enhancing arts education for social impact, I found myself holding and facilitating the first visual art therapy training in South Africa, which is also, as I understand, a first for the continent.

Abstract: This article takes seriously the artistic, intellectual, literary, and curatorial approaches to curation that frame, display, and make meaning out of what is unrepresentable, such as the empty pedestal on which had sat a colonial and/or Confederate monument. By momentarily stepping away from the traditional role of museums to preserve and protect art objects, the article points out the ways exhibitions can produce and affect moods and emotions. If traditionally, museums can account for ownership and custodianship, can an account, therefore, of exhibitions consider spiritual, emotional, or psychic phenomena? In a post-conflict setting such as South Africa, exhibitions like the 2nd Johannesburg Biennale, which centred works about traumatic events like genocide in Rwanda and violent subjugation under apartheid in South Africa, led inevitably to privatisation and art market expansion. The article points to curator Okwui Enwezor’s interest in Africa and Asia.

Legislation in South Africa now provides for the inclusion of arts and culture and adult literacy in the education system and art libraries can help promote this Government initiative by distributing their resources widely. The Library of the South African National Gallery is playing an unusual and non-traditional role in helping redress past inequities. It uses visual art, with its concern with expression and communication, to encourage adult learning and stimulate articulacy by encouraging learners to ‘read’ texts from the mass media and visual artworks in order to develop skills in all kinds of literacy. SANG’s project shows how language and artworks can be linked together productively, contributing to the basic education and training of adults.

AbstractWe aimed to examine the correlates of antiretroviral therapy (ART) deferral to inform ART demand creation and retention interventions for patients diagnosed with HIV during the Universal Test and Treat (UTT) policy in South Africa. We conducted a cohort study enrolling newly diagnosed HIV-positive adults (≥ 18 years), at four primary healthcare clinics in Johannesburg between October 2017 and August 2018. Patients were interviewed immediately after HIV diagnosis, and ART initiation was determined through medical record review up to six-months post-test. ART deferral was defined as not starting ART six months after HIV diagnosis. Participants who were not on ART six-months post-test were traced and interviewed telephonically to determine reasons for ART deferral. Modified Poisson regression was used to evaluate correlates of six-months ART deferral. We adjusted for baseline demographic and clinical factors. We present crude and adjusted risk ratios (aRR) associated with ART deferral. Overall, 99/652 (15.2%) had deferred ART by six months, 20.5% men and 12.2% women. Baseline predictors of ART deferral were older age at diagnosis (adjusted risk ratio (aRR) 1.5 for 30–39.9 vs 18–29.9 years, 95% confidence intervals (CI): 1.0–2.2), disclosure of intentions to test for HIV (aRR 2.2 non-disclosure vs disclosure to a partner/spouse, 95% CI: 1.4–3.6) and HIV testing history (aRR 1.7 for > 12 months vs < 12 months/no prior test, 95% CI: 1.0–2.8). Additionally, having a primary house in another country (aRR 2.1 vs current house, 95% CI: 1.4–3.1) and testing alone (RR 4.6 vs partner/spouse support, 95% CI: 1.2–18.3) predicted ART deferral among men. Among the 43/99 six-months interviews, women (71.4%) were more likely to self-report ART initiation than men (RR 0.4, 95% CI: 0.2–0.8) and participants who relocated within SA (RR 2.1 vs not relocated, 95% CI: 1.2–3.5) were more likely to still not be on ART. Under the treat-all ART policy, nearly 15.2% of study participants deferred ART initiation up to six months after the HIV diagnosis. Our analysis highlighted the need to pay particular attention to patients who show little social preparation for HIV testing and mobile populations.

This article takes a critical and intimate look at Okwui Enwezor’s work in South Africa during the 1990s and asserts that the international exhibition he curated in Johannesburg in 1997—the Second Johannesburg Biennale, Trade Routes: History and Geography—is an important lens through which to explore Africa’s entangled histories. Trade Routes mattered as much for the discourse it produced as for the artworks it presented. The exhibition checklist features extraordinary works that were made between 1989 and 1997 by artists whose critical acclaim we take for granted today but who were at that time still underappreciated or emerging. Trade Routes not only challenged the status of the existing canon on African art but also proposed a new counter-canon. Additionally, Trade Routes and Enwezor’s concept of the meeting of worlds might have greater analytical potential as a metaphor for the meeting point of two indecipherable South Africas. Under apartheid, Johannesburg was two “countries,” and people lived in two different realities, depending on one’s history, geography, race, ethnicity, class, gender, culture, education, and opportunities. Enwezor constantly confronted the legacy of racism in small and big ways in South Africa. He was at the center of critical debates about race and representation. While there are all kinds of practical guidelines for how to talk about racism within the larger culture, we still do not have one for talking about racial inequality and racism in institutions, exhibition histories, curatorial practice, and the commercial art world. Instead, we have Okwui Enwezor to accompany us on our quest and to remind us to keep consulting both histories and imaginaries, theories and practices, and to continue to interrogate how cycles are reproduced or radically ruptured.

Art museums can help to promote art in society, but not all artists have their work selected for permanent collections or temporary exhibitions, and museums may be isolated from society. In Europe and North America, the primary function of museum libraries is to serve the parent institution, thereby serving the wider community only indirectly. In South Africa, where there are comparatively fewer museums, libraries, and publications concerned with the visual arts, and where there are so many disadvantaged people, it is vital that special collections such as the South Africa National Gallery (SANG) Library collection are made accessible in the widest possible sense and that museum library information programmes should be directed externally, as well as internally to the museum staff.

Artbooks, which are a combined form of picture and story book created using mixed media, can be a simple yet powerful way of supporting children affected by war and displacement to tell their stories. They allow children to work through the creative arts, which protects them from being overwhelmed by difficult memories. They also allow, even very young children, to show us how they cope with past violence and present injustice by recalling and representing the small everyday overcomings of their lives – a garden they planted in DRC, a mother who walks them across a busy Johannesburg street, a curtain blowing in the door of their new home – just as it did in their old home. The books allow them to witness to the injustice of xenophobic violence by neighbours and the immoveable bureaucracy attached to accessing documents, through representing the small details of their lives in crayons and paint. Making artbooks also allows for some measure of meaning-making in the chaos of the everyday in a hostile city where their parents struggle to maintain a normal life for them. Books are also a powerful way for children to safely share their stories and advocate for changed attitudes, laws and policies in the increasingly migrant-hostile South African society. The article will tell the story of a book-making project run over a number of years at a community counselling centre that works with families on the move in Johannesburg South Africa. It will also describe how some of the children’s books have become a powerful advocacy tool through their inclusion in the digital library of the African Storybook project. The article will explore some of the practical details of the project and the theory around the power of the representation of the everyday which we are beginning to derive from the work.

Introduction South Africa has a high prevalence of Human immunodeficiency virus (HIV) infection with an estimated 7 million people with HIV (PWH). Significant progress has been made in implementing anti-retroviral therapy (ART) with 4 million patients on ART in 2017 compared with 400 000 in 2007. HIV-associated lymphomas remain a public health concern in our setting. Patterns of changes in lymphoma are well documented in high-income countries following wide-scale ART, however, there are limited published data available from our region. This study aimed to compare epidemiological characteristics of high-grade B-cell lymphomas (HG BLPDs) in PWH presenting to the academic hospitals in Johannesburg, South Africa, prior to and post implementation of a wide-scale ART programme. Methods This study was approved by the Human Research Ethics committee of the University of the Witwatersrand (protocol number: M130280). All patients with newly diagnosed lymphoma (B- and T-cell non-Hodgkin and Hodgkin lymphoma) during 2007 and 2017 in the Johannesburg academic complex of hospitals (South Africa) were identified via a comprehensive search of the laboratory information system (LIS) utilizing SNOMED codes and a detailed pathology record review. Limited demographic and clinical data were collected for each patient. Statistical analysis was performed using GraphPad Prism software, version 7.0 (San Diego, California, United States). Continuous data are presented as the median (interquartile range (IQR)) and categorical data as frequencies and percentages. The Mann-Whitney and Fisher's exact or Chi-square test were used to compare continuous and categorical variables respectively. Results and Discussion The total number of cases of lymphoma diagnosed in the Johannesburg state-sector hospitals showed a marked increase from 397 in 2007 to 582 in 2017. This may represent an improvement in access to health-care, more extensive diagnostic work-up and significantly increased HIV testing in lymphoma patients (p&lt;0.0001) in the later time period. HG BLPDs remained the most commonly diagnosed lymphoma subtype, comprising 69% (2007) and 60% (2017) of all lymphomas diagnosed and 78% and 69% of cases in PWH with lymphoma respectively. There were significantly more PWH presenting with HG BLPD on ART in 2017 (p&lt;0.0001), with a median duration of therapy of 24 months (interquartile range 12-48). No significant change in the percentage of patients with extranodal (68.4% vs 73.1%) or bone marrow involvement (26.9% vs 24.2%) was noted. There was no significant change in prognostic markers, with the exception of lactate dehydrogenase (LDH) levels which showed a significant decline in 2017 (p&lt;0.0001). This may be due to a significantly increased absolute number and proportion of diffuse large B-Cell Lymphoma (DLBCL) cases relative to the other HG BLPDs which were diagnosed in 2017 (p=0.0004), whilst Burkitt leukemia/lymphoma (BL) and high-grade B-cell lymphoma (HGBL) showed no significant increase (p=0,1886), and plasmablastic lymphoma (PBL) appeared to have declined in overall number and proportion (although this did not reach statistical significance (p=0,0721)). PWH presenting with lymphoma showed significant changes in virologic control as expected, with a significant decline in the median HIV viral load (HIVVL) (p=0.0032), increase in the proportion of patients with an HIVVL &lt;1000 (15.3% in 2007 vs 52.4% in 2017; p&lt;0.0001) and changed distribution of VL (p&lt;0.0001) in 2017 as compared to 2007 (Table 1 and Figure 1). Despite the improvement in virological suppression, there was no significant change in median CD4+ T-cell count (p=0.1473), change in proportion of patients with CD4 count&lt;200 x106/l (69.2% in 2007 vs 62.1% in 2017; p=0.1541) or change in distribution of CD4 counts (p=0.5084) (Table 1 and Figure 1). Conclusions: A marked increase in the number of lymphoma cases diagnosed in the state-sector hospitals in Johannesburg was noted over the study period with HG BLPD remaining the most commonly diagnosed subtype in PWH despite significant improvements in virological control. This suggests that virological control alone may not be protective and that delayed or incomplete immunologic recovery as a consequence of late ART initiation may be contributing. Public health initiatives to promote early access to ARV therapy at higher CD4 counts may assist in decreasing the incidence of HG BLPDs in our setting. Disclosures No relevant conflicts of interest to declare.

Background. The paediatric HIV treatment programme in South Africa (SA) has grown since its inception in 2004. Despite this impressive scale-up of antiretroviral therapy (ART) in children, the proportion of children started on ART and retained in care remains unacceptably low, with only 47% of the 340 000 HIV-positive children in SA on ART in 2020. Johannesburg is one of the districts in SA with the largest number of children living with HIV who are not on ART, and is a priority district for paediatric case finding and retention. Objectives. To describe the dynamics of the paediatric HIV programme in Johannesburg, SA. Methods. A secondary analysis was conducted on patient-level HIV treatment data from TIER.Net, the nationally mandated HIV/ART database. Children aged <15 years who received ART between January 2004 and June 2019 at public health facilities in Johannesburg were included. We reported the number of children on ART and the number who entered and exited the programme by age group over time, and analysed the trends of these indicators. Results. By December 2018, 7 630 children aged <15 years remained in Johannesburg’s paediatric ART programme: 82.5% were aged 5 - <15 years, with 54.1% of these being 10 - <15 years old. During the study period, 19 850 children were newly initiated on ART. New initiations slowed from 2013, to range from 1 172 to 1 373 yearly. In 2018, 34.2% of initiators were aged <1 year, 24.2% 1 - <5 years and 41.6% 5 - <15 years. Despite these initiations, the number of children on ART only grew by 97 in 2018, owing to programme losses. In 2018, 924 children (12.1%) aged out, 35 (0.5%) died and 983 (12.9%) were lost to follow-up (LTFU), the latter having increased from 10.7% in 2017. Of children who aged out of the paediatric ART programme, 56.3% remained in care at the same facility. Conclusion. Early in the SA ART roll-out, many children were found to be HIV infected and started on ART. This number started to slow in 2013, after which the growth rate of the paediatric HIV programme also began to slow. Scale-up of methods for identifying older children with HIV is needed. While ageing out of the paediatric programme is a consideration, the number of children LTFU remains unacceptably high. Further interrogation of barriers to paediatric retention is needed to help realise the Joint United Nations Programme on HIV and AIDS (UNAIDS) 90:90:90 goals for children in SA.

Background Retention in care is required for optimal clinical outcomes in people living with HIV (PLHIV). Although most PLHIV in South Africa know their HIV status, only 70% are on antiretroviral therapy (ART). Improved retention in care is needed to get closer to sustained ART for all. In January 2019, Anova Health Institute conducted a campaign to encourage patients who had interrupted ART to return to care. Methods Data collection was conducted in one region of Johannesburg. This mixed methods study consisted of two components: 1) healthcare providers entered data into a structured tool for all patients re-initiating ART at nine clinics over a nine-month period, 2) Semi-structured interviews were conducted with a sub-set of patients. Responses to the tool were analysed descriptively, we report frequencies, and percentages. A thematic approach was used to analyse participant experiences in-depth. Results 562 people re-initiated ART, 66% were women, 75% were 25–49 years old. The three most common reasons for disengagement from care were mobility (30%), ART related factors (15%), and time limitations due to work (10%). Reasons for returning included it becoming easier to attend the clinic (34%) and worry about not being on ART (19%). Mobile interview participants often forgot their medical files and expressed that managing their ART was difficult because they often needed a transfer letter to gain access to ART at another facility. On the other hand, clinics that had flexible and extended hours facilitated retention in care. Conclusion In both the quantitative data, and the qualitative analysis, changing life circumstances was the most prominent reason for disengagement from care. Health services were not perceived to be responsive to life changes or mobility, leading to disengagement. More client-centred and responsive health services should improve retention on ART.

Background. In 2004 the World Health Organization (WHO) released the Interim Policy on Collaborative TB/HIV activities. According to the policy, for people living with HIV (PLWH), activities include intensified case finding, isoniazid preventive therapy (IPT) and infection control. For TB patients, activities included HIV counselling and testing (HCT), prevention messages, and cotrimoxazole preventive therapy (CPT), care and support, and antiretroviral therapy (ART) for those with HIV-associated TB. While important progress has been made in implementation, targets of the WHO Global Plan to Stop TB have not been reached. Objective. To quantify TB/HIV integration at 3 primary healthcare clinics in Johannesburg, South Africa. Methods. Routinely collected TB and HIV data from the HCT register, TB ‘suspect’ register, TB treatment register, clinic files and HIV electronic database, collected over a 3-month period, were reviewed. Results. Of 1 104 people receiving HCT: 306 (28%) were HIV-positive; a CD4 count was documented for 57%; and few received TB screening or IPT. In clinic encounters among PLWH, 921 (15%) had documented TB symptoms; only 10% were assessed by smear microscopy, and few asymptomatic PLWH were offered IPT. Infection control was poorly documented and implemented. HIV status was documented for 155 (75%) of the 208 TB patients; 90% were HIV-positive and 88% had a documented CD4 count. Provision of CPT and ART was poorly documented. Conclusion. The coverage of most TB/HIV collaborative activities was below Global Plan targets. The lack of standardised recording tools and incomplete documentation impeded assessment at facility level and limited the accuracy of compiled data.

Th e use of tactical urbanism and creative placemaking in the revitalisation of public space has received growing research interest. In Johannesburg, there is evidence of these approaches in the revitalisation of Th e Wilds, a nature reserve located near the inner-city. Th e Wilds experienced neglect and decline due to increased crime. By the mid-2010s, an artist championed the bottom-up revitalisation of Th e Wilds through routine maintenance, the introduction of public art, and events to encourage engagement with the space. Th is study draws on personal communication and semi-structured interviews with key informants and utilises netnography. It was found that the use of public art and social media resulted in an increase in visitor numbers and volunteers who assisted in the maintenance, restoration and engagement with the space. Th e use of tactical urbanism and creative placemaking, however, has brought volunteers into conflict with the city over the usage and co-management of The Wilds.

Among those with HIV, anemia is a strong risk factor for disease progression and death independent of CD4 count and viral load. Understanding the role of anemia in HIV treatment is critical to developing strategies to reduce morbidity and mortality. We conducted a prospective analysis among 10,259 HIV-infected adults initiating first-line ART between April 2004 and August 2009 in Johannesburg, South Africa. The prevalence of anemia at ART initiation was 25.8%. Mean hemoglobin increased independent of baseline CD4. Females, lower BMI, WHO stage III/IV, lower CD4 count, and zidovudine use were associated with increased risk of developing anemia during follow-up. After initiation of ART, hemoglobin improved, regardless of regimen type and the degree of immunosuppression. Between 0 and 6 months on ART, the magnitude of hemoglobin increase was linearly related to CD4 count. However, between 6 and 24 months on ART, hemoglobin levels showed a sustained overall increase, the magnitude of which was similar regardless of baseline CD4 level. This increase in hemoglobin was seen even among patients on zidovudine containing regimens. Since low hemoglobin is an established adverse prognostic marker, prompt identification of anemia may result in improved morbidity and mortality of patients initiating ART.

Adolescents experience disproportionately high rates of poor ART outcomes compared to adults despite prolonged use of antiretroviral therapy in Southern African treatment programs, presenting a significant challenge to national attempts to meet the UNAIDS 90-90-90 targets for 2020. This cohort study among adolescents aged 12–20 years accessing ART care at two urban public-sector clinics in Johannesburg between September and November 2013 aimed to identify factors potentially associated with poor attendance at clinic visits. Patients were followed up through routine medical records to identify missed visits (failing to attend clinic within 30 days of scheduled visit date) up to 2 years after enrolment. We enrolled 126 adolescents on ART for a median of 6.3 years (IQR: 2.7–8.4). A total of 47 (38%) adolescents missed a scheduled visit within 24 months of enrolment. Older adolescents (18–20 years) were more likely to miss a visit compared to adolescents aged 12–14 years (risk ratio (RR) = 1.72; 95% CI: 1.00–2.95). Those who were identified to have difficulty in taking medication (RR = 1.57; 95% CI: 1.13–2.18) as a barrier to care were more likely to miss a visit compared to adolescents who did not. Awareness of treatment fatigue, challenges to taking ART, and caregiver difficulties is important when considering interventions to improve treatment outcomes among adolescents.

Background Studies from high income countries report that HIV-positive people have an impaired systolic and diastolic cardiac function compared to HIV-negative people. It is unclear if results can be translated directly to the Sub-Saharan Africa context. This study assesses electro- and echocardiographic characteristics in an urban African population, comparing HIV-positive people (treated and not yet treated) with HIV-negative controls. Methods We conducted a cross-sectional study in Johannesburg, South Africa. We enrolled HIV-positive participants from three randomized controlled trials that had recruited participants from routine HIV testing programs. HIV-negative controls were recruited from the community. Data were collected on demographics, cardiovascular risk factors, medical history and electrocardiographic and echocardiographic characteristics. Results In total, 394 HIV-positive participants and 153 controls were enrolled. The mean age of HIV-positive participants was 40±9 years (controls: 35±10 years), and 34% were male (controls: 50%). Of HIV-positive participants 36% were overweight or obese (controls: 44%), 23% had hypertension (controls: 28%) and 12% were current smoker (controls: 37%). Median time since HIV diagnosis was 6.0 years (IQR 2.3–10.0) and median treatment duration was 4.0 years (IQR 0.0–8.0), 50% had undetectable viral load. The frequency of anatomical cardiac abnormalities was low and did not differ between people with and without HIV. We observed no relation between HIV or anti-retroviral therapy (ART) and systolic or diastolic heart function. There was an association between ART use and corrected QT interval: +11.8 ms compared to HIV-negative controls (p<0.01) and +18.9 ms compared to ART-naïve participants (p = 0.01). We also observed a higher left ventricular mass index in participants on ART (+7.8 g/m2, p<0.01), but this association disappeared after adjusting for CD4 cell count, viral load and HIV-duration. Conclusion The low number of major cardiac abnormalities in this relatively young, well managed urban African HIV-positive population is reassuring. The increase in corrected QT interval and left ventricular mass may contribute to higher cardiac mortality and morbidity in people living with HIV in the long term.

Use of the antiretroviral drug efavirenz (EFV) is not recommended by the WHO or South African HIV treatment guidelines during the first trimester of pregnancy due to potential fetal teratogenicity; there is little evidence of how clinicians manage EFV-related fertility concerns. Women on antiretroviral therapy (ART) were enrolled into a prospective cohort in four public clinics in Johannesburg, South Africa. Fertility intentions, ART regimens, and pregnancy testing were routinely assessed during visits. Women reporting that they were trying to conceive while on EFV were referred for regimen changes. Kaplan-Meier estimators were used to assess incidence across ART regimens. From the 822 women with followup visits between August 2009–March 2011, 170 pregnancies were detected during study followup, including 56 EFV conceptions. Pregnancy incidence rates were comparable across EFV, nevirapine, and lopinavir/ritonavir person-years (95% 100/users (P=0.25)); incidence rates on EFV were 18.6 Confidence Interval: 14.2–24.2). Treatment substitution from EFV was made for 57 women, due to pregnancy intentions or actual pregnancy; however, regimen changes were not systematically applied across women. High rates of pregnancy on EFV and inconsistencies in treatment management suggest that clearer guidelines are needed regarding how to manage fertility-related issues in. women on EFV-based regimens.

AwqafSA (www.awqafSA.org.za), a South African Muslim NGO, has beenin constant contact with IRCICA (the Islamic Research Centre for IslamicHistory, Art and Culture: www3.ircica.org), an affiliate of the Organization ofthe Islamic Conference, for several years regarding possible cooperation. On18 April 2005, this contact culminated in Halit Eren’s (director-general, IRCICA)meeting with a few organizations and their representatives regarding theforthcoming “International Symposium on Islamic Civilization in SouthernAfrica,” scheduled for the following year. AwqafSA and IRCICA, aware ofthe fact that very little research has been done on Islam in southern Africa,have strongly advocated holding a symposium to bring scholars, researchers,and stakeholders together to share their thoughts on their respective countriesand communities. At this meeting, it was agreed that AwqafSA would be thelocal host in partnership with IRCICA and that the University of Johannesburgwould be the third partner in this important historical venture.The symposium took place between 1-3 September 2006 at theUniversity of Johannesburg. A few months earlier, on 28 June 2006 to beexact, Ebrahim Rasool (premier, Western Cape Province) formally launchedthe symposium at Leeuwenhof, his official residence. In his short speech, hestressed the multicultural nature of South African society and the importanceof holding such a symposium in the country, a symposium that will allowparticipants – particularly South Africans – to do some “rainbow gazing”and critically assess their position within South Africa. The premier was alsoone of the keynote speakers at the symposium. Essop Pahad (minister,Office of the President) connected the symposium proceedings to the AfricanRenaissance process as well as to the significant Timbuktu Project(www.timbuktufoundation.org; www.timbuktuheritage.org) spearheaded byShamil Jeppie (the University of Cape Town). He also touched upon newevidence of the influence of Islam in the Limpopo Valley, northern SouthAfrica. In his concluding remarks, he emphatically rejected Huntington’s“clash of civilizations” thesis ...

Background. We evaluated whether a pilot program providing point-of-care (POC), but not rapid, CD4 testing (BD FACSCount) immediately after testing HIV-positive improved retention in care.Methods. We conducted a retrospective record review at the Themba Lethu Clinic in Johannesburg, South Africa. We compared all walk-in patients testing HIV-positive during February, July 2010 (pilot POC period) to patients testing positive during January 2008–February 2009 (baseline period). The outcome for those with a≤250cells/mm3when testing HIV-positive was initiating ART<16weeks after HIV testing.Results. 771 patients had CD4 results from the day of HIV testing (421 pilots, 350 baselines). ART initiation within 16 weeks was 49% in the pilot period and 46% in the baseline period. While all 421 patients during the pilot period should have been offered the POC test, patient records indicate that only 73% of them were actually offered it, and among these patients only 63% accepted the offer.Conclusions. Offering CD4 testing using a point-of-care, but not rapid, technology and without other health system changes had minor impacts on the uptake of HIV care and treatment. Point-of-care technologies alone may not be enough to improve linkage to care and treatment after HIV testing.

Multiple factors make adherence to antiretroviral therapy (ART) a complex process. This study aims to describe the barriers and facilitators to adherence for patients receiving first-line and second-line ART, identify different adherence strategies utilized and make recommendations for an improved adherence strategy. This mixed method parallel convergent study will be conducted in seven high volume public health facilities in Gauteng and one in Limpopo province in South Africa. The study consists of four phases; a retrospective secondary data analysis of a large cohort of patients on ART (using TIER.Net, an ART patient and data management system for recording and monitoring patients on ART and tuberculosis (TB)) from seven Johannesburg inner-city public health facilities (Gauteng province); a secondary data analysis of the Intensified Treatment Monitoring Accumulation (ITREMA) trial (a randomized control trial which ran from June 2015 to January 2019) conducted at the Ndlovu Medical Center (Limpopo province); in-depth interviews with people living with Human Immunodeficiency Virus (PLHIV) who are taking ART (in both urban and rural settings); and a systematic review of the impact of treatment adherence interventions for chronic conditions in sub-Saharan Africa. Data will be collected on demographics, socio-economic status, treatment support, retention in care status, disclosure, stigma, clinical markers (CD4 count and viral load (VL)), self-reported adherence information, intrapersonal, and interpersonal factors, community networks, and policy level factors. The systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting and Population, Interventions, Comparisons and Outcomes (PICO) criteria. Analyses will involve tests of association (Chi-square and t-test), thematic analysis (deductive and inductive approaches) and network meta-analysis. Using an integrated multilevel socio-ecological framework this study will describe the factors associated with adherence for PLHIV who are taking first-line or second-line ART. Implementing evidence-based adherence approaches, when taken up, will improve patient’s overall health outcomes. Our study results will provide guidance regarding context-specific intervention strategies to improve ART adherence.

ObjectivesTo assess delays to antiretroviral therapy (ART) initiation before and after the Universal Test and Treat (UTT) and the same-day initiation (SDI) of ART policy periods in Johannesburg, South Africa.DesignProspective cohort study.SettingPatients were recruited from six primary health clinics in Johannesburg.ParticipantsOverall, 1029 newly diagnosed HIV positive adults (≥18 years) were consecutively enrolled by referral from the testing counsellor between April and December 2015 (pre-UTT n=146), July and August 2017 (UTT, n=141) and October 2017 and August 2018 (SDI, n=742).Main outcome measuresCox proportional hazards regression was used to assess predictors of 30 days ART initiation. Additionally, predictors of immediate ART initiation were evaluated using Poisson regression.ResultsOverall, 30 days ART proportions were 71.9% overall, 36.9% pre-UTT (44.3% of those eligible), 65.9% under UTT and 79.9% under the SDI policy. The median days to ART initiation declined from 21 pre-UTT (IQR: 15–30) to 8 (IQR: 6–16) under UTT and 5 days (IQR: 0–8) under the SDI policy. However, only 150 (20.2%) of the SDI cohort-initiated ART immediately after HIV diagnosis. Living in a two-adult home (adjusted HR (aHR) 1.2 vs living alone, 95% CI 1.0 to 1.5) increased the likelihood of 30-day ART. Missing baseline cluster of differentiation four (CD4) data decreased the likelihood of 30 days ART by 40% (aHR 0.6 vs CD4 <350 cells/µL, 95% CI 0.5 to 0.7). More women took up immediate ART (adjusted relative risk (aRR) 1.3, 95% CI 1.0 to 1.9). Participants ≥40 years (aRR 0.6 vs 18–24 years, 95% CI 0.4 to 0.9) were less likely to start ART immediately after HIV diagnosis. However, immediate ART rates increased with longer policy implementation time (aRR 0.2 for <3 months vs >10 months, 95% CI 0.1 to 0.4).ConclusionsThe study results highlight a positive move towards earlier ART initiation during the UTT and SDI periods and emphasise a need to increase same-day ART implementation further.

Abstract Background There is a paucity of data on the burden of congenital cytomegalovirus (cCMV) infections in low- and middle-income countries, including their association with maternal human immunodeficiency virus (HIV) infections. We investigated the prevalence of cCMV in a patient population with a high rate of HIV and antiretroviral therapy (ART) use during pregnancy in Soweto, Johannesburg. Methods Saliva from neonates were screened for cytomegalovirus (CMV) infection by polymerase chain reaction (PCR) at birth. Additional saliva and urine samples were tested within 3 weeks of birth to confirm positive saliva results. HIV PCR testing was done on the whole blood of HIV-exposed neonates. Maternal and neonatal data were extracted from clinical records. Results Of 2685 neonates screened for cCMV, 828 (31%) were born to HIV-infected women, 95% of whom (790/828) were on ART at delivery. The overall prevalence of cCMV was 2.5% (95% confidence interval [CI] 1.9–3.2), with significantly higher cCMV prevalence in HIV-exposed neonates (5.2%, 95% CI 3.8–6.9) than HIV-unexposed neonates (1.4%, 95% CI 0.9–2.0). The risk of in utero HIV infection was 20-fold greater (odds ratio 20.1, 95% CI 6.09–66.46) in HIV-exposed, cCMV-infected neonates, and this increased risk was not associated with the maternal CD4+ T-cell count or the maternal duration of ART. Conclusions The prevalence of cCMV in our setting is substantially higher than the global estimate of 0.64%, partly due to the increased susceptibility for cCMV in HIV-exposed neonates. The significantly increased risk of in utero HIV infection in neonates with cCMV indicates that CMV coinfection plays a major role in the residual burden of in utero HIV transmission, even in the era of ART.

ObjectiveThis study described the demographics, treatment information and identified characteristics associated with virological failure and being lost to follow-up (LTFU) for patients with HIV on first-line and second-line antiretroviral therapy (ART) regimens in a large South African cohort.DesignA quantitative retrospective cohort study using secondary data analysis.SettingSeven Johannesburg inner city facilities.ParticipantsUnique records of 123 002 people with HIV receiving ART at any point in the period 1 April 2004 to 29 February 2020 were included.MeasuresDemographic characteristics, ART status, CD4 count information and retention status were collected and analysed as covariates of outcomes (viral load (VL) and LTFU).ResultsOf the total study patients, 95% (n=1 17 260) were on a first-line regimen and 5% (n=5742) were on a second-line regimen. Almost two-thirds were female (64%, n=79 226). Most patients (60%, n=72 430) were initiated on an efavirenz-based, tenofovir disoproxil fumarate-based and emtricitabine-based regimen (fixed-dose combination). 91% (n=76 737) achieved viral suppression at least once since initiating on ART and 60% (n=57 981) remained in care as at the end of February 2020. Patients from the community health centre and primary healthcare clinics were not only more likely to be virally suppressed but also more likely to be LTFU. Patients on second-line regimens were less likely to reach viral suppression (adjusted OR (aOR)=0.26, CI=0.23 to 0.28) and more likely to be LTFU (aOR=1.21, CI=1.09 to 1.35). Being older (≥25 years) and having a recent CD4 cell count≥100 cells/µL were predictors of viral suppression and retention in patients on ART.ConclusionPatients on first-line regimens had higher VL suppression rates and were more likely to remain in care than those on a second-line regimen. Being younger and having low CD4 cell counts were associated with poor outcomes, suggesting priority groups for ART adherence support.

Introduction We sought to understand the Undetectable = Untransmittable (U = U) communication needs of persons living with HIV (PLHIV) and barriers to U = U communication among healthcare providers (HCPs) in South Africa. Methods We conducted five focus group discussions (FGDs) with HCPs (N = 42) including nurses and counsellors from primary healthcare clinics (PHCs) in the Gauteng and Free State Provinces of South Africa, three FGDs (N = 27) with PLHIV recruited by snowball sampling from civil society organizations, and 27 in-depth interviews (IDIs) with recently diagnosed PLHIV in Johannesburg. IDIs and FGDs were audio recorded, transcribed, translated to English, and analysed thematically. Results PLHIV were largely unaware and sceptical of U = U as the message appeared to contradict the mainstream HIV prevention clinical guidance. The low viral load (VL) knowledge further reduced confidence in U = U. PLHIV need support and guidance on the best approaches for sharing U = U information and disclosing their VL status to their partners, highlighting the central role of community understanding of U = U and VL to mediate the desired stigma reduction, social acceptance and emotional benefits of U = U for PLHIV. HCPs were uneasy about sharing U = U due to concerns about risk compensation and ART non-adherence and worried about enabling any ensuing HIV transmission. HCPs also need a simple, unambiguous, and consistent narrative for U = U, integrated with other HIV prevention messages. PLHIV and HCPs alike recommended a patient-centred approach to communicating U = U, focusing primarily on attaining viral suppression and emphasizing that condomless sex is only safe during periods of ART adherence. Conclusions These data highlight the need for simple U = U communication support targeting both HCP and PLHIV. Culturally appropriate communication materials, with training and ongoing mentorship of the clinic staff, are essential to improve patient-centred U = U communication in clinics.

"Exhibitions of the Painters Otto Fikentscher (1862 Zwickau ‒ 1945 Baden Baden) and Franz Domscheit/Pranas Domsaitis (1873 Kropiens/Gajewo ‒ 1962 Cape Town) in Sibiu. The paper is dealing with two art events, which occured in 1914 and 1924 and were organized by the Art Association Sebastian Hann. The protagonists were the animal painter Otto Fikentscher and the Expressionist Franz Domscheit/Pranas Domsaitis, both esteemed artists from Germany. The only source reporting about the events was the important German daily newspaper from Transylvania, Siebenbürgisch-Deutsches Tageblatt. While Fikentscher’s exhibition, which comprised several paintings showing specimens from the Transylvanian fauna, was received with enthusiasm, Franz Domscheit’s show, much more difficult to be understood by the provincials (both, critics and public), did not enjoy recognition. Fikentscher intended to come back to Sibiu the same year with another exhibition, an intention impeded by the outbreak of WWI and the events of its aftermath. Although initially some of the intellectuals from Sibiu intended to convince Domscheit to settle in their town in order to enrich the local art scene, the failure of the exhibition made it invalid. The paper also deals with the most important biographical data of the two artists and makes consideration about their artworks. Keywords: Otto Fikentscher, animal painter, Transylvania, Sibiu, Association Sebastian Hann, Franz Domscheit/Pranas Domsaitis, Impressionism, Expressionism, degenerate art, South Africa, Pranas Domsaitis Gallery, Lithuania, Klaipeda. "

South Africa rolled out Universal Test-and-Treat (UTT) in 2016, extending treatment eligibility to all persons living with HIV (PLHIV). We sought to understand how PLHIV in Johannesburg, South Africa, interpret and experience their HIV status, five years into the UTT era. In May 2021, we conducted in-depth interviews (IDI) (N = 27) with adult (≥18 years) PLHIV referred by HIV counsellors at three peri-urban primary healthcare clinics. We also conducted three focus group discussions (FGDs) (N = 27) with adult PLHIV recruited from clinics or from civil society organisations through snowball sampling. Follow-up interviews were conducted with 29 IDI and FGD participants. Participants were asked to reflect on their HIV diagnosis, what their HIV status meant to them and how, if at all, being HIV-positive affected their lives. Interviews and focus group discussions were audio-recorded, transcribed, translated to English, and analysed using a grounded theory approach. Participants perceived that HIV was common, that PLHIV could live a normal life with antiretroviral therapy (ART), and that ART was widely accessible. However, HIV elicited feelings of guilt and shame as a sexually transmitted disease. Participants used the language of “blame” in discussing HIV transmission, citing their own reckless behaviour or blaming their partner for infecting them. Participants feared transmitting HIV to others and felt responsible for avoiding transmission. To manage transmission anxiety, participants avoided sexual relationships, chose HIV-positive partners, and/or insisted on using condoms. Many participants feared–or had previously experienced–rejection by partners due to their HIV status and reported hiding their medication, avoiding disclosure, or avoiding relationships altogether. Most participants were not aware that undetectable HIV is untransmittable (U = U). Participants who were aware of U = U expressed less anxiety about transmitting HIV to others and greater confidence in having relationships. Despite perceiving HIV as a manageable chronic condition, PLHIV still faced transmission anxiety and fears of rejection by their partners. Disseminating information on U = U could reduce the psychosocial burdens of living with HIV, encourage open communication with partners, and remove barriers to HIV testing and treatment adherence.

Background. The 95-95-95 strategy implementation is a positive initiative for moving the HIV tide towards elimination, with a focus on addressing the huge inequalities in existence in access to HIV services.Objectives. To establish performance towards the 90-90-90 and 95-95-95 targets and trends in HIV positivity rates since strategy implementation rollout in the City of Johannesburg (CoJ), South Africa. Methods. This was a descriptive study, part of the bigger quasi-experimental study using the monthly District Health Information System during the implementation and rollout of the 90-90-90 strategy. HIV access trends were tracked and compared with the set strategy implementation targets. In addition, the HIV positivity rate was analysed to observe trends. A time trend analysis for aggregated data was performed on all the measured indicators to determine whether the decrease or increase was statistically significant. P<0.05 was used to indicate statistical significance. Results. The study has shown that by March 2022, 15 months after December 2020, CoJ had reached 91-65-88. There were significant steady increases in the number of people who knew their HIV status (slope = 0.044, p<0.001) and initiating on antiretroviral therapy (ART) (slope = 0.001, p<0.001), and significant decreases for overall HIV positivity rate (slope = –0.016, p<0.001), adolescent positivity rate (slope = –0.0087, p<0.001) and antenatal care HIV positivity rate (slope = –0.013, p<0.001). Conclusion. This study has established positive progress made by the CoJ towards HIV testing, ART initiation, viral load suppression and HIV positivity rate. On the other hand, gaps in linkage to care after testing positive have been highlighted. It is therefore critical in the 95-95-95 strategy implementation era to focus on finding those missed during the 90-90-90 phase through revised and renewed innovative approaches.

<abstract><sec> <title>Background</title> <p>High proportion of people living with HIV (PLHIV) who are in the prime of their reproductive years desire to have children. There are limited studies that explore the range of fertility intentions for PLHIV. This study investigated the fertility desires and intentions of PLHIV and the associated factors.</p> </sec><sec> <title>Methods</title> <p>This was a cross-sectional study of 442 PLHIV receiving antiretroviral treatment (ART) in health facilities in Soweto, an urban township that is situated in the City of Johannesburg in South Africa. STATA version 13 was used to analyze the data.</p> </sec><sec> <title>Results</title> <p>The participants' mean age was 36.3 years, 70% were females, 79.6% had at least one biological child, and 36% had 3+ children. Almost half (47%) expressed the desire for children, saying that this was because they had no biological children, or their partners wanted children, or they wanted children of a particular sex, or were feeling healthy after taking ART. An increased fertility desire was associated with absence of biological children (AOR = 5.06, 95% CI: 2.11–12.1) and with being married (AOR = 2.63, 95% CI: 1.31–5.27). A decreased fertility desire was associated with being aged 36+ (AOR = 2.63, 95% CI: 1.31–5.27), having primary education (AOR = 0.11, 95% CI: 0.01–1.30) and having ≥4 years of ART duration (AOR = 0.45, 95% CI: 0.24–0.81).</p> </sec><sec> <title>Conclusion</title> <p>Individual factors played a significant role in shaping the fertility desires of PLHIV in this setting. The high desire for children underscore the need to integrate reproductive health services in HIV and AIDS care and treatment services and develop safer conception programmes to help PLHIV to conceive and have children safely.</p> </sec></abstract>

Cities as elusive, invisible, yet to come. ‘[T]he city is no-man's land’ (Grace Khunou, p. 240 in Mbembe and Nuttall). ‘Lagos is no man's land’ (heard in Lagos by the present writer, August 2010). A picture of a strangely empty and disrupted man-made landscape (William Kentridge, pp. 349–350 in Mbembe and Nuttall), balanced by a dense but also personless urban scene (by the same author, pp. 35–6 in the same text). … The slippage between conventional social scientific terms of runaway urbanization, the teeming human vitality of African cities, and the elusiveness of the titles, sayings and images of these three books, opens up the rich vein for research and writing into which these authors work their ways. Johannesburg. Kinshasa. Pikine (Dakar). Winterveld (a South African urban area outside Pretoria). Douala. Jeddah. The books reviewed here are based on detailed field research in six particular cities. They all juxtapose the categories of ‘metropolis’ and ‘modernity’ to the category of ‘Africa’, all positing the anomaly this move may represent in the categorical social scientific mind. The subtitles immediately indicate a different starting point from the analytics of population, geography and governance. With an approach through ‘tales’ (De Boeck and Plissart) and ‘reading the city’ (Mbembe and Nuttall), the authors indicate an alternative intellectual reach. They start from visual imagery, the language arts and the social mediations through which the lives lived in urban ‘modern’ Africa are expressed, communicated, understood, configured and conserved. Their aims evoked in my mind the modern art – rather than the analytics – of other cities. So here we have ‘circulation’ and vehicles as symbols and sounds without too much attention to traffic (the Lagos ‘go slow’; the accidents); ‘bodies’ without much attention to food or toilet needs or aging; ‘authority’ evaded or permeating rather than personified in mayors, town councils and multitudes of other officials and employees. In the ether of the invisible, what circulates are symbols and expressions; what emanates from bodies is sexual tension, aesthetic sensibility and physical vulnerability (‘bodies in danger’, De Boeck and Plissart, p. 117); what bears down oppressively is constraint and neglect of all kinds. In brief, what strikes the perceptive mind is precisely what bursts out of the conventional forms and has not yet taken a newly conventionalized shape. Through this orientation, all three books bring the humanities and artistic sensibilities to the question of the spirits, souls, inspirations, dangers, images and memories that inhabit the crowded spaces between buildings and people, insects and people, people and people.

Abstract Background Cryptococcal antigen (CrAg) screening and treatment with preemptive fluconazole reduces the incidence of clinically evident cryptococcal meningitis in individuals living with advanced human immunodeficiency virus (HIV) disease. However, mortality remains higher in CrAg-positive than in CrAg-negative patients with similar CD4+ T-lymphocyte counts. Methods We conducted a cohort study to investigate causes of morbidity and mortality during 6 months of follow-up among asymptomatic CrAg-positive and CrAg-negative (ratio of 1:2) patients living with HIV with CD4 counts &lt;100 cells/µL attending 2 hospitals in Johannesburg, South Africa. When possible, minimally invasive autopsy (MIA) was performed on participants who died. Results Sixty-seven CrAg-positive and 134 CrAg-negative patients were enrolled. Death occurred in 17/67 (25%) CrAg-positive and 12/134 (9%) CrAg-negative participants (hazard ratio for death, adjusted for CD4 count, 3.0; 95% confidence interval, 1.4–6.7; P = .006). Cryptococcal disease was an immediate or contributing cause of death in 12/17 (71%) CrAg-positive participants. Postmortem cryptococcal meningitis and pulmonary cryptococcosis were identified at MIA in all 4 CrAg-positive participants, 3 of whom had negative cerebrospinal fluid CrAg tests from lumbar punctures (LPs) at the time of CrAg screening. Conclusions Cryptococcal disease was an important cause of mortality among asymptomatic CrAg-positive participants despite LPs to identify and treat those with subclinical cryptococcal meningitis and preemptive fluconazole for those without meningitis. Thorough investigation for cryptococcal disease with LPs and blood cultures, prompt ART initiation, and more intensive antifungals may reduce mortality among asymptomatic CrAg-positive patients identified through screening.

We developed a motivational interviewing (MI) counselling training and support program for lay counsellors in South Africa–branded "Thusa-Thuso—helping you help", commonly referred to as Thusa-Thuso. We present the results of a pilot study to determine the program’s impact on MI technical skills and qualitatively assess the feasibility of a training-of-trainers (TOT) scale-up strategy among counselling staff of non-governmental (NGO) support partners of the human immunodeficiency virus (HIV) treatment program in South Africa. We enrolled adult (≥ 18 years) lay counsellors from ten primary healthcare clinics in Johannesburg (South Africa) selected to participate in the Thusa-Thuso training and support program. Counsellors attended the ten-day baseline and quarterly refresher training over 12 months (October 2018-October 2019). Each counsellor submitted two audio recordings of mock counselling sessions held during the ten-day baseline training and two additional recordings of sessions with consenting patients after each quarterly contact session. We reviewed the recordings using the MI treatment integrity (MITI) coding system to determine MI technical (cultivating change talk and softening sustain talk) and relational (empathy and partnership) competency scores before and after training. After 12 months of support with pilot site counsellors, we were asked to scale up the training to NGO partner team trainers in a once-off five-day Training of trainers (TOT) format (n = 127 trainees from November 2020 to January 2021). We report TOT training experiences from focus group discussions (n = 42) conducted six months after the TOT sessions. Of the 25 enrolled lay counsellors from participating facilities, 10 completed the 12-month Thusa-Thuso program. Attrition over the 12 months was caused by death (n = 3), site exclusion/resignations (n = 10), and absence (n = 2). MI competencies improved as follows: the technical skills score increased from a mean of 2.5 (standard deviation (SD): 0.8) to 3.1 (SD: 0.5), with a mean difference of 0.6 (95% confidence interval (CI): 0.04, 0.9). The MI relational skills score improved from a mean of 3.20 (SD: 0.7) to 3.5 (SD: 0.6), with a mean difference of 0.3 (95% CI: -0.3, 8.5). End-point qualitative data from the counsellors highlighted the value of identifying and addressing specific skill deficiencies and the importance of counsellors being able to self-monitor skill development using the MITI review process. Participants appreciated the ongoing support to clarify practical MI applications. The TOT program tools were valuable for ongoing on-the-job development and monitoring of quality counselling skills. However, the MITI review process was perceived to be too involved for large-scale application and was adapted into a scoring form to document sit-in mentoring sessions. The Thusa-Thuso MI intervention can improve counsellor motivation and skills over time. In addition, the program can be scaled up using an adapted TOT process supplemented with fidelity assessment tools, which are valuable for skills development and ongoing maintenance. However, further studies are needed to determine the effect of the Thusa-Thuso program on patient ART adherence and retention in care. Trial registration: Pan African Clinical Trials Registry No: PACTR202212796722256 (12 December 2022).

How have gender and racial norms conveyed by illustrated magazines—whose circulation exploded in Africa in the 1960s—affected photographers’ local practices? And how, in turn, have they themselves generated this gendered visual order? This article aims to shed light on this two-fold question by proposing a diachronic analysis of the influence of models of femininity transmitted by the illustrated press on the visual imagination of a Ghanaian photographer—as seen in his photographs taken between the 1950s and the 1980s. It explores the links between the publications of the pan-African magazine Drum (the most widely circulated magazine in English-speaking Africa at the time) and its translation into the art of portraiture as practiced by James Barnor (1929-), a photographer with a transnational career, between Ghana and England. Because his professional and personal career path tracked the evolution of these gendered norms, James Barnor became both the repository and the instigator of an idealized vision of “the” African woman.By means of an intersectional focus, the issues of gender norms and of racial biases are examined in parallel to better understand how the photographer appropriated throughout his career the shifting codes of a “female glamour” reinvented for Africa during the post-independence period. While numerous studies have examined the modalities of this codification, in the present paper they are addressed through an in-depth exploration of the photographer's archives, now held in Paris, and combined with an analysis of early issues of Drum. The aim is to juxtapose images intended for publication, i.e. public, with private images in order to consider how the standards of fashion photography infused Barnor’s practices which lie at the crossroad of different social worlds. The corpus composed of portraits of young women is also informed by numerous interviews with the photographer and some of his models, which provide behind-the-scenes insights relative to the published images by exploring their political and social contexts.We first look at Drum’s editorial strategy from its launch in South Africa to its expansion throughout West Africa. While the magazine initially borrowed from white Western references such as Life, it gradually became, to some extent, a showcase for black pride on the continent and in the global diaspora. Then, we study Barnor’s early studio practice as already acutely aware of the codes of femininity enacted by the magazine: this is shown through his “recycling” of the poses and the composition of the images. During the ten years he spent in England, from 1959 to 1969, his collaboration with Drum gave rise to a gallery of portraits of anonymous young women, who became ordinary icons for an ideal African femininity in the context of the diaspora. Finally, in the 1970s, Barnor’s return to Ghana saw the reuse of these codes inherited from the globalized fashion industry combined with the emerging iconography produced by African-American models as a means to create social documentary. In this way, he contributed to an aesthetic of blackness that was constructed within a transnational framework.

Abstract In this paper, the author asserts that the Johannesburg Art Gallery has also done remarkably well in preserving archival material in the field of black visual art. Such documents shed light on the operations of the visual art industry in South Africa before the democratic dispensation of 1994. He argues that heritage practitioners, artists, and scholars can immensely enhance their knowledge through study of these records. The author also thinks that it is crucial for this unique collection to be digitized for preservation and access.

I hate being misunderstood. I guess we all do, but it goes with the territory. I use the word coloured, and he seems offended: 'We Brits don't say 'coloured'. It's regarded as patronising. We say black, if we say anything. And if we do it's for reasons of simple practicality. It doesn't matter. ' Of course, what he seems to be missing, is that the word coloured in South Africa now refers less to skin colour, and more to a distinct cultural group, with it's own language (a dialect of Afrikaans), food (of Malay origin), and music. To say black in this context would be inaccurate, and cause confusion. Danya and Kyla attend the Yeoville Community School, situated in a vibrant and culturally diverse suburb of Johannesburg. On returning from school one day Danya announces: 'We have to do something at school about our culture. What is our culture Daddy?'To which her father replies, 'Go and ask your mother.' 'Well…we're sort of New Age, sort of holistic…', Toni fumbles. A few days later… 'So what did you do in the end?' Soli asks. 'Oh, us and all the other coloured kids sang, Daar Kom die Alabama'1 says Kyla. It would seem that children want to know where they come from. 'I want you to divide yourself up into your different race groups', the facilitator says. We are in a Managing Diversity workshop, and he means the old South African race classification system, but of course he wants to see what we do with it. We end up with a group of Blacks (including three 'Asians'); an African group (including two 'Whites'); a White group (two); and the Human Race (two).'Why didn't you join the white group?' Thloki asks the Human Race.'I don't define myself by my race', I reply.'Ha! Wait till there's a war over resources' he laughs, 'then you'll quickly pick a side!' The postmodernist argument ensues: 'There is no such thing as race…all these arbitrary classifications…it's nothing but a social construct!''Well you never lived as a black person under apartheid. It was very real to me!'The facilitator aims to mediate/translate for the rest of us: 'Well yes, it is just a social construct. But one which had very real consequences for people.' 'Nobody goes into town anymore' a woman says. To which Har Bhajan replies, 'When I was last in town, there were lots of people there.' Of course, what she means is, hardly any white people go into town anymore. (And she's right about that.) But what is that, the way certain people become invisible, depending on who's looking? My friend Karima and I attend an Al Jarreau concert. Fairly expensive tickets, and almost the entire audience is black. I'm not sure why I'm quite so surprised. But this is Sandton, the richest formerly white suburb of Johannesburg. Perhaps working in the NGO sector I've missed how much things are actually changing… I wonder how many people in the audience have been into town lately. With the shift in power, and the -- albeit slow -- levelling of the playing field, now it is possible for white South Africans to be at the receiving end of racial discrimination too… I am visiting my cousin. He is 60, and a musician. But times are tough for him now. His brother was shot dead in his driveway while someone stole his car. And it's hard for him to find work. 'I am too white, now', he says. He is not bitter, just saddened. In his day he had probably the most famous jazz club in Johannesburg. Rumours it was called. 'The best little bootlegger in Bellevue' he called himself. He was known for breaking the law then. His club was racially integrated long before it was allowed. Controversial South African artist, Beezy Bailey, has an alter ego: 'The creation of Joyce was born of the frustration of 'increasingly prevalent affirmative action'. Bailey submitted two artworks for a triennial exhibition. One was with the traditional 'Beezy Bailey' signature (rejected) the other signed 'Joyce Ntobe'! The latter now enjoys an honoured place in the SA National Gallery as part of its permanent collection. When the curator of the SA National Gallery wanted to work on a paper about three black women artists, Joyce Ntobe being one, Bailey let the cat out the bag which caused a huge media 'scandale'.' (Carmel Art) I spent three months in London, and I realised how easy it is to be white there. Or rather, how easy it is to not be white. Of course, it 'doesn't matter' there, because it doesn't matter. It's easy to donate a monthly cheque to Worldvision, and read about the latest chaos in Zimbabwe in the free rag on the tube, and never have to look overwhelming poverty and disease in the face. But when you live on the African continent, you are very aware of being white. At the diversity workshop, I realise how white South Africans seem to get to take the rap here for the actions of white people on the planet. It's not just the effects of apartheid that black South Africans are angry about it seems, it's also the effects of the global economy, that cause the rich to become richer, and the poor to become poorer. Oh sure, that's not just an issue of race, but the poorest on our planet remain 'people of colour', and wealth remains concentrated in the West/North. I realise also that the Black and African groups at the workshop have one thing that they agree on quite strongly - the importance of making the African continent one's focus. Though the two of us in the Human Race group have both read Naomi Klein's No Logo -- and care about the effects on the poor of economic globalisation -- our sense of 'internationalism' is not viewed in a positive light, but seen rather as 'elitist'. * * * 'The thing about the Dutch' says Gary, 'is that they're pragmatic. They're not politically correct -- call the prostitutes prostitutes, not sex workers, but tax them, and give them health care. They have a strong human rights culture.' The Afrikaners are descendents of these transparent, curtainless Dutch. Sometimes I can see it. 'It is not words that make for bigotry, but attitudes', says columnist Ira Pilgrim. 'Some of the most bigoted people I have known always used the 'correct' words.'2 I am not politically correct. There are certain words I'd never use, and couldn't bring myself to, not out of political correctness, but because they're invested with hate. But words like 'whitey', darkie' and 'honky', where I sit, are terms of endearment. I'd never use them on strangers, but amongst friends, they're terms of affection and irony, because we're laughing at ourselves, and each other. 'It's hard to explain to anyone' Gary continues, 'what it's like living in a place where -- from the time you wake up in the morning, till you close your eyes at night -- every breath that you take is politicised.' Gary left the country because he didn't want to be conscripted to fight a war he didn't believe in. He's done well for himself in Europe. But he had to give up his homeland. I catch a 'Zola', the mini-bus taxi named after South Africa's barefoot runner Zola Budd, probably most famous for inadvertently tripping Mary Decker at the 1984 Olympics (Finnegan). Zola was little and fast, like the taxi's that 'zip, zip, zip' -- often to the infuriation of other motorists -- hence the affectionate nickname. They're the peril of the road, but the saviour of the immobile masses, with their unique language and hand signals. I overhear bits of Zulu conversation, including 'Brooke…Ridge…Thorne.' Our soaps, too, are politicised. It would seem that even black South Africans watch The Bold and the Beautiful for light relief. Usually I am the only whitey here, but accepted as just another carless commuter moving from A to B. Despite the safety risks of bad driving, I enjoy it. I did a Zulu course a few years ago. I didn't learn much Zulu -- discovered I don't have the tongue or an ear for African languages -- but I learnt a lot from the course nevertheless. 'Tell us about an experience that you've had, that was a result of cultural misunderstandings' says the facilitator. 'I spent much of my first year at University hungry' says Nhlanhla. 'My white friends would offer me food when I was visiting, but I would refuse, because in our culture, if you ask you don't really want to give. We just hand you a plate.' Nombulelo tells of the time she went on a yoga retreat. She was confused when she started to undress openly in the dormitory, and got disapproving looks from the other women. 'Why?' she wondered, 'we are all women together?' But these were Hindu women, whose sense of modesty was different from the openness of African women. For the whiteys, the major confusion seems to come from the issue of timekeeping. 'African time' is often referred to. Though in London, I did hear talk of 'Caribbean time'. Perhaps the concept of being on time is a particularly Western one (Makhale-Mahlangu). We are visiting friends of friends. There's an unlikely combination at the dinner table. She is tall and dark. I am short and fair. 'So where do you two know each other from?' Cairo asks. 'I'm Andie's sister', Kim replies. She reads the dumbfoundedness in Cairo's face. 'What can I say…my line got a bit deviated!' she laughs. She has my father's sense of humour. So have I. I ask my father, when he first became aware of racial prejudice. 'I was about six years old', he says. 'I threw my ball out of the school grounds, and called to the black man outside: 'Boy, please would you throw my ball back to me?' And the man replied: 'I am not a boy. I am old enough to be your grandfather.'' I am thinking about the time in our lives before we become aware of race… A friend tells me a story about how her six-year-old daughter came home from school and asked, 'Mommy, what's a [racist-term-not-to-be-repeated]?' She'd been called that. The late Lenny Bruce, controversial American comedian and social critic in the sixties, argued that it is 'the word that gives it the power of violence'3, and if we used 'the words' colloquially often enough, and began to invest them with new meanings, they would lose their power to hurt us. I am about to board a bus…'Woza (come) Mama', says the driver. 'Uyaphi?' (Where are you going?) '…green green, I'm going away to where the grass is greener still', come the Reggae sounds from his radio. We are discussing whether we should be focusing on our sameness or our differences. 'Of course we all want the same things…a home, a job, an education for our children', says Karima, but it's our differences that make us interesting.' I agree. Notes 1 Daar Kom die Alabama (Here Comes the Alabama) is a traditional 'Cape Coloured' song, originally sung in tribute to the Alabama, a confederate ship that docked in Cape Town in 1863. On board were Al Jolson-esque (Burlesque) performers, whom the slaves admired, and they imitated their style of performance. This tradition continues still today with the 'Coon Carnival' held on New Years Day and 'Tweede Nuwe Jaar' (Second New Year). It is said that the custom of Tweede Nuwe Jaar originated as a holiday for the slaves, who were too busy attending to their masters' needs on the first. For more information on the Coon Carnival, see http://www.iias.nl/host/ccrss/cp/cp3/cp3-__171___.html. 2 While the author makes some important general points about the drawbacks of political correctness, his reference to South Africa (including the correction) are in fact incorrect. The apartheid government had four major 'population groups' in it's classification system: African (black), Coloured, Asian and White. (The term black was used then only informally.) These were then sub-divided into other categories. See http://www.csvr.org.za/race.htm for further details. 3 The relevant extract from Julian Barry's 1971 play Lenny, can be found at http://www.abc.net.au/rn/talks/8.30/relrpt/stories/s271585.htm. References Barry, Julian. Lenny. Random House, 1971. http://www.freenetpages.co.uk/hp/lennybruce/ Downloaded 14 April 2002. Carmel Art Galleries. Beezy Bailey Curriculum Vitae, at http://www.carmelart.co.za/site/cvbb.htm Downloaded 14 April 2002. Finnegan, Mark. 'The 10 worst mishaps in the history of sport.' Observer Sport Monthly 5 November (2000). http://www.observer.co.uk/osm/story/0,69... Downloaded 14 April 2002. Klein, Naomi. No Logo: Taking Aim at the Brand Bullies. USA: Picador, 2000. http://www.nologo.org/ Downloaded 14 April 2002. Makhale-Mahlangu, Palesa. 'Reflections on Trauma Counselling Methods.' Seminar presented at the Centre for the Study of Violence and Reconciliation, Johannesburg, 31 July 1996. http://www.csvr.org.za/articles/artpales.htm Downloaded 14 April 2002. Martin, Denis-Constant. 'The Famous Invincible Darkies Cape Town's Coon Carnival: Aesthetic Transformation, Collective Representations and Social Meanings', 1998. http://www.iias.nl/host/ccrss/cp/cp3/cp3-__171___.html Downloaded 14 April 2002. Pilgrim, Ira. 'Kikes, Niggers, Queers, Scotchmen and Chinamen', Mendocino County Observer, 22 March (1990). http://www.mcn.org/c/irapilgrim/race02.html Downloaded 14 April 2002. Transfer of African Language Knowledge (TALK). http://www.icon.co.za/~sadiverse/about.htm Downloaded 14 April 2002. Andie Miller was born, and spent the first 23 years of her life at the Southern-most tip of the African continent, in Cape Town. She currently works as webmaster for the Centre for the Study of Violence and Reconciliation, and the National Development Agency in Johannesburg, South Africa. Links http://www.observer.co.uk/osm/story/0 http://www.iias.nl/host/ccrss/cp/cp3/cp3-__171___.html http://www.carmelart.co.za/site/cvbb.htm http://www.csvr.org.za/ http://www.abc.net.au/rn/talks/8.30/relrpt/stories/s271585.htm http://www.csvr.org.za/articles/artpales.htm http://www.nologo.org/ http://www.mcn.org/c/irapilgrim/race02.html http://www.freenetpages.co.uk/hp/lennybruce/ http://www.icon.co.za/~sadiverse/about.htm http://www.csvr.org.za/race.htm http://www.nda.org.za/ Citation reference for this article MLA Style Miller, Andie. "Multiculturalism and Shades of Meaning in the New South Africa" M/C: A Journal of Media and Culture 5.3 (2002). [your date of access] < http://www.media-culture.org.au/0207/shadesofmeaning.php>. Chicago Style Miller, Andie, "Multiculturalism and Shades of Meaning in the New South Africa" M/C: A Journal of Media and Culture 5, no. 3 (2002), < http://www.media-culture.org.au/0207/shadesofmeaning.php> ([your date of access]). APA Style Miller, Andie. (2002) Multiculturalism and Shades of Meaning in the New South Africa. M/C: A Journal of Media and Culture 5(3). < http://www.media-culture.org.au/0207/shadesofmeaning.php> ([your date of access]).

This paper argues that artist Dope Saint Jude is transforming South African hip-hop by queering a genre that has predominantly been male and heteronormative. Specifically, I analyse the opening skit of her music video “Keep in Touch” in order to unpack the ways which she revives Gayle, a gay language that adopted double-coded forms of speech during the apartheid era—a context in which homosexuals were criminalised. The use of Gayle and spaces close to the city centre of Cape Town (such as Salt River and Woodstock) speaks to the city as it was before it was transformed by the decline of industries due to the country’s adoption of neoliberal economics and, more recently, by the gentrification of these spaces. Dope Saint Jude therefore reclaims these city spaces through her use of gay modes of speech that have a long history in Cape Town and by positioning her work as hip-hop, which has been popular in the city for well over two decades. Her inclusion of transgender MC and DJ Angel Ho pushes the boundaries of hegemonic and binary conceptions of gender identity even further. In essence, Dope Saint Jude is transforming local hip-hop in a context that is shaped significantly by US cultural imperialism. The artist is also transforming our perspective of spaces that have been altered by neoliberal economics.Setting the SceneDope Saint Jude (DSJ) is a queer MC from Elsies River, a working class township located on Cape Town's Cape Flats in South Africa. Elsies River was defined as a “coloured” neighbourhood under the apartheid state's Group Areas Act, which segregated South Africans racially. With the aid of the Population Registration Act, citizens were classified, not merely along the lines of white, Asian, or black—black subjects were also divided into further categories. The apartheid state also distinguished between black and “coloured” subjects. Michael MacDonald contends that segregation “ordained blacks to be inferior to whites; apartheid cast them to be indelibly different” (11). Apartheid declared “African claims in South Africa to be inferior to white claims” and effectively claimed that black subjects “belonged elsewhere, in societies of their own, because their race was different” (ibid). The term “coloured” defined people as “mixed race” to separate communities that might otherwise have identified as black in the broad and inclusive sense (Erasmus 16). Racial categorisation was used to create a racial hierarchy with white subjects at the top of that hierarchy and those classified as black receiving the least resources and benefits. This frustrated attempts to establish broad alliances of black struggles against apartheid. It is in this sense that race is socially and politically constructed and continues to have currency, despite the fact that biologically essentialist understandings of race have been discredited (Yudell 13–14). Thanks to apartheid town planning and resource allocation, many townships on the Cape Flats were poverty-stricken and plagued by gang violence (Salo 363). This continues to be the case because post-apartheid South Africa's embrace of neoliberal economics failed to address racialised class inequalities significantly (Haupt, Static 6–8). This is the '90s context in which socially conscious hip-hop crews, such as Prophets of da City or Black Noise, came together. They drew inspiration from Black Consciousness philosophy via their exposure to US hip-hop crews such as Public Enemy in order to challenge apartheid policies, including their racial interpellation as “coloured” as distinct from the more inclusive category, black (Haupt, “Black Thing” 178). Prophets of da City—whose co-founding member, Shaheen Ariefdien, also lived in Elsies River—was the first South African hip-hop outfit to record an album. Whilst much of their work was performed in English, they quickly transformed the genre by rapping in non-standard varieties of Afrikaans and by including MCs who rap in African languages (ibid). They therefore succeeded in addressing key issues related to race, language, and class disparities in relation to South Africa's transition to democracy (Haupt, “Black Thing”; Haupt, Stealing Empire). However, as is the case with mainstream US hip-hop, specifically gangsta rap (Clay 149), South African hip-hop has been largely dominated by heterosexual men. This includes the more commercial hip-hop scene, which is largely perceived to be located in Johannesburg, where male MCs like AKA and Cassper Nyovest became celebrities. However, certain female MCs have claimed the genre, notably EJ von Lyrik and Burni Aman who are formerly of Godessa, the first female hip-hop crew to record and perform locally and internationally (Haupt, Stealing Empire 166; Haupt, “Can a Woman in Hip-Hop”). DSJ therefore presents the exception to a largely heteronormative and male-dominated South African music industry and hip-hop scene as she transforms it with her queer politics. While queer hip-hop is not new in the US (Pabón and Smalls), this is new territory for South Africa. Writing about the US MC Jean Grae in the context of a “male-dominated music industry and genre,” Shanté Paradigm Smalls contends,Heteronormativity blocks the materiality of the experiences of Black people. Yet, many Black people strive for a heteronormative effect if not “reality”. In hip hop, there is a particular emphasis on maintaining the rigidity of categories, even if those categories fail [sic]. (87) DSJ challenges these rigid categories. Keep in TouchDSJ's most visible entry onto the media landscape to date has been her appearance in an H&M recycling campaign with British Sri Lankan artist MIA (H&M), some fashion shoots, her new EP—Reimagine (Dope Saint Jude)—and recent Finnish, US and French tours as well as her YouTube channel, which features her music videos. As the characters’ theatrical costumes suggest, “Keep in Touch” is possibly the most camp and playful music video she has produced. It commences somewhat comically with Dope Saint Jude walking down Salt River main road to a public telephone, where she and a young woman in pig tails exchange dirty looks. Salt River is located at the foot of Devil's Peak not far from Cape Town's CBD. Many factories were located there, but the area is also surrounded by low-income housing, which was designated a “coloured” area under apartheid. After apartheid, neighbourhoods such as Salt River, Woodstock, and the Bo-Kaap became increasingly gentrified and, instead of becoming more inclusive, many parts of Cape Town continued to be influenced by policies that enable racialised inequalities. Dope Saint Jude calls Angel Ho: DSJ: Awêh, Angie! Yoh, you must check this kak sturvy girl here by the pay phone. [Turns to the girl, who walks away as she bursts a chewing gum bubble.] Ja, you better keep in touch. Anyway, listen here, what are you wys?Angel Ho: Ah, just at the salon getting my hair did. What's good? DSJ: Wanna catch on kak today?Angel Ho: Yes, honey. But, first, let me Gayle you this. By the jol by the art gallery, this Wendy, nuh. This Wendy tapped me on the shoulder and wys me, “This is a place of decorum.”DSJ: What did she wys?Angel Ho: De-corum. She basically told me this is not your house. DSJ: I know you told that girl to keep in touch!Angel Ho: Yes, Mama! I'm Paula, I told that bitch, “Keep in touch!” [Points index finger in the air.](Saint Jude, Dope, “Keep in Touch”)Angel Ho's name is a play on the male name Angelo and refers to the trope of the ho (whore) in gangsta rap lyrics and in music videos that present objectified women as secondary to male, heterosexual narratives (Sharpley-Whiting 23; Collins 27). The queering of Angelo, along with Angel Ho’s non-binary styling in terms of hair, make-up, and attire, appropriates a heterosexist, sexualised stereotype of women in order to create room for a gender identity that operates beyond heteronormative male-female binaries. Angel Ho’s location in a hair salon also speaks to stereotypical associations of salons with women and gay subjects. In a discussion of gender stereotypes about hair salons, Kristen Barber argues that beauty work has traditionally been “associated with women and with gay men” and that “the body beautiful has been tightly linked to the concept of femininity” (455–56). During the telephonic exchange, Angel Ho and Dope Saint Jude code-switch between standard and non-standard varieties of English and Afrikaans, as the opening appellation, “Awêh,” suggests. In this context, the term is a friendly greeting, which intimates solidarity. “Sturvy” means pretentious, whilst “kak” means shit, but here it is used to qualify “sturvy” and means that the girl at the pay phone is very pretentious or “full of airs.” To be “wys” means to be wise, but it can also mean that you are showing someone something or educating them. The meanings of these terms shift, depending on the context. The language practices in this skit are in line with the work of earlier hip-hop crews, such as Prophets of da City and Brasse vannie Kaap, to validate black, multilingual forms of speech and expression that challenge the linguistic imperialism of standard English and Afrikaans in South Africa, which has eleven official languages (Haupt, “Black Thing”; Haupt, Stealing Empire; Williams). Henry Louis Gates’s research on African American speech varieties and literary practices emerging from the repressive context of slavery is essential to understanding hip-hop’s language politics. Hip-hop artists' multilingual wordplay creates parallel discursive universes that operate both on the syntagmatic axis of meaning-making and the paradigmatic axis (Gates 49; Haupt, “Stealing Empire” 76–77). Historically, these discursive universes were those of the slave masters and the slaves, respectively. While white hegemonic meanings are produced on the syntagmatic axis (which is ordered and linear), black modes of speech as seen in hip-hop word play operate on the paradigmatic axis, which is connotative and non-linear (ibid). Distinguishing between Signifyin(g) / Signification (upper case, meaning black expression) and signification (lower case, meaning white dominant expression), he argues that “the signifier ‘Signification’ has remained identical in spelling to its white counterpart to demonstrate [. . .] that a simultaneous, but negated, parallel discursive (ontological, political) universe exists within the larger white discursive universe” (Gates 49). The meanings of terms and expressions can change, depending on the context and manner in which they are used. It is therefore the shared experiences of speech communities (such as slavery or racist/sexist oppression) that determine the negotiated meanings of certain forms of expression. Gayle as a Parallel Discursive UniverseDSJ and Angel Ho's performance of Gayle takes these linguistic practices further. Viewers are offered points of entry into Gayle via the music video’s subtitles. We learn that Wendy is code for a white person and that to keep in touch means exactly the opposite. Saint Jude explains that Gayle is a very fun queer language that was used to kind of mask what people were saying [. . .] It hides meanings and it makes use of women's names [. . . .] But the thing about Gayle is it's constantly changing [. . .] So everywhere you go, you kind of have to pick it up according to the context that you're in. (Ovens, Saint Jude and Haupt)According to Kathryn Luyt, “Gayle originated as Moffietaal [gay language] in the coloured gay drag culture of the Western Cape as a form of slang amongst Afrikaans-speakers which over time, grew into a stylect used by gay English and Afrikaans-speakers across South Africa” (Luyt 8; Cage 4). Given that the apartheid state criminalised homosexuals, Gayle was coded to evade detection and to seek out other members of this speech community (Luyt 8). Luyt qualifies the term “language” by arguing, “The term ‘language’ here, is used not as a constructed language with its own grammar, syntax, morphology and phonology, but in the same way as linguists would discuss women’s language, as a way of speaking, a kind of sociolect” (Luyt 8; Cage 1). However, the double-coded nature of Gayle allows one to think of it as creating a parallel discursive universe as Gates describes it (49). Whereas African American and Cape Flats discursive practices function parallel to white, hegemonic discourses, gay modes of speech run parallel to heteronormative communication. Exclusion and MicroaggressionsThe skit brings both discursive practices into play by creating room for one to consider that DSJ queers a male-dominated genre that is shaped by US cultural imperialism (Haupt, Stealing Empire 166) as a way of speaking back to intersectional forms of marginalisation (Crenshaw 1244), which are created by “white supremacist capitalist patriarchy” (hooks 116). This is significant in South Africa where “curative rape” of lesbians and other forms of homophobic violence are prominent (cf. Gqola; Hames; Msibi). Angel Ho's anecdote conveys a sense of the extent to which black individuals are subject to scrutiny. Ho's interpretation of the claim that the gallery “is a place of decorum” is correct: it is not Ho's house. Black queer subjects are not meant to feel at home or feel a sense of ownership. This functions as a racial microaggression: “subtle insults (verbal, nonverbal, and/or visual) directed toward people of color, often automatically or unconsciously” (Solorzano, Ceja, and Yosso 60). This speaks to DSJ's use of Salt River, Woodstock, and Bo-Kaap for the music video, which features black queer bodies in performance—all of these spaces are being gentrified, effectively pushing working class people of colour out of the city (cf. Didier, Morange, and Peyroux; Lemanski). Gustav Visser explains that gentrification has come to mean a unit-by-unit acquisition of housing which replaces low-income residents with high-income residents, and which occurs independent of the structural condition, architecture, tenure or original cost level of the housing (although it is usually renovated for or by the new occupiers). (81–82) In South Africa this inequity plays out along racial lines because its neoliberal economic policies created a small black elite without improving the lives of the black working class. Instead, the “new African bourgeoisie, because it shares racial identities with the bulk of the poor and class interests with white economic elites, is in position to mediate the reinforcing cleavages between rich whites and poor blacks without having to make more radical changes” (MacDonald 158). In a news article about a working class Salt River family of colour’s battle against an eviction, Christine Hogg explains, “Gentrification often means the poor are displaced as the rich move in or buildings are upgraded by new businesses. In Woodstock and Salt River both are happening at a pace.” Angel Ho’s anecdote, as told from a Woodstock hair salon, conveys a sense of what Woodstock’s transformation from a coloured, working class Group Area to an upmarket, trendy, and arty space would mean for people of colour, including black, queer subjects. One could argue that this reading of the video is undermined by DSJ’s work with global brand H&M. Was she was snared by neoliberal economics? Perhaps, but one response is that the seeds of any subculture’s commercial co-option lie in the fact it speaks through commodities (for example clothing, make-up, CDs, vinyl, or iTunes / mp3 downloads (Hebdige 95; Haupt, Stealing Empire 144–45). Subcultures have a window period in which to challenge hegemonic ideologies before they are delegitimated or commercially co-opted. Hardt and Negri contend that the means that extend the reach of corporate globalisation could be used to challenge it from within it (44–46; Haupt, Stealing Empire 26). DSJ utilises her H&M work, social media, the hip-hop genre, and international networks to exploit that window period to help mainstream black queer identity politics.ConclusionDSJ speaks back to processes of exclusion from the city, which was transformed by apartheid and, more recently, gentrification, by claiming it as a creative and playful space for queer subjects of colour. She uses Gayle to lay claim to the city as it has a long history in Cape Town. In fact, she says that she is not reviving Gayle, but is simply “putting it on a bigger platform” (Ovens, Saint Jude, and Haupt). The use of subtitles in the video suggests that she wants to mainstream queer identity politics. Saint Jude also transforms hip-hop heteronormativity by queering the genre and by locating her work within the history of Cape hip-hop’s multilingual wordplay. ReferencesBarber, Kristin. “The Well-Coiffed Man: Class, Race, and Heterosexual Masculinity in the Hair Salon.” Gender and Society 22.4 (2008): 455–76.Cage, Ken. “An Investigation into the Form and Function of Language Used by Gay Men in South Africa.” Rand Afrikaans University: MA thesis, 1999.Clay, Andreana. “‘I Used to Be Scared of the Dick’: Queer Women of Color and Hip-Hop Masculinity.” Home Girls Make Some Noise: Hip Hop Feminism Anthology. Ed. Gwendolyn D. Pough, Elain Richardson, Aisha Durham, and Rachel Raimist. California: Sojourns, 2007.Collins, Patricia Hill. Black Sexual Politics: African Americans, Gender, and the New Racism. New York: Routledge, 2005. Crenshaw, Kimberle. “Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color”. 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Siden apartheids fald i starten af 1990erne, har genstande tidligere klassificeret som etnografiske artefakter, i stigende grad fundet vej ind på kunstgallerierne i Sydafrika. Her behandles de som kunstværker, der fremhæves for deres æstetiske kvaliteter, fremfor de kulturhistoriske kontekster, de er skabt i. I denne artikel, der bygger på feltarbejde foretaget på museer og kunstgallerier i Cape Town og Johannesburg i perioden 2016-2018, undersøger jeg konsekvenserne ved denne ekspansion af klassifikatoriske grænser og fremhæver, hvordan en række sydafrikanske kuratorer afviser ekspansionens påståede valorisering: For dem er genstandenes indlemmelse i kategorien kunst ikke en valorisering, men snarere en måde hvorpå skaberne bag såkaldt traditionel afrikansk kunst fortsat eksotiseres. Men hvor er der plads til såkaldt traditionel kunst fra Afrika, hvis ikke på kunstmuseer som Johannesburg Art Gallery og Cape Towns nye Zeitz Museum of Contemporary Art Africa? Hvor er der plads til afrikansk kunst, der ikke er printet, malet eller fremstillet fortrinsvist med æstetisk konsumering for øje?

ObjectiveAntiretroviral therapy (ART) nearly eliminates HIV transmission. Yet information on treatment as prevention (TasP) has been slow to diffuse in sub-Saharan Africa. We assessed TasP knowledge among university students in South Africa.MethodsWe conducted a cross-sectional survey of first-year university students at a large public university in Johannesburg, South Africa, all of whom would have recently completed secondary school HIV curricula. Respondents were asked to consider the likelihood of HIV transmission in a serodiscordant couple having condomless sex with and without virally suppressive ART. Beliefs were elicited using a 0–20 visual scale. Perceived TasP efficacy was computed as the relative reduction in risk associated with virally suppressive ART. We compared beliefs with estimates from the scientific literature and assessed associations with demographics, HIV testing history and qualitative measures of HIV knowledge and risk perception.ResultsThe analysis included 365 university students ages 18-25 years (48% female, 56% from Gauteng Province). On average, perceived annual risk of HIV transmission with virally suppressive ART was 73%; the objective risk is <1%. On average, respondents perceived that virally suppressive ART reduced annual transmission risk by 17%; the objective reduction in risk is >96%. We observed no differences in perceived TasP efficacy by participant characteristics and testing history. Perceived TasP efficacy was correlated with the (correct) belief that HIV risk increases with sexual frequency.ConclusionsUniversity students in South Africa underestimated the prevention benefits of HIV treatment. Low knowledge of TasP could limit demand for HIV testing and treatment among young adults.