Containment and contagion: how to strengthen families to support youth HIV prevention in South Africa

There has been little research done in South Africa that investigates how families nested within communities can be strengthened to support the prevention of HIV infection in youth. A focused ethnographic case-study approach was employed to better understand how families in a semi-rural area outside Durban, South Africa, could support youth to make healthy life choices, particularly with respect to HIV risk behaviour. This involved a volunteer convenience sample of parents or caregivers and key community members. A psychodynamic extension of social representational theory was applied to an interpretation of the data. The findings suggest that caregivers of youth feel disempowered and unsupported in a context of fractured and un-containing leadership structures, which works against social cohesion. In the context of social change and relatively new and threatening phenomena such as HIV/AIDS, we argue that strong unified leadership structures are necessary to assist with anchoring the unfamiliar and rendering it manageable, as well as to form the building blocks of social cohesion, a protective social environmental factor for youth. In addition, we suggest that programmes aimed at empowering parents or caregivers with knowledge about HIV/AIDS as well as renegotiating parental practices to promote greater parental authority, would be important interventions at a family level.