Mobilising AID(S)? Contesting HIV as a Social and Economic Resource among Youth in South Africa's Eastern Cape

This article explores how perinatally infected youth in the Eastern Cape province of South Africa tactically engage with both the burdens and potential resources of growing up with the human immunodeficiency virus (HIV). Further, it asks how this might shape their interpretation and practice of anti-retroviral therapy (ART). By activating particular categories of need – related to death, illness and orphanhood – HIV-positive youth and their families are able to access vital health and social care, sometimes in unprecedented and privileged ways. This has been enabled by the profound effect that acquired immune-deficiency syndrome (AIDS) has had on how state and donor resources are allocated.Drawing on eight months of qualitative fieldwork, we examine the ambiguous position of young ART users. While many perinatally infected youth endure compounding burdens of chronic morbidity, daily medication-taking and parental loss, they also capitalise on the particular weight ascribed to these burdens within South Africa's care economy. The additional assistance they receive can produce community and family resentments, born out of the scandalous confluence of access to resources with a stigmatised and incurable illness. Thus, in addition to its scientific properties, HIV treatment also has symbolic and social roles for youth. The ways in which young people use ART should be interpreted amid a preceding social order, in which post-apartheid communities partake in contentious struggles for survival and upward mobility. Future policy and programming can benefit from a deeper understanding of the social stakes involved in young people's engagement with ART support services.