HIV responsibilisation: Stigma, disclosure, and care in the age of 90-90-90

Abstract

The announcement that World AIDS Day would mark its 30th anniversary with the theme “know your status” was the result of significant advancements in the global response to the HIV/AIDS epidemic. In making this declaration, UNAIDS emphasised that knowing one's status is crucial to achieving the 90-90-90 targets, namely that by 2020, 90% of all people living with HIV will know their status, receive sustained antiretroviral therapy, and have viral suppression. Far removed from an earlier period when access to antiretroviral therapy was limited or unavailable, the “know your status” campaign represents a more hopeful moment. Yet even with its laudatory goal, the campaign reflects a larger trend in global health emphasising that being responsible for one's own health obligates caring for the health of others. The intention of this paper is to engage with geographic scholarship on care to examine how living with HIV involves both personal responsibility and responsibilisation. Drawing from fieldwork in rural South Africa, the paper outlines the challenges for those living with HIV, particularly when stigma and other needs remain stark. We conclude by identifying points of convergence and divergence between theories of responsibility, responsibilisation, and an ethics of care.