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Ancestors and Antiretrovirals

The Biopolitics of HIV/AIDS in Post-Apartheid South Africa

In the years since the end of apartheid, South Africans have enjoyed a progressive constitution, considerable access to social services for the poor and sick, and a booming economy that has made their nation into one of the wealthiest on the continent. At the same time, South Africa experiences extremely unequal income distribution, and its citizens suffer the highest prevalence of HIV in the world. As Archbishop Desmond Tutu has noted, “AIDS is South Africa’s new apartheid.”

In Ancestors and Antiretrovirals, Claire Laurier Decoteau backs up Tutu’s assertion with powerful arguments about how this came to pass. Decoteau traces the historical shifts in health policy after apartheid and describes their effects, detailing, in particular, the changing relationship between biomedical and indigenous health care, both at the national and the local level. Decoteau tells this story from the perspective of those living with and dying from AIDS in Johannesburg’s squatter camps. At the same time, she exposes the complex and often contradictory ways that the South African government has failed to balance the demands of neoliberal capital with the considerable health needs of its population.

344 pages | 27 halftones, 7 tables | 6 x 9 | © 2013

African Studies

Anthropology: Cultural and Social Anthropology

Geography: Social and Political Geography


Political Science: Public Policy

Sociology: General Sociology, Medical Sociology


"Decoteau has undertaken ten years of research in South Africa, artfully presenting the lived experience of people infected with HIV/AIDS residing in the shantytowns around Johannesburg, and interweaving them with a sophisticated theoretical discussion of the complex issues surrounding the politics of HIV/AIDS in South Africa. She does a fantastic job in giving voice to the people caught in the middle of a multitude of crisscrossing processes and structures."


"Ancestors and Antiretrovirals is a highly accessible book for non-sociologists that does not sacrifice analytic rigor in its presentation of peoples’ lives. Decoteau is a gifted photographer and purveyor of mixed methods who skillfully interlaces seemingly divergent theorists to articulate complex distinctions and integrations of tradition and modernity."


"Decoteau eloquently traces the politics of HIV and AIDS from 1994 through 2010 in Post-Apartheid South Africa. She describes important shifts in health policy and nestles them in real-life stories of people living with HIV and dying from AIDS. Her ethnographic data, collected over ten years, highlights several key issues including the changing relationship between indigenous and biomedical health care and the complex and often contradictory way that the South African government failed to balance a neoliberal existence (i.e., political movement beginning in the 1960s that blends traditional liberal concerns for social justice with an emphasis on economic growth.) with the health needs of its citizens."


"Decoteau’s ambitious project spans a 14-year history (1996–2010) during which South Africa’s national HIV/AIDS policies swung between extremes as the country’s leaders attempted to find a way forward amid deepening inequalities and a worsening epidemic."

Medical Anthropology Quarterly

Ancestors and Antiretrovirals is timely and relevant. . . . Decoteau’s inventive use of theory, able analysis of discourse, and commitment to tether her work to lived experience provide a model for young scholars. The postcolonial paradox Decoteau formulates—and her examination of the discursive uses of ‘tradition’ and ‘modernity’ to resolve its abiding challenge—not only illuminates AIDS conflicts of the recent past, but also offers useful tools for analyzing current and future political contestation in postapartheid South Africa.”

International Journal of African Historical Studies

 “In Ancestors and Antiretrovirals, Claire Decoteau draws together ethnographic fieldwork, unique insights into the experience of people suffering from AIDS at a time of callous governmental indifference, and a thorough reading of cultural politics to situate South Africa in the global economic system. Decoteau not only illuminates the many still baffling aspects of the epidemic and post-apartheid politics in South Africa, but challenges some of the core assumptions of Western social science. This is essential reading.”

Adam Ashforth | author of Witchcraft, Violence, and Democracy in South Africa

“Claire Laurier Decoteau is at the forefront of the new global sociology. Her articulation of analysis with ethnographic detail is expert, yet reads effortlessly; her ability to view the political complexities of South Africa from a new theoretical angle is admirable; and her depth of understanding about what is at stake in the fight over AIDS is relevant to anyone who wonders how power works all over the globe. Ancestors and Antiretrovirals will be an iconic text for a new generation of global work, and marks the emergence of a bold new theoretical voice in sociology.”

Isaac Ariail Reed | author of Interpretation and Social Knowledge: On the Use of Theory in the Human

Table of Contents

Note on Terminology
Introduction Postcolonial Paradox

1 The Struggle for Life in South Africa’s Slums
2 A State in Denial
3 Biomedical Citizenship
4 The Politicization of Sexuality
5 Hybridity

Coda Life Strategies



ASA Section on Medial Sociology: Eliot Freidson Award
Honorable Mention

ASA Theory Section: Lewis A. Coser Award for Theoretical Agenda Setting

Science, Knowledge, and Technology section, American Sociological Association: Robert K. Merton Award
Honorable Mention

ASA Theory Section: The Theory Book Prize
Honorable Mention

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