Sunday Times (Johannesburg) - June 12, 2005
Philippa Garson

"'When you're drunk you have this positive mentality. You feel so confident, but in the morning, when you wake up, you start wondering what you did'"

AGROUP of men stands in the middle of the room, holding hands randomly across each other's bodies in a messy human knot. They step over each other's arms, contorting themselves, trying to transform the knot into a circle.

Time runs out and the knot is still a knot. Everyone laughs and returns to their seats. The tension dissipates and the support group for HIV-positive men, at Soweto's Chris Hani Baragwanath Hospital, is about to begin.

Neo Makaqa, the young facilitator of the group - run by HIVSA under the auspices of the hospital's Perinatal HIV Research Unit - explains: "We're trying to tell them these are the problems we're facing. They have to come up with a solution of how to untie the knot without letting go of their hands. Normally people see each other's problems from a distance. But if we can communicate them to each other we can come up with solutions."

For these men, most of whom live in Soweto, problems often seem insurmountable. HIV squats on top of their daily struggles with poverty and unemployment, adding new risks like broken relationships, ill-health and rejection by family or friends.

In addition, HIV is forcing them to rethink the typically macho behaviours that probably got them through life before - such as bottling up their feelings, having girlfriends on the side, intimidating their partners or shrugging off their health problems.

Before, they felt they didn't have to worry too much about how they had sex or their emotional well-being. But to ignore these things now could be an express train to death. If they have unsafe sex, they will re-infect themselves with new strains of the virus.

If they live in denial, their health will deteriorate. If they don't support their partners, they in turn won't get the care and support they need.

Today's group kicks off with the pitfalls of mixing alcohol and sex. A young man in a red cap blurts out: "Sex is very important. I'll say it straight. Let's not take it as a joke. Your parents made you when they were sober. Why do you have to drink before sex? I used to drink a lot. I saw that what I was doing was so wrong. We don't condomise when we're drunk."

A smart-looking man in a black shirt nods in agreement: "When you're drunk you have this positive mentality. You feel so confident, but in the morning, when you wake up, you start wondering what you did.

"Most of these guys get this disease from being drunk in the pub. I think I made a mistake in the pub one night. If I was drunk I would do it without a condom."

After plenty of animated talk about how "ugly girls look fantastic" after a few drinks, a middle-aged man in a beige, zip-up jersey chips in irritably: "Are you trying to tell me we all got HIV because we were drunk?"

"All we're saying," says Mandla Mthethwa, the other young facilitator, "is that when you are drunk you do things without knowing it."

Mthethwa and Makaqa have a tough job. Every Wednesday morning these two youngsters must traverse a prickly terrain with a diverse group of men who are there because of one thing - HIV. Many are twice their age; some would rather be elsewhere. While most are enthusiastic regulars, a few - plucked from the queue of the Perinatal HIV Research Unit's Wellness Clinic and assured they will not lose their place while they attend the group - look dazed or disgruntled.

A young Casanova, his eyes hidden by a kwaito-style hat pulled low, is particularly hostile today: "Do I have to be here? I want to know my rights," he simmers before retreating into sulky silence.

These are not easy times. Whether these men are trendy and aspirant, factory workers or self-employed, young, middle-aged or elderly, HIV has shaken their lives, forcing them to rethink so much that they once took for granted.

Some have been HIV-positive for many years and do battle daily with ailments and illnesses; others are still fit and new to the challenges of living with the disease.

Many speak of how refusing to accept or disclose their HIV status almost killed them or those they know.

"Don't delay in disclosing," says an elderly man in denim. My friend knew he was positive but didn't tell anyone. The strain of keeping it inside is what killed him. If you don't disclose you will bring problems to your family and everyone around you."

But many men fear that if they tell their wives or girlfriends, their story will be "all over Soweto". Others agonise over how to break the news to potential girlfriends or whether to start a new relationship at all.

"How do you take a wife and marry her if you are sick?" asks a burly man in baggy cotton pants. "Is your manhood affected if you are positive? All guys don't want to live as bachelors for the rest of their lives."

Despite the pain and sadness in these men's lives, they are clearly charged by the togetherness of the group and perhaps by the realisation that they are at the heart of a slow but astounding transformation of what it means to be real men.

Time is up. The group was "hot" today everyone agrees. Even the disgruntled kwaito wannabe is moved to say: "I've learnt a lot. I feel very relieved. When you attend the group you realise you are not alone."

A middle-aged man in a yellow cap nods: "Someone said once: 'Don't laugh at a person until you know your status.' At this point in time we no longer laugh. We are human beings. We feel the pain of it."

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