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Images of HIV-positive Motherhood

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A central argument of the book is that maternal HIV-positive experience is more complex than the caricatures presented in the public and scientific imagination, and that it is important to understand HIV-positive motherhood from the mother’s perspective, and not just from the more seductive and socially sanctioned perspective of her child. One way of thinking about the social imagination of HIV-positive motherhood is through images of HIV-positive mothers. When I came upon the photographs presented below through contemplating the disjunctions between social discourses and lived experiences of HIV-infected maternity, my first response to the photographs was of both familiarity and shock, since they were so patently about human suffering. Images contextualise, because ‘seeing comes before words’ (Berger, 1972: 7). Photographs give the reader faces and environments that cannot be conveyed in words.

As I examined the photographs further, however, it became clear that this is not all photographs do. They also objectify, exploit, distance and victimise (Berger, 1972; Sontag, 2003). They create a disturbance of ownership, transforming subject into object, owned now by the photographer and the onlooker (Barthes, 1980). This is perhaps particularly the case when one regards the pain of others (Sontag, 2003), a genre of photography that has become almost synonymous with ‘art’. The more gruesome the photograph, the more ‘serious’ the photographer. In this sense, photographs decontextualise. As Barthes (1980: 90) puts it, a photograph ‘is without culture: when it is painful, nothing in it can transform grief into mourning’.

As Sontag (2003) struggles against her earlier ideas (Sontag, 1979) that such photographs exploit and sap our capacity to respond meaningfully to the pain of others, she comes upon a similar political dilemma. Are such photographs good or bad? Do they create empathy or apathy? Should they be upheld as showing us what we should know or should they be critiqued for turning human suffering into a masquerade? It seems that she does not entirely settle these dilemmas. For example, much of her essay is critical, but it ends with praise for photographs dealing with the pain of others, because they remind us that we do not understand. Of particular relevance to the photographs under discussion here, she also leaves the political implications unsettled:

The more remote or exotic the place, the more likely we are to have full frontal views of the dead and dying. Thus postcolonial Africa exists in the consciousness of the general public in the rich world … mainly as a succession of unforgettable photographs of large-eyed victims … [including] of whole families of indigent villagers dying of AIDS. These sights carry a double message. They show a suffering that is outrageous, unjust, and should be repaired. They confirm that this is the sort of thing that happens in that place. The ubiquity of those photographs, and those horrors, cannot help but nourish belief in the inevitability of tragedy in the benighted or backward – that is, poor – parts of the world (Sontag, 2003: 63–64; emphasis added).

The photographs chosen for presentation here are largely from highly acclaimed photographers whose explicit motivation is always to provoke awareness and empathy. Shock is used to promote a realisation of the severity of the epidemic. Outwardly, then, they aim to portray the first side of Sontag’s ‘double message’, showing the outrageousness of suffering. They have achieved fame (and publication), however, in the developed world, and cannot escape its obverse: as Sontag says, they potentially ‘confirm that this is the sort of thing that happens in … the benighted or backward – that is, poor – parts of the world’. The majority of photographs depicting AIDS in Africa fall into two broad categories, either portraying graphic images of suffering, often of emaciated bodies; or showing people’s pride and defiance in response to the epidemic. In both categories, there are many faces, whether sick and hopeless; sad and mournful; or joyful, loving or defiant in the face of prejudice.

However, the more I examined the photographs, the more I noticed how consistently mothers were portrayed differently to ‘people’ and how infection seemed to be written differently in the presentation of their bodies. Although the focus of this study is not on the analysis of media images, I have found it useful to consider these photographs, because of their powerful portrayal of the HIV-positive mother in the public imagination. Interpretations offered for each photograph are partial, focusing on what the photograph may tell us about constructions of HIV-positive motherhood, but there is no claim of an ‘authoritative’ interpretation, and the reader is invited to reinterpret them according to his/her own understanding.

It is not entirely true that ‘harrowing photographs do not inevitably lose their power to shock. But they are not much help if the task is to understand’ (Sontag, 2003: 80). These photographs can therefore problematise the way in which HIV-positive motherhood is constructed. Whether intended by the photographer or not, the ways in which the ‘HIV-positive mother’ is portrayed, and the fact that she is often portrayed differently, bring some kind of understanding of the anxieties that this figure evokes and the social discourses in which she is located.

For example, Gideon Mendel’s photo essay on AIDS in South Africa (Mendel, 2002), published in The Guardian, aims to portray the human faces and stories behind the appalling statistics. Like many other AIDS photographers, Mendel captures the tragedy of AIDS, but he also explicitly aims to convey the multiple faces of the pandemic, including those of hope, courage and laughter, and of the tenacity of those speaking out in his photographs against the prejudice associated with the pandemic. He presents photographs of a variety of people in different situations. When visiting his website, one sees among these a photograph (photograph 1) of three women, one holding her baby, and reads the caption: ‘Why can’t they give us the treatment to make the mother healthy because who is going to look after that negative child if we are gone?’



By clicking on the photograph, the viewer enters the antenatal clinic where these women are sitting (photograph 2).

When viewed in its context, the photograph is no longer about HIV-positive mothers defiantly speaking out. On the contrary, amid the many faces and voices in the essay, the mothers, hiding behind their hospital files, are silent and hidden. Their facelessness is noticeable, evoking the shame of being HIV-positive mothers. This shame is counterposed against the familiar slogan, ‘Be wise condomize’, on the wall, which advice, the composition implies, these women clearly did not follow, their pregnant bodies proof of their irresponsible sexuality.

The mother in photograph 3, from Mendel’s collection, is also hidden, this time behind a hot-water bottle. The focal point of the photograph is her thin and presumably HIV-positive child. The foregrounding of the child’s thin body leads one to imagine both shame and guilt: the mother is responsible for her child’s infection. She is sad and ashamed, but she is also damaging or destructive. Attention is detracted away from the reflection in the mirror. Even at the margins of the photograph, even in reflection, the mother’s face cannot see and cannot be seen.

James Nachtwey (2001), whose photo essay in Time provoked debate about its graphic depictions of the horror of AIDS and its inclusion of emaciated bodies, includes a group of photographs united by the theme of motherhood and childhood. The mother’s body is not at all emaciated: it is not present at all. Instead, the mother is represented in her absence, either replaced by images of caretakers holding children or by images of abandoned orphans or street children living in abject circumstances as a result, it is implied, of maternal HIV. It seems that motherhood is shocking enough without the need for emaciated maternal bodies – there are very few such images to be found across the collections. Two photographs from Nachtwey’s collection indicate her threat.


In the first (photograph 4), grandmother and grandchild gaze unhappily into the distance. We are told that both have AIDS. The photograph comments on the coexistence of AIDS independently contracted within families, portraying the pathos of grandmother and child, who obviously contracted HIV from different sources. The absence of the mother (the viewer is likely to imagine that she is dead, since the grandmother is caring for her child) directs sympathy towards the child and leaves the mother only insinuated as the source of infection. The mother is present in the form of her opposite: the Virgin Mary tending to the baby Jesus in the picture on the wall exemplifies the pinnacle of motherhood. The photograph presents us with categories of innocence: the child, the caring grandmother and the good mother who is an asexual virgin. The photograph is typically silent on the father, the other partner in infection. He is present only in the form of Joseph in the picture on the wall, possibly the most ineffectual father in history; the father figure, but not the real father.



The actual mother is present in the next photograph (photograph 5) as a person rather than as a representation. The caption reads: ‘A mother of several children (left) was afflicted by AIDS and had to be taken care of by one of her daughters, who consequently could no longer attend school.’ The photograph confronts us with the tragedy of AIDS-related illness. Set in a domestic scene, it brings us closer to the struggles of everyday life. It also tells us a story about mothers and children: we are told that the mother has ‘several children’, and that the young woman in the photograph is one of those children. Here the threat is not only of infection, but of reproductivity, implied in the caption as irresponsibly endless. This procreative threat, it is implied, is also destructive, not only to the mother herself, but also to her daughter, who has been obliged to give up her schooling – and therefore her future – in order to care for her mother. It is unclear who the subject of the photograph is, the sick mother or the deprived daughter, but the photograph seems to imply the recursivity of the threat of maternal infection and its invasion of the subjecthood of her child.


Photograph 6 is from a collection by Gideon Mendel entitled ‘Looking AIDS in the face’ and this photograph reflects a familiar theme in which ‘looking AIDS in the face’ often involves looking at faceless bodies. This person chose to be photographed with her hands at the focal point ‘as a symbol of her renewed capacity to do her domestic chores’. The photograph is thus about activity and a renewed sense of agency in the world. It overtly draws attention to her hands, but covertly draws our attention to what her hands embrace: her tummy. The caption accompanying her photograph tells us something more about this tummy: she had previously been pregnant and her child, born prematurely, died at three months, around the same time that she discovered she was HIV-positive. The photograph is therefore ostensibly about her hands, but the traces of her tummy, and the sense of the proximity of procreation and destruction that is evoked, transform our understanding of the image.

The ‘Looking AIDS in the face’ collection is distinct in two ways. Firstly, those photographed were free to choose how they would like to represent themselves (hence the frame in the background), thereby taking some ownership over the form of representation. Secondly,

[u]nlike much … other work done on the issue of HIV/AIDS in Africa, there are no images of sick and dying people here. The people photographed are dynamic and empowered. The haunting power of this work lies in the fact that while most of the images are gentle, the traumatic and painful material is contained within the text (Mendel, 2006: 43).

This collection aims, therefore, not to shock or to re-present, but to reflect images as chosen by those being photographed. Within this collection, there is a series of photographs in which mothers chose to represent their maternal presence, but also their maternal facelessness. Mother and baby are positioned in different configurations, but each photograph foregrounds the innocent child in contrast to the faceless mother.

In photograph 7, the baby shields the mother’s face and the mother shields her baby from the camera. It is almost as if they are sharing a private moment. The caption tells us that the mother chose this frame because her baby had just tested HIV-negative. Despite this joyful news, the baby hides the mother’s identity.





The mothers in photographs 8 and 9 both chose to represent their choice to bottle feed rather than breastfeed their babies in order to minimise the risk of HIV transmission. In both cases, the image is about the baby. The women hide their faces so as to avoid recognition, and also because their faces are less important than the bottle and the primary subject, the child.

Photograph 10 offers a similar representation of the centrality of the child and marginality of the mother. This particular mother is waiting for her baby to be old enough to be tested and is therefore unsure of her baby’s status. It is this issue that is, for her, centre frame.

In contrast to images of facelessness, absence and destructiveness, photograph 11 presents a different image of the HIV-positive mother. This mother and her baby are both HIV-positive, but she has decided to represent an intimate moment between herself and her baby. Unusually, both her face and her joy are visible. She has refused to be represented as tragic, destructive or absent. The composition of the photograph also suggests the possibility of a maternal position in which the mother is the subject of the photograph: the child’s face is somewhat blurred, with the effect that the mother is centre frame.


My telling of these images is from the point of view of my search for the mother within them; it provides one possible account in order to suggest that it is difficult for the idea of the HIV-positive mother to enter into the social world except through fantasies of abjection, infection, absence, blame and guilt. Around the edges of her body lurks dangerous sexuality, but not, ironically, a gendered relationship. The images do not portray fathers. Men are largely absent, despite their crucial role in the family drama of HIV/AIDS. Of course, these portrayals capture the seriousness and tragedy of HIV infection, as well as the desire to hide one’s face; but, I would suggest, they also capture the fear and horror of public images of HIV-positive motherhood, fear and horror that belongs more squarely in the imagination of the onlooker than in the totality of the HIV-positive mother. The final image (photograph 11), but perhaps also the peripheries of the other images, suggests a different way of imagining and a different area of maternal imagination, and it is this multiplicity of maternity that this book will aim to explore.

Contradicting Maternity

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