[attachment=806125]
For one group of HIV-positive South Africans, potent drugs and changing attitudes offer new hope.

Across sub-Saharan Africa the HIV/AIDS statistics are terrifying: more than 26 million people living with the virus, 2.3 million deaths a year from AIDS-related illnesses. For 12 years I've documented the effects of the disease on individual Africans, their families and communities. Over time it's become clear to me that my photographs alone can't convey the human reality of the pandemic. These days I travel with both a camera and a recorder so people can tell me in their own words how HIV/AIDS has changed their lives.

The South Africans telling their stories in these pages are from Lusikisiki, a rural region in the Eastern Cape Province, where huts cradle in the creases of green hills. Poverty has always plagued the area, and now the pandemic has further complicated survival. Yet in some ways the sufferers here are more fortunate than most Africans grappling with the disease. In the past two years nearly 800 people in Lusikisiki have been treated with antiretroviral (ARV) drugs. The drugs are administered by Siyaphila La, "we are living here," a joint project of the Nelson Mandela Foundation, Médecins Sans Frontières (Doctors Without Borders) South Africa, and the local health department.

Siyaphila La is proving wrong the widely held idea that the three-pill drug therapy used by millions of Westerners but only 11 percent of Africans with AIDS is too expensive and too complicated to administer in poor African communities. The project relies on nurses in clinics rather than on doctors in hospitals, on inexpensive generic ARV drugs, and on the commitment of patients and families to the daily treatment regimen. Siyaphila La is also challenging the social stigma associated with HIV/AIDS by changing perceptions. Instead of dreading the disease as a killer—something to be denied rather than faced—the people of Lusikisiki now see it as a manageable chronic illness. Patients, as well as their families, medical staff, and others in the community, wear T-shirts with an HIV-positive logo. The openness with which people here confront their condition has given them a strength and bravery I find humbling.

The word Lusikisiki is meant to mimic the sound of wind rustling reeds. Perhaps that wind will soon be heard throughout the continent.