HbAA hemoglobins in RBCs have no problem with O2 stress but have no protection from the plasmodium. These people are infected and die from malaria.
HbSS proteins cause sickling RBCs and these people die from their genetic condition.
HbSA is the heterozygote individual with a tendency towards RBC sickling with O2 stress BUT HbS proteins inhibit the malarial plasmodium's growth. Plasmodium infected cells are likeliest to sickle and this kills the parasite but not the host.
Heterozygotes however have positive selection with reproductive success so the HbS & HbA allele frequency is stabilized between the opposing selective pressures. 50% of the children born to two carriers will die from being homozygotic but half will have reproductive success from being heterozygotes. This mixed phenotype was fit enough to keep the HbS allele in the population's gene pool so such a detrimental allele established due to the greater selective pressure from the parasite.
The reality is actually more complex as these people have an African horticultural complex of plants that provides cyanates, metabolites that prevent or reduce RBC sickling with HbS in plasmodium free cells. The metabolites reduce the cost of the alleles. Cyanate metabolites, such as thiocyanate, further inhibit the growth cycle of plasmodium in the RBC. Infected cells are much more likely to sickle or be removed by the immune system so the malarial load is reduced.
The heterozygotes have more severe symptoms when not eating the plants.
http://webcache.googleusercontent.com/search?q=cache:kbG-R86IN0EJ:www2.ku.edu/~lba/courses/articles/Crawford%2520Carib.pdf+&cd=6&hl=en&ct=clnk&gl=us&client=firefox-a