Recently there has been a focus on a preaching approach to tackling the spread of HIV/AIDS. There has also been a significant amount of criticism around this approach. The ÃƒÂ¢Ã¢â€šÂ¬Ã‹Å“ABCÃƒÂ¢Ã¢â€šÂ¬Ã¢â€žÂ¢ campaign has failed to produce any significant results, despite its being foregrounded as the preferred approach to curb the spread of HIV/AIDS. Even the Catholic Church has recently revised its policy on condom use, writes Ricky Hunt in the JournAIDS blog.
According to the Commission for Africa 2005 report, ÃƒÂ¢Ã¢â€šÂ¬Ã…â€œTackling HIV and AIDS requires a holistic response for treatment, prevention and care that recognises the wider cultural and social context and which is supported by well-functioning health systems. Indeed, where cultural norms have not been taken into account in HIV and AIDS prevention strategies, prevalence rates continue to rise.ÃƒÂ¢Ã¢â€šÂ¬Ã‚Â
What we have to realise is that weÃƒÂ¢Ã¢â€šÂ¬Ã¢â€žÂ¢re dealing with real people who lead real lives and face real (often problematic) social hardships. There are factors like transactional sex because of poverty, and sexual violence and rape, which deprive many people, particularly women, of the capacity to choose to have safe sex. To try to moralistically change those ÃƒÂ¢Ã¢â€šÂ¬Ã‹Å“habitsÃƒÂ¢Ã¢â€šÂ¬Ã¢â€žÂ¢ not only creates resentment on behalf of those being preached at, but is logistically unrealistic.
Most people whom the campaign is being aimed at live in dire circumstances, often in rural areas, and are subjected to harsh conditions. They are sick and dying because they are infected with the virus and because they are denied access to treatment and care. Then, instead of giving some form of concrete help (such as health care), informed outsiders come into their communities to tell hem to abstain from sex ÃƒÂ¢Ã¢â€šÂ¬Ã¢â‚¬Å“ not to only engage in protected sex, but not to have any at all, without considering the myriad of practical reasons why they are having unprotected sex in the first place.
Perhaps a more persuasive approach would be to consider aspects of culture when trying to alter behaviours. Perhaps prevention campaigns might be more effective if they engage discourses like community dialogue and traditional theatre to punt the message rather than obtrusively laying the strategy out. One such initiative that comes to mind is ÃƒÂ¢Ã¢â€šÂ¬Ã‹Å“AREPP: Theatre for LifeÃƒÂ¢Ã¢â€šÂ¬Ã¢â€žÂ¢ , a theatre company that travels to schools, informing and educating the youth about important social issues.
Their approach goes something like this: put on a play that uses language that is appropriate for the audience that interrogates the dangers of HIV/AIDS and its spread and acquisition. Include the relevant social dilemmas. Illustrate preventative measures that can be taken. Make it accessible and enjoyable (where possible) for the audience. Then provide condoms and counselling.
Many different factors have made Southern Africa fertile ground for the spread of the epidemic ÃƒÂ¢Ã¢â€šÂ¬Ã¢â‚¬Å“ an intricate balance of poverty, violence, lack of health care infrastructure, lack of political will, a culture of widespread sexual abuse and misogyny and stigma, all entrenched and perpetrated by the previous ruling regime. For an effective intervention strategy to be reached, one has to take the above factors (and factors related to them) into consideration, as real people cannot escape their real life situations. How about working with culture instead of opposing it?