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AIDS, Culture, and Africa

Edited by Douglas A. Feldman

Publication Year: 2008

Too often, approaches to dealing with the problems posed by the spread of HIV have been one dimensional, with the assumption that what works in one place will work in another. Douglas Feldman has collected a group of essays representing a wide range of original ideas, methodologies, and suggestions that make a significant contribution to the field of AIDS research, both in Africa and beyond.

AIDS, Culture, and Africa examines such key issues as HIV transmission, condom use, sexual patterns, male circumcision, political factors, gender, poverty, and behavioral change. It features the research of those working in different countries in Africa, with different communities within those countries, and with different age, class, religious, and ethnic groups within those communities.

These original, previously unpublished essays also address the need for a greater anthropological perspective in the increasingly medicalized and politicized study of HIV and AIDS. As a whole, they pave the way for a deeper cultural understanding necessary to effectively reverse the catastrophic growth of HIV/AIDS on the continent.

Published by: University Press of Florida

Title Page, Copyright, Dedication

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pp. i-v

Contents

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pp. vii-viii

Tables

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pp. ix-

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Preface

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pp. xi-xiv

Kigali, Rwanda, August 1985: I was in the main hospital, Centre Hôpitalier de Kigali, in the Rwandan capital interviewing AIDS patients there to try to find out how they became HIV infected. Back in the United States, most people with AIDS were gay men; but here in Africa, I was being told that most were heterosexual. ...

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1. AIDS, Culture, and Africa: The Anthropological Perspective

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pp. 1-17

Since 1985, anthropologists have been making significant contributions to the study of HIV/AIDS in sub-Saharan Africa. Without a steady or consistent source of funding, especially in the earlier years, anthropological research on HIV/AIDS in Africa has informed other major fields, including epidemiology, public health, health education, biomedicine, health policy...

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2. Confounding Conventional Wisdom: The Ju/’hoansi and HIV/AIDS

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pp. 18-34

Over the last thirty years, the Ju/’hoansi have become one of the classic cases in the anthropological literature documenting the lifeways of a contemporary hunting and gathering society (Lee 1979, 2003; Lee and DeVore 1976; Marshall 1976). Less well known is the fact that the Ju/’hoansi, straddling the border between Botswana and Namibia, are located in the heart...

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3. Gendered Responses to Living with AIDS: Case Studies in Rwanda

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pp. 35-56

In order to gain an understanding of why HIV prevalence rates remain high and how HIV prevention could be achieved in sub-Saharan Africa, it is necessary to understand how HIV-infected individuals respond to their situation. It is also necessary to understand how those individuals respond so that needed resources can be allocated and made available to people living...

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4. A Theory of Social Proximity: Accounting for Societal-Level Behavior Change

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pp. 57-73

An important man, a vice president of a country, recently died after a long illness, involving multiple hospitalizations in a foreign country. The illness was variously reported through the local and international newspapers as pancreatitis, a heart attack, gout, a chest infection, and an “undisclosed illness.” The vice president actually died of complications from antiretroviral...

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5. Male Circumcision in the AIDS Era: New Relevance of an Old Topic

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pp. 74-87

Rites of passage, particularly circumcision and related initiation rites, have long been of interest to anthropologists. My own generation (which began our studies during the 1960s), like generations of anthropologists before and since, spent many hours reading lengthy and detailed descriptions of rites of passage around the world. Those of us headed for fieldwork in Africa...

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6. Factors That Influence Ivorian Women’s Risk Perception of STIs and HIV

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pp. 88-106

Côte d’Ivoire, a small coastal nation in West Africa, is among the fifteen countries in the world most affected by HIV/AIDS, with an overall estimated infection rate of 9.7 percent. Estimates hold that between 7 and 10 percent of Ivorian females aged fifteen to twenty-four years are infected with HIV, while rates for males in the same cohort are much lower, at 2 to 4 percent (UNAIDS 2002). ...

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7. Courage, Conquest, and Condoms: Harmful Ideologies of Masculinity and Sexual Encounters in Zambia in the Time of HIV/AIDS

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pp. 107-122

This chapter draws upon research designed to explore the manner in which mission-educated men in Zambia constructed their sexuality and sexual practices, in order to investigate how these contributed to sexual risk taking and the instability of safer sex practices.1 It is based on the assumption that a relationship often exists between how a man acts sexually and how he acts...

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8. Attitudes toward HIV/AIDS among Zambian High School Students

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pp. 123-144

It might be expected that when a stigmatized disease becomes endemic in a particular society, the social stigma toward people with that disease would decline. But this has not been the case throughout much of sub-Saharan Africa, where a quarter-century after the visible emergence of AIDS, stigma toward and discrimination against persons living with HIV remain strong. ...

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9. Myths of Science, Myths of Sex: Homophobia and HIV Vulnerability in Namibia

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pp. 145-169

The study of gay and lesbian social movements in southern Africa has received notable attention within contemporary scholarship. In particular, academics have discussed how social actors and groups draw on global and local cultural resources and discourses in their social struggles for legitimacy (Hoad 1999; Phillips 2000). The formation of transnational coalitions...

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10. HIV/AIDS Prevention: Strategies for Improving Prevention Efforts in Africa

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pp. 170-200

This chapter addresses constraints hindering HIV/AIDS prevention in Africa, examines some reasons behind program failures, and lists components for successful HIV/AIDS prevention strategies. It also discusses research needs for developing effective interventions and the role of anthropological research in developing policies to support effective HIV/AIDS interventions. ...

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11. Tugende Uganda: Issues in Defining “Sex” and “Sexual Partners” in Africa

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pp. 201-219

This chapter draws on data from AIDS-related research that I was involved with in several countries between 1989 and 1998. Most of the examples are from Uganda, hence the title “Tugende Uganda” (Let’s go to Uganda). Uganda was the first country in Africa that I visited, and I will always think of it as a second home. On the first day of my first visit in April 1989...

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12. HIV/AIDS and the Context of Polygyny and Other Marital and Sexual Unions in Africa: Implications for Risk Assessment and Interventions

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pp. 220-238

Some attention has been paid to the impact AIDS has had on the African family with respect to widows and orphans. Orphans and vulnerable children have especially been the target of funding and multiple interventions to address their needs. Limited observations have been made about the impact of AIDS on formal marital arrangements, but little has been done...

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13. Gender, Poverty, and AIDS Risk: Case Studies from Rural Uganda

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pp. 239-254

AIDS currently affects all African countries, especially those in eastern, southern, and central Africa (WHO 2002). HIV/AIDS is transmitted there primarily by heterosexual contact (Mann and Tarantola 1996; UNAIDS 2002). In several African countries, such as Uganda, available data demonstrates that increasingly more women than men are infected with HIV (Berkley et al. 1990; STD/AIDS Control Programme 2002). ...

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14. Culture in Action: Reactions to Social Responses to HIV/AIDS in Africa

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pp. 255-275

Discourses around HIV/AIDS in Africa are permeated with references to “culture” or “cultural practice.” This is as true of the spoken word as it is of popular and academic texts that emanate both from Africans themselves and from outside observers. Indeed, referring to “culture” often provides a handy cover for arenas of human behavior that are not fully understood by...

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15. Conclusion: It’s Not Just About AIDS—The Underlying Agenda to Control HIV in Africa

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pp. 276-283

Clearly, the work of anthropologists on HIV/AIDS in Africa has been enormous and crucial since 1985. It is likely that this trend will continue over the coming decades as well. The role of the applied medical anthropologist is no longer seen as peripheral by those in the public health community, but central to both an understanding of public health...

Contributors

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pp. 285-288

Index

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pp. 289-293


E-ISBN-13: 9780813045115
Print-ISBN-13: 9780813032535
Print-ISBN-10: 0813032539

Page Count: 312
Illustrations: 5 tables
Publication Year: 2008