AIDS, Culture, and Africa

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

14 Culture in Action Reactions to Social Responses to HIV/AIDS in Africa Eleanor Preston-Whyte Culture and Tradition in Africa 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 either the speaker, the writer, or possibly the potential audience. For all concerned , however, “culture” is a useful vehicle for indicating what is at once both familiar and understood, in general terms. When used by outsiders, scant sympathy may be expressed for “culture” if this is thought to inhibit successful HIV/AIDS interventions. Similarly, in much of the early medical literature, “culture” was uncritically assumed to be essentially static and the cause of the vulnerability to infection of particular individuals and groups. This often led to negative stereotyping, marginalization, and possibly even the victimization of those concerned. At the same time, however, in the groundswell of calls for an African renaissance, “African culture” has assumed a revived and iconic importance on the continent (Makgoba 1999). Even this terrain is not uncontroversial or uncontested, particularly in the light of evidence that culture in the form of “tradition” may serve to justify and entrench long standing power and gender inequalities, some of which have been shown to be inimical to attempts to curb the spread of HIV (Leclerc-Madlala 2001, 2002a, 2002b, 2002c; Scorgie 2002). The end result of either a denigration of the culture of the African “other” 256 Eleanor Preston-Whyte or the valorization of African tradition is much the same. Discussion is closed, and there appears to be no pressing need, or justification, for further critical reflection on the nature of the role that culture may or may not play in generating high-risk behavior. Pertinent examples of this occur when men justify the expectation of having multiple sex partners by reference to polygyny in “traditional African culture,” or justify violence against women who refuse them sex in terms of traditional male rights over women. It is argued here that it is this closing off of questioning, rather than culture per se, that creates barriers to the development of effective interventions designed to quell the spread and course of the AIDS epidemic in Africa. In itself, the closure of discussion represents a culture of silence that, whether it is the result of ignorance of appropriate methodological tools for understanding culture or of political sensitivity to criticisms of cultural tradition, serves to intensify the growing AIDS crisis on the continent. This silence, although different in origin, adds to the everyday silence engendered by the near universal stigma that surrounds the epidemic in all parts of the world. As in the case of all generalizations, there are exceptions to the above strictures on the use of the notion of culture within the context of the AIDS epidemic. The exceptions indicate how notions of culture and tradition are used by ordinary people, first to understand how culture operates in the epidemic , and second to map how African peoples’ common understandings of culture are sometimes being used to fight the AIDS epidemic. Interpreting and understanding culture have long been the terrain of anthropology, and it is essentially an anthropological perspective that is presented here. It is one, however, that seeks to speak to a multidisciplinary audience, and particularly an audience that includes biomedical and health scientists working in the AIDS terrain, in research, in clinical practice, or in public health. It seeks also to address laypeople, and especially those infected and affected by the epidemic, whose voices continue to be silenced by fear and stigma and who, in a desperate attempt to understand the epidemic and its spread, themselves resort to explanations couched in terms of “our culture” or “our tradition.” In following this route, I will attempt to interpret what people on the continent believe they are doing when they invoke “culture” as an explanation of their beliefs and actions in the face of the crises and emotional turmoil created by HIV/AIDS (Geertz 1983; Reynolds Whyte 2002). After some introductory remarks about the nature of culture and the closely associated notion of local context, I give a brief indication of some of the lessons that may be learned from the global AIDS epidemic. Perti- [3.15.5.183] Project...