Transcript Happy Marriage or Fatal Attraction?

HIV/AIDS in Your Community
An analysis of essays written by South African Youth
Presented af Nordic Africa Seminar
Roskilde & Malmø, 6-7 November 2008
Today’s Presentation
 Broader
contexts of Grahamstown
Study: A critical assessment of
HIV/AIDS Communication (in Africa)
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Research experiences informing the study
 HIV/AIDS
Essay Study
Disconnects –
Communication Challenges
 Communication
Cultural Studies (I)
 Latin
American Tradition (J.MartinBarbero, N.García-Canclini, J.González,
R.Ortiz + Paulo Freire)
 Popular Culture in Everyday Life – i.e.
telenovelas
 Enhancing Cultural Citizenship
 A Liberating Potential in Drama and Storytelling
Cultural Studies (II)
 Historical
formation of social and cultural
practices
 Historical formation of audiences
 The limitations of mass media in achieving
behaviour change
HIV/AIDS Communication
(Health Communication)
 Inherited
strategies from family planning
(Diffusion, persuasion, effects, behaviour
 Social marketing)
 Slow development of genuine strategies
 Limitations include
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Short-term
Limited formative research
Simplified message transmission
Inadequate monitoring and evaluation
A Science and a Practice on the
Move?
 Bridging
diffusion and behaviour change
with empowerment and participation
 Bridging mostly in words, less in action
 Community based strategies using media
 The Comm Discipline Challenged?
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Our response to development challenges
How we feed theory into pratice
The need for
Qualitative Audience Studies
 Audience
ethnography
 Micro-studies of social and cultural
practices
 Contexts of histories & policies, institutions
and discursive environments
Youth in Grahamstown
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A micro-cosmos of South Africa
120.000 inhabitants
5 schools selected
124 essays written in 11th grade
10 focus-group discussions (60 students)
A close-up study of 18 youth:
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Photoethnography
Participant Observation
3 x Individual Interviews with each
Mini KAP-study
Understanding the pandemic..
 ’to
understand the HIV pandemic in Africa
is to understand how people who live with
it explain it, or rather how they construct
schemes of risk assessment in the face of
it. It is by listening to the ’stories’ that we
can understand the context in which the
pandemic is constructed, including factors
that may promote or constrain behaviour
change (Rugalema 2004: 192)
Essay Task
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124 students, 15-19 year old, 5 different
secondary schools
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Essays written based on the following statement:
HIV/AIDS affects each and every one of us, no
matter how ’special’ we think we are, and is
rapidly becoming a part of everyone’s reality.
Drawing on own experience, to what degree do
you think this statement is true, and why?’
Township girl (1)
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HIV/ Aids is the killer in our days, especially to our youth. People of
Rhini are just making fun of people who are living with HIV/AIDS,
that is why we have funerals every weekend. It’s also one of the
reason that people who are HIV positive don’t come forward, they
end up turning to alcohol and drugs. Even in hospitals once you are
told by the doctor that you are HIV positive, they told everyone that
you are HIV positive, before you even tell your own family. (…)
People always think that if they tell their families about their status,
they would not be accepted. There is a girl that I know who is HIV
positive. The first person she told was her school Principal. The
principal told her teachers and the teachers told the students. No
one wanted to be associated with this girl. They treated her so
badly that she quite school. The way that they where talking to her
as if she was not a human being (NB8-F).
Township girl (2)
Close by to my house there is a little girl who is HIV positive, at her
home it’s only her sister who knows about the young girl’s status.
They are both scared that if they tell their parents, they will chase
her away from home. Her sister told me, and asked if I could keep it
a secret. In clinics people who are HIV positive are being treated
badly. Even if you ask them to get you some water, they will shout
at you for no reason. Even if you are still in bad condition to be
discharged, they will tell you that you need to go home because
there’s no place for you here.You can just go home and die there. If
your family knows your status they wont take you to the doctor or
hospital, only when your situation is worsened they will take you to
TEMBA SANTA HOSPITAL ( TB Hospital) and say you had TB.
Even at your funeral they will just say you died of TB. I think if we
can learn to be more open about AIDS, we can defeat it (NB9-F).
Issues appearing in the texts…
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Stigma – ill treatment in hospitals, silence or gossip in
the community, lack of disclosure.
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Fear/Identities at Risk – healthy youth with a future.
Ontological insecurity. The future is getting stuck!
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Stress and Denial – ’dont care’ attitude. Some are
constructing an ’other’ who is more at risk. Individual and
collective denial. Alcoholism, violence.
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Gender Inequality – men decide, but blame women,
prostitution.
Youth Perceptions
 Massive
recognition of HIV/AIDS being a
big problem, in the community and in the
country: ITS REAL!
 Often spoken of as a ’killer disease’ –
seen as a death sentence
 A manifest expression of fear to get the
virus
Modes of Transmission
 They
demonstrate high levels of
knowledge about transmission
 Very stereotype and gendered
accusations (men accusing women to bear
the largest responsibility for carelessness
in protection and in spread of virus – most
in lowest income schools)
Forms of Prevention
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A clear understanding of how to prevent HIV. All key
messages come trhough (slogan-like):
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’the great this is to talk about it’
’And to the youth,they must stick to one partner and be
protected, the condoms are there for safe sex’
’Use a condom because HIV/AIDS is a killer disease’
’I think the solution is to condomize’
’Message: Please, ’don’t compromise, condimize, people’
’AIDS kills our people so we must fight it’
’don’t be shy, talk about it, eat good food, especially fruit and
vegetables, and drink juice, not alcohol’
’Wrap it, or Zip it’
Personal Experiences with
HIV/AIDS
 Many
(esp from low income schools)
express knowing someone or know of
someone having HIV, AIDS or having died
of AIDS
 Many of the students from low income
schools have been to funerals
(characterized by lack of openess about
what the person died of)
The Burden of Stigma
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Statements show a persistent pattern of reaction
amongst community members: PLWHAs or just people
suspected of being positive seem to experience social
marginalization, isolation and ill treatment by other
community members:
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If you talk about your status, you live for a long time. When you
don’t talk about it, you always think about it and you suffer in the
process and you die. What I don’t like is when the community
treats people living with HIV/AIDS badly. Instead of welcoming
them from your house you chase them away. Other families they
start to dislike you when you are HIV+. Even if you where
drinking with a jug, people who are not positive they won’t use it.
People who are living with HIV/AIDS, we need to support them
so that they wont think about their status. When someone is
HIV/AIDS I urge people not to make fun of people who are HIV+
Living in Silence
 Stigma
leading to no disclosure until when
close to dying
 Its very difficult to talk openly about HIV+
status
 Many essays tell stories about strong
emotional reaction and fatalistic behaviour
amongst PLWHA, from deliberate
intentions to spread the virus to suicide
Inclined to Action
 Need
for more care and support
 Need for change of individual sexual
practices
 Only a few (high income) students seem to
acknowledge a need to fight contextual
aspects such as poverty
Comm.Challenges
1.
To tackle issues as stigma, stigma and stigma
2. To tackle issues as fear and denial
3. To address underlying social, cultural, political,
economic and spiritual contexts
4. To build trust using media language
5. To ensure joint efforts at community level
Communication Disconnect (1)
 Discrepancy
between immensity of
HIV/AIDS problem and the thundering
silence about it.
 Its about stigma >>> invisibility of people
 Absence of voice
Communication Challenge (1)
 Rights,
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Representation and Public Sphere
Right to Communicate: VOICE
Visibility in the media and other public
spheres
Understand better the mechanisms of today’s
public sphere
Create a speech environment on HIV/AIDS
Communication Disconnect (2)
A
lack of connection between the media
language used (genres, aesthetics, format,
language) and the culturally appropriate
and lived experiences of the audiences
Communication Challenge (2)
 Popular
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Culture and Cultural Citizenship
Produce culturally appropriate content
Enhance cultural citizenship to support citizen
identity
Communication Disconnect (3)
 The
immense contradiction between
solutions proposed in campaigns and the
actual need for much more far-reaching
solutions
Communication Challenge (3)
 Power
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Struggles and Change Processes
Address unequal power relations
Broaden the problem definition from a health
problem to a development problem