02 Niang Sahara Confer5


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02 Niang Sahara Confer5

  1. 1. SAHARA 5th African Conference on Social Aspect of HIV/AIDS ------------------ SOCIOCULTURAL RESPONSES TO HIV ------------- CULTURE : AN AFRICAN PERSPECTIVE ON HIV PREVENTION Cheikh Ibrahima Niang SAHARA, Université Cheikh Anta Diop, Dakar, Senegal
  2. 2. Progress is made • Level off or Decline of HIV Prevalence among Pregnant women attending antenatal clinics in – South Africa, Swaziland, Lesotho, Namibia, Botswana, Zambia, Zimbabwe (26 in 2002 to 16 in 2006) • Decline among young people and among the General Population associated with behavioral change documented in – Uganda, Kenya, Rwanda, Benin, Burkina Faso, Ghana, Cote d’Ivoire (in Abidjan from 10% in 2001 to 6.9% in 2006) • Low and stable prevalence in the general population – in Mali, Senegal (0.7%) • Progress in PMTCT: – Pregnant women tested for HIV rose from 17% (2007) to 28% (2008) • Increased number of people having access to ARV treatment in – most of African countries in particular in South Africa and Botswana
  3. 3. …Still too little and too slow • Low speed of prevention effects – Every day over 6800 persons become infected with HIV and 5700 die from AIDS • Sub-Saharan Africa: More than 2 out of 3 of adults and nearly 90% of children infected with HIV live in sub-Saharan Africa • Crisis for young people – Half of new cases (15 to 24) • Gender crisis – AIDS has the double face of a woman and the baby she carries on her back • 61% of adults living with HIV in Sub Saharan Africa are women (sex ratio 1 man for 4 women, for some age groups in some countries) • Low percentage of Pregnant women receiving PMTC (less than 10% for many of African countries) • High prevalence of HIV among Female sex workers (Senegal: 19%) • Crisis of Epidemiological denial and human rights violations against MSM and sexual minorities
  4. 4. Biomedical research and Societal Contexts • Body of knowledge on biomedical responses that work – (condom, circumcision, behavioral change…) • Gap Biomedical Research – Sociocultural contexts – Antagonistic approach to culture (by the scientific official discourse) • Culture seen as a set of practices (mainly “harmful practices”) • Unequal epistemological status (science, basic science, “hard science” constructed as the hegemonic fabric of the truth) • Culture is seen associated to traditions which are considered as Static, one-dimensional, one-semantic / used to justify gender and social inequalities • Missing research questions • How culture is a framework of understanding and functions as a fabric of identities and decisions making processes concerning HIV/AIDS prevention? • What are the Cultural Concepts underlying cultural practices? • What are the multiple senses associated to cultural concepts and web of concepts (Polysemic)? • How to reconstruct harmony between biomedical research findings and reinterpretation of cultural concepts? • How cultural research and biomedical findings could provide ground for social transformation needed for HIV prevention?
  5. 5. Sociocultural context for HIV/AIDS prevention among youth • “Etic perspective” on Youth vulnerability to HIV/AIDS • Intergenerational sex • Multiple concurrent partners • Socioeconomic vulnerability • Sexual debut without having sex education • “Emic perspective” on Risk taking as a metaphor for sexuality • Wolof (Senegal): HIV/AIDS risk taking as a metaphor of masculinity The Guerrier (warrior) : “Gelbi Jaralnama SIDA” (this women deserves I get AIDS) • B. Davidson: (about the Venda girls in 1920s) “The Venda sexually mature girl who continually stay with her mother was… called “afraid of men” (the same in Wolof)… not considered as a normal human being (wolof symbolic of beads “songe ko”: attack him; “songe ma” attack me) • Articulating risk taking metaphors with HIV/AIDS preventive messages • The warrior is the one who take the risk of facing social and interpersonal adverse effects of condom use • Fulle (individual responsibility and self protection) applied to sex education among the Wolof: “You seduce the one you want he seduce you”
  6. 6. Cultural capital for youth sex education • Inter-femoral non penetrative sex – Documented in ethnographic research • Masai, Luo, Zulu, Venda (Gregersen 1982; Werner 1987); The word exist in Wolof, Senegal (ñapaaxu) – Concept: • Sex is not a sin • Sex is a mechanism for harmony (cosmological harmony) Wolof: sey / seey • Control : A compromise between expression of sexual pleasure and delaying penetrative sex that has to be integrated in social rituals (above interpersonal relationship) • Offence of the women in case of premarital pregnancy (family apology) • Provisional concepts in case of non virginity (at the marriage) – Unknown (Interfamily arrangements) – Juddu alarbay kayré • Concept of compromise as condition for individual self expression
  7. 7. Cultural heritage for women’s responses to HIV • Structural factors affecting women and HIV/AIDS – Gender inequalities and power unbalance – Women Socioeconomic vulnerability – Violence against women • Social networks of women as a fabric of “sexual power” (tuur; mbotaay) – Sexual codes and tools for sexual power • Beads, Incense, traditional perfume, postures and attitudes • Discourse of self esteem (taasu) – Surveillance of male sexuality (multiple partners) • Intra gender secret is stronger than cross gender secret; The story of Cocc “jigeen, soppal te bul woolu”
  8. 8. Facing socioeconomic vulnerability • AIDS women’s economic dependency – Micro processuses of economic survival for women and children – Accomplishment of prescribed social roles • Taylor (1992; Faser 2001) How to bring dignity apart from redistribution and material support – Cammen – jigeen model • Jigeen = women; my jigeen = my sister (biologic or social sister), not my wife • Cammen = my brother (the one with whom I have a sexual taboo) • Cammen – jigeen the strongest mutual social and economic support unit – Other support units: Baay-doom; Nijaay-jarbaat • The naming system excludes sexual relations • But they happens; when they happens they are hidden • Suggar dady: nak fayda (lost of personality; non eligible to prestigious functions) – Rewards for non sexual partners • Premarital : in some cases extra marital sex (dube in Cote d’Ivoire) • Tudde doom (to name the child after him/her) • Honorific status: Njekke; bayle
  9. 9. PMTCT and social construction of maternities • Structural issues – Non attendance of antenatal visits and of medically assisted delivery – Breastfeeding – Violence and social exclusion around the HIV status of the female spouse • Women centered maternity – Uncertainty and Non spoken – Women observation (posture, spit, food, urine) • Concept of breastfeeding – Breastmilk is a genealogical vehicle including the male part (wolof soow) – The breastmilk can be spoiled (but the decision on the quality of the milk is a collective) • Women’s counter power (how to reinforce women’s networks to face HIV AIDS related violence and exclusion) – Boo amul werukaay, da ngay gawa danu (if you do not have social support, you become vulnerable) – Dimba and violence – Women’s networks in towns
  10. 10. Traditional protection to sexual minorities • Situation of increased vulnerability to HIV – Violence, discrimination and social exclusion against MSM, sexual minorities and People living with AIDS (recent case of Senegal) • Heritage of Cultural Concept – Men women (Goorjigeen)’s model in Senegal • Recognized identity • Social roles (entertainers, counselors, social capital engineers) • Political roles alongside with Diriyanke – Crowder (1950) : • « The elders and faithful Muslims condemn men for this, but it is typical of African tolerance that they are left very much alone” • Looking beyong classical gender paradigms – Ghana (Eva Meyerowitz 1920 - 1940) • “Men who dressed as women and engaged in homosexual relations with other men were not stigmatized... There were good reasons for Akan men to become women; the status of women among the matrilineal Akan was exceptionally high”. – The Gabra (John Colman Wood, 1999) • «… they regard their most prestigious men – the d’abella, who are ritual experts- as women »
  11. 11. Communication challenges • Successes and limitations of biomedical discourses • Social networks are interconnected communication networks • Low-Beer and al. : The most important behavioural changes in Uganda associated with communication networks: The societal communication networks … proved to be more effective than the institutional mass communication channels. • Heritage of social capital • Huge cross communities, cross gender communication for traditional circumcision that could be re-conceptualized for medical circumcision for HIV Prevention (Africa is the birth place of the invention of circumcision; 2300 BC) • James Fernandez (1986 among Fang in central Africa) : How consensus are generated by multitudes of specific operations of various forms of verbal and ritual, through “performances” and metaphors • New Metaphors for AIDS prevention • Foot, urine (STIs) • purse, sox (youth and young women “condom revolution” and bias in quantitative studies) • Societal metaphors for community mobilization – Lesotho: KHOLUMOLUMO (Dr. Mokhantso Makoae, HSRC, personal communication) similitude in Senegal (Diola) • KHOLUMOLUMO and Transforming mythology into metaphors • The monster, The fishermen’s filets (social networks), the child (the powerless or marginalized person)
  12. 12. Conclusion • More ethnographic and qualitative research need to be done in order to study why things that work technically do not work at the societal level • The process to response to that question will help to produce a new discourse and new response to HIV/AIDS • The paradigm shift is underway • As in African mythologies and in recent struggle for freedom and human rights in Africa, it’s a woman who takes the initial step to change the course of “business as usual” • So, Thank to Dr Olive Shisana the founding mother of the new vision that focus on social sciences and multidisciplinary research and response across Africa