Silence, Aids And Sexual Culture In Africa

WIN News, Wntr, 2001 by Suzanne Leclerc

BY SUZANNE LECLERC-MADLALA, SCHOOL OF ANTHROPOLOGY AND PSYCHOLOGY, UNIVERSITY OF NATAL, FROM 'AIDS BULLETIN' SEPTEMBER 2000

"There is a mystery at the heart of the AIDS epidemic in Africa that scholars have explored but have been unable to explain. . .The mystery. . . has to do with that stubborn and multi-layered AIDS silence, or what the professionals call 'the denial' that has consistently characterised the AIDS pandemic in Africa . . The silence has to do with. . . that much used and abused, dearly beloved sacred cow. . . called 'culture'. In the two weeks following the AIDS 2000 Conference, incidences have impressed upon me, once again, the hopeless situation of women in the face of AIDS. . .

Thandi, shortly after her wedding, inherited two orphaned children from her sister-in-law who had died of AIDS. Now, a second sister-in-law is dying of AIDS, and her sickly baby has constant diarrhoea. What bothers Thandi is the fact that she is a trained nurse, equipped with knowledge that might be helpful: but as a sister-in-law, in her husband's home, and one without a child of her own, she dare not open her mouth. How could she suggest that there might be something seriously wrong with the baby? They would say that she is jealous. . . She keeps quiet. Perhaps she herself will be the next sister-in-law in that home to go down in silence. . .

People in KwaZulu-Natal are dying like flies. Going to funerals has now become the premier weekend activity, as it was in the late 80s to early 90s, during the 'total onslaught' years. Admittedly, this epidemic is not only affecting women, but their stories have a special poignancy that is embedded in a kind of silence and helplessness that does not affect men. Millions of women are being squashed under the weight of the compounded multiple silences of AIDS. Has the AIDS 2000 'Break the Silence' Conference really helped them?. . .

More than anywhere else in the world, the advent of AIDS in Africa was met with apathy, or what some researchers have called 'an under-reaction'. This was noted at all levels of society, whether individual, communal or national. This under-reaction stood in stark contrast to responses in other parts of the World. In Europe, the USA and Australia, for example, marked sexual behavioural change indicated drastic developments in the first year of HIV/AIDS being seriously discussed. In Thailand, the first evidence of the arrival of AIDS saw a rapid dwindling of clients at brothels, to the extent that many were forced to close due to lack of business. The scenario for both North America and parts of South America was similar. It was recognised that prevention education campaigns would have to constitute a sustained effort. These reactions occurred as a response to HIV levels that were a fraction of those found in Africa. Yet, no such reaction was recorded for Africa. . .

The general lack of behavioural change was once attributed to scant information. Over time, this explanation has become less tenable, as ongoing studies demonstrate a combination of adequate knowledge with continued high-risk behaviour. Today, there is hardly any doubt that more intensive or better constructed information campaigns will do little to change behaviour. . .

By turning our collective attention to academic debates on the origins or existence of AIDS, we are conveniently avoiding facing up to sensitive issues around sexual culture. By pinning our hopes on vaccines and cures, we risk 'over-medicalising' our engagement with AIDS. We simply cannot afford to get lost among the trees and lose sight of the forest, the latter being the socio-cultural-sexual context that provides such a fertile breeding ground for HIV/AIDS.

More provocative still is the evidence that has been gathered since the AIDS epidemic began in Africa on the sexual culture that characterises much of sub-Saharan Africa, specifically with regard to levels of premarital sexual relations and extramarital relations. There is a significant body of well-researched and well-documented social science studies that points to high level of premarital sexual activity, extramarital relations and sexual violence, making African societies, taken as a whole, more at risk for both STDs and HIV/AIDS than those in other parts of the world. In many communities, women can expect a beating, not only if they suggest condom usage, but also if they refuse sex, if they curtail a relationship, are found to have another partner or are suspected of having another partner.

'Gifts for sex' is a practice that expresses itself most strongly in premarital and extramarital relationships. . . Only recently, with Christianity, has sexuality become bound up with religious belief systems that imply sinfulness, and it has never been related, as in Europe, with romanticism. Sex, then, could be viewed rather more objectively and instrumentally in an African context. Selling sex for money or other material benefits in the face of Africa's entrenched poverty and women's continued financial dependence on men is one form of transactional sex."