HIV/AIDS IN AN AFRICAN CONTEXT

Western View of HIV/AIDS

    Unsafe Sex with Multiple Partners
    Intravenous Drug Use

African Context – 71% of HIV/AIDS Cases

    History, Economics, Politics, Culture

        Colonialism
        War and Civil Conflict
        Indigenous Beliefs and Customs

The Case of South Africa – Population 44 Million

    First Known Case Diagnosed in 1987

    5.5 Million HIV Positive (12.6% of population)
        
        170,000 – White
        5.3 million – Black
        4,500 New Infections Per Day
        3,300 Births Per Day

    Predictions for 2010

        17 Million Dead
        > 50% of Black Population HIV Positive
        Nearly 6% of White Population HIV Positive

Colonial Legacy
    
    Two Societies: First World vs. Third World

    Self-imposed and Legislated Segregation

        Apartheid
    
    Incapacity to Govern
        
        Breakdown of State Medical Services
    
    Result: Racial Differences in Rates of HIV/AIDS Infection

DISCUSSION:

➢    Is there a role for psychology in post-colonial nation building?

Border Wars and the Struggle for Liberation

    Human Migration – Civilian and Military
    
        Refugees

        Soldiers and Insurgents from Adjacent States

            South African Defense Forces
            
                12,000 of 72,000 (17%) HIV Positive
    
    Unified and Democratic Government in 1994
                
        Relaxed Borders
        Illegal Immigration (3 million)

DISCUSSION:

➢    Is there a conflict prevention / peace building role for psychology?

African Cosmology

    Worldviews that Guide Purposive Behavior

    Guidelines Regulate Sacred Rituals and Social Behavior
    
    Risky Lifestyles in an African Context
    
        Concern with Lineage and Survival
            
        Sexually Active
            
        Male-dominated Double Standards
                
                Polygamy
                “Dry sex”
            
        Youth and Sexuality

            2/3 Chance of Being Infected
              
            Ukumetsha
          
             Initiation Ceremonies

                Male and Female Circumcision

            Widespread Beliefs About Unprotected Sex

        Causal Explanations of Illness
            
            Seldom Attributed to Natural Causes
                
                HIV/AIDS Not Attributed to HIV Virus
            
            Harmful Intentions Cause Illness
                
                Disturbed Ancestors
                Evildoers (Baloi)
            
            Diagnosis and Treatment
                
                Consult a Nganga or Sangoma
                Identify and Deal with Evildoers
                Appease Disturbed Ancestors

            Life-Death and Time

                No Life-Death Divide
        
                Death Fuses Past with Present

                    Unites People with Ancestors

                Time is Marked by Events

                    Current Events Determined by Past
                    Future Beyond 2 Years Is “Non-time”

            Language

                Symbolic Descriptions

                    Rich in Emotional Expression
        
                    Obscures Understanding
               
                       Protective Function of Words

                       Response to Newspaper Reports

                “The communication is wrong.  We produce all these brochures, yet the message is
                irrelevnt.  It is not real” (Kuzwayo, 2000).

DISCUSSION:
➢    Can psychology contribute to disease management given the African context just described?