Johannesburg - Why do alternative, non-scientific explanations of HIV and Aids continue to circulate in townships after almost 30 years of Aids education?
This is the question Wits University Professor of Sociology, David Dickinson, sought to understand and answer in his new book A Different Kind Of Aids.
The book is based on two research projects, one of which was with a group of 28 African HIV and Aids peer educators in “Digco”, a pseudonym for a local mining company, between October 2008 and June 2009.
The educators were asked to identify “Aids myths” circulating within their communities.
Dickinson defines the myths as beliefs about HIV and Aids that are not medically correct but present in the peer educators’ communities and further differentiates between “folk” and “lay” theories.
The second research project was the development of stories, or rather, parables, that the peer educators could use to counter the Aids myths.
However, what was key for Dickinson was making sense of people’s beliefs in the context of their realities.
“When people talk of Aids myths, they can really be grouped together into folk categories, such as racism as an explanation for Aids, witchcraft and cleansing, as well as religious beliefs. And then lay theories, which are more about who is ‘safe’ to have sex with and ways in which HIV infection can be avoided,” Dickinson explained.
Lay theories, he told The Star, had some links to scientific explanations.
For example, Dickinson said: “The friction theory links closely to science… and suggests that whenever you have sex there is some damage even if you can’t see it that allows the blood to transfer. It’s not wrong, but isn’t a complete theory. It suggests ‘friction is tight on first round of sex, so you must wear condom and thereafter can get rid of condom’.”
Another lay theory was the “penis sucks” theory, that suggests that the penis sucks up “dirty” fluid inside the woman during orgasm and so it is “safe” to have sex without a condom as long as the man ejaculated before the woman reached orgasm.
“When you link to the ‘why’ there are these theories, you see there is a logic applied, but not that you think it’s right. But it’s logic and that makes it strong and powerful,” he added.
The rest of the book, while exploring township life, also explores why these alternative theories make sense in people’s lives.
Dickinson stated: “I do a detailed work with four township individuals, three infected with HIV, one a caregiver of one infected, without judging them or scaring them by telling them what to believe. But rather, for them to explore their individual construction of belief.”
Dickinson said it took a long time for him to reach a point where he could do that and break away from what he terms the “Aids establishment”.
“I’m not disagreeing with the nature of HIV/Aids, I’m disagreeing with the approach of people around it. When it comes to beliefs and prevention, for example, and actually using antiretrovirals, the establishment messages have missed the mark,” he argued.
He continued: “It was hard for me to come to that conclusion, that I’d have to stop telling people what to do and rather listen to what people felt and what was going on for them and their context of what they were dealing with.
“We are more complicated than being just scientific bodies, aren’t we?”
Alternative theories were often blamed for damaging scientific credibility, Dickinson said.
“Actually, some of the scientific beliefs look very exotic when you’re not a scientist,” he said with a laugh.
“Some people almost roll over laughing at what scientists say because to them it sounds bizarre… it’s out of context and they don’t see the framework the scientist used. If we expect them to see the scientific framework, don’t we have to see their framework?” - The Star