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HIV, Poverty, and Sex in Sub-Saharan Africa: Why the Condom Does Not Protect Women from the AIDS Virus

HIV, Poverty, and Sex in Sub-Saharan Africa: Why the Condom Does Not Protect Women from the AIDS Virus

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Published by Lisa Woods
Do condoms exacerbate HIV/AIDS in Sub-Saharan Africa, or has the scientific community been drawn into yet another row with the Vatican on the legitimacy of condoms? This paper is in response to Pope Benedict XVI’s assertion that “You can’t resolve it [HIV] with the distribution of condoms.” It juxtaposes the cacophony of discourses – religious, moralist, scientific, and anthropological – against ethnographic and statistical trends that show in spite of condom social marketing, the condom faces an uphill battle to social acceptance. The paper looks at the reliance of the biomedical community on the condom and offers that the co-factors of infection, such as poverty and gender inequality are no match for the condom, and must be factored into a de-medicalized approach of HIV prevention. Condom promotion is not completely ruled out, rather anthropologists are challenged to partner with biomedical researchers to include the co-factors of HIV infection such as poverty and gender inequality, on HIV/AIDS prevention research agendas, if Africa is to ever witness a true decrease in HIV prevalence rates, rather than stabilization attributed to “die-off.”
Do condoms exacerbate HIV/AIDS in Sub-Saharan Africa, or has the scientific community been drawn into yet another row with the Vatican on the legitimacy of condoms? This paper is in response to Pope Benedict XVI’s assertion that “You can’t resolve it [HIV] with the distribution of condoms.” It juxtaposes the cacophony of discourses – religious, moralist, scientific, and anthropological – against ethnographic and statistical trends that show in spite of condom social marketing, the condom faces an uphill battle to social acceptance. The paper looks at the reliance of the biomedical community on the condom and offers that the co-factors of infection, such as poverty and gender inequality are no match for the condom, and must be factored into a de-medicalized approach of HIV prevention. Condom promotion is not completely ruled out, rather anthropologists are challenged to partner with biomedical researchers to include the co-factors of HIV infection such as poverty and gender inequality, on HIV/AIDS prevention research agendas, if Africa is to ever witness a true decrease in HIV prevalence rates, rather than stabilization attributed to “die-off.”

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Published by: Lisa Woods on Jan 24, 2010
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1
HIV, SEX AND POVERTY IN SUB-SAHARAN AFRICA: WHY THECONDOM DOESN’T PROTECT WOMEN FROM THE AIDS VIRUS
LisaNicolWoodsDissertationSupervisorDr.EdwardSimpsonMedicalAnthropologyThisdissertationissubmittedinpartialfulfilmentoftherequirementsforthedegreeofMAMedicalAnthropologyoftheSchoolofOrientalandAfricanStudies(UniversityofLondon)15September200910,000words
Declaration
Ihavereadandunderstoodregulation17.9(RegulationsforStudentsofSOAS)concerningplagiarism.Iundertakethatallmaterialpresentedforexaminationismyownworkandhasnotbeenwrittenforme,inwholeorinpart,byanyotherperson(s).IalsoundertakethatanyquotationorparaphrasefromthepublishedorunpublishedworkofanotherpersonhasbeendulyacknowledgedintheworkwhichIpresentforexamination.IgivepermissionforacopyofmydissertationtobeheldattheSchool’sdiscretion,followingfinalexamination,tobemadeavailableforreference.
Name
:LisaNicolWoods
Signature:
 
2
HIV, SEX AND POVERTY IN SUB-SAHARAN AFRICA: WHY THECONDOM DOESN’T PROTECT WOMEN FROM THE AIDS VIRUS
 
Eitherpeople’sbeliefsaboutcondoms,fertilityanddiseasepreventthemfrom practicingsafesexortheyareconstrainedbythelargersocialconditionsintheirlivessuchaspovertyandunemploymentthatresultinkindofresignation,afeelingthatHIVisinevitable,andbeyondone’spowertoprevent–HelenEsptein(2001:20).
1
ForwomenmostatriskofHIVinfection,lifechoicesarelimitedbyracism,sexism, politicalviolenceandgrindingpoverty–PaulFarmer(1996:33)
MenarethesolutiontoHIVprevention–ChristineObbo(1993)
 2
 Abstract:
DocondomsexacerbateHIV/AIDSinSub‐SaharanAfrica,orhasthescientificcommunitybeendrawnintoyetanotherrowwiththeVaticanonthelegitimacyofcondoms?ThispaperisinresponsetoPopeBenedictXVI’sassertionthat“Youcan’tresolveit[HIV]withthedistributionofcondoms.”Itjuxtaposesthecacophonyofdiscourses–religious,moralist,scientific,andanthropological–againstethnographicandstatisticaltrendsthatshowinspiteofcondomsocialmarketing,thecondomfacesanuphillbattletosocialacceptance.Thepaperlooksattherelianceofthebiomedicalcommunityonthecondomandoffersthattheco‐factorsofinfection,suchaspovertyandgenderinequalityarenomatchforthecondom,andmustbefactoredintoade‐medicalizedapproachofHIVprevention.Condompromotionisnotcompletelyruledout,ratheranthropologistsarechallengedtopartnerwithbiomedicalresearcherstoincludetheco‐factorsofHIVinfectionsuchaspovertyandgenderinequality,onHIV/AIDSpreventionresearchagendas,ifAfricaistoeverwitnessa
true
decreaseinHIVprevalencerates,ratherthanstabilizationattributedto“die‐off.”
 
3
 
TABLE OF CONTENTS
INTRODUCTION 4
 
CHAPTER 1 THE DISHARMONIOUS DISCOURSES ON AIDS IN AFRICA 8
 
A
NTHROPOLOGICAL
C
ONTRIBUTIONS TO
AIDS
 
R
ESEARCH IN
A
FRICA
8
 
A
NTHROPOLOGISTS AS
H
ANDMAIDENS
8
 
A
NTHROPOLOGISTS AS
C
ULTURAL
E
XPERTS
:
 
T
HE
C
OMMUNITY
P
ARADIGM
9
 
A
NTHROPOLOGISTS AS
P
OLITICAL
E
CONOMISTS
:
 
T
HE
S
TRUCTURAL
V
IOLENCE
P
ARADIGM
10
 
T
HE
F
UTURE
:
 
A
N
A
NTHROPOLOGICAL
S
YNTHESIS
10
 
AIDS,
 
C
ONDOMS AND THE
B
IOPOLITICAL
11
 
F
ROM
G
LOBAL TO
L
OCAL
:
 
R
ELIGION
S
I
NFLUENCE ON
C
ONDOM
P
ROMOTION AND
U
SE
13
 
A
 
M
INI
ANTHROPOLOGY OF
C
ONDOM
P
ROMOTION IN
A
FRICA
15
 
CHAPTER 2 FEMALE BODIES, MALE CONTROL 19
 
T
HE
P
ERFORMANCE OF
T
RUST
20
 
T
HE
R
ISKY
S
EX OF
M
ARRIED
C
OUPLES
21
 
T
HE
S
YMBOLIC AND
M
ATERIAL
V
ALUE OF
F
ERTILITY
23
 
CHAPTER 3 THE SOCIAL AND COSMOLOGICAL DIMENSIONS OF SEX 25
 
R
EPRESENTATIONS OF
S
EMEN
25
 
C
ONDOMS AND
G
OOD
S
EX
D
ON
T
M
IX
26
 
CHAPTER 4 THE SOCIAL PRODUCTION OF AIDS 28
 
T
HE
S
EXUAL
C
ONSEQUENCES OF
P
OVERTY
28
 
M
ASCULINITY
,
 
M
IGRATION
,
AND
S
EXUAL
R
ISK
T
AKING
29
 
CONCLUSION 31
 

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