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Challenging culture in HIV campaigns

A billboard in Kampala, Uganda, promoting faithfulness
(Zoe Flood/IRIN)

Over a glass of wine in a bar in Kampala, the Ugandan capital, two young women have a heated discussion about Tim*, who is married to their friend Becky*; Tim's "side-dish", or mistress, is pregnant and the two women disagree over whether Becky should leave him or not.



"Becky knew what to expect when she married him; she shouldn't be surprised," one of the women says.



"No way - it's one thing to cheat, but for him not to wear a condom means he doesn't care about Becky at all... Next she could find out she has HIV," the other said.



While the women were at odds over Becky's next move, they both agreed that fidelity was not something one could expect from men in their society.



Multiple partners



Since the 1980s, Uganda's HIV prevention campaigns have focused heavily on fidelity to a single sexual partner, with abstinence and condom use being the two other major tenets.



However, there has been some debate about whether “multiple concurrent partnerships” are indeed one of the forces behind Africa's epidemic - a 2009 study found "limited evidence" that concurrency was driving HIV/AIDS in Africa - but for many Ugandans, the main problem with “zero-grazing” - sticking to one sexual partner - campaigns is their attempt to alter centuries of tradition.

 

Polygyny is on the decline in Uganda, but statistics show that an estimated 28 percent of women are in polygynous unions. Men who have one wife will often have at least one long-term mistress outside of marriage.



"This is our culture; I come from a polygamous family and although I have one wife now, who is to say I won't take another one down the line," Philip Wanyama, a taxi driver in Kampala, told IRIN/PlusNews. "I don't see why anyone should tell me not to do so." 



Condescending campaigns? 



According to Sylvia Tamale, a professor at Uganda's Makerere University, and a sociologist and feminist, the problem is that African countries have bought wholesale into a “paternalistic” attitude towards their cultures.









''We have uncritically bought into the 'risky cultural practices' frame, which is racist, moralistic and paternalistic''

"We have uncritically bought into the 'risky cultural practices' frame, which is racist, moralistic and paternalistic," she told IRIN/PlusNews. "It has also become the main resource of public health advocates and policy-makers, resulting in two decades of muddled approaches to HIV prevention in Africa with minimal success.



"It has become evident that the insensitive approaches that call for the elimination of cultural and sexual practices will not yield significant results," she added. "The key is not to fight people's cultures and identities but rather to raise their awareness levels of practising the safe exchange of body fluids... studies have shown that cultures are flexible enough to adapt to new threats such as those posed by HIV."



Changing epidemic, changing initiatives



But according to James Kigozi, spokesman for the Uganda AIDS Commission, the nature of the country's AIDS epidemic, where HIV infection is spreading fastest in long-term, stable partnerships, calls for drastic measures.



"We are not shy in any way about telling people to abandon cultural practices that put them in danger of HIV," he told IRIN/PlusNews. "A changing epidemic needs changing initiatives."


















Read more
 Love in the time of HIV/AIDS
 Dangerous sex in "small houses"
 The slang of sexual networks

He noted that the recent "One Love" national campaign that candidly encourages people to abandon their "side-dishes" and "get off the sexual network" had made significant inroads in raising awareness about HIV risk within long-term relationships.



"For the first time in many years, we are hearing from our partners and institutions of higher learning that people are actually listening to the HIV message and not ignoring it, as has been the case with many previous prevention campaigns," he added.



A balancing act



Daudi Ochieng, head of communications at the Uganda Health Marketing Group (UHMG), which is running the "One Love" campaign, acknowledges the challenge of trying to sell fidelity in a culture where multiple concurrent partnerships are so common.



"This is why we also advocate for condom use; if you can't stick to one partner, use a condom," he added. "But trying to get both messages out simultaneously is difficult - people question whether we are preaching fidelity or promoting condoms.



"We can't change a culture that took hundreds of years to build in one day - the earlier we realize that the better, so it is important to offer people all the options to protect themselves," he added.



* Not their real names



kr/ks/mw

This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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