Peer education runs afoul of taboos, culture of masculinity

You’re in: AIDS at 25 Coverage / AIDS Educators Face Uphill Battle in South Africa

Credit: Sean Warren

—Cape Town

Here in South Africa, where 15% of the population is infected with HIV, there is a popular and fallacious rumor about condoms: Hold a water-filled condom to the light, the story goes, and you’ll see tiny worms that have been planted by the white minority to infect black users with HIV. Of course, the “worms” are droplets of lubricant, no more harmful than water. But this and other misguided views about HIV complicate matters in a country that desperately needs effective HIV/AIDS prevention.

Current “billboard” mass-media campaigns that promote abstinence and condoms aren’t keeping pace with the epidemic, explained Harvard University researcher Charles Deutsch, who has worked on HIV/AIDS prevention in Africa for most of his career. “People need more context, they need face-to-face dialogue about sex and intimacy.”

To that end, Deutsch and his colleagues throughout South Africa are hoping to spark a new dialogue with a world’s first: the Southern African Center for the Study and Support of Peer Education, which is now being established at the University of Witwatersrand, in Johannesburg, in partnership with Harvard University. Scheduled to open in 2007, the center—funded by President Bush’s Plan for AIDS Relief (PEPFAR) and the South African Business Coalition on HIV and AIDS—will train advanced peer educators to communicate to specific groups whose needs these educators already understand. The center, which is taking applications from US government branches, such as the CDC, the US Agency for International Development, and the Peace Corps,as well as South Africans;will develop standards, accreditation processes and, it is hoped, career paths.

“They live in the presence of a very frightening danger,” Campbell explained. “So, they remove themselves from it by denial.”

The first goal is to get people speaking comfortably about sex. “A lot of evidence shows that people in sub-Saharan Africa are just very reluctant to talk about it,” says Catherine Campbell, a South African sociologist at the London School of Economics, and author of the book Letting Them Die: Why HIV/AIDS Prevention Programmes Fail. “Any open discussion of sex is just completely taboo.”

The challenges that peer educators face are clearly evident at Philippi Township, near Capetown, where most of the 500,000 residents are under-employed and bored, and teens face sexual pressures early on. Teenage peer educators who assembled for an interview at the local high school said that HIV/AIDS simply isn’t a top concern for the teen community here. “The thing they care about most is not getting pregnant,” one said.

“They live in the presence of a very frightening danger,” Campbell explained. “So, they remove themselves from it by denial.” At the same time, she added, South African youth culture pushes boys and girls alike towards high-risk behavior. Boys learn to publicly reject fear—including fear of HIV/AIDS that would lead them to use condoms—while girls learn to publicly deny their own sexual desire and eschew condoms.

“We want to help kids see by their own thinking and talking that abstinence makes sense in the pandemic and that condom use for sexually active people is essential,” said Deutsch. “When we’re dealing with kids, especially those aged 10-to-15 or so, we try to help them articulate and endorse norms of abstinence that are in their culture anyway.”

Originally published August 17, 2006


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