Reviewed by Gary Marquardt (Westminster College)
Published on H-SAfrica (January, 2010)
Commissioned by Myriam Houssay-Holzschuch
Anthropological Antidotes to AIDS in Africa
Anthropologists have consistently been on the cutting edge of understanding African societies in ways that many of us in the humanities and sciences only realize later on in our own research endeavors. Douglas A. Feldman’s edited collection, AIDS, Culture and Africa, is no exception. In over fifteen chapters, the reader is exposed to an array of new perspectives that challenge current and popular assumptions about the spread of AIDS and HIV in sub-Saharan Africa. Books that focus on a rapidly evolving subject matter, such as the African AIDS pandemic, often risk premature obscurity. This will, no doubt, be true of certain chapters in this collection. However, the strength of Feldman’s work lies in its ability to push the accepted boundaries of and call for more research on issues that are consistent and enduring; cultural practices, perceptions of sexual relationships, and socioeconomic status are a few such examples.
The most notable successes in this collection are the authors’ collective abilities to obliterate the one-dimensional view of HIV/AIDS in Africa that receives most of the Western media’s attention. Three central targets of this collection include the general reluctance of condom use among African men; the perceived “common” practice of multiple sex partners; and African reluctance to follow prevention models proposed by outside countries, namely, the United States, that place parameters on sexual behaviors in exchange for HIV/AIDS program funding.
Studies analyzing gendered responses to HIV/AIDS and perceptions of sexual relationships get at the heart of some key misunderstandings disseminated by the West about this pandemic. Ruth Cornfield and Stella Babalola look at gendered responses to HIV/AIDS in Rwanda and come to the general conclusion that women and men respond in behaviorally similar but socially different ways after contracting the disease. One of the most revealing conclusions reached by Cornfield and Babalola is that both women and men generally continued to maintain multiple sexual relationships and practiced unprotected sex after becoming aware of their positive status. What’s more, however, is that both genders continued these practices for very different reasons. On the one hand, men continued extramarital affairs “to avoid suspicion in order to maintain their ‘normal’ social identity as defined by their male friends and for fear of losing face” (p. 47). Women, on the other hand, continued for economic reasons, often exchanging sex for money in a bid to financially support their families and themselves.
But one’s sexual life is not predicated on the presence or absence of HIV/AIDS. Kim Longfield’s essay is particularly revealing when considering condom use and multiple sex partners. Longfield presents a complex, albeit entertaining, description of “partner supercategories” as cited by some of her female interviewees. “Boyfriend/girlfriend,” “marriage material,” “spare tire,” “sugar daddy/auntie,” “rich fool,” “arm candy,” “one-night stand,” “prostitute,” and “friend” are not only indicative of the vast swath of sexual relationships, but are also infused with their own particular expectations of the partners in each category. A “spare tire,” for example, usually holds second place to one’s marital partner, and may provide money or gifts in exchange for sex but is often seen as temporary and holding no emotional commitment. A “spare tire” differs from a “sugar daddy” in length and scope as these later men associate with women for a much longer time, and are constantly gifting their younger partners and providing them with mentoring in future careers; the emotional commitment is also void in this relationship.
“Trust” is a common term used by women in Longfield’s study and reveals much about the perceived risks of HIV and AIDS. A woman’s level of trust in her partner(s) often dictated the types of sexual activities she was willing to engage in; predictably, many women abstained from oral or anal sex with anyone they thought had numerous sexually active partners. Trust, however, seemed to be less of an issue for the majority of women engaged in vaginal penetration as this act was seen by most as less intimate than oral or anal sex. Trust also is attached to condom use; many women stated that if they asked their partner to wear a condom, it implied a lack of trust in their relationship. If this request involved a steady partner, for example, it would imply a lack of trust and perhaps signal a change or end in the relationship. In light of the varied and complex pieces of evidence, Longfield wages a strong argument that HIV/AIDS is part of a bigger set of issues that women consider when navigating their sexual relationships.
Attitudes toward and practices among same-sex partners are also addressed in the case of Namibia. The stigma against homosexuals, especially in African societies, is well known in the wake of Robert Mugabe’s much publicized antihomosexual rhetoric of the 1990s. According to Robert Lorway, however, appearances are not always what they seem. Lorway discusses the Lesbian, Gay, Bi, and Transgendered (LGBT) communities in Namibia and argues that the dominant discussion of HIV/AIDS as a heterosexual disease in Africa has misleading, perhaps dangerous, connotations. Self-labeling (or identity) among young males seems to be the issue in this case study. Through interviews with and fieldwork among the members of The Rainbow Project (TRP, an LGBT support and advocacy group), Lorway sheds light on the often repressive, state-sponsored culture against the LGBT community in Namibia. Moreover, he reveals and attempts to incorporate the apparent hypocritical actions by those who are some of the most fervent advocates of antigay policy in Namibia. In his interviews with “moffies,” described as effeminate men in Namibia, many discuss their intimate and consistent sexual relationships with other men who aggressively closet their actions in order to avoid the stigma associated with homosexuality, often speaking out against such acts in public to tow the official party line and avoid public scrutiny. Again, however, HIV/AIDS is not a foremost issue on TRP’s agenda; while important, other legal and social matters, such as the sodomy laws and open discrimination in public facilities (namely, state hospitals), need to be addressed in order to legitimate those who identify themselves as part of the LGBT community. Without political enfranchisement, Lorway suggests, this community cannot play an important role in the fight against HIV/AIDS in Namibia.
Resulting from these social, economic, and political analyses, many essays also scrutinize international politics over HIV/AIDS prevention programs in Africa; the results and suggestions are well informed. Much of the attention is aimed directly at George W. Bush’s African initiatives, namely, the President's Emergency Plan For AIDS Relief (PEPFAR) and the “Abstain, Be Faithful, Use Condoms” Program, also known as ABC. No fewer than six of the fifteen chapters in this book make mention of these initiatives. Most authors disapprove of these programs; their comments range from mild disapproval, arguing that such programs do not conform (nor consider) African sociosexual behaviors, to outright condemnation. In his conclusion, Feldman pulls no punches calling the Bush initiatives “an ideological tool for shaping the values and behaviors of millions of persons in less developed nations” (p. 281). Fundamentalist churches, abstinence only programs, and U.S.-based pharmaceutical companies, Feldman argues, are the real beneficiaries in the expansion of such programs as they will receive most of the funding.
While insightful and tied tightly to the core issues addressed in this collection, most mentions of Bush’s initiatives, with the slight exception of Feldman’s conclusion, are thankfully brief. In the age of Barack Obama, PEPFAR and ABC are likely to undergo some noticeable changes. Therefore, the book’s relative lack of contemporary political analysis ensures that it will weather premature obscurity. Attention on the shifting foci of social, economic, and political behavior among African societies remains the most important contribution of this book and renders itself useful not only to anthropologists but also to historians, political scientists, epidemiologists, sociologists, and academics in development studies, to name a few.
If there is additional discussion of this review, you may access it through the network, at: https://networks.h-net.org/h-safrica.
Gary Marquardt. Review of Feldman, Douglas A., ed., AIDS, Culture, and Africa.
H-SAfrica, H-Net Reviews.
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