Youth, HIV/AIDS and the importance of sexual culture and context

Abstract

Twenty years of the sub-Saharan HIV/AIDS epidemic has impressed upon us the extent to which this disease is far more than a public health challenge. As it ravishes fragile economics, decreases life expectancies, increases women's burdens, generates orphans and decimates the dreams and futures of millions of people, HIV/AIDS has become nothing less than the most ominous development challenge facing the African continent. Contemplation of the sheer magnitude of the social repercussions brought in the wake of HIV/AIDS incurs the risk of crippling our senses and blocking the imagination needed for addressing this crisis. Indeed, the personal impact is sharpened rather than mitigated by the realization that this disease is, after all, almost entirely preventable. The poignancy of this simple but painful truth was clearly articulated in 1991 when President Museveni of Uganda declared to his parliament: 'They are telling us that a thin piece of rubber stands between us and the future of our continent!' (Museveni 1997). Still today, more than a decade after the time of that statement, many hopes for Africa are vested in that thin piece of rubber. Primary prevention through behaviour change involving safer-sex practices is still the most viable and potentially effective option for halting the spread of HIV/AIDS in these resource poor countries where affordable treatment is lacking (Davis and Weller, 1999; Donovan and Ross, 2000; Pequegnat and Stover, 2000). This paper focuses on the socio-cultural context in which the enactment of 'highrisk' youth sexual activity takes place. It is divided into two parts: the first examines the general body of research on HIV/AIDS and youth, with particular reference to South Africa; the second discusses some recent findings from ongoing ethnographic research at St Wendolin's, a peri-urban Zulu-speaking community in Durban, on aspects of sexual culture that enhance the spread of HIV/AIDS. Currently it is estimated that between 30-40% of the adult population of KwaZulu-Natal is HIV infected (Whiteside and Sunter 2000). As a whole, African communities in the greater metropolitan Durban area, and indeed throughout KwaZulu-Natal province, represent high seroprevalence epicentres for HIV/AIDS.</p