HIV/AIDS: What messages do our girls hear?

Sugar Daddy: "It's true that AIDS kills, so I'll only go out with young girls who don't have it yet!" from Zambuko 3, Chishona, Fomu 3, Herbert Chimhundu, College Press, 2004 (1995)

To start off the new year, I’m going to post a modified version of a paper I gave at a conference on HIV/AIDS held at the University of Oregon in April, 2009. The conference was organized in part by Janis Weeks, a member of Tariro’s board of directors, and the mother of Jake Roberts, who has appeared as a guest author on our blog.

This paper is a way to open up discussion on the kinds of messages Tariro students hear about HIV/AIDS, an aspect of our work which has wide resonance for other individuals and organizations involved in HIV education and prevention.  After spending the past year in Zimbabwe conducting dissertation research for my PhD and working with Tariro, I became aware of how various discourses on HIV/AIDS compete for space in the public sphere, complicating HIV education and prevention efforts,  My paper explores how these discourses impact Tariro’s students.  It is built around two basic questions: first, what kinds of messages do our students hear and see about HIV/AIDS?  And second, what personal emotions and reactions do they express in response to the disease?  Specifically, I focus on the messages about HIV/AIDS that our students hear in school, as part of the government curriculum on health.

In small group discussions and individual interviews, our students identified the school curriculum as a major source of information on HIV/AIDS.   Many students said that HIV/AIDS came up as a discussion topic during larger units on health, with their teachers working from information on HIV/AIDS included in their school textbooks.  Many students additionally identified books, including textbooks and other books, as major sources of information on HIV/AIDS.  Somewhat to my surprise, in fact, books were the primary source of media conveying information about HIV/AIDS to secondary school children enrolled in Tariro, as many live in families with no access to televisions or radios, while books are accessible at their schools, as well as through Tariro’s lending library.

The textbooks used in Zimbabwean schools, however, draw heavily upon a very particular kind of discourse about HIV/AIDS, as exemplified by the following image from a high school textbook.

Depiction of AIDS in a Zimbabwean high school textbook. From Rurimi RwaAmai, Bhuku 2, T.K. Tsodzo, College Press Publishers, 2001 (1992)

In textbooks, HIV/AIDS is repeatedly represented through stereotyped imagery of bedridden and skeletal AIDS sufferers, as well as through images such as the skull and crossbones motif in this photo.  The Shona speech bubble here says, “Watch out, AIDS kills!”  This emphasis on the suffering and death seems meant to scare adolescents into taking HIV/AIDS seriously.   Here is another example from a school textbook:

Skeletal AIDS suffer in a high school textbook, from Rurimi RwaAmai, Bhuku 4, T.K. Tsodzo, College Press Publishers, 2007 (1995)

However, at best, these images represent an attempt to deploy a very blunt weapon against a disease with a complex bio-medical and socio-cultural profile.  This type of imagery has largely been abandoned by most organizations working in HIV prevention and treatment, as it may have undesired effects, including effects contrary to those originally intended.  In the words of HIV prevention worker Barb Ncube, early HIV prevention campaigns featuring this type of imagery “made it like a huge mystery, something really scary.  They used the wrong tactic, they just wanted to scare people away from it.  And in doing that, it made people more promiscuous because they felt helpless.  They started feeling like, ‘Ah, well, we probably all have it, let’s just have unprotected sex anyway.’”

While these scare tactics are much less frequent in contemporary public health campaigns, however, many Tariro students seem to have internalized a discourse equating HIV infection with full-blown AIDS, suffering, and death, as shown in the following picture.

Depiction of HIV/AIDS by Tariro students at an empowerment camp art therapy workshop

This drawing was made in an art therapy workshop held during our annual empowerment camp.  Here, we see how one group of Tariro students depicted the disease visually through the image of a corpse lying inside a coffin, accompanied by the following poem: “AIDS brings sickness with no cure/Sickness that makes you unable to eat/You are left thin, unable to survive, without a good life/ Once you have AIDS.”

In addition to imagery of those infected with HIV as deathly specters, textbooks commonly cite prostitution as the primary means of transmission of HIV.   For example, one textbook used in Form 2, the equivalent of grade nine, the five major causes of AIDS are listed as follows: prostitution, blood transfusions, coming into contact with infected blood, having medicinal incisions made by a traditional healer, and being bitten by someone who is infected.  The textbook goes on to say, “In order not to contract HIV/AIDS follow traditional customs of abstinence if you are still young and sticking to one partner if you are mature.” (Rurimi RwaAmai, Bhuku 2, T.K. Tsodzo, College Press Publishers, 2001 (1992) ) Likewise, the unit on HIV/AIDS in one Form 3 textbook consists of the reproduction of an newspaper article about a prostitute who admits to being HIV positive, but continues sleeping with customers. (Zambuko 3, Chishona, Fomu 3, Herbert Chimhundu, College Press, 2004 (1995))

This type of discourse ties the transmission of HIV exclusively to transactional sex, leaving no room for discussion about methods of safer sex, except within the confines of marriage.  For youth, the only acceptable response to HIV becomes abstinence.  The logical conclusion of this discourse is expressed in another book targeted specifically toward teenaged girls in Zimbabwe, with the Shona title of “Grandmother and Granddaughter.”  As this book explicitly states, “Experimenting with condoms is regarded as the game of loose, immoral girls who go about having casual sex for prostitution business, whether using condoms or not.  A well groomed girl does not take chances in having casual sex.  With the advent of HIV and AIDS, if married couples discover that one partner is HIV positive, yes it’s recommended that they use condoms.  But, not with a pretty virgin girl…”  (Mbuya NeMuzukuru: A girl’s journey to adolescence in Zimbabwe: Reviving African culture for today’s women, by Rose Siyachitema.  Gweru: Galaxy of Arts Production, 2005).

Many teenaged girls are thus denied knowledge about how different sexual behaviors carry varying degrees of risk, as this knowledge is seen as inappropriate for young women.  For example, at one condom demonstration I witnessed at a community center in Zimbabwe, women told two teenaged girls, one wearing a school uniform, to leave the demonstration area as the demonstration was not appropriate for them to witness.  Likewise, Tariro students reported being barred from condom demonstrations held at their schools in conjunction with mobile voluntary testing and counseling units, as they were under the age of sixteen, the legal age of consent in Zimbabwe.

For teenaged girls, the equation of premarital sex with prostitution, a discourse asserting prostitution to be the major method of HIV transmission, and the deliberate withholding of information on safer sex practices amounts to a death sentence.  However, all girls with whom I spoke had deeply internalized this discourse of abstinence.   In a group interview with ten Tariro students in Epworth, for example, girls identified abstinence as the most important message or information a person could have about HIV/AIDS.  Other Tariro students likewise identified abstinence as the most important prevention method, and it was often the only prevention method suggested.  In the words of one student, “People should abstain.  That’s number one.  Because condoms are not one hundred percent perfect.  So people should just abstain.”

For many Tariro students, however, it was clear that abstinence was an unrealistic prevention method.  Over the past year, two girls who had recently completed their secondary school education through Tariro fell pregnant and were sent to live with their boyfriends’ families, and two other girls were likewise sent to live with their boyfriends’ families when their guardians discovered they were sexually active, although they were not pregnant at the time.  These common discourses on HIV/AIDS pose major challenges to organizations working in HIV education and prevention, complicating intervention efforts.

When dealing with students who have largely internalized a discourse on HIV/AIDS which equates AIDS with death, and asserts that its main transmission method is through prostitution, how can we provide alternative models through which to understand the disease?  How can we break through the silence surrounding sexual activity among teenaged girls in order to provide girls with life-saving information on safer sex? And how might we work with community leaders, parents, and guardians to emphasize important cultural values, including abstinence, in conjunction with important biomedical information on AIDS transmission and prevention?

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