1. SAHARA
5th African Conference on Social Aspect of HIV/AIDS
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SOCIOCULTURAL RESPONSES TO HIV
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CULTURE : AN AFRICAN
PERSPECTIVE ON HIV PREVENTION
Cheikh Ibrahima Niang
SAHARA,
Université Cheikh Anta Diop, Dakar, Senegal

2. Progress is made
• Level off or Decline of HIV Prevalence among Pregnant
women attending antenatal clinics in
– South Africa, Swaziland, Lesotho, Namibia, Botswana, Zambia,
Zimbabwe (26 in 2002 to 16 in 2006)
• Decline among young people and among the General
Population associated with behavioral change
documented in
– Uganda, Kenya, Rwanda, Benin, Burkina Faso, Ghana, Cote
d’Ivoire (in Abidjan from 10% in 2001 to 6.9% in 2006)
• Low and stable prevalence in the general population
– in Mali, Senegal (0.7%)
• Progress in PMTCT:
– Pregnant women tested for HIV rose from 17% (2007) to 28%
(2008)
• Increased number of people having access to ARV
treatment in
– most of African countries in particular in South Africa and
Botswana

3. …Still too little and too slow
• Low speed of prevention effects
– Every day over 6800 persons become infected with HIV and
5700 die from AIDS
• Sub-Saharan Africa: More than 2 out of 3 of adults and nearly 90%
of children infected with HIV live in sub-Saharan Africa
• Crisis for young people
– Half of new cases (15 to 24)
• Gender crisis
– AIDS has the double face of a woman and the baby she carries
on her back
• 61% of adults living with HIV in Sub Saharan Africa are women (sex
ratio 1 man for 4 women, for some age groups in some countries)
• Low percentage of Pregnant women receiving PMTC (less than
10% for many of African countries)
• High prevalence of HIV among Female sex workers (Senegal: 19%)
• Crisis of Epidemiological denial and human rights
violations against MSM and sexual minorities

4. Biomedical research and Societal Contexts
• Body of knowledge on biomedical responses that work
– (condom, circumcision, behavioral change…)
• Gap Biomedical Research – Sociocultural contexts
– Antagonistic approach to culture (by the scientific official discourse)
• Culture seen as a set of practices (mainly “harmful practices”)
• Unequal epistemological status (science, basic science, “hard science”
constructed as the hegemonic fabric of the truth)
• Culture is seen associated to traditions which are considered as Static,
one-dimensional, one-semantic / used to justify gender and social
inequalities
• Missing research questions
• How culture is a framework of understanding and functions as a fabric
of identities and decisions making processes concerning HIV/AIDS
prevention?
• What are the Cultural Concepts underlying cultural practices?
• What are the multiple senses associated to cultural concepts and web
of concepts (Polysemic)?
• How to reconstruct harmony between biomedical research findings and
reinterpretation of cultural concepts?
• How cultural research and biomedical findings could provide ground for
social transformation needed for HIV prevention?

5. Sociocultural context for HIV/AIDS prevention among youth
• “Etic perspective” on Youth vulnerability to HIV/AIDS
• Intergenerational sex
• Multiple concurrent partners
• Socioeconomic vulnerability
• Sexual debut without having sex education
• “Emic perspective” on Risk taking as a metaphor for
sexuality
• Wolof (Senegal): HIV/AIDS risk taking as a metaphor of masculinity The
Guerrier (warrior) : “Gelbi Jaralnama SIDA” (this women deserves I get
AIDS)
• B. Davidson: (about the Venda girls in 1920s) “The Venda sexually
mature girl who continually stay with her mother was… called “afraid of
men” (the same in Wolof)… not considered as a normal human being
(wolof symbolic of beads “songe ko”: attack him; “songe ma” attack me)
• Articulating risk taking metaphors with HIV/AIDS preventive
messages
• The warrior is the one who take the risk of facing social and
interpersonal adverse effects of condom use
• Fulle (individual responsibility and self protection) applied to sex
education among the Wolof: “You seduce the one you want he seduce
you”

6. Cultural capital for youth sex education
• Inter-femoral non penetrative sex
– Documented in ethnographic research
• Masai, Luo, Zulu, Venda (Gregersen 1982; Werner 1987); The word
exist in Wolof, Senegal (ñapaaxu)
– Concept:
• Sex is not a sin
• Sex is a mechanism for harmony (cosmological harmony) Wolof: sey /
seey
• Control : A compromise between expression of sexual pleasure and
delaying penetrative sex that has to be integrated in social rituals (above
interpersonal relationship)
• Offence of the women in case of premarital pregnancy (family apology)
• Provisional concepts in case of non virginity (at the
marriage)
– Unknown (Interfamily arrangements)
– Juddu alarbay kayré
• Concept of compromise as condition for individual self
expression

7. Cultural heritage for women’s responses to HIV
• Structural factors affecting women and HIV/AIDS
– Gender inequalities and power unbalance
– Women Socioeconomic vulnerability
– Violence against women
• Social networks of women as a fabric of “sexual
power” (tuur; mbotaay)
– Sexual codes and tools for sexual power
• Beads, Incense, traditional perfume, postures and attitudes
• Discourse of self esteem (taasu)
– Surveillance of male sexuality (multiple partners)
• Intra gender secret is stronger than cross gender secret; The
story of Cocc “jigeen, soppal te bul woolu”

8. Facing socioeconomic vulnerability
• AIDS women’s economic dependency
– Micro processuses of economic survival for women and children
– Accomplishment of prescribed social roles
• Taylor (1992; Faser 2001) How to bring dignity apart from
redistribution and material support
– Cammen – jigeen model
• Jigeen = women; my jigeen = my sister (biologic or social sister), not
my wife
• Cammen = my brother (the one with whom I have a sexual taboo)
• Cammen – jigeen the strongest mutual social and economic support
unit
– Other support units: Baay-doom; Nijaay-jarbaat
• The naming system excludes sexual relations
• But they happens; when they happens they are hidden
• Suggar dady: nak fayda (lost of personality; non eligible to prestigious
functions)
– Rewards for non sexual partners
• Premarital : in some cases extra marital sex (dube in Cote d’Ivoire)
• Tudde doom (to name the child after him/her)
• Honorific status: Njekke; bayle

9. PMTCT and social construction of maternities
• Structural issues
– Non attendance of antenatal visits and of medically assisted delivery
– Breastfeeding
– Violence and social exclusion around the HIV status of the female spouse
• Women centered maternity
– Uncertainty and Non spoken
– Women observation (posture, spit, food, urine)
• Concept of breastfeeding
– Breastmilk is a genealogical vehicle including the male part (wolof soow)
– The breastmilk can be spoiled (but the decision on the quality of the milk
is a collective)
• Women’s counter power (how to reinforce women’s networks to face
HIV AIDS related violence and exclusion)
– Boo amul werukaay, da ngay gawa danu (if you do not have social
support, you become vulnerable)
– Dimba and violence
– Women’s networks in towns

10. Traditional protection to sexual minorities
• Situation of increased vulnerability to HIV
– Violence, discrimination and social exclusion against MSM, sexual
minorities and People living with AIDS (recent case of Senegal)
• Heritage of Cultural Concept
– Men women (Goorjigeen)’s model in Senegal
• Recognized identity
• Social roles (entertainers, counselors, social capital engineers)
• Political roles alongside with Diriyanke
– Crowder (1950) :
• « The elders and faithful Muslims condemn men for this, but it is typical
of African tolerance that they are left very much alone”
• Looking beyong classical gender paradigms
– Ghana (Eva Meyerowitz 1920 - 1940)
• “Men who dressed as women and engaged in homosexual relations with
other men were not stigmatized... There were good reasons for Akan
men to become women; the status of women among the matrilineal Akan
was exceptionally high”.
– The Gabra (John Colman Wood, 1999)
• «… they regard their most prestigious men – the d’abella, who are ritual
experts- as women »

11. Communication challenges
• Successes and limitations of biomedical discourses
• Social networks are interconnected communication networks
• Low-Beer and al. : The most important behavioural changes in Uganda
associated with communication networks: The societal communication
networks … proved to be more effective than the institutional mass
communication channels.
• Heritage of social capital
• Huge cross communities, cross gender communication for traditional
circumcision that could be re-conceptualized for medical circumcision for HIV
Prevention (Africa is the birth place of the invention of circumcision; 2300 BC)
• James Fernandez (1986 among Fang in central Africa) : How consensus are
generated by multitudes of specific operations of various forms of verbal
and ritual, through “performances” and metaphors
• New Metaphors for AIDS prevention
• Foot, urine (STIs)
• purse, sox (youth and young women “condom revolution” and bias in
quantitative studies)
• Societal metaphors for community mobilization
– Lesotho: KHOLUMOLUMO (Dr. Mokhantso Makoae, HSRC, personal
communication) similitude in Senegal (Diola)
• KHOLUMOLUMO and Transforming mythology into metaphors
• The monster, The fishermen’s filets (social networks), the child (the powerless
or marginalized person)

12. Conclusion
• More ethnographic and qualitative research need to be
done in order to study why things that work technically
do not work at the societal level
• The process to response to that question will help to
produce a new discourse and new response to HIV/AIDS
• The paradigm shift is underway
• As in African mythologies and in recent struggle for
freedom and human rights in Africa, it’s a woman who
takes the initial step to change the course of “business
as usual”
• So, Thank to Dr Olive Shisana the founding mother of
the new vision that focus on social sciences and
multidisciplinary research and response across Africa