Global Ethics Corner: HIV Prevention and Behavior Change in Africa: Are Western-Imported Methods Working?

Nov 25, 2011

Are Western-imported methods for fighting HIV/AIDS working in Sub-Saharan Africa? Some critics argue that campaigns more aligned with traditional African values could be more effective in fighting the disease than Western campaigns focused on abstinence and safe sex.

Former U.S. President George W. Bush's AIDS prevention campaigns required that a third of all programs be abstinence-only and faith-based. The Obama administration has lifted that mandate, but the question remains: Are U.S. and other Western HIV prevention programs ideologically driven?

Many HIV prevention campaigns in Sub-Saharan Africa are based on Western campaigns like ABC: Abstain, Be Faithful, and Condomize. The ABC method is meant to alter behavior that increases the risk of HIV infection, but has been criticized for being too representative of Christian American cultural beliefs. Once credited with Uganda's initial success in lowering HIV rates, the ABC method is now viewed more critically.

Despite the United States' investment of over $30 billion on HIV/AIDS projects worldwide, HIV rates in the region have largely stayed constant or diminished only slightly. Still, many prominent celebrities, economists, and other wealthy Americans continue to encourage us to donate to HIV prevention in Africa.

Many academics and public health and development experts argue that Western-imported programs are ineffective and culturally inappropriate.

Though agency and individuality are emphasized as American values, most African cultures emphasize compliance with community-wide practices and discourage self-interested action.

The University of Botswana integrated local cultural norms into its AIDS prevention media campaign in 2005. The campaign paired traditional Botswana proverbs with positive messages about condom use and faithfulness. The proverbs drew upon positive cultural aspects that encouraged HIV-preventative changes in behavior.

What do you think: Would AIDS prevention campaigns be more effective if they shifted to incorporate local cultural beliefs? Or does a U.S. program need to reflect and export Western values?

By Julie Mellin

Photo Credits in Order of Appearance:
Telfair H. Brown, Sr/United States Coast Guard
Pete Souza
Pierre Holtz/UNICEF
Matt Corks
Remy Steinegger/World Economic Forum
Erik Cleves Kristensen
Kimberly Burns/USAID
ArjunIyer/CAPTION: University of Botswana
Fiona Bradley

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