ALQ,November 2006 Edition - Core Beliefs and Underlying Factors

Editorial...

Bringing AIDS under control will require tackling with greater resolve the underlying factors that fuel these epidemics including social inequalities and injustices these are extraordinary challenges that demand extraordinary responses. [UNAIDS, 2005]

It is these very same ‘underlying factors’ that seem to be the persistent challenge to the effectiveness of current responses to HIV and AIDS realities. Despite the enormous efforts, resources and time spent in addressing the pandemic and its underlying factors, gendered inequalities and injustices, gender violence, and social, cultural and religious belief, value and norm systems justifying the ‘status quo’ prevail - persistently fuelling the pandemic.

It is within the context of ‘tackling’ these factors that this edition of the ALQ focuses on core beliefs and underlying factors fuelling the HIV pandemic. The various articles in this issue examine a broad range of realities as to the extent to which various core beliefs and/or underlying factors not only fuel the HIV and AIDS pandemic, but also impact on the effectiveness of HIV prevention, treatment, care and support initiatives and programmes. The impact of various gendered realities on the pandemic, the link between sexual violence and HIV, the pandemic in the context of violence, the involvement of men in responses to HIV, the ‘region specific’ underlying factors of the pandemic, perceptions of gender and gender violence amongst adolescent boys, as well as the right to be different, the right to make reproductive choices and the ‘excuses’ for the violation of rights are some of the issues explored in this edition.

The integral features of the ALQ introduce experiences with core beliefs from an NGO in Mpumalanga, and experiences from a VCT study site in rural Tanzania. This issue is also ‘making a point’ about workplace approaches to HIV and AIDS.

In this edition, Johanna Kehler examines various gendered realities as to their impact on the HIV and AIDS pandemic. Analysing the inherent barriers of the gendered societal context to the effectiveness of current approaches to HIV and AIDS, she argues that as long as gendered inequalities, imbalances and injustices are not addressed and challenged as ‘the’ underlying factor, efforts will remain to have little impact and gendered realities will continue to fuel the pandemic.

The meaning and implications of the ‘right to be different’ as provided for in the Constitution is explored by Pierre de Vos. Discussing various constitutional provisions and their interpretation by the Constitutional Court, he argues that any views, culture and beliefs used to justify the marginalisation or exclusion of anyone from the benefits of social acceptance, is against the constitutional imperative to respect difference and not to reject it.

Recognising the link between sexual violence and HIV, Meaka Biggs raises the question as to whether or not the relationship between the two is adequately understood and addressed. She examines the various realities, underlying factors and correlations of the two pandemics and argues that only as and when the underlying factors of women’s lack of reproductive and sexual autonomy and choice, as well as the gendered nature of power and control in society are taken into account, can prevention strategies and awareness campaigns be effective.

The concept of ‘dethroned men’ is introduced by Dumisane Remombo. Acknowledging unequal gender relations as the most serious underlying factor that fuels the HIV pandemic, he explores the impact of the ‘new social order’ on men and argues that the success of responses to the pandemic will remain limited, since current HIV strategies and approaches fail to involve men as solution seekers and partners.

Findings of a study exploring the perceptions of adolescent boys pertaining to gender, sex and violence are introduced by Rachel Elfenbein. Based on research data indicating a lack of a critical engagement with issues of gender, sex and violence in the boys’ lives, she argues that this very same environmental context could contribute to the perpetuation of gender violence and the spread of HIV, if not addressed by means of human rights-based sex education for children and youth.

Katharina Tangri examines the extent to which women living with HIV and AIDS are in the position to make reproductive choices. Analysing various underlying factors of the pandemic in Botswana, such as gender inequalities, violence and abuse, as well as stigma and discrimination, she argues that it is imperative to make informed reproductive choices, if the fundamental right to found a family is to become a reality for every woman, irrespective of her HIV status.

Recognising the seemingly relentless spread of the HIV pandemic in Southern Africa and the disproportionate impact on women and girl children, Suzanne Leclerc-Madlala raises the question as to the ‘real’ underlying factors for the pandemic in the region. She examines the impact of various ‘region-specific’ underlying factors and argues that reducing multiple concurrent sexual relationships, introducing male circumcision, and addressing gender inequalities, especially from the perspective of male involvement and responsibility for HIV prevention, are some of the interventions carrying hope for effective and relevant responses to HIV in the region.

Focussing on the context of violence, Rakgadi Mohlahlane looks at various factors fuelling the HIV and AIDS pandemic. Analysing various forms of violence, including structural violence, she argues that as long as strategies and approaches to violence and to HIV and AIDS perpetuate, rather than address, the polarised environment of ‘men as perpetrators’ and ‘women as helpless victims’, responses to either pandemic will remain limited.

Recognising the gap between rights and realities, Emma Harvey reflects on discrimination and the various ‘excuses’ for its occurrence. Exploring factors, such as culture, religion, upbringing and ‘human nature’ as the common reasons for discrimination, she argues that these very same reasons become ‘excuses’ to justify the continued occurrence of discrimination of the ‘other’, despite the fundamental right not to be discriminated against.

Experiences from Nelspruit, Mpumalanga in responding to the concurrent pandemics of sexual violence and HIV and AIDS are introduced by Barbara Kenyon. She discusses some of the sexual assault realities, including the impact of the ‘virgin myth’ and approaches to prevention, and argues that current prevention strategies fail to de-mystify and/or respond to prevailing myths and beliefs fuelling the pandemics.

Project Afiki, a behavioural/social science intervention on HIV incidence is introduced by Laurie Abler, Gad Kilonzo and Jessie Mbwambo. The article highlights realities and challenges of community-based VCT research in rural Tanzania, and discusses some of the experiences and initial findings in affecting motivations and barriers to test from the study site in Kisarawe, Tanzania.

Looking at workplace approaches to HIV and AIDS, Shawn Hattingh is ‘making a point’ about the extent to which current HIV workplace policies and programmes are in the position to enable the constitutionally guaranteed right to fair labour practices. He examines the impact of various HIV workplace policies and programmes and argues that current responses to HIV in the workplace will remain to have limited impact, since they fail to address stigma and discrimination in all its forms, and to take into account workers’ human rights in the development and implementation of HIV workplace policies and programmes.

Identifying and examining the various underlying factors fuelling the HIV pandemic, seem to highlight the real challenge how to ‘tackle’ the core beliefs apparently ‘justifying’ the persistence of the underlying factors. Irrespective of the particular identified ‘factor’, the recurring challenge seems to be ‘gender’, which is perpetuating inequalities, injustices, violence in all its forms, and the marginalisation and exclusion of the ‘less powerful’ – often reasoned, explained and ‘justified’ by core beliefs. However, despite its recognition, it appears that ‘gender’ is continuously the ‘factor’ least considered and, thus, HIV approaches and strategies remain largely ineffective.

If we are to agree that ‘gender’ is the core belief that needs to be addressed and challenged, then we need to agree that this is indeed an ‘extraordinary challenge’, since it questions the very same foundation of society, the very same foundation of who we are to be as people and how we are to interact with one another, of what we belief to be ‘appropriate’ behaviour and/or treatment of people. It is also the very same foundation that, with persistence, describes who is the ‘victim’ and who is the ‘perpetrator’, as it, with the same amount of persistence, resists to change, especially to the much required ‘behavioural change’.

However, if we are to ‘tackle with greater resolve the underlying factors’ fuelling pandemics in the context of ‘gender’, then one of the ‘extraordinary responses’ may have to include the acknowledgement that in the context of current pandemics, people are equally ‘at risk’ to be ‘helpless victims’, ‘perpetrators’, ‘solution seekers’ and/or ‘agents of change’. Similarly, it might need acknowledging that people are equally as ‘prone’ to be violated, marginalised, excluded and discriminated against, as they are ‘prone’ to violate, marginalise, exclude and discriminate against the ‘other’. Thus, the ‘extraordinary response’ required seems to be ‘engendering’ society, its various realities, and the various responses, strategies and approaches to society’s ’extraordinary challenges’.

So, if, the ‘response’ is to create an enabling environment for ‘bringing AIDS under control’, then the environment needs to be ‘engendered’ so as to be ‘enabling’ for people to be ‘in control’ of the pandemic. If we fail to create such an environment, the underlying factors will remain unchallenged; the gendered nature of society will continue to determine the gendered nature of any pandemic; and the access to, and realisation of, fundamental rights and freedoms will remain gendered and so ‘justify’ the marginalisation and exclusion of the ‘other’ who is ‘less powerful’. Thus, the extent to which people are in the position to claim and enjoy human rights, and to ‘take control’, will continue to be determined by their ‘gender’, rather than their ‘humanness’. Subsequently, the persistent failure and/or resistance to ‘engender’ society will manifest itself in ‘lack of ability’ to develop and implement effective responses to the ‘extraordinary challenges’ of the HIV and AIDS pandemic. And so, ‘gender’, if not ‘tackled with great resolve’, will remain to be the ‘status quo’...Johanna Kehler