This week (Week 5) the readings focused on issues of HIV in relationship to youth, gender and sexuality. Admittedly, for me this was a difficult week of readings. Ideally, discussions of gender and sexuality need to be framed by giving the students a set of terms, readings, and initial ideas. Given that none of the students are Women's Studies majors, very few of them would have had exposure to these ideas in their regular coursework.
Therefore in some way it was a challenge. Before we can really discuss issues like heteronormativity, gender relations, and sexuality it is ideally necessary to introduce these concepts, explain their meanings and their applicability in terms and with examples that might be familiar to students in their everyday practice. Certainly, if I had the opportunity to teach the class again, I would have provided more basic women's studies readings of this nature in order to set the tone for the discussion. After that, then it is possible to have a discussion about heteronormativity in relation to HIV prevention and education.
That being said though I felt the students did a good job with the amount of material and the difficulty of the material presented to them. In the aggregate, I provided this week's readings so that students could get more of a sense of the structural and systemic issues that effect HIV prevention.
What are the reasons why women might be more vulnerable to HIV infection beyond simple biology? How do societies structured by patriarchy contribute to increased risk of infection? How is poverty feminized and racialized in ways that expose particular groups of women (both in the developing world and in the United States) to disease? How do the same mechanisms of patriarchy and heteronormativity silence and add stigma to both women and lgbti (lesbian gay bisexual transgender and intersex) individuals, and how does this present additional challenges to tackling the epidemic in the African and U.S. contexts? How do these same mechanisms conspire to marginalize and de-prioritize the voices of youth?
I hope that the readings were an opening to help students begin to engage the complex issues of sexuality as culturally constructed, gender roles and expectations as culturally mandated and potentially coercive and, heteronormativity and patriarchy as mechanisms that add to and intersect with other forms of structural inequalities such as race and class. What I also hope that students were able to learn from of the readings was that these mechanisms of gender inequality also have a negative effect on men as well. That is gender expectations and norms often have the effect of hurting men as much as they hurt women.
Tuesday, February 8, 2011
Community, Culture and HIV
Last week's readings and class discussion touched upon a topic that is very central to me. How do we explain the failure of multimillion dollar interventions in decreasing the HIV epidemic both here and abroad? Are people simply ignorant? Are cultural practices simply backward, retrograde and in need of change? Is HIV only the result of poor individual behavior choices? These are the questions that I hoped to begin to explore in the set of readings that I have assigned to students over the last few weeks.
Traditionally, I feel that discussions of HIV spoke at communities rather than working with communities. The difference is subtle but important. Interventions developed from completely outside of communities that are targeted toward changing behavior in my estimation pathologize and "other" the very communities that they are supposed to serve. Furthermore, "behavior" as the sole education and prevention mechanism of HIV prevention obscures the structural and systemic causes of disease and death.
Toward that end, I wanted to offer the students a set of readings that challenged the traditional approach to HIV and AIDS in Botswana. Saturday is For Funerals presented an account of HIV/AIDS that in my opinion marginalized the voices of those most affected by the disease. That the Botswana government has relied primarily on outside advice to tackle the HIV/AIDS epidemic can be interpreted in a multitude of ways and I will leave that up to the students to decide.
What I hoped the readings for this week did (See Week 4 of the syllabus: readings posted on www.netvibes.com/adpbotswana : See class Wiki Section) was to offer the students an alternative explanation for the continued high rates of HIV infection in communities most at risk. While much is made of the unacceptably high rates of HIV infection, it must be remembered that the majority of people in Botswana are HIV negative? What are the ways in which communities negotiate risk? How do they understand disease and the body? How are communities coping with the sense of crisis? What are the mechanisms for care and well-being?
What I hoped to focus on was the idea that there are some things that communities are getting right and that more attention needs to be paid to how they approach illness, disease, and care. A paradigm of HIV education that suggests that communities have nothing whatsoever to offer to researchers is a paradigm that is doomed to fail. Simply put, people either tune out or dismiss information when that information presents them, their bodies, their communities, and their sexual practices in a light that suggests that they are ignorant, backward and uneducated.
Ideally what the readings from this week did was to examine various different communal conceptualizations of care and disease. Ultimately, I hoped that students would be able to think critically about how these communal conceptualizations could be harnessed in order to develop more effective strategies of prevention, care, and treatment.
The discussion in class for this week seemed to suggest that my attempts to foster this debate met with mixed success. Certainly, some of the students appeared to understand the point of the readings, which was not to question the efficacy of the causal agent of HIV or AIDS. Rather it was to suggest that communal understandings of illness and disease needed to be accounted for in the development of prevention mechanisms. Others, seemed frustrated and concerned that Western "science" was being ignored in favor of unproven and untested "traditional" conceptualizations.
Unfortunately, this is not a winnable debate. What I would also encourage students to think about however, is that Western science is far from unbiased particularly when it comes to the study of populations that are disempowered and the diseases that disproportionately effect them.
I think that as researchers it is imperative to see research with communities as a collaborative practice and not a top down approach that suggest that these communities have nothing to contribute to the discussion. Furthermore, the weakness of the ABC model, which is based overwhelmingly on behavior modification and change is that it does not allow us to account for structural and systemic mechanisms that contribute to high rights of HIV infection. To focus solely on behavior modification (which I must clarify is an important and necessary mechanism for reducing HIV infection) is to also absolve society of the forms of inequality that it allows to continue to exist that make particular populations more vulnerable to HIV infection and less likely to live should they become infected.
Traditionally, I feel that discussions of HIV spoke at communities rather than working with communities. The difference is subtle but important. Interventions developed from completely outside of communities that are targeted toward changing behavior in my estimation pathologize and "other" the very communities that they are supposed to serve. Furthermore, "behavior" as the sole education and prevention mechanism of HIV prevention obscures the structural and systemic causes of disease and death.
Toward that end, I wanted to offer the students a set of readings that challenged the traditional approach to HIV and AIDS in Botswana. Saturday is For Funerals presented an account of HIV/AIDS that in my opinion marginalized the voices of those most affected by the disease. That the Botswana government has relied primarily on outside advice to tackle the HIV/AIDS epidemic can be interpreted in a multitude of ways and I will leave that up to the students to decide.
What I hoped the readings for this week did (See Week 4 of the syllabus: readings posted on www.netvibes.com/adpbotswana : See class Wiki Section) was to offer the students an alternative explanation for the continued high rates of HIV infection in communities most at risk. While much is made of the unacceptably high rates of HIV infection, it must be remembered that the majority of people in Botswana are HIV negative? What are the ways in which communities negotiate risk? How do they understand disease and the body? How are communities coping with the sense of crisis? What are the mechanisms for care and well-being?
What I hoped to focus on was the idea that there are some things that communities are getting right and that more attention needs to be paid to how they approach illness, disease, and care. A paradigm of HIV education that suggests that communities have nothing whatsoever to offer to researchers is a paradigm that is doomed to fail. Simply put, people either tune out or dismiss information when that information presents them, their bodies, their communities, and their sexual practices in a light that suggests that they are ignorant, backward and uneducated.
Ideally what the readings from this week did was to examine various different communal conceptualizations of care and disease. Ultimately, I hoped that students would be able to think critically about how these communal conceptualizations could be harnessed in order to develop more effective strategies of prevention, care, and treatment.
The discussion in class for this week seemed to suggest that my attempts to foster this debate met with mixed success. Certainly, some of the students appeared to understand the point of the readings, which was not to question the efficacy of the causal agent of HIV or AIDS. Rather it was to suggest that communal understandings of illness and disease needed to be accounted for in the development of prevention mechanisms. Others, seemed frustrated and concerned that Western "science" was being ignored in favor of unproven and untested "traditional" conceptualizations.
Unfortunately, this is not a winnable debate. What I would also encourage students to think about however, is that Western science is far from unbiased particularly when it comes to the study of populations that are disempowered and the diseases that disproportionately effect them.
I think that as researchers it is imperative to see research with communities as a collaborative practice and not a top down approach that suggest that these communities have nothing to contribute to the discussion. Furthermore, the weakness of the ABC model, which is based overwhelmingly on behavior modification and change is that it does not allow us to account for structural and systemic mechanisms that contribute to high rights of HIV infection. To focus solely on behavior modification (which I must clarify is an important and necessary mechanism for reducing HIV infection) is to also absolve society of the forms of inequality that it allows to continue to exist that make particular populations more vulnerable to HIV infection and less likely to live should they become infected.
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