Examining HIV diffusion through cultural explanations : a cross-sectional comparison of sub-Saharan Africa

Master Thesis

2009

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University of Cape Town

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Across the globe more than 33 million people are believed to be infected with HIV/AIDS. The majority of these cases are in sub-Saharan Africa. Now that biomedical causes and behavioural risks are firmly established in the literature, social scientists must attempt to understand the underlying cultural foundations that may account for behavioural change, or a lack of change. This work is an empirical study into cultural explanations for HIV diffusion since the year 2000. Its main goal is to inform attempts to create more effective prevention programs and policy. This study utilizes a database constructed from interviews with ordinary citizens in five sub-Saharan African countries surveyed during the 2000 wave of the World Values Survey (WVS), and various health and demographic information sources. Eight thousand interviews were aggregated into thirty-one regional units for the analysis. Cultural values obtained from the WVS were compared with changes in HIV prevalence rates from 2000 to 2005 (HIV diffusion). The study focuses on three aspects of culture: female disempowerment, levels of social capital, and religiosity. Each of these broad concepts was dissected into at least three sub-concepts using data reduction methods. The relationship between these sub-concepts and HIV diffusion were compared before and after controls for education, poverty and urbanization were utilized. Based on these correlations, culture appears to be important to understanding HIV diffusion. However, its effects are not consistent. Broadly, two conclusions can be drawn from the data. First, cultural impacts vary by country. Programs based on each country's cultural dynamics will likely have more success than continent wide programs. Culture has stronger correlations with HIV diffusion in countries with smaller epidemics. Secondly, the data shows no clear relationship between different religious denominations and HIV diffusion. In addition, the correlations that exist between HIV diffusion and religiosity all show that increased religiosity leads to more diffusion. Therefore, international aid programs should avoid using religious doctrine and religious organizations as ways to enact sexual behaviour modification and reduce the spread of HIV. By creating secular, country specific programs international aid agencies can help counteract the cultural norms that appear to increase HIV diffusion.
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Includes bibliographical references (leaves 75-84).

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