The Story You’ve Heard About AIDS in Africa Is Wrong

Health and medicine explained.
March 27 2013 8:30 AM

Good News on AIDS in Africa

Deaths are down, and the heroes of the story aren’t who you think.

(Continued from Page 1)

In addition to pushing ideas about sexual morality that have roots (even if shallow ones) in religious texts, religious leaders have been promoting innovations to prevent the spread of HIV. These stories, too, have gone untold—unacknowledged by the scientific literature and Western press. We have to wonder why, because condoms, divorce, and booze often make for excellent stories.

On condoms—the public health buff’s favorite subject—religious leaders have been taking pragmatic positions. Most support the use of condoms to prevent HIV transmission. In the late 1980s, a Catholic priest in Tanzania, Father Bernard Joinet, designed a prevention campaign that used images of lifeboats in a sea of AIDS, including one (rubber) boat labeled “condom.” With the support of many religious leaders and organizations, including the Islamic Medical Association of Uganda, this balanced and pragmatic message quickly diffused throughout East Africa.

Of course, support for condoms doesn’t mean that religious leaders are excitedly doling out condoms after communion. They are simply resigned to condoms as a lesser evil. At the same time, they criticize what they see as an obsessive focus on condom promotion on simple pragmatic grounds. First, condom-sex isn’t sustainable in real relationships where there is a desire to procreate. (Childbearing remains important in Africa!) A second factor is pleasure. Said one of the many people we interviewed: “Sex with a condom is like eating a banana with the peel still on it. I’ve never liked those gadgets.” This is why most of the more than 200 religious leaders we interviewed think that condoms are not a sustainable way for couples to live their lives, navigate their relationships, and fully enjoy sex. With regrets to the Vatican and to its critics, low levels of condom use across Africa have little to do with official church teachings. When it comes to AIDS in contemporary Africa, official positions have taken a back seat to pragmatic ideas about how to avoid infection.

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This pragmatism is evident in messages about alternative prevention strategies—many of which are endorsed by religious leaders. We frequently found religious leaders articulating new ways to navigate risky relationships, especially risky marriages, where one partner (imagine a careless, womanizing husband) is putting the other (stereotypically, a woman) at risk. In Malawi, we have documented a liberalization of attitudes toward divorce that, importantly, is specific to AIDS. Female-initiated divorce is not just tolerated under these circumstances—it is actively supported. Religious communities have been economically and emotionally supporting women who leave philandering husbands to protect themselves and to reduce the chance of their children being orphaned. New vocabulary for a religiously just divorce has emerged as AIDS has spread. Women have been using these ideas to pressure their husbands to change their ways and to kick out dangerous husbands (“Take your mat and go!” as our colleague Enid Schatz has described it) while leaving their own reputations intact.

Another example is related to religious prohibitions against alcohol consumption. Religious leaders from historically imbibing traditions have begun to preach about abstaining from alcohol, and many from historically teetotaling traditions have intensified their message. They have also begun to police members’ drinking. To Western ears this sounds like an effort to exert quasi-inquisitional religious authority over individuals. But understand the context. Many of us drink in the comfort of our own homes (often accompanied by our loving partners). But consumption of alcohol across Africa tends to be more public and to occur in places that provide opportunities for unsafe sex: Women working at bars and bottle shops often double as prostitutes. So the religious leaders we interviewed not only preach against drinking and drunkenness, they also patrol local bars to deter members from wandering down a road that might lead to temptation and compromised decision-making. This is true not only of Christians. At the behest of his female congregants, one of our favorite imams camps out each evening at the trading center to send thirsty male Muslims safely home to their wives before they even have the chance to make a bad choice.

There is a more empirically accurate narrative about religion and AIDS in Africa, and we’ve described it at length in our recent book Religion and AIDS in Africa. There is no ambiguity in the data: Religion has been central to curbing the spread of HIV in local communities across sub-Saharan Africa. Measurable changes and improvements were detectable before PEPFAR and Gates dollars started rolling in. This leaves the puzzle of why this story has remained untold for so long while atypical stories of religious leaders pushing abstinence and burning condoms continue to circulate widely.

Is this just a typical misrepresentation of Africa? That seems a plausible explanation. With some exceptions, journalistic coverage of Africa tends to be flawed, especially when it deals with religion. Favored topics are religious superstitions, leaders’ malfeasance, and poverty-porn featuring witchcraft. Since we can’t get into the heads of Western journalists on the Africa beat or their editors, we make no assumptions about the underlying motives here. But it is 2013, and the West is still in the thrall of the outdated assumption that societies need to jettison old superstitions (religion in particular) in order to modernize. More troubling, Westerners have a hard time seeing anything uniquely African as a positive source of change.

There’s a more general problem, neatly captured in Binyavanga Wainaina’s amusing piece for Granta called “How to Write About Africa.” In the standard narrative, ignorant or aimless Africans passively await guidance and assistance from plucky Westerners who ride in to help—often to intense applause. (Think of Nick Kristof’s regular columns praising earnest American volunteers.) Like Wainaina, we read such stories cautiously and suspiciously. Beyond being mildly offensive, these narratives simply don’t fit the Africa we know—a place, like any other, in which people converse about and respond to AIDS, famine, war, and plain-old daily hardships in contested and complex ways. On the world’s most religious continent, people use religious ideas, language, and organizations to address problems, big and small. This is the source of religion’s positive contribution to the recent improvements in Africa’s AIDS situation. Such stories need to be told.

Jenny Trinitapoli is an assistant professor of sociology, demography, and religious studies at Penn State University. She is a co-author of Religion and AIDS in Africa.

Alexander Weinreb is an associate professor in the department of sociology and a research associate of the Population Research Center at the University of Texas at Austin. He is a author of Religion and AIDS in Africa.  

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