Political determinants of variable aetiology resonance: explaining the African AIDS epidemics

Abstract

Notwithstanding the massive social and economic disruptions caused by HIV/AIDS in many sub-Saharan countries, the epidemic does not pose a serious political threat to African governments. Based on an analysis of today's dominant aetiologic framing of HIV/AIDS in sub-Saharan Africa, this paper argues that the behaviour-centred explanatory approach contributes to the political domestication of the epidemic. The behavioural aetiology suffers from a double reductionism: It concentrates on sexual transmission only and, within sexual transmission, it focuses exclusively on the immediate cause of transmission (unprotected sex), omitting that biological co-factors increase populations' vulnerability to infection. By overlooking these non-behaviour-related determinants of sexual HIV transmission, this explanatory approach implicitly blames individual behaviours for the spread of the virus. Conversely, the likely underestimation (if not the outright denial) of iatrogenic HIV transmission exonerates governments and donor agencies. The variable political resonance of different explanatory approaches is not random and the translation of the available bio-medical and epidemiological evidence into prevention measures is politically mediated.