Sex, morality and AIDS: The perils of moralistic discourses in HIV prevention campaigns among university students

Abstract

In 2003, the United States government released $15 billion through the President's Emergency Fund for AIDS Relief (PEPFAR) to support HIV/AIDS interventions in 15 sub-Saharan African countries. This came as a relief to these countries which were struggling to scale up the provision of anti-retroviral treatment. The allocation of a significant proportion of this fund to abstinence-only and be faithful campaigns generated a huge debate amongst researchers and health practitioners in the region. Many questioned PEPFAR's strategy that, besides ignoring contexts of sexual practice, was also seen to be undermining condom promotion. This article examines the relevance of abstinence-only campaigns amongst university students, based on a PhD study conducted at three universities in KwaZulu-Natal, South Africa. The study analysed responses to ABC, and voluntary counselling and testing campaigns on seven campuses. Questionnaires were administered to a total of 1 400 participants at the three universities selected. In-depth interviews were further conducted with 24 students and three HIV/AIDS programme administrators drawn from across the three universities. The study established that abstinence messages were often interpreted through religious or traditional moral codes, rather than the HIV prevention code. While this interpretation generated a positive response amongst students who subscribed to religious or traditional moral values, it also became a basis for rejection of the abstinence strategy by others. The students’ frames of reference with regard to sex, HIV/AIDS, and the HIV prevention notion of abstinence, were ultimately underpinned by their daily experiences within their social groups. It is, therefore, argued that in the context of group dynamics, the categories of sexual activity/nonactivity exist as a continuum of possibilities, hence the abstinence option should be promoted alongside other options, such as being faithful to one partner and using condoms correctly and consistently, rather than as a fixed option.