The news that four in five Swazi men refuse to be tested for the HIV virus has spread across the world. The Agence France Press (AFP) news agency sent out a report on Friday (30 May 2008) based on the publication of the Swaziland National Demographic and Health survey.
AFP reported, that ‘four out of five men in Swaziland, the nation with the world's highest rate of HIV, would refuse to undertake a test for the AIDS virus, official figures showed on Friday.
‘A total 79.6 percent of those questioned in a survey said they would not be willing to take a test while only a minority (46 percent) said they were prepared to use condoms, the central statistics office said.’
This news prompted a lot of interest in the world’s media and also on blogsites.
One blogsite picked up on the AFP report and linked the HIV testing to condom use and the controversy that has been raging about whether male circumcision helps to prevent HIV infection. It also ties in quite well with the controversy in Swaziland about branding people who are HIV positive.
The blogsite, called Male Circumcision and HIV, a public health weblog says that researchers have taken advantage of African culture to promote circumcision.
This is what it said.
Nothing tells the story of HIV in Africa than the recent headline, Four in five Swazi men reject AIDS testing: survey. One begins to wonder whether the real message behind the HIV epidemic in countries like Swaziland is that culturally these societies are simply ill-equipped to deal with a disease like HIV.
In light of the evident low transmission rates around the world outside of Africa, except in certain subpopulations, one is forced to conclude that there must be something about sub-Saharan Africa that HIV finds exceptionally hospitable. What could it be except culture?
Viewed in this light, it isn’t so hard to see the point of view of people like Daniel Halperin, Robert Bailey, Helen Epstein and even Elizabeth Pisani. All of these commentators (and others) except perhaps Pisani basically say that condoms don’t work in Africa (see PlusNews article Tackling low condom use). Abstinence doesn’t work in Africa. Monogamy doesn’t work in Africa. And even voluntary testing and counseling doesn't work in Africa. And they are right -- to a point.
They go wrong in saying these things don't work anywhere. That position is demonstrably untrue, especially in places like Brazil and Thailand. Halperin and Bailey particularly may be intentionally disingenuous when they publicly seek to discredit all methods other than the one they are selling in light of the ineffectiveness of the traditional approaches. They can only get away with it because there is a grain of truth there that ABC works poorly in some settings compared to the rest of the world. And it's quite notable that their greatest success is where this truth seems most evident.
Apart from the ripple effects of a concerted effort to discredit enduring methods of prevention, perhaps a more disturbing implication of their stance is that people's rights should now take a backseat to prevention efforts. Low or no tolerance for ‘stupid’ behaviour as Pisani puts it, or attempts to discredit traditional methods of prevention that ‘lack evidence’ as Bailey and Halperin are trying to do to their eternal shame, point to a new approach that coerces people into undergoing sexual surgery and encourages the international community to give up on first world approaches to HIV prevention in Africa.
Circumcision may not prevent HIV infection, but its implementation will pave the way for other draconian measures, perhaps including criminalization of infection, monitoring or even registration of the infected, and perhaps eventual restrictions on HIV positive individuals' civil rights.
A new intolerance has arrived on the scene that should rightly frighten Africans. The question remains, will it scare them into changing their ways any more than the spectre of AIDS itself?
See also
SHOCKING LIVES FOR SWAZI WOMEN
SWAZI CIRCUMCISION – MORE FEARS
SWAZI HIV BRANDING ROW GOES ON
First published 5 June 2008
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