spirit and healing in africa - University of the Free State

location of health) lead unavoidably to an emphasis on human (sexual) behavior. Since the virus
is transmitted through sexual activity, it seems justifiable to include the element of behavior
modification in the attempts to stop or at least reduce the spread of the virus. And this is what
happened in most intervention programs: they were designed according to the behavior paradigm
based on the assumption that change in the (sexual) behavior of the individual will lead to fewer
infections with HIV.
The best-known behavior modification models that have found their way into the African context
are the ABC (Abstinence, Be faithful, use Condoms) programs. Numerous schools, faith-based
and non-governmental organizations, as well as governmental institutions promote the vision of
ABC as the most viable way to reduce the HIV infection rates. Basically all health education
textbooks and curricula are designed on the basis of the risk behavior paradigm, and its main
idea is that prevention is mostly a matter of behavioral change, and that behavior change will be
established by providing access to information and to condoms. In the first decades of the
HIV/AIDS epidemic, the behavior modification approach turned out to be rather effective. The
strategy of arresting the spread of the virus by focusing on AIDS education and on the
distribution of condoms resulted in the creation of a barrier between those who carried the virus
and those who were not (yet) infected, in a relatively short period of time (Stillwaggon
2003:811).
However, the immediate downside of the behavior paradigm and its methods was the fact that
the barrier that was supposed to stop the spread of the virus turned out to be the impetus for
stigmatization and discrimination. Those who were infected or who ran a high risk of being
infected became segregated from those who were not included in the risk target group. Both
biomedical and popular perspectives understood AIDS as an urban disease, with sex workers,
their clients, the military and long distance truckers as the core transmitters of the virus (Schoepf
2004:16). These categories of people were defined as high risk groups on the basis of their
having multiple sex partners. The assumption was that reducing viral transmission was mainly a
matter of concentrating on these high risk groups and on behavior modification. One serious
consequence of this behavior-centered approach turned out to be the stigmatization of the risk
target groups.
Another major complication of the risk behavior paradigm is its focus on Africans’ sexual
behavior. Despite aiming to influence and alter sexual behavior, adherents of the behavior
paradigm have failed to effectively curb the risk sexual behavior of Africans. Liddell et.al.
(2005:692) have indicated that one of the main reasons for this inadequacy is the difficulty of
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