spirit and healing in africa - University of the Free State

people make sense of health and illness, particularly with regard to HIV/AIDS. A brief
discussion of the history of HIV/AIDS in Africa, and of the powerful association of HIV/AIDS
with Africa (and vice versa) provides the general backdrop of the HIV/AIDS discourse.
Due to the dominance of the (Western) biomedical system, the exploration of the discourse starts
with the biomedical approach to HIV/AIDS in the African context. A description of the
development of biomedicine in Africa, of which colonial medicine is the most prominent
representative, is followed by an elaboration on some specific biomedical methods in the context
of HIV-spread. The nature of epidemiological constructs of HIV/AIDS in Africa has led to an
emphasis on the behavioral paradigm: the idea that the spread of the virus can be halted mainly
by changing human (sexual) behavior. As will be shown, this focus on behavioral change
resulted in racism and stereotyping. The second part of this chapter moves beyond epidemiology,
following current research trends in the field of HIV/AIDS in the African context. The ‘beyond
epidemiology’ approach aims to reveal the social and religious dimensions of AIDS perceptions.
The importance of the social representations approach is to bring to the fore how a person, based
on their experience as well as with the help of familiar concepts, attributes a certain meaning to
his or her health condition. This means that there has been a paradigm shift within the
HIV/AIDS discourse: biomedical constructs as well as grass roots level constructs constitute a
reservoir that people use to make sense of HIV/AIDS in the African context.
4.1 DISCOURSE ON HIV/AIDS IN AFRICA
The discourse on HIV/AIDS in Africa is vast. A brief look at the history of HIV/AIDS in the
African context reveals an immense array of perspectives on the various aspects of HIV. For
example, the proto-history, origins and stages of awareness of AIDS, the development of
treatment and ARVs, the involvement of international organizations, their projects and their
funding, the responses by African governments, the increasing influence of faith-based and
community projects, the critical reflection on the HIV discourse itself — these are but a few of
the themes that make up the discourse on HIV/AIDS in Africa. The extent of the issues at stake
in combination with the multitude of ideas, models, reports, intervention programs and methods
make it very difficult to maintain a clear overview of the discourse. Moreover, the range of
disciplines (epidemiology, pharmaceutics, healthcare and treatment, psychology, socio-political
development, critical discourse analysis, human rights, media, anthropology, theology and
development studies) that are involved in the HIV/AIDS discourse, increases the
multifariousness within the discourse: contradicting theories and approaches are embraced and
validated within the same discourse.
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