Introduction
The epidemiological processes of HIV/AIDS are quite complex, with the background knowledge and misinformation about its etiology in connection to sex and homosexuals, it makes those people afflicted the by pandemic vulnerable to different labels which are constructed around cultural, religious, medical and social understanding of the disease process. In this essay therefore it will be argued that a uni-dimisional approach to HIV/AIDS, thus the biomedical, is not adequate and misleading as well as costly to the management and understanding of the epidemic and condom usage.
A reflection on the biomedical model is imperative; this essay will seek to understand the biomedical model and what it has to offer to the epidemiological processes and dynamics of the epidemic. This essay again will outline a number of factors that make condom usage in the face of the pandemic a difficult strategy to entrust with successful results and at the same time it will seek the alternative approach and understanding of the disease process and condom usage, thus the social and cultural dimensions of HIV/AIDS and its impact and influences on condom usage. It will be again looked at that an open mindedness and a multi dimensional approach to the epidemic and condom usage will be an imperative alternative to a successful campaign against the epidemic- for condom usage on its own is a phenomena coated with various religious, cultural, medical and social constructs and taboos that need to be deconstructed to understand why in the face of massive condom roll out, with their availability in almost all the convenient places, we still see HIV statistics rising as days unfold.
The biomedical perspective approach to HIV and AIDS and condom use.
At the foremost it is imperative to look at the factors that make a human being, thus cultural, social, biological and psychological. Thus an understanding and study a human being should embrace all these fundamental dimensions. In other words human beings are a multi dimensional representation, constructed from various inputs from the foregone dimensions. In HIV/AIDS epidemiological process however, it is important to appreciate the domination of the biomedical model approach- thus it looks at the Infected person as a victim of the virus and that this person or a partner, may have been part of the at risk group, indulging in unprotected sex with multiple partners and if this person had used a proper condom there could have been no infection- it is thus a linear view of looking at the epidemic and its processes. In the biomedical perspective approach to HIV/AIDS the focus of intervention is on limiting the spread of the virus through indulgence in protected sex, thus by using condoms, sticking to one partner and abstinence; as earlier alluded to the primary focus is on the prevention of exposure to the virus. Thus a continued spread of the disease is blamed on the people’s carelessness and ignorance about condom usage. On this plane therefore, it will be noted that it is a key assumption that with a huge roll out of condoms, freely available and with a massive education campaign both in the media and communities either through groups and other mediums like posters, people will be able to take proactive measures to stay safe by doing the ‘right’ things, using condoms. However it is important to know that “often the simple access to free condom does not translate to consistent use” (Burmudes Riberio D Cruz 2004:145). On this plane we will appreciate that there is educational and information saturation about the dangers of the disease and what unsafe sex would result into- people exactly know the consequences but rather it is the biomedical approach’s limitation that it does not take cognizance of different multi factorial influences in which HIV/AIDS is continuously being manufactured. It is important to appreciate the different power imbalances that are central to different cultural groups, the effects of rampart poverty and the inequality constructed around gender roles and responsibilities- this will be looked at more in the social cultural perspective as an approach to understanding condom usage.
Thus biomedical perspective as a linear model of explaining the viral prevalence is open to creating stigma and labels; because it is also true that to disrupt the circle of HIV life there is need to stop certain habits which continuously manufacture and transmit the disease, thus multiple sex relationships are viewed as fertile grounds for the spread and continuation of the epidemic. This leads to the fallacy that all people with HIV infection are or may have been in multiple sex partnerships. This coupled with social and religious taboos that surround sex makes the affected, vulnerable to labels like immoral and unholy. Thus it is true that this biomedical approach has got equally a negative element to it that makes people shy away from seeking the required help, in that the emphasis on abstinence and condom usage incarcerates otherwise potential social cultural energy and strategies of prevention in the people to being ‘backward’ and ‘traditional’ with no room in the present management of diseases. From this premise then we will appreciate that the focus of the biomedical model to health is that of the disease and damage which needs to be repaired through healing and treatment, it does not take cognizance of the different multi factorial processes that are in play in the human life. In this, health is associated with the absence of the diseases, not peoples coping and social and cultural support systems that capacitate people to live with their ailments and disorders. Thus it is limited and does not encourage generation of enough resources from the communities and individuals. The biomedical model reduces people to unknowledgeable and that there is something pathological in their life processes that needs to be changed and in this it is the role of the medical officer who takes the position of the expert to diagnose and manage the people’s problems- this relegates people to passive participants in their own life processes and equally increases the gap between the service provider and the client. It is this gap that is a source of misinformation. In this we will appreciate that to meet people’s needs adequately there is need for their total involvement and participation in anything that has to do with their lives, for it is equally true that it is the people themselves who know better of the factors that surround their lives. An exploration of the strength and weaknesses of these factors and the broader social context in which these people function is central to a successful service delivery program. It is in this premise important to appreciate that looking at condom usage as a strategy to HV/AIDS management through the lenses of the biomedical perspective can be misleading and costly to human life and it is from this that we will seek to understand the social cultural dimensions strength over the biomedical dimension in their approach to condom usage.
The social cultural dimension as an approach to understanding condom usage.
South Africa as a nation has been manufactured with different multi factorial influences, the apartheid social order created a society that was divided a long racial and ethnic line with white people occupying the highest socioeconomic echelons. In this social order we will appreciate the social and economic imbalances, with black women at the lowest point of the economic ladder. Coupled to this was the system of home lands which split families into two with men working either in the mines or factories in town, this left women to take charge of the families and the responsibility of looking after children. Through thick and thin women had to find income to feed their children. However it will be a fallacy to assume that all women that were away from their husbands managed their lives through selling sex. In this we will however appreciate that the split families encouraged exportation of HIV/AIDS. From the mines men carried money and the possessions they had acquired for their families but it is also true that through this HIV was transmitted from town to rural areas through men’s periodical visits to their spouses.
The increase in urbanization of the South African cities and an increase in mining led to the influx of informal settlements with many females becoming commercial sex workers. Such an environment socializes children to live in a poverty trap through which the survival mechanism for teenage females and their elders to engage in dark corner trade of sex. The vulnerability to HIV/AIDS for this group can not be over emphasized for the choices to engage in protective measures around sex time lie far out of their reach, it is the men that have the power to decide the ‘spices’ of sex, like condoms, ‘he who buys the burger chooses the sauce to go with it’. For the economic side of sex and cultural and socio political circumstances have favored men to be superior to women. Thus men are central to the spread and even a successful prevention program.
On another premise it will be important to appreciate that the South African society is highly patriarchal, in which men are deemed as superior to women. Especially in black communities, a girl child is socialized to be a good and responsible wife, being responsible to men means being submissive and unquestioningly agreeing to men’s needs. Coupled with the lobola and bride wealth concepts women are meant to be possessions of men. This robs women of the power to negotiate for equal opportunity in marriages and at the same time, it does not empower women to lobby for condom usage despite knowing that their husbands may have multiple relationships. In this premise we will appreciate that women are put into awkward position in which they are supposed to be culturally right and at the same time facing a grim reality that they may get infected by the virus due to inability to negotiate for condom usage. It is also true that women’s promiscuity is taken as enough grounds for divorce while the socio cultural factors have constructed men’s promiscuity as non questionable behavior. In the face of all these realities women do not have the power to ask for condom use, for men would get this as mistrust for them.
The socio economic radar of the South African society places women at the bottom of economic development. In the face of HIV and AIDS, this places women in unenviable position, in which due to poverty they have to make sure that they do not disappoint the men who are the benefactors of their socio economic support. This on it own makes women vulnerable to accepting anything that men say for fear of losing the financial support. On this plane it is important to appreciate that women find themselves, pushed to the wall in that the socio economic and cultural dynamics work in favor of men. In line with this, we will equally appreciate the gross inequality challenges that face women in heterosexual relationships with the power tilting towards men due to the gender differences. Men are socialized as superior to women, this often times becomes an entry point for gender based violence and even unfair opportunities and it is imperative to acknowledge that this does not spare bedroom politics in which women have no power over men’s choices which equally entails vulnerability to non condom use in the face of the knowledge that the partner may be having multiple sex partners.
It is at this point equally important to highlight the vulnerability of men to the pandemic due to the different factors that make them opt for ‘flesh to flesh’ in the face of the knowledge about the pandemic and freely available condoms. Flesh to flesh is presumed to guarantee “pleasure and their health” (Campbell, 2003:71). It is true that knowledge on its own does not translate to change, to assume this would be arbitrary for it would be avoiding the different factors that govern the life processes. Masculinity can be deceptive, for a misunderstanding of it entails being tough aggressive and risk taker while this is a weakness which exposes a number of men to the pandemic. “Closely intertwined with this is a notion of masculinity which brings together the concepts of bravely, fearlessness, and persistence” Campbell (2003: 32). Men some times assume that using a condom is not man enough, for a man cannot eat sweets with their wrappers. At the same time men equally believe that using a condom on a beautiful girl is a waste of resources, real sex means a physical contact and this therefore means that using a condom denies one of the physical touch and emotional support, as Campbell (2003: 33) found out “flesh to flesh sexual contact may often come to symbolize a form of emotional intimacy that is lacking in other areas of their lives”.
It is equally important at this point to outline counter challenges to the massive campaign for condom usage; the other sector of the religious sector assumes that the use of a condom is evil and that the only way to remain true to ones religious values is through abstinence and being faithful to each other. For cultural adults, it is a belief that sex is only meant for married couples not for youths, this makes teens be at risk of the pandemic, the fear of having condoms found on them by their parents makes them go for the lesser evil, which is usually flesh on flesh. Condoms for adults are a representation of irresponsibility and promiscuity, thus encouraging youngster to use condoms is like telling them to be promiscuous. This again would be a premise through which it can be argued that the greatest proportion of adults do not use condoms. At the same time, “young men known to be using condoms would be jeered at and belittled by their friends. Many said they had been accused of being stupid after telling peers that they had used a condom” (Campbell and MacPhail, 2003: 125). With illiteracy levels quite high and coupled with the different myths that traditionally surround condoms, makes people more vulnerable. It was a belief in Malawi at the time condoms were popularized as an alternative strategy to prevention of the pandemic, that they were infested with chemicals that could lender the user infertile and that the aim was to reduce the population not prevention of HIV.
Conclusion
In the face of all the outlined factors, it makes it almost impossible to trust that the massive condom roll out will be a successful strategy. On this plane, it is imperative to appreciate that a biomedical perspective as earlier alluded to is not adequate to achieve a successful war with the spread of the virus. Thus a successful strategy will seek to understand the broader social, political economic and cultural factors that perpetuate the spread and prevalence of the pandemic. Thus it is fair then to say that the social cultural perspective empowers us to know the dynamics that surround sex and condom usage. It is with this knowledge that a successful and holistic strategy that empowers the people as active participants in their life course and process that will achieve positive results in the battle to mitigate the pandemic. The social cultural perspective lays bare the economic and cultural power imbalances that are equally key players to the spread of the pandemic, which makes the use of the condom almost nigh. Thus in the face of all the stipulated factors in this essay, it is therefore imperative to argue that a successful prevention strategy should be coupled with community development initiatives that should empower the underprivileged to seek their way out of the poverty trap, for it is with that in mind that communities would be created that are economically and cultural permissive to the integral development of human life. It is imperative at this level to appreciate what (Campbell, 2003: 82) calls the growing assertiveness of women; this is another resource that ought to be taken advantage of by policy makers and the government, through creation of policies that promote inclusion of women as well as eradicating rampart poverty which is central to structural disadvantage experienced by women. It is with this realization that a society can be created that has equal respect for women and the girl child.
The prevention and mitigation of the pandemic therefore needs to be looked at from a multi disciplinary eye- incorporating all central key areas to human life would be a positive step to understand why in the face of the massive condom roll out and a mass education campaign, we still have negative development as regards condom usage. Thus it is with this realization that the biomedical approach coupled with the social cultural perspective, functioning on the same footing and with equal strength, would form a successful partnership in successfully understanding condom usage and alternative measures in the prevention of the pandemic.
References:
Burmudes Riberio D Cruz, C (2004) From policy to practice: the anthropology of condom use in Kauffman, K and Lindauer, D (eds) AIDS and South Africa: the social expression of a pandemic. New York, Palgrave Macmillan.
Campbell, C (2003) Selling sex in the times of AIDS in Letting the die: Campbell, C (2003) Going underground and going after women in Letting the die: How often HIV/AIDS programmes fail. Cape Town. Double Storey.
Campbell, C and MacPhail C (2003) Condoms are good but I hate those things In Letting them die: How HIV/AIDS prevention programmes often fail. Cape Town. Double Storey.
The epidemiological processes of HIV/AIDS are quite complex, with the background knowledge and misinformation about its etiology in connection to sex and homosexuals, it makes those people afflicted the by pandemic vulnerable to different labels which are constructed around cultural, religious, medical and social understanding of the disease process. In this essay therefore it will be argued that a uni-dimisional approach to HIV/AIDS, thus the biomedical, is not adequate and misleading as well as costly to the management and understanding of the epidemic and condom usage.
A reflection on the biomedical model is imperative; this essay will seek to understand the biomedical model and what it has to offer to the epidemiological processes and dynamics of the epidemic. This essay again will outline a number of factors that make condom usage in the face of the pandemic a difficult strategy to entrust with successful results and at the same time it will seek the alternative approach and understanding of the disease process and condom usage, thus the social and cultural dimensions of HIV/AIDS and its impact and influences on condom usage. It will be again looked at that an open mindedness and a multi dimensional approach to the epidemic and condom usage will be an imperative alternative to a successful campaign against the epidemic- for condom usage on its own is a phenomena coated with various religious, cultural, medical and social constructs and taboos that need to be deconstructed to understand why in the face of massive condom roll out, with their availability in almost all the convenient places, we still see HIV statistics rising as days unfold.
The biomedical perspective approach to HIV and AIDS and condom use.
At the foremost it is imperative to look at the factors that make a human being, thus cultural, social, biological and psychological. Thus an understanding and study a human being should embrace all these fundamental dimensions. In other words human beings are a multi dimensional representation, constructed from various inputs from the foregone dimensions. In HIV/AIDS epidemiological process however, it is important to appreciate the domination of the biomedical model approach- thus it looks at the Infected person as a victim of the virus and that this person or a partner, may have been part of the at risk group, indulging in unprotected sex with multiple partners and if this person had used a proper condom there could have been no infection- it is thus a linear view of looking at the epidemic and its processes. In the biomedical perspective approach to HIV/AIDS the focus of intervention is on limiting the spread of the virus through indulgence in protected sex, thus by using condoms, sticking to one partner and abstinence; as earlier alluded to the primary focus is on the prevention of exposure to the virus. Thus a continued spread of the disease is blamed on the people’s carelessness and ignorance about condom usage. On this plane therefore, it will be noted that it is a key assumption that with a huge roll out of condoms, freely available and with a massive education campaign both in the media and communities either through groups and other mediums like posters, people will be able to take proactive measures to stay safe by doing the ‘right’ things, using condoms. However it is important to know that “often the simple access to free condom does not translate to consistent use” (Burmudes Riberio D Cruz 2004:145). On this plane we will appreciate that there is educational and information saturation about the dangers of the disease and what unsafe sex would result into- people exactly know the consequences but rather it is the biomedical approach’s limitation that it does not take cognizance of different multi factorial influences in which HIV/AIDS is continuously being manufactured. It is important to appreciate the different power imbalances that are central to different cultural groups, the effects of rampart poverty and the inequality constructed around gender roles and responsibilities- this will be looked at more in the social cultural perspective as an approach to understanding condom usage.
Thus biomedical perspective as a linear model of explaining the viral prevalence is open to creating stigma and labels; because it is also true that to disrupt the circle of HIV life there is need to stop certain habits which continuously manufacture and transmit the disease, thus multiple sex relationships are viewed as fertile grounds for the spread and continuation of the epidemic. This leads to the fallacy that all people with HIV infection are or may have been in multiple sex partnerships. This coupled with social and religious taboos that surround sex makes the affected, vulnerable to labels like immoral and unholy. Thus it is true that this biomedical approach has got equally a negative element to it that makes people shy away from seeking the required help, in that the emphasis on abstinence and condom usage incarcerates otherwise potential social cultural energy and strategies of prevention in the people to being ‘backward’ and ‘traditional’ with no room in the present management of diseases. From this premise then we will appreciate that the focus of the biomedical model to health is that of the disease and damage which needs to be repaired through healing and treatment, it does not take cognizance of the different multi factorial processes that are in play in the human life. In this, health is associated with the absence of the diseases, not peoples coping and social and cultural support systems that capacitate people to live with their ailments and disorders. Thus it is limited and does not encourage generation of enough resources from the communities and individuals. The biomedical model reduces people to unknowledgeable and that there is something pathological in their life processes that needs to be changed and in this it is the role of the medical officer who takes the position of the expert to diagnose and manage the people’s problems- this relegates people to passive participants in their own life processes and equally increases the gap between the service provider and the client. It is this gap that is a source of misinformation. In this we will appreciate that to meet people’s needs adequately there is need for their total involvement and participation in anything that has to do with their lives, for it is equally true that it is the people themselves who know better of the factors that surround their lives. An exploration of the strength and weaknesses of these factors and the broader social context in which these people function is central to a successful service delivery program. It is in this premise important to appreciate that looking at condom usage as a strategy to HV/AIDS management through the lenses of the biomedical perspective can be misleading and costly to human life and it is from this that we will seek to understand the social cultural dimensions strength over the biomedical dimension in their approach to condom usage.
The social cultural dimension as an approach to understanding condom usage.
South Africa as a nation has been manufactured with different multi factorial influences, the apartheid social order created a society that was divided a long racial and ethnic line with white people occupying the highest socioeconomic echelons. In this social order we will appreciate the social and economic imbalances, with black women at the lowest point of the economic ladder. Coupled to this was the system of home lands which split families into two with men working either in the mines or factories in town, this left women to take charge of the families and the responsibility of looking after children. Through thick and thin women had to find income to feed their children. However it will be a fallacy to assume that all women that were away from their husbands managed their lives through selling sex. In this we will however appreciate that the split families encouraged exportation of HIV/AIDS. From the mines men carried money and the possessions they had acquired for their families but it is also true that through this HIV was transmitted from town to rural areas through men’s periodical visits to their spouses.
The increase in urbanization of the South African cities and an increase in mining led to the influx of informal settlements with many females becoming commercial sex workers. Such an environment socializes children to live in a poverty trap through which the survival mechanism for teenage females and their elders to engage in dark corner trade of sex. The vulnerability to HIV/AIDS for this group can not be over emphasized for the choices to engage in protective measures around sex time lie far out of their reach, it is the men that have the power to decide the ‘spices’ of sex, like condoms, ‘he who buys the burger chooses the sauce to go with it’. For the economic side of sex and cultural and socio political circumstances have favored men to be superior to women. Thus men are central to the spread and even a successful prevention program.
On another premise it will be important to appreciate that the South African society is highly patriarchal, in which men are deemed as superior to women. Especially in black communities, a girl child is socialized to be a good and responsible wife, being responsible to men means being submissive and unquestioningly agreeing to men’s needs. Coupled with the lobola and bride wealth concepts women are meant to be possessions of men. This robs women of the power to negotiate for equal opportunity in marriages and at the same time, it does not empower women to lobby for condom usage despite knowing that their husbands may have multiple relationships. In this premise we will appreciate that women are put into awkward position in which they are supposed to be culturally right and at the same time facing a grim reality that they may get infected by the virus due to inability to negotiate for condom usage. It is also true that women’s promiscuity is taken as enough grounds for divorce while the socio cultural factors have constructed men’s promiscuity as non questionable behavior. In the face of all these realities women do not have the power to ask for condom use, for men would get this as mistrust for them.
The socio economic radar of the South African society places women at the bottom of economic development. In the face of HIV and AIDS, this places women in unenviable position, in which due to poverty they have to make sure that they do not disappoint the men who are the benefactors of their socio economic support. This on it own makes women vulnerable to accepting anything that men say for fear of losing the financial support. On this plane it is important to appreciate that women find themselves, pushed to the wall in that the socio economic and cultural dynamics work in favor of men. In line with this, we will equally appreciate the gross inequality challenges that face women in heterosexual relationships with the power tilting towards men due to the gender differences. Men are socialized as superior to women, this often times becomes an entry point for gender based violence and even unfair opportunities and it is imperative to acknowledge that this does not spare bedroom politics in which women have no power over men’s choices which equally entails vulnerability to non condom use in the face of the knowledge that the partner may be having multiple sex partners.
It is at this point equally important to highlight the vulnerability of men to the pandemic due to the different factors that make them opt for ‘flesh to flesh’ in the face of the knowledge about the pandemic and freely available condoms. Flesh to flesh is presumed to guarantee “pleasure and their health” (Campbell, 2003:71). It is true that knowledge on its own does not translate to change, to assume this would be arbitrary for it would be avoiding the different factors that govern the life processes. Masculinity can be deceptive, for a misunderstanding of it entails being tough aggressive and risk taker while this is a weakness which exposes a number of men to the pandemic. “Closely intertwined with this is a notion of masculinity which brings together the concepts of bravely, fearlessness, and persistence” Campbell (2003: 32). Men some times assume that using a condom is not man enough, for a man cannot eat sweets with their wrappers. At the same time men equally believe that using a condom on a beautiful girl is a waste of resources, real sex means a physical contact and this therefore means that using a condom denies one of the physical touch and emotional support, as Campbell (2003: 33) found out “flesh to flesh sexual contact may often come to symbolize a form of emotional intimacy that is lacking in other areas of their lives”.
It is equally important at this point to outline counter challenges to the massive campaign for condom usage; the other sector of the religious sector assumes that the use of a condom is evil and that the only way to remain true to ones religious values is through abstinence and being faithful to each other. For cultural adults, it is a belief that sex is only meant for married couples not for youths, this makes teens be at risk of the pandemic, the fear of having condoms found on them by their parents makes them go for the lesser evil, which is usually flesh on flesh. Condoms for adults are a representation of irresponsibility and promiscuity, thus encouraging youngster to use condoms is like telling them to be promiscuous. This again would be a premise through which it can be argued that the greatest proportion of adults do not use condoms. At the same time, “young men known to be using condoms would be jeered at and belittled by their friends. Many said they had been accused of being stupid after telling peers that they had used a condom” (Campbell and MacPhail, 2003: 125). With illiteracy levels quite high and coupled with the different myths that traditionally surround condoms, makes people more vulnerable. It was a belief in Malawi at the time condoms were popularized as an alternative strategy to prevention of the pandemic, that they were infested with chemicals that could lender the user infertile and that the aim was to reduce the population not prevention of HIV.
Conclusion
In the face of all the outlined factors, it makes it almost impossible to trust that the massive condom roll out will be a successful strategy. On this plane, it is imperative to appreciate that a biomedical perspective as earlier alluded to is not adequate to achieve a successful war with the spread of the virus. Thus a successful strategy will seek to understand the broader social, political economic and cultural factors that perpetuate the spread and prevalence of the pandemic. Thus it is fair then to say that the social cultural perspective empowers us to know the dynamics that surround sex and condom usage. It is with this knowledge that a successful and holistic strategy that empowers the people as active participants in their life course and process that will achieve positive results in the battle to mitigate the pandemic. The social cultural perspective lays bare the economic and cultural power imbalances that are equally key players to the spread of the pandemic, which makes the use of the condom almost nigh. Thus in the face of all the stipulated factors in this essay, it is therefore imperative to argue that a successful prevention strategy should be coupled with community development initiatives that should empower the underprivileged to seek their way out of the poverty trap, for it is with that in mind that communities would be created that are economically and cultural permissive to the integral development of human life. It is imperative at this level to appreciate what (Campbell, 2003: 82) calls the growing assertiveness of women; this is another resource that ought to be taken advantage of by policy makers and the government, through creation of policies that promote inclusion of women as well as eradicating rampart poverty which is central to structural disadvantage experienced by women. It is with this realization that a society can be created that has equal respect for women and the girl child.
The prevention and mitigation of the pandemic therefore needs to be looked at from a multi disciplinary eye- incorporating all central key areas to human life would be a positive step to understand why in the face of the massive condom roll out and a mass education campaign, we still have negative development as regards condom usage. Thus it is with this realization that the biomedical approach coupled with the social cultural perspective, functioning on the same footing and with equal strength, would form a successful partnership in successfully understanding condom usage and alternative measures in the prevention of the pandemic.
References:
Burmudes Riberio D Cruz, C (2004) From policy to practice: the anthropology of condom use in Kauffman, K and Lindauer, D (eds) AIDS and South Africa: the social expression of a pandemic. New York, Palgrave Macmillan.
Campbell, C (2003) Selling sex in the times of AIDS in Letting the die: Campbell, C (2003) Going underground and going after women in Letting the die: How often HIV/AIDS programmes fail. Cape Town. Double Storey.
Campbell, C and MacPhail C (2003) Condoms are good but I hate those things In Letting them die: How HIV/AIDS prevention programmes often fail. Cape Town. Double Storey.
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