Overview

The vast majority of non-biomedical research on HIV/AIDS has been behavioural research, usually by survey methods, counting people's sex acts, partners, preferences, places, times and reasons for sex, and assessing levels of risk for HIV infection, revealing the dominance of seeing sex largely as behaviours. However, the notion of behaviours denudes sex of all meaning and pleasure. It neglects, as a result, how meaning and pleasure rely on context, how context exemplifies culture, and how culture is structured by history and discourse. When we drive our understanding of the epidemic by behaviours alone, we fail to comprehend that many of the social determinants of behaviour lie beyond the conscious apprehension of immediate acts and volitions, i.e. sexual behaviours are socially embedded practices. If we fail to understand the determinants of HIV risk and vulnerability as profoundly social- and by social is meant relational, contextual, cultural, political, economic, historical, symbolic and discursive- we fail to understand best how to intervene. Also, in such behavioural surveys, we are often concerned more with the sex of the sexual partner than the meaning of sex without a condom or an understanding of which circumstances within a sexual economy structure risk as, say, pleasure or intimacy, or social membership or an act of self-actualisation. Research undertaken in the mid-1990s among young people in seven developing countries revealed the importance of changing sexual meanings, sexual cultures and sexual identities in the patterns of sexual activity, forms of partnering, and meanings of sexual safety for young people within rapidly changing cultures.

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9781594548703

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Karl Peltzer, MA Clin Psych, PhD Research Associate, Department of Research Administration and Development, University of Limpopo, South Africa Supa Pengpid, DrPH, Professor at ASEAN Institute for Health Development, Mahidol University, Thailand

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