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HIV/AIDS in Guadeloupe (FWI) Popular knowledge. A coherent cultural system Gaëlle BOMBEREAU. OBJECTIVES. Improving pre & postvention Appropriate HIV communication Having a preventive ethic Respect of cultures, values, taboos. BETTER UNDERSTANDING FOR A BETTER RESPONSE. Analyse
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HIV/AIDSin Guadeloupe (FWI)Popular knowledge A coherent cultural system Gaëlle BOMBEREAU
OBJECTIVES Improving pre & postvention Appropriate HIV communication Having a preventive ethic Respect of cultures, values, taboos...
BETTER UNDERSTANDING FOR A BETTER RESPONSE Analyse • Popular knowledge related to Hiv/aids & PLWHA • Social representations • Believes • Values, Etc… Analyse • Cultural, social and symbolic logics • Local risk management
HIV/AIDS IN GUADELOUPE 2003 Population 440 000 PLWHA 2701 AIDS cases 1092 Half of PLWHA discover their statusat AIDS stage
EPIDEMIOLOGY CARIBBEAN PROFILE Transmission • Heterosexual 62% • Unknown26% • MSM7,2 % • IDU & MTCT minor 60% of PLWHA 30-50 years
BEHAVIOUR • No safe sex • Multi-partnership • Frequent STI’s (syphilis, …) • Abortions • Teenager pregnancy • Emergencycontraception
Good knowledge but No safe sex No hiv testing Stigma & discrimination of PLWHA A KAP-GAP
A KAP-G AP Explaining the consequences of acts or the medical gravityof certain behaviors is not enough to support behavioral change
METHODOLOGY A Caribbean socio-anthropology about : Fear, Suspicion, prevention • Body, health, disease, • religion, magic, • family, gender, sexuality • Aids
METHODOLOGY An ethno-methodology • Observation as Guadeloupean residente • interviews semi-structured among physicians, psychologist, social worker, etc.
General populationVS PLWHA METHODOLOGY Survey among • Questionnaires • Semi-structured interviews • Focus group
POPULAR KNOWLEDGE Related to AIDS A illness • Serious • « who kill » • Incurable • Additive
POPULAR KNOWLEDGE Related to AIDS • Visible on the body • An animal, a monster that eat inside the body • Contagious
POPULAR KNOWLEDGE Related to PLWHA Actors • Sexual • Deviants • Homosexual • Sexual vagrants • Sex Worker • Unfaithful women
POPULAR KNOWLEDGE • AIDS Sexual deviance Contagious disease
THE FEAR CREATES A MYTH & THE MYTH CALMS DOWN THE FEAR Myth construction • AIDS is an illness that • « doesn’t touch my sexual activities » • « threat me daily » allows a control about the disease
PLWHA RECEPTION • « AIDS, SEXUAL DEVIANCE » • Integration of guilty • Victim status • Out of any guilty
PLWHA RECEPTION « AIDS, CONTAGIOUS ILLNESS » Need ritual protection, purification • Transmission by contact • Transmission by corporal liquids
RECOMMANDATIONS Improving pre & postvention Appropriate HIV communication : Breaking with diffusion of the « good words » • In learning cultural system before elaborating programs • Having a preventive ethic to appreciate the popular logics
RECOMMANDATIONS Breaking with medical messages Information must popularize No reduction of health messages
RECOMMANDATIONS Breaking the usual AIDS moral reading Sex is licentious All sexual liberty = sexual deviance
RECOMMANDATIONS Breaking the usual AIDS moral reading « sexuality-pleasure » no reproductive sexuality sin divine punishment
RECOMMANDATIONS No safe multi-partnership is the danger not the multi-partnership itself In general, no safe sex is the danger not a form a sexuality
RECOMMANDATIONS Prevention ≠ social or moral reform To make aware of responsibilities ≠ to make feel guilty Prevention = adopting or keeping new behaviors with clear information
. « l’éducation à la santé ne peut être une simple forme de missionnariat traditionnel visant à apporter la bonne nouvelle à des païens » (R.Massé, Cultures et santé publique, 1995)
. Merci Gaëlle BOMBEREAU