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topics like sexual health and HIV and AIDS” (Mutonyi, 2007 p.189). The author concluded that “this is primarily due to cultural constraints that dictate selective presentation of sexual health matters and limited accessibility to information, which prevents holistic HIV and AIDS education” (p. 190).
Researchers have also found that knowledge about HIV and AIDS tends to be gendered. For example, the Cameroon Demographic and Health Survey (CDHS, 2004) found that among 15-29 years old, 27% of females and 35% of males reported accurate HIV knowledge. Similarly, Selikow, Zulu and Cedras (2002) and Zierler and Krieger (1997) indicate that while women at high risk of HIV infection may know that condoms can prevent transmission, they are often restricted from insisting on the use of condoms because of their economic dependence on men. According to them, being at the mercy of men denies women the choice to decide whether or not to have sex, or whether a condom is used or not. Similarly, a quantitative survey by Taylor, Dlamini, Kagoro, Jinabhai, Sathiparsad& De Vries, (2002) who studied 901 secondary school learners in Ugu North in Rural Kwazulu-Natal, South Africa, revealed that although 64.8 per cent of the learners viewed the threat of acquiring HIV and AIDS as discouraging multiple sexual partners, 16.5 per cent indicated that they would want to have more than one partner. In addition, Sathiparsad and Taylor’s (2006) study in rural KwaZulu-Natal in South Africa found that even though teenagers were informed about sexually transmitted infections, including HIV and AIDS, this information did not inspire a positive change concerning sexual behaviour, they still did not engage in safe sexual behaviour.
Key among the factors that continue to influence understandings and discourses about HIV and AIDS is the HIV-related stigma as well as the taboo related to talking about sex and sexuality, particularly between adults and young people. As a result, young people in particular, have found strategies for
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talking about sex and sexuality and about HIV and AIDS, including the use of metaphors and analogies.
2.5.2 HIV and AIDS Metaphors
As argued above, in many communities, messages about sex and sexuality are considered taboo as topics for public dialogue and discussion. Thus, community members, including teachers and learners, tend to use analogies, metaphors and similes to talk about sex and sexuality and to discuss HIV and AIDS. While there might be some benefits in this strategy, as it enables young people to talk about difficult content, some researchers argue that using it for instruction can lead to misconceptions, especially if students do not understand the communicated meaning (Pittman, 1999; Hamilton, 2000;
Nashon, 2004). An area that demonstrates misconceptions of young people about HIV and AIDS is in the metaphors and analogies that they use to talk about the epidemic and their understanding thereof. These metaphors are linked to various experiences, issues and occurrences in young people’s lives as well as to the myths and misconception about HIV and AIDS. For example, Mutonyi’s (2007) study among Grade 11 students in four Ugandan schools found that students expressed their views of HIV and AIDS through analogies including that “HIV and AIDS is a weapon of mass destruction;
AIDS is a terrorist; AIDS is like a polythene bag; and AIDS is a passport to death” (p.196). The study found that in their view of HIV and AIDS as ‘a weapon of mass destruction’, some students suggested HIV and AIDS kills people in large numbers, while others used the analogy because they believed that HIV ‘was man- made’, explaining that if people could produce the anthrax virus, they could also manufacture HIV and AIDS (Mutonyi, 2007). Similarly, when explaining AIDS as ‘a terrorist’, some learners suggested that people never know when a terrorist might strike and therefore, live in fear. In the same study, students also used other metaphors to express their understanding of HIV and AIDS.
These included:
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• “HIV and AIDS is a guardian angel because if you are going to mess, remember HIV and AIDS is watching you”;
• “Remember not to peel the banana before you eat, you will get HIV”;
• “HIV and AIDS is a monster, it has come to rob us of life, making us not enjoy life because we fear AIDS will eat us”, and
• “Girls should remember not to open their ‘bibles’ until they are sure the boys are wearing those ‘glasses’” (Mutonyi, 2007 p.197).
Similarly, Sontag’s (2008) study in the United States found that AIDS has been associated with metaphors. In particular, two very powerful metaphors are often used to discuss the disease. The first is the notion of HIV and AIDS as an enemy (invader) that enters into a country (the body) unannounced to fight (cause pain) the country’s residents (white blood cells that protect the body against diseases). Thus, the body has to protect itself from its enemy (HIV and AIDS). Sontag argued that “society had become more accustomed to fighting ideological wars” (p. 3) and as such, it had become easy to theorize starting/excelling in a war against a disease. Secondly, HIV transmission is linked to pollution. This creates hostility between the general population and the disease carriers who are seen as contaminated. “Because HIV is sexually transmitted and because the groups most at-risk for AIDS in its earliest years were populations seen as engaging in behaviours condemned by society (homosexuality, illegal drug use, sex work), AIDS was seen as a judgment or punishment on the patient” (Sontag, 2008, p. 3).
In Namibia, a study conducted in the Caprivi, the region hardest hit by HIV and AIDS, found that people referred to HIV and AIDS as simbandembande (fish eagle), which takes away small fish from the water. This reflects the belief that HIV and AIDS take away people’s lives and is meant to scare
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and to discourage them from engaging in risky behaviours (Thomas, 2008). For the same reasons, another study conducted among the Ovambo people found that HIV and AIDS was referred to as ekiya (thorn), and Katanga kamufifi (hot ball) (Thomas, 2008). The metaphors are drawn from the socio-cultural world. For example, a thorn and a hot ball represent pain and danger that can be caused by a piercing and hot object in the same way that HIV and AIDS bring pain in individuals and family members as well as society at large. In addition, scholars such as Boers (2003) and Boerger (2005) argue that metaphors can lead to message distortion and hinder effective communication between and among communities, especially when they do not share the same understanding, symbols and language used.
The literature suggests that on one hand, the use of metaphors can be helpful in passing messages that the society regards as taboo to be discussed openly. On the other hand, the use of metaphors may distort messages, particularly where the meaning of such metaphors is not shared by the communicators or where communicators come from different socio-cultural backgrounds. This thesis argues that metaphors tend to influence how young people understand and make meaning of HIV and AIDS messages that they receive from curricula interventions within and outside the education system.
2.5.3 Myths and misconceptions about HIV and AIDS
The literature suggests that regardless of the gigantic efforts made to provide HIV and AIDS messages to young people by various social institutions, young people still strongly hold some myths and misconceptions about the epidemic. One area where myths and misconceptions are prominent is in relation to condom use. This idea is often related to perceived trust or mistrust between the two individuals involved in an intimate relationship. For example, one of the early studies by Worth (1989) on resistance to condoms among high risk minority women in New York City found that they resisted
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using condoms because they viewed condoms as unnatural and un pleasurable. Similarly, in a study by Mutonyi (2007) in Uganda, condom use was presumed to be an indication that one is having a promiscuous relationship, mainly outside one’s home or within an external relationship; this presumption had the propensity of creating conflict between partners. In an effort to want to show love and trust and because of one’s fear of being rejected, partners may find themselves taking the risk of unsafe sex. This is evident in various studies (see for example Greig et al, 2010; Halpern et al, 2010; Malta et al, 2011; Brêtas et al 2011 and Marques et al, 2012) which found that in a new sexual relationship young people usually use condoms during sexual intercourse. However, as the relationship progresses, they believe that they are not at risk and start engaging in unprotected sex.
They believe that being in a long-term relationship means that they can trust each other.
In addition, the perceived poor architecture or quality of the condom has led to misconception about condom use and safer sexual practices. For example, Mulwo’s (2009) study among students at three universities in South Africa found that while government supplied free condoms to universities, a quarter of the students were found to have not used condoms at the last sex because of their perceptions that the government-distributed free condoms of poor quality and that they are ‘unsafe’
in comparison to brands that could be purchased. Kempner (2014), writing in the context of the US, in a commentary titled: “The Much -Maligned Condom: Why We Can’t Be Surprised That Use Is Down Among Teens” explains that HIV and AIDS is surrounded by messages suggesting that condoms are not effective because they break. This misconception can prevent individuals from taking precautions to protect themselves against HIV infection. Such misconceptions might make it difficult for people to engage with and respond to the various contextual factors that impact on their responses to the epidemic.
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A related misconception is that using condoms decreases sexual pleasure (Mutonyi, 2007; Francis, 2012). For example, in Latin America, Camargo et al. (2011) found that adolescents did not use condoms because of their belief that they impair sexual pleasure. Similarly, the study conducted by Mutonyi (2007) in Uganda found that boys felt that condoms reduced sexual pleasure. Boers’ (2003) study among Ugandan students also found that boys were against the use of condoms, arguing that using condom is like eating an unwrapped sweet/candy. These misconceptions suggest that prevention education is either not addressing these misconceptions or is doing so inadequately. Unless addressed, such misconceptions might lead to risky sexual behaviour among young people, and increase the rates of HIV infection among this population.
The literature suggests that the HIV and AIDS information that young people get from varying social institutions, including schools, influence how they understand and respond to interventions. Thus, based on the notion that the ways in which people organise their behaviour towards situations is influenced by the meanings they ascribe to such situations, this study examined how young people in a Lesotho secondary school understand and respond to the HIV and AIDS messages that they receive from the school curriculum.