I begin by developing a critique of the dominant behavior change theories underlying HIV and AIDS interventions, and the way they conceptualize the relationship between the individual and society. The conceptual and methodological tools inherent in CHAT allowed for the creation of the context of sexual activity. Through a historical and current contextualization of sexual activity, CHAT-based analysis of the data enabled an articulation of contradictions and turbulence within the activity system.
Analysis of the relationship between the subject and the object of the activity system revealed the phallocentric investment of identity as an. This dynamic of system activity structures the strength and resistance to change in the interaction. By considering the status of the activity system, this analysis facilitated understanding of the lack of behavior change in response to HIV and AIDS.
2 The third stage of the activity system of sexual activity 157 3 Mechanisms for monitoring and managing sexuality and reproduction 162.
Note
Introduction
22 million of those living with HIV in the world, i.e. 67% of the total, live in sub-Saharan Africa. The following table details the HIV and AIDS epidemic in South Africa in 2007. HIV and AIDS in South Africa in 2007 (UNAIDS/WHO Epidemiological Fact Sheets on HIV and AIDS, 2008 Update) .
Since the start of the epidemic, 25 million people worldwide have died from HIV-related causes. There are biomedical and behavioral drivers (Whiteside, 2008) of the epidemic that increase susceptibility to HIV infection. In the second half of the dissertation I show how CHAT offers a way to...
Through a specific operationalization of the concept of context, activity theory contrasts dramatically with the dominant theories of behavior change and enables a different understanding of the problem of behavior change in the context of HIV and AIDS.
HIV and behaviour change theories
- Individual-centred theories
- Impact of interventions using these theories
- Cognitivist/rationalist focus
- Individualist assumptions
- Dialectical interaction
- The analytic inseparability of the individual and society
- The social nature of action
This conceptualization is evident in the assumption in many of the theories of behavior change that underlies actions. This is evident in the way in which interventions based on these theories target an aspect of the individual's attitude, belief and/or cognition. Thus, agency is related to the individual's access to social, economic, and political resources.
There are also power differences in the interaction related to the relative age of the participants. The inseparability of individual and social levels of analysis has important implications for the nature of action. This perspective is, to a limited degree, evident in some of the theorizing in the HIV and AIDS literature.
However, some major assumptions about functioning and the relationship between the individual and the context have not been adequately addressed.
Cultural Historical Activity Theory
- The relationship between the individual and society
- A focus on activity
- Mediation
- Vygotsky’s theory and ‘behaviour change’
- Levels of activity
- Model of an activity system
- Characteristics of activity systems
Marx's theorization of the activity of work contains a fundamentally dialectical conception of the relationship between people and context. To understand this we need to examine Marx's articulation of the relationship between the 'object' and the 'subject'. The Soviet theorist Evald Ilyenkov's articulation of the relationship between the material and the 'ideal' elaborates this idea.
In other words, it provides the means to understand the origin of human consciousness in the material reality of the world. Through the activity of the artist Michelangelo, a lifeless piece of marble becomes an image of a woman and a man. For example, I come to a different understanding of the concepts that I originally used in the research process of writing this thesis (transforming this object).
The dialectical view of the individual-social relationship has important implications for the focus of an investigation of human action. That should actually be the result of this man's activity. In his presentation of activity levels (see Table 5 below), and building on his example of hunting, Leontiev argues that collective activity is driven by an object-related motive (obtaining food); the middle level of individual (or group action) is driven by a goal (to drive the animal away from us and toward those who will kill it); and the lower level of automated operations is determined by the conditions and instruments of the action at hand (the objective conditions under which the hunt is carried out) (Engeström, 1987).
Therefore, this analysis must be situated in the rules and structures of the social world that organize and constrain activity (Engeström, 1996). The minimal elements of the activity system are subject, object, result, mediating artefacts (tools and signs), rules, community and division of labor (Engeström, 1996). For example, a doctor's authority in the consultation activity may dominate the patient's accounts of her symptoms.
The activity system thus describes the dialectical relationship between the individual and the environment and locates activity in the rules and structures of the social world. In this way, the notion of the activity system helps to reformulate the concept of context, which turns out to be so problematic in the field of HIV and AIDS.
Methodology
- Key principles of qualitative research
- Recovering the notion of activity
- Re-appropriating ‘context’
- The dynamic nature of activity: contradictions and change
- Data collection techniques
- Autonomy and respect for the dignity of persons
- Non-maleficence
- Beneficence
- The first stage of processing the data
- Constructing the activity system(s)
- Analysing the activity system: working with turbulence
In the next section, I outline the broad principles of the interpretive, humanistic and social constructionist. In particular, the activity system of sexual activity was the 'object entity' of the study. What and how is the individual's sexual activity conditioned in this context.
14% of the economically active population who are employed (Census 2001) seek work in mining, industry and domestically, in areas outside the Amathole Basin (for example in East London, Port Elizabeth, Cape Town and Johannesburg) (Chimere- Dan, 1996). Most of the teachers do not live in the area but commute daily to the Amathole Basin. The focus in the data collection process was on the sexual 'biographies' of the participants.
Thorough documentation of the research process is a crucial aspect of ensuring reliability, and this is described in the section below. The focus group discussions took place in the kindergarten building in one of the villages. It would have been better if the research process had been conducted in the language of the participants.
Participants were reminded of the purpose of the study and what would be discussed in the interview. What tools (conceptual and physical) mediated sexual activity in the earlier phases of the activity system.
Historical activity system analysis
- Mechanisms for the regulation of sexuality
- Mechanisms for the regulation of sexual activity
For this first stage of the activity system, I rely on secondary data in the form of A major obstacle in this early form of the activity system was the negative outcome of pregnancy. In this first stage of the activity system, peer socialization structures (as the community component of the activity system) play a critical role in the regulation of sexual activity in youth.
As in the first phase of the activity system, discretion was expected in front of the elderly. In this second phase of the activity, the system causing unplanned pregnancy remained a problematic outcome of the activity. As in the first phase of the activity system, the risk of premarital pregnancy was managed by establishing limited forms of sexual release.
As in the first phase of the activity system, girls were given a special responsibility to ensure that boundaries were respected. These two sets of beliefs generated a tension in the community component of the activity system. In this second phase of the activity system, this established a tension between the legitimate sexuality of adolescents and the prohibition of sexual activity.
In this second phase of the activity system, however, participation in these events was controversial. This was not mentioned in the historical data reflecting the first phase of the activity system. In contrast to the previous phase of the activity system, sexual activity itself becomes regulated, but not reproduction.
This was referred to in a historical account of the first phase of the activity system as creating familiarity with sexual matters (Delius & Glaser, 2002). In this second phase of the activity system, tension begins to emerge regarding the norms of sexual behavior in the community component of the activity system.
The current activity system of sexual activity
- Penalising premarital pregnancy
- The significance of the injectable contraceptive
- Parental regulation of contraceptive use
- Intercrural sex versus penetrative sex
- Social and cultural events linked to peer socialization processes
- Subject-object relationship
- Division of labour
In this third phase of the activity system, it appears that many parents thus observe sexual activity, rather than regulate it. In this phase of the activity system, there are significant changes in the formal mechanisms that monitor, regulate and manage sexual activity. In the second phase of the activity system, the mechanisms for controlling sexuality were virginity testing and the penalization of premarital pregnancy.
In this third phase of the activity system, a slightly reduced form of penalization of premarital pregnancy is still evident. In this phase of the activity system, premarital pregnancy still affects descent, inheritance rights and access to resources. The reaction of the father (who would bear the financial costs of a premarital pregnancy) is punishable.
The most important change in this phase of the activity system is the anchoring of the use of injectable contraceptives. However, the purpose of the activity system in this study is different for male and female subjects. The third phase of the activity system maintains this standard for young men.
This apprehension was also evident in the narratives of the younger participants of this third phase of the activity system. In the second stage of the sexual activity system, in this research context, there is a special dynamic in the interaction between men and women. In the second phase of the activity system, the male role of initiator of the relationship is preserved in the sexual act itself.
21 In age terms, this couple spans both the second and the third phase of the activity system. The gender roles in the initiation of sex continue in the third and current phase of the activity system.
