How did the scientific world respond to the HIV/AIDS epidemic?

One of the immediate consequences was a remarkable increase in concern with and funding for research on sexuality. New emphasis was placed on the urgent need for more adequate and current data on the nature of sexual behavior. From the mid- to late 80s until the present time, much of the social science research activity that emerged in response to AIDS focuses on surveys of risk-related sexual behavior and on the knowledge, attitudes and beliefs about sexuality that may be associated with the risk of HIV infection. They tried to collect information about the numbers of sexual partners, the frequency of different sexual practices, previous experience with other sexually transmitted diseases, and all kinds of issues that they believed may be associated with the spread of the HIV infection. The primary goal was to guide prevention and intervention policies designed to reduce behaviors associated with increased risk for HIV infection.

Why was the relative effectiveness of the research instruments and the intervention strategies questioned?

There were difficulties with translating and adapting research protocols for cross-cultural application. There were radically different understandings of sexual expression and practices in different societies and cultures. By the end of the 80s scientists realized that they needed more information on the complex set of social, structural and cultural factors that mediate the structure of risk in every population group. The dynamics of individual psychology was not able to fully explain and influence changes in sexual conduct without considering these broader issues.

How did the approach to HIV/AIDS research change in the 90s ?

Biomedical and epidemiological approaches and the psychological approach to sexuality were dominating the agenda of behavioral research. Until in the early 90s, anthropology started finding alternative approaches to research sexuality and AIDS. At least two major tendencies can be identified.

• A growing consensus on the interpretation of cultural meaning as central to a better understanding of both the sexual transmission of HIV in different social settings and the possibilities that may exist for responding to it through the design of more culturally appropriate prevention programs.

• Increasing concern with the impact of a range of wider structural factors that could be seen as creating vulnerability to HIV infection as well as conditioning the possibilities for sexual risk reduction in specific social contexts.

What does the cultural meaning with regards to the HIV/AIDS research entail?

By the end of the nineties, some broader cultural factors began to be identified as important to really understanding the social dimensions of HIV/AIDS. There was starting to be more attention for the broader set of social representations and cultural meanings that could be shaping or constructing sexual experience in different contexts. This new attention to sexual meaning did not consider isolated individuals, but social persons who are integrated in the context of specific cultural settings. They wanted to find out what the sexual practices mean to the people involved, the significant contexts in which they take place, the social scripting of sexual encounters and the diverse sexual cultures and subcultures that are present or emerging. Especially, emphasis has been given to the cross-cultural diversity that exists in the construction of same-sex interactions.

What is meant with the term “structural violence”?

Since the nineties, research has also started looking at the political and economic factors that played a role in the epidemic, and how they may also have prevented AIDS prevention programs in being effective. This research looks at forms of structural violence, which determine the social vulnerability of both groups and individuals. It looks at the interactive effects of social factors like poverty and economic exploitation, sexual oppression, gender power, racism, and social exclusion.

How does structural violence influence the HIV epidemic?

Structural violence finds itself in political and economic systems and relates itself to economic development, housing, migration and immigration, labor, health, education, and welfare. It creates a structure of possibilities of sexual interactions between people. Think of the ways in which they define the availability of potential sexual partners and practices. These possibilities are defined through the implicit and explicit rules and regulations that are imposed by the sexual cultures of specific communities as well as the economic and political power relations that underpin these sexual cultures. Social and cultural rules place certain limitations on the potential for negotiation in sexual interactions (and thus create possibilities for sexual violence to occur, for the use of contraceptives, sexual negotiation).