After all, it's 2012, we were supposed to have this epidemic licked by now. Why, despite billions of dollars' worth of interventions and three decades of high-profile messaging, does AIDS remain such a pressing problem?This is particularly puzzling in the case of southern Africa, where close to 20 percent of the adult population carries HIV.In Swaziland, where I am from, the figure reaches 42 percent in antenatal clinics. These numbers are shocking in any context, but in light of the massive prevention effort that has been underway since the 1980s they truly boggle the mind. Clearly something isn't working in our battle against AIDS.
The anti-AIDS effort is failing because it fundamentally misperceives the problem. It starts from the assumption that the AIDS burden reflects a culture of sexual promiscuity, moral depravity and basic ignorance among Africans.This is why the primary AIDS programmes - the World Bank, UNAIDS and most NGOs - peddle "awareness" and "behaviour change" as the frontline solutions.Not only does this narrative carry obvious racist undertones, it's also just not true: southern Africans are not ignorant about HIV/AIDS. In fact, stats show that most of them are highly knowledgeable about it, and often know more than their Western counterparts. The problem is that this knowledge doesn't translate into behaviour change. A recent study shows that awareness "changes the behaviour of, at most, one in four people - generally those who are more affluent". In other words, "behaviour change" programmes are failing at a rate of 3 to 1.
