Media and HIV/AIDS in East and Southern Africa: a Resource Book
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SOUTHERN AFRICA: A resource book © The United Nations Educational, Scientific and Cultural Organization — 2000 This book has been prepared by the Communication Division of UNESCO. Editor: S.T. Kwame Boafo in collaboration with Carlos A. Arnaldo. The authors are responsible for the choice and the presentation of the facts contained in this book and for the opinions expressed therein, which are not necessarily those of UNESCO and do not commit the Organization. The designations employed and the presentation of material throughoutthis publication do not imply the expression of any opinion whatsoeveron the part of UNESCO concerning the legal status of any country,territory, city or area, or ofits authorities or concerning the delimination ofits frontiers or boundaries. Layout & cover design: Eric Loddé Printed by: Panoply TABLE OF CONTENTS PART I. GENERAL REVIEW Introduction S.T) Kwame Boafo and Martin Foreman CHAPTER | ABC of HIV/AIDS 15 Martin Foreman CHAPTER 2 Ethical Guide 25 Martin Foreman CHAPTER 3 Media functions in HIV/AIDS prevention and management 37 Wambui Kiai PART Il. INVESTIGATIVE REPORTING ON CAUSES AND SPREAD OF HIV/AIDS: CASE STUDIES CHAPTER 4 Highly mobile population drives the spread of HIV/AIDSin Kenya 51 Rose Lukalo CHAPTER 5 The impact of migrant populations on the spread of HIV/AIDS in Uganda 63 Charles B. Rwabukwali et al. CHAPTER 6 Migrants with HIV/AIDS: A challenge to the media in Tanzania 70 Mkasafari Mlay CHAPTER 7 The impact of negative cultural practices on the spread of HIV/AIDS in Zambia 75 Parkie Mbozi CHAPTER 8 In Namibia AIDSis stalking the active at work whoare also the active in bed 83 Rukee Tjingaete PARTIll. CONTENT ANALYSES OF MEDIA COVERAGE OF HIV/AIDS CHAPTER 9 Mass media and the AIDS pandemic in Kenya, 1997-98: A moral panic perspective 91 Lewis Odhiambo CHAPTER 10 The coverage of HIV/AIDS in Ugandan media: A content analysis study 109 Nassanga Goretti Linda CHAPTER 11 The Zambian newspapers and AIDS 121 Francis P. Kasoma CHAPTER 12 The coverage of HIV/AIDS in Namibian media: A content analysis study 133 Kingo J. Mchombu | PART GENERAL REVIEW INTRODUCTION S.T. Kwame Boafo, Martin Foreman, Sector of Communication, Panos Institute, Information and Informatics, London, England UNESCO, Paris, France The HIV/AIDS epidemic — the epidemic of often confused response to AIDS, sometimes Acquired Immune Deficiency Syndrome that spreading fear and hostility, sometimes pro- results from infection with Human Immunodefi- viding cool and accurate analysis. All too ciency Virus — is perhaps the worstcrisis facing often the media have reported uncritically the Africa today. Within the last twenty years this statements of governments, non-governmental fatal disease has spread to every country on the organisations and individuals. This can globe. By the end of 1998 it had taken the lives change. At the start of a new millenium,there of almost 14 million people. A further 33 mil- is an opportunity and a need for all the media lion were living with the virus, 22 million of to provide the leadership that will encourage whom were in Africa. the public and the leaders of our communities More than any other disease, HIV/AIDSis to take positive steps to overcomethis disease. as much a social as a medical problem. Primar- These steps will differ from country to ily transmitted through one of the commonest country. There are many Africans, from farm- human activities, sexual intercourse, it brings ers on the banks of the Nile to miners in the protracted illness and early death to men and Copperbelt of Zambia, from prosperous busi- women in the prime of their lives, kills new- nesswomen to homeless and impoverished born children and leaves their older brothers refugees, from the active youngto the resting and sisters in emotional and physical misery. old. Our cultures, languages, traditions, land- The epidemic feeds on the deep divisions scapes and histories are rich and varied; our within our societies — illiteracy, ignorance, potential without limit. This resource book poverty and inequality between the sexes — and cannot reflect such variety and wealth; it can, deepensthose divisions by making our commu- however, speak to our common humanity, nities poorer. helping us to share our experiences and unite In all but a few countries, the response to our response. HIV/AIDS can be defeated; it AIDShas been inadequate. Millions of men and needs only the commonwill to do so. women whoare fully aware of the threat of HIV are unwilling or unable to protect themselves and HIV: WHAT IT IS, WHAT IT DOES their partners. Community, religious and politi- cal leaders have failed to understand the extent HIV is a virus — an organism too small to be and the complex nature of the epidemic and have seen by the naked eye. Viruses survive by failed to provide the leadership required to pro- entering and reproducing within the living tect their citizens’ lives and livelihoods. Andall cells of larger organisms. HIV belongs to the too often the reaction towards those affected by class knownasretroviruses, whose reproduc- the disease has been fear, hatred and contempt tion is based on RNA(ribonucleic acid) rather instead of the compassion and assistance that than DNA (deoxyribonucleic acid). they and society as a whole require. HIV enters and replicates within a type of Since the beginning of the epidemic, the blood cell called CD4 cells. These normally media have both reflected and moulded the form part of the body's immune system,circu- lating in the blood and attacking disease organ- There is a 25% to 40% chanceof this happen- isms. As it replicates, HIV destroys CD4 cells, ing. That figure is significantly reduced if the reducing the body’s immunity to other diseases. mother takes Zidovudine (AZT — other drugs Eventually these other diseases, known as are also under development for this purpose). opportunistic infections, overcome the body’s About 3% of cases worldwide are the result of resistance andthe patient dies. Although an indi- mother-child transmission; the rate in Africa is vidual whose immune system has been compro- about 8%. mised by HIV is subject to any disease, some HIV can also be transmitted in transfusions opportunistic infections are more common than of blood products if they are not screened others. These include Mycobacterium avium (tested) and through injections of medicinal or complex (MAC), which causes tuberculosis; recreational drugs if the injecting equipmentis Pneumocystis carinii, which causes a severe not sterilized. It can also be transmitted in any form of pneumonia; herpes viruses; toxoplas- other situation where the blood of an individual mosis and a range of bacterial infections. with the virus enters another’s bloodstream. Although tests are available to indicate This occasionally happensin hospital accidents, whether an individual has contracted HIV, they when a syringe with infected blood accidentally are not widespread in many parts of Africa. pricks a nurse, doctor or other patient. It may That means that many people only discover happen during shaving and male or femalecir- they have contracted the virus whentheyfallill cumcision (also known as genital mutilation) if with an opportunistic infection which may not the cutting implementis not sterilized between respond to regular treatment. Others learn the use. It can also be the consequence of a road or fact when a recently born child falls ill. other accident where several people’s blood is Because the virus can be transmitted from spilled. mother to new-born, diagnosis of AIDS in the The virus is not transmitted by mosquitoes, infant confirms that the mother, and probably bed lice or other insects, nor by sharing cooking also the father, is HIV-positive — living with the or eating utensils, nor by physical contact such virus. Depending on the severity of the illness as hugging, kissing or sharing a bed,toilet facil- and on how far advanced the HIV infection is, ities or other aspects of home life. the individual may recover. Inevitably, how- ever, with their immune system weakened, SEX AND RISK without treatment they will fall ill again and eventually die. Even though sex is the commonest means of HIV transmission, it does not occur in every HARD TO CATCH sexual act. A number of factors influence whetheror not the virus will pass from one per- It is not easy to contract HIV. The virus has to son to another andit is impossible to estimate enter the body through the bloodstream andthat the extent of the risk in each individual act of only occurs in clearly defined circumstances. intercourse. All that can be said is that the more The commonestis sexual intercourse, when the often an individual has unprotected (without a virus in seminal fluid enters the bloodstream condom) sex with a partner with HIV, the more through the mucous membraneof the vagina or likely they are to contract the virus. rectum, or when the virus, present in vaginal In general, however, in any act of intercourse fluid or in blood in lesions in the rectum, enters a woman is more liable to contract HIV from a tiny lesions in the penis. Worldwide, about 90% man with the virus than vice versa. This is of cases of transmission occur this way. because the virus is present in greater quantities HIV can also be transmitted from a mother in semen than in vaginal fluid and because the with the virus to her new born child in the epithelium (the layer of cells) of the vagina and womb, during birth or through breast-feeding. cervix appear more subject to minuscule rup- tures than the penis. In the absence of other fac- contract the disease. In fact HIV can be con- tors, such as other sexually transmitted infec- tracted by anyone who has sexual intercourse or tions and howrecently the infected partner con- comes into contact with contaminated blood, tracted the virus, a woman is twice aslikely to and experience has shownthatthe result ofallo- contract HIV during vaginal intercourse than a cating “responsibility” for AIDS is often to lull man.