In the wake of the announcement at the 6th South African Congress and HIV & AIDS, I have been giving more thought to the question of why the prevalence in southern and South Africa has bee rising, rather than stabilizing or falling, as has been expected for some time. In front of Aaron Motsoeledi, the Minister of Health, and members of his department, and an audience of some 4000 ACTIVE HIV/AIDS prevention and treatemnt practitioners, Olive Shisana announced that prevalence was at an all-time high. Knowledge about HIV and how to prevent it was ALSO at an all-time high among the general population, but so was unprotected sex, and so was the number of concurrent partners.
Clearly, there is a large problem here, not just with HIV, but with our theoretical perspectives. We all believe--and so far it seems to be ONLY a belief--that knowledge and education and communication should have an effect on ‘behaviour’. Knowledge, education, & communication here mean what is taught in all the well funded and now nearly pervasive HIV/AIDS education and ‘communication for behaviour change’ interventions. They have not ‘worked’ in South Africa.
‘Behaviour’ here implies ‘sexual behaviour’, that is a set of human activities that are assumed to be ‘biological’, and more or less automatic. In other words, this set of human activities is not called ‘social action’, or ‘recreation’, or anything else that implies value, motive and meaning, but is rather termed ‘behaviour’. In this ‘scientific’ worldview, sex is a behaviour like blinking or walking. Just as we can be taught to turn the walk into dance, with careful instruction, we continue to assume that sexual ‘behaviour’, like walking, can be trained into something like a dance. The dance we try to teach the sexually inclined person is to put on a condom, or not to ‘dance’ at all. It is not surprising that it does not work much of the time. Indeed the question is, if and when it does work, why should it work at all?
The pervasive use of the term ‘behaviour’ (meaning sex and ‘sexual behaviour) means that for biomedicine and science, as well as for the ordinary man with his dick in his hand, sex is nature. It is ’natural’ behaviour. And yet, we wish to change it through communication and education, the very definition of culture.
But let me address one issue out of the many about why this is so difficult, and perhaps not possible at all.
One belief that almost all humans share--scientists, biomedical professionals, the religious, and the ordinary person--is the belief that sex is ‘natural’. They/we seem to believe this despite the fact that we also believe that it can be taught (or must not be taught--implying, of course, for the religious that is can be taught), and that it is ‘acquired by [people] as a member of society’, to use E B Tylor’s famous definition of culture. It is has to be taught, or can be taught, or should not be taught, then it is--by definition--culture, not nature. And yet, one of the most widely held cultural beliefs is that sex is not-culture, that is, it is ‘nature’.
The condom, however, is a form of dress. It is a ‘raincoat’, a ‘sweet wrapper’, ‘an umbrella’, a ‘rubber’, a ‘french letter’. Its use has to be taught. It is not by any stretch of the imagination ‘natural’. Its cultural nature is beyond doubt.
The problem in these terms, then, is how the condom as an item of ‘culture’ is to be integrated into a fact of nature. Can we make the condom ‘natural’ when it is effectively a form of dress (or decoration) that functions as ‘protection’, and whose use has to be taught. Alternatively, can we make sex into culture?
The manifest un-naturalness of the condom makes the first alternative unlikely, and probably impossible. It is never going to skin, and even if it were, putting on one’s own skin is not something that anyone would want to get used to. But can sex be culture?
In fact, it already is. It is the culture of science and of religious beliefs that makes us see sex as ’natural’, that is, as part of nature. Under these conditions, sex and condoms are never going to mix, and the very ‘science’ involves queers the pictures so completely that this combination of nature-culture is unlikely. As we see again and again, empirically, it is rarely observed.
It would be easier, then, to begin to understand sex as culture, to teach it as an ‘art’, that is, AS CULTURE. This involves valuing sex as a form of expression, perhaps not like any other, but at least a form that could be understood as cultural form rather than as ‘fact of nature’.
This re-valueing of sex would make it at least PLAUSIBLE that education and communication might have an effect of sex as social action and as cultural form, rather than sex as neurological reflex with a minimal bit of motor coordination required.
As it stands, condoms are refused by many because they involve getting ‘dressed’ just as one has undressed, and getting cultural in the middle of what (we firmly believe) is all natural.
It will be easier to revalue our belief that sex is ‘natural’ than it will be to make the condom part of nature. We know this because human cultures in many times and places have done precisely this. The Kama Sutra, for instance, and the other ‘Oriental' ars erotica,’ as Michel Foucault noticed (though not crediting his probable sources, as usual, since the insight is hardly original with him), is not equivalent to a ‘scientia sexualis’. But as the the art and graffiti of Pompeii and Herculaneum, and many other Ancient sources show, Foucault was entirely wrong that this was a divide between the East and the West. The Ancient world also had its ‘ars erotica’ as the Song of Songs (Song of Solomon) clearly shows, and which is available to everyone, if not in their bookcase or bedside table, then on the Internet.