As a proud member of the ‘High-Five’ club 17 yr. old Pretty* will happily share details of how she came to be part of this exclusive sisterhood. Entry is based on one simple requirement: You need to have five concurrent boyfriends. According to Pretty this is no small achievement. Certain skills such as an ability to juggle different schedules and a greater-than-normal capacity to lie and deceive would seem to be essential. Honing these skills would help a girl to keep several boyfriends happy, and keeping them happy not only involves sex but also making a partner think that he is the girl’s ‘one and only’. Pretty says that not all boyfriends need to think you are faithful to them, especially the older married ones who are usually “more understanding because they already have a life.” It’s the younger ones who apparently have problems with partner infidelity. “Boys my age are so insecure these days,” says Pretty, “that’s why they expect you to love them.”

Pretty is a Grade 11 pupil at an elite Durban private school. Bright, articulate and confident, her knowledge of HIV/AIDS is considerable. When asked how she manages to combine school work with helping around the house, babysitting a young nephew and cavorting with several boyfriends, Pretty describes a whirl-wind life of which only her friends, mostly fellow members of the ‘High-Five’ club, are aware. At half-past two Pretty’s taxi-driver boyfriend fetches her from the schoolyard gate and either spends the rest of the afternoon with her or drops her in town. Once there she window-shops and meets boyfriend Number 2 who works as a security guard at Woolworth’s. She either visits him there or at his flat in town if he’s working another shift. Then taxi-driver boyfriend picks her up to bring her home before 5pm , when her mother returns from work. She tells her mother she studies with friends after school. Boyfriends 3 and 4 are seen mostly on weekends; one is married and the other is an engaged father of three. “We might go to La Lucia Mall, somewhere out of town, to a restaurant or a club, whatever. The one who’s not married has his own room, we sometimes just go there, listen to music, you know.” Boyfriend Number 5 is a fellow high-schooler with plans to go to Tech. Asked if her mother is concerned about her absences and late hours, Pretty claims that her mother doesn’t really care and that she just assumes Pretty is at a friend’s house. In addition Pretty says that her mother believes everything she tells her.

Pretty and her fellow ‘High-Fivers’ could easily be the poster-girls for HIV/AIDS in our country. They put lovely, fresh faces onto our horror statistics. According to the HSRC, of the almost 600,000 South Africans who acquired HIV in 2005, 90% of those in the 15-24 year age group were women. For southern Africa as a whole young women aged 15-24 comprise over 75% of all HIV infections found in that particular age-group. It is not so much the actual number of sexual partners that is increasing their risk for HIV, but the fact that these are concurrent partners who are drawn together in a dense, interconnected sexual network where condom use is rarely more than an occasional feature.

Long suspected to be a primary driver of HIV, research evidence is increasingly revealing exactly how this common pattern of multiple partnering is sustaining high rates of HIV/AIDS in sub-Saharan Africa . Recent studies have pointed to the initial surge in viral loads that make people far more contagious when they are newly infected then they are later during the course of infection. With this being the case, the difference between having several partners over several years as opposed to having several partners over several months is a crucial difference. Where the latter pattern prevails, one would expect to find what scientists describe as “wider and more lethal epidemics with high HIV prevalence across the general population.” The 2005 Nelson Mandela Survey reported that about 40% of young South African men and almost 25% of young women aged 15-24 had more than one current partner. Research tells us that this type of sexual partnering is common throughout the region. While a majority of men and women at any time have only one partner, the proportion of reported multiple partners is substantially higher in Africa than elsewhere. In places like Lesotho , where poverty clearly plays a role in encouraging multiple partnering, the WHO reported that 55% of men and 39% of women had two or more current partners.

To date partner reduction programmes or other approaches that address the ‘B’ element of the ‘ABC’ strategy, have received relatively little attention in most of Africa . This may be because larger social patterns that have long functioned as ways to address inequalities of power and wealth have helped to ‘naturalise’ and legitimise multiple partnering. Moral obligations to support needy kin and patron-client ties are as crucial to African social life today as they have been for centuries passed. Some scholars have argued that sexual ties are woven into this social safety-net and help to explain the transactional element common in most all sexual relationships throughout the sub-continent, whether married or unmarried, long or short term. The polygamous system, in its formal or informal practice, is an expression of this process.

The forces then that push men and women into seeking multiple partners are more complex than most of us care to think. It is not simply a question of men’s nature or women’s poverty, and neither is it just about modern trends towards sexual permissiveness. African men with money and position are expected to help others, and those same social expectations exert their pressure on men’s relationships with women. For women, studies from as far a field as Nigeria, Uganda, Tanzania and Botswana describe forms of transactional sex that enable them to make contacts that allow some to advance in careers, reach high social status, or to invest and become economically independent. Recent studies in eastern and southern Africa show that HIV prevalence increases with wealth, especially for women. Based on these and similar studies conducted in South Africa it seems clear that although poor women will seek multiple partners to feed themselves and their children, others want luxuries that range from lotions to cellphones, or are dissatisfy with their husband’s performance or seeking ‘revenge’ for partner’s infidelity.

Our pet explanation that economic desperation causes HIV/AIDS is woefully inadequate. In this part of the world it has much to do with the gendered interface of the widening gap between rich and poor and the blurred lines between patriarchal privilege and patriarchal duty that makes everyone in society vulnerable to this disease. A better understanding of the forces that collude to undermine efforts aimed at HIV prevention should help us to focus on the need to match our intervention targets against our main epidemic drivers…and multiple concurrent partnerships is a big driver.

On the eve of the 3rd South African AIDS Conference our new National Strategic Plan for HIV/AIDS will be on wide display. We are set to tell the world that we hope to half the number of new HIV infections by 2012. This is a very tall order and one which we haven’t a hope of fulfilling if girls like Pretty and their partners aren’t brought onboard. Their current lifestyle spells disaster not just for them but for their other partners and those partner’s partners, present and future, and all their children. There is a need for a very clear and unequivocal message that multiple concurrent partnering in the context of exceedingly high rates of HIV and unsafe sex is a near-perfect recipe for early death and social destruction. Having spelt it out we can only hope that modern and ambitious ‘High-Fivers’, and all those who aspire to join the club, will actually care. Suzanne Leclerc-Madlala, Mike Saneka and Sabelo Zondo

__________________________________________

The authors are members of the Anthropology Department of the University of KwaZulu-Natal and current recipients of the HIV/AIDS and the Media Project Fellowship run by the Perinatal HIV Research Unit and the Journalism Programme at WITS University . This is the first in a series of five articles on HIV/AIDS. This article was first published in the Sunday Tribune on June 3 2007.

*name changed

Statement by Elizabeth Mataka, United Nations Secretary-General’s Special Envoy for AIDS in Africa on the occasion of Laura Bush, US First Lady’s visit to Zambia, June 28 2007.

We welcome Mrs. Laura Bush, First Lady of the United States of America, to Africa and to Zambia in particular. We are happy that she has found time in her busy schedule to visit Africa and learn of the achievements that have been made through support from the American people through PEPFAR. It is however, imperative that during her visit to Africa, she also learns about the problems we are experiencing and how we think the U.S. support can be more responsive to AIDS in Africa.

PEPFAR set 5 year performance targets in Zambia including support to the prevention of 398,000 HIV infections; provision of ART to 85,000 PLWH and care for 505,000 people affected by AIDS, with 177,000 receiving palliative care and care and support to 328,000 orphans and vulnerable children.

There has been considerable progress in terms of reaching these targets. However, HIV and its related illness’ is increasingly a chronic disease which needs more long term programming rather that project support. It is therefore very disturbing to hear that the U.S. would reduce the target percentage of people living with AIDS who would be supported on treatment with the U.S. Funds. It is equally disturbing that when U.S.

Congress recently attempted to increase U.S. funding for the Global Fund to Fight ADIS, Tuberculosis and Malaria, the White House expressed its opposition to that effort. The Global Fund is saving lives in Zambia, just as PEPFAR is saving lives, therefore, the Global Fund must be given maximum support.

The world pledged to reach universal access to prevention, treatment, care and support; this is therefore not the time for the U.S. to shrink its ambitious treatment scale-up.

Prevention remains a critical component of the response to AIDS. However, prevention strategies need to be programmed in relation to the epidemic in Africa and in accordance with National realities, rather than driven from a formula developed in the U.S. Data collected must determine the most appropriate intervention, for example, there is no evidence to suggest that abstinence programming for young people has produced good results.

What seems to have happened however has been confusion over the messages that are being put out to the communities, for example, the Government in Zambia has been very clear on the ABC message emphasizing all three but with some PEPFAR insists on promoting the abstinence only messages for young people. People are entitled to all available information for informed choices relevant to their particular situation.

An understanding of the drivers of the epidemic in Zambia is currently taking place. It is hoped that this information will guide the development of a national HIV prevention strategy including the strategies and targets which all partners will buy into. Prevention programming also needs to be integrated into existing community based, family oriented care models rather than stand-alone projects which are set-up just for them and have no linkages to the National Prevention Agenda.

Of particular concern is the vulnerability of women and children to infection with HIV. There needs to be a deliberate focus on women and girls within the PEPFAR programming. Although there has been support to institutions working in this area, it has not been affirmative. This means that gender-based budgeting needs to occur within the PEPFAR programme. More support therefore needs to be given to the upstream dialogue on issues that put women and girls at risk – the legal, economic, social and educational issues. Like other partners – UN and bilateral donors supporting the national Gender strategy, implementing this in the PEPFAR programming will go a long way to ensuring that the programming is evidence-informed.

Zambia has developed a Health Sector Human Resource plan, this plan is still yet to materialize into tangible pledges of financial support. It is hoped that US resources will support the plan significantly. Of note, is that the plan is for both public and non-public actors. With an ART programme that provides free services, the numbers of people seeking treatment keep rising. For this year’s COP 2007, PEPFAR has allocated some funds into the national doctor’s retention scheme together with the other bilateral donors, as a trial. It is generally agreed that more could be done in ensuring that a nurses / community health worker retention scheme or similar is supported with many more resources from PEPFAR.

Finally, let me express concern about PEPFAR’s implementation model, PEPFAR should open up to effective local organizations, and work with them instead of favouring external groups that do not increase national capacity to respond to AIDS. PEPFAR needs to invest in strengthening the national capacity to respond to AIDS, I believe this is possible.

Courtesy of safaids media resource desk.

A Health Reporting Conference under the theme “Opening up New Possibilities through Dialogue”, took place from the 10th to the 11th of May in Johannesburg, South Africa. Organised by Wits University and Africa Media Assignments the conference sought to find out the state of health reporting in South Africa. Although the conference was for South African journalists, the issues that came out of it are of importance to all journalists south of the Sahara as the issues are the same across the region.

While there has generally been a lot of improvement in the covering of health issues in the region by both electronic and print media, with almost every newspaper or news bulletin having one health story, especially on HIV and AIDS, per copy or edition, there are still many issues that need to be addressed.

Experts attending the conference, such as the Wits School of Journalism, the Media Monitoring Project and editors of big media houses like IRIN PlusNews, said it was important for the media to continuously work on their reporting skills so that they can become effective communicators.

Below are some of the key questions that all journalists ought to ask themselves:

* Do you rely heavily on copy provided by experts? This includes Government communication, press releases and research findings.
* If so, have you asked yourself what your experts are experts on, and whether their expertise will be of relevance to your writing and to your audience?
* Are you the type that just gets a research paper from an expert and goes to bed with the story?
* Are we as journalists doing our own research?
* Are Internet sources always correct?
* Are you looking for underlying issues and values out of the stories that you come across? For instance, if the story is that the public health sector is crumbling, have you ever looked at why this is so?
* It seems that the private health sector is always good - no queues, and prompt and efficient service – have you ever wondered why?

Don’t you think looking at all these issues would make good reading while at the same time educating and lobbying for change and action in crucial sectors?

* How much attention are you giving to educating your audience in your story?
* Is there any educational content?
* As journalists, it is of crucial importance for us to ask ourselves what we aim to achieve with the stories we cover and the way we cover them - for example that good piece of journalism where one gets someone living with HIV or cancer to open up and speak about his or her life.
* Does it seek to establish how many sexual partners the source had before they realised they were infected? If so, do you seek to educate your readers on the dangers of having too many sexual partners, or do you aim to show that this person, your “source”, deserves to be infected because they have been careless?
* What is the underlying motive of your story?
* Is it to inform, educate or entertain?
* Is it to sensationalise to push up sales or push up sales and inform at the same time?

If, as journalists, we ask those key questions we will come up with better stories

Some fertile ground for news this week includes: looking at the public health sector: what is going on it in your respective country and area? How many resources is your government putting into the health sector? Perhaps the private sector or civil society is supporting the health sector in some way?

Courtesy of www.safaids.org.zw

How journalists should work with scientists in health reporting

RECENTLY I was one of the delegates at a health-care media seminar. It was sponsored by Medscheme and supported by Africa Media Assignments, Perinatal HIV/Aids Research Unit (PHRU) and the Wits HIV/Aids and the Media Project.

What fascinated me about the exchange was the level at which scientists and journalists found it difficult to speak the same language about health issues, particularly HIV/Aids.

Often these two groups were suspicious of each other. Kanyi Ndaki, a health reporter, described it as "mistrust between the scientific community and journalists".

She said journalists found it difficult to deal with people who did not trust and respect them. She, however, accepted that journalists had a problem in understanding science. This resulted in overstating and dumbing-down statistics and figures.

Although there are several health issues that affect us, one that we cannot escape mentioning is HIV/Aids. In retrospect, HIV/Aids in the media has been portrayed as a "killer". Messages on TV, radio, print and other forms of media "scared the audience off".

Rachel Jewekes, director the Medical Research Council’s Gender and Health Unit and one of the panellists in the exchange, observed a situation where the media focused on portraying those infected as innocent victims leading to stigmatisation.

The linking of HIV/Aids to a horrible death has made those infected resist rather than accept their status, she said. This encouraged denial, limiting testing and support for those infected.

Jewekes said that reporting on HIV/Aids had led to the dissemination of harmful myths such as virgin cleansing and rape (the infected believing they would be cured of HIV/Aids if the raped a virgin) including baby rape. This area of reporting (rape) has been uncritical. There is very little educational component in such reporting.

The idea of baby rape, she added, had been repeated several times in the media perpetrating the myth. She urged journalists to take clear responsibility in what they reported.

Increasingly examples of good reporting involved the use of various sources and angles, including educational angles and what she called "social value-based journalism" which presented ways in which people could make real meaning of Aids in their lives.

Problems in reporting often lie in accuracy in statistics and media accuracy. Journalists should have a critical reflection of their sources of information (mainly scientists).

They should be health experts and act as social leaders in HIV/Aids and other health issues. They should challenge attitudes and values through rigorous fact-checking, and searching for underlying issues rather than attention-grabbing parts of a story.

Marietje Myburg, the regional co-ordinator (communication) in the Governance and Aids Programme, talked about "what journalists need to know from science to enable them to tell citizens what they need to know".

This was a situation where journalists hold scientists responsible to give citizens power to know.

They should not simplify what was complicated and not complicate what was simple.

Reporting on science required honesty, she said. Journalists should ask if they were sure about what they wrote.

They should know the extent to which the story accommodated the experience of strangers.

As far as journalism was concerned, this was a tall order indeed. Journalists could try to include all the recommendations discussed above when reporting, particularly on HIV/Aids. But it did not necessary mean that their reporting would lead to behavioural changes.

Dr Soul Johnson, managing director of Health Development Africa, suggested that enforcing certain standards on reporting (by law) and the way advertising presented issues of national importance. However, he added that people’s perceptions of social norms influenced how other people behaved. HIV/Aids, being a complex issue, a simple media intervention or reporting could hardly address such a complexity.

HIV/Aids involved issues of gender relations – perceived societal cultural norms and traditions and how to overcome such issues were beyond the ability of a media intervention. Johnson suggested a solution through ethical standards in reporting by giving a story a human face.

In the case of HIV/Aids, then, it should have some information on how to cope. Journalists can work with scientists in the science of health if they are expected to be active participants in the process - Fredrick Ogenga.

Health journo’s fall short of the mark

Journalists reporting on health matters needed to know their territory to avoid being influenced by power politics and biased scientists, according to a speaker at a recent conference on health reporting.

The HIV AIDS and the Media Project, a partnership between the Wits Journalism department and the Perinatal HIV Research Unit, and Africa Media Assignments hosted the conference last week on Thursday at Hacklebrooke Conference Centre in Craighall Park.

Speakers said health journalists were at a loss when it came to reporting on science and statistics.

Former Rand Daily Mail and Business Day health reporter Pat Sidley said reporters should learn the territory, in order to avoid being influenced by power politics and biased scientists. She said that patients would be able to manage disease better if journalists were more efficient in their communication with the public.

Claire Keeton, the Sunday Times health reporter, said that health journalists had a huge responsibility to put out accurate information regarding health matters.

She described her struggle to make health reporting more attractive, and detailed examples of how the Sunday Times failed to prioritise health reporting. She said that there was a need to interrogate, probe and challenge the government so that health reporting did not occur merely on a superficial level. She encouraged the media to promote more campaigns such as the Sunday Times "Everyone Knows Somebody" endeavour to create more awareness about the HIV pandemic.

Dr Rachel Jewkes, Director of the Gender and Health unit at the Medical Research Council and a regular contributor to the media, said that the form of health reporting in South Africa and the world over had lead to unhealthy reverence for medical experts’ opinions. She said that journalists should be critical and diverse in their reporting, and should avoid sensationalism and rather concentrate on the underlying issues and values. She made mention of how AIDS reporting contributed to stigma in the initial phase of the epidemic. She said that the role of health journalists should be to put health on the agenda of the public.

It was agreed that health reporters should reflect on social justice values and should be trained in health politics and economics. They should hold the government and the medical profession accountable to the patient.

Speakers at the conference included senior Wits ethics and law lecturer Franz Kruger and Wits PhD fellow Natalie Ridgard - Mohammed Ravat.

AIDS denialism is not a new phenomenon by any means. It has been around since the epidemic began virus popped up in the 1980s. One would think that in the face of the overwhelming scientific evidence, denialists might have quietened down over time, but that is far from the case.

However, denial is not an unusual response to unfortunate circumstances. Freud posits denial as the first reaction in a series of defence mechanisms when confronted with an unpleasant event. HIV/AIDS is particularly difficult to face, and perhaps one could understand the scepticism and denialism surrounding it when it surfaced.

But over 20 years later, there is still a surprisingly considerable faction of AIDS dissidents. The facts about the virus have been unequivocally established, the science has been proven, but many people still deny that it is as harmful as the evidence states.

Two books which show just how damaging AIDS denialism can be have recently featured significantly in the media. Christopher Hope and Liz McGregor, two prominent South African writers, have recently been embroiled in a debacle over a case of suspected plagiarism. Hope’s novel, My Mother’s Lovers, has some striking similarities to McGregor’s novel, Khabzela: The Life and Times of a South African, which was published prior to the release of Hope’s.

While the similarities might be more than coincidentally striking, one has to remember that, particularly in South Africa and particularly around the time both novels are set, there was a great deal of coverage of AIDS denialism in the media. A simple Google search on “AIDS denialists” and “garlic” yields information and individuals that are present in both novels.

The story received coverage on the second page of the Mail&Guardian in the June 1-7 issue, as well as a significant amount of publicity across a range of media broadcasts and publications. Granted, their works both share some uncanny parallels, but they are both representations of actual events. McGregor’s is a biography of former YFM DJ Khabzela in the time preceding his HIV-related death. Hope never actually refers to Khabzela, but his character shares an astonishing likeness to him, as would many other HIV positive people in the time the books are both set (the height of denialist credibility).

The controversy over the plagiarism scandal seems to have overshadowed the real story – and the reason the two authors wrote their books in the first place. Both Hope and McGregor intended to expose the faulty logic of AIDS denialists and debunk their following and movement.

What is disturbing is that it looks like the story of Khabzela, the inspiration behind the two hugely successful texts, has been forgotten. While the (somewhat petty) Hope-McGregor fiasco makes page two, the HIV/AIDS barometer (a feature in the Mail&Guardian that contains the number of people who have died of AIDS in South Africa up to the present date and which in the past appeared previously on page two), only makes it somewhere into the middle of the paper, and Khabzela’s life and death, like the lives and deaths of so many other people in South Africa who have died of AIDS, is forgotten by a media that only responds to sensationalism - Ricky Hunt.

The media has missed an opportunity to report on and expose working conditions in the public health care sector in their coverage of the large-scale public sector strike.

In their latest newsletter the Treatment Action Campaign draw attention to how the media has focused on the actions of striking workers but have not examined the equally, if not more damaging, responses to the strike by the state.

The newsletter reads: “The media has covered the intimidation and violent disruption of health services by some strikers. Rightly, such actions have been condemned. But there has been almost no coverage of the far more systematic and dangerous disruption of health services by government’s rash actions in response to the strike.”

The media has also failed to engage with the deeper issues that have motivated the strike – particularly among health care workers. Nurses, pharmacists and hospital and clinic support staff play a critical role in the health care system and yet they perform their tasks under extremely difficult working conditions for very little pay.

TAC has lodged a case in the Cape High Court to reinstate dismissed health workers in Khayelitsha. TAC is acting on behalf of patients with chronic illnesses whose lives have been placed at risk due to the dismissals.

According to Mandla Majola, TAC’s Khayelitsha co-ordinator, the dismissals will certainly lead to a human resources crisis and will affect “emergency, chronic, child and reproductive health services”.

Journalists have also been blind to how the strike offered a way to get in-depth stories about patient’s experiences into the public domain. While these stories are hardly ever granted space in the news media, the stories of patients such as those TAC is representing in this case are the stories that should have been filling the pages of our papers over the last few weeks.

One of the applicants in the case has an HIV-positive daughter who needs to collect her anti-retroviral drugs. Besides the detrimental effects the disruption in her supply of medication will have on her health, disruptions in the supply of anti-retroviral therapy can lead to the development of drug-resistant HIV. The same applicant has a son who requires medication for TB and similarly, if he does not have access to treatment could develop a drug-resistant strain. The woman also fears that other members of her family could contract TB.

By highlighting a story like this one, journalists can draw attention to how the government’s lack of support for health care workers has devastating effects. At the same time an article about treatment disruption can serve an educative role and can inform people about multi-drug resistant TB and HIV and how this comes about.

In an affidavit in support of TAC’s case, Dr Eric Goemaere director of Medecins Sans Frontieres in Khayelithsa, writes that the dismissals will cause “irreparable harm to thousands of individual patients in Khayelitsha, both adults and children with HIV/AIDS, who may become ill and die as a consequence of inevitable treatment interruptions [that] will limit their constitutional rights to life, dignity and health.”

While the case will certainly make the papers, it remains to be seen whether journalists will rise to the challenge of engaging with the life and death issues the case entails. Reporting the facts is just not enough - Kylie Thomas.

South African comedian David Kau has a column in the June 10 th edition of the new daily newspaper The Times. His article "Double-ply condoms for higher grades" is disturbing – and not just because it isn’t funny.

Kau suggests that a solution for the high numbers of pregnancies among teenage girls in South Africa would be to supply them with double-ply condoms.

A sense of humour is essential in this world we live in - but not at the expense of being responsible.

Double-ply condoms do not exist. It is worrying that Kau suggests (twice) wearing two condoms, a practice counter-productive to even bothering to use a condom in the first place. I’m rather surprised that sort of old myth slipped into print again. The editor obviously didn’t seem to think it was problematic that the article reinforces the crazy idea that wearing two condoms doubles your chances of protection from HIV infection.

In fact, the article really doesn’t seem to have been edited at all. If it has been edited, then that is more worrying still. This kind of misinformation about HIV/AIDS does have serious implications. One can’t assume that everyone reading the paper will know it’s a joke, even if a bad one. Kau’s article raises the question: Are there some things we just shouldn’t joke about? As Pieter Dirk-Uys has shown this isn’t necessarily so. HIV and AIDS prevention messages can be conveyed in humorous ways and this can be a really effective way to reach young people. However, Kau’s article simply reinforces dangerous myths and stereotypes.

The most disturbing aspect about the piece is that all of this is coming from someone who ought to know better, and as a comedian, is without doubt a role model to countless young people out there. If there was one article young South Africans read in the whole newspaper, it was probably this one - Joey Hasson (Joey is a social development consultant and he works at Symba).

Recently there has been a focus on a preaching approach to tackling the spread of HIV/AIDS. There has also been a significant amount of criticism around this approach. The ‘ABC’ campaign has failed to produce any significant results, despite its being foregrounded as the preferred approach to curb the spread of HIV/AIDS. Even the Catholic Church has recently revised its policy on condom use .

A colleague of mine was recently on hold at one of South Africa’s largest cell phone providers, Vodaworld (for an inordinate amount of time), and Shaggy’s “A little bit of [one girl] in my life, a little bit [another girl] on the side, a little bit of [yet another girl] is all I need,” etc, etc, was left on repeat. This started me thinking about the kind of power popular media has to inform how we behave. . Exposure to pop music is inescapable – you hear it on the radio, in shopping malls, when you’re on hold on a customer care line.

Even worse is the negative self-image that is perpetuated for girls. In a popular 50 Cent song, he raps, “Boy my hoes are clean, just like my guns.” Now, the kind of message that sends out is frightening, particularly when it creates expectations of appropriate behaviours and creates a global culture of adolescents trying to emulate their icons.

What I think is most frightening about it is its commonplace advocation of promiscuous sex with multiple partners. Gone are the days when all popular music spoke of nauseatingly sentimental drivel and unrequited love. Now it’s about how many more scantily-clad, ganja-toking, women one thug can cram into his convertible than the other. So many music videos (especially hip-hop ones) border on soft porn.

What is troubling is not only that the message is being proliferated across so many forms of media, it’s that people, especially the youth, buy into it. They are programmed to because the idea is commercially viable – it may be a nothing more than mythical, machismo-driven fantasy, but it looks glamorous, and it is the commercial media’s objective to make it seem tangible.

It is designed to be uncomplicated and catchy, despite its never-failing ubiquity, and it’s marketed as the ever-elusive notion of ‘cool’, thereby pushing the youth towards it. Perhaps the issue is being treated so flippantly because the music is created in the US , where HIV/AIDS isn’t as much of a problem as it is here.

With the HIV/AIDS epidemic as rampant as it is, we cannot afford any more casualties. If we are serious about implementing interventions to curb the spread of the virus, there needs to be a concerted effort to educate, inform and lead people (especially the youth) in a healthier direction.

The President’s Emergency Plan for AIDS Relief (PEPFAR) has allocated 20% of its funding for five years to “HIV prevention activities, of which 33 percent must be spent on abstinence-until-marriage programs,” according to the Center for Global Development .

It is not my intention to tackle the expediency of the “abstinence and faithfulness” campaign at this point. Whether it is doing good, regardless of how much good other interventions (such as primary health care) could be doing, I’d rather not discuss at this point. Whether policy to preach abstinence but not facilitate safe sex is wise, I’ll save for another time.

But one thing is clear: without consolidating our efforts and focusing them more widely across all forms of media, PEPFAR’s programme cannot hope to persuade more youth than gangsta rappers. Maybe if pop icons started advocating safe sex, consciousness would be raised and the rate of infection would drop. You feel me, dog? - Ricky Hunt

Recently there has been a significant amount of debate around the benefits of male circumcision. Its combative role in the struggle against the HIV/AIDS epidemic has been proven by considerable factual evidence .

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Does it make sense for mainstream media outlets to run articles claiming to overturn the overwhelming consensus of scientists and scientific institutions on a scientific issue? When the issue is a matter of life and death, such as whether HIV causes AIDS, or whether condoms reduce the risk of transmitting HIV, is it even ethical to do so?

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