Taking Culture and Context Seriously: Advancing Health Communication Research on HIV/AIDS Prevention in Tanzania with the PEN-3 Cultural Model

Abstract

Although health communication research on the effects of a radio soap opera on HIV/AIDS prevention in Tanzania was groundbreaking, it was conducted from individualistic and Western perspectives that either ignored Tanzania’s cultural context or implicitly conflated it with barriers to health; furthermore, adult HIV/AIDS prevalence rates in Tanzania and other nations of Africa remain the highest in the world. This study of HIV/AIDS prevention in Tanzania drew on the PEN-3 cultural model to foreground the cultural contexts of HIV/AIDS. Interviews with 36 leaders of community-based HIV/AIDS non-governmental organizations in Dar es Salaam pointed to the PEN-3 dimension of ‘nurturers’ (i.e., cultural practices in families and marriages). Through a PEN-3 assessment that crossed this dimension with the ‘cultural empowerment’ domain, the study found the positive nurturers of changing circumcision practices and rites of passage before marriages, the existential nurturers of privacy in the African extended family and grandparents caring for people living with HIV/AIDS, and the negative nurturers of families (e.g., female genital mutilation), marriages (e.g., arranged marriages of young girls), and late-night celebrations. The study concludes with implications for research and practice.

Keywords:

• Culture and health
• HIV/AIDS prevention
• PEN-3 cultural model
• Tanzania

Author note

The author acknowledges his Lord and Savior Jesus Christ and dedicates this article to the memory of his grandmother, (Deaconess) Rebecca Folorunso Olufowote (1918-2014). Correspondence concerning this article should be addressed to James O. Olufowote, PhD. Department of Communication, University of Oklahoma, 610 Elm Ave., Room 227, Norman, Oklahoma 73019. Email: [email protected]

Notes

1 Based on United Nations Programme on HIV/AIDS (2020) estimates: 1 = Eswatini (27.3% adult HIV prevalence rate); 2 = Lesotho (23.6); 3 = South Africa (20.4); 4 = Botswanna (20.3); 5 = Zimbabwe (12.7); 6 = Mozambique (12.6); 7 = Namibia (11.8); 8 = Zambia (11.3); 9 = Malawi (9.2); 10 = Equatorial Guinea (7.1); 11 = Uganda (5.7); 12 = Kenya (4.7); 13 = Tanzania (4.6); 14 = Gabon (3.8); 15 = Cameroon (3.6); 15 = Central African Republic (3.6)

2 Sample questions included, “How, if at all, is HIV/AIDS a problem in Tanzania,” “Please describe the work your organization does in the area of HIV/AIDS,” “How does Tanzanian culture promote (and prevent) the spread of HIV/AIDS?”

3 The demographics questionnaire contained measurements for variables such as age, education, gender, number of years employed with current NGO, and NGO jurisdiction.

4 By excluding the final step of grounded theory (selective coding; Glaser & Strauss, 1967), the CCM can draw guidance from a pre-existing theory and/or an interrelated set of sensitizing concepts.

5 For instance, a “late-night celebrations” category emerged that blurred the distinction between involvement of extended family members and members of the broader community.