Social geography of risk: The role of time, place and antiretroviral therapy in conceptions about the sexual risk of HIV in Kahe, Kilimanjaro, Tanzania

Abstract

The epidemiological pattern of HIV/AIDS in Africa and Tanzania is characterized by geographical variations in HIV prevalence. Despite the geographical variations, heterosexual contact remains the predominant mode of HIV transmission. The article examines the interrelationships of social, spatial and temporal issues in explaining the sexual risk of HIV/AIDS amongst youths in rural Tanzania. Drawing on discussions with young people, the authors employ a comparative approach to establish categories of social practices that explain HIV risk. HIV risk is largely influenced by social interaction as youths engage in routine day-to-day activities in different geographical locales. The availability of antiretroviral treatment ushered in new dynamics in locally available strategies to manage the risk of HIV infection. Gender relations appear to have an underlining influence in determining the timing and place of risk as well as ways of controlling risk. The study participants emphasized both social and biomedical interventions to manage and control sexual activity and risk. Youth-focused and community-wide interventions addressing HIV prevention, care and treatment need to recognize the fact that the HIV epidemic in Tanzania is increasingly becoming a rural phenomenon structured by a wide range of local, national and global processes.

Keywords:

• HIV/AIDS
• risk management
• rural Tanzania
• young people

Acknowledgements

We are grateful to the study participants, school and village authorities and other members of the community in Kahe for their support and participation. Ameria Jackson Baitu and other staff of the Ministry of Lands and Human Settlements Development are thanked for facilitating the preparation of the map of Kahe. The research was in part funded by a grant from the Norwegian Programme for Development, Research and Education (NUFU) and facilitated by the collaborating institutions of the Muhimbili University of Health and Allied Sciences, Kilimanjaro Christian Medical College and Centre for Educational Development in Health, Arusha, in Tanzania, and the Universities of Oslo and Bergen in Norway. Additional financial support was provided through the Centre for Prevention of Global Infections (GLOBINF) at the University of Oslo.