allAfrica.com: Africa: Putting Human Faces on HIV/Aids (Page 1 of 2)

The widely acclaimed book, 28: Stories of Aids in Africa, has been highly praised for humanizing the story of HIV and Aids in Africa for readers around the world. The book tells the stories of 28 people affected by the virus – one for every million of those believed to be living with HIV in sub-Saharan Africa. Stephanie Nolen, author of the book and Africa bureau chief for the Toronto Globe and Mail, told AllAfrica's Cindy Shiner that her goal was to help readers get past the statistics and to put a human face on those 28 million people.

What did you hope to achieve by writing 28?

It's easier to care about this issue when you start to see those affected as individual people and to understand that it is every bit as disturbing to hear the news that you have HIV in a little counselor's office in Malawi as it is in New York or London or Toronto or Sydney.

I was writing for a northern, or developed world audience, trying to get them past the lack of engagement with this issue, which I think sometimes comes either from being paralyzed from the statistics or from thinking, "Well, sure Aids in Africa is bad but it's just one more bad thing in a place full of bad things so it's really not any different." [I wanted] to say actually that all of those [living with HIV] are people with families, people who had dreams and ambitions, people who would be as terrified by this news as you would be.

Have you succeeded in doing this? And if so, how do you measure it?

I have no idea, I think because it's almost impossible to measure. The ultimate goal was a broad change in Western public opinion and I don't know how one would assess that.

The response to the book has been quite gratifying. It's been published in 13 or 14 countries in a number of different languages and I've received lots and lots of mail from readers and really good attendance in places where I've spoken about it, either by myself or with people who were featured in it. So that's heartening because your gut feel when you set out to write a book about HIV in Africa is that no one will read it.

When I started writing the book, and certainly when I started reporting on this issue in Africa full time, there was a complete lack of interested engagement in the North. Over the time… I was covering this issue I saw a lot of things change. By the time I was finished, the GAP had a clothing line for the issue (HIV/Aids). So obviously it was on the radar in the West in a way that it just didn't used to be at all.

I don't really know how I would separate out the impact of 28 from things like the involvement of Bono or the efforts of Bill and Melinda Gates. I think a lot of things happened at once and 28 was a part of that.

Once you began reporting on the pandemic in Africa, did you come to realize that you had misperceptions about HIV/Aids and if so how were they turned around?

I wouldn't say that I had misperceptions that changed particularly. I think maybe I [developed] a deeper understanding of how these issues are incredibly complicated.

To give you an example, I was writing about migrant labor and the role that that's played in transmission of the virus. I was talking to some epidemiologists who had been tracking communities of miners who come from either rural South Africa or the surrounding countries to work in the mines around Johannesburg. The miners are here for a couple of years and then they go back home. And I was writing about how that quite often those men will have sexual partners in the cities where they live – which is not difficult to understand if they're away from home for a couple of years – and then they take the virus back home with them and infect their wives. That's the standard route of transmission that's discussed.

But in talking with these epidemiologists, they said, "Well, actually, when we survey miners we find that half of them are in couples where one partner is infected and the other isn't and half the time it was the women who were infected and not the men." What that says, of course, is that when these men went away, their female partners, their wives, were also choosing to have other partners, again perfectly understandable, [for] people looking for companionship, intimacy, sex, possibly financial support, while their partner was gone for years at a time.

The discussion around how the virus is transmitted is always about men and quite often there's a very loaded discussion of African men and their sexuality – which to some degree has its origins in behavior that has been extremely damaging… Nobody was talking about the fact that there were a lot of women choosing to have partners when their husbands were away and what that meant for the transmission of the virus. And, of course, until you're honest about that and really looking at all the ways the virus is moving you're not going to be able to come up with good strategies to respond.

That's a very long way of saying that I learned that there's a standard way that the African pandemic is discussed and below that is a very, very deep layer of nuance that much more often is glossed over.

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