HIV/AIDS in rural Botswana: poverty gender inequality marginalization and stigma

HIV/AIDS in Africa has strong connections to development, poverty and gender inequality. Botswana continues to face one of the highest HIV/AIDS prevalence rates in the world. The common approaches to dealing with HIV prevalence based on medical and behaviour models have not been effective in curtailing this epidemic. Particularly in rural areas, people avoid facing the reality of HIV/AIDS due to fear and stigma. In this project, the linkage between HIV/AIDS and relevant social, economic and cultural factors is explored in rural areas of northern Botswana, where marginalized minority groups, particularly the San, live in extreme poverty. Data were collected through semi-structured interviews and focus group discussions between March and October 2004. The analysis indicates that poverty, gender inequality, traditional beliefs related to illness and healing, marginalization, and stigma interact and create the key barriers to current HIV prevention strategies. Recommendations based on my seven months of fieldwork suggest that HIV/AIDS prevention programmes must address poverty eradication, gender equality, cultural sensitivity, marginalization and stigma reduction at all levels. Economic-social rights and non-mainstream cultures of marginalized people must be respected and incorporated into policy decisions so that the communities gain ownership of prevention strategies against devastating HIV/AIDS problems.--Page ii.