AIDS, Behavior, and Culture: Understanding Evidence-Based Prevention (Key Questions in Anthropology)

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9781598744798: AIDS, Behavior, and Culture: Understanding Evidence-Based Prevention (Key Questions in Anthropology)

AIDS, Behavior, and Culture presents a bold challenge to the prevailing wisdom of “the global AIDS industry” and offers an alternative framework for understanding what works in HIV prevention. Arguing for a behavior-based approach, Green and Ruark make the case that the most effective programs are those that encourage fundamental behavioral changes such as abstinence, delay of sex, faithfulness, and cessation of injection drug use. Successful programs are locally based, low cost, low tech, innovative, and built on existing cultural structures. In contrast, they argue that anthropologists and public health practitioners focus on counseling, testing, condoms, and treatment, and impose their Western values, culture, and political ideologies in an attempt to “liberate” non-Western people from sexual repression and homophobia. This provocative book is essential reading for anyone working in HIV/AIDS prevention, and a stimulating introduction to the key controversies and approaches in global health and medical anthropology for students and general readers.

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About the Author:

Edward C. Green is currently Director of the New Paradigm Fund in Washington DC and an Associate at the Johns Hopkins University.  He was formerly a senior research scientist at the Harvard School of Public Health (2002-2010) and Director of the AIDS Prevention Research Project at the Harvard Center for Population and Development Studies. He is the author of numerous books, edited volumes, and academic articles, including the seminal Rethinking AIDS Prevention: Learning from Successes in Developing Countries (Praeger, 2003). He has also published books and articles about indigenous knowledge and behaviors related to medicine and healing. Ms. Ruark is co-author, with Edward C. Green, of The ABC Approach to Preventing the Sexual Transmission of HIV: Common Questions and Answers (2007), a monograph that is being used by numerous non-governmental organizations and by the United States Agency for International Development.

Review:

"In AIDS, Behavior, and Culture, Green and Ruark present compelling evidence that new and innovative approaches are called for if the HIV pandemic is to be managed. Their anthropological approach gives the reader insight and perspective that conventional wisdom simply does not allow: they propose that interventions should ‘start where the target audiences are, emotionally, spiritually, culturally and physically’ and take into account peoples realities before barging in to their world with a bunch of preconceived ideas and notions about what should be happening. This is a very courageous book that anyone involved in behaviour change needs to read before implementing what they feel is the solution to the problem. I for one wished I had read a book like this before starting my personal journey with HIV 28 years ago, as I would have done many things differently thanks to their insights."

--David Patient, Positive Living, South Africa



AIDS, Behavior, and Culture should be on every Africanist medical anthropology reading list. Edward Green, an anthropologist with long background in field research and an established record of insightful publications on the HIV/AIDS epidemic in Africa, teams up in this book with a rising young epidemiologist to argue convincingly and with fresh research evidence for the importance of behavioral change in coming to grips with the still spreading HIV/AIDS epidemic."
- John M. Janzen, University of Kansas – Lawrence



"AIDS is truly a unique epidemic. AIDS, Behavior, and Culture: Understanding Evidence-Based Prevention is a discussion of HIV prevention in today\'s world, hoping to zero in on what works in stopping the spread of the virus. Authors Edward Green and Allison Ruark hold that behavior is the best avenue for controlling the virus, encouraging wise avoidance of promiscuity, wiser choice of sexual partners, and battling the blight of drugs. With criticism of some other approaches and an analysis of the history of prevention, AIDS, Behavior, and Culture is a fascinating read with many thoughtful ideas on how the Western world can best battle this disease." -The Midwest Book Review



"[Green and Ruark] clearly explain why applying anthropological methods is so crucial to AIDS prevention in sub-Saharan Africa, where expensive Western interventions involving testing, drug treatment, and condom promotion have not worked. The authors carefully correct misinformation; distinguish between the generalized hyperepidemics in southern Africa and concentrated epidemics in at-risk populations (e.g., sex workers) in Southeast Asian countries; and describe successful community programs that have involved local traditional initial sexual experience, reducing incidence of multiple/concurrent sexual partners, and male circumcision have been associated with HIV decline. The book presents and analyzes detailed comparative country data. Summing Up: Essential." -CHOICE

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