\u27The AIDS is coming and there is nowhere to run...\u27: Culture, gender, and the politics of Kisongo Maasai women and girls\u27 vulnerability to HIV/AIDS (Immune deficiency, Tanzania)

This thesis outlines the research findings and implications for practice generated from the, “A Gender Issue: Reducing the Vulnerability of Kisongo Maasai Girls to HIV/AIDS” project, which was a participatory action research (PAR) study in collaboration with the Kisongo Maasai in Northern Tanzania. The objectives of the study were to explore the factors that may contribute to girls’ vulnerability to HIV/AIDS, and develop a culturally-specific framework that may contribute to effective design and administration of program and policy-level interventions. The findings of this study illustrate the ‘politics of health’ that determine girls’ vulnerability to HIV/AIDS. It presents a cultural analysis that identifies some of the cultural/ideological values, customs, institutions and the subsequent social order that undermines girls’ social, sexual, economic, and political power. The paper illustrates the relationship between socio-cultural phenomena, unequal power, and girls’ vulnerability to HIV/AIDS. It illustrates socio-cultural phenomena that may potentially facilitate transmission and expose girls to transmission networks, and it highlights girls’ structural vulnerability, impeding their access to essential instrumental factors, such as educational opportunity and activities; social services; health training, information, and services; access to economic resources and activities, and representation and participation in the structures that manage and govern community affairs. Following the cultural analysis, the paper shifts the emphasis from the Maasai community to the political economy that has shaped contemporary cultural phenomena. It briefly explores the impact of extrinsic and external factors, such as colonialism, state expansion and control, the infiltration of market economy, and ‘development’ schema, on the construction and reproduction of Maasai ethnicity. It illustrates the intimate and dynamic relationship between “external factors,” ethnicity, and girls’ vulnerability, and specifically emphasizes the relationship between girls’ vulnerability and the “politics of development.” It proposes an Anti-Oppressive Development model that may facilitate intercultural solidarity and guide the content and process of prevention programs. Lastly, the paper presents a Prevention Program Model that integrates the findings of this research. It attempts to mainstream culture and process into HIV prevention programming, combining technical assistance with self-help/dialogical approaches to facilitate technical capacity, socio-cultural adaption and redistribution of power. The model emphasizes the distinction between technical assistance and other approaches, and suggests that, independent of other approaches, technical assistance will not substantially reduce girls’ vulnerability to HIV/AIDS. In general, the paper reorients attention to the social-determinants of health and the “politics of development.” Too often, HIV prevention programs are characterized by Western assumptions concerning sexual behavior and choices, which assumes that sexual behavior and choices is a personal issue, mediated by cognitive processes and personal attitudes. In contrast, this paper illustrates that girls’ sexual behavior and choices is also a social issue, mediated by socio-cultural, economic and political factors that facilitate their exposure to transmission and impede their access to resources, services and opportunities that are instrumental to reducing vulnerability. In relation to Kisongo Masaai girls’ vulnerability to HIV/AIDS, the personal is political. The “politics of health” of Masaii girls is facilitated by the intra-community power relations that characterize their immediate socio-cultural environment, as well as the intimately related ‘extra-community’ power relations that have characterized development schema and foreign intervention. Reducing girls’ vulnerability will therefore, first and foremost, focus on transforming the “politics of development,” in order to re-empower the Masaai community with the intention of collaboratively administering locally-generated strategies to redress the impact of contemporary socio-cultural, economic, and political influences