UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

“Let’s talk sex scientifically!” : examining sub-Saharan states’ communication strategies in sexual health from AIDS programming in relation to their political leverage and stigmas against HIV’s key populations Lo, Dustin


Background: Different Sub-Saharan States, such as Botswana, Kenya and Malawi, use different policy approaches to mitigate AIDS epidemic, which generate different public receptions towards the government and HIV-prone key populations, aside from trends in HIV prevalence. This research explores factors which can affect people’s subscription to governments’ “scientific”, “evidence-based” paradigms, beyond traditional culture and state’s capacities in service deliveries, and into states’ discourses in their policy articulations and programming. Method: Theoretically guided by Schmidt’s (2008) Discursive Institutionalism and Gauvin’s (2014) “3i model”, an interpretive critical discourse analysis is conducted between Botswana, Kenya and Malawi, in light of their policy documents derived from national HIV Strategies. It takes a “medley” approach to compare state’s problem definition on AIDS, framing on significant ideas, and qualities of policies, particularly in regards to HIV-related interactions: behavioural change interventions and counseling. Studies of the cases of Botswana and Kenya are extended to empowerment and stigma mitigation towards key populations, with references to the legacies of states’ policy discourses, their Key Population Survey, and conceptualizations in “human rights”. Results In early 2010s, the majority of people in Botswana show willingness to comply to state’s behavioural advices and services on HIV, and increasingly, to seek for government’s support in personal matters. The rates are lower in both Kenya and Malawi, despite former’s relatively high adequacy and level of HIV-knowledge than the latter. The state of Botswana “universalizes” dis-courses towards a public health regime, which Malawi attempts but fails; Kenya “privatizes” the matter of health instead. Despite policy efforts to empower key populations in human rights means, stigma against them remain in both Botswana and Kenya, primarily perpetuated by the society (Botswana) or authorities (Kenya). Conclusion Discourses stimulating interactionally equitable interactions in national AIDS’ policy programming, aided by resource adequacy, are necessary to foster “scientific” behavioural change from traditional influences in sexual health, to establish state’s hegemony in national the public health regime. However, legal rights alone, stemmed from state’s attitudinal and policy changes, carries little direct effect to compel against everyday societal stigma against the sexually discriminated people.

Item Media

Item Citations and Data


Attribution 4.0 International