The Spread of AIDS in Developing Countries: A Psycho-Cultural Approach

In developing countries HIV and AIDS are widespread, especially in sub-Saharan Africa. Most authors attribute the spread of the disease to economic and social factors such as poverty, unequal sexual relationships and lack of condoms. This article tries to show that these social factors are not sufficient to explain why people do not modify their risky sexual behavior in societies with infection rates up to 40% but behave in the same way as they did before AIDS was known. An analysis of cognitive structures may help to understand why a disease, transmission of which is easy to avoid by behavior change, could have disseminated so much. One important cause is that people do not recognize HIV/AIDS as a natural and physical phenomenon that can be treated and encountered by cautious and careful behavior. It is seen as a magical power that can only be fought by mystical forces, not by scrupulousness in sexual behavior and relationships. Preoperational modes of thought (Piaget, 2001) can explain this kind of world view and behavior. Keywords: Cognitive development; AIDS; Sexual behavior; Intelligence; Knowledge; Education. 1. Distribution of AIDS and Conventional Explanations Increases of HIV and AIDS among populations of different continents, world regions and countries develop in disparate ways and at disparate levels. The infection rates in highly developed countries such as Europe, Japan, Australia, and in Islamic countries are low, followed in a second row by North and Latin America. The situation in sub-Saharan Africa is worse. 1.1% of the world population are infected. The rate in North Africa and in Europe comes to 0.3%, but in sub-Saharan Africa to 7.4%. Although only 13% of the world's total population lives in sub-Saharan Africa, 65% of all people worldwide infected by HIV and 75% of deaths caused by AIDS can be found there. In the year 2003 37% of the population in Botswana was infected, in Zimbabwe 25%, in South Africa 22%, and in Zambia 16.5% (CIA, 2003; UNAIDS, 2003). After a fast spread of HIV and AIDS in the U.S. and Europe in the eighties it was possible to stop the increase of infection rates, even if the disease is not completely eliminated. Although there are good conditions (high mobility and sexual liberties) for a fast spread of HIV and AIDS in the developed countries, information campaigns have changed attitudes and behavior in a way that the HIV-rate has no chance to grow further. People understood the dangers of unprotected sexual intercourse, especially with partners to whom they were not married or stably connected, and as a consequence they have changed their behavior. A good indicator for the growth of scrupulousness has been the increased use of condoms especially in insecure relationships from the early eighties up to now. Structure-genetic sociology (Oesterdiekhoff 2006, 1997, 2000) attributes the stop of the spread of HIV/AIDS in the industrialized countries beyond a marginal level to the formal-operational cognitive structures of populations: Rational modes of thought enable the modern populations to react to threats like sexually transmitted diseases with cautious and rational behavior. The low infection rates in Islamic countries are due to restricted sexual norms, especially referring to married and unmarried women. The rise of infection rates in Latin America, some parts of Asia and especially in sub-Saharan Africa is usually attributed by most authors to factors such as poverty, social structures, unequal sexual relationships, lack of condoms, ignorance and superstition. The spread of HIV/AIDS in sub-Saharan Africa is sometimes explained by polygamy or even promiscuity, lack of condoms, and fatalism. Very often the people concerned do not want to know about their infection status and do not worry about the dangers of infecting other persons (Jackson, 2002; Grill, 2005; Benn & Weinreich, 2003). 2. Problems of Rational Choice Theory The critical analysis of the explanatory status of these factors must conclude that they are not sufficient to explain the spread of AIDS and rising infection rates. …