AIDS and the Community


by Dr Ian Clarke.

Many AIDS programmes involve the community. But even though programmes work in the community, the community may not feel involved in them. There is a huge difference between something that is community located and something that is community controlled

COMMUNITY LOCATED - located in the community but actually controlled by people from outside

COMMUNITY CONTROLLED - most of the ideas and control come from the community

A good way to understand whether there is real community participation is to ask, ‘Will this project continue without outside support?’

In the case of AIDS, community participation is very important. Preventing the spread of AIDS will only happen when people change their behaviour. However, people are all part of their communities. The community affects their behaviour. It is very difficult for one person to change behaviour if the community expects a different kind of behaviour.

Knowledge about AIDS is now fairly easily available – but many communities do not know what to do with this information. They often do not see how their accepted values and lifestyles affect the spread of AIDS. They do not see how the new information can make a difference in their lives. They still do not see how to change their behaviour.

Photo: Mike WebbFirst, encourage the community to learn more about itself. When people begin talking together about AIDS, they begin to look at how AIDS affects them. They begin to understand how their own local values and behaviour affect the AIDS situation. Outsiders need to understand the community’s values – to learn about why certain kinds of behaviour are acceptable. This can only happen if the community talks and outsiders listen. Providing opportunities where people can meet and talk openly is not easy. It requires some understanding of how the community works and the enthusiasm to continue encouraging people to move their discussion forward.

Next, provide the opportunity for community leaders to speak out about AIDS and what is happening in their community. As people have the opportunity to deal with the issues they are facing, they will get away from superficial ‘right’ answers and work out their own responses to the problem. At this point, outsiders may be helpful in supporting them. They will need resources and support to maintain their enthusiasm and develop their ideas.

In many countries the churches have a large role to play in all this. They are part of the local community. They can show an alternative lifestyle and can show love, acceptance and support for AIDS patients. People with AIDS or HIV infection are not ‘bad’. They are not responsible for this epidemic. Because people often feel guilty, they try to hide their condition. The church can show the way of acceptance – AIDS patients will not have to hide if they know there are people to love and support them.

Changing attitudes and priorities within communities takes a long time. When it does happen, it can have a great impact on individuals. When our communities take hold of the AIDS situation themselves and find their own answers, only then will we see the changes in individual behaviour for which we long.

Dr Ian Clarke worked for many years as a CMS missionary in Uganda, setting up Kiwoko Hospital.