Pathogens & Prejudice An exploratory study about the effects of ethnic attitudes on perceptions of HIV/AIDS risk and HIV/AIDS programs in Kenya

Abstract

Ethnic diversity often results in low public service provision. Similarly, ethnic divisions compromise the effectiveness of national HIV/AIDS responses; since HIV/AIDS is a stigmatized disease, ethnic groups often blame each other for the disease rather than take responsibility of the disease. I hypothesized that similar dynamics occur at the individual level. Specifically, I predicted that priming ethnic attitudes in study participants will decrease their sense of HIV risk; decrease their sense of the urgency of HIV/AIDS programs; increase the likelihood that they support a regional, rather than a national approach to HIV; and increase the likelihood that they prefer prevention programs to treatment programs. I conducted a randomized field experiment among nine Kikuyu communities in Nakuru, Kenya, using HIV theater outreaches as a tool to prime ethnic attitudes. Both treatment and control groups viewed a skit in which a young woman who is in dire financial straights is approached by a neighbor who offers her help in return for unprotected sex. Treatment groups were told that the neighbor character comes from the Luo tribe, while control groups did not receive any information about the neighbor’s tribe. I administered individual surveys and held group discussions at each site to determine whether there were any systematic differences between treatment and control groups in the participants’ reactions to the skit and in their opinions about HIV/AIDS risk and HIV/AIDS programs. Statistical analysis of the survey responses showed that no systematic differences surfaced between treatment and control groups. The null results, however, did not necessarily invalidate the initial hypothesis, because the treatment was ineffective. Another study with larger sample size, a priming tool that is more standardizable than theater outreaches, and more permutations of the ethnic affiliations of the participants and the prime would have produced a more definitive conclusion about the hypothesis. Despite null quantitative results, qualitative observations during group discussions provided insights into Kenyans’ perceptions of HIV/AIDS risk and HIV/AIDS programs. For one, stereotypes against the Luo tribe (that they are uneducated, uncircumcised, and sexually hyperactive) are real and affected the participants’ assessment of HIV risk in the outreach skit. Furthermore, audience members from all sites had a tendency to assign blame to HIV-positive persons for being infected with HIV; prefer prevention programs to treatment programs because treatment programs benefit the ‘undeserving’; favor circumcision programs, but have misconceptions about its preventative benefits; and call for more personal forms of HIV education and outreach. In light of these results, the Kenyan government should make an effort to increase awareness about the preventative benefits of HIV treatment and about the partial nature of circumcision’s preventative benefits. The Kenyan government should also focus less on impersonal, entertainment- based media for HIV communication, and utilize more community-based dialogue and personal interaction as avenues for raising HIV awareness.