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Social representations of mother-to-child transmission of HIV and its prevention in narratives by young Africans from five countries, 1997–2014: Implications for communication

Author

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  • Winskell, Kate
  • Kus, Landy
  • Sabben, Gaëlle
  • Mbakwem, Benjamin C.
  • Tiéndrébéogo, Georges
  • Singleton, Robyn

Abstract

International recommendations related to the prevention of mother-to-child transmission (PMTCT) of HIV have evolved rapidly over time; recommendations have also varied contextually in line with local constraints and national policies. This study examines how young Africans made sense of mother-to-child transmission (MTCT) and PMTCT and related barriers and facilitators between 1997 and 2014 in the context of these complex and changing recommendations. It uses a distinctive data source: 1343 creative narratives submitted to HIV-themed scriptwriting competitions by young people aged 10–24 from 5 African countries (Senegal, Burkina Faso, Nigeria, Kenya, and Swaziland) between 1997 and 2014. The study triangulates between analysis of quantifiable characteristics of the narratives, thematic qualitative analysis, and narrative-based approaches. MTCT occurs in 8% of the narratives (108), while it is prevented in 5% (65). Narratives differ according to whether they depict MTCT or PMTCT (or, rarely, both), evolve over time, and show cross-national thematic variation. In the aggregate, representations shift in line with increased access to testing and antiretroviral medications, with PMTCT narratives becoming more frequent and MTCT narratives becoming more hopeful as diagnosis becomes the gateway to ART access. However, storylines of intergenerational tragedy in which MTCT is depicted as inevitable persist through 2014. Alongside cross-national differences in theme and tone, narratives from higher prevalence Swaziland and Kenya situate MTCT/PMTCT more centrally within descriptions of life with HIV. Findings illustrate the need to improve communication about PMTCT, reframing negative cultural narratives to reflect the full promise of developments of the past decade and a half.

Suggested Citation

  • Winskell, Kate & Kus, Landy & Sabben, Gaëlle & Mbakwem, Benjamin C. & Tiéndrébéogo, Georges & Singleton, Robyn, 2018. "Social representations of mother-to-child transmission of HIV and its prevention in narratives by young Africans from five countries, 1997–2014: Implications for communication," Social Science & Medicine, Elsevier, vol. 211(C), pages 234-242.
    • Handle: RePEc:eee:socmed:v:211:y:2018:i:c:p:234-242
    DOI: 10.1016/j.socscimed.2018.06.006
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    References listed on IDEAS

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    1. Winskell, Kate & Obyerodhyambo, Oby & Stephenson, Rob, 2011. "Making sense of condoms: Social representations in young people's HIV-related narratives from six African countries," Social Science & Medicine, Elsevier, vol. 72(6), pages 953-961, March.
    2. Våga, Bodil Bø & Moland, Karen Marie & Evjen-Olsen, Bjørg & Blystad, Astrid, 2014. "Reflections on informed choice in resource-poor settings: The case of infant feeding counselling in PMTCT programmes in Tanzania," Social Science & Medicine, Elsevier, vol. 105(C), pages 22-29.
    3. Sema K Sgaier & Radhay S Gupta & Raghuram Rao & Ajay Gaikwad & Sonali Harangule & Suvidha Dhamne & Sateesh Gowda & Sylvia Jayakumar & Banadakoppa M Ramesh, 2012. "Prevention of Parent to Child Transmission (PPTCT) Program Data in India: An Emerging Data Set for Appraising the HIV Epidemic," PLOS ONE, Public Library of Science, vol. 7(11), pages 1-8, November.
    4. Winskell, Kate & Hill, Elizabeth & Obyerodhyambo, Oby, 2011. "Comparing HIV-related symbolic stigma in six African countries: Social representations in young people’s narratives," Social Science & Medicine, Elsevier, vol. 73(8), pages 1257-1265.
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