Volume 11, Issue 1
Robert J. Thornton. Unimagined Community: Sex, Networks, and AIDS in Uganda and South Africa. London: The Regents of the University of California, 2008.
In the age of increasingly self-congratulatory and highly moralizing international HIV/AIDS interventions such as Bush’s PEPFAR (The President’s Emergency Plan for AIDS Reduction), Robert J. Thornton’s Unimagined Communities offers fresh anthropological insight into the conundrums of AIDS epidemiology. Thornton’s research for this book started with a contradictory observation: why did HIV prevalence fall in Uganda while this poor country’s fertility rate continued to climb, while at the same time, HIV prevalence has risen dramatically in South Africa, one of the continent’s wealthiest countries with the lowest fertility rate? Scientific explanations and behavior change approaches to HIV prevention like ABC (abstinence, be faithful, use condoms) did not satisfy Thornton. So, he set out to explain the contrasting trends in Uganda and South Africa from a different angle: sexual networks. “My principal finding,” Thornton writes, “is that change in HIV prevalence is primarily determined by the difference in the configuration of large-scale sexual networks rather than the cumulative effect of behavior change, a necessary but not sufficient condition” (p. 1).
Thornton achieves his principal finding by contrasting the late twentieth-century histories of the two countries as well as examining social attitudes toward sex, disease, land, mobility, and status that characterize the rise and fall of HIV prevalence in Uganda and South Africa. Because of the secretive nature of sex as a social relationship, the vast networks of people linked by sexual activity remain ‘unimagined communities’ (to contrast with Benedict Anderson’s notion of the nation as an imagined community) in which “…the sexual network is never imagined and never represented by those who do in fact participate in it” (p. xx). Thus sexually-transmitted diseases such as HIV/AIDS can easily flourish. The good news: understanding that sexual networks rather than individual behavior are what drive HIV prevalence can change the course of the AIDS epidemic. The bad news: prevention and treatment programs designed to do so have thus far failed horribly—and possibly contributed to the rapid transmission of the disease—by focusing instead on highly charged moral discourses of individual behavior. Further, Thornton’s explanation AIDS reduction in Uganda intimates that this may have been more an accident of historical events than a result of a conscious effort on the part of the government and the citizenry. He suggests, in fact, that the political instability in Uganda in the 70s and 80s may have contributed to the decline of HIV rates in the early 90s by limiting the scope of sexual networks to highly localized environments. That fact makes Uganda’s success in reversing its HIV prevalence rate much less replicable in places such as South Africa with very different social landscapes.
Still, Thornton’s intriguing theory reminds us, importantly, that AIDS is a complex socially transmitted disease whose spread is reliant on historical and cultural factors as much as epidemiology. In the process, he exposes political motives of various prevention and treatment aid projects that have, at best, contributed only a small part to AIDS relief, while at worst exacerbating the problem. It is thus important that this book comes out at this historical moment. Between the neoconservative Bush era of AIDS intervention and the Pope’s statements on the ineffectiveness of condoms during his 2009 visit to Africa, Thornton’s claims that moralizing solutions have gotten us nowhere in the fight against AIDS only gain more contemporary salience.
The book’s only notable drawback is that it sometimes lacks systematically gathered ethnographic evidence (many of Thornton’s ethnographic examples are anecdotal). Instead, Thornton makes rather sweeping statements about widespread cultural beliefs. More ethnographic evidence could have provided richer detail to illustrate points as it bolstered arguments to help substantiate Thornton’s claims, rather than running the risk of essentializing very diverse attitudes and beliefs. As it stands, however, Unimagined Community provides both reasonable explanations for why HIV reduction programs have failed and practical prevention solutions based on a well developed sexual network theory. Scholars and practitioners would do well to familiarize themselves with Thornton’s anthropological approach to understanding HIV transmission.
Kristen Cheney University of Dayton