ABSTRACT

Introduction: HIV prevention as a behaviour in context The research project ‘HIV Prevention as a Behaviour in the Context of Women’s Sexual Relationships’ (Helfferich et al., 1996), commissioned by the German Federal Ministry for Research and Technology, brought two new aspects to the discussion concerning the development of appropriate prevention concepts. The first aspect was a gender-specific perspective in light of the increasing number of women becoming infected with HIV through heterosexual intercourse. (See Marcus, Chapter 3.) The second aspect was the observation that even the most successful campaigns providing information about HIV risk had their limits; the frequency with which higher risk sexual behaviour occurs in spite of partners ‘knowing better’ is a sign of resistance regarding these campaigns and the need to provide new ways of conducting prevention. The questions underlying the study were: what is the function, meaning and usefulness of risk behaviour? In what context is this behaviour so integrated as to be maintained in spite of knowing the inherent danger involved? Some studies have examined the situational context of risk behaviour and the barriers to communication about HIV (Gerhards and Schmidt, 1992; Ahlemeyer, 1993; see also Ahlemeyer, Chapter 10). Although this work has been able to clarify the dynamics of various forms of sexual encounter, it has not identified the circumstances in which rules of interpersonal interaction take on a subjective relevance. The focus of our work can therefore be described as ‘the context of the context’, or in other words, exploring factors which mitigate the effects which the relational context has on HIV risk-taking

This focus on the context of HIV risk in the broadest sense takes into account not only the particular relational situation but also the history of the individuals involved as well as societal influences. The latter refers particularly to the various forms of male and female sexuality as well as gender-related behaviour found in specific groups in society. The resulting patterns of meaning and behaviour define sexual risk in ways which are sanctioned by society.