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This book provides an overview of health behaviour intervention
priorities in LMICs. It covers the most important health risks or
problems in LMICs including childhood and maternal under-nutrition,
other diet-related risk factors and physical inactivity, sexual and
reproductive health, addictive substances, road traffic injury and
violence, common mental health risk, parasitic infections and
environmental risks. For all these health risks, health behaviour
interventions are comprehensively described, with application to
LMICs.
The vast majority of non-biomedical research on HIV/AIDS has been
behavioural research, usually by survey methods, counting people's
sex acts, partners, preferences, places, times and reasons for sex,
and assessing levels of risk for HIV infection, revealing the
dominance of seeing sex largely as behaviours. However, the notion
of behaviours denudes sex of all meaning and pleasure. It neglects,
as a result, how meaning and pleasure rely on context, how context
exemplifies culture, and how culture is structured by history and
discourse. When we drive our understanding of the epidemic by
behaviours alone, we fail to comprehend that many of the social
determinants of behaviour lie beyond the conscious apprehension of
immediate acts and volitions, i.e. sexual behaviours are socially
embedded practices. If we fail to understand the determinants of
HIV risk and vulnerability as profoundly social- and by social is
meant relational, contextual, cultural, political, economic,
historical, symbolic and discursive- we fail to understand best how
to intervene. Also, in such behavioural surveys, we are often
concerned more with the sex of the sexual partner than the meaning
of sex without a condom or an understanding of which circumstances
within a sexual economy structure risk as, say, pleasure or
intimacy, or social membership or an act of self-actualisation.
Research undertaken in the mid-1990s among young people in seven
developing countries revealed the importance of changing sexual
meanings, sexual cultures and sexual identities in the patterns of
sexual activity, forms of partnering, and meanings of sexual safety
for young people within rapidly changing cultures.
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