Catherine Campbell and James Currey, Letting them die: why HIV/AIDS prevention programmes fail, Oxford. In association with the International African Institute, 2003, 216pp. ISBN 0-85255-868-6; £12.95 pbk. Indiana University Press: Bloomington and Indianapolis. ISBN 0-253-21635-4; $22.95 pbk

✍ Scribed by Melvyn Freeman

• Publisher: John Wiley and Sons
• Year: 2004
• Tongue: English
• Weight: 41 KB
• Volume: 19
• Category: Article
• ISSN: 0749-6753
• DOI: 10.1002/hpm.754

✦ Synopsis

Sub-Saharan Africa is in desperate need of knowledge and experiences that will help reduce the spread of HIV. Catherine Campbell's book 'Letting Them Die: Why HIV/AIDS Prevention Programmes Fail' takes us a significant step forward in the quest of the former-though unfortunately not the latter. The expectation that both enhanced knowledge and the documentation of a successful experience may have been a product of 'Letting them die' is based on the fact that the book is largely about an HIV prevention programme which was initiated with an intention of illustrating an effective intervention and possibly becoming an example of 'best practice'.

Sadly, the programme did not reach its practical goals. That a project with so much going for it in terms of resources, intellect and conception did not succeed in meeting its most important objectives (most notably of decreased rates of sexually transmitted infections in the intervention area) is particularly disheartening as workable solutions are so urgently needed. Moreover, if a programme such as this did not succeed, how are any going to?

On a much more positive note the intellectual learning and the increased theoretical knowledge that we gain from this book more than makes up for the fact that we are denied an example of best practice and the question of 'if not this then what' is at least partially answered in the book. To the extent that much has been learned from the project, the endeavour can largely be regarded as a success rather than a failure.

What was different about the intervention written about in this book from most other HIV prevention programmes was that it moves beyond individualistic and behavioural conceptualizations and models of HIV interventions (which have not been very successful in reversing the AIDS pandemic), to a much more holistic and complex theoretical and practical paradigm. Campbell notes, that despite reasonably good knowledge of HIV/AIDS and its transmission, people still tend to engage in risky behaviours and concludes that 'the forces shaping sexual behaviour and sexual health are far more complex than individual rational decisions based on simple factual knowledge about health risks, and the availability of medical services'. She also notes problems with the purely medical approach aimed at, for example, treating STIs. Her approach was guided theoretically by social psychology