TOP DOWN AND BOTTOM-UP PERSPECTIVES ON HIV/AIDS: COORDINATING THE PREVENTIVE LINKAGE: LESSONS FROM THE AJEGUNLE COMMUNITY OF LAGOS STATE NIGERIA
Abstract
HIV/AIDS prevention study of 2005 in Ajegunle discovered ‘talking past each other’ both on the part of the NGOs and the people living with HIV/AIDS in the community. After a decade, the narratives changed to ’talking to each other’, which suggests a new preventive approach which has helped to curtail the infection and disunity within the families and the community at large. This research compares the official discourses on HIV/AIDS and those, which came from people and families in Ajegunle, Lagos, a deprived area of 1.8 million people made up of low-income families and rural migrants. The perspectives of INGOs, politicians, and government aid agencies along with local NGO’s are contrasted with those of a range of stakeholders from Ajegunle- (sex workers, women in antenatal clinic, husbands of pregnant women in the hospital, doctors and nurses, clients of sex workers [young men of the street and truck drivers, etc]). Generally, the study indicated that effective preventive action is no longer severely inhibited unlike in the past where people talk past each other because of the disease. From a community development perspective it is argued that the distinctive features of the pandemic in Nigeria and its association with poverty and deprivation require that the felt needs and views of those on the “bottom of the heap” need to become the focus of an empowering “bottom-up” approach to HIV/AIDS prevention if it is to make a greater impact. This suggests that new thinking about multi-sectoral responses with full community participation is required to undertake more effective preventive action. This will require suitable policy response, focused around community capacity building.
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