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Overview
This volume focuses on the role of language in the construction of knowledge about HIV/AIDS in diverse regions of the world. The collection of studies yields helpful insights about the discursive construction of this knowledge in both formal and informal contexts, while demonstrating how the tools of applied linguistics can be exercised to reveal a deeper understanding of the production and dissemination of this knowledge. The authors use a range of qualitative methodologies to critically explore the role of language and discourse in educational contexts in which various and sometimes competing forms of knowledge about HIV/AIDS are constructed. They draw on various forms of discourse analysis, ethnography, and social semiotics to interpret meaning-making practices in HIV/AIDS education in Australia, Cambodia, Burkina Faso, Hong Kong, India, South Africa, Tanzania, Thailand, and Uganda.
Product Details
| ISBN-13: | 9781847693839 |
|---|---|
| Publisher: | Multilingual Matters Ltd. |
| Publication date: | 12/04/2009 |
| Series: | Critical Language and Literacy Studies , #5 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 280 |
| File size: | 24 MB |
| Note: | This product may take a few minutes to download. |
About the Author
Dr Christina Higgins is an Assistant Professor in the Department of Second Language Studies at the University of Hawaii at Manoa, where she teaches courses in sociolinguistics, discourse analysis, and intercultural communication. Her recent research has focused on communication in NGO-sponsored HIV/AIDS prevention and awareness education in Tanzania, where she has investigated the discursive construction of local and global worldviews. In her book, English as a local language: Post-colonial identities and multilingual practices (Multilingual Matters), she has also explored the role of language and popular culture in HIV/AIDS awareness efforts in hip hop lyrics and in public health advertisements. Her website can be found at http://www2.hawaii.edu/~cmhiggin.
Dr Bonny Norton is Professor and Distinguished University Scholar in the Department of Language and Literacy Education, University of British Columbia, Canada. Her award-winning research addresses identity and language learning, education and international development, and critical literacy. Her current research investigates the use of innovative technology to promote multilingual literacy in sub-Saharan Africa. Recent publications include Identity and Language Learning (Longman/Pearson, 2000); Critical Pedagogies and Language Learning (Cambridge University Press, 2004, w. K. Toohey); and Gender and English Language Learners (TESOL, 2004, w. A. Pavlenko). Her website can be found at http://lerc.educ.ubc.ca/fac/norton/.
Bonny Norton (FRSC) is a University Killam Professor and Distinguished University Scholar in the Department of Language and Literacy Education, University of British Columbia, Canada. Her primary research interests are identity and language learning, digital storytelling, and open technology. A Fellow of the Royal Society of Canada and the American Educational Research Association, she was awarded the BC 2020 Academic of the Year Award for her leadership of the Global Storybooks project (https://globalstorybooks.net/). Her website is https://faculty.educ.ubc.ca/norton/
Read an Excerpt
Language and HIV/AIDS
By Christina Higgins, Bonny Norton
Multilingual Matters
Copyright © 2010 Christina Higgins, Bonny Norton and the authors of individual chaptersAll rights reserved.
ISBN: 978-1-84769-383-9
CHAPTER 1
Lengths of Life: Stories of Being with HIV
WILLIAM SAVAGE
Introduction
The premise of this chapter is that an effective way for people to understand about HIV and AIDS is for them to learn to listen to and tell stories of what it is like to be infected with the virus and/or affected by the epidemic. Framed around life, location, self and journey, I narrate parts of my story of learning to live and be well as an HIV-positive gay man. While this is a reflective essay on my experiences, I also reference additional perspectives in the other 11 chapters about living and working with HIV and AIDS around the world. In many ways, all of the chapters in this collection are also stories; in some the faces of the people are easily seen, and in others we need to look carefully at and through the numbers and descriptions for the faces to emerge. As Rodney Jones (this volume) points out, 'If AIDS educators wish to understand how to implement truly "community based" prevention efforts, they must understand how people talk about and teach one another about HIV in their everyday lives, and how community constructions of HIV and the risks associated with it appropriate, adapt and contest more official constructions from media and public health discourses'.
Although colleagues in our various fields continue to debate the place of autobiography and narrative inquiry in research, it is not my intention here to review that dialogue. Rather I want to celebrate some of what listening to and telling stories offer us as people who work at or are intrigued by the intersection of education and applied linguistics and HIV and AIDS, what Pavlenko (2007: 166–167) refers to as 'attention to ways in which storytellers use language to interpret experiences and position themselves as particular kinds of people'. It is among my purposes to be part of what Bell (2002: 209, referencing Canagarajah, 1996) highlights as an 'opportunity for marginalized groups to participate in knowledge construction in the academy'.
Lengths of Life
'My name is Bill Savage and I tested positive for HIV in December 1995.' I had gone to Sydney, Australia, from where I lived and worked in Bangkok, uncertain at that time as to what might happen if I tested positive as a foreign resident of Thailand. For years I had lived with the fear of getting tested, and somehow knew that I was positive. I was in Sydney for six months of residence at the university where I started a PhD program. It was toward the end of that stay and just before I was to return to Bangkok and to my Thai partner of over five years, that I made an appointment to get tested.
Clearly busy with his daily appointments, my diagnosing doctor took just enough time for me during that first session, talking with me as a counselor might, asking about my family's medical history and any difficult circumstances in our lives. Feeling at ease with him, I spoke about my mother having Huntington's disease and having been in a nursing home for seven years (she would die less than a year later). I talked about my own fears of having Huntington's, ever since finding out that Mom had it, back in 1975 when I was 15, and living with that dread for the 20 years since, then at 35, the age around which my mother and grandmother had started showing the symptoms. I told him about Laura, the second of my three younger sisters, murdered two-and-a-half years before, shot in the back of the head in a restaurant robbery, and how she and I had been so close, at the time the only person in my family I had told that I was gay.
The doctor no doubt said more than what I remember, but this is what stays with me: 'With all that you've been through, and with what I feel from you today', he said, 'I sense that you are a self-healer and that will be useful, whether you test positive or negative'. We moved from our chairs around his desk to an examining table, upon which I sat as he prepared the syringe. Watching as he inserted the needle in the vein of my arm, and seeing my blood flow into the vial, a wave of relief washed over me. The fear of getting tested disappeared instantly; no longer was I its prisoner, and soon there would be no uncertainty about my HIV status. That was my first lesson in what to do with fear, one I had to keep learning again and again as each of the next fears came into and left my life one after another.
A week later I returned to the doctor's office for the results. I was sitting in the reception area waiting for my appointment when the doctor came in to speak with the receptionist, saw me and from the look on his face and the way he greeted me, I knew that I was HIV-positive. When he actually told me a few minutes later, I am not sure today whether I was thinking about death, but I do remember a deeply subconscious refrain of 'you go to Sydney, you test positive, you die'. The remaining time with the doctor was spent discussing clinical details, numbers, a few further tests for any opportunistic infections, and how I might follow up these life-changing results once I got back to Thailand. I called my partner and told him and also a close friend at the international university where I worked, thinking that at least one person at my workplace should know.
When I got back to Bangkok, through another close friend, I found a doctor who treated HIV-positive people at his clinic and began a seven-year relationship with him in which I would go in every six months for CD4 and viral load testing. (CD4, or T-cells, are the white blood cells responsible for the body's immune system response, while the viral load measures the amount of virus in the blood.) Over that time, the CD4 counts remained in the normal range and the viral loads fluctuated from low to higher and back again, although for those years, neither number ever reached a point where going onto the antiretroviral (ARV) drugs was recommended. I was made much more unwell by fear and by the slow dawning realization of dark sides of my psyche that were at play. In retrospect, I understand that I was mentally unwell.
In those early years, I told few people that I was HIV-positive, only the closest of friends. It felt much the same as when I first came out and began to accept myself as gay – when I tested positive for homosexuality – with the consuming fear of what people's reactions would be. I now see that this was all also part of my own coming to terms with deeper parts of myself, and that I had a lot to work on that I was not yet even acknowledging. I was certainly not taking care of myself, continuing what I now consider to be destructive behaviors, and not seeking ways of being mentally, emotionally and spiritually grounded. One of the strongest fears was telling my father about my HIV status. Laura had been killed in 1993; the oldest of my three younger sisters Sandy started showing the symptoms of Huntington's around the time I got tested and my mother died with that disease in October 1996. How could I possibly add to my father's sadness?
In December 2003, eight years after my diagnosis, I got the first disappointing test results from my doctor in Thailand, the CD4s showing a decreasing trend over that year and the viral load increasing. It occurred to me that I was 'not going to get away with it after all', it being not taking care of myself. In short, the results scared life back into me. On a single day, I stopped smoking, decided not to drink alcohol anymore, got off caffeine, went back to my swimming, yoga and meditation practices, and got my diet back on track by returning to my vegetarian ways. What was important was that these were the very things I had been struggling with for decades, all the things I wanted to continue doing or not doing, the characteristics of the sort of person I wanted to be and now was closer than ever to being.
The doctor asked me to come back in three, rather than six, months for the next tests, in March 2004. Those results were 378 for the CD4s, a further large drop, the first time below the normal range, and nearing the treatment-indicative 350 mark. The viral load was 32,000, a big drop from what it had reached three months earlier. My first thoughts upon hearing that news could have been 'well, that didn't work', that being the lifestyle changes of three months. But my reaction was, rather, how happy I was that I had finally been able to overcome those struggles, how much more mentally well I was, to be able to hear those results and deal with the realities of the situation.
My doctor asked me to come back in a month for another round of tests and suggested that I start thinking about going onto the ARV treatment, which has always been an inevitable next phase for me. In the meantime, I went on holiday to Australia to meet my father and stepmother from Louisiana, which allowed me to visit my diagnosing doctor again. He confirmed that 350 was the current CD4 number below which doctors were advising people to go on the drugs. He also talked about my being a 'long-term slow progressor', as my Thai doctor had done, and that people were no longer referred to as 'non-progressors' since everyone with HIV is progressing to some degree. The Sydney doctor also said how he thought that it was significant that I had been able to overcome my substance addictions and work on (what I have come to think of as) my mental (in)capacity to engage in healthy behaviors, and that this would have a long-term impact on my well-being.
Back in Bangkok for the next tests in April 2004, the CD4 number was 38, and the viral load went down a bit to 27,000. Again, I was able to get these results with a measure of acceptance I was happy to experience, and I went shortly after that to buy pill boxes to start the ARVs. My doctor referred me to another doctor at the HIV center at one of the best hospitals in Thailand. He wanted me to see the new doctor right away, as if there was no time to lose. An HIV-positive friend who has been doing well on the drugs for years and with whom I had been in e-mail contact throughout all of this, implored me in a message to 'stop reading this message and get yourself to the hospital and onto the drugs'. But I just did not feel the urgency. In fact, to this day, I have never been sick in a way obviously related to being HIV-positive, and I felt good.
When I met the new doctor for the first time, he looked at the current numbers and the past trend, and said, 'Yes, it is time for you to go onto the drugs – what are you doing next week?' I was leaving for a short work trip to Nairobi the next day. He advised against starting the drugs while traveling since we would not know whether there would be any side effects, and he suggested that we take another round of tests so that he would have a baseline for his work with me.
When he called the numbers up on the screen when I next saw him in May 2004, he asked, 'This is amazing, what have you been doing?' The CD4s were up to 820 and the viral load was down to 7000! I responded that it was either amazing or the 38 was a mistake, which does happen with these tests. Still, the trend over the past year had been a decreasing CD4 count. The appointment ended with the doctor saying that there was no way I should start the ARV treatment with numbers like those. So it seemed to be just me, the power of positive and wholesome living, and the love and respect of and for a lot of people in my world.
In July 2004, I took a first big step by coming out to myself and others as an HIV-positive person at the 15th International AIDS Conference that was held in Bangkok. I went along to sessions for HIV-positive people, spent time in the lounge set up for positive people and played a role in the conference as writer, director and emcee of the opening program of the AIDS Film Festival. In the script, I even allowed a tacit acknowledgment of my own HIV status by saying, 'As we will hear in a moment, this week's film screenings show us faces, names, lives and identities; they tell us other people's stories, and they will remind us, once again, of who we are and what we should be doing, as people living with, affected by and concerned with HIV and AIDS'.
In August 2004, a second important step was to tell my father and stepmother about being HIV-positive. I went to Louisiana for a three-week visit and decided to tell them on the second night I was there. I just said it: 'I want you to know that I am HIV-positive; I have known for nine years; and I am healthy'. The way they responded lifted the burden and blockage to telling other people, to being open and out about my status. They were caring, loving, supportive and curious. In fact, I wondered whether they had understood what I had told them. Did they even know what HIV was? They had and they did. My father said that he was sorry that I had HIV, that he had much to learn about it, but mostly he was sad to know that I had carried this alone for that many years before I felt I could tell him. I sensed again what 'freedom from fear' is; our relationship changed fundamentally, and the new level of authenticity brought strength and togetherness a little over a year later when my sister Sandy died unexpectedly prematurely with Huntington's disease.
For the next three years, the CD4 counts remained within the normal range and the viral loads continued to fluctuate as they always had. I stayed with my changed lifestyle and in November 2005 started doing Kundalini Yoga, which was to become the practice through which I continued to transform myself and my life. In August of 2007, the viral load leapt from an already-high 165,000 to over 400,000, which seemed like an awful lot of virus! Because the CD4s were still above the range of concern, my doctor suggested that I come back in a couple of months for another test. At that time, in October 2007, while the viral load had dropped to 159,000, the CD4s had come down to 475. Knowing that I was about to make the move to live in New Orleans in December, the doctor suggested that I consider going onto the ARVs that day, so that he could monitor me over the next two months in Thailand. I immediately got started on a Kundalini Yoga set of a vigorous exercise sequence called 'immune fitness' and a powerful meditation called 'immune system booster: the inner sun', and the test results were almost identical to the time before. The changes I made in my lifestyle the first time were easy in comparison with the more subtle ones that would be necessary this time, taking all of my practices to their next levels, as I continue to seek that still, quiet place that has come to be my intended destination and destiny.
I realized at that time that I had created a story for myself that going onto the ARVs was a failure. Having been healthy for 12 years without them meant that I had failed if and when I needed to start the drugs. In reality, it is a blessing that they are available to me. More deeply, I have come to realize that I have been making choices to change and to heal, to continue a difficult journey of discovery: Who is this self? Can I break free of what is holding me back from a path to well-being? This has little to do with being HIV-positive or not. And so the next step into the unknown was my arrival at my new home in New Orleans, uncertain as to what awaited me. Through providential circumstances I met the young man who would become my doctor, discovered that I was eligible as an HIV-positive uninsured resident of Louisiana for affordable care and treatment, and had another round of tests that affirmed that it was time to start the ARVs, which began in February 2008. With the gift of the advances in HIV science over the years, I began on Atripla, a single daily pill with the combination of efavirenz, emtricitabine and tenofovir. The only side effect I have experienced so far on the medication is the feeling of having increased energy levels, which my late sister Sandy's sister-in-law, a physical therapist, articulated for me as: Now I am taking these drugs to fight the virus, so I do not have to do that myself any more and can use my own energy for my health and my life. After two months, my viral load had come down to 266 from over 200,000 and the CD4 count had increased from 370 to 440, and so I embarked on the next leg of this journey.
There are two among the many dimensions of this experience that I want to conclude my story-thus-far with: fear and a notion of 'lengths of life'. I have come to believe that how people live their lives, and how they experience other people's, is determined in part by how they deal with fear: their own and their responses to other people's. As I mentioned early in my narrative, actually having the HIV test done enabled me finally to face a long-standing fear, and to learn what that feels like, as I applied and continue to apply that learning to each fear as it has arisen. These have mostly centered around the knowledge that there was something about me that if other people knew, there would be uncertain reactions and consequences: colleagues, superiors and administrators at my place of employment; acquaintances and government officials in the country where I lived as a foreigner; long-time and newer friends in various places around the world; my immediate and extended family in the United States and even people I had not yet met. There was something about me that I and a few other people knew and I had the nearly-debilitating experience over the years of feeling like I was not being my authentic self. Along with the fear of hiding this piece of information was a deeper fear of becoming ill, of dying and of death.
(Continues...)
Excerpted from Language and HIV/AIDS by Christina Higgins, Bonny Norton. Copyright © 2010 Christina Higgins, Bonny Norton and the authors of individual chapters. Excerpted by permission of Multilingual Matters.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
Introduction - Applied Linguistics, Local Knowledge, and HIV/AIDS - Christina Higgins and Bonny Norton
Chapter 1 Lengths of Life – Stories of Being with HIV - William Savage
Chapter 2 Ugandan Students’ Visual Representations of Health Literacies: A Focus on HIV/AIDS Knowledge - Harriet Mutonyi and Maureen E. Kendrick
Chapter 3 Is It Safer to Talk about Sex in Spanish or English?: Performing Young Adulthood in Oaxaca, Mexico - Àngeles Clemente and Michael J. Higgins
Chapter 4 Safe Sex – Not So Straightforward: Intersubjective Positioning in Gay Men’s Accounts of Sexual Exposure to HIV - Henrike Körner
Chapter 5 Dangerous Dogmas: AIDS, Discourse, and the Reality of the Rakhel System in India - Noushin Khushrushahi
Chapter 6 Discursive Constructions of Responsibility in HIV/AIDS Prevention: Investigating Re-entextualization Practices in Tanzania - Christina Higgins
Chapter 7 Uganda’s ABC Program on HIV/AIDS Prevention: A Discursive Site of Struggle - Shelley Jones and Bonny Norton
Chapter 8 Learning about AIDS Online: Identity and Expertise on a Gay Internet Forum - Rodney H. Jones
Chapter 9 Contextualizing Local Knowledge: Reformulation in HIV/AIDS Prevention in Burkina Faso - Martina Drescher
Chapter 10 What Difference Does This Make?: Studying Southern African Youth as Knowledge Producers within a New Literacy of HIV and AIDS - Claudia Mitchell, Jean Stuart, Naydene de Lange, Relebohile Moletsane, Thabisile Buthelezi, June Larkin, and Sarah Flicker
Chapter 11 Articulations of Knowing: NGOs and HIV-positive Health in India - Mark Finn and Srikant Sarangi
Chapter 12 Signs Show the Way: Reading HIV Prevention on the Andaman Islands - Annabelle Mooney