Pfeiffer James
Department of Anthropology, Case Western Reserve University, USA.
Med Anthropol Q. 2004 Mar;18(1):77-103. doi: 10.1525/maq.2004.18.1.77.
Despite significant debate about the efficacy, ideology, and ethics of the method, condom social marketing (CSM) has become the dominant approach to AIDS education in many sub-Saharan African countries. However, critics have charged that social marketing (SM) distracts from the structural determinants of health-related behavior and excludes genuine community participation. This article argues that the diffusion of SM techniques in Africa is not driven by demonstrated efficacy but is attributable to the promotion of privatization and free markets in the structural adjustment era across the region. The CSM experience in a central Mozambican community reveals the dangers of using the method at the expense of community dialogue and participation to confront the AIDS epidemic. The advertising campaign developed to sell condoms has clashed with Pentecostal and Independent Churches, now a majority of the population, that have expanded rapidly across the region spreading a contrasting message about sexuality and risky behavior.
尽管对于避孕套社会营销（CSM）这种方法的功效、理念和伦理存在大量争论，但它已成为撒哈拉以南非洲许多国家艾滋病教育的主要方式。然而，批评者指责社会营销（SM）忽视了健康相关行为的结构决定因素，并且排斥真正的社区参与。本文认为，SM技术在非洲的传播并非由已证实的功效推动，而是归因于该地区在结构调整时代对私有化和自由市场的推广。莫桑比克中部一个社区的CSM经历揭示了以牺牲社区对话和参与为代价使用该方法应对艾滋病疫情的危险性。为推销避孕套而开展的广告活动与五旬节派教会和独立教会发生了冲突，这些教会目前在该地区占多数，它们迅速扩张，传播着关于性和危险行为的截然不同的信息。
