AIDS action-research with women in Kinshasa, Zaire.

AIDS has assumed epidemic proportions in Central Africa. Knowledge of culturally constructed gender relations and sexual meanings is crucial to developing prevention strategies and reducing the impact of AIDS. CONNAISSIDA, a transdisciplinary medical anthropology research project, developed culturally appropriate community-based empowerment workshops. These used cognitive, emotional and social stimulants to provoke critical reflection and action. Collaborative relationships developed in workshops were used to study sexual relations in many contexts. Significant changes in knowledge and action were observed. Nevertheless, economic necessity and inequality limited the ability of many women to avoid sexual risk. Economic crisis, structural adjustment and debt reimbursement policies have exacerbated poverty, particularly among women. Linking macrolevel political economy to microlevel sociocultural analysis shows how strategies adopted for survival contribute to sexual risk. Therefore broader socioeconomic changes that reduce poverty and gender subordination are necessary to control the HIV/AIDS epidemic. Findings from Zaire are widely applicable in the region.