Hope: an overlooked tool in the battle against HIV/Aids

New research funded by the Economic and Social Research Council (ESRC) argues that hope is a powerful tool in the battle to stop the spread of HIV/AIDS.

Almost 30 years into the AIDS epidemic a medical vaccine for the disease remains elusive. Efforts to control the spread of HIV have been fairly successful in Western countries but have met little success in Africa. For example, life expectancy at birth is now estimated to be 36 years in Botswana, instead of 71 years without AIDS. It is expected to drop towards 30 within the next ten years.

ESRC Professorial Fellow, Tony Barnett, from the London School of Economics, argues: “Current policies to tackle HIV/AIDS in Africa emphasise individual behaviour such as the ABC approach to prevention: Abstain, Be faithful, Condomise. However, these measures require that people have hope for the future and goals to aim for. And if wider economic and social circumstances are so poor that people lack hope for the future, then these current policies will have limited success.”

People with hope for the future are less likely to engage in activities in the present that put them at risk of illness in the future. Those without hope for the future, by contrast, place a low value on the future. For example, men who lack hope for the future may be unwilling to surrender immediate pleasure in return for a far-off future benefit by wearing a condom.

Increasing evidence shows that policies to combat AIDS that focus exclusively on individual behaviour are flawed if they dissociate behavioural change from the social, economic and cultural contexts. Security, stability, expectations of seeing the birth of grandchildren and their coming to adulthood, expectations of seeing a small enterprise grow bigger or a tree crop plantation come to maturity – these are all signs and indicators of hope that can have vital impacts on decisions and behaviours.

In contrast HIV/AIDS can destroy hope, resulting in vicious spirals that damage societies and lead to further HIV infections. When life prospects are so poor, people have little incentive to save for the future and to educate children. AIDS has also led to a growing number of orphans in Africa. Without financial, educational and emotional support for the future, a growing number of young people in Africa are less prepared for life and more vulnerable to HIV/AIDS.

“Hope is quite straightforward to measure via questionnaires and surveys can help to identify high risk environments,” concludes Professor Barnett.

“Although there is not a great deal of experience in developing programmes to increase hope, policies such as cash support for children, microfinance for small businesses, women’s education, reduced discriminations against sexual minorities and health system reform will improve the wider environment. And with more to live for, interventions to encourage individuals to change their behaviour are more likely to succeed.”