Preaching Prevention. Lydia Boyd

primarily because foreign HIV/AIDS policy makers resist talking about morality in the context of AIDS. Ugandans, he noted, are “religious, we’re family oriented.” Therefore, he argued, the people are responsive to a message of abstinence and faithfulness. As I have outlined above, the story of Uganda’s success is far more complicated than Walusimbi would have it be. But the rhetoric he uses to couch his criticisms is attractive, emphasizing Ugandans’ own moral authority and autonomy in the fight against AIDS—a fight that is now, undeniably, driven by a global economic and political agenda far removed from Ugandans’ home communities.

      FIGURE 1.1. “Safe sex is no sex!” rally in support of abstinence, Kampala, October 2006

      While Walusimbi frames his protest against the perceived intrusion of external funders and their “amoral” agenda, his message gained prominence because of the worldwide controversies surrounding American HIV/AIDS policy. He characterizes his message as one of Ugandan youth empowerment, but the message’s power is derived from a connection to international—and especially American—Christian discourses regarding morality and AIDS. The meaning Ugandans attribute to Walusimbi’s message about personal accountability and self-control is an issue I take up in later chapters. But the landscape of AIDS activism in the early years of the twenty-first century, an era deeply shaped by a compassionate response on the part of President Bush’s conservative religious base, can be followed in Walusimbi’s rhetoric.

       Conclusion

      In the late 1980s and into the 1990s Ugandans did in fact adapt their behavior, delaying sexual debut and reducing their concurrent partnerships—effectively abstaining and becoming more faithful, thus reducing HIV prevalence in the country. But the story of PEPFAR is a story of how behavior change was taken out of the broader structural and cultural matrix that had brought it force and shape and how it was given a new kind of agency through the ideals of “compassionate care” championed by the U.S. government. Starting in 2003, when behavior change was adopted as a buzzword by President Bush and his advisers, abstinence and faithfulness had evolved into a singular abbreviation for individual choices that emphasized personal accountability for disease risk and prevention—choices that could be promoted and exported globally. This was an interpretation of prevention success that buttressed other objectives of American humanitarianism of the era, an orientation to compassionate aid that helped outline and reinforce the dominant frameworks of neoliberal social action—autonomy and individual agency—that often obscured alternative ethical practices and modes of action that had figured prominently in earlier Ugandan efforts to mobilize against the AIDS epidemic. In chapter 2, I take up the Ugandan context more directly, focusing on the history that lead up to the introduction of PEPFAR. This is a history not of the epidemic itself but of forms of moral activism in the face of social change, activism that informed the more recent iteration of moral authority so effectively claimed by Walusimbi and his peers.

       2

      AIDS AT HOME

       Urbanization, Religious Change, and the Politics of the Household in Twentieth- and Twenty-First-Century Uganda

      In 2006, I attended a gospel music concert, organized by local churches to promote youth abstinence, at the upscale Serena Hotel in central Kampala. At the beginning of the concert a high-profile army colonel gave an introductory speech drawing surprising corollaries between AIDS and the ongoing war in northern Uganda.¹ The main emphasis of his speech was that both tragedies—the war and the epidemic—had been caused by an erosion of cultural values. Young people, he explained, had forgotten how to “behave.” AIDS, he continued, was “not being helped by this business of boyfriend and girlfriend.” He stressed that the norms of “traditional culture” dictated that marriages should be arranged by families, not according to the whims of young people’s desires. His comments drew a frightening parallel between the horrors of the civil war and the sexual promiscuity he blamed for the epidemic: both were supposedly driven by a growing lack of civility and respect for cultural norms.