RESEARCHING THE REAL WORLD



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© Lee Harvey 2012–2017

Page updated 9 October, 2017

Citation reference: Harvey, L., 2012–2017, Researching the Real World, available at qualityresearchinternational.com/methodology
All rights belong to author.


 

A Guide to Methodology

CASE STUDY Condom use in Malawi

Iddo Tavory and Ann Swidler (2009) explored condom use in Malawi, a country with a high AIDS rate: approximately 12 percent of Malawi's adult population is HIV positive  (Government of Malawi, 2004; UNAIDS, 2006) and AIDS is the leading cause of death for people ages 15 to 49 (Doctor, 2002).

They undertook a semiotic analysis of condom use, as part of the Malawi Diffusion and Ideational Change Project (MDICP), a longitudinal survey in three rural areas (Mchinji in the central region, Rumphi in the north, and Balaka in the south) that explored how social networks affected fertility-related behaviour and attitudes.

They argued that a semiotic perspective provides an explanation for what appears to be irrational behaviour in the face of widespread awareness of HIV infection in sub-Saharan Africa.  In the study in Malawi the authors found that there was very little use of condoms in 'love' relationships (which includes marriages and also some short-term partnerships) despite the very low cost of government subsidised condoms.

The survey began in 1998, and the initial sample consisted of approximately 1,500 women and their husbands. This sample was re-interviewed in 2001, 2004, and 2006, and included new husbands of widowed or divorced women. In 2004, 1,500 men and women ages 15 to 24 (married and unmarried) was added to the survey.

As the surveys, unsurprisingly, did not reveal how people talk to each other about condoms, the semiotic analysis was based on 600 journals (totalling over 5000 single-spaced pages) written, often hurriedly, by 22 local assistants based on conversations about AIDS that they overheard or participated in during their daily lives. The journals recorded the views of a wide range of the population and capturing everything from marketplace scandals and court proceedings to casual conversations in bars and on minibuses.

An advantage of the data collection method is that the journals are naturalistic in as much as they present ideas, concepts, and beliefs that occur in natural settings rather than the artificial interview situation. The journals are free from interview effects (including respondents' tendency to give answers they believe the interviewer wants to hear), have no pre-set categories and the data relates to practical situations rather than abstract ideals. However, a disadvantage is that the data's accuracy depends on the memory of those recording conversations after the event. Tavory and Swidler (2009, p. 175) argued that  'remembered conversations may provide better access to public culture than would a complete rendering of what people actually said to each other'. It is also possible that those writing the journals fabricated incidents and conversations, although the authors' examination of the journals convinced them that they are genuine accounts (with the exception of one journalist, whose material was discounted, as he 'tried passing off pamphlet materials as conversations overheard' (Tavory & Swidler, 2009, p. 175)).

The journals were supplemented by 20 in-depth interviews (a convenience sample of ten males and ten females) with respondents who were doing time-consuming tedious tasks (washing clothes, walking along the road, sitting in the market). The interviewers asked about views on condom use, and whether, when and why the respondent or their friends used or did not use condoms.

The data was coded using a software program and 'we let the concepts and categories emerge from the data' although 'starting with a focused question: What codes, metaphors, and meanings governed how people talked about condoms and condom use?' (Tavory & Swidler, 2009, p. 174).

Tavory and Swidler then did a fine-grained coding of the discussion of condom use, which revealed what they called the 'semiotic axes' (dimensions that delineate an array of meanings). Three axes emerged that framed the analysis: 'sweetness' of sex; trust and love between sexual partners; and assessments of risk and danger.

Three elements are important in a semiotic analysis; first Saussure's idea that any sign has meaning only in relation to other signs (See Section 5.10.2). Second, that a shared social code constitutes an array of likely meanings of words and actions, independent of what an individual may actually intend to signify. Third, this allows for conflicting significations and thus shifts in the meanings of an interaction. Although condom use occurs in many aspects of Malawian life, the authors 'focus on sensuality, love and trust, and risk because these are the central themes that emerge from our data' (Tavory & Swidler, 2009, p. 173).

Analyzing the multiple axes that define the semiotic space…of the condom shows how individuals can code and decode a gesture, object, or statement. Conceptualizing condom use within such a semiotic space recognizes that the condom does not have a fixed meaning, but rather serves as a gesture or statement within a larger system of signification—a system encompassing the self, the other, the nature of a relationship, and concerning danger, disease, and desire. In this sense, the interactional meanings that interest us are “second order” symbols …. Moreover, a semiotic space suggests that meanings can shift within that space, so the meaning of condom use can change registers or locations even within a particular interaction…. (Tavory & Swidler, 2009, pp. 172–3)

Thus, refusal to use condoms does not derive from stubborn cultural beliefs that refuse to acknowledge the dangers of AIDS. Instead, using condoms signals something about the character of a sexual relationship that a semiotic analysis revealed. The authors argued that without a semiotic perspective on culture, the 'gap between attitudes and behaviour with respect to condom use remains opaque' (Tavory & Swidler, 2009, p. 172).

The authors asserted that any cultural object, such as a condom, has multiple possible connections to other cultural meanings, which may be contradictory or competing, allowing creative interpretation and renegotiation of an object's significance.

Their reported analysis includes the following examples.

Sensuality is the first semiotic axis that structures the meanings of condom use. The most common metaphor for the sexual act in Malawi, as well as in other parts of south and southeast Africa, is that of “sweetness”… This metaphor refers to semen and the contact with sexual fluids during sex, as well as the pleasure of the sexual act more generally. It is mostly men that talk about the sweetness of sex, but some women use this metaphor too. These conversations vary from the occasional remark that sex is “very sweet,” to elaborate descriptions of how men and women feel sweetness while having intercourse. As the following excerpt shows, the sensation of sweetness is important in some people's decisions not to use condoms:
Dili said, “I have said already, I believe, that I can't and I don't even think of using the condom when I am having sex because I don't see the importance [the point] of using [a condom] because when having sex I mean to feel sweet. Her real sweetness, not that I should be having sex with a condom. It's better to continue with masturbation than acting like you are having sex with a woman while you are sexing yourself and the rubber!” (Tavory & Swidler, 2009, p. 176).

This language of sweetness is closely tied to men's, as well as some women's, unwillingness to use a condom: one cannot experience sexual pleasure when using a condom.

The axis of sweetness describes not only sexual interactions, but also men and women who are conceived as sexually competent and desirable. This might seem deceptively similar to the English use of sweetness to refer to sexual partnership. However, while in English “sweetheart” refers to a loved partner, the language of sweetness in Malawi provides a criterion for evaluating sex itself. For example, in one diary, a wife finds out that her husband has another partner, instigating a fight between the wife and the lover in which the lover mocks the wife using the language of sweetness:
You are also a stupid woman. Your husband is fed up with you, you are no longer sweet. This is why he has come and proposed me. I did not propose to him but he was the one who came alone proposing to me and I am sure that he can't leave me, he is satisfied of me. (Tavory & Swidler, 2009, p. 176).

Unlike Western notions of sweet sex,  for rural Malawians, sweetness refers not only to the sexual act but specifically to the release of semen.  'Contact with semen and vaginal fluids is the essence of sexual pleasure itself. So the use of condoms does not just dull sexual sensation, it eliminates its essential element. A local physiological understanding lies behind the Malawian understanding of sexual pleasure' (Tavory & Swidler, 2009, pp. 176–77).

The sweetness of the semen is also related to fertility…
Some people were laughing at her husband, saying that his wife has revealed that he is a useless man in terms of sex. He does not produce live sperm. He is not sweet. He is barren.…
Although the husband can have sex with his wife, the act is flawed. Being barren, his semen lacks the sweetness of fertility; the sexual act is “not sweet.” The idea of the sweetness of the semen itself is also seen in the following interview excerpt, in which a 22-year-old married man claims he wouldn't mind using condoms, but he thinks his partner feels the difference:
R: Aaah! Sleeping with a partner without a condom cannot be similar to having sex with a partner with a condom. It's different.
I: What is the difference?
R: The difference is that aaah! [slight laugh] It's different for her to be satisfied and believe that indeed I have slept with a man, because those things [sperms] have the stoppage block.
… If sexual pleasure depends on the release of semen into the woman, condom use becomes much more problematic than in cultures where sensuality is tied to the friction and build-up leading to orgasm. While condoms only diminish the sensuality of friction in the Western context, they completely obliterate sensuality in the Malawian context by preventing both men and women from experiencing “the sweet.” (Tavory & Swidler, 2009, p. 177)

Similar analyses were used for the other two main axes. For example, on the issue of trust two intertwined and potentially opposed meanings are invoked:

On the one hand, people may seek partners believed to be safe and either avoid or use condoms with those considered unsafe (Watkins 2004). However, if a relationship becomes defined as love, the connection between condom use and trust is inverted, as condom use signifies the absence of love, trust, and intimacy. The practical semiotics of the transition from a casual relationship to a love relationship make the assessment of risk and the use of condoms inappropriate, a sign of a loveless relationship. (Tavory & Swidler, 2009, pp. 184)

The authors summarised by stating, inter alia, that traditional rural cultural beliefs are not the reason for using or not using condoms.

Rather, these semiotic axes serve as pragmatic tools of knowledge and deliberation “ready to hand” that Malawians use to perform the social navigation of everyday life. Sweetness, risk, trust, and love are all modes of signification that shape subjects' decisions and interactions. To understand variations in Malawians' willingness to use condoms, one must first understand how these social semiotics frame everyday decisions. (Tavory & Swidler, 2009, pp. 184)

The authors point out that rationales and meanings are not fixed but change and issues such as religious prohibitions, distrust of government and challenges to masculinity that were prominent (in some countries) in the 1990s has moved on.

Our interviews suggest that for some younger Malawians, using condoms even with regular partners is becoming acceptable, perhaps as a marker of rational modernity….. A new semiotic strategy seems to be emerging in whichusing a condom every time with every partner avoids the association of condoms with particular sorts of partners or relationships. The semiotic mapping we offer here is synchronic, but semiotic structures are ever-changing. The idea of “structure” should be understood more as a point of reference for establishing meaning within a dynamic and diachronic process, rather than as a fixed framework of meaning (Bourdieu, 1977; Garfinkel, 2002; Sewell, 1999). (Tavory & Swidler, 2009, pp. 184)

In conclusion, the authors suggest that the semiotic axes have implications for both AIDS studies in Africa and policy deliberations. Public health interventions should consider both accurate health information and semiotic framing. In Malawi, for example, an emphasis on untrustworthy partners and promiscuity in promoting condoms to prevent HIV may be counter-productive. An alternative approach might be to frame condom use as expressing love and care to a trusted partner.

 

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