Epistemology and Epidemiology: Local Interpretations of AIDS Epidemiology in Rural Malawi

Gigi Santow, Independent Consultant
Susan Watkins, University of California, Los Angeles
Michael D. Bracher, Independent Researcher

In this paper we use a rich set of ethnographic journals collected in rural Malawi to examine understandings of the epidemiology of STIs and HIV. The journals vividly show Malawians publicly and urgently grappling with epidemiology of the new and confusing disease. In their local social networks, people ask each other why some people known to be promiscuous have died, while others known to be equally promiscuous are still alive? How can it be that an innocent wife dies before her philandering husband? Is sex once with an infected person inevitably fatal? We find that between the first journals in 1999 and the present, some of these questions have been resolved; others remain puzzling. We also compare current interpretations of the epidemiology of HIV with what is accepted objectively, on the basis of medical research, to be its natural history.