Making meaning in the time of AIDS: longitudinal narratives from the Malawi Journals Project

Abstract

The Malawi Journals Project is one of the longest-running observational field studies in rural sub-Saharan Africa, ongoing since 1999. The journals provide real-time accounts of the unfolding epidemic, from the days when AIDS was considered by rural Malawians to be a death sentence, through the advent of international AIDS organisations bearing advice on avoiding infections by self-control, and then the turn to institutionally-based efforts to control infection through HIV testing and antiretroviral medications. This paper examines the epistemological and substantive contributions of the Journals Project, which we and others who have analysed the journals have made to understanding the AIDS epidemic. The paper has three primary aims. The first is to provide evidence of the chasm between the top-down perspectives of global actors with a mandate to address the pandemic and the bottom-up perspectives of local actors trying to avoid dying from AIDS, perspectives that are often contradictory. Second, beyond what can be learned from the journals about individual and collective responses to AIDS, they suggest the value of longitudinal observational field studies as a method for understanding how cultural change occurs. And third, as an example of the potential of longitudinal field studies as a research method on AIDS as well as other topics, we have structured our argument around the broader empirical and theoretical debates in the social sciences featured in published and presented analyses of the Malawi journals data: multiple moral logics, the course of global flows of information and injunctions, and the collective deliberation that produces authoritative local knowledge.

Keywords: gender, community, antiretrovirals, narrative, qualitative methods