Maasai Girls’ Experiences of Ukimwi ni Homa (AIDS Is a Fever): Idioms of Vulnerability and HIV Risk in East Africa

Abstract

There have been enormous strides in response to the AIDS epidemic in the past decades; however, adolescent girls and young women (AGYW) remain at high risk for new HIV infection throughout sub-Saharan Africa. Recognizing this continued discrepancy, I call for more attention to girls’ perceptions of vulnerabilities by revisiting an ethnographic study of HIV risk carried out in 2004 in a rural community in Kenya. My analysis situates Maasai AGYW perceptions and understandings of HIV risk as a culturally constructed idiom of distress: “Ukimwi ni Homa” (AIDS is a fever). I examine the emic perspectives of HIV vulnerability and the association of sexual relationships within the context of economic precarity. Findings demonstrate how references to fevers expressed feelings of helplessness, which increased indifference to HIV risk. This indifference led AGYW to prioritize imminent economic needs over long-term effects of a viral infection that they perceived as inevitable. Critically reflecting on AGYW understandings of their own risk perceptions can influence effective HIV intervention design. My conclusions support the need for tailoring combination prevention approaches to address perceived vulnerabilities within populations. Such perspectives add valuable insights to studies rooted in cultural constructions of illness perspective.