My first concrete experience with HIV research took place in 2007. I had applied, interviewed and been selected to participate in a 2-month research and volunteer internship in the country of Namibia. The internship program that I joined had been established several years prior and had a reputation for being an incredible learning experience for those selected to participate. Undergraduate students from various faculties within the University of Toronto were selected to travel to Namibia to conduct research and volunteer within a local AIDS service organization (ASO).
With very little applied training or education (in research methods, on HIV in a Namibian context, on community-based approaches to research), I flew overseas and landed first in Windhoek before driving eight hours north to a rural town called Ongwediva.
For the volunteer portion of my internship, I worked within an organization that provided microfinance loans and HIV education to women who were supporting orphans and/or other vulnerable children (OVC). OVC are defined as a child 18 years of age or under who has lost one or both of their parents or primary caregivers and is in need of protection. In Namibia, more than 28% of those 18 years of age and under are classified as OVC with a shockingly high percentage of children orphaned because of HIV and AIDS.
The first time I travelled to Namibia in 2007 (1), the national HIV prevalence rate was hovering around 15%, which is a high despite the fact that the population of the country was just under 2 million at the time. Although the country’s population isn’t large, dealing with thousands of people living with HIV in the context of a weak infrastructure is challenging. While the HIV prevalence in Namibia has shifted slightly since 2007 (the latest report shows a national prevalence rate of 13.1%), Namibia still ranks amongst the top ten worst countries globally in relation to adult HIV prevalence. I believe that the history of a consistently high HIV prevalence rate was the reason the internship program was established in Namibia.
Outside of some readings completed prior to departure, we were not required to complete any courses or training to prepare us for the research projects we were about to undertake. On top of this, students traveling abroad were expected to create a research project that we would embark upon once we arrived in Namibia without consultation from our Namibian “partners”.
At the time, I remember feeling frustrated with these expectations; how could I be expected to develop a research project not only without the necessary training in methodologies but also without ever having been to Namibia or communicated with any of the potential organizations or ASOs that I might end up working with?
Though I did not realize this at this time, I was operating within a colonial research structure which placed me, the undertrained, naïve, and eager (yet ignorant) undergrad, in a position of authority over the research including who would be involved and what and who would be studied. This structure positioned me as the research “expert” regardless of my inexperience both in research and in Namibia. Yet my overall academic immaturity and ignorance was irrelevant and became secondary to the incredible experience I was about to undertake.
Critical considerations about how to ethically engage in an international research expedition were not a focal point and emphasis was placed on ensuring that the experiences of the University of Torontop (Western) students were monumental. Though I was aware that entire bodies of critical literature existed on research methodologies and approaches, HIV engagement and international work yet community-based research and ideas around the greater involvement of people living with HIV and AIDS (the GIPA Principle) failed to make an appearance in the internship program or research structure we were being churned through.
(The Greater Involvement of People Living with HIV & AIDS (GIPA) Principle was introduced and formalized at the 1994 Paris AIDS Summit when more than 40 countries committed to “support a greater involvement of people living with HIV at all ... levels ... and to ... stimulate the creation of supportive, legal and social environments”. )
The GIPA Principle aims to ensure people living with HIV and AIDS are the backbone and key contributors to program development, policy-making and implementation and that this involvement is meaningful rather than tokenistic. This principle seeks to highlight the rights and responsibilities of those living with HIV and AIDS including the right to self-determination and the ability to play an active role in decision-making processes that impact their lives. Despite the widespread acceptance and global approval of the GIPA Principle, there is still much work to be done in order to more fully immerse this approach into various sectors including international student research on HIV and AIDS.
While the benefits of applying the GIPA Principle are evident, there are often many challenges which stand in the way of successful implementation/involvement of people living with HIV including HIV-related stigma, inexperience with research, distrust of researchers, and that involvement in research may not be prioritized compared to other components in life (social, health, family, etc.) (2) Within the context of academic, social research, community-based (participatory) research (CBR) has emerged and solidified itself as a methodological process for conducting research in a way that positions itself in opposition to many of the more historically conventional approaches. CBR not only emphasizes the involvement and collaboration of community members at all stages of research (from project design and development to data collection and analysis to knowledge dissemination and translation) but rather understands meaningful community involvement as imperative and integral to the research process; in essence, meaningful community involvement is non-negotiable.
Theoretically and depending on the goals and objectives of a research project, CBR represents an almost utopian approach to research which moves away from some of the more historically troubling aspects associated with some research practices. In practice however, CBR is far from perfect and – like the GIPA Principle – faces barriers in practice. The insider-outsider dilemma is often sited as a consistently challenging issue for CBR as is the general distrust that communities often/may have towards researchers. (3)
My own university experiences with international research on HIV prevention serve as a case study to demonstrate not only the invisibility of the GIPA Principle and CBR in practice but the near complete absence of them. Many Western universities not only offer but promote student involvement in exchange or abroad programs which provide these students with infinite opportunities to expand their minds, experience different socio-cultural perspectives, increase their chances of accessing additional opportunities and importantly, aggrandize their CVs. This was my experience in both my undergraduate and graduate degrees at two academic institutions in Canada; this was also the experience of many of my university peers.
While I felt I had learned many valuable lessons on my first excursion to Namibia during my undergraduate degree, in hindsight, it is evident that many more lessons remained unexamined. While I made the effort to think more critically about my social and global location in the work I was participating in, this critical thinking did not permeate my thought process in a way that drastically impacted my actions as I still actively chose to pursue a graduate degree which included traveling back to Namibia to conduct research.
While I take full responsibility for my actions and choices within both my undergraduate and graduate degrees, I think it is also important to recognize that I was operating within a system which very much facilitated my goals of engaging in international work yet simultaneously did not provide adequate training in order to do this work critically, ethically or meaningfully.
As one would expect, my initial experience of travelling overseas to conduct “research” in Namibia created a slew of subsequent opportunities. Even though several years have passed since both my excursions to Namibia, I am still reaping the benefits of them via conference presentations and publications. Conversely, I doubt very much that the organizations and participants I worked with are fairing as well.
(1) I travelled to Namibia a second time in 2009-2010 to conduct my MA field research. This time, I travelled to Walvis Bay, an area in Namibia that experiences high levels of mobility via two transnational highways and the country’s only deep-water port where international boats can dock. In addition to high levels of mobility, Walvis Bay also experiences rates of HIV around 10-15% higher than the national prevalence rate (25-30%); it was for this reason that I chose to conduct my research in this town.
(2)Travers, R., Wilson, M.G., Flicker, S., Guta, A., Bereket, T., McKay, C., van der Meulen, A., Cleverly, S., Dickie, M., Globerman, J., & Rourke, S.B. (2008). The greater involvement of people living with AIDS principle: Theory versus practice in Ontario’s HIV/AIDS community-based research sector. AIDS Care. 20: 615-624.
(3)Fockler, L.A. (2010). Community researchers’ experiences with community-based research. (Unpublished master’s thesis). McMaster University: Hamilton.