In the late 1990s in Zimbabwe, single women, young women and girls would encounter such posters with AIDS prevention messages in various locations when going to schools, hospitals and shopping areas in Gweru:

GIRLS! -Avoid Sex, Drugs and Sugar Daddies -Be smart- AIDS is A Reality -Smart Girls- Say "NO" to Sex -Tell Guys, "They can't use you" -Giving In to Sex ain't Smart- Beware! -WHO said, Sex Guarantees Marriage? -Give In to Sex and Get Dumped. -Rush into Sex - Rush into AIDS. -Your Body is Your Right - Protect it! - Think, Refuse, Be Firm YOU Are SMART - Secure Your Future!

It turned out that the messages on the posters were misleading, as they were in English, rather than Ndebele or Shona, the most widely spoken languages in Zimbabwe. According to Shiripinda, (2003), the organization that printed the posters had intended them for both school girls as well as young, single adult women. Unfortunately, the messages were not understood that way for linguistic reasons. First of all, the term "girl" posed a problem. In Shona, girls under the age of 18 are referred to as unmarried virgins (vasikana). However, young unmarried women over age 18 are referred to as (tskikombi). Although the posters were addressed to unmarried females in general, the single women who were interviewed about the posters assumed that the casual, colloquial messages were for school girls only, because the warnings were addressed to "girls". This is regrettable, because many young women over 18 are sexually active, often in relationships with older men, and their rate of HIV infection reached 14.7 per cent by 2005 (1).

(1) Females, aged 15-24. UNAIDS 2006.
This incident illustrates the linguistic dilemmas that confront organizations that do education, advocacy and counseling work related to HIV and AIDS in countries where most of the population speaks non-European languages.

HIV and AIDS work using non-standard languages

In other parts of the world, a European language may be the official language of a country, but most citizens, and particularly less educated ones, will speak a Creole or pidgin version of the official language. This has important implications for education, sensitization and counseling on HIV and AIDS. In 1991, according to Royes (1999), the Jamaican Ministry of Health commissioned a study from an independent researcher to study HIV and AIDS issues among MSM (Men Who Have Sex with Men). It is important to note that, due to the contemporary wide-spread use of the Jamaican Creole language, and to the vernacular of gay and street subcultures, certain terms and concepts used in Standard English were not understood by some of the respondents. This observation was particularly apparent among men who were younger and of a lower socioeconomic status. General terms, such as monogamy, HIV, STDs and promiscuous, were not readily understood by these participants. Thus, the terms were either translated by the interviewers or interpreted in relation to the overall sense of the concept was solicited. It should also be noted that the words "homosexual" and "heterosexual" are relatively new to the majority of Jamaicans, especially to the general public. The researcher, however, asked participants to describe themselves as "straight", "gay", or "bisexual" and the men generally did not have difficulty identifying themselves according to one of these more colloquial terms. The formative research of this study revealed the following indigenous names that are popularly used:

Table 1: Selected Jamaican Creole and Standard English Terms relating to sexuality

Jamaican Creole Terms	Meaning (in Standard English)
Batty Man	Describing physical act by gay males ("buttocks man")
Sodomite	Lesbian
Sport	Gay man
"Him, a such"	"He is that way"
-Spanish machete; -Razor Blade; -Him cut 2 sides	Bisexual
-A friend of Dorothy's; -A member of the church; -He plays cricket.	Gay person

Source: Royes (1999)

A similar situation prevails in Nigeria, a country with over 200 indigenous languages. Standard British English was imposed by the colonial administration and remains the official language of this federal republic. Over the years, however, Pidgin English emerged, as uneducated people had initially to deal with the colonial administration and later with persons speaking languages from other parts of Nigeria. In effect, Pidgin English is the unofficial lingua franca of Nigeria. Pidgin English is the main medium of discussion in AIDS-related discussions, including sensitization and counseling, on Bonny Island, a high-prevalence area close to the Niger Delta. While the Ibani language is the indigenous tongue, the presence of thousands of migrants from other parts of Nigeria has necessitated the use of Pidgin English in general discussions of AIDS issues on Bonny Island. The following is a glimpse of the terminology being used in HIV/AIDS-related work, comparing Standard English with terms in Pidgin English and the Ibani and Igbo languages.

Table 2: Selected Nigerian Pidgin, Ibani and Igbo Terms relating to sexuality

Standard English	Pidgin English	Ibani	Igbo
AIDS	AIDS, 8 + 1, earthquake	Kini- baba - obi	Oria Ojo
Abstinence	Hold body	Bu-olo	jide owein
Condom	Rubber, blom-blom, rain coat	Su
Treatment	Treatment	Obi-gwo	Igwo-oria
Prostitute	Ashawo, Ogbongidi	Sefibo	Akuna kuna
Prostitution	Hustling; night duty	Sefi
Unfaithful	waka waka	Amawangi	Onyegarin garin
Sexually Transmitted Infections	ghono		Nshi Nwanyi
Faithful	One man one woman
Sex workers' clients (black) (2)	saikrokro

Source: The Ibani-se HIV/AIDS Initiative, Bonny Island, Nigeria

(2) Commercial sex work is rampant on Bonny Island, where the gas and petroleum industry is staffed mainly by male workers living away from their families. The local sex workers distinguish between their African customers and their (more affluent and therefore desirable) European customers. White people are generally referred to as oyibo in Pidgin English.

 

In encouraging HIV prevention among local people or migrant security guards who patrol the petroleum and gas compounds, choosing the right terminology is important. It is more effective to talk about "hold body" if one is single or to focus on "one man, one woman" if one is married or in a monogamous relationship than to preach "abstinence" or being "faithful" in those terms.

The role of sociolinguistics in developing appropriate HIV and AIDS terminology

Talking about AIDS-related issues is delicate and requires terminology that will not offend or bewilder the persons who read documents or attend meetings and counseling sessions on HIV and AIDS. In the beginning of the HIV and AIDS epidemic materials promoting safe sex and AIDS awareness were produced in North America and Western Europe, where standards of language use and cultural appropriateness were often starkly different from the norms of most other cultures in the world.

The development of terminology for HIV and AIDS work in South Africa

Scientific and technical terminology enabling people to discuss sexual and anatomical issues without embarrassment or offence evolved in Western countries long before the advent of the HIV and AIDS epidemic. For example, English provides at least three registers which can be used to discuss sexual issues; there is vulgar or obscene language, polite social language and scientific or technical language. On the other hand, according to Crawhall (1999), in southern Africa, most cultures prohibit or limit the use of sexually explicit language in public. In Nguni cultures (3), for instance, there were traditionally strict rules about language and gender that carried over into sexual matters. The importance of maintaining respect, or ukuhlonipha, in talking to one's elders or members of the opposite sex made it difficult to discuss sexual practices or anatomy in any detail. As a result, at the beginning of the epidemic, South African AIDS educators felt obliged to resort to self-censorship to avoid offending people when using English terminology. When using indigenous languages, AIDS educators were faced with the challenge of how to be sexually explicit and precise without losing their audiences by giving offence. In discussions about HIV transmission, participants who chose a register so remote from explicitness that it was obscure were required to be more precise and accurate. For example, a participant would refer to penetration as ukwabelana isondo (literally: to share a small piece of cloth). This polite term is widely understood in Xhosa and has come into increasing public usage through AIDS education. It is in contrast with more vulgar (e.g., less respectful) terms such as ukulalana (to sleep together).

(3) The Nguni People of South Africa include the Zulu, Xhosa and Ndebele, who reside all across the country (SouthAfrica.com, 2007).

According to Crawhall, workshops brought together social workers, medical personnel and other concerned persons to develop acceptable terminology in local languages to talk about HIV and AIDS. The discussions were participatory and the facilitator of the discussions had to take the sometimes participants to a new level of explicitness that made clear, for example, which fluids go where during any particular sexual act. Whether starting with isondo in Xhosa or intercourse in English, the participants would be asked to be more precise. The facilitator would ask, "What happens?" Having established a commitment to openness and a relatively comfortable register, the participant would go down one more level in precision. This could be: indoda ifaka ubhuti kusisi (literally: the man puts his brother in the sister) or in English, the man puts his penis in the vagina.

Crawhall also notes that there is another register in Xhosa where a person might say: indoda ifaka incanca enyweni (literally: the man puts his penis in the vagina). However, the terms are generally considered disrespectful and would not be used in front of anyone to whom respect is due. Use of such terms in a workshop would likely give extreme offence to participants. On the other hand, the use of terms like 'brother' and 'sister', instead of 'penis' and 'vagina' in English would sound evasive. Someone using such terms in Europe or North America might be admonished to use specific terminology and stop "beating around the bush". The workshop team found that it was important to let participants choose empowering and respectful terminology. Using a sociolinguistic approach to safe sex promotion from a linguistic and semantic point of view there is no need to force the participants to abandon euphemisms when they are adequately precise. The cultural implications of violating sociolinguistic norms of English and Xhosa should not be taken as equivalent. There is a substantial difference between the English distinctions between medical register, vulgar register, and coy euphemisms on the one hand and Xhosa distinctions between respectful language and disrespectful language.

The development and use of terminology for HIV and AIDS work in the Ivory Coast

While French is the official language of the Ivory Coast, Ivorians speak more than 60 local and regional languages (4). Despite a myriad of information sources on HIV and AIDS in French available in the country, much of the information has not been reaching vulnerable segments of the population.

(4) The author is indebted to Mr. Kouassi Yeboua of REPMASCI (Network of Media, Arts and Sports Professionals) for the internal documentation on the use of Ivorian languages in HIV and AIDS work.

Therefore, in order to make sure that messages are getting through, the Réseau des Professionnels des Médias des Arts et du Sport (REPMASCI) has played an important role in developing glossaries of culturally acceptable and understood terms for use in sensitization, education and counseling related to HVI and AIDS. The (US) President's Emergency Plan for AIDS Relief (PEPFAR) has funded the creation of lexicons for talking about HIV and AIDS in sixteen indigenous languages through a $95,000 grant to assist with the launch, production and dissemination of these lexicons on HIV and AIDS. Through combining words, applying new meanings to old words, and creating new ones, committees of linguistic experts were able to literally give local populations the words with which to talk about HIV and AIDS. For example, in Abbey (a coastal language), the new word for HIV/AIDS is m'piaharele orogba, literally translated as "a sickness of blood", while in Baoulé, spoken in the central area of the Ivory Coast, n'zissikoklo, means to die slowly from a disease. REPMASCI is now working with radios broadcasting in indigenous languages, as well as agricultural extension agents, teachers and community leaders to put the lexicons to use with rural and underserved populations (PEPFAR, 2005). Further examples from the REPMASCI lexicon for Malinké, are presented below:

Table 3: Selected Standard English and Malinké terms relating to HIV and AIDS

English	Malinké (5)	Literal translation (6)
AIDS	Jatigifaga bana	"the illness that kills its host"
Virus	Ninfarinnin	"this little body"
The development of AIDS	Jetigifagabana banbali	"to get the never-ending illness"
To use a condom	Ka mananin don	"to put on the 'little plastic [thing]"
An infected person		"the person who has the seed of the illness"
HIV-negative	Jatigifagabannantan	"The host who can't be killed"
HIV- positive		"the host who can be killed"
Sexual transmission		"the worldly way"
Transmission through blood	jori sira	"via the blood"

(5) REPMASCI, Extrait du document de lexique VIH-SIDA en langues nationales.
(6) Explanation of Malinké terms : personal communication, Gérard Diarra, Paris, 07/12/2007 and Fana Tangara, Bamako, 08/12/2007.

Source: REPMASCI, English translation by the author.

REPMASCI and its partners have chosen to work with the 16 most widely-spoken languages in the Ivory Coast. Two of them, Baoulé and Malinké, are actually spoken by many people throughout the country. For that reason, sensitization, education and counseling are done in the primary local language as well as Baoulé and Malinké (7). For example, the languages used in HIV and AIDS work in southern Ivory Coast are the following:

(7) The Baoulé people are of the Akan group and are from the central region of the Ivory Coast. The Malinké are a Manding ethnic group. Approximately 7,750,000 Malinké are scattered throughout West Africa (Wikipedia).

Table 4: The use of local and additional languages for HIV and AIDS work in southern Ivory Coast

Zones	Local Language	Additional Languages
Centre-Ouest	Bété +	Baoulé and Malinké
Est	Agni and Abron +	Baoulé and Malinké
Sud-Ouest	Kroumen +	Baoulé and Malinké
Sud Lagunaire	Adjoukrou +	Baoulé and Malinké

Source: REPMASCI

One of the most important actors in HIV and AIDS work in rural areas is ANADER (Agence Nationale d'Appui au Développement Rural - Côte d'Ivoire), or the National Rural Development Agency of the Ivory Coast, which has a wide extension network in the southern part of the country. REPMASCI had developed the following methodology for supporting HIV and AIDS sensitization, education and counseling work through ANADER.

At the village level, ANADER selects three Community Advisors (including one woman) who are members of the Village Anti-AIDS Committees. The Village Advisors receive training on a number of topics, including information-education-communication techniques, VCT, the care of OVCs and PMTCT and therefore have more skills than the other members of the Village Anti-AIDS Committees. The Village Advisors serve as peer educators and interpreters who orchestrate all meetings on HIV issues (such as the viewing of sensitization films, HIV testing provided by mobile units, pre- and post-test counseling, identification of OVCs and so forth). The meetings tend to be in single-sex groups. For example, some sensitization sessions for men are held in the fields. The female member of the Community Advisor team can organize certain meetings for women only in order to show them the female condom and encourage them to speak openly and ask questions about HIV and AIDS issues. The knowledge of HIV and AIDS terminology in the local language is essential to the success of these meetings.

The training process involves cross-checking for accuracy and correct understanding of terms. The REPMASCI and ANADER training for the Community Advisors includes a translation test with statements like the ones below:

Translate the following texts [from French] into local languages paying particular attention to the meaning of the underlined words. (in green)

Text No.1: The ways of contracting the virus

There are three main ways by which the AIDS virus (HIV) can be transmitted from an infected person to a healthy person.

These ways are: via sex, through blood and from mother to child.

Text No.2: The ways of spreading the virus

A person infected with HIV who has sexual relations with another person without the protection of a condom can transmit the virus to this partner.

REPMASCI and ANADER are satisfied with the results of the training. The translation exercise did not pose any major problem since the training was conducted both in French and in local languages. Village Advisors are chosen for training by ANADER based on their knowledge of French and local languages.

Diagram 1: The practical applications of local languages in HIV and AIDS work in rural Ivory Coast

REPMASCI Trainers

Provide training on HIV and AIDS-related terminology to

ANADER Field Agents, who replicate the training for

Community Advisors, who Organize HIV and AIDS awareness, sensitization and education activities at the local level:

ADVOCACY: focus on decision-makers and influential people: village chiefs, notables; efforts to ban traditional but risky practices such as obliging widows to marry their brothers-in-law or younger sisters to marry their brothers-in-law to take the place of deceased older sisters

GROUP DISCUSSIONS: about STIs and HIV and AIDS issues in groups of men or women of the same age group and having similar or the same professional or personal interests

HOME VISITS: to pre-identified families infected or affected by HIV and AIDS issues; counseling given to individual family members, as needed.

SKETCHES: staged at public ceremonies and gatherings to use drama to sensitize the public about HIV and AIDS issues.

 

Because the 16 languages covered by the PEPFAR-REPMASCI initiative constitute less than a third of the total languages spoken in the country, further work is planned to expand the lexicons to include more languages. The Institute of Applied Linguistics at the University of Abidjan - Cocody, will provide technical assistance for the next phase of work.

Another initiative worth mentioning is a northern Cameroon project managed by the French Cultural Centre in Garoua in partnership with Radio Bénoué (a UNESCO-supported radio station run by women). The project is partially sponsored by the Merck Company Foundation. Its goal is to broadcast HIV/AIDS information in French and mostly in Fulfuldé, the main local language used in the three provinces constituting roughly 40 per cent of the country. Fulfuldé is also spoken in northern Nigeria, southern Chad and the Central African Republic, which border northern Cameroon. The project responds to needs reflected in indicators that show high levels of risk behavior, a lack of adequate knowledge about HIV prevention and high levels of stigma related to PLWAs in northern Cameroon.

There is a long way to go in responding to HIV and AIDS using local languages, but in many ways, "the ice is broken" and the initial reluctance to discuss sexuality has been overcome. A participatory and sensitive approach to letting speakers of a given language develop appropriate terminology seems to be the best way to go.

List of Acronyms and Abbreviations

AIDS	Acquired Immuno-deficiency Syndrome
ANADER	Agence Nationale d'Appui au Développement Rural
HIV	Human Immuno-deficiency Virus
MSM	Men Who have Sex with Men
OVC	Orphan and Vulnerable Children
PEFFAR	President's Emergency Plan for AIDS Relief
PMTCT	Prevention of Mother-to-Child Transmission
REPMASCI	Réseau des Professionnels des Médias des Arts et du Sport
UNAIDS	United Nations AIDS [Agency]
UNESCO	United Nations Educational, Scientific and Cultural Organization

Bibliography and web sites

Crawhall, N., 1999: Using a socio-linguistic approach to safe sex promotion in Cape Town: the challenge of multiculturalism, in Becker, C. and Dozon, J.-P. (eds), Experiencing and Understanding AIDS in Africa. Dakar, CODESRA." document accessed on 07/12/2007 at: http://www.codesria.org/Links/Publications/aids/crawhall.pdf

PEPFAR (2005). "Cote d'Ivoire - The language of HIV/AIDS". The President's Emergency Plan for AIDS Relief: March 2005 Newsletter. Washington, D.C. Office of the U.S. Global AIDS Coordinator. Accessed on 07/12/2007 at: http://www.pepfar.gov/press/75994.htm

Royes, Heather (1999) A Cultural Approach to HIV/AIDS Prevention and Care. "Jamaica's Experience Country Report" Paris: UNESCO/UNAIDS Research Project Studies and Reports, Special Series, Issue No. 8. Cultural Policies for Development Unit.
UNESCO. Accessed on 07/12/2007 at http://unesdoc.unesco.org/images/0012/001206/120689e.pdf

Shiripinda, Iris. (2003). Young women and sex in Africa in the times of HIV/AIDS. A case of Zimbabwe. Paper presented at Gender and power in the New Europe, the 5th European Feminist Research Conference. August 20-24, 2003 Lund University, Sweden. Accessed on 07/12/2007 at: http://www.iiav.nl/epublications/2003/Gender_and_power/
5thfeminist/paper_791.pdf

SouthAfrica.com (2007). "The Nguni People of South Africa", Accessed on 07/12/2007 at http://www.southafrica.com/blog/the-nguni-people-of-south-africa

UNAIDS (2006). Global Summary of the AIDS Epidemic, December, 2006. Geneva. UNAIDS.

Personal communications

Table 2: Terminology in English, Pidgin English, Ibani and Igbo.
Dr. Ibiba Chidi, Mr. Sunday Samson, Ms. Justicia Green and Mr. Bara Brown of the Ibani-se HIV/AIDS Initiative, an NGO on Bonny Island Nigeria. E-mail communication 04/072007.

Table 3: Terminology in English and Malinké.

Conversation with Gérard Diarra (Paris) 07/12/2007; email from Fana Tangara (Bamako) 08/12/2007.

Article by Mr. Eric Allemano, December 2007.
Photos for HIV@MSD Newsletter: Donald De Korte and Sophie d'Aurelle de Paladines