HIV: Geography of an Epidemic
French Emperor Napoleon Bonaparte is credited for saying that “A good sketch is better than a long speech”. Nowadays, the representation below of the HIV epidemic taken from the 2010 UNAIDS HIV epidemic update is a classic and illustrates both the extent of the epidemic worldwide and its concentration in some geographic areas. The choice of a particular shade of red to represent the percentage of those living with HIV highlights the plight of the African continent. The shade of red growing darker toward the southeast of the continent reminds us that it is home to 22.5 million of the 33.3 million infected with HIV worldwide, five and a half of them in South Africa alone.
In one single and rather simple picture South Africa (and Botswana) is most immediately recognisable as the country which bears the brunt of the epidemic. With that picture-triggered insight flows a stream of other pictures and mental associations about Africa, “hot and dusty with rolling grasslands and huge herds of animals and tall, thin people who are starving”, and South Africa plagued by apartheid, poverty, Noble prize president, AIDS denialist president, football world cup and slums, men raping women and other images too often prompted by mainstream media reporting than personal experience. Such is the power of a sketch.
But a few pages later, the UNAIDS report presents a slightly different picture of the epidemic in sub-Saharan Africa.
Using similar shade of red but a different scale to represent HIV prevalence, it is no longer South Africa that bears the brunt of the HIV epidemic but neighbouring Botswana (as well as Lesotho and Swaziland, harder to spot). Little is usually known about Botswana but for its history of diamonds mining and for being the set for Alexander McCall Smith’s novel, but by the power of representation, and a change of scale, Botswana is now the African country most affected by HIV: estimated rate of new HIV infection (incidence) and percentage of people living with HIV (prevalence) are respectively 1.56 & 24.8 in Botswana and 1.49 & 17.8 in South Africa. Actually the epidmic is even worse in Swaziland but the scale does not allow visualising this information.
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