Complex HIV/AIDS Landscapes: Reflections on How 'Path Creation' Influenced an Action-Oriented Intervention

摘要

This article reflects on the way in which the path creation theorem influenced an intervention designed to overcome an intractable challenge during a community-university partnership in the Limpopo Province, South Africa. The intractable challenge related to the legacy of the Abstain, Be Faithful, Condomise (ABC) campaign that was mounted in the early 1990s to reduce the global impact of HIV/AIDS. Despite the context of the HIV/AIDS epidemic having shifted significantly since the ABC slogan was invented, the community partner-who focus on HIV/AIDS-related work-reported that the ABC-legacy continued to be a source of frustration in their work. In order to begin the process of overcoming the challenge, the partnership decided to go beyond the conventional boundaries of community-based HIV/AIDS discourses and develop an intervention influenced by complexity. The guiding heuristic for the design was the path creation theorem, placing special emphasis on the initial conditions, contingency, self-reinforcing mechanisms and lock-ins. The findings from the reflection indicate that concepts associated with path creation added value to the design-particularly from the perspective of incorporating processes of emergence over contingent events. The article concludes by suggesting that the path creation theorem was a flexible heuristic and that the application may have opened opportunities to explore the synergies between managing complex systems and more conventional forms of managing community-based interventions relating to HIV/AIDS.