Community Viral Load Management: Can Attractors Contribute to Developing an Improved Bio-social Response to HIV Risk-reduction?

This article reports on the first twelve months of a pilot study that was designed to improve community responses to HIV/AIDS in rural South Africa. The framework was designed to enable the modification of emergent attractor landscapes. Specifically, we report on the introduction of a primary probe; the secondary, community initiated probes and the attractors that emerged through the process. Probes were designed to stimulate frame changes amongst participants that would influence social practices. Attractors represent the empirically visible culmination of discrete patterns that influence the dynamic landscape. Managing or modifying these patterns, thus changing the landscape, including social practices, is the principle that underpins the framework. The findings were analysed using a qualitative methodology called causal layered analysis. Six attractors emerged that contribute to reducing the aggregate community viral load, and three attractors emerged that detract from that ambition. The first pilot has provided insights into improving the framework and has had an impact at multiple scales suggesting that the framework is a promising tool for engaging with the bio-social aspects of the contemporary epidemic.