Language practices in radio programs on HIV/AIDS: A call for culturally-sanctioned ways of communication

Mozambique is one of the African countries hardest hit by the HIV epidemic, with 2010 data showing a prevalence rate of 11.5% among adults (Instituto Nacional de Saúde (INS), Instituto Nacional de Estatística (INE) and ICF Macro 2010). The effect of the pandemic on the country’s human development and related economic growth is potentially devastating as HIV and AIDS are most prevalent in adults in their productive prime. Through specialised programs, the media have been playing a key role in education initiatives aiming at reducing the infection rate in the country. Amongst other things, these programs have revealed a number of linguistic and sociolinguistic patterns which are worth being investigated. Considering HIV/AIDS radio programs broadcast in Changana, I show how Changana speakers have been developing their language as well as reinventing their discourses in order to respond to these new context-specific communicative demands. In this paper, I consider some of the communication strategies used, including the coinage of terminology and the engineering of socially appropriate ways of talking about sexuality and sexually transmitted diseases in public spaces.


Introduction
In the absence of a vaccine or a cure for the HI-virus, prevention through education is regarded as the best approach to respond to the global HIV epidemic. The ABC (Abstinence, Be faithful and use a Condom) model has been one of the pervasive HIV/AIDS prevention models adopted in southern Africa. Despite its pervasiveness, this model of health education has been subject to criticism because, amongst other things, it is assumed that it focuses on the individual instead of social groups and represents AIDS as a behavioural disease associated with improper, censurable sexual conduct (cf. Paulo 2004;Ambe-Uva 2005;Passador 2009).
The way(s) in which language is used in education efforts is not the sole reason as to why HIV prevalence and incidence rates are on the rise in Africa and elsewhere. Other factors should also be taken into account, such as structural constraints on human agency, such as poverty, sexual abuse and patriarchy, which also have a bearing on the spread of the pandemic (see Yankeh and Aggleton 2008;Higgins and Norton 2010;Jones and Norton 2010). However, drawing on Stroud (2009), one can argue that language still plays a crucial role as it is a co-equal factor in the 'nexus' of poverty and disempowerment.
Moreover, as Mehan (1984:181) points out, "language can be seen as a window into attitudes and life patterns or into correlations between one aspect of social structure and another". This is a view which conceptualises language as a mediating force in people's lives. In Mehan's terms, this sociolinguistic view underscores the "importance of looking at the window of language and not just through it". In this context, I believe that, by framing language within its social and cultural contexts, sociolinguistically-informed approaches to discourse may contribute to understanding and explaining communication failures as well as to strengthening HIV/AIDS communication awareness campaigns in Africa. The calls from experts for culturally appropriate communication strategies to HIV education and prevention resonate this view of language as a symbolic form of cultural manifestation.
Against this background, the present paper analyses linguistic and sociolinguistic patterns represented in HIV/AIDS discourses in Mozambique. Listening to and considering the discourses developed in HIV/AIDS radio programs presented in Changana, I will demonstrate how speakers have been reinventing their language and discourses in order for them to respond appropriately to these new context-specific communicative demands. I will consider some of the communication strategies used by Changana speakers. From the language user perspective, communication strategies can be defined as interactional processes adopted by speakers to express and negotiate meaning in contextually appropriate ways. The strategies analysed include lexical coinage and the re-engineering of socially appropriate ways of talking about sex-related issues in public spaces.
The study shows how Mozambicans are engineering their local languages in order to refer to sexual practices and related topics, although this has not been framed within top-level corpus planning initiatives and efforts aimed at integrating local knowledge into official discourses on HIV/AIDS. The suggestion advanced in the study is that, in order to mobilise the http://spilplus.journals.ac.za communities and achieve long term success, HIV/AIDS education and prevention strategies should consistently include corpus planning and take into account culturally sanctioned norms of communication, as well as respect and optimise traditional beliefs and practices that are not detrimental to the people's health.

Methodology
This study is based on the premise that communication and health education effectiveness "is dependent on understanding the social and cultural conditions that influence behaviour of a target group" (Ambe-Uva 2005:180 This study is based on data collected from radio programs on health issues broadcast by the state-run Radio Mozambique. Radio Mozambique is a national radio network with 10 affiliate stations broadcasting from the provincial capitals, making it 'the largest media organisation in the country' (Inforasaid 2012). This radio organisation has a national service which broadcasts nationwide in Portuguese. The affiliate stations broadcast in a mixture of Portuguese and the major local languages of the respective provinces.
Radio has an immense reach in Mozambique in that it is the major source of information for a large number of citizens, particularly in rural Mozambique. Estimates indicate that Radio Mozambique and community radio stations are the source of news and broadcast entertainment for 60% of Mozambicans who cannot speak Portuguese, the country's official language (Inforasaid 2012). According to the most recent national survey on HIV/AIDS (INS et al. 2010), 80% of women and 91% of men in Mozambique listen to the radio at least once a week. This gives an indication of the people's level of exposure to HIV/AIDS education and prevention messages, especially considering that all affiliate stations of Radio Mozambique include health education programs in local languages. In a multilingual and multicultural country like Mozambique, where the majority of the population barely speak Portuguese, radio programs in local languages are of crucial importance as they help to overcome language barriers in the dissemination of HIV/AIDS knowledge.
One of the advantages of HIV/AIDS education via radio programs is that it offers effective opportunities for anonymity. Where people hesitate to discuss HIV/AIDS issues in face-toface public spaces, radio programs which include anonymous interviews and/or call-ins from listeners help to counter this communication problem. For example, unidentified listeners can phone into the program to discuss their choices and opinions with experts. In turn, experts can offer medical, social and psychological counselling regarding HIV/AIDS to a wide audience. This form of unconstrained communication is likely to offer good quality data, as it may reveal 'genuine' perceptions and behaviours attached to sexuality and HIV/AIDS-related issues.
I chose to analyse data from two health education programs, namely A nossa saúde 2 ("our health") and Tchovatchova ("push-push"). The former is broadcast by the Maputo affiliate station of Radio Mozambique, and the latter by the Gaza province affiliate station. Both are weekly programs broadcast in Changana and they target all age groups. Data were taken from 10 radio programs dedicated to HIV/AIDS issues. Most of the excerpts analysed in this paper were taken from the program A nossa saúde (for no specific reason other than that these best illustrate the points made in this study). In these programs, journalists invite experts such as medical practitioners and health activists to offer medical, social and psychological counselling regarding HIV/AIDS to listeners. These experts are linked to different institutions, including governmental and non-governmental organizations. In some cases, the programs are based on interviews with members of the public, in which they are asked to provide their opinions and preferences on issues relating to HIV/AIDS. For ethical reasons, code names (for example, "Mr M.", and "J" for Journalist) have been used to refer to the different participants involved in the radio programs which were analysed in this study.
Relevant extracts of the programs were transcribed and analysed. The analysis focuses on linguistic, discursive and socio-anthropological dimensions. Based on these analytical perspectives, the inferences made here are not solely based on linguistic forms but also on contextual dimensions of their production, including interactional and socio-anthropological dimensions. Therefore, following sociolinguistically-informed ethnographic approaches to discourse, like linguistic ethnography (see Rampton 2007), I explore the connections between discourse and socio-cultural structures and processes.

Lexical development in Changana
One of the consequences of the subaltern status assigned to African languages in Mozambique has been that these languages have not been influenced by language planning efforts which would encourage systems of codification, including the development of grammar books, http://spilplus.journals.ac.za dictionaries and the necessary vocabulary to cope with the challenges of science and technology.
The low levels of codification of most local African languages have led many people to maintain the myth that these languages are incapable of serving as vehicles for advanced knowledge, including biomedical knowledge. However, as linguists have argued, all living languages have considerable potential for growth and development and can cope with the challenges of modernity (see, amongst others, Bamgbose 1999;Obanya 1999;Campbell-Makini 2000). Indeed, evidence indicates that grassroots users of local African languages in Mozambique are responding to the complex challenges posed by developments in health education, with particular reference to HIV/AIDS education and prevention. So far, however, such responses are happening in a spontaneous and ad hoc fashion, outside of institutional corpus planning initiatives. The terms have mainly been created by medical and health professionals, social workers and activists working for governmental and non-governmental organizations chiefly as a way of filling gaps between their communicative intentions and technical linguistic resources available in African languages. The expectation is that, with corpus planning and lexical development coordinating bodies, there would be better opportunities to technically sanction the terms being created as well as to maximize "the intersection between local and global discourses on HIV/AIDS" (Higgins and Norton 2010).
Data presented in this section show how speakers of Changana have been developing specialised terms in order to represent concepts which are relevant in public communication about HIV/AIDS and sexuality. Linguistic strategies used to expand Changana terminology include (i) semantic extension of Changana existing terms, (ii) borrowing of terms from Portuguese, and (iii) translation of Portuguese loan terms.

Semantic extension
Semantic extension is a strategy which involves the extension of the meaning(s) of an already existing word to express specialised concepts (Batibo 1992). In Extract 1, the word xitlhangu or "condom" used by Mr M., a health expert, illustrates the application of this term's development strategy. [When you have sex with your lover, be it a man or a woman, use a condom in order to protect yourself...] The original meaning of the term xitlhangu is "shield". However, in this context, it represents the concept of 'condom'. As can be understood, there is a metaphoric relation between the referents 'shield' and 'condom', as both serve as protective objects.
Another term of which the meanings have been extended is xipungwana. The original meaning for xipungwana is "worm", but in a medical context it represents the concept of 'virus'. In Extract 2, Mr M. uses the term to explain the destructive action of the HI-virus. [The virus (of HIV) destroys the immune system which makes the body vulnerable to different sorts of diseases.] Note the redundancy of this expression: considering the fact that HIV stands for Human Immunodeficiency Virus, it would be enough to simply say "HIV". However, even in the discourse in Portuguese, speakers also say vírus de HIV, meaning "HIV virus". This may be the strategy speakers use to specify the type of virus in question. Table 1 shows some of the technical terms created through semantic extension. Most of the terms presented in Table 1 are already being used by ordinary citizens, but there are others which are still part of the discourse of health educators and practitioners only, or at least of those speakers who are more exposed to HIV/AIDS messages.

Borrowing
Borrowing refers to the importation of linguistic forms, such as words and morphemes, from another language (cf. Katamba 1993). In addition to using Changana linguistic resources to create new terms, speakers also borrow terms mainly from Portuguese. This language can be regarded as the source of technical terms, including those related to HIV/AIDS. The fact that biomedical and epidemiological aspects of HIV/AIDS, as well as international prevention models, adopted in Mozambique are primarily communicated though Portuguese may explain why this language has been the source of technical terms used in Changana and in other local languages. In addition, there are also some English borrowings (e.g. "HIV") used in Changana, though these are not borrowed directly from this language, but from Mozambican Portuguese where they are also used.
In the Extract 3, the journalist (J1) used the English and Portuguese acronyms HIV and SIDA ("AIDS"), respectively, in her introduction to the program. She also used the borrowed word maantiretrovhirali ("antiretroviral"), used here in the plural form. The English acronym HIV is also used as such in Mozambican Portuguese, which indicates that Changana speakers did not borrow this term from the source language, but indirectly from Portuguese. Although there are attempts to translate Human Immunodeficiency Virus 3 (HIV) and Sindroma de Imunodeficiência Adquirida 4 (SIDA) into Changana, especially in specialised written discourse, the general tendency is to use the corresponding English and Portuguese acronyms instead. These seem to be easily understood by ordinary speakers than the equivalent full Changana translations. Despite the popular use of the term maantiretrovhirali, when there is a need, it is also defined as mimirhi yomathisa HIV or "drugs for weakening HIV".
In general, borrowed words have to be adjusted to the grammatical patterns of Changana. For example, following the Changana noun class assignment, the word ma-antiretrovhiral-i, which is the plural form of "antiretroviral", received the noun prefix ma-, indicating that it belongs to class 6 5 . In addition, instead of ending with the consonant 'l' as is the case in Portuguese, the borrowed noun ends with the vowel -i, responding to the consonant-vowel (CV) basic syllabic pattern of Changana and other Bantu languages. Another common method of accommodating borrowed words pertains to the insertion of vowels or deletion of consonants in order to eliminate clusters involving sonorant sounds, as required by the rules of Changana.
For some technical concepts, speakers seem to have no choice but to use the corresponding Portuguese terms (i.e. code-switch). Mr M.'s use of the terms indução ("induction") and reacção alérgica ("allergic reaction") in Extract 4 illustrates this strategy. Although these terms can also be regarded as borrowings from Portuguese, they differ from ordinary borrowings since they are not adjusted to the grammatical rules of Changana and do not seem to be part of the lexicon of ordinary speakers of Changana in their discourses related to HIV/AIDS. The way in which these terms have been used in Extract 4 substantiates their exclusion from what can be called "ordinary borrowings". In this extract, Mr M. was indeed aware of the fact that the Portuguese words indução and reacção alérgica could not be (easily) understood by ordinary Changana listeners. This can be indicated by his use of the discursive marker "what we call" to introduce those terms. In order to make his message understandable, these two terms were followed by explanations which were introduced by the expressions "which means that" and "that is", respectively. This can be regarded as an instance of code-switching: the speaker had to switch into Portuguese given the lack of "immediate" equivalent Changana words to represent the desired concepts. Table 2 illustrates some HIV/AIDS-related borrowed words which are used in Changana. As is evident, most of these terms refer to the biomedical semantic field. [Today we will talk about complications arising when a person living with HIV/AIDS stops taking what is called antiretroviral drugs.] Aiming at fighting against discrimination of people affected by the HIV pandemic, different communication guidelines recommend what is called "positive language" for HIV/AIDS information and education. One term commonly included in guidelines such as these is "people/person living with HIV/AIDS" (PLHA), which is presented as the recommended alternative to the somewhat negative equivalent "HIV-positive person" or "HIV-infected person". In order to convey the same meaning, speakers of Changana have translated the Portuguese version of this expression as munhu lweyi ahanyaka ni HIV/SIDA (literally "person who lives with HIV/AIDS").
Another illustrative case of loan translation can be found in Extract 6, where Mr M. uses the expression ndlela ya nsawutisu ("immune system") to explain the function of the immune system.
[Usually, people living with HIV/AIDS are attacked by different diseases because this virus destroys the immune system. The function of the immune system is to protect the body against micro-organisms which cause diseases.] Table 3 shows some of the loan translations used in Changana.

3.2
The language of secrecy and culturally appropriate rules of speaking As sociologically-and anthropologically-orientated studies have revealed (Verheij 2007;Ambasa-Shisanya 2007;Sigamoney 2009;Audet et al. 2010), silence and secrecy are part of culturally appropriate ways of communicating about sexuality and sex-related diseases in Africa. Amongst other things, silence and secrecy about sexuality and sex-related diseases are usually taken as "an indicator of respect for oneself, one's kin, and the community" (see Sigamoney (2009:1-2), in relation to Basotho).
Accordingly, speakers of African languages have, when silence is not suitable, developed culturally appropriate ways of talking about these issues, which include the use of metaphors, euphemisms and other indirect references. These are culturally perceived as ways of adhering to the communicative requirement of secrecy regarding sexuality and sex-related diseases, and still achieving a seemingly conflicting aim of actually talking about a tabooed topic of critical importance for healthcare. These strategies can be captured in the discourse of Changana speakers taking part in HIV/AIDS-related radio programs. Extract 7 below is a replication of Extract 1 with the emphasis on different words. [When you have sex with your lover, be it a man or a woman, use a condom, in order to protect yourself...] The Changana word for "sexual intercourse" is seldom uttered in public, not even in a conversation involving sexual partners. Instead, speakers tend to use metaphors or euphemisms to refer to this act. The term kufambelana masangu, literally "to share mats with someone", is regarded as less loaded than the equivalent direct expression for having sex.
Other socially sanctioned expressions used to refer to sexual intercourse include kutlanga ("playing") and kutlhokola mavele ("ripping the corn"). Of course, these terms cannot be regarded as neologisms as they have been used for generations, well before the emergence of HIV/AIDS. However, they merit attention here because, on the one hand, their currency is particularly linked to this context of HIV/AIDS and, on the other hand, they illustrate well how speakers respond to culturally sanctioned norms of communication. Interestingly, equivalent terms with the same function are also used in other Bantu languages in the southern region of Africa (see Sigamoney 2009 in relation to Basotho).
As has been pointed out in relation to other African contexts (Sigamoney 2009 on Lesotho), the meanings in the language of secrecy frequently require insider knowledge to be correctly decoded. In other words, cultural outsiders may find it difficult, perhaps impossible, to understand the meanings conveyed in these contexts, even in cases where they can speak the language used. Some of the euphemisms and metaphors used in Changana sex-related discourse are shown in the Tables 4 and 5: This extract foregrounds some of the basic Changana rules of speaking. Amongst other things, the extract reveals that sexuality and sex-related issues are taboo among Changana people and, as such, they should not be talked about in a public forum, especially when that forum involves participants of different genders and/or age groups. Moreover, although the speaker conceded that elders can learn from young people, his speech presupposes that, in a traditional Changana mindset, knowledge is passed from the elders (who are regarded as the sources of wisdom) onto new generations, and not vice versa.
The conclusion that can be drawn from this account is that the poor representation of Changana male participants in HIV/AIDS prevention activities has, at least in part, to do with their dissatisfaction with the breach of culturally sanctioned communication norms. In this case, what is at stake is not just the type of language or genre used but the situational context of communication as a whole, which includes considerations about where communication takes place, who participates in the communication exchange, what the roles assigned to each category of participants are and what the topic and purpose of the conversation is.
The analysis presented here suggests that communication about HIV/AIDS education and prevention could be more effective if culturally appropriate rules of communication were observed. The promotion of peer talk may be one way of achieving this goal. In a peer talk arrangement, people of the same age group and gender gather to learn from each other and discuss HIV/AIDS-related issues more openly. Preferably, health experts, activists and other advisers should also be of the same age group and/or gender as the people who convene in order to approach these issues.
Cultural norms and practices such as sexual initiation, so-called "widow cleansing", and traditional healing involving the use of unsterilized cutting objects are among the attested risk factors for HIV infection in Mozambique (see Paulo 2004;INS et al. 2010;Audet et al. 2010). Radio programmes have been instrumental not only in bringing these sensitive issues into public debate but also in disseminating innovative ways of making them safer. In Extract 9, Mr Z., a member of the community, justifies why some Changana people continue to observe the ritual of widow cleansing (kucinga), a widespread practice across sub-Saharan Africa which is believed to purify women after the death of their husbands. [That's correct... but in traditional terms it is required that a woman who has lost her husband be subject to a cleansing ritual in order to be purified... eeh... in order to be ready to start a new life. It is required that she sleeps with a brother-in-law. However, nowadays... mainly because of this global epidemic, some refuse to be purified or purify their sisters-in-law by means of sexual intercourse. Nowadays, many prefer alternative ways of observing the purification rite such as the sole use of herbal remedies and/or magic charms, which do not involve sexual intercourse between the widow and her brother-in-law or any hired professional cleanser... However, many do not trust these alternative ways of purification... they are used to the sexual cleansing rite.] In this account, Mr Z restates the traditional importance of the widow-cleansing ritual. After the death of their husbands, widows are considered to be in an impure state which is perceived to be harmful to themselves and to other people. In this context, the cleansing ritual is taken as a necessary practice to reverse this impure state and allow the widow to start a new life. However, in a further development, the speaker notes that there are alternative ways of observing the purification rite which do not necessarily involve sexual intercourse between the widow and her brother-in-law or with any hired "professional" cleanser. The speaker stated, though, that many do not trust such alternative ways of purification.
Although there is a lot to be done in order to change traditional beliefs and practices, this account shows how the emergence of HIV/AIDS is prompting social and behavioural change, especially as far as sex-related practices are concerned. This shows that tradition is not as static as it is usually perceived or presented but something that can be changed as a result of socio-historical contingencies. So, instead of trying to ban traditional practices such as widow cleansing, education and prevention programs should try to make these practices safer. This can be achieved through the encouragement of approaches that do not put people at risk of HIV infection, such as widow purification rituals which do not involve sexual intercourse. Radio programs and other forms of dissemination of information should play a role in helping people alter their vision of life by creating a space for the promotion of innovative forms of interaction between local or traditional and biomedical or global forms of knowledge (Drescher 2010).

Closing remarks
As Bamgbose (1999:14) points out, "a language cannot be used in a wider range of domains if it is not developed, and it will not be developed unless there is a need to use it in a wider range of domains". The data analysed in this paper substantiate this cycle. Indeed, the use of local African languages such as Changana in HIV/AIDS education and prevention campaigns has prompted their development in this domain, which further substantiates the view that all languages have considerable potential for growth and development and can cope with the challenges of modernity. http://spilplus.journals.ac.za The study showed how speakers of Changana have been engaged in language engineering processes aimed at responding to the complex challenges posed by communication about sexuality and HIV/AIDS, especially with regard to biomedical and epidemiological aspects of the disease. The strategies used to enable their language to cope with these challenges include semantic extension, borrowing, and loan translation. However, as indicated earlier, these language development initiatives are happening spontaneously in Mozambique, which, amongst other things, constrain the institutionalization and consistent use of the coined terms, hence the call for official corpus planning endeavours.
The analysed data show that, in addition to grammatical rules, the engineering of structural aspects of the Changana language is also informed by culturally-sanctioned norms of speaking, which include, amongst other things, consideration of the situational context in which newly devised or semantically extended terms are used. As discussed, what matters is not just the type of language or genre used, but also considerations about the place of communication, the roles assigned to the participants involved, as well as the topic and purpose of the conversation. The use of metaphors, euphemisms and indirect words to convey sex-related issues as well as the approach of these sensitive issues in groups separated by age, gender, etc. are part of this obedience of culturally appropriate rules of communication. However, as has been shown, there are cases where health educators and practitioners neglect these rules of communication, for example, when they talk about sexuality and sex-related issues in public forums involving participants of different genders and/or age groups. Based on the gathered evidence, the suggestion is that, in order to mobilise local communities and succeed, HIV/AIDS education and prevention strategies should incorporate these norms of speaking.
As is consistent with findings from other studies, the Changana case presented in this article reveals that traditional beliefs and practices can be changed or modified according to specific socio-historical conditions. The emergence of HIV/AIDS and its devastating impact on individual, community and societal levels has been leading some community members to reinvent safer ways of performing certain traditional practices. Evidence reported in this study shows, for example, how some Changana people are exploring alternative ways of widow purification which do not involve sexual intercourse, but rather herbal remedies and exorcism.
These new practices demonstrate the dynamic nature of the traditional world. Although tradition is usually presented as static, unchangeable and as opposite to modernity, actual practice indicates that these two worlds "are constantly relating and interpenetrating, blending and merging" (Passador 2009:689). This is particularly true in this era of "glocalization" 9 , in which, chiefly for pragmatic reasons, people tend to swing between the two worlds according to contingent circumstances. This can be substantiated by the attested fact that in cases of diseases, for example, many Africans (irrespective of their level of education or socioeconomic status) resort to both modern biomedicine and traditional healing and witchcraft (Passador 2009). In this case, instead of clashing, tradition and modernity are perceived as complementing each other. In this sense, radio programs like the ones explored in this study have played a key role in changing people's beliefs and practices, by creating and disseminating spaces for debate regarding innovative ways of adapting traditional visions of life to the changing circumstances dictated by the spread of HIV/AIDS. http://spilplus.journals.ac.za As has been pointed out, traditional African beliefs and practices have important implications for HIV/AIDS education and prevention in Africa. Given this context and drawing on other studies (e.g. Van Dyk 2001;Verheij 2007;Sigamoney 2009), the suggestion is that, instead of trying to eliminate traditional beliefs and practices, HIV/AIDS education and prevention strategies should accept and respect these forms of representation as long as they are not harmful to the people's health. However, when traditional practices are perceived to contribute to the spread of HIV/AIDS, effort should be made in order to make them safer, as is the case of widow cleansing. My view is that even in the most conservative traditional settings there will always be opportunities to encourage people to change beliefs and practices that can be harmful to their health.
In summary, language development in Mozambique's Africa languages is being carried out by grassroots actors in a bid to fill the void created by the lack of macro-level language planning for health. The suggestion put forward in this study is that, in order to mobilise the communities and achieve long-term success, HIV/AIDS education and prevention strategies should consistently include corpus planning within institutions and take into account culturally sanctioned norms of communication, as well as respect and optimise traditional beliefs and practices. This suggestion is consistent with international calls for promoting the interception between local and global discourses on HIV/AIDS education, countering the current heteroglossic biomedical discourse (Drescher 2010;Higgins and Norton 2010).