So a friend of mine, Jane Simmonds, has just left the PHASA 2016 conference (Public Health Association of South Africa) and I am thinking about a question that that she told me she was asked relating to the presentation she gave at the conference. She presented her findings on how to facilitate communication about sex, sexuality and HIV and AIDS between grandmothers and the grandchildren in their care. The question she was asked was “ But what about culture? Doesn’t culture stop us speaking to children about sex?” This was the response she gave…

“There isn’t a culture that I’m committed to, to the point where I would say, I don’t do this, I don’t do that, because of my culture. Knowledge I do seek because culture doesn’t work anymore … It doesn’t work, death comes.” ‒ Sindi (59, caregiver of four children).

These are the words of a grandmother who was part of her study in Alexandra Township, Johannesburg. Sindi (not her real name) had lost 3 daughters to AIDS and is now looking after 4 grandchildren. Her biggest worry is that her grandchildren are becoming sexually active and she doesn’t them to get HIV or have unplanned pregnancies resulting in her have to look after great grandchildren as well as grandchildren. She explained that although she loved her grandchildren and was committed to looking after them and caring for them, she was tired. Her body was tired and she found it difficult to cope. She faced numerous stressors daily including financial insecurity.

All the grandmothers in Jane’s research study expressed their fear of talking about sex to their grandchildren but they acknowledged that they had lost their own children to a consequence of sexual behaviour- AIDS- and that they needed to do something about talking about sex. They hadn’t had converstions about sex with their parents while growing up and, as a consequence, they didn’t know how to do this.“Now you must discuss issues [that] weren’t discussed with you and therefore aren’t open about is a bit difficult … When the time to discuss it all of these topics … you feel overwhelmed and somewhat defeated.” ‒ Lerato (59, caregiver of two children).

So we designed an intervention to help grandmothers talk to their grandchildren about sex, sexuality and HIV and AIDS. It was a workshop called GOgogoGO and we taught the grandmothers about HIV and AIDS and how to talk about sex to their grandchildren. This is what they asked us to do- “What would help me … is that you could teach me how to facilitate a thorough and deeper conversation because you have knowledge on how I could tell a child about these things.” ‒ Thoko (63, caregiver of one child)

So we taught them what we could. We shared information about HIV and AIDS; about condoms; tranmission; HCT; MMC; PEP; PrEP and most importantly we gave them guidelines on how to talk about sex, sexuality and HIV and AIDS. This is what Thuli had to say after the GogogoGO training- “I am no longer scared… before I was …shy but now I can open up. You know us black people are afraid of talking about this, but now I can.” ‒ Thuli (60, caregiver of three children)

I think these grandmothers are showing us the answer to the culture question. It is enough- it is enough hiding behind culture, taboo, stigma and ignorance. We can no longer blame other things for not being able to reduce teenage pregnancies and HIV transmission. We need to take responsibility and talk about sex. Talking about HIV and teenage pregnancy and not mentioning sex is like talking about lung cancer and not discussing smoking. Culture can no longer be used as a reason or excuse to not talk about sex and sexuality. People are having sex- we need to talk about it.