‘She was bewitched and caught an illness similar to AIDS’: AIDS and sexually transmitted infection causation beliefs in rural northern Tanzania GERRY MSHANA 1 , MARY L. PLUMMER 1,2,3 , JOYCE WAMOYI 1,3 , ZACHAYO S. SHIGONGO 1 , DAVID A. ROSS 1,2 , & DANIEL WIGHT 4 1 National Institute for Medical Research, Mwanza, Tanzania, 2 Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, UK, 3 African Medical and Research Foundation, Mwanza, Tanzania, and 4 Social and Public Health Sciences Unit, Medical Research Council, Glasgow, UK Abstract HIV/AIDS programmes and interventions are more likely to succeed if they engage with local people’s beliefs about AIDS causation. This study examined beliefs about general illness, sexually-transmitted infection (STI) and AIDS aetiology in rural Mwanza, Tanzania. From 1999–2002, participant observation was carried out in nine villages for a total of 158 person-weeks. Beliefs about general illness causation included God’s will, chance, natural/biological, ancestral spirits, and witchcraft. STIs were generally attributed to natural causes, but beliefs about AIDS causation were more complex. Few villagers had heard of HIV, but most had heard of AIDS and understood that AIDS could be contracted through sex. A small proportion of villagers knew that such an infected person might appear healthy, but they generally believed the asymptomatic period to last only a few months after exposure; if healthy beyond that, the person was not believed to have been infected. Many people in all villages reported belief in both a ‘real’ (natural) AIDS, which leads to certain death, and a similar illness caused by witchcraft, which can be cured using traditional medicine. Punishment of accused witches occurs officially and informally, and this may increase with increasing AIDS deaths. There is an urgent need for culturally appropriate interventions to address HIV/AIDS causation beliefs in the region. Re ´sume ´ Les programmes et les interventions de lutte contre le VIH/Sida ont plus de chances d’atteindre leurs objectifs s’ils prennent en conside ´ration les croyances locales sur la causalite ´ du sida. Cette e ´tude a examine ´ les croyances sur la maladie en ge ´ne ´ral, les infections sexuellement transmissibles (IST) et l’e ´tiologie du sida dans le Mwanza rural, en Tanzanie. De 1999 a ` 2002, une observation participante a e ´te ´ mene ´e dans neuf villages, avec un total de 158 personnes par semaine. Les croyances sur la causalite ´ de la maladie en ge ´ne ´ral comprennent la volonte ´ de Dieu, le hasard, des causes naturelles/biologiques, l’intervention d’esprits ancestraux et la sorcellerie. Les IST sont ge ´ne ´ralement impute ´es a ` des causes naturelles, mais les croyances sur la causalite ´ du sida sont plus complexes. Peu de villageois avaient entendu parler du VIH, mais la plupart d’entre eux avaient entendu parler du sida et compris qu’il peut s’attraper par voie sexuelle. Correspondence: Mary Plummer, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. E-mail: mary.plummer@lshtm.ac.uk Culture, Health & Sexuality, January–February 2006; 8(1): 45–58 ISSN 1369-1058 print/ISSN 1464-5351 online # 2006 Taylor & Francis DOI: 10.1080/13691050500469731