Thornton's anthropological work explores the differing nature of the HIV epidemic in Uganda and South Africa: South Africa continues to have an HIV prevalence that is amongst the highest in the world, whilst Uganda is hailed as a success. He uses a theory of sexual networks to explore how Uganda's HIV prevalence decreased as fertility rates remained high, whilst South Africa's rose, despite the country having the lowest fertility rate in Africa. His monograph is essentially a comparison between the two African countries, and his discussion covers politics, pharmaceuticals, media representations of the epidemic and their (mis)educative role, health legislation and policies, sexuality and stigmatization. Thornton's historical contextualizing provides a detailed background to the epidemics in both countries, showing how differing histories have created divergent sexual network configurations along which HIV spreads.
His argument is based on the idea of linkages – it is not individuals, but their networks that should be the focus of HIV prevention measures. Thornton argues that invisible and ‘unimagined’ sexual networks are the means by which HIV is transmitted, and that these networks form a social structure that is difficult to disrupt. This in turn has implications for prevention efforts. If we use the theory of sexual networks, HIV/AIDS becomes a public concern, not an individual one. He attributes the failure of HIV education and awareness campaigns to a lack of understanding about the efficiency of networks in transmitting HIV. He believes that realizing the significance of sexual networks and consequently reconfiguring them can greatly reduce HIV prevalence in South Africa. Throughout the book, Thornton reminds us of the complexities of HIV transmission, and shows us the importance of studying the epidemiological and social aspects of the virus to understand and prevent it.
The book is divided into eleven chapters, each of which addresses a different element of the epidemic. Chapter 2 uses mathematical formulae to configure the sexual networks of Uganda and South Africa – although when the author himself suggests that readers ‘not interested in the mathematics can skip over these sections’, he creates the temptation to do just that! Whilst some readers may be deterred by this chapter, the wealth of historical and epidemiological information on HIV/AIDS in Uganda and South Africa throughout this and other chapters makes this book well worth exploring. Individual chapters do not have to be read in sequence, and stand-alone chapters would make valuable contributions to reading lists. The interdisciplinary nature of Unimagined Communities means that scholars of epidemiology, the social sciences and public health can gain from Thornton's work.
One of the main critiques I have of Unimagined Community is the lack of ethnographic material. In Chapter 10, for example, Thornton discusses research conducted with sangomas (traditional healers) at great length, but there are very few direct examples. His work remains anthropological in essence, however, and the depth and quality of the research that went into Unimagined Communities is evident. Like many other anthropological monographs, Thornton's voice and experiences are clearly present in his writings and it is notable that the way he ‘knows AIDS’ is linked to his personal background and experiences within Africa. His arguments are convincing, and he succeeds in showing the important role that anthropological research has to play in the field of HIV prevention.
