Dissertations / Theses on the topic 'HIV/AIDS Vulnerability and women in Kenya'

The objective of this thesis is to examine which socio-economic, structural and cultural factors may influence Indian women’s propensity to contract HIV and later their ability to access the relevant healthcare services for their condition. The research draws on two theoretical frameworks, the first being Barnett and Whiteside’s (2002) concept of social structural factors of disease transmission. Second, Anderson and Aday’s (1981) model of access examines how a variety of structural and resource-based factors, e.g. area of residence, can influence usage of healthcare facilities. Two stages of data analysis were undertaken, the first being secondary statistical analysis of the National Family Health Survey III. The survey provided state level estimates on the HIV sero-status of the general population in India and data on demographic and socio-economic determinants for family planning, nutrition, utilization of healthcare and emerging health issues. The second stage of analysis consisted of a set of qualitative interviews conducted in Andhra Pradesh, India. Thirty-three interviews were conducted with female sero-positive patients and ten with HIV-infected women who were providing social services to others with the same condition. Statistical results on social structural determinants of HIV transmission illustrated that Indian women who were formerly married (OR=5.27, CI=3.07-9.04), lived in higher prevalence states (OR=3.48, CI=2.19-5.54), had a low level of education (OR=2.27, CI=1.40-3.68) and were employed (OR=1.45, CI=0.96-2.18) had significantly (<.05) higher odds of being HIV-positive in comparison to those who were not. Findings in the qualitative phase of analysis were similar but participants’ narratives illustrated that their risk of contracting HIV begun before they even had the opportunity to seek a match as they seemed to live in communities with a high level of HIV prevalence. Many of the participants commented that there were factors outside of their sphere of control, e.g. lack of education, which resulted in them having a narrow choice of potential partners. Additionally, statistical results on female participants’ access to healthcare services indicated the vast majority of HIV-positive respondents were almost certainly not aware of their sero-status as they had not undertaken an HIV test prior to the survey. As the sample of female HIV infected respondents was relatively small, it was difficult to ascertain which social factors had an impact on these participants utilisation of HIV testing services. On the other hand, respondents’ narratives from the qualitative stage of research highlighted on social structural factors which could potentially influence WLHA’s continual utilisation of HIV-related healthcare services. It was found that participants experienced the most barriers to accessing healthcare facilities in the initial phases of their treatment. These barriers were mediated by the structure of healthcare services, culturally sanctioned medical practices (e.g. physicians refusal to inform the patient of their sero-status) and quality of services.

Today it has been estimated that 40 million people worldwide are carrying the deadly virus known as HIV. Despite the fact that the virus can affect men and women alike, an increasing proportion of people living with HIV are women and girls, and this proportion is continuing to grow. This writing is dedicated to explore the factors that drive the epidemic.

The purpose of this paper is to explore the links between gender inequality and women's vulnerability to HIV/AIDS as well as to enhance our understanding of what is it like to be a young woman in Zambia, a country where the HIV/AIDS epidemic has hit hard. The research is done through a qualitative study with secondary sources and interviews as means of collecting data. The point of departure is theories of gender inequality, where the patriarchal structures and men's domination over women are explained.

The result of this study is that gender inequality, the subordination of women and men's predatory behaviour are major contributors of the epidemic, the larger numbers of women with HIV/AIDS and the women's younger age.

INTRODUCTION: Kenya like the rest of Sub-Saharan Africa continues to be plagued with high rates of AIDS/HIV. Research has shown that cultural practices have serious implications for the spread of HIV/AIDS, as well as other communicable diseases. One of the practices that have been speculated to have an impact on AIDS/HIV is female genital mutilation (FGM). Despite efforts to eradicate the practice, prevalence of FGM in Kenya remains relatively high. Researchers have postulated that various forms of FGM may be associated with the spread of HIV/AIDS. OBJECTIVE: The purpose of this study is to determine the relationship between FGM and HIV/AIDS using a representative sample of Kenyan girls and women. METHODS: Data (n=3271) from the Kenya 2003 Demographic and Health Survey was used for this study. Chi-square test was used to examine the distribution of selected risk factors across HIV/AIDS status. Odds ratios from multivariate logistic regression analyses were used to determine association between FGM and HIV/AIDS. RESULTS: This study shows an inverse association (OR=0.508; 95% CI: 0.376-0.687) between FGM and HIV/AIDS, after adjusting for confounding variables. DISCUSSION: The inverse association between FGM and HIV/AIDS established in this study suggests a possible protective effect of female circumcision against HIV/AIDS. This finding suggests therefore the need to authenticate this inverse association in different populations and also to determine the mechanisms for the observed association.

As Infecções Sexualmente Transmissíveis (IST) ainda constituem um grave problema de saúde pública que assola cada vez mais o público feminino, sendo acentuada pela vulnerabilidade individual, social e programática. Assim, este estudo teve como objetivo identificar e analisar as vulnerabilidades de mulheres quilombolas do Rio Trombetas (PA) para as IST/HIV/aids. Trata-se de um estudo exploratório, descritivo, prospectivo, transversal com abordagem quantitativa. A coleta de dados deu-se por meio de entrevista individual realizada no domicílio, a partir de um questionário semiestruturado, após aprovação do Comitê de Ética da Escola de Enfermagem da USP, sob o parecer: 1.667.309. Para a análise dos resultados foi adotado como referencial o conceito de vulnerabilidade. Esta pesquisa foi realizada em oito comunidades quilombolas do alto Trombetas, localizadas no município de Oriximiná, região Oeste do Estado do Pará, com a participação de 139 mulheres. A média de idade foi de 30 anos e as cores autodeclaradas prevalentes foram a negra e a parda. A maioria das mulheres possuía o ensino fundamental completo e intitulou-se casada. Quanto à história pregressa de IST, 56,8% citaram apresentar em algum momento sinais e sintomas de IST, porém, apenas 25,2% informaram sempre fazer uso do preservativo masculino nas relações sexuais e 12,6% do preservativo feminino. Em relação aos motivos para o não uso do preservativo feminino, 52,5% das mulheres justificaram a sua indisponibilidade. Quanto ao conhecimento sobre as IST, 69,1% já haviam recebido algumas informações, verificou-se que pouco mais da metade, 55,4%, respondeu sobre a forma correta de transmissão e que a prevenção é feita através do uso da camisinha (80,6%). Apenas 44,6% das mulheres consideram a existência de risco para contrair uma IST/HIV/aids e que este risco é acentuado pela infidelidade do parceiro (45,2%). Apesar de se considerarem em risco, as mesmas classificam o grau de exposição individual a possível infecção em baixo risco (64,6%) e apenas 8,1% classificam em alto risco. Verificou-se a inexistência de serviços de saúde na comunidade e quanto a atividade de prevenção para as IST/HIV/aids apenas 48,9% das pesquisadas participaram de alguma atividade educativa. Os resultados evidenciam fragilidades de conhecimento, das mulheres frente à prevenção das IST/HIV/aids, potencializado pela ausência de serviços de saúde e ações nas comunidades. Pelo exposto, foi possível identificar que as mulheres quilombolas são vulneráveis nas três dimensões: individual, social e programática para as IST/HIV/aids. Neste contexto é de extrema importância a efetivação dos serviços e ações de saúde nessas localidades, através de políticas públicas responsáveis e comprometidas, com a participação da enfermagem, o principal agente do cuidado comunitário dentro do elo de promoção e prevenção da saúde.
Sexually Transmitted Infections (STIs) still constitute a serious public health problem that increasingly plaguing the female audience, and is accentuated by the individual, social and programmatic vulnerability. Thus, this study aimed to identify and analyze the vulnerabilities of Quilombolas women from the Trombetas River (PA) for STI/ HIV/ AIDS. This is an exploratory, descriptive, prospective, cross-sectional study with a quantitative approach. Data collection was done by means of an individual interview conducted at home, using a semi-structured questionnaire, after approval by the Ethics Committee of the School Nursing of USP, on opinion No. 1.667.309. For the analysis of the results, the vulnerability concept was adopted as reference. This research was carried out in eight quilombola communities of Alto Trombetas, located in the municipality of Oriximiná, western region of the State of Pará, with the participation of 139 women. The mean age was 30 years and the prevalent self-declared colors were black and brown. Most of the women had completed elementary education and titled married. Regarding the previous history of ISTs, 56.8% mentioned that they presented signs and symptoms of STI, but only 25.2% reported using the male condom in sexual intercourse and 12.6% of the female condom. Regarding the reasons for not using the female condom, 52.5% of the women justified their unavailability. As to knowledge about STIs, 69.1% had already received some information, it was found than slightly more than half, 55.4%, answered on the correct form of transmission and that prevention is done through the use of condoms (80.6%). Only 44.6% of women consider the risk of contracting STI /HIV/AIDS and that this risk is accentuated by partner infidelity (45.2%). Although considered at risk, they classify the degree of individual exposure to possible low-risk contamination (64.6%) and only 8.1% rank at high risk. The lack of health services in the community and the prevention activity for STI /HIV/AIDS, only 48.9% of those surveyed participated in some educational activity. The results show weaknesses in women\'s knowledge regarding STI /HIV/AIDS prevention, which is enhanced by the absence of health services and community actions. From the foregoing, it was possible to identify that quilombola women are vulnerable in three dimensions: individual, social and programmatic for STI /HIV/AIDS. In this context, it is extremely important to carry out health services and actions in these localities through responsible and committed public policies, with the participation of nursing, the main agent of community care within the link of promotion and prevention of health.

Objetivo. A vulnerabilidade individual é estabelecida num espaço de relações entre sujeitos, nesse sentido o estudo buscou compreender a vulnerabilidade de mulheres negras e não negras que vivem com HIV/AIDS à reinfecção e ao adoecimento, em três serviços públicos de referência para o tratamento de DST/AIDS do Estado de São Paulo. Métodos. A pesquisa foi realizada com 1.068 mulheres maiores de 18 anos (526 não negras e 542 negras), voluntárias, atendidas em três serviços públicos de referência para o tratamento de DST/AIDS do Estado de São Paulo, de setembro de 1999 a fevereiro de 2000. As mulheres souberam da pesquisa após contato com a equipe de recepção das instituições, na sala de espera, e aquelas que aceitaram participar assinaram o termo de consentimento pós-informado. O termo de consentimento e o protocolo de estudo foram aprovados pelos Comitês de Ética de cada uma das instituições participantes. As entrevistas realizaram-se em ambiente privado e foram conduzidas por profissionais do sexo feminino, de nível superior. O instrumento para coleta de dados foi um questionário semi-estruturado que possibilitava à entrevistada falar sobre suas experiências e impressões em diferentes momentos da vida, especialmente depois da revelação do diagnóstico de soropositividade para o HIV. Na análise estatística utilizou-se o teste qui-quadrado Pearson e intervalos de confiança de 95%. Para estudar a interação entre as variáveis utilizou-se o modelo loglinear CHAID (Chi-squared Automatic Interaction Detector). Os programas de análise estatística utilizados foram: EpiInfo versão 6.04, SPSS versão 8.0 and Answer Tree versão 3.0. Resultados. As condições de ordem social que contribuíram mais fortemente para a vulnerabilidade individual de mulheres negras foram: dificuldades de acesso à educação formal, condições de moradia e habitação menos favoráveis, baixo rendimento individual e familiar per capita, responsabilidade pelo cuidado de maior número de pessoas, dificuldade de acesso ao teste diagnóstico, dificuldade de acesso às informações sobre terapia anti-retroviral para o recém-nascido e sobre redução de danos no uso de drogas injetáveis, dificuldade em adotar comportamentos protetores – tais como o uso de preservativo –, menores possibilidades de acompanhamento realizado por outro médico que não o infectologista ou ginecologista, menores chances de atendimento nutricional, menos facilidade em obter outros remédios além do coquetel. Os fatores de ordem cognitiva que contribuíram para o aumento da vulnerabilidade das mulheres negras foram: baixa percepção de risco individual de infecção e a conseqüente falta de iniciativa em procurar um serviço de saúde que oferecesse o teste, dificuldade em entender o que os profissionais dizem, em esclarecer suas dúvidas ou falar sobre suas preocupações, dificuldades em entender a evolução de seus quadros clínicos. Os achados permitiram identificar que as mulheres negras estavam menos conscientes sobre o problema e sobre as formas de enfrentá-lo, encontrando, na maioria das situações, menores possibilidades de transformar suas condutas. Do ponto de vista subjetivo, a qualidade do aconselhamento anterior e posterior ao teste, a piora da vida sexual após o diagnóstico e a dificuldade em falar sobre o assunto com os profissionais mais diretamente envolvidos no cuidado, como é o caso dos médicos infectologista e ginecologista, também influenciaram os processos de vulnerabilização. As mulheres não negras apresentaram-se mais atentas em avaliar as situações inadequadas ocorridas no serviço de saúde. Conclusões. Ao incorporar a raça como categoria analítica foi possível compreender melhor a multidimensionalidade, a instabilidade e a assimetria da vulnerabilidade. As experiências e impressões descritas pelas mulheres estudadas apontam a necessidade de reconhecimento das diferenças e de suas especificidades; de investimento no desenvolvimento institucional, nas políticas e programas de formação profissional continuada, com ênfase na humanização do cuidado, na melhoria da qualidade de comunicação e relação interpessoal e na aquisição de habilidades para o manejo de questões inerentes às relações raciais e de gênero. Do mesmo modo, tais experiências ressaltaram a necessidade de ampliação do repertório de direitos que as mulheres dominam para que elas próprias cooperem na redução ou superação de suas vulnerabilidades.
Objective. Individual vulnerability is established in the context of intersubjective relations. In this sense, the present study sought to compare vulnerability to recurrent infections and illness among women living with HIV/AIDS. Methods. The study group was composed of 1068 volunteers, over 18 years of age (526 non-Black and 542 Black women) being attended by three public services, which are references for the treatment of STD/AIDS within the State of Sao Paulo during the period between September 1999 and February 2000. The women learned of the study by face-to-face contact with the reception staff in the waiting room and those who accepted to participate were asked to sign an informed consent form. The Institutional Ethics Committees of the participating centers approved the consent form and the study protocol. College-level female trained performed interviews in private rooms. Data collection instrument was a semi structured questionnaire that asked participant to express her experiences concerning different time points in her life, especially after she was diagnosed as HIV-infected. Statistical analysis was carried out using Pearson chi-squared test and their corresponding 95% confidence intervals were calculated using the exact maximum likelihood estimates. Chi-squared Automatic Interaction Detector (CHAID) log linear model was used to study the relationship between variables. EpiInfo version 6.04, SPSS version 8.0 and Answer Tree version 3.0 software were used. Results. The social conditions which most strongly affected the individual vulnerability of Black women were: difficulties with respect to access to formal education; less favorable living conditions; low individual and family per capita income; responsibility for the care of a greater number of people; problems with respect to diagnostic tests; difficulties with respect to access to information on anti-retroviral therapy for newborns and reducing damage with the use of injected drugs, difficulties in adopting protective behavior, such as the use of condoms, less possibilities of accompaniment by other physicians besides the gynecologist and the specialist in infectious diseases; less opportunities of receiving nutritional orientation; less facilities in obtaining other medicines besides the cocktail.The cognitive factors which contributed towards, increasing women’s vulnerability were: low degree of awareness as to the individual risk of infection and, consequently, the lack of initiative in looking for a health service which offers HIV testing, difficulties in comprehending the discourse of health professionals and in talking to the latter about their misgivings and their doubts, difficulties in comprehending the evolution of their clinical condition. The finding suggest that Black women living with HIV/AIDS were less aware of their condition and of how to deal with it, encountering, in the majority of cases, less possibilities of transforming their behavior. From a subjective point of view, the quality of counseling activities, the decrease in the quality of their sexual life after diagnosis and the difficulties they faced when discussing these issues with the physicians directly responsible for their care, such as the specialist in infectious diseases and the gynecologist, influenced the process whereby they became increasingly vulnerable. The non-Black women appeared to be more aware of the inadequate situations occurring in the health services. Conclusions. By incorporating race as an analytic category, it was possible to gain a better understanding of the multiple dimensions, the instability and the asymmetry of vulnerability. The experiences and impressions described by the women in this study point towards the necessity of recognizing differences and specificities when investing in institutional development, in policies and in programs geared towards professional training with emphasis on the humanization of care, on the improvement of the quality of communication and of interpersonal relationships and towards the management of issues which are inherent to relationships between “races” groups and between genders. Likewise, they underscore the need to broaden the repertoire of rights these women are aware of so they themselves may cooperate in the reduction of or in the process of overcoming their vulnerabilities.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-09-22T18:29:44Z No. of bitstreams: 1 valescanunesdosreis.pdf: 1595105 bytes, checksum: 5bda38f447c549da923d6340b14115e1 (MD5)
Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-26T20:30:10Z (GMT) No. of bitstreams: 1 valescanunesdosreis.pdf: 1595105 bytes, checksum: 5bda38f447c549da923d6340b14115e1 (MD5)
Made available in DSpace on 2016-09-26T20:30:11Z (GMT). No. of bitstreams: 1 valescanunesdosreis.pdf: 1595105 bytes, checksum: 5bda38f447c549da923d6340b14115e1 (MD5) Previous issue date: 2010-04-16
Em decorrência do avanço da epidemia do HIV/Aids no mundo, as mulheres passaram a representar uma parcela significativa dos portadores do HIV/Aids, e hoje no Brasil, como em outros países, dividem igualmente o número de casos identificados com os homens. Em geral, a aids atinge especialmente as mulheres pertencentes à classe econômica menos favorecida, com menor grau de escolaridade, às jovens, às casadas e heterossexuais. Assim, com vistas a contribuir para a problematização do discurso da prevenção do HIV/Aids no segmento feminino, esta pesquisa teve como objetivos: identificar os espaços onde mulheres acessam as informações sobre o HIV/Aids; descrever as representações sociais sobre o HIV/Aids de mulheres matriculadas em uma escola pública de ensino médio; analisar os fatores que orientam a adoção de medidas protetoras ao HIV/Aids para essas mulheres; analisar as relações entre as representações sociais sobre o HIV/Aids e as estratégias que as mulheres utilizam para reduzir a vulnerabilidade à infecção pelo HIV. O estudo desenvolveu-se a partir da abordagem social da pesquisa qualitativa tendo como princípio teórico as Representações Sociais. Os dados foram coletados por meio da entrevista semiestruturada junto a vinte mulheres do curso noturno de uma escola pública do município de Juiz de Fora/MG. Os dados foram analisados conforme a análise temática proposta por Bardin. Os depoimentos obtidos permitiram construir três categorias: as mulheres desenhando o acesso à informação sobre a aids; mulheres em cena: representações sobre o HIV/Aids; e pensando e fazendo prevenção: mulheres reduzindo a vulnerabilidade ao HIV/Aids. A partir da análise das categorias elencadas, vislumbramos a necessidade de voltar para as mulheres, em seus diferentes contextos e realidades, um olhar mais atento, cuidadoso e holístico, principalmente relacionado à questão da educação para a saúde sexual, que valorize as diferenças culturais e de gênero, no intuito de promover a formação de cidadãs conscientes de suas escolhas, instrumentalizandoas para a adoção de comportamentos e condutas sexuais protetoras e menos vulneráveis ao HIV/Aids. E a partir de uma postura crítico-reflexiva, as representações das mulheres evidenciam a urgência de se estabelecer, de forma consistente e efetiva, o vínculo entre a escola e os serviços de saúde, no sentido de, num esforço conjunto, criar e estabelecer programas e projetos de intervenção que tenham como um de seus objetivos sensibilizar as mulheres para a escolha de comportamentos que estejam alinhados as suas reais percepções de risco.
With the advance of the worldwide HIV/AIDS epidemic women have become a significant segment of HIV/AIDS carriers, being now responsible for as many cases as those identified in men. AIDS generally affects women from underprivileged classes, with fewer schooling years, of a younger age, of married status and of heterosexual orientation. In order to contribute to the discourse on HIV/AIDS prevention in the female segment, this research aimed to: identify the spaces from which women access information on HIV/AIDS; describe the social representations of HIV/AIDS for women regularly attending a public secondary school; analyze the factors orienting the adoption of HIV/AIDS preventive measures by these women; and analyze the relationship between the social representations of HIV/AIDS and the strategies used by these women to reduce their vulnerability to HIV infection. The study was developed from the social approach to the qualitative research, with Social Representations as the theoretical principle. The data were collected through a semi-structured interview of twenty women from the night shift of a public school of the municipality of Juiz de Fora-MG, Brazil. The data were analyzed according to the thematic analysis proposed by Bardin. The statements obtained generated three categories: women designing access to AIDS information; women on stage: HIV/AIDS representations; and thinking and preventing: women reducing their vulnerability to HIV/AIDS. The analysis of these categories showed the need of a more attentive, careful, and comprehensive approach to these women in their different contexts and realities, chiefly concerning sexual education, and giving due value to cultural and genre differences, so that they become fully aware of their choices and empowered to adopt protective sexual behavior that makes them less vulnerable to HIV/AIDS. From a critical and reflexive stance, the women`s representations highlight the urgency to establish consistent and effective links between the school and health services, in a common effort to develop and establish intervention programs and projects aiming, among other things, to motivate women to choose behaviors suited to their actual risk perceptions.

Este estudo situado na área da Comunicação e da Saúde, teve por objetivo analisar sentidos relacionados à vulnerabilidade feminina ao HIV/aids produzidos por receptoras de um programa radiofônico voltado ao enfrentamento do HIV/aids, transmitido por uma rádio comunitária da cidade de São Paulo. Para isso, articula conceitos de gênero, da produção social dos discursos, produção de sentidos, vulnerabilidade feminina ao HIV/aids. A análise, realizada com base em entrevistas com receptoras do programa radiofônico, elegeu a categoria gênero como instância de mediação para interpretação dos sentidos produzidos na recepção. Os resultados indicam que possíveis transformações/mudanças relacionadas à sexualidade e à prevenção ao HIV/aids nos relacionamentos afetivo-sexuais são muito permeáveis ao desejo do homem. Indicam também que a inserção do programa radiofônico Silvia e Você na rede discursiva provocou deslocamentos importantes tendo em vista o enfrentamento da epidemia
This study is located in the area of Communication and Health, had intended to analyze senses related to women\'s vulnerability to HIV/aids produced by receivers of a radio program targeted to confront HIV/aids, transmitted by a communitarian radio of Sao Paulo city. To do this, articulates concepts of gender, social discourse production, production of senses, women\'s vulnerability to HIV/aids. The analysis, based on interviews with receivers of a radio program, named category genre as instance of mediation for interpretation of the senses produced at reception. The results indicate that possible transformations/changes related to sexuality and HIV/aids prevention in affective-sexual relationships are very permeable to the desire of man. Also indicate that the insertion of radio program Silvia and You on the discursive network caused major shifts in order to confront the epidemic

This phenomenological study was designed to understand the lived experiences of a purposive sample of 9 participants from local villages in Nairobi, Kenya, who had sexual behaviors that contributed to higher HIV risk exposure. Past studies have provided information about the increased rates of HIV infection; however, little has been done to identify the solutions for minimizing the negative impact of HIV among concurrent partnerships. The study investigated the role of high risk cultural practices among participants in married and cohabitating unions. The conceptual framework of the study was gender and power theory, which addresses the complex sexual relationships between men and women. Semi-structured, open-ended questions were used to obtain data from 4 males and 5 females between the ages of 28 and 46 who had been sexually active for more than 12 months. Data was collected on participants' cultural perspectives on condom use, HIV risk behaviors, and sexual morality. The interviews were transcribed and reviewed for consistent patterns of high risk sexual behaviors prior to coding. Through the use of NVivo, seven emergent themes were common among the participants. Findings from the small scale sexual risk behavioral data showed that among these participants, condom use and partner fidelity in unequal partnerships were low. The study also indicated the importance of developing an HIV intervention that focuses on gender and power in long-term sexual partnerships. The implications for positive social change included awareness that gender inequality exists among concurrent unions and formulating an effective cultural HIV prevention strategy for couples.

This study emerged from the high prevalence rate of HIV and AIDS infection among women in Sub-Saharan Africa, which has no exception to Namibia. Women have been vulnerable to HIV and AIDS let alone on sex related issues since the epidemic emerged, but not research has been done specifically to Okalongo women. The way in which women vulnerable to HIV and AIDS infection were explored by examined social and cultural identities that affect women’s sexual relations in negotiating sex and safe sex. Qualitative study on a sample of fifteen women was conducted in Okalongo. The purpose of this study was to investigate the conceptions and experiences of women in negotiating sex and safe sex with their husband and partners. Feminist theory guided the methodology and analysis of data. I assumed that gender roles andsexuality are socially constructed, shaped by religion, social, political, and economic influences and modified throughout life. Feminist theory assisted in documentary the ways in which the female’s gender and sexuality in Okalongo is shaped by cultural influences and by institutions that disadvantage female and other oppressed groups by silencing their voices. The feminist further guided the discussion of the contradicting messages about women’s sexuality and their experiences, as women complied, conformed and even colluded with their oppression. To address the issue under study, the primary analysis of data from the focus group discussion and individual interview were utilised. The following themes were the heart of analysis: Women Positionality, Normalisation and Compliance, Women Agency and Male Dominance Power, Women Perceptions of Risk, Sex Education in and out of school among Women.In this study the data suggested that women in Okalongo are more vulnerable to their lack of assertiveness, as they have difficult in developing an authoritative voice, they tend to be humble about their achievements and knowledge and to only assertively when concerned about others. The findings supported the literature that women’s vulnerability is strongly influenced and tied by broader forces present in the society. Women’s vulnerability is real and needs to be tackled for any progress to occur in the fight against AIDS. Until factors that constraints and enabling women agency to negotiate sex and safe sex acknowledged and addressed, women will continue to succumb to the HIV pandemic.

Estudou-se a experiência de mulheres vivendo com HIV e aids também conviverem com situações de violência por parceiro íntimo, e as repercussões destes entrecruzamentos para o cuidado de sua saúde. Tomamos como referência o conceito de vulnerabilidade já formulado para a AIDS e retrabalhado especificamente para as questões de gênero, permitindo explorar o conceito nas situações de violência doméstica contra as mulheres. Partiu-se do pressuposto que os contextos do HIV/Aids podem gerar situações de violência de mulheres soropositivas e que as representações amorosas, o ideal de conjugalidade e de família podem influenciar no impacto do cuidado da saúde das mulheres. Foram realizadas 20 entrevistas em profundidade com mulheres em acompanhamento do HIV/Aids, inseridas nos Serviços de Saúde da Rede Especializada em DST/Aids da cidade de São Paulo, na modalidade história de vida. Encontraram-se diversos contextos da vulnerabilidade, denominada de gênero, nas narrativas produzidas, na infância, adolescência e fase adulta, reforçando padrões hegemônicos de gênero ao longo dos diferentes ciclos de vida dessas mulheres. O estudo aponta que as experiências do adoecimento na revelação do diagnóstico é o elemento disparador de medos e sofrimentos em decorrência da reação dos parceiros e a das preocupações com os filhos. O diagnóstico do HIV é o momento não só do contato com a doença, mas de desvelar ou reconhecer situações de violência. É a partir das concepções e contextos de vida que as mulheres identificam o modo de se situarem no enfrentamento do HIV e da violência. O cuidado da saúde foi abordado tanto como cuidado de si, quanto na relação com os serviços de saúde, o que mostrou a grande preocupação representada pelas dificuldades que, em função de suas condições de portadoras do HIV, essas mulheres viam para se manterem na condição tradicional de cuidadoras, dentro das referências do padrão social de gênero, quer em torno de seus adoecimentos e expectativas de vida futura, quer para com os filhos. Tais preocupações surgem como justificativas da manutenção da família diante de parceiros violentos. Embora presente, observou-se que o tema violência não é pauta na atenção à saúde da mulher vivendo com HIV e aids, nos serviços de saúde especializados. A vulnerabilidade de gênero destaca-se pela ênfase na condição materna, em que por ela e para ela as mulheres dão significados às suas vidas, ao adoecimento e ao cuidado.
This work studied the experience of women living with HIV and AIDS also live with situations of violence by their intimate partner and the implications of these intersections for their health care. We took as reference the concept of vulnerability already formulated to AIDS and adapted for gender issues, allowing explore it in situations of domestic violence against women. We started from the assumption that the contexts of HIV / AIDS can lead to situations of domestic violence involving HIV positive women and that the representations of love, the ideal of marital and family can influence on health care of these women. We made 20 in-depth interviews with women living with HIV / AIDS, followed on STD / AIDS reference centers of the Municipality of São Paulo, using living history method. We found in the narratives several contexts of the so called gender vulnerability occurred in childhood, adolescence and adulthood, reinforcing hegemonic gender patterns over the different life cycles of these women. The study shows that the fact of the diagnosis disclosure to be made during an illness is the element that triggers fear and suffering in relation to the reaction of the partners and worries with their children. The time of HIV diagnosis is not only the moment of contact with the disease, but also the time to uncover or recognize situations of violence. It is through conceptions and contexts of life that women identify how to locate themselves in the struggle against HIV and violence. Health care was addressed as much as caring for oneself as well in relation with the health services. This approach showed the great concern about the difficulties perceived by these women in order to keep the condition of traditional caregivers within the references of hegemonic social pattern of gender, either about their illnesses and future life expectations either about children. Such concerns arise as a justification for maintaining the family when there is coexistence with a violent partner. Although present, it was observed that violence is not an issue discussed in health care of women living with HIV and AIDS in specialized health services. The vulnerability of gender of these women is distinguished by an emphasis on maternal condition which gives meaning to their lives, illness and care.

Includes bibliographical references (p.115-128).
This thesis explores discourses on gender and gender based violence produced in the 16 Days of Activism Against Women Abuse campaign 2007 in Khayelitsha, Cape Town. The public awareness campaign united a number of local, community based organisations that work in the overlapping fields of HIV/AIDS and gender based violence. For the purpose of this study, three of the most vocal organisations in this campaign were chosen as research participants; The local branch of the Treatment Action Campaign (TAC) Khayelitsha, the Rape Survivors Centre Simelela, and the youth drama group Masibambisane. Assuming that discourses are embedded in unequal relations of power, this study adopts a discourse analytical approach to the 'gendering' of HI VIA IDS to reveal how knowledge and meanings are produced, reproduced and contested between more powerful institutions and a marginalised community. The thesis first explores dominant discourses on HIV/AIDS and gender in development discourse and social and biomedical research, and uncovers how HIV/AIDS risks are mostly related to women's lack of power and inherent vulnerability to violence. Such hegemonic discourses are then also found in international and national guidelines and policy frameworks that address the 'gendered' risks of HIV and AIDS, while at the same time these frameworks also promote approaches to HIV/AIDS that acknowledge contextual and societal factors that shape vulnerability. Eventually, a review of international and national frameworks that address the 'dual epidemics' shows how the so called 'community sector' is often highlighted as a crucial partner in multi-sectoral approaches to HIV/AIDS. The empirical study then aims at locating such discourses in a localised, South African context, and explores the ways in which dominant discourses are reproduced, contested, and redefined by community activists. Empirical data is collected through participant observation with the organisations coordinating the campaign, recording of speeches delivered during the public events, and semi-structured, qualitative interviews with five key members of the organisations. A discursive analysis of the data reveals that femininity and masculinity are mainly constructed in rather conservative ways, portraying women as inherently vulnerable and men as either perpetrators of violence, or protectors of women and children. These constructions of gender are based in a patriarchal, hegemonic notion of masculinity as powerful and responsible for the suffering or salvation of weak and vulnerable women. However, within these hegemonic gender notions, women speakers simultaneously contest their victimhood status by claiming their rights as citizens of South Africa, by relocating power in their collective struggle, and by reframing their vulnerabilities as embedded in intersecting inequalities of gender, class and race, and as members of a community largely marginalised by the state. The multitude of discourses at play in the public campaign point at the necessity for a re-reading of the intersections of HIV/AIDS, gender inequality and gender based violence beyond victim-agent dualisms.

There is an abundance of biomedical and social science research relating to HIV/AIDS which has focused on understanding the disease from a medical crisis. The research has attended to matters of prevention and clinical treatment. This study is a naturalistic study which explores the socio-economic and political-cultural aspects of the disease in and on the lives of nine women living in one of the world’s mega slums, Kibera in Kenya. The study is based on the assumption that the HIV/AIDS pandemic has brought about social disruption and profound changes to the micro contexts of community and family life. Cultural norms, practices and values that historically sustained the fabric of African life are slowly being stripped away as those infected with HIV and their families cope with the impact of the chronic illness. Living as HIV+ women is yet one more challenge that these women face every day. They struggle to provide self-care and a healthy life for those they are responsible for within an environment that lacks so many social determinants of health. Using a methodological convergence of narrative, feminist and Indigenous methodologies within a post-colonial paradigm, I have explored how nine HIV+ African women story/experience their daily lives and participate in community activities. Consideration of the reality of the day to day experiences of HIV+ women living in an African slum settlement may offer insights for government, policy makers, and community-based and non-government organizations to better support and promote quality of life for those living with HIV/AIDS.
Graduate

Purpose: To explore sexual practices of married women, which make them vulnerable to HIV infection in a rural setting, and the implications such practices have for the HIV/AIDS epidemic. Methodology: An ethnographic approach was used to explore the phenomenon of, which was sexual practices of married women, both ancient and contemporary. Unstructured interviews and focus group discussions were undertaken. The researcher applied the principle of theoretical saturation and a total of fifty participants were included in the study. All the interviews were taped and transcribed. Data analysis was done manually by the researcher, using themes and sub-themes. Findings: Married women engage in short term sexual relationships with secret lovers which are either concurrent or frequent while their husbands are away on migrant labour. A number of factors that cause women to engage in such risky sexual practices were identified. Some of these factors included scarcity of men due to migration and economical resources, the fact that women cannot negotiate safe sex due to gender and cultural factors; limited knowledge of infections particularly HIV/AIDS, life skills including their sexual rights and how to exercises these rights, and economic skills. Recommendations included the designing of an intervention program to sensitise and empower women on factors that make them vulnerable to HIV infection. Conclusions: Married women in the rural KwaZulu-Natal indulge in multiple concurrent or successive extramarital partnerships in the absence of their migrant men. These sexual practices place them in a vulnerable position to get HIV infection as they engage in risky sexual behavior without condom use. They also have fear of being rejected by their secret lovers and their own husbands because of women's economic dependency on men.
Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

This is an exploratory study that seeks to establish the extent to which traditional theologies on 'imago Dei' may contribute to the vulnerability of Catholic single women to HIV and AIDS. It employs a feminist framework of study to critically analyse how androcentric theologies on imago Dei informed by the Greek philosophies of Plato and Aristotle and advanced by the Church fathers do contribute to the dehumanisation of women. Argued in this study, is that these teachings could be responsible for single women‟s vulnerability in the context of HIV and AIDS. Following extensive research done on women, HIV and AIDS, this study also presents cultural, social, economic and religious factors as players in women‟s susceptibility to HIV and AIDS. However, in a unique and particular way, this study seeks and presents a possible connection between the Catholic Church‟s teachings on imago Dei and the vulnerability of Catholic single women to HIV and AIDS.
Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

The objective of this research is to explore the perceptions of rural Samburu women in Kenya with regard to HIV/AIDS in terms of their knowledge, attitudes, beliefs and opinions; to examine several HIV/AIDS awareness channels that have been used to communicate HIV/AIDS messages to the Samburu women to determine how effective they have been in effecting behaviour change.This study is an example of how a communication audit can be carried out on a certain sub-group of a community in order to suggest a tailor-made communication strategy in an effort to stop the spread of HIV among the Samburu women. This study is also a confirmation that the prevention strategies that have been in use to communicate to Samburu women have been inadequate and need to be revised to address the knowledge gaps that exist. The study is located within a relatively new field of health communication where health messages are evaluated to determine whether target audiences are receiving these messages and changing their behaviour in order to live healthier lives. This area of study is also supported by behaviour change models such as the Health Belief Model (HBM), the Social Cognitive Theory (SCT), Diffusion of Innovations Theory, Cultural Models, and Strategic Communication. A qualitative study was undertaken in 2008 by way of ten focus group discussions with Samburu women and eleven in-depth interviews with professionals who ran HIV/AIDS programmes in the Samburu district. The focus groups were constituted by means of convenience sampling whereas the snowball strategy was utilised for the selection of participants for in-depth interviews. The questioning route for the focus group discussions for the Samburu women was guided by five themes namely: knowledge levels of the women; cultural aspects that made the women vulnerable to HIV/AIDS; beliefs about HIV/AIDS; attitudes towards HIV/AIDS; and the different channels of communication used to convey HIV/AIDS messages. The interview schedule for the professionals consisted of open-ended questions and face-to-face interviews were carried out using this schedule.
Communication Sciences
D. Litt. et Phil. (Communication)

Background AIDS remains one of the world’s most serious health challenges affecting more females than men. The differences in the spread of Human Immunodeficiency Virus (HIV) among gender groups stem from biology, sexual behaviour and socially constructed gender differences between women and men in roles and responsibilities, access to resources and decision-making power. It could also be due to the females’ status in society which could be justified by lower economic and decision making ability. Purpose The purpose of this study was to explore and describe the role of gender in the spread of HIV among women of reproductive age in Ethiopia; with the view of developing gender sensitive HIV and AIDS prevention strategies. Methods The study used sequential mixed method with quantitative and qualitative paradigm. During first phase of the study, health facility based descriptive cross-sectional study design was used. Data was collected from 422 respondents using a structured questionnaire. Forty participants were recruited by purposive sampling from representatives working in reproductive health or related fields. Results About 83.2% of respondents reported that sexual intercourse discussion should be initiated by male partners. This showed that majority of respondents were dependent on their male partners in decision-making regarding sexual matters in their relationship. Multiple sexual partners were common among the respondents. One third of the respondents reported to have had intercourse with more than one partner during the past twelve months of the study period. Higher proportion of respondents (61.4%, n=259) had never used condom during sexual intercourse with their partner/s. As a result these risky sexual practices are a potential threat for spread of HIV and AIDS among women. Thus developed guidelines would alleviate the existing problems through implementation of strategies of HIV and AIDS prevention to enhance women’s status at household and different administrative structure level. Conclusion Gender disparities in relation to negotiating sexual relations among the study respondents were found to be still relevant. The culture that has placed men at the helm of leadership in sexual matters is strongly upheld and that includes who recommends use of preventive measures and who regulates when and how to enter into a sexual relationship. Guidelines for gender sensitive prevention strategies if applied appropriately would educate women and men to make decision about what directly affects their health
Health Studies
D. Litt. et Phil. (Health Studies)

The purpose of this study was to investigate the role of food gardens in influencing the vulnerability of women in rural communities to HIV-infections. The study was conducted at the Makotse Women's Club in rural Limpopo. Qualitative field research was used and five participants were purposefully selected for participation in face-to-face interviews. The study found that the women's involvement in the food gardens enabled them to take responsibility for their own lives. Participation in food gardens gave these women an opportunity for income generation, the chance to access healthy food sources to improve their and their families' diets and a sense of meaning and purpose in their lives. Financial independence from husbands and male partners freed them from poverty and male domination. Through exposure to HIV and AIDS education programmes offered at the food gardens the women were empowered with knowledge about sexual health, hence reducing their vulnerability to HIV-AIDS.
Sociology
M. A. ((Social Behaviour Studies in HIV/AIDS))

This dissertation brings into perspective the plight of AIDS widows in Kisumu. Often widowhood in general focuses on the older women, while AIDS has created a generation of young widows. A high percentage of these widows are immediately pushed into poverty by the death of husbands. AIDS widows' poverty and vulnerability to external shocks and stresses increases dramatically, while the delicate process of juggling competing needs and pressures becomes a far greater challenge. The range of forces against which widows in Kisumu must struggle is formidable: low self-esteem, complex family relationships, hostile or indifferent communities, systemic gender discrimination and harassment, property loss, unemployment or underemployment, lack of education and a daily grind that leaves widows with scant energy to contemplate the possibility of transforming and regaining their dignity/condition. For these reasons this dissertation contends that the church has an obligation to strategise a holistic intervention to care for these widows who are part of the church and society. This dissertation manifests an on going struggle and quest for adequate instruments to understand AIDS widows in the light of God's promise of the fullness of life to all. AIDS leads to severe social, psychological and financial consequences for the affected families, hence the challenging question how the widows can move from deprivation to begin self-reliant sustainable livelihood is addressed. Since widows' lives are complex and constantly changing, their livelihoods wholly depend on their identifying and building their own various strengths, assets and capabilities. In this way the dissertation suggests that the following areas should be secured overtime. Supportive relationships, networks and environments, that is relatives, the church and church organization, government and other agencies should pool and pull together with the widows. Long-term earning power and financial security is badly needed. That means that their property should be secured and their land be on their hands for continuous utilization, contrast to the current state where they are ejected and driven away of their homes. Up-to-date skills, knowledge, self-esteem, motivation, self-confidence and spiritual well being. In this area it is suggested that capacity building would play a major role in moulding their current and future life. Finally the church is challenged to cultivate an alternative theology to address the ever-growing problem of marginalization and violence against widows. That is to say all forms of prejudice, for example stereotyping, isolation and condemnation must be strongly rejected and urgent need for justice, reason and deep faith be employed. As a result the widows would be integrated and feel valued in the society and the church.
Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2004.

The study was motivated by a concern for the high vulnerability of poor African women to HIV/AIDS in South Africa and an understanding of their role in the growing informal trade sector in Durban. As the institution responsible for managing informal trade development, this study examines the role of local government in addressing AIDS vulnerability and impact within this economic sector. Local government in South Africa is at the centre of potentially conflicting policy agendas: promoting citizen participation in social and economic development while creating an efficient and competitive local economy. The research outlines how the challenge of meeting these divergent goals has influenced policy approaches to informal trade and the extent to which these constrain or support women traders and their enterprises. The study examines how this in turn influences their economic vulnerability to HIV/AIDS. The study also explores the institutional attitudes and current approaches to addressing HIV/AIDS in the informal trade sector and explores the potential for a targeted and integrated response. In-depth interviews with local government staff and external stakeholders were used to investigate institutional perspectives on the significance of HIV/AIDS and the importance of creating appropriate local level interventions within informal trade settings. Interviews also assessed current management and support strategies for informal trade and examined whether these create an enabling environment for women to protect themselves and their enterprises against the threat and impact of HIV/AIDS. Interviews were supported by an extensive review of gender and HIV/AIDS literature and analysis of relevant policy regarding informal economy and SMME development in South Africa. The study found that the multiple pressures on local government, as well as institutional restructuring and staff changes have inhibited progress towards implementing an effective management strategy for informal trade. A lack of regulation threatens the security and livelihoods of survivalist women traders, and high barriers to obtaining permits to trade impact negatively on women due to their multiple constraints and responsibilities. The study revealed that priority in providing holistic business support, including skills development and financial services, is skewed towards more profitable enterprises which has excluded most women traders. This has restricted women's productive capacity and enterprise development and heightened their economic vulnerability to HIV infection and impact. This is compounded by a lack of functional, representative organisations to convey the concerns of marginalised female traders to local government. It is likely that the prevalence of HIV/AIDS in informal markets in Durban is high. However, stigma and discrimination has prevented widespread disclosure. The vulnerability of women and the impact of HIV/AIDS on their enterprises and local economic development is recognised by staff working at street level, but not by key decision makers. This, in conjunction with the marginalisation of the sector as a whole, has influenced the lack of progress in developing a co-ordinated multidisciplinary response to HIV/AIDS among informal workers. Few interventions which directly address HIV/AIDS have been put in place in the informal workplace, largely because of a lack of understanding of the crisis; its conceptualisation as a health issue only; and the fixed location of local government's response within the health department. Acknowledging the resource and capacity constraints within local government, the study concludes by outlining a series of realistic potential interventions which can be mainstreamed within the standard functions of local government. A shift in thinking is required to conceptualise AIDS as a workplace issue, and recognise the significance of its economic impact. Women traders need to be considered as valuable and vulnerable workers, as well as mothers and carers and therefore as an important group for targeted HIV/AIDS interventions. The study calls for gender-sensitive measures to be implemented, which recognise the specific needs and constraints of women in the informal trade sector.
Thesis (M.Dev.Studies.)-University of KwaZulu-Natal, Durban, 2004.

Women face a greater risk of HIV infection worldwide than men. This study explored socio-economic, cultural and environmental factors influencing young women’s vulnerability to HIV. A quantitative explorative study was conducted among young women in Sunnyside, Pretoria. A sample of 158 young women in the age group 18 to 24 years from all language groups was randomly selected to participate in this study. The findings showed that poverty, peer pressure and multiple sexual partners were the main factors that influenced young women in Sunnyside’s vulnerability to HIV. Behavioural change and social change were recommended as long-term processes, which need to be taken into consideration. Findings from the Sexual Relationship Power Scales show that young women between 18 and 21 years experience physical abuse, emotional abuse, sexual abuse and forced sex in their relationships. The study concluded with specific recommendations for the successful implementation of policy makers and planners to protect women.
Health Studies
M.A. (Social Behaviour Studies in HIV/AIDS)

Background: Non-disclosure of HIV positive status to a partner threatens to reverse gains made in prevention of mother-to-child transmission (PMTCT) in resource limited settings. Determining the association between non-disclosure and infant HIV acquisition is important to justify focussing on disclosure as a strategy in PMTCT programmes. Objective: To determine the association between non-disclosure of HIV positive status to a partner and mother-to-child transmission (MTCT). Methods: Using a matched case-control design, we compared 34 HIV positive infants to 146 HIV negative infants and evaluated whether the mothers had disclosed their HIV status to their partner. Results: Non-disclosure was more frequent among cases (overall, 16.7%; cases, 52.8%; controls 7.6%), p<0.001 and significantly associated with MTCT (aOR 8.9 (3.0-26.3); p<0.0001), with male partner involvement partially mediating the effect of non-disclosure on MTCT. Conclusions: There is a need for PMTCT programs to focus on strategies to improve male partner involvement and partner disclosure without compromising the woman’s safety.
Health Studies
M. (Public Health)