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UNESCO HIV and Health Education Clearinghouse

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  1. Women's empowerment and choice of contraceptive methods in selected African countries

    Few studies have examined the different dimensions of women's empowerment and contraceptive use in African countries. Data for this study came from the latest round of Demographic and Health Surveys conducted between 2006 and 2008 in Namibia, Zambia, Ghana and Uganda. Responses from married or cohabiting women ages 15–49 were analyzed for six dimensions of empowerment and the current use of female-only methods or couple methods. Bivariate and multivariate multinomial regressions were used to identify associations between the empowerment dimensions and method use. …

  2. I did it for him, not for me: an exploratory study of factors influencing sexual debut among female university students in Durban, South Africa

    The authors used qualitative interviews to explore influences on first sexual intercourse among 10 young women who had sexual debut within a year of enrolling in the university. University culture of sexual permissiveness and pressure from sexually experienced friends and male partners were the main factors influencing sexual debut. Ambivalence and a range of coercive behaviors characterized first sex. Participants were unprepared for sex and lacked power in deciding the timing and circumstances of first sex, which resulted in physical and emotional pain and regret. …

  3. Transactional sexual relationships, sexually transmitted infection risk, and condom use among young Black Women in peri-urban areas of the Western Cape Province of South Africa

    This study evaluated the relationship between having a history of transactional sexual relationships with condom use and STI risk. Participants completed a behavioral questionnaire and provided self-collected vaginal swabs which were tested for chlamydia trachomatis, neisseria gonorrhea, and trichomonas vaginalis. Multinomial logistic regression was used to compare condom use rates and STI risk among women with a history of transactional sexual relationships to women with a history of casual sexual relationships and those with no history of casual sexual relationships. …

  4. They arrested me for loving a schoolgirl: ethnography, HIV, and a feminist assessment of the age of consent law as a gender-based structural intervention in Uganda

    In 1990 women's rights activists in Uganda successfully lobbied to amend the Defilement Law, raising the age of sexual consent for adolescent females from fourteen to eighteen years old and increasing the maximum sentence to death by hanging. The amendment can be considered a macro-level intervention designed to address the social and health inequalities affecting young women and girls, particularly their disproportionately high rate of HIV as compared to their male counterparts. …

  5. Gendered perceptions of HIV risk among young women and men in a high-HIV-prevalence setting

    It has become evident that sexual health and HIV-risk behaviours cannot be addressed effectively without paying adequate attention to constructions of gender and sexuality. While the body of literature examining these themes is growing and becoming more nuanced, there is still a significant gap in our understanding of the relationship between gendered sexual identities and vulnerabilities to disease. In particular, few studies have explored how youths themselves perceive this relationship, and how these perceptions may differ among males and females. …

  6. Perspectives on intimate partner violence in Swaziland amongst 18–29-year-old men undergoing medical circumcision

    Intimate partner violence (IPV) is perceived as a major contributor to HIV transmission in Swaziland. This exploratory study aimed to develop a culturally-specific understanding of men's perspectives of IPV. Focus group methods were used to gather information from 45 young urban Swazi men who had undergone medical male circumcision. A thematic analysis was conducted focussing on the manifestations of IPV and socio-cultural and economic factors which underpin, circumstances which trigger and social responses to IPV. …

  7. Individual and community-level tolerance of spouse abuse and the association with the circumstances of first sex among youth from six sub-Saharan African countries

    Youth who engage in early and premarital sex are at risk of HIV and sexually transmitted infections. Most prevention programs ignore the mediating influence of the threat and experience of violence on these outcomes. Using nationally representative data from Lesotho, Malawi, Zimbabwe, Kenya, Tanzania, and Uganda, the autors used multivariate analyses to examine the association between individual- and community-level tolerance of spouse abuse on the age and circumstances of sexual debut among female youth. The youth sample sizes ranged from a high of 5007 in Malawi to a low of 3050 in Lesotho. …

  8. Paying to prevent HIV infection in young women?

    Between a quarter and a third of young women in sub-Saharan Africa are infected with HIV by the time they reach their early 20s. Structural factors such as poor education, poverty, and gender and power inequalities are important determinants of young women’s vulnerability to HIV infection. In The Lancet, Sarah Baird and colleagues report the results of a randomised controlled trial done with adolescent girls in rural Malawi, examining the effects of a cash transfer programme on risk of HIV infection. …

  9. Assessing knowledge, attitude, and practice of emergency contraception: a cross-sectional study among Ethiopian undergraduate female students

    The importance of Emergency contraception (EC) is evident in preventing unintended pregnancies and its ill consequences like unintended child delivery or unsafe abortion, which are the most common causes of maternal mortality. Knowing that Ethiopia is one of the countries with highest maternal mortality rate, this study aimed to assess the knowledge, attitude and practice of EC, and to further elucidate the relationship between these factors and some socioeconomic and demographic characteristics among female undergraduate students of Addis Ababa University. …

  10. Improving the HIV response for women in Latin America: barriers to integrated advocacy for sexual and reproductive health and rights

    Civil society plays an important health governance role by influencing international sexual, reproductive health and HIV agendas as expressed in international conferences; monitoring and evaluating implementation; and holding governments accountable for their commitments. Integration of sexual and reproductive health (SRH) and HIV services to achieve the health-related MDGs would seem to be a strategic joint advocacy agenda for the women's sexual and reproductive health movement and HIV activists, particularly women living with HIV. …

  11. Impact of five years of peer-mediated interventions on sexual behavior and sexually transmitted infections among female sex workers in Mombasa, Kenya

    Background: Since 2000, peer-mediated interventions among female sex workers (FSW) in Mombasa Kenya have promoted behavioural change through improving knowledge, attitudes and awareness of HIV serostatus, and aimed to prevent HIV and other sexually transmitted infection (STI) by facilitating early STI treatment. Impact of these interventions was evaluated among those who attended peer education and at the FSW population level. Methods: A pre-intervention survey in 2000, recruited 503 FSW using snowball sampling. …

  12. Gender and sexuality: emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention

    Research shows that gender power inequity in relationships and intimate partner violence places women at enhanced risk of HIV infection. Men who have been violent towards their partners are more likely to have HIV. Men's behaviours show a clustering of violent and risky sexual practices, suggesting important connections. This paper draws on Raewyn Connell's notion of hegemonic masculinity and reflections on emphasized femininities to argue that these sexual, and male violent, practices are rooted in and flow from cultural ideals of gender identities. …

  13. Reproductive health for refugees by refugees in Guinea IV: Peer education and HIV knowledge, attitudes, and reported practices

    Peer education has long been used to promote HIV awareness and reduce risk. However, little has been written about its use in refugee settings. This study aimed to assess whether refugee peer education could improve HIV knowledge, attitudes and practices among Guinean refugees. The study also assessed whether gender, age or formal education were more strongly associated to improved HIV outcomes than peer education. Data was collected through a cross-sectional survey of 889 men and women in 23 camps throughout the Forest Region, Guinea. …

  14. The Social Conditions for Successful Peer Education: A Comparison of Two HIV Prevention Programs Run by Sex Workers in India and South Africa

    Peer education is increasingly being used to combat the spread of HIV and AIDS. However, results are inconsistent. This study systematically compares the context and implementation of two peer educational approaches among sex workers in India and South Africa, which had contrasting outcomes, to identify factors leading to success or failure. The Indian intervention's success was enabled by: a stable, supportive social, material and political context; and an ethos of community development which committed resources to sex worker empowerment, ownership and involvement. …

  15. HIV knowledge, risk perception, and safer sex practices among female sex workers in Port Moresby, Papua New Guinea

    This qualitative study aimed to understand how knowledge of HIV and risk perceptiosn influence safer sex practices among female sex workers in Port Moresby, Papua New Guinea. Focus group discussions and semistructured interviews were used to gather data on female sex workers (FSW) (n=174) from 19 sites. FSWs also completed a structured, demographic questionnaire. Although some FSWs had misconceptions, the majority knew about HIV risk, transmission and prevention methods. …

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