Gender
Leclerc-Madlala S. Age-disparate and intergenerational sex in southern Africa: the dynamics of hypervulnerability. AIDS. 2008;22 Suppl 4:S17-25.
Leclerc-Madlala reviews the current state of knowledge on age-disparate sexual relationships in the context of the southern African HIV hyperepidemic. Disproportionately high HIV infection rates among young women aged 15-24 years have been attributed to their greater involvement in relationships with older-aged partners. Whereas early studies emphasized economic concerns in the context of poverty as driving girls to accept or seek the attentions of older employed men, close-grained studies reveal a complex interplay of meanings and motives that prompt both men and women across socioeconomic strata to engage in intergenerational sex. Studies have revealed that age-disparate relationships are meaningful and perceived as beneficial at a number of levels, including social, physical, psychological, as well as economic and symbolic. In the context of growing economic inequalities and cultural expectations for men to give and women to receive a compensation for sex, relationships with older men are a common and readily available way through which young women gain materially, affirm self-worth, achieve social goals, increase longer-term life chances, or otherwise add value and enjoyment to life. Awareness of HIV risks in these relationships remains low. HIV prevention policies and programmes need to start from an understanding of how those engaged in risky behaviour perceive their sexual relationships and conceptualize the choices they make and the strategies they use. A more comprehensive policy on women and girls with better integration of communities in assessing and addressing issues, and an expansion of campaigns and programmes on the role of men as protectors and supporters of women are recommended.
Editors’ note: This excellent review describes the facilitating social factors in both rural and urban settings that may motivate younger women to value age-disparate sexual relationships for their potential to provide access to social, emotional, symbolic, and financial capital. While young women often hold positive perceptions toward age-disparate relationships, they are aware of the dangers of dependency and unsafe sex leading to pregnancy and sexually transmitted infections including HIV. Although they may be pushed into sexual liaisons with older men for survival reasons, many young women do not perceive themselves as victims. Acknowledging the implicit transactional and reciprocal elements of age-disparate sex and the wider realities of women’s lives in southern Africa is fundamental to a two-pronged approach that focuses on empowering women while working to change men’s behaviours and attitudes. In communities most at risk, creative ways need to be found to support male champions for HIV prevention who represent a masculinity that protects self and others from HIV. This article appeared in a journal supplement of papers drawn from a UNAIDS-convened consultation on the vulnerability of young women in southern Africa. The entire supplement can be downloaded free of charge, if you are among the first 5000 people interested, at https://articleworks.cadmus.com/doc/926318.
Ntaganira J, Muula AS, Masaisa F, Dusabeyezu F, Siziya S, Rudatsikira E. Intimate partner violence among pregnant women in Rwanda. BMC Womens Health. 2008;8:17.
Intimate partner violence, defined as actual or threatened physical, sexual, psychological, and emotional abuse by current or former partners is a global public health concern. The prevalence and determinants of intimate partner violence against pregnant women has not been described in Rwanda. A study was conducted to identify variables associated with intimate partner violence among Rwandan pregnant women. A convenient sample of 600 pregnant women attending antenatal clinics were administered a questionnaire which included items on demographics, HIV status, intimate partner violence, and alcohol use by the male partner. Mean age and proportions of intimate partner violence in different groups were assessed. Odds of intimate partner violence were estimated using logistic regression analysis. Of the 600 respondents, 35.1% reported intimate partner violence in the last 12 months. HIV-positive pregnant women had higher rates of all forms of intimate partner violence than HIV-negative pregnant women: pulling hair (44.3% vs. 20.3%), slapping (32.0% vs. 15.3%), kicking with fists (36.3% vs. 19.7%), throwing to the ground and kicking with feet (23.3% vs. 12.7%), and burning with hot liquid (4.1% vs. 3.5%). HIV-positive participants were more than twice likely to report physical intimate partner violence than those who were HIV-negative (OR = 2.38; 95% CI [1.59, 3.57]). Other factors positively associated with physical intimate partner violence included sexual abuse before the age of 14 years (OR = 2.69; 95% CI [1.69, 4.29]), having an alcohol drinking male partner (OR = 4.10; 95% CI [2.48, 6.77] for occasional drinkers and OR = 3.37; 95% CI [2.05, 5.54] for heavy drinkers), and having a male partner with other sexual partners (OR = 1.53; 95% CI [1.15, 2.20]. Education was negatively associated with lifetime intimate partner violence. In reporting on prevalence of intimate partner violence among pregnant women attending antenatal care in Rwanda, Central Africa, the authors advocate that screening for intimate partner violence be an integral part of HIV care, as well as routine antenatal care. Services for battered women should also be made available.
Post new comment