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‘Relationships on campus are situationships’: A grounded theory study of sexual relationships at a Ugandan university. PLoS One 2022; 17:e0271495. [PMID: 35900965 PMCID: PMC9333243 DOI: 10.1371/journal.pone.0271495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 07/01/2022] [Indexed: 11/19/2022] Open
Abstract
Understanding the complexities of sexual relationships is essential to understand the risky sexual behaviours among young people in Ugandan universities. Nine focus group discussions conducted with 31 males and 33 female students in 2014 utilising the grounded theory approach explored the role of sexual relationships in their lives. ‘Relationships in campus are situationships’ emerged as the core category and referred to the variety of sexual interactions within relationships among young people in a Ugandan university. The study findings indicated that sexual interactions often follow a sexual script that undergoes transitions to negotiate various situations. The sexual scripts in these situationships were strongly influenced by local socio-cultural norms and global aspirations among young people. Students often discussed these sexual scripts within a wider discourse on transactional sexual relationships. The motivations for transactional sexual relationships ranged from ‘fulfilling aspirations’ of various kinds on the one hand to ‘being forced into trading sex’ to overcome socio-economic vulnerabilities. Sexual relationships were facilitated by the perception of a university as a sexualized space in which one may enjoy a period of emerging adulthood characterized by exploration in relationships, access to alcohol and prolonged delay in assuming the traditional adult roles of marriage and family. The sexual scripts at the cultural level were grounded in traditional gender roles although at the same time, were under transition during university life with the growing influence of globalization and consumerism in the Ugandan society. Young men and young women must be engaged to critically challenge the implicit assumptions about sexual interactions within various situations that may put them at risk for poor sexual health outcomes.
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Aventin Á, Gordon S, Laurenzi C, Rabie S, Tomlinson M, Lohan M, Stewart J, Thurston A, Lohfeld L, Melendez-Torres GJ, Makhetha M, Chideya Y, Skeen S. Adolescent condom use in Southern Africa: narrative systematic review and conceptual model of multilevel barriers and facilitators. BMC Public Health 2021; 21:1228. [PMID: 34172027 PMCID: PMC8234649 DOI: 10.1186/s12889-021-11306-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Adolescent HIV and pregnancy rates in Southern Africa are amongst the highest in the world. Despite decades of sexual and reproductive health (SRH) programming targeting adolescents, recent trends suggest there is a continued need for interventions targeting condom use for this age group. METHODS This review synthesises evidence from qualitative studies that describe the determinants of condom use among adolescents in Southern Africa. We conducted systematic searches in four databases. Data were extracted, appraised for quality and analysed using a 'best-fit' framework synthesis approach. RESULTS We coded deductively findings from 23 original studies using an a priori framework and subsequently conducted thematic analysis. Synthesised findings produced six key themes relating to: 1) pervasive unequal gender norms and restrictive masculinities favouring male sexual decision-making and stigmatising condom use in committed relationships; 2) other social norms reflecting negative constructions of adolescent sexuality and non-traditional family planning; 3) economic and political barriers including poverty and a lack of policy support for condom use; 4) service-level barriers including a lack of youth-friendly SRH services and comprehensive sex education in schools; 5) interpersonal barriers and facilitators including unequal power dynamics in sexual partnerships, peer influences and encouraging condoning condom use, and inadequate communication about SRH from parents/caregivers; and 6) negative attitudes and beliefs about condoms and condom use among adolescents. A conceptual model was generated to describe determinants of condom use, illustrating individual-, interpersonal- and structural-level barriers and facilitating factors. CONCLUSION SRH programming targeting barriers and facilitators of condom use at multiple levels is recommended in Southern Africa. We present a multilevel integrated model of barriers and facilitators to guide adolescent SRH decision-making, programme planning and evaluation. Given the existence of multilevel barriers and facilitators, interventions should, likewise, take a multilevel approach that incorporates locally relevant understanding of the individual-, interpersonal- and structural-level barriers and facilitators to condom use among adolescents in the region.
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Affiliation(s)
- Áine Aventin
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Sarah Gordon
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Christina Laurenzi
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Stephan Rabie
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, Cape Town, South Africa
| | - Mark Tomlinson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Maria Lohan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Jackie Stewart
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Allen Thurston
- School of Education, Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, Northern Ireland
| | - Lynne Lohfeld
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | | | - Moroesi Makhetha
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
- World Vision, Maseru, Lesotho
| | - Yeukai Chideya
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Sarah Skeen
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
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Correlates of mistimed and unwanted pregnancy among women in the Democratic Republic of Congo. J Biosoc Sci 2019; 52:382-399. [PMID: 31409440 DOI: 10.1017/s0021932019000518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Unwanted and mistimed pregnancies impose threats on the health and well-being of the mother and child and limit the acquisition of optimal sexual and reproductive health services, especially in resource-constrained settings like the Democratic Republic of Congo (DRC). This study aimed to determine the prevalence and correlates of mistimed and unwanted pregnancies among women in the DRC. Data were drawn from the 2013-14 DRC Demographic Health Survey (EDS-RDC II). Bivariate and multivariate logistic regression analysis was performed to identify correlates of mistimed and unwanted pregnancies. Sequential logistic regression modelling including distal (place of residence), intermediate (socio-demographic and socioeconomic factors) and proximal (reproductive health and family planning) factors was performed using multivariate analysis. More than a quarter (28%) of pregnancies were reported as unintended (23% mistimed and 5% unwanted). Women who wanted no more children (aOR 1.21; CI: 1.01, 1.44) had less than 24 months of birth spacing (aOR 2.14; CI: 1.80, 2.54) and those who intended to use a family planning method (aOR 1.24; CI: 1.01, 1.52) reported more often that their last pregnancy was mistimed. Women with five or more children (aOR 2.13; CI: 1.30, 3.49), those wanting no more children (aOR 13.07; CI: 9.59, 17.81) and those with more than 48 months of birth spacing (aOR 2.31; CI: 1.26, 4.23) were more likely to report their last pregnancy as unwanted. The high rate of unintended pregnancies in the DRC shows the urgency to act on the fertility behaviour of women. The associated intermediate factors for mistimed and unwanted pregnancy indicate the need to accelerate family planning programmes, particularly for women of high parity and those who want no more children. Likewise, health promotion measures at the grassroots level to ensure women's empowerment and increase women's autonomy in health care are necessary to address the social factors associated with mistimed pregnancy.
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Costenbader E, Zissette S, Martinez A, LeMasters K, Dagadu NA, Deepan P, Shaw B. Getting to intent: Are social norms influencing intentions to use modern contraception in the DRC? PLoS One 2019; 14:e0219617. [PMID: 31310641 PMCID: PMC6634398 DOI: 10.1371/journal.pone.0219617] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 06/27/2019] [Indexed: 12/02/2022] Open
Abstract
Meeting the reproductive health needs of women in post-conflict settings is a global health priority. In the Democratic Republic of the Congo, social norms perpetuate gender-based violence and contribute to low contraceptive use and high fertility. The Masculinité, Famille, et Foi (MFF) intervention is working with communities in Kinshasa to create normative environments supportive of modern contraception access and use. Our analysis uses survey data collected from 900 men and women in 17 community groups prior to the MFF intervention. We aimed to measure the extent to which social norms influence intentions to use modern contraception. Using multiple items to assess social norms and reference groups related to family planning and gender equity, we identified four distinct social norms constructs through factor analysis. Through structural equation modeling, we found that social norms influence intentions to use modern contraception overall, but that normative influence varies by gender.
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Affiliation(s)
| | | | | | - Katherine LeMasters
- FHI 360, Durham, NC, United States of America
- University of North Carolina Gillings School of Public Health, Chapel Hill, NC, United States of America
| | - Nana Apenem Dagadu
- Institute of Reproductive Health at Georgetown University, Washington, DC, United States of America
| | | | - Bryan Shaw
- Institute of Reproductive Health at Georgetown University, Washington, DC, United States of America
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Mulumeoderhwa M. 'It's not good to eat a candy in a wrapper': male students' perspectives on condom use and concurrent sexual partnerships in the eastern Democratic Republic of Congo. SAHARA J 2018; 15:89-102. [PMID: 30149788 PMCID: PMC6116706 DOI: 10.1080/17290376.2018.1516160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This paper reports on fieldwork carried out in 2011 with aim to investigate young men's perspectives about condoms use, concurrent sexual partnerships and sex in the context of HIV/AIDS. This study employed a qualitative approach to collect data from 28 boys aged 16-20 from two urban and two rural high schools in South Kivu province. Four focus group discussions and 20 individual interviews were conducted among them. The findings showed that most students identified condoms as unsafe and untrustworthy. Reasons given for the mistrust of condoms were related to the belief that condoms do not give enough protection from Sexually Transmitted Infections, HIV and pregnancies. Most participants believe that condoms have a 'small hole' or are unreliable and are therefore not effective in prevention. They also mentioned that condoms encourage inappropriate sexual activity. They prefer flesh-to-flesh sex rather than protected sex using a condom. However, a few participants acknowledged the importance of condom use. Despite the risk of HIV transmission, boys believe that it is appropriate for them to have concurrent sexual partnerships. They justified the concurrent sexual partnerships as a way of ensuring that they cannot miss a girl to satisfy their sexual desire. Given the boys' failure to use condoms and their strong inclination to concurrent sexual partnerships, there is a need for heath groups and stakeholders within the area to increase awareness about condoms' effectiveness and improve knowledge dissemination on Sexually Transmitted Diseases and how they are prevented.
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Affiliation(s)
- Maroyi Mulumeoderhwa
- Faculty of Top Management, Institute for Reconciliation and Social Justice, University of the Free State, Bloemfontein, South Africa
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Lusey H, San Sebastian M, Christianson M, Edin KE. Prevalence and correlates of gender inequitable norms among young, church-going women and men in Kinshasa, Democratic Republic of Congo. BMC Public Health 2018; 18:887. [PMID: 30016960 PMCID: PMC6050660 DOI: 10.1186/s12889-018-5742-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 06/22/2018] [Indexed: 11/10/2022] Open
Abstract
Background Prolonged political instability may have exacerbated gender inequitable beliefs in the Democratic Republic of Congo (DRC). The aim of this study was to assess attitudes related to gender-equitable norms and its determinants among young, church-going women and men in Kinshasa, DRC. Method Data were collected through a cross-sectional survey with 291 church-going women and 289 men aged 18–24 years old, residing in three disadvantaged communes of Kinshasa. Variables included sociodemographic characteristics, attitudes towards gender equality, and responses to issues related to the gender-equitable men (GEM) scale. The GEM scale is a 24 item-questionnaire developed to measure attitudes towards gender equitable norms. Logistic regression was applied to discover the associations between the independent variables and the GEM outcome. Results Our study reflected the existence of attitudes hampering gender equality that were endorsed by both women and men. For example, 91.4% of women and 83% of men agreed with the statement “a woman’s most important role is to take care of her home and cook for her family”. Similarly, 88.3% of women and 82.9% of men concurred with the idea that men need more sex than women. These findings coexisted with a few equitable norms, because 93.7% of women and 92.3% of men agreed that a man and a woman should decide together if they want to have children. A positive association was found in both women and men between being educated, being single and separated and having supportive attitudes towards gender equality and a higher GEM scale score. Residency in Camp Luka and Masina was also a significant social determinant associated with equitable gender norms among men whilst job status was only significant among women. Conclusion While both women and men had high levels of gender inequitable norms, those with more education, single, and with supportive attitudes to gender equality had high GEM scale scores. The results highlight an urgent need for the church to challenge and change gender norms among church youths.
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Affiliation(s)
- Hendrew Lusey
- World Council of Churches, Ecumenical HIV and AIDS Initiative and Advocacy (EHAIA), Central Africa regional office, C/o Salvation Army Headquarters, Avenue colonel Ebeya No. 23, B.P: 8636, Kinshasa Gombe, Democratic Republic of Congo. .,Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. .,Sexual and Reproductive Health, Department of Nursing, Umeå University, Umeå, Sweden.
| | - Miguel San Sebastian
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Monica Christianson
- Sexual and Reproductive Health, Department of Nursing, Umeå University, Umeå, Sweden
| | - Kerstin E Edin
- Sexual and Reproductive Health, Department of Nursing, Umeå University, Umeå, Sweden
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Jacques-Aviñó C, García de Olalla P, González Antelo A, Fernández Quevedo M, Romaní O, Caylà JA. The theory of masculinity in studies on HIV. A systematic review. Glob Public Health 2018; 14:601-620. [PMID: 29972098 DOI: 10.1080/17441692.2018.1493133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study aimed to describe the methodological characteristics of publications on HIV and masculinity, to identify possible information gaps and determine the main thematic areas. A systematic review was conducted of gender, masculinity, HIV infection and other sexually-transmitted infections in original articles published between 1992 and 2015. Original studies published from Pubmed and Scopus were included. A total of 303 articles were identified, of which 187 were selected. Most of the studies were qualitative and the most widely used technique was the interview. Twenty-nine-point five percent of studies were performed in South Africa, 20.8% in the USA, and 3.2% in Europe. Fifteen percent of the studies were performed in heterosexuals, 12.8% in men who have sex with men, and 60% did not specify the sexual orientation of the population. Eight thematic areas were defined, the most frequent being sexuality and risk behaviours, defined by men's need to demonstrate they were sexually active and a breadwinner. Most studies on HIV and masculinity show a gender bias by not specifying the sexual identity of the population. Studies should consider diversity in sexual and cultural identity in different contexts, including in Europe, to carry out more effective HIV interventions from a masculinity perspective.
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Affiliation(s)
- Constanza Jacques-Aviñó
- a Servicio de Epidemiología , Agència de Salud Pública de Barcelona , Barcelona , Spain.,b Universitat Rovira i Virgili (URV) , Tarragona , Spain
| | - Patricia García de Olalla
- a Servicio de Epidemiología , Agència de Salud Pública de Barcelona , Barcelona , Spain.,c Epidemiología y Salud Pública , CIBER , Spain
| | - Alicia González Antelo
- d Servicio Medicina Preventiva y Epidemiología , Hospital Vall d'Hebrón , Barcelona , Spain
| | | | - Oriol Romaní
- c Epidemiología y Salud Pública , CIBER , Spain.,e Medical Anthropology Research Center (MARC- URV) , Tarragona , Spain
| | - Joan A Caylà
- a Servicio de Epidemiología , Agència de Salud Pública de Barcelona , Barcelona , Spain.,c Epidemiología y Salud Pública , CIBER , Spain
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Nanda G, Dal Santo L, Konde JN, de Negri B. Barriers to achieving the first 90%: gender norms and HIV testing among men in the Democratic Republic of the Congo. AIDS Care 2018; 30:1231-1238. [PMID: 29947246 DOI: 10.1080/09540121.2018.1489100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Gender inequality and gender norms are key social drivers of the HIV epidemic through their influences on sexual relationships, behavior, and risk taking. However, few empirical studies have measured the influence of gender norms on HIV sexual-risk behaviors and HIV testing among men in sub-Saharan Africa. We analyzed cross-sectional, survey data from 399 sexually active men (ages 18-39) in Democratic Republic of the Congo to examine the relationship between the men's support for inequitable gender norms and their HIV-risk behaviors. Logistic regression analyses revealed that moderate and strong levels of support for inequitable gender norms were significantly associated with never having been tested for HIV (AOR = 2.92, p < .05 and AOR = 3.41, p < .01, for moderate and strong support, respectively). Our findings indicate that changing the prevailing gender norms should be prioritized in HIV-prevention efforts that aim to increase counseling and testing for men.
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Affiliation(s)
- Geeta Nanda
- a Global Health, Population, and Nutrition Department , FHI 360 , Washington , DC , USA
| | - Leila Dal Santo
- a Global Health, Population, and Nutrition Department , FHI 360 , Washington , DC , USA
| | - Joel Nkiama Konde
- b School of Public Health , University of Kinshasa , Kinshasa , Democratic Republic of the Congo
| | - Berengere de Negri
- a Global Health, Population, and Nutrition Department , FHI 360 , Washington , DC , USA
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Mulumeoderhwa M. Virginity Requirement Versus Sexually-Active Young People: What Girls and Boys Think About Virginity in South Kivu, Democratic Republic of Congo. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:565-575. [PMID: 28879518 DOI: 10.1007/s10508-017-1038-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 04/21/2017] [Accepted: 07/07/2017] [Indexed: 06/07/2023]
Abstract
This article aims to explore Congolese male and female high school students' cultural attitudes concerning virginity. The study employed a qualitative approach to collect data from 56 boys and girls aged 16-20 years old. Eight focus group discussions and 40 individual interviews were conducted among participants from two urban and two rural high schools in South Kivu province. Findings indicate that men are disappointed when they marry non-virgin girls. In fact, most male and female participants perceived girls who were virgins as trustworthy individuals. They believe that the girl's virginity loss brings shame to her family. However, some female participants clearly dissociate from societal views or norms about virginity, and remark that virginity itself is not the key to a successful household nor a guarantee for remaining faithful after marriage. Such traditional norms-in the context of high levels of rape-place enormous pressure on young women and cause them to lie about virginity because they fear losing their fiancés. They indicated that they would lie about it regardless of any consequences they may encounter. In fact, some traditional beliefs need to be challenged and modified.
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Affiliation(s)
- Maroyi Mulumeoderhwa
- Institute for Reconciliation and Social Justice, Faculty of Top Management, University of the Free State - UFS, DF Malherbe House, Graduandi Lane, PO Box 339, Bloemfontein, 9300, Republic of South Africa.
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Burgueño E, Carlos S, Lopez-Del Burgo C, Osorio A, Stozek M, Ndarabu A, Muamba P, Tshisuaka P, De Irala J. Forced sexual intercourse and its association with HIV status among people attending HIV Voluntary Counseling and Testing in a healthcare center in Kinshasa (DRC). PLoS One 2017; 12:e0189632. [PMID: 29253857 PMCID: PMC5734756 DOI: 10.1371/journal.pone.0189632] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/29/2017] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Sexual violence, an HIV determinant, is an integrated behavior in the D.R.Congo. We aimed to analyze the prevalence of forced sexual intercourse (FSI) among people receiving HIV Voluntary Counseling and Testing in a hospital in Kinshasa, and its association with socio-demographics, behaviors and HIV status. METHODOLOGY Case-control study (2010-2012). Two-hundred and seventy-four cases with a new HIV+ test and 1,340 controls with an HIV- test were interviewed about HIV-related knowledge, attitudes and behaviors, including FSI. RESULTS Thirty-four percent of the participants declared having had FSI (38% of women and 32% of men). Being a woman, aged 25-49 and reporting multiple sexual partners were associated with reporting FSI. For men, being single was protective against FSI; and cohabiting, having a high socioeconomic status, and alcohol consumption increased the odds. For women, being single, divorced/separated and widow was associated with reporting FSI. A significant positive association was found between FSI and an HIV positive test. CONCLUSION Among our Congolese population, FSI was strongly associated with HIV infection and it was also associated with alcohol consumption and multiple sexual partnerships, other key HIV determinants. These behaviors need to be identified as potential risk factors of FSI during counseling interventions. Researchers, practitioners and decision-makers should work together to get violence prevention integrated into health, social and educational policies.
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Affiliation(s)
- Eduardo Burgueño
- CEFA-Monkole, Kinshasa, Democratic Republic of the Congo
- School of Medicine, University of Mwene-Ditu, Mwene-Ditu, Democratic Republic of the Congo
| | - Silvia Carlos
- Preventive Medicine and Public Health Department, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
- * E-mail:
| | - Cristina Lopez-Del Burgo
- Preventive Medicine and Public Health Department, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
| | - Alfonso Osorio
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Maria Stozek
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
| | - Adolphe Ndarabu
- Monkole Hospital, Kinshasa, Democratic Republic of the Congo
| | - Philémon Muamba
- School of Law and Politics, Catholic University of Congo, Kinshasa, Democratic Republic of the Congo
| | | | - Jokin De Irala
- Preventive Medicine and Public Health Department, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
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Lusey H, San Sebastian M, Christianson M, Edin KE. Factors associated with gender equality among church-going young men in Kinshasa, Democratic Republic of Congo: a cross-sectional study. Int J Equity Health 2017; 16:213. [PMID: 29228996 PMCID: PMC5725947 DOI: 10.1186/s12939-017-0707-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 11/23/2017] [Indexed: 11/20/2022] Open
Abstract
Background While women and girls are made vulnerable by inequitable and violent versions of masculinities, there is increasing evidence that gender equality will not be achieved without partnering with men. The aim of this study was to assess gender-equitable norms and their determinants among church-going young men in Kinshasa, the Democratic Republic of Congo. Method A cross-sectional study was carried out among 289 church-going young men, aged 18–24 years, residing in three disadvantaged communes of Kinshasa. Variables included sociodemographic characteristics, attitudes towards gender equality and responses to issues related to the Gender-Equitable Men (GEM) scale. Logistic regression was applied to identify the associations between sociodemographic characteristics, attitudes and the GEM scale. Results The findings provide evidence of attitudes and beliefs that act as barriers to gender equality. For instance, the majority of church-going young men (83.74%) agreed that a man is the only decision maker in the home and about half (50.87%) of the respondents supported the statement “There are times a woman deserves to be beaten”. Similarly, around half of the participants agreed with the idea of men’s uncontrollable sex drive (50.87%) and men’s toughness (50.17%). Close to half of the participants (44.29%) agreed that it is women’s responsibility to prevent pregnancy. These attitudes co-existed with a few gender-equitable norms as 82.70% agreed on the importance of joint decisions concerning family planning. An association between education, certain places of residence, being single or separated, and supportive attitudes towards gender equality was found with higher scores for the GEM. Conclusion Our study findings indicate that a high proportion of church-going young men do not endorse gender-equitable norms. Therefore, churches urgently need comprehensive gender equality and masculinity policies and programmes to influence young men’s attitudes and behaviours. The promotion of gender equality in schools and the wider community also need to be encouraged.
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Affiliation(s)
- Hendrew Lusey
- World Council of Churches, Central Africa Regional Coordinator of the Ecumenical HIV and AIDS Initiative in Africa (EHAIA), C/o Salvation Army Headquarter, Avenue Colonel Ebeya no 23, B.P. 8636, Kinshasa Gombe, Democratic Republic of Congo. .,Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden. .,Department of Nursing, Sexual and Reproductive Health, Umeå University, Umeå, Sweden.
| | - Miguel San Sebastian
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Monica Christianson
- Department of Nursing, Sexual and Reproductive Health, Umeå University, Umeå, Sweden
| | - Kerstin E Edin
- Department of Nursing, Sexual and Reproductive Health, Umeå University, Umeå, Sweden
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Odimegwu C, Somefun OD. Ethnicity, gender and risky sexual behaviour among Nigeria youth: an alternative explanation. Reprod Health 2017; 14:16. [PMID: 28143542 PMCID: PMC5282662 DOI: 10.1186/s12978-017-0284-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 01/07/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While studies in demography and public health have acknowledged the role of ethnic differences, the influence of ethnicity on youth sexual behaviour in Nigeria has received little or no attention. It is important to know how cultural norms and gender roles, which vary by ethnicity, may promote or prevent risky behaviour. Such information could provide insights into previously undetected sexual behaviour in multi-ethnic situations. METHODS The Nigeria Demographic and Health Surveys (NDHS) for 2003, 2008 and 2013 were pooled to examine the relationship between ethnicity and youth sexual reproductive health, proxied by age at sexual debut, multiple sexual partners (MSP) and condom use at last sexual activity, among the 6304 females and 1549 males who reported being sexually active in the four weeks preceding the survey. Multivariate analysis using a Cox proportional hazard regression model was used to determine the risk factors for early sexual activity among young people (15-24). Logistic regression was used to predict condom use at last sexual activity and MSP. RESULTS The median age at first sexual activity was 16 for females and 17 for males. 43% of male youths used condoms in their last sexual activity, compared to only 16% among females and a higher number of males (81%) had multiple sexual partners compared to females (35%). For females, elevated risks of first sex was higher among Hausa/Fulanis aged 15-19 and elevated risk of first sex was higher among Yoruba males. CONCLUSION This study provides further evidence that in order to promote protective sexual behaviours among youth in Nigeria, social, cultural and gender-specific tactics should be put in place for the prevention of HIV and other STIs.
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Affiliation(s)
- Clifford Odimegwu
- Demography and Population Studies, School of Public Health and Social Sciences, Faculty of Humanities, University of the Witwatersrand, Johannesburg, 2000 South Africa
| | - Oluwaseyi Dolapo Somefun
- Demography and Population Studies, School of Public Health and Social Sciences, Faculty of Humanities, University of the Witwatersrand, Johannesburg, 2000 South Africa
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Edin K, Nilsson B, Ivarsson A, Kinsman J, Norris SA, Kahn K. Perspectives on intimate relationships among young people in rural South Africa: the logic of risk. CULTURE, HEALTH & SEXUALITY 2016; 18:1010-1024. [PMID: 26986221 DOI: 10.1080/13691058.2016.1155749] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This paper explores how young people in rural South Africa understand gender, dating, sexuality and risk-taking in adolescence. The empirical material drawn upon consists of 20 interviews with young men and women (aged 18-19) and reflects normative gender patterns characterised by compulsory heterosexuality and dating as obligatory, and representing key symbols of normality. However, different meanings of heterosexual relationships are articulated in the interviews, for example in the recurring concept of 'passing time', and these meanings show that a relationship can be something arbitrary: a way to reduce boredom and have casual sex. Such a rationale for engaging in a relationship reflects one of several other normative gender patterns, which relate to the trivialisation of dating and sexual risk-taking, and which entail making compromises and legitimising deviations from the 'ideal' life-script and the hope of a better future. However, risks do not exclusively represent something bad, dangerous or immoral, because they are also used as excuses to avoid sex, HIV acquisition and early pregnancy. In conclusion, various interrelated issues can both undermine and/or reinforce risk awareness and subsequent risk behaviour. Recognition of this tension is essential when framing policies to support young people to reduce sexual risk-taking behaviour.
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Affiliation(s)
- Kerstin Edin
- a Department of Nursing, Midwifery , Umeå University , Umeå , Sweden
- b Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit , Umeå University , Umeå , Sweden
- e MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Bo Nilsson
- c Department of Culture and Media Studies , Umeå University , Umeå , Sweden
| | - Anneli Ivarsson
- b Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit , Umeå University , Umeå , Sweden
- e MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - John Kinsman
- b Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit , Umeå University , Umeå , Sweden
| | - Shane A Norris
- d MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Kathleen Kahn
- b Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit , Umeå University , Umeå , Sweden
- e MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
- f INDEPTH Network , Accra , Ghana
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Fleming PJ, DiClemente RJ, Barrington C. Masculinity and HIV: Dimensions of Masculine Norms that Contribute to Men's HIV-Related Sexual Behaviors. AIDS Behav 2016; 20:788-98. [PMID: 26696261 PMCID: PMC4799765 DOI: 10.1007/s10461-015-1264-y] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Numerous studies have documented a relationship between masculine norms and men's HIV-related sexual behaviors, but intervening upon this relationship requires a nuanced understanding of the specific aspects of masculine norms that shape men's sexual behaviors. We integrate theories on masculinities with empirical HIV research to identify specific dimensions of masculine norms that influence men's HIV-related sexual behaviors. We identify three major dimensions of masculine norms that shape men's sexual behavior: (1) uncontrollable male sex drive, (2) capacity to perform sexually, and (3) power over others. While the existing literature does help explain the relationship between masculine norms and men's sexual behaviors several gaps remain including: a recognition of context-specific masculinities, an interrogation of the positive influences of masculinity, adoption of an intersectional approach, assessment of changes in norms and behaviors over time, and rigorous evaluations of gender-transformative approaches. Addressing these gaps in future research may optimize prevention efforts.
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Affiliation(s)
- Paul J Fleming
- Division of Global Public Health, University of California, San Diego, 9500 Gilman Drive MC 0507, La Jolla, CA, 92093, USA.
| | - Ralph J DiClemente
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA
- Center for AIDS Research, Prevention Sciences & Epidemiology Core, Atlanta, GA, USA
| | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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