Search

This paper explores the manifestation of HIV-related stigma in seven- and eight-year-old white South African children's responses to HIV and AIDS. Drawing from elements of ethnographic and interview data, it shows how young children's responses to HIV and AIDS are inscribed within popular accounts of contagion and articulate gendered, sexual, raced and classed discourses in South Africa. Rejecting static accounts of stigma, the paper shows how children resist and confirm power inequalities involving intense self-regulation as well as inscribing within discourses of care and concern for others infected with HIV and AIDS. The findings have implications for scaling up educational efforts to address awareness of HIV and AIDS and stigma, but also to build on positive insights that young children demonstrate with regard to the disease. [ABSTRACT FROM AUTHOR]

Ritual male circumcision is among the most secretive and sacred of rites practiced by the Xhosa of South Africa. Recently, the alarming rate of death and injury among initiates has led to the spotlight of media attention and government regulation being focused on traditional circumcision. While many of the physical components of the ritual have been little altered by the centuries, its cultural and social meanings have not remained unchanged. This paper attempts to understand how some of these cultural and social meanings have shifted, particularly with respect to attitudes towards sex and the role that circumcision schools traditionally played in the sexual socialisation of Xhosa youth. Ritual circumcision is often defended on the basis of its usefulness as a mechanism for the maintenance of social order, particularly in relation to the perceived crisis in youth sexuality marked by extremely high levels of gender-based violence as well as HIV infection. However, the paper suggests two key ways in which traditional Xhosa circumcision has changed. These include the erosion of the role which circumcision schools once played in the sexual socialisation of young men and the emergence of the idea that initiation gives men the unlimited and unquestionable right to access to sex rather than marking the point at which sexual responsibility and restraint is introduced into the lifestyle of young men. [ABSTRACT FROM AUTHOR]

This paper analyses how TIME magazine represents sub-Saharan African women in its coverage of HIV/AIDS. As rates of infection escalate across the continent, researchers are increasingly emphasising the need to understand the socioeconomic and cultural contexts that make women particularly vulnerable to infection. Yet popular media representations of AIDS continue to rely on older colonial imageries of Africa as the feminised, diseased 'dark continent'. This article identifies three major themes in TIME's representation of sub-Saharan African women and HIV/AIDS: the metaphor of Africa as a woman in crisis, the construction of women as the means of transmission, and the engendered nature of the debate about the impact of international development policies. It is argued that the reliance on familiar cultural narratives often obscures the epidemiological, economic and cultural realities within which sub-Saharan women live. Not merely a consequence of unprotected sex, AIDS in sub-Saharan Africa is also the result of global economics and politics, reflecting the inequities between the West and Africa, male and female, white and black. The paper concludes with a call for further research on the role of representations of HIV/AIDS and its actual routes of transmission. [ABSTRACT FROM AUTHOR]

The primary objective in this study was to explore what HIV and AIDS mean to seven- and eight-year-old children in South Africa and how sexual and gender dynamics are embedded within these meanings. Against representations that associate young children with innocence, the paper argues for a more capacious view of young children as sexual and gendered agents with the ability to exercise their rights. In contrast to research that addresses children as relatively passive desexualised beings, focusing on their dependence on adults, their innocence and their need for protection, this paper examines how HIV and AIDS are constructed and negotiated by young people. It views children not simply in terms of their need for sexual rights but as potentially active participants in the negotiation of their rights. Viewing children's rights as highly contested, the notion that young children have sexual rights opens up possibilities for children (including those from marginalised groups) to talk about their concerns and pleasures, fears and hopes, as well as issues relating to sexual rights and resistances. By working creatively with teachers, it may be possible to broaden young children's knowledge of HIV and AIDS and sexuality within a more supportive environment. [ABSTRACT FROM AUTHOR]

This paper questions international public health theories that characterize AIDS in Africa as an unambiguous heterosexual epidemic. It does so by describing the daily sexual lives of a community of Namibian youth who engage in same‐sex sexual practices. The author outlines how the ongoing vilification of “homosexuals” by ruling State officials serves as a stigmatizing backdrop against which young people experience and practice their sexuality. Drawing upon 20 months of ethnographic research, the paper discusses the HIV sexual risk perceptions and practices of young men, highlighting the complexities in sexual subjectivity that form within the cultural politics of competing masculinities, state‐sponsored anti‐homosexual rhetoric and transnational queer rights protest. Bounded and monolithic notions of gender and sexual identity do not lend themselves to HIV risk and vulnerability analysis in this community. [ABSTRACT FROM AUTHOR]

This paper draws on 49 qualitative interviews to explore the contextual antecedents of methamphetamine use in a sample of gay and bisexual Manhattan men. The paper distinguishes itself from the public health literature on crystal methamphetamine use in this population by shifting the analytic focus from individual‐level factors of drug use to the role of social context. While individual‐level factors—including self esteem and social awkwardness—are related to methamphetamine use, we argue that these factors arise in and are exacerbated by interactional pressures attendant to Manhattan's gay sexual subculture, which revolve around the expectation of peak sexual performance. Because methamphetamine is associated with increased self‐esteem, increased libido, greater sexual endurance, diminished sexual inhibition, and a higher threshold for pain, the drug is used strategically by gay and bisexual men to negotiate sexual sociality and increase sexual pleasure. Hence, we suggest that there exists an elective affinity between Manhattan's gay sexual subculture and the particular pharmacological effects of methamphetamine—whereby the former strongly favours the latter as a systematic pattern of response. In turn, this relationship is linked to unsafe sexual practices or the social conditions that put gay men ‘at risk of risk’ of HIV infection. [ABSTRACT FROM AUTHOR]

The HIV epidemic has had a profound impact on people's everyday life in most African societies. A large proportion of all new HIV infections involves young people between 15 and 25 years. The objective of this paper is to explore local moral worlds of young people in Bobo‐Dioulasso, Burkina Faso, and discuss how the HIVS epidemic affects their reflections on their everyday life and their perceptions of sexual relationships. Based on anthropological fieldwork, including focus‐group discussions, in‐depth interviews and participant observation, a total of 57 young people between 15 and 25 years were followed over a 3‐month period. Using the notion of ‘lifestyle’, the paper shows how structural factors of unemployment and poverty paired with global discourse on AIDS present the young people with frustrations and quandaries in relation to their hopes and images of love, faithfulness and modern living. The data shows that the HIV epidemic contributes to and accelerates their feeling of living in a risk society and of being at risk. In order to cope with these uncertainties and contingencies, local discourses of trust and fidelity become extremely important and to most young people HIV prevention is synonymous with finding a faithful partner and/or using condoms. [ABSTRACT FROM AUTHOR]

The expanding AIDS epidemic in Mozambique is fuelled principally by heterosexual transmission, with young people identified as a key group for prevention efforts. However, little is known about the sexual behaviour of young people in Mozambique and the protective practices they adopt. This paper seeks to identify the contexts and rules governing sexual risk-taking among young people in Maputo. In doing so, the paper affirms the importance of context in understanding risk practices, but highlights the fluidity of practice as an important limitation for the use of contextual analysis in prevention interventions. By focusing on one innovation, the saca cena one-night stand, this paper shows how a subgroup of young people in Maputo has redefined a “risky” sexual practice to include exclusive condom use. As a risk context, the saca cena dictates a set of implicit rules emphasizing anonymity, discretion, verbal and non-verbal cues, and for a set of select innovators, condom use. The saca cena challenges the hegemonic gender roles found among many young people in Maputo of male dominance through sexual conquest and female acquiescence. Instead, the practice allows young people to be both adventurous and responsible. The discourse demonstrates how sexual identities have been redefined to combine risk reduction with sexual experimentation and the satiation of desire. [ABSTRACT FROM AUTHOR]

Developing interpersonal communication skills is a key component in HIV prevention. Understanding the contexts and content of communication about HIV and AIDS among young people is important for the development of effective programmes and interventions. The aim of this paper is to build on study findings suggesting that significant differences exist between young people in- and out-of-school in exposure to AIDS-related information and communication in Kilimanjaro. In-depth interviews were conducted with young people between the ages of 13 and 18. Data were analyzed using a thematic and comparative approach to explore similarities and differences. A trinity of factors including access, agency and ambiguity emerged as influencing communication about HIV and AIDS. The role of social networks in structuring differences in communication is examined. Findings reveal a discourse laden with fear and mistrust. Coupled with low levels of health literacy, young people regardless of school attendance demonstrate an inability to critically appraise modes of transmission and prevention. An increased emphasis should be placed on the development of critical health literacy and open dialogue. Accessible, unambiguous and culturally relevant interventions built on an understanding of barriers to open communication, which link with community-based initiatives to stimulate dialogue and debate, are needed. [ABSTRACT FROM AUTHOR]

This paper presents the findings, shares the methodology and outlines the benefits of a multi-country participatory research process on a unique data source: stories about HIV and AIDS written by young Africans. Between 1997 and 2005, more than 105,000 young people from 37 countries participated in competitions inviting them to think up storylines for short fiction films to educate their communities about HIV and AIDS as part of the 'Scenarios from Africa' communication process. The winning stories were selected by juries made up of: PLWH and other local specialists in prevention, treatment and care; former contest winners and other young people; and communication specialists, including the top African directors, who went on to transform the ideas into short films. In 2005, over 200 jurors selected 30 winners from the 22,894 stories submitted that year by 63,327 contest participants. After reading around 200 stories each and participating in the selection process, jurors compiled their observations and recommendations. The jurors' findings reveal notable persistent shortcomings in existing communication efforts and identify key emerging needs. In some areas, they show remarkable consistency across the continent. Jurors view this as a powerful needs assessment, networking and capacity building process that motivates action. [ABSTRACT FROM AUTHOR]

This paper examines the culturally shaped meanings of AIDS and perceptions of accidental occupational exposure to HIV among a group of twenty nurses in Bangkok, Thailand. The findings are based on data collected as a part of a larger mixed-methods study that examined how perceptions of risk behaviours (including sexual promiscuity) shape health workers' perceptions of patients living with HIV/AIDS. Nurses' narratives revealed that despite acknowledgement of the low probability of occupational exposure to HIV, the fear of HIV infection remained and was largely driven by the enormity of the anticipated social (rather than the health) consequences of being HIV-positive. The perceived certainty of social ostracism was reinforced by participants' observations of the social rejection experienced by people living with HIV/AIDS both within and outside clinical settings. For female nurses, the dominant social perception that women living with HIV/AIDS were violators of gender norms, and thus 'guilty' victims, was an issue central to their self-identities. Ways of improving care for people living with HIV in the light of the nurses concerns and future research are discussed. [ABSTRACT FROM AUTHOR]

Most social science research on HIV has focused on prevention. The arrival of new therapies generated more studies on life with HIV. However most have been carried out in developed world contexts. Much less is known about the vast majority of those living with HIV and dying from AIDS. If this gap is to be filled, more qualitative research will be needed on affected individuals in the developing world and also among migrants who have left developing countries to live in the diaspora. It will also be essential to explore the lives of individuals from the same communities who may experience HIV in very different ways as a result of their gender and/or sexuality. This paper presents findings from three studies of Black African migrants living with HIV in London. It uses an intersectional approach to examine the similarities and the differences between the experiences of heterosexual women, heterosexual men and gay and/or bisexual men. The article highlights the importance of research of this kind both for providing the evidence base for context-specific policy development and also for making better conceptual and theoretical sense of the impact of HIV on individuals and their lives. [ABSTRACT FROM AUTHOR]

This paper aims to explore South African Life Orientation teachers' perception and practice of teaching HIV/AIDS and sexuality in a cultural perspective. We aim to investigate how teachers respond to perceived cultural differences between the local community and the content of their teaching. Data were collected through interviews with teachers who taught students in grades 8 or 9 in public high schools. The teachers expressed differing viewpoints regarding the rationale for teaching about HIV/AIDS and sexuality. Many teachers saw teaching these topics as a response to declining moral standards, while others suggested that they were teaching issues that parents failed to address. The teachers were more concerned about young people's sexual behaviour than about preventing HIV/AIDS. They perceived that cultural contradictions between what was taught and local cultural values were an issue to which they needed to respond, although they differed in terms of how to respond. Some took an adaptive approach to try to avoid conflicts, while others claimed the moral neutrality of their teaching. Teaching about sexuality was perceived to be challenging in terms of language and communication norms. Teaching about HIV/AIDS was perceived as challenging because teachers often needed to convince students about the reality of AIDS. [ABSTRACT FROM AUTHOR]

This paper analyses two female sexual practices in Tete Province, Mozambique: (1) the practice of elongating the labia minora and (2) what is sometimes called 'dry sex' involving the insertion of natural and/or synthetic products into the vagina or the ingestion of these products orally. These practices are fundamental to the construction of female identity, eroticism and the experience of pleasure. Notions such as 'closed/open', 'dry/damp', 'hot/cold', 'heavy/light', 'life/death', 'wealth/poverty' and 'sweet/not sweet' are central to local understandings of sexual practices and reproduction. These notions may affect the women's sexual health because they influence preferences for sex without a condom. These practices may also be associated with the alteration of the vaginal flora and vaginal lesions that may make women more vulnerable to sexually transmitted infections. [ABSTRACT FROM AUTHOR]

This paper reports on an exploratory study examining the role of sexual cleansing rituals in the transmission of HIV among the Luo community in western Kenya. Data were collected using both in-depth interviews and focus group discussions. The study population consisted of 38 widows, 12 community elders and 44 cleansers. Data were collected on non-behavioural causes, behavioural causes and behavioural indicators associated with sexual rituals. Content analysis revealed five central themes: the effect of the ritual on sexual behaviours; factors contributing to the continued practice of the ritual, including a sub-theme on the commercialization of the ritual; the inseparable relationship between the sanctity of sex, prosperity and fertility of the land; and the effects of modernization on the ritual, including a sub-theme on the effects of mass media on HIV-prevention awareness campaigns. Causal factors of unchanging sexual behaviours are deeply rooted in traditional beliefs, which the community uphold strongly. These beliefs encourage men and women to have multiple sexual partners in a context where the use of condoms is rejected and little HIV testing is carried out. [ABSTRACT FROM AUTHOR]

HIV transmission in Vietnam is strongly linked to drug injection, but there is the potential for an epidemic driven by sexual behaviour. HIV-education programmes to date focus largely on personal responsibility and fail to address adequately other aspects of HIV-related risks in social contexts. Based on ethnographic fieldwork conducted in 2002, this paper examines the association between HIV-related risks (unsafe drug use and unsafe sex) and gender relations among injecting drug users. Three patterns of relationships are analysed: between injecting drug users and their injecting partners; between injecting drug users and their smoking partners; and between injecting drug users and their non-using partners. Data shows that intimate relations play an important role in managing HIV-related risks among injecting drug users. HIV prevention must pay due attention to the specific contexts of injecting drug users' lives. Some implications of these findings are discussed and relevant recommendations are proposed. [ABSTRACT FROM AUTHOR]

This paper uses ethnographic data from a sex workers' HIV project in India to consider the appropriateness of individual, social/group and structural theories of health behaviour when applied to HIV-prevention initiatives. Existing theories are critiqued for their modernist representation of behaviour as determined by individual rational decision-making processes or by external structural forces, with inadequate recognition being given to the roles that human agency, subjective meaning and local context play in everyday actions. Analysis of sex workers' accounts of their sexual practices suggests that existing theories of health behaviour can only partially account for sexual behaviour change retrospectively and that they have limited predictive value with respect to the outcomes of individual sexual encounters. Our data show that these outcomes were, in fact, highly context dependent, while possibilities for action were ultimately strongly constrained by structural forces. Findings suggest that interventions need to adopt an integrated, structurally-oriented approach for promoting safer sexual practices in sex work settings. Recognising that no one model of health behaviour is likely to be adequate in explaining or predicting behaviour change encourages responsiveness to local people's agency, recognises the different (health- and non-health-related) registers of risk with which people operate and encourages flexibility according to local contingencies and contexts. [ABSTRACT FROM AUTHOR]

This paper examines the link between heterosexual marriage and women's vulnerability to HIV in Indonesia. In this country, gender relations are currently dominated by traditional beliefs and practices and by religious morality. Data for the current study were collected by means of documentary analysis and archival research as well as by means of expert informant interviews. Findings suggest that traditional practices such as polygamy, early marriage and contract marriage (mut'a) play an important role in enhancing women's likelihood of acquiring HIV within the Indonesian context. [ABSTRACT FROM AUTHOR]

This paper reports on an exploratory study of the sexual behaviour of young Africans living in Windsor, Canada. Twenty-five face-to-face interviews were conducted with thirteen men and twelve women aged 18 to 25 years. Data analysis enabled the identification of four main themes: awareness and concerns about STIs/HIV; partner's influence on negotiating sex or discussing sexual matters; effects of migration and availability of healthcare on perceptions of own risk and assumptions about HIV prevalence in Canada; and discomfort talking about sex. Findings highlight the influence of gender power in determining the nature of sexual activities and outcomes, as well as risky sexual behaviours. Future actions to decrease HIV transmission in Canada should address these issues in ways that are culturally sensitive and culturally inclusive. [ABSTRACT FROM AUTHOR]

At online internet newsgroups, members who self-identify as Giftgivers and Bugchasers post messages describing exchanging HIV as a gift, as the Gift. Using the literature on the social function of gift exchanges, this paper considers how Giftgiver and Bugchaser messages mobilize the language of gifts. In doing so, newsgroup members generate an ontological narrative wherein HIV, as the Gift, promotes social bonds, the creation and maintenance of self identity and social roles, and the meeting of particular goals. Thus the Gift appears to fulfill (at least discursively) many of the social functions of gift exchanges as described in the literature. Online newsgroups function as fora for the expression of a contrarian, transgressive HIV/AIDS narrative and act as 'carnivalesque' spaces in which normative social roles and meaning are inverted in the establishment of a realm whereby HIV becomes a gift. [ABSTRACT FROM AUTHOR]

This paper describes the experiences and concerns of women participating in a short-term AZT intervention feasibility study to prevent mother-to-child HIV transmission at three sites in India. The study used qualitative methods to examine the experiences of 31 women during late pregnancy, delivery and at post-natal visits. It also elicited the perspectives of 19 healthcare providers. Frequent visits required during late-pregnancy and the post-natal period presented concerns for the women in the study. Women's understanding of the long-term implications of participating in the intervention study was poor, and living with uncertainty about the HIV status of the newborn was a major concern. The provision of psychosocial support is essential in future intervention studies and should be incorporated on an ongoing basis. Networking with women-centred support groups may be helpful in enabling women to gain the long-term benefits of this type of intervention. [ABSTRACT FROM AUTHOR]

This paper reports on an assessment of community preparedness for HIV vaccine trials in the Democratic Republic of Congo. Formative research was conducted in the capital city of Kinshasa during the period October 2003 to March 2004 to answer questions pertinent to planning trials of a preventive HIV vaccine and to identify related issues. Twenty-seven in-depth interviews and two focus groups were held with potential trial participants and community leaders. Data was collected on the subjects of vaccines, HIV/AIDS and sexual behaviour, and an HIV vaccine. The study also sought to identify factors that motivate a person to volunteer for a vaccine trial or which are disincentives to participation, along with preparedness of the larger community for trials. Personal concerns for health and for the impact of the epidemic on families and country were common motivations for participation. The danger of an experimental vaccine and the stigma of a positive HIV antibody test as the result of vaccination are major concerns and disincentives. The health, educational, and local non-governmental sectors are identified as having important roles to play in assuring preparedness for trials, although significant challenges exist to achieving community preparedness. [ABSTRACT FROM AUTHOR]

The HIV epidemic has had major impact on men who have sex with men in China. Most current studies view male-to-male sex as a behavioural dimension or variable affecting HIV infection, paying little attention to the socio-cultural meanings of homosexuality and their impacts on men's experiences with HIV/AIDS. This oversight has impeded understanding of the health practices of this population. Based on a qualitative study of experiences of Chinese people living with HIV/AIDS, this paper explores the complex processes in which men who have sex with men struggle and negotiate with their sexuality, family obligations, and this disease. To facilitate Chinese men who have sex with men in responding effectively to HIV and AIDS, researchers and practitioners should take into account a wide range of contextual factors including desired gender roles, family obligations, homophobia, and HIV-related stigma that contribute to current constructions of 'homosexuality' in China. [ABSTRACT FROM AUTHOR]

Behaviour change models in HIV prevention tend to consider that risky sexual behaviours reflect risk assessments and that by changing risk assessments behaviour can be changed. Risk assessment is however culturally constructed. Individuals use heuristics or bounded cognitive devices derived from broader cultural meaning systems to rationalize uncertainty. In this study, we identify some of the cultural heuristics used by migrant men in Goa, India to assess their risk of HIV infection from different sexual partners. Data derives from a series of in‐depth interviews and a locally informed survey. Cultural heuristics identified include visual heuristics, heuristics of gender roles, vigilance and trust. The paper argues that, for more culturally informed HIV/AIDS behaviour change interventions, knowledge of cultural heuristics is essential. [ABSTRACT FROM AUTHOR]

Conventional health services often present barriers to sex workers seeking health care resulting in untreated sexually transmitted infections (STI) and increased risk of HIV infection. A brothel‐based clinic was established to provide STI treatment for sex workers who worked in the inner city suburb of Hillbrow, South Africa. Qualitative research demonstrated that the clinic was acceptable to women in terms of service quality, accessibility, and efficacy, and positively influenced health‐seeking behaviours, health awareness, and condom use. The intervention also transformed the image of the hotels from sites of ‘dirt and disease’ into ‘healthy brothels’. The paper concludes that clinical services offered on site are a viable alternative to the provision of conventional clinical services. [ABSTRACT FROM AUTHOR]

Currently, in a number of public and semi‐public forums in Barbados, the idea of ‘sexual rights’ is being discussed and debated. However, different meanings are attached to ‘rights’. This paper examines how these meanings demonstrate that different interpretations of sexuality, society, and morality are circulating through Barbados today. It also addresses whether or not sexual rights discourses are the best way to advocate for social justice or bring about changes to socio‐sexual attitudes in the Caribbean. It is argued that framing justice and equality through rights talk may have deleterious effects for its advocates, as there is no ‘clear’ or transparent universality as to what rights means. It is suggested that it may be more efficacious for groups who are stigmatized based on sexual orientation to develop vernacular strategies with values and/or logics stressing elements of justice, equality, dignity and respect for personhood, which include but also move beyond sexual orientation as a principal identification. [ABSTRACT FROM AUTHOR]

The paper examines the context of women's risk for HIV by assessing men's and women's sexual behaviour, attitudes towards sex work, and perception of risk for HIV in the city of Chiang Mai, Thailand. The findings are based on data collected in the mid‐1990s, at the height of the epidemic. A range of significant issues were highlighted by the men and women who participated in this study. First, some men continued to have unsafe sex with sex workers. Second, fear of HIV motivated men to seek out friends and acquaintances instead of sex workers for sexual encounters because they were considered ‘safe’ from infection. Third, women in this study were largely unaware of this expansion of the sexual network beyond the sex work itself. Lastly, women's sexuality was largely unrecognized in public health responses, or by the male and female participants, leaving them at risk for HIV. Résumé Dans cet article, l'auteur explore le contexte dans lequel la femme risque d'attraper le virus du Sida dans la ville de Chiang Mai en Thaïlande. Il examine le comportement sexuel des hommes et des femmes, leur attitude vis‐à‐vis des métiers du sexe et la perception du risque d'attraper le VIH. Ses conclusions sont tirées des données recueillies au milieu des années 90, au plus fort de l'épidémie. Les hommes et les femmes qui participèrent à cette recherche soulignèrent un certain nombre de thèmes importants. Tout d'abord, certains hommes continuaient à avoir des rapports sexuels non protégés avec des professionnelles du sexe. Deuxièmement, au lieu d'avoir recours aux professionnelles du sexe, les hommes, étant donné leur crainte du Sida, étaient conduits à chercher des partenaires sexuels parmi leurs amies et connaissances car ces personnes étaient censées ne présenter aucun danger par rapport à l'éventuelle transmission du virus. Troisièmement, les femmes qui participèrent à cette recherche ignoraient en grande partie cette extension du réseau sexuel au delà du milieu professionnel du sexe proprement dit. Enfin, la sexualité des femmes était en grande partie méconnue de ceux chargés de promouvoir la politique de santé publique; les participants hommes et femmes n'en tenaient pas compte non plus, ce qui mettait les femmes en danger d'attraper le VIH. Resumen En este artículo examino en qué contexto las mujeres corren el riesgo de contraer VIH valorando la conducta sexual de hombres y mujeres, las actitudes hacia el trabajo sexual y la percepción de riesgo de HIV en la ciudad tailandesa de Chiang Mai. Los resultados se basan en datos recopilados durante mediados de los noventa cuando la epidemia estaba en su punto más álgido. Los hombres y mujeres que participaron en este estudio destacaron una serie de cuestiones importantes. En primer lugar, algunos hombres seguían teniendo sexo arriesgado con las trabajadoras sexuales. En segundo lugar, el miedo a contraer VIH motivaba a los hombres a buscar amigas y conocidas en lugar de trabajadoras sexuales para sus encuentros amorosos porque pensaban que así estaban seguros de no infectarse. En tercer lugar, las mujeres de este estudio desconocían en gran medida la expansión de la red sexual más allá del trabajo sexual. Por último, la sexualidad de las mujeres en general no era reconocida en las respuestas de salud pública o por los participantes masculinos y femeninos, con lo que corrían el riesgo de contraer VIH. [ABSTRACT FROM AUTHOR]

Recent studies suggest that regular male partners who engage in unprotected anal intercourse (UAI) are currently at risk of HIV infection. In this paper, we try to offer a single and coherent theoretical framework to understand this profile of HIV infection. Data on transformations of intimacy in recent times, UAI and condom use between regular male partners and their correlates are reviewed. Firstly, we describe the social and historical context of modern intimate relationships. The differentiation of intimate relationships and their newfound autonomy from traditional social forces are explored to determine how they may contribute to the destabilization of intimate trajectories. Secondly, we theorize UAI as an attempt to stabilize intimate relationships and a strategy to reaffirm mutual trust, desire and intimacy between regular male partners. The impacts of such an approach to social vulnerability and HIV prevention are also discussed. Résumé Des études récentes suggèrent que les relations anales non protégées entre partenaires masculins réguliers, et non plus uniquement celles entre partenaires occasionnels, constituent un facteur de risque de séroconversion au VIH. Dans cet article, nous proposons une lecture sociologique de la vulnérabilité sociale au VIH qui met l'accent sur la quéte d'intimité entre les partenaires réguliers comme facteur de vulnérabilité. En résumé, nous proposons que le processus de différenciation et d'autonomisation des relations intimes à l'égard des déterminants sociaux traditionnels notamment liés à la stratification a contribué à rendre instables les trajectoires intimes, qui deviennent plus difficiles à initier et à faire durer. Nous théorisons la prise de risques sexuels comme une tentative de stabilisation de la relation intime et une réitération de la confiance mutuelle. Les impacts d'une telle approche de la vulnérabilité sociale au pour la prévention sont discutés. Resumen Según los recientes estudios, los hombres que tienen relaciones anales sin protección, no solo con compañeros ocasionales sino también con parejas sexuales estables, corren el riesgo de infectarse con el virus de inmunodeficiencia humana (VIH). En este artículo, proponemos una lectura sociológica de la vulnerabilidad social frente al VIH, el cual hace un énfasis sobre la intimidad entre parejas estables como factor de riesgo. Asimismo, analizaremos las diferencias entre las relaciones íntimas y su nueva autonomía lejos de las fuerzas sociales tradicionales, a fin de determinar como podrían éstas contribuir a desestabilizar las trayectorias de la pareja con respecto a la intimidad. De otra parte, suponemos que el no uso del preservativo en las relaciones anales es empleado como una manera de afianzar las relaciones de pareja, y al mismo tiempo, este tipo de estrategia es utilizado para reafirmar la fidelidad mutua entre homosexuales con relaciones estables. Las repercusiones de este planteamiento, en cuanto a la vulnerabilidad social y la prevención del VIH, serán discutidas a lo largo del artículo. [ABSTRACT FROM AUTHOR]

In much of HIV/AIDS prevention literature, women are depicted as passive and ill‐equipped to confront the epidemic without external support to enhance their status, autonomy, and negotiation skills. This paper critically evaluates this depiction, using data from in‐depth interviews conducted with married couples in rural Malawi. It focuses on the extent to which married women perceive that they have the ability to protect themselves from infection and on the prevention strategies that they employ. Interview data suggest that women have identified a range of contextually appropriate ways to resist exposure to HIV. These strategies include sitting and discussing the dangers of HIV/AIDS with their husbands; utilizing social networks for advice and as advocates; publicly confronting husbands' girlfriends; and divorcing men who do not adopt safer practices. These locally‐formulated strategies are not likely to be followed consistently, and they may not be the most effective strategies in preventing husbands from straying or protecting women from contracting HIV/AIDS. Their existence, however, demonstrates that rural Malawian women believe that they have some agency to protect themselves; and, they are in fact using locally appropriate strategies to do so. [ABSTRACT FROM AUTHOR]

Drawing from ethnographic, archival and secondary research, this article examines multiple-sexual partners in historical perspective in KwaZulu-Natal, a South Africa province where one in three people are thought to be HIV positive. Research on masculinities, multiple-partners, and AIDS has been predominantly directed towards the present day. This paper stresses the importance of unraveling the antecedents of contemporary masculinities particularly the gendered cultural politics through which they have been produced. Arguing against dominant conceptions of African masculinity as being innate or static, it charts the rise and fall of the isoka , the Zulu man with multiple-sexual partners, over the last century. Showing how the isoka developed through changing conditions occasioned by capitalism, migrant labour and Christianity, it contends that an important turning point took place from the 1970s when high unemployment threatened previous expressions of manliness, notably marriage, setting up an independent household and becoming umnumzana (a household head). The high value placed on men seeking multiple-partners increasingly filled the void left by men's inability to become men through previous means. Turning to the contemporary period, the article argues that, shaken by the huge AIDS deaths, men are betraying increasing doubts about the isoka masculinity. [ABSTRACT FROM AUTHOR]

This paper reports on a study of the relationship of homophobia to HIV/AIDS-related stigma in Jamaica. Ethnography, key informant interviews and focus groups were used to gather data from a sample of 33 male and female adults during the summer of 2003. The sample included health and social service providers, HIV positive men and women, and men and women with same sex partners in urban and rural Jamaica. A strong and consistent relationship between homophobia and HIV/AIDS-related stigma was reported, but the relationship varied according to geographic location, social class, gender, and skin colour (complexion)—to the extent that this coincided with class. Stigma against people living with HIV/AIDS and homosexuality was implicated in low levels of use of HIV testing, treatment and care services and the reluctance of HIV positive people to reveal their serostatus to their sexual partners. Data reveal a pressing need for anti-stigma measures for both homophobia and HIV/AIDS, and for training for health and human service professionals. [ABSTRACT FROM AUTHOR]

Studies of men who have sex with men in South Asian countries including Bangladesh have tended to focus mainly on measuring male-to-male sexual risk behaviours, with less attention being given to understanding the nature and meaning of their sexual relations with women. This can result in missed opportunities for HIV/AIDS-related intervention. This paper, based on a small scale qualitative study, attempts to develop a cultural model to understand men who have sex with men's sexual relations with women within a gender and masculinity framework. Findings reveal that in Bangladesh men who have sex with men frequently surrender to societal pressures to marry, become husbands and shoulder fatherhood. This forces some women to become the silent sufferers of some of the negative consequences of hetero-normative patriarchal practice. Importantly, however, men who have sex with men consider sex with women a form of real sex within a framework of masculine sexual potency irrespective of preference, desire or eroticism. Thus, challenges exist to undertaking sexual health promotion and HIV/AIDS prevention in culturally sensitive ways. [ABSTRACT FROM AUTHOR]