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Adolescent girls and young women have recently gained a central position in gender equality and development. However, little research investigates female experiences of the complex dynamics of both change and resistance to change in gender norms and structures. Drawing on the work of Bourdieu, Connell and Schippers to analyse longitudinal in-depth interviews, this paper explores how girls in northern Uganda learn, challenge and (re)produce patriarchal structures throughout the life-course and across social fields. It highlights the costs, consequences and benefits at stake in expressing hegemonic femininity and expands understanding of how adolescent girls and young women actively strategise to protect their wellbeing and create space for contestation. Findings call for greater attention to the coexistence of resistance to, and reproduction of, gender orders, and offer opportunities for additional research for theory building and programme implementation. [ABSTRACT FROM AUTHOR]

Adolescent girls and young women have recently gained a central position in gender equality and development. However, little research investigates female experiences of the complex dynamics of both change and resistance to change in gender norms and structures. Drawing on the work of Bourdieu, Connell and Schippers to analyse longitudinal in-depth interviews, this paper explores how girls in northern Uganda learn, challenge and (re)produce patriarchal structures throughout the life-course and across social fields. It highlights the costs, consequences and benefits at stake in expressing hegemonic femininity and expands understanding of how adolescent girls and young women actively strategise to protect their wellbeing and create space for contestation. Findings call for greater attention to the coexistence of resistance to, and reproduction of, gender orders, and offer opportunities for additional research for theory building and programme implementation. [ABSTRACT FROM AUTHOR]

Women are most exposed to sexual health risks within their marital relationships, primarily due to the sexually risky behaviours of their spouses. Studies show that expanding agency is critical for women to mitigate both physical and sexual health risks and is linked to increased psycho-social well-being and economic independence. Drawing on qualitative and quantitative primary data collected from a peri-urban community in Zambia, this paper explores how women exert agency in a community where few educational and economic opportunities and substantial food insecurity exacerbate women's risk for HIV within their marital relationships. It also examines how expressions of agency within marital unions can reduce HIV risk exposure and lead to socio-economic benefits. However, expressions of agency can also create physical, psycho-social and sexual health risks, particularly when spouses do not support independent decision-making and actions that women consider necessary to support the household and maintain intimacy. Findings highlight the importance of community involvement and addressing harmful socio-cultural norms to foster the realisation of women's agency. [ABSTRACT FROM AUTHOR]

With the expansion of access to HIV testing and antiretroviral therapy in sub-Saharan Africa, questions have emerged as to whether stigma remains a useful concept for understanding the effects of AIDS. There is, however, a paucity of research on how HIV-positive Africans - especially African men - experience living with AIDS. This paper addresses this gap and draws on findings from ethnographic fieldwork in 2004 and 2009 with a support group for HIV-positive men in Kampala, Uganda. The paper demonstrates that stigma is central to how men in this context coped with HIV and AIDS and it provides a conceptual framework that links men's experiences of AIDS stigma to conceptions of masculinity. In so doing, findings highlight both the possibilities and challenges of involving African men more fully in HIV prevention. [ABSTRACT FROM AUTHOR]

This paper challenges two common perceptions regarding transactional sex relationships particularly in Africa: that they are primarily resorted to as survival strategies by economically disadvantaged young women and that sex and money are always exchanged within these relationships. Instead, I show how, in reality, young women and the men they date may use these relationships primarily to compete for social status in their peer groups as well as to fashion themselves as high-status, successful modern subjects. Often, for these particular female students, and indeed the men they date, transactional sex often involves more than a straightforward exchange of sex and money. Ethnographic data was collected at the University of Zimbabwe between August 2006 and December 2007 using participant observation and in-depth interviews. This paper focuses on the experiences of ten female students who were, or had been, involved in transactional sex as well as on interviews conducted with four male students who were 'mediating' transactional sex relationships on campus. Findings suggest the importance of taking into account the contexts in which transactional sex occurs. Transactional sex takes different shapes and holds different meanings depending on where it manifests itself. [ABSTRACT FROM AUTHOR]

This paper draws upon recent research in Durban, South Africa to unravel the complexities of care ethics in the context of humanitarian aid. It investigates how the gendering of care shapes the provision of aid in the context of the HIV in Africa constructing an image of 'virile' and 'violent' African masculinity. Humanitarian organisations construct imagined relations of caring, invoking notions of a shared humanity as informing the imperative to facilitate change. This paper draws on varied examples of research and NGO activity to illustrate how these relations of care are strongly gendered. Humanitarian interventions that invoke universalising conceptions of need could instead draw on feminist care ethics that seeks to balance rights, justice and care in ways that attend to the webs of relationships through which specific lived realities are shaped. Essentialising feminised discourses on care result in a skewed analysis of international crises that invariably construct women (and children) as victims in need of care, which at best ignore the lived experiences of men and, at worst, cast men as virile and violent vectors of disease and social disorder. [ABSTRACT FROM AUTHOR]

This paper explores the structural role of the family and parenting in young people's sexual and reproductive health. The study involved eight weeks of participant observation, 26 in-depth interviews, and 11 group discussions with young people aged 14–24 years, and 20 in-depth interviews and 6 group discussions with parents/carers of children in this age group. At an individual level, parenting and family structure were found to affect young people's sexual behaviour by influencing children's self-confidence and interactional competence, limiting discussion of sexual health and shaping economic provision for children, which in turn affected parental authority and daughters' engagement in risky sexual behaviour. Sexual norms are reproduced both through parents' explicit prohibitions and their own behaviours. Girls are socialised to accept men's superiority, which shapes their negotiation of sexual relationships. Interventions to improve young people's sexual and reproductive health should recognise the structural effects of parenting, both in terms of direct influences on children and the dynamics by which structural barriers such as gendered power relations and cultural norms around sexuality are transmitted across generations. [ABSTRACT FROM AUTHOR]

In this paper, I reflect on the notion of ‘African men’ as it is employed in global health scholarship and disentangle the way the idea is used as a generative concept. I explore how this notion circulates and gets modified, adapted and reproduced by scholars, on the one hand, and by various groups of men in Africa, on the other. I argue that the use of the idea of African men as ana prioricategory in scholarly imagination and practice presents us with stereotypes that impede much research. I then briefly connect with what has been analysed as the hegemonic discourse on Africa as the paradigm of difference, and the history of local modes of self-presentation as Africans. In Kenya, among both men and women, the use of the phrase African men as a natural category of sexual agents has been used to explain or justify men's multiple sexual relations. Yet if we look more closely at men's experiences, it becomes clear how men are caught up in conflicting discourses of masculinity. I conclude that we need to analyse gender as a performative quality that is both constructed and meaningful. [ABSTRACT FROM AUTHOR]

Although stigma towards HIV-positive women for both continuing and terminating a pregnancy has been documented, to date few studies have examined relative stigma towards one outcome versus the other. This study seeks to describe community attitudes towards each of two possible elective outcomes of an HIV-positive woman's pregnancy – induced abortion or birth – to determine which garners more stigma and document characteristics of community members associated with stigmatising attitudes towards each outcome. Data come from community-based interviews with reproductive-aged men and women, 2401 in Zambia and 2452 in Nigeria. Bivariate and multivariate analyses revealed that respondents from both countries overwhelmingly favoured continued childbearing for HIV-positive pregnant women, but support for induced abortion was slightly higher in scenarios in which anti-retroviral therapy (ART) was unavailable. Zambian respondents held more stigmatising attitudes towards abortion for HIV-positive women than did Nigerian respondents. Women held more stigmatising attitudes towards abortion for HIV-positive women than men, particularly in Zambia. From a sexual and reproductive health and rights perspective, efforts to assist HIV-positive women in preventing unintended pregnancy and to support them in their pregnancy decisions when they do become pregnant should be encouraged in order to combat the social stigma documented in this paper. [ABSTRACT FROM PUBLISHER]

Understanding gender in Africa is essential to creating policy and designing interventions to address key reproductive-health issues such as HIV/AIDS and maternal mortality that are particularly pressing for the continent and are strongly related to gender inequality. The addition of questions to capture women's empowerment and autonomy on the MEASURE/Demographic and Health Surveys (DHS) in the late-1990s expanded opportunities to examine the relationship between gender and reproductive health. These questions provide valuable information on trends and individual-level associations between gender inequality and health. Given that women's empowerment, status and autonomy are largely dependent on contextually-specific gender systems, however, supplementary qualitative studies to validate and contextualise these data would strengthen analyses significantly. This paper provides examples of how such mixed-methods work would improve understandings of gender and reproductive health in Africa by validating survey questions, providing insights into how to analyse and interpret DHS data and illuminating the processes and mechanisms behind gendered experiences. Additionally, this work could help improve future survey research on gender and reproductive health. [ABSTRACT FROM AUTHOR]

This paper examines the implementation of Western HIV testing norms – counselling, consent and confidentiality (‘3Cs’) – in Malawi, a high prevalence, rural African setting. It considers the differential perspectives of three categories of stakeholders: proponents, implementers and intended beneficiaries. The proponents are members of the ‘Counseling and Testing Establishment’. For them, the 3Cs are human rights imports that are worth defending formally, but not always worth prioritising in practice. The implementers are HIV Counsellors. For them, knowledge of the 3Cs as Western biomedical jargon distinguishes them from villagers, but places them in situations where the ethics of testing conflict with their moral concerns for those whom they were trained to help, thus they adapt them in practice. And the intended beneficiaries, the rural Malawians whose rights are meant to be protected by the 3Cs, perceive the norms as protecting themselves as individuals, but as harming rather than benefitting their communities. The case study of Malawi illustrates a tension between Western, individual rights-oriented public health norms and local concerns for the health and wellbeing of the imagined communities that they are meant to benefit. [ABSTRACT FROM AUTHOR]

Based on research in Tanzania, this paper critically examines the widely circulating notion that African same-sex attracted men are hard-to-reach individuals and populations. Despite expectations to the contrary, it was neither time consuming nor difficult to identify and get to know same-sex attracted men in Dar es Salaam. On the contrary, a large and diverse group of such men could readily be encountered, befriended and involved in HIV-related research. The fieldwork was characterised by communicative openness and the researcher was treated with immense kindliness, hospitality and inclusivity. While we may not be in a position to say that the situation is identical everywhere else, we find reason to caution against accepting and propagating unexplained, unexamined and unverified claims to the effect that same-sex attracted men in Africa cannot be reached. We argue that such claims contribute to stigmatise same-sex attracted men and to hinder much-needed HIV-related research and programming. [ABSTRACT FROM AUTHOR]

In the sub-Saharan African AIDS epidemic there is no shortage of formal messages about HIV distributed through health clinics, NGOs and the media. These messages, however, do not always address the issues that are of most importance for people living in the epidemic and learning how to navigate it safely. In rural Malawi, one message that has been absent concerns the implications of HIV for childbearing. Using data from in-depth interviews, this paper argues that rural Malawians socially constructed their own belief system and came to believe strongly that pregnancy and childbirth would negatively impact the disease progression of HIV-positive women. Through the recursive processes of selective observation, interpretation of formal public health messages and discussion within social networks, rural Malawians concluded that HIV and childbearing did not go together. In an uncertain world, social constructive processes such as these that are fluid and responsive to local circumstances are particularly important for making sense of the seemingly senseless and for developing tools to navigate unsettled times. [ABSTRACT FROM AUTHOR]

Reducing rates of teenage pregnancy is an important part of the agenda of action for meeting most of the Millenium Development Goals. South Africa has important lessons for other countries in this regard as the rate of teenage pregnancy is high but has declined very substantially over the last twenty years. The country experiences waves of moral panic about teenage pregnancy, with assertions that current problems are rooted in accepting or even encouraging the sexual appetites of young people rather than sternly disciplining them. In this paper, we argue that the key to success in teenage pregnancy reduction has been an empowering social policy agenda that has sought to work with young people, making them aware of their rights and the risks of sexual intercourse. Furthermore, family responses and education policy have greatly reduced the potential negative impact of teenage pregnancy on the lives of teenage girls. There is tremendous scope for further progress in reducing teenage pregnancy and we argue that this lies in paying more attention to issues of gender and sexuality, including the terms and conditions under which teenagers have sex. There needs to be critical reflection and engagement with men and boys on issues of masculinity, including their role in child rearing, as well as examination within families of their engagement with supporting pregnancy prevention and responses to pregnancies. [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]

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 examines the personal and social ramifications of infertility in an African urban population with low fertility. The study was conducted in Moshi, Tanzania, a multi-ethnic community with relatively high levels of education and a well developed health services infrastructure. The major question to be addressed was whether in a low fertility urban population, both primary and secondary infertility bring about serious personal ramifications for women similar to those in rural areas. The methodology included a survey of 2,019 women and in-depth interviews with 25 fertile and 25 infertile women. Of the 1,549 sexually active women in a regular union, 2.7% had never had a child in spite of trying to conceive for at least two years. Of the 1,352 women who had previously had a child, an additional 6.1% were subsequently infertile. The most important finding from the qualitative analysis concerns the major difference between childlessness and subsequent infertility (or primary and secondary infertility) in terms of implications for the effected women. These findings underline the importance of bearing a child in sub-Saharan African populations. [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]