18 results
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2. 'If she gets married when she is young, she will give birth to many kids': a qualitative study of child marriage practices amongst nomadic pastoralist communities in Kenya.
- Author
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Lowe, Hattie, Kenny, Leah, Hassan, Rahma, Bacchus, Loraine J., Njoroge, Pauline, Dagadu, Nana Apenem, Hossain, Mazeda, and Cislaghi, Beniamino
- Subjects
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CHILD marriage , *NOMADS , *FAMILY size , *SOCIAL norms , *GIRLS' health , *QUALITATIVE research - Abstract
Child marriage is associated with adverse health and social outcomes for women and girls. Among pastoralists in Kenya, child marriage is believed to be higher compared to the national average. This paper explores how social norms and contextual factors sustain child marriage in communities living in conflict-affected North Eastern Kenya. In-depth interviews were carried out with nomadic and semi-nomadic women and men of reproductive age in Wajir and Mandera counties. Participants were purposively sampled across a range of age groups and community types. Interviews were analysed thematically and guided by a social norms approach. We found changes in the way young couples meet and evidence for negative perceptions of child marriage due to its impact on the girls' reproductive health and gender inequality. Despite this, child marriage was common amongst nomadic and semi-nomadic women. Two overarching themes explained child marriage practices: 1) gender norms, and 2) desire for large family size. Our findings complement the global literature, while contributing perspectives of pastoralist groups. Contextual factors of poverty, traditional pastoral lifestyles and limited formal education opportunities for girls, supported large family norms and gender norms that encouraged and sustained child marriage. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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3. Male sex workers' (in)visible risky bodies in international health development: now you see them, now you don't.
- Author
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Woensdregt, Lise and Nencel, Lorraine
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SEX workers , *MALE employees , *WORLD health , *UNSAFE sex , *SEX work - Abstract
International health development discourse constructs and regulates male sex workers as risky bodies in need of interventions for HIV. Drawing on ethnographic research among male sex workers and interviews with development sector actors in Nairobi, Kenya, this paper shows how the identification of male sex workers as a high-risk group for HIV offers a singular conceptualisation of their bodies as risky and renders invisible broader everyday struggles for security and wellbeing. Within these everyday struggles, male sex workers experience bodily risk as they are exposed not only to HIV, but also to being outed or outing themselves as gay. Interview findings show that development actors recognise and are empathic to male sex workers' security risks but have limited opportunity to address these due to restrictive donor regimes. To contribute to enduring change and develop appropriate and effective programmes, it is important for donors to continue funding HIV activities in relation to male sex work, while broadening their understandings of risk. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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4. Men's needs and women's fears: gender-related power dynamics in contraceptive use and coping with consequences in a rural setting in Kenya.
- Author
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Obare, Francis, Odwe, George, and Cleland, John
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CONTRACEPTION , *OLDER automobile drivers , *POWER (Social sciences) , *SEXUAL partners , *INTIMATE partner violence , *SEXUAL excitement , *PSYCHOLOGICAL adaptation - Abstract
This paper examines gender-related power influences on contraceptive use and coping with consequences in a rural setting in Kenya. Data come from in-depth interviews conducted in 2018 with 42 women who participated in a longitudinal study implemented in Homa Bay County. Data were analysed using an exploratory inductive content analytic approach. The findings show that the key drivers of gender-related power influence on contraceptive use and coping with consequences included: 1) the extent to which the women managed to provide sex and sexual pleasure to their partners when they were using contraception; 2) men's readiness to provide permission and resources that women needed and the latter's ability to overcome challenges in obtaining the same from their partners; and 3) women's fears concerning infidelity and partner violence, which influenced the actions they took to reduce instances that could make their partners suspect them of engaging in extra-marital affairs, drive their partners into such affairs, or encourage their partners to direct emotional or physical violence on them. Findings suggest the need for gender-transformative actions combining empowerment programmes for women with information, education and communications activities targeting both men and women. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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5. Understanding ethnic variations in HIV prevalence in Kenya: the role of cultural practices.
- Author
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Magadi, Monica, Gazimbi, Martin, Wafula, Charles, and Kaseje, Margaret
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HUMAN sexuality , *HIV , *CIRCUMCISION , *POLYGYNY , *LOGISTIC regression analysis - Abstract
Patterns of HIV prevalence in Kenya suggest that areas where various cultural practices are prevalent bear a disproportionate burden of HIV. This paper examines (i) the contextual effects of cultural practices (polygyny, male circumcision) and related sexual behaviour factors on HIV prevalence and (ii) the extent to which specific cultural practices in a community/county might explain existing ethnic variations in HIV prevalence in Kenya. The analysis applies multilevel logistic regression to data from the 2012/13 Kenya AIDS Indicator Survey. The results reveal striking ethnic variations in HIV prevalence in Kenya. The prevalence of polygyny in a community is positively associated with HIV prevalence, while a higher level of male circumcision in a county is protective for both men and women. The effects of these factors are stronger for men than women at both individual and contextual (community/county) levels. These cultural practices and associated risk factors partly explain existing ethnic differences in HIV prevalence in Kenya, but there remain significant ethnic variations that are not explained by these cultural practices or related sexual behaviour factors. These call for stronger empirical evidence to offer stronger theoretical explanations and inform effective policy and practice to address HIV epidemic in adversely affected communities in Kenya and similar settings in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]
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- 2021
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6. Understanding men, mood, and avoidable deaths from AIDS in Western Kenya.
- Author
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Aellah, Gemma
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AIDS , *COLLECTIVE consciousness , *HIV , *DRUG resistance , *TREATMENT effectiveness - Abstract
A person diagnosed with HIV today might never experience AIDS, nor transmit HIV. Advances in treatment effectiveness and coverage has made the UN 2030 vision for the 'end of AIDS' thinkable. Yet drug adherence and resistance are continuing challenges, contributing to avoidable deaths in high burden African countries, especially among men. The mood of global policy rhetoric is hopeful, though cautious. The mood of people living with HIV struggling to adhere to life-saving medication is harder to capture, but vital to understand. This paper draws on ethnographic fieldwork with a high burden population in Kenya to explore specific socio-economic contexts that lead to a potent mixture of fatalism and ambition among men now in their thirties who came of age during the devastating 1990s AIDS crisis. It seeks to understand why some HIV-positive members of this bio-generation find it hard to take their life-saving medication consistently, gambling with their lives and the lives of others in pursuit of a life that counts. It argues that mood - here understood as a shared generational consciousness and collective affect created by experiencing specific historical moments - should be taken seriously as legitimate evidence in HIV programming decisions. [ABSTRACT FROM AUTHOR]
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- 2020
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7. Understanding different positions on female genital cutting among Maasai and Samburu communities in Kenya: a cultural psychological perspective.
- Author
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Graamans, Ernst, Ofware, Peter, Nguura, Peter, Smet, Eefje, and ten Have, Wouter
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FEMALE genital mutilation , *MAASAI (African people) , *SAMBURU (African people) , *ETHNOPSYCHOLOGY - Abstract
This paper presents an analysis of different positions on female genital cutting, either legitimising the practice or challenging it. The framework it offers has been developed from cultural psychological theory and qualitative data collected in Maasai communities around Loitokitok and Magadi, Kajiado County, and Samburu communities around Wamba, Samburu County, in Kenya. Over the course of one month, 94 respondents were interviewed using maximum variation sampling. Triangulation took place by means of participant observation of significant events, such as alternative rites, participation in daily activities and informal talks while staying at traditional homesteads and kraals. The framework adds to understanding of why more contextual approaches and holistic interventions are required to bring an end to female genital cutting. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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8. Vocabulary used by sexual offenders: meaning and implications.
- Author
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Muchoki, Samuel
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SEX offenders , *VOCABULARY , *RAPE , *VIOLENT crimes , *SEXUAL abuse victims - Abstract
This paper examines how some sexual violence offenders use culturally acquired vocabularies to describe episodes of rape. The paper is based on an analysis of 12 accounts obtained from death-row inmates in Kenya who had been convicted of violent crimes and sexual violence. The accounts were elicited while conducting a larger study to explore the individual motivations, and social and cultural factors that predispose men to acts of rape. Findings suggest that some sex offenders are immersed in normative cultural expectations about sexuality and gender and that, within this framework, they endeavour to create a picture that shifts the blame from themselves to their victims. They attempt to foster the belief that women and girls, in one way or another, provoke rape. Such vocabularies are used to trivialise and neutralise instances of rape within the wider society. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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9. 'If you start thinking positively, you won't miss sex': narratives of sexual (in)activity among people living with HIV in Nairobi's informal settlements.
- Author
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Undie, Chi-Chi, Ziraba, Abdhalah Kasiira, Madise, Nyovani, Kebaso, John, and Kimani-Murage, Elizabeth
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SEXUAL intercourse , *HIV-positive persons , *AIDS prevention - Abstract
Drawing on qualitative data, this paper examines narratives of sexual activity (or the lack thereof) among people living with HIV in two urban poor contexts in Kenya and the ways in which these narratives intersect with the discourse of a ubiquitous HIV-prevention strategy - the 'ABC' (Abstinence, Be Faithful, Condom Use) approach. The exploration of these narratives gives insight into the ways that the notions and meanings around sexual activity are informed and re-shaped by the experience of living with HIV in urban poor settings and into the complex ways in which the components of the ABC approach feature in the lives of PLHIV in these contexts. As the sexuality of people living with HIV in sub-Saharan Africa is an under-researched area, this paper sheds light on the realities of living with HIV in urban poor settings and illuminates the context that informs constructions of sexuality in this milieui. [ABSTRACT FROM AUTHOR]
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- 2009
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10. Patterns of fertility preferences and contraceptive behaviour over time: change and continuities among the urban poor in Nairobi, Kenya.
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Beguy, Donatien and Mberu, Blessing
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URBAN poor , *HUMAN reproduction , *FERTILITY , *HUMAN fertility - Abstract
The main objective of this paper is to investigate the association between fertility preferences and contraceptive use among 15–49-year-old women living in Korogocho and Viwandani, informal settlements in Nairobi, Kenya. We draw on longitudinal data collected under the Maternal and Child Health project conducted between 2006 and 2010 in the two settlements. There is substantial regularity and stability but also unusual instability in reported fertility preferences over time among women living in these settings. Younger women, aged 15–24 years, are likely to change their preferences over time, passing from limiting to wanting additional children. But women aged 35–49 are likely to change their preferences from desiring more children to limiting their childbearing. The desire to limit childbearing is strongly associated with the use of modern and long-acting contraceptive methods. Findings have major implications for the success of family planning programmes in informal settlements where access to and knowledge about contraception may be limited. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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11. The idea of African men: dealing with the cultural contradictions of sex in academia and in Kenya.
- Author
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Spronk, Rachel
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AFRICANS , *HUMAN sexuality , *SCHOLARS , *ETHNOLOGY - Abstract
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]
- Published
- 2014
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12. Age matters: differential impact of service quality on contraceptive uptake among post-abortion clients in Kenya.
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Tavrow, Paula, Withers, Mellissa, and McMullen, Kara
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ABORTION clinics , *QUALITY of service , *ABORTION , *CONTRACEPTIVES , *FAMILY planning - Abstract
This paper analyses the impact of high quality, user-friendly, comprehensive sliding-scale post-abortion services on clients' uptake of contraception in a Kenyan town. Data were drawn from detailed physician records in a private clinic that served 1080 post-abortion clients in 2006. All clients received confidential family planning counselling and were offered a complete range of contraceptives at no additional cost. One quarter of clients were below age 19. Prior to the abortion, no client aged 10–18 years reported having used contraception, as compared to 60% of clients aged 27–46 years. After the abortion and family planning counselling session, only 6% of clients aged 10–18 chose a method, as compared to 96% of clients aged 27–46, even though contraception was free, the provider strongly promoted family planning to everyone and all clients had just experienced an unwanted pregnancy. Significant predictors of contraceptive uptake post-abortion were: having a child, a previous termination, prior contraceptive use and being older than 21. These findings suggest that availability, affordability and youth-friendliness are not sufficient to overcome psycho-social barriers to contraceptive use for sexually-active young people in Kenya. To reduce unwanted pregnancies, more attention may be needed to developing youth-friendly communities that support responsible sexuality among adolescents. [ABSTRACT FROM PUBLISHER]
- Published
- 2012
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13. Partners and clients of female sex workers in an informal urban settlement in Nairobi, Kenya.
- Author
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Ngugi, Elizabeth, Benoit, Cecilia, Hallgrimsdottir, Helga, Jansson, Mikael, and Roth, EricAbella
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HIV infections , *MULTIVARIATE analysis , *REGRESSION analysis , *PATH analysis (Statistics) , *BUSINESS cycles - Abstract
This paper compares and contrasts number of partners and condom use behaviour for female sex workers and a sample of women working in other economic activities, with both samples drawn from the large informal settlement of Kibera, Nairobi. As expected, univariate analysis revealed much higher numbers of overall sexual partners and higher levels of condom use among female sex workers compared to Kibera women in other occupations. An unexpected finding, however, was that female sex workers with a romantic partner had significantly fewer sexual partners per unit time than female sex workers without such a partner. This finding held for multivariate analysis, with negative binomial regression analyses showing that having a romantic partner was significantly associated with reductions in total number of both sexual partners overall and with sexual partners who did not use condoms. In contrast, HIV status, education, number of immediate family members and levels of alcohol consumption were non-significant factors for both regression analyses. Results suggest that female sex workers' romantic partners act as more than sources of possible HIV infection; rather, romantic partners appear to have an important positive impact on health. We discuss this finding in light of possible harm-reduction programmes focusing on female sex workers and their romantic partners. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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14. Engaging men who have sex with men in operations research in Kenya.
- Author
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Onyango-Ouma, Washington, Birungi, Harriet, and Geibel, Scott
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SAME-sex relationships , *DISEASE risk factors , *HIV infection transmission , *PRIVACY - Abstract
Research on men who have sex with men (MSM) in Africa is severely constrained. This paper examines the process of engaging MSM in research in a context where same-sex relationships are criminalised and socially stigmatised. Despite difficulties in researching MSM in Kenya, a convenient sample of 500 men was enrolled into a study aimed at understanding HIV/STI risks and prevention needs. Lessons drawn from this study highlight innovative methodological approaches and processes to working with and researching MSM in homophobic communities. Researchers willing to venture into MSM research in such contexts should be prepared to deal with among others, issues such as, seeking ethical approval for a study whose subjects are considered to engage in illegal activities, assuring study participants of their privacy and confidentiality and questioning of their own integrity. This study shows that despite difficulties, research of this kind can be carried out in Kenya. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
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15. HIV/AIDS and cultural practices in western Kenya: the impact of sexual cleansing rituals on sexual behaviours.
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Ayikukwei, Rose, Ngare, Duncan, Sidle, John, Ayuku, David, Baliddawa, Joyce, and Greene, James
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MANNERS & customs , *SEXUALLY transmitted diseases , *FOCUS groups , *HIV-positive persons , *HUMAN behavior , *SEX customs , *MODERNIZATION (Social science) , *MASS media & sex , *CONDOMS - Abstract
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]
- Published
- 2008
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16. Secrecy, disclosure and accidental discovery: Perspectives of diaphragm users in Mombasa, Kenya.
- Author
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Okal, Jerry, Stadler, Jonathan, Ombidi, Wilkister, Jao, Irene, Luchters, Stanley, Temmerman, Marleen, and Chersich, MatthewF.
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VAGINAL diaphragms , *BIRTH control , *HIV , *SEXUALLY transmitted diseases , *SEXUAL intercourse , *HEALTH behavior , *SEX workers , *WOMEN'S health - Abstract
The diaphragm is receiving renewed attention as a promising female-controlled method of preventing HIV and other sexually-transmitted infections. It is anticipated that female-controlled technologies will reduce women's biological susceptibility and assist in counteracting their sociocultural vulnerability to HIV. Understanding the subjective experiences of diaphragm users in different settings has the potential to inform the development and promotion of such methods. This paper explores the perspectives of female sex workers and women attending sexual and reproductive health services in Mombasa, Kenya. Data are reported from focus group discussions and in-depth interviews with women and men, following a prospective study investigating diaphragm continuation rates over six months. Discussions highlighted covert use of the diaphragm, during sex work or with casual partners, and coital independence as favourable attributes. These features were especially pronounced compared with male condoms. Few difficulties with diaphragm use were reported, although its insertion and removal occasionally presented problems. Many women - especially those in long term partnerships - wished to disclose its use but found the disclosure process highly problematic. Accidental discovery often resulted in partner conflict. Although future uptake of the diaphragm may be high in this setting, its use may be limited to certain types of relationships and relationship context. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
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17. The social meanings of death from HIV/AIDS: an African interpretative view.
- Author
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Nzioka, Charles
- Subjects
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HIV , *SOCIAL aspects of death , *MORTALITY - Abstract
Death from HIV/AIDS is increasingly common in Kenya. However, the ways in which people diagnosed with HIV/AIDS and society more generally make sense of this kind of death has been little investigated. By analysing accounts from a sample of fourteen heterosexual people diagnosed HIV positive and presented for treatment in four specialized clinics in Nairobi, and other accounts elicited from members of the clergy and lay persons, this paper examines how people make sense of death from HIV/AIDS. To be infected by HIV equates to death, and because AIDS acts as a metaphor for moral and physical contamination, HIV infection confers on the individual a spoilt image and identity. This image and identity is projected into life beyond physical death, and is reinforced, popularized and legitimized by Christian and African religious schema in such a way that death from HIV/AIDS is now constructed and experienced as 'permanent'. This kind of death has implications for the way in which people living with HIV/AIDS seek treatment and manage an HIV seropositive status. It is also relevant to an understanding of the ways in which funerals and burials for people dying of HIV/AIDS are now being organized in Kenya. [ABSTRACT FROM AUTHOR]
- Published
- 2000
- Full Text
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18. Putting sex on the table: sex, sexuality and masculinity among HIV-positive men in Nairobi, Kenya.
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Kageha Igonya, Emmy and Moyer, Eileen
- Subjects
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HIV-positive men , *HIV infections , *THERAPEUTICS , *SEX therapy , *SEX education , *MASCULINITY - Abstract
Psychosocial support groups offer an important space for people living with HIV to pursue greater wellbeing as they learn how to accept and live with their HIV status. They are critical for the cultivation of responsible and adherent patients. Occasionally, support groups provide spaces where members are encouraged to discuss sexual struggles related to being HIV-positive, including sexual performance issues, sexual relationships, fertility desires and communicating with sexual partners. This paper examines an HIV-positive men's sex therapy support group at Kenyatta National Hospital in Nairobi, Kenya, where HIV-positive men access information about HIV and treatment, while getting tips on restoring sexual functioning and improving sexual gratification from medical experts, peer counsellors and fellow group members. In the group setting, members worked to rediscover and reconstruct masculinity under the guidance of a range of experts, while focusing on regaining or improving sexual prowess. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
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