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This paper provides a comparative analysis of modes of dialogue, non‐verbal communication and embodied action relating to sex and health in two contrasting countries—India and South Africa—which have the world's two most heavily HIV‐affected populations (in terms of numbers of people living with HIV). Drawing on material derived from multiple studies, including ethnographic and other forms of qualitative and multi‐disciplinary research, the paper identifies commonalities as well as differences in communication relating to sex and sexual health in these diverse settings. The paper considers: first, how and by whom sex is and is not talked about, in public discourse and private conversation; second, how sexual intention and desire are communicated through indirect, non‐verbal means in everyday life; and third, how references to sexuality and the sexual body re‐enter within a more explicit set of indigenous discourses about health (rather than ‘sexual health’ per se ), such as semen loss in India and womb ‘dirtiness’ in South Africa. The concluding section reflects on the implications of a comparative analysis such as this for current policy emphases on the importance of promoting verbal communication skills as part of ‘life skills’ for HIV prevention. [ABSTRACT FROM AUTHOR]

The southern Indian state of Tamil Nadu has experienced a dramatic decline in fertility, accompanied by a trend of increased son preference. This paper reports on findings from qualitative interviews with women in rural villages about their fertility decision-making. Specifically addressed are the reasons behind increasing son preference and the consequences of this change. Findings suggest that daughter aversion, fuelled primarily by the perceived economic burden of daughters due to the proliferation of dowry, is playing a larger role in fertility decision-making than son preference. The desire for a son is often trumped by the worry over having many daughters. Women use various means of controlling the sex of their children, which in this study appear to be primarily female infanticide. It is important to distinguish between son preference and daughter aversion and to examine repercussions of low fertility within this setting. [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 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]

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]

This paper discusses the heterosexual peer networks and partnerships among low-income, unmarried, college-going youth in an Indian metropolitan city. Findings derive from a study conducted in Mumbai using focus group discussions, in-depth interviews and a survey. Typologies of heterosexual peer networks identified include platonic 'bhai-behen' ('brothersister like'), romantic 'true love', and transitory and sexual 'time pass' relationships. The three typologies each reinforce dominant cultural norms of heterosexuality and, importantly, define the boundaries of sexual behaviour for unmarried youth. The category bhai-behen is important as a boundary marker distinguishing it from the tabooed true love and time pass friendships. The boundaries of these friendships are fluid and boys use this fluidity to their advantage as they engage in multiple relationships, while girls mainly engage in single, true love relationships. Findings contribute to an understanding of sexual culture among college youth in metropolitan India. [ABSTRACT FROM AUTHOR]

This paper describes findings from a study on spousal communication and sexual decision making among women and men from a low-income community in Mumbai. The study explored the link between contextual, individual and socio-economic factors, sexual behaviours and communication to highlight sexual health consequences for women and men. It utilized a combination of qualitative and quantitative methods including a community profile survey, focus group discussions, repeated in-depth interviews, pile sorting and the sequencing of sexual behaviours. Family structure and duration of marriage were found to influence the quality of marital sexual relationship. Early experiences of violence and coercive sex limited women's participation in, and enjoyment of, sex. Respondents revealed a normative sequence of pre-coital sexual behaviours; those reporting sexual violence invariably violated this sequence. Women's experiences of sexual violence revealed lower perceived equity compared with men. Respondents reporting an absence of sexual violence revealed increased satisfaction in sex and highlighted positive aspects of the marital relationship. [ABSTRACT FROM AUTHOR]

This paper explores the ways in which newly married working-class adolescent women of Mumbai, India deal with their marital sexual experiences to transform their bodies from a body-for-others to become also a body-for-self. Using qualitative data gathered through repeated focus group discussions and in-depth interviews with 100 women, I examine the ways women used their bodies in culturally expected ways through participation in sexual activity and reproduction to acquire personal honour. Through the daily disciplining of sexual relations, women characterized their sexual bodily experiences to move from reluctance, shyness, and fear to one of pragmatism. Older married women invoked discourses of ideal femininity to normalize what newly married adolescents perceived as unpleasant events. In retrospect these women, who had experienced gains of status as mothers and honour as married women, transformed the disciplining of their bodies into a force for personal transformation, raising the possibility that their actions can be read as both submission and resistance to existing patriarchal norms. [ABSTRACT FROM AUTHOR]