In South Africa, traditional versions of masculinity that once bestowed power and privilege onto ... more In South Africa, traditional versions of masculinity that once bestowed power and privilege onto white heterosexual men are being contested. White adolescent males must negotiate this changing environment at a time when they themselves are engaging in the process of identity development. Given the recent emergence of the masculine body ideal, the muscular mesomorph, and its association with traditional masculinity, this study sought to examine the relationship between traditional masculinity, conflict resolution and body image among a sample of predominantly white adolescent males in South Africa. The relationships between these variables were examined in accordance with Connell's theory of body-reflexive practices (1995), which views the body as both an “object” and “agent” of practice. Our findings revealed that support for traditional masculine norms among adolescent males was associated with the desire for a larger, more muscular body and the use of maladaptive conflict resolution styles that exhibit a low concern for the welfare of others. In the context of recent sociocultural changes, these findings suggest that conflict resolution and the redefinition of the male body may be an emerging arena that provides new possibilities for young white males to enact a form of male power that is seen to be maladaptive in our context.
ABSTRACT This study investigated the relationship between masculinities, cultural worldviews and ... more ABSTRACT This study investigated the relationship between masculinities, cultural worldviews and societal risk perceptions in a sample of adolescent school-going boys in South Africa. Connell’s theory of hegemonic masculinity and cultural theory of risk provided the theoretical frameworks for this study. The findings showed that males conforming to the traditional masculinity type were more likely to endorse a hierarchical and individualist worldview. They were also less concerned about the impact of a number of societal risks on the South African public such as environmental risks and risks associated with crime and social instability than participants conforming to the progressive masculinity type. Participants conforming to progressive masculine norms were more likely to hold an egalitarian worldview. The results of mediation analyses suggest that among self-identified traditional and progressive males in our study, judgements about certain risk concerns are best understood through their views of society and the preferred forms of social organisation and power in society. Given the above findings, it is suggested that intervention strategies in risk management need to appreciate that subjective processes of risk identification are fundamentally gendered in nature and may be influenced by one’s cultural worldview.
New HIV infections and AIDS-related deaths among children and adolescent girls and young women (a... more New HIV infections and AIDS-related deaths among children and adolescent girls and young women (aged 15-24 years) in eastern and southern Africa continue to occur at unacceptably high rates. The COVID-19 pandemic has also severely undermined ongoing initiatives for HIV prevention and treatment, threatening to set the region back further in its efforts to end AIDS by 2030. Major impediments exist to attaining the UNAIDS 2025 targets among children, adolescent girls, young women, young mothers living with HIV, and young female sex workers residing in eastern and southern Africa. Each population has specific but overlapping needs with regard to diagnosis and linkage to and retention in care. Urgent action is needed to intensify and improve programmes for HIV prevention and treatment, including sexual and reproductive health services for adolescent girls and young women, HIV-positive young mothers, and young female sex workers.
Background: Comprehensive sexuality education (CSE) seeks to reduce risky sexual behaviour and su... more Background: Comprehensive sexuality education (CSE) seeks to reduce risky sexual behaviour and subsequent incidence of unintended pregnancy and HIV among school going adolescents. This study evaluates differences between in and out of school adolescent girls and the effect of exposure to CSE on key biomedical and behavioural indicators in South Africa. Methods: Data were collected from a household-based representative sample of adolescent girls (between the ages 12–18 years) in four high HIV prevalence DREAMS implementation districts in South Africa. Independent variables included school attendance and exposure to CSE, with outcome variables measuring prevalence of HIV, pregnancy and sexual behaviour, including condom use, incidence of age disparate relationships and transactional sex. Findings Attending school is associated with reduced adjusted odds of having engaged in sexual activity (AOR: 0·58, 95% CI: 0·48-0·70, p < 0·001); using condoms inconsistently in the previous 12 mo...
Introduction Adherence to antiretroviral therapy (ART) remains a key challenge to achieving the f... more Introduction Adherence to antiretroviral therapy (ART) remains a key challenge to achieving the fast-track goal of ending the HIV epidemic by 2030. To provide a more comprehensive indication of whether interventions designed to promote ART adherence might benefit from targeting body image perceptions, we aim to conduct a systematic review to synthesise existing evidence on the association between body image and ART adherence. Methods and analysis A systematic review of peer-reviewed observational studies and randomised controlled trials that have investigated the association between body image and adherence to ART will be performed. JSTOR, PsycARTICLES, PsycINFO, PubMed, ScienceDirect and Web of Science databases will be searched from 1 January 2000 to 31 March 2021. Eligible records will consider body image as either an independent variable or a mediator, whereas ART adherence will be assessed as an outcome variable. Study selection will follow the Preferred Reporting Items for Sys...
Achieving the UNAIDS 90-90-90 targets by 2020 is contingent on identifying and addressing mental ... more Achieving the UNAIDS 90-90-90 targets by 2020 is contingent on identifying and addressing mental health challenges that may affect HIV testing and treatment-related behaviors. This study is based on survey data from KwaZulu-Natal, South Africa (2014–2015). HIV positive women who reported higher depression scores had a lower odds of having tested previously for HIV (15–25 years: AOR = 0.90, 95% CI [0.83, 0.98]; 26–49 years: AOR = 0.90, 95% CI [0.84, 0.96]). Because HIV testing behavior represents a gateway to treatment, the findings suggest mental health may be one challenge to attaining the UNAIDS 90-90-90 targets.
Background: Studies suggest that offering HIV self-testing (HIVST) increases short-term HIV testi... more Background: Studies suggest that offering HIV self-testing (HIVST) increases short-term HIV testing rates, but few have looked at long-term outcomes.Methods: We conducted a randomized controlled trial (RIDIE 55847d64a454f) on the impact of offering free oral HIVST to 305 truck drivers recruited from two clinics in Kenya. We previously reported that those offered HIVST were more likely to accept testing. Here we report on the 6-month follow-up during which intervention participants could pick-up HIVST kits from eight clinics.Results: There was no difference in HIV testing during 6-month follow-up between participants in the intervention and the standard of care (SOC) arms (OR = 1.0, p = 0.877). The most common reasons given for not testing were lack of time (69.6%), low risk (27.2%), fear of knowing HIV status (20.8%), and had tested recently (8.0%). The null association was not modified by having tested at baseline (interaction p = 0.613), baseline risk behaviors (number of partners...
The COVID-19 pandemic has created extraordinary challenges and prompted remarkable social changes... more The COVID-19 pandemic has created extraordinary challenges and prompted remarkable social changes around the world. The implications of the novel coronavirus and the public health control measures that have been implemented to mitigate its impact are likely to be accompanied by a unique set of consequences for specific populations living in low income-countries that have fragile health systems and pervasive social-structural vulnerabilities. This paper discusses the implications of COVID-19 and related public health interventions for children and young people living in Eastern and Southern Africa. Actionable prevention, care, and health promotion initiatives are proposed to attenuate the negative effects of the pandemic and government-enforced movement restrictions on children and young people.
In South Africa, traditional versions of masculinity that once bestowed power and privilege onto ... more In South Africa, traditional versions of masculinity that once bestowed power and privilege onto white heterosexual men are being contested. White adolescent males must negotiate this changing environment at a time when they themselves are engaging in the process of identity development. Given the recent emergence of the masculine body ideal, the muscular mesomorph, and its association with traditional masculinity, this study sought to examine the relationship between traditional masculinity, conflict resolution and body image among a sample of predominantly white adolescent males in South Africa. The relationships between these variables were examined in accordance with Connell's theory of body-reflexive practices (1995), which views the body as both an “object” and “agent” of practice. Our findings revealed that support for traditional masculine norms among adolescent males was associated with the desire for a larger, more muscular body and the use of maladaptive conflict resolution styles that exhibit a low concern for the welfare of others. In the context of recent sociocultural changes, these findings suggest that conflict resolution and the redefinition of the male body may be an emerging arena that provides new possibilities for young white males to enact a form of male power that is seen to be maladaptive in our context.
ABSTRACT This study investigated the relationship between masculinities, cultural worldviews and ... more ABSTRACT This study investigated the relationship between masculinities, cultural worldviews and societal risk perceptions in a sample of adolescent school-going boys in South Africa. Connell’s theory of hegemonic masculinity and cultural theory of risk provided the theoretical frameworks for this study. The findings showed that males conforming to the traditional masculinity type were more likely to endorse a hierarchical and individualist worldview. They were also less concerned about the impact of a number of societal risks on the South African public such as environmental risks and risks associated with crime and social instability than participants conforming to the progressive masculinity type. Participants conforming to progressive masculine norms were more likely to hold an egalitarian worldview. The results of mediation analyses suggest that among self-identified traditional and progressive males in our study, judgements about certain risk concerns are best understood through their views of society and the preferred forms of social organisation and power in society. Given the above findings, it is suggested that intervention strategies in risk management need to appreciate that subjective processes of risk identification are fundamentally gendered in nature and may be influenced by one’s cultural worldview.
New HIV infections and AIDS-related deaths among children and adolescent girls and young women (a... more New HIV infections and AIDS-related deaths among children and adolescent girls and young women (aged 15-24 years) in eastern and southern Africa continue to occur at unacceptably high rates. The COVID-19 pandemic has also severely undermined ongoing initiatives for HIV prevention and treatment, threatening to set the region back further in its efforts to end AIDS by 2030. Major impediments exist to attaining the UNAIDS 2025 targets among children, adolescent girls, young women, young mothers living with HIV, and young female sex workers residing in eastern and southern Africa. Each population has specific but overlapping needs with regard to diagnosis and linkage to and retention in care. Urgent action is needed to intensify and improve programmes for HIV prevention and treatment, including sexual and reproductive health services for adolescent girls and young women, HIV-positive young mothers, and young female sex workers.
Background: Comprehensive sexuality education (CSE) seeks to reduce risky sexual behaviour and su... more Background: Comprehensive sexuality education (CSE) seeks to reduce risky sexual behaviour and subsequent incidence of unintended pregnancy and HIV among school going adolescents. This study evaluates differences between in and out of school adolescent girls and the effect of exposure to CSE on key biomedical and behavioural indicators in South Africa. Methods: Data were collected from a household-based representative sample of adolescent girls (between the ages 12–18 years) in four high HIV prevalence DREAMS implementation districts in South Africa. Independent variables included school attendance and exposure to CSE, with outcome variables measuring prevalence of HIV, pregnancy and sexual behaviour, including condom use, incidence of age disparate relationships and transactional sex. Findings Attending school is associated with reduced adjusted odds of having engaged in sexual activity (AOR: 0·58, 95% CI: 0·48-0·70, p < 0·001); using condoms inconsistently in the previous 12 mo...
Introduction Adherence to antiretroviral therapy (ART) remains a key challenge to achieving the f... more Introduction Adherence to antiretroviral therapy (ART) remains a key challenge to achieving the fast-track goal of ending the HIV epidemic by 2030. To provide a more comprehensive indication of whether interventions designed to promote ART adherence might benefit from targeting body image perceptions, we aim to conduct a systematic review to synthesise existing evidence on the association between body image and ART adherence. Methods and analysis A systematic review of peer-reviewed observational studies and randomised controlled trials that have investigated the association between body image and adherence to ART will be performed. JSTOR, PsycARTICLES, PsycINFO, PubMed, ScienceDirect and Web of Science databases will be searched from 1 January 2000 to 31 March 2021. Eligible records will consider body image as either an independent variable or a mediator, whereas ART adherence will be assessed as an outcome variable. Study selection will follow the Preferred Reporting Items for Sys...
Achieving the UNAIDS 90-90-90 targets by 2020 is contingent on identifying and addressing mental ... more Achieving the UNAIDS 90-90-90 targets by 2020 is contingent on identifying and addressing mental health challenges that may affect HIV testing and treatment-related behaviors. This study is based on survey data from KwaZulu-Natal, South Africa (2014–2015). HIV positive women who reported higher depression scores had a lower odds of having tested previously for HIV (15–25 years: AOR = 0.90, 95% CI [0.83, 0.98]; 26–49 years: AOR = 0.90, 95% CI [0.84, 0.96]). Because HIV testing behavior represents a gateway to treatment, the findings suggest mental health may be one challenge to attaining the UNAIDS 90-90-90 targets.
Background: Studies suggest that offering HIV self-testing (HIVST) increases short-term HIV testi... more Background: Studies suggest that offering HIV self-testing (HIVST) increases short-term HIV testing rates, but few have looked at long-term outcomes.Methods: We conducted a randomized controlled trial (RIDIE 55847d64a454f) on the impact of offering free oral HIVST to 305 truck drivers recruited from two clinics in Kenya. We previously reported that those offered HIVST were more likely to accept testing. Here we report on the 6-month follow-up during which intervention participants could pick-up HIVST kits from eight clinics.Results: There was no difference in HIV testing during 6-month follow-up between participants in the intervention and the standard of care (SOC) arms (OR = 1.0, p = 0.877). The most common reasons given for not testing were lack of time (69.6%), low risk (27.2%), fear of knowing HIV status (20.8%), and had tested recently (8.0%). The null association was not modified by having tested at baseline (interaction p = 0.613), baseline risk behaviors (number of partners...
The COVID-19 pandemic has created extraordinary challenges and prompted remarkable social changes... more The COVID-19 pandemic has created extraordinary challenges and prompted remarkable social changes around the world. The implications of the novel coronavirus and the public health control measures that have been implemented to mitigate its impact are likely to be accompanied by a unique set of consequences for specific populations living in low income-countries that have fragile health systems and pervasive social-structural vulnerabilities. This paper discusses the implications of COVID-19 and related public health interventions for children and young people living in Eastern and Southern Africa. Actionable prevention, care, and health promotion initiatives are proposed to attenuate the negative effects of the pandemic and government-enforced movement restrictions on children and young people.
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