Congratulations to Yanga Zembe who successfully completed her PhD at Karolinska Institutet, Stockholm, Sweden. The aim of her dissertation was to analyse and explore HIV, sexual risk taking, intimate partner violence and relationship power inequity among young, black women aged 16−24 who have multiple sexual partners in a peri-urban setting in the Western Cape, South Africa.
Young women face the highest risk of HIV infection than any other group in South Africa, and those who have multiple sexual partners are thought to be particularly vulnerable to HIV. However, little is known about the extent and organisation of sexual risk factors such as inconsistent condom use, transactional sex, age mixing and intimate partner violence among women who have multiple sexual partners. Further, there is limited knowledge on how the continuities between the apartheid and post-apartheid periods may be affecting the ways in which poor, young, black women use their sexual behaviour to negotiate life in the country.
The young women featured in this dissertation presented with a constellation of high-risk sexual behaviours that clustered to form a risk syndrome. Multiple concurrent sexual partnering, transactional sex and age mixing were shown to hold important economic and existential meanings for the young women. They used these sexual risk behaviours to pursue social inclusion and avoid exclusion in a local context marked by social and economic inequalities, new and sudden exposure to commodities, global technologies, and a strong and punitive popular youth culture. Importantly, despite high levels of violence in their relationships, the young women challenged prevailing gender and cultural norms regarding women’s roles in intimate relationships with younger men, sought sexual pleasure and were shown to experience relationship power inconsistently. However, their sexual risk behaviours were inherently structured to exacerbate vulnerability to male dominance, extremely high levels of violence, and ultimately HIV. A combination of macro-level and bottom up strategies that address social, economic and gender inequalities and the negative impact of global technologies and peer pressure on young women are urgently needed in South Africa.
Yandisa Sikweyiya has recently been awarded the degree of Doctor of Philosophy (PhD) from the University of the Witwatersrand, School of Public Health. His dissertation is titled: ‘Perceptions of participants and community members about research on gender-based violence”.
The thesis, by publication, presents five peer reviewed journal publications which include a review of ethical guidelines in Gender Based Violence research practices globally; a case study of ethical dilemmas confronting researchers working on sensitive issues such as Gender Based Violence; articles on researchers’ perceptions about safety and risks in gender-based violence research; and on potential and actual participants’ experiences of participating in community based research on sensitive topics. Dr Sikweyiya’s cutting-edge research has contributed to new knowledge and interpretation of ethical practices in the gender based violence research arena.
Dr Sikweyiya was supervised by Prof. Rachel Jewkes (Acting Vice President and Director of the Gender and Health Research Unit, MRC).
Aník Gevers from the Gender & Health Research Unit, recently graduated with a PhD in Psychiatry and Mental Health from the University of Cape Town. Her thesis, titled ‘An Exploration of the Nature of Contemporary Adolescents’ Intimate Relationships’, was supervised by Dr Cathy Mathews (Health Systems Research Unit) and Prof. Rachel Jewkes (Acting Vice President and Gender and Health Research Unit Director).
Aník’s PhD thesis contributed a nuanced understanding of contemporary adolescents’ intimate relationships to inform intervention development. Intimate relationships in adolescence play an important role in psychosocial development and can impact on relationships during adulthood. There is a need for evidence-based interventions to prevent intimate partner violence (IPV), promote sexual and reproductive health, and equitable, enjoyable relationships during adolescence.
A series of studies was undertaken to explore (a) contemporary adolescents’ ideas about and experiences of relationships; (b) young adolescents’ sexual behaviour and dating; (c) adolescents’ conceptions of a good relationship; and (d) evidence-based guidelines for developing school-based violence prevention interventions. For study (a), qualitative data were collected during focus group discussions and in-depth interviews with 14−18 year olds. Survey data from 13−16 year olds (for study b) and 15−18 year olds (for study c) were analysed using regression analyses. A desktop review informed study (d).
Adolescents’ intimate relationships are fluid and unstructured, highly gendered, and greatly influenced by peer relationships. However, experience with relationships and sex are varied. For girls, good relationships were associated with having a mutual main partnership with an older, educated boyfriend in which there was good, open communication, particularly about sexual and reproductive health. For boys, a mutual main partnership and very little quarrelling were associated with good relationships. Young adolescents reported engaging in a variety of sexual behaviours ranging from kissing to sexual intercourse with the former more common than the latter.
These findings indicate a need for early interventions that are carefully adapted and acceptable to adolescents who have varying levels of experience with relationships, sex and violence. Adolescents would benefit from developing gender equitable attitudes; critically reflecting on their ideas and practices related to good and poor relationships; building sexual decision-making skills to better prepare them to develop and maintain good, healthy relationships, and end poor or abusive ones. Interventions should incorporate adolescents’ perspectives and balance evidence-based best practice and resource availability.
Congratulations to Dr Nadine Burnhams from the Alcohol and Drug Abuse Research Unit who graduated with her PhD from the University of Cape Town on 6 June 2013. The title of Dr Burnhams’ thesis is ‘The effectiveness of a substance abuse and substance-related HIV workplace prevention programme implemented within a service industry in Cape Town, South Africa.’
This study tested the effectiveness of a substance abuse and substance-related HIV prevention programme designed for use within a South African workplace setting. There were several phases to the study. Phase 1 involved a systematic review to identify a suitable intervention to prevent substance abuse and substance-related HIV risks at the workplace. This was followed by the selection of a substance abuse and substance-related HIV prevention programme for implementation within a service industry in Cape Town, South Africa. Phase 2 employed a cross-sectional study design for collecting baseline data on substance abuse and substance-related HIV risks at the selected workplace. Phase 3 involved adapting the selected evidence-based substance abuse and substance-related HIV risks prevention programme for application in the selected workplace. This phase was followed by an outcomes evaluation, using a clustered randomised controlled trial of the implemented programme. For this phase, data were gathered from 325 employees who were employed in two divisions within a local municipality. The Team Awareness (TA) intervention, an eight hour evidence-based programme addressing behavioural risk among employees, was administered to 168 employees in the intervention arm.
The 157 employees in the control arm received a one hour wellness talk. Self-report questionnaires were used to gather data on demographic variables, the work environment, policy and EAP service utilisation, substance abuse behaviours, co-worker substance abuse and substance-related HIV risks. Data were analysed using a random effects model accounting for clustering. Qualitative in-depth interviews with eight participants, all senior management in the organisation where the study was conducted, concluded the study. This study found that alcohol is the most commonly abused substance reported by persons in this sample. Of the sample surveyed, more than three-quarters indicated alcohol misuse, with only a small proportion of employees reporting drug use. A third of employees who reported alcohol use also reported engaging in risky sexual practices. The results suggest that employees who received TA showed significant reduction in the risky use of alcohol from baseline to three month follow-up. TA was also found to increase willingness to use the EAP service and improve employee knowledge in relation to workplace substance abuse polices. These findings highlight the need for evidence-based prevention programmes in workplace settings. Findings also show that an evidence-based work place intervention, such as TA, can lead to reductions in problem drinking, increase help-seeking behaviours, and create positive attitudes towards policies that regulate substance-abuse within the workplace environment. The study makes useful recommendations for research practice and policy to help organisations address the burden of substance abuse.