Browsing by Author "Cooper, Di"

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    Determinants of HIV voluntary counselling and testing among the youth: The case of Botswana
    (2010) Mokalake, Ellen N; Cooper, Di
    This study was conducted in Gaborone city, Botswana. Botswana is a small country in south central part of Africa with a population of 1.7 million (Botswana population census, 2001) The overall aim of the study was to examine barriers and facilitating factors influencing the readiness for and acceptability of voluntary HIV testing among the youth aged 18-24 years in Gaborone, Botswana. A quantitative methodology was used in this study. A multistage sampling strategy was also used to recruit one hundred and forty four (144) participants. Information on socio-demographic characteristic, knowledge and utilization of VCT sexual behaviour and perception of risk was gathered by use of a self administered structured questionnaire. STATA version 8 was used to analyse the results of this study. Summary statistics, chi-square test and logistic regression were employed in the analysis. Participants comprised of students from senior secondary schools and tertiary education institutions from the sampled schools of Gaborone. The modal level of education was secondary and the more than half of participants (56%) were females. Their age ranged from 18-24 years. The majority of participants (75%) were sexually active and just over a third 36% of all participants considered themselves not at risk of HIV. VCT knowledge was reported by a significant proportion (59%) who also reported knowledge of VCT sites. HIV testing was reported by a minority of participants 42% and the most commonly reported reason for testing was media campaigns encouraging HIV testing whilst the most commonly reported reason for not testing was never been sexually active. Findings from this study revealed that, HIV test acceptance among the youth is still an area that needs greater attention. The facilitation of HIV testing amongst the young people and removal of barriers to testing can be achieved through a focus on use of strategies that seem vii to work such as the media. Also, there is need to ensure utilization of VCT services by youth through making them understand of the role that VCT plays in preventing HIV and AIDS.
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    Failed contraception?
    (2004) Morroni, Chelsea; Myer, Landon; Cooper, Di
    The frequency, cost and harms of the procedure must have been weighed up by the British National Health Service (NHS) — usually pretty sensible about their medical recommendations — which proposed 3-yearly screening for women aged between 50 and 64 years. Obviously more cancers would be discovered by 2-yearly rather than 3-yearly screening, and yet more by annual screening. Six-monthly screening, in turn, would clearly yield more cancers than annual screening. This would fit well with Dr Whitehorn’s ‘simple arithmetic’. However a balance has to be found between benefits and harms, and we chose the NHS one. The following organised screening programmes recommend 2- yearly mammography, most of them for women between 50 and 69 years: Australia, Finland, Iceland, Israel, Netherlands, France, Belgium, Canada, Denmark, Ireland, Italy, Norway, Portugal and Greece. Annual mammography, and mammography at an early age are the usual recommendations of interest groups. They are also the recommendation of the correspondence printed above. Like Dr Paul Sneider, we conclude with a quote from Boyle: ‘Every woman has a right to participate in an organised screening program . . .’. This right, alas, does not apply to this country, where other health care priorities make an organised programme an impossibility. However, should a woman have the privilege of medical aid, or be able to afford mammography, it is her choice to undergo it, a choice open to only a minority of South Africans. The majority of South African women would, in our opinion, be well served by an organised programme of ‘breast awareness’, a proposal that Dr Russell Whitehorn finds difficult to fathom.
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    A gendered perspective of a community's perception of microbicide introduction
    (2005) Harries, Jane; Orner, Phyllis; Cooper, Di
    South Africa is currently experiencing one of the worst HIV/AIDS epidemics in the world. The epidemic features distinctive age and gender distributions, with young women at greatest risk, and overall proportionally more women affected than men. Current HIV prevention strategies are limited as women's risk is frequently derived from their partners' behaviours rather than their own. The development of a microbicide for HIV prevention may offer the possibility of reducing women’s risk of infection in situations where other more effective methods cannot be used. An environment conducive to introducing a microbicide is critical to avoid some of the obstacles that have historically inhibited similar technological innovations. This study, which formed part of a larger qualitative research project, explored local sexual practices as they related to a female-initiated intra-vaginal product and the broader gender and sexual relations that underpin perceptions around possible microbicide use. An understanding of gender related factors is crucial in exploring women's access and ability to use a microbicide. Twenty-two focus groups and 11 in-depth interviews were held with community participants who resided in Langa, Cape Town. Data was analyzed using a grounded theory approach. Respondents expressed keen support for microbicides, underscored by desperation related to the AIDS epidemic and recognition of women's greater risk. Discussions amongst both women and men around microbicide use revealed numerous ways in which a new preventive technology could impact on broader gender relations. Issues around condom use, partner communication, meanings attributed to changes in vaginal moisture levels, covert use, potential for partner discord, and gender-based violence were linked by respondents to the varying ways in which the microbicide could impact on their daily lives. While the microbicide has the potential to "empower" women, inequitable gender relations and other social and economic problems will need to be addressed in order to halt the spread of the AIDS epidemic in South Africa.
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    The prevalence and determinants of emotional, physical and sexual violence from a partner among HIV-positive individuals attending HIV care in greater Gugulethu area of Cape Town, South Africa
    (2008) Nglazi, Mweete D; Cooper, Di
    South Africa has high levels of both HIV/AIDS and intimate partner violence (IPV) among women. Research on the links between HIV/AIDS and IPV show that women who experience IPV are nearly two times more likely to be HIV-positive compared to women who do not. While there is increasing evidence on HIV-positive status disclosure-related IPV, studies are unclear on whether IPV is higher among HIV-positive women.
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    Prevalence and determinants of non-barrier contraceptive use in HIV-positive women who attend HIV services at public sector clinics in Gugulethu
    (2010) Maksimoski, Nancy; Cooper, Di; Myer, Landon
    [Background] South Africa has one of the highest prevalences of HIV-infection in women of reproductive age and a high rate of unplanned pregnancy. It is important to explore contraceptive use in HIV-positive women to better understand how to facilitate service delivery to those women wishing to avoid pregnancy. While it is critical to emphasise condom use, information is needed on the factors that contribute to nonbarrier contraceptive use (NBCU) and its prevalence among HIV-positive women in order to afford women the opportunity to choose to have maximum dual method protection to prevent both infection and unwanted pregnancy. While there is literature on people living with AIDS and contraceptive use from other areas of the world, there is little quantitative research conducted in a South African context, although there is evidence of a high proportion of unwanted pregnancy among HIVpositive women in this setting. [ Rationale and Justification for Research ] Information is needed to understand the factors that contribute to NBCU by HIVpositive women, including the prevalence of these determinants. By better understanding the obstacles to non-barrier contraceptive use, both HIV and reproductive health services will better be able to provide more appropriate contraceptive health care to HIV-positive women. [ Aims ] The aim of this study is to determine the prevalence of NBCU and the types of methods used innon-pregnant, HIV-positive women, and to determine the factors that influence the choice of NBCU. [ Objectives ] To determine the prevalence of NBCU in a population of HIV-positive South African females; To determine what factors influence NBCU in women infected with HIV, including whether or not NBCU changes after an HIV-positive diagnosis; To compare the NBCU prevalence among HIV-positive women who want children in the future to 8 those who do not want children in the future, and who are currently on antiretroviral therapy (ART) to those who are not currently on ART; To determine what factors influence NBCU for particular subsets of women, including those with and without fertility intentions in the next 12 months and women currently on and not on ART; To determine the unmet need for non-barrier contraception in HIV-positive women. [ Methods ] This study will form a part of a larger cross-sectional study, which collected data on the fertility intentions and the utilization of HIV and reproductive health services of 459 HIV-seropositive men and women from the peri-urban informal settlement of Gugulethu, located outside of Cape Town, from May to September 2006. Data was collected by trained fieldworkers through the use of a standardised quantitative survey instrument. A qualitative study consisting of in-depth interviews and focus groups with HIV-infected men was also conducted as part of the larger research project. After being cleaned, data was transferred to STATA Release 10 (STATACorp, College Station, USA) where bi-variate and multi-variate statistical analysis was performed. [ Ethics ] The Ethical Review Committee of the World Health Organisation and the Research Ethics Committee of the University of Cape Town, the research partners in this study, granted ethical approval to the larger cross-sectional study to which this sub-study is part. All participants who agreed to the voluntary interview provided informed consent, and although the risk of personal harm was very low, effort was put forth to minimise non-maleficence.
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    The provision and use of contraception amongst antenatal and postpartum women in a rural area of the Eastern Cape
    (2006) Hani, Andiswa; Cooper, Di
    In South Africa's public sector maternity services injectible progestogen-only contraceptives (POCs) have typically been administered after delivery to women choosing to use these methods. A series of studies arose in response to the draft South African National Contraceptive Guidelines (1999), which recommended that women wishing to use the POC as their contraception method postnatally be advised to delay use of the POCs until six weeks postpartum. This recommendation followed the international guidelines of the WHO and the IPPF, which were based on theoretical concerns that the early transfer of small amounts of hormones to the infant through breastmilk may affect its growth development. The studies sought to investigate the feasibility of recommending this delay in POC administration, taking into account both the mother's risk of pregnancey in the early postpartum period and her ability to return to a health service at six weeks post-delivery, to initiate a method of contraception.
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    Reappraising men's sexual behaviors and gendered attitudes from the sexual-history narratives of South African men and women in a time of HIV/AIDS.
    (2013) Stern, Erin Andrea; Cooper, Di; Buikema, Rosemarie
    While the frequent positioning of men's sexual behaviours as driving the HIV epidemic in South Africa has generated much interest in men's sexuality, much research to date has presented men as a homogenous group, or treats male sexuality as a set of isolated, individually driven behaviours. As a result, the current body of knowledge provides only a partial basis for meeting men's sexual and reproductive health (SRH) needs and addressing HIV-prevention among men. A narrative approach, which foregrounds the diversity and meaning in participant's lived experiences, was used in this study to examine the subjective and social impact of dominant norms of masculinity on South African men's sexual behaviours and gendered attitudes. This was expected to yield more nuanced, and contextualised understandings of men's SRH, with practical consideration for what means of men's sexual health can be enhanced. Fifty sexual-history interviews and ten focus group discussions with men, and twenty-five sexual-history interviews with women, were conducted with participants purposely sampled from three age categories (aged 18–24, 25–54, and 55+ years), a range of language and racial backgrounds, and urban and rural sites across five provinces in South Africa. The interviews were structured to elicit accounts of early knowledge of sex and sexual experimentation and to explore the range of sexual relationships and experiences among men and women throughout their adulthood. Participants' engagement with the risk of sexually transmitted infections, including HIV, and their reproductive health management were also explored. The data were analysed using the principles of thematic and narrative analysis, with NVivo software used for data management. The data appreciates the diversity and fluidity in men and women's lived experiences while recognising the social and cultural norms that structure sexuality. The narratives reveal a number of footholds for understanding how individual men both conform to and resist gender norms that can be damaging to their SRH. Such findings provide insights to inform how programmes and services could better engage men in HIV prevention and care. Especially, the study points to the value of a narrative approach to more deeply understand men's sexual risk and agency and the social structures, meanings and experiences that underlie it.
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    Seeing HIV through the eyes of perinatally infected adolescents living with HIV, on antiretroviral treatment
    (2012) Holele, Pearl; Cooper, Di
    As perinatally infected adolescents living with HIV (ADLHIV) grow older and gain a greater sense of independence, disclosure issues and adherence to antiretroviral treatment (ART) have become major concerns. However, research on how adolescents view and cope with these challenges remains limited, especially in Sub-Saharan Africa. We explored ADLHIV's understanding of their infection and its perceived effects on their well-being, and ultimately, on their attitude towards life-long adherence to ART.
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    We don't see ourselves as different : a web of possibilities for disabled women : how black disabled women in poor communities equalise opportunities for human development and social change
    (2005) Lorenzo, Theresa; Cooper, Di; Kathard, Harsha
    This thesis plots a participatory action research (PAR) study that was done in collaboration with disabled women in Khayelitsha and Brown's Farm on the outskirts of Cape Town, South Africa, over a two and a half year period. The aim of the study was to explore how disabled women living in poor communities equalise opportunities for human development and social change. The PAR approach was used to encourage the participation of disabled women to produce new knowledge and consciousness-raising related to the barriers faced and strategies used for their development since acquiring their impairments. The research partners were the SACLA Health Project, the Disabled Women's Development Project of Disabled People South Africa and the Division of Occupational Therapy, University of Cape Town.
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    Women's views on and experiences of condom use : an exploration of how this impacts on women's sexual satisfaction and male condom use among women
    (2011) Mehlomakulu, Vuyelwa; Cooper, Di
    Consistent condom use amongst women and men is one of the important safer sexual practices in combating the spread of HIV/AIDS. This dissertation examines factors which hinder or facilitate consistent male condom use, particularly as it relates to women's sexual satisfaction. Findings indicated that women felt that it was important to use condoms during sexual intercourse in order to obtain protection against HIV, STIs and pregnancy. Just over half of the women reported condom use at last sexual intercourse. Women's own sexual dissatisfaction was regarded as one of the main reasons why condoms were not consistently used by women. The results of this study suggest that that while it is important for HIV/AIDS interventions to focus it is also important to better understand a less investigated issue of women's own possible resistance to male condom use.