Browsing by Subject "sexual and reproductive health"

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    Determinants of voluntary or coerced sexual debut among Black African female adolescents in Soweto, South Africa: Findings from The Birth to Twenty Plus cohort study
    (2018) Nyemba, Dorothy Chiwoniso; Ramjith, Jordache; Cornell, Morna; Mabaso, Musawenkosi
    Early sexual debut whether voluntary or coerced increases exposure to high risk sex which leads to unplanned pregnancy, sexually transmitted infections including HIV and reproductive heal th problems during adolescence. This study aim s to examine the risk factors for age of sexual debut, either voluntary or coerced among Black African female adolescents from the Birth to Twenty cohort study in Soweto, South Africa . Part A is the study protocol which outlines the rationale for conducting this study , study aim, research methodology, analysis plan and ethical considerations. Part B forms the literature review which gives a summary of the existing literature and provides context for the dissertation. The objectives of the literature review were to identify published literature on determinants of either voluntary or coerced sexual debut in adolescents and identify gaps for further research. Part C is the manuscript presenting the results and discussion on the implications of key findings. The results showed that there are many Black African female adolescents who are engaging in early sexual debut and there is prevalenc e of coerced sexual debut among adolescents of similar age. Socio-economic status and maternal education were found to be significantly associated with coerced sexual debut. There is a need for interventions to delay sexual debut among young female adolescents from low socio-economic backgrounds and lower maternal education.
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    Framing rights and responsibilities: accounts of women with a history of AIDS activism
    (BioMed Central Ltd, 2011) MacGregor, Hayley; Mills, Elizabeth
    BACKGROUND: In South Africa, policy with respect to HIV/AIDS has had a strong rights-based framing in line with international trends and in keeping with the constitutional overhaul in the post-Apartheid era. There have also been considerable advances since 1994 towards legal enshrinement of sexual and reproductive health rights and in the provision of related services. Since HIV in this setting has heavily affected women of reproductive age, there has been discussion about the particular needs of this subgroup, especially in the context of service integration. This paper is concerned with the way in which HIV positive women conceptualise these rights and whether they wish and are able to actualise them in their daily lives. METHODS: In 2003 a group of women involved with the Treatment Action Campaign and Medicines Sans Frontieres participated in an initiative to 'map' their bodies as affected by the virus. A book containing the maps and narratives was published and used as a political tool to pressure the government of the day to roll out antiretroviral therapy (ART) to the population. In 2008, the authors coordinated an initiative that involved conducting follow-up in-depth interviews in which five of these women reflected on those body maps and on how their lives had changed in the intervening five years since gaining the right to treatment through the public sector. RESULTS: Drawing upon this qualitative data and published sources, these new accounts are analysed in order to reflect the perspectives of these women living with chronic HIV with respect to their sexual relations and fertility desires. The paper reveals difficulties faced by these women in negotiating sexual relationships and disclosure of their HIV positive status. It focuses on how they perceive relative responsibilities in terms of taking preventative measures in sexual encounters. Women adopt tactics within a context characterised by various inequalities in order to 'make do', such as by remaining silent about their status. Concerns about childbearing can be addressed by information and support from a health care worker. CONCLUSIONS: Women's experience of HIV as a chronic illness and the need to adhere to ART, is linked to the way in which the language of responsibility can come to counter-balance a language of rights in treatment programmes.