Social and Cultural Determinants of the Spread of HIV/AIDS, STIs and Gender Based Violence in High Risk Areas: A Case of Road Construction Sites in Tanzania


Jeckoniah, John Nshimba. 2018. “Social and Cultural Determinants of the Spread of HIV/AIDS, STIs and Gender Based Violence in High Risk Areas: A Case of Road Construction Sites in Tanzania.” International Journal of Development and Sustainability 7 (7): 2187–203.

Author: John Nshimba Jeckoniah


High mobility of sexually active population continues to be a risky factor for the spread of STIs and HIV, both in the source and destination sites. This paper analyses the social and cultural determinants for the spread of STIs and HIV along road construction sites which harbour a number of migrant workers from rural and urban areas. The study adopted a cross-sectional study design, using a structured questionnaire for respondents, a checklist for key informants and a guide for focus group discussants. A total of 308 respondents, including eighteen key informants and 20 focus group discussions were involved. Descriptive statistical analysis was employed for quantitative data whereas ethnographic content analysis was used for qualitative data. It was found that the level of knowledge about HIV/AIDS, how the disease spreads and the prevention methods was generally high. However, a corresponding change in sexual behavioural response was low. Many respondents still practise risky sexual behaviour, have many sexual partners and are inconsistent in using condoms. Some misconception about HIV/AIDS spread were also found. Also, there are many incidences of gender based violence which are under reported. Social and cultural factors responsible for the spread of HIV/AIDS include low risk perception and marital instability. It is recommended to the government and NGOs to involve and support local organizations for capacity building against HIV.

Keywords: social determinants, HIV, AIDS, STI, gender based violence, Tanzania

Topics: Displacement & Migration, Migration, Gender, Gender-Based Violence, Health, HIV/AIDS, Sexual Violence, Violence Regions: Africa, East Africa Countries: Tanzania

Year: 2018

The Case for Women's Rights to Land in Tanzania: Some Observations in the Context of AIDS


Manji, Ambreena S. 1996. “The Case for Women's Rights to Land in Tanzania: Some Observations in the Context of AIDS.” UTAFITI 3 (2): 11-38.  

Author: Ambreena S. Manji


“In the last two decades, the issue of women's independent rights to land has come to be debated both internationally and in the Tanzanian context. Two decades ago, it is arguable that the issue was barely admissible in the discourse over public policy. The dominant conception of women and land was one which subsumed the interests of women under that of men, and assumed a congruence of interest between members of the family such that men's access to land was thought to also guarantee that of women. With the completion of a number of studies in the intervening twenty years, this assumption has been challenged, and the question of women's rights to land has come to be investigated in its own right. The extent to which the debate has shifted in Tanzania was demonstrated by the International Women's Day celebrations in 1977 where the issue of women and land took a central place. This paper attempts to make the case for women's rights to land, and delineate what is meant by such rights.These arguments are made in the context of, the AIDS epidemic, and I will draw on my observations and conversations with women in the Muleba district of Kagera and my investigation of cases involving land disputes in the Courts,2 to demonstrate the important connections between women's experiences of AIDS and their ability to own, control or manage land. However, it is clear from my research in Kagera that women are faced with disputes and struggles over land in varied and numerous contexts. Therefore, whilst the AIDS epidemic brings into sharp focus the issue of women's rights to land, it is important to remember that even if we were not faced with an epidemic of such proportions and characteristics, the issue of women and land is pressing and is deserves attention. The AIDS epidemic, as I argue below, serves to remind us of the urgency of the issue.” (Manji 1996, 11).

Topics: Gender, Gendered Power Relations, Gender Equality/Inequality, Health, HIV/AIDS, Rights, Land Rights, Women's Rights Regions: Africa, East Africa Countries: Tanzania

Year: 1996

The Convergence of HIV/AIDS and Customary Tenure on Women’s Access to Land in Rural Malawi


Tschirhart, Naomi, Lucky Kabanga, and Sue Nichols. 2015. “The Convergence of HIV/AIDS and Customary Tenure on Women’s Access to Land in Rural Malawi.” SAHARA-J: Journal of Social Aspects of HIV/AIDS 12 (1): 134-46.

Authors: Naomi Tschirhart, Lucky Kabanga, Sue Nichols


This paper examines the convergence of HIV/AIDS and the social processes through which women access customary land in rural Malawi. Data were collected from focus group discussions with women in patrilineal and matrilineal communities. Women’s land tenure is primarily determined through kinship group membership, customary inheritance practices and location of residence. In patrilineal communities, land is inherited through the male lineage and women access land through relationships with male members who are the rightful heirs. Conversely in matrilineal matrilocal communities, women as daughters directly inherit the land. This research found that in patrilineal communities, HIV/AIDS, gendered inequalities embedded in customary inheritance practices and resource shortages combine to affect women’s access to land. HIV/AIDS may cause the termination of a woman’s relationship with the access individual due to stigma or the individual’s death. Termination of such relationships increases tenure insecurity for women accessing land in a community where they do not have inheritance rights. In contrast to the patrilineal patrilocal experience, research on matrilineal matrilocal communities demonstrates that where women are the inheritors of the land and have robust land tenure rights, they are not at risk of losing their access to land due to HIV/AIDS.

Keywords: HIV/AIDS, land rights, women, customary, matrilineal, patrilineal

Topics: Gender, Gender Analysis, Women, Gendered Power Relations, Gender Equality/Inequality, Gender Hierarchies, Health, HIV/AIDS, Land Tenure, Rights, Land Rights, Women's Rights Regions: Africa, Southern Africa Countries: Malawi

Year: 2015

Pathways among Human Security, Gender, and HIV/AIDS in Sub-Saharan Africa


O'Manique, Colleen, and Sandra J. MacLean. 2010. “Pathways among Human Security, Gender, and HIV/AIDS in Sub-Saharan Africa.” Canadian Journal of African Studies / Revue Canadienne Des Études Africaines 44 (3): 457-78.


Authors: Colleen O'Manique, Sandra J. MacLean


La théorie traditionnelle de la sécurité perçoit les préoccupations d'ordre sanitaire comme menaces isolées à l'intérêt national, séparés analytiquement de leurs causes et contextes sociaux et politico-économiques élargis. Si la notion de la sécurité humaine est limitée à ces mêmes paramètres, comme dans la définition étroite de la sécurité humaine comme "absence de la peur," et que la santé n'est perçue comme question de sécurité qu'une fois qu' apparaît la violence ouverte, en particulier la violence militaire, le potentiel tant explicatif qu'émancipateur de la notion est diminuée. Cependant, un vaste concept de la sécurité humaine qui englobe "l'absence du besoin" offre un espace conceptuel permettant d'identifier et d'analyser la nature des relations sociales, politiques et économiques qui caractérisent aujourd'hui les problèmes de santé mondiaux, tels que le VIH/sida. Dans le cadre conceptuel de la sécurité humaine, une analyse qui éclaire les dimensions sexospécifiques de la sécurité humaine — en termes de prédisposition individuelle à la maladie, d'accès au traitement et de d'impacts sur les moyens de subsistance — est essentielle afin de fournir des éclairements pouvant orienter des politiques efficaces contre le VIH/sida. En outre, les politiques doivent prendre en compte les multiples facteurs sociaux, culturels, économiques et politiques qui déterminent le cheminement de la maladie.
Traditional security theory has treated health concerns as isolated threats to national interest, separated analytically from their broader social and political economy causes and contexts. If the concept of human-security is restricted to these same parameters, as in the narrow definition of human security as "freedom from fear," and health is considered to be an issue of security only when overt physical, especially military, violence is involved, the explanatory as well as emancipatory potential of the concept is diminished. However, a broad concept of human security that encompasses "freedom from want" offers a conceptual space for identifying and analyzing the relevant social, political and economic connections that characterize contemporary global health problems such as HIV/AIDS. Within the conceptual framework of human security, a gender analysis that illuminates the gender dimensions of human security — in terms of individual disease risk, access to treatment, and impacts on livelihood — is critical to providing insights to guide effective policy on HIV/AIDS. Also, policies need to take into account the multiple social, cultural, economic and political factors that determine the disease pathways.

Topics: Economies, Gender, Gender Analysis, Health, HIV/AIDS, Livelihoods, Security, Human Security

Year: 2010

Human Security, Gender-Based Violence and the Spread of HIV/AIDS in Africa: A Feminist Analysis


Thomas, Lahoma, and Rebecca Tiessen. 2010. "Human Security, Gender-Based Violence and the Spread of HIV/AIDS in Africa: A Feminist Analysis." Canadian Journal of African Studies / Revue Canadienne Des Études Africaines 44 (3): 479-502.

Authors: Lahoma Thomas , Rebecca Tiessen


La santé et la sécurité des femmes de tous âges sont menacées en situations de conflit et d'après-conflit partout en Afrique. La violence sexuelle et sexiste et la propagation du virus de l'immunodéficience humaine/syndrome d'immunodéficience acquise (VIH/sida) sont autant d'armes utilisées en périodes de conflit, mais elles ont aussi des effets à long terme sur la santé et la sécurité postconflictuelles des femmes et des jeunes filles. Cet article s'appuie sur des recherches empiriques et pratiques menées en Ouganda entre 2007 et 2008 auprès de membres de collectivités du nord de l'Ouganda victimes de la violence sexuelle et sexiste et des intervenants auprès des victimes du viol et des personnes séropositives. Les résultats de ces recherches empiriques soulignent la persistance de la violence faite aux femmes en situation d'après-conflit et pourquoi l'expression de cette violence doit être placée dans le contexte de la sexospécificité et des masculinités. Nos résultats mettent en évidence la façon dont la violence faite aux femmes en situation d'après-conflit (en particulier, la violence domestique envers les femmes, l'inceste et la maltraitance sexuelle des enfants) sert à réaffirmer la masculinité et à récupérer le sens de la virilité mis en cause lors de conflits quand les membres masculins de la communauté ont été incapables de protéger leurs familles.
Women and girls face specific health and human security threats in conflict and post-conflict situations throughout Africa. Gender and sexual-based violence (GSBV) and the spread of the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) are weapons used in conflict, but they also have long term effects on the human security and well-being of women and girls post-conflict. This article draws on empirical and field research carried out in Uganda between 2007 and 2008 with community members in northern Uganda who have experienced GSBV and those who are working to help survivors of rape and HIV infection. The findings from empirical research carried out in northern Uganda underscores the ongoing violence women face in a post-conflict environment and why the expression of violence against women must be understood in the context of gender relations and masculinities. Our findings highlight the ways in which violence against women in post-conflict situations (particularly domestic abuse against women, incest and child sexual assaults) is used to re-assert masculinities and to reclaim a sense of manhood that was challenged during the conflict when male community members were unable to protect their families.

Topics: Domestic Violence, Gender, Women, Girls, Masculinity/ies, Gender-Based Violence, Gendered Power Relations, Health, HIV/AIDS, Post-Conflict, Security, Human Security, Sexual Violence, Rape, SV against Women Regions: Africa, East Africa Countries: Uganda

Year: 2010

Climate Disasters Contaminate Women: Investigating Cross-National Linkages between Disasters, Food Insecurity, and Women's HIV in Less-Developed Countries


Austin, Kelly F., Mark D. Noble, Laura A. McKinney. 2020. "Climate Disasters Contaminate Women: Investigating Cross-National Linkages between Disasters, Food Insecurity, and Women's HIV in Less-Developed Countries." Global Health Governance (May): 85-102.

Authors: Kelly F. Austin, Mark D. Noble, Laura A. McKinney


HIV/AIDS remains a serious public health threat in less-developed countries, especially for women. Drawing on ecofeminist perspectives, we explore linkages between climaterelated disasters, food insecurity, and HIV transmission. Using data from over 90 lessdeveloped countries, we construct a structural equation model to analyze the direct and indirect influences on the percent of the adult population living with HIV who are women. We find that climate-related disasters are a significant factor shaping women’s HIV vulnerability indirectly through increased food insecurity. Food insecurity is theorized to alter social relationships and behaviors, including risky sexual behaviors, forced sex, and transactional sexual relationships. Our results confirm that disasters lead to conditions of hunger and resource deprivation, which serve to escalate HIV transmission among vulnerable women in poor countries.

Topics: Environment, Environmental Disasters, Feminisms, Ecofeminism, Gender, Women, Health, HIV/AIDS, Security, Food Security

Year: 2020

Engendering Care: HIV, Humanitarian Assistance in Africa and the Reproduction of Gender Stereotypes


Mindry, Deborah. 2010. "Engendering Care: HIV, Humanitarian Assistance in Africa and the Reproduction of Gender Stereotypes." Culture, Health & Sexuality 12 (5): 555-68.


Author: Deborah Mindry


This paper draws upon recent research in Durban, South Africa to unravel the complexities of care ethics in the context of humanitarian aid. It investigates how the gendering of care shapes the provision of aid in the context of the HIV in Africa constructing an image of ‘virile’ and ‘violent’ African masculinity. Humanitarian organisations construct imagined relations of caring, invoking notions of a shared humanity as informing the imperative to facilitate change. This paper draws on varied examples of research and NGO activity to illustrate how these relations of care are strongly gendered. Humanitarian interventions that invoke universalising conceptions of need could instead draw on feminist care ethics that seeks to balance rights, justice and care in ways that attend to the webs of relationships through which specific lived realities are shaped. Essentialising feminised discourses on care result in a skewed analysis of international crises that invariably construct women (and children) as victims in need of care, which at best ignore the lived experiences of men and, at worst, cast men as virile and violent vectors of disease and social disorder.
Cet article s'inspire d'une récente recherche à Durban, en Afrique du Sud, pour révéler les complexités de l'éthique des soins dans le contexte de l'aide humanitaire. Il examine la manière dont l'intégration des notions de genre aux soins détermine l'approvisionnement en aide dans le contexte du VIH en Afrique, en conceptualisant une image de la masculinité africaine «virile» et «violente». Les organisations humanitaires conceptualisent des relations imaginées du soin, basées sur des notions d'humanité solidaire qui informent l'impératif de la facilitation du changement. Cet article s'inspire d'exemples variés de recherche et d'activité des ONG pour illustrer l'intensité avec laquelle ces relations de soins sont basées sur le genre. Les interventions humanitaires qui invoquent l'universalisation des conceptions des besoins devraient plutôt s'inspirer de l'éthique féministe des soins, qui cherche à équilibrer les droits, la justice et les soins de manière à assister les réseaux des relations à travers lesquelles les réalités spécifiques vécues sont définies. L'essentialisation des discours féminisés sur les soins a pour résultat une analyse faussée des crises internationales qui, de manière invariable, conceptualisent les femmes (et les enfants) comme des victimes nécessitant des soins et, au mieux, ignorent les expériences vécues des hommes; au pire, représentent ces derniers comme des vecteurs virils et violents de la maladie et du désordre social.
Este artículo se basa en los recientes estudios en Durban, Sudáfrica, que revelan las complejidades de la ética asistencial en el contexto de la ayuda humanitaria. Analizamos cómo la cuestión del género en la asistencia determina la concesión de ayudas en el contexto del VIH en África construyendo una imagen de masculinidad africana ‘viril’ y ‘violenta. Las organizaciones humanitarias construyen relaciones imaginarias de asistencia invocando nociones de una humanidad compartida que hace imperativo facilitar cambios. En este artículo presentamos varios ejemplos de investigaciones y de las actividades de las ONG para ilustrar cómo estas relaciones de asistencia vienen determinadas en gran medida por el sexo. Las intervenciones humanitarias que invocan conceptos universales de necesidad podrían basarse mejor en la ética de asistencia feminista que intenta equilibrar los derechos, la justicia y la asistencia prestando atención a las redes de relaciones que forman las realidades específicas vividas. Los discursos feministas que esencializan la atención llevan a un análisis sesgado de las crisis internacionales que invariablemente caracteriza a las mujeres (y niños) como víctimas que necesitan cuidados y, en el mejor de los casos, ignora las experiencias vividas por los hombres y, en el peor, representa a los hombres como vectores viriles y violentos de trastornos sociales y enfermedades.

Keywords: Gender, Africa, masculinity, HIV/AIDS, humanitarian aid

Topics: Feminisms, Gender, Masculinity/ies, Health, HIV/AIDS, Humanitarian Assistance, NGOs Regions: Africa, Southern Africa Countries: South Africa

Year: 2010

Girlhood, Violence, and Humanitarian Assistance


Namuggala, Victoria Flavia. 2018. "Girlhood, Violence, and Humanitarian Assistance." In Childhood, Youth Identity, and Violence in Formerly Displaced Communities in Uganda, 107-37. Cham: Palgrave Macmillan.

Author: Victoria Flavia Namuggala


This chapter concentrates on humanitarian assistance as a major component of survival during situations of displacement. Despite its contribution in saving lives, humanitarian assistance has its own controversies especially from the perspective of the beneficiaries. My discussion centers on such complexities concentrating on young women in northern Uganda. To bring this out clearly, I examine the nature of aid provided and how recipients conceptualize it, the gendered experiences involved and the sociocultural dynamics that inform the implementation of humanitarian assistance. I conclude that humanitarian assistance at times facilitates violence against young women characterized by starvation, sexual violence, survival sex, early and forced marriages, and increased spread of HIV/AIDS. This is due to operation through cultural patriarchal structures that sustain power hierarchies in favor of men.

Topics: Age, Youth, Displacement & Migration, Gender, Women, Gendered Power Relations, Patriarchy, Health, HIV/AIDS, Humanitarian Assistance, Sexual Violence, Violence Regions: Africa, East Africa Countries: Uganda

Year: 2018

Evaluating the Effectiveness of Sexual and Reproductive Health Services during Humanitarian Crises: A Systematic Review


Singh, Neha S., James Smith, Sarindi Aryasinghe, Rajat Khosla, Lale Say, and Karl Blanchet. 2018.  “Evaluating the Effectiveness of Sexual and Reproductive Health Services during Humanitarian Crises: A Systematic Review.” PLoS One 13 (7): 1-19.

Authors: Neha S. Singh, James Smith, Sarindi Aryasinghe, Rajat Khosla, Lale Say, Karl Blanchet


Background: An estimated 32 million women and girls of reproductive age living in emergency situations, all of whom require sexual and reproductive health (SRH) information and services. This systematic review assessed the effect of SRH interventions, including the Minimum Initial Service Package (MISP) on a range of health outcomes from the onset of emergencies.
Methods and Findings: We searched EMBASE, Global Health, MEDLINE and PsychINFO databases from January 1, 1980 to April 10, 2017. This review was registered with the PROSPERO database with identifier number CRD42017082102. We found 29 studies meet the inclusion criteria. We found high quality evidence to support the effectiveness of specific SRH interventions, such as home visits and peer-led educational and counselling, training of lower-level health care providers, community health workers (CHWs) to promote SRH services, a three-tiered network of health workers providing reproductive and maternal health services, integration of HIV and SRH services, and men’s discussion groups for reducing intimate partner violence. We found moderate quality evidence to support transport-based referral systems, community-based SRH education, CHW delivery of injectable contraceptives, wider literacy programmes, and birth preparedness interventions. No studies reported interventions related to fistulae, and only one study focused on abortion services.
Conclusions: Despite increased attention to SRH in humanitarian crises, the sector has made little progress in advancing the evidence base for the effectiveness of SRH interventions, including the MISP, in crisis settings. A greater quantity and quality of more timely research is needed to ascertain the effectiveness of delivering SRH interventions in a variety of humanitarian crises.


Topics: Armed Conflict, Domestic Violence, Education, Environment, Environmental Disasters, Gender, Women, Girls, Health, HIV/AIDS, Reproductive Health, Humanitarian Assistance Regions: Americas, Caribbean countries, Asia, South Asia, Southeast Asia Countries: Haiti, Pakistan, Philippines

Year: 2018

Gendered Dimensions of Population Mobility Associated with HIV Across Three Epidemics in Rural Eastern Africa


Camlin, Carol S., Adam Akullian, Torsten B. Neilands, Monica Getahun, Anna Bershteyn, Sarah Ssali, Elvin Geng, Monica Gandhi, Craig R. Cohen, Irene Maeri, Patrick Eyul, Maya L. Petersen, Diane V. Havlir, Moses R. Kamya, Elizabeth A. Bukusi, and Edwin Charlebois. and Charlebois. 2019. "Gendered Dimensions of Population Mobility Associated with HIV Across Three Epidemics in Rural Eastern Africa." Health & Place 57: 339-51.

Authors: Carol S. Camlin, Adam Akullian, Torsten B. Neilands, Monica Getahun, Anna Bershteyn, Sarah Ssali, Elvin Geng, Monica Gandhi, Craig R. Cohen, Irene Maeri, Patrick Eyul, Maya L. Petersen, Diane V. Havlir, Moses R. Kamya, Elizabeth A. Bukusi, Edwin D. Charlebois


Mobility in sub-Saharan Africa links geographically-separate HIV epidemics, intensifies transmission by enabling higher-risk sexual behavior, and disrupts care. This population-based observational cohort study measured complex dimensions of mobility in rural Uganda and Kenya. Survey data were collected every 6 months beginning in 2016 from a random sample of 2308 adults in 12 communities across three regions, stratified by intervention arm, baseline residential stability and HIV status. Analyses were survey-weighted and stratified by sex, region, and HIV status. In this study, there were large differences in the forms and magnitude of mobility across regions, between men and women, and by HIV status. We found that adult migration varied widely by region, higher proportions of men than women migrated within the past one and five years, and men predominated across all but the most localized scales of migration: a higher proportion of women than men migrated within county of origin. Labor-related mobility was more common among men than women, while women were more likely to travel for non-labor reasons. Labor-related mobility was associated with HIV positive status for both men and women, adjusting for age and region, but the association was especially pronounced in women. The forms, drivers, and correlates of mobility in eastern Africa are complex and highly gendered. An in-depth understanding of mobility may help improve implementation and address gaps in the HIV prevention and care continua.

Keywords: HIV, mobility, migration, gender, Kenya, Uganda, population-based

Topics: Displacement & Migration, Migration, Gender, Health, HIV/AIDS, Livelihoods Regions: Africa, East Africa Countries: Kenya, Uganda

Year: 2019


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