Browsing by Author "Govender, Kaymarlin."

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Adolescents living with HIV and AIDS in Chiredzi district, Zimbabwe: experiences of disclosure, stigma, sexuality and social support to treatment adherence.
(2020) Jimu, Christopher.; Govender, Kaymarlin.
The study explores experiences of disclosure, stigma, sexuality and social support to treatment adherence for HIV positive adolescents in Chiredzi district, Zimbabwe.This qualitative study adopts a multiple interpretive case study methodology to explore the intricacies of living with HIV as an adolescent. Twenty (n=22) adolescents aged between 13 and 19 were recruited to participate in this study while attending social support or when they came to collect their medication. Individual in-depth interviews were carried out asking adolescence about their personal romantic lives, experiences and difficulties they must face while living with HIV/AIDS. Findings revealed that adolescents living with HIV (ALHIV) are confronted with stigma and discrimination while simultaneously grappling with emotional issues such as dealing with disclosure. Consequent to these challenges, adolescents (particularly males) adopt several coping mechanisms to deal with the difficulties and these include (but not limited to) non-disclosure of their seropositive status to their sexual partners thereby risking reinfection and exposing their partners to HIV. Social support was minimal. Non-disclosure of seropositive status contributed to poor adherence to or defaulting HIV medication. Further, findings further attest to the fact that adolescents refrain from disclosing their HIV status because they want to fit in with their peers and romantic partners. Presumably, this justifies why, while there has been a decline in the number of new HIV infections among all ages, there has been a significant escalation in HIV infection among the adolescent population, amid a high incidence of virological failure. Evidently, statistics will maintain an upward trajectory if proper measures are not implemented. The study concludes that a life-cycle approach to HIV prevention and management is crucial in responding to adolescent HIV/AIDS challenges because risks of HIV infection, the challenges of accessing services and the solutions to these challenges change at different stages of someone’s life. This scenario justifies the adoption and implementation of the principle of biomedical holistic approach in order to find suitable education programmes for the community, health workers and adolescents.
An analysis of community based health approaches in the delivery of integrated sexual, reproductive health and HIV services for adolescents with disabilities in Siaya County, Kenya.
(2019) Mbanga, Paul James.; Govender, Kaymarlin.
There is evidence of widening health disparities among vulnerable groups and inadequacies in the public health care system in sub-Saharan Africa (SSA), including Kenya. In particular, adolescents with disabilities (AWDs) confront many challenges in accessing health services. Their increasing primary care needs and rights in terms of sexual and reproductive health (SRH) is beyond the capacity of the conventional health system. While the Community Based Health Care (CBHC) approach has improved basic health services for maternal and child health as well as HIV and AIDS interventions, its capacity and utility to address the SRH and HIV interventions required by AWDs is not adequately studied in Kenya. Furthermore, debates persist on the overall quality of services provided through such primary health care systems. This study therefore investigated the CBHC approach as an option for improving AWDs‘ access to and use of Kenya‗s state-run adolescent SRH and HIV services in Siaya County of rural Kenya. The descriptive qualitative case study design used systems theory that featured Urie Bronfenbrenner‗s bio-ecological (Person-Process-Contexts-Time) and the World Health Organisation‘s (WHO‘s) (building blocks) health systems assessment frameworks as the main models to conceptualize, design, collect, analyze and interpret the data. Qualitative methods of data collection were used to explore purposively selected CBHC programs, and included semi-structured interviews, focus group discussions, observations, case narrations and record reviews. The study exposed serious institutional level inadequacies of the existing CHBC approaches, which were largely mediated by the disabling operating environment in the county health system. These ranged from poor staffing, inadequate financing, inadequate family support and community care, and unresponsive policy and legislation frameworks that lack enforcement mechanisms. Furthermore, the study found challenges associated with personal attributes including age, gender, type of disability, schooling and awareness of risks and available community-based services. Sexual and xii gender- based violence against the backdrop of an irresponsive justice system dominated the plight of AWDs in the county. As a result of analysing these factors, the evidence suggests a need to address the unique challenges surrounding the multi-dimensional issues that mediate access to and use of healthcare for adolescents living with disabilities to achieve equitable access to SRH & HIV services. In particular, the government should foster positive mechanisms of supporting community- based programs through co- financing with donors to expand the resource base for effective health services delivery, including SRH and HIV services for AWDs. Moreover, responsive policies and legal frameworks that were inclusive in approach to community care for AWDs would need to be clearly enunciated and enforced by the government and its stakeholders. Lack of data related to AWDs should be addressed to facilitate effective programming.
Analysis of policy for protection of HIV positive adolescent girls against vulnerabilities faced in using contraception in Malawi.
(2022) Bulage, Patience.; Govender, Kaymarlin.
There are challenges faced in accessing and using contraception by adolescent girls, but the reality is worse for adolescent girls living with HIV. Thus, it is important to investigate the extent to which current policies in Malawi put into account the vulnerabilities faced by this sub-population. This study therefore sought to answer the following research questions: 1. What are the structural and socio-cultural issues affecting the use of contraception among AGLHIV in Malawi? 2. What policy provisions are in place in Malawi to address the issues/risks faced by AGLHIV during reach and use of contraception? 3. What implementation challenges affect the effectiveness of the available policy provisions? This study was guided by the healthy policy triangle (HPT) framework and it was qualitative in nature, using both secondary and primary data collection methods. The findings include; • Access to contraception by adolescent girls living with HIV is hampered by several structural and socio-cultural issues, mainly; the mode of service provision, supply chain and infrastructural challenges, age restrictions, conditioned access, as well as integration challenges. The socio-cultural issues include; the high momentum for children, male dominance, social labelling, non-disclosure of HIV serostatus to sexual partners, social sensitivity, perpetuation of harmful content, and a general lack of social support, and poor risk perception. • The available provisions include those addressing gender-based violence, discrimination and stigma, community engagement, confidentiality, and emphasis on adolescent girls and young women. However, most of the provisions are broadly stated and gaps exist too. • Effective implementation is affected largely by cascading challenges, lack of sufficient funding, limited political will, low comprehension of policy directives, limited participation of target population, coordination challenges, social resistance, effects of decentralization, low capacity of implementing partners and the slow pace of behaviour change among the targeted population and communities. While the policy environment in Malawi is seemingly favourable, undertones exist around harmonization, and representation of interest groups, mainly PLHIV groups. Policy makers ought not to continue ignoring the importance of formulating HIV-sensitive policies which can give way to social protection programs for the most vulnerable within the society, given the benefits of a healthy youthful population.
Body image and antiretroviral therapy adherence among adolescents and young people living with HIV in Durban, South Africa.
(2021) Nyamaruze, Patrick.; Govender, Kaymarlin.
Background: The benefits of antiretroviral therapy (ART) for treating HIV among adolescents and young people living HIV (AYPLHIV) may be undermined by non-adherence to ART. Several reasons for non-adherence to ART have been reported among young people including internalised HIV-related stigma, body image concerns, and depression. Research into how AYPLHIV experience and make sense of feared or actual body changes is limited, yet these changes have emotional and psychological implications which may curtail adherence to ART. This doctoral thesis investigated the relationship between body image and various psychosocial factors; and explored the perceptions and feelings about body appearance among AYPLHIV in Durban, South Africa. Method: A cross sectional, convergent parallel mixed method approach was adopted in which quantitative and qualitative data were concurrently collected in the same phase of the research process using non-probability sampling. For the quantitative part of the study, a total of 76 AYPLHIV (15-24 years) were conveniently sampled. Qualitative data were obtained through a series of semi-structured in-depth interviews with a sub-set of 18 AYPLHIV who were purposively and conveniently recruited from the quantitative sample. Descriptive statistics, Pearson Product Moment correlations, and mediational analyses were used to analyse the quantitative data whereas thematic analysis was used for the qualitative data analysis. Results: The converging quantitative and qualitative results from this study provide evidence that body image is a significant issue among AYPLHIV and is differentially associated with various psychosocial factors. Self-esteem and adherence to ART were indirectly associated through a two-step path of internalised HIV-related stigma and then body appreciation. Findings from the qualitative analysis showed physical and psychosocial effects of living with HIV among young people including weight loss, body dissatisfaction and social withdrawal. Coping mechanisms such as social support networks and physical exercises were highlighted as important in counteracting the physical and psychosocial effects of negative body image and living with HIV. Conclusion: The findings from this study suggest that body image concerns are central to the health and well-being of AYPLHIV as they are related to several psychosocial challenges. The findings underscore the need for development of multi-pronged interventions to boost body image.
Body image and antiretroviral therapy adherence among people living with HIV: a protocol for a systematic review and meta-analysis.
(BMJ Open., 2021) Nyamaruze, Patrick.; Cowden, Richard Gregory.; Padgett, R Noah.; Govender, Kaymarlin.
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 Systematic Reviews and Meta-Analyses guidelines and study quality will be assessed using relevant tools developed by the National Institute of Health. If sufficient data are available, a meta-analysis will be conducted. Effect size estimates will be aggregated using a random effects meta-analysis approach. Publication bias and its impact will be evaluated through the use of a funnel plot and the trim-and-fill method. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to report on the overall quality of evidence.
The construction of masculinity amongst sex offenders in Limpopo province.
(2019) Selepe, Dorothy Mabore Mandu.; Lindegger, Graham Charles.; Govender, Kaymarlin.
The construction of masculinity is vital in understanding the development of men since it has an influence on how a man perceives himself and on his behaviour. The high rape statistics have recently prompted an examination of the South African masculinity constructs and their implications of sexual violence against women. It is against this background that this study explored how sex offenders in the Correctional Centres construct masculinity, in relation to accounts of their sexual offences. Social Constructionism was selected as a conceptual lens of enquiry because it is believed that knowledge and truth are socially constructed. This approach was used to understand the role of social interaction and discourses in the constructions of masculinities. Given the exploratory nature of this study, qualitative interviews were used to examine how sex offenders create meaning around their experiences. Data was drawn from five Correctional Centres in Limpopo Province and purposive sampling was used to select the participants. Nineteen (19) sex offenders were drawn through the saturation approach to participate in the study. Data was collected by means of the use of semi-structured interviews and open-ended questions with probes and prompts to elicit a detailed description of their experiences in relation to the objectives of the study. Discourse analysis was used to identify and analyse the available discourses that sex offenders drew from, to construct their masculinities and to account for their sex offences. The findings of the study indicate that the construction of masculinities was informed by discourses of procreation, provision, initiation, sexuality and possession of assets. Since these men are placed in a confined environment with limited resources, it emerged that the participants use the available resources, such as their physical strength, toughness and perseverance to construct their masculinities. Furthermore, it was found that the participants use the blame discourse to account for their sexual offences. Most of them denied their offences. Instead, they blamed the victims and used discourses of unexplained sexual desires, sexual entitlement, absent mothers, provocative dress code and unfair laws to justify and account for their sexual offences. Based on these findings, it is recommended that multisectoral interventions are adopted to enable men to resist unhealthy and violent discourses. The promise of multi-sectoral and long-term interventions with sexual offenders is that discourses of sexual violence can be replaced with masculine discourses that advocate empathy, love, respect and tolerance of diversity.
Donor-NGO accountability mechanisms and the implications for HIV and AIDS: perspective from NGOs on service effectiveness in South Africa.
(2019) Mpofu, Limkile.; Govender, Kaymarlin.; Whitman, Jim.
The study investigates the nature and extent of HIV and AIDS donor accountability mechanisms to see whether they were diminishing NGOs' capacity to achieve positive outcomes for beneficiaries. In particular, it focuses on the degree to which accountability mechanisms might inhibit NGOs from achieving the outcomes they share with the donors. The study examines the operations of both national and international NGOs that work on HIV and AIDS, focusing on the mechanisms of accountability to their donors, both public and private because the advent of HIV pandemic globally and especially in sub- Saharan Africa brought with it the urgency for actions and responses beyond the public sector. The study analyzed how the power disequilibrium between donors and recipient NGOs limits development outcomes. The focus would often shift from addressing the beneficiaries' needs at the grassroots level to the donors' administrative requirements. An in-depth interpretive case study approach was adopted to study five HIV and AIDS NGOs in Gauteng, South Africa. The researcher chose South Africa because it has the largest and most high-profile HIV pandemic globally, with an estimated 7.2 million people living with HIV in 2017. The study's findings were analyzed and interpreted through the lens of the basic accountability mechanism theory of Julia Steets. The study findings revealed that accountability is not a ‘one size fits all’ concept and practice because of the socio-economic and cultural differences that exist in different contexts. The study revealed the dynamic and complex relations between the HIV /AIDS NGOs and donors in their efforts to serve the beneficiaries. Donor dependency and service distribution affected interactions between donors, NGOs and beneficiaries. The study concluded that NGOs cannot be simultaneously concerned with accountability on the scale now often required of them without impacting their operations. They are experiencing severe difficulties mediating the tensions between balancing donor organizational interests and beneficiaries' interests as the NGOs’ administrative burden of accountability mechanisms has detracted time and resources from their main work of providing services and from developing equitable accountability mechanisms between themselves and the beneficiaries of their projects. This limits NGOs’ capacities to develop further community level interventions and detracts from close relations with beneficiaries in ways that address what the beneficiaries say they need with regard to HIV/AIDs services. Overall, the study is a contemporary attempt to contribute towards theory development in contextual accountability in the donor-NGO development structure. Key Words: Accountability Mechanisms, Accountability Practices, HIV & AIDS NGOs, Donors, Beneficiaries, Programs, service delivery, sanctions and rewards, Donor-NGO relations.
Early resumption of sex following voluntary medical male circumcision amongst school-going males.
(Public Library of Science., 2016) George, Gavin Lloyd.; Govender, Kaymarlin.; Beckett, Sean.; Montague, Carl.; Fröhlich, Janet Ann.
Abstract available in pdf.
Factors associated with the take-up of voluntary medical male circumcision amongst learners in rural KwaZulu-Natal.
(National Inquiry Services Centre., 2017) George, Gavin Lloyd.; Govender, Kaymarlin.; Beckett, Sean.; Montague, Carl.; Fröhlich, Janet Ann.
Abstract available in pdf.
Hegemonic and shamed masculinities: implications of traumatic historical impacts on black men in a post democratic South Africa.
Govender, Kaymarlin.; Cartwright, Duncan James.
The landscape of post-Apartheid South Africa is characterised by high levels of male perpetrated violence against women, children and other men with blame often attributed to victims rather than perpetrators (Hayes & Abbot, 2016). The aberrant behaviours and attitudes of men (also referred to as toxic masculinity) has been central to the notion of a so-called contemporary ‘crisis in masculinity’ with violence and risk taking behaviours (alcohol, substance abuse, sexual risk taking) embedded in male culture. While previous explanations of the ‘modern day crisis’ among men can be largely attributed to South Africa’s history of violent and traumatic struggles of domination over place, ideology and bodies, there is a paucity of work theorising this crisis from a socio-historical and psychodynamic trauma paradigm. In this vein, this paper delves into key periods of our history (referred to as ‘chosen traumas’) that have had persistent disruptive influences on particularly, black masculinity, which have collectively contributed to the modern day crisis. Our argument relies on the idea that unresolved historical traumas have a transgenerational ‘haunting’ effect on contemporary identities (Gordon, 1997; Layton, 2019). Focusing on black men who were subjected to a violent and repressive past, we have argued that ghosts of the pre-Apartheid to post-Apartheid modern day South Africa continue to have cumulative impacts on the black male psyche. It is suggested that these past traumas, together with contemporary representations of black masculinity, have led to a deep sense of unresolved shame, the dynamics of which we have attempted to illuminate using psychodynamic and masculinity theory. The paper concludes with some recommendations on dealing with unresolved traumas and violence.
Hegemonic masculinity and risky sexual behaviours in KwaZulu-Natal, South Africa.
(African - British Journals., 2021) Byaruhanga, Ronald.; Andersson, Lena.; Govender, Kaymarlin.
This study assessed the relationship between hegemonic masculinity and HIV risky behaviours among men in UMgungundlovu district, Kwazulu-Natal, South Africa. Methodology: The data was collected through a cross-sectional survey where 10,000 households were approached using a structured questionnaire, but only 3,895 men were considered for this study due to data completeness. Both descriptive and regression analyses were employed in data analysis using Stata 16. Results: The largest group of participants were aged 20-24 years (23%), had incomplete education (50%), no income (60%), always lived in the community (62.5%), were not away from home (91.7%), and were separated but still legally married (85.4%). In the regression analysis, only sex after drinking (β=0.54, P=0.025) and non-use of condoms (β=-0.37, P=0.005; β=-0.48, P=0.004) were significantly associated with masculinity norms. Conclusion: Hegemonic masculinity is associated with risky behaviours, incredibly sex after drinking and non-condom use, and safe male circumcision is a modifier to this relationship.
The impact on HIV testing over 6 months when free oral HIV self-test kits were available to truck drivers in Kenya: a randomized controlled trial.
(Frontiers Media S.A., 2021) Kelvin, Elizabeth A.; George, Gavin.; Romo, Matthew L.; Mantell, Joanne E.; Mwai, Eva.; Nyaga, Eston N.; Odhiambo, Jacob O.; Govender, Kaymarlin.
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 in past 6 months, interaction p = 0.881, had transactional sex in past 6 months, interaction p = 0.599), nor having spent at least half of the past 30 nights away from home for work (interaction p = 0.304). Most participants indicated a preference for the characteristics associated with the SOC [preference for blood-based tests (69.4%), provider-administered testing (74.6%) testing in a clinic (70.1%)]. However, those in the intervention arm were more likely to prefer an oral swab test than those in the SOC (36.6 vs. 24.6%, p = 0.029). Conclusions: Offering HIVST kits to truck drivers through a clinic network had little impact on testing rates over the 6-month follow-up when participants had to return to the clinic to access HIVST. Clinic-based distribution of HIVST kits may not address some major barriers to testing, such as lack of time to go to a clinic, fear of knowing one’s status and low risk perception. Preferred HIV testing attributes were consistent with the SOC for most participants, but oral swab preference was higher among those in the intervention arm, who had seen the oral HIVST and had the opportunity to try it. This suggests that preferences may change with exposure to different testing modalities.
An in-depth investigation of the experience of sexual assault and factors that determine non-adherence to post exposure prophylaxis (PEP) after sexual assault in a sample of raped women survivors attending a public health clinic in the Eastern Cape.
(2008) Khuzwayo, Nelisiwe.; Govender, Kaymarlin.; Abrahams, Naeemah.
Prevention of HIV following sexual assault is an important aspect of rape care. This includes taking Post Exposure Prophylaxis for 28 days. The present study aimed to provide an in-depth understanding of social and environmental factors that predisposed, promoted and also served as barriers to adherence to post exposure prophylaxis to prevent HIV infection after sexual assault in women in the Eastern Cape Province. The study involved a purposive sample of women who were offered Post Exposure Prophylaxis (PEP) after a sexual assault. Sixteen women were accessed at the Sinawe Referral Centre and participated in the study. Their ages ranged from 16 to 73 years. An interview guide was developed to assist the researcher, and semistructured, in-depth interviews were used to collect data. These women were interviewed at the end of 28 days of taking the prophylactic medication. The data were analyzed inductively using grounded theory. Only three women completed the 28 days of PEP treatment. Participants gave different explanations for why they did not complete the treatment with only four participants returning to the centre for their medication. Some reported having no money for transport; others mentioned deciding to discontinue the medication because of its side-effects. Poor support systems, both within the community and the health services, including the provision of conflicting information also played a role. The study showed that few women were able to complete their PEP medication and knowledge about the service and access to it were the main factors that lead to non-adherence. There is an urgent need for the improvement of PEP services particular in the support to the women during the period of taking the PEP treatment to ensure protection from HIV after a sexual assault.
Investigating the interrelations between systems of support in 13 to 18 year old adolescents: a network analysis of resilience promoting system in a high and middle-income country.
(WILEY., 2021) Höltge, Jan.; Theron, Linda.; Van Rensburg, Angelique.; Cowden, Richard Gregory.; Govender, Kaymarlin.; Ungar, Michael.
Adolescents’ ability to function well under adversity relies on a network of interrelated support systems. This study investigated how consecutive age groups differ in the interactions between their support systems. A secondary data analysis of cross-sectional studies that assessed individual, caregiver, and contextual resources using the Child and Youth Resilience Measure (Ungar & Liebenberg, 2005) in 13- to 18-year-olds in Canada (N = 2,311) and South Africa (N = 3,039) was conducted applying network analysis. Individual and contextual systems generally showed the highest interconnectivity. While the interconnectivity between the individual and caregiver system declined in the Canadian sample, a u-shaped pattern was found for South Africa. The findings give first insights into cross-cultural and context-dependent patterns of interconnectivity between fundamental resource systems during adolescence.
"Mirror, mirror on the wall who's the buffest of them all" : traditional masculine role norms and body image discrepancy in Indian school going boys.
(2010) Martin, Jarred.; Govender, Kaymarlin.
This study investigated the relationship between traditional masculine role norms, body image discrepancy, body appearance schemas, and sociocultural attitudes towards appearance in a sample of 495 Indian South African school going boys, between the ages of 13 and 18 years old. The main objective of this research study was to investigate the interrelationships between these variables in terms of how they relate to the experience of body image discrepancy for Indian males in the context of the regulatory norms and practices of traditional masculine ideology. Also examined were the traditional male role norms associated with the boys’ cognitive body appearance schemata. In addition this study attempted to identify the role played by the portrayal of Indian male somatoforms in Indian cinema on the personal and collective evaluation of masculine appearance for a sample of Indian school boys. The variables of interest were measured using the Masculine Role Norms Inventory (MRNI; Levant & Fisher, 1998), Lynch and Zellner’s Body Figure Drawings (1999), Appearance Schemas Inventory (ASI; Cash & Labarge, 1999), and the Sociocultural Attitudes Towards Appearance Scale-3 (SATAQ-3; Thompson, van den Berg, Roehrig, Guarda, & Heinberg, 2004). The above constructs were considered in light of biographical questions which pertained to self-worth, the psycho-behavioural implications of pursuing an enhanced appearance, and Indian cinema. The findings of this study showed how a sample of South African Indian boys are defining and refining a localized masculine sense of self within the broader interplays of South African gender relations and masculinities. Analysis revealed the traditional masculine role norms of status-seeking, heterosexism, anti-femininity, and emotional stoicism, shared positive and significant correlations with body image discrepancy. Nontraditional masculine attitudes were similarly associated with body image discrepancy. Moreover it was shown that the influences of sociocultural attitudes towards appearance, and a more substantial investment in body appearance, were key ingredients for participants positioning an athletically muscular and toned male body as their ethnomorphological and masculine ideal. Finally, concerning trends in steroid and supplement use were illustrated as foremost risk behaviours associated with support for a muscularised, traditionally masculine subjective and normative agenda.
Retrospective reports of parent-adolescent communication about sex education and issues related to sexuality in a sample of female university students.
(2011) Valayden, Devandran.; Govender, Kaymarlin.
Aim. The aim of this research was to explore parent-adolescent communication about sex and sexuality among university students. Background. The rates of HIV/AIDS and pregnancy among adolescents in South Africa are very problematic issues. In the context of children and adolescents' sexual socialization, both Western studies and studies from African countries have found that families, especially parents, are crucial in influencing adolescent attitudes, decision-making and participation in sexual behaviour. Methods. A qualitative study was conducted using focus groups to examine parent-adolescent sex education among university students. Findings. Participants reported that parents generally avoided discussions about sex especially fathers, framed sex negatively and highlighted the negative effects of sex such as HIV/AIDS and pregnancy. The reasons participants believed that parents were uncomfortable in discussing sex were due to insufficient knowledge to explain certain aspects of sex, that sex was taboo, that by discussing sex it would be viewed as condoning or encouraging sexual activity. Conclusion. Parents need to be educated regarding the benefits that comprehensive sex education will have for their children, in the light of the massive problem of HIV/AIDS in South Africa. Education on these matters is vital for all young people.
A social constructionist study of masculinity and its effects on health seeking behaviours among men who are at risk of cardiovascular disease.
(2018) Hamlyn, Christopher John.; Govender, Kaymarlin.
In a world that has gender constructions, the masculine and the feminine, these gender constructions are used to highlight differences, and from this emerges differences in power that has an important effect on the phenomenon of health (Hollway, 1984). Males, as opposed to females, have lower life expectancies, which has been associated with a higher level of risk behaviours as well as a lower level of health seeking behaviours ( Connell, 1995; Will H Courtenay, 2000; J kahn, 2009). The prevalence of cardiovascular disease is something of concern, as approached by Seedat (2000), which showed the indiscriminate nature of cardiovascular disease amongst males regardless of race. The way in which masculinity is constructed has been seen to emanate from multiple constructions including work roles, and thus the changing work climate is something that, in conjunction with cardiovascular disease, needs to be explored in order to see how, and if, there has been indeed a negative effect (Connell, 1995). The combination of masculinity and cardiovascular diseases is something that needs to be explored in relation to construction. The results of this effect can then be subsequently used to design interventions to either slow down the degradation or seek to create an equilibrium in order to minimise harm.
"Sticks and stones" : social dominance, bullying and early adolescent boys.
(2009) Adams, Leigh Andrea.; Govender, Kaymarlin.
The study is concerned with the ways early adolescent males understand and experience bullying within a hetero-normative school context. The research focuses on the ways in which bullying occurs, and how it relates to identity development amongst young boys. Key theoretical constructs include multiple masculinities, social dominance theory, and social constructionism. The researcher adopted an ethnographic approach. Constructs were explored through the use of four focus groups and one individual interview with 20 Grade 8 learners at a co-educational high school. Three dominant themes emerged from the discussions. The Embodied Self explores the expression and development of gender identity through the construction of the physical and performative male body. Displaced Masculinities explores the gradual shift in power that young men have experienced in terms of current representations of gender, race and technology. The third theme, Recovering Power, identifies subtle subversion strategies that young males reproduce to recover social power. Bullying is normalised within the school context and is understood as a physical and psychological process that differentiates desirable and undesirable masculinities. Masculinities are actively policed by peers, forcing boys to position themselves against the ideal hegemonic masculinity underpinning feelings of uncertainty and instability. Recommendations include continued opportunities for discussion of gender issues at a formative school level, focused policy development addressing the abuse of communication technologies, and translation of gender research into policy and legislation to recognise the role and responsibilities of men, with the major aim of reducing inequality.
Strengthening HIV surveillance in the antiretroviral therapy era: rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africa.
(BioMed Central., 2015) Kharsany, Ayesha Bibi Mahomed.; Cawood, Cherie.; Khanyile, David.; Grobler, Anna Christina.; McKinnon, Lyle R.; Samsunder, Natasha.; Fröhlich, Janet Ann.; Abdool Karim, Quarraisha.; Puren, Adrian.; Welte, Alex.; George, Gavin Lloyd.; Govender, Kaymarlin.; Toledo, Carlos.; Chipeta, Zawadi.; Zembe, Lycias.; Glenshaw, Mary T.; Madurai, Lorna.; Deyde, Varough M.; Bere, Alfred.
Abstract available in pdf.
Underdogs on top : troubling positions for boys and a diagnosis of Attention Deficit Hyperactivity Disorder.
(2017) Tucker, Leigh Adams.; Govender, Kaymarlin.
Attention Deficit Hyperactivity Disorder (ADHD) accounts for one of the largest number of health referrals amongst children. As a mental health diagnosis, it has undergone multiple conceptual revisions over the years, where it is now classed as a neurodevelopmental disorder. ADHD remains a highly controversial subject, sparking debate at the interface of parenting responsibilities, effective schooling practices, predisposing trauma, and the ethics of the medicated child. In the midst of these debates, one of the strongest issues to emerge is the high proportion of boys that are diagnosed with ADHD, as well as the sex and gender divide in symptoms, referral, and treatment choice. Lack of research involving children, particularly those with disabilities, highlights the limitations of ableist and developmental assumptions. Although there is a growing body of peer-reviewed literature on young people’s experiences of ADHD, these accounts tend toward the descriptive and fail to take account of how young people manage their condition as part of identity-making processes. Given the above, the main objective of the study was to understand how boys who were diagnosed with ADHD understood their illness and managed their condition in a school setting. Educators’ views were also sought to bring an adult perspective to this issue. The study was guided by feminist post-structural ethnography, located at one public full service school named Riven Primary. Given the in-depth nature of the study, attention was also granted to situated performances of boys across Remedial and Mainstream learning spaces and public or private conversational spaces. Analysis focused on group interactions and private interviews with nine boys aged 9 to 11 years of age, all of whom had previously received a diagnosis of ADHD and medical forms of management. Five of these boys were enrolled in the on-site Remedial Unit, while four boys were based within the Mainstream section of the school. Separate focus group interviews were also held with Remedial and Mainstream educators from the site. Analysis of the educator and boy accounts reinforce the power and prevalence of the biomedical discourse. Accounts of ADHD stigma was related to observed behaviours and public responses towards diagnosis and medication. Educators’ perceptions of risk and vulnerability associated with ADHD typically intersected with broader social assumptions of childhood, sex, and gender. For this group, three broad storylines emerged (flunk, hunk, or punk), which provide different claims as to the deterministic nature of ADHD and the levels of accountability for the child and the family system. Medication was a powerful signifier for responsibility and success, among boys and educators alike. It was also symbolic of chronic illness and weakened masculinities. Boys were palpably aware of their ADHD-related social and educational vulnerabilities that rendered them as biologically faulty, underachieving, and unhinged outcasts. However, the label of ADHD or the experience of medication was not taken up by all boys in a one-dimensional manner. Instead, there were tendencies to reinforce, resist and, at times, reframe representations of the unruly ADHD child through resources and strategies that spoke to broader narratives of success, maturity, and heroism. In this regard, the so-called “Underdogs” worked very hard to regain credibility through discourses of shared disadvantage, as well as a passion and determination to succeed through adherence to the ADHD medication. Boys were also careful not to take up illness positions when it rendered them powerless. Typically, masculine constructs such as sport and future employment were constructed as potentially enabling spaces for ADHD, in efforts to counter responses around illness and dependency on medication. In general, the study findings resist the notion of ADHD as a singular, universal concept and instead make a cogent argument for the socially situated nature of the diagnosis. The feminist post-structural analytical frame helped to disrupt simplistic constructions of ADHD through making visible the impairments boys experienced at the interface of shifting social identifiers and in different conversational contexts. These situated performances ultimately worked to reframe their disabilities and masculinities in either beneficial or problematic ways. Engaging in research that involves children with disabilities elevates discourses of risk, stigma, and protection. Working in these contexts makes visible the insecurities that plague research development and clinical practice, while also expanding considerations of what constitutes ethical conduct for adult stakeholders. In closing, recommendations are made for investing in strength-based or resiliency enhancing processes that help boys cope with the stigma associated with ADHD.