STD/AIDS prevention in Portuguese-speaking Africa: a review of the recent literature in the social sciences and health Prevenção das DST/AIDS nos países africanos de língua ofi cial portuguesa: revisão da literatura

نویسنده

  • Simone Monteiro
چکیده

The article reviews academic literature in the social sciences and health on the problems and challenges of STD/AIDS prevention in Portuguese-speaking African countries. Based on a bibliographic survey of the SciELO, PubMed, and Sociological Abstracts databases between 1997 and 2007, the research under review was organized into two groups, according to content. The first group of studies sought to understand STD/AIDS vulnerability among social groups by examining local cultural and socioeconomic factors as related to gender dynamics, sexuality, color/race, religion and health care. The second group encompassed critical assessments of shortcomings in the STD/AIDS educational messages delivered by governments and international agencies. Attention is called to the way in which the presence of traditional medicine systems and the occurrence of civil wars in the post-colonial period impact the STD/AIDS epidemic in the African countries under study. Acquired Immunodeficiency Syndrome; Sexually Transmitted Diseases; Prevention; Gender; Africa This exploratory study reviews the literature in the field of the social sciences and health on the problems and challenges of STD/AIDS prevention in sub-Saharan Africa, with a focus on research in Portuguese-speaking African countries (known by the acronym PALOP, for Países Africanos de Língua Oficial Portuguesa): Mozambique, Angola, Cape Verde, Guinea-Bissau, Equatorial Guinea, and São Tomé and Príncipe. The survey encompassed scientific production from 1997 to 2007 available in the SciELO, PubMed, and Sociological Abstracts databases. Methodologically, the search cross-referenced descriptors related to AIDS, African countries and prevention, and socio-cultural dimensions like gender and sexuality, among others. The studies were divided into two groups. The first examined vulnerability to STD/AIDS among social groups, based on analyses of the cultural and socio-economic factors linked to gender roles, sexuality, emotional and sexual interactions, religious affiliation, social networks, educational level, and access to social goods and healthcare services. The second group offered critical evaluations of shortcomings in the educational STD/AIDS messages of governments and international agencies. Attention is called to the specific features of African countries, including a marked reliance on traditional medicine and recent civil wars. Although the factors examined in both groups constitute specific dimensions, in the complexity of the real world they are all interFÓRUM FORUM 680 Cad. Saúde Pública, Rio de Janeiro, 25(3):680-686, mar, 2009 twined, with relations of mutual determination and association, and they should be interpreted in conjunction. Cultural and socio-economic dimensions of the HIV/AIDS epidemic The concept of gender – that is, cultural attributes associated with the female or male sex – has made its growing influence felt in the world literature on the HIV/AIDS epidemic. Interpretations of rising HIV transmission through heterosexual relations and among women, especially in contexts of socio-economic inequality and social marginality, have taken into account the implications of hierarchical relations, which are characterized by the hegemony of male power and concomitant greater female subjugation, partly grounded in the control of sexuality. These features are found in various contexts in sub-Saharan Africa. Reflecting this tendency, the literature under review explores how local gender dynamics matter to our understanding of STD/AIDS vulnerability and how these dynamics are interdependent on the socio-economic conditions of the contexts in question. The present text discusses these factors based on the surveyed studies on Portuguesespeaking African countries, except for Equatorial Guinea and São Tomé and Príncipe, where no research was identified. Studies conducted in Mozambique, and in rural regions in particular, draw a connection between vulnerability both to the AIDS epidemic and social practices by which men control female sexuality and to childbearing and reproduction of the family, which constitutes an important cultural value. These factors clash with prevention messages centered on the negotiated use of condoms. Within this universe, widows are especially vulnerable, as they have no ownership rights to their husband’s estate and are subject to rape and sexual exploitation by male family members 1. Approaching from the factors of gender, socioeconomic conditions, educational level, and religious affiliation, other analyses have contributed to a deeper understanding of local logic systems and their implications when it comes to constructing ideas about health and risk. In this regard, one set of research 2,3,4,5 addresses the way in which religious beliefs in subSaharan Africa shape social and gender norms and influence the interpretation of prevention messages. One illustration of this approach is a study 2 conducted in rural Mozambique and in urban areas of the capital among members of two types of denominations: “mainline” (Catholic and Presbyterian) and “curative” (Assembly of God, Zionist, and Apostolic). The study found gender asymmetry in messages about STD/AIDS prevention and in members’ views and practices within both types of denominations. Centered around family values and moral standards, the prevention messages aimed at men emphasized the risks of extramarital sex. Among women, protective recommendations focused on a commitment to housework and to the husband’s sexual satisfaction. Differences were observed between the social profiles of members of each group and between doctrinal messages. With most of their members coming from lower, rural classes, curative denominations display a more homogenous profile and lesser doctrinal flexibility. Mainline denominations, however, display greater social diversity, openness, and political connections, which means their members enjoy greater exposure to other messages and are more flexible about sexual morality. In other words, despite similarities between the messages of both religious types, the meaning assigned to each message depends upon members’ educational level and social environment. Likewise, research into the new meanings attributed to control over sexuality in the more well-to-do urban regions of Mozambique suggests that sexual mores may be growing more flexible. Some authors have observed that young, urban, educated middle-class females are more likely to challenge traditionally defined gender roles, putting them in a more advantageous position in sexual negotiations and leaving them less vulnerable 6,7. Karlyn 8 analyzes one sexual practice among young people in the capital of Mozambique, known as saca cena, where casual sexual contact does not follow traditional gender rules. During these practices, young females play an active role in sexual conquest and negotiation, indicating increased assimilation of prevention messages. According to research, signs of new perceptions and new meanings within specific regions and groups are still rather insignificant. Studies focusing on national surveys show that for males and females aged 15 to 24, their perception of the risk of acquiring HIV is unrealistic. Gender asymmetries are visible in the fact that men receive more education. Women tend to marry earlier and have relations only with their husbands, while men marry later and have a greater number of partners 9,10. Other studies have shown that involvement in a stable, monogamist relationship presents a major barrier to the use of condoms by young people, as the participants tend to place trust in their partner based on their established ties. Prevention campaigns reinforce this notion when they center on sexual abstinence, being STD/AIDS PREVENTION IN PORTUGUESE-SPEAKING AFRICA 681 Cad. Saúde Pública, Rio de Janeiro, 25(3):680-686, mar, 2009

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Forum: challenges in STD/AIDS prevention in Portuguese-speaking African countries: contributions from social research and from a gender approach. Introduction.

This forum on the challenges of preventing STD/AIDS in Portuguese-speaking African countries contains three articles and a postscript. The first paper reviews academic production on the topic from the fields of the social sciences and of health, with special attention on how local cultural and socioeconomic factors impact the dynamics of the epidemic. Based on an ethnographic study of a region ...

متن کامل

Preventing violence by intimate partners in adolescence: an integrative review* A prevenção da violência por parceiro(a) íntimo(a) na adolescência: uma revisão integrativa La prevención de la violencia por pareja íntima en la adolescencia: una revisión integradora

4 Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem em Saúde Coletiva, São Paulo, SP, Brazil. ABSTRACT Objective: To analyze the scientific literature on preventing intimate partner violence among adolescents in the field of health based on gender and generational categories. Method: This was an integrative review. We searched for articles using LILACS, PubMed/MEDLINE,...

متن کامل

Sexually transmitted infections in Iran: A literature review

Background: The global burden of sexually transmitted infections (STIs) is noticeable and important. However, most STIs are curable and all of them are preventable. In this article, we reviewed and evaluated STI prevalence, current services, existing programs, and the challenges of control and management them in Iran. Materials and Methods: The author searched literature published from 2005 ...

متن کامل

Social networks in nursing work processes: an integrative literature review As redes sociais nos processos de trabalho em enfermagem: revisão integrativa da literatura Las redes sociales en los procesos laborales de enfermería: revisión integrativa de la literatura

www.ee.usp.br/reeusp Rev Esc Enferm USP · 2017;51:e03219 1 Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, SP, Brazil. AbstrAct Objective: To identify and analyze the available evidence in the literature on the use of social networks in nursing work processes. Method: An integrative review of the literature conducted in PubMed, CINAHL, EMBASE and LILACS databa...

متن کامل

Situation of Linkage between Sexual and Reproductive Health and HIV-Related Policies in Islamic Republic of Iran – A Rapid Assessment in 2011–2

The number of sexual transmission of HIV is increasing globally. Sexual and Reproductive Health (SRH) issues and HIV/AIDS related problems are rooted in common grounds such as poverty, gender inequality, and social exclusion. As a result, international health organizations have suggested the integration of SRH services with HIV/AIDS services as a strategy to control HIV and to improve people’s ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره   شماره 

صفحات  -

تاریخ انتشار 2009