Pub Date : 2021-12-01DOI: 10.1080/17290376.2021.1894225
L Gittings, R Hodes, C Colvin, S Mbula, P Kom
This paper explores how HIV-positive abakhwetha (young male initiates) undergoing ulwaluko (traditional Xhosa initiation and circumcision) engage with HIV-related biomedical care and treatment. Health-focused life history narratives (n = 36), semi-structured interviews (n = 32) and analysis of health facility files (n = 41) with adolescent boys and young men (ages 13-24) living with HIV, and semi-structured interviews with traditional and biomedical health practitioners (n = 14) were conducted in 2017 and 2018. This research was part of the Mzantsi Wakho study, a longitudinal, mixed methods study of adolescents living with HIV (n = 1060). Findings demonstrate that ulwaluko rules of not engaging with biomedical care and treatment pose a challenge for initiates who are taking chronic medicine. Fears of inadvertent disclosure of their HIV-positive status collide with the pressure to successfully complete ulwaluko in order to be legitimised as men. In response to this dilemma, they engage a variety of strategies - including taking medicine in secret by hiding them, having a trusted person deliver them discretely, and stopping medicine-taking altogether. The three months following ulwaluko also pose a challenge in accessing biomedical treatment and care. In this time of high surveillance, amakrwala (new men) do not present at health facilities for fear of being thought to have had a botched circumcision or to have contravened 'manhood rules' and left ulwaluko before having healed properly. To get around this, those who continued taking medicine engaged caregiver pick-ups. Beyond suggesting that ulwaluko is a high-risk time for disengagement from biomedical treatment and care, this paper builds on a robust scholarship on the importance of locality and context in gender and health research. It documents the creativity, agency and resilience of initiates and their families as they subvert and re-signify health-related masculine norms.
{"title":"'If you are found taking medicine, you will be called names and considered less of a man': young men's engagement with HIV treatment and care during ulwaluko (traditional initiation and circumcision) in the Eastern Cape Province of South Africa.","authors":"L Gittings, R Hodes, C Colvin, S Mbula, P Kom","doi":"10.1080/17290376.2021.1894225","DOIUrl":"10.1080/17290376.2021.1894225","url":null,"abstract":"<p><p>This paper explores how HIV-positive <i>abakhwetha</i> (young male initiates) undergoing <i>ulwaluko</i> (traditional Xhosa initiation and circumcision) engage with HIV-related biomedical care and treatment. Health-focused life history narratives (<i>n</i> = 36), semi-structured interviews (<i>n</i> = 32) and analysis of health facility files (<i>n</i> = 41) with adolescent boys and young men (ages 13-24) living with HIV, and semi-structured interviews with traditional and biomedical health practitioners (<i>n</i> = 14) were conducted in 2017 and 2018. This research was part of the Mzantsi Wakho study, a longitudinal, mixed methods study of adolescents living with HIV (<i>n</i> = 1060). Findings demonstrate that ulwaluko rules of not engaging with biomedical care and treatment pose a challenge for initiates who are taking chronic medicine. Fears of inadvertent disclosure of their HIV-positive status collide with the pressure to successfully complete ulwaluko in order to be legitimised as men. In response to this dilemma, they engage a variety of strategies - including taking medicine in secret by hiding them, having a trusted person deliver them discretely, and stopping medicine-taking altogether. The three months following ulwaluko also pose a challenge in accessing biomedical treatment and care. In this time of high surveillance, <i>amakrwala</i> (new men) do not present at health facilities for fear of being thought to have had a botched circumcision or to have contravened 'manhood rules' and left ulwaluko before having healed properly. To get around this, those who continued taking medicine engaged caregiver pick-ups. Beyond suggesting that ulwaluko is a high-risk time for disengagement from biomedical treatment and care, this paper builds on a robust scholarship on the importance of locality and context in gender and health research. It documents the creativity, agency and resilience of initiates and their families as they subvert and re-signify health-related masculine norms.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2021.1894225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25595428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.1007/978-3-030-69819-5_5
I. Young
{"title":"Anticipating Policy, Orienting Services, Celebrating Provision: Reflecting on Scotland’s PrEP Journey","authors":"I. Young","doi":"10.1007/978-3-030-69819-5_5","DOIUrl":"https://doi.org/10.1007/978-3-030-69819-5_5","url":null,"abstract":"","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74292707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.1007/978-3-030-69819-5_21
M. Rosengarten
{"title":"An Unfinished History: A Story of Ongoing Events and Mutating HIV Problems","authors":"M. Rosengarten","doi":"10.1007/978-3-030-69819-5_21","DOIUrl":"https://doi.org/10.1007/978-3-030-69819-5_21","url":null,"abstract":"","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78531257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.1007/978-3-030-69819-5_19
S. Bernays, Allen Asiimwe, Edward Tumwesige, J. Seeley
{"title":"The Drive to Take an HIV Test in Rural Uganda: A Risk to Prevention for Young People?","authors":"S. Bernays, Allen Asiimwe, Edward Tumwesige, J. Seeley","doi":"10.1007/978-3-030-69819-5_19","DOIUrl":"https://doi.org/10.1007/978-3-030-69819-5_19","url":null,"abstract":"","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83481053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1007/978-3-030-69437-1
John H. Stadler
{"title":"Public Secrets and Private Sufferings in the South African AIDS Epidemic","authors":"John H. Stadler","doi":"10.1007/978-3-030-69437-1","DOIUrl":"https://doi.org/10.1007/978-3-030-69437-1","url":null,"abstract":"","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72745957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1007/978-3-030-69819-5_11
S. Paparini
{"title":"The Political Life of PrEP in England: An Ethnographic Account","authors":"S. Paparini","doi":"10.1007/978-3-030-69819-5_11","DOIUrl":"https://doi.org/10.1007/978-3-030-69819-5_11","url":null,"abstract":"","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81893995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1007/978-3-030-77048-8
C. Logie
{"title":"Working with Excluded Populations in HIV","authors":"C. Logie","doi":"10.1007/978-3-030-77048-8","DOIUrl":"https://doi.org/10.1007/978-3-030-77048-8","url":null,"abstract":"","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85152516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1007/978-3-030-69437-1_3
J. Stadler
{"title":"Truth and Harm: Dangerous Knowledge and Popular Epidemiologies of HIV","authors":"J. Stadler","doi":"10.1007/978-3-030-69437-1_3","DOIUrl":"https://doi.org/10.1007/978-3-030-69437-1_3","url":null,"abstract":"","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80528662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1007/978-3-030-69819-5_20
Lisa Lazarus, R. Lorway, S. Reza-Paul
{"title":"Entangled Bodies in a PrEP Demonstration Project","authors":"Lisa Lazarus, R. Lorway, S. Reza-Paul","doi":"10.1007/978-3-030-69819-5_20","DOIUrl":"https://doi.org/10.1007/978-3-030-69819-5_20","url":null,"abstract":"","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83129345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1007/978-3-030-69819-5_17
M. Skovdal, Phyllis Magoge-Mandizvidza, Rufurwokuda Maswera, Melinda Moyo, C. Nyamukapa, Ranjeeta Thomas, S. Gregson
{"title":"Stigma and Confidentiality Indiscretions: Intersecting Obstacles to the Delivery of Pre-Exposure Prophylaxis to Adolescent Girls and Young Women in East Zimbabwe","authors":"M. Skovdal, Phyllis Magoge-Mandizvidza, Rufurwokuda Maswera, Melinda Moyo, C. Nyamukapa, Ranjeeta Thomas, S. Gregson","doi":"10.1007/978-3-030-69819-5_17","DOIUrl":"https://doi.org/10.1007/978-3-030-69819-5_17","url":null,"abstract":"","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76476940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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