This study reports on the prevalence and circumstances of sexual violence in girls in Swaziland, and assesses the negative health consequences. It obtained data from a nationally representative sample of 1,244 girls and women aged 13–24 years from selected households in Swaziland between, with a two-stage cluster design. It found that 33.2% of respondents reported an incident of sexual violence before they reached 18 years of age, mostly by men or boys from the neighbourhood and boyfriends or husbands. Sexual violence was associated with reported lifetime experience of sexually transmitted diseases, pregnancy complications or miscarriages, unwanted pregnancy and depression. Knowledge of the high prevalence of sexual violence against girls in Swaziland and its associated serious health-related conditions and behaviours should be used to develop effective HIV and sexually transmitted diseases prevention strategies.
Values, Policies and Rights
This study considered whether female youths from communities with higher sexual violence were at greater risk of negative reproductive health outcomes. It used data from a 2003 nationally representative household survey of youths aged 15–24 years in South Africa. The key independent variable was whether a woman had ever been threatened or forced to have sex. The variable was aggregated to the community level to determine, with control for individual-level experience with violence, whether the community-level prevalence of violence was associated with HIV status and adolescent pregnancy among female, sexually experienced, never-married youths. The study found that youths from communities with greater sexual violence were significantly more likely to have experienced an adolescent pregnancy or to be HIV-positive than were youths from communities experiencing lower sexual violence. Youths from communities with greater community-level violence were also less likely to have used a condom at their last sexual encounter. Individual-level violence was only associated with condom non-use. Programmes to reduce adolescent pregnancies and HIV risk in South Africa and elsewhere in sub-Saharan Africa must address sexual violence as part of effective prevention strategies.
According to this article, it is common in Uganda to hear arguments that men rape women because women wear indecent clothing or invite men into their homes or drink late into the night with men or accept a ride home. Much less discussion focuses on the male’s responsibility. The author of the article examines an incident ofalleged rape reported in July 2011 in Uganda’s national media. The media and the public condemned the complainant as a reckless and oversexed con-woman, the author of this article notes. Ensuing debates and responses in the media since the story broke have implied that even as rape victims, women bear sole responsibility for protecting themselves. With regard to sexual violence against women in Uganda, the author concludes it is time men started seeing women as human beings and not sexualised objects.
Recent legislative developments in Africa have focused international attention on the legal status of lesbian, gay, bisexual and transgender (LGBT) people in the continent. Attempts by various African governments to revise or introduce new legislation on same-sex sexual conduct and marriage, and the response of the international community, has sparked extensive coverage of the associated political, social and cultural controversies. Away from the headlines are several African countries that have never criminalised same- sex sexual conduct and that are outliers to the apparent ‘trend’ of discriminatory legislation in the continent. One of these is Rwanda. Compared with the situation in neighbouring countries, state-sponsored homophobia appears negligible in Rwanda, and violent attacks are minimal. In the international arena, Rwanda has emerged as an unlikely champion for LGBT rights, and domestically has designated sexual orientation as a ‘private matter’. This study explores Rwanda’s relatively progressive position on LGBT-related issues and its implications for Rwandan civil society. It examines the strategies employed by national as well as international actors to advance LGBT rights and to address social and economic marginalisation. The study questions assumptions about the uniformity of the ‘African experience’ and seeks to enhance understanding of the nuance and diversity that exists both within and between countries on the continent.
In this study researchers investigated the reasons for poor implementation of Ghana’s legal abortion policy to better understand how providers shape and implement policy and how provider-level barriers might be overcome. They conducted in-depth interviews with 43 health professionals of different levels at three hospitals in Accra, as well as staff from smaller and private sector facilities, and analysed relevant policy and related documents. The findings show that health providers’ views shape provision of safe-abortion services. Providers experience conflicts between their religious and moral beliefs about the sanctity of (foetal) life and their duty to provide safe-abortion care. Obstetricians were more moderate while midwives were more driven by fundamental religious values condemning abortion as sinful. In addition to personal views and dilemmas, ‘social pressures’ (perceived views of others concerning abortion) and the actions of facility managers affected providers’ decision to (openly) provide abortion services. Providers tend to use personal discretion in deciding if and when to provide abortion services, and develop ‘coping mechanisms’ which impede implementation of abortion policy. The authors recommend that these findings be included in future evidence-based practice.
The starting point for this study is the principle that a rights-based approach should be used in framing public policy. The study therefore seeks to address the challenge of combining the ethical aspect of social rights with viable ways of strengthening citizens' entitlement to such rights in highly inequitable and relatively poor societies. It includes an analysis of various aspects of social protection systems (health care, social security and poverty reduction) and their potential to guarantee social rights in structurally heterogeneous societies.
This report presents findings from a qualitative and quantitative survey of present and future efforts by Brazil, Russia, India, China and South Africa to improve global health. It examines these roles within the broader context of international development and foreign assistance. BRICS foreign assistance spending is still relatively small when compared to overall spending by the US and Western European countries, but in recent years it has been increasing rapidly. Today, among the BRICS, China is by far the largest contributor to foreign assistance, and South Africa is estimated to be the smallest by a significant margin. Brazil and Russia prioritise health within their broader assistance agendas, while China, India and South Africa tend to focus on other issue areas. Though their health commitments vary significantly in both size and scope, each of the BRICS has contributed to global health through financing, capacity building, dramatically improved access to affordable medicines, and development of new tools and strategies. In this context, BRICS policymakers themselves have recognised their potential to have even greater global health impact when they committed in 2011 to ‘support and undertake inclusive global public health cooperation projects, including through South-South and triangular co-operation’.
Proposed reforms to Angola's Penal Code have divided opinion in the country about whether HIV-positive people who intentionally infect others with the virus should be punished.The law under discussion calls for a sentence of between three and 10 years in prison for those who knowingly pass on infectious diseases, including HIV. Some argue that the law will act as a deterrent; others say it will bring more problems than benefits.
This research report highlights the lack of priority given to tackling gender-based violence against women by the major international HIV funding organisations. The research found that the funding bodies continue to treat violence against women as a supplementary issue rather than as something integral to all aspects of their work on HIV. Funding for programmes which combat gender-based violence is a separate stream and these initiatives have not benefited from the increase in funding for HIV programmes in the last number of years. It is very difficult to track the exact amount of money the major funding bodies are devoting to these initiatives and difficult to hold them accountable on this issue. The report recommends that these institutions develop a clear policy framework that gives priority to violence against women and girls, and the link with HIV.
According to this article, recent studies suggest that women stuck in financially dependent relationships are at greatest risk for HIV infection in African countries. Women afraid of violence and abuse, stigmatisation, being labelled adulterous or being abandoned may be too frightened or intimidated to pursue testing and treatment. Also, the extra costs - US$2 or more - to travel to clinics are prohibitive. In effect, poor and unemployed women have been forced by men to forfeit their reproductive rights in issues pertaining to sex and protection from HIV. Women who are dependent on men for their livelihood are forced to have unprotected sex with their husbands or partners, even if they know they have cheated on them. Sex workers allege that married men especially from the middle class and the upper classes are willing to pay more for sex without a condom. The author concludes that silence on this topic in the media and the research community is a powerful ally in male domination of women economically and socially, and a driver in the spread of HIV.