Afr J AIDS Res. 2017 Sep;16(3):193-202. doi: 10.2989/16085906.2017.1349682.
Delivering culturally sensitive, sexual health education in western Kenya: a phenomenological case study.
While generic programmes have been created to raise sexual health awareness, these cannot always be applied to communities whose cultures and circumstances make them especially vulnerable to infection. Taking a phenomenological approach, this paper examines the circumstances of the Gusii people of Kisii, Kenya, and examines the specific challenges of providing sexual health education to the community as experienced by an ethnic Gusii woman, Joyce Ombasa. Joyce’s story reveals that the Gusii living in and around rural villages have several cultural characteristics that make them susceptible to HIV/AIDS and that render community health education problematic, especially if offered by a female educator of the same ethnicity. Women cannot teach men. Discussions of sex and condom use, and viewing the naked bodies of the opposite sex are taboo. Promiscuity is commonplace and there is a reluctance to use condoms and to undergo HIV testing. Female circumcision persists and there is a high rate of sexual violence, incest and intergenerational sexual intercourse. In addition, government policies and legislation threaten to exacerbate some of the sexually risky behaviours. Bringing HIV education and female empowerment to the rural Gusii requires a culturally sensitive approach, discarding sexual abstinence messages in favour of harm minimisation, including the promotion of condom use, regular HIV testing and the rejection of female circumcision and intergenerational sex. Trust needs to be built through tactics such as adopting a complex and fluid outsider identity and replacing formal sex education with training in income generating skills and casual discussions regarding condoms and sexual health.
The experiences of African women giving birth in Brisbane, Australia.
Murray L, Windsor C, Parker E, Tewfik O.
School of Public Health, Queensland University of Technology, Kelvin Grove, Brisbane, Australia. firstname.lastname@example.org
Our purpose in this research was to uncover first-person descriptions of the birth experiences of African refugee women in Brisbane, Australia, and to explore the common themes that emerged from their experiences. We conducted semistructured interviews with 10 African refugees who had given birth in Brisbane. Essences universal to childbirth such as pain, control, and experiences of caregivers featured prominently in participants’ descriptions of their experiences. Their experiences, however, were further overshadowed by issues such as language barriers, the refugee experience, female genital mutilation (FGM), and encounters with health services with limited cultural competence.
Female genital cutting starts to decline among women in Oromia, Ethiopia.
Rahlenbeck S, Mekonnen W, Melkamu Y.
Department of Public Health, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia. email@example.com
The study explored factors influencing attitudes towards the practice of female genital cutting (FGC) among women in Oromia region, Ethiopia. Representative data from 2221 women aged 15-49 years from the Ethiopia Demographic and Health Survey in 2005 were evaluated. Overall, 88.4% of women had undergone FGC. Prevalence significantly decreased with birth date, ranging from 95.1% in women aged 45-49 years to 75.8% in those aged 15-19 years. Overall, 63.7% of women favoured the discontinuation of FGC, while 29.7% favoured its continuation. Education was strongly correlated with a stance against the practice: while only 54.6% of illiterate women were against it, this figure was 95.5% among women who had completed secondary school. While the reported prevalence was similar among Christian (87.8%) and Islamic women (89.1%), 56.3% of Islamic women favoured discontinuation compared with 70.5% of Christian women. The higher that women scored on empowerment indices, the more they opposed the practice. In logistic regression models, educational level (P=0.001), personal FGC experience (P=0.001), religious affiliation (P=0.02) and self-empowerment were factors (P=0.01 and P=0.004) significantly associated with favouring discontinuation. Future efforts encouraging an end to FGC must include the illiterate population in the Oromia region and focus on improving the status of women.
Genitals and ethnicity: the politics of genital modifications
Johnsdotter S, Essen B
The discrepancy in societal attitudes toward female genital cosmetic surgery for European women and female genital cutting in primarily African girl children and women raises the following fundamental question. How can it be that extensive genitalmodifications, including reduction of labial and clitoral tissue, are considered acceptable and perfectly legal in many European countries, while those same societies have legislation making female genital cutting illegal, and the World Health Organization bans even the “pricking” of the female genitals? At present, tensions are obvious as regards the modification offemale genitalia, and current legislation and medical practice show inconsistencies in relation to women of different ethnic backgrounds. As regards the right to health, it is questionable both whether genital cosmetic surgery is always free of complications and whether female genital cutting always leads to them. Activists, national policymakers and other stakeholders, including cosmetic genital surgeons, need to be aware of these inconsistencies and find ways to resolve them and adopt non-discriminatory policies. This is not necessarily an issue of either permitting or banning all forms of genitalcutting, but about identifying a consistent and coherent stance in which key social values – including protection of children, bodily integrity, bodily autonomy, and equality before the law – are upheld.
Arch Sex Behav. 2009 Apr;38(2):178-85. Epub 2007 Oct 18.
The effects of female genital mutilation on the onset of sexual activity and marriage in Guinea.
Van Rossem R, Gage AJ. Vakgroep Sociologie, Universiteit Gent, Korte Meer 3-5, 9000, Ghent, Belgium. firstname.lastname@example.org
Female genital mutilation (FGM) is almost universal in Guinea and practiced by all ethnic and religious groups and social classes, although the prevalence of the various types of FGM varies by socioeconomic group. A common explanation for FGM practices is that they contribute to the social control over female sexuality and enhance the marriageability of women. These claims were tested using the 1999 Guinea Demographic and Health Survey (DHS) (N = 6753). Event history techniques were used to examine the effect of type of FGM on the age at first sex and the age at first marriage and logistic regression for the effect of FGM on premarital sex. The results showed that the type of FGM had a significant zero-order effect on the age at first marriage and the prevalence of premarital sex, but not on the age at first sex. However, these effects became non-significant once controls for age, religion, ethnicity, education, residence, and wealth were added to the model. Variations in sexual behavior, therefore, were unrelated to type of FGM, but reflected differences in the social characteristics of the participants.