Deconstructing the 'sugar daddy': A critical review of the constructions of men in intergenerational sexual relationships in South Africa

Since a recent Human Sciences Research Council (HSRC) prevalence study highlighted the relationship between intergenerational sex and risk of HIV infection, a range of studies in Southern Africa have documented the commonality of sexual relations between older men and young women. For the most part, these studies have focused on the material and status benefits for the young women, and on their vulnerability to HIV, violence and unwanted pregnancies, within the context of gender power inequalities to negotiate safe and equitable sex. In this Focus we review this literature and argue that there is a relative absence of focus on attempting to understand the older men's positions. We suggest the need for research that offers a more nuanced account of the complexities of men's performances of sexuality, which will move beyond depicting older men as inevitable perpetrators of unequal sexual relationships with younger women. In order to better understand and address the complexities of intergenerational sexual relationships, men's constructions of their sexuality and their gains and investments in such relationships require more critical analysis.IS

Taxi ‘sugar daddies’ and taxi queens: male taxi driver attitudes regarding transactional relationships in the Western Cape, South Africa

Media reports are emerging on the phenomenon of young girls who travel with older mini-bus taxi drivers, and who are thought to have sex with the drivers in exchange for gifts and money. The extent to which such relationships might facilitate unsafe sexual practices and increased risks for both the men and the young women, often referred to as taxi queens, remains an important question in the light of the current challenges of HIV/AIDS in sub-Saharan Africa. However, very little research has been undertaken on this issue, especially regarding the perceptions and experiences of taxi drivers. Thus this paper aims to provide some preliminary findings on taxi drivers’ attitudes and beliefs about taxi queens and their relationships with taxi drivers. A 22-item questionnaire was administered to 223 male taxi drivers in two regions in the Western Cape Province, South Africa. Taxi drivers in this study largely saw the relationship between taxi drivers and the young girls who ride with them as providing status for both the girls and drivers, and there seemed to be recognition of the transactional nature of the relationship between taxi drivers and taxi queens. The stigmatisation of young girls who ride with taxi drivers was evident. Drivers had knowledge and awareness of the risks of unsafe sex and supported condom use, although there appeared to be some uncertainty and confusion about the likelihood of HIV infection between drivers and girls. While taxi drivers recognised the role of alcohol in relationships with young girls, they seemed to deny that the abuse of drugs was common. The study highlights a number of key areas that need to be explored with men in the taxi industry, in order to address risk behaviours for both taxi drivers and the girls who ride with them

TRENDS, DRIVERS AND HEALTH RISKS OF ADOLESCENT FATHERHOOD IN SUB-SAHARAN AFRICA

The study examined the trends, determinants and health risks of adolescent fatherhood in countries where adolescent-girl pregnancy/motherhood are decried but with permissive male sexual latitude. Male-recode datasets of Demographic Health Survey (2000-2014) for Nigeria, Ethiopia and Zambia were used. The surveys were grouped into 3-Waves: Wave 1 (2000 and 2004); Wave 2 (2005 to 2009) and waves 3 (2010 to 2014). Ethiopia data consisted of 2000, 2005 and 2011 datasets; Nigeria‘s datasets included 2003, 2008 and 2013 while Zambia set of data featured 2002, 2007 and 2014. Wave-1 consists of 2000, 2002 and 2003 datasets; Wave-2 has 2005, 2007 and 2008 datasets while 2011, 2013 and 2014 data were used for Wave- 3. These files in each wave were grouped together and then combined into a single file. All data were weighted to ensure representation and analyses were split by countries and by waves to show the trends across .the years and for different countries. The study employed univariate, bivariate analysis and binary logistics that tested the log-odds of adolescent fatherhood with respect to selected sexual behaviour indices, individual and shared demographic variables. The results, among others, indicated that more than one out of every five adolescents has had two or more sexual partners. The likelihood of adolescent fatherhood is inversely related to condom use, but positively associated with increasing age at first cohabitation and higher number of multiple sexual partnerships (≥ 2) at odd-ratio of 1.673 and 1.769 in 2005/2009 and 2010/2014, respectively. Adolescents that have attained primary and tertiary education, and who are professionals and skilled labourers were 0.379, 0.313, 0.213 and 0.403 times (respectively) less likely to father a child as adolescent. The positive association between rural place of residence and adolescent fatherhood in the past shifted to urban residents in 2010/2014. The study concludes that enlightenment on the use of condom and testing for STIs/HIV and AIDS should be intensified. Increasing access to higher formal education including job opportunities is crucial to interventions towards boys’ vulnerability to fatherhood. The authors recommend support from policy-takers, governments and other stakeholders towards male adolescent access to higher education, skills acquisition, and campaigns against boys and girls cohabitations in the study locations and by extension sub-Saharan Africa in general

An unusually powerful mode of low-frequency sound interference due to defective hair bundles of the auditory outer hair cells

International audienceA detrimental perceptive consequence of damaged auditory sen-sory hair cells consists in a pronounced masking effect exerted by low-frequency sounds, thought to occur when auditory threshold elevation substantially exceeds 40 dB. Here, we identified the submembrane scaffold protein Nherf1 as a hair-bundle component of the differentiating outer hair cells (OHCs). Nherf1 −/− mice dis-played OHC hair-bundle shape anomalies in the mid and basal co-chlea, normally tuned to mid-and high-frequency tones, and mild (22–35 dB) hearing-threshold elevations restricted to midhigh sound frequencies. This mild decrease in hearing sensitivity was, however, discordant with almost nonresponding OHCs at the co-chlear base as assessed by distortion-product otoacoustic emissions and cochlear microphonic potentials. Moreover, unlike wild-type mice, responses of Nherf1 −/− mice to high-frequency (20–40 kHz

Nothing as Practical as a Good Theory? The Theoretical Basis of HIV Prevention Interventions for Young People in sub-Saharan Africa: a Systematic Review

This paper assesses the extent to which HIV prevention interventions for young people in sub-Saharan Africa are grounded in theory and if theory-based interventions are more effective. Three databases were searched for evaluation studies of HIV prevention interventions for youth. Additional articles were identified on websites of international organisations and through searching references. 34 interventions were included; 25 mentioned the use of theory. Social Cognitive Theory was most prominent (n = 13), followed by Health Belief Model (n = 7), and Theory of Reasoned Action/Planned Behaviour (n = 6). These cognitive behavioural theories assume that cognitions drive sexual behaviour. Reporting on choice and use of theory was low. Only three articles provided information about why a particular theory was selected. Interventions used theory to inform content (n = 13), for evaluation purposes (n = 4) or both (n = 7). No patterns of differential effectiveness could be detected between studies using and not using theory, or according to whether a theory informed content, and/or evaluation. We discuss characteristics of the theories that might account for the limited effectiveness observed, including overreliance on cognitions that likely vary according to type of sexual behaviour and other personal factors, inadequately address interpersonal factors, and failure to account for contextual factors

Partner age differences and associated sexual risk behaviours among adolescent girls and young women in a cash transfer programme for schooling in Malawi

Background: Age disparities in sexual relationships have been proposed as a key risk factor for HIV transmission in Sub-Saharan Africa, but evidence remains inconclusive. The SIHR study, a cluster randomised trial of a cash transfer programme in Malawi, found that young women in the intervention groups were less likely to have had a sexual partner aged 25 or older, and less likely to test positive for HIV and HSV-2 at follow-up compared to control groups. We examined the hypotheses that girls in the intervention groups had smaller age differences than control groups and that large age differences were associated with relationship-level HIV transmission risk factors: inconsistent condom use, sex frequency, and relationship duration. Methods: We conducted an analysis of schoolgirls in the Schooling, Income, and Health Risk (SIHR) study aged 13-22 at baseline (n = 2907). We investigated the effects of study arm, trial stage and participant age on age differences in sexual relationships using a linear mixed-effects model. Cumulative-link mixed-effects models were used to estimate the effect of relationship age difference on condom use and sex frequency, and a Cox proportional hazard model was used to estimate the effect of relationship age difference on relationship duration. We controlled for the girl's age, number of partners, study group and study round. Results: Girls receiving cash transfers, on average, had smaller age differences in relationships compared to controls, though the estimated difference was not statistically significant (-0.43 years; 95% CI: -1.03, 0.17). The older the participant was, the smaller her age differences (-0.67 per 4-year increase in age; 95% CI: -0.99, - 0.35). Among controls, after the cash transfers had ended the average age difference was 0.82 years larger than during the intervention (95% CI: 0.43, 1.21), suggesting a possible indirect effect of the study on behaviour in the community as a whole. Across treatment groups, larger age differences in relationships were associated with lower levels of condom use, more frequent sex, and longer relationship durations. Conclusions: Cash-transfer programmes may prevent HIV transmission in part by encouraging young women to form age-similar relationships, which are characterised by increased condom use and reduced sex frequency. The benefits of these programmes may extend to those who are not directly receiving the cash

Severe hearing loss and outer hair cell death in homozygous Foxo3 knockout mice after moderate noise exposure

Noise induced hearing loss (NIHL) is a disease that affects millions of Americans. Identifying genetic pathways that influence recovery from noise exposure is an important step forward in understanding NIHL. The transcription factor Foxo3 integrates the cellular response to oxidative stress and plays a role in extending lifespan in many organisms, including humans. Here we show that Foxo3 is required for auditory function after noise exposure in a mouse model system, measured by ABR. Absent Foxo3, outer hair cells are lost throughout the middle and higher frequencies. SEM reveals persistent damage to some surviving outer hair cell stereocilia. However, DPOAE analysis reveals that some function is preserved in low frequency outer hair cells, despite concomitant profound hearing loss. Inner hair cells, auditory synapses and spiral ganglion neurons are all present after noise exposure in the Foxo3KO/KO fourteen days post noise (DPN). We also report anti-Foxo3 immunofluorescence in adult human outer hair cells. Taken together, these data implicate Foxo3 and its transcriptional targets in outer hair cell survival after noise damage. An additional role for Foxo3 in preserving hearing is likely, as low frequency auditory function is absent in noise exposed Foxo3KO/KOs even though all cells and structures are present

Unloosing the Gordian knot of peroxisome formation

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordPeroxisome biogenesis is governed by molecular machineries, which are either unique to peroxisomes or are partially shared with mitochondria. As peroxisomes have important protective functions in the cell, modulation of their number is important for human health and disease. Significant progress has been made towards our understanding of the mechanisms of peroxisome formation, revealing a remarkable plasticity of the peroxisome biogenesis pathway. Here we discuss most recent findings with particular focus on peroxisome formation in mammalian cells.This work was supported by the Biotechnology and Biological Sciences Research Council (BB/K006231/1, BB/N01541X/1 to M.S.)

A review of trials investigating efavirenz-induced neuropsychiatric side effects and the implications

Background: Efavirenz is part of the first-line treatment for HIV patients including South Africa with approximately 50% experiencing neuropsychiatric side effects. Objective: Systematic review of papers reporting neuropsychiatric side effects with efavirenz published between January 2001 and December 2014 to provide guidance. Results: 13 articles were reviewed. Patient ages ranged between 37 to 41 years, with a high percentage males. Scales used to measure incidence and severity of side effects were varied; with disease severity or stage not reported. Patients with psychoses were excluded. Most commonly reported side effects were a reduction in sleep quality, depression, dizziness and anxiety. These were generally mild and not warranting discontinuation of efavirenz. Conclusion: Difficult to directly compare the studies. Standardised methods need to be introduced and all patient groups represented including the elderly, children, patients with active symptomatic illness and more women especially among the African population