'Ukuba yindoda kwelixesha' ('To be a man in these times'): Fatherhood, marginality and forms of life among young men in Gugulethu, Cape Town

My thesis examines how young, marginalised men in Gugulethu, a poor township in Cape Town, formulate their conceptions of fatherhood and fathering, and understand their roles and involvement with their children. Far from being a simple biological function, the nature of fatherhood among these young men is shaped by social, economic, political and historical conditions and by the moral standards that surround their daily existence. The men who are the focus of this study were selected on the basis of findings from an earlier study of infants born to HIV+ women. That study demonstrated the erratic nature of fatherhood in the picture of infant life. I traced some of the fathers of those infants, and developed a snowball sample. The young men in this study live a life of social displacement and alienation. They do not have access to gainful employment; many have been imprisoned; all use drugs; few are in stable relationships; few have independent households despite having fathered children. I show in the thesis that while the relationships I describe are unique in many ways, core cultural tropes, such as the significance of children, the role of marriage, the social place of initiation, among others, play through them, albeit in ways that undermine their potential. Despite a rhetoric which exhorts men to 'be responsible', most of the challenges that confront young African men today can be traced to legacies of colonialism, urbanisation, and apartheid which destroyed clans and families' ability to retain both the specific practices and the meaning and function of traditional practices and the material means by which families could be maintained. I note in particular the absence of father figures in these young men's lives. These findings lead me to explore the role of men in attachment. While many men have been able to create positive self-identities and roles, those with whom I worked have struggled to attain socially sanctioned ideals of masculinity, work, parenting and partnering. They inhabit forms of masculinity that rest on danger, even as they desire social approval. Drawing from Raewyn Connell's idea of hegemonic masculinity, I show how these masculinities are not predetermined but constructed within a specific social and historical context

The intermediary function of NGOs in HIV/AIDS responses : a case study of the Lady Frere district of the Eastern Cape

The HIV/AIDS epidemic has serious effects on society. It has been described as the biggest threat to the development of South Africa, with severe economic, social and human impact. In the Lady Frere District in the Eastern Cape Province, like in many other areas that are greatly affected by the epidemic in this country, young people are considered by the local Department of Health to be a particularly vulnerable group due to various predisposing biological, social, cultural, and economical factors. Despite the efforts that have been made to educate and encourage prevention, especially by the local Masibambane Non-governmental Organisation (MNGO) to inform these communities about the dangers of the epidemic, people's behaviour have been slow to change and the disease continues to spread. This research is conducted against the escalating HIV / AIDS pandemic in the Lady Frere District. The fundamental aim of this project is to examine the intermediary function of the MNGO in HIV/AIDS responses. The study seeks to evaluate the way in which this local NGO operates on the ground in contributing to a community's response to the HIV/AIDS pandemic. In other words, the thesis tries to indicate how this local NGO, in dealing with the HIV/AIDS issue, interfaces with the community and related stakeholders. It examines how young people in the Lady Frere District perceive HIV/AIDS. A literature review demonstrates that the specific aims and objectives of this project represent a fairly new area of research in South Africa. I propose in the thesis that a simple act of joining and being regularly involved in a community organisation such as the MNGO will have significant impact on individuals' health and well-being. The thesis is crying for a need to restore the notion of "ubuntu" (meaning humanity) which is fundamentally based on social capital to assist these communities to rebuild trust which is essential in people living with HIV/AIDS. Based on my assessment it seems that intermediary NGOs, like the traditional NGOs and the private sector, will have little impact in terms of changing the conditions of the poor and the marginalised people. This is because in practice, like the conventional NGOs, intermediary NGOs serve the interests of donors and national governments or those who give them financial support to continue existing

Community context and individual factors associated with arrests among young men in a South African township.

BackgroundIn high-income countries, individual- and community-level factors are associated with increased contact with the criminal justice system. However, little is known about how these factors contribute to the risk of arrest in South Africa, which has one of the highest rates of arrests globally. We examine both individual- and community-level factors associated with arrests among young men living in the townships of Cape Town.MethodsData were collected from a stratified community sample of 906 young men aged 18-29 years old living in 18 township neighborhoods. Communities with high and low rates of arrest were identified. Logistic regression models were used to assess which individual-level (such as substance use and mental health status) and community-level (such as infrastructure and presence of bars and gangs) factors predict arrests.ResultsSignificant predictors of arrests were substance use, gang activity, being older, more stressed, and less educated. Living in communities with better infrastructure and in more recently established communities populated by recent immigrants was associated with having a history of arrests.ConclusionsWhen considering both individual- and community-level factors, substance use and gang violence are the strongest predictors of arrests among young men in South Africa. Unexpectedly, communities with better infrastructure have higher arrest rates. Community programs are needed to combat substance use and gang activity as a pathway out of risk among South African young men.Trial registrationClinicalTrials.gov registration #NCT02358226, registered Nov 24, 2014

Criterion validity of self-reports of alcohol, cannabis, and methamphetamine use among young men in Cape Town, South Africa.

Valid measurement of substance use is necessary to evaluate preventive and treatment interventions. Self-report is fast and inexpensive, but its accuracy can be hampered by social desirability bias and imperfect recall. We examined the agreement between self-report of recent use and rapid diagnostic tests for three substances (alcohol, cannabis, and methamphetamine) among 904 young men living in Cape Town, South Africa. Rapid diagnostic tests detected the respective substances in 32%, 52%, and 22% of men. Among those who tested positive, 61% (95% CI [56%, 66%]), 70% ([67%, 74%]), and 48% ([42%, 54%]) admitted use. Men were moderately more willing to admit use of cannabis than alcohol (log OR 0.42) or admit use of alcohol than methamphetamine (log OR 0.53). Our findings show that self-report has reasonable criterion validity in this population, but criterion validity can vary substantially depending on the substance

Gender-specific HIV and substance abuse prevention strategies for South African men: study protocol for a randomized controlled trial.

BackgroundYoung men in South Africa face concurrent epidemics of HIV, drug and alcohol abuse, and unemployment. Standard HIV prevention programs, located in healthcare settings and/or using counseling models, fail to engage men. Soccer and vocational training are examined as contexts to deliver male-specific, HIV prevention programs.MethodsYoung men (n = 1200) are randomly assigned by neighborhood to one of three conditions: 1) soccer league (n = 400; eight neighborhoods); 2) soccer league plus vocational training (n = 400; eight neighborhoods); or 3) a control condition (n = 400; eight neighborhoods). Soccer practices and games occur three times per week and vocational training is delivered by Silulo Ulutho Technologies and Zenzele Training and Development. At baseline, 6 months, 12 months, and 24 months, the relative efficacy of these strategies to increase the number of significant outcomes (NSO) among 15 outcomes which occur (1) or not (0) are summed and compared using binomial logistic regressions. The summary primary outcome reflects recent HIV testing, substance abuse, employment, sexual risk, violence, arrests, and mental health status.DiscussionThe failure of men to utilize HIV prevention programs highlights the need for gender-specific intervention strategies. However, men in groups can provoke and encourage greater risk-taking among themselves. The current protocol evaluates a male-specific strategy to influence men's risk for HIV, as well as to improve their ability to contribute to family income and daily routines. Both interventions are expected to significantly benefit men compared with the control condition.Trial registrationClinicalTrials.gov registration, NCT02358226 . Registered 24 November 2014

Gender-specific HIV and substance abuse prevention strategies for South African men : study protocol for a randomized controlled trial

CITATION: Rotheram-Borus, M. J., et al. 2018. Gender-specific HIV and substance abuse prevention strategies for South African men : study protocol for a randomized controlled trial. Trials, 19:417, doi:10.1186/s13063-018-2804-3.The original publication is available at https://trialsjournal.biomedcentral.comBackground: Young men in South Africa face concurrent epidemics of HIV, drug and alcohol abuse, and unemployment. Standard HIV prevention programs, located in healthcare settings and/or using counseling models, fail to engage men. Soccer and vocational training are examined as contexts to deliver male-specific, HIV prevention programs. Methods: Young men (n = 1200) are randomly assigned by neighborhood to one of three conditions: 1) soccer league (n = 400; eight neighborhoods); 2) soccer league plus vocational training (n = 400; eight neighborhoods); or 3) a control condition (n = 400; eight neighborhoods). Soccer practices and games occur three times per week and vocational training is delivered by Silulo Ulutho Technologies and Zenzele Training and Development. At baseline, 6 months, 12 months, and 24 months, the relative efficacy of these strategies to increase the number of significant outcomes (NSO) among 15 outcomes which occur (1) or not (0) are summed and compared using binomial logistic regressions. The summary primary outcome reflects recent HIV testing, substance abuse, employment, sexual risk, violence, arrests, and mental health status. Discussion: The failure of men to utilize HIV prevention programs highlights the need for gender-specific intervention strategies. However, men in groups can provoke and encourage greater risk-taking among themselves. The current protocol evaluates a male-specific strategy to influence men’s risk for HIV, as well as to improve their ability to contribute to family income and daily routines. Both interventions are expected to significantly benefit men compared with the control condition.https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-018-2804-3Publisher's versio

Gender-specific HIV and substance abuse prevention strategies for South African men: study protocol for a randomized controlled trial.

BackgroundYoung men in South Africa face concurrent epidemics of HIV, drug and alcohol abuse, and unemployment. Standard HIV prevention programs, located in healthcare settings and/or using counseling models, fail to engage men. Soccer and vocational training are examined as contexts to deliver male-specific, HIV prevention programs.MethodsYoung men (n = 1200) are randomly assigned by neighborhood to one of three conditions: 1) soccer league (n = 400; eight neighborhoods); 2) soccer league plus vocational training (n = 400; eight neighborhoods); or 3) a control condition (n = 400; eight neighborhoods). Soccer practices and games occur three times per week and vocational training is delivered by Silulo Ulutho Technologies and Zenzele Training and Development. At baseline, 6 months, 12 months, and 24 months, the relative efficacy of these strategies to increase the number of significant outcomes (NSO) among 15 outcomes which occur (1) or not (0) are summed and compared using binomial logistic regressions. The summary primary outcome reflects recent HIV testing, substance abuse, employment, sexual risk, violence, arrests, and mental health status.DiscussionThe failure of men to utilize HIV prevention programs highlights the need for gender-specific intervention strategies. However, men in groups can provoke and encourage greater risk-taking among themselves. The current protocol evaluates a male-specific strategy to influence men's risk for HIV, as well as to improve their ability to contribute to family income and daily routines. Both interventions are expected to significantly benefit men compared with the control condition.Trial registrationClinicalTrials.gov registration, NCT02358226 . Registered 24 November 2014

Community context and individual factors associated with arrests among young men in a South African township

CITATION: Christodoulou, J., et al. 2019. Community context and individual factors associated with arrests among young men in a South African township. PLoS ONE, 14(1):e0209073, doi:10.1371/journal.pone.0209073.The original publication is available at https://journals.plos.org/plosone/Background: In high-income countries, individual- and community-level factors are associated with increased contact with the criminal justice system. However, little is known about how these factors contribute to the risk of arrest in South Africa, which has one of the highest rates of arrests globally. We examine both individual- and community-level factors associated with arrests among young men living in the townships of Cape Town. Methods: Data were collected from a stratified community sample of 906 young men aged 18–29 years old living in 18 township neighborhoods. Communities with high and low rates of arrest were identified. Logistic regression models were used to assess which individual-level (such as substance use and mental health status) and community-level (such as infrastructure and presence of bars and gangs) factors predict arrests. Results: Significant predictors of arrests were substance use, gang activity, being older, more stressed, and less educated. Living in communities with better infrastructure and in more recently established communities populated by recent immigrants was associated with having a history of arrests. Conclusions: When considering both individual- and community-level factors, substance use and gang violence are the strongest predictors of arrests among young men in South Africa. Unexpectedly, communities with better infrastructure have higher arrest rates. Community programs are needed to combat substance use and gang activity as a pathway out of risk among South African young men.https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0209073Publisher's versio

Community context and individual factors associated with arrests among young men in a South African township.

BackgroundIn high-income countries, individual- and community-level factors are associated with increased contact with the criminal justice system. However, little is known about how these factors contribute to the risk of arrest in South Africa, which has one of the highest rates of arrests globally. We examine both individual- and community-level factors associated with arrests among young men living in the townships of Cape Town.MethodsData were collected from a stratified community sample of 906 young men aged 18-29 years old living in 18 township neighborhoods. Communities with high and low rates of arrest were identified. Logistic regression models were used to assess which individual-level (such as substance use and mental health status) and community-level (such as infrastructure and presence of bars and gangs) factors predict arrests.ResultsSignificant predictors of arrests were substance use, gang activity, being older, more stressed, and less educated. Living in communities with better infrastructure and in more recently established communities populated by recent immigrants was associated with having a history of arrests.ConclusionsWhen considering both individual- and community-level factors, substance use and gang violence are the strongest predictors of arrests among young men in South Africa. Unexpectedly, communities with better infrastructure have higher arrest rates. Community programs are needed to combat substance use and gang activity as a pathway out of risk among South African young men.Trial registrationClinicalTrials.gov registration #NCT02358226, registered Nov 24, 2014