3 research outputs found
Socio-behaviour challenges to phase III HIV vaccine trials in sub-Saharan Africa
Background: A number of countries in sub-Saharan Africa are preparing for HIV vaccine efficacy trials. Social and behavioural factors related to HIV transmission require examination in each setting where these trials are considered. As part of this, several countries have also recently begun preparatory research investigating relevant social and behavioural issues. There is a need for a review of the literature to help focus such research efforts in Sub-Saharan Africa.
Objective: To examine key social and behavioural issues that may impact on the conduct of HIV vaccine efficacy trials in sub-Saharan Africa.
Design: Literature review
Methods: Major databases (PubMed, PsychInfo, EBSCOhost, and AIDSline) were searched for literature that discussed social and behavioural issues related to HIV vaccine trials. Three areas are highlighted as being particularly significant for HIV vaccine research: (1) willingness to participate in future HIV vaccine efficacy trials, (2) retention of participants in studies, and (3) sexual risk reporting during trials. For each of these topics, major findings from both developed and developing countries are described and avenues for further research are discussed.
Results: There are few data from Sub-Saharan Africa regarding willingness to participate in HIV vaccine trials. Data on participant retention rates varies widely, and maintaining large cohorts of individuals within Phase III trials presents an important challenge. In addition, the possible impact of trial participation on sexual disinhibition, and response bias on sexual risk-reporting remain as issues for HIV vaccine trials in African contexts.
Conclusions: Social and behavioural research forms an important part of preparations for HIV vaccine efficacy trials, and there is a clear need for more research of this type in Sub-Saharan Africa. Innovative approaches are required to address issues such as willingness to participate in vaccine research, participant retention during efficacy trials, and the accurate reporting by participants of sexual risk behaviours
Postpartum mood disorders : a feminist critique with specific reference to postnatal depression
Thesis (MA)--University of Stellenbosch, 2002ENGLISH ABSTRACT: This review examines the medical model's conceptualisation of postnatal depression
(pND) from a feminist perspective. The arguments are fourfold: Firstly, it argues that
the fundamental problem underlying the concept of PND is its conception as existing
on a continuum with psychosis at the most severe end and maternity blues at the least
severe end. The link with psychosis implies that it is potentially pathological requiring
medical and psychiatric intervention. On the other hand its link with maternity blues
gives scientific credence to continued research on emotional sequelae of reproduction
that are below the psychiatric threshold of urgency. Secondly, the medical model's
construction of PND implies that women are predisposed to mental illness because of
their ability to bear children and thus pathologises normal experiences of childbirth.
Thirdly, the medical model's preoccupation with classification and categorisation has
become little more than an exercise in labeling that has removed women from their
own experiences. Focusing on birth as an activity that is separate from the rest of
pregnancy objectify women and ignores the socio-political context within which they
give birth and care for their infants. Fourthly, it is argued that a different way of
researching postpartum mood disorders is necessary to overcome a reductionistic and
pathological model of childbirth. This is important if healthcare delivery hopes to
provide adequate treatment for all women in the postnatal period. Especially in South
Africa, where the dominant culture has for many years defined the experiences of the
'other', it is important to generate research that should include the 'voices' of the
'other' to prevent hegemonic practice from assuming an expert understanding of
PND. This review does not deny the contributions from the medical establishment,
but argues that a critique of its underlying assumptions is important to prevent women
from being further marginalised by ignoring the socio-political context in which their
lives are embedded. The implications for research within South Africa are also
addressed.AFRIKAANSE OPSOMMING: Hierdie oorsig ondersoek die mediese model se konseptualisering van postnatale
depressie vanuit 'n feministiese perspektief. Die argument is vierledig: Eerstens blyk
die konseptualisering van postnatale depressie, naamlik dat dit op 'n kontinuum
bestaan, met psigose aan die mees disfunksionele kant en 'maternity blues' aan die
minder ernstige kant, 'n fundamentele, onderliggende probleem te wees. Die verband
met psigose impliseer dat postnatale depressie potensieel patologies is en mediese en
psigiatriese insette benodig. Die verband met 'maternity blues' aan die ander kant,
bied wetenskaplike begronding vir volgehoue navorsing op die gebied van emosionele
aspekte van kindergeboorte wat nie van psigiatriese belang is nie. Tweedens impliseer
die mediese model se konstruksie van postnatale depressie dat vroue 'n predisposisie
tot geestessiektes het bloot deur die feit dat hulle die vermoë het om kinders voort te
bring. Sodoende word patologiese kenmerke gekoppel aan normale ervarings van
kindergeboorte. Derdens het die mediese model se beheptheid met klassifikasie en
kategorisering verval in etikettering wat vroue van hul eie ervarings vervreem. Deur
te fokus op geboorte as 'n aktiwiteit wat verwyder is van die res van swangerskap
maak van vroue objekte wat verwyderd is van die sosio-politieke konteks waarbinne
hulle geboorte skenk en sorg vir hul babas. Vierdens word dit beredeneer dat 'n nuwe
benadering tot navorsing oor postpartum gemoedsteurings daar gestel behoort te word
om 'n reduksionistiese en patologiese model van kindergeboorte te voorkom. Dit is
belangrik as gesondheidsorgdienste hoop om toereikende behandeling te bied vir alle
vroue in die postnatale periode. Veral in Suid-Afrika, waar 'n dominante kultuurgroep
vir so lank die ervarings van ander omskryf het, is dit belangrik om navorsing voort te
bring wat die 'stemme' van die 'ander' insluit om sodoende te verhoed dat die
heersende praktykvoeringe van die dag 'n eensydige deskundige-verstaan van
postnatale depressie voorveronderstel. Hierdie oorsig ontken nie die bydraes van die
mediese model nie, maar beredeneer die feit dat 'n kritiese beskouing van die
onderliggende aannames belangrik is om sodoende te verhoed dat vroue verder
gemarginaliseer word deurdat die sosio-politieke konteks waarin hul lewens gegrond
is, buite rekening gelaat word. Die implikasies vir navorsing binne 'n Suid-Afrikaanse
konteks word dus ook ondersoek
Socio-behaviour challenges to phase III HIV vaccine trials in Sub-Saharan Africa
BACKGROUND: A number of countries in sub-Saharan Africa are preparing for HIV vaccine efficacy trials. Social and behavioural factors related to HIV transmission require examination in each setting where these trials are considered. As part of this, several countries have also recently begun preparatory research investigating relevant social and behavioural issues. There is a need for a review of the literature to help focus such research efforts in Sub-Saharan Africa. OBJECTIVE: To examine key social and behavioural issues that may impact on the conduct of HIV vaccine efficacy trials in sub-Saharan Africa. DESIGN: Literature review METHODS: Major databases (PubMed, PsychInfo, EBSCOhost, and AIDSline) were searched for literature that discussed social and behavioural issues related to HIV vaccine trials. Three areas are highlighted as being particularly significant for HIV vaccine research: (1) willingness to participate in future HIV vaccine efficacy trials, (2) retention of participants in studies, and (3) sexual risk reporting during trials. For each of these topics, major findings from both developed and developing countries are described and avenues for further research are discussed. RESULTS: There are few data from Sub-Saharan Africa regarding willingness to participate in HIV vaccine trials. Data on participant retention rates varies widely, and maintaining large cohorts of individuals within Phase III trials presents an important challenge. In addition, the possible impact of trial participation on sexual disinhibition, and response bias on sexual risk-reporting remain as issues for HIV vaccine trials in African contexts. CONCLUSIONS: Social and behavioural research forms an important part of preparations for HIV vaccine efficacy trials, and there is a clear need for more research of this type in Sub-Saharan Africa. Innovative approaches are required to address issues such as willingness to participate in vaccine research, participant retention during efficacy trials, and the accurate reporting by participants of sexual risk behaviours