Narratives of transactional sex on a university campus

Given the imperatives of HIV and gender equality, South African researchers have foregrounded transactional sex as a common practice that contributes to unsafe and inequitable sexual practices. This paper presents findings from a qualitative study with a group of students at a South African university, drawing on narratives that speak to the dynamics of reportedly widespread transactional sex on campus. Since many of these relationships are inscribed within unequal power dynamics across the urban-rural and local-‘foreigner’ divides, and across differences of wealth, age and status that intersect with gender in multiple, complex ways, it is argued that these may be exacerbating unsafe and coercive sexual practices among this group of young people. The paper further argues for a critical, reflexive position on transactional sex, pointing to the way in which participants articulate a binaristic response to transactional relationships that simultaneously serves to reproduce a silencing of a discourse on female sexual desires, alongside a simplistic and deterministic picture of masculinity underpinned by the male sexual drive discourse.Web of Scienc

Coercive sexual practices and gender-based violence on a university campus

When a 22-year-old University of the Western Cape (UWC) female student was stabbed to death by her boyfriend (another student) in her room in the university residence on 25 August 2008, the entire campus was left reeling. Bringing the stark reality of gender-based violence (GBV) so close to home, the tragedy was a powerful reminder of the limits of more than a decade of legislative change, concerted activism, education, consciousness-raising and knowledge production aimed at challenging gender-based power inequalities. This article reflects on the relationships between violence, coercion and heterosexuality on a specific campus by drawing on data generated by a qualitative study at UWC that explored student constructions of heterosexual relationships in the light of national imperatives around HIV/AIDS and GBV. Involving 20 focus groups with male and female students over the course of 2008 and 2009, the study revealed that unequal and coercive practices are common in heterosexual relationships on this campus. The study underlined the necessity of understanding these relationships as produced through power inequalities inherent in normative gender roles, and also drew attention to ways in which gender power inequalities intersect in complex and sometimes contradictory ways with other forms of inequality on campus – in particular, class, age and geographical origin. While both men and women students appeared to experience pressure (linked to peer acceptance and material gain) to engage in (hetero)sexual relationships, it seems that first-year female students from poor, rural backgrounds are particularly vulnerable to the transactional and unequal relationships associated with coercive and sometimes even violent sexual practices. Alcohol and substance abuse also appear to be linked to unsafe and abusive sexual practices, and again it is young female students new to campus life who are most vulnerable. This article draws on the data from this larger study to explore experiences and understandings of the most vulnerable – young female students – in unpacking connections between (hetero)sexuality and violent and coercive sex in an educational institution.International Bibliography of Social Science

Trends in HIV risk behaviour of incoming first-year students at a South African university: 2007–2012

The aim of the research on which this article is based was to understand the behavioural changes of the target student populationover time to ensure that future prevention programmes are more effective in changing behaviour. This study reports on quantitativedata collected at the University of the Western Cape over a six-year period between 2007 and 2012. All the students attending theorientation sessions and who were willing to complete the anonymous questionnaire during each of the six years were included inthe study. Data were collected on the following aspects and subjects: sexual activity, age at first sexual encounter, number of sexualpartners, condom usage, knowledge of how to use a condom, perceived ability to discuss condoms usage with a sexual partner,perception of HIV risk and HIV testing as well as the intention to be tested. Reported alcohol and drug usage, as well asdepressive symptoms, was also recorded. The percentage of students reporting having had vaginal sex prior to enteringuniversity increased from 44% in 2007 to 51% in 2012 but, alarmingly, the consistent use of condoms decreased from 60% in2007 to 51% in 2012. The average onset age of about 15.6 years for males and 16.7 years for females for vaginal sex did notchange over the six-year period. No difference in smoking patterns or drug use was seen over the period of the study, but thenumber of entering students who indicated that they consumed alcohol increased significantly from 48% in 2007 to 58% in2012

Understanding leisure-related program effects by using process data in the HealthWise South Africa Project

As the push for evidence-based programming gathers momentum, many human services programs and interventions are under increased scrutiny to justify their effectiveness across different conditions and populations. Government agencies and the public want to be assured that their resources are being put to good use on programs that are effective and efficient. Thus, programs are increasingly based on theory and evaluated through randomized control trials using longitudinal data. Despite this progress, hypothesized outcomes are often not detected and/or their effect sizes are small. Moreover, findings may go against intuition or “gut feelings” on the part of project staff. Given the need to understand how program implementation issues relate to outcomes, this study focuses on whether process measures that focus on program implementation and fidelity can shed light on associated outcomes. In particular, we linked the process evaluation of the HealthWise motivation lesson with outcomes across four waves of data collection. We hypothesized that HealthWise would increase learners’ intrinsic and identified forms of motivation, and decrease amotivation and extrinsic motivation. We did not hypothesize a direction of effects on introjected motivation due to its conceptual ambiguity. Data came from youth in four intervention schools (n = 902, 41.1%) and five control schools (n = 1291, 58.9%) who were participating in a multi-cohort, longitudinal study. The schools were in a township near Cape Town, South Africa. For each cohort, baseline data are collected on learners as they begin grade 8. We currently have four waves of data collected on the first cohort, which is the focus of this paper. The mean age of the sample at wave 3 was 15.0 years (SD = .86) and 51% of students were female. Results suggested that there was evidence of an overall program effect of the curriculum on amotivation regardless of fidelity of implementation. Compared to the control schools, all treatment school learners reported lower levels of amotivation in wave 4 compared to wave 3, as hypothesized. Using process evaluation data to monitor implementation fi147 delity, however, we also conclude that the school with better trained teachers who also reported higher levels of program fidelity had better outcomes than the other schools. We discuss the implications of linking process data with outcome data and the associated methodological challenges in linking these data.Web of Scienc

Linking Life Skills and Norms with adolescent substance use and delinquency in South Africa

We examined factors targeted in two popular prevention approaches with adolescent drug use and delinquency in South Africa. We hypothesized adolescent life skills to be inversely related, and perceived norms to be directly related to later drug use and delinquency. Multiple regression and a relative weights approach were conducted for each outcome using a sample of 714 South African adolescents ages 15 to 19 years (M = 15.8 years, 57% female). Perceived norms predicted gateway drug use. Conflict resolution skills (inversely) and perceived peer acceptability (directly) predicted harder drug use and delinquency. The “culture of violence” within some South African schools may make conflict resolution skills more salient for preventing harder drug use and delinquency.Department of HE and Training approved lis

Translational research in South Africa: evaluating implementation quality using a factorial design

Background: HealthWise South Africa: Life Skills for Adolescents (HW) is an evidence- based substance use and sexual risk prevention program that emphasizes the positive use of leisure time. Since 2000, this program has evolved from pilot testing through an efficacy trial involving over 7,000 youth in the Cape Town area. Beginning in 2011, through 2015, we are undertaking a new study that expands HW to all schools in the Metro South Education District. Objective: This paper describes a research study designed in partnership with our South African collaborators that examines three factors hypothesized to affect the quality and fidelity of HW implementation: enhanced teacher training; teacher support, structure and supervision; and enhanced school environment. Methods: Teachers and students from 56 schools in the Cape Town area will participate in this study. Teacher observations are the primary means of collecting data on factors affecting implementation quality. These factors address the practical concerns of teachers and schools related to likelihood of use and cost-effectiveness, and are hypothesized to be "active ingredients" related to high-quality program implementation in real-world settings. An innovative factorial experimental design was chosen to enable estimation of the individual effect of each of the three factors. Results: Because this paper describes the conceptualization of our study, results are not yet available. Conclusions: The results of this study may have both substantive and methodological implications for advancing Type 2 translational research

Predicting substance use behavior among South African adolescents: The role of leisure experiences across time

Using seven waves of data, collected twice a year from the 8th through the 11th grades in a low-resource community in Cape Town, South Africa, we aimed to describe the developmental trends in three specific leisure experiences (leisure boredom, new leisure interests, and healthy leisure) and substance use (cigarettes, alcohol, and marijuana) behaviors and to investigate the ways in which changes in leisure experiences predict changes in substance use behaviors over time. Results indicated that adolescents’ substance use increased significantly across adolescence, but that leisure experiences remained fairly stable over time. We also found that adolescent leisure experiences predicted baseline substance use and that changes in leisure experiences predicted changes in substance use behaviors over time, with leisure boredom emerging as the most consistent and strongest predictor of alcohol, cigarette, and marijuana use. Implications for interventions that target time use and leisure experiences are discussed.Web of Scienc

Factors affecting condom usage among Cape Town high school students

Includes bibliographical references.The HIV/AIDS epidemic in South Africa is characterised mainly by heterosexual transmission and an extremely rapid spread among adolescents and young adults in their early twenties, indicating the need for an increased focus on preventive efforts aimed at this age group. Apart from the development of a cure or vaccine to prevent HIV transmission, preventive programmes clearly offer the best chance of halting the spread of HIV, and these need to be based on behavioural change to modify or prevent risk behaviours. The challenge is to develop suitable theory-based programmes that address and promote safer sex behaviour, taking into account the local social and cultural environment. This cross-sectional study focused on a key HIV preventive behaviour, namely condom usage, and used as its research target adolescents, a key risk group for HIV infection in South Africa. It aimed to investigate the key variables that influence condom usage among adolescents in the Cape Town metropolitan area. The study was based on an integrated theoretical model using constructs from 5 of the most common social cognitive behavioural theories, namely, the Health Belief Model, Bandura’s Social Cognitive Theory, the Theory of Reasoned Action, the Theory of Planned Behaviour and the Theory of Subjective Culture and Interpersonal Relations. In addition, variables from Basch’s construct availability model were included. The sample comprised a representative three-stage sample of grade 11 adolescents from 36 schools in the Cape Town Metropolitan area (n = 1931). Formative research, in the form of an elicitation study using to focus group interviews with a purposive sample of adolescents, was used to develop the theory-based self-completion questionnaire used in this study. Twelve constructs were included in the questionnaire as potential correlates of condom use, namely: intention, self-standards, self-efficacy, affect, attitude, beliefs, norms, condom availability, health concern, worry about AIDS, construct availability and condom availability. The dependent variable was condom use on the last coital episode

Healthwise South Africa: cultural adaptation of a school-based risk prevention programme

There is a need for effective prevention programmes aimed at reducing risk behaviour among South African adolescents. Health Wise South Africa is a school-based programme designed to reduce sexual and substance use risk behaviour, and promote positive use of leisure time among high-school learners (students). Based on successful programmes in the United States of America, Health Wise was developed for use in South Africa and pilot tested in four South African high schools. We carried out a process evaluation to establish the fidelity of implementation and make sure HealthWise was culturally relevant. Data sources comprised focus groups with educators and learners, lesson evaluations and observations, and interviews with school principals. Qualitative analysis of data highlighted pertinent cultural and contextual factors and identified areas for modifying Health Wise in order to promote better programme-consumer fit. These areas centred on time, language, and leisure. We noted a dynamic tension between the educators’ desire to adhere to plan, and to make adaptations in accordance with learners’ needs and the context. Ultimately, researchers need to find a balance between fidelity of implementation and programme adaptation to obtain effective programmes that are culturally acceptable to local consumers.Web of Scienc