HIV-positive adolescents who engage in unsafe sex are at heightened risk for transmitting or re-acquiring HIV. Disclosure of HIV-status to sexual partners may impact on condom use, but no large-scale, mixed methods studies have explored the effects of adolescent knowledge of one’s HIV status, knowledge of partner status, and disclosure to partners on safer sex. This study aimed to identify whether knowledge of HIV-status by HIV-positive adolescents and partners was associated with safer sex. 684 HIV-positive adolescents who had ever initiated ART in 39 health facilities in the Eastern Cape, South Africa, were interviewed using standardised questionnaires. Quantitative analyses used multivariate logistic regressions, controlling for confounders. Qualitative research included interviews, focus group discussions and observations with 43 HIV-positive teenagers, and their caregivers and healthcare workers. Knowledge of HIV-status among HIV-positive adolescents was associated with safer sexual practices, but knowing partner’s status and disclosure of HIV-positive status to sexual partners were not. These findings challenge assumptions that disclosure is automatically protective in sexual and romantic relationships for HIV-positive adolescents.
The Centre for Social Science Research is hosting a two-day symposium on the relationship and interaction between the diversity of families and households, on the one hand, and the institutions and policies of the state, on the other. The symposium will include four sessions. Each session will examine a specific issue and engage with claims about the benefits and harms of state actions for specific individuals and families such as vulnerable children, female headed households, transnational families and individuals in customary marriages. The symposium aims to engage with scholars and policy makers on a discussion that analyses how and whether state policies and laws are supporting families. A distinguished global scholar, Prof. Lynn Jamieson (University of Edinburgh and Director of Centre for Research on Families and Relationships), will present at a plenary session. The symposium will launch the official opening of FaSRU (the Families and Societies Research Unit) within the CSSR and act as the symposium of the ‘The functioning and consequences of transnational child raising arrangements in South and North: Angolan, Nigerian and Ghanaian migrant parents living in South Africa and The Netherlands (TCRA-SAN)’ project, a collaboration between the CSSR and the Faculty of Arts and Social Sciences at Maastricht University, The Netherlands.
Rajen Govender is the Chairperson of the Service Quality Measurs (SQM) National Advisory Committee, which has been developing measures of the quality of interventions to address South Africa's massive problem of substance abuse. The SQM initiative comprises a partnership of researchers, practitioners, administrators, and other role-players and stakeholders drawn from treatment services providers, government, NGOs and universities/research facilities. The SQM methodology comprises a rigorous set of administrative and consumer perception measures which address key issues of access, equity, quality and outcomes in substance abuse health care. Additionally, to account for co-occurring health conditions, the SQM also collects information on HIV and HIV testing. The SQM measures have been tested and validated through two pilot studies and are now ready for implementation.
Barrington Moore’s famous line “no bourgeoisie, no democracy” is one of the most quoted claims in political science. But has the rise of the African middle class promoted democratic consolidation? This paper uses the case of Kenya to investigate the attitudes and behaviors of the middle class. Analysis of Afrobarometer survey data reveals that the middle class is more likely to hold pro-democratic attitudes. This suggests that Moore’s argument deserves to be taken seriously, at least in some African countries, and that contemporary demographic changes will improve the prospects for democratic consolidation. However, qualitative evidence from the Kenyan 2013 general election raises important questions about the resilience of these attitudes. The middle class may be more inclined to democratic attitudes than their less well off counterparts, but class continues to intersect with ethnicity and its political salience is likely to wax and wane as a result.
Nic Cheeseman is an Associate Professor of African Politics at Oxford University and the co-editor of African Affairs. His research addresses a range of questions such as whether populism is an effective strategy of political mobilization in Africa, how paying tax changes citizens’ attitudes towards democracy and corruption, and the conditions under which ruling parties lose power. In addition to a number of book chapters and articles, he has published two co-edited collections: Our Turn To Eat (2010), which covers the politics of Kenya since independence, and The Handbook of African Politics (2013). A monograph, Democracy in Africa, has just been published by Cambridge University Press and a second book, How to Rig An Election, is currently under contract with Yale. Nic is also an advisor to a number of policy makers including the Cabinet Office, Foreign Office, and the Department for International Development of the UK government, the Instituto Rio Branco of the Brazilian government, the Lagos State Government, and the African Progress Panel
“Best practices” prescriptions for reform have long dominated the development discourse, but they confuse the goals of development with the journey of getting from here to there. In this seminar, Brian Levy will lay out an alternative approach which he develops in his recent book, Working with the Grain (New York: Oxford University Press, 2014).
The book takes as its point of departure the realities of a country’s economy, polity and society, and directs attention towards the challenges of initiating and sustaining forward development momentum. It builds on new institutional economics, organizational theory and political economy analysis to explore “good fit” approaches to the analysis of how divergent developing country contexts influence the feasibility of alternative reform options. The analysis distinguishes between “top down” options which endeavor to strengthen formal institutions, and options supporting the emergence of “islands of effectiveness”. Sometimes the binding constraint to forward movement can be institutional, making governance reform the priority; at other times, the priority can better be on inclusive growth. Taking the decade-or-so time horizon of policymakers, the book explores how to nudge things along -- seeking gains that initially may seem quite modest but can, sometimes, give rise to a cascading sequence of change for the better.
Brian Levy is the Academic Director of the Graduate School of Development Policy and Practice at the University of Cape Town. He also teaches at the School of Advanced International Studies, Johns Hopkins University in Washington DC. He worked at the World Bank from 1989 to 2012, including as manager of the Africa Vice Presidency Public Sector Reform and Capacity Building Unit, and as head of the secretariat responsible for the design and implementation of the World Bank Group's governance and anti-corruption strategy. He has published widely on the interactions among institutions, political economy and development policy. He completed his Ph.D in economics at Harvard University in 1983.
Early adolescents (13-15 years) are an ideal target for preventive interventions targeting healthy sexual and mental behaviors. Engaging families in adolescent prevention is developmentally appropriate for early adolescents (13-15 years). However, few family-based adolescent HIV interventions have been empirically tested in South Africa and few HIV interventions take an integrated HIV-mental health approach.
We describe a set of preliminary studies in South Africa and the existing literature documented the intersections between poor mental health and HIV risk. We then describe preliminary qualitative work conducted to inform the design of a resilience-focused family preventive intervention targeting prevention of adolescent HIV risk and depression. This intervention is derived from the integration and adaptation of two existing best-evidence models for HIV risk reduction and prevention of depression. Adaptation needs were assessed utilizing k=8 focus groups with Xhosa-speaking mixed gender adolescents and parents or guardians and n=25 interviews with HIV and mental health experts. Qualitative data were recorded, transcribed verbatim, translated from Xhosa to English, and analyzed in NVivo using a thematic analysis. Respondents identified social and contextual challenges for HIV prevention including age disparate sexual relationships driven by economic needs, adolescent gang violence, and sexual violence. Respondents described aspects of family interactions that presented both challenges and opportunities for family-based adolescent HIV prevention. Parent-child communication on mental health and sexual topics were taboo, with these conversations perceived as an invitation for children to engage in HIV risk behavior. Parents experienced social sanctions for discussing sex and animosity towards children who asked about sex. However, respondents also identified unique cultural conceptions of family resilience that could be leveraged to increase intervention engagement, including family meetings and communal parenting. Qualitative findings guided alteration of existing intervention content, and the addition of new content, topics, and delivery modalities for South Africa. This included a strengthened emphasis on family resilience; how mental health affects sexual decision making; parental monitoring, positive parenting; and building efficacy around parent-adolescent communication on the topics of sex and mental health are important target foci for a family-based intervention. The adapted family intervention will be tested in a randomized pilot trial in 2015-2016.
I examine whether the African elite and middle classes have distinctive social attitudes, relative to poorer or lower class African people, and whether this has changed over the 2000s, in order to understand better how the rapid growth of the African middle classes affects social and political life in post-apartheid South Africa. The chapter uses survey data (from the Institute for Justice and Reconciliation’s South African Reconciliation Barometer) to show that the African middle classes assess much more positively than the poor the economic changes that have taken place in post-apartheid South Africa, and that this differential has grown over time. The middle classes are aware of their privilege, but seem to underestimate the challenges facing the poor. They are also more positive about improved inter-racial relations since 1994, perhaps because they enjoy very much more inter-racial interaction than do the poor. In terms of public policy, the middle classes support more strongly affirmative action, but are also more likely to say that the government does too much for people and probably see less need for active policies around employment creation. Overall, the growth of the African middle classes seems to be good for race relations but reduces the likelihood of pro-poor policies to challenge inequalities of class.
The recent expansion of budget-financed antipoverty transfer programmes in Latin America reflects a shift away from the stratified, Bismarckian, social protection institutions which dominated social policy in the 20th century. The inclusion of low income and informal groups through emerging social assistance institutions has been largely vertical, as opposed to horizontal, leading to parallel institutions supporting formal and informal groups. The paper discusses the main trends and considers the political sustainability of dual institutions in the region.
Armando Barrientos is Professor and Research Director at the Brooks World Poverty Institute at the University of Manchester in the UK. His research focuses on the linkages existing between welfare programmes and labour markets in developing countries, and on policies addressing poverty and population ageing. His most recent books are ‘Social Protection for the Poor and Poorest’ (2008, edited with D. Hulme, Palgrave); ‘Just Give Money to the Poor’ (2010, with J. Hanlon and D. Hulme, Kumarian Press); ‘Demographics, Employment and Old Age Security: Emerging Trends and Challenges in South Asia’ (2010, edited with Moneer Alam, MacMillan), and ‘Social Assistance in Developing Countries’ (2013, Cambridge University Press).
Dr Rebecca Hodes is the new Director of the AIDS and Society Research Unit (ASRU), which is one of four research units within the CSSR. Rebecca is the author of Broadcasting the Pandemic: A History of HIV on South African Television HSRC Press, 2014), based on her doctoral thesis (from Oxford), as well as journal articles and book chapters in the field of public health and the history of medicine with a focus on sexual and reproductive rights and the AIDS epidemic. After completing her doctorate she worked for the Treatment Action Campaign (TAC) as manager of the policy, communications and research department, before coming to UCT as a post-doctoral fellow, first in ASRU and then in the Institute for Humanities in Africa (HUMA). In 2013, Rebecca was awarded a grant by the International AIDS Society, as a part of the Collaborative Initiative for Pediatric HIV Education and Research (CIPHER), and she returned to ASRU.
Our colleague and friend, Ncedeka Mbune, passed away tragically last weekend. Ncedeka worked in the CSSR for almost 10 years. During this time, she worked across a range of projects, and provided much-needed organisational and administrative support to many students and staff members. Ncedeka was known for her gentle presence, her warmth and her wit. She will be missed and mourned by us all.
Body maps: 2002&2012
Flora Hajdu presents results from a recent research project on the effects on smallholders of the MFPP and AsgiSA agricultural development programmes in the Eastern Cape. The project resulted in two papers as well as a PhD thesis entitled “From Betterment to Bt maize: “Agricultural Development and the introduction of Genetically Modified Maize to South African Smallholders” by Klara Jacobson. This presentation will focus on a paper on poverty-related aspects, where we show that the poorer smallholders faced various difficulties in securing benefits from these programmes. The one-dimensional view of the programmes of ‘raising effectiveness’ in smallholder agriculture through raising yields is questioned. Furthermore, smallholders are shown to barely have noticed the insect resistance of the GM maize - instead other properties of the ‘new maize’, which could equally well be found in much cheaper hybrid or open pollinated varieties of maize, were important to the poor.
Flora will also talk briefly about her current plans to seek funding from Sweden for researching the potential of cash transfers in South Africa.
The Institute for Justice and Reconciliation (IJR) have, since 2002, conducted a regular survey of public opinion on reconciliation in South Africa. The IJR and CSSR work closely together on a number of projects (including the Afrobarometer and a book project using the reconciliation survey data). The IJR is advertising for a Project Officer to work on this South African Reconciliation Barometer.
As part of the LIWPR research project, Dr Eduard Grebe today interviewed His Excellency John A. Kufuor, President of Ghana from 2000 to 2008, about the substantial welfare reforms introduced during his term of office. These include a major restructuring of the contributory pensions system, the introduction of a national health insurance scheme, a school feeding scheme and the flagship Livelihoods Empowerment Against Poverty (LEAP) cash transfer scheme. The research forms part of a broader study of the politics of welfare policy reforms in Africa under the direction of Prof Jeremy Seekings.
Eduard Grebe (CSSR Postdoctoral Research Fellow) with John A. Kufuor (Former President of Ghana) in Accra on Thursday 6 November 2014.
Congratulations to Sihle Nontshokweni for being awarded the first Thembi Losi Leadership and Legacy Award at the graduation ceremony for the South African Washington International Program (SAWIP). The Award was established in memory of the late Thembakazi Losi, who had been (with Sihle) a participant in SAWIP. Well done Sihle!
Sihle writes from Washington:
At the beginning of this year I was selected for the South African Washington International Program (SAWIP). Thembi (my friend) was similarly selected for this program in 2011.
Upon her passing a Thembi Losi: Leadership and Legacy Award was established which is awarded at each SAWIP Graduation Ceremony to a SAWIP graduand who most reflects symbolic qualities of Thembi’s favourite flower; Orchids. These qualities include: love, generosity, fortitude and the ability to work with others. The criteria for this award are detailed on this page.