Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113529

M. Catherine Maternowska, PhD, MPH, Center for Reproductive Health Research and Policy, University of California, San Francisco, P.O. Box 997413, MS8400, Sacramento, CA 95899-7413, 916-650-0318, maternowska@obgyn.ucsf.edu

Zimbabwe claims one of the most sustained and severe HIV epidemics worldwide. Now mirroring a pattern typical in Southern Africa, HIV in Zimbabwe disproportionately affects young women. A recent study in rural Zimbabwe points to age differences between partners as one significant determinant of such differences (Gregson et al 2002). Drawing on an analysis of 12 focus group discussions and 12 in-depth interviews, collected between 2000 and 2001 in Chitungwiza and Epworth, Zimbabwe, this study seeks to explain reasons why young Zimbabwean women (16-19 years of age) are so vulnerable to infection. The qualitative analysis shows that perceived risk of STIs, including HIV infection, and unwanted pregnancy is high among young women. However, preventative behavior practice is thwarted by dominant social norms. While young women acknowledge the ‘Sugar Daddy' phenomenon—where sex is exchanged for economic gifts and where the ability to negotiate condom use is limited—focusing solely on this transaction as the nexus of transmission falls short. Findings show that a range of complex issues constrain young women's ability to prevent sexual ill health. This complexity is explored by highlighting the multiple spaces and places in which young women live and interact—the household, the community and society at large—demonstrating how social and economic dynamics and pressures are contributing to young women's vulnerability. Our findings also suggest that social and sexual attitudes and norms, and the possibility of changing them, are shaped by broader contextual factors that need be incorporated into future prevention efforts.

Learning Objectives:

• 1.Describe patterns of HIV/AIDS, STIs and unwanted pregnancy among young women in urban and peri-urban Zimbabwe;
• 2.Articulate how risk, interpreted through the concepts of space and place, is context dependent and requires effective means of methodological inquiry;
• 3.Identify a new lens from which to view high-risk behaviors and resultant ill-reproductive health and subsequently design more appropriate programs.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.