 Articles- Social Identity and Community Effects on Contraceptive Use and Intentions in Southern Ethiopia
Dennis P. Hogan is Robert E. Turner Distinguished Professor of Population Studies and Professor of Sociology, and Belay Biratu is a doctoral candidate, Population Studies and Training Center, Box 1836, Brown University, 200 Maxcy Hall, 112 George Street, Providence, RI 02912. E-mail: Dennis_Hogan@brown.edu. In this study, data gathered in southern Ethiopia are used to explain how ethnic and religious identities affect current or intended contraceptive use. The only compositional factors that increase the likelihood of birth limitation are having a member of the family with a higher level of education and community access to health services. Compositional factors by themselves do not explain Muslim and ethnic variations in contraceptive use and intentions. Village health and economic crises do not promote birth limitation. One normative economic factor—the practice of sons’ inheritance of land from their fathers—considerably reduces the likelihood of contraceptive use, but does not account for religious and ethnic differentials. No evidence is found of a minority-status effect on contraception. Exposure to ethnic and religious diversity in the community of residence substantially increases the likelihood of emergent birth limitation, especially among the predominant Muslim Silte population. (Studies in Family Planning 2004; 35[2]: 79–90)
- Factors Associated with Contraceptive Use in Late- and Post-apartheid South Africa
Sarah Burgard is Robert Wood Johnson Health and Society Scholar, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1214 South University, Ann Arbor, MI 48104-2548. E-mail: burgards@umich.edu. In 1994, South Africa underwent a transition from the institutionalized racism of an apartheid state to a nonracial democracy. This study uses data from two surveys conducted in the style of the Demographic and Health Surveys to compare patterns and predictors of racial differences in modern contraceptive use in the late- and post-apartheid periods. Age-group-specific logistic regression models show that despite strong state family planning programs targeting black women, these women were less likely than nonblacks to practice modern contraception both before and after the political transition, even after controlling for large racial-group differences in sociodemographic characteristics and the distribution of socioeconomic resources. Black, colored, Indian, and white women show different patterns of contraceptive use across their reproductive careers; in particular, young, unmarried black and colored women show high levels of use. Use of injectable contraceptives is also high among black and colored women, whereas injectables are not the primary method used by Indian or white women. These findings are discussed in light of their research and policy implications. (Studies in Family Planning 2004; 35[2]: 91–104)
- The Moral Lens of Population Control: Condoms and Controversies in Southern Malawi
Amy Kaler is Assistant Professor, Department of Sociology, University of Alberta, 5–21 HM Tory Building, Edmonton, Canada T6G 2H4. E-mail: akaler@ualberta.ca. The study presents an investigation of stories about condoms in southern Malawi. Malawians’ concerns about coercive population control imposed by a national government or international cabal provide a moral lens through which condoms and other health promotions are viewed, with unknown but probably negative impact on the use of condoms. The focus of the study is on the long shadow cast by population control because it is under-researched and, in fact, virtually unmentioned in most studies of health promotion, yet appears to be common if not ubiquitous. Moreover, this long shadow poses a distinct challenge to HIV-prevention and intervention efforts. The data for the study were gathered by six Malawian research assistants in Balaka district, in southern Malawi, who kept journals over a period of three years in which they recorded conversations and everyday chats that they observed. These journals demonstrate that condoms do not arrive in communities as neutral, value-free objects; rather they enter a social setting permeated with ideas about health, self-protection, and danger. The lens of population control has proved to be both durable and flexible, providing a moral context in which both commodities and actors can be understood. Disentangling condoms from the symbolic nexus in which they are fused with disease, population control, and malevolence will be an ongoing challenge in the struggle to prevent the spread of HIV/AIDS in Malawi. (Studies in Family Planning 2004; 35[2]: 105–115)
Reports - Condom Use Within Marital and Cohabiting Partnerships in KwaZulu-Natal, South Africa
Pranitha Maharaj is a Research Fellow, School of Development Studies, University of KwaZulu-Natal, Durban, 4041, South Africa. E-mail: maharajp7@nu.ac.za. John Cleland is Professor of Medical Demography, Centre for Population Studies, London School of Hygiene and Tropical Medicine. Traditionally, the major focus of condom-promotion strategies has been on increasing use outside marriage. This study explores the extent and determinants of condom use within marital and cohabiting partnerships in KwaZulu-Natal, South Africa. In focus-group discussions, in-depth interviews, and individual survey responses, knowledge of condoms as an effective method of dual protection against the risk of pregnancy and disease was found to be high. Consistent with numerous other studies, this study found widespread disapproval of condom use within marriage. Only 14 percent of men and 17 percent of women reported consistent or “occasional” condom use. Nevertheless, condom use is much higher among urban, more-educated individuals than among their rural, less-educated counterparts. Apart from education, perceived risk of HIV infection from the partner is the most powerful determinant of use within marital and cohabiting partnerships, particularly for women. Resistance to condoms within marital and cohabiting partnerships is not immutable, however, and women may not be as powerless to protect themselves as is often reported. (Studies in Family Planning 2004: 35[2]: 116–124)
- Relationships Between Older Men and Younger Women: Implications for STIs/HIV in Kenya
Kim Longfield is Senior Researcher, Population Services International (PSI)/Asia, Wave Place – 18th Floor, 55 Wireless Road, Bangkok, 10330, Thailand. E-mail: klongfield@psiasia.org. Anne Glick is HIV/AIDS Technical Advisor, PSI, Kinshasa, Congo. At the time that this article was written, Margaret Waithaka was Research Manager, PSI/Kenya, Nairobi, Kenya. John Berman is Senior Director, AIDSMark, PSI, Washington, DC. The aim of this study is to contribute to the understanding of motivations for cross-generational relationships and how the perception of risk of acquiring sexually transmitted infections (STIs) including HIV affects condom use in Kenya. Eight focus-group discussions were conducted with women and 28 interviews were held with men in four Kenyan towns. Ethnograph 5.0 computer software was used for the analysis of data. Women’s primary incentive for engaging in such relationships is financial; men seek sexual gratification. Pressure from peers compels women to find older partners. Although some peers encourage such relationships, other groups, especially wives, same-aged boyfriends, and parents, disapprove of them. Couples are preoccupied by the threat of discovery. STI/HIV risk perception is low, and couples rarely use condoms. Material gain, sexual gratification, emotional factors, and recognition from peers override concern for STI/HIV risk. Women’s ability to negotiate condom use is compromised by age and economic disparities. Programmatic strategies include communicating information about such relationships’ STI/HIV risk, promoting consistent condom use, decreasing peer pressure to pursue such relationships, and improving women’s access to alternative sources of income. (Studies in Family Planning 2004; 35[2]: 125–134)
Data - Mauritania 2000–2001: Results from the Demographic and Health Survey
- Nepal 2001: Results from the Demographic and Health Survey
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