Zambian male adolescents' perceptions about premarital sexual relationships

The role adolescent boys play in premarital sexual activities, gender power relations, and the reproductive health risks they are exposed to, has received little attention in research. This qualitative study has aimed to explore Zambian male adolescents' perceptions and expectations about premarital sexual relationships. Seven focus group discussions were conducted between November 2000 and May 2001, in George and Chimwemwe compounds, with 53 boys aged 15 to 19. The findings reveal that adolescent premarital sexual relationships are common and considered by many boys as a prerequisite to achieving an adult male's autonomy and status. The boys viewed themselves as the privileged gender, with greater freedom than girls, and were the major decision-makers on sexual matters in relationships. The results indicate that traditional values and stereotypical gender roles continue to influence Zambian boys' male identity. However, a sense of ambiguity among the boys on issues of gender imbalance in premarital relationships indicates a potential and preparedness to break with traditional trends — a true challenge for public health priorities and interventions.     

Community impact of HIV status disclosure through an integrated community home-based care programme

The integration of HIV-prevention activities into care has received little attention within or outside formal healthcare settings. The contribution of community home-based care services in facilitating disclosure of HIV status and reducing stigma have also not been described. This study examines the community impact of an integrated community home-based care (ICHC) programme on HIV-prevention efforts and disclosure of status. Quantitative data was collected from 363 people living with HIV (PLHIV) and 1 028 members of their micro-communities; of these, 211 and 586, respectively, were in the ICHC programme (thus representing the ICHC-served group) and 152 and 442, respectively, were not in the programme (representing the non-served or control group). The micro-community group served by the ICHC programme reported significantly more positive attitudes towards HIV, better knowledge of HIV, fewer instances of sexually-transmitted infections, a tendency for fewer sexual partners, and less perceived risk of acquiring HIV than the non-served micro-community group. Also, the micro-community served by the programme did not show significantly better uptake of voluntary counselling and testing than did the non-served micro-community. There was no difference in condom-use between the two groups.     

The protective effect of male circumcision on HIV infection in a sample of Kenyan men

This article examines the association between male circumcision and HIV infection in a national sample. The analysis is based on the 2003 Kenya Demographic and Health Survey (KDHS), a nationally representative household-based population survey of adults, in which male respondents self-reported their circumcision status. In addition, in some households eligible for individual interview, blood samples were subsequently anonymously obtained for HIV testing, making this the first study linking socio-demographic information to HIV status at the national level. The study sample is limited to 3 413 men aged 15–54 years who gave valid information on their circumcision and HIV statuses. Nearly 5% of the men were HIV-positive, and 86% had been circumcised. HIV prevalence was significantly higher among the uncircumcised men (12%) than among the circumcised men (3%). This indication of the protective effect of male circumcision on HIV infection remained statistically significant (OR 0.15; 95%CI: 0.09–0.23) even after controlling for the effects of socio-demographic variables, age at first sexual intercourse, and use of paid sex. Based on these results, we recommend that HIV-prevention advocates and activists, scholars, bio-medical communities and political leaders find ways to include this oldest surgical procedure in their HIV/AIDS discourses and programmes in sub-Saharan Africa.