Diane Cooper | University of the Western Cape (original) (raw)

Papers by Diane Cooper

Research paper thumbnail of Challenges to microbicide introduction in South Africa

Social Science & Medicine, 2006

Qualitative research was conducted in South Africa to determine perceptions about intra-vaginal m... more Qualitative research was conducted in South Africa to determine perceptions about intra-vaginal microbicides in order to better understand the socioeconomic, cultural and structural contexts for the support of future introduction of this new HIV prevention method. Focus group discussions and in-depth interviews were conducted at community, health service, and policy levels of inquiry. The main study site was a black working class urban area close to Cape Town.

Research paper thumbnail of Conscientious objection and its impact on abortion service provision in South Africa: a qualitative study

Reproductive Health, 2014

Despite abortion being legally available in South Africa after a change in legislation in 1996, b... more Despite abortion being legally available in South Africa after a change in legislation in 1996, barriers to accessing safe abortion services continue to exist. These barriers include provider opposition to abortion often on the grounds of religious or moral beliefs including the unregulated practice of conscientious objection. Few studies have explored how providers in South Africa make sense of, or understand, conscientious objection in terms of refusing to provide abortion care services and the consequent impact on abortion access.

Research paper thumbnail of Renegotiating intimate relationships with men: how HIV shapes attitudes and experiences of marriage for South African women living with HIV: 'Now in my life, everything I do, looking at my health

Acta juridica (Cape Town, South Africa), 2013

This paper explores marriage attitudes and practices among Xhosa-speaking women living with HIV (... more This paper explores marriage attitudes and practices among Xhosa-speaking women living with HIV (WLHIV) in Cape Town, South Africa. It reports on a study that assessed the fertility intentions of a cohort of people living with HIV, aimed at informing an HIV care intervention. It draws on qualitative data generated from 30 successive interviews with WHLIV in wave 1, 23 interviews in wave 2 and 20 follow-up interviews in wave 3. Gender inequality, marriage and HIV are strongly intertwined. Broader layers of South Africa's history, politics and socio-economic and cultural contexts have consequences for the fluidity in intimate relations, marriage and motherhood for WLHIV. Key and conflicting themes emerge that impact on marriage and motherhood. Firstly, marriage is the 'last on a list of priorities' for WLHIV, who wish to further their children's education, to work, to earn money, and to achieve this rapidly because of their HIV-positive status. We demonstrate that the ...

Research paper thumbnail of Assessing Programmatic Needs

New Directions for Student Services, 2000

Research paper thumbnail of The relationship between hegemonic norms of masculinity and men's conceptualization of sexually coercive acts by women in South Africa

Journal of interpersonal violence, 2015

While sexual abuse against women and girls in South Africa has generated much deserved attention,... more While sexual abuse against women and girls in South Africa has generated much deserved attention, the awareness of men's experiences of sexual coercion is limited, and often restricted to a homosexual context. This article illuminates men's experiences of pressurized sex in a heterosexual context, which were revealed in a broader men's sexual health study. Fifty sexual history narrative interviews were conducted with men purposively sampled from three age categories: (18-24, 25-54, and 55+), a wide range of cultural and racial backgrounds, and in urban and rural sites across five provinces in South Africa. Narrative interviews began with accounts of early knowledge of sex and sexual experimentation and explored the range of sexual relationships and experiences through adulthood. The narratives privileged the diversity of men's conceptualizations of and the impact of reportedly sexually coercive experiences by women. Many men described feeling unready for their first ...

Research paper thumbnail of HIV and pre-neoplastic and neoplastic lesions of the cervix in South Africa: a case-control study

BMC cancer, 2006

Cervical cancer and infection with human immunodeficiency virus (HIV) are both major public healt... more Cervical cancer and infection with human immunodeficiency virus (HIV) are both major public health problems in South Africa. The aim of this study was to determine the risk of cervical pre-cancer and cancer among HIV positive women in South Africa. Data were derived from a case-control study that examined the association between hormonal contraceptives and invasive cervical cancer. The study was conducted in the Western Cape (South Africa), from January 1998 to December 2001. There were 486 women with invasive cervical cancer, 103 control women with atypical squamous cells of undetermined significance (ASCUS), 53 with low-grade squamous intraepithelial lesions (LSIL), 50 with high-grade squamous intraepithelial lesions (HSIL) and 1159 with normal cytology. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multiple logistic regression. The adjusted odds ratios associated with HIV infection were: 4.4 [95% CI (2.3 - 8.4) for ASCUS, 7.4 (3.5 - 15.7) for LSIL, 5.8 ...

Research paper thumbnail of Risk of invasive cancer of the cervix in relation to the use of injectable progestogen contraceptives and combined estrogen/progestogen oral contraceptives (South Africa)

Cancer causes & control : CCC, 2003

Cervical cancer is caused by specific types of the human papilloma virus (HPV), but not all infec... more Cervical cancer is caused by specific types of the human papilloma virus (HPV), but not all infected women develop cancer. It has been hypothesized that hormonal contraceptives may potentiate the oncogenicity of HPV infection. In a case-control study of colored and black women in the Western Cape Province, South Africa, 524 incident cases of clinically evident invasive cervical cancer (stages 1b-1V) were compared with 1541 controls, and with a subgroup of 254 HPV-positive controls. For injectable progestogen contraceptives (95% of which were depot medroxyprogesterone acetate) the overall relative risk, adjusted for confounding, was 1.0 (95% confidence interval 0.8-1.3); for combined estrogen/progestogen oral contraceptives the corresponding estimate was 0.8 (0.7-1.1). When the data were divided into categories of duration of use extending to > or = 15 years, or according to age, ethnic group, or recency of use, there was no consistent evidence of an increased risk. The findings w...

Research paper thumbnail of Sexual and reproductive health perceptions and practices as revealed in the sexual history narratives of South African men living in a time of HIV/AIDS

SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2014

The frequent positioning of men's sexual risk-taking as driving the HIV/AIDS epidemic in South Af... more The frequent positioning of men's sexual risk-taking as driving the HIV/AIDS epidemic in South Africa has triggered interest in men's sexual and reproductive health (SRH) perceptions, attitudes, and practices. Much research, however, presents men as a homogenous group, and focuses on the quantifiable aspects of male sexual behaviors, providing an inadequate basis for understanding men's SRH needs and addressing the gendered aspects of HIV prevention. This study used sexual history narratives to yield more nuanced and contextualized understandings of male sexuality as it relates to SRH. Fifty sexual life history individual interviews and 10 focus-group discussions (FGDs) with men, as well as 25 sexual life history interviews with women, were conducted with participants purposively sampled from three age categories: (18 -24, 25 -55, and 55+ years), a wide range of cultural and racial backgrounds, and in urban and rural sites across 5 provinces in South Africa. Interviews and FGDs elicited stories of participant's early knowledge of sex and sexual experimentation and then explored sexual relationships and experiences in adulthood-including engagement with HIV risks and SRH management. The data were analyzed using a thematic approach. Many male participants conformed to dominant norms of masculinity associated with a high risk of sexually transmitted infections including HIV, such as having regular unprotected sex, reluctance to test for HIV, and poor SRH-seeking behaviors. Yet, the narrative accounts reveal instances of men taking steps to protect their own SRH and that of their partners, and the complex ways in which hegemonic gender norms influence men and women's SRH. Ultimately, the study points to the value of sexual biographies for gaining a deeper understanding of male sexuality, and the social structures, meanings, and experiences that underlie it. Such insights are critical to more effectively engaging men in HIV prevention efforts.

Research paper thumbnail of A qualitative exploration of HIV-positive pregnant women's decision-making regarding abortion in Cape Town, South Africa

SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2010

'Ils nous apportent le SIDA et disent que c'est nous qui le leur donnons' : Le contexte socio-str... more 'Ils nous apportent le SIDA et disent que c'est nous qui le leur donnons' : Le contexte socio-structurel de la vulnérabilité des travailleuses du sexe face à l'infection par le VIH à Ibadan, au Nigeria JENNIFER MUNOZ, ADEBOLA ADEDIMEJI, OLAYEMI ALAWODE 62 Perceived stigma among patients receiving antiretroviral treatment: A prospective randomised trial comparing an m-DOT strategy with standard-of-care in Kenya Stigmatisation perçue par les patients recevant un traitement antirétroviral: un essai randomisé prospectif comparant une stratégie m-DOT (traitement modifié sous surveillance directe) à la norme de précaution au Kenya SUSAN KAAI, SANDRA BULLOCK, AVINA SARNA, MATTHEW CHERSICH, STANLEY LUCHTERS, SCOTT GEIBEL, PAUL MUNYAO, KISHORCHANDRA MANDALIYA, MARLEEN TEMMERMAN, NAOMI RUTENBERG 71 A comparison in HIV-associated stigma among healthcare workers in urban and rural Gujarat Comparaison de la stigmatisation associée au VIH parmi les travailleurs de la santé dans les zones urbaines et rurales du Gujarat KARTAVYA J VYAS, GULAB R PATEL, DEEPAK SHUKLA, WILLIAM C MATHEWS 76 The quality of material care provided by grandparents for their orphaned grandchildren in the context of HIV/ AIDS and poverty: a study of Kopanong municipality, free State La qualité de la prise en charge matérielle fournie par les grandsparents aux petits-enfants orphelins dans le contexte du VIH/Sida et de la pauvreté: une étude de la municipalité de Kopanong, Free State

Research paper thumbnail of The HIV epidemic and sexual and reproductive health policy integration: views of South African policymakers

Research paper thumbnail of Medical Abortion: The Possibilities for Introduction in the Public Sector in South Africa

Reproductive Health Matters, 2005

Medical abortion is safe and effective and has been approved for use in early termination of preg... more Medical abortion is safe and effective and has been approved for use in early termination of pregnancy in South Africa since 2001. The Department of Health is currently considering its introduction in the public health sector. The attitudes of women seeking abortion and of health care providers towards medical abortion have not previously been described. Data were derived from a quantitative survey of 673 women attending abortion services in the provinces of Gauteng, Mpumalanga and the Western Cape. In-depth interviews in Soweto and Cape Town were conducted with 20 public health doctors, nurses, a social worker and facility managers, and in Cape Town with four provincial policymakers. Although medical abortion was not yet being offered, 21% of women interviewed were early enough in pregnancy (eight weeks or less) to be eligible for medical abortion. Access to health facilities, including those for abortion, was reasonable for urban women but more limited for rural women. Rural women also incurred greater travel costs to reach a facility. Most women thought medical abortion would be acceptable and would have been willing to try it, had it been available. Policymakers and providers were supportive, as they felt medical abortion could relieve the burden on current services. How to increase access to abortion services in rural areas needs to be addressed. A 2005 Reproductive Health Matters. All rights reserved.

Research paper thumbnail of Corrigendum to ““Life is still going on”: Reproductive intentions among HIV-positive women and men in South Africa”

Social Science & Medicine, 2007

This article reports on qualitative research investigating HIV positive individuals' reproductive... more This article reports on qualitative research investigating HIV positive individuals' reproductive intentions and their influencing factors in Cape Town, South Africa.

Research paper thumbnail of Challenges to microbicide introduction in South Africa

Social Science & Medicine, 2006

Qualitative research was conducted in South Africa to determine perceptions about intra-vaginal m... more Qualitative research was conducted in South Africa to determine perceptions about intra-vaginal microbicides in order to better understand the socioeconomic, cultural and structural contexts for the support of future introduction of this new HIV prevention method. Focus group discussions and in-depth interviews were conducted at community, health service, and policy levels of inquiry. The main study site was a black working class urban area close to Cape Town.

Research paper thumbnail of “Life is still going on”: Reproductive intentions among HIV-positive women and men in South Africa

Social Science & Medicine, 2007

This article reports on qualitative research investigating HIV positive individuals' reproductive... more This article reports on qualitative research investigating HIV positive individuals' reproductive intentions and their influencing factors in Cape Town, South Africa.

Research paper thumbnail of Ten Years of Democracy in South Africa

Reproductive Health Matters, 2004

The advent of democracy in South Africa in 1994 created a unique opportunity for new laws and pol... more The advent of democracy in South Africa in 1994 created a unique opportunity for new laws and policies to be passed. Today, a decade later, South African reproductive health policies and the laws that underwrite them are among the most progressive and comprehensive in the world in terms of the recognition that they give to human rights, including sexual and

Research paper thumbnail of Narratives of distress about birth in South African public maternity settings: A qualitative study

Midwifery, 2014

Objective: to explore the factors associated with negative birth experiences in South African pub... more Objective: to explore the factors associated with negative birth experiences in South African public maternity settings from the perspective of women 0 s birth narratives. Design: an explorative, qualitative research study using a narrative methodological framework and unstructured interviewing. Setting: the city of Cape Town in South Africa. Participants: 33 low-income women aged 18-42 years who had recently given birth to an infant in the public maternity sector. Findings: more than half of the women (n ¼ 18) narrated 'narratives of distress' in relation to their birth experiences. One third narrated 'good' birth experiences and four women told minimalistic or neutral birth narratives. This paper reports only on factors associated with women 0 s distress narratives. Narratives of distress were associated with poor quality of intrapartum care and characterised by the following four themes, namely (1) negative interpersonal relations with caregivers, (2) lack of information, (3) neglect and abandonment and (4) the absence of a labour companion. Key conclusions and implications for practice: poor relationships with caregivers emerged as central to women 0 s distress narratives. Interventions aimed at improving interpersonal communication, connection and rapport between caregivers and labouring women are central to improving quality of care in resource-constrained settings.

Research paper thumbnail of HIV-infected women in ART programmes

The Lancet, 2005

... Lancet 2004; 364: 1916-1918. Full Text | PDF(86KB) | CrossRef | PubMed. 2 Harrison A,Montgome... more ... Lancet 2004; 364: 1916-1918. Full Text | PDF(86KB) | CrossRef | PubMed. 2 Harrison A,Montgomery E. Life histories, reproductive histories: rural South African women's narratives of fertility, reproductive health and illness. J South Afr Stud 2001; 27: 311-328. ...

Research paper thumbnail of Integrating medical abortion into safe abortion services: experience from three pilot sites in South Africa

Journal of Family Planning and Reproductive Health Care, 2008

Research paper thumbnail of Limited Pap screening associated with reduced risk of cervical cancer in South Africa

International Journal of Epidemiology, 2003

In South Africa, cancer of the cervix is the most common malignancy in African women and the four... more In South Africa, cancer of the cervix is the most common malignancy in African women and the fourth most common in white women, with an overall age standardized incidence rate of 22 per 100 000 per year. The lifetime risk is approximately 1 in 41, and 5000 new cases are reported annually. 1 Cervical cancer is a disease of early and late middle age. Isolated cases occur among young women, but incidence rates rise sharply from age 35 with 87% of cases occurring in women over that age. 2 In developed countries, cervical cancer has become rare, but it remains a leading cause of cancer death in disadvantaged populations.

Research paper thumbnail of Bone status after cessation of use of injectable progestin contraceptives

Contraception, 2007

Background: Women using injectable progestin contraceptives (IPCs) have lower bone mineral densit... more Background: Women using injectable progestin contraceptives (IPCs) have lower bone mineral density than nonusers. We assessed whether bone loss is completely reversible after cessation of IPC use, whether different IPCs have different effects and whether effects vary by age at first use. Study Design: In a cross-sectional study in Cape Town, South Africa, 3487 premenopausal black and mixed race women aged 18-44 years were interviewed for information on contraceptive history and risk factors for decreased bone mineral density, and ultrasound measurements of the left calcaneus were taken. Adjusted means of the ultrasound measures for categories of IPC use were obtained using multivariable linear regression. Results: Current users of IPCs had the lowest ultrasound measures, while the measures of women who had ceased IPC use at least 2-3 years previously were similar to or greater than those of never users of IPCs. The effects of depot medroxyprogesterone acetate and norethisterone enanthate were similar. The calcaneus measures were unrelated to age at which use began after control for confounding factors. Conclusion: The data suggest that bone loss during IPC use is reversible and that this loss of bone is completely recovered several years after cessation of use.

Research paper thumbnail of Challenges to microbicide introduction in South Africa

Social Science & Medicine, 2006

Qualitative research was conducted in South Africa to determine perceptions about intra-vaginal m... more Qualitative research was conducted in South Africa to determine perceptions about intra-vaginal microbicides in order to better understand the socioeconomic, cultural and structural contexts for the support of future introduction of this new HIV prevention method. Focus group discussions and in-depth interviews were conducted at community, health service, and policy levels of inquiry. The main study site was a black working class urban area close to Cape Town.

Research paper thumbnail of Conscientious objection and its impact on abortion service provision in South Africa: a qualitative study

Reproductive Health, 2014

Despite abortion being legally available in South Africa after a change in legislation in 1996, b... more Despite abortion being legally available in South Africa after a change in legislation in 1996, barriers to accessing safe abortion services continue to exist. These barriers include provider opposition to abortion often on the grounds of religious or moral beliefs including the unregulated practice of conscientious objection. Few studies have explored how providers in South Africa make sense of, or understand, conscientious objection in terms of refusing to provide abortion care services and the consequent impact on abortion access.

Research paper thumbnail of Renegotiating intimate relationships with men: how HIV shapes attitudes and experiences of marriage for South African women living with HIV: 'Now in my life, everything I do, looking at my health

Acta juridica (Cape Town, South Africa), 2013

This paper explores marriage attitudes and practices among Xhosa-speaking women living with HIV (... more This paper explores marriage attitudes and practices among Xhosa-speaking women living with HIV (WLHIV) in Cape Town, South Africa. It reports on a study that assessed the fertility intentions of a cohort of people living with HIV, aimed at informing an HIV care intervention. It draws on qualitative data generated from 30 successive interviews with WHLIV in wave 1, 23 interviews in wave 2 and 20 follow-up interviews in wave 3. Gender inequality, marriage and HIV are strongly intertwined. Broader layers of South Africa's history, politics and socio-economic and cultural contexts have consequences for the fluidity in intimate relations, marriage and motherhood for WLHIV. Key and conflicting themes emerge that impact on marriage and motherhood. Firstly, marriage is the 'last on a list of priorities' for WLHIV, who wish to further their children's education, to work, to earn money, and to achieve this rapidly because of their HIV-positive status. We demonstrate that the ...

Research paper thumbnail of Assessing Programmatic Needs

New Directions for Student Services, 2000

Research paper thumbnail of The relationship between hegemonic norms of masculinity and men's conceptualization of sexually coercive acts by women in South Africa

Journal of interpersonal violence, 2015

While sexual abuse against women and girls in South Africa has generated much deserved attention,... more While sexual abuse against women and girls in South Africa has generated much deserved attention, the awareness of men's experiences of sexual coercion is limited, and often restricted to a homosexual context. This article illuminates men's experiences of pressurized sex in a heterosexual context, which were revealed in a broader men's sexual health study. Fifty sexual history narrative interviews were conducted with men purposively sampled from three age categories: (18-24, 25-54, and 55+), a wide range of cultural and racial backgrounds, and in urban and rural sites across five provinces in South Africa. Narrative interviews began with accounts of early knowledge of sex and sexual experimentation and explored the range of sexual relationships and experiences through adulthood. The narratives privileged the diversity of men's conceptualizations of and the impact of reportedly sexually coercive experiences by women. Many men described feeling unready for their first ...

Research paper thumbnail of HIV and pre-neoplastic and neoplastic lesions of the cervix in South Africa: a case-control study

BMC cancer, 2006

Cervical cancer and infection with human immunodeficiency virus (HIV) are both major public healt... more Cervical cancer and infection with human immunodeficiency virus (HIV) are both major public health problems in South Africa. The aim of this study was to determine the risk of cervical pre-cancer and cancer among HIV positive women in South Africa. Data were derived from a case-control study that examined the association between hormonal contraceptives and invasive cervical cancer. The study was conducted in the Western Cape (South Africa), from January 1998 to December 2001. There were 486 women with invasive cervical cancer, 103 control women with atypical squamous cells of undetermined significance (ASCUS), 53 with low-grade squamous intraepithelial lesions (LSIL), 50 with high-grade squamous intraepithelial lesions (HSIL) and 1159 with normal cytology. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multiple logistic regression. The adjusted odds ratios associated with HIV infection were: 4.4 [95% CI (2.3 - 8.4) for ASCUS, 7.4 (3.5 - 15.7) for LSIL, 5.8 ...

Research paper thumbnail of Risk of invasive cancer of the cervix in relation to the use of injectable progestogen contraceptives and combined estrogen/progestogen oral contraceptives (South Africa)

Cancer causes & control : CCC, 2003

Cervical cancer is caused by specific types of the human papilloma virus (HPV), but not all infec... more Cervical cancer is caused by specific types of the human papilloma virus (HPV), but not all infected women develop cancer. It has been hypothesized that hormonal contraceptives may potentiate the oncogenicity of HPV infection. In a case-control study of colored and black women in the Western Cape Province, South Africa, 524 incident cases of clinically evident invasive cervical cancer (stages 1b-1V) were compared with 1541 controls, and with a subgroup of 254 HPV-positive controls. For injectable progestogen contraceptives (95% of which were depot medroxyprogesterone acetate) the overall relative risk, adjusted for confounding, was 1.0 (95% confidence interval 0.8-1.3); for combined estrogen/progestogen oral contraceptives the corresponding estimate was 0.8 (0.7-1.1). When the data were divided into categories of duration of use extending to > or = 15 years, or according to age, ethnic group, or recency of use, there was no consistent evidence of an increased risk. The findings w...

Research paper thumbnail of Sexual and reproductive health perceptions and practices as revealed in the sexual history narratives of South African men living in a time of HIV/AIDS

SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2014

The frequent positioning of men's sexual risk-taking as driving the HIV/AIDS epidemic in South Af... more The frequent positioning of men's sexual risk-taking as driving the HIV/AIDS epidemic in South Africa has triggered interest in men's sexual and reproductive health (SRH) perceptions, attitudes, and practices. Much research, however, presents men as a homogenous group, and focuses on the quantifiable aspects of male sexual behaviors, providing an inadequate basis for understanding men's SRH needs and addressing the gendered aspects of HIV prevention. This study used sexual history narratives to yield more nuanced and contextualized understandings of male sexuality as it relates to SRH. Fifty sexual life history individual interviews and 10 focus-group discussions (FGDs) with men, as well as 25 sexual life history interviews with women, were conducted with participants purposively sampled from three age categories: (18 -24, 25 -55, and 55+ years), a wide range of cultural and racial backgrounds, and in urban and rural sites across 5 provinces in South Africa. Interviews and FGDs elicited stories of participant's early knowledge of sex and sexual experimentation and then explored sexual relationships and experiences in adulthood-including engagement with HIV risks and SRH management. The data were analyzed using a thematic approach. Many male participants conformed to dominant norms of masculinity associated with a high risk of sexually transmitted infections including HIV, such as having regular unprotected sex, reluctance to test for HIV, and poor SRH-seeking behaviors. Yet, the narrative accounts reveal instances of men taking steps to protect their own SRH and that of their partners, and the complex ways in which hegemonic gender norms influence men and women's SRH. Ultimately, the study points to the value of sexual biographies for gaining a deeper understanding of male sexuality, and the social structures, meanings, and experiences that underlie it. Such insights are critical to more effectively engaging men in HIV prevention efforts.

Research paper thumbnail of A qualitative exploration of HIV-positive pregnant women's decision-making regarding abortion in Cape Town, South Africa

SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2010

'Ils nous apportent le SIDA et disent que c'est nous qui le leur donnons' : Le contexte socio-str... more 'Ils nous apportent le SIDA et disent que c'est nous qui le leur donnons' : Le contexte socio-structurel de la vulnérabilité des travailleuses du sexe face à l'infection par le VIH à Ibadan, au Nigeria JENNIFER MUNOZ, ADEBOLA ADEDIMEJI, OLAYEMI ALAWODE 62 Perceived stigma among patients receiving antiretroviral treatment: A prospective randomised trial comparing an m-DOT strategy with standard-of-care in Kenya Stigmatisation perçue par les patients recevant un traitement antirétroviral: un essai randomisé prospectif comparant une stratégie m-DOT (traitement modifié sous surveillance directe) à la norme de précaution au Kenya SUSAN KAAI, SANDRA BULLOCK, AVINA SARNA, MATTHEW CHERSICH, STANLEY LUCHTERS, SCOTT GEIBEL, PAUL MUNYAO, KISHORCHANDRA MANDALIYA, MARLEEN TEMMERMAN, NAOMI RUTENBERG 71 A comparison in HIV-associated stigma among healthcare workers in urban and rural Gujarat Comparaison de la stigmatisation associée au VIH parmi les travailleurs de la santé dans les zones urbaines et rurales du Gujarat KARTAVYA J VYAS, GULAB R PATEL, DEEPAK SHUKLA, WILLIAM C MATHEWS 76 The quality of material care provided by grandparents for their orphaned grandchildren in the context of HIV/ AIDS and poverty: a study of Kopanong municipality, free State La qualité de la prise en charge matérielle fournie par les grandsparents aux petits-enfants orphelins dans le contexte du VIH/Sida et de la pauvreté: une étude de la municipalité de Kopanong, Free State

Research paper thumbnail of The HIV epidemic and sexual and reproductive health policy integration: views of South African policymakers

Research paper thumbnail of Medical Abortion: The Possibilities for Introduction in the Public Sector in South Africa

Reproductive Health Matters, 2005

Medical abortion is safe and effective and has been approved for use in early termination of preg... more Medical abortion is safe and effective and has been approved for use in early termination of pregnancy in South Africa since 2001. The Department of Health is currently considering its introduction in the public health sector. The attitudes of women seeking abortion and of health care providers towards medical abortion have not previously been described. Data were derived from a quantitative survey of 673 women attending abortion services in the provinces of Gauteng, Mpumalanga and the Western Cape. In-depth interviews in Soweto and Cape Town were conducted with 20 public health doctors, nurses, a social worker and facility managers, and in Cape Town with four provincial policymakers. Although medical abortion was not yet being offered, 21% of women interviewed were early enough in pregnancy (eight weeks or less) to be eligible for medical abortion. Access to health facilities, including those for abortion, was reasonable for urban women but more limited for rural women. Rural women also incurred greater travel costs to reach a facility. Most women thought medical abortion would be acceptable and would have been willing to try it, had it been available. Policymakers and providers were supportive, as they felt medical abortion could relieve the burden on current services. How to increase access to abortion services in rural areas needs to be addressed. A 2005 Reproductive Health Matters. All rights reserved.

Research paper thumbnail of Corrigendum to ““Life is still going on”: Reproductive intentions among HIV-positive women and men in South Africa”

Social Science & Medicine, 2007

This article reports on qualitative research investigating HIV positive individuals' reproductive... more This article reports on qualitative research investigating HIV positive individuals' reproductive intentions and their influencing factors in Cape Town, South Africa.

Research paper thumbnail of Challenges to microbicide introduction in South Africa

Social Science & Medicine, 2006

Qualitative research was conducted in South Africa to determine perceptions about intra-vaginal m... more Qualitative research was conducted in South Africa to determine perceptions about intra-vaginal microbicides in order to better understand the socioeconomic, cultural and structural contexts for the support of future introduction of this new HIV prevention method. Focus group discussions and in-depth interviews were conducted at community, health service, and policy levels of inquiry. The main study site was a black working class urban area close to Cape Town.

Research paper thumbnail of “Life is still going on”: Reproductive intentions among HIV-positive women and men in South Africa

Social Science & Medicine, 2007

This article reports on qualitative research investigating HIV positive individuals' reproductive... more This article reports on qualitative research investigating HIV positive individuals' reproductive intentions and their influencing factors in Cape Town, South Africa.

Research paper thumbnail of Ten Years of Democracy in South Africa

Reproductive Health Matters, 2004

The advent of democracy in South Africa in 1994 created a unique opportunity for new laws and pol... more The advent of democracy in South Africa in 1994 created a unique opportunity for new laws and policies to be passed. Today, a decade later, South African reproductive health policies and the laws that underwrite them are among the most progressive and comprehensive in the world in terms of the recognition that they give to human rights, including sexual and

Research paper thumbnail of Narratives of distress about birth in South African public maternity settings: A qualitative study

Midwifery, 2014

Objective: to explore the factors associated with negative birth experiences in South African pub... more Objective: to explore the factors associated with negative birth experiences in South African public maternity settings from the perspective of women 0 s birth narratives. Design: an explorative, qualitative research study using a narrative methodological framework and unstructured interviewing. Setting: the city of Cape Town in South Africa. Participants: 33 low-income women aged 18-42 years who had recently given birth to an infant in the public maternity sector. Findings: more than half of the women (n ¼ 18) narrated 'narratives of distress' in relation to their birth experiences. One third narrated 'good' birth experiences and four women told minimalistic or neutral birth narratives. This paper reports only on factors associated with women 0 s distress narratives. Narratives of distress were associated with poor quality of intrapartum care and characterised by the following four themes, namely (1) negative interpersonal relations with caregivers, (2) lack of information, (3) neglect and abandonment and (4) the absence of a labour companion. Key conclusions and implications for practice: poor relationships with caregivers emerged as central to women 0 s distress narratives. Interventions aimed at improving interpersonal communication, connection and rapport between caregivers and labouring women are central to improving quality of care in resource-constrained settings.

Research paper thumbnail of HIV-infected women in ART programmes

The Lancet, 2005

... Lancet 2004; 364: 1916-1918. Full Text | PDF(86KB) | CrossRef | PubMed. 2 Harrison A,Montgome... more ... Lancet 2004; 364: 1916-1918. Full Text | PDF(86KB) | CrossRef | PubMed. 2 Harrison A,Montgomery E. Life histories, reproductive histories: rural South African women's narratives of fertility, reproductive health and illness. J South Afr Stud 2001; 27: 311-328. ...

Research paper thumbnail of Integrating medical abortion into safe abortion services: experience from three pilot sites in South Africa

Journal of Family Planning and Reproductive Health Care, 2008

Research paper thumbnail of Limited Pap screening associated with reduced risk of cervical cancer in South Africa

International Journal of Epidemiology, 2003

In South Africa, cancer of the cervix is the most common malignancy in African women and the four... more In South Africa, cancer of the cervix is the most common malignancy in African women and the fourth most common in white women, with an overall age standardized incidence rate of 22 per 100 000 per year. The lifetime risk is approximately 1 in 41, and 5000 new cases are reported annually. 1 Cervical cancer is a disease of early and late middle age. Isolated cases occur among young women, but incidence rates rise sharply from age 35 with 87% of cases occurring in women over that age. 2 In developed countries, cervical cancer has become rare, but it remains a leading cause of cancer death in disadvantaged populations.

Research paper thumbnail of Bone status after cessation of use of injectable progestin contraceptives

Contraception, 2007

Background: Women using injectable progestin contraceptives (IPCs) have lower bone mineral densit... more Background: Women using injectable progestin contraceptives (IPCs) have lower bone mineral density than nonusers. We assessed whether bone loss is completely reversible after cessation of IPC use, whether different IPCs have different effects and whether effects vary by age at first use. Study Design: In a cross-sectional study in Cape Town, South Africa, 3487 premenopausal black and mixed race women aged 18-44 years were interviewed for information on contraceptive history and risk factors for decreased bone mineral density, and ultrasound measurements of the left calcaneus were taken. Adjusted means of the ultrasound measures for categories of IPC use were obtained using multivariable linear regression. Results: Current users of IPCs had the lowest ultrasound measures, while the measures of women who had ceased IPC use at least 2-3 years previously were similar to or greater than those of never users of IPCs. The effects of depot medroxyprogesterone acetate and norethisterone enanthate were similar. The calcaneus measures were unrelated to age at which use began after control for confounding factors. Conclusion: The data suggest that bone loss during IPC use is reversible and that this loss of bone is completely recovered several years after cessation of use.