Women and HIV in a moderate prevalence setting: an integrative review

Redman-MacLaren, Michelle; Mills, Jane; Tommbe, Rachael; MacLaren, David; Speare, Rick; McBride, William J. H.

doi:10.1186/1471-2458-13-552

Cited by 10 publications

(19 citation statements)

References 35 publications

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“…Results demonstrate a positive attitude towards establishing a safer version of the pre-colonial MICs in Yangoru-Saussia. Results also expand evidence for local, national and international policy makers to support locally appropriate HIV prevention strategies in PNG and other culturally, linguistically and geographically diverse nations [ 9 , 14 , 31 , 33 , 34 , 41 , 42 , 53 – 57 ].…”

Section: Discussionsupporting

confidence: 54%

Re-establishing safer medical-circumcision-integrated initiation ceremonies for HIV prevention in a rural setting in Papua New Guinea. A multi-method acceptability study

et al. 2017

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BackgroundEfforts to stem the spread of Human Immunodeficiency Virus (HIV) in Papua New Guinea (PNG) are hampered by multiple interrelated factors including limited health services, extreme diversities in culture and language and highly prevalent gender inequity, domestic violence and poverty. In the rural district of Yangoru-Saussia, a revival of previously ceased male initiation ceremonies (MICs) is being considered for a comprehensive approach to HIV prevention. In this study, we explore the local acceptability of this undertaking including replacing traditional penile cutting practices with medical male circumcision (MMC).MethodsA multi-method study comprising three phases. Phase one, focus group discussions with male elders to explore locally appropriate approaches to HIV prevention; Phase two, interviews and a cross-sectional survey with community men and women to assess views on MICs that include MMC for HIV prevention; Phase three, interviews with cultural leaders and a cross sectional survey to assess the acceptability of replacing traditional penile bleeding with MMC.ResultsCultural leaders expressed that re-establishing MICs was locally appropriate for HIV prevention given the focus on character building and cultural preservation. Most surveyed participants (81.5%) supported re-establishing MICs and 92.2% supported adapting MICs with MMC. Changes to penile bleeding emerged as a contentious and contested issue given its cultural significance in symbolizing initiates’ transition from childhood to adulthood. Participants were concerned about potential clash with modern education, introduced religious beliefs and limited government support in leadership and funding.ConclusionsMost people in this study in Yangoru-Saussia support re-establishing MICs and replacing traditional penile bleeding with MMC. This culturally-sensitive alignment of MMC (and HIV prevention) with revived MICs responds to a national health priority in PNG and acts as an example of providing culturally-sensitive male circumcision for HIV prevention recommended by WHO/UNAIDS. However, the implementation of this undertaking will require considerable effort, especially when modern pursuits in education and religion must be factored and when there is expectation for local authorities to lead and provide funding.

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Section: Discussionsupporting

confidence: 54%

Re-establishing safer medical-circumcision-integrated initiation ceremonies for HIV prevention in a rural setting in Papua New Guinea. A multi-method acceptability study

et al. 2017

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“…In PNG, gender refers to the characteristics assigned to women and men by the society in which they live [ 11 ]. Gender influences the type of tasks undertaken by men and women, employment opportunities and can indicate vulnerability to inter-personal violence and HIV [ 12 – 15 ]. Matching the gender of the researcher and research participant therefore reflects social and cultural patterns [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Co-interviewing across gender and culture: expanding qualitative research methods in Melanesia

et al. 2014

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BackgroundThe social and cultural positions of both researchers and research participants influence qualitative methods and study findings. In Papua New Guinea (PNG), as in other contexts, gender is a key organising characteristic and needs to be central to the design and conduct of research. The colonial history between researcher and participant is also critical to understanding potential power differences. This is particularly relevant to public health research, much of which has emerged from a positivist paradigm. This paper describes our critical reflection of flexible researcher responses enacted during qualitative research in PNG.MethodsLed by a senior male HIV researcher from PNG, a male from a PNG university and a female from an Australian university conducted qualitative interviews about faith-based responses to HIV in PNG. The two researchers planned to conduct one-on-one interviews matching gender of participants and interviewer. However, while conducting the study, four participants explicitly requested to be interviewed by both researchers. This experience led us to critically consider socially and culturally situated ways of understanding semi-structured interviewing for public health research in Melanesia.ResultsNew understandings about public health research include: (i) a challenge to the convention that the researcher holds more power than the research participant, (ii) the importance of audience in Melanesia, (iii) cultural safety can be provided when two people co-interview and (iv) the effect an esteemed leader heading the research may have on people’s willingness to participate. Researchers who occupy insider-outsider roles in PNG may provide participants new possibilities to communicate key ideas.ConclusionsOur recent experience has taught us public health research methods that are gender sensitive and culturally situated are pivotal to successful research in Melanesia. Qualitative research requires adaptability and reflexivity. Public health research methods must continue to expand to reflect the diverse worldviews of research participants. Researchers need to remain open to new possibilities for learning.

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“…The issue of gender violence in Tari bears directly on HIV vulnerability. Much of the literature about AIDS in Papua New Guinea has emphasized gender-based violence, especially sexual violence, as being a significant factor in Papua New Guinea's epidemic (Seeley and Butcher 2006, Lepani 2008, Lewis et al 2008, Hammar 2010, Eves 2010, Redman-MacLaren et al 2013, Shih et al 2017. How to theorize this violence has been a troubling question.…”

Section: Gender and Hiv In Tarimentioning

confidence: 99%

Fencing in AIDS: Gender, Vulnerability, and Care in Papua New Guinea

Wardlow

2020

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Acknowled gments This book is based on research carried out over almost ten years, and there are consequently many, many individuals and organizations to thank for their assistance, friendship, and support. As always, my deepest thanks go to Mary Tamia and June Pogaya, my beloved besties in Tari, who have shared everything with me-stories, food, families, insights, laughter, tears, fear, and, fury. I am also deeply thankful for Jacinta Hayabe's friendship since 1996. During our many long, cigarette-filled, latenight conversations, she proved an invaluable interlocutor and especially helped me understand the complex political field of women's groups in the region. I am grateful to Michael Parali, Luke Magala, Ken Angobe, and Thomas Mindibi, the four wonderful men who worked as my field assistants in 2004, were brave enough to pose forthright questions about love, sex, marriage, extramarital relationships, and HIV to their peers, and had no compunction about telling me when interview questions were problematic. My deepest condolences go to the family of Joseph Warai, who directed the Community Based Health Care (CBHC) NGO in the mid 2000s and was very supportive of my 2004 research project. Joseph and the whole CBHC team persevered in delivering health promotion and income-generating projects to people in the Tari area during a desperate and precarious period, and they were a source of hope and inspiration for many. I was also sad to learn that Sister Pauline Agilo had died. She was a comfort to many people living with HIV and AIDS, and especially helped people as best she could in the pre-antiretroviral era. During my research stints in 2010, 2011, 2012, and 2013, a number of health workers assisted me by telling patients about my research and asking them if they were interested in being interviewed. They also, with the permission of patients, x Acknowledgments allowed me to observe some of their counselling sessions, and they shared with me their concerns about patients' living situations and about the sometimes unreliable availability of antiretrovirals and other essential medicines in Tari. I am especially grateful for Margaret Parale's friendship and assistance during this research. Employees of the Oil Search Health Foundation also assisted in recruiting participants for me, and provided me with useful data about Tari's HIV prevalence. Jethiro Harrison and Ruben Enoch were University of Papua New Guinea student interns with me in Tari for a few weeks in 2013. Among other things, they helped me to understand the powerful allure of Port Moresby that can attach itself to those who have lived there and attract other people when they return to rural areas. I am also grateful to the staff of Médecins sans frontières in Tari who were so generous to me, especially when my guesthouse did not have water or electricity. I feel profoundly lucky to belong to the Department of Anthropology at the University of Toronto, where I have wonderful and brilliant colleagues, whose ideas have influenced mine. I am also grateful to ...

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Women and HIV in a moderate prevalence setting: an integrative review

Cited by 10 publications

References 35 publications

Re-establishing safer medical-circumcision-integrated initiation ceremonies for HIV prevention in a rural setting in Papua New Guinea. A multi-method acceptability study

Re-establishing safer medical-circumcision-integrated initiation ceremonies for HIV prevention in a rural setting in Papua New Guinea. A multi-method acceptability study

Co-interviewing across gender and culture: expanding qualitative research methods in Melanesia

Fencing in AIDS: Gender, Vulnerability, and Care in Papua New Guinea

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