Browsing by Author "Suzanne Maman"

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    Decision-making and cash spending patterns of adolescent girls and young women participating in a cash-transfer intervention in Tanzania: Implications for sexual health
    (2019-12-06) Joyce Wamoyi; Peter Balvanz; Margaret W; Gichane; Suzanne Maman; Samuel Mugunga; Esther Majani; Audrey Pettifor
    Although cash transfers (CT) have been recommended as a strategy to address structural drivers of HIV, the evidence of the effects of CT on sexual risk and HIV outcomes is mixed. This could partly be due to CT implementation dynamics and beneficiary interpersonal factors. We conducted an assessment of CT component of the DREAMS programme in Tanzania. We explored how AGYW spent their CT over time, to whom they disclosed cash receipt, and where they sought advice on CT use. The study employed qualitative research methods including: 20 longitudinal in-depth interviews (IDIs) and 60 cross-sectional IDIs with AGYW in the CT programme. Data were analysed thematically. AGYW use of CT fell into five categories: business development, survival, self-care, helping family, and savings. The primary uses of CT funds were investment in businesses and livestock for savings. AGYW use of cash changed over instalments. AGYW consulted a variety of sources when deciding on how to use the cash, primarily mothers, programme personnel, and long-term partners/husbands. CT programmes that give cash directly to AGYW and have a strong entrepreneurial mentorship component could have implications for HIV prevention, SRH, and overall social and economic development.
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    Hope, the Household Environment, and Sexual Risk Behaviors Among Young Women in Rural South Africa (HPTN 068)
    (2018-06) Lauren M Hill; Laurie Abler; Suzanne Maman; Rhian Twine; Kathleen Kahn; Catherine MacPhail; Audrey Pettifor
    We assessed the psychological trait of hope as an explanatory mediator in the relationship between the home environment and sexual risk behaviors among 2533 young women in rural South Africa. Hope mediated the relationship between average household age and sexual debut (mediated effect = −0.003, p<.05), and between household consumption and sexual debut (mediated effect = −0.019, p<.05). Both higher average household age (β = 0.01; 95%CI: 0.00, 0.01) and greater household consumption (β = 0.05; 95%CI: 0.02, 0.08) were marginally associated with higher hope. In turn, greater hope was associated with lower odds of sexual debut (aOR= 0.62; 95%CI: 0.52, 0.74). These results provide important preliminary evidence of the role of the home environment in shaping protective psychological assets and healthy sexual behaviors. Continued exploration of the relationship between hope and the home environment may help to explain why young women in this context have a disproportionate risk for HIV.
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    Individual and Relationship-Level Correlates of Transactional Sex Among Adolescent Girls and Young Women in Malawi: A Multilevel Analysis
    (2022-03) Margaret W Gichane; Nora E Rosenberg; Catherine Zimmer; Audrey E Pettifor; Suzanne Maman; Bertha Maseko; Kathryn E Moracco
    Transactional sex increases HIV risk among adolescent girls and young women (AGYW). Understanding the individual and dyadic nature of transactional sex may provide evidence for risk reduction interventions. Multilevel logistic regression was used to cross-sectionally examine correlates of transactional sex among AGYW in Lilongwe, Malawi. Participants (N = 920) reported 1227 relationships. Individual-level associations were found between being divorced/widowed (AOR 5.07, 95% CI 1.93, 13.25), married (AOR 0.26, 95% CI 0.09, 0.72), or unstably housed (AOR 7.11, 95% CI 2.74, 18.47) and transactional sex. At the relationship-level, transactional sex occurred in relationships with: non-primary primary partners (AOR 4.06, 95% CI 2.37, 6.94), perceived partner concurrency (AOR 1.85, 95% CI 1.11, 3.08), and feared violence with couples HIV testing (AOR 2.81, 95% CI 1.26, 6.29), and less likely to occur in relationships with children (AOR 0.15, 95% CI 0.06, 0.38). Multiple co-occurring social and structural vulnerabilities increase transactional sex engagement warranting the need for social protection and gender transformative approaches.
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    The sky is the limit; I am going there”: experiences of hope among young women receiving a conditional cash transfer in rural South Africa
    (2021-05-05) Kaitlyn Atkins; Catherine MacPhail; Suzanne Maman; Nomhle Khoza; Rhian Twine; F. Xavier Gomez-Olive; Audrey Pettifor; Kathleen Kahn
    Young women in South Africa face elevated risk of HIV infection compared to male peers. Cash transfers may mitigate their risk for HIV; however, there is limited understanding of mechanisms of impact. We explored hope as one potential mechanism. Longitudinal qualitative analysis was used to explore how cash transfer recipients in the HPTN 068 study conceptualised hope and how the intervention influenced their hope over time. We found the intervention increased confidence, alleviated financial stressors and instilled in young women the belief that a better life, defined as being educated, independent and supportive to family, was attainable. Findings support hope as a critical outcome of cash transfer and other economic strengthening interventions.
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    The Sky is the Limit; I am Going There”: Experiences of Hope Among Young Women Receiving a Conditional Cash Transfer in Rural South Africa
    (2021-05-05) Kaitlyn Atkins; Catherine MacPhail; Suzanne Maman; Nomhle Khoza; Rhian Twine; F Xavier Gomez-Olive; Audrey Pettifor; Kathleen Kahn
    Young women in South Africa face elevated risk of HIV infection compared to male peers. Cash transfers may mitigate their risk for HIV; however, there is limited understanding of mechanisms of impact. We explored hope as one potential mechanism. Longitudinal qualitative analysis was used to explore how cash transfer recipients in the HPTN 068 study conceptualised hope and how the intervention influenced their hope over time. We found the intervention increased confidence, alleviated financial stressors and instilled in young women the belief that a better life, defined as being educated, independent and supportive to family, was attainable. Findings support hope as a critical outcome of cash transfer and other economic strengthening interventions.