*Electronic Theses and Dissertations (Masters)

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    Blindsided, othered, losing, coping: Experiences of syndemics among Nigerian-born migrant women in Johannesburg, South Africa
    (University of the Witwatersrand, Johannesburg, 2023-07) Oyenubi, Adetola; de Gruchy, Thea; Vearey, Jo
    Background and rationale - Migrants in South Africa frequently face complex challenges that negatively affect their mental and physical health. Current literature has mostly focused on identifying these health conditions with little attention paid to the socioeconomic factors that exacerbate the overall well-being of these migrants. To fill this gap, this study explores the health experiences of migrant women in Johannesburg through the lenses of social determinants of health, othering, and coping strategies. Method - The syndemic framework serves as the foundation for this qualitative study, which examines migrant women's lived experiences and how they interpret their health in the context of the stressors they experience in the city. Data from twenty-one Nigerian-born migrant women were analysed using thematic analysis. Findings - Participants' lived experiences represent syndemic suffering, which Mendenhall describes as experiences of poor health that are due to non-biological factors. These complexities include being blindsided by high expectations of a better life in Johannesburg versus sentiments of disappointment with reality, as well as the pressures of being othered in a new society. All of this has resulted in participants losing their health owing to an array of mental health issues and chronic diseases they suffer from. In the midst of their hardships, these women have discovered ways to cope through social support, religion, mobile technology, and self-care. Conclusion - This study contributes to the literature and praxis on social determinants of migrant health, othering, and the syndemic frameworks by providing insight through the findings of this study. By identifying and exploring syndemics among migrant communities in urban Johannesburg, we can explore how syndemic suffering for migrant women shares commonalities with, but also diverges from, that experienced by South African women.
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    The Socio-Demographic Factors Associated with Condom Consensus among Adolescents in South Africa
    (University of the Witwatersrand, Johannesburg, 2022-07) Guambe, Malesedi Pokello; Frade, Sasha
    Background: Evidence highlights that heterosexual condomless sex among adolescents aged 15 to 24 years is argued by the literature to be a contributor to the high HIV prevalence, STIs, and adolescent pregnancies. As South Africa seeks to reduce new HIV infections by approximately 80%, condom use is of paramount importance. This is due to the fact that condoms are a preventative method that can protect against HIV transmission, STIs and unwanted pregnancies. Previous studies have shown that mutual agreement about using a condom improves consistent condom use among sexual partners. This study therefore investigates the socio-demographic factors associated with condom consensus among adolescents in South Africa. Methodology: This is a cross-sectional study, conducted using secondary data from the South African National HIV Prevalence, HIV Incidence, Behavior and Communication Survey (SABSSM) collected from January to December 2017. The study sampled 2 995 adolescents aged 15 to 24 years in South Africa. The software STATA 14 has been used to manage and analyze data. Descriptive statistics were computed to describe the characteristics of the study population. Cross-tabulation and Pearson Chi2 test were computed to test for association between socio-demographic factors and condom consensus. In order to examine the relationship between socio-demographic factors and condom consensus, binary logistic regression was used. Key Results: The study found condom accessibility and frequency of condom use to be significantly associated with condom consensus. Findings show that condom consensus was 0.457 less likely for adolescents who reported that condoms were not easily accessible, compared to adolescent with easier access. Statistical significance for condom accessibility is p=0.031. Furthermore, the likelihood of condom consensus for frequency of condom use was more likely (AOR,1.931; CI, 1.185-3.145) for adolescents who reported using condoms almost every-time and less likely (AOR, 0.563, CI, 0.379-0.798) for adolescents who used condoms sometimes. Main conclusion: This study found association for condom accessibility and condom consensus, as well as for frequency of condom use and condom consensus. For other socio-demographic factors there was no statistical significance with condom consensus. This study suggests that exposure of Social and Behavioral Change Communication programs needs to be increased among adolescents in South Africa. Central to reducing HIV infections, STIs, and adolescent pregnancy are programs that will influence behavior change among adolescents. At the core of such programs, there is a need for counselling on condom consensus and encouragement about not consuming alcohol before sexual intercourse. Additionally, these programs should make condom accessibility adolescent friendly, so as to encourage using condoms all the time as this is central to reducing new HIV infections, STIs, and adolescent pregnancy.