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Adolescents and men are two populations that perform poorly within the HIV cascade of care, having worse AIDS-related health outcomes, and experiencing higher levels of HIV-related stigma. This paper explores institutional health system discrimination as experienced by adolescent boys with perinatally-acquired HIV, situating them within the social and gendered contexts of the Eastern Cape Province, South Africa. Life history narratives (n = 36) and in-depth semi-structured interviews (n = 32) with adolescent boys living with HIV aged 13–22 were conducted in 2017-2018. In-depth semi-structured interviews with biomedical and traditional health practitioners (n = 14), analysis of health facility files (n = 41) and clinic observations were also conducted. Together, triangulated sources point to an incongruence between the complex needs of adoelscent boys and young men living with HIV and their experiences within the health system. Two institutional discrimination-related deterrents to retention in care were identified: (1) lack of confidentiality due to health facility layouts and practices that visibilised people living with HIV; and (2) mistreatment in the form of shouting. This article contributes to the limited literature on the experiences of young men within the HIV continuum of care, focusing on how stigma influences how young men experience and engage with the health sector. [ABSTRACT FROM AUTHOR]

Adolescence and young adulthood are important periods of transition and therefore for action and intervention to ensure future sexual and reproductive health (SRH). Caregiver-adolescent communication about sex and sexuality is a protective factor for SRH, but there are often barriers to this. Adults’ perspectives are limited within the literature but important as they should lead this process. This paper uses exploratory qualitative data from indepth interviews with 40 purposively sampled community stakeholders and key informants to explore their insights into the perceived, experienced or expected challenges adults’ experience when having these conversations within a high HIV prevalence, South African context. Findings suggest that respondents recognised the value of communication and were generally willing to try it. However, they identified barriers such as fear, discomfort and limited knowledge and perceived capacity to do so. They show that in high prevalence contexts adults grapple with their own personal risks, behaviours and fears that may affect their ability to have these conversations. This demonstrates the need to equip caregivers with the confidence and ability to communicate about sex and HIV, alongside managing their own complex risks and situations to overcome barriers. It is also necessary to shift the negative framing of adolescents and sex. [ABSTRACT FROM AUTHOR]

A noticeable tendency in the first generation of scholarship on sexual orientation and gender identity/expression (SOGIE) in Africa has been the focus on urban or modern institutional settings. A dominant theme is to document people's struggles against stigma, fear and violence to better inform interventions to strengthen human rights and sexual health for all. In some cases, unintentionally, the impression conveyed of Africa is of a continent with cultures that are uniformly, hostile to SOGIE rights. The present study arises from a large survey among boys and men in KwaZulu-Natal, South Africa that problematises that impression. The study revealed unexpectedly high levels of same-sex sexual experience among boys and men in a mostly rural, culturally conservative setting. Following from that revelation, we conducted in-depth interviews to gain insight into their lives. Informants did indeed recount many incidents of discrimination and violence and admitted to sometimes severe emotional health problems. Yet they also spoke of finding love, acceptance, allies, resources, humour and hope for the future. In this paper, we tease out key themes from the interviews in relation to trends in the scholarship. [ABSTRACT FROM AUTHOR]

Uptake of contraceptive implants has declined in South Africa since their introduction in 2014, with side effects and inadequate health provider training cited as primary contributors underlying a poor community perception of implants. In this paper we explore a theme that emerged unexpectedly during analysis of our research in Cape Town that may be an additional factor in this decline: narratives of women being assaulted by robbers who physically remove the implants for smoking as drugs. Narratives were described consistently across interviews and focus groups with youth (aged 18–24 years) and in interviews with health providers, with six participants (two young people, four health providers) sharing personal experiences of robbery. While there was a range of perspectives on whether narratives are based on real experiences or are myths, there was strong consensus that narratives of implant robbery may be influencing women's decisions around implant use in Cape Town. This is a potent example of how perceptions of new products can affect uptake and offers important lessons for implementers to reflect on in planning for rollout of other health technologies. [ABSTRACT FROM AUTHOR]

The HIV epidemic is strongly gendered. Women and girls are more likely to contract HIV for biological and social reasons in Sub-Saharan Africa and men living with HIV are more likely to be lost to follow-up and die on antiretroviral therapy (ART) than women. Care work is also gendered, with women shouldering the burden of HIV care-related work. This paper considers the potential of male delivered community health work to improve men's HIV-related health outcomes and shift gendered norms related to care work. It describes the experiences and perspectives of eight HIV community health workers and their clients from the Cape Town area, and reviews current evidence on male-focused HIV and sexual and reproductive health services, gender transformation and men and care. Findings suggest that meaningfully involving more men in HIV care work may be a way to shift damaging hegemonic masculine norms related to care and health, and that South Africa's roll-out of National Health Insurance could be an opportunity to do so. Barriers to engaging men in this feminised profession are also explored. [ABSTRACT FROM AUTHOR]

The ways in which rural women living with and/or affected by HIV are portrayed in films can potentially influence how social transformation is imagined, including the extent to which the women can be involved in problem-solving processes. This is because, in addition to conceptualising the problem, such representations often place women in a certain position in relation to, or within, the problematic situation, which in turn influences how solutions are framed. This paper uses a discursive approach to explore the portrayal of South African rural women living with and/or affected by HIV in Darrell Roodt's film, Yesterday (2004), which is set in rural KwaZulu-Natal. It considers how the film deals with the tension between structural violence and rural women's agency in grappling with HIV. Structural violence has a significant impact on the experiences of rural women and, hence, their health outcomes. However, when representing rural women, too heavy an emphasis on structural violence runs the risk of portraying them as passive or helpless victims, thus severely limiting their agency. [ABSTRACT FROM AUTHOR]

There is global recognition that competent and willing health care providers remain the most important determinant of safe abortion or termination of pregnancy services. The psychosocial well-being of providers is critical to the provision of responsive termination of pregnancy services. In light of the dearth of scholarly attention on termination of pregnancy providers' coping strategies in low- and middle-income countries, this paper explores coping strategies among these providers in the urban Gauteng and the mixed rural-urban North West provinces of South Africa. During 2015, in-depth interviews were conducted with 30 termination of pregnancy providers working at abortion facilities in these provinces. Questions focused on providers' lived experiences of abortion service provision, the meanings they attached to their work and their reported coping strategies. Interpretative phenomenological analysis was used to analyse the interviews. Interviewees' mean age was 45.8 years, all were professional nurses and the majority were female (82%), working for an average of 3.6 years in abortion services. Four overlapping themes emerged in relation to reported coping strategies: silence and concealing emotions; seeking support; detachment or disengagement; and belief systems. Study findings point to the need for effective, sustainable employee wellness programmes, within an overall context of positive practice environments. [ABSTRACT FROM AUTHOR]

Despite public health interventions targeting sex workers in an attempt to increase condom use, HIV still remains a significant health issue for those involved in the sex industry in many countries. In this paper, we analyse data collected as part of an ethnographic study of sex work in Soweto, South Africa. We show that the main problems with consistent condom use are clients who threaten violence if sex workers insist on condoms, clients who are 'rough' and refuse to stop intercourse when the condom breaks, and clients who offer to pay more money for unprotected sex. These issues relate to unequal gender norms that disempower female sex workers and dismiss the importance of consent in sexual relationships. The criminalisation of sex work increases vulnerability and reduces sex workers' agency as sex workers are reluctant to report crimes committed against them. Persistent 'whore stigma' adds to this dynamic by dehumanising sex workers. In conclusion, we advocate for decriminalisation and posit that public health interventions aimed at increasing condom use and reducing HIV rates need to specifically engage clients, address unequal gender norms and involve local communities to tackle stigma directed against sex workers. [ABSTRACT FROM AUTHOR]

South Africa continues to bear a heavy burden of HIV and a significant proportion of the nation's population consists of immigrants from other severely afflicted African nations. Yet little is known about how migrant populations respond to HIV in shifting cultural and clinical landscapes. Analysing 21 ethnographic life history interviews, this paper explores the social complexities of living with antiretroviral therapy and disclosure of serostatus among HIV-positive Mozambican migrants in Johannesburg. It focuses on (i) conceptualising the 'biosocial ambiance of illness'; (ii) how transformations occur in perceptions of disease; and (iii) how stigma produces an ambit of loneliness and secrecy, which inflects disclosure unevenly in different life-spaces and health-worlds. The net effect of these three processes is a silence which is detrimental to the social normalisation of HIV, treatment-seeking and clinical drug adherence, which in turn may increase rates of morbidity and mortality and contribute to drug resistance. [ABSTRACT FROM AUTHOR]

This paper explores young women's experiences and constructions of love-relationships and intimate partner violence in South Africa, and the role of agency in women's decisions to remain in or leave violent love-relationships. Understanding why young women stay in or leave violent love-relationships is key to developing nuanced understandings of agency and informing intimate partner violence prevention interventions. Data were collected from 15 young women in informal settlements in eThekwini Municipality, South Africa, via in-depth interviews, photovoice and participant observation, and were analysed inductively. While women's love-relationships were frequently violent, they often stayed in them for long periods, usually because the relationships met other important aspirations, including the desire for respect and dignity. Nonetheless, many women left when they no longer felt loved and respected, which they believed was shown by men's behaviours, specifically: indiscreet affairs; not spending time together; not spending money on her and any child(ren); and public (and humiliating) violence. Emotional and economic support from families also influenced women's decisions about leaving or staying. These data demonstrate that agency goes beyond definitive acts of leaving violent relationships; rather it is fluid, contested and contextual, with many factors influencing young women's goals and actions. [ABSTRACT FROM AUTHOR]

Across South Africa there is a growing body of work that explores gender dynamics in heterosexual relationships between young people aged 15–24 years. This is mainly influenced by the high prevalence of HIV and the incidence of intimate partner violence in this age group. Most studies to date have been based upon non-disabled young people, with limited focus on young disabled people. In an attempt to address this gap, this paper describes findings from a study conducted with 22 Zulu-speaking young people with visual and physical disabilities in KwaZulu-Natal. Throughout the findings, young disabled participants appeared to downplay their disability with respect to intimate relationships and accentuated the interweaving of complementary and contentious discourses of gender and cultural identity. Taking cognisance of the intersectionality of gender and cultural discourses, the paper extend constructs of disabled sexualities beyond an exclusive gaze on disability in the South African context. [ABSTRACT FROM PUBLISHER]

The literature on intergenerational sexual relationships in Africa focuses predominantly on economic motivations. This paper aims to identify the common reasons for older male sexual partners among young women in South Africa. Data for the study came from the Fourth South African National HIV, Behaviour and Health Survey 2012. A representative sample of 620 young women (15-24 years old) with older male sexual partners was extracted. A multiple logistic regression analysis was conducted to adjust for potential confounders. The authors found that more than a quarter of sexually active young women engaged in age-disparate relationships. The majority of the respondents did not see age as an important factor, while financial support ranked fourth in the list of reasons for having older partners. Women who were 20-24 years old (AOR 1.16, CI: 0.59287-1.87493), divorced, separated or widowed (AOR 1.38, CI: 0.65360-1.92105) and who were students or learners (AOR 1.85, CI: 0.41943-1.29402) were more likely to have an older partner for financial reasons. Thus, financial motivations are not the predominant reason for age-disparate relationships; instead, other reasons including age not being important and feeling secure were more cited. Not all young women in South Africa are seeking financial assistance from older sexual partners. [ABSTRACT FROM AUTHOR]

Notions of womanhood inculcate naturalised ideologies of femininity, sexuality, motherhood and caregiving. The paper asks how disability stigma intersects with womanhood to characterise intimate partnerships in South Africa. In-depth interviews with 30 women with a range of disabilities were conducted in informal settlements in Cape Town. Findings suggest that disability stigma may hamper attainment of normative womanhood and sexual relationships for women with disabilities in South Africa. Limited opportunities to meet potential partners, hegemonic gender expectations and restricted sexual and physical contact shape their intimate partnerships. However, women with disabilities also challenge ableist constructs of normalcy and discredit negative images of disabled womanhood. Because of this, theoretical models of intimate partner violence should consider the influence of disability on constructions of sexuality and norms in intimate partnerships. Building on women with disabilities' stigma-avoidance strategies will help facilitate better relationship outcomes. Social norms interventions with broader society, communities, women with disabilities and their partners, family and carers can help destabilise assumptions that women with disabilities are unable to have long-lasting and fulfilling sexual and intimate partnerships. Moreover, accessible and relevant sexuality education and information on relationships, intimate partner violence, maternal and sexual and reproductive health care can ensure healthy and safe intimate partnerships for women with disabilities. [ABSTRACT FROM AUTHOR]

This paper explores how some South African teenage fathers in rural KwaZulu-Natal engage in heterosexual relationships. Drawing on findings from a qualitative based study with twenty teenage fathers aged between seventeen and nineteen years old, we examine how they talk about two highly sexualised gatherings - umhlalaphansi (an overnight Zulu dance ceremony) and inkwari (a weekend-long rave-like party). We find that these social and cultural gatherings provide opportunities to express gender and sexuality whilst simultaneously increasing the risk for early childbearing. Umhlalaphansi is produced at the cultural nexus which supports respect and cultural norms that prohibit sexual secrecy and unregulated sexuality. Paradoxically, umhlalaphansi is a key site in which teenage men and women engaged in courtships, sexual relationships and risky sexual conduct. Inkwari lacks cultural scripts and is based on partying, alcohol, drug use and engagement in spontaneous sexual encounters. We show how these two sites provide opportunities for young men to pursue sexuality in ways that are risky as they increase vulnerability for unplanned teenage fatherhood. Our conclusion provides some implications for school-based interventions to tackle sexual risk within rural contexts in South Africa. [ABSTRACT FROM AUTHOR]

Theoretical refinement of the concept of reproductive justice has been called for. In this paper, I propose the use of a supportability reparative justice approach. Drawing on intra-categorical intersectionality, the supportability aspect starts from the event of a pregnancy to unravel the interwoven embodied and social realities implicated in women experiencing pregnancy as personally supportable/unsupportable, and socially supported/unsupported. The reparative justice aspect highlights the need for social repair in the case of unsupportable pregnancies and relies on Ernesto Verdeja's critical theory of reparative justice in which he outlines four reparative dimensions. Using abortion within the South African context, I show how this framework may be put to use: (1) the facilitation of autonomous decision-making (individual material dimension) requires understanding women within context, and less emphasis on individual-driven 'choice'; (2) the provision of legal, safe state-sponsored healthcare resources (collective material dimension) demands political will and abortion service provision to be regarded as a moral as well as a healthcare priority; (3) overcoming stigma and the spoiled identities (collective symbolic dimension) requires significant feminist action to deconstruct negative discourses and to foreground positive narratives; and (4) understanding individual lived experiences (individual symbolic dimension) means deep listening within the social dynamics of particular contexts. [ABSTRACT FROM AUTHOR]

Sexual practices among gay and other men who have sex with men are evolving in South Africa and heteronormative stereotypes are being contested. This paper draws from a larger qualitative study on how men construct a gay identity and negotiate their relationships within contemporary South African contexts, following constitutional and legal changes, in this respect. A feminist, social constructionist approach was used to collect and analyse data from in-depth interviews with 15 self-identified gay men, aged 20 to 46 years, drawn from a university in the larger Cape Metropole, South Africa. Interviews were audio-recorded, transcribed verbatim and analysed using thematic and narrative analysis. 'Bottoms' revealed being powerful in receptive sex. Other men deconstructed the binaries of masculine/feminine and resisted heteronormativity by engaging in fluid constructions in their relationships, whereby participants 'switched' or 'flipped' or did not recognise stereotypical roles when practising sex. There may be value in making these flexible and reciprocal sexual practices better known about and promoted as non-normative African models of sexual practice. [ABSTRACT FROM AUTHOR]

In studies of sexual risk behaviour among youth, the role of dominant conceptions of masculinity and femininity has received increasing attention. However, where research has sought to explore femininity, it has predominantly focused on adolescent girls. This paper departs from previous research by offering insights into how young women negotiate their femininity as they transition from adolescence to adulthood and encounter changing social contexts. Drawing on data from ethnographic enquiry, it argues that as young women transition out of school and into emerging adulthood, their options for negotiating different types of femininity become constrained, with consequences for engagement in sexual risk behaviours. This may to some extent explain why in some South African contexts older young women are more vulnerable to HIV infection than adolescent girls. The paper offer insights into future prospects for youth development programming seeking to reduce young women’s vulnerability to risk. [ABSTRACT FROM PUBLISHER]

This paper explores arguments for and against same-sex marriage as ‘movement advocacy’ in the USA as a backdrop to the proposition that, despite the influence of US discourses on South African debates about same-sex marriage, US discussions are less important to understanding South African responses than controversies about marriage itself in the country. The paper works in two sections. First it sketches legal and critical tensions within the USA around the implications of same-sex marriage activism, drawing on work from Franke, Brandzel, Grossman, Puar and others. Second, it notes arguments on queer homonationalisms, made most forcefully by Puar, concerning the effects and interests of ‘exporting’ US legal ideals to countries elsewhere, especially poorer countries. It then moves to offer suggestions for ways of nuancing this argument through stronger critical attention to context concerning radically shifting notions of marriage within those countries themselves, using South Africa as a case study. This section draws on recent work by Judge, van Zyl, Scott, Mkhize and Adebayo and Nyameza, among others. [ABSTRACT FROM AUTHOR]

Older adults have been largely overlooked in community studies of HIV in highly endemic African countries. In our rural study site in Mpumalanga Province, South Africa, HIV prevalence among those aged 50 and older is 16.5%, suggesting that older adults are at risk of both acquiring and transmitting HIV. This paper utilises community-based focus-group interviews with older rural South African men and women to better understand the normative environment in which they come to understand and make decisions about their health as they age in an HIV endemic setting. We analyse the dimensions of an inductively emerging theme:ku ti hlayisa(to take care of yourself). For older adults, ‘taking care’ in an age of AIDS represented: (1) an individualised pathway to achieving old-age respectability through the taking up of responsibilities and behaviours that characterise being an older person, (2) a set of gendered norms and strategies for reducing one’s HIV risk, and (3) a shared responsibility for attenuating the impact of the HIV epidemic in the local community. Findings reflect the individual, interdependent and communal ways in which older rural South Africans understand HIV risk and prevention, ways that also map onto current epidemiological thinking for improving HIV-related outcomes in high-prevalence settings. [ABSTRACT FROM PUBLISHER]

Few studies of the transition to adulthood in Africa analyse young people’s own definitions of the events that confer adult status, and how adulthood is actually attained. This paper examines the experience of transitioning to womanhood in rural Mpumalanga Province, South Africa, drawing on interviews with 18 women aged 18–39. Three primary experiences characterised this transition: puberty and emerging body awareness, spending time with boys, and having a child. More important than the timing of these experiences, however, was whether women ‘behaved well’ and maintained respectability as they transitioned to adulthood. Behavioural standards reinforcing ideal femininity were focused on dress, manner and talk, and were particularly stringent for mothers. Findings emphasise the value of emic models of adulthood for understanding how youth experience this transition and provide an important counter-narrative to the literature focused primarily on the risk African youth face during this period of change in the life course. [ABSTRACT FROM PUBLISHER]

This paper explores condom use and lubrication practices among Black men who have sex with men in South African townships. Results are from 81 in-depth individual interviews conducted among a purposive sample from four townships surrounding Pretoria as part of a larger qualitative study. Awareness that condoms should be used to have safer anal sex was ubiquitous. Fewer men reported that lubricants should be used to facilitate anal intercourse. Partner pressure and partner distrust were the most common barriers cited for not using condoms and lubricants. Knowledge about condom-lubricant compatibility was rare. Condom problems were a norm, with widespread expectations of condom failure. Men’s subjectivities – their perceptions of and preferences for specific brands, types and flavours of condoms and lubricants – influenced engagement with such safer-sex technologies. However, what was available in these settings was often neither what men needed nor preferred. Findings show the need to enhance access to appropriate and comprehensive: safer-sex supplies, health services and health education, and underline the importance of efforts to develop targeted programmes relevant to experiences of men who have sex with men in the South African context. [ABSTRACT FROM PUBLISHER]

This paper explores how vulnerability is produced through the adoption of sexually scripted practices by young people in a rural area in the Eastern Cape of South Africa. It uses script theory to explore how scripted practices sustain and reproduce dominant gender norms, and in the process reproduce vulnerability for young women. Qualitative data drawn from 23 individual interviews and six focus groups with participants between 18 and 35 years of age were analysed to explore how sexual relationships are configured. An analysis of how relationships are arranged and constructed illustrates the material practices which allow vulnerability to occur. A critical set of practices such asukucheckha(going to see a girlfriend),ukuoutha(going out to sleep over at a boyfriend’s room) andukushiywa(being replaced) are scripted into relationships and essential for their functioning. However, scripted practices at the cultural level make it difficult for young women to negotiate sexual safety at the interpersonal level, jeopardising personal and sexual safety. A focus on scripted sexual practices highlights the reproduction of sexual vulnerability particularly for young women. Interventions need to attend to the material realities which produce vulnerability for young women. [ABSTRACT FROM PUBLISHER]

In predominantly isiXhosa-speaking township communities in South Africa, men who have sex with men negotiate their identities and sexual practices alongside heteronormative cultural scripts of what it means to be a man. Such idealised notions of masculinity are predicated on the selective appropriation of cultural practices that preserve (heterosexual) male privilege and power. In this paper, we explore the identity work done by men who have sex with men, with particular reference to male circumcision as a cultural practice widely drawn on to inform and regulate normative masculinity. Through a narrative-discursive analysis of the accounts provided by men who have sex with men from township communities, we highlight how participants’ dissident sexualities are constructed as compromising their masculine identities. Participating in cultural practices such as traditional circumcision aligns participants to the idealised forms of masculinity that afford men full citizenship in their communities. Study findings suggest that sexual dissidence is less troubling to participants than deviating from gendered markers of hegemonic masculinity, and point to ways in which marginalised men might have an interest in maintaining the dominant gendered order. We conclude with implications for research and programmatic work with gay, bisexual and other men who have sex with men. [ABSTRACT FROM PUBLISHER]

This paper explores how young people in rural South Africa understand gender, dating, sexuality and risk-taking in adolescence. The empirical material drawn upon consists of 20 interviews with young men and women (aged 18–19) and reflects normative gender patterns characterised by compulsory heterosexuality and dating as obligatory, and representing key symbols of normality. However, different meanings of heterosexual relationships are articulated in the interviews, for example in the recurring concept of ‘passing time’, and these meanings show that a relationship can be something arbitrary: a way to reduce boredom and have casual sex. Such a rationale for engaging in a relationship reflects one of several other normative gender patterns, which relate to the trivialisation of dating and sexual risk-taking, and which entail making compromises and legitimising deviations from the ‘ideal’ life-script and the hope of a better future. However, risks do not exclusively represent something bad, dangerous or immoral, because they are also used as excuses to avoid sex, HIV acquisition and early pregnancy. In conclusion, various interrelated issues can both undermine and/or reinforce risk awareness and subsequent risk behaviour. Recognition of this tension is essential when framing policies to support young people to reduce sexual risk-taking behaviour. [ABSTRACT FROM PUBLISHER]

Sexual risk-taking is influenced by individual, interpersonal and social factors. This paper presents findings from a qualitative follow-up study to a clinical trial evaluating biomedical HIV prevention products among African women, explored participants’ perceptions and experiences of heterosexual penile-anal intercourse, as well as the gendered power dynamics and relationship contexts in which this sexual behaviour occurs. In-depth interviews were conducted with 88 women from South Africa, Uganda and Zimbabwe. Findings reveal that despite its social stigmatisation, women engage in penile-anal intercourse for reasons including male pleasure, relationship security, hiding infidelity, menstruation, vaginal infections, money and beliefs that it will prevent HIV transmission. In addition, participants described experiences of non-consensual penile-anal intercourse. We used sexual scripting theory as an analytical framework with which to describe the sociocultural and relationship contexts and gendered power dynamics in which these practices occur. These data on the distinct individual, dyadic and social contexts of heterosexual penile-anal intercourse, and the specific factors that may contribute to women’s HIV risk, make a unique contribution to our understanding of heterosexual behaviour in these sub-Saharan countries, thereby helping to inform both current and future HIV prevention efforts for women in the region. [ABSTRACT FROM PUBLISHER]

South Africa has seen a rapid increase in scholarship and programmatic interventions focusing on gender and sexuality, and more recently on boys, men and masculinities. In this paper, we argue that a deterministic discourse on men's sexuality and masculinity in general is inherent in many current understandings of adolescent male sexuality, which tend to assume that young women are vulnerable and powerless and young men are sexually powerful and inevitably also the perpetrators of sexual violence. Framed within a feminist, social constructionist the oretical perspective, the current research looked at how the masculinity and sexuality of South African young men is constructed, challenged or maintained. Focus groups were conducted with young men between the ages of 15 and 20 years from five different schools in two regions of South Africa, the Western and Eastern Cape. Data were analysed using Gilligan's listening guide method. Findings suggest that participants in this study have internalised the notion of themselves as dangerous, but were also exploring other possible ways of being male and being sexual, demonstrating more complex experiences of manhood. We argue for the importance of documenting and highlighting the precariousness, vulnerability and uncertainty of young men in scholarly and programmatic work on masculinities. [ABSTRACT FROM AUTHOR]

Ultrasonography images and their derivatives have been taken up in a range of ‘public’ spaces, including medical textbooks, the media, anti-abortion material, advertising, the Internet and public health facilities. Feminists have critiqued the personification of the foetus, the bifurcation of the woman’s body and the reduction of the pregnant woman to a disembodied womb. What has received less attention is how these images frequently intersect with race, class, gender and heteronormativity in the creation of idealised and normative understandings of pregnancy. This paper focuses on the discursive positioning of pregnant women as ‘mothers’ and foetuses as ‘babies’ in online media targeted at a South African audience, where race and class continue to intersect in complex ways. We show how the ontologically specific understandings of ‘mummies’ and ‘babies’ emerge through the use of foetal images to construct specific understandings of the ‘ideal’ pregnancy. In the process, pregnant women are made responsible for ensuring that their pregnancy conforms to these ideals, which includes the purchasing of the various goods advertised by the websites. Not only does this point to a commodification of pregnancy, but also serves to reinforce a cultural understanding of White, middle-class pregnancy as constituting the normative ‘correct’ form of pregnancy. [ABSTRACT FROM PUBLISHER]

Gender norms that privilege men's sexual power and pleasure, and distrust of condom use in intimate relationships, leave women vulnerable to HIV and other sexually transmitted infections. Vaginal microbicides allow women to exert a degree of control over their sexual health, through responsibility for product insertion as well as the possibility of covert use. In practice, however, the uptake of new HIV-prevention products is heavily influenced by partnership dynamics. This paper presents a secondary analysis of data from two qualitative sub-studies conducted during a Phase 3 microbicide efficacy trial in South Africa. Using transcripts from in-depth interviews and focus group discussions with 278 female trial participants and 27 male partners, we investigated the extent to which women disclosed microbicide use to their partners, and the level and types of male engagement with microbicide use. Most women chose to communicate with their partners about the trial, but the timing and content of associated discussions differed according to their motivation for disclosure. Men provided their partners with both moral and practical support, but reported a desire for greater involvement in decision-making surrounding microbicide uptake and use. The findings inform recommendations for constructive male participation in future trials and, ultimately, introduction of a marketed product. [ABSTRACT FROM PUBLISHER]

Research reveals how homophobia and stigma link closely to HIV among men who have sex with men in sub-Saharan Africa. This paper considers the varying impact of homophobic stigma on HIV prevention programmes among men who have sex with men in South Africa. It explores how a community-based HIV prevention programme based in the peri-urban townships of Cape Town was ‘translated’ to peri-urban Johannesburg. Drawing on interviews with volunteers and programme facilitators in Johannesburg, it argues that an altered homophobic environment to that found in Cape Town gave different opportunities to engage both with other men who have sex with men and the broader community. It also argues that programme facilitators should be mindful of how varying degrees of homophobic stigma may relate to broader theoretical debates about sexual binary relationships, which can help us understand why particular programmes choose to focus on certain activities rather than others. [ABSTRACT FROM PUBLISHER]

This paper reports on the stigma and discrimination experienced by lesbian, gay, bisexual and transgender students at a rural university in South Africa. Twenty lesbian, gay, bisexual and transgender students recruited through snowball sampling participated in this study. Interpretative Phenomenological Analysis was used as a framework for data analysis. Findings indicate that religion-related stigma and discrimination are common at a rural-based university in South Africa. Lesbian, gay, bisexual and transgender students are typically ascribed a range of labels, including ‘sinners’, ‘devils’ and ‘demon possessed’. They are also exposed to a number of discriminatory acts, such as the denial of financial and healthcare services and threats of and/or actual rape. Study participants reported attempts to convert lesbian, gay, bisexual and transgender students' sexual orientation which involved the use of intervention in the form of prayers. Derogatory labelling and associated discriminatory acts, for example the threat of rape, led many students to conceal their sexual identity, not attend specific classes, terminate their studies and even attempt suicide. Universities should develop policies to promote greater social inclusion and the acceptance of lesbian, gay, bisexual and transgender students. Policies should also specify the steps or approaches to be taken in addressing discriminatory practices. [ABSTRACT FROM PUBLISHER]

Commercial sex is an everyday occurrence across a range of contexts in South Africa. In this paper we turn our attention to the often-marginalised role of the buyers of sex by drawing on narrative interviews with male clients of female sex workers recruited through online advertisements in order to explore the ways in which heterosexual men construct, negotiate and perform their masculinity and sexuality through talking about their experiences of paying for sex. We highlight parallels between men’s narratives of paying for sex and dominant discourses of gender and heterosexuality. We show how men draw on heteronormative sexual scripts in constructing and making sense of paid sexual encounters and how men are simultaneously able to construct and enact a particular idealised version of masculinity and male sexuality through their talk on paying for sex. Finally, we discuss how online resources could be used more extensively in future research with the male clients of sex workers. [ABSTRACT FROM PUBLISHER]

Understanding the health needs and experiences of South African lesbian and bisexual women is imperative for implementing effective and inclusive public health strategies. Such understanding, however, is limited due to the exclusion of these women from most existing research on healthcare access in the region. This paper bridges that gap by investigating the healthcare experiences of lesbian and bisexual women in Cape Town. Data were gathered from 22 interviews with self-identified lesbian and bisexual community members and university students in the Cape Town area. Interviews explored obstacles women face in accessing affirming services, different experiences with public and private healthcare, fear of stigma/discrimination, availability of relevant sexual health information and suggestions to improve existing programmes. Findings suggest that South African lesbians and bisexual women may have a range of both positive and negative experiences in public and private health services, that they use protective strategies when ‘coming out’ and that they find that sexual health information pertinent to them is largely unavailable. These discussions contribute to a more inclusive understanding of the experiences of lesbian and bisexual women accessing healthcare and other services and help to inform providers, thereby enabling them to deliver more meaningful care to lesbian, gay, bisexual and transgender persons in South Africa. [ABSTRACT FROM AUTHOR]

In South Africa over the last two decades, births to girls under the age of 20 years of age have steadily declined. The reason for the decline has been attributed to progressive social and educational policies and more accommodating reactions from families. This paper uses ethnographic data collected in 2001–2002 and again in 2013 in order to compare young women's perceptions and experiences of early childbearing at the turn of the twenty-first century with those of young women a decade later. It makes two main contributions to the literature on early childbearing in South Africa. First, it provides insight into the changes that have occurred regarding how young women experience pregnancy and motherhood over the last decade. Second, it considers changes not only in relation to time but also in relation to the significant social and ideological changes. [ABSTRACT FROM AUTHOR]