Socio-cultural factors oppress and construct women as men’s objects of desire and pleasure, thus increasing women’s vulnerability to HIV infection and, subsequently, maintaining the HIV and AIDS epidemic and prevalence in South Africa’s rural areas. South Africa’s rural women and their sexuality has not received adequate attention to date. This qualitative study sought to explore rural women’s perceptions on their sexuality and HIV prevention within the socio-cultural context of Schoemansdal (South Africa). A sample of ten participants, who are women from the Swazi ethnic group between the ages of twenty and fifty, were purposefully drawn to participate in this study. Data were collected by means of tape–recorded, face-to-face interviews and focus group discussions. Results of the study reveal that women’s social and cultural contexts have an influence on their perceptions of sexuality and HIV prevention, and that this poses a hindrance to women’s HIV-prevention behaviours such as condom use. The study’s findings reveal that in examining HIV infection and prevention, women’s diverse contexts and experiences cannot continue to be overlooked. This is because they may provide relevant understanding of the epidemic that is plaguing South Africa’s rural women. / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

Unwanted and unintended pregnancies pose major reproductive health challenges to women throughout the world. Despite the availability of modern contraceptives, many women and men fail to use contraceptives effectively. This research focussed on reasons for not using contraceptives effectively in the Northern Tshwane area of the Gauteng Province of the Republic of South Africa (RSA). Structured interviews were conducted with 83 women and 71 men about their contraceptive practices. Age, religion, educational level and residential areas influenced clients' contraceptive practices. These results were categorised for adult males and females as well as for adolescent males and females. Adolescents encountered problems in accessing contraceptive services. Adult females knew most about traditional contraceptives, although men knew about some of these methods, and adolescents used some of them. All respondents could gain additional knowledge about modern contraceptives. The respondents' knowledge about · emergency contraceptives was extremely limited. Although most respondents knew about legalised choice on.termination of pregnancy (CTOP) services in the RSA, they did not know when nor how to access these services. Nurses working in contraceptive health services, revealed during a focus group discussion that a lack of resources (including shortages of malcondoms, contraceptive injections and oral contraceptives) hampered the quality of services that could be rendered. Of particular concern was the nonavailability of Norplant implants and female condoms. Nurses expressed a need for pecific national policy guidelines about supplying contraception to adolescents. Although most nurses knew about emergency contraceptives, they did not promote its use because they assumed that clients would misuse emergency contraceptives.instead of using contraceptives regularly. The nurses indicated that very few facilities offered CTOP services. The nurses regarded women who obtained repeated CTOPs to be misusing these services and suggested that limitations should be placed on the number-of times any woman could obtain such services. The negative attitudes of community members and of colleagues towards persons working in CTOP services caused hardships for them. Recommendations address ways in which contraceptive services could be improved. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)

Indiana University-Purdue University Indianapolis (IUPUI) / While the majority of chronic pain patients report receiving inadequate care, there is evidence that female and Black patients receive less analgesic medications and treatment for their chronic pain compared to male and White patients, respectively. While treatment disparities have been evidenced in the literature, there is little understanding of provider-factors, such as their decision-making awareness and attitudes, which may contribute to the differences in treatment. This investigation employed quantitative and qualitative procedures to examine the relationship between patient demographics and chronic pain treatment variability, providers’ awareness of these non-medical influences on their decisions, and the extent to which providers’ gender and racial attitudes associate with their treatment decisions. Twenty healthcare trainees made pain treatment decisions (opioid, antidepressant, physical therapy, pain specialty referral) for 16 computer-simulated patients presenting with chronic low back pain; patient sex and race were manipulated across vignettes. Participants then selected among 9 factors, including patient demographics, to indicate which factors influenced their treatment decisions for the simulated patients and completed gender and racial attitude measures. After online study completion, follow-up semi-structured interviews were conducted to discuss the medical/non-medical factors that influence trainees’ clinical treatment decisions. Quantitative analysis indicated that 5%-25% of trainees were actually influenced (p<0.10) by patient sex and race in their treatments, and on the whole, trainees gave higher antidepressant ratings to White than Black patients (p<.05). Fifty-five percent demonstrated concordance, or awareness, between their actual and reported use of patient demographics. Follow-up McNemar’s test indicated trainees were generally aware of the influence of demographics on their decisions. Overall, gender and racial attitudes did not associate with trainees’ treatment decisions, except trainees’ complementary stereotypes about Black individuals were positively associated with their opioid decisions for White patients. During qualitative interviews, aware and unaware trainees discussed similar themes related to sex and racial/ethnic differences in pain presentation and tailoring treatments. We found that (1) a subset of trainees were influenced by patient sex and race when making chronic pain treatment decisions, (2) trainees were generally aware of the influence of patient demographics, and (3) trainees discussed differences in pain presentation based on patients’ sex and ethnic origin. These findings suggest trainees’ are influenced by patient demographics and hold stereotypes about patient populations, which may play a role in their decision-making.

The purpose of this study was to explore and describe contributing factors that influence the perceptions of women with fibroids from diverse cultures regarding hysterectomy. The area of research was delimited to issues of hysterectomy among women with fibroid uterus. The study employed a descriptive explorative method and data were collected by means of structured questionnaires. The study was conducted in one academic referral hospital, over a period of six months. The respondents were the patients with fibroid uterus and the doctors and nurses in the gynaecological units of the hospital. The majority of the patients indicated that they were afraid of undergoing a hysterectomy because of the social stigma associated with this life-saving procedure, such as alienation or marginalization by members of their respective communities. The nursing staff and gynaecologists in the unit emphasized the deep-seated fear of hysterectomy amongst women from diverse cultures. The study found that women need information about their bodies and how they function. Health education is also needed for women and their communities. Research is needed amongst members of different communities and diverse cultures to voice their perceptions of women undergoing hysterectomy because of ill health. / Health Studies / M.A. (Health studies)

The purpose of this study was to explore and describe contributing factors that influence the perceptions of women with fibroids from diverse cultures regarding hysterectomy. The area of research was delimited to issues of hysterectomy among women with fibroid uterus. The study employed a descriptive explorative method and data were collected by means of structured questionnaires. The study was conducted in one academic referral hospital, over a period of six months. The respondents were the patients with fibroid uterus and the doctors and nurses in the gynaecological units of the hospital. The majority of the patients indicated that they were afraid of undergoing a hysterectomy because of the social stigma associated with this life-saving procedure, such as alienation or marginalization by members of their respective communities. The nursing staff and gynaecologists in the unit emphasized the deep-seated fear of hysterectomy amongst women from diverse cultures. The study found that women need information about their bodies and how they function. Health education is also needed for women and their communities. Research is needed amongst members of different communities and diverse cultures to voice their perceptions of women undergoing hysterectomy because of ill health. / Health Studies / M.A. (Health studies)