Making sense of fidelity: young Africans' cross-national and longitudinal representations of fidelity and infidelity in their HIV-related creative narratives, 1997-2014.

Mutual fidelity and partner reduction have been identified as key behavioural strategies to prevent HIV transmission in sub-Saharan Africa, particularly following recognition of the role that multiple concurrent sexual partnerships play in driving generalised HIV epidemics. We analysed social representations of fidelity and infidelity in a sample of 1,343 narratives about HIV written by young Africans between 1997 and 2014. The narratives were written at four different time points (1997, 2005, 2008, 2014) by authors aged 10-24 in urban and rural areas of Senegal, Burkina Faso, South-east Nigeria, Kenya and Eswatini. We combined three analytical approaches: descriptive statistics of quantifiable characteristics of the narratives, thematic data analysis and a narrative-based approach. In the sample, fidelity is often promoted as the ideal by narrators, peers and romantic partners, in line with broader discourses around HIV prevention, romantic relationships, familial obligations, and religious and moral imperatives. However, mutual fidelity is rarely modelled in the narratives and representations of combining methods to prevent HIV from entering relationships via infidelity are uncommon. Representations of fidelity reflect loss-framed fear arousal techniques that perpetuate HIV-related stigma. Narrative-based approaches that facilitate skills-building, critical reflection and address stigma can better address fidelity and partner reduction.

Young Africans' social representations of sexual abuse of power in their HIV-related creative narratives, 2005-2014: cultural scripts and applied possibilities.

The sexual abuse of power is a form of sexual coercion in which individuals - typically male - use their positions of authority to obtain sex. We analysed social representations of sexual abuse of power in a sample of 1,446 narratives about HIV written by young Africans between 2005 and 2014. The narratives were prepared at five different points in time (2005, 2008, 2011, 2013 and 2014) by authors aged 10-24 in urban and rural areas of Swaziland, Kenya, South-East Nigeria, Burkina Faso and Senegal. We combined three analytical approaches: descriptive statistics of quantifiable characteristics of the narratives, thematic data analysis and a narrative-based approach. Analysis revealed two underlying cultural scripts describing the sexual abuse of power between (a) teachers and female students, and (b) male employers and domestic workers. Cross-national variation was evident in the emphasis authors placed on socio-contextual inequalities, particularly poverty, and on individual level blame. While a minority of Nigerian and Burkinabe authors depicted female characters creatively exercising agency and avoiding unwanted sex, overall there was little critique of underlying assumptions of male sexual entitlement and female responsibility for controlling male sexuality in the context of unequal control of resources. We outline recommendations for strategies to deconstruct these harmful scripts.

Measles outbreak investigation in Southwest Ethiopia, February 2017.

Effective response to complex disease outbreaks requires health workers to be equipped with the necessary knowledge and skills. This case study, based on an actual measles outbreak that occurred in Ethiopia in January 2017, was developed to enhance participants' knowledge and skills on disease outbreak investigation and response using epidemiological study designs. This case study is prepared for health care workers with an advanced level of training in public health. This case study should be completed in a classroom setting and takes approximately 3 hours to complete.