Taxi 'Sugar Daddies' and Taxi queens: Male Taxi Driver Attitudes Regarding Transactional Relationships in the Western Cape; South Africa

Media reports are emerging on the phenomenon of young girls who travel with older mini-bus taxi drivers; and who are thought to have sex with the drivers in exchange for gifts and money. The extent to which such relationships might facilitate unsafe sexual practices and increased risks for both the men and the young women; often referred to as taxi queens; remains an important question in the light of the current challenges of HIV/AIDS in sub-Saharan Africa. However; very little research has been undertaken on this issue; especially regarding the perceptions and experiences of taxi drivers. Thus this paper aims to provide some preliminary findings on taxi drivers' attitudes and beliefs about taxi queens and their relationships with taxi drivers. A 22-item questionnaire was administered to 223 male taxi drivers in two regions in the Western Cape Province; South Africa. Taxi drivers in this study largely saw the relationship between taxi drivers and the young girls who ride with them as providing status for both the girls and drivers; and there seemed to be recognition of the transactional nature of the relationship between taxi drivers and taxi queens. The stigmatisation of young girls who ride with taxi drivers was evident. Drivers had knowledge and awareness of the risks of unsafe sex and supported condom use; although there appeared to be some uncertainty and confusion about the likelihood of HIV infection between drivers and girls. While taxi drivers recognised the role of alcohol in relationships with young girls; they seemed to deny that the abuse of drugs was common. The study highlights a number of key areas that need to be explored with men in the taxi industry; in order to address risk behaviours for both taxi drivers and the girls who ride with them

Stigma and discrimination experiences of HIV-positive men who have sex with men in Cape Town, South Africa.

Since the primary mode of HIV transmission in sub-Saharan Africa is heterosexual, research focusing on the sexual behaviour of men who have sex with men (MSM) is scant. Currently it is unknown how many people living with HIV in South Africa are MSM and there is even less known about the stigmatisation and discrimination of HIV-positive MSM. The current study examined the stigma and discrimination experiences of MSM living with HIV/AIDS in South Africa. Anonymous venue-based surveys were collected from 92 HIV-positive MSM and 330 HIV-positive men who only reported sex with women (MSW). Internalised stigma was high among all HIV-positive men who took part in the survey, with 56% of men reporting that they concealed their HIV status from others. HIV-positive MSM reported experiencing greater social isolation and discrimination resulting from being HIV-positive, including loss of housing or employment due to their HIV status, however these differences were not significant. Mental health interventions, as well as structural changes for protection against discrimination, are needed for HIV-positive South African MSM.

Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa.

BACKGROUND: The HIV epidemic continues to amplify in southern Africa and there is a growing need for HIV prevention interventions among people who have tested HIV positive. METHODS: Anonymous surveys were completed by 413 HIV-positive men and 641 HIV-positive women sampled from HIV/AIDS services; 73% were <35 years old, 70% Black African, 70% unemployed, 75% unmarried, and 50% taking antiretroviral treatment. RESULTS: Among the 903 (85%) participants who were currently sexually active, 378 (42%) had sex with a person to whom they had not disclosed their HIV status in the previous 3 months. Participants who had not disclosed their HIV status to their sex partners were considerably more likely to have multiple partners, HIV-negative partners, partners of unknown HIV status and unprotected intercourse with non-concordant sex partners. Not disclosing their HIV status to partners was also associated with having lost a job or a place to stay because of being HIV positive and feeling less able to disclose to partners. CONCLUSIONS: HIV-related stigma and discrimination are associated with not disclosing HIV status to sex partners, and non-disclosure is closely associated with HIV transmission risk behaviours. Interventions are needed in South Africa to reduce the AIDS stigma and discrimination and to assist people with HIV to make effective decisions on disclosure.

Social constructions of gender roles, gender-based violence and HIV/AIDS in two communities of the Western Cape, South Africa.

The links between gender roles, gender-based violence and HIV/AIDS risk are complex and culturally specific. In this qualitative study we investigated how women and men in two black communities in the Western Cape, South Africa, constructed their gender identities and roles, how they understood gender-based violence, and what they believed about the links between gender relations and HIV risk. First we conducted 16 key informant interviews with members of relevant stakeholder organisations. Then we held eight focus group discussions with community members in single-sex groups. Key findings included the perception that although traditional gender roles were still very much in evidence, shifts in power between men and women were occurring. Also, gender-based violence was regarded as a major problem throughout communities, and was seen to be fuelled by unemployment, poverty and alcohol abuse. HIV/AIDS was regarded as particularly a problem of African communities, with strong themes of stigma, discrimination, and especially 'othering' evident. Developing effective HIV/AIDS interventions in these communities will require tackling the overlapping as well as divergent constructions of gender, gender violence and HIV which emerged in the study.

The evaluation of immediate behavioural outcomes of the syndromic case management approach for the treatment of patients with sexually transmitted infections at PHC centres in South Africa: knowledge, attitudes, beliefs and sexual behaviour.

This study aimed to determine the immediate behavioural outcomes of the WHO syndromic case management model for STIs in the public health sector in South Africa, on the levels of knowledge, attitudes and beliefs, and behavioural practices (KABPs) concerning STIs. An outcomes evaluation was conducted using KABP methodology. Exit interviews were conducted with 126 STI and non-STI patients at 24 primary health care (PHC) centres in four provinces. Both groups were found to have equally high levels of knowledge about STIs and their attitudes towards and beliefs about STIs were mostly practical and slightly negative, with only promiscuity both stereotyped and stigmatised. However, both groups were found to engage in risky sexual behavioural practices although they also indicated very strong intentions to use condoms in future. Overall, no significant differences were found between the two groups on any of the variables investigated. The implications of these findings for the control and prevention of both classic STIs and HIV/AIDS in South Africa are discussed.

Green fluorescent protein as a novel tool to measure apoptosis and necrosis.

BACKGROUND: Several apoptosis-detecting methods are currently available. Many of them are work intensive and require the additional use of antibodies, dyes, specific substrates, or enzymatic reactions. A simple, fast, and reliable method was developed to test for apoptosis or necrosis using mouse and human cell lines (e.g., Jurkat, A20.2J, and PB3c cells) stably transfected with a vector coding for green fluorescent protein (GFP) as indicator cells. METHODS: Apoptosis in GFP-transfected cell lines was induced either by soluble Fas-Ligand (sFasL), recombinant human TRAIL (rhTRAIL), or interleukin-3 (IL-3) deprivation. Necrosis was induced by polyclonal anti-A20 and complement treatment of GFP-transfected A20. Cells were analyzed by flow cytometry for GFP fluorescence. Propidium iodide and Annexin V staining were used to confirm the results obtained with the GFP-method. RESULTS: Live GFP-transfected cells show a strong fluorescence intensity, which is significantly diminished upon induction of apoptosis, whereas necrotic GFP-transfected cells almost completely lose their GFP-associated fluorescence. Apoptosis but not necrosis of GFP-transfected cells was blocked by the use of a caspase inhibitor. The results are highly comparable to conventional apoptosis-detecting methods. CONCLUSIONS: The advantage of our GFP-based assay compared with other methods is the analysis of apoptosis or necrosis without the necessity for additional staining or washing steps, making it an ideal tool for screening apoptotic or necrotic stimuli.

Prevention implications of AIDS discourses among South African women.

Social constructionist and feminist analyses have done much to extend the understanding of AIDS beyond the biomedical to include social accounts of the constitution of AIDS knowledge and meanings. However, these frameworks have not translated easily into realistic responses to the paradox of women being seen as responsible for HIV prevention, while they lack the power to implement safe sex behavior. This study explores the range and interplay of discursive themes which South African women drew on regarding AIDS and identifies constraints and opportunities for realistic prevention. The research involved 14 focus group discussions with women. Two main interpretative repertoires regarding AIDS were identified from the texts: one concerning the medicalization and the other the stigmatization of the disease. Although these representations were not unchallenged, the pervasive sense was of denial of own risk, fear, and fatalism. However, the analysis highlighted the complexity of issues to be faced in developing effective prevention initiatives.

PIP: In African countries, where women lack social status and access to economic resources, gendered power relations can increase their vulnerability to acquired immunodeficiency syndrome (AIDS). To further understanding of how South African women experience AIDS, 14 focus groups with a total of 95 participants were conducted. Two main AIDS-related themes emerged: medicalization and stigmatization. Women spoke of AIDS as a grave, infectious, and incurable epidemic. This medical discourse served to reinforce an image of medical professionals as experts with the power to develop preventive strategies for the general population. Notable was a lack of reference to traditional conceptions of health and illness -- a phenomenon that further distanced AIDS from the realm of common experience. Also evident was an association of AIDS with sexual promiscuity and a tendency to stigmatize its victims. AIDS was perceived as a traumatic, shameful event that would lead infected persons to withdraw from traditional sources of social support. High levels of fear of AIDS resulted in increased denial of risk and fatalism about any potential for curbing the epidemic. Most participants did not consider themselves or their partners at risk; AIDS was viewed as a disease that affects prostitutes, injecting drug users, homosexuals, and Whites. Charges of racial discrimination were prominent in the discussions, and past government campaigns to curb South Africa's Black population fostered suspicion of condom use promotion.

Social Constructions of Gender Roles; Gender-Based Violence and HIV/AIDS in two Communities of the Western Cape; South Africa

The links between gender roles; gender-based violence and HIV/AIDS risk are complex and culturally specific. In this qualitative study we investigated how women and men in two black communities in the Western Cape; South Africa; constructed their gender identities and roles; how they understood gender-based violence; and what they believed about the links between gender relations and HIV risk. First we conducted 16 key informant interviews with members of relevant stakeholder organisations. Then we held eight focus group discussions with community members in single-sex groups. Key findings included the perception that although traditional gender roles were still very much in evidence; shifts in power between men and women were occurring. Also; gender-based violence was regarded as a major problem throughout communities; and was seen to be fuelled by unemployment; poverty and alcohol abuse. HIV/AIDS was regarded as particularly a problem of African communities; with strong themes of stigma; discrimination; and especially 'othering' evident. Developing effective HIV/AIDS interventions in these communities will require tackling the overlapping as well as divergent constructions of gender; gender violence and HIV which emerged in the study