Author Archives: Becca Fielding-Miller

Registration Open! From AIDS Crisis to Opportunity: What the World Can Learn From Swaziland

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crisis_to_oppertunity

Registration is now open for our upcoming meeting!

Delegates will have the opportunity to learn about the latest research on HIV in Swaziland, including work that will be presented at the Durban AIDS Conference.

The meeting will feature networking opportunities to support relationships and communication between Government, community stakeholders, and leading Swazi and international researchers.

People living with HIV, people with disabilities, key populations, women, youth, and other marginalized people are particularly invited to attend.

Delegates will be asked to pay a nominal registration fee of SZL 350 or $40 USD. Bursaries are available for those who qualify.

Register here: ConferenceRegistrationForm

From AIDS Crisis to Opportunity: What the World Can Learn from Swaziland

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crisis_to_oppertunity

The Swaziland National Emergency Response Council on HIV and AIDS (NERCHA) and Ministry of Health, in partnership with The Swaziland AIDS Research Network and the Balsillie School of International Affairs is pleased to issue a call for abstracts for an upcoming meeting From AIDS Crisis to Opportunities: What the world can learn from Swaziland from July 12th – 14th.

This meeting will be held in Swaziland and is designed to capitalize on the adjacency of the 2016 International AIDS conference in Durban. The objective is to build networking and dissemination opportunities for Government, community, and leading Swazi and international researchers. Delegates will be asked to pay a nominal registration fee, with bursaries available for those who qualify.

Registration and further conference details will be posted on this website in mid-April.

Cultural consensus modeling to measure transactional sex in Swaziland: Scale building and validation

Rebecca Fielding-Miller, Kristin Dunkle, Hannah Cooper, Michael Windle, Craig Hadley

Transactional sex is associated with increased risk of HIV and gender based violence in southern Africa and around the world. However the typical quantitative operationalization, “the exchange of gifts or money for sex,” can be at odds with a wide array of relationship types and motivations described in qualitative explorations. To build on the strengths of both qualitative and quantitative research streams, we used cultural consensus models to identify distinct models of transactional sex in Swaziland. The process allowed us to build and validate emic scales of transactional sex, while identifying key informants for qualitative interviews within each model to contextualize women’s experiences and risk perceptions. We used logistic and multinomial logistic regression models to measure associations with condom use and social status outcomes. Fieldwork was conducted between November 2013 and December 2014 in the Hhohho and Manzini regions. We identified three distinct models of transactional sex in Swaziland based on 124 Swazi women’s emic valuation of what they hoped to receive in exchange for sex with their partners. In a clinic-based survey (n = 406), consensus model scales were more sensitive to condom use than the etic definition. Model consonance had distinct effects on social status for the three different models. Transactional sex is better measured as an emic spectrum of expectations within a relationship, rather than an etic binary relationship type. Cultural consensus models allowed us to blend qualitative and quantitative approaches to create an emicly valid quantitative scale grounded in qualitative context.

Read more in the journal Social Science and Medicine

Call for Abstracts!

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National HIV and AIDS Conference

“From AIDS Crisis to Opportunities: What the world can learn from Swaziland”

12 -14 July, 2016

The Swaziland National Emergency Response Council on HIV and AIDS (NERCHA) and Ministry of Health, in partnership with The Swaziland AIDS Research Network and the Balsillie School of International Affairs is pleased to issue a call for abstracts for an upcoming conference with the theme “From AIDS Crisis to Opportunities: What the world can learn from Swaziland” from 12th – 14th July 2016.

 

This meeting will be held in Swaziland and is designed to capitalize on the adjacency of the 2016 International AIDS conference in Durban from 18 – 22 July 2016. The objective is to build networking and dissemination opportunities for Government, community, and leading Swazi and international researchers.

 

Abstracts can be submitted on aspects of HIV prevention, treatment or impact mitigation as these relate to Swaziland, and on the following sub-themes:

  • Funding and Economics which include the HIV funding landscape, economics of HIV, HIV response efficiencies and effectiveness.
  • Social Sciences which will comprise of behavioral and cultural influences, law, policy, impact mitigation, human rights and gender issues, stigma and discrimination
  • Treatment, care and support which include research around the  treatment cascade (e.g. compliance), innovative drugs and complementary and alternative therapies (including Traditional Health Practitioners)
  • Systems and synergies which will focus on HIV and AIDS mainstreaming, health systems, community systems and other sectors including decentralization of the response, role of civil society and academic institutions.
  • Leadership and Policy that will entail discussions on political leadership, traditional leadership, laws, policies, partnerships and collaboration.

 

We strongly encourage submissions from those who have submitted abstracts to the International AIDS Conference, 2016 and also from people living with HIV, women, sexual minorities, key populations, youth, students, people with disabilities, and community activists and organizers.

 

Final abstracts will be selected by the conference organizers using a blinded process. Following the conference, outstanding abstracts’ authors will be invited to submit completed manuscripts for a dedicated issue of the African Journal of AIDS Research. In addition, a few of the outstanding abstracts will be selected for sponsorship to participate at the International AIDS Conference in Durban, 18 – 24 July, 2016.

 

Submission deadline is March 11, 2016. Abstracts should be submitted to tengetile.dlamini@nercha.org.sz

 

All abstracts must be in English, no more than 350 words, and may relate to research or practice. Please structure your abstracts using the headings below:

 

Research:

Sub-theme – Title of the abstract and sub-theme abstract is submitted for consideration

Objective – Description of the problem, objective of the study, and research question with study hypothesis, if applicable.

Methods – Methods for exploring research question or statistically testing the hypothesis and description of sampling framework.

Results – Summary of findings.

Conclusion – Brief description of study implications and relevance

 

Practice:

Sub-theme – Title of the abstract and sub-theme abstract is submitted for consideration

Project – Description of the project

Issue – Need or problem addressed by the project

Results – Summary of implementation process, including barriers and facilitators.

Lessons Learned – Implications of project and suggested way forward.

 

For queries and further details please contact tengetile.dlamini@nercha.org.sz

Upcoming Webinar: What do we mean when we say transactional sex?

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Transactional sex is an important driver of the HIV epidemic, but one that is difficult to operationalize and measure. This study used cultural consensus modeling, a measurement approach borrowed from cultural anthropology, to identify three distinct models of transactional sex in Swaziland:

  • A rural model composed of slightly older women with slightly lower education
  • An urban model predominated by relatively well educated women
  • A model primarily practised by university students

The cultural consensus model process resulted in a weighted scale that could be used to measure the degree to which a clinic-based sample of women participated in each of the three models.

This webinar discusses how the study found that the social acceptability of the model had important ramifications for what strategy women used to protect themselves from HIV within their relationship

Sign up here: http://strive.lshtm.ac.uk/news/what-do-we-mean-when-we-say-transactional-sex-–-learning-lab-18-february-2016

Cultural consensus modeling to measure transactional sex in Swaziland: Scale building and validation

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Rebecca Fielding-Miller, Kristin Dunkle, Hannah Cooper, Michael Windle, Craig Hadley

Transactional sex is associated with increased risk of HIV and gender based violence in southern Africa and around the world. However the typical quantitative operationalization, “the exchange of gifts or money for sex,” can be at odds with a wide array of relationship types and motivations described in qualitative explorations. To build on the strengths of both qualitative and quantitative research streams, we used cultural consensus models to identify distinct models of transactional sex in Swaziland. The process allowed us to build and validate emic scales of transactional sex, while identifying key informants for qualitative interviews within each model to contextualize women’s experiences and risk perceptions. We used logistic and multinomial logistic regression models to measure associations with condom use and social status outcomes. Fieldwork was conducted between November 2013 and December 2014 in the Hhohho and Manzini regions. We identified three distinct models of transactional sex in Swaziland based on 124 Swazi women’s emic valuation of what they hoped to receive in exchange for sex with their partners. In a clinic-based survey (n=406), consensus model scales were more sensitive to condom use than the etic definition. Model consonance had distinct effects on social status for the three different models. Transactional sex is better measured as an emic spectrum of expectations within a relationship, rather than an etic binary relationship type. Cultural consensus models allowed us to blend qualitative and quantitative approaches to create an emicly valid quantitative scale grounded in qualitative context.

Read more in the journal Social Science and Medicine

Reckoning HIV/AIDS care: A longitudinal study of community home-based caregivers and clients in Swaziland

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Robin Root, Arnau van Wyngaard, Alan Whiteside

The article is a descriptive case study of a community home-based care (CHBC) organisation in Swaziland that depicts the convergence of CHBC expansion with substantially improved health outcomes. Comprised of 993 care supporters who tend to 3 839 clients in 37 communities across southern Swaziland, Shiselweni Home-based Care (SHBC) is illustrative of many resource-limited communities throughout Africa that have mobilised, at varying degrees of formality, to address the individual and household suffering associated with HIV/AIDS. To better understand the potential significance of global and national health policy/programming reliance on community health workers (task shifting), we analysed longitudinal data on both care supporter and client cohorts from 2008 to 2013. Most CHBC studies report data from only one cohort. Foremost, our analysis demonstrated a dramatic decline (71.4%) among SHBC clients in overall mortality from 32.2% to 9.2% between 2008 and 2013. Although the study was not designed to establish statistical significance or causality between SHBC expansion and health impact, our findings detail a compelling convergence among CHBC, improved HIV health practices, and declines in client mortality. Our analysis indicated (1) the potential contributions of community health workers to individual and community wellbeing, (2) the challenges of task-shifting agendas, above all comprehensive support of community health workers/care supporters, and (3) the importance of data collection to monitor and strengthen the critical health services assigned to CHBC. Detailed study of CHBC operations and practices is helpful also for advancing government and donor HIV/AIDS strategies, especially with respect to health services decentralisation, in Swaziland and similarly profiled settings

Read more in the African Journal of AIDS Research

Closing the health gap in a generation: exploring the association between household characteristics and schooling status among orphans and vulnerable children in Swaziland

BN Dlamini, C Chiao

Swaziland has one of the highest HIV/AIDS prevalences in the world, which has contributed to many Swazi children being left as orphans and vulnerable children (OVC). In 2010, there were 78,000 AIDS orphans in the country and the number is expected to increase given the current HIV prevalence. The WHO aims to close the gap in a generation and eliminate health inequality; as a result the Swazi Government began in 2005 to provide financial support to the education of OVC. Prior research has indicated that household characteristics are some of the major determinants with respect to schooling status among children. We have examined the association between household characteristics and schooling status of OVC. Schooling status may vary by gender and by age, as well as by other sociodemographic factors, in sub-Saharan African societies, and therefore we have also included a comprehensive set of appropriate variables in all of our multivariate analyses. Using existing data from the Swaziland Multiple Indicator Cluster Survey 2010, a total of 5890 children aged 7-18 years old were analyzed. The results from the multivariate logistic regressions showed that non-OVC were more likely than OVC to be in school (OR = 2.18, p < 0.001), even after taking other variables into considerations. The OVC in socioeconomically disadvantaged households, such as those with lower levels of household wealt, and those who resided in an urban area, were less likely to be in school. These findings suggest that education programs for OVC need to be household-appropriate.

Read more in the journal AIDS Care

Urban cemeteries in Swaziland: Materializing dignity

Casey Golomski

This photo essay traces the materiality of urban cemeteries in Swaziland to underscore the production of dignity in contemporary funeral culture. Increasingly, death and burial in town are realities for many people who have lost social ties or land tenure in rural areas where burials customarily take place. Urban burials register anxieties about cultural and socio-economic change and the value of human life, but new mortuary consumer markets have incited novel commemorative practices that qualify these burials as dignified. The photos derive from long-term ethnographic research in Swaziland on transformations of dying, death and funerals in the wake Southern Africa’s HIV/Aids epidemic.

Read more in the journal Anthropology Southern Africa