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Ezobudoda (manhood things) a qualitative study of HIV-positive adolescent boys and young mens health practices in the Eastern Cape Province of South Africa
Men are less vulnerable to HIV acquisition than women, but have poorer HIV-related outcomes. They access HIV services less often and later, and are more likely to die while on antiretroviral therapy (ART). The adolescent HIV epidemic presents further challenges, and AIDS-related illness is the leadi...
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| Format: | Thesis |
| Language: | English |
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Department of Public Health and Family Medicine
2020
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| _version_ | 1867613201722507264 |
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| access_status_str | Open Access |
| author | Gittings, Lesley Blinn |
| author2 | Colvin, Christopher |
| author_browse | Colvin, Christopher Gittings, Lesley Blinn |
| author_facet | Colvin, Christopher Gittings, Lesley Blinn |
| author_sort | Gittings, Lesley Blinn |
| collection | Thesis |
| description | Men are less vulnerable to HIV acquisition than women, but have poorer HIV-related outcomes. They access HIV services less often and later, and are more likely to die while on antiretroviral therapy (ART). The adolescent HIV epidemic presents further challenges, and AIDS-related illness is the leading cause of death among adolescents in sub-Saharan Africa. Such deaths have tripled since 2000, while declining in all other age groups. There is a clear need to better understand health practices for adolescent boys and young men living with HIV, and the processes through which these practices are formed and sustained. This doctorate explores the biosocial lives of adolescent boys and young men living with HIV in the Eastern Cape Province of South Africa. It engaged health-focused life history narratives (n=36), semi-structured interviews (n=32) and analysis of health facility files (n=43), alongside semi-structured interviews with traditional and biomedical health practitioners (n=14). Young male participants were among the first generation to grow up with access to ART and democratic freedoms. In a context where HIV-positivity and men’s inability to fulfil traditional roles are considered signs of social and moral decay, they felt pressure to be ‘good’ HIV-positive patients and respectable young men. As younger children, they performed to norms of HIVpositive patienthood. As they became older, norms of masculinity, including financial achievement, ulwaluko (traditional initiation/circumcision), ‘moral’ behaviour and engaged fatherhood became more important and began to conflict with performances of ‘good’ patienthood. This was most apparent during and following ulwaluko, where societal norms made it difficult to engage with biomedical treatment and care. Despite this, participants and their families demonstrated agency, creativity and resilience in subverting and re-signifying these norms. Participants did not access traditional products or services for HIV-related issues, a finding that deviates from much of the literature. This study suggests that health practices are mediated not only by gender and culture, but also childhood experiences of growing up deeply embedded in the health system, through which participants forged additional health-seeking tools. Findings affirm the syncretic nature of traditional beliefs, documenting the plural and complementary ways that participants engaged with traditional products and services. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/31665 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:21.936Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Department of Public Health and Family Medicine |
| publisherStr | Department of Public Health and Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/31665 Ezobudoda (manhood things) a qualitative study of HIV-positive adolescent boys and young mens health practices in the Eastern Cape Province of South Africa Gittings, Lesley Blinn Colvin, Christopher Hodes, Rebecca Social and Behavioural Sciences Men are less vulnerable to HIV acquisition than women, but have poorer HIV-related outcomes. They access HIV services less often and later, and are more likely to die while on antiretroviral therapy (ART). The adolescent HIV epidemic presents further challenges, and AIDS-related illness is the leading cause of death among adolescents in sub-Saharan Africa. Such deaths have tripled since 2000, while declining in all other age groups. There is a clear need to better understand health practices for adolescent boys and young men living with HIV, and the processes through which these practices are formed and sustained. This doctorate explores the biosocial lives of adolescent boys and young men living with HIV in the Eastern Cape Province of South Africa. It engaged health-focused life history narratives (n=36), semi-structured interviews (n=32) and analysis of health facility files (n=43), alongside semi-structured interviews with traditional and biomedical health practitioners (n=14). Young male participants were among the first generation to grow up with access to ART and democratic freedoms. In a context where HIV-positivity and men’s inability to fulfil traditional roles are considered signs of social and moral decay, they felt pressure to be ‘good’ HIV-positive patients and respectable young men. As younger children, they performed to norms of HIVpositive patienthood. As they became older, norms of masculinity, including financial achievement, ulwaluko (traditional initiation/circumcision), ‘moral’ behaviour and engaged fatherhood became more important and began to conflict with performances of ‘good’ patienthood. This was most apparent during and following ulwaluko, where societal norms made it difficult to engage with biomedical treatment and care. Despite this, participants and their families demonstrated agency, creativity and resilience in subverting and re-signifying these norms. Participants did not access traditional products or services for HIV-related issues, a finding that deviates from much of the literature. This study suggests that health practices are mediated not only by gender and culture, but also childhood experiences of growing up deeply embedded in the health system, through which participants forged additional health-seeking tools. Findings affirm the syncretic nature of traditional beliefs, documenting the plural and complementary ways that participants engaged with traditional products and services. 2020-04-23T01:47:04Z 2020-04-23T01:47:04Z 2019 2020-04-23T01:18:05Z Doctoral Thesis Doctoral PhD https://hdl.handle.net/11427/31665 eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences |
| spellingShingle | Social and Behavioural Sciences Gittings, Lesley Blinn Ezobudoda (manhood things) a qualitative study of HIV-positive adolescent boys and young mens health practices in the Eastern Cape Province of South Africa |
| thesis_degree_str | Doctoral |
| title | Ezobudoda (manhood things) a qualitative study of HIV-positive adolescent boys and young mens health practices in the Eastern Cape Province of South Africa |
| title_full | Ezobudoda (manhood things) a qualitative study of HIV-positive adolescent boys and young mens health practices in the Eastern Cape Province of South Africa |
| title_fullStr | Ezobudoda (manhood things) a qualitative study of HIV-positive adolescent boys and young mens health practices in the Eastern Cape Province of South Africa |
| title_full_unstemmed | Ezobudoda (manhood things) a qualitative study of HIV-positive adolescent boys and young mens health practices in the Eastern Cape Province of South Africa |
| title_short | Ezobudoda (manhood things) a qualitative study of HIV-positive adolescent boys and young mens health practices in the Eastern Cape Province of South Africa |
| title_sort | ezobudoda manhood things a qualitative study of hiv positive adolescent boys and young mens health practices in the eastern cape province of south africa |
| topic | Social and Behavioural Sciences |
| url | https://hdl.handle.net/11427/31665 |
| work_keys_str_mv | AT gittingslesleyblinn ezobudodamanhoodthingsaqualitativestudyofhivpositiveadolescentboysandyoungmenshealthpracticesintheeasterncapeprovinceofsouthafrica |