The PhD Abstracts below were published in MSo Volumes 6, 7 & 8.

Empowerment and HIV Prevention among Women in Nigeria

The Relative Significance of Behavioural and Structural Determinants
Dr Oluwatosin Alo, University of Warwick
Aims: To explore why women in long-term heterosexual relationships in Nigeria are constrained in negotiating safe-sex and how the current interventions are limited. As the dominant ideology in HIV prevention, behavioural models support individual-level interventions and public health communications, drawing on the assumptions that lack of knowledge and individual’s attitudes to HIV are the main problems. However, as underpinned by social determinants theories, the key question raised is whether behavioural models adequately uncover the experiences of vulnerable women, given that they fail to take account of how contextual forces limit women’s ability to undertake safe-sex practices. Methods: This qualitative research was conducted with low and high socio-economic status women, low and high socio-economic status men, and local HIV/AIDS agencies. There were six focus group discussions and 29 in-depth interviews, involving 91 participants who were chosen purposively.

Results: First, this study reveals that the women’s inability to negotiate safe-sex was significantly conditioned by their social environments. In spite of their knowledge of HIV prevention, they were constrained by the fears of relationships breakup, economic insecurity, violence, and the difficulties in justifying why they feel the need to insist on condom use, especially since initiating condom use is antithetical to trust. Second, evidence suggests that women’s access to life opportunities (i.e. higher education and economic power) might be instrumental. However, it does not automatically constitute a direct means of empowering them to negotiate safe sex because of widespread culture of patriarchy.

Conclusions: Policy and strategy on HIV prevention in Nigeria should not be confined to narrow mechanistic individual-level interventions underpinned by behavioural models, but should take a combination approach, focusing on how social, behavioural and biomedical factors overlap in promoting women’s disempowerments which run-counter to safe sex practices.

Dr Oluwatosin Alo

University of Warwick

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Abstracts are published here as provided by the author and in the order in which we receive them.