Young African women must have empowering and receptive social environments for HIV prevention

Abstract

This paper describes a study which explored the lives of young Ugandan women through their voices, and related the findings to HIV prevention paradigms. The research was conducted in the context of the continuing vulnerability of young Ugandan women to HIV; reflected in disproportionately high prevalence compared to young men. The participants of the study were 15 young women aged 15–19 years, from Busoga Region in Eastern Uganda. Given the focus on young women's voices within norms of gender inequality, a narrative methodology was used as a safe space for participants to speak about their lives, expanding on research experiences with young people. The methods used included drawing; written stories and drama; aspirational writing and diary keeping. Forty-eight narratives, in image and word form, represented everyday experiences in young women's lives, as well as difficult experiences of inequality and resistance. Young women portrayed considerable social barriers to empowerment, and a challenging environment of poverty and educational limitations. Young women's representations were analysed using a gender empowerment and positive sexuality framework. The resulting analysis was then critically applied to HIV prevention paradigms. Evidence from the study showed that prevailing HIV prevention paradigms reinforce the difficulties faced by young women in their sexual lives. This research adds to calls for alternative and wider approaches to HIV prevention, underpinned by gender empowerment. Alternative approaches need to build young African women's voices in the spaces of homes, schools and communities. It is vital, however, that such efforts are embedded in more radical change leading to social environments receptive to the needs of young women.

Keywords:

• young women
• HIV
• Africa
• Uganda
• gender empowerment

Acknowledgements

Thanks to the young women participants in this research for so generously giving their time and sharing their experiences with us. Thanks also to fellow researchers Louise Waite of University of Leeds; Patrick Walugembe and Evelyn Namubiru of STF Uganda; and to Cathy Watson, STF Director, and COMDIS, Nuffield Institute of Health and Development, University of Leeds, for enabling us to undertake this research. Special thanks also to the external reviewers and to my colleague, Shoba Nayar, for her invaluable help.

Notes

1. Participants’ names have been changed.