Making sense of condoms: Social representations in young people’s HIV-related narratives from six African countries

• Type of Material: Article
• Authors: Kate Winskell Enger, Emory University; Oby Obyerodhyambo, Emory University; Robert Stephenson, Emory University
• Language: English
• Date: 2011-03
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2011 Elsevier Ltd. All rights reserved.
• License: Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported
• Final Published Version (URL): http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21388731
• Title of Journal or Parent Work: Social Science and Medicine
• ISSN: 0277-9536
• Volume: 72
• Issue: 6
• Start Page: 953
• End Page: 961
• Grant/Funding Information: This research was also supported in part by the Emory Center for AIDS Research (P30 AI050409) and by Emory Global Health Institute.; The research described here was supported by Grant Number 1 R03 HD054323 01 A1 from the National Institute of Child Health and Human Development.
• Keywords: narratives; HIV; South-East Nigeria; Namibia; social representations; Burkina Faso; Senegal; youth; condoms; Kenya; Swaziland
• Research Categories: Health Sciences, Public Health; Sociology, General; Biology, Virology

Abstract

Condoms are an essential component of comprehensive efforts to control the HIV epidemic, both for those who know their status and for those who do not. Although young people account for almost half of all new HIV infections, reported condom use among them remains low in many sub-Saharan African countries. In order to inform education and communication efforts to increase condom use, we examined social representations of condoms among young people aged 10–24 in six African countries/regions with diverse HIV prevalence rates: Swaziland, Namibia, Kenya, South-East Nigeria, Burkina Faso, and Senegal. We used a unique data source, namely 11,354 creative ideas contributed from these countries to a continent-wide scriptwriting contest, held from 1st February to 15th April 2005, on the theme of HIV/AIDS. We stratified each country sample by the sex, age (10–14, 15–19, 20–24), and urban/rural location of the author and randomly selected up to 10 narratives for each of the 12 resulting strata, netting a total sample of 586 texts for the six countries. We analyzed the narratives qualitatively using thematic data analysis and narrative-based methodologies. Differences were observed across settings in the prominence accorded to condoms, the assessment of their effectiveness, and certain barriers to and facilitators of their use. Moralization emerged as a key impediment to positive representations of condoms, while humour was an appealing means to normalize them. The social representations in the narratives identify communication needs in and across settings and provide youth-focused ideas and perspectives to inform future intervention efforts.