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Deslauriers V, Bignami S, Delaunay V, Sandberg J. Does social integration really protect against loneliness? Gender determinants in a rural population in Senegal. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:423-434. [PMID: 38078637 DOI: 10.3917/spub.234.0423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Introduction This study aims to test a measure of loneliness and to document its determinants among rural men and women in Senegal. Methods Data from the Niakhar Social Networks and Health Project were used. The analysis sample was composed of 1261 residents aged 16 years and older. Analyses were stratified by gender. Associations between loneliness and its determinants (socio-demographic characteristics and level of social integration) were examined with multivariate logistic regressions. Results Loneliness affects almost one in three people. Its prevalence is more significant for women. Multivariate analyses indicate that for both men and women, older age intensifies loneliness and recent migration experience protects against loneliness. Other factors act differently according to gender. Widowhood or divorce for men, and residential isolation for women, worsen the experience of loneliness. Social integration protects men against loneliness, but this relationship is not found for women. Finally, the effect of the level of social integration on loneliness varies with age. Conclusions This study, which documents a phenomenon which is often neglected by misconceptions about social solidarities in these societies, suggests that loneliness is not linked to the same issues for men and women. For men, being socially integrated and being in a union are protective, whereas for women, poor social integration does not appear to be a clear source of loneliness, unlike residential isolation.
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Affiliation(s)
| | | | - Valérie Delaunay
- Institut de recherche pour le développement, Laboratoire Population Environnement Développement – Marseille – France
| | - John Sandberg
- George Washington University, School of public health – Washington – USA
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Fiorentino M, Coulibaly A, Kamissoko A, Dramé S, Koné A, Traoré S, Koné M, Fofana S, Kanicomo F, Bagayoko G, Cissé M, Girard G, Spire B, Dembélé Keita B, Sagaon-Teyssier L. Highly precarious general and sexual health conditions of young domestic servants: results from a qualitative exploratory study and perspectives for community-based research in Bamako, Mali. AIDS Care 2023; 35:2024-2035. [PMID: 36929739 DOI: 10.1080/09540121.2023.2189225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
Most domestic servants (DS) in Mali are very young female migrants living in precarious conditions. We aimed to understand their living and working conditions in relation to their general and sexual health. Seven focus groups (53 participants) were conducted by the DS community-based organization ADDAD. Narratives were thematically analyzed using an inductive method. The dominant emerging theme was DS' strong dependence on their employers. Employers' attitudes regarding DS workload, the provision of food, water and hygiene products, housing conditions, and healthcare cover, appeared decisive for DS' physical and mental health, and the type of healthcare they used (self-medication, traditional care, healthcare facilities). Psychological, physical and sexual violence in employers' households was frequent. HIV/STI prevention knowledge was poor. These results highlight the serious risks for DS in terms of HIV/STI and unwanted pregnancies. DS were interested in receiving healthcare from ADDAD; this was motivated by the organization's trusting and understanding community-based environment, and DS' fear of discrimination in healthcare facilities. This study highlights the relevance of tackling the defense of rights and sexual health promotion for DS at the community level. Its findings can help identify research questions to evaluate the extent to which DS constitute a key HIV population.
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Affiliation(s)
- Marion Fiorentino
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Abdouramane Coulibaly
- Faculté de médecine et d'Odontosomatologie de Bamako, IMU 3189 "Environnement, santé, sociétés", Bamako, Mali
| | - Aliou Kamissoko
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire (CIRSAC), Bamako, Mali
| | - Souleymane Dramé
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire (CIRSAC), Bamako, Mali
| | - Aïchata Koné
- ADDAD Association de Défense des Droits des Aide-ménagères et Domestiques, Bamako, Mali
| | - Sokona Traoré
- ADDAD Association de Défense des Droits des Aide-ménagères et Domestiques, Bamako, Mali
| | - Mariam Koné
- ADDAD Association de Défense des Droits des Aide-ménagères et Domestiques, Bamako, Mali
| | - Sitan Fofana
- ADDAD Association de Défense des Droits des Aide-ménagères et Domestiques, Bamako, Mali
| | | | - Gnamé Bagayoko
- ADDAD Association de Défense des Droits des Aide-ménagères et Domestiques, Bamako, Mali
| | - Mamadou Cissé
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire (CIRSAC), Bamako, Mali
| | - Gabriel Girard
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Bruno Spire
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Bintou Dembélé Keita
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire (CIRSAC), Bamako, Mali
| | - Luis Sagaon-Teyssier
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire (CIRSAC), Bamako, Mali
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Lee JK, Gutin SA, Getahun M, Okiring J, Neilands TB, Akullian A, Ssali S, Cohen CR, Maeri I, Eyul P, Kamya MR, Bukusi EA, Charlebois ED, Camlin CS. Condom, modern contraceptive, and dual method use are associated with HIV status and relationship concurrency in a context of high mobility: A cross-sectional study of women of reproductive age in rural Kenya and Uganda, 2016. Contraception 2023; 117:13-21. [PMID: 36115610 PMCID: PMC9984206 DOI: 10.1016/j.contraception.2022.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Mobility (international/internal migration, and localized mobility) is a key driver of the HIV epidemic. While mobility is associated with higher-risk sexual behavior in women, a possible association with condom, modern contraceptive, and dual method use among women living with HIV (WLHIV), is unknown. In addition, HIV status and sexual behaviors such as relationship concurrency may also affect condom, modern contraceptive, and dual method use. STUDY DESIGN We surveyed sexually active women (N = 1067) aged 15 to 49 in 12 communities in Kenya and Uganda participating in a test-and-treat trial in 2015 to 2016. Generalized (unordered) multinomial logistic regression models accounting for community clustering examined associations between mobility (overnight travel away from home in past 6 months and any migration within past 2 years) and condom, modern contraceptive (i.e., oral contraceptive pills, injectables, intrauterine devices, implants, vasectomy, tubal ligation; excluding male/female condoms), and dual method use within past 6 months, adjusting for key covariates such as HIV status and relationship concurrency. RESULTS WLHIV relative to HIV-negative women (ratios of relative risk [RRR] = 3.76, 95% confidence interval [CI]: 2.40-5.89), and women in concurrent relative to monogamous relationships (RRR = 4.03, 95% CI 1.9-8.50) had higher odds of condom use alone. In contraceptive use models, WLHIV relative to HIV-negative women were less likely to use modern contraceptive methods alone (RRR = 0.51, 95% CI 0.36-0.73). Relationship concurrency (RRR = 4.51, 95% CI 2.10-9.67) and HIV status (RRR = 3.97, 95% CI 2.43-6.50) were associated with higher odds of dual method use while mobility was marginally associated with higher odds of dual method use (RRR = 1.65, 95% CI 0.99-2.77, p = 0.057). CONCLUSIONS Mobility had a potential impact on dual method use in Kenya and Uganda. In addition, our findings highlight that WLHIV were using condoms and dual methods more, but modern contraceptives less, than HIV-negative women. Those in concurrent relationships were also more likely to use condoms or dual methods. These findings suggest that in a context of high mobility, women may be appropriately assessing risks and taking measures to protect themselves and their partners from unintended pregnancies and acquisition and transmission of HIV. IMPLICATIONS Our findings point to a need to strengthen accessibility of sexual and reproductive health services for both mobile and residentially stable women in settings of high mobility and high HIV prevalence.
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Affiliation(s)
- Joi K. Lee
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA,Corresponding author: Joi Lee, , Advancing New Standards in Reproductive Health (ANSIRH) Program, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), 1330 Broadway, Suite 1100, Oakland, CA 94512
| | - Sarah A. Gutin
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, USA
| | - Monica Getahun
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jaffer Okiring
- Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
| | - Torsten B. Neilands
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, USA
| | - Adam Akullian
- Institute for Disease Modeling (IDM), Seattle, Washington, USA
| | - Sarah Ssali
- Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda,School of Women and Gender Studies, Makerere University College of Health Sciences, Kampala, Uganda
| | - Craig R. Cohen
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Irene Maeri
- Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Patrick Eyul
- Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
| | - Moses R. Kamya
- Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda,School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Elizabeth A. Bukusi
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA,Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Edwin D. Charlebois
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, USA
| | - Carol S. Camlin
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA,Division of Prevention Science, Department of Medicine, University of California, San Francisco, USA
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Mounchit N. Étendre ses espaces d’agir dans la
sphère conjugale : la migration comme ressource. ENFANCES, FAMILLES, GÉNÉRATIONS 2020. [DOI: 10.7202/1070315ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cadre de la recherche : S’inscrivant dans
une recherche interrogeant les effets de l’expérience migratoire sur les
parcours conjugaux, cet article s’intéresse aux modalités des réagencements
observés. Si la lecture des travaux existants amène au constat des répercussions
inégales du départ sur les rapports de genre (entre contraintes et espaces
d’autonomie, notamment pour les femmes), la question du « comment » des
transformations à l’œuvre reste encore à explorer (Catarino et Morokvasic,
2005).
Objectifs : En abordant l’espace conjugal
comme un lieu traversé par des rapports de pouvoir, il s’agit de voir comment la
situation migratoire intervient dans la formulation des règles de la vie
conjugale et de quelles manières elle forme une ressource à disposition des
individus dans le cadre des rapports de force conjugaux.
Méthodologie : Ce travail s’appuie sur
les résultats d’une recherche doctorale principalement basée sur la conduite de
quarante entretiens biographiques menés auprès de femmes émigrées d’Afrique de
l’Ouest et centrale résidant en France.
Résultats : Trois modes de mobilisation
de la situation migratoire, par les migrantes elles-mêmes ou par leur conjoint,
ont été mis au jour : la migration comme lieu d’un cadre normatif pourvoyeur
d’autres « règles du jeu » à faire valoir dans le couple et ses pratiques ;
comme lieu d’une dette administrative imposée à un(e) conjoint(e)
rejoignant(e) ; ou comme projet alternatif à une situation conjugale
insatisfaisante. Ces usages de la migration se cristallisent autour d’enjeux
d’autonomie.
Conclusions : La ressource migratoire se
voit sollicitée comme levier d’action pour modifier, concrètement, les formes de
la vie conjugale.
Contribution : Il est ici question de
mettre en relief les résonances de l’expérience migratoire dans l’espace
conjugal, invitant à la compter parmi les ressources mobilisables par les
individus.
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Affiliation(s)
- Nadia Mounchit
- Doctorante au Centre Max Weber, Université Lumière Lyon 2,
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