"Cycles of Risks; The Harsh Realities of ""Married"" Adolescent Girls in an AIDS Impacted area in Rural SW Uganda."

"Objectives: To a)Profile the lives of ""married"" adolescent girls and the decisions made which may have placed them vulnerable to HIV infection b) Explore attitudes and perceptions of young girls toward the disease. pervasive in rural Rakai is the assumption that young girls are prey for older men. Although it is assumed that they are free from infection; their risk realities are far more complicated. Methods: This ethnographic study used both in depth; open ended interviews and focus groups with ""married"" girls less than 19. Results: The study site is a trading centre with high prevalence of HIV and extensive history of prostitution. This rural centre offers the young girl opportunity for employment (access to cash) as house or bar girls; and asylum from abusive situations stemming from stepmother scenarios and witchcraft in the village. Support is inevitably associated with men; either in marriage or multiple relationships. Fatalism encourages the ease with which a young girl will enter into successive relationships which constitute ""cycles"" of risk. Given the nature of the relationship; and the economic inflexibility of the partner; testing and condom negotiation are not acceptable alternatives. Conclusions: The profiles of young attached girls indicate the harsh realities many will experience in adolescent life. The voices and choices of young girls are vivid testimonials to the potential for transmission and the necessity of targeting interventions for adolescent girls."

"""We are Dying and Getting Finished; Who Will We Leave These Ones For?"" Women's Concerns about Childbearing in Rural Rakai; SW Uganda."

Objectives: To a) Establish the parameters of reproductive choice amongst women who are at high risk for HIV infection. b) Discuss the impact ofthese parameters on issues concerning perinatal transmission. Methods: Research wasdone in amixed ethinicity trading centre in AIDS affected SW Uganda. This ethnographic study used both in-depth; open ended interviews and focus groups with women who believe they are infected or have been tested HIV positive. Results: Regardless of' marriage form' birth control including condom use is perceived to be non negotiable. 'They only use them with those women from out' 'Men want to be associated with many numbers of children... want to leave someone behind' 'Did you come here just to eat?' Women do exercise reproductive choice; either in refusal or without husbands' knowledge (pills; injections; traditional methods). The consquences of refusal to either have sex or produce children are very restrictive; they lead to separation(leaving women economically vulnerable) or the men will go out and find another woman. Little change occurs in relationships where positive sero-status of one or both partners is a real possibility. Evidence suggests that certainty of sero-status gives the impetus to make hard decisions;reproductively. Uncertainty leads to both confusion and fatalism. REgardless of access to cash; sick babies are neglected(immunization; breast feeding; treatment) by both parents. ''This one is slimming anyway''. Mothers experience both the stigma and associated burdens of caring for the sick child. In addition they often decide not to treat themselves. Birth of healthy babies indicate that parents are negative. Conclusion: The voices of women are a testimony to the constraints they expirience sexually and reproductively. They do have a 'choice'. However ;the repercussions of this choice; particularly in high risk environments become restrictive and burdensome