Knowledge of Hiv Transmission and Sexual Behavior Among Zimbabwean Adolescent Females in Atlanta, Georgia: The Role of Culture and Dual Socialization

By Loveness Mabhunu

It is universally agreed that HIV/AIDS constitutes one of the most serious threats to human life in our era. The immigration of Zimbabwean people into America plays a major role in the socialization of Zimbabwean adolescents. Zimbabwean adolescents are exposed to the Western culture of sexual socialization, which is different from the African culture. The social bonds and traditions that used to shape Zimbabwean young peoples behavior and help them make the transition to adulthood have weakened in the face of migrating to Western countries. The main problem is the transition and loss of cultural identity that affect Zimbabwean adolescents knowledge of HIV/AIDS transmission and sexual behavior.

• Language: English
• Publisher: Xlibris US
• Release date: Oct 16, 2013
• ISBN: 9781493105809

Loveness Mabhunu

Dr. Loveness Mabhunu is a native of Zimbabwe. A recipient of Fulbright Scholarship, Delta Kappa Gamma World Fellowship, and IPS Scholarship, she graduated from the University of Zimbabwe with a BA HONS and MA in religious studies and PhD in women’s studies at Clark Atlanta University. Dr. Mabhunu has experience as a researcher in the following areas: women, girl child, and HIV/AIDS; traditional Zimbabwean culture and its relevance to HIV prevention; and women and religion. She has presented papers at conferences and seminars in Zimbabwe, Mexico City, and the United States. Dr. Mabhunu is also a motivational speaker. Her dream is to empower women throughout the world.

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Copyright © 2013 by Loveness Mabhunu.

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Rev. date: 10/11/2013

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CONTENTS

DEDICATION

ACKNOWLEDGMENTS

DEFINITION OF TERMS

LIST OF ABBREVIATIONS

CHAPTER 1

CHAPTER 2

CHAPTER 3

CHAPTER 4

CHAPTER 5

APPENDIX A

APPENDIX B

BIBLIOGRAPHY

DEDICATION

For my beloved children, Victoria Kundai and Takunda Victor, Jr. Thanks for enduring my absence during the completion of this book.

Will always love and cherish you.

ACKNOWLEDGMENTS

First and foremost, I thank God for his grace, favor, and blessings throughout my life and educational journey. This book is a culmination of all the support that I have received from my family, my friends, and my mentors/professors who bear their stamp on my personal and intellectual growth. I dedicate this book to my beloved children: Victoria Kundai and Takunda Victor, who endured my absence to complete this journey. To my dear and lovely mother, Felicitas Makura, whose love, support, generosity, and encouragement throughout my life made it possible for me to pursue doctoral studies, your wisdom encouraged me to fly. I also dedicate this book to my late grandparents, Jerita Mayemurei and Gideon Mabhunu Makura, whose inspiration, influence, and pride in my accomplishments will be greatly missed. I am extremely grateful to my mentors, Dr. Sandra Taylor and Dr. Regina Bryant, for their expertise, guidance, and tireless commitment to the process. Your willingness to support me regardless of your busy schedules is greatly appreciated. Special thanks to Dr. Josephine Bradley, my committee chair, for your inspiration and dedication to ensure that the process was successful. Your enthusiastic support and valuable assistance are greatly appreciated. I am grateful to my uncle, Rev. John Gumbo, and his family for their love and for believing in me. Never would have made it without your inspiration and encouragement. I love you all dearly. Lastly, I am indebted to all the Zimbabwean adolescents in Atlanta, Georgia, for sharing your experiences with me. Without your help, this journey would not have come to fruition. Thanks to everyone else whom I might have overlooked.

DEFINITION OF TERMS

Adolescence—The development period between the age group of 13 and 22 years. It is a period of physical and deep emotional changes.

Afrocentricism—The dominance of African cultural patterns.

AIDS—Acquired immunodeficiency syndrome. It includes all HIV-infected people who have fewer than 200 CD4t T cells per cubic millimeter of blood (CDC, 2005).

African-American/Black—A person having origins/ancestors in Africa.

Cognitive—This is how individual participants perceive the need to change behavior.

Culture—The language, beliefs, values, norms, behaviors, and material objects (e.g., clothing, hairstyle, and jewelry) that are passed from one generation to the next.

Gross Domestic Product (GDP)—Measures how a country is performing on the global market.

Human Immunodeficiency Virus (HIV)—Is the virus that causes acquired immunodeficiency syndrome; it replicates in blood and kills the T cells.

Knowledge of HIV Transmission—Comprehensive correct knowledge of HIV that men and women share to correctly identify major ways of preventing transmission of HIV (like using condoms and abstinence).

Metropolitan Atlanta—A wide area outside the city limits.

Sexual Behavior—Is a form of physical intimacy that may be directed to reproduction and to enjoyment.

Sex Lock—The traditional method of preventing sexual intercourse from happening, especially penetration.

Sexually Transmitted Diseases—Refers to infections and/or viruses that are transmitted through sexual activity. This includes HIV infection.

Socialization—A process by which people learn the ways of society or of particular groups.

Social Learning Theory—The process of acquiring and gaining growth, knowledge, and understanding or skill.

T cell—A type of white blood cell essential to the body’s immune system; helps regulate the immune system. The level of T cells in an HIV-positive person serves as an indicator of the progression of HIV infection.

Zimbabwean—Persons born in Zimbabwe with naturalized parents.

LIST OF ABBREVIATIONS

ABC Abstinence, Be faithful, and Condom use

AIDS Acquired Immunodeficiency Syndrome

CDC Centers for Disease Control and Prevention

ESAP Economic Structural Adjustment Policy

GDP Gross Domestic Product

HIV Human Immunodeficiency Virus

NAC National AIDS Council

NACP National AIDS Co-ordination Program

NGO Nongovernmental Organization

SCT Social Cognitive Theory

SLT Social Learning Theory

STDs Sexually Transmitted Diseases

UNAIDS United Nations Acquired Immunodeficiency Syndrome

UNDP United Nations Development Program

UNGASS United Nations General Assembly Special Session

UNICEF United Nations Children’s Fund

UNFP United Nations Family Planning

UNPF United Nations Population Fund

USA United States of America

WHO World Health Organization

ZWAN Zimbabwe Women AIDS Network

CHAPTER 1

INTRODUCTION

The purpose of this research was to examine the level of knowledge of HIV/AIDS transmission and sexual behavior among Zimbabwean female adolescents aged 13-22 years who reside in metropolitan Atlanta, Georgia. The research also explored the adolescents’ experiences related to different socializations regarding sexuality and gender outside their traditional socialization. The primary motivation for this study was based on the realization that the reproductive health of black female adolescents is not well represented. In Zimbabwe, the acquired immunodeficiency syndrome (AIDS) and its twin infection, the human immunodeficiency virus (HIV), have been spreading at astonishing speed for approximately 25 years, and it is now one of the world’s greatest health challenges. Throughout Zimbabwe, the AIDS pandemic is affecting large numbers of adolescents, leading to serious psychological, social, economic, and educational problems. The disease has a significant effect on women, children, and their families. One in four people in the southern region of Africa, including Zimbabwe, in the productive age group (15-49 years) is living with HIV.¹ This means that fewer adults must support more people, and the burden of care is shifted to society’s weakest and most marginalized: women and girls. Desperate people adopt damaging and high-risk survival strategies, such as exchanging sex for food or cash. Children are especially at risk for HIV infection. According to recent UNICEF figures, there are currently 160,000 Zimbabwean children infected with HIV/AIDS. Today 3 million children live with AIDS and over 13 million have been orphaned by AIDS, most of them in sub-Saharan Africa.² Children under 14 years of age offer a window of hope to stop the spread of HIV/AIDS. If given proper awareness about preventing disease and behavior change, they have a significantly improved chance of protecting their own lives and the lives of other people.

In the United States of America, HIV/AIDS hits African-Americans the hardest. HIV/AIDS has become a silent yet deadly epidemic for African-Americans. Even though African-Americans account for about 12% of the United States population, they account for about half (49%) of the people who are HIV infected.³ The adolescent population represents the majority of new infections. Among young people infected with HIV, African-Americans comprise the largest group, accounting for 55% of all HIV infections among 13 to 24 year olds.⁴ In the United States, women of color are overrepresented among female HIV/AIDS cases. Women of color accounted for 80% of all women living with HIV/AIDS in 2004; the overwhelming majority 64% of this total is African-American women.⁵ In particular, Georgia has the highest AIDS case rate and highest teenage pregnancy rate in the United States. Of particular note are statistics from the metropolitan Atlanta area, which show some of the highest rates of STDs and HIV/AIDS in the state.⁶ Most of the Zimbabwean adolescents live in this city with highest rates of infection.

Despite advances in biomedical research, there is still no preventive vaccine or medical cure for this deadly disease. Consequently, efforts to change high-risk behaviors remain the only viable means to prevent HIV infection. The target group for this study is Zimbabwean female adolescents who reside in metropolitan Atlanta aged 13-22. These adolescents in the United States face a dual socialization challenge (that is, African versus Western cultural beliefs and values). The focus on adolescent females is based on trends of prevalence of HIV/AIDS among females. Women have become the fastest-growing subgroup of AIDS cases worldwide. Adolescent females who are sexually active are at an increased risk of contracting HIV. Educational efforts about safe sex practices must be tailored to teenage girls. Adolescents need to be equipped with adequate information. Without proper education about sex, adolescent females will continue to engage in risky behavior.

Statement of the Problem

It is universally agreed that HIV/AIDS constitutes one of the most serious threats to human life in our era and represents one of the greatest problems for the socioeconomic development of many countries. HIV/AIDS has become one of the leading causes of death. The epidemic has a serious impact on women worldwide. Globally, some of the highest rates of new infections are occurring among black women in both the developed and the developing world. High school and college students are at high risk of HIV infection due to unsafe sexual behaviors, experimentation with alcohol and drugs, and failure to see themselves at risk for infection. Spira and Bajos, in their findings, conclude that female adolescents and young women under the age of 24 are at increased risk for contracting HIV because they are more likely to have multiple sex partners and are less able to negotiate safer sex practices.⁷ The poor economic conditions in Zimbabwe exert great pressure on young girls to engage in unsafe sexual activities. Many girls have turned to commercial sex work increasingly; they are involved in sexual networks to earn a living. In many cases, wealthy and elder men, referred to as sugar daddies, entice these young women with money to have unprotected sex. Such circumstances may contribute to HIV/AIDS infection among youth. In urban Zimbabwe, the general HIV prevalence rate is 18% among adolescent girls aged 15-19 years.⁸ This statistic clearly shows that adolescents are at an increased risk of HIV infection.

The impact of the political unrest to the socioeconomic status of the country of Zimbabwe led to the diaspora of Zimbabwean people. The majority of Zimbabweans who migrated to the United States live in Atlanta, Georgia. Job opportunities, weather conditions, and a large black population attract Zimbabweans to Atlanta. However, the HIV infection rate is alarmingly high among African-Americans. African-American adolescents in Atlanta account for more HIV and AIDS infections than any other group. Fifty percent of new HIV infections are occurring in youth 16-24 years old.⁹ Adolescents are now identified as one of the fastest-growing groups in the state of Georgia to be infected with HIV, accounting for 23% of all the AIDS cases.¹⁰ Recent trends indicate that the disease is now affecting many women in Atlanta at growing rates. Zimbabwean adolescents interact more with African-American adolescents because they are of the same race. As a result, Zimbabwean female adolescents who reside in Atlanta face a higher risk of being exposed to HIV infection because more people with HIV are living in black communities, and most blacks have partners who are of the same race/ethnicity.

The immigration of Zimbabwean people into America plays a major role in the socialization of Zimbabwean female adolescents. Socialization is how culture is transmitted from one generation to another. Culture pertains to traditions, beliefs, values, religious practices, dress, relationships, gender issues, and sexual behavior. There is a general consensus that the migration of people constitutes culture shock. This involves where you live, what you eat, how you dress, your language, and so forth. Culture shock plays a major role in socialization. Culture assumes a significant role in the socialization process by shaping the specific beliefs and values held by parents. Zimbabwean adolescents in Atlanta face dual socialization challenges. As Espin has noted, immigrant and ethnic minority groups may preserve aspects of their traditional culture related to sexuality long after they have adopted other aspects of the host culture.¹¹ Loss of identity, values needed to survive, and traditions they are expected to keep in a new environment affect the behavior of adolescents. Zimbabwean parents face a dual socialization challenge of not only transmitting their own traditions, beliefs, and values, but also those of the American society. Zimbabwean adolescents are exposed to the Western culture of sexual socialization, which is different from the African culture. Zimbabwean youth often find it very difficult, if not challenging, to always be judged through a European social construct or cultural lens. They have separate needs when assimilating into the American culture.

In traditional Zimbabwean communities, sex education is the job of aunts, uncles, elders in the community, and grandparents. Initiation ceremonies marked the transition of boys and girls from adolescence to adulthood. However, these cultural practices are subjugated and suppressed by Westernization; these practices are deemed backward. Furthermore, for those in the diaspora, the children are living with their parents. They left their aunts, uncles, and grandparents back home in Zimbabwe. The aunts and grandparents were traditionally important in the education of girls. In contrast, in America, sex education is passed from parents, grandparents, church, schools, friends, media, and Internet. Media and Internet are becoming popular for sex knowledge among young people. The social bonds and traditions that used to shape Zimbabwean young people’s behavior and help them make the transition to adulthood have weakened in the face of migrating to Western countries. The