Using a cultural model to assess female condom use in Mpumalanga, South Africa

by Webster, Jonas Dewitt.

Culture is identified as a set of implicit and explicit guidelines inherited by members of a particular society that tell them how to view the world, experience it emotionally, and to how to “behave in relation to other people, to supernatural forces or gods, and to the natural environment” (Helman 1990, p 2). Culture plays a vital role in determining the level of health of the individual, family and community. Recently, public health researchers have begun to recognize culture’s position in health promotion by applying it to existing socio-behavioral variables to develop health-related interventions. The purpose of this study is to conduct a secondary data analysis of socio-cultural findings from the evaluation of an STI/HIV/AIDS prevention effort – the Mpumalanga Female Condom Project (MFCP). The study uses the PEN-3 model, a framework developed to centralize culture in health promotion interventions (Airhihenbuwa, 1995, 1999), to conduct a modified content analysis of phrases, words and issues from focus groups, open-ended questions, and key informant interviews to identify the relationship between culture and female condom acceptance and use in a peer education-focused communitywide STI/HIV/AIDS prevention effort. The PEN-3 Model helped describe the Mpumalanga peer educator, community member and MFCP staff knowledge, attitudes, and practices related to the female condom prevention effort. The analysis indicated that culture in the context of gender relations (the status of women in relation to men in society and community and the influence on sexual negotiation and decision-making) and communication are key factors in female condom acceptance and use in this community. Finally the Mpumalanga Female Condom Project helped to positively shape attitudes and norms that guide prevention behaviors related to STI/HIV/AIDS in the community. These iii findings support theory that critical analysis through a cultural framework is a key factor in promoting behavior change at the individual, family and community level. iv