Conference Presentations by Marion Stevens
Hampshire College, Amherst MA 2
Papers by Marion Stevens
SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance / SAHARA , Human Sciences Research Council, 2005
This paper provides a framework analysing the response of South African companies to HIV/AIDS. Dr... more This paper provides a framework analysing the response of South African companies to HIV/AIDS. Drawing on three case studies of companies, each with over 20,000 South African-based employees, we identify six 'drivers' that influence corporate behaviour regarding HIV/AIDS: legal requirements, voluntary regulation, business costs, social pressures, visibility of the disease, and individuals within companies. We suggest that costs calculations, while possibly underestimating indirect and macro-implications, are not key in driving company responses to HIV/AIDS. The law and voluntary regulation have influenced, but not determined, the response of companies to HIV/AIDS. Social pressures on companies are of importance, but the scale and complexity of need in South Africa has seen the deflecting of this driver. Of greater reference in determining responses has been the social pressure of other companies' responses. The general visibility of the AIDS epidemic is also a significan...
One of the striking features of the HIV epidemic in sub-Saharan Africa is that it is increasingly... more One of the striking features of the HIV epidemic in sub-Saharan Africa is that it is increasingly feminised, with women comprising a growing proportion of those infected and affected. While access to HIV treatment has been an area of contestation in South Africa, women's sexual and reproductive health has been neglected. Historically, the paradigm of Prevention of Mother-to-Child Transmission (PMTCT) led the way as a clear, evidenced-based method of prevention. Many HIV-positive women, after dealing with their initial diagnosis and stabilisation on treatment, express the desire to have a child. There is an absence of treatment guidelines for women of reproductive age that include options for Highly Active Antiretroviral Therapy (HAART) and options around fertility intentions. Abortion and HIV services are not integrated, linked or regulated. There are limited spaces to address sexual and reproductive health and rights. There is a need to move from an HIV and AIDS maternal healt...
African Journal of AIDS Research, 2007
Hospitals are workplaces in which HIV has double significance. Needlestick accidents link patient... more Hospitals are workplaces in which HIV has double significance. Needlestick accidents link patients, healthcare workers and cleaning staff through the risk of occupational exposure to HIV. Additionally, concern over needlestick injuries may embody HIV stigma, discrimination and fear. This paper draws on qualitative research from a one-year case study at a large, private South African healthcare company that runs a number of hospitals across the country. Issues surrounding needlestick injuries were discussed with hospital managers, union members, infection-control nurses, health and safety representatives, HIV/AIDS counsellors, and general nursing staff. Needlestick injuries presented a complex set of technical and personal concerns. The research shows that cost-management, human rights, health and safety procedures, stigma and discrimination, and the quality of patient care are all relevant to needlestick injuries in an era of HIV. Participants' concerns focused on: establishing safety procedures, the cost and efficacy of waste disposal systems, access to post-exposure prophylaxis, legal implications, and baseline HIV tests following needlestick injuries. The last topic revealed numerous other issues, including the possibility of health workers 'legitimising' sexually acquired HIV infection by passing it off as an occupational accident. Healthcare facilities should ensure procedures that minimise occupational exposure to HIV and that minimise infection risk in the event of accidents. We propose that hospitals ought to directly encourage staff to learn their HIV status and seek disease management when needed. Likewise, better approaches to dealing with HIV stigma and discrimination are needed, especially to dispel myths of good and bad ways of contracting HIV.
African Journal of AIDS Research, 2008
In South Africa, the private sector has responded to the HIV epidemic by providing treatment in t... more In South Africa, the private sector has responded to the HIV epidemic by providing treatment in the form of highly active antiretroviral therapy (HAART). The private sector has paved the way for policy and treatment regimens, while the public sector has reviewed health-systems capacity and the political will to provide treatment. The paradigm of prevention of mother-to-child transmission of HIV (PMTCT) has led the way as a clear evidenced-based method of treatment and prevention in South Africa. In sub-Saharan Africa, the HIV epidemic is feminised as a growing proportion of infections occurs among women or affects women. While access to HIV treatment has been contested in South Africa, women's sexual and reproductive health has been neglected. This paper is a reflection and critical review of current practice. Many HIV-positive women desire to choose to have a child, while the best choice of contraception for women on HAART is not well understood. In some areas there are reports of women being forced to accept injectable contraceptives. Some women who learn of their HIV-positive status during pregnancy may want to choose to terminate their pregnancy. There is a clear absence of HIV/AIDS-treatment guidelines for women of reproductive age, including options for HAART and options regarding fertility intentions. A range of other sexual and reproductive health areas (relevant to both the public and private health sectors) are neglected; these include depression and anxiety, violence against women, HIV-testing practices, screening for cervical cancer, and vaccination. Given the narrow focus of HAART, it is important to expand HIV treatment conceptually, by applying a broader view of the needs of working women (and men), and so contribute to better HIV prevention and treatment practices. There is a need to move from an HIV/AIDS-care maternal-health paradigm to one that embraces women's sexual and reproductive health and rights.
Reproductive health matters, 2015
Information and Communications Technology (ICT) offers enormous opportunity and innovation to imp... more Information and Communications Technology (ICT) offers enormous opportunity and innovation to improve public health and health systems.This paper explores the intersections between mHealth and sexual and reproductive health and rights in both policy and practice. It is a qualitative study, informed by policy review and key informant interviews. Three case studies provide evidence of what is happening on the ground in relation to ICTs and reproductive health and rights. We argue that in terms of policy, there is little overlap between health rights and communication technology. In the area of practice, however, significant interventions address aspects of reproductive health. At present, the extent to which mHealth addresses the full range of reproductive justice and sexual and reproductive health and rights is limited, particularly in terms of government initiatives. The paper argues that mHealth projects tend to avoid contentious aspects of sexual health, while addressing favourabl...
AIDS Research and Human Retroviruses, 2014
Reproductive Health Matters, 1995
The Women's Health Conference in South Africa in December 1994 aimed to identify women'... more The Women's Health Conference in South Africa in December 1994 aimed to identify women's health needs and translate them into policy proposals. The process was inclusive and bottom up and cut across barriers of race, class and ideology. Prior to the conference, policy groups developed draftproposals on major areas of women's health, while provincial networking got input from the grassroots.
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Conference Presentations by Marion Stevens
Papers by Marion Stevens