Disempowerment and Psychological Distress in the Lives of Young People in Eastern Cape, South Africa

A qualitative study was conducted in Butterworth, in the rural Eastern Cape Province of South Africa, to explore sources of distress for young people. Semi-structured, individual in-depth interviews were conducted with 16 men and 24 women aged 16–22 years. The findings revealed interconnections between structural factors such as death, poverty, unemployment and gender injustices to cause distress. Negative home dynamics such as disinheritance, financial hardships, undisclosed paternal identity, substance abuse, child abuse and unpredictable informal adoption circumstances were worries of the participants. Worries over their inability to complete school dominated the narratives of orphaned participants. Lack of communication and consultation within families on important matters contributed to distress. Distress related to sexual relationships, such as infidelity, an unacknowledged pregnancy, intimate partner violence, transactional sex and sexual orientation were evident only in women’s narratives. Strengthening of families, improving financial security, extension of social grants and no-fee school policies are needed to alleviate distress in young people in this area. These findings are a call for the monitoring of policy delivery imperatives for child protection.     

Career needs of Eastern Cape pupils in South Africa

School guidance and counselling services ought to be designed and implemented to meet the needs of the pupils. The high school guidance programme should operate in a preventive way and attempt to equip pupils with information, skills and attitudes so that they can successfully negotiate the challenges of adolescence. If school group guidance lessons are to meet the pupils' needs and are to be experienced by the pupils as being relevant to their lives, then they must address the expressed needs of the pupils (apart from other issues considered important by appropriate authorities). A methodological approach to defining such needs is presented. It emphasises the importance of the pupils themselves describing their needs, and seeks to avoid the pupils having to respond in the form of ticks and checklists to the ideas of others. The pupil protocols were analysed in a qualitative manner and a number of categories and themes emerged. The needs relating to careers are outlined. Discussion centres on these results, on the differences between schools, and on the implications of these findings for a future single, non-racial education department in South Africa with a common curriculum for all.     

Belonging and Social Identity Among Young People in Western Sydney,Australia

This article explores young people’s everyday life in multiethnic Australian communities. The focus is on interethnic social identity and belonging to the Australian society. The research gives an insight into social relationships, social networks and attitudes to the Australian culture among young people living in multiethnic neighbourhoods. Conceptually, the research is framed around Bourdieu’s habitus discourse and the influence of social and cultural capital on young people’s perceptions and attitudes. A survey of 339 young people residing in Western and South Western Sydney, Australia, was undertaken in 2007. Ninety-five percent of the young people were from minority migrant backgrounds, and two thirds were born in Australia. The majority of them feel good about living in Australia, while only a small percentage rarely or never share this feeling. The findings demonstrate a more positive atmosphere and contradict evidence highlighted by pessimistic predictions of anti-immigrant and anti-multiculturalism critics. For many people of minority ethnic backgrounds, the Australian multicultural society works in a cohesive and inclusive way most of the time. The findings, even when sometimes contradictory, emphasise that the Australian multicultural society was working well in 2007. The young people in the research acknowledged to be influenced by the Cronulla riots, but it had a minor influence on their perception of social identity, social networks or feeling connected to Australia.     

Social determinants of subjective well-being among young adults living in the Eastern Cape,South Africa

We investigated the relationships between certain social determinants (age, gender, marital status, education, income, and employment) and subjective well-being (SWB) in a young adult population in the Eastern Cape Province in South Africa. The participants consisted of 977 persons aged 18 to 40 years living in the historically deprived Eastern Cape, South Africa (females = 48%; age range = 18 to 40; rural dwellers = 15%). We measured their SWB utilising the World Health Organization (Ten) Well-Being Scale. Results following analysis of variance showed that age, education, and income were predictors of SWB. Higher SWB was associated with being older, having a higher level of formal education, and having a higher level of income. However, employment status did not have a significant relationship with SWB, suggesting the relative importance of other social indicators of social functioning in this population.     

Health care practitioners' perceptions of public mental health care in the Eastern Cape,South Africa

This qualitative study explored the perceptions of health care practitioners (HCPs) concerning public mental health care in the Eastern Cape Province of South Africa. Data were collected from thirteen purposively selected HCPs using in-depth unstructured interviews (males?=?6, females?=?7). Data were transcribed verbatim and later thematically analysed. The findings suggest that mental health professionals perceive mental health services to be both inadequate and of suboptimal quality. Specifically, they perceived public mental health care to have lower priority, to be poorly resourced and lacking in patient-oriented care qualities.     

Community and health facility influences on contraceptive method choice in the Eastern Cape, South Africa

CONTEXT: Although a growing number of studies have examined how community factors influence contraceptive use, few have explored how such factors affect method choice. METHODS: Data from the 1998 South Africa Demographic and Health Survey and the 1998 Eastern Cape Facility Survey were used to examine community and health facility influences on the method choices of 1,165 women aged 15-49 who lived in the Eastern Cape. Relative risk ratios from multilevel multinomial models assessed how method choice varied between communities. RESULTS: The likelihood of using the pill or a more permanent method rather than the injection rose with the proportion of women in a community who controlled their earnings (risk ratios, 3.2 and 3.8, respectively). In communities with higher proportions of females with only a primary education, women were less likely to use the pill instead of the injection (0.1). Higher doctor staffing levels were associated with a greater likelihood of using the pill or a more permanent method (1.5 and 1.4), and having more expired methods in stock was associated with increased use of a more permanent method (2.1). Several facility factors were associated with a decreased likelihood of using the pill rather than the injection: higher numbers of community health workers in an area and higher numbers of facility nurses who had received training on HIV/AIDS in the last year (0.9 for each). Yet a substantial amount of variation in method choice was not accounted for by these variables. CONCLUSION: Future research should emphasize the collection of community-level data on structural, behavioral and cultural factors to help explain the variation in method choice between communities.     

Psychological Distress and Associated Factors Among a Sample of Pregnant Women in South Africa

We sought to identify the prevalence of psychological distress and associated factors among pregnant women who were patients at antenatal primary care clinics in a South Africa district. A cross-sectional study using systematic sampling was conducted among 1497 pregnant women (age range=18 to 47 years; mean age=26.6 years, SD=6.1; Black African=98%), with a mean gestational age of 6.5 months (SD=1.6). They completed the Kessler Psychological Distress Scale, a measure of psychological distress. Results showed high rates of severe psychological distress (26.5%). Increased distress was in multivariate analysis associated with having had an STI (other than HIV), being unhappy about current pregnancy, and HIV positive. Identification of pregnant women with psychological distress in public health clinics is crucial for effective and appropriate targeted interventions.     

Hazardous Alcohol Use among Persons Living with Human Immunodeficiency Virus Infection in the Eastern Cape,South Africa

The study assessed the prevalence of hazardous alcohol use among people living with HIV (PLHIV) and its correlates with socio-economic characteristics, disease variables and ART adherence in South Africa. The sample included 607 PLHIV (males =475, females =132; age range =18–61), sampled by all districts in the Eastern Cape. Participants were recruited through a health facility in the community through key informants or a support group. Results indicate that male PLHIV were more often than female PLHIV “past month” (18.9% vs. 6.1%) and hazardous alcohol drinkers (6.1% vs. 2.7%); using a cut-off score of 8 and more on the Alcohol Use Disorders Identification Test (AUDIT). Not having a disability grant for HIV/AIDS and the disability grant terminated were both related to past month alcohol use, while having the “disability grant stopped” was also related with hazardous or harmful drinking. Not having an AIDS diagnosis and not being on ART were both associated with past month alcohol use and hazardous or harmful drinking. CD4 counts and non-adherence to ART were both not significantly related with alcohol use status. Brief health provider initiated alcohol interventions for PLHIV should be promoted, with emphasis on targeting men.     

Identity Status,Gender, and Social Comparison Among Young Adults

The aim of this study was to investigate identity status globally and across identity domains among young Swedish adult women and men. Also, potential differences in social comparison among identity statuses were evaluated. The results showed that most of the 124 participants (50% women, M_age 33.29 years) were assigned to an achieved global identity and had made identity-defining commitments across domains. Gender differences in identity status were found in the occupational and parenthood domains. In addition, differences in social comparison orientation were found only in the parenthood domain, whereas those assigned to moratorium scored higher in social comparison than did those assigned to foreclosure and diffusion. These results bring important knowledge to our understanding of identity during young adulthood.     

Young People,Sexuality, and HIV Prevention Within Christian Faith Communities in South Africa: A Cross-Sectional Survey

Faith communities exert a powerful influence on the life of their members, and studies are needed about how they may be able to influence young people’s attitudes regarding sexuality and HIV prevention. Data were collected through a self-administered questionnaire from young people (811), aged 15–24 years, affiliated to the Roman Catholic Church, the Lutheran Church and the Assemblies of God. The majority of participants perceived themselves at risk of HIV infection (53 %). Premarital sexual abstinence was the most frequently (88 %) reported prevention message, followed by faithfulness (23 %), HIV testing (18 %) and condom use (17 %). Furthermore, religious affiliation was associated with education on sexuality and HIV in youth groups, with better information given to members of the Lutheran and Catholic churches. Faith communities need to strengthen their capacity to educate young people in a more holistic way about sexuality and HIV prevention.     

Cognitive and Behavioral Contributions to Depression Severity,Quality of Life,and Functioning Among People Living With HIV in South Africa

Cognitive-behavioral treatments for depression typically address both behavioral (e.g., activation) and cognitive (e.g., rumination) components, and consequently improve quality of life (QOL) and function in high-resource settings. However, little is known about the cross-cultural applicability and relative contribution of these components to depression symptom severity, QOL, and functional impairment in South Africa and other resource-limited global settings with high HIV prevalence rates.Persons with HIV (N = 274) from a peri-urban community outside Cape Town, South Africa, were administered multiple measures of depression (Hamilton Depression Scale, Centre for Epidemiological Studies Depression Scale, South African Depression Scale), cognitive and behavioral components related to depression (Ruminative Response Scale, Behavioral Activation for Depression Scale), and measures of QOL and functioning (Sheehan Disability Scale, Quality of Life Enjoyment and Satisfaction Scale—Short Form). Multiple linear regression models were fit to assess the relative contribution of behavioral and cognitive components to depression severity, QOL, and functional impairment in this population.Models accounting for age and sex revealed that lower levels of behavioral activation (BA) were significantly associated with all measures of depression, as well as with QOL and functional impairment (all ps < .01). Rumination was associated with all measures of depression (all ps < .01), but not with QOL or functional impairment.The consistent and unique association of BA with depression, QOL, and functional impairment bolsters its importance as a treatment target for this population.     

HIV voluntary counselling and testing among recently initiated and traditionally circumcised men in the Eastern Cape Province of South Africa

HIV voluntary counselling and testing (VCT) is a cornerstone of the national strategic plan for HIV/AIDS treatment, care and support in South Africa. However, research shows that the utilisation of VCT services is disappointingly low, particular among males. This article focuses on the factors associated with the intention to test for HIV-infection among recently initiated and traditionally circumcised men in the rural areas of Eastern Cape Province, South Africa. Individual face-to-face interviews were conducted among 1656 sexually active men. Logistic regression analyses were used to explore the association between intention to test for HIV and psychosocial factors. Overall, 35.1% of the participants reported ever having tested for HIV. Intention to test for HIV was positively associated with perceived probability of getting an STI, positive attitudes towards gender-based violence, received general teachings about being a responsible man and highest grade passed. These findings provide specific information that can be used in the development of a focused cultural sensitive STI/HIV prevention programme aimed to increase VCT uptake among sexually active young men, which can be integrated into initiation and health education practices.     

Theoretical Antecedents of Distress Disclosure in a Community Sample of Young People1

The Distress Disclosure Index ( Kahn & Hessling, 2001 ) measures the tendency to disclose psychological distress and is important in understanding psychological well‐being, interpersonal relationships, and help seeking. This paper used the disclosure decision model ( Omarzu, 2000 ) to explore the theoretical antecedents of distress disclosure. Results of a community‐based survey of 17–18‐year‐olds in South Wales (United Kingdom), suggesting that private self‐consciousness, social support, and femininity were associated with higher distress disclosure. Shame was associated with lower distress disclosure. Moderating effects of gender and gender identity were also explored. Social support and femininity both interacted with gender to predict distress disclosure. The results suggest a number of interventions to increase distress disclosure in young men and women.     

Prejudice, Ethnic Identity, Contact and Ethnic Group Preferences Among Dutch Young Adolescents

Social identity theory, the contact hypothesis, and prejudice research are three important perspectives for studying ingroup information and preferences in the context of ethnic groups. This paper studies the utility of the three perspectives in a particular interethnic group context among 160 Dutch subjects between 12 and 15 years of age. The results show that the evaluation of ethnic identity and rate of cross-ethnic contact are strongly correlated with ingroup formation and preference. Prejudicial attitudes seem to be dependent on contact and especially on the evaluation of ethnic identity. Prejudice seems to be a function of positive identification with the Dutch as a group. Applied implications for ethnic-group relations are discussed.     

Characteristics of students receiving counselling services at the University of Cape Town, South Africa

The aim of the study was to document the correlates of receiving counselling services at the University of Cape Town, South Africa. The 932 students who received counselling over a 3-year period were compared with the other 23,158 students registered at the university. Data were obtained from the university computerised record system. Women, Black people and 20-24-year-olds were significantly more likely to receive counselling services. When adjusting for these demographic variables, non-English speakers, humanities students, undergraduates, first-year students, students who were eligible to receive financial assistance, and students from outside Cape Town were significantly more likely to receive counselling. New research is required to determine the reasons for these findings.     

Influences on life aspirations among adolescents in a low-income community in Cape Town,South Africa

The aim of this study was to determine the influences on adolescents’ aspirations from a low-income community in Cape Town. A sequential mixed method exploratory design was used following two distinct phases. The qualitative phase comprised focus group interviews with 118 grade 12 learners attending a school in a low-income community (age range: 16–19 years) and focused on identifying factors influencing life aspirations. The quantitative phase with 191 adolescents (males?=?54.45 %, females?=?45.55 %); age range: 14–18 years) from the same community aimed to ascertain the influences of personal attributes on self-aspirations. Participants completed the Expectations/Aspirations measure, the New General Self-Efficacy Scale, the Rosenberg Self-Esteem Scale and the Multidimensional Scale of Perceived Social Support. Qualitative data were thematically analysed. Quantitative data were analysed using multiple regression. The findings revealed that self-efficacy, self-esteem and social support were the most critical factors influencing adolescents’ aspirations. Self-efficacy was a major determinant of life aspirations among the adolescents. Life skills programmes with youth from disadvantaged communities should seek to incorporate training aimed at developing adolescents’ self-efficacy.