Date of Award:

5-2011

Document Type:

Dissertation

Degree Name:

Doctor of Philosophy (PhD)

Department:

Sociology and Anthropology

Department name when degree awarded

Sociology, Social Work, and Anthropology

Committee Chair(s)

Douglas Jackson-Smith

Committee

Douglas Jackson-Smith

Committee

Eric Reither

Committee

Christy Glass

Committee

Amy Bailey

Committee

Ron Munger

Abstract

The HIV/AIDS epidemic is currently one of the greatest health challenges being faced by many developing nations, especially countries of Sub-Saharan Africa. It is estimated that more than 25 million Sub-Saharan Africans are infected with the disease, with more than 2.8 million new infected cases in 2006. Mortality from the disease is high, with an estimated 2.1 million having already died from the disease. Women are more likely to be infected with the disease, and account for more than half of all global HIV/AIDS cases. Sub-Saharan African (SSA) women, specifically, constitute about 77 percent of all HIV/AIDS cases in the region. The incidence of the disease varies by region in SSA with the East and Southern regions having the highest infection rates (often exceeding forty percent of the adult population). By contrast, countries in the western region have rates that do not generally exceed ten percent. Within the western region, Cameroon provides an interesting case because it has a relatively high rate of HIV for this region, particularly among women.

Generally speaking, female vulnerability is a huge factor in the incidence and prevalence of the disease across the world and a woman’s socioeconomic status (SES) frequently plays a substantial role in increasing her risk of being HIV positive, especially for women in the low socioeconomic categories. Previous research indicates, however, that in the Cameroon case, higher socioeconomic status women may be more susceptible to HIV, which contradicts traditional epidemiological theory. Based on this fact, this study tried to look at why women in the high socioeconomic status groups were more likely to be HIV positive despite having access to increased resources that should have limited their risk. More importantly, this study also sought to see if the factors that increased HIV risk for women in Cameroon varied by their socioeconomic status.

This study uses the Cameroon Demographic and Health Survey to explore the factors linked to HIV status among Cameroonian women in different SES classes. The results of the study show that factors or pathways that increase risk for low SES women do not follow the expected conventional patterns as they tend to have similar risk factors as the other SES groups. However, what seems to increase risk for low SES women in Cameroon was having a partner in a higher SES category. By contrast, though women in the higher SES group showed benefits of increased resources (such as access to health care, knowledge about HIV, and power in relationships), which should have protected them, the pathway of risk for this group failed to follow this expected pattern. What accounted for the higher rates of HIV among high SES women was their own sexual behaviors, especially longer years of premarital sexual intercourse.

In conclusion, though the SES-HIV relationship remains complex, the factors that increase or decrease HIV risk did vary by socioeconomic status. This study posits, therefore, that an effective HIV/AIDS policy must take into consideration differences in risk factors across SES groups, and an effective policy must include a complimentary approach that targets women with more resources (which is not currently the case).

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Comments

Publication made available electronically January 13, 2012.

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