Jones, Gary Page (2019) HIV and young people: perceptions of risk, resilience and dignity in an urban slum. PhD thesis, James Cook University.

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Abstract

Young people are at the centre of the HIV pandemic. Although global incidence of HIV is diminishing, for many cohorts below the age of 24, such as slum-dwelling youth, prevalence has, overall, plateaued or increased. HIV in eastern and southern Africa, the region hit hardest by the disease, is becoming an urban phenomenon and aggregating in informal slum settings. A new genre of research is called for that provides insight into the urban evolution of HIV and identifies entry points for tackling root causes of risk and vulnerability.

This is a novel piece of research carried out in two urban slums in Nairobi, Kenya: Korogocho and Majengo. Each site was politically marginalised and inhabited mostly by young people facing a generalised HIV epidemic. In contrast to the predominant quantitative research tradition in Kenya, this is a qualitative study that seeks to understand perceptions of HIV and the processes involved in managing risk from the point of view of young people. A constructivist grounded theory methodology was adopted given its fit with the study’s theoretical conception and topic of inquiry. Two methods were used to generate primary data: first, 25 semi-structured interviews with men and women aged 18–24 years; and second, a photovoice exercise involving nine participants. During interviewing and photovoice, rich data emerged that were sorted into a progression of open, focussed and theoretical codes. The simultaneous process of data generation and analysis pointed to where the research needed to go next and formed an integral part of constructing social theory. An inductive coding approach gradually created a higher conceptual order moving from descriptive to explanatory in which core properties, dimensions and relationships pertaining to the slum universe were captured and synthesised.

Through creating a storyline, participants' experiential approach to life was brought into sharp focus as was the role of individual agency and purpose. Research conclusions were interrogated within the domains of individual, environmental and structural determinants and checked against the literature to establish the principle of knowledge generation and translation. The study constructs a theoretical model, 'HIV and the Integrity of Risk —Dignifying Resilience in Disadvantage,' which accounts for young people’s action driven by the exigencies of survival and in which HIV forms part of the compendium of a life lived on the edge. Risk, as this study finds, is about the integrity to perceive advantage in the daily struggle to find sustenance, to take life on with all its pitfalls and gain resilience within the social realm capable of managing processes at the heart of HIV. This research calls for further inquiry that explores measures taken by young slum dwellers to dignify their lives and avoid episodes of humiliation and the impact these have on the social epidemiology of HIV. As a means of helping to control the epidemic, HIV research must continue to prioritise innovative people-centred slum-based social inquiry that highlights what matters most to the people most at risk and the people holding the key to ending AIDS.

Item ID:	64298
Item Type:	Thesis (PhD)
Keywords:	HIV, human immunodeficiency virus, young people, urban slums, vulnerability and risk, resilience, self-perception, dignity, Nairobi, Kenya
Related URLs:	https://researchonline.jcu.edu.au/41538/
Copyright Information:	Copyright © 2019 Gary Page Jones.
Additional Information:	One published work by this author, relevant to the thesis but not forming part of it, is stored in ResearchOnline@JCU. Please see the Related URLs field. Jones, Gary (2016) HIV and Young People: risk and resilience in the urban slum. SpringerBriefs in Public Health . Springer, Cham, Switzerland.
Date Deposited:	07 Sep 2020 12:26
FoR Codes:	11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111708 Health and Community Services @ 30% 16 STUDIES IN HUMAN SOCIETY > 1605 Policy and Administration > 160508 Health Policy @ 30% 16 STUDIES IN HUMAN SOCIETY > 1699 Other Studies in Human Society > 169999 Studies in Human Society not elsewhere classified @ 40%
SEO Codes:	92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920404 Disease Distribution and Transmission (incl. Surveillance and Response) @ 40% 92 HEALTH > 9202 Health and Support Services > 920208 Health Inequalities @ 30% 97 EXPANDING KNOWLEDGE > 970111 Expanding Knowledge in the Medical and Health Sciences @ 30%
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