title: Understanding gender power relations, transactional sex and HIV in fishing communities in Southern Malawi
Creators: name: MacPherson, Eleanor
Publisher: name: University of Liverpool Repository
Year: 2015

description: Over the past 30 years, HIV/AIDS has had a devastating impact on the lives of millions of people around the world. Despite successes in the roll out of HIV treatment programmes, HIV prevention programmes have been less successful in lowering incidence rates. Certain groups have been found to experience significantly higher prevalence than seen in the general population, with fishing communities representing one key group with significantly higher risk of HIV infection. In fishing communities, gender power relations and economic vulnerability intersect in ways that mean that individuals are particularly vulnerable to HIV infection. In the past decade, there has increasingly been a focus on structural drivers of HIV transmission such as gender power relations. Gender differences are fundamentally underpinned by power inequalities in society and can result in the subordination of women and their interests in a manner that favours men. This thesis set out to understand how gendered structural drivers shaped vulnerability to HIV in fishing communities, and to develop interventions to address these structural drivers. The research was conducted in two fishing communities in the rural district of Mangochi in Southern Malawi. The design of the study drew on social relations theory and second-wave feminism. The research methodology used qualitative and participatory methods to address four key research objectives: (1) to understand gender power relations in fishing communities in Southern Malawi; (2) to explore and document the key drivers and facilitators of participation in transactional sex in the study villages; (3) to document individual and community perceptions of HIV risk and transactional sex in the study villages; (4) to develop a HIV prevention strategy to address risk of HIV/AIDS among fishing communities in southern Lake Malawi. Key findings are that in fishing communities, transactional sex was common and took a variety of forms, ranging from gift-giving within relationships, to-sex-for fish exchanges, to sex worker encounters. Power differences between couples in transactional sexual encounters shaped individuals’ abilities to negotiate condom use. The context and motivations for transactional sex varied and were mediated by economic need and social position both of men and women. Microfinance is a tool that can alleviate poverty and potentially prevent HIV. However, in the fishing context microfinance loan repayment procedures often increased female fish traders’ vulnerability to HIV. Participants had a good understanding of HIV risk yet this did not result in the adoption of risk-reduction strategies. Building on these findings, the thesis presents suggested HIV interventions that were developed through participatory community workshops. Interventions identified included: working with men and boys to support transformation of gender roles and normative behaviour; enforcing legislation to improve the ecological environment to reduce the impact of decline fish stocks and environmental hazards on risk-taking behaviour; improving access to HIV testing and treatment services; and improving living and working conditions of men and women working in the fishing industry. In conclusion, this thesis demonstrates the urgent need to introduce structural interventions in fishing communities in Southern Malawi and provides clear recommendations for implementing potential interventions.