African Women Research Articles

"We are mothers, sisters, and lovers too": Examining young Black women's experiences navigating sex and sexual health.

In Canada, there is a lack of research that addresses the sexual health and well-being of African, Caribbean, and Blackyoung women. This paper aims to gather perspectives of young Black women to address the social contexts of how young Black women navigate issues related to sex and sexual health. Young Black women experience unique dynamics in navigating their sexualities and sexual healthcare. The nuanced experiences stem from social contexts with historical underpinnings, such as the perception of Black women's bodies, Black identity, gender roles, and sexual double standards. This Community-Based Participatory Researchstudy (N = 24) utilized focus groups to examine young Black women's experiences navigating sexual health. Employing a thematic analysis, participants identified four themes representing their narratives of navigating sexual health. The themes included the perceptions and hypersexuality of Black women's bodies, navigating sexual double standards and gender roles as Black women, diverse Blackness, and migration experiences concerning sexual health and surveillance of Black women's bodies. This paper is intended to add to scholarly discourse and will include practical strategies for use by researchers and community practitioners in sexual health within the Black community.

Obesity, beverage consumption and sleep patterns in rural African women in relation to advertising of these beverages.

The burden of obesity-related, non-communicable diseases in South Africa is persistent, with poor and black South African women particularly vulnerable. The purpose of the present study was to determine relationships between obesity, physical activity, sleep patterns and beverage consumption among black South African women in a rural village in the Limpopo province. A cross-sectional study was conducted among 200 rural-dwelling African women. Data were collected on beverage consumption, sociodemographic information, sleep patterns and anthropometry using self-reported questionnaires. The mean body mass index (BMI) was 28.5±7.3kg/m2, with 40% being classified as obese (BMI ≥30kg/m2) and the mean sleep score was 4.68±2.51. Participants with very bad habitual sleeping patterns consumed significantly more sugar-sweetened beverages and alcohol than those with very good sleeping patterns. We also observed that when total coffee with sugar, fruit juice, total sugar-sweetened beverages and weight decreased the number of hours participants slept increased. The study identified significant associations between body weight, sleep duration and sugar-sweetened beverage consumption among rural black South African women. This underscores a need to address unhealthy lifestyle behaviours to lower incidences of non-communicable diseases in rural-dwelling women.

Prognostic Significance of Nuclear Factor kappa B (p65) among Breast Cancer Patients in Cape Coast Teaching Hospital.

Breast cancer is the most prevalent cancer among African women, with high mortality rates in Ghana. Nuclear factor kappa B (NF-kB) has been associated with tumor progression in breast cancer. However, its clinical validation is controversial and understudied with no known published data on NF-kB (p65) among breast cancer patients in Ghana and other African countries. This study assessed the prognostic significance of NF-kB(p65) expression and its association with various clinicopathological features in breast cancer patients. 90 formalin-fixed breast cancer tissues and 15 normal breast tissues were used to determine the expression of NF-kB (p65) using immunohistochemistry. We explored the correlation between expression of NF-kB (p65) and clinicopathological features. NF-kB (p65) was expressed in 86.7% of breast cancer tissues. There was a significant relationship between NF-kB (p65) expression and tumor grade, proliferation index (Ki67), and molecular subtype. High NF-kB (p65) expression in tumor grade 3 was about 10 times that of grade 1 (54.2% versus 5.1%), and Ki67 > 20 was 79.7% compared to 20.3% for Ki67 ≤ 20. Patients with triple-negative breast cancer (TNBC) had 49.1% overexpression of NF-kB (p65) compared to 17%, 25.4% and 8.5% for luminal A, luminal B, and HER 2 cases respectively. This study demonstrates that NF-kB (p65) was highly expressed among breast cancer patients at Cape Coast Teaching Hospital, Ghana especially in TNBC. NF-kB (p65) could serve as a biomarker for cancer stage, progression, prognosis, and as a therapeutic target.

The performance of single and combination test strategies using visual inspection, cytology, high-risk HPV DNA and HPV16/18 to screen South African women with and without HIV-infection

BackgroundCervical cancer screening strategies should ideally be informed by population-specific data. Strategies recommended for secondary prevention, are often inadequately studied in populations with high cervical disease burdens. This report describes the test performance measured against CIN2 + /CIN3 + histology in HIV-positive women (HPW) and HIV-negative women (HNW) with the aim to determine the most effective strategies to identify South African women at risk.MethodsPrimary screening using visual inspection, cytology and HPV DNA (cobas®) was performed in two South African provinces on 456 HPW and 639 HNW participating in the multicentric DiaVACCS trial. Histology was obtained for 91.7% screen-positive and 42.7% screen-negative participants, and unavailable histology was determined by multiple imputation to adjust for verification bias. Cross-sectional test performance was calculated for single and combination test strategies with and without intermediate risk categories using different cut-offs. Minimum acceptability for sensitivity and specificity, treatment and follow-up numbers were considered to evaluate strategies.ResultsThe only single test to reach acceptability in HPW was cytology (LSIL) [sensitivity 71.2%; specificity 90.5%; treatment 33.4%]; in HNW only HPV (hr) qualified [sensitivity 68.2%; specificity 85.2%; treatment 23.5%]. The universally best performing strategy which also resulted in smaller treatment numbers without intermediate risk group was primary HPV(hr), with treatment of both HPV(16/18) and cytology (ASCUS +) [HPW: sensitivity 73.6%; specificity 89.7%; treatment 34.7%. HNW: sensitivity 59.1%; specificity 93.6%; treatment 13.9%].DNA testing for hrHPV (any) and hrHPV (16/18) was the best universally acceptable strategy with an intermediate risk category (early follow-up) in HPW [sensitivity 82.1%; specificity 96.4%; treatment 17.1%; follow-up 31.4%] and HNW [sensitivity 68.2%; specificity 96.7%; treatment 7.6%; follow-up 15.9%]. In comparison, using both HPV (16/18) and cytology (ASCUS +) as secondary tests in hrHPV positive women, decreased follow-up [HPW 13.8%, HNW 9.6%], but increased treatment [HPW 34.7%, HNW 13.9%].ConclusionUsing hrHPV (any) as primary and both HPV16/18 and cytology as secondary tests, was universally acceptable without an intermediate risk group. Strategies with follow-up groups improved screening performance with smaller treatment numbers, but with effective management of the intermediate risk group as prerequisite.

African women migration researchers and the question of reflexivity

Reflexivity has received a lot of attention in recent years, but there is little on how to initiate reflexivity amongst those who are not familiar with it. This paper explores how to initiate reflexivity work and what difference it can make to the initiates in how we research and what we write about, and how this work can be done collaboratively between women in different locales. It breaks new ground by drawing on duo-reflexivity between three African women migration researchers reflecting on their role in collaborative research. In doing so, it unravels the complexities of insider-outsider status in global-North/South research and shows the importance of intersectional reflexivity, which addresses gender, social class, nationality, research setting, and discipline as we researched migration and inclusive growth in Africa. The paper unpacks gender as a category and how we approach it, how we experience it as part of our daily researching lives, and as a research topic in Ghana, Kenya, and Nigeria. Furthermore, we throw a global South perspective on taken for granted categories such as income to show how reflexivity is important when researching migrants and non-migrants for a global audience. The paper ends with some thoughts on our experience of undertaking this reflexivity exercise. We offer this as an invitation to researchers, especially those from the global South, who may also be new to reflexivity.

"I've accepted it because at the end of the day there is nothing, I can do about it": A qualitative study exploring the experiences of women living with the HIV, intimate partner violence and mental health syndemic in Mpumalanga, South Africa.

In South Africa, Mental Health (MH), HIV, and Intimate Partner Violence (IPV) form a syndemic, that disproportionately affects women. These challenges are often co-occurring and create complex adversities for women. Recognising these intersections and the broader socio-cultural dynamics at play is crucial to understanding the layered experiences of these women and developing effective interventions. This research explores the experiences of the women living with at least two of the epidemics (HIV, IPV and or MH) and how they cope. A qualitative study design was used and 20 women (22-60 years) were recruited from Mpumalanga, South Africa. To be eligible for the study the women had to have experienced at least two of the epidemics. Data were collected through home-based interviews, arts-based activities, and analysed thematically using MAXQDA (2022) software. MH challenges were prevalent among all the participants and were linked to both IPV and HIV, resulting in symptoms such as anxiety, depression, and suicidal thoughts. In relation to the HIV-MH link, MH challenges in this combination included feelings of denial, sadness and anxiety related to participant's HIV diagnosis. A bidirectional relationship also existed in the IPV-MH group where pre-existing MH challenges among women increased their vulnerability of having violent partners, whilst IPV also increased MH challenges. In the IPV-MH-HIV group early childhood violence exposure was linked with MH challenges and later victimization and vulnerability to HIV. Participants primarily used religion, acceptance, occasional alcohol, and family support as coping strategies. Particularly in IPV situations, alcohol use/misuse was the most prevalent coping strategies. The study highlights the syndemic relationship between HIV, IPV and MH challenges among South African women living in a peri-urban community, with a central emphasis on MH challenges. Interventions should holistically address these challenges, with particular focus on MH challenges, cultural sensitivity, and promotion of healthy coping strategies.

Sirenomelia or mermaid syndrome with a cleft lip in a Tanzanian newborn: a case report

BackgroundSirenomelia or sirenomelia sequence, also known as mermaid syndrome, is a rare congenital anomaly involving the caudal region of the body. The syndrome is characterized by partial or complete fusion of lower extremities, renal agenesis, absent urinary tract, ambiguous external genitalia, imperforate anus, and single umbilical artery. Sirenomelia is often associated with several visceral congenital malformations, rendering it invariably incompatible with extrauterine life.Case presentationWe present the case of 22-year-old Black African woman who delivered a term newborn by caesarean section at a gestation age of 37 weeks due to obstructed labor with fetal distress. The newborn was a fresh stillbirth weighing 2100 g and had fusion of the lower extremities, a single upper limb, ambiguous genitalia, imperforate anus, and a cleft lip. The mother had made only two prenatal visits, at which she was found to be normotensive and normoglycemic. She was not screened for routine fetomaternal infections and missed supplementation for folic acid during the critical first trimester. She did not undergo any obstetric ultrasonography. The parents of the newborn were not close relatives and there was no family history of consanguinity. Further genetic testing was not performed due to lack of laboratory capacity, and post mortem examination was not permitted due to cultural taboo and restrictions relating to handling of deceased newborns.ConclusionSirenomelia is a rare congenital malformation with very poor prognosis. Specific interventions during pre-conception and early prenatal care are critical in the prevention of specific congenital anomalies. Early obstetric ultrasonography is invaluable for diagnosis of sirenomelia as well as counseling for possible termination of pregnancy.

Hagar’s spirituality prior to and after captivity: An African and gendered perspective

This study is an exploration of the Hagar narrative from the perspective of African Womanist Theology. The article focuses on the spirituality of Hagar before and after her captivity (Gn 16). The research takes an Afrocentric perspective and uses a postcolonial lens to comment on the preceding text as well as consider how this story is captured in Judaism, Christianity and Islam. At the core of the article is an attempt at reclaiming the African in Hagar who is largely portrayed in the stories of Sarah and Abraham within a Hebrew perspective which itself is arguably imperial. The aim is to inspire modern African women (and in the diaspora) to reclaim their African spirituality within their stories and experiences. Summarily, the article is a critique of the colonial project, slavery and its legacies in dehumanising and disenfranchising people and African knowledge systems. The article is structured as follows: firstly, it introduces the Hagar and/or Hajar traditions from the perspectives of Judaism, Christianity and Islam. Secondly, it takes a step back to consider Hagar’s identity as an Egyptian princess before she encountered Sarah and Abraham. The article also discusses how Hagar’s past in Egypt had a bearing on her spiritual encounters when she and her son Ishmael and/or Ismail were exiled. Finally, the article concludes with a recommendation for continued reflection on an African spirituality narrative of the Hagar traditions alongside the predominant narratives from Abrahamic religions.Contribution: This article demonstrates that the religious scriptures must be read from liberation perspectives such as the postcolonial paradigm to inspire the recovery of authentic experiences of the oppressed and displaced, and it is an inspiration to African women to reclaim their true identity and spirituality.

Abstract PO5-09-08: Cancer Health Disparities among non-Hispanic African women: A systematic review of the disparities, reasons and probable intervention

Abstract Health equity places health inequities in historical and social context and calls for action to address injustice and enhance health. As an ethical and human rights value that drives us to end health inequities, health equality is defined as everyone having a fair and just opportunity to be as healthy as feasible. According to this perspective, structural discrimination and marginalization cause health disparities that can be avoided. If these issues are not resolved, social and economic injustices, bias, and unfavorable outcomes that affect all of us will continue to exist. The idea of cancer health equality recognizes that there is still considerable work to be done to change the social structures and historical momentum that have contributed to different cancer outcomes, and that this work can only succeed if it is done. In USA, non-Hispanic black women experience a complicated and multifaceted disparity in breast cancer incidence and outcome. It's possible that social, economic, and behavioral variables contribute to discrepancies. Black women are less likely to breastfeed after childbirth, statistically more likely to have diabetes, heart disease, and obesity, all of which are risk factors for breast cancer. Compared to white women, they are more likely to lack adequate health insurance or access to medical facilities, which could have an impact on screening, follow-up treatment, and therapy completion. It has become evident via more study that biology also plays a part. Black women are more likely to be diagnosed at younger ages and at higher rates with more aggressive subtypes of breast cancer, such as triple-negative breast cancer (TNBC) and inflammatory breast cancer. The National Institute on Minority Health and Health Disparities (NIMHD) established a research framework to characterize the multiple domains of influence (biological, behavioral, physical environment, sociocultural environment, and health care system) that may act across various levels of influence to impact health. A literature search was conducted using the National Library of Medicine's PubMed search engine. Triple negative breast cancer (TNBC) is a common malignancy in African American women. The incidence of TNBC is higher in women of African ancestry and is associated with overall poor prognosis. This disparity is due to the presence/absence of oncogenes/tumor suppressor genes, mutations and altered signaling pathways that might predispose premenopausal African American women to TNBC. Multiple socioeconomic factors influence the access to standard care, novel treatments and inclusion in clinical trials and contribute to overall prognoses. This review focuses on the epidemiology, molecular alterations, and treatment-related disparities in African Americans with breast cancer. This poster will elaborate the racial disparity in terms of breast cancer among the African-American women in USA, the reasons and it's effects on health equity. Citation Format: Tasnuva Khan Efa. Cancer Health Disparities among non-Hispanic African women: A systematic review of the disparities, reasons and probable intervention [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-09-08.

Abstract PS18-09: The DARC side of Breast Cancer - DARC, Duffy-null and African ancestry influence in the Triple Negative Breast Cancer tumor microenvironment

Abstract Background. Despite a recent convergence of breast cancer (BC) incidence rates between African American (AA) and European American (EA) women, AA women continue to have ~40% higher mortality rates. BC is a heterogeneous collection of diseases, where African ancestry women are disproportionately burdened with the most aggressive subtype of BC, triple negative BC (TNBC). We have previously reported that the African ancestry-specific Duffy-null allele (FY-) is a risk factor for TNBC diagnoses. FY- is a promoter variant that removes expression of the Duffy Antigen Receptor for Chemokines (DARC/ACKR1), from red blood cells (RBCs). DARC serves as a portal of entry for Plasmodium vivax malaria parasite, and FY- confers immunity, leading to fixation of FY- among Sub-Saharan African populations. DARC is an atypical chemokine receptor that functions to modulate chemokine levels in circulation and tissues to aid immune cell recruitment. DARC is also expressed on breast tumor epithelial cells, however the significance of DARC in the TNBC tumor microenvironment (TME) has not fully been explored. Leveraging our African ancestry enriched International Study for the Center of Breast Cancer Subtypes cohort and in vivo murine models, we employed multi-omics approaches to explore the function of FY- and DARC expression across cell types in the TNBC TME. Genomics. Using transcriptomic data from the TCGA BC cohort, we have previously reported that DARC expression is highly correlated with deconvoluted immune cell abundance using CIBERSORT. To build upon this finding among TNBC patients, we have analyzed RNAseq data from two cohorts of African ancestry women to explore correlation of DARC expression status and immune cell abundance. Among TNBC cases, we report that higher DARC expression was significantly associated with increased immune cell abundance, with increases in B cell, T cell and monocyte populations. Using whole genome sequencing data across 86 African ancestry cases, we are currently investigating germline FY- status with mutational signatures. Circulating biomarkers. Patient plasma was collected prior to surgery, where Luminex multiplex assays were performed to quantify levels of >40 circulating chemokines and cytokines. FY- status has been determined for ~550 patients using single-plex or multiplex PCR genotyping methods from germline saliva DNA. Our univariate analyses show several circulating chemokines, including CCL2, CXCL2, CXCL6 and CXCL11, have significant differences between FY- and non-FY- BC patients. Curation of clinicopathological variables for multivariate analysis is ongoing. Murine models. We crossed C3(1)Tag BC transgenic mice with a DARC knock-out (KO) line to generate mice lacking DARC expression that spontaneously develop tumors in the mammary fat pads. The C3(1)Tag model is reported to have similar gene expression profiles to basal-like TNBC tumors. Tumors were collected at pre-determined time points of 25 and 30 weeks, where DARC KO mice had increased tumor size and tumor burden at 30 weeks. Initial fluorescent staining revealed an increase in immune cell infiltration in the TME of DARC expressing mice compared to DARC KO mice. To further explore this, we employed multiplex staining across a representative cohort of DARC expressing and KO mice at 25 and 30 weeks to capture the specific immune cell populations infiltrating the TME. Conclusions. TNBC tumors have worse prognosis due to lack of targeted therapeutic options. Increased immunogenicity of TNBC tumors, especially among African ancestry women may be driven in part by DARC expression. Characterization of FY- status, in coordination with DARC among other cell types in the TNBC TME could present new opportunities for biomarker and/or therapeutic development to improve prognosis for these underserved populations. Citation Format: Rachel Martini, Stevens Patino, Emma Guyonnet, Brian Stonaker, Isra Elhussein, Julie Sahler, Avery August, Nancy Manley, Rick Kittles, Clayton Yates, Lisa Newman, Melissa Davis. The DARC side of Breast Cancer - DARC, Duffy-null and African ancestry influence in the Triple Negative Breast Cancer tumor microenvironment [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS18-09.

Innovative register and feminist critique in Mark Behr’s The Smell of Apples

Mark Behr’s artistic exploration of the horrific legacy of Afrikaner racist and masculinist ideology in The Smell of Apples has attracted substantial critical attention. This is perhaps what has elevated his novel to a post-apartheid South African literary canon. While it has been read as an exculpatory narrative—an exploration of how white South Africans disclosed their complicity in apartheid’s atrocities and/or a disclosure of how the apartheid system violated their rights—there is critical blindness to other important themes that the novel grapples with. This is why I offer a limited reading of Behr’s critique of Afrikaner gender oppression. My exploration, which focuses on Behr’s exposition of gender discrimination of upper-middle class women in an Afrikaner society, is anchored on two questions: how does Behr deploy an innovative register—eavesdropping child witness-narrator and a written letter—to unveil the oppression of upper-middle class white South African women in the Afrikaner polity? Second, how does he script the feminist agency of the ‘mother of the nation’ figure who is muzzled by Afrikaner patriarchy? I foreground Maria Pia Lara’s thinking about the liberational potential of literary texts in my discussion of Behr’s exposition of the gendered oppression of certain categories of women by Afrikaner patriarchy.

Radikaal versus beskeie: Die vroegste vrouestemme teen patriargie in die Suid-Afrikaanse literatuursisteem

This article explores similar social experiences of South Africa in the English and Afrikaans literary systems respectively. It investigates the reflection of patriarchy as an ideological presupposition of South African society in the earliest writings of two South African writers, Olive Schreiner (1855–1920) and Maria Elizabeth Rothmann (1875–1975) (known as M. E. R.). In doing this, it offers a discussion of how these women’s involvement in South African politics sought to address the situation that political rule during the late 1800s and early 1900s created for South African women in the broader context of the South African War. The practice of gender politics as a response to these social experiences is discussed, while the contribution of Schreiner’s radical voice to the stereotyping of the Afrikaner woman is compared to the modest voice with which M. E. R. fought for the rights of these stereotyped women. The article concludes that the nature of, and similarities and differences between their feminist voices determined Schreiner’s and M. E. R.’s contribution to their respective literary systems, as well as their contribution to English and Afrikaans prose.

Infection-related severe maternal outcomes and case fatality rates in 43 low and middle-income countries across the WHO regions: Results from the Global Maternal Sepsis Study (GLOSS).

The highest toll of maternal mortality due to infections is reported in low and middle-income countries (LMICs). However, more evidence is needed to understand the differences in infection-related severe maternal outcomes (SMO) and fatality rates across the WHO regions. This study aimed to compare the burden of infection-related SMO and case fatality rates across the WHO regions using the Global Maternal Sepsis Study (GLOSS) data. GLOSS was a hospital-based one-week inception prospective cohort study of pregnant or recently pregnant women admitted with suspected or confirmed infection in 2017. Four hundred and eight (408) hospitals from 43 LMICs in the six WHO regions were considered in this analysis. We used a logistic regression model to compare the odds of infection-related SMOs by region. We then calculated the fatality rate as the proportion of deaths over the total number of SMOs, defined as maternal deaths and near-misses. The proportion of SMO was 19.6% (n = 141) in Africa, compared to 18%(n = 22), 15.9%(n = 50), 14.7%(n = 48), 12.1%(n = 95), and 10.8%(n = 21) in the Western Pacific, European, Eastern Meditteranean, Americas, and South-Eastern Asian regions, respectively. Women in Africa were more likely to experience SMO than those in the Americas (aOR = 2.41, 95%CI: [1.78 to 2.83]), in South-East Asia (aOR = 2.60, 95%CI: [1.57 to 4.32]), and the Eastern Mediterranean region (aOR = 1.58, 95%CI: [1.08 to 2.32]). The case fatality rate was 14.3%[3.05% to 36.34%] (n/N = 3/21) and 11.4%[6.63% to 17.77%] (n/N = 16/141) in the South-East Asia and Africa, respectively. Infection-related SMOs and case fatality rates were highest in Africa and Southeast Asia. Specific attention and actions are needed to prevent infection-related maternal deaths and severe morbidity in these two regions.

An HIV-1 risk assessment tool for women aged 15-49 in African countries: A pooled analysis across 15 nationally representative surveys.

Women in Africa disproportionately acquire HIV-1. Understanding which women are most likely to acquire HIV-1 can guide focused prevention with pre-exposure prophylaxis (PrEP). Our objective is to identify women at highest risk of HIV-1 and estimate PrEP efficiency at different sensitivity levels. Nationally representative data were collected from 2015-2019 from 15 population-based household surveys. This analysis included women aged 15-49 who tested HIV-1 sero-negative or had recent HIV-1. Least absolute shrinkage and selection operator regression models were fit with 28 variables to predict recent HIV-1. Models were trained on the full population and internally cross-validated. Performance was evaluated using area under the receiver-operating-characteristic curve (AUC), sensitivity, and number needed to treat (NNT) with PrEP to avert one infection. Among 209,012 participants 248 had recent HIV-1 infection, representing 118 million women and 402,000 (95% CI: 309,000-495,000) new annual infections. Two variables were retained in the model: living in a subnational area with high HIV-1 viremia and having a sexual partner living outside the home. Full-population AUC was 0.80 (95% CI: 0.76-0.84); cross-validated AUC was 0.79 (95% CI: 0.75-0.84). At a sensitivity of 33%, up to 130,000 cases could be averted if 7.9 million women were perfectly adherent to PrEP; NNT would be 61. At a sensitivity of 67%, up to 260,000 cases could be averted if 25.1 million women were perfectly adherent to PrEP; the NNT would be 96. This risk assessment tool was generalizable, predictive, and parsimonious with tradeoffs between reach and efficiency.

Coloniality, modern subjectivities in Kenya and exclusion of African women in preventing violent extremism

Cosmetic attention to contextual nuances has been a major obstacle in many programmes for preventing violent extremism (PVE) in Kenya. The study highlights how donor-funded interventions often disregard cultural values and local experience by posing a subtle resistance to learn from the knowledge of local actors. The non-recognition of contextual knowledge postures a gender problem, increasing chances for systemic exclusion of African women from the knowledge production system. The paper interrogates how modern subjectivities, entrenched in contemporary interventions, exude colonial legacies in PVE. Using decolonial theory and interviews with local practitioners, the study submits that many donor-funded PVE approaches risk pushing further the voice of indigenous African women to the periphery of knowledge production. The paper concludes that PVE interventions in the local context have an opportunity for reinforcing indigenous perspectives through a decisive decolonial strategy in the women peace and security agenda.

0374 Dimensions of Sleep Health and Mood Disorders in Middle Eastern/North African Women

Abstract Introduction Insomnia symptoms are a common sleep disturbance during midlife. However, emerging evidence suggests that midlife women also experience increased risk of obstructive sleep apnea and short sleep duration. Cohorts of women in midlife have mostly included white women, despite suspected sleep health disparities among women from underrepresented racial and ethnic backgrounds. To address this gap, we conducted a pilot study that examined sleep health among women from Middle Eastern/North African (MENA) ancestry. Methods This pilot study enrolled 77 women aged 40-60y from MENA ancestry, recruited mostly from Michigan. Women provided demographic, lifestyle, sleep and health information through interviews with structured and validated questionnaires, including the Pittsburgh Sleep Quality Index (PSQI) and Patient Health Questionnaire (PHQ-9). Risk for obstructive sleep apnea (OSA) was evaluated using the STOP questionnaire+BMI and a subset of the women was tested with Watch-PAT, a one-night home sleep apnea testing device (OSA diagnosis, apnea-hypopnea index pAHI3%>5/h). The menopause rating scale was used to collect data on psychological and physiological symptoms. Results Mean age of women was 48y±5 years and mean BMI was 27.6±5 kg/cm2. Anxiety, irritability, and depression symptoms were identified in 33%, 25% and 31% of women. Half reported trouble falling asleep within 30 minutes, and 73% experienced nocturnal and early morning awakenings three or more times per week. Most women (75%) were aware of adequate sleep recommendations, but 54% reported short sleep duration, < 6 hours, and 30% reported < 5 hours of sleep per night. A STOP+BMI score ≥3 was observed in 20% of women. Twenty women were tested for OSA and 75% had it (mean pAHI3%=12.6/h). Moderate and severe OSA was apparent among 20% and 10% of the 20 women. Concurrent OSA and insomnia symptoms were observed among 40% of women. The odds ratio of insomnia were 9-fold and 3-fold for women with depression and anxiety, respectively. Conclusion We found a high burden of poor sleep and sleep disorders among midlife women from MENA ancestry. Moreover, poor sleep was associated with symptoms of depression and anxiety, raising the possibility that efforts to improve sleep health could benefit the mental health of these women as well. Support (if any)

South Africa: Wealth Gap, Employment Imbalance, and Education Inequality in South Africa

This study uses changes in education and work between men and women to estimate the impact of gender inequality on the wealth gap in South Africa. Although the low enrollment rate of males in primary education continues to occur, social factors of gender inequality led to higher graduation rates and unemployment rates for females than for males, even though they have higher enrollment rates. These findings prove that gender inequality in society leads to job and income imbalances. for this paper, the innovation lies in the logical analysis of the three factors together, rather than the research on the influence of one element. Interestingly, even with the promotion of women's rights in South African society, gender bias has been affecting people's behaviour and subconsciousness at work, making people ignore that South African women have higher learning and skilled workability, which can improve the social economy more than men.

Exploring sustainable aesthetics through repurposed studio waste materials for unorthodox finishes

This study recycles and repurposes discarded studio waste materials, such as broken ceramics, glass fragments, sawdust, and bits of shattered P.O.P molds, to create visually compelling creative works. The interest for this study is inspired by the prolific generation of waste that arises from the studio learning practices of sculpture and ceramic students. A studio-based research approach utilizing Aesthetico-Action Research design is employed in a systematic approach to explore the feasibility and promise of composite amalgamation. The researchers mix resin and fiberglass composite materials with the various types of studio waste. The primary objective is to achieve creative outcomes with unconventional and unique finishes. The technique, philosophical and symbolic application, and usage of these materials in creating distinct art pieces including an exclusive “African woman” offer intriguing insights. The study reveals that the studio can efficiently repurpose waste materials, creating new cast materials for sculptures and ceramic works with distinctive and non-traditional finishes. This highlights the intrinsic transforming capacity of disposable waste materials, presenting a compelling opportunity for new and sustainable artistic practice where material finishes are not concealed.

Maternal and infant outcomes in women with sickle cell disease: a matched cohort study

ObjectiveWomen with sickle cell disease (SCD) have adverse maternal and infant outcomes. Our aim was to determine whether the outcomes of SCD mothers and their infants differed from African or...

Baseline knowledge on risk factors, symptoms and intended behavior of women and men towards screening and treatment of cervical cancer in rural Uganda: a cross-sectional study

BackgroundKnowledge of risk factors and symptoms of cervical cancer has been found to promote uptake of screening of cervical cancer. Most interventions targeted women without much involvement of men (husbands/decision makers) who are often decision makers in many low- and middle-income countries. This study aimed at assessing baseline knowledge and intended behavior of both women and men to enable design specific targeted messages to increase uptake of cervical cancer screening and promote early detection of women with symptoms.MethodsThis cross-sectional study was conducted in two districts in Western Uganda using the modified African Women Awareness of CANcer (AWACAN) questionnaire. Women aged 30—49 years and their husbands/decision makers were interviewed. Knowledge on risk factors and symptoms, intended behavior and barriers towards participation in cervical cancer screening and treatment were assessed. Descriptive and logistic regression analyses were done to establish the association between knowledge levels and other factors comparing women to men.ResultsA total of 724 women and 692 men were enrolled. Of these, 71.0% women and 67.2% men had ever heard of cervical cancer and 8.8% women had ever been screened. Knowledge of risk factors and symptoms of cervical cancer was high and similar for both women and men.Lack of decision making by women was associated with low knowledge of risk factors (X2 = 14.542; p = 0.01), low education (X2 = 36.05, p < 0.01) and older age (X2 = 17.33, p < 0.01). Men had better help seeking behavior than women (X2 = 64.96, p < 0.01, OR = 0.39, 95% CI: 0.31—0.50) and were more confident and skilled in recognising a sign or symptom of cervical cancer (X2 = 27.28, p < 0.01, OR = 0.52, CI (0.40—0.67).ConclusionThe baseline knowledge for cervical cancer was high in majority of participants and similar in both women and men. Their intended behavior towards screening was also positive but screening uptake was very low. This study suggests developing messages on multiple interventions to promote screening behavior in addition to education, consisting of male involvement, women empowerment and making services available, accessible and women friendly.