South African Women Research Articles

Factors Associated with Sexual Intercourse Frequency Among South African Women: Evidence from a National Cross-sectional Survey

Background: Engaging in regular healthy sexual intercourse activities is good for human health and well-being. Greater sexual intercourse frequency (SIF) for people in relationships is often associated with well-being, greater relationship satisfaction, reduced mortality, increased life expectancy, positive emotions and happiness, while lack of sexual activity is usually associated with depression and marital disharmony. Aim: The primary purpose of this study is to identify the factors associated with SIF among women in South Africa. Data and Methods: The South African Demographic and Health Survey 2016 data were used, and the negative binomial regression model (NBRM) was employed for analysis. Results: Age was significantly associated with high SIF (IRR = 1.02; p < .001). African women had significantly higher SIF than Indian/Asian women (IRR = 1.28; p = .049). Married women had a significantly higher SIF than women who were never married (IRR = 1.42; p < .001). Women who resided in urban areas were significantly associated with higher SIF than women who resided in rural areas (IRR = 1.14; p < .001). Conclusion: Being young, being Indian/Asian, being unmarried, and residing in rural areas is associated with low SIF, whereas being older, being African, being married, and staying in urban areas is associated with high SIF. Generally, without violating cultural, religious and societal beliefs, married women should be taught about the benefits of sexual intercourse activity (SIA) and be encouraged not to be ashamed of entering into sexual intercourse activities.

Meaning of work for South African women during the pandemic

Orientation: The coronavirus disease 2019 (COVID-19) pandemic disrupted workplaces worldwide, prompting a re-evaluation of the meaning and significance of work, particularly among women who were uniquely impacted by the crisis.Research purpose: This study aimed to understand the meaning that South African women attributed to their work during the pandemic. Additionally, the research aligned with the Sustainable Development Goals (SDGs 3, 5 and 8), contributing to efforts to improve well-being, promote gender equality and ensure decent work.Motivation for the study: Understanding how the pandemic altered women’s perceptions and experiences of work can provide valuable insights for human resource professionals, helping to create more inclusive and supportive work environments.Research approach/design and method: A generic qualitative approach was employed, involving 10 semi-structured interviews with South African women who were formally employed both before and during the pandemic. Thematic analysis was used to interpret the data collected.Main findings: The study revealed that women had individual motivations for their chosen work, with the meaning of work varying among participants. Factors such as organisational and personal challenges, as well as the support received, significantly shaped these meanings.Practical/managerial implications: Organisations need to consider the unique challenges and support needs of women in the workplace, especially in the context of recovery from the pandemic.Contribution/value-add: The study enriches the body of literature on the meaning of work, particularly focussing on South African women during the COVID-19 pandemic, and informs organisational practices that can better support employees during crises and beyond.

Investigating the association between hair progesterone, anxiety, sleep quality, and other determinants in South African females

BackgroundAnxiety symptoms and poor sleep quality are common in women. The role of sex hormones, particularly progesterone, in anxiety and sleep quality in women is understudied. Measurement of hair progesterone concentrations (HPC) is a promising method to investigate the effects of progesterone on anxiety symptoms and sleep quality in women. ObjectivesWe analysed sociodemographic, hair-related, and clinical factors associated with HPC and investigated the association between HPC and anxiety severity and sleep quality in a sample of 159 South African women (mean age: 46.5 years; range: 18-79 years). MethodsData were obtained from control participants from the SHARED ROOTS study. HPC were determined using an established liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Unadjusted and adjusted multiple linear regression models were used to investigate whether sleep quality, measured with the Pittsburgh Sleep Quality Index (PSQI), and anxiety, measured with the Spielberger State-Trait Anxiety Inventory (STAI), were associated with HPC. Significant sociodemographic, hair-related, and clinical factors were adjusted for. ResultsHPC was significantly associated with age, duration of sample storage, hormonal treatment, postmenopausal status, and the number of different types of trauma exposures in adjusted models. Neither anxiety severity nor sleep quality was significantly associated with HPC. ConclusionsCertain demographic, hair related, and clinical factors were associated with HPC and need to be considered in future research using HPC. Although anxiety and sleep were not associated with HPC, greater trauma exposure was associated with higher HPC, suggesting an association between severe stress and hypothalamic-pituitary-gonadal (HPG) axis functioning.

Surface protein distribution in Group B Streptococcus isolates from South Africa and identifying vaccine targets through in silico analysis.

Group B Streptococcus (GBS) is a major cause of pneumonia, sepsis, and meningitis in infants younger than 3 months of age. Furthermore, GBS infection in pregnant women is associated with stillbirths and pre-term delivery. It also causes disease in immunocompromised adults and the elderly, but the highest incidence of the disease occurs in neonates and young infants. At this time, there are no licensed vaccines against GBS. Complete GBS genome sequencing has helped identify genetically conserved and immunogenic proteins, which could serve as vaccine immunogens. In this study, in silico reverse vaccinology method were used to evaluate the prevalence and conservation of GBS proteins in invasive and colonizing isolates from South African infants and women, respectively. Furthermore, this study aimed to predict potential GBS vaccine targets by evaluating metrics such as antigenicity, physico-chemical properties, subcellular localization, secondary and tertiary structures, and epitope prediction and conservation. A total of 648 invasive and 603 colonizing GBS isolate sequences were screened against a panel of 89 candidate GBS proteins. Ten of the 89 proteins were highly genetically conserved in invasive and colonizing GBS isolates, nine of which were computationally inferred proteins (gbs2106, SAN_1577, SAN_0356, SAN_1808, SAN_1685, SAN_0413, SAN_0990, SAN_1040, SAN_0226) and one was the surface Immunogenic Protein (SIP). Additionally, the nine proteins were predicted to be more antigenic than the SIP protein (antigenicity score of > 0.6498), highlighting their potential as GBS vaccine antigen targets.

Exploring marital safety: three South African wives living with HIV in nonmutual monogamous marriage

For wives who have been sexually monogamous, their being infected with HIV disrupts the cultural assumption of sexual safety in marriage. This phenomenological interview study shows how three married South African women, who were diagnosed with HIV and had reported being monogamous, experienced gendered distress while contemplating the failures of married coupledom in offering safety and familial stability. Constructionist thematic analysis showed three themes to represent changes in the marital unit. The first theme, HIV as Demarcation of Enduring Disruption, pointed to infection as the harbinger of distressing relational dynamics. The second theme, Feeling Controlled, reflected domains in which the wives felt trapped: restricted freedoms and obligatory intimacy. The third theme, Relational Deterioration, showed meanings about infidelity, fights or arguments, and distress about partner disengagement. Highlighted in this analysis is that, for two women, male control and disempowerment after having been infected with HIV added to their experiences of feeling trapped because they felt pressured into regressing into subservient spousal roles. They were required to retreat into household, mothering, and child care duties. The study’s practice implication is that, to address the aftermath of the discovery of HIV infection in heterosexual married couples, wherein sexual monogamy remains the unquestioned norm, health psychology and clinical interventions should incorporate a gendered approach in counselling formulation.

Egg providers in eGoli

AbstractIn South Africa's urban hubs, young women are increasingly participating in the global fertility market by donating their eggs. Egg providers, who supply oocytes for others’ use in fertility treatment, are a key resource in the fertility market, and they are emblematic of new forms of biolabor. Egg markets have tapped into a precariously middle‐class population of young Black women in Johannesburg, where the neoliberal state has largely retreated from fostering social mobility. What role does egg donation play in the social world of young South African women? I approach this question by extending Cohen's concept of “operability,” which can illuminate how egg donation becomes a means for young women to enact modernity, or relationality beyond the postapartheid state and the horizons of their social worlds, structured as they are by the entanglements of race, class, and gender.

Examining the psychometric properties of the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 among young urban South African women

BackgroundValid, reliable, and easy-to-administer scales are crucial for identifying mental health conditions, especially in LMICs where such scales tend not to be validated. This study aims to address this gap by investigating the psychometric properties and factorial structure of the PHQ-9 and GAD-7 in a sample of young women in Soweto, South Africa. MethodsThe PHQ-9 and GAD-7 were administered to 6028 women aged 18–28 years old. Cronbach's alpha, Mokken scale analysis, and Confirmatory Factor Analysis were used to provide support for the internal consistency and construct validity of these scales. ResultsBoth scales demonstrated good internal consistency (α = 0.81 for PHQ-9 and α = 0.84 for GAD-7). Internal consistency reliability was further supported by positive inter-item correlations and item-by-scale correlations for all items on both measures. CFA of the PHQ-9 and GAD-7 showed a reasonable fit for the 1-factor model and 2-factor models (depression and anxiety with somatic and cognitive subtypes). LimitationsThis study was limited to young African women in urban Soweto who were proficient in English, which may affect generalizability. Differences in language or cultural context may impact the accuracy and applicability of these scales to other African populations. ConclusionThe PHQ-9 and GAD-7 are valid and reliable for identifying psychological distress in the studied population. Despite showing good psychometric properties, further diagnostic assessment is needed to confirm clinical diagnoses. The scales are useful for identifying those at risk but not a substitute for comprehensive diagnostic evaluations.

Barriers and enablers to breast cancer screening in rural South Africa

Background: The breast cancer burden on the South African healthcare system is severe, with rural South African women often diagnosed at an advanced stage of the disease. South Africa’s rural areas are classified as low-resource settings with limited medical services and infrastructure. The impact of breast cancer on rural communities in South Africa requires ongoing research to better understand the severity of this disease among one of the most vulnerable populations.Objectives: This study aimed to explore the barriers and enablers of breast cancer screening among rural South African women.Method: An exploratory qualitative study was utilised. A semi-structured interview was conducted with 22 rural South African women. Data were analysed using thematic analysis. This study utilised the care-seeking behaviour theory as its theoretical framework.Results: Participants identified many barriers to breast cancer screening, including individual affordability, transportation, rural services, infrastructure, health professional behaviour, and the lack of educational materials. Several factors are suggested to enable the screening of breast cancer in rural South Africa, including breast cancer campaigns, health education, the involvement of key stakeholders, and promotional materials.Conclusion: Despite the many barriers to breast cancer screening among rural South African women, there is still hope in implementing the various promotional tools outlined in this study and ensuring that breast self-examination is an alternative, affordable screening method.Contribution: The purpose of this article is to contribute to the attainment of the Sustainable Development Goal (SDG) 3, which focusses reducing premature mortality from non-communicable diseases, including cancer.

Insights into coaching effectiveness: Perspectives from coaches and players in South African Women's Rugby

Sports coaching involves navigating ambiguity and uncertainty in stakeholders’ perspectives and managing a dynamic micro-political environment. This study explores the relationship between coaching efficacy and effectiveness in South African Women's Rugby. It examines how a coach's belief in their ability to influence athlete learning and performance (coaching efficacy) correlates with the actual impact on athletes (coaching effectiveness). By aligning coaches’ perceived competence with tangible athlete outcomes, the study provides insights into factors influencing coaching practices and athlete development. The study involved 28 women players (mean age: 24.8 ± 4.0 years) and 8 coaches (mean age: 41 ± 3.8 years) who participated in semi-structured online interviews. The interview script, derived from the Coaching Effectiveness Survey (CES) tool, was analysed using Braun and Clarke's 6-step process of thematic content analysis. Under the four efficacy dimensions, sub-themes emerged as follow: 1) motivation (climate created by the coach and a motivational climate experienced by the players), 2) technique (coaching physical, technical, and tactical aspects of rugby), 3) game strategy (guiding players to successful outcomes), and 4) character-building efficacy (cultivating a positive environment for sportswomanship and holistic development). The findings incorporate feedback from players and coaches, highlighting firsthand experiences of coaching effectiveness. This approach enables experts to identify effective coaching strategies and those needing refinement within Women's Rugby. The study's findings promise to inform future coach development frameworks and foster a comprehensive understanding of coaching effectiveness in the dynamic landscape of Women's Rugby worldwide.

Perceptions of the attributes of new long-acting HIV pre-exposure prophylaxis formulations compared with a daily, oral dose among South African young women: a qualitative study

ABSTRACT Oral PrEP is highly effective against the acquisition of HIV but is underutilised by young women. New options, like the monthly dapivirine vaginal ring (DVR) and injectable long-acting cabotegravir (CAB-LA), are emerging. However, little is known about young women’s perceptions of these alternatives. This qualitative study explored perceptions of the attributes of PrEP technologies in South Africa. Young women accessing sexual health services were purposively selected to participate in 22 in-depth interviews, five focus group discussions and two workshops using the nominal group technique, between August 2022 and March 2023. A thematic approach guided by the diffusion of innovation attributes, including relative advantage, compatibility with the student's lives, complexity of the technology, and trialability, was used for data analysis. The DVR was the least preferred because of lower efficacy, the perceived complexity of inserting it in the vagina and some safety concerns. Oral PrEP, which some had tried and discontinued, was least compatible with students’ busy schedules. Integrating PrEP and contraceptives with similar return visit patterns could enhance service delivery. Intensive demand creation campaigns will be needed to increase PrEP utilisation and dispel myths about the vaginal ring.

Black women’s filicidal rage in zones of impoverishment

ABSTRACT Visual and written accounts of rage in popular media tend to associate rage with violent masculinities. 1 Filicide brings women’s rage into sharp relief. By reading South African women in relation to their ancestral peer, Sila van den Kaap and through a ‘black deformative’ analysis of media accounts and an interview of filicide in South Africa, this paper asserts that black women have ample cause for rage. Filicide brings the purportedly personal into public light and compels a response. Although the response tends to pathologise filicidal women, it calls attention to the conditions of impoverishment that black women live under. The paper suggests that filicidal women’s refusal of the conditions of mothering, may also be an enactment of a strike against gendered scripts of care. Their own subsequent suicide might simultaneously be read as an opting out and as reaching for freedom beyond the interdiction of impoverishment. The findings suggest that rage is a crucial action-oriented affect in the expression and striving for black freedoms of which women are always core protagonists.

Exploring the burden of care: challenges faced by caregivers of HIV-infected children in Limpopo Province, South Africa

The number of new HIV cases worldwide has gradually declined; however, South African adolescent females and young women continue to account for the most infections. Although the availability and accessibility of antiretroviral drugs have improved the survival rates of women, some still transmit HIV to their children despite the availability of HIV prevention interventions, resulting in a dual responsibility for the care of themselves and their infected children. This study aims to explore the challenges experienced by caregivers of HIV-infected children in Limpopo Province. The study employed qualitative, exploratory, and descriptive designs, and data was collected from 12 caregivers through semi-structured interviews. Data were analysed using Tesch’s eight steps of analysis. The study identified three challenges facing caregivers of HIV-positive children. Caregivers struggled with disclosure and stigma, finding it difficult to reveal the child's HIV status. The burden of care was significant, including the management of the child's unstable health, ensuring compliance with treatment, and attending frequent hospital visits. The unemployment rate posed a financial burden, particularly in arranging hospital travel costs and providing adequate nutrition to HIV-infected children. These challenges highlight the need for increased support for caregivers of HIV-infected children, including education and awareness campaigns to reduce stigma. Policymakers should consider providing financial support to caregivers. A holistic, multisectoral approach involving healthcare, education, social services, and policymakers is essential.

Identification of HPV16 Lineages in South African and Mozambican Women with Normal and Abnormal Cervical Cytology.

Human papillomavirus 16 (HPV16) is an oncogenic virus responsible for the majority of invasive cervical cancer cases worldwide. Due to genetic modifications, some variants are more oncogenic than others. We analysed the HPV16 phylogeny in HPV16-positive cervical Desoxyribonucleic Acid (DNA) samples collected from South African and Mozambican women to detect the circulating lineages. Polymerase chain reaction (PCR) amplification of the long control region (LCR) and 300 nucleotides of the E6 region was performed using HPV16-specific primers on HPV16-positive cervical samples collected in women from South Africa and Mozambique. HPV16 sequences were obtained through Next Generation Sequencing (NGS) methods. Geneious prime and MEGA 11 software were used to align the sequences to 16 HPV16 reference sequences, gathering the A, B, C, and D lineages and generating the phylogenetic tree. Single nucleotide polymorphisms (SNPs) in the LCR and E6 regions were analysed and the phylogenetic tree was generated using Geneious Prime software. Fifty-eight sequences were analysed. Of these sequences, 79% (46/58) were from women who had abnormal cervical cytology. Fifteen SNPs in the LCR and eight in the E6 region were found to be the most common in all sequences. The phylogenetic analysis determined that 45% of the isolates belonged to the A1 sublineage (European variant), 34% belonged to the C1 sublineage (African 1 variant), 16% belonged to the B1 and B2 sublineage (African 2 variant), two isolates belonged to the D1-3 sublineages (Asian-American variant), and one to the North American variant. The African and European HPV16 variants were the most common circulating lineages in South African and Mozambican women. A high-grade squamous intraepithelial lesion (HSIL) was the most common cervical abnormality observed and linked to European and African lineages. These findings may contribute to understanding molecular HPV16 epidemiology in South Africa and Mozambique.

Adapting an evidence-based contingency management and text messaging intervention for South African perinatal women who drink

South Africa has one of the highest prevalence rates globally for fetal alcohol spectrum disorders. Despite this, few interventions are routinely available for countering the adverse effects of perinatal drinking. The current study used the ADAPT-ITT framework to guide the development of a behavioral intervention with remote alcohol use monitoring and provision of financial incentives contingent on alcohol abstinence for people who are pregnant and postpartum. The study aims to maximize the intervention’s relevance, acceptance, and effectiveness in reducing alcohol use during pregnancy and lactation, ultimately improving maternal and infant health outcomes in South Africa. Thirty-two in-depth interviews with people who were pregnant and 16 key-informant interviews with clinic and community members were conducted to help inform the intervention. The adapted intervention was pretested with 20 people who were pregnant or breastfeeding, and additional feedback was obtained from the community collaborative board. While there was widespread support for the intervention elements, some concerns were raised, including perceived high street value of a monitoring device, access to mobile phones to use such a device, frequency of monitoring, cheating when using a remote monitoring device, devices being lost or stolen, and the sustainability of long-term monitoring. The adapted intervention combines alcohol monitoring-based contingency management with text-based health promotion and information on where to access services tailored to maternal populations ready for testing in feasibility and efficacy trials.

Gestation-dependent increase in cervicovaginal pro-inflammatory cytokines and cervical extracellular matrix proteins is associated with spontaneous preterm delivery within 2 weeks of index assessment in South African women.

Inflammation-induced remodelling of gestational tissues that underpins spontaneous preterm birth (sPTB, delivery < 37 weeks' gestation) may vary by race and context. To explore relationships between markers of these pathological processes, we (a) characterised the cervicovaginal fluid (CVF) cytokine profiles of pregnant South African women at risk of PTB; (b) determined CVF matrix-metalloproteinase-9 (MMP-9) and its regulator tissue inhibitor of metalloproteinase-1 (TIMP-1); and (c) explored the predictive potential of these markers for sPTB. The concentrations of 10 inflammatory cytokines and MMP-9 and TIMP-1 were determined by ELISA in CVF samples from 47 non-labouring women at high risk of PTB. We studied CVF sampled at three gestational time points (GTPs): GTP1 (20-22 weeks, n = 37), GTP2 (26-28 weeks, n = 40), and GTP3 (34-36 weeks, n = 29) and analysed for changes in protein concentrations and predictive capacities (area under the ROC curve (AUC) and 95% confidence interval (CI)) for sPTB. There were 11 (GTP1), 13 (GTP2), and 6 (GTP3) women who delivered preterm within 85.3 ± 25.9, 51.3 ± 15.3, and 11.8 ± 7.5 (mean ± SD) days after assessment, respectively. At GTP1, IL-8 was higher (4-fold, p = 0.02), whereas GM-CSF was lower (~1.4-fold, p = 0.03) in the preterm compared with term women with an average AUC = 0.73. At GTP2, IL-1β (18-fold, p < 0.0001), IL-8 (4-fold, p = 0.03), MMP-9 (17-fold, p = 0.0007), MMP-9/TIMP-1 ratio (9-fold, p = 0.004), and MMP-9/GM-CSF ratio (87-fold, p = 0.005) were higher in preterm compared with term women with an average AUC = 0.80. By contrast, IL-10 was associated with term delivery with an AUC (95% CI) = 0.75 (0.55-0.90). At GTP3, IL-1β (58-fold, p = 0.0003), IL-8 (12-fold, p = 0.002), MMP-9 (296-fold, p = 0.03), and TIMP-1 (35-fold, p = 0.01) were higher in preterm compared with term women with an average AUC = 0.85. Elevated IL-1β was associated with delivery within 14 days of assessment with AUC = 0.85 (0.67-0.96). Overall, elevated MMP-9 at GTP3 had the highest (13.3) positive likelihood ratio for distinguishing women at risk of sPTB. Lastly, a positive correlation between MMP-9 and TIMP-1 at all GTPs (ρ ≥ 0.61, p < 0.01) for women delivering at term was only observed at GTP1 for those who delivered preterm (ρ = 0.70, p < 0.03). In this cohort, sPTB is associated with gestation-dependent increase in pro-inflammatory cytokines, decreased IL-10 and GM-CSF, and dysregulated MMP-9-TIMP-1 interaction. Levels of cytokine (especially IL-1β) and ECM remodelling proteins rise significantly in the final 2 weeks before the onset of labour when sPTB is imminent. The signalling mechanisms for these ECM remodelling observations remain to be elucidated.

“I will find the best method that will work for me”: navigating contraceptive journeys amongst South African adolescent girls and young women

BackgroundGiven that South Africa has one of the highest rates of pregnancy amongst adolescent girls and young women (AGYW) globally, the provision of contraceptives to this group has been a key focus in recent years. Pregnancy prevention involves an on-going continuum of decision-making around contraceptive method choice, uptake, use, experience, continuation, and discontinuation.MethodsThis paper presents analysis of data from a cross-sectional survey with 2376 AGYW, as well as qualitative in-depth interviews (IDIs) with 54 AGYW, inclusive of contraceptive journey narratives. We examine the preferences, valued characteristics, choices, beliefs, understandings and experiences of choosing and using contraceptives amongst AGYW in two South African communities characterised by high rates of pregnancy.ResultsThese findings shed light on the preferences towards, beliefs about, and experiences of choosing, using and discontinuing contraceptive methods amongst this population, with survey data suggesting that the most popular methods were the injection, followed by the implant, and then the oral pill. Findings illustrate the complexity and dynamic nature of contraceptive decision-making and the varied embodied and lived experiences of contraceptive use, and how these are impacted by contraception service provision.ConclusionsOur findings show that contraception experiences of each individual are cumulative, and comprise a continuum of method initiation, use, discontinuation, method switching and on-going circular decision-making influenced by multiple social, structural, contextual and interpersonal factors, combined with shifting preferences, values and needs. To maximise the use of contraceptives amongst South African AGYW, it is necessary to provide responsive contraception service provision to reflect the changing contexts and preferences of users, in order to ensure that pregnancy prevention needs are catered for throughout their reproductive life course.

Navigating Uncharted Territory: A post Covid-19 Exploration of the Resilience of Women Owned Small Businesses in the Wake of the Pandemic

Resilience has long been acknowledged in the literature as a crucial aspect of the entrepreneur's character and personality. Additionally, it is acknowledged as a vital component of the entrepreneurial process that propels businesses to great outcomes. However, to the researchers’ knowledge, there remains limited understanding regarding how women-owned small businesses in South Africa withstand and function during challenging social and economic crises like the COVID-19 pandemic. In the post-modern period we live in today, women will inevitably play an important part in business and economic development, and they are eager to become involved and make a difference in their communities. The COVID-19 pandemic has intensified the challenges faced by female entrepreneurs in growing their businesses. This research focuses on investigating how resilient South African women entrepreneurs have been in response to the pandemic. Drawing from resilience theory, the study employed a qualitative approach to gather and analyze data from a group of 15 women entrepreneurs based in the Eastern Cape Province of South Africa, using thematic analysis. The following four themes emerged from the findings; business agility; optimistic outlook; leveraged digital technology; and business networks. This research enhances existing resilience theory by integrating fresh insights gathered from the resilience strategies employed by female entrepreneurs in times of crisis. Results from the study are also expected to contribute to sustaining South African women owned small businesses and empowering their resilience, despite adversities.

Maternal Identity and Muslim Ethics: South African Women’s Experiences

Maternal Identity and Muslim Ethics: South African Women’s Experiences

Age-dependent changes in skin features and perceived facial appearance in women of five ethnic groups.

Research documents effects of skin features on assessments of age, health and attractiveness of female faces. Ethnic variation also has been reported for the impact of age-related changes in skin features on face assessments. Here, we investigate women's self-ratings across age cohorts and ethnic groups and discrepancies with (non-expert) assessor ratings of facial appearance together with age-dependent changes in skin features. Faces of women 20-65 years from five ethnic groups (each n = 36) were imaged. Participants provided self-ratings of age, health and attractiveness, and were judged on these attributes by members of the same ethnic group (each n = 120). Digital image analysis was used to quantify skin gloss, tone evenness, wrinkling and sagging. Age-dependent changes in ratings and skin features within and between ethnic groups were assessed by comparing information from 10-year cohorts. We also tested whether menopausal status could be predicted by self-ratings, assessor ratings and image-based skin features. Women of all ethnic groups judged themselves younger and higher in attractiveness and health compared to third-party assessors, with the largest discrepancies for age in French women and for attractiveness and health in South African women. In Indian and South African women, specular gloss and skin tone evenness were lower compared to other participants, and sagging was higher in Indian, Japanese and South African women compared to Chinese and French women. Women's menopausal status could be predicted from assessor ratings and image-based skin features but not from self-ratings. There are differences between women's self-ratings and assessor ratings of facial appearance. These discrepancies vary with female age and ethnicity. Age and ethnicity effects also are evident in age-dependent changes in skin features within and across ethnic groups, which together with assessor (but not self-) ratings of facial appearance predict menopausal status.

Gender-based violence and femicide interventions-perspectives from community members and activists in South Africa.

Globally, Gender-Based Violence and Femicide (GBVF) remains a multifaceted social issue in the 21st century. Despite the ratification of international treaties and national laws, South Africa continues to have alarmingly high levels of GBVF, which were worsened during the Covid-19 national lockdown. The 2020 crime statistics reported that one in five South African women were victims of GBVF and South African Police Services (SAPS) data from 2015 to 2020 showed that seven women are killed daily nationwide. Despite copious studies on GBVF, the voices of local community members and activists as key collaborators in such research have been excluded. Therefore, this study used a mixed methods approach to determine the known interventions to decrease or eliminate GBVF and their effectiveness in seven communities across South Africa. The study included 191 participants in a survey for the quantitative aspect as well as a qualitative aspect of the study. Community members participated in gender-specific focus group discussions, while activists had a focus group of their own to obtain data on interventions. Our findings showed that three main forms of interventions existed in South Africa, viz. government-led campaigns that normally occurred during the 16 days of activism against violence towards women and children, community-led campaigns in response to GBVF cases reported in the media as well as NGO-led initiatives to support GBV survivors. However, these interventions were stifled by the social and cultural stigma against reporting GBVF, a lack of sustainability, decreased visibility, poor organisation and management as well as a lack of funding. Therefore, our findings show that while the South African government has made strides in its efforts to eliminate GBVF, there are no sustainable community level programming and interventions aimed at changing social norms and toxic masculinity that perpetuate GBVF. In conclusion, we recommend that efforts be made to implement intervention initiatives that go beyond creating awareness on GBVF, but partner with local NGO-led organizations to engage in programming and intervention that is aimed at changing social norms.