Cultural and gender issues related to HIV/AIDS prevention in rural Swaziland: a focus group analysis

HIV/AIDS is a serious public health problem in Swaziland, a small land-locked Southern African country. The epidemic affects all subpopulations, but women are increasingly at risk for contracting the disease. Focus groups were conducted in a rural area to obtain qualitative information on the rural dimensions of HIV/AIDS, vulnerability to HIV/AIDS, and sociocultural factors influencing the spread of AIDS. Five themes were identified from analyses of the focus groups that are relevant in developing an AIDS prevention program for this population in Swaziland. Implications for future research and health care practice focus on gender-sensitive cultural research (e.g., women and men's roles and responsibilities in rural Swaziland society) and how social, economic, and cultural factors impact the spread of AIDS. Recommendations include reorienting and allocating resources for health, education, and social services to address the relative neglect of rural areas and strengthening policies and programs to achieve the equal participation of all women in all aspects of society's decisions. Specifically, policies related to economic and food security should result in programs to improve local access by women to all resources.