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Title Page Understanding Perceptions of Risk Among Youth TITLE PAGE UNDERSTANDING PERCEPTIONS OF RISK AMONG YOUTH IN A SOUTH AFRICAN TOWNSHIP By MICHELLE L. NEBERGALL Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Anthropology CASE WESTERN RESERVE UNIVERSITY August 2014 COMMITTEE APPROVAL SHEET CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES We hereby approve the thesis/dissertation of Michelle L. Nebergall Candidate for the degree of Doctor of Philosophy*. Committee Chair Dr. Janet McGrath Committee Member Dr. Jill Korbin Committee Member Dr. Eileen Anderson-Fye Committee Member Dr. Scott Frank Date of Defense 28 March 2014 *We also certify that written approval has been obtained for any proprietary material contained therein. 2 COPYRIGHT © 2014 Michelle L. Nebergall All rights reserved TABLE OF CONTENTS TITLE PAGE .................................................................................................................................................. 1 COMMITTEE APPROVAL SHEET ......................................................................................................... 2 COPYRIGHT © 2014 ................................................................................................................................. 3 TABLE OF CONTENTS ............................................................................................................................. 4 LIST OF TABLES ....................................................................................................................................... 11 ACKNOWLEDGMENTS .......................................................................................................................... 13 LIST OF ABBREVIATIONS .................................................................................................................... 15 UNDERSTANDING PERCEPTIONS OF RISK AMONG YOUTH ................................................ 16 CHAPTER 1. INTRODUCTION ......................................................................................................... 18 1.1 StuDy Framework .................................................................................................................. 18 1.2 Study Objectives ..................................................................................................................... 19 1.3 Significance ............................................................................................................................... 21 1.4 Chapter Overview .................................................................................................................. 22 CHAPTER 2. BACKGROUND AND SIGNIFICANCE ...................................................................... 24 2.1 Anthropological Perspectives on Adolescence anD Youth ................................... 25 2.2 Anthropological approaches to stuDy of risk ............................................................. 34 2.2.1 The Concept of Risk .................................................................................................. 34 2.2.2 Risk Perception ........................................................................................................... 51 2.2.3 Risky Environments .................................................................................................. 60 2.2.4 Gender and Risk .......................................................................................................... 67 2.4 Conclusion to Background and Significance .............................................................. 72 CHAPTER 3. THE SOUTH AFRICAN CONTEXT ............................................................................ 74 3.1 Introduction ............................................................................................................................. 74 3.2 Historical Context .................................................................................................................. 78 3.3 Socio-Economic Context ........................................................................................................ 85 3.4 HIV anD AIDS in South Africa ............................................................................................ 102 3.5 Youth in South Africa ........................................................................................................ 109 3.6 Description of Field site ................................................................................................... 118 3.7 Entering the Field ............................................................................................................... 126 CHAPTER 4. METHODS .................................................................................................................. 130 4.1 Overview ................................................................................................................................ 130 4.1.1 Study Phases ............................................................................................................. 130 4.1.2 Research Assistants ............................................................................................... 131 4.1.3 Language ..................................................................................................................... 131 4.1.4 Pilot Testing Data Collection Instruments anD ProceDures ................. 132 4.2 Sampling anD Recruitment ProceDures .................................................................... 132 4.2.1 Overview ..................................................................................................................... 132 4.2.2 Phase 1 Sampling anD Recruitment ................................................................ 133 4.2.3 Phase 2 Sampling anD Recruitment ................................................................ 135 4.2.3.1 SeconD Youth Sample ..................................................................................... 135 4.2.3.2 Key Informant Sample ................................................................................... 137 4.2.3.3 Community LeaDer Sample ......................................................................... 137 4.2.3.4 Youth Samples 1 anD 2 .................................................................................. 138 5 4.3 Data Collection Procedures ........................................................................................... 139 4.3.1 Phase 1 Data Collection Procedures ............................................................... 139 4.3.1.1 Focus Groups ................................................................................................ 139 4.3.1.2 SMS and MXit on Cell Phones .................................................................. 141 4.3.1.3 Diaries ................................................................................................................... 143 4.3.2 Phase 2 Data Collection Procedures ............................................................... 143 4.3.2.1 StructureD Risk Assessment Questionnaire ......................................... 143 4.3.2.2 Youth Interviews .......................................................................................... 144 4.3.2.3 Community LeaDer Interviews .................................................................. 145 4.3.2.4 Key Informant Data ..................................................................................... 145 4.3.2.5 Participant Observation ............................................................................ 146 4.4 Data Management anD Analysis ProceDures .......................................................... 146 4.5 Ethical Considerations ...................................................................................................... 151 4.5.1 Ethics Review ............................................................................................................ 151 4.5.2 InformeD Consent ................................................................................................... 151 4.5.3 Protections and Service Referrals ................................................................... 152 4.5.4 Incentives for Participation ................................................................................ 152 4.6 Scope anD Limitations ........................................................................................................ 154 CHAPTER 5. FOCUS GROUP DATA ............................................................................................ 156 5.1 Overview ................................................................................................................................ 156 5.2 Focus Group Sample Characteristics .......................................................................... 156 5.3 How the risk of HIV infection is perceived in everyday life ............................. 158 5.4 Perceptions of Other Inter-Related Risks in Daily Life .......................................... 170 6 5.5 Strategies useD by youth to manage risks ................................................................... 177 5.6 Contextual Factors ................................................................................................................ 189 5.7 Summary ................................................................................................................................... 196 CHAPTER 6. DIARY DATA ............................................................................................................
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