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A University of Sussex Phd Thesis Available Online Via Sussex A University of Sussex PhD thesis Available online via Sussex Research Online: http://sro.sussex.ac.uk/ This thesis is protected by copyright which belongs to the author. This thesis cannot be reproduced or quoted extensively from without first obtaining permission in writing from the Author The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the Author When referring to this work, full bibliographic details including the author, title, awarding institution and date of the thesis must be given Please visit Sussex Research Online for more information and further details University of Sussex, School of Law, Politics and Sociology (Gender Studies). Agnes Adama Campbell Nee Kallay This thesis is submitted as part fulfilment of the degree of Doctor of Philosophy in Gender Studies Gambian women, violence and its intersection with HIV/AIDS: Agency through feminist participatory research 21 st December 2017 i i DECLARATION I hereby declare that this thesis has not been and will not be, submitted in whole or in part to another University for the award of any other degree. The data has been obtained from fieldwork using a participatory feminist research approach. I take full responsibility for the production of the thesis which is my own original work. Signature: Agnes Adama Campbell Nee Kallay....... iiii ABSTRACT Research has identified a strong correlation between HIV/AIDS and gender-based violence, yet few studies centre the experiential knowledge of HIV sero-positive women and practitioners. This thesis, based on fieldwork conducted in the Gambia, is grounded in data on HIV positive women’s experiences of violence and practices of resistance, revealing context specific complexities and challenges. Data collection methods included diaries, focus groups and in-depth individual interviews with a participant group of sixty sero-positive women in six Gambian HIV Support Societies, and twenty field practitioners working in the areas of violence and HIV/AIDS. I argue in this thesis that there are intersecting underlying factors (patriarchy, gerontocracy and structural violence) that contribute to women’s experiences of violence and abuse that render them vulnerable to HIV. In addition, that alongside the more visible gendered violences which intersect with HIV/AIDS. Accounts of women living with HIV revealed that stigma is discreditable and discredited attributes. It contends that stigma should be seen as an ‘everyday’ practice of normalised violence, which has very harmful emotional, psychological, economic and physical effects. The research also suggests that violence against women in the context of HIV is not limited solely to male perpetrators. In the Gambia there has been limited success in the translation of women’s rights agendas into concrete and effective interventions, partly due to a lack of attention to socio-cultural context and the lived experiences of HIV positive women. The thesis concludes that culturally specific, integrated health and social justice approaches are necessary, which are grounded in women’s everyday practices of agency and resistance, and which in particular address the fear of dethronement (loss of power, privileges and prestige) amongst men and older members of society. iii3 TABLE OF CONTENTS DECLARATION....................................................................................................................i ABSTRACT ...........................................................................................................................ii TABLE OF CONTENTS …………………………………………………..…………. iii LIST OF FIGURES ......................................................................................................... viii ACRONYMS AND ABBREVIATIION ......................................................................... ix DEDICATION ………………………………………………. ............................................... iix ACKNOWLEDGEMENTS…………………………. ........................................................... iiix CHAPTER 1: INTRODUCTION ................................................................................ 1 1.0 Introduction ……………………………............................................………. ......... 1 1.1 Research questions… ………………………. .......................................................... 5 1.2 The current thesis….…………………...................................………………. .......... 6 1.3 Research rationale……………………..........................……………………. .......... 7 1.4 Research objectives…………………....................…………………………. ........... 7 1.5 Organisation of the thesis……………...........................…………………. ............... 8 CHAPTER 2: THE RESEARCH CONTEXT………………………...…. ................. 10 2.0 The Gambian social context………………………………………………. ............. 10 2.1. Tourism and trade relations ...................................................................................... 12 2.2 Poverty and underdevelopment…………………………………. ............................. 13 2.2.1 The Gambian economy ........................................................................................... 14 2.3 Overlapping gender and structural inequalities ......................................................... 18 2.3.1 Gender inequality and the link with violence ......................................................... 21 2.3.2 Intersections of ethnicity, religion and interacting structural factors fueling harmful traditional practices ............................................................................................ 27 2.3.3. The practice of virginity sealing (locally known as ‘fata’). ................................... 31 2.3.4 Perpetrators and instigators of VAW ................................................................................................................................ 32 2.3.5 Interventions to prevent VAW in the Gambia ......................................................... 33 2.4 Conclusion. ................................................................................................................ 39 i4v CHAPTER 3: CONCEPTUALISING VIOLENCE AGAINST WOMEN (VAW): THE LITERATURE REVIEW .................................................................................................. 41 3.0 Introduction ………………………………………………. ..................................... 41 3.1 The literature review strategy adopted for Chapters 3 and 4………………........… . 41 3.2 Feminism...................................................................………. .................................... 44 3.2.1 Definition and conceptions of power and patriarchy .............................................. 45 3.2.2 Millet (1969) conception of patriarchy……. .......................................................... 46 3.3 Family violence theories ............................................................................................ 47 3.3.1 Feminist theories on violence against women. ....................................................... 50 3.3.2 The conception of the ‘continuum of violence’ ...................................................... 52 3.4 Avoiding universalism and Western-centrism ............................................................... 55 3.4.1 Exploring key intersectionality theoretical arguments ............................................ 55 3.4.2 Post-colonial critiques ............................................................................................ 58 3.5 Ecological and intersectionality perspectives ............................................................ 68 3.6 My preferred theoretical conception of VAW ............................................................................................................ 71 3.7 Conclusion. ......................................................................................................................73 CHAPTER 4: LITERATURE REVIEW OF HIV/AIDS AND STIGMA…..…. ...... 76 4.1 Introduction. ....................................................................................................................76 4.2 Overview and definition of HIV/AIDS ..................................................................... 76 4.3 HIV/AIDS in the Gambia .......................................................................................... 78 4.3.1 Why study HIV and VAW in a low-prevalence country? ....................................... 78 4.3.2 Gender disaggregated data on HIV .......................................................................................................................................................... 80 4.3.3 Interventions for HIV/AIDS prevention, support and care ..................................... 81 4.3 General conceptions of stigma................................................................................... 82 4.3.1 Conceptualising HIV disease stigma ...................................................................... 85 4.3.1.1 Self-stigma: internalised stigma ........................................................................... 87 4.3.2 Stigmatisation processes: Contexts, power and intersecting forces ........................ 89 4.3.3 Exploring the gaps in HIV disease stigma theorisation .......................................... 90 4.4 Exploring the link between violence and HIV .......................................................................... 91 4.5 Stigma resistance and agency .................................................................................... 93 4.6 Conclusions......................................................................................................................93
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