TY - JOUR
T1 - Applying the Dynamic Social Systems Model to HIV Prevention in a Rural African Context
T2 - The Maasai and the Esoto Dance
AU - Siegler, Aaron J.
AU - Mbwambo, Jessie K.
AU - DiClemente, Ralph J.
N1 - Funding Information:
This study was supported by Grant Number F31MH082647 from the National Institute for Mental Health and was facilitated by the Center for AIDS Research at Emory University (P30AI050409).
PY - 2013/12
Y1 - 2013/12
N2 - This study applied the Dynamic Social Systems Model (DSSM) to the issue of HIV risk among the Maasai tribe of Tanzania, using data from a cross-sectional, cluster survey among 370 randomly selected participants from Ngorongoro and Siha Districts. A culturally appropriate survey instrument was developed to explore traditions reportedly coadunate with sexual partnership, including "wife sharing", fertility rituals, and various traditional dances. One dance, esoto, accounted for more than two thirds of participants' lifetime sexual partners (n = 10.5). The DSSM, combining structural and systems theories, was applied to systematize complex multilevel factors regarding esoto practice. Participants reported multifaceted beliefs regarding esoto; a majority viewed the dance as exciting and essential, yet most men feared social stigma and three quarters of women had experienced physical punishment for nonattendance. In multivariate logistic regression, esoto attendance was predicted by female gender (adjusted odds ratio [AOR] = 4.67, 95% confidence interval [CI] = 1.6-13.2), higher positive beliefs regarding esoto (AOR = 2.84, 95% CI = 1.9-4.2), and Maasai life cycle events (AOR = 0.06, 95% CI = 0.01-0.47). The DSSM proved useful for characterizing esoto and for revealing feedback loops that maintain esoto, thus indicating avenues for future interventions.
AB - This study applied the Dynamic Social Systems Model (DSSM) to the issue of HIV risk among the Maasai tribe of Tanzania, using data from a cross-sectional, cluster survey among 370 randomly selected participants from Ngorongoro and Siha Districts. A culturally appropriate survey instrument was developed to explore traditions reportedly coadunate with sexual partnership, including "wife sharing", fertility rituals, and various traditional dances. One dance, esoto, accounted for more than two thirds of participants' lifetime sexual partners (n = 10.5). The DSSM, combining structural and systems theories, was applied to systematize complex multilevel factors regarding esoto practice. Participants reported multifaceted beliefs regarding esoto; a majority viewed the dance as exciting and essential, yet most men feared social stigma and three quarters of women had experienced physical punishment for nonattendance. In multivariate logistic regression, esoto attendance was predicted by female gender (adjusted odds ratio [AOR] = 4.67, 95% confidence interval [CI] = 1.6-13.2), higher positive beliefs regarding esoto (AOR = 2.84, 95% CI = 1.9-4.2), and Maasai life cycle events (AOR = 0.06, 95% CI = 0.01-0.47). The DSSM proved useful for characterizing esoto and for revealing feedback loops that maintain esoto, thus indicating avenues for future interventions.
KW - HIV/AIDS
KW - behavioral theories
KW - international health
KW - measurement issues
KW - sex behavior
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U2 - 10.1177/1090198112474004
DO - 10.1177/1090198112474004
M3 - Article
C2 - 23372030
AN - SCOPUS:84887525600
SN - 1090-1981
VL - 40
SP - 683
EP - 693
JO - Health Education and Behavior
JF - Health Education and Behavior
IS - 6
ER -