Dr. Debie LeBeau Spence and her colleagues use a variety of qualitative and quantitative research methods to examine aspects of HIV and AIDS in Namibia and southern Africa. Dr. LeBeau uses her medical anthropology training to study a wide range of socio-structural factors that affects the spread of HIV and its impact on populations. Some socio-structural factors that impact HIV infection rates include: gender inequality, migration and poverty. Dr. LeBeau has also studied HIV vulnerability among migrants, mobile and associated populations. Her most recent study examines the link between HIV transmission and alcohol consumption and sexual relationships.

Dr. LeBeau's home page

Traditional Medicine  in Africa

Ethnicity and Inequality in Namibia

Social Science Research Workbook

Izilwane Research in Africa

Gender Issues in Africa

Gender Training and Research Programme (GTRP/ UNAM)

Medical Sociology /Anthropology Workbook

This research examines key areas of HIV vulnerability and risk-taking versus areas for HIV help-seeking behavior through the cognitive perceptions of migrants, mobile and associated populations using qualitative data collection methods such as a mapping exercise. Informants were asked to map HIV vulnerability factors such as bars and truck stops, as well as HIV preventive factors such as available health care services, location and availability of condoms, and sources of sexual health information. This research was funded by the International Organization of Migration (IOM), Partnership on HIV/AIDS and Mobile Populations in Southern Africa (PHAMSA) and conducted through the Institute for Public Policy Research (IPPR).

               Barbara Rijks                                      Graham Hopwood, Director
            International Organization for Migration     Institute for Public Policy Research (IPPR)
            826 Government Avenue                              PO Box 6566
            Pretoria 0001, South Africa                           Eros, Windhoek, Namibia
            tel: +27 12 342 2789                                   tel: +26461-240-514

This ebook, based on the aforementioned research, found that mobile populations in Namibia include fishermen, truck drivers, uniformed government officials, and informal cross-border traders. They are vulnerable to HIV because they report a high frequency and number of sexual partnerships with local populations and sex workers. Most mobile people meet sexual partners at nightclubs and bars located in and around towns. An additional contributing factor to HIV vulnerability is men who refuse to use condoms. The movement of people across the Namibian border, as well as their proximity to neighboring countries, makes the Katima Mulilo and Oshikango areas of high vulnerability. The majority of HIV risk-taking occurs in nightclubs and bars in town between sex workers and these temporary residents.

This paper summarizes the main findings for the Walvis Bay section of the above mentioned larger study done for the International Organisation on Migration. It looks at the dynamics of HIV risk behavior among three groups of highly mobile sub-populations most at risk for HIV infections: fishermen, truck drivers and sex workers. In addition to discussing the nature of the interactions between the three groups, it draws attention to the spatial dimensions of the interactions. It also identifies the reasons why each of the groups is vulnerable, points to efforts to reduce their risk and the challenges faced by those who design and implement these programs. It also draws attention to key attitudes related to risky activities.

This was an anthropological exchange research program between the Department of Sociology (UNAM), the Centre for African Studies (CNRS/EHESS), the Centre for Research on Public Health Issues (University of Paris 13) and the Department of Community Health, University of Witswatersrand (WITS); with research funded by the Centre National de la Recherche Scientifique, Paris. The findings from this research indicate that migration and gender inequality are significant contributing factors to the spread of HIV in southern Africa.
 
 

The first part of this publication examines women's and men's perception of women's current socio-economic status within contemporary Namibian society, their knowledge about contemporary social issues relating to women, and how they think women's lives have changed since Independence. The findings indicate that gender inequality is a social structural factor that places women at greater risk of HIV infection due to their inability to lower risk-taking behavior. Important factors for this discussion include women's social status vis-à-vis men, customary practices, women's access to and control over their own economics, women's control over their own sexuality, women's exposure to gender based violence such as domestic violence and rape, and government initiatives aimed at greater gender equality.
 

The second part of this publication examines aspects of life for migrants. Although the focus of the research is placing migration within the rubrics of the HIV/AIDS pandemic, there are various social and economic structural factors that tend to put migrants in a 'high risk milieu' which place them at greater risk of HIV infection and, given their fragmented social and sexual networks with rural and urban social and familial links, leads them to be a significant contributing factor to the progressive spread of the disease. The most prevalent reason for migrants' and their sexual partners' vulnerability to HIV is that migrants do not have consistent condoms use, but have a fragmented sexual network. Migrants have social relationships in various locations which allow them to also maintain multiple sexual relationships with little or no social repercussions, unlike the more settled populations who are more likely to face social pressure from their partners, friends, family members and even communities to maintain a limited sexual network.

This research was conducted on behalf of the Namibian College of Open Learning (NAMCOL) and the Centre for External Studies (CES) at the University of Namibia. Dr. Trudie Frindt coordinated the project and wrote the literature review and background sections of the report. Dr. Debie LeBeau provided guidance in the development of the survey instrument as well as conducting data analysis and writing the data sections of the report. This report examines NAMCOL staff members' and learners' Knowledge, Attitudes and Practices (KAPs) on HIV/AIDS at four NAMCOL centers to provide facts based information to NAMCOL management, staff members and learners. The data indicate fundamental differences between NAMCOL staff members' and learners' HIV and AIDS KAPs. Staff members see the pandemic from the point of view of family and community members who are more likely to have seen the effects of AIDS and have a desire to mitigate the impact. Learners are younger and have higher sexual and health risk-taking behavior - although they are also more likely to use condoms.

This anthropological research focused on health and risk-taking behavior in the ethnically Owambo areas of northern Namibia using both qualitative and quantitative research methods. The research was conducted by the Department of Sociology, University of Namibia and funded by Service de Cooperation et d'Action Culturelle de l'Ambassade de France. The resulting publication, Taking Risk, Taking Responsibility: An Anthropological Assessment of Health Care and Risk Behaviour in Northern Namibia by Debie LeBeau, Tom Fox, Heike Becker and Pempelani Mufune, indicates that there are specific social and cultural constraints to more widespread use of condoms as well as social external determinants such as poverty, migrancy, alcohol abuse and a degree of fatalism within the population, all of which influence the spread of HIV. The document demonstrates that socio-cultural sexual beliefs and behaviors such as the marked social inequality between men and women, sexual violence within relationships, and perceptions of manhood as an excuse for promiscuity influence sexual risk-taking. 

This chapter reviews the relationship between poverty and the epidemiology of HIV in northern Namibia. The chapter argues that although HIV is a physiological affliction, significant socio-economic factors, inherent in the structure of society, influence the unabated spread of HIV in many areas of southern Africa, and specifically in Namibia. These factors include: 1) what can best be termed 'diseases of poverty' which lower the body's immuno-response system; 2) a 'paralysis in poverty' which causes daily subsistence activities to take precedence over lowering HIV risk-taking behavior; and 3) women's lower socio-economic status vis-à-vis men which places them at particular risk of contracting HIV. 
 

Once AIDS has affected economically marginalized families, the disease reinforces the family's economic vulnerability by eliminating economically active members of the family and precipitating direct and indirect costs to the family in the form of food, health care and funeral expenses for the sick and dying; thus creating a deepening economic crisis for affected families. AIDS adds to women's already over-burdened domestic responsibilities in caring for AIDS patients and children orphaned by AIDS. In addition, AIDS has already and will continue to alter the very social fabric of affected families by creating child-headed households when both parents have died from AIDS and the extended family structure can no longer absorb all children orphaned by AIDS. 
 

For other publications not found on this website go to:
http://unam-na.academia.edu/DebieLeBeauSpence

Contact Dr. Debie LeBeau Spence
For further information and copies of publications contact:

By Phone or email:                                By Surface Mail:
                                                                         Debie LeBeau Spence
PHONE: +1-915-988-2550                                      Silver Fern Ranch
EMAIL: lebeau@developmentafrica.com                   55013-B 62/180 HWY
                          or                                                       El Paso, Tx 79938
           dr_lebeau@yahoo.com (dr_lebeau)