Browsing by Author "Miller, Ann Neville"

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    Couples' communication on sexual and relational issues among the Akamba in Kenya
    (African Journal of AIDS Research, 2009-11) Miller, Ann Neville; Golding, Lenette; wa Ngula, Kyalo; Wambua, MaryAnne; Mutua, Evans; Kizito, Mary N.; Teti, Caroline; Booker, Nancy Achieng’ ; Mwithia, Kinya Jesica ; Rubin, Donald L
    A large portion of HIV transmission in sub-Saharan Africa occurs among married couples, yet the majority of research on safer-sex communication has focused on communication between couples in casual relationships. This paper explores how committed Kamba couples in Machakos District, Kenya, communicate about sensitive relational issues. The findings from focus group discussions with five groups of males and five groups of females are presented. The couples freely shared their thoughts about daily and economic issues and certain aspects of family planning and sexuality. Methods for raising sensitive issues with partners included monitoring the spouse’s mood, gradual or indirect revelation, mentioning topics during sex, and use of third-party intermediaries. Interference by extended family members, especially husbands’ mothers, and male authoritarian roles emerged as hindrances to effective communication between couples. The implications for HIV prevention regarding gender differences and the role of families in couples’ communication are discussed
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    Heavy Sexual Content Versus Safer Sex Content: A Content Analysis of the Entertainment Education Drama Shuga
    (Health Communication, 2016-04-07) Achieng’ Booker, Nancy; Miller, Ann Neville; Ngure, Peter Kamau
    Extremely popular with Kenyan youth, the entertainment-education drama Shuga was designed with specific goals of promoting condom use, single versus multiple sexual partners, and destigmatization of HIV. Almost as soon as it aired, however, it generated controversy due to its extensive sexual themes and relatively explicit portrayal of sexual issues. To determine how safer sex, antistigma messages, and overall sexual content were integrated into Shuga, we conducted a content analysis. Results indicated that condom use and HIV destigmatization messages were frequently and clearly communicated. Negative consequences for risky sexual behavior were communicated over the course of the entire series. Messages about multiple concurrent partnerships were not evident. In addition, in terms of scenes per hour of programming, Shuga had 10.3 times the amount of sexual content overall, 8.2 times the amount of sexual talk, 17.8 times the amount of sexual behavior, and 9.4 times the amount of sexual intercourse as found in previous analysis of U.S. entertainment programming. Research is needed to determine how these factors may interact to influence adolescent viewers of entertainment education dramas.
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    Implications of High-/Low-Context Communication for Target Audience Member Interpretation of Messages in the Nimechill Abstinence Campaign in Nairobi, Kenya
    (Health Communication, 2011-04) Muraya, Julie Gathoni; Miller, Ann Neville; Mjomba, Leonard Majalia
    Although it ran on multiple mass media for the better part of a year, end line evaluation of the Nimechill youth abstinence campaign in Kenya indicated that exposure to the campaign had no relationship to youth decisions to defer sexual debut. One possible explanation of this lack of association could be that target audience members derived inconsistent and confusing meanings from visuals as opposed to text in the campaign. Employing Hall’s concept of high- and low-context communication, we assessed target population interpretation of four campaign posters via twelve focus groups discussions and four individual in-depth interviews with Nairobi youth. We found that although participants endorsed and recognized campaign objectives, contextual cues in some campaign visuals were interpreted by participants as being contradictory to the abstinence message in the poster texts. In addition noticeable differences arose between the lowincome and middle-/high-income groups in interpretation of one of the posters. We conclude with recommendations regarding use of visuals in high-context cultures and involvement of youth from various socio-economic strata in campaign planning.
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    The Importance of Formative Research in Mass Media Campaigns Addressing Health Disparities: Two Kenyan case studies
    (2013-01) Miller, Ann Neville; Muraya, Julie Gathoni; Thuo, Ann Muthoni; Mjomba, Leonard Majalia
    As compared to their urban middle-income counterparts, women and children living in rural areas and urban informal settlements in Kenya face special challenges in accessing health information and services. Television and print health information is often confined to towns and cities and shortages of health workers and supplies hamper most rural health care systems (CBS, 2004). At the same time, rapid urbanization has put unprecedented strain on the existing resources in the cities and has resulted in high rates of unemployment, poverty, and poor health outcomes especially among women and children living in informal settlements (Africa Population and Health Research Center, 2002; Mutua-Kombo, 2001; Ngimwa, Ocholla, & Ojiambo, 1997Only middle- and upper-class Kenyans who live in the largest urban centers have As compared to their urban middle-income counterparts, women and children living in rural areas and urban informal settlements in Kenya face special challenges in accessing health information and services. Television and print health information is often confined to towns and cities and shortages of health workers and supplies hamper most rural health care systems (CBS, 2004). At the same time, rapid urbanization has put unprecedented strain on the existing resources in the cities and has resulted in high rates of unemployment, poverty, and poor health outcomes especially among women and children living in informal settlements (Africa Population and Health Research Center, 2002; Mutua-Kombo, 2001; Ngimwa, Ocholla, & Ojiambo, 1997Only middle- and upper-class Kenyans who live in the largest urban centers have ready access to information about prevention and care, and can take advantage of a range of early detection technologies and treatment options at private hospitals.
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    Kenyan pastors’ perspectives on communicating about sexual behaviour and HIV
    (African Journal of AIDS Research, 2011-09) Miller, Ann Neville; Mwithia, Kinya Jesica; Kizito, Mary N.; Njoroge, Lucy
    The article presents an analysis of in-depth interviews with 18 leaders of Christian churches in Nairobi, Kenya, regarding the content and context of messages they disseminate to their congregations about sexual behaviour and HIV. The content of messages was nearly consistent across the different denominations. However, three sorts of tensions were identified within pastoral communication about these topics: the need to discuss sex and HIV versus societal taboos against speaking about those issues from the pulpit; traditional cultural norms versus current lifestyles; and the ideals of abstinence and fidelity versus the reality of congregants’ sexual behaviour. Although some of the religious leaders accepted the idea of condom use, no denominational patterns were noted on that subject, except with respect to Catholic priests. Pentecostal leaders were notable for describing proactive strategies to address both the ideal/real dilemma and the tension between church norms and current media content about sexuality and HIV.
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    Kenyan patients’ attitudes regarding doctor ethnicity and doctor–patient ethnic discordance
    (Patient Education and Counseling, 2010) Miller, Ann Neville; Mwithia, Kinya Jesica ; Booker, Nancy Achieng’ ; Kizito, Mary N.; wa Ngula, Kyalo
    Objective: This study explored Kenyan patients’ perspectives on the role of ethnicity in the doctor– patient relationship. Methods: 221 participants completed questionnaires on ethnicity in doctor–patient relationships; eight focus groups were held with low- and middle-income urban and rural women. Results: About half of participants expressed no preference for doctor ethnicity. Participants rated demographic factors as less important than factors related to the doctor’s qualifications, communication skills, and cost of service. Those who did indicate a preference were more likely to prefer Indian doctors for eye problems and Europeans for major surgery, cancer, and heart problems. With less severe medical issues participants were more likely to prefer a doctor who was ethnically concordant with them. Reasons for this centered around communication issues. In contrast, several focus group participants did not want to be treated by doctors from their own ethnic group because of concerns about confidentiality. Conclusion: Additional research is needed on negative implications of patient–provider concordance. Practice implications: Medical service providers must be aware of concerns about ethnic concordance. Alternatively medical centers that deal with sensitive medical information need to consider hiring staff who are not of the majority ethnic group in their region.
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    Managing communication surrounding tungiasis stigma in Kenya
    (Routledge Taylor & Francis, 2015-12-20) Kimotho, Stephen Gichuhi; Miller, Ann Neville; Ngure, Peter Kamau
    Tungiasis is a neglected parasitic skin disease widespread in resourcepoor communities in sub-Saharan Africa, South America and the Caribbean. Stigmatisation of tungiasis sufferers has been identified as a key reason why tungiasis frequently progresses untreated in many parts of the world, however little research has investigated the specifics of tungiasis stigma or the communication strategies sufferers use to manage stigmatization. This article reports results of focus group and in-depth interviews regarding strategies used to manage tungiasis stigma from the perspective of persons living with tungiasis in Murang’a County, Kenya. Most frequently mentioned were withdrawal tactics. Participants also engaged in refutation strategies to deny responsibility for their condition. Implications for stigma management communication theory are discussed.
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    The Relationship Between Nairobi Adolescents’ Media Use and their Sexual Beliefs and Attitudes
    (African Journal of AIDS Research, 2017-06) Miller, Ann Neville; Kinnally, William; Maleche, Hellen; Booker, Nancy Achieng’
    Adolescents in sub-Saharan Africa are at risk for contracting HIV. Although media campaigns have educated the population as a whole, few studies are available about the time sub-Saharan African youth spend listening to and viewing sexual messages via the entertainment and informational media. The goals of this project were: 1) to investigate what programming Nairobi adolescents access; and 2) to investigate the association between frequency of access and level of focus on physical relationships with adolescents’ perceptions of descriptive norms of peer sexual behaviour, and their attitudes regarding men as sex driven, women as sex objects, and dating as a sport. A total of 464 students from 6 Nairobi secondary schools were surveyed. When students’ favourite musicians had a strong focus on physical relationships in their songs, those students estimated the prevalence of risky sexual behaviours among their peers higher. These students also endorsed gender stereotypical and casual attitudes about sex. Large amounts of time spend on the Internet was predictive of all sexual attitude variables. Students whose favourite TV programmes had a strong focus on physical relationships also estimated prevalence of peer sexual behaviour as high.