The Couple and HIV/AIDS in Sub-Saharan Africa: Telling the Partner, Sexual Activity and ChildbearingDesgrées Du Loû Annabel
In Africa, where HIV/AIDS is widespread and HIV is mainly spread by heterosexual intercourse and from mother to child during pregnancy, childbirth or breastfeeding, the couple is the primary site of sexual HIV transmission. When a woman is infected with HIV, the decision to have a child involves the risk of vertical transmission. This article, based on a review of African studies of the subject and results of research programmes conducted in Abidjan between 1997 and 2001, examines changes in sexual and reproductive behaviour in the face of the AIDS threat. After a preliminary overview of trends in the general population, the article focuses on women who have learned during pregnancy that they are HIV-positive, through a mother-to-baby HIV-transmission prevention programme. It discusses how they manage the risk of sexual and vertical transmission of the virus, in their couple and their reproductive decisions. The difficulty these women have in divulging their HIV infection to their partners and then negotiating the adoption of new practices proves to be a major obstacle to behavioural change. The success of future prevention programmes will depend on their ability to take the relationship between man and woman in the couple into account.
Economic Crisis and Mortality : The Case of Antananarivo, 1976-2000
Waltisperger Dominique, Meslé France
In the past forty years, Madagascar’s GDP has shrunk more than 30%. The almost continuous deterioration in living conditions has been marked by extremely severe economic crises, most notably in the mid-1980s. Analysis of death registers in the capital, Antananarivo, provides a means to track changes in mortality and main causes of death since 1976. In the past twenty-five years, the rise in poverty has substantially counteracted the positive effects of preventive health initiatives: it has triggered the emergence of diseases thought to have been eradicated several decades ago (tuberculosis, malaria, cholera) in population groups hitherto regarded as less vulnerable (young adult males). The 1986 crisis had the most dramatic impact, particularly among children aged 1-4. The political and economic choices made at the time plunged the country into a state of nutritional deficiency so severe that, within one decade, more than ten years of life expectancy at birth were lost.
Progress has been achieved in recent years and life expectancy has very recently returned to its mid-1970s levels. While the levels are comparable, the distribution of causes of death has been significantly modified. The share of acute and infant diseases has fallen, whereas that of chronic diseases has risen. Madagascar’s health outlook remains very uncertain however. In the current economic and political climate, it is by no means certain that the fragile decline in infectious mortality will be maintained and the rise of new pathologies kept in check.
Identity in Question : The Development of a Survey in France
Ville Isabelle, Guérin-Pace France
In 2003, INSEE conducted the Life History survey on identity construction, with the aim of analysing present-day forms of social integration through description of the social tie, both real and symbolic, constructed in individual histories and collective affiliations. The article presents the conceptual foundations of a project that has its rationale in the context of recent structural modifications, notably those affecting two key institutions and traditional sites of integration, work and the family, but also relationships with free time, new forms of involvement, geographical mobility, etc. The authors relate the different stages in the survey design. A preliminary qualitative study was used, first, to catalogue the different forms of identity definition-status-based, psychological, narrative-that respondents use to define themselves, and second, to show the diversity of the themes of identification, the meaning and values attached to them, and the ways in which people link them together to construct their identity. This qualitative phase guided the development of an open-ended questionnaire that combined retrospective biographical data with objective and more subjective data pertaining to the various social affiliations-affiliations that may be de facto, appropriated or at times imposed.
Housing and Household Size in Local Population Dynamics : The Example of Paris
Dittgen Alfred
Territorial population change is the result of natural change and migration, with the first primarily affecting national populations, and the second local populations. At local level, migration patterns depend largely upon housing or, more specifically, on changes in the number of primary residences and in their occupancy. Hence, the depopulation of Paris "intra muros" since the Second World War can be explained by a decline in the number of primary residences - despite an increase in the number of dwellings - and, above all, a decrease in household size which, like elsewhere in France and the Western world, reflects the "couple crisis" and demographic ageing, but equally the appeal of Paris for singles and small households and the "banishment" of families to the suburbs.
This pattern of urban residence can be explained by several factors, above all by the size of dwellings - small in Paris and larger in the suburbs - and their higher cost inside Paris than beyond the city limits. These factors are raising the proportion of young adults and of professionals and higher-level occupations in the Parisian population. This trend is especially pronounced in the central districts, where the small dwellings and animated social life are particularly attractive to the singles population.
