Open Access. Powered by Scholars. Published by Universities.®

Social and Behavioral Sciences Commons

Open Access. Powered by Scholars. Published by Universities.®

International and Area Studies

Sub-Saharan Africa

Institution
Publication Year
Publication
Publication Type

Articles 1 - 30 of 56

Full-Text Articles in Social and Behavioral Sciences

A Study And Critique Of Sexual Violence Against Disabled Individuals In Sub-Saharan Africa: Implications For Policy And Practice Of Trauma-Informed Care, Kaeley Sells Jun 2024

A Study And Critique Of Sexual Violence Against Disabled Individuals In Sub-Saharan Africa: Implications For Policy And Practice Of Trauma-Informed Care, Kaeley Sells

Lux et Fides: A Journal for Undergraduate Christian Scholars

This paper examines and critiques current sexual violence against disabled individuals in Sub-Saharan Africa by evaluating the social and cultural stigma present that perpetuates cycles of vulnerabilities. Currently, women and girls with disabilities are disproportionally at risk for sexual violence as economic, cultural, and political structures in many Sub-Saharan African countries fail to recognize and adequately protect those with disabilities. Incorporating evidence from journals, books, reviews, and studies, this paper demonstrates the need for non-government and government actors to recognize the need to provide protection and trauma-informed care for disabled individuals.


Terrorism In Africa: An Analysis Of The Efficacy Of U.S. Counterterrorism, Max Yong Apr 2024

Terrorism In Africa: An Analysis Of The Efficacy Of U.S. Counterterrorism, Max Yong

Global Tides

This paper seeks to identify whether United States aid to Africa has impacted violent terrorist activity on the continent. The existing literature has produced a range of critiques. Many have voiced concern about foreign terrorist organizations (FTO) growing and blame ineffective efforts by the U.S. for this reality. Instances of African nations, in the face of persisting security challenges from FTOs, turning to political adversaries of the U.S. for assistance is evidence of this sentiment. Furthermore, terror attacks since the onset of the U.S. Global War on Terror (GWOT) have only remained higher than in the previous era. Others have …


Review Of Democratic Backsliding In Africa? Autocratization, Resilience, And Contention, Robert Press Aug 2023

Review Of Democratic Backsliding In Africa? Autocratization, Resilience, And Contention, Robert Press

The Journal of Social Encounters

No abstract provided.


Misinformation In Countries With Limited Technological Literacies: How Individuals In Sub-Sahara Africa Engage With Fake News, Gregory Gondwe Jan 2023

Misinformation In Countries With Limited Technological Literacies: How Individuals In Sub-Sahara Africa Engage With Fake News, Gregory Gondwe

Communication Studies Faculty Publications

In an event where the problem of information access is almost terra incognita, the derivate challenge is whether too much information is bad. Most research suggests so, yet very few attempts have been made to examine the digital inequalities and literacies that shape how an individual is exposed, consumes, shares, and ends up believing in fake news. This study builds upon focus group data from six sub-Saharan countries to examine how people in sub-Saharan Africa engage with misinformation. This study focuses on variations in digital access and literacy, which indicate how individuals in Africa are exposed to, consume, spread, and …


Girls’ Education And Child Marriage In Central Africa | Insights From Qualitative Fieldwork Part Ii: The Republic Of Congo, Jean-Christophe Boungou Bazika, Wolf Ulrich Mféré Akiana, Quentin Wodon Jan 2023

Girls’ Education And Child Marriage In Central Africa | Insights From Qualitative Fieldwork Part Ii: The Republic Of Congo, Jean-Christophe Boungou Bazika, Wolf Ulrich Mféré Akiana, Quentin Wodon

Journal of Global Catholicism

Child marriage is defined as a formal or informal union before the age of 18. As in much of sub-Saharan Africa, the prevalence of child marriage remains high in the Republic of Congo (RoC), in part because educational attainment for girls is low. Based on qualitative fieldwork, this article looks at communities’ perceptions of child marriage and girls’ education and their suggestions for programs and policies that could improve outcomes for girls. The article also discusses potential implications for Catholic and other faith-based schools, as well as faith leaders.


Girls’ Education And Child Marriage In Central Africa | Insights From Qualitative Fieldwork Part I: The Democratic Republic Of Congo, Geneviève Bagamboula Mayamona, Jean-Christophe Boungou Bazika, Quentin Wodon Jan 2023

Girls’ Education And Child Marriage In Central Africa | Insights From Qualitative Fieldwork Part I: The Democratic Republic Of Congo, Geneviève Bagamboula Mayamona, Jean-Christophe Boungou Bazika, Quentin Wodon

Journal of Global Catholicism

Child marriage is defined as a formal or informal union before the age of 18. As in much of Sub-Saharan Africa, the prevalence of child marriage remains high in the Democratic Republic of Congo (DRC) in part because educational attainment for girls is too low. Based on qualitative fieldwork, this article looks at communities’ perceptions of child marriage and girls’ education and their suggestions for programs and policies that could improve outcomes for girls. The article also discusses potential implications for Catholic and other faith-based schools, as well as faith leaders.


A Case Study Of Makerere University In Uganda Through The Lens Of U.S. Land-Grant Higher Education, Christina L. Hand Jan 2023

A Case Study Of Makerere University In Uganda Through The Lens Of U.S. Land-Grant Higher Education, Christina L. Hand

Graduate Theses, Dissertations, and Problem Reports

This case study examines Makerere University through the lens of U.S. land-grant ideal and normative domains in order to provide a deeper understanding of global higher education. A case study uses multiple types of data to create a holistic perspective. As well as interviewing Makerere stakeholders representing diverse sectors, numerous documents and different types of media were analyzed enabling a triangulation of data. Six major themes emerged focusing on Makerere’s aspiration to be a research-led institution, the impact of neoliberalism, challenges in undergraduate education, the importance of reputation and saga, the ever-present role of the Ugandan government, and the continuing …


Explanatory Models Of Autism In Nigeria: Exploring Sociocultural Beliefs To Inform Systems Of Care, Gabrielle Udoka Robertson May 2021

Explanatory Models Of Autism In Nigeria: Exploring Sociocultural Beliefs To Inform Systems Of Care, Gabrielle Udoka Robertson

Honors Theses

Advancements in the diagnosis, understanding, and treatment of individuals with autism spectrum disorder (ASD) have yet to benefit children and families struggling with ASD in Nigeria and other African countries. Not only is there a scarcity of research on ASD in sub- Saharan Africa, but also a lack of mental health and special education services and a lack of understanding of the sociocultural considerations that must inform culturally responsive care. As such, this study explored the sociocultural conceptualizations of autism spectrum disorder (ASD) in Nigeria and how these conceptualizations affect the experiences and care of people with autism. The unique …


Environmentally Related Urbanization And Violence Potential, Christina Bagaglio Slentz Apr 2021

Environmentally Related Urbanization And Violence Potential, Christina Bagaglio Slentz

Graduate Program in International Studies Theses & Dissertations

In contrast to historical examples in which urban increase is accompanied by the pull factors of wealth and development, post-industrialized sub-Saharan African urbanization patterns are characterized by a lack of economic growth, confounding experts. Simultaneously, African conflict scholars have observed a major geographical shift in African conflict onset, moving out of rural regions and into urban centers. Recognizing the effects of increasing climate variability and threatened agricultural livelihoods, this study hypothesizes perceived economic advantage in cities induces human movement with potential for over-urbanization dynamics that exacerbate civil unrest.

To investigate, a Panarchy theoretical framework of nested adaptive cycles is used …


Birth Registration And Educational Access In Sub-Saharan Africa: The Case For An Explanatory Spatial Research Design, Thomas Edward Griffin Jan 2021

Birth Registration And Educational Access In Sub-Saharan Africa: The Case For An Explanatory Spatial Research Design, Thomas Edward Griffin

Graduate College Dissertations and Theses

In 2019, the United Nations Children’s Fund (UNICEF) estimated the global number of children under the age of 5 without birth registrations at 166 million, with the largest share being present in Sub-Saharan Africa. As the author witnessed firsthand while working in Cameroon, the lack of birth registration documentation (i.e. birth certificates) precluded students from progressing from primary to secondary education. Struck by this example of social exclusion, the purpose of this study was to examine the extent to which birth registration acted as a barrier to educational access in primary and secondary education systems elsewhere across Sub-Saharan Africa. An …


The Importance Of Cognitive Domains And The Returns To Schooling In South Africa: Evidence From Two Labor Surveys, Plamen Nikolov, Nusrat Jimi Mar 2020

The Importance Of Cognitive Domains And The Returns To Schooling In South Africa: Evidence From Two Labor Surveys, Plamen Nikolov, Nusrat Jimi

Economics Faculty Scholarship

Numerous studies have considered the important role of cognition in estimating the returns to schooling. How cognitive abilities affect schooling may have important policy implications, especially in developing countries during periods of increasing educational attainment. Using two longitudinal labor surveys that collect direct proxy measures of cognitive skills, we study the importance of specific cognitive domains for the returns to schooling in two samples. We instrument for schooling levels and we find that each additional year of schooling leads to an increase in earnings by approximately 18-20 percent. The estimated effect sizes—based on the two-stage least squares estimates—are above the …


A Comparative Study Of Electoral Systems: Majoritarian Rules And Electoral Violence In Africa, Gavin M. Kiger Jan 2019

A Comparative Study Of Electoral Systems: Majoritarian Rules And Electoral Violence In Africa, Gavin M. Kiger

Electronic Theses and Dissertations

An increasing trend of violent elections is undermining the former optimism over multi-party elections in Africa. Electoral systems are frequently associated with election violence, but the effects of different systems are relatively unknown. This study addresses this gap and assesses whether conditions for electoral violence are greater under certain electoral systems compared to others. Using a new time-series cross sectional (TSCS) dataset, I conduct an analysis of election violence in sub-Saharan Africa from 1995-2013. Overall, I find evidence for the violence-permitting nature of majoritarian systems, and the violence-constraining nature of proportional representation systems. These findings remain after controlling for the …


Social Entrepreneurship: Exploring The Bricolage Model In Nigeria, Michael Ogunleye Jan 2019

Social Entrepreneurship: Exploring The Bricolage Model In Nigeria, Michael Ogunleye

Walden Dissertations and Doctoral Studies

Nigerian entrepreneurs face government barriers and lack the skills and awareness needed for successfully creating and scaling public value in resource-constrained environments. The concept of bricolage, which involves doing business by making do with resources at hand, has been addressed in the literature, but not as it occurs among Nigerian entrepreneurs. This study was conducted with the aim of narrowing this gap in knowledge by exploring how Nigerian entrepreneurs have successfully carried out their businesses. The research question addressed how Nigerian entrepreneurs overcame critical situations to successfully address the challenges of scaling and creating public value, and whether the theory …


Success Factors For Power Project Development Businesses In Sub-Saharan Africa, Kodjo Galevissi Afidegnon Jan 2019

Success Factors For Power Project Development Businesses In Sub-Saharan Africa, Kodjo Galevissi Afidegnon

Walden Dissertations and Doctoral Studies

Despite the financing gap in the sub-Saharan Africa power sector, private investors struggle to capitalize on the opportunity because of the high failure rate of power project development companies. Using the conceptual framework of the behavioral finance theory, this multiple case study was conducted to explore the strategies used by executives of 4 companies in sub-Saharan Africa who successfully developed power projects within the last 5 years. Data were collected from semistructured interviews and a review of government and institutions' websites. Yin's 5-phased cycle for analyzing case studies provided the guidelines for data analysis. Three themes emerged from data analysis: …


Pharmaceutical Industry's Effect On Socioeconomic Development In Sub-Saharan Africa In Relation To Family Planning Accessibility, Tessa Demarest Jan 2019

Pharmaceutical Industry's Effect On Socioeconomic Development In Sub-Saharan Africa In Relation To Family Planning Accessibility, Tessa Demarest

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

There is a large unmet need for family planning services in sub-Saharan Africa (Goodkind et al, 2018). Pharmaceutical companies contribute to the accessibility of medications in developing countries (Cottingham & Berer, 2011). If the pharmaceutical industry strongly affects access to contraceptives in sub-Saharan Africa, then it is possible that adjustments made to the industry would increase access to contraceptives. I explored how contraceptives change the economic and social development of subSaharan Africa to determine if contraception benefits Africans enough for their shortage to be a serious injustice. This is followed by how the pharmaceutical industry affects access to and types …


The Differentiation Of Smallholder Farming And Household Food Responsibilities In Northern Ghana, Siera Vercillo Nov 2018

The Differentiation Of Smallholder Farming And Household Food Responsibilities In Northern Ghana, Siera Vercillo

Electronic Thesis and Dissertation Repository

One of the most urgent problems facing sub-Saharan Africa is that many people lack access to safe, nutritious, and culturally appropriate food, particularly in semi-arid regions such as northern Ghana. An important indication of this problem within Ghana is that stunting rates due to prolonged undernourishment are significantly higher in the northern regions than in other parts of the country, despite claims of an overall increase in the availability of food. Broadly, this dissertation employs qualitative case study research in the Northern Region (interviews N=109 and 12 focus groups) to describe the changes in access to resources, roles and …


Sustainable Energy Transitions: Changing The ‘Business As Usual’ Trajectory In Sub-Saharan African Urban Areas, Mark Borchers, Megan Euston-Brown, Simon Bawakyillenuo, Alex Ndibwami, Simon Batchelor Oct 2018

Sustainable Energy Transitions: Changing The ‘Business As Usual’ Trajectory In Sub-Saharan African Urban Areas, Mark Borchers, Megan Euston-Brown, Simon Bawakyillenuo, Alex Ndibwami, Simon Batchelor

International Journal of African Development

This paper describes a novel approach to helping municipal authorities address the sustainable energy challenges associated with rapidly growing urban populations in Sub-Saharan Africa. Population in Africa is expected to double between 2010 and 2040, and substantial urban growth is expected in small and medium-sized cities where local government capacity constraints are most serious. A long-term partnership between municipal authorities, NGOs, and academics can build capacity, and a prescribed strategy can lead to progress on the ground. In order to contribute to future action, the paper argues for a greater role of local government in sustainable energy transitions, and presents …


Measuring Women's Empowerment In Sub-Saharan Africa: Exploratory And Confirmatory Factor Analyses Of The Demographic And Health Surveys, Ibitola O. Asaolu, Halimatou Alaofè, Jayleen K. L. Gunn, Akosua K. Adu, Amanda J. Monroy, John E. Ehiri, Mary H. Hayden, Kacey C. Ernst Jun 2018

Measuring Women's Empowerment In Sub-Saharan Africa: Exploratory And Confirmatory Factor Analyses Of The Demographic And Health Surveys, Ibitola O. Asaolu, Halimatou Alaofè, Jayleen K. L. Gunn, Akosua K. Adu, Amanda J. Monroy, John E. Ehiri, Mary H. Hayden, Kacey C. Ernst

Epidemiology and Environmental Health Faculty Publications

Background: Women's status and empowerment influence health, nutrition, and socioeconomic status of women and their children. Despite its benefits, however, research on women's empowerment in Sub-Saharan Africa (SSA) is limited in scope and geography. Empowerment is variably defined and data for comparison across regions is often limited. The objective of the current study was to identify domains of empowerment from a widely available data source, Demographic and Health Surveys, across multiple regions in SSA.

Methods: Demographic and Health Surveys from nineteen countries representing four African regions were used for the analysis. A total of 26 indicators across different dimensions (economic, …


Influence Of Dietary Salt Knowledge, Perceptions, And Beliefs On Consumption Choices After Stroke In Uganda, Martin N. Kaddumukasa, Elly Katabira, Martha Sajatovic, Svetlana Pundik, Mark Kaddumukasa, Larry B. Goldstein Dec 2017

Influence Of Dietary Salt Knowledge, Perceptions, And Beliefs On Consumption Choices After Stroke In Uganda, Martin N. Kaddumukasa, Elly Katabira, Martha Sajatovic, Svetlana Pundik, Mark Kaddumukasa, Larry B. Goldstein

Neurology Faculty Publications

Background

Previous research on Uganda's poststroke population revealed that their level of dietary salt knowledge did not lead to healthier consumption choices.

Purpose

Identify barriers and motivators for healthy dietary behaviors and evaluate the understanding of widely accepted salt regulation mechanisms among poststroke patients in Uganda.

Methods

Convergent parallel mixed methods triangulation design comprised a cross-sectional survey (n = 81) and 8 focus group discussions with 7-10 poststroke participants in each group. We assessed participant characteristics and obtained insights into their salt consumption attitudes, perceptions, and knowledge. Qualitative responses were analyzed using an inductive approach with thematic analytic procedures. Relationships …


Providing Refuge: A Regime Analysis Of Legal Protections For Displaced Persons In Sub-Saharan Africa, Natasha Bennett, Hannah K. Brown Nov 2017

Providing Refuge: A Regime Analysis Of Legal Protections For Displaced Persons In Sub-Saharan Africa, Natasha Bennett, Hannah K. Brown

Biennial Conference: The Social Practice of Human Rights

While refugees are entitled to the right of asylum vis-a-vis the U.N. 1951 Convention Relating to the Status of Refugees and the subsequent 1967 Protocol, which includes rights of a legal resident in the host country, African states vary in their domestic implementation of refugee rights.

Sub-Saharan Africa host approximately 29 percent of the world’s refugees and as such represents a key region for understanding the dynamics of refugee rights and protections. With 45 member states having ratified (another 4 having signed) the Organization of African Unity’s 1969 Convention Governing the Specific Aspects of the Refugee Problem in Africa (OAU …


The Impact Of Aid On The Economic Growth Of Developing Countries (Ldcs) In Sub-Saharan Africa, Maurice W. Phiri Jan 2017

The Impact Of Aid On The Economic Growth Of Developing Countries (Ldcs) In Sub-Saharan Africa, Maurice W. Phiri

Gettysburg Economic Review

Least Developed Countries (LDCs) of Sub-Saharan African have been recipients of official development assistance for more than 5 decades; however they are still characterized by chronic problems of poverty, low living standards and weak economic growth. The hot question is: Is aid effective in promoting economic growth? Thus, this paper investigates the impact of aid on the economic growth of 12 least developed countries in Sub-Saharan Africa over a period of 20 years. I take a fixed effects instrumental variable approach and the results imply that aid has a statistically insignificant negative impact on economic growth. I therefore conclude that …


The Strategic Potential Of Community-Based Hybrid Models: The Case Of Global Business Services In Africa, Stephan Manning, Chacko G. Kannothra, Nichole K. Wissman-Weber Jan 2017

The Strategic Potential Of Community-Based Hybrid Models: The Case Of Global Business Services In Africa, Stephan Manning, Chacko G. Kannothra, Nichole K. Wissman-Weber

Management and Marketing Faculty Publication Series

As a latecomer economy, Africa faces persistent difficulties with catching up in global markets. This study examines the strategic potential of community-based hybrid models, which balance market profitability with social impact in local communities. Focusing on the global business services industry in Kenya and South Africa, and the practice of ‘impact sourcing’ – hiring and training of disadvantaged staff servicing business clients – we find that while regular providers struggle to compete with global peers, hybrid model adopters manage to access underutilized labor pools through community organizations, and target less competitive niche client markets. We further identify key industry, institutional …


Exploring The Impact Of Information And Communication Technology (Ict) On Intermediation Market Structure In The Microfinance Industry, Frederick Riggins, David Weber Jun 2016

Exploring The Impact Of Information And Communication Technology (Ict) On Intermediation Market Structure In The Microfinance Industry, Frederick Riggins, David Weber

The African Journal of Information Systems

The microfinance industry provides financial services to the world’s poor in hopes of moving individuals and families out of poverty. In 2013 there were 4.7 million active microfinance borrowers in Africa. This represents a smaller percentage of the population compared to other regions of the world, indicating the potential for rapid growth of microfinance in Africa. However, microfinance is maturing, in part due to the adoption of information and communication technologies (ICTs). This research examines how ICTs are changing the microfinance industry given recent advancements in mobile banking, Internet usage, and connectivity. By examining the microfinance market structure, we determine …


Mobile Health And Its Role In Addressing Maternal Health In Sub-Saharan Africa, Tarikwa M. Leveille May 2016

Mobile Health And Its Role In Addressing Maternal Health In Sub-Saharan Africa, Tarikwa M. Leveille

International Development, Community and Environment (IDCE)

ABSTRACT Background: In the last 10-15 years, mobile health (mHealth) interventions have generated considerable interest as tools for sustainable development in the global health sector as well as to improve access to care for remotely isolated populations in Sub-Saharan Africa. This paper explores existing literature on mHealth for clinical data collection for maternal health, discusses some of its benefits and challenges, and addresses mHealth’s limitations, such as 1) inadequate monitoring and evaluation framework; (2) inability for project scalability; and (3) lack of partnerships that are unsustainable and inclusive of all stakeholders. Although the healthcare sector acknowledges the potential benefits of …


Preferential Trade Agreements And Quality Of Government In Sub-Saharan Africa, Sharon Camara May 2016

Preferential Trade Agreements And Quality Of Government In Sub-Saharan Africa, Sharon Camara

Dissertations

Objectives. Sub-Saharan African (SSA) nations have made concerted attempts at economic integration and openness with use of preferential trade agreements (PTAs) beginning in the latter half of the 1990s. These changes could result in increases in trade and growth. The World Bank’s Good Governance indicators are designed to assess the quality of institutions in a given country. The objective is to assess the impact of PTAs and Good Governance indicators on trade in SSA nations. Methods. Data on trade y was generated based on exports defined by the International Monetary Fund’s (IMF) Direction of Trade statistics, and both OLS and …


Universalizing Primary Education In Sierra Leone: Promises And Pitfalls On The Path To Equity, Grace Pai Jan 2016

Universalizing Primary Education In Sierra Leone: Promises And Pitfalls On The Path To Equity, Grace Pai

Publications and Research

What barriers remain in the progress towards achieving Universal Primary Education (UPE), and how does the UPE agenda affect out-of-school children? Through a mixture of historical, quantitative and qualitative methods of analysis, this study examines these questions using the developing context of Sierra Leone as a case study.

Findings from over 100 interviews show that first of all, the most salient barrier that prevents children from participating in primary school is the fact that school is not free de facto in spite of the national abolishment of primary school fees in 2004. Rather than commonly cited constraints such as a …


Reconstructing Education In Post-Conflict Sierra Leone, Grace Pai Jan 2016

Reconstructing Education In Post-Conflict Sierra Leone, Grace Pai

Publications and Research

This study finds that by prioritizing universal development programmes instead of employing a conflict-sensitive approach rooted in attending to the specific inequities present in Sierra Leone, the current education system is ignoring the needs and desires of certain subpopulations of youth. Specifically, although the state has been very successful in increasing overall access to basic education for both boys and girls in rural Sierra Leone, the current focus on improving the quality of academic education has sidelined the growth of technical and vocational education that many youth desire. Instead, sectors such as tertiary education are prioritized above all else.

Furthermore, …


An Analysis Of Education Reform In Sub-Saharan Africa, Katharine Eger Jan 2016

An Analysis Of Education Reform In Sub-Saharan Africa, Katharine Eger

CMC Senior Theses

Sub-Saharan Africa continues to fall behind other developing regions regarding educational attainment, despite recent progress in enrollment. This thesis examines a variety of external conditional factors that could contribute to a country’s relative success, in terms of years spent in school using a prediction model that compares years enrolled in secondary education as a foundation to determine over- and under-performing countries in sub-Saharan Africa.

By exploring various educational policies, historical patterns, and projects executed in Rwanda, South Africa, Ghana, and Botswana, this thesis sheds light on four main challenges that can impact educational attainment: ethnic and racial tensions, an acute …


Examining Human Capital Capacity’S Influence On Human Development And Poverty Reduction In Sub-Saharan Africa, Theodore J. Davis Jr. Dec 2015

Examining Human Capital Capacity’S Influence On Human Development And Poverty Reduction In Sub-Saharan Africa, Theodore J. Davis Jr.

International Journal of African Development

The aim of this paper is to examine and expand our focus on human capital capacity building as a foundation for poverty reduction in Sub-Saharan Africa. The data showed significant differences in the human capital capacity building characteristics as measured by demographic, education and gender equality characteristics. In analyzing select human capital capacity building markers, the findings suggest that the educational indicators were among the strongest in explaining the variation in human development in Sub-Saharan Africa. The findings showed that gender inequality was a serious inhibitor of human development in Sub-Saharan Africa. Overall, the Sub-Saharan nations with the lowest level …


Rush To Judgment: The Sti-Treatment Trials And Hiv In Sub-Saharan Africa, Eileen Stillwaggon, Larry Sawers May 2015

Rush To Judgment: The Sti-Treatment Trials And Hiv In Sub-Saharan Africa, Eileen Stillwaggon, Larry Sawers

Economics Faculty Publications

Introduction: The extraordinarily high incidence of HIV in sub-Saharan Africa led to the search for cofactor infections that could explain the high rates of transmission in the region. Genital inflammation and lesions caused by sexually transmitted infections (STIs) were a probable mechanism, and numerous observational studies indicated several STI cofactors. Nine out of the ten randomized controlled trials (RCTs), however, failed to demonstrate that treating STIs could lower HIV incidence. We evaluate all 10 trials to determine if their design permits the conclusion, widely believed, that STI treatment is ineffective in reducing HIV incidence.

Discussion: Examination of the …