Graduate Studies

 

First Advisor

Lisa Kort-Butler

Second Advisor

Kelsy Burke

Degree Name

Doctor of Philosophy (Ph.D.)

Committee Members

Gcobani Qambela, Jody Kellas, Julia McQuillan

Department

Sociology

Date of this Version

7-2025

Document Type

Dissertation

Citation

A dissertation presented to the Graduate College of the University of Nebraska in partial fulfillment of requirements for the degree of Doctor of Philosophy

Major: Sociology

Under the supervision of Professors Lisa Kort-Butler and Kelsy Burke

Lincoln, Nebraska, July 2025

Comments

Copyright 2025, Esihle Lupindo. Used by permission

Abstract

This dissertation uses survey data primarily from Wave 1 of the Health and Aging in Africa: Longitudinal Study of In-depth Community in South Africa (HAALSI) which was collected in 2015 to study the sexual health of Black men in rural Mpumalanga, South Africa. Broadly speaking, I examine aging men’s sexual health as it related to HIV, well-being, loneliness, social networks and disclosure. The definition that I use for sexual health was coined by MacPhail and Campbell (2001) who define it as “not only sexual practices but also what people know and believe about sex, particularly what they think is natural, proper and desirable” (p. 3).

I focus on aging men in rural areas because the majority of existing studies on sexual health in South Africa focus on young people who are based in urban areas, ignoring rural and peri-urban locations (Qambela, 2018; Phaswana-Mafuya, Peltzer and Pengpid, 2019). Older populations are frequently ignored because there is an “incorrect assumption about their lack of sexual risk-taking” (Rosenberg et al, 2018, p. 2). This leads to earlier symptoms of AIDS-related complications being dismissed as alignments associated with aging (Munthree and Maharaj, 2013, p. 123) and seldom sexual health.

The exclusive focus on men is to move away from the general pattern of comparing men and women. Overall, in chapter four, I found that there was no association between living with HIV and feeling respected but men with higher self-reported levels of happiness and those with primary and high school education said they felt respected. I use as one of my measures of well-being. In chapter five I found that men who had tested, had a high school education and had adverse childhoods often saw themselves as being at lower risk of infection but in the absence of adverse childhoods, men who had women as sexual partners saw themselves as being at a reduced risk of infection. In chapter six I found that disclosure generally increased perceived emotional support yet people with some tertiary education reported less support. Additionally, receiving support was associated with lower odds of knowing where to go to access HIV treatment.

Advisors: Lisa Kort-Butler and Kelsy Burke

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