Almost 21% of Zimbabwe's population of roughly 13 million people live with HIV infection while 1.6 million children (23%) have been orphaned. The epidemic is further worsening children's lives by decreasing access to health services, education, shelter, clothing, vocational training, legal protection, psychosocial support, and care from family members. Understanding the psychosocial effects on children of being orphaned or made vulnerable by the epidemic is vital if further problems in childhood and later life are to be averted. Objectives: 1. To develop a theoretical framework for understanding the relationships between orphan experience, psychosocial distress, and child experiences and adult life chances; 2. To compare and contrast levels of psychosocial distress by form (i.e. paternal only, maternal only and double) and duration of orphanhood in Zimbabwe; 3. To assess the cumulative impact of psychosocial distress experienced in childhood on risky behaviour outcomes in adolescence and adult life experiences; 4. To assess how appropriate and sensitive the methods and tools used in the study were to the children's plight. Methods: Stata version 9.0 was used to conduct statistical analyses of data from three survey sources: the Zimbabwe Oye Baseline Survey 2004, the Manicaland Child Cohort Study, and the Manicaland HIV/SID Prevention Project. Qualitative data were collected and used to aid interpretation of the statistical results. Results: In the national ayC survey (ages 12-17 years), psychosocial distress was more common in females and younger children. Orphans overall and each form of orphan were at greater risk of developing psychosocial distress than non-orphans. In multivariate analyses, being resident in an urban area (Coeff, 0.16; 95% CI, 0.04-0.28), on a commercial farm (Coeff, 0.46; 95% CI, 0.08-0.84), in the poorest 20% of households (Coeff, 0.14; 95% CI, 0.04-0.24), in a household that had received external Support (Coeft', 0.21; 95% CI, -0.01-0.44) and not being related to the closest caregiver (Coeff, 0.14; 95% CI, 0.03-0.24) were associated with psychosocial distress. Being in a female-headed household (Coeff; -0.11; 95% CI, -0.19- -0.02) and receiving psychosocial support from the closest caregiver (Coeff, -0.05; 95% CI, -0.09- -0.01) had protective effects against psychosocial distress. Maternal and paternal orphans were significantly more likely than non-OYC to have engaged in sexual activity. These differences were reduced after controlling for psychosocial distress. In Manicaland, eastern Zimbabwe, paternal and double orphans were at increased risk of psychosocial distress. Orphans were more likely to have started sex and to have engaged in substance abuse. However, the only (borderline) significant result was increased likelihood of paternal orphans having engaged in substance abuse [p = 0.056]. Conclusion: Orphaned children in Zimbabwe suffer greater psychosocial distress which may lead to increased likelihood of sexual debut and HIV infection. The impact of strategies to provide psychosocial support should be evaluated scientifically.

This study describes the HIV/AIDS knowledge of Form 1 secondary school learners in Harare. Structured interviews were conducted with 75 learners from four schools representing a low density, a high density, a rural and a private school. Most learners had obtained their HIVAIDS knowledge from schools and a few did so from their parents. None of the learners had reportedly yet engaged in sexual activities and all had heard about HIV, but not all knew what HIV was, and even fewer could define AIDS. Generally the learners’ HIV/AIDS knowledge levels were high but some misconceptions persisted. Future programmes should emphasise that there is no cure for HIV/AIDS, and that condoms should be used at every sexual encounter. Radio, television and school programmes should emphasise that every person can become infected with HIV/AIDS, if preventive measures are disregarded. / Public Health / M.A. (Public Health)

This study assessed the role of the International Organization for Migration (IOM) in HIV-prevention among mobile and vulnerable populations (MVPs) and potential emigrants in Beitbridge. A mixed-method approach, which combines quantitative and qualitative approaches, was used in this action research. A total of 20 in-depth face-toface interviews were conducted with key informants and 56 self-administered questionnaires were completed by MVPs and potential emigrants in Beitbridge. The study found that a number of effective strategies are currently being implemented as a preventative measure by the IOM within MVPs and potential emigrants’ communities in Beitbridge. At the same time, however, in order to ensure sustainability of these HIVprevention initiatives, the IOM must promote long-term synergies with other strategic partners throughout the project cycle. It is recommended that, the IOM strategically position itself by moving a step further from being the sole provider of emergency humanitarian support towards devising sustainable and durable solutions among MVPs and potential emigrants. / Sociology / M.A. (Social Behaviour Studies in HIV-AIDS)

This study described sexual behaviours among adolescents living with the Human Immunodeficiency Virus (HIV) in Zimbabwe. This study utilised a quantitative descriptive design. Data was collected using structured questionnaires from 341 adolescents living with HIV. Findings revealed that some adolescents were sexually active and had early onset of sexual activity (before their sixteenth birthday). A good proportion of sexually active adolescents were noted not to practise safer sex and the main reason was condom inaccessibility and some had multiple sex partners. Factors independently associated with being sexually active included exposure to erotic content on television programmes, having a psychiatric diagnosis, discussions of sexuality with health worker and older age. Adolescents` behaviours living with HIV and the issue of availability of condoms may play a part in the spread of HIV. More discussions and research on sexuality of adolescents are recommended / Health Studies / M.A. (Public Health)

Factors that Impact on Learning in Orphanhood in Zimbabwe The aim of the study was to provide scientific knowledge on the factors impacting on the learning profile of orphans as compared to those who are not orphaned, and to identify the relationships between these factors and learning outcomes. This is a quantitative study and the Evaluation-Process and Outcome design was used. Structured quantitative data collection methods, questionnaires, interviews, observation and document analysis were used in this study. Maslow’s humanistic motivation theory of learning is the theoretical framework. The population included form four students and teachers from the Harare Metropole Province in Zimbabwe. A stratified random sampling procedure was used to sample schools, and the simple random procedure was used to sample both students and teachers. The experimental design was used to allow comparisons among orphans and between orphans and non-orphans. Ethical principles including consent, confidentiality and privacy were adhered to. Measures to uphold the quality of the study were applied. In the study it was found that in the peri-urban area, students who had been orphaned for one year or less performed poorly compared to other orphans and to non-orphaned students in their average examination marks, (p<. 023). Lack of books was significantly different amongst the non-orphaned and orphans (p<. 003), mostly affecting those orphaned for one year or less. There was a significant difference in the performance of orphans whose mothers had died and those whose mothers were alive, according to their average coursework marks (p<. 001) and average examination marks (p<. 005). The performance of single orphans, double orphans and non- orphans did not differ significantly, but the post hoc analysis revealed that in most subjects double orphans performed worse than single orphans and non-orphaned students. In the HIV/AIDS/Reproductive health and life-skills teaching-learning sessions observed, the majority of teachers, 12, (66.7%) (n =18) did not agree that relevant assignments were being given and 16 (88.9%) (n =18) did not agree that reading references were available. The majority of students (55.2% n = 509) had inadequate information on HIV and AIDS prevention, and those orphaned for one year or less (62% n = 29) and those orphaned for two to three years (62.5% n = 48) had even less information on HIV and AIDS prevention than the other groups. There was a difference in what the students perceived as life skills and what the teachers reported as life skills. It is recommended that this study be replicated on a larger scale and that factors that impact on learning be studied in national school settings in order to determine orphans’ and non-orphans’ learning outcomes. / Health Studies / D. Litt. et Phil. (Health Studies)

This study describes the HIV/AIDS knowledge of Form 1 secondary school learners in Harare. Structured interviews were conducted with 75 learners from four schools representing a low density, a high density, a rural and a private school. Most learners had obtained their HIVAIDS knowledge from schools and a few did so from their parents. None of the learners had reportedly yet engaged in sexual activities and all had heard about HIV, but not all knew what HIV was, and even fewer could define AIDS. Generally the learners’ HIV/AIDS knowledge levels were high but some misconceptions persisted. Future programmes should emphasise that there is no cure for HIV/AIDS, and that condoms should be used at every sexual encounter. Radio, television and school programmes should emphasise that every person can become infected with HIV/AIDS, if preventive measures are disregarded. / Public Health / M.A. (Public Health)

This study assessed the role of the International Organization for Migration (IOM) in HIV-prevention among mobile and vulnerable populations (MVPs) and potential emigrants in Beitbridge. A mixed-method approach, which combines quantitative and qualitative approaches, was used in this action research. A total of 20 in-depth face-toface interviews were conducted with key informants and 56 self-administered questionnaires were completed by MVPs and potential emigrants in Beitbridge. The study found that a number of effective strategies are currently being implemented as a preventative measure by the IOM within MVPs and potential emigrants’ communities in Beitbridge. At the same time, however, in order to ensure sustainability of these HIVprevention initiatives, the IOM must promote long-term synergies with other strategic partners throughout the project cycle. It is recommended that, the IOM strategically position itself by moving a step further from being the sole provider of emergency humanitarian support towards devising sustainable and durable solutions among MVPs and potential emigrants. / Sociology / M.A. (Social Behaviour Studies in HIV-AIDS)

This study described sexual behaviours among adolescents living with the Human Immunodeficiency Virus (HIV) in Zimbabwe. This study utilised a quantitative descriptive design. Data was collected using structured questionnaires from 341 adolescents living with HIV. Findings revealed that some adolescents were sexually active and had early onset of sexual activity (before their sixteenth birthday). A good proportion of sexually active adolescents were noted not to practise safer sex and the main reason was condom inaccessibility and some had multiple sex partners. Factors independently associated with being sexually active included exposure to erotic content on television programmes, having a psychiatric diagnosis, discussions of sexuality with health worker and older age. Adolescents` behaviours living with HIV and the issue of availability of condoms may play a part in the spread of HIV. More discussions and research on sexuality of adolescents are recommended / Health Studies / M.A. (Public Health)

This study was an attempt to investigate the influence of socio-cultural factors on HIV prevention strategies among HIV discordant couples in Harare, Zimbabwe. HIV sero-discordance is a scenario whereby one partner is HIV-positive and the other is HIV-negative. HIV sero-discordant couples are a unique and vulnerable population that encounters many peculiar challenges. When dealing with this population, researchers have to deal with contradictory ideas and perceptions presented by each partner making up the couples and also understand the relationship in the context of cultural values, norms and the dynamic of power and oppression. In addition to this, the concept of HIV sero-discordance and the frequency of its occurrence are poorly understood in most African communities. Despite the growing evidence of HIV discordance, HIV prevention strategies have largely focused on clinical aspects at the expense of socio-cultural issues that impact on HIV prevention strategies targeted at HIV sero- discordant couples. The study seeks to contribute to the conceptualization and design of intervention programs dealing with sero-discordance. The study is underpinned by the symbolic interactionism theory and was qualitative in design involving 13 HIV discordant couples in heterosexual relationships enrolled in the HIV Preventions Trials Network 052 Study (HPTN 052 Study) being undertaken by the University of Zimbabwe’s department of medicine. The study utilized 2 Focus Group Discussions (FGD) and 10 in-depth interviews (IDI) to collect data. The study’s findings indicate that discordant couples are in fact critical stakeholders in the uptake of all the available HIV prevention strategies. Failure to acknowledge this tenet is self-defeating as evidenced by the perception of viewing condom use within a marriage as humiliating for a woman. The study further noted that practitioners in the HIV prevention domain must guard against over-relying on the scientifically demonstrated efficacy of the strategies. The study recommends that HIV prevention strategies must be socially and culturally acceptable and embedded for them to be more efficacious. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)

Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is a global problem. Introduction of antiretroviral therapy (ART) came as a relief to people living with HIV and AIDS as it improved their quality of life. However, maintaining high adherence levels to antiretroviral treatment is still a challenge in some settings yet strict adherence to treatment instructions is critical for successful suppression of HIV. A qualitative, descriptive phenomenological research was conducted to explore factors that influence adherence to antiretroviral therapy at Beatrice Road Infectious Disease Hospital (BRIDH). Purposive homogenous sampling was done. Data was collected from twenty patients through in-depth interviews. Study findings identified five main themes that facilitate adherence and these entail knowledge on HIV and AIDS and ART, motivation to live, adherence support networks, good service delivery and factors related to medication / Health Studies / M.A. (Public Health)