This study identifies differing interests which have impacted how Acquired Immune Deficiency Syndrome (AIDS) prevention programmes in Vancouver have evolved. Drawing largely upon the writings of Michel Foucault with respect to power, knowledge and sexuality, discursive trends in materials are identified, categorized and compared to consider how pertinent subjugated knowledges have developed. The interplay between knowledge-regimes (the benedicted) and subjugated knowledges (the interdicted) are explicated through textual analyses of the materials collected. The findings suggest that knowledges cultivated within the male homosexual communities of Vancouver ensured the implementation of prevention programmes contextually relevant to their own milieu. These strategies were also integrated into broader prevention initiatives designed for society in-general, once their efficacy was apparent. Implications for community education and public health education are discussed, and areas for future research are identified.

Sexuality is made relevant in the way language is used as a matter of the identity of a group or individuals. Sex, for human beings, is not merely instinctive behaviour. It is meaningful-cultural behaviour and as such is semiotically loaded with meaning. Listening and talking about sex highlights conventions, taken-for-granted assumptions about the way things have to be done. Language as the most powerful representational system shapes our understanding of what we do and how we do them in relation to sex. Our understanding of sexual scripts about the sexuality of a particular group of people is through language as a signifying practice. The study of listening and talking is not merely an investigation of how sex is talked about, but how respondents enact sexuality and sexual identity vis-à-vis its linguistically loaded forms of representations in a variety of discourse genres. Representation and its inherent process of signification draws on lived experiences and the daily talk of people in interaction. A theoretical perspective is presented not as a model to be tested, but as testimony to the rich literature on the nature and function of language as a political arena, semiotically loaded with meanings that are taken for granted. It is concluded that the appropriation of cultural myths is encoded in language and as such language is a legitimate area of inquiry especially in understanding sexual scripts in the context HIV/AIDS. The study engages reported high risk sexual encounters such as multiple and concurrent partnerships, as well as unsafe sex practices which have been identified in literature as fanning the embers of the epidemic. Ideologies influencing developing communication campaigns in light of these discourses become a serious challenge as the conventional basis for such campaigns is in socio-cognitive theories, few of which can be assumed to apply with regard to the discursive representations of sexual practices and the inherent risks. Drawing on a cross-sectional survey of 1400 students on seven campuses, conceptually triangulated via focused-ethnography, listening analysis and discourse analysis, this research examines perceptions, interpretations, attitudes, and practices of sexuality and HIV/AIDS. The research is a multi-method and inter-disciplinary approach located within cultural studies to interrogate the gap between knowledge, attitudes, beliefs and behaviour modification in the light of the HIV/AIDS epidemic. This research discusses these findings and offers a critical appraisal of sexual behaviour in the context of ABC (Abstain, Be faithful, Condomise) as ideologically encoded in cultural and relational myths. I found that students are sexually active with reported multiple and concurrent sexual partnerships. Postgraduate students were less likely to report having had used a condom at their last coital encounter compared with the often younger undergraduate students. Condom use continues to be a norm in the universities surveyed. This is truer for students who reported multiple sexual partnerships. Amongst the dominant scripts that came out in the ethnographic inquiry are: sex as uncontrollable biological drive; females are responsible for safe sex practices; strong social scripts elevate male sexual prowess and show disdain for female affirmative sexualities, risk is discounted using a form of post modern fatalism (resistance to regulation); and physical status, based on appearance of a possible partner, is used to select ‘sexually safe’ partners. I have concluded that a deeper understanding of the cultural and sexual scripts obtained from students is critical for appropriate design and implementation of interventions aimed at stemming the tide of the HIV epidemic. I have also demonstrated that interventions that only emphasise the rational dimensions of human behaviour are more likely to miss their target audience as sex is more than a choice of Cartesian rationality (linear choice). / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2008.

This study will explore and investigate the response of the Free Methodist Church of Southern Africa (FMCSA) to HIV and AIDS in the Southern KwaZulu-Natal region. It will also reflect on how the Wesleyan Healthcare Response (WHCR) can be used as an inspiration for this Church to fulfil its mission in engaging with HIV and AIDS from a gender-sensitive perspective. With reference to the knowledge that religions possess assets for addressing HIV and AIDS and gender inequality, the study argues that the FMCSA possess the necessary resource to address these interconnected challenges which it is not profitably employing currently. This resource is the theological and practical healthcare response developed by the founder of Methodism, John Wesley, during his lifetime. Using the missio Dei theory to explain the mission of the church in the world, and considering Jesus‘ healing ministry as patterns of the missio Dei‘s materialisation in times of health crises, the study suggests that the FMCSA as a Christian church is expected to respond to HIV and AIDS, a contemporary health crisis in South Africa. The study also hypothesises that Wesley‘s healthcare response is a legacy to the Free Methodists that the FMCSA can appropriate as an effective asset to fulfil missio Dei in time of HIV and AIDS and its gendered nature in the South African context. Therefore, the question responded to in this study is: how can the Wesleyan Healthcare Response inspire the FMCSA to respond to the HIV and AIDS pandemic from a gender-sensitive perspective? The following objectives were formulated in order to respond to this question: 1. to explore the discursive account of HIV and AIDS and its gendered nature in South Africa and the response of the FMCSA; 2. to critically reflect on WHCR as FMCSA‘s potential resource for missio Dei's fulfilment in time of HIV and AIDS; 3. to examine the attitude and concrete response to HIV and AIDS pandemic in the Free Methodist Southern KwaZulu-Natal (FMSKZN); 4. to assess the extent to which WHCR has been used as a resource for addressing HIV and AIDS by the Free Methodist Southern KwaZulu-Natal; 5. to suggest insights to make WHCR a resource to respond to HIV and AIDS within the Southern KwaZulu-Natal context. The data for the study was collected using empirical and non-empirical research methods. Therefore, in addition to the written sources, individual interviews with selected church leaders and caregivers and focus group discussions with ordinary adult and youth church members in five circuits of the FMSKZN were conducted. In examining the attitudes and concrete responses to HIV and AIDS in the FMSKZN, the study realised that this Church failed to learn from WHCR in order to fulfil missio Dei during this pandemic in terms of gender issues. It therefore postulates insights from WHCR that will help fill the gaps identified in the response of this Church to HIV and AIDS and its gendered nature. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.

This thesis explores the problem of sexual behaviour change in a country which has the largest number of people living with HIV in the world. Despite awareness of HIV, and knowledge of protective behaviours, many young South Africans still engage in risky sexual practices, exposing themselves to risk of HIV infection. This lack of behaviour change by people who know the risks involved is the focus of this thesis. I begin by developing a critique of the dominant behaviour change theories which underpin HIV and AIDS interventions, and the way in which they conceptualise the relationship between the individual and society. These theories assume a universal, rational individual who engages in decision-making before action, or is prevented by problematic factors of ‘context’ (e.g. poverty, culture, gender dynamics) from engaging in appropriate protective health decisions. This conceptualisation of behaviour is inadequate in understanding the problem of behaviour change. Cultural-historical activity theory (CHAT), with its roots in the theories of Marx, Engels, Vygotsky and Leontiev, enables a different gaze on the problem of behaviour change, shifting the primary focus from cognition to activity. This provides an alternative dialectical conceptualisation of the relationship between the individual and society. In this thesis I articulate and extend the methodology inherent in CHAT. In a study conducted in a rural area in South Africa I recruited qualitative research processes to explore the cultural-historical context of early sexual experiences leading to intercourse; and the participants’ experiences of sexual activity in relation to HIV and AIDS. The conceptual and methodological tools inherent in CHAT enabled the production of the context of sexual activity. The focus on sexual activity as the central object unit and the analysis of the activity system illuminated the activity of sex as a social practice, produced and enacted within particular interpersonal, social and historical dynamics. Through an historical and current contextualisation of sexual activity CHAT-based analysis of the data enabled an articulation of contradictions and turbulence within the activity system. The problem of a lack of behaviour change is understood through this production of context. Activity system analysis revealed how the introduction of the injectable contraceptive gendered the division of labour in sexual activity. An analysis of the relationship between the subject and the object of the activity system revealed a phalocentric identity investment as an outcome of sexual activity. This analysis also illustrated the relative invisibility of HIV compared to pregnancy as a negative outcome of sexual activity. These dynamics of the activity system structure power and resistance to change in the interaction. By accounting for the status of the activity system this analysis facilitated an understanding of a lack of behaviour change in response to HIV and AIDS. This research process forms the basis for a tentative proposal for intervention using the CHAT-based Change Laboratory approach. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2009.

The interface between apartheid and Aids in the unique South African context between 1987 and 1990 is particularly striking. Natal was such a volatile ground, one rocked by political violence and threatened by a world epidemic. A literary study of the four years' Natal Witness Aids articles and an oral witness by four clergy living in Natal at the times reveal an intriguing debate and deeds by the people in Natal. The difficulty in ascertaining the actual spread of the disease in South Africa was imperative in the search for a reliable information system. Neither the random testing prior to 1987 nor the secret testing between 1987 and 1989 produced reliable Aids statistics. The launching of surveillance testing in 1990 not only amounted to a reliable information system but also revealed staggering statistics reports. Not only was the infection doubling every six months, but it was becoming predominantly heterosexual and exacerbated in the black race. A close study of the Natal Witness articles reveals that the Natal Aids debate could be chronologically divided into four characteristic periods. The 1987 debate was an international debate because the focus was on what was happening in North America and in Europe. The 1988 debate was an African debate because the focus on Aids for the first time placed the African continent on spotlight indicating signs of its future lead in infection and mortality. The 1989 debate was a South African debate because the articles featured miner's plague and the gay plague and their possible negative influence on the economy. The 1990 debate zoomed into the Natal province as it revealed attitudes, myths, and controversies that underpinned the Aids disease. The Natal Witness reports are both contrasted and complemented by the reflections of four Christian ministers who served in Natal at the time. The clergy used particular philosophical frameworks to reconstruct their experiences. According to Sol Jacobs, a 'black consciousness' Methodist priest, the churches did not engage in prevention because of their racial divisions. Vic Bredencamp witnessed a judgemental church, one that could not deal with the Aids disease because of its punitive theology. Ronald Nicolson, an Anglican priest, only witnessed an ignorant church, one that could not become involved in Aids prevention because of its paralysis ignorance. Lastly, Paul Decock, a Catholic priest, witnessed an active church, one that was actively involved in Aids activism as early as 1987. The ministers differed immensely on how the church responded to the Aids disease as well as in the reasons for that particular response. Both the articles and the interviews were found to be misleading in several instances. Through editing and selection, the articles left out important details and articles. The interviewees could barely establish a chronology in their memory of events. With the help of internal and external evidence however, both the interviews and the articles complement each other in establishing the Aids experiences of the Christians in Natal. / Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.

HIV/AIDS is a challenge that African society will have to contend with for a number of years to come. Sub-Saharan Africa is the region most affected by HIV/AIDS in the world. The combination of poverty, natural disasters, violence, abuse of women and children, social and political chaos, and mass migration to cities, all accelerate the spread of HIV. Equally, HIV/AIDS increases the risk of a household or individual becoming more impoverished and makes communities vulnerable to other infectious and poverty-related diseases such as tuberculosis. It presents a huge challenge to the church. South Africa's HIV/AIDS statistics are alarming and the nation is beginning to feel the impact through the loss of economically active people, increasing demand on health care, child headed households and increasing mortality rate due to AIDS. AIDS underrnines life and the great possibilities that our new democracy could bring. Faced with the devastating impact of AIDS, families and communities seek ways and means of surviving and carry on with life. They utilise every resource at their disposal to make a living. Making use of the sustainable livelihoods approach, this study recognises this fact and investigates how people survive, what resources or assets they have, how they utilise these, the constraints they are faced with both in a accessing and in utilising resources, and how the culmination of these efforts impacts upon them. Building on these insights this study focused on how the church at Hinge Township in Que'enstown could enhance the agency of families affected by AIDS. The study argues that the church can contribute by (i) addressing the underlying factors that contribute to the vulnerability context; (ii) building the asset portfolio of households affected by AIDS; (iii) chaUenging the policies and structures which inhibit the livelihood options of such households; and (iv) enhancing the existing livelihood strategies. Examples of each of these actions, drawn from the context of Hinge, are provided. / Thesis (M.Th.)-University of KwaZulu- Natal, Pietermaritzburg, 2004.

Paul Germond and Sepetla Molapo have defined bophelo as a particular BaSotho conception of health and religion. This scholarship defining bophelo derives several policy principles for public health seeking to appreciate religious entities as assets: 1) should actively engage religious entities and to treat them as potential assets in HIV prevention 2) that the value of religion for health is typically not tangible to western scientific and technical methodologies 3) health and religion are sought at a communal level, at which individuals are united through bonds of trust and a common set of cultural practices, often expressed with reference ancestor reverence. Germond and Molapo argue that conceptions of health and religion in other southern African cultures and nations are closely analogous to bophelo, and sketch the relevance of these conceptions for the effectiveness of the public health response to the HIV epidemic in southern Africa. The President’s Emergency Plan for AIDS Relief (PEPFAR) is the United States initiative to prevent HIV and treat AIDS across the globe. PEPFAR is notable for funding a high proportion of faith-based organizations for HIV prevention relative to other major HIV and AIDS initiatives. This is study of two faith-based organizations, HOPE Worldwide and Youth for Christ. Both received funding from PEPFAR to conduct HIV prevention programs in Durban in 2007. The study assesses the conceptions of religion as an asset for their interventions with specific reference to the principles of Germond and Molapo’s bophelo scholarship. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

In the next few years South Africa with be faced with immense socio-economic problems created by the HIV/AIDS epidemic, not least of which will be the impact on children and their families. Evidence from other African countries shows that the presence oflarge numbers of AIDS orphans has major implications for the societies in which they live. Reports from these countries suggest that, even in the midst of high rates of HIV/AIDS, the African extended family system is remarkably persistent. However there is also evidence"that HIV/AIDS affected children face an increased risk of poor health care, of dropping out of school, of abuse and exploitation. The majority of communities affected by HIV/AIDS in South Africa are already poor, yet HIV/AIDS will place a huge strain on available resources. As the epidemic develops, an increasing number of children are likely to fall through the extended family safetynet and pressure will rise on welfare organisations to provide alternative forms of care. The welfare sector must therefore urgently find innovative ways both to support traditional forms of child care, and to develop new models of care. Welfare organisations are being faced with the challenges presented by HIV/AIDS at a time when national welfare policy is in a process of change. The White Paper for Social Welfare (Department ofWelfare, 1997), promotes a major shift of approach to welfare provision. The new approach is based on the principle wof'developmental social elfare'. This is a broad concept incorporating ideas such as 'building human capacity', 'promoting self-reliance', creating 'appropriate' services through 'community development' and the promotion ofincome generating activities. Organisations are encouraged to move away from a concentration on rehabilitative services and institutional care and to develop a preventative approach which relies more on community-based services and 'community' care. This important shift in welfare policy is being introduced within the constraints of the government's macro-economic strategy GEAR (Growth Employment and Redistribution). GEAR aims to create jobs and to link growth to redistribution. This is to be achieved through a tight monetary policy in which reduction of the budget deficit and 'fiscal restraint' are major emphases. Spending on welfare, along with the rest ofthe public sector is thus constrained within tight budgets. This thesis looks at a changing welfare policy in relation to the development of strategies to support children affected by HIV/AIDs. It explores themes contained in the 'developmental social welfare' paradigm and considers the impact ofthe HIV/AIDS epidemic through an examination of the literature and through empirical research. It focuses on the implementation of macro policy change at an organisational level. The following broad questions formed the basis for this research. 1. Given the growing HIV/AIDS epidemic in KwaZulu-Natal, what is being done by welfare organisations, and by whom, to provide care and support for children affected by HIV/AIDS? 2. Are welfare organisations in KwaZulu-Natal devising 'developmental social welfare' approaches to respond to the challenge of HIV/AIDS? If so, how is this approach being developed to assist children affected by the epidemic? What issues are being encountered? 3. In view of the fact that the AIDS epidemic in South Africa is several years behind other sub-Saharan African countries, are there any lessons that can be learned from other African countries about alternative models of care for affected children which have been developed? The research uses a case study approach within a qualitative research methodology. Research methods used were participant observation, interviews, questionnaires and collection of documentary sources. Three case studies are presented which look at different models of care and support for children affected by HIV/AIDS in the Pietermaritzburg district ofKwaZulu-Natal. Each ofthe case studies focuses on themes contained in the 'developmental social welfare' approach. The first case study looks at a community-based project for the support of HIV/AIDS affected children. It focuses on concepts such as community development and community action and at ideas of 'building human capacity' and 'self reliance'. The second case study considers the theme of,appropriateness' through the development an 'appropriate' adoption service for African children. The third case study, considers the issue of maximising resources through a study of a 'cluster' foster care scheme for HIV positive children. This study paints a picture both of potential disaster and of some possible ways forward. It highlights the achievements of the case study organisations. These include the promotion of awareness about the needs of vulnerable children through a community-based approach, as well as the development of new models of adoption for abandoned children and fostering for mv positive children. However, it also highlights the difficulties which faced these organisations, in particular budgetary constraints and the context of poverty within which they were operating. Tensions were found between the slow progress of community development' and the immediate needs of poor children and their carers in a rapidly progressing HIV/AIDS epidemic. The study points to the important role played by state social grants and the need to protect these . benefits. The study provides examples of the gendered nature of 'developmental social welfare' policies, specifically with regard to notions of 'self reliance' and community care. It proposes the need for a better analysis of the concepts contained within the 'developmental social welfare approach'. The need for a closer collaboration between the state and the non governmental sector is seen as critical to the development of a 'holistic' approach to the support of HIV/AIDS affected children. / Thesis (M.Dev. Studies)-University of Natal, Durban, 1998.

This study explores the ways in which Grade Two boys and girls (aged 7-9) in a predominantly Black school construct their knowledge of HIV and AIDS. The study also seeks to explore how young children, in giving meaning to HIV and AIDS, position themselves as gendered beings in the context of HIV and AIDS. By focussing on the construction of young children’s identities in response to AIDS, this study demonstrates how children, in responding to AIDS, do gender and sexuality. There is very little work around gender and young children, let alone gender, HIV and AIDS, and sexuality. This is because of the ways in which children are perceived to be nonsexual, degendered and without the capacity to think beyond a certain stage of development (See Bhana, 2006; 2007a; 2007b; 2008; Silin, 1995; MacNaughton, 2000 as exceptions). By drawing upon qualitative and feminist methodological approaches, this study positions young children as having their own identities, as active participants who are capable of making meaning. This study shows that AIDS is embedded within social, economic, cultural, political and ideological contexts and that the ways in which these children give meanings to HIV and AIDS are embedded within these contexts. In responding to AIDS, the children in this study inform us of their relationship to AIDS within social processes including sexuality, gender, race and class, and they show us how these are actively acted upon. This study also shows the children positioning themselves as gendered beings with the capacity to think, feel and enact their sexuality. In doing so, they dispel many notions which position young children as unknowing, asexual beings. / Thesis (M.Ed.) - University of KwaZulu-Natal, Durban, 2008.

The AIDS epidemic in Sub-Saharan Africa threatens to roll back decades of development progress as the epidemic has contributed to rising child mortality, sharp reductions in life expectancy and has already orphaned a generation of children (Andrews et al 2006). UNAIDS (2007) notes that sub-Saharan Africa is the epicentre of the epidemic with an estimated figure of 22.5 million people having said to be living with HIV at the end of 2007. Approximately 1.7 million people were infected with HIV during the same year. UNAIDS (2007) further notes that one fifth of the adult population in Zimbabwe are living with HIV/AIDS. A total of 135 000 adults are estimated to have died between January 2003 and August 2003 as a result of HIV/AIDS related complications (Kujinga 2004:126). The HIV epidemic infects mostly the economically active household members and thus has the potential to draw households into poverty and even deeper poverty for those already in a state of deprivation. When hit by HIV/AIDS, like any other shock, households will adopt coping mechanisms; but in Zimbabwe’s context of hyperinflation and economic instability, how viable are these livelihood strategies? The objectives of this study were to explore the livelihood strategies that urban households resort to in response to the effects of HIV/AIDS in Zimbabwe; and to assess the feasibility of these strategies in the context of the country’s current socio-economic turmoil. A qualitative methodology making use of ethnographic techniques such as semistructured individual interviews, focus group discussions and observations was employed to gather this data. Results indicate that households are limited in livelihood options due to underlying structural problems such as hyperinflation, resource and cash shortages as well as market failure. Households engaged in livelihood strategies such as use of savings, the sale of assets and commercial sex work. / Thesis ((M.A.)-University of KwaZulu-Natal, Durban, 2009.