M.Cur. / HIV and AIDS education as a prevention strategy is priority number one in the National Strategic Plan for South Africa. Prevention of illnesses is also an integral part of primary health care (Department of Health, 2007: 10). There are different role players offering age-appropriate HIV and AIDS education to primary school learners, such as educators (within the Life Orientation programme), school health nurses (as part of health promotion) and non-governmental organisation (NGO) peer educators who visit schools per invitation or as part of their programme. Knowledge of collaboration amongst different role payers is necessary in order to pool the complementary strengths and maximise the positive impact of education on adolescents’ sexual behaviour. The design used in this research is quantitative and descriptive in nature. The respondents were clustered according to categories, namely school health nurses, primary school educators and NGO peer educators. As school health nurses (n=8) and peer educators (n=15) constituted a small population, they were all included in the study. Systematic random sampling was used to select respondents from the population of educators (N=75: n=42). A developed questionnaire was distributed to the consenting respondents who met the inclusion criteria. A checklist was also developed to review policies and guidelines used as a framework for providing HIV and AIDS education to learners by role players. A pilot study was conducted. The Statistical Package for Social Science (SPSS14.0) for Windows was used to analyse the data.

M.Cur. / The HIV/AIDS pandemic is posing major challenges to all sectors in South Africa, including the Health sector of the City of Johannesburg. The Health sector of the City of Johannesburg, as a result of the pandemic, is faced with increasing demands on its scarce resources at a time of major reform at local government level including transformation of the health sector. The inhabitants of the City of Johannesburg are particularly vulnerable to high levels of HIV/AIDS infection because of job prospects in the city, a good transport infrastructure, high levels of mobility of the community, the existence of single sex-hostels, marginalised communities living in informal settlements, poverty income inequality. An increase in the prevalence of HIV/AIDS is inevitable, unless a concerted effort is established to curtail the spread of the disease. An impact analysis conducted, revealed that already in the year 2000 an estimated 168 921 HIV infected persons were living in the city (City of Johannesburg, 2001 :21). In high-risk groups, such as attenders to services for the treatment of Sexually Transmitted Infections (STls), prevalence rates as high as 53% among females, and 35.8% among male persons were recorded (SAIMR, 2000:1). The City of Johannesburg, a local government structure, has not formally adopted a strategic plan to address the pandemic. The national and proVincial governments have responded to the pandemic and their 3-5 year strategic plans are known and pUblished. In spite of the absence of an official strategic plan to address the pandemic in the City of Johannesburg, the political will and strategic intentions to address the pandemic have been declared by management. Although all sectors of the City are affected, it is generally assumed that the Health sector would assume the leading role in addressing the pandemic. The objective of this study has thus been to explore and describe a strategy for the management of HIV/AIDS by the Health sector of the City of Johannesburg. The question presented for research was formulated as follows: " What strategy should be adopted by the Health sector of the City of Johannesburg to manage the HIV/AIDS pandemic in future?" An exploratory, descriptive and quantitative research design was utilised. The strategy for the management of HIV/AIDS was formulated according to the UNAIDS "Guide to the strategic planning process for a national response to HIV/AIDS" (1998), and the content validity was determined according to Lynn (1986) "Determination and quantification of Content Validity".

There is an escalation of HIV and AIDS among the youth in South Africa and other developing countries. Research on HIV and AIDS risk factors has tended to focus more on poverty, gender, race, illiteracy, and violence than personality factors that could influence an individual` s health-protective behaviour. Previous studies have also shown that wealth, education, race, and gender may not make an individual more or less vulnerable to HIV infection. This study argued that locus of control could influence an individual` s health-protective behaviour and that external locus of control could be a risk factor in HIV and AIDS risk reduction. The aim of this study was to investigate the efficacy of a locus of control-based training programme in reducing HIV and AIDS risk among university students. The locus of control-based variables that formed the training programme for HIV and AIDS risk reduction among university students were: social systems control, self-control, fatalism, achievement-oriented behaviour, deferment of gratification, personal values and expectancies, and social alienation. These locus of control-based variables were regarded as contexts in which individuals could exhibit health risk behaviours. A sample of 257 first-year university students participated in the study. There were (N = 170) female participants and (N = 87) male participants drawn from the University of the Witwatersrand. The study was a pretest-posttest repeated measures design. Data were analysed using t tests, correlations, multiple regression, structural equation modelling, and repeated measures tests. The results of this study showed significant differences in health risks between participants with an external locus of control and participants with an internal locus of control. There was a significant relationship between locus of control-based variables and HIV and AIDS risk. The locus of control-based training programme significantly modified personality and significantly reduced locus of control-based health risks and HIV and AIDS risk. Directions for future research on locus of control, health risks, and HIV and AIDS risk could focus on the development and implementation of various locus of control-based training programmes in South Africa. Locus of control should be targeted as a health risk factor in HIV and AIDS risk reduction training programmes.

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. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

A dissertation submitted in partial fulfillment of the requirements for the Degree of Applied Master of Arts in the Department of Psychology, Faculty of Arts at the University of Zululand, 2000. / This study was aimed at describing levels of AIDS knowledge, HIV infection and risk reduction, attitudes towards AIDS and people with AIDS (PWAs), sexual behaviour, condom use as well as attitudes, beliefs and perceptions about condoms, the impact which perceived norms and self-efficacy have on condom use, sexual behaviour and AIDS preventative behaviour(APB). Results of the study have shown that knowledge levels were high among Zululand university students. A comparison of the different sexes shows that females had a slightly higher level of knowledge than males. The three most popular choices identified as sources of AIDS knowledge were campus health, clinic/doctor and a friend. The majority of the sample was negative, rejecting and intolerant with regard to the proximity to PWAs. Many also held judgemental, fatalistic and moralistic attitudes with regard to AIDS and PWAs. Half of the respondents showed compassion with regard to the legal and social welfare of PWAs. The majority of the sample was sexually active, with a substantial number of subjects engaging in sexual intercourse with multiple partners. Condoms were least used among this latter group and only a third used condoms consistently. However, the majority intended to use condoms in future sexual encounters and this intention was stronger among students with one sexual partner. The Pearson product moment correlation revealed that attitudes, perceived norms and self-efficacy were associated with condom use and sexual behaviour. Knowledge of AIDS per se had no impact on sexual behaviour and condom use. The multiple regression analysis showed that attitudes and self-efficacy are the strongest predictor variables of condom use. Finally gender had no effect on sexual activity, number of sexual partners, condom use, perceived norms and self-efficacy.

No description available.

Background. In the United States, adolescents are the age group least likely to be aware of their HIV infection and linked to care in a timely manner, contributing to disproportionately low rates of viral suppression and increased risk of transmitting HIV to others. A major barrier to health care for adolescents relates to confidentiality concerns, such as fears that parent/guardian consent will be required or that parents, guardians, or others will be informed of test results. This suggests that state laws related to confidentiality in sexual and reproductive health services could influence their HIV testing practices. Guided by Andersen’s Behavioral Model of Health Services Use, this dissertation utilizes a large, representative sample of sexually active high school students from the 2019 state-level Youth Risk Behavior Surveillance System (YRBSS) to investigate the potential impact of five state-level confidentiality-relevant laws on U.S. adolescents’ HIV testing practices. Methods. Data on HIV testing and individual characteristics (i.e., potential individual-level confounders/covariates) were aggregated from 25 states that participated in the 2019 state-level YRBSS. Data on contextual characteristics (i.e., potential state-level confounders/covariates) were obtained from the United States Census Bureau and the Behavior Risk Factor Surveillance System. Information about state-level confidentiality-relevant laws was compiled from the Guttmacher Institute and the Center for HIV Law and Policy to create five variables indicating whether state laws were confidentiality-promoting at the time of the 2019 state-level YRBSS. Multilevel logistic regression was used to test the following hypotheses: 1. After adjusting for individual and contextual characteristics, confidentiality-promoting state laws will be positively associated with HIV testing among sexually active U.S. high school students, such that odds of self-reported lifetime HIV testing will be significantly higher when states (a) explicitly allow minors to consent to HIV testing, (b) do not have age of consent requirements, (c) do not permit parental/guardian notification, (d) protect the confidentiality of minors insured as dependents, and (e) do not have HIV-specific criminal laws that require disclosure to sexual and/or needle-sharing partners, as compared to states with non-confidentiality-promoting laws. 2. After adjusting for individual and contextual characteristics, sex will moderate the relationship between state-level confidentiality-relevant laws and HIV testing among sexually active U.S. high school students, such that associations between confidentiality-promoting state laws and self-reported lifetime HIV testing will significantly differ between males and females. 3. After adjusting for individual and contextual characteristics, young men who have sex with men (YMSM) status will moderate the relationship between state-level confidentiality-relevant laws and HIV testing among sexually active male high school students, such that associations between confidentiality-promoting state laws and lifetime HIV testing will be significantly stronger among males who report same-sex sexual contact than among males who report opposite-sex sexual contact only. Results. Findings supported the first hypothesis that parental notification not being permitted would be positively associated with HIV testing among sexually active U.S. high school students. After adjusting for individual (i.e., sex, grade level, race/ethnicity, sexual identity) and contextual (i.e., percentage of the state population aged 25 and older with a high school diploma or higher, median household income, lifetime HIV testing among adults) characteristics, odds of self-reported lifetime HIV testing were significantly higher in states that do not permit parent/guardian notification (adjusted odds ratio [aOR]: 1.07; 95% confidence interval [CI]: 1.04-1.11; p<.001) than in states that allow health care providers to inform parents or guardians that their child is seeking or receiving STI services. However, results did not support the hypothesis that the other confidentiality-promoting state laws would be positively associated with HIV testing among sexually active U.S. high school students; as compared to states with non-confidentiality-promoting laws, odds of self-reported lifetime HIV testing were significantly lower in states that explicitly allow minors to consent to HIV testing, do not have age requirements to consent to HIV testing, and do not have HIV-specific criminal laws that require disclosure. Results supported the second hypothesis that sex would moderate the relationship between state-level confidentiality-relevant laws and HIV testing among sexually active U.S. high school students, as associations between confidentiality-promoting state laws and lifetime HIV testing differed significantly between males and females. After adjusting for individual and contextual characteristics, the effects of living in a state without age requirements or HIV-specific criminal laws with disclosure requirements on lifetime HIV testing for females were 1.53 (CI: 1.07-2.20; p=.020) and 1.56 (CI: 1.16-2.10; p=.003) times those of males, respectively. Meanwhile, the effects of state laws that explicitly allow minors to consent to HIV testing, do not permit parental notification, and protect the confidentiality of minors insured as dependents on lifetime HIV testing for females were 0.73 (CI: 0.55-0.96; p=.025), 0.72 (CI: 0.52-0.99; p=.043), and 0.66 (CI: 0.48-0.90; p=.008) times those of males, respectively. Analyses with these data failed to reject the null hypothesis for the third [alternative] hypothesis that associations between confidentiality-promoting state laws and self-reported lifetime HIV testing would be significantly stronger among sexually active males who report same-sex sexual contact than among males who report opposite-sex sexual contact only. Conclusions. Findings provide evidence that parental notification not being permitted is associated with significantly increased odds of lifetime HIV testing among sexually active U.S. adolescents, and that sex differentially affects associations between state-level confidentiality-relevant laws and sexually active U.S. adolescents’ HIV testing practices. Parental/guardian notification not being permitted may increase access to and utilization of HIV testing among sexually active U.S. adolescents. Furthermore, confidentiality-promoting laws – particularly those that explicitly include HIV testing in the package of STI services to which minors may consent, do not permit health care providers to notify parents/guardians that their child is seeking or receiving STI services, and protect the confidentiality of minors insured as dependents – may facilitate access to and utilization of HIV testing for sexually active male adolescents. Altogether, this dissertation provides compelling preliminary evidence for efforts to better understand and address structural determinants of HIV and HIV prevention among sexually active U.S. adolescents. Results underscore the need for a comprehensive, multi-level approach to adolescent HIV prevention that goes beyond a focus on reducing individual-level risk factors to increase protective factors at the structural level (e.g., confidentiality-promoting state laws). To address HIV-related health inequities among young people in the United States, advocates must fight for the passage of state laws that protect adolescents’ right to confidential sexual and reproductive health care.

Since early 1983, the incidence and prevalence of heterosexually transmitted AIDS among women have increased at an alarming rate. However, due to the conceptualization of AIDS as a "gay male" disease, little research attention has been devoted to the prevention of HIV infection among women. The purpose of the current intervention was to test the utility of extending a behavioral social influence/diffusion of innovation approach to a group of heterosexual women. A randomized experimental field design was used to compare a community intervention (AIDS education materials plus the training of individuals identified as key opinion leaders to serve as peer behavior change agents) with a comparison intervention (AIDS education materials alone). The study was conducted at a small liberal arts college for women. Two dormitories were randomly assigned to either an intervention or comparison condition. Twenty-four women, living in the intervention dormitory, were identified as key opinion leaders among their female peers. These key opinion leaders then received information concerning the basic epidemiology of AIDS and other STDs, misconceptions about the transmission of AIDS/STDs among heterosexual women, gender constraints that impact health behavior change among women, and practical risk reduction strategies. Opinion leaders also received training in specific conversation skills to endorse HIV-protective behavior and to convey a change in normative sexual behavior to women living in the intervention dormitory. At pre- and post-intervention, 580 surveys were collected from both the intervention and comparison dormitories. Using an anonymous identification code, survey data were matched for 192 comparison and intervention participants. The major dependent variables included (a) AIDS/STD risk behavior knowledge, (b) perceived risk, (c) perception of peer norms for HIV-risky and HIV-protective behaviors, (d) stage of health behavior change, (e) intentions to practice safer sex, (f) socially and sexually assertive behavior, (g) HIV-risky sexual behavior, and (h) alcohol and drug use. Condom-taking behavior provided a nonreactive measure of behavioral intentions. A number of direct training effects were found for the key opinion leaders, including an increase in AIDS/STD risk behavior knowledge, conversation skills, and empathic assertion. However, there was no change in behavioral intentions, stage of change, perceptions of peer norms for HIV-protective behavior, or reported HIV-risky behavior. Analysis of covariance on posttest scores, using pretest scores as covariates, showed that, relative to the comparison participants, the intervention participants increased their AIDS/STD risk behavior knowledge and the number of AIDS/STD related peer conversations. No other treatment effects due to diffusion of innovation were found. The rate of risky sexual behavior for the intervention period was relatively low. However, descriptive statistics revealed a pattern of HIV-risky behavior in the current sample suggesting that HIV/STD risk may increase over time as a function of unprotected vaginal and oral intercourse and serial monogamy. The implication of these findings are discussed in terms of future interventions targeting heterosexual women. / Ph. D.

Thesis (MBA)--Stellenbosch University, 2006. / ENGLISH ABSTRACT: HIV/AIDS is one of the most devastating pandemics the world has ever faced. SubSaharan Africa remains the region most affected where more two thirds of the total HIV positive population resides. Despite this region trying to grapple with many negative factors like political unrest, draughts, armed conflict, it now also have to content with HIV/AIDS. HIV/AIDS has already killed ten times more Africans than all of the armed conflicts on the African continent combined (The Washington Quarterly, 2001:191-196). Many of the Sub-Saharan countries are renowned for unemployment and poverty which can be partly be alleviated by economic growth. Studies by Bonnel (2000) concluded that a typical Sub-Saharan country with a 20% HIV/AIDS prevalence rate, would suffer a 2.6% reduction in GDP growth per annum. This indicates that South Africa, where an estimated S.5 million HIV positive people resides (the most in globe) and ever increasing HIV prevalence, is in a serious predicament. There are many interacting variables causing the negative socioeconomic decline. At organisational level direct and indirect costs attributable to HIV, results in a severe decline of profitability and jeopardises sustainable economic activity. Direct costs include costs for medical treatment, health insurance, funeral expenses, retirement and disability and costs to manage HIV in the workplace. Indirect costs include absenteeism and loss of productivity, retraining and recruiting of employees to fill deceased employees' places etc. Although South African organisations acknowledge and predict that HIV/AIDS will have an ever-increasing negative impact on their business, the response to dealing with this issue has been insufficient. The deficient response could be partly ascribed to a lack of guidance, deficient proof of cost effectiveness with no real measurement for the outcomes of intervention programs. This study will critically evaluate a KAPB (knowledge, attitude, perception and behaviour) survey as a second-generation HIV surveillance tool that could address these organisational concerns. KAPB surveys have advantages like providing guidance and increasing cost effectiveness of HIV programs, benchmarking interventions and providing a platform for communication design and feedback to stakeholders. These benefits should motivate organisations to initiate programs that address HIV at an organisational level. KAPB surveys evaluate four employee factors related to HIV - knowledge, attitudes, perception and sexual behaviour. This report will critically evaluate the appropriateness of measuring these factors and some tools used to measure these factors. Further elaboration of the methodology during the execution of a KAPB survey will highlight the current best practices identified in literature. The report will also highlight the obstacles and ways of negotiating them when conducting a KPAB survey. The study will conclude that a well -executed KAPB survey through its many benefits should motivate and assist organisations in designing and implementing HIV/AIDS programs. / AFRIKAANSE OPSOMMING: HIV is een van die ernstigste pandemies wat die wereld al ooit beleef het. Die state in die Sub-Sahara streek is die ergste geaffekteer en meer as twee derdes van die totale HIV positiewe populasie kom in die gebied voor. Die streek wat deurgaans geteister word deur politieke onrus, droogte, oorlog, moet nou ook probeer tred hou met MIV /VIGS. MIV/VIGS het tot op hede alreeds tien keer meer mense gedood as al die oorloë op die Afrika continent saam (The Washington Quarterly, 2001: 191-196). Die meeste van die state in Sub-Sahara word gekenmerk deur werkloosheid en armoede wat deels verlig kan word deur ekonomiese groei. Studies deur Bonnel (2000) het getoon dat die tipiese staat in Sub-Sahara, met 'n 20% MIV insidensie 'n vermindering van tot 2.6% groei in die GDP kan ondervind. Dit voorspel dat Suid-Afrika met 'n voorspelde 5.5 miljoen HIV positiewe inwoners (die meeste in die wereld) ekonomiese noodlot in die oog staar. Daar is verskeie faktore wat saamwerk om die negatiewe ekonomiese 'effek van MIV/VIGS te bewerkstellig. Organisasies se ekonomiese vooruitgang en oorlewing word bedreig deur direkte en indirect kostes van MIV. Direkte kostes wat organisasies moet aangaan sluit in mediese behandeling, mediese fonds bydraes, begrafnis onkostes, aftrede en ongeskiktheidspensioenbetalings. Indirekte kostes sluit in afwesighede, verlies aan produktiwiteit en die heropleiding en werwing van werknemers wat afgestorwe werknemers se plek moet neem. Ten spyte van die feit dat organisasies erken en voorspel dat MIV/VIGS 'n negatiewe impak op die ekonomies welvaart van organisasies sal hê, het weining van die organisasies aksie geneem om die probleem aan te spreek. 'n Moontlike rede vir die onvoldoende aksie kan toegeskryf word aan die tekort aan leiding, bewyse vir kostedoeltreffendheid en geen werklike maatstaf om die programme se resultate te evalueer. Hierdie studie sal KGPG (kennis, gevoelens, persepsie ' en gedrag) studies as 'n tweede generasie MIV opname, krities evalueer. KGPG studies bied verskeie voordele soos om leiding vir HIV programme te bied en verbeterde koste effetiwiteit van MIV programme te bewerkstellig. KGPG studies voorsien ook 'n maatstaf om MIV programme te evalueer en 'n kommunikaise platvorm tussen aandeelhouers. Hierdie voordele sal moontlik organisasies motiveer om aksie te neem en MIV in die organisasie aan te spreek. KGPG studies evalueer vier werknemer faktore met betrekking to MIV /VIGS. Die vier faktore is kennis, gevoelens, persepsie en seksuale gedrag. Die verslag sal die vier faktore krities evalueer vir toepaslikheid en ook fokus op die instrumente wat die faktore evalueer. Aanbevelings sal ook gemaak word ten opsigte van die korrekte en beste metodes wat gevold moet work tydens 'n KGPG studie. Die struikelblokke wat ondervind kan word tydens 'n KGPG studie asook hoe om dit te oorkom sal bespreek word. Die verslag sal bewys dat 'n KGPG studie wat uitgevoer word in Iyn met die beste praktyk baie waarde kan toevoeg tot organisasies ten opsigte van die beplanning en uitvoering van programme om MIV/VIGS te bekamp.

With the spread of the Human Immuno-Deficiency Virus and sexually transmitted diseases, it is extremely important for sexually active individuals to protect themselves properly if they decide to engage in sexual intercourse. Knowledge of HIV and the Acquired Immune Deficiency Syndrome has been associated with safer sexual practices, but knowledge alone does not totally explain risky sexual practices. This study examined how 154 college students' knowledge of HIV/AIDS, relationship status, perceptions of condom use, and perceptions of personal risk affect condom use during sexual intercourse. The impact of trust and love justifications along with the approval of peers were also examined. Perceptions of condom use and perceptions of personal risk were compared by gender and ethnicity; how perception of personal risk is related to condom use and condom use intentions was also examined. Condom use intention was found to be a significant predictor of condom use, and a significant difference of means for condom use intentions was reported between individuals who used condoms during their last experience with sexual intercourse and those who did not use condoms during their last sexual experience