介紹 / 愛滋病在中國男男性行為者中的流行持續增長，而新感染HIV的男男性行為者扮演著重要角色。本民族志研究採用了社會生態模式來探討與新感染HIV的男男性行為者中HIV二代傳播、心理健康、以及使用健康服務相關的問題。研究方法包括深入訪談、焦點小組訪談、非正式訪談和參與觀察。此外還採訪了志願者和醫護人員。資料分析採用主題內容分析法。 / 結果 / 在確診為HIV呈陽性後，大多數的男男性行為者經受過一定程度的心理及精神上的問題。與HIV相關的緊張性刺激影響著他們適應這個確診。HIV與一些重要的心理、社會和文化的條件呈現一種綜合流行。而大多數的男男性行為者通過自身的應變能力逐漸康復，其中一些人甚至體驗到某種程度的成長。人的應變能力是一種基於個人與環境互動的建構。 / 11名（占24.4%）HIV呈陽性的男男性行為者報告發生過無保護的肛交行為。基於性伴侶的不同類型，與無保護肛交行為相關的因素則有所不同。這些無保護的肛交行為往往同時伴隨著物質濫用、對風險的錯誤認識、以及消極的情緒或者心理和精神問題。阻礙無保護肛交行為發生的積極因素包括社會支援、自我保健、自我保護和志願服務。 / 自上而下的公共衛生服務傾向於控制和檢測而不是賦權于男男性行為人群，並且在很大程度上忽視了新感染HIV的男男性行為者的心理和精神健康、性健康、以及自我保健的能力。新感染HIV的男男性行為者的未滿足的需求已經被識別，且他們更願意到男男性行為人群的社區，尤其是感染者小組那裏去尋求服務和支援。但男男性行為人群的草根組織卻缺乏資金和技術的支持。 / 結論 / 新感染HIV的男男性行為者所遭遇的問題都植根於特定的個人際遇以及他們所生活的社會生態系統。是時候採取一種廣泛而綜合的“健康同志社區的觀點、促進自我保健的策略、以及具有文化敏感性和社會效能的措施來預防HIV的二代傳播以及促進新感染HIV的男男性行為者的社會福祉。人類行為的非線性的特徵要求愛滋病健康行為研究從強調生物行為的範式轉移到著重愛滋病的社會根源的範式中來。 / Introduction / Newly diagnosed HIV positive men who have sex with men (NHIVMSM) play an important role in accelerating the high HIV prevalence in China. This ethnographic study, employing a modified social ecological model integrating concepts of adaptation, cognition, affect and action, investigated the inter-related issues on secondary HIV transmission, mental health and services utilization in this population. Methodologies included in-depth interviews, focus groups, informal interviews and participant observations. Moreover, information was also obtained from volunteers and health care workers. Thematic content analysis was performed. / Results / Most respondents commonly experienced psychological or mental health problems (e.g. depressive symptoms and anxiety) after their HIV diagnosis. HIV stressors, such as constraints of being HIV positive, limited information and knowledge of HIV/AIDS, ART and its side effects, associated co-morbidities and significant costs in health care, appeared to shape their adaptation to the diagnosis. Moreover, a syndemic was apparent among NHIVMSM and some influential psycho-social and cultural conditions, such as adversities in their migrants’ life, social suffering as MSM, cultural trauma, stigma and discrimination. Most respondents drew on a range of personal resilience strategies and some respondents testified to have achieved post-traumatic growth. Resilience was presented within a person-situation interactional construct. / Eleven (24.4%) respondents reported practicing unprotected anal intercourse (UAI). Several respondents reported their UAI had occurred in the first few months after their diagnosis when they suffered considerably from uncertainty, perceived stigma and identity struggles. Factors associated with UAI were based on differing partner types, such as fear of losing partners in a context of non-serostatus disclosure in lovers or stable partners, tongzhi (gay) sauna setting and moral judgment in casual partners, and poor economic status in commercial partners. UAI usually happened simultaneously in context of substance use, risk misconceptions, encountering negative emotion or mental health problems. Positive factors against UAI included social support, self-care, self-protection and volunteerism. / The current top-down public health services tended to operate on control and surveillance instead of empowering MSM. This approach largely ignored psychological and mental health, sexual health and self-care capacities among NHIVMSM, whose unmet needs were identified as preferring to obtain services and support from MSM and/or PLWH communities. However, current MSM organizations lacked funding and technical support. Health care providers operated with suboptimal care protocols, training and technical support. Coordination and collaborations among health care institutes and MSM communities were relatively weak. Tailored participatory health care is warranted, such as volunteerism, greater involvement of PLWH, health navigators and building supportive environment and services. / Conclusions / The problems of psychological and mental health, risky sexual behavior (UAI) and health services utilization that NHIVMSM encountered resulted from interactions between personal experiences and the social ecological systems they inhabited. Recommendation drawn include adopting a comprehensive and inclusive “healthy MSM community“ approach and a strategy of facilitating self-care to carry out culturally sensitive and socially effective measures to prevent secondary HIV transmission and to promote wellbeing among NHIVMSM. An emerging theoretical implication is that the nonlinearity of human behaviour requires paradigm shifting from a bio-behavioural emphasis to the social origin of HIV/AIDS. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Li, Haochu. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 425-457). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; appendixes includes Chinese. / Abstract (English) --- p.iv / Abstract (Chinese) --- p.vii / Acknowledgements --- p.ix / Table of Contents --- p.xi / List of Tables and Figures --- p.xv / Glossary --- p.xvi / Abbreviation --- p.xviii / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Background --- p.1 / Chapter 1.1.1 --- High HIV prevalence and incidence among MSM in China --- p.1 / Chapter 1.1.2 --- Social and cultural environment faced by HIV positive MSM --- p.3 / Chapter 1.2 --- Sexual risk and secondary HIV transmission among HIV positive (and newly diagnosed) MSM --- p.7 / Chapter 1.3 --- Psychological and mental health among HIV positive (and newly diagnosed) MSM --- p.10 / Chapter 1.4 --- Health service utilization among HIV positive (and newly diagnosed) MSM --- p.13 / Chapter 1.5 --- Exploring complexities of secondary HIV transmission through qualitative studies --- p.14 / Chapter 1.6 --- Theories, concepts and the research framework --- p.15 / Chapter 1.6.1 --- Conceptualization of adaptation in medical anthropology --- p.15 / Chapter 1.6.2 --- The social ecological model --- p.17 / Chapter 1.6.3 --- Cognitive adaptation and self-control --- p.19 / Chapter 1.6.4 --- Emotion and motivation are influential in health behaviour --- p.21 / Chapter 1.6.5 --- Action world and its role in health behaviour --- p.24 / Chapter 1.6.6 --- Social control/social order --- p.26 / Chapter 1.6.7 --- Stigma --- p.27 / Chapter 1.6.8 --- Identity control --- p.29 / Chapter 1.6.9 --- Research framework --- p.32 / Chapter 1.7 --- Goals, objectives and research questions --- p.34 / Chapter Chapter 2 --- Methodology --- p.38 / Chapter 2.1. --- Entrée into the field --- p.38 / Chapter 2.1.1 --- The start of the research --- p.38 / Chapter 2.1.2 --- Pilot work --- p.39 / Chapter 2.2 --- The participants --- p.43 / Chapter 2.3 --- Data collection --- p.50 / Chapter 2.4 --- Data analysis --- p.58 / Chapter 2.5 --- Rigour --- p.62 / Chapter 2.6 --- Reflexivity --- p.68 / Chapter 2.7 --- Ethical considerations --- p.75 / Chapter Chapter 3 --- Social circumstances and MSM communities in Shenzhen --- p.78 / Chapter 3.1 --- Population and economic circumstances --- p.78 / Chapter 3.2 --- Shifting political situation --- p.80 / Chapter 3.3 --- A migrant society --- p.87 / Chapter 3.4 --- Shenzhen Culture --- p.93 / Chapter 3.5 --- MSM community and tongzhi subculture --- p.98 / Chapter 3.6 --- The subgroup of HIV positive MSM --- p.113 / Chapter 3.7 --- Public health implications --- p.117 / Chapter Chapter 4 --- Health care system and services related to HIV case detection and follow up --- p.118 / Chapter 4.1 --- Formal health care system --- p.118 / Chapter 4.2 --- Health insurance --- p.125 / Chapter 4.3 --- “Four Free and One Care“ policy --- p.126 / Chapter 4.4 --- Informal health care --- p.127 / Chapter 4.5 --- Services related to HIV case detection and follow up --- p.131 / Chapter Chapter 5 --- Psychological and mental health --- p.142 / Chapter 5.1 --- Negative mental health outcomes --- p.142 / Chapter 5.1.1 --- Depressive symptoms --- p.142 / Chapter 5.1.2 --- Anxiety symptoms --- p.146 / Chapter 5.1.3 --- Factors associated with negative mental health outcome --- p.150 / Chapter 5.1.3.1 --- Individual factors --- p.150 / Chapter 5.1.3.2 --- Interpersonal factors --- p.157 / Chapter 5.1.3.3 --- Cultural factors in community and family --- p.160 / Chapter 5.1.3.4 --- Institutional and structural factors --- p.163 / Chapter 5.2 --- Positive mental health outcomes --- p.166 / Chapter 5.2.1 --- Integrating negative experiences and recovery --- p.166 / Chapter 5.2.2 --- Resources for recovery --- p.169 / Chapter 5.2.3 --- Back to normal functioning --- p.170 / Chapter 5.2.4 --- Post-traumatic growth --- p.172 / Chapter 5.2.5 --- Factors associated with positive mental health outcome --- p.175 / Chapter 5.2.5.1 --- Individual factors --- p.175 / Chapter 5.2.5.2 --- Interpersonal factor --- p.181 / Chapter 5.2.5.3 --- Community-related factors --- p.184 / Chapter 5.2.5.4 --- Institutional factors --- p.187 / Chapter 5.3 --- Public health concern of suicidal ideation --- p.190 / Chapter 5.4 --- Impacts of psychological and mental health --- p.194 / Chapter 5.5 --- Summary of psychological and mental health in a modified socio-ecological mode --- p.195 / Chapter 5.6 --- Discussion --- p.197 / Chapter 5.6.1 --- The emerging of a syndemic in HIV and some psycho-social and cultural conditions --- p.197 / Chapter 5.6.2 --- Powerful social and cultural factors associated with mental health --- p.200 / Chapter 5.6.3 --- Resilience among newly diagnosed HIV positive MSM --- p.208 / Chapter 5.6.4 --- Service implications --- p.213 / Chapter Chapter 6 --- Sexual risk --- p.221 / Chapter 6.1 --- Continued unprotected anal intercourse (UAI) after being diagnosed HIV positive --- p.221 / Chapter 6.2 --- Changes in practising UAI during the study period --- p.222 / Chapter 6.3 --- Factors associated with UAI with non-commercial sex partners --- p.224 / Chapter 6.3.1 --- Individual factors --- p.225 / Chapter 6.3.2 --- Interpersonal factors --- p.229 / Chapter 6.3.3 --- Community-based factors --- p.231 / Chapter 6.3.4 --- Institutional factors --- p.234 / Chapter 6.4 --- UAI with commercial sex partners --- p.235 / Chapter 6.5 --- Comparing factors associated with UAI among commercial and non-commercial partners --- p.238 / Chapter 6.6 --- Reduced risky behaviour after diagnosis --- p.239 / Chapter 6.7 --- Factors associated with condom use --- p.241 / Chapter 6.7.1 --- Individual factors --- p.241 / Chapter 6.7.2 --- Interpersonal factors --- p.246 / Chapter 6.7.3 --- Community factors --- p.248 / Chapter 6.8 --- Other special issues related to risky sexual behaviour --- p.250 / Chapter 6.9 --- Summary of sexual risk in a modified socio-ecological model --- p.261 / Chapter 6.10 --- Discussion --- p.263 / Chapter 6.10.1 --- Prevalence of UAI --- p.263 / Chapter 6.10.2 --- Partner types and UAI --- p.265 / Chapter 6.10.2.1 --- Fear of losing partners in a context of non-serostatus disclosure --- p.266 / Chapter 6.10.2.2 --- Anonymous sexual encounters and moral judgment --- p.267 / Chapter 6.10.2.3 --- Economic barriers --- p.270 / Chapter 6.10.2.4 --- Intrapersonal contexts --- p.271 / Chapter 6.10.3 --- Critical views on some practices --- p.274 / Chapter 6.10.4 --- Emerging positive experiences from Shenzhen --- p.276 / Chapter 6.10.5 --- Service implications --- p.279 / Chapter Chapter 7 --- Health service seeking --- p.285 / Chapter 7.1 --- Problems identified in health service seeking --- p.285 / Chapter 7.2 --- Processes of adaptation --- p.289 / Chapter 7.3 --- Negative factors associated with health service seeking --- p.296 / Chapter 7.3.1 --- Individual factors --- p.296 / Chapter 7.3.2 --- Interpersonal factors --- p.302 / Chapter 7.3.3 --- Community-based factors --- p.304 / Chapter 7.3.4 --- Health care institution-based factors --- p.309 / Chapter 7.4 --- Positive factors associated with health service seeking --- p.319 / Chapter 7.4.1 --- Individual factors --- p.319 / Chapter 7.4.2 --- Interpersonal factors --- p.321 / Chapter 7.4.3 --- Community-based factors --- p.325 / Chapter 7.4.4 --- Factors in the health care institutes--free services --- p.328 / Chapter 7.5 --- Summary of health service seeking in a modified socio-ecological model --- p.329 / Chapter 7.6 --- Discussion --- p.331 / Chapter 7.6.1 --- Problems in health care institutes --- p.331 / Chapter 7.6.1.1 --- The top-down approach -- controlling instead of community building --- p.331 / Chapter 7.6.1.2 --- Problems among health care providers --- p.335 / Chapter 7.6.2 --- Tailored participatory approach to health care and education for HIV positive MSM --- p.339 / Chapter 7.6.3 --- Necessity for developing MSM communities --- p.342 / Chapter 7.6.4 --- Service implications --- p.349 / Chapter Chapter 8 --- Discussion and implications --- p.355 / Chapter 8.1 --- The occurrences of UAI and its hidden meaning --- p.355 / Chapter 8.2 --- Informing the future HIV epidemic among MSM in Shenzhen --- p.357 / Chapter 8.3 --- Difficulties of controlling the HIV epidemic among MSM --- p.361 / Chapter 8.4 --- New HIV prevention approach --- p.368 / Chapter 8.5 --- Critiquing theories for recommended changes --- p.386 / Chapter 8.6 --- Limitations of the study --- p.400 / Chapter 8.7 --- Conclusion --- p.405 / Appendix I to IX --- p.409 / Bibliography --- p.425

M. Tech. Marketing / Describes the level of awareness of HIV/AIDS, exposure to information, accessibility to condoms and sexual conduct of inhabitants of Kinshasa regarding HIV/AIDS issues under the scrutiny of HIV social marketing campaigns. Secondly, the study aims at investigating the relationships between level of awareness of HIV/AIDS, exposure to information, accessibility to condoms, poverty/equity and sexual conduct amongst the inhabitants of Kinshasa. Thirdly, it intends to determine the difference between groups with regard to gender, age and socio-economic status.

This study is concerned with corporate policy on IllV/AIDS. This was investigated by speaking to key-informants from fifteen enterprises in KwaZulu Natal. They were asked about their policies and programmes and what they had put in place to combat this epidemic. The rational choice model was used as a framework for analysis ofthe policies. This model is discussed in the first part ofthe study and was chosen as it seems to reflect the dominant policy outlook in South Africa and may shape the way that organisations .respond. The second part of the project is the report and discussion of the findings. It is a presentation ofthe responses given by the key informants regarding their perceptions and understanding of the problem of IllV/AIDS as well as the policies .of their companies regarding the same. Mostofthe companies in the study did not have policies specific to. IDV/AIDS. Some had general guidelines and treated HIV/AIDS as any major illness. There seemed to be denial, especially among the management, of the seriousness of the disease despite evidence ofits significant impact within the various organisations. There were few to no resources set aside formv/AIDS programmes and interventions and this seems important in defining the IllV/AIDS problem as one of the future rather than the present In the third part of this project, the theoretical framework and the findings were linked. There was an attempt to answer the question ofhow rational the policy process is within the companies in the study and .whether the responses of these organisations can be understood in the context ofthe rational choice model. It seems that this model does aid in understanding of the policy process when there is a realisation· that it interacts with other human mctors to create what we observe. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2001.

In South Africa, both the number of people entering prison, and the number of people infected with HIV, are steadily increasing. While reliable statistics are not available on the number of HIV+ prisoners, the characteristics of the typical prisoner are those of a demographic group at high risk for HIV infection. As a result, many prisoners will already be HIV positive upon entering the prison. Additionally, the prison environment creates many situations of high risk behaviour for HIV transmission, which means there is also an as yet undetermined portion of inmates who will contract HIV while incarcerated. The current government policy is to provide HIV testing and condoms in conjunction with counselling, although poor design and implementation of this policy has limited its impact. In addition to issues of HIV infection and transmission, the government must address the needs of prisoners who have developed full-blown AlDS and will likely die as a result while imprisoned. AIDS is already the leading cause of death for prisoners in many countries, as well as in South Africa Adequate medical care, proper nutrition, and early release for those in the late stages of AIDS, are the international standards for minimum humane treatment of these prisoners. Today, crippling bureaucracy prevents the humanitarian release of dying· prisoners from South African prisons. Reliable data on the nature and extent of HIV/AIDS infection in South African prisons has yet to be obtained, owing to the closed nature of the prison administration. In order to design and implement effective policies, the secrecy surrounding the prison system must be eliminated so that further research and study may take place. Unlinked, anonymous HIV testing should be undertaken on a sample of the prison population so that accurate information and projections about HIV/AIDS in prison may become available. Until the government allows the issue to be quantified, the design and implementation of better policies will not be possible. The best HIV/AIDS policies are those which recognise the impact of prisoners' health on public health in general. Because the prisoner population consists of a core transmitter group, the pnson provides a critical intervention opponunity for the prevention of HIV infection in the greater community Further research on this issue should therefore focus on the evaluation, design, and implementation of intervention programs Intervention in the prison environment should include targeted education and use of existing gang structures to engender behavioural change The issues of HIV/AIDS in prison are compounded by issues of prison reform in general. The conditions in South Africa prisons are unconsitutional, and exacerbate the problems presented by HIV/AlDS. The most pressing problem in South African prisons is overcrowding; a problem which the Department of Correctional Services is all but powerless to address. Just as HIV/AIDS in the general community requires a multi-sectoral solution, so too does HIV/AIDS in the correctional setting. The Department of Correctional Services must re-evaluate both its policies and its entire policy making process in order to address HIV/AIDS in South African prisons. / Thesis (M.A.)-University of Natal,Durban, 2001.

This pilot study aimed to contribute to the development of a methodology for researching various aspects of the relationship between HIV/AIDS and suicide in South Africa. To date, few systematic studies into this relationship have been conducted in South Africa. Specifically this study investigated the aspect of suicidal ideation in relation to HIV seroposivity, CD4 cell counts and social support. Although this study did not find increased suicidality in this sample of people living with HIV, the findings highlighted variables that may need to be studied in greater depth and outlined suggestions for further research methodology. Further research could indicate the extent to which suicide assessment and counselling is needed for people living with HIV/AIDS. This in turn could inform policy makers as to the inclusion of suicide assessment into the protocol for Voluntary Counselling and Testing (VCT). / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

This study explores the subjective experiences of persons who have been informed of a positive HIV antibody test and, from their point of view, explains the meaning and impact that HIV discovery has on their quality of life. In this qualitative narrative study, a racially specific, low-income sample of 10 HIV-infected men and women shared their stories of living with the virus during in-depth interviews. Findings of a multi-staged narrative analysis suggest that for people like those in this study, stigma associated with mv infection results in the concealment of the diagnosis by the individual for fear of being labeled as deviant from the rest ofthe community. Secondly, the tragic manner in which these respondents narrated HIV discovery signifies the negative impact the disease has on their quality of life. Lastly, there is evidence for the effectiveness ofthe primary health-care services on the HIV positive patients. Implications for these findings are elaborated. / Thesis (M.Soc.Sc.)-University of Natal, Pietermaritzburg, 2000.

This thesis is an analysis of a creative design HIV/AIDS communication programme named Siyazama (we are trying) that works in association with rural traditional beaded cloth doll makers from KwaZulu-Natal province in South Africa. As a reflective thesis it represents a hermeneutic opportunity to ascertain the extent to which an interdisciplinary programme of HIV/AIDS education and training impacted on the lives of the women involved and how their expert skills of craftswomen were employed to understand and address the growing HIV/AIDS epidemic. What began in 1996 on invitation from the African Art Centre in Durban as a simple intervention to upgrade craft techniques and craft construction developed of its own accord into a unique HIV/AIDS intervention in 1999. The communication mode in which the rural women were skilled - beadwork - was long used by women in KwaZulu-Natal as a mode of communication to circumvent the Zulu cultural taboo on discussion of matters of emotional and sexual intimacy called hlonipha. In the modern era of HIV/AIDS, this same mode has been revived and reworked as a means for affecting communication about the many sensitive and taboo issues that surround this disease. There is much scientific evidence which points to the fact that women in this part of the world are far more susceptible than men to HIV infection, largely due to their lower social status, their economic dependence on men and their need to manage the large-scale poverty that affects them and their families. All of this contributes to increasing their vulnerability to AIDS. Ethnographic analysis of the experience of HIV/AIDS amongst Zulu-speaking craftswomen in KwaZulu-Natal has also revealed the nature of the complex cultural belief system that is alive and articulated in the local art and AIDS interface. This thesis describes the myriad ways in which a particular group of rural women of KwaZulu-Natal, owing to certain customary prescriptions, appear as largely silenced on sexual and sensitive relationship issues. Yet, their expert abilities in beadwork have afforded these women the opportunity to express innermost concerns about the epidemic in three dimensional forms. The historical record of KwaZulu-Natal shows us how beadwork was often used traditionally by women to take the place of speaking. The Siyazama Project beadwork exhibit, comprising over 300 pieces of individual beaded artifacts and collected between 1999 and 2005, provides verification of the continued existence of this form of expression. It is an archive of the fields of inquiry which were covered in the Siyazama educational programme starting with 'breaking the silence on AIDS' in 1999 and ending with anti-retroviral therapies (ART) in 2005. The relationship between the beaded crafts and the AIDS educational information which was received during the course of the Siyazama AIDS educational programme is explained through an analysis of this beaded collection. As an in depth qualitative study of the experiences and impact of the HIV/AIDS intervention with women beadworkers from rural communities in KwaZulu-Natal, this thesis represents an attempt to account for how a creative design HIV/AIDS communication programme has impacted on the lives of the women reached by the programme, and how their skills as craftswomen have been utilized to make sense of the local HIV/AIDS epidemic whilst raising awareness about AIDS in their communities. The overall aim of the study is to interpret the effect and effectiveness of beadwork craft as a visual metaphoric mode of expression, and to define the way the project sought to circumvent particular cultural taboos on the discussion of sexuality and other matters of personal intimacy. The study describes some of the common beliefs and attitudes that persisted at the time at which the project commenced and demonstrates how these have been 're-written and re-corded' in beadwork throughout the six-year duration of the intervention. My focus throughout is on assessing the value of this project through proposing the medium of beadwork as a contemporary and unique cultural archive that speaks to the complexities of HIV/AIDS in Southern Africa. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2006.

As the second decade of AIDS draws to a close, researchers and others involved in the AIDS effort have come to appreciate that complex interactions between social, cultural, biological and economic forces are involved in shaping the epidemiological course of the disease. Nevertheless, the process by which these variables interact and affect each other remains poorly understood, with many of the shaping forces yet to be fully explored. In South Africa, the sociocultural matrix in which the AIDS epidemic is embedded and its role in shaping the interpretation and experience of AIDS have not been fully analyzed. This thesis represents an attempt to elucidate the finer nuances of some commonly-held local beliefs, perceptions, symbolic representations, ethnomedical explanatory models and mythologies associated with AIDS. These associations are viewed as directly informing the way in which Zulu-speaking people are experiencing and responding to HIV/AIDS in KwaZulu Natal, currently home to 1/3 of the country's estimated 3 million HIV infected people. In particular, the focus is on the gender patterning of AIDS, with ethnographic data drawn from extensive field experience at St Wendolin's Mission, a peri-urban settlement in the Marianhill district of Durban. The shared perception of women as naturally 'dirty', as sexually 'out of control' and suspected of using witchcraft in new ways, are identified and discussed as key conceptual strands contributing to the sociocultural construction of HIV/AIDS in that community. It is argued that these notions are metaphorically joining and combining in ways that 'gender' the AIDS epidemic and simultaneously 'demonize' women. The central tenet of this thesis is that HIV/AIDS is fundamentally associated with women as a female caused and transmitted disease that can and does affect men. The author argues that the gendered construction of AIDS in St Wendolin's is a reflection of patriarchal resistance to women's changing roles and expectations that represent an overstepping of culturally defined moral boundaries. Deeply embedded ways of thinking associated with notions of gender are viewed as germane to the disempowerment of women that ultimately impedes the fight against HIV/AIDS. The thesis concludes with a discussion on the opportunity which the current AIDS epidemic presents for wider sociocultural transformation, and how this might be achieved through an AIDS 'education for liberation' based on the philosophies of Paulo Freire. / Thesis (Ph.D.)-University of Natal, Durban, 1999.

The overall objectives of the study are to analyse the economic impact of HIV/AIDS on income-earning urban households and in so doing to develop a methodology for HIV/AIDS household surveys. The study started with 125 households in the first wave. Of these, 113 households were followed over 4 waves (2), over a 12-month period, and across two cohorts referred to as affected (3) and non-affected (4) households. Data on the household were collected from the financial head (5) using the diary method. The methodology for this study was done after a review of 33 HIV/AIDS economic studies conducted around the world. The study obtained buy-in and support from various stakeholders in government, nongovernment organisations, community, academic and funding institutions as from people living with HIV/AIDS. Due to the comprehensive design of the research instrument, the study is able to draw relationships between the various facets of the household and the possible influence that HIV/AIDS has on them. Methodologically, the study found that there are "hidden" costs of morbidity and mortality that needs to be quantified. The costs of health care and funerals are higher in the affected cohort, as expected, due to the frequency of illness or death and not necessarily because there are cost differences as a result of whether a household member has HIV/AIDS or not. The key finding is that affected households re-organise themselves in terms of household size, composition and structure as well as through transfers in, income from grants and other non-market sources, especially to pay for funeral costs. Surviving members are affected not only socially and economically but also psychologically and the needs of this group should not be ignored. (2) Each visit is referred to as a wave (3) Affected household is a household where at least one person is HIV positive (4) Non-Affected household is a household where the index case is HIV negative and no other members presented with an HIV/AIDS-related symptom (5) The person responsible for the finances in the household. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2004.

This thesis sets out to describe and discuss male street prostitution as it occurs in Durban. The aim is to examine to what degree male street prostitutes are at risk of HIV infection, and make appropriate recommendations for HIV intervention. The field data, gathered through participant observation, revealed significant differences between the two research sites, refiecting broader race and class divisions in the South African society. At the same time, the in-depth case studies of the individual participants suggest that they share similar socio-economic life histories characterised by poverty and dysfunctional families, and hold similar world-views. The research was conducted within a social constructionist framework, guided by theories of human sexuality. Yet, sexuality was not the framework within which the male street prostitutes in Durban attached meaning to their profession. Professing to be largely heterosexual, the respondents engaged in homosexual sexual acts without considering themselves to be homosexual, reflecting and amplifying the fluid nature of human sexuality. It was, however, within an economic framework that the male street prostitutes who participated in this study understood and interpreted their profession. The sexual aspect of their activities was far less important than the economic gain to them, and prostitution was interpreted as a survival strategy, A significant finding of this research is that male street prostitutes in Durban face a considerably higher risk of exposure to HIV from their non-paying sexual partners (lovers) than from their paying sex partners (clients). The research participants all had a good knowledge of HIV and the potential danger of transmission whilst engaging in unsafe commercial sex. In their private love lives, the participants were less cautious about exposing themselves and their partners to HIV infection, hence the conclusion that the respondents face a greater threat of HIV infection from their lovers than from their clients. Finally, male street prostitutes, like female street prostitutes, do however face some risk of HIV infection as a result of their involvement with commercial sex. The illegal nature of their activities is considered to contribute to an environment conducive to the transmission of HIV, and this thesis argues for a change in the legal status of commercial sex work as a primary component of HIV intervention in this vulnerable group of men and women. / Thesis (M.A.)-University of Natal, Durban, 2000.