Thesis (MSc (Nursing))--Cape Peninsula University of Technology, 2018 / Primary health care (PHC) is a frontline health care approach. It is the point of contact where people are kept well and where their quality of life is improved. All people diagnosed as HIV- positive are retested prior to antiretroviral therapy (ART) initiation to verify their serostatus. ART initiation is seen as a non-emergency treatment that provides many benefits if its initiation is accelerated, for example following up pregnant women after being diagnosed with HIV. However, accelerated initiation may lead clients to start treatment before they are ready to adhere to treatment outcomes. The purpose of this study was to describe the nurse support for young adults during a first antiretroviral therapy visit at an urban primary health care clinic in Malawi. A descriptive phenomenological design was followed at an urban setup in Zomba city, Malawi. The sample was selected through purposive sampling until data saturation was obtained. Individual semi- structured interviews were conducted with young adults aged 19 25 who have visited the clinic for their first ART according to an interview schedule and field notes for around 30 minutes in a private room. The data was analysed using distinctive process and a consensus meeting was held between the researcher and independent coder. The findings of the study could help the PHC services to retain and re-engage the young adults in HIV care and aid the Government of Malawi in achieving its Sustainable Development Goal (SDG) 3. Principles of trustworthiness and ethics were adhered to throughout the research process. Six themes, each with separate categories, emerged from the data analysis on the experience of young adults during their first visit for ART at an urban PHC clinic in Malawi. The results indicated the need for an environment that enhances a client-orientated approach with a focus on holistic well-being. Knowledge management should be used to provide relevant and sufficient information to a newcomer while maintaining ethics under difficult circumstances. The legal environment should have a focus on supporting clients that need comprehensive ART treatment. Motivation of the patient regarding taking antiretroviral treatment (ART) is thus essential. Young adults express the need to be supported by nurses with relevant information, privacy and confidentiality and the trusting client/nurse relationship which could help them to retain in ART care. Recommendations of this study was that nurses should be offered in-service training on youthfriendly programmes which focuses on the health care of young adults during their HIV/ART services. Nurses need to create trusting relationship for the young adults and providing in door game at the waiting area to keep them busy as they are waiting for the services. Nursing managers to lobby for funding to extend the clinic and be role models in providing relevant information to young adults. It was concluded that a first visit was both positive and challenging to the participant s; however, they experienced the health providers on the first visit to be caring and supportive.

Thesis (MSc)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Adolescents are regarded as a high risk group in South Africa with the highest human immunodeficiency virus (HIV) incidence occurring in this group. Prevention among adolescents is therefore a key in decreasing the HIV burden. This thesis aims to assist in the design of trials by simulating the potential outcomes of a combination prevention trial in adolescents. We develop a stochastic individual-based model stratified by sex and age. We then use this model to determine the impact of various prevention packages on HIV incidence among adolescents participating in a hypothetical trial over a three year period. The trial that is simulated involves an intervention arm, in which adolescents are offered a choice of a prevention methods (including medical male circumcision (MMC), oral pre-exposure prophylaxis (PrEP) and antiretroviral-based vaginal microbicides (ARV-VM)), and a control arm. We predict that the impact of a full prevention package on HIV incidence would be a 46% per personyear( PPY) (95% CI 45–47%) risk reduction. The combination of MMC and PrEP has a substantial impact on HIV incidence in males, with a 51% PPY (95% CI 49–53%) relative risk of HIV infection. Offering women the choice of PrEP, a microbicide gel or a microbicide in the form of a vaginal ring would be less effective, with a 57% PPY (95% CI 56–58%) relative risk of HIV acquisition. This is not substantially different from the relative risk estimated when the vaginal ring alone is offered, as the ring is assumed to be the most accept able of the three prevention methods. We determine a sample size requirement of approximately 1013 in each arm of a trial would achieve 80% power to detect a statistically significant reduction in HIV risk. We find that the relative risk is sensitive to the assumed degree of correlation between condom use and the acceptability of the prevention method. We also find that the most efficient trial design may be to offer both MMC and PrEP to males but to offer only a microbicide ring to females. Further work is required to better understand the processes by which adolescent prevention method choices are made. / AFRIKAANSE OPSOMMING: Adolessente word beskou as ‘n hoe risiko groep in Suid Afrika, met die hoogste menslike immuniteitsgebrekvirus (MIV) insidensie in hierdie groep. Voorkoming van MIV onder adolessente is daarom noodsaaklik om die MIV las te verminder. Die doel van hierdie tesis is om te help met die ontwerp van studies deur die moontlike uitkomste van ‘n kombinasie-voorkoming studie in adolessente te simuleer. Ons het ‘n stogastiese individu-gebaseerde model, gestratifiseer met betrekking tot seks en ouderdom, ontwikkel. Ons het toe die model gebruik om die impak van ‘n verskeinheid van voorkomingspakette op MIV insidensie onder adolessente wat deelneem aan ‘n hipotetiese proef oor ‘n drie jaar periode, te bepaal. Die proef wat gesimuleer word behels a intervensie groep, waarin die jong volwassenes ‘n keuse van voorbehoedings metodes (insluitende mediese manlike besnydenis (MMB), pre-blootstelling profilakse (PrBP) en anti-retrovirale vaginale mikrobisiedes (ARV-VM)) aangebied word, en ‘n kontrole groep. Ons voorspel dat die impak van ‘n volle voorkomingspaket op MIV insidensie ‘n 46% per persoon-jaar (PPJ) (95% VI 47–47%) risiko vermindering sal wees. Die kombinasie van MMB en PrBP het ‘n substansiele impak op MIV insidensie onder mans, met ‘n relatiewe risiko van MIV infeksie van 51% PPJ (95% VI 49–53%). Om die keuse van PrBP, ‘n mikrobisiede gel of ‘n mikrobisiede in die vorm van ‘n vaginale ring aan vrouens te bied, is minder effektief, met ‘n relatiewe risiko van MIV infeksie van 57% PPJ (95% VI 56%–58%). Hierdie verskil nie substansieel van die beraamde relatiewe risiko in die geval waar slegs die vaginale ring gebied word nie, aangesien daar aanvaar word dat die ring die mees aanvaarde van die drie voorkomingsmetodes is. Ons het bepaal dat ‘n steekproef van ongeveer 1013 individue in elke arm van die proef nodig is om ‘n 80% kans te he om ‘n statisties betekenisvolle afname in MIV-risiko te bespeur. Ons vind dat die relatiewe risiko sensitief is tot die aanvaarde graad van die korrelasies tussen kondoom-gebruik en die aanvaarding van die voorkomings metodes. Ons het ook gevind dat dit mag wees dat die mees doeltreffende proef ontwerp is om beide MMB en PrBP vir mans en slegs ‘n mikrobisiede ring vir vrouens te bied. Verdere werk word benodig om die prosesse waarby jong volwassenes keuses maak oor voorkomingsmetodes te verstaan.

M.Ed. ( Educational Psychology) / This research study shows that young HIV sufferers undergo disturbances involving the mind, body and spirit causing a variety of future adjustment difficulties, problems and coping abilities. This is attributed to fear, loss, grief, guilt, denial, anger, anxiety, depression, stress, physiological changes, pain and hypochondria. This study indicates that they are particularly fearful about being isolated and rejected. They are overwhelmed by thoughts of loss of everything, accompanied by profound feelings of grief. Guilt and self-reproach affect their health further, having an effect on them both physically and mentally. The uncertainty of their future having contracted HIV intensifies anger with themselves as well as others. This also brings about anxiety due to lack of information and appropriate support systems in Soweto...

A research report submitted to the School of Social Science, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Arts in the field of Demography and Population Studies for the year 2015 / Introduction: Early sexual debut remains a public health concern, and it continues to gather interest among researchers. In part interest is driven by the unchanging age at sexual debut and even though the age of sexual debut remains unchanged, the rate of early sexual debut keeps rising in many developing countries (Pettifor et al, 2009). Approximately 60% of young people in South Africa report to have had sexual intercourse by the time they are 16 years old (Peltzer, 2006). Furthermore early sexual debut has been identified as an indicator of risky sexual behaviour; as it exacerbates the individuals exposure to sexually transmitted diseases especially HIV, which is most prevalent among the youth in the ages 15-24 years old (Mchunu, 2012). Similarly, violence also remains a public health concern as it endangers the development of young people. Approximately 3.5 million people report injuries caused by violence every year, and violence accounts for 30% of mortality (Norman et al, 2010). A prevalent feature of violence is the dual role of young men as victims and as perpetrators of violence (Seedat et al, 2009). In some areas of South Africa homicide deaths of males outnumber those of females at a rate of 7 males to 1 female death (Seedat et al, 2009). Furthermore other reported consequences of violence among the youth are mental health problems, injuries and a negative education outcome among young people in South Africa. Young people are future leaders and parents of South Africa and it is therefore important to have a study that will examine the association between two factors that have been deemed as risk factors for the development of young people. The general objective of this study is to examine the association between violence and early sexual debut among youth in South Africa. The first specific objective of the study is to identify the level of early sexual debut among youth in South Africa, while the second specific objective of the study is to examine the association between violence and early sexual debut controlling for socio-economic and demographic variables. Methodology: Data was obtained from the National HIV communication survey with a sample of 1 873,956 females and 932,397 males. who are in their youth (15-24 years old). Data was managed using the STATA 12 and was analysed in a way that answers the objectives of the study. For descriptive analysis, frequency tables and graphs were used. A chi-square test was conducted, to test for an association between violence and early sexual debut and for multivariate analysis the study employed a multinomial logistic model / GR2017

This work examines sexual behavioural change and the likely predisposing factors in the era of HIV/AIDS among young adults in Uganda and South Africa. It explores the potential role of young adults' self-perceived risk of HIV infection in sexual behavioural decisions regarding adoption of safe sex practices, in particular 'use of condoms' and 'limiting number of sexual partners '. This work further recognises that Uganda and South Africa are countries with social, cultural, economic, and political contexts, which contexts have been described by many as inextricably linked with sexual behaviour, and which often determine the choices young adults make regarding sexual activity. These are therefore examined. In order to achieve this, a rigorous examination and analysis of self-perceived risk of HIV/AIDS in relation to societal factors was done to determine which variables of the two categories best explains sexual behaviour. This is placed in the context of young female adults between the ages of 15 to 24 in Uganda and South Africa. The formulation of this study, which places emphasis on examining the potential role of self-perceived risk of HIV/AIDS as a predisposing factor for sexual behavioural change, and in Uganda and South Africa is based on a number of aspects as highlighted below: • That both Uganda and South Africa at one point or another were and/or are faced with high prevalence levels of HIV/AIDS; • That both have and/or are yet to be faced with high mortality, which is HIV/AIDS related and such profound consequences will/or have had inadvertent effects on individual, both socially and economically. In some respects, this has also affected individual perceptions regarding HIV infection; • Recognition that the progression of HIV/AIDS in Uganda was much faster than in South Africa, and this meant higher prevalence, higher mortality rates, which then triggered both government and non-governmental response towards preventing further spread. Since these factors are beginning to emerge in South Africa, one therefore asks the question as to whether the pandemic will take similar trends as those reported in Uganda. This would also enable the identification of similarities and differences in the likely determinants of sexual behavior considering these countries have different backgrounds; • In both countries, education programmes have been rigorous and that the level of awareness is at a point that would enable sexual behavioural change to occur; • A recognition that in Uganda, as shown in a number of reports and existing literature, the prevalence of HIV has declined and for this reason, it has become imperative to try and examine the likely factors leading to reduced HIV/AIDS prevalence, and to compare with what is happening in South Africa. This would enable the examination of any possible lessons that could be learnt in the reduction of the prevalence in South Africa. In the quest to achieve the set goals, a number of steps were undertaken which included looking at available literature and more importantly analysing two sets of Demographic Health Survey (DHS) data. The South Africa Demographic Health Survey of 1998 (SADHS) and the Ugandan Demographic Health Survey (UDHS) of 2000/1. All young female adults between the ages of 15 to 24 were selected from both data sets. 3,229 and 4,559 young female adults were selected in Uganda and South Africa respectively leading to a total sample size of 7,688. Findings showed that self-perceived risk of HIV/AIDS was one of the factors that did impact on sexual behaviour. This was more prominent in Uganda and less so in South Africa. Other factors found to affect sexual behaviour included age of respondent, socio-cultural and to a small extent, socio-economic factors. The conclusion that can be drawn from this work shows clearly that self-perceived risk of HIV/AIDS is an important factor determining sexual behaviour, but also shows that some societal variables are important. Therefore, in the face of HIV/AIDS and with increased levels of number of people experiencing deaths due to AIDS, selfperceived risk of HIV/AIDS is a factor worth considering when looking at sexual behaviour. As part of the recommendations, education programmes yet to be formulated should take into account the effect of HIV and AIDS on sexual behavioural change. / Thesis (M.A.)-University of Natal, Durban, 2003.

This paper focuses on boys and young men's attitudes, knowledge and practices with regard to pregnancy and HIV infection. The objective of the study is to ascertain how boys and young men perceive the risks of pregnancy and HIV infection. The study further investigates the strategies which the sexually active respondents considered as appropriate, practical and effective in coping with these risks. The study was based on the secondary data which was extracted from the transitions to adulthood survey conducted in KwaZulu Natal during 2001. The analysis was restricted to young men aged 14 to 24 years. The major findings from the study revealed that young men did not perceive themselves at risk of HIV infection. Overall, respondents were fairly knowledgeable about HIV/AIDS and knew where to access condoms, how HIV is contracted or transmitted etc. Findings also indicated that many respondents regarded pregnancy as a matter of great concern. Many respondents perceived pregnancy as highly problematic and were concerned to protect themselves against this risk. The major finding for this study revealed that the majority of sexually active young men used condoms for preventing both pregnancy and HIV/AIDS; while some also used various contraceptive methods to prevent pregnancy. A major factor promoting consistent condom use was the perception of pregnancy as highly problematic. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2006.

No abstract available. / Thesis (M.Dev.Studies)-University of Natal, Durban, 2002.

In light of the current HIV/ AIDS epidemic. the sexual risk taking and health seeking behaviour of South African adolescents is of extreme interest to rescearchers and programme implementers. Using a database of adolescents between the ages of 14 and 22 from Durban Metro and Mtunzini Magisterial District in KwaZulu-Natal Province. This paper seeks to investigate which antecedents impact most on adolescent sexual behaviour. Risk taking behaviour of interest is whether or not a condom was worn at last intercourse. The analysis also seeks to test the impact of Life Skills education in school on this behavioural outcome. Although much of the literature has pointed to more distal factors having greater influence on adolescent health seeking and risk taking behaviour. This analysis has showed that issues relating more closely to levels of communication within a relationship, attitudes towards the use of condoms. and previous health seeking behaviour. have the greatest impact on condom use. Those adolescents who wore a condom the first time they had sex. who felt they could confidently convince their partner to use a condom and who maintain high levels of communication with their partner. were found most likely to have used a condom the last time they had intercourse. / Thesis (M.Dev.Studies)-University of Natal, Durban, 2000.

This study explores the meanings that young African schoolgirls aged 16 turning 17 from a high school in Umlazi, Durban give to their sexual identities. Using qualitative research methods in the form of semi-structured open-ended interviews and focus group discussions, their understandings of sex, sexuality and sexual risk were explored. The aim was to investigate why these young girls expose themselves to risk by engaging in unprotected sex, in spite of sex education and many interventions and campaigns related to Human Immune- Deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) infections' awareness which these girls receive in school. Poverty, unemployment and crime plague this community and it is within this context that these girls make sense of their sexual identities. The main findings of this study are that these young girls resist being placed in a subordinate position and the patriarchal system which the society and boys attempt to impose. Furthermore, most of these girls come from broken families where grandparents have a responsibility to sustain the family. In the process, girls expose themselves to sexual risk as they become vulnerable to peer pressure. Girls' response to their challenges with regards to sexual identity is to act like boys, have multiple partners, and dump the boys who demand sexual favours. In response, this study aims to enlighten the girls regarding the dangers inherent in their behaviour and to assist them with safer ways of assuming 'girl power'. Girl power implies that girls are empowered with skills to be self confidence, be confident with themselves by protecting themselves from sexual infections and to take informed decisions as they negotiate their sexualities. The findings reveal that girls reject the patriarchy that subordinates them and are now taking a position of girl power. I conclude that, in assuming their power over boys, these young girls want to behave like boys and have multiple partners which put them at risk. / Thesis (M.Ed.)-University of KwaZulu-Natal, Durban, 2012.

Thesis (M.N.)--Memorial University of Newfoundland, 1996. / Typescript. Bibliography: leaves 94-104. Also available online.