Young people are faced with high levels of HIV/AIDS and unwanted pregnancy in South Africa. In this context it is important to understand the reproductive decision-making process with regard to these sexual risks. The study draws on in-depth interviews conducted with 20 Black students aged 18 to 24 years at the Walter Sisulu University. The study found that there was a high level of awareness of unwanted pregnancy and HIV/AIDS. However, many young people engaged in risky sexual behaviours. Differing gender roles seemed to significantly promote risky sex and discouraged shared decision making. The study suggests that men often dominated the decision-making process. In addition, partner coercion was prevalent, and it negatively affected the health choices of young people. Other factors that were barriers to adopting prevention strategies included the negative attitudes of health providers and limited communication between parents and children and also, between sexual partners. Young people were afraid to freely discuss sexual issues and preferred actions to avoid antagonizing partners who might suspect infidelity, lack of commitment and HIV infection. Some young people also expressed concern that contraceptives were not safe. Young people emphasized the negative repercussions of HIV/AIDS and unwanted pregnancy and the importance of creating greater awareness of the risks and adopting prevention strategies. However, the study findings point to the need for health promotion interventions to go beyond risk awareness and incorporate the cultural, social and economic contextual factors in which the behaviour takes place. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2008.

BACKGROUND: HIV/AIDS has seemingly conquered all medical means of prevention. An approach is therefore needed which focuses on the future of a generation, in equipping today‟s children with the necessary knowledge and skills, to prevent future HIV/AIDS infections and implications. In an attempt to combat HIV/AIDS, Life Orientation has been incorporated in the South African school curriculum as one of the learning areas. Children hereby are receiving knowledge on HIV/AIDS and life skills. Research however, has found that young people do not necessarily respond to, or internalise information received. Programmes which focus on interactive participation and experiential learning are needed for desired outcomes. Specific focus on self-esteem, self-efficacy, communication and a sense of future are also necessary, as these aspects play a crucial role in health behaviour or the lack thereof. iThemba Lethu has been endorsed by the KwaZulu-Natal Department of Education and focuses specifically on these issues. iThemba Lethu has granted Indlela permission to use their programme in schools in the Amaoti community, referred to as the Indlela Life Skills programme, to make a positive contribution to the youth of this vulnerable community. Because programme evaluation is an integral part of programme implementation and development, this study will focus on process evaluation of the Indlela programme. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

This qualitative study using a phenomenological design, aimed at exploring and describing and exploring the experiences of HIV positive clients defaulting Isoniazid Preventive Therapy services in the Bhisho Primary Health Care Services. The emphasis was on the factors leading clients to default. An in- depth unstructured face to face interviews were done on 14 participants from 4 clinics or facilities under Bhisho Primary Health Care Services. From the respondents’ responses it can be noted that work and family related issues, ignorance of patients, side effects, and negligence of nurses and denial of HIV status were identified as reasons for defaulting. Having knowledge about the treatment and health providers’ attitudes to patients also played a role in patients defaulting their treatment.Many suggestions were then put forward by the respondents to curb defaulting among patients. These included the use of text message reminders, not to discrimination HIV patients because of their status, to use consulting rooms for privacy and also nurses and caregivers to control their attitudes when dealing with patients.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of MSc Epidemiology (Infectious Disease Epidemiology), Johannesburg, November 2017 / Tuberculosis (TB) is a leading cause of death worldwide, causing more deaths than HIV/AIDS. A TB patient can have pulmonary or extrapulmonary TB or both. South Africa has a high incidence rate of TB, recording 834 cases per 100 000 population in 2015, compared to 142 per 100 000 globally. Loss to follow-up (LTFU) rates during TB treatment in South Africa have ranged from 7% to 30%. The factors associated with LTFU can be divided into four groups: socioeconomic factors, patient-related factors, treatment factors, and health system or programmatic factors. Socioeconomic factors include a lack of support and a low socioeconomic status. Patient related factors include substance abuse, beliefs and low TB knowledge, while treatment factors include side effects and a history of LTFU. Among health system or programmatic factors that contribute to LTFU are a poor relationship with the healthcare workers and large treatment programmes. Studies to determine the factors associated with LTFU in HIV-uninfected TB patients are few as most studies have focused on HIV/TB co-infected patients. Co-infected patients make up almost 60% of TB patients. The aim of this study was to determine the demographic and clinical factors associated with LTFU in HIV-uninfected TB patients who registered for TB treatment in Ekurhuleni North sub-district from 1st January 2011 to 30th June 2012. LTFU was defined as a lack of a documented treatment outcome among TB patients who should have completed TB treatment based on TB treatment start date. The study was a retrospective cohort study involving the secondary analysis of routine TB treatment data collected from 18 primary care clinics in Ekurhuleni North sub-district. The participants were described at the beginning of TB treatment using clinical and demographic data. The treatment duration and outcomes were also described. The burden of LTFU was determined. Univariate and multivariate logistic regression and Cox proportional hazards regression were used to determine the factors associated with LTFU. In addition, survival analysis was conducted to determine if there was a difference in the time to LTFU among HIV uninfected TB patients based on clinical and demographic factors. Sensitivity analysis of the multivariate logistic regression and Cox proportional hazards regression was carried out to compare the results obtained when follow-up was restricted to 8 months to those obtained for 12 months of follow-up. Sensitivity analysis was also conducted around the definition of LTFU. The impact on the results of multivariate logistic regression after assuming that participants who had a missing treatment outcome in the primary study were not lost to follow up was determined. Five hundred and fifteen participants were included in the analysis. The median age of the participants was 33 years (IQR: 26-47). Fifty-eight percent of the participants were male. Pulmonary TB was the most common form of TB among the participants. The rate of treatment success was 77.67% and that of LTFU was 17.28%. Of those lost to follow-up, 60 had a missing treatment outcome and 29 had default as an outcome in the primary study. The median length of treatment was 6.39 months (IQR: 5.67-7.44), and the median time to LTFU was 3.67 months (IQR: 1.54-6.33). Eighty-two percent of the participants had a documented change of treatment phase. Clinics with a high patient burden had a similar proportion of poor outcomes (death, LTFU and treatment failure) to clinics with low patient burdens. Significant differences in change of treatment phase and length of treatment were observed between those lost to follow up and those not lost to follow-up. LTFU took place throughout TB treatment, with a steady increase in the probability of LTFU over the first 6 months of follow-up. None of the factors investigated had a significant effect on time to LTFU. Following logistic regression and Cox proportional hazards regression analyses, none of the factors assessed were significantly associated with LTFU. Sensitivity analysis showed that censoring the participants at 8 months did not change the results of the logistic regression analysis. For Cox proportional hazards regression, female participants had a 5% lower risk of LTFU compared to male participants in the 12-month analysis. In the 8 month analysis, female participants had a 5% higher risk of LTFU. When participants with a missing treatment outcome were not considered lost to follow-up, sex was found to be significantly associated with LTFU. Female participants had a 66% lower risk of LTFU compared to male participants. A limitation of the use of secondary data in this study was that the study question asked in this study was different from the question that was asked in the primary study. As a result, the variables collected in the primary study were different from the variables required in this study. Information on socioeconomic status, residence type, comorbidities, treatment clinics and health system factors was not available. None of the factors investigated in this study were significantly associated with LTFU in HIV uninfected TB patients in Ekurhuleni North sub-district. The factors influencing LTFU in Ekurhuleni North may not have been investigated in this study. More studies need to be conducted with a wide range of variables in Ekurhuleni North to determine the factors that influence LTFU among HIV-uninfected TB patients. / XL2018

Thesis (PhD)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: The risk of human immunodeficiency virus type-1 (HIV-1) infection and rate of progression towards development of the acquired immunodeficiency syndrome (AIDS) is determined by a combination of viral characteristics, immune function and host genetic variation. Although mutations of the chemokine and chemokine co-receptor genes and allelic variation of the major histocompatibility complex (MHC) have been studied extensively, variation in these host genetic factors does not explain the differences in HIV/AIDS susceptibility in all cases. This study represents the first analysis of new candidate genes implicated in iron metabolism and immune function in relation to HIV-1 disease in the African context. Both case-control association studies and genotype-phenotype correlations were performed to determine the potential functional significance of genetic variants that may be involved, either directly or indirectly, in susceptibility to HIV-1 disease in the South African population. Genotyping was performed to identify potentially important polymorphisms in the solute carrier family 11 member 1 (SLC11A 1), haemochromatosis (HFE) and protein-tyrosine phosphatase receptor-type C (PTPRC/CD45) genes in HIV-seropositive versus HIVseronegative individuals. This was followed by HLA-B27 genotyping in HIV-1 infected individuals with known disease status to determine the potential impact of combined genotypes for different mutations identified in the same study cohort. Preferential association with any of the mutations screened for in the CCR5, SLC 11A1, HFE or CD45 genes were not detected in HLA-B27 positive individuals identified. These findings were in accordance with the independent protective role of HLA-B27 in relation to disease progression in HIV-1 infected individuals. Although differences in allelic distribution were not significant between the study groups, an apparently African-specific mutation 32A~G, identified in an exonic splicing silencer element (ESS-1) of the CD45 gene, appeared to predominate in HIV-1 infected subjects with WHO Class I disease status and slow progression to AIDS. This mutation was present in 35.7% (5/14) of HIV-seropositive individuals with WHO Class I disease status, whilst absent in 22 HIV-seropositive patients with rapid disease progression. This finding may be related to differences in proportions of both CD4+ and CD8+ subsets observed following flow cytometry (FACs) analys.s in two HIV-seropositive individuals with mutation 32A~G, compared with an HIV-seropositive individual without this mutation. Analysis of the iron-related SLC11A1 and HFE genes did not reveal significant associations with modified risk of HIV-1 infection or progression to AIDS in our predominantly African study population. However, the effect of the virus on iron metabolism was demonstrated for the first time at the DNA level. Haemoglobin levels were significantly reduced in both HIV-seropositive (P=O.004) and HIV-seronegative (P=O.02) Black Africans with mutation IVS3-48c~g in the HFE gene, compared with mutationnegative individuals in both groups. Since this effect was more pronounced in HIV-infected individuals compared with controls, presence of the HFE mutation seems to result in an even stronger effect on haemoglobin levels, which may be related to the acute phase response following virus infection. This effect possibly results from genetic variation in a nearby gene involved in innate immunity, most likely in the HLA region on chromosome 6. It therefore seems possible that genetic variation in any of the host molecules involved in response to infection could contribute to clinical outcome. The significance of the multitude of host genetic factors investigated in this study, or previously implicated in susceptibility to HIV-1 infection and disease progression, revealed a complex interrelationship between the host and HIV-1. In some instances the disease process following HIV-1 infection depends on combined effects of different mutations occurring in the same individual, while independent effects of specific genes in conjunction with environmental influences may explain diverse clinical outcomes in others. / AFRIKAANSE OPSOMMING: Die risiko vir menslike immuniteitsgebrek virus tipe-1 (MIV-1) infeksie en die progressietempo vir ontwikkeling van die verworwe immuniteits gebrek sindroom (VIGS) word hoofsaaklik deur fn kombinasie van virale eienskappe, immuunfunksie en gasheer genetiese variasie bepaal. Alhoewel mutasies van die chemokien en chemokien koreseptor gene en alleliese variasie van die major weefsel-verenigbaarheidskompleks (MWVK) reeds omvattend bestudeer is, verklaar variasie van hierdie gasheer genetiese faktore nie noodwendig verskille in vatbaarheid vir MIVNIGS in alle gevalle nie. Hierdie studie verteenwoordig die eerste analise van nuwe kandidaatgene, geïmpliseer in yster metabolisme en immuunfunksie in die konteks van MIV-1 siekte in Swart bevolkingsgroepe. Beide gevalle-kontrole assosiasie-studies en genotipe-fenotipe korrelasies is uitgevoer om moontlik betekenisvolle verwantskappe met genetiese variante te bepaal, wat moontlik direk of indirek betrokke mag wees in vatbaarheid vir MIV-1 siekte in die Suid Afrikaanse populasie. Genotipering van die solute draer familie 11 lid 1 (SLC11A1), hemochromatose (HFE) en protein-tirosien fosfatase reseptor-tipe C (PTFRC/CD45) gene is uitgevoer in beide MIVseropositiewe en MIV-seronegatiewe individue. Daaropvolgend is genotipering van die menslike leukosien antigeen-B27 (MLA-B27) uitgevoer in MIV-1 geïnfekteerde individue met bekende siekte-status, om die potensiële impak van gekombineerde genotipes te bepaal vir verskillende mutasies wat in dieselfde studie populasie geïdentifiseer is. Voorkeur-assosiasie is nie waargeneem vir enige van die mutasies waarvoor geanaliseer is in die CCR5, SLC11A1, HFE of CD45 gene nie. Hierdie bevinding is in ooreenstemming met die onafhanklike rol van MLA-B27 in verwantskap met siekte progressie in MIV-1 geïnfekteerde individue. Alhoewel die alleelverspreiding van In Afrika-spesifieke mutasie 32A~GI wat in In eksoniese splytingsdemper-element (ESS-1) van die CD45 geen geïdentifiseer is, nie statisties betekenisvolle verskille getoon het tussen studiegroepe nie, is die mutasie oorheersend waargeneem in MIV-1 geïnfekteerde individue met WGO Klas I siektestatus en stadige progressie na VIGS. Hierdie mutasie was teenwoordig in 35.7% (5/14) van HIV-seropositiewe individue met WGO Klas I siekte-status, terwyl dit afwesig was in 22 HIV-seropositiewe pasiënte met vinnige siekteprogressie. Hierdie bevinding mag moontlik verband hou met verskille in verhoudings van beide die CD4+ en CD8+ substelle, soos waargeneem gedurende vloei sitometriese (VAS, FACs) analise in twee HIV-seropositiewe individue met mutasie 32A---+G, in vergelyking met en HIV-seropositiewe individu sonder hierdie mutasie. Analise van die yster-verwante SLC11A 1 en HFE gene het nie betekenisvolle assosiasies opgelewer met gemodifiseerde risiko vir MIV-1 siekte of progressie na VIGS in die hoofsaaklik Swart studie-populasie nie. Die effek van die virus op ystermetabolisme is wel vir die eerste keer op DNS vlak gedemonstreer. Hemoglobien vlakke was betekenisvol verlaag in beide MIV-seropositiewe (P=O.004) en MIV-seronegatiewe (P=O.02) Swart individue met die HFE geen IVS3-48C---+G mutasie, in vergelyking met mutasie-negatiewe individue in beide groepe. Aangesien hierdie effek meer uitgesproke was in MIVgeïnfekteerde individue as in kontroles, blyk dit dat die teenwoordigheid van die HFE mutasie die hemoglobienvlakke tot engroter mate beïnvloed weens die akute fase respons wat verband hou met die virusinfeksie. Hierdie effek kan moontlik toegeskryf word aan genetiese variasie in ennaasliggende geen wat in aangebore immuniteit betrokke is, heel moontlik in die MLA gebied van chromosoom 6. Dit wil dus voorkom asof genetiese variasie in enige van die gasheer molekules betrokke by respons op infeksie kan bydra tot die kliniese uitkoms. Die belangrike rol van die veelvuldige gasheer genetiese faktore wat in hierdie studie bestudeer is, of wat voorheen geïmpliseer is in vatbaarheid vir MIV-1 infeksie en siekte progressie, het enkomplekse inter-verwantskap tussen gasheer en MIV-1 geopenbaar. In sommige gevalle is die siekte-proses na MIV-1 infeksie afhanklik van gekombineerde effekte van verskillende mutasies in dieselfde individu, terwylonafhanklike effekte van spesifieke gene tesame met omgewings-invloede uiteenlopende kliniese uitkomste in ander mag verklaar.

Set in the mining sector, the aim of this study was to explore the experiences, insights and reflections of a particular group of peer educator's with regard to their organisation’s peer education programme. Using the PRECEDE-PROCEED Model (Green & Kreuter, 1991) as an organising framework, this study explored the pre-disposing, enabling and reinforcing factors that had an impact on this HIV/AIDS peer education programme. The specific objectives to be assessed in this study were the peer educator’s perceived impact on attitude and behaviour change amongst employees; the perceived organisational barriers and supports that peer educators encountered in programme delivery as well as further training needs of the peer educators. Using an interpretivist paradigm, the study was concerned with describing and interpreting people’s feelings and experiences with qualitative depth. Interviewees comprised of a non-probability saturation sample of five current adult peer educators and one adult ex-peer educator, employed in the Eastern Region of the Organisation (KwaZulu-Natal). In addition the regional manager and the human resource manager were interviewed. Semi-structured tape recorded interviews were used to collect data from the peer educators, and the data was transcribed verbatim from the digital recording. Themes were induced and coded by looking for reoccurring peer educator views, following which the researcher was able to induce potential predisposing, enabling and reinforcing factors that the peer educators faced in programme delivery. Based on the findings of the study, appropriate recommendations are offered with a view to improving programme delivery and quality. Finally, the main constraints which limited the study findings are considered. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

M.B.A. / The purpose of this research project will be to test the impacts of HIV/AIDS and the manner in which it will influence changes in marketing strategies for Retail Food Companies in the future. The research questions posed are: What do Retail Food Companies perceive the impact of HIV/AIDS to be on their customer profile in the next 5 years? Do Retail Food Companies have marketing strategies in place to address the impact of HIV/AIDS on their primary target market? Do Retail Food Companies perceive HIV/AIDS to impact on their current product portfolio and their product portfolio in the next 5 years?

This paper explores discourses of HIV/AIDS evident in a South African daily newspaper from 1985 to 2000, and discusses the implications of these in terms of the way in which HIV/AIDS is constructed in society. In this paper I utilize a Foucauldian analysis of the relationship between power and knowledge. The discursive framework of the war against HIV/AIDS is used to show how different groups of subjects are positioned in relations of power. Within this the power of western science and medicine is influential and supports and informs other discourses of HIV/AIDS. I argue that the discursive framework constructing HIV/AIDS as a war does far more than provide a useful vehicle within which HIV/AIDS can be understood as it supports certain institutions and groups of people above others. The paper concludes by identifying the silenced voices of women and dissidents, and calling for greater reflection concerning the critical analysis of current issues surrounding HIV/AIDS.

Submitted in fulfillment of the requirements for the Degree Master of Arts in Sociology at the University of Zululand, South Africa, 2003. / It gives me pleasure to present the first report on "Prisoner's awareness on HIV-AIDS with reference to Empangeni Qalakabusha prison. The compilation of this research emanates from the willingness to inform, educate, advice and guide the Government and Prison management on the issues relating to HIV-AIDS in South African prisons, since less has been compiled in relation to this issue. The report reflects on the most important challenges facing our prison society, their causes and consequences. This is done to ascertain whether there is progress, activities or means done in relation to developing HIV-AIDS awareness in the prison institutions. The contents of this report are organized and delivered in a series of four chapters, dealing with specific and different contents, under the umbrella of the main study topic. Each chapter simply begins with an introduction, which gives an overview of the material entertained in that particular section. An inclusive response from all Empangeni Qalakabusha prison stakeholders' through questionnaires and interviews form bases of this qualitative study report findings. Recommendations are made inter alia some of the findings. These recommendations are aimed at all South Africans facing this epidemic. The researcher also sincerely hopes that information on this report will be used to promote the culture of "Breaking the silence" around this silent killer of our nation. As South Africa faces the challenges of its renewal or renaissance, there is no greater potential barrier to the attainment of this vision than the spectra of the HIVAIDS epidemi

Knowing about .AIDS and the manner in which it can be contracted in the workplace is essentlal for preventing infection. This thesis attempts to explore whether non-medlcal hospital workers are placed at risk of Infection by virtue of their ignorance of the virus and further seeks to investigate whether "expert" knowledge possessed by professional health workers is disseminated to less-skilled and less-knowledgeable workers. Processes around class and status involved in social closure are investigated to account for the lack of communication concerning AIDS amongst hospital workers. Two research procedures were adopted in this study, namely the intensive interview and participant observation. Findings of the thesis indicate that though all hospital workers are at risk of AIDS infection, unskilled workers remain more vulnerable because they lack knowledge and awareness of the virus. Factors of class, status, educational opportunity and professional elitism striate the hospital workforce and result in exclusionary practices, including the non-dissemination of knowledge about AIDS in the hospital work setting