Each year approximately 600 000 infants, most of them in Sub-Saharan Africa are born with HIV infection as a result of mother to child transmission of HIV. Whereas significant progress has been made in reduction of mother to child transmission of HIV in developed countries, the situation remains desperate in developing countries. Progress has been hampered by shortage of staff, facilities, limited access to voluntary counselling and testing and lack of support for women by their partners and communities. The challenge is to increase voluntary counselling and testing uptake during antenatal care. Onandjokwe district in Northern Namibia is currently introducing the Prevention of Mother to Child Transmission Program (PMTCT). It has been found the previous PMTCT programs have failed because they adopted a top down approach where there was no community consultation. This study was conducted to explore the community perceptions, knowledge and attitudes regarding mother to child transmission of HIV through focus group discussions and in-depth interviews of key community members.

Thesis (MPhil)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: While there has been several studies that have been conducted targeting university students at state owned universities in South Africa, specifically on the impact of HIV/AIDS epidemic, no extensive study was conducted to establish what informs adoption of high risk sexual behaviour among university students in the context of HIV, STI and unplanned pregnancy epidemics at any of the state owned South African universities, let alone private universities. In order to address this identified gap in the body of knowledge, a cross-sectional study underpinned by the ‘social norms’ theory was undertaken at a private university in the Gauteng Province, South Africa to establish why undergraduate students engage in high risk sexual behaviour that puts them at risk of contracting HIV, STIs and unplanned pregnancy. Quantitative data was collected from 342 students through a questionnaire and qualitative data was collected from 38 students through the focus group discussions. Findings revealed that early sexual debut, intergenerational sex, multiple and concurrent partners, unprotected sex, sex under the influence of alcohol and illegal drugs and transactional sex constitute high risk sexual behaviour. The study concluded that peer pressure, independence, financial needs, drug and alcohol abuse, fear of being an outcast, need to identify with modernity, lack of individual perception of risk, campus culture and sexual partner influence are the factors influencing the adoption of high risk sexual behaviour on campus. Based on the findings and conclusions, recommendations are provided for the development of an HIV prevention programme on campus that is aimed at mitigating the negative consequences of the HIV/AIDS, STIs and unplanned pregnancy epidemics. / AFRIKAANSE OPSOMMING: Die literatuur toon aan dat daar alhoewel daar wel studies onderneem is ten einde die impak van die MIV epidemie onder studente aan openbare universiteite te bepaal onderneem is, daar nog steeds baie min kennis in hierdie verband bestaan. Die faktore wat ‘n rol vervul in hoërisiko seksuele gedrag onder studente aan hierdie universiteit is grootliks onbekend. Ten einde hierdie gaping te probeer oorbrug is hierdie studie onderneem aan ‘n privaat universiteit in Gauteng provinsie in Suid-Afrika. Die doel van die studie was om vas te stel wat voorgraadse studente motiveer om hoë seksuele gedrag te beoefen, wetende dat hulle hulleself blootstel aan MIV-infeksie en onbeplande swangerskappe. ‘n Steekproef van 342 student is in die studie gebruik en ‘n vraelys is deur hulle voltooi. ‘n Verdere 38 student het deelgeneem aan ‘n fokusgroepbespreking. Resultate toon aan dat studente dikwels meer as een seksuele maat het; dat seks beoefen word terwyl studente onder die invloed van alkohol is; dat seks dikwels onbeskermend plaasvind en dat alle hierdie faktore bydraend is tot hoë blootstelling aan MIV-infeksie. Die studie het verder gevind dat groepsdruk, finansiële probleme, dwelm- en alkoholmisbruik en groepsdruk verdere bydraende faktore tot hoë-risiko gedrag onder studente is. Resultate van die studie is gebruik om aanbevelings te maak vir die ontwikkeling van ‘n MIV-voorkomingsprogram wat daarop gerig is om die oordrag MIV en onbeplande swangerskappe aan die universiteit ( wat in die studie ondersoek is ) te bekamp.

According to the 2005 Ethiopian Demographic Health Survey, HIV prevalence in Gambella region where Fugnido refugee camp is located is 6%, which is the highest prevalence data recorded in the country. Similarly, the United Nations High Commissioner for Refugees (UNHCR) Health Information System (HIS) demonstrates that Fugnido has the highest HIV prevalence compared to other refugee camps in Ethiopia and furthermore shows variation in prevalence among the two main ethnic groups in the camp, namely Agnuak and Nuer (about 8.5% and 2.3% respectively). The study seeks to investigate why a significant difference exists in the number of people with known HIV positive status among the Agnuak community compared to the Nuer community in the Fugnido refugee camp in Ethiopia. It does this by investigating factors that are presumed to explain HIV high risk-behaviour and vulnerability. This was a cross-sectional study of Agnuak and Nuer tribes living at the Fugnido refugee camp. The sampled population involved men and women refugees from the ages of 15 to 49 years. The study used a mixed method approach or methodological triangulation. Cluster sampling technique was used for the quantitative data collection. The sample size was 831 refugees (439 Agnuak and 390 Nuer). Seven (7) Focus Group Discussions (FGDs) and 3 Key Informant (KI) interviews was used for the qualitative data collection. Findings show that the Agnuak were almost 4 times (OR=3.8, 95% CI [1.9-7.4] p < 0.05) more likely to practice risky behaviour compared to 0.3 times (OR=0.3, 95% CI [0.1- 0.9] p < 0.05) likelihood among the Nuer refugees. Factors associated with differences in risky behaviour for both Agnuak and Nuer included, inter alia, primary education as the highest level of education attained, 50% among the Agnuak (OR=0.5, 95% CI [0.3-0.8] p < 0.05), compared to Nuer community’s 30% (OR=0.3, 95% CI [0.2-0.6] p < 0.05). Access to HIV and voluntary counselling and testing (VCT) services was lower for the Agnuak (OR=1.8, 95% CI [1.1-2.9] p < 0.05) compared to the Nuer (OR=2.9, 95% CI [1.6-5.1] p < 0.05). Unlike the Nuer refugees, the Agnuak refugees who had experienced forced sex (OR=7.3, 95% CI [2.9-18.8] p < 0.05) and had a positive attitude (lack of or reduced stigma) towards HIV (OR=2.1, 95% CI [1.3-3.7] p < 0.05) were more positively associated with risky 6 behaviour (than the Nuer). The Nuer had no factor associated with risky behaviour that was different from that of the Agnuak. The study revealed more Agnuak refugees than Nuer refugees had been engaged in risky sexual behaviour by having multiple sex partners and being involved in transactional sex. The Nuer was more closed and reserved to having sexual relations outside of their group than the Agnuak were which contributed to their relatively lower HIV prevalence. Furthermore, there was very low condom use among the Nuer community compared to the Agnuak community, which was based on differential attitudes between the two communities concerning trust of partner and monogamous relations. The study findings recommend that humanitarian workers and community partners need to collaborate to develop congruent HIV interventions that go beyond traditional strategies of distributing condoms and focus on correct and consistent use of condoms in the camp. Humanitarian and community workers’ understanding the socioeconomic context of the communities and the influence of cultural and other factors, including behaviour with intervention strategies,could also curb the epidemic. / Sociology / M.A. (Sociology)

According to the 2005 Ethiopian Demographic Health Survey, HIV prevalence in Gambella region where Fugnido refugee camp is located is 6%, which is the highest prevalence data recorded in the country. Similarly, the United Nations High Commissioner for Refugees (UNHCR) Health Information System (HIS) demonstrates that Fugnido has the highest HIV prevalence compared to other refugee camps in Ethiopia and furthermore shows variation in prevalence among the two main ethnic groups in the camp, namely Agnuak and Nuer (about 8.5% and 2.3% respectively). The study seeks to investigate why a significant difference exists in the number of people with known HIV positive status among the Agnuak community compared to the Nuer community in the Fugnido refugee camp in Ethiopia. It does this by investigating factors that are presumed to explain HIV high risk-behaviour and vulnerability. This was a cross-sectional study of Agnuak and Nuer tribes living at the Fugnido refugee camp. The sampled population involved men and women refugees from the ages of 15 to 49 years. The study used a mixed method approach or methodological triangulation. Cluster sampling technique was used for the quantitative data collection. The sample size was 831 refugees (439 Agnuak and 390 Nuer). Seven (7) Focus Group Discussions (FGDs) and 3 Key Informant (KI) interviews was used for the qualitative data collection. Findings show that the Agnuak were almost 4 times (OR=3.8, 95% CI [1.9-7.4] p < 0.05) more likely to practice risky behaviour compared to 0.3 times (OR=0.3, 95% CI [0.1- 0.9] p < 0.05) likelihood among the Nuer refugees. Factors associated with differences in risky behaviour for both Agnuak and Nuer included, inter alia, primary education as the highest level of education attained, 50% among the Agnuak (OR=0.5, 95% CI [0.3-0.8] p < 0.05), compared to Nuer community’s 30% (OR=0.3, 95% CI [0.2-0.6] p < 0.05). Access to HIV and voluntary counselling and testing (VCT) services was lower for the Agnuak (OR=1.8, 95% CI [1.1-2.9] p < 0.05) compared to the Nuer (OR=2.9, 95% CI [1.6-5.1] p < 0.05). Unlike the Nuer refugees, the Agnuak refugees who had experienced forced sex (OR=7.3, 95% CI [2.9-18.8] p < 0.05) and had a positive attitude (lack of or reduced stigma) towards HIV (OR=2.1, 95% CI [1.3-3.7] p < 0.05) were more positively associated with risky 6 behaviour (than the Nuer). The Nuer had no factor associated with risky behaviour that was different from that of the Agnuak. The study revealed more Agnuak refugees than Nuer refugees had been engaged in risky sexual behaviour by having multiple sex partners and being involved in transactional sex. The Nuer was more closed and reserved to having sexual relations outside of their group than the Agnuak were which contributed to their relatively lower HIV prevalence. Furthermore, there was very low condom use among the Nuer community compared to the Agnuak community, which was based on differential attitudes between the two communities concerning trust of partner and monogamous relations. The study findings recommend that humanitarian workers and community partners need to collaborate to develop congruent HIV interventions that go beyond traditional strategies of distributing condoms and focus on correct and consistent use of condoms in the camp. Humanitarian and community workers’ understanding the socioeconomic context of the communities and the influence of cultural and other factors, including behaviour with intervention strategies,could also curb the epidemic. / Sociology / M.A. (Sociology)

The HIV and AIDS crisis can be presented as a socio-ecological issue, with an ever-increasing impact on both human beings and the environment. Teaching about socio-ecological issues and the consideration of individual capabilities has become crucial within HIV and AIDS education programmes. Issues of deforestation, land degradation and other environmental problems have worsened since the advent of HIV and AIDS, especially in developing countries. The My Future is My Choice (MFMC) programme has been identified as an important HIV and AIDS education initiative that caters for young people in Namibian secondary schools (Grades 8-12). One of the themes within the programme (Facing HIV and AIDS) is highlighted in this study. This study was constituted as a case study of one school in rural Omuthiya, in the Oshikoto region. The study investigated the opportunities for the integration of a focus on socio-ecological issues and risks, within the MFMC education programme. The study also investigated the way in which the program develops learners‟ capabilities to respond to HIV and AIDS related socio-ecological issues and risks/vulnerabilities. The study also presents the constraints and enabling factors influencing the implementation of the programme. This study used a qualitative, interpretive case study methodology. The research methods included the analysis of eight documents and nineteen semi-structured interviews, with the Programme Coordinator, the Programme Facilitator, the School Principal and with the programme participants. The analysis also included two focus group discussions with a group of learners; and two classroom observations; and the learners' submissions (reflection sheets). Convenience sampling was used, and ethical issues were taken into consideration throughout the study. The study revealed the following as key findings:  The aims and objectives of the HIV and AIDS education programme can enhance and constrain the development of capabilities, as well as opportunities and challenges for the integration of a focus on socio-environmental issues and risks as additional learning content.  Teaching and learning methods that are participatory and rooted within the learner centered approach can make the integration of HIV and AIDS inherent socio-environmental issues and risks into the MFMC education programme possible.  The values and beliefs inherent within the MFMC education programme stand as opportunities for the successful development of capabilities in the education programme. The study concluded by recommending that capabilities within the MFMC programme be developed through teaching learners about their rights, respect for human dignity, and the right to health and to living the life free from discriminatory practices, as a moral entitlement of each and every individual. While teaching learners about their right to health and the importance of healthy diets, this study found that the programme could include learning about food production and handling practices for the benefit of those living with HIV and AIDS, while caring for the environment. Another recommendation was that future research should consider actively involving young people in decision-making with regard to the programme, as this will allow them to choose and decide on what knowledge and skills they need and want to acquire. The study further explained that this will promote the programme participants‟ sense of agency, and their freedom to choose what they value being and doing as an important element in enhancing learner capabilities. Ultimately, this will also enable the learners to acquire the necessary skills and knowledge they need in order to respond to the socio-ecological problems they face in their communities.

The purpose of the study was to show the variables that influence adolescents' sexual activities that have not been well defined. What leads adolescents to be more sexually active than previous generations? A Survey was conducted at the Fontana Unified School District.

A random sample of 365 students attending a university in northern Texas returned a mailed questionnaire measuring the students' knowledge of Acquired Immuno-Deficiency Syndrome (AIDS), their perceived susceptibility to AIDS, and their sexual practices during the last year. The students had high knowledge levels about AIDS in general. However, 70% did not worry about getting AIDS. Collectively, there was a display of concern until it became a personal issue. The students (59%) saw themselves as less likely than most people to get AIDS. Although 70% of this sexually active group did not use condoms, they still did not perceive themselves as susceptible to AIDS.

Thesis (MPhil)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: Mineworkers in South Africa are in abundance as mining is the main occupation especially in the former black homeland. These mineworkers retrenched or retire, and returned to their homeland. Transkei is a former black homeland where abundant retired mineworkers reside to their destiny. Migrancy, which for century has been such a conspicuous feature of the South African labour system, and thought to be a significant contributor to the spread of HIV/AIDS (Lurie M, 2000). The migrant labour system in Transkei region was attributed very extensively to contagious disease especially related with sexually transmitted diseases (STI) like HIV/AIDS. It is estimated that 2 million of the 5 million black mineworkers in South Africa at the time were migrant labourers. Majority of them are from the Transkei region. The ex-mineworkers in this study group are between 41 and 78 years of age (mean 55 years). They have serviced in the mines from 5 to 48 years (mean 20 years). All are married, and having children between 1 and 10 ((mean 6). Fifty seven percent ex-mineworkers did not answer about their number of sexpartners. Only 43% mentioned that they have one partner. Only 31% mineworkers were consuming alcohol. Of them 9% were consuming everyday, and 18% twice in a week. In this study, HIV/AIDS related knowledge, attitudes and behaviour of exmineworkers, living in the remote rural areas of Transkei region of Eastern Cape, were elicited by sending questionnaires to them. Only 19.9% have replied back. There is absolute lack of knowledge in 13.6%, and negative attitude in 27% of the ex-mineworkers. Risks of unsafe sex have been observed among 69%. Of them, 48% have mentioned that they have trust in their wives. Urinary tract symptoms were indicated by 18%, and HIV positivity was reported by 4.5% of mineworkers. There is suicidal tendency (life is not worth living) was found in 22.7% of ex-mineworkers, and a majority (16%) mentioned that it is related with their sickness. Majority of ex-mineworkers have good knowledge about HIV/AIDS, and positive attitude for the survivals. They have also been practicing sex without condoms, but they have provided reasoning to be a faithful to their partners. There is a high level of awareness and a positive attitude towards HIV/AIDS individuals. It was observed that there is less risk taking sexual behaviour among exmineworkers. / AFRIKAANSE OPSOMMING: 'n Groot gedeelte van Suid-Afrikaanse mynwerkers is uit die Transkei gebied afkomstig. Daar word konserwatief beraam dat tussen twee en vyf miljoen mynwerkers jaarliks tussen hulle werkplek en die myne migreer en dat hierdie migrasie ingrypende inplikasies vir die verspreiding van die MI-virus het. Die doel van hierdie studie is om die kennis, houding en gedrag van mynwerkers ten opsigte van MIV/Vigs by 'n steekproef van 198 voormalige mynwerkers in die Transkei te toets. Die inligting is deur middel van 'n vraelys en onderhoude gedoen en daar word tot die gevolgtrekking gekom dat die kennis van Vigs en die voorkoming daarvan besonder goed is by hierdie steekproef. Die implikasies van die bevindinge van die studie word uitgespel en voorstelle vir verdere studies word aan die hand gedoen.

Technical and Vocational Education and Training (TVET) colleges have become institutions of choice in the Department of Higher Education and Training (DHET) attracting youth between 15 and 24 years of age. College campuses are an opportune space for mixing of students with Grade 10 equivalence up to students with post-matriculation level. Students who enrol at TVET colleges for the first time are vulnerable to Human Immunodeficiency Virus (HIV) and Acquired Immuno Deficiency Syndrome (AIDS) since they mingle with students of different ages and diverse experiences. Sometimes they can be taken advantage of as the environment is inviting for transactional sex practices, casual and multi-partner sexual relationships with benefactors / “blessers”, promising them the world as angel babies, sugar pups and tuition babies in the sugar bowl of dating scene, hence risky sexual behaviours make college first year students vulnerable to HIV and AIDS. A qualitative research approach was followed underpinned by constructivism as a research paradigm. The theoretical framework followed in this study was the Social Cognitive Theory (SCT). A purposive sampling technique was used and six students who had enrolled in a TVET college as first year students for National Certificate Vocational (NCV) level 2 and were sexually active and willing to talk about the risky sexual behaviours they engaged in, participated during focus group interviews. Three students selected from the six were interviewed individually. The thematic analysis approach was used to identify patterns and themes which were considered for major findings. Findings of the study revealed that TVET college students who are enrolled as first year students in the NCV programme engage themselves in risky sexual behaviours such as transactional sex, casual and multi-partner sexual relationships, not using condoms, putting themselves at risk of contracting HIV. Among factors that were found to be contributing to risky behaviours were that students are away from the supervision of parents, peer pressure, partying, poverty, sugar daddy and sugar mummy (cougar) / Ben 10 with dating life style. / Psychology of Education / M. Ed. (Guidance and Counselling)

The aim of the study was to offer solutions for the enhancement of Indonesia’s HIV and AIDS policy and to suggest future possibilities. In the process, the gendered nature of the epidemic was explored. In light of the relatively lower rates of employment among Indonesian women, this study also sought to gain insights into the possible reasons for many women appearing to be attached to domesticity. In the first phase of the study, interviews with stakeholders in HIV and AIDS prevention were conducted, followed by a Delphi exercise involving 23 HIV and AIDS experts. In the second phase, 28 women from various ethnicities were interviewed, including those in polygamous and contract marriages. The overall results were interpreted through the lens of complexity theory. Fewer than half of the proposed objectives were approved by the experts in the Delphi round. These were interventions mainly aimed at the risk groups while most objectives relating to education about HIV and AIDS and safer sex for the general public failed to obtain consensus. Reasons for the lack of consensus were differences in perceptions associated with human rights, moral reasoning, the unfeasibility of certain statements and personal conviction about the control of the epidemic. Emphasis on men’s and women’s innate characteristics; men’s role as breadwinner; women’s primary role as wife, mother and educator of their children; and unplanned pregnancies emerged as major themes from the qualitative phase. While the adat and Islam revival movements may have endorsed the ideals of the New Order state ideology, Javanese rituals regarded as violating Islam teachings were abandoned. Ignorance about safer sex and HIV and AIDS was also established. Interpretation of the results through the lens of complexity theory revealed that the national HIV and AIDS policy needs to encompass interventions for the general population, which would include comprehensive sex education in schools and media campaigns focusing on women. It was found that women’s vulnerability to HIV and their penchant for domesticity appear to be associated with their perceived primary role as wife and mother, as promoted by the adat-based New Order state ideology. / Sociology / D. Litt. et Phil. (Sociology)