M.A. / Die doel van hierdie studie is om riglyne vir n geïntegreerde seksualiteit program vir adolosente daar te stel wat aandag skenk aan dwelmmisbruik en verhoogde HIV risiko. Daar is nie hipoteses geformuleer nie. Navorsing vrae is gestel en n literatuurstudie is aan die hand van die vrae gedoen. Daar is gepoog om die profiel van die skool gaande adolosent wat dwelmmiddels misbruik vas te stel. Verder is daar gepoog om die frekwensie van dwelmmisbruik by adolosente vas te stel, sowel as hulle kennis oor die verwantskap tussen HIV/Vigs en dwelmmisbruik. Daar is na die aard en effektiwiteit van huidige seksualiteit programme in die onderwys gekyk om vas te stel of hulle doeltreffend is. n Kwantitatiewe data insamelings metode is gebruik. n Beskrywende en n ondersoekende navorsings ontwerp is gebruik in die studie. Twee honderd-en-vyftig vraelyste is by twee skole versprei. Adolosente van graad agt tot graad elf het die vraelyste ewekansig beantwoord. Die hulp van Statistiese Konsultasie Dienste, te RAU, is ingewin met die optrek van die vraelys sowel as die verwerking van die data. Die profiel van die respondente toon dat die meerderheid 15 jaar en ouer is. Die meeste van die respondente was meisies. Graad nege leerders was die meerderheid van respondente terwyl die ander drie grade eweredig versprei was. Die respondente het meestal by beide of minstens by een biologiese ouer gewoon. Afrikane was die meerderheid van respondente. Blankes was tweede meeste verteenwoordig en die res was verteenwoordig deur Asiërs en Kleurlinge. Leerders het hul skool prestasie as gemiddeld beleef. Belangstelling in skoolwerk was matig. Die misbruik van dwelmmiddels het n verhoogde misbruik oor die naweek getoon. Al die dwelmmiddels was in n mate gebruik, met dagga as die gewildste middel. Die respondente was ambivalent oor die invloed van verhoogde risiko vir HIV met alkohol misbruik. Die meerderheid het bevestig dat daar n verhoogde risiko vir HIV is met die misbruik van dwelmmiddels. Die meerderheid van die adolosente is nie seksueel aktief nie. Die respondente wat wel seksueel aktief is, erken dat hulle in meeste gevalle onder die invloed van dwelmmiddels was tydens hulle laaste seksuele omgang. Die skool is geïdentifiseer as die prominentste plek waar leerders oor dwelmmiddels leer. Die media en tweedens, die skool, is aangedui as die belangrikste plek van leer aangaande HIV. Die leerders verkies klasse waar beide geslagte teenwoordig is. Die medium van onderwys wat verkies word, is n dialoog vorm. Daar is twee groepe adolosente geïdentifiseer in die studie. Die minderheid van adolosente is in gevaar van HIV/Vigs. Die ontwikkeling van n omvattende geïntegreerde seksualiteit program moet gemik wees op die groep adolosente. Aanbevelings met betrekking tot die ontwikkeling van n geïntegreerde seksualiteit program word aan die hand gedoen. / Prof. L. Patel

The proportion of HIV-positive people over the age of 50 is increasing rapidly in New York City. An estimated half of those living with HIV are over 50. While many are long-term survivors, reflecting the transformation of HIV from a life-threatening illness to a chronic disease—due to the advent of highly active antiretroviral therapy (HAART) in 1996—others are newly diagnosed or newly infected. However, relatively few studies have examined how older adults with HIV/AIDS are aging well, and whether these strategies are associated with a reduction in risk behaviors. To address these gaps, paper one, using a basic qualitative research methodology and constructivist grounded theory analysis approach, had two related objectives: (1) to explore the lived experience of men over 50 with HIV/AIDS in New York City; (2) to examine the ways in which individuals have aged successfully. Based on the findings of the aforementioned paper, paper two and paper three, using the Research on Older Adults with HIV/AIDS (ROAH) data set, determined if loneliness predicted condomless sex in the past three months and chemsex (paper 2) and if loneliness predicted a reduced CD4 count and substance use in the past three months. Using the three-paper model, the following dissertation sheds new insight into how older adults age well with HIV/AIDS but finds that loneliness does not predict negative health and risk behaviors in this group. The dissertation does, however, highlight other avenues for research, policy and practice based on the results.

The objectives of the study are to explore the effectiveness of the ABC HIV prevention strategy in South Africa with the purpose of establishing problem areas of the ABC HIV prevention strategy in South Africa. A systematic review design was followed. Electronic databases; Google scholar, Medline and PubMed were searched using broad combination of keywords to obtain all relevant articles. Studies written in English, published between 2000 and 2010, were selected if they met the inclusion criteria. In order to be included the study had to discuss the ABC HIV prevention strategy with the focus on effectiveness of the strategy. The Critical appraisal instrument for qualitative research studies (CASP, 2006) and Quality Assessment Tool for Quantitative studies (Effective Public Health Practice Project, 2005) were used to critically appraise the 9 studies that met the inclusion criteria. Thematic analysis was used for the analysis process. The findings regarding each objective were combined in a summary of findings. The findings revealed that the South African population engages in sexual activities at an early age. Males and females have concurrent sexual partnerships, which mean they are not faithful to their primary sexual partners and lastly, women are unable to use or negotiate condom use. Identified problem areas of the ABC HIV prevention strategy in South Africa were that the age gap between sexual partners is a problem as women cannot negotiate condom use with their seniors. The notion of love and romance that influences the use of condoms, has a negative impact whereby condom use is unacceptable in a long term relationship, irrespective of the level of faithfulness. Low socio-economic status of women that makes women to be dependent on men and also prone to engage in transactional sex. Lastly, local norms about sexuality that men subscribe to, to prove masculinity. / Thesis (M.Cur) North-West University, Mafikeng Campus, 2011

Thesis (MBA)--Stellenbosch University, 2006. / ENGLISH ABSTRACT: In South Africa more people are living with AIDS than in any other country in the world. It is now evident that HIV/AIDS has developed into a pandemic that not only affects the health of individuals, but does expand to households, communities and the nation. The stigma of HIV/AIDS is most likely the single most important reason why people, organisations and the government tend to shy away from the problem. The prime aim of business is to make money, but the fact that AIDS affects people at the peak of their productive years when they would normally not require medical attention, will impact negatively on the organisation's bottom line results. Apart from government, business is the only group that has the capacity and resources to successfully implement strategies in the fight against HIV and AIDS. This study provides a theoretical introduction to HIV and AIDS but also indicates that small to medium size organisations are slow to react to the threat that HIV and AIDS will have to their business and also the country. The study shows that large organisations have definitely been successful in their fight against the disease. The study concludes that knowing the prevalence rate of HIV in a organisation and adapting the strategy accordingly is essential for long term sustainability of the organisation. CISCO was selected as the case study to substantiate the above-mentioned opinions and conclusions. / AFRIKAANSE OPSOMMING: In Suid Afrika woon daar meer mense met VIGS as enige in enige ander land in die wereld. Dit is tans duidelik dat MIV/VIGS ontwikkel het in 'n pandemie wat nie net die gesondheid van individue raak nie, maar wat ook uitkring na huishoudings, gemeenskappe en die nasie. Die stigma van MIV/VIGS is heel waarskynlik die grootste enkele rede waarom organisasies en die regering wegskram van die probleem. Die hoofdoel van 'n besigheid is om wins te maak, maar die feit dat VIGS mense tydens die toppunt van hulle produktiewe jare affekteer wanneer hulle normaalweg geen mediese versorging sou benodig nie, gaan 'n negatiewe effek op organisasies se winsgewendheid hê. Behalwe vir die regering is privaat besighede die enigste groep wat beskik oor die kapasiteit en hulpbronne om strategiee te implimenteer wat suksesvol sal wees in die stryd teen MIV en VIGS. Hierdie studie gee 'n teoretiese inleiding oor MIV en VIGS. Dit dui ook daarop dat klein tot medium grootte organisasies stadig reageer op die bedreiging wat MIV en VIGS vir hul besigheid en die land kan inhou. Die studie toon dat groter organisasies meer sukses behaal in hulle stryd teen die siekte. Die studie bevind dat dit vir die volhoubaarheid van 'n organisasie belangrik is om te weet wat die voorkoms syfers van MIV in die organisasie is en die strategie ten opsigte van MIV en VIGS dienooreenkomstig aan te pas. CISCO is as 'n gevallestudie gebruik om bogenoemde waarnemings en aanbevelings te staaf.

Thesis (MPhil)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Several studies have reported that thirty million people are living with HIV/AIDS in sub-Saharan Africa. Fifty percent of the infected adults are women aged between 15 and 49 years. In Lesotho, HIV/AIDS has also been declared a national emergency and an estimated 180,000 women out of 330,000 adults, and 27,000 children are living with HIV/AIDS. Statistics have shown that the majority of AIDS cases occur in adults aged 15 and 49 years in Lesotho. Presently women are the fastest growing infected population in Lesotho. Regardless of the growing numbers of women infected with HIV/AIDS, experiences of women living with HIV/AIDS have received little attention in Lesotho. Qualitative research in this area is necessary to gain access to women's perceptions of their HIV positive status. In this study, the experiences and coping strategies of Basotho women living with HIV/AIDS were investigated. The study used a feminist approach to research. Feminist research stresses the multiplicity of knowledge and it is useful to understand the subjective experiences of women. Indepth, face-to-face interviews were conducted with five women ranging between 29 and 46 years, purposefully drawn from Positive Action Society Lesotho (PASL). Grounded theory was used to analyse the data. Findings indicate that women's risk for exposure to HIV is related to their ability to protect themselves by negotiating a safe sexual relationship. Women who feel powerless in their relationships are less likely to protect themselves against HIVexposure. These perceptions of powerlessness are the result of a broad array of experiences that may include exposure to gender-based violence and restricted economic opportunities. The results show that it is common for women to be shocked, depressed, and discouraged when they find that they are living with HIV/AIDS as can be expected. It is also difficult for women to disclose their HIV positive status to family, friends and community members because of stigma attached to HIV/AIDS. Participants developed different ways of coping with their status such as religion, healthy life style, AIDS counselling and social networks. There was a profound sense of anxiety about the future care of children. The study concludes with a number of recommendations to promote an environment that will make it possible for women living with HIV/AIDS to cope with their illness. / AFRIKAANSE OPSOMMING: Studies het bevind dat daar ongeveer dertig miljoen mense in sub-Sahara Afrika is wat met MIVNIGS leef. Vyftig persent van geinfekteerde volwassenes is vroue tussen die ouderdom van 15-49 jaar. In Lesotho is MIVNIGS as 'n nasionale ramp verklaar en daar word beraam dat 330,000 volwassenes, 180,000 vroue en 27,000 kinders MIVNIGS het. Statistiek het ook getoon dat die meerderheid VIGS gevalle in Lesotho voorkom by volwassenes in die ouderdomsgroep 15-49 jaar. Vroue is tans die vinnigste groeiende groep. Ten spyte van die groeiende getalle vroue wat met MIVNIGS geinfekteer is, het die ervaringe van vroue in Lesotho wat met MIVNIGS saamleef tot dusver relatief min aandag geniet. Kwalitatiewe navorsing in hierdie verband is nodig om toegang tot vroue se persepsies te verkry rakende hul eie MIV positiewe status. In hierdie studie is die ervaringe en hanteringsmeganismes van Basoetoe vroue wat MIVNIGS het, ondersoek. Die studie het 'n feministiese benadering gebruik, wat die multiplisiteit van kennis en die subjektiewe ervaringe van vroue beklemtoon. In-diepte aangesig-tot-aangesig onderhoude is met vroue tussen 29-46 jaar gevoer. Gegronde teorie is gebruik om die data te analiseer. Bevindinge dui aan dat vroue se risiko vir blootstelling aan MIV verband hou met hul vermoë om hulself te beskerm deur te onderhandel vir 'n veilige seksuele verhouding met 'n maat. Vroue wat magteloos in hul verhoudings voel, is waarskynlik minder suksesvol om hulself teen MIV blootstelling te beskerm. Hierdie persepsies van magteloosheid is die resultaat van 'n breë spektrum ervaringe wat sekondêre status, blootstelling aan geweld, en beperkte ekonomiese geleenthede insluit. Soos wat verwag word, toon die bevindinge dat dit algemeen vir vroue is om geskok, deppressief en ontmoedig te wees wanneer hulle uitvind dat hul MIVNIGS het. Dit is ook moeilik vir vroue om hul MIV status aan familie, vriende en gemeenskapslede bekend te maak weens die stigma wat aan MIVNIGS kleef. Respondente het verskeie wyses ontwikkelom hul status te hanteer, soos godsdiens, 'n gesonde leefstyl, VIGS raadgewing en sosiale netwerke. Daar was ook 'n intense bekommernis by vroue oor die toekomstige sorg vir hul kinders. Die studie sluit af met 'n aantal aanbevelings om 'n omgewing te promoveer wat dit vir vroue wat met MIVNIGS leef moontlik sal maak om hul siekte te hanteer.

<p>The district health report for Livingstone, Zambia, outlined an increasing prevalence of HIV/AIDS iun the district. In 1998 the prevalence wsas at 29%, in 2000 at 30%, in 2002 at 31.8% and in 2004 at 31%. This was above the national prevalence of 20% according to CBoH statistics of 2004. The district has been implementing the HIV/AIDS prevention in various organizations during the past 3 years. Most of the organizations implementing the HIV/AIDS preventive activities do not work collaboratively with other sectors and this has resulted in un-coordinated activities and wstage of the limited resources. This exploratory qualitative study aimed at undestanding participants' perceptions of factors influencing coordination between different organizations that are involved in the implementation of HIV/AIDS activities, and to note the impact that this had in the implementation of activities in a multisectoral approach to HIV/AIDS prevention.</p>

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.

This study investigates the impact of the scale-up of antiretroviral treatment (ART) on the health system in South Africa. It looks at the positive and negative effects of treatment scale-up on human resources and staff morale, on HIV prevention programmes, and on other health system programmes, looking specifically at the integration of programmes and the use of infrastructure. There is much debate as to the place of treatment as a response to the epidemic because it has been found to be less cost-effective than prevention interventions. However this study argues that it is difficult to accurately assess cost effectiveness because it does not take into account other ways in which treatment may be effective, such as its impact on other aspects of health care, most notably on staff morale and on prevention. Thus this study investigates the impact of treatment intervention on the health system as a whole in order to determine the effectiveness of treatment as a policy response. This research uses data collected in 2006 at two sites in South Africa: the Ilembe district in KwaZulu-Natal province and the Cape Winelands Region in the Western Cape province. Twenty-one health care professionals were interviewed across the two sites in order to determine their perspectives on the impacts of ART scale-up on these aspects of the health care system. Interviews were conducted at hospitals, clinics and on hospice where ART was being administered ART scale-up, as predicted, was having a mixed impact on the health system as a whole. For the most part, the programmes were not having negative impacts on the rest of the health system in the form of taking infrastructure, funding, or human resources from other departments. The programmes, on separate budgets, were not directly taking resources from other departments, although there were some instances of borrowing space, staff, or equipment when necessary. The treatment programmes were reported to be adding further strain to an already resource-limited health care system, which was most notable in the issues of space and staff shortages. In addition, the treatment programmes did not appear to be bringing in additional funding, staff development, or infrastructure to benefit the health system as a whole.The major positive impact of the ART rollout on the health system was creating positive staff morale and a sense of hope throughout the health system. The health system was now able to address HIVIAIDS and was able to provide treatment whereas prior to rollout there was little apart from palliative care that could be done for people living with HIVIAIDS. In addition, treatment was adding to prevention efforts by raising awareness in the community about HIV/AIDS and by increasing uptake of voluntary counseling and testing. There is a need to address the resource limitations in the health care system, most notably human resource shortages. The success of treatment programmes was dependent on having motivated and dedicated staff. It is necessary to further attract and retain health care professionals to the field in order to ensure the sustainable success of ART rollout. Funding also needs to be addressed to ensure that sustainable resources are available to support the ever-growing needs of the treatment programmes. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2008.

<p>The 24-item scale has been used extensively to assess the attitudes towards AIDS precautions. This study investigated the usefulness and validity of the instrument in a South African setting, fourteen years after the development of the instrument. If a new structure could be found statistically, the HIV/AIDS prevention strategies could be more effective in aiding campaigns to change attitudes and sexual behaviour.</p>

This study focuses on the impact of HIV/AIDS on women in Namibia. Namibia, with a population of only 1.7 million people, is ranked as the seventh highest country in the world in terms of HIV/AIDS infections. The percentage of women living with HIV/AIDS in Namibia accounts for 54% of the total of 68 196 people in the country living with the virus. Women are also diagnosed with the disease at a younger age (30) in comparison to their male counterparts (35 years). Desoite their needs, women living with HIV/AIDS bear a triple burden of caring for those living with HIV/AIDS, caring for themselves and coping with the responses to their infection. There are few focused intervention strategies to support and care for women living with HIV/AIDS in Namibia.