Submitted in partial fulfilment of the academic requirements for the degree: Master of Education - Research Methodology in the Department of Educational Psychology of the Faculty of Education at the University of Zululand, 2010. / There is ongoing debate regarding the public health message of introducing a microbicide that is less efficacious than condoms into the HIV prevention field. One key issue is whether the availability of microbicides would undermine women's bargaining power to negotiate condom use. Most microbicide trials report increased condom use among participants. This analysis attempts to separate the influence of increased safer sex counselling from the direct impact of gel use as a facilitator to condom acceptability. In-depth interviews were conducted with a random sample of women participating in the MDP 301 Phase III microbicide trial, and a sub-sample of their male partners. Data from 63 female and 5 male interviews were analysed to assess the impact that participating in a clinical trial and using a vaginal microbicide/placebo gel had on condom usage. Two thirds of women reported not using condoms prior to study participation due to male opposition. Most of the women interviewed were unable to explain their partners' resistance to condoms. Some of the underlying factors were related to men's resistance to using condoms with a main or long term partner (as opposed to casual partners); preference for skin-to-skin contact; or rumours about negative health implications such as condoms containing maggots. A third of women started using condoms, although inconsistently, after joining the trial. Women used participation in the trial as the rationale for discussing the risks of HfV infection and condom use with their partners. Men appeared to be more willing to use condoms in the presence of gel, and this was partially due to the gel counteracting the negative effects of condom use on sexual pleasure. Joining the trial appeared to create an opportunity for women to discuss sex with their partners, and the introduction of gel into the relationship serves as a bargaining tool for condom use with their partners.

This study uses non-random and snowball sampling methodologies in order to get a truer insight into the life, activities and health care problems of 100 drug using prostitutes, and 50 non using prostitutes in Manchester, contacted directly in the streets or saunas / massage parlours. A subsidiary study of 120 male clients of female prostitutes was also conducted by means of self-completed questionnaires and telephone interviews. Among the sample in the main study of female prostitutes, drug users, 71% of whom were injecting users, were shown to have had a much more disrupted childhood than non users. They were also more likely to take risks in relation to condom use, to the type of sexual and drug taking activities they were engaged in, and to their general health care. A majority had been for an HIV test, with 2 reporting a positive result. Most of them (78%) had had at least one pregnancy, 10% of these making their first contact with health services whilst in labour. Access to methadone scripts tended to reduce criminal activity and rates of injecting, but only 13% had regular contact with community drug services which were not regarded as very useful. 4 The client study revealed that 62% of the sample were either married or living with a regular partner, and 86% in full time employment. One fifth had had a venereal disease check, and one fifth an HIV test (none reported positive). A majority used condoms (mostly supplied by the prostitute), although 23% reported not using one in their last contact. Clear implications arise from the study for the health, social services and criminal justice systems to ensure greater efforts are made to respond to the needs of female drug users.

ABSTRACT Background: Previous studies have shown that HIV prevalence rates are relatively high while condom use is low in migrant communities in South Africa (Zuma 2003, Weltz 2007, IOM 2008). This study seeks to investigate factors associated with condom use in selected commercial farms in Limpopo and Mpumalanga provinces of South Africa. Methodology: This study is a secondary data analysis of the Integrated Biological and Behavioural Surveillance Survey (IBBSS) implemented by the International Organisation for Migration (IOM) in 2010 among 2,810 farm workers. The study population comprises all sexually active non-South African nationals who have worked on the farm from a period of less than one year to over ten years. Majority of the migrants are from Zimbabwe, Mozambique and Swaziland. The outcome variable is condom use at the last intercourse while the explanatory variables include sex, age, marital status, financial stability, sexual abuse, condom availability, transactional sex, attending an HIV function and period worked on the farm. Data analysis was undertaken in three stages. Firstly, univariate analysis of the variables was done to provide descriptive statistics of the study population. The second stage was bivariate analysis producing unadjusted odds ratios to examine the association between each of the predictor variables and the outcome variable. The final stage was multivariate analysis using logistic regression and producing odds ratios to examine the association of more than one predictor variable with the outcome variable. Results: The results show that access to free condoms, having sex while drunk, financial stability and living arrangements with spouse are the factors associated with condom use among migrant farm workers in Limpopo and Mpumalanga. Among migrant men financial stability and access to free condoms were significant while among women, marital status, having attended an HIV function, having sex while drunk and living arrangements with spouse are the significant factors associated with condom use. Unexpectedly, socioeconomic factors such as transactional sex, forced sex and demographic factors such as age, proved to be insignificantly associated with condom use. Conclusion: It was noted that condom use levels and determinants vary between male and female migrants. Although men portrayed exhibiting more high risk sexual behavior, women proved to be more vulnerable. Policies and programmes targeting migrant farm workers should be gender sensitive.

Thesis (Ph. D.)--UCLA, 2008. / Vita. Includes bibliographical references (leaves 130-151).

Thesis (Ph. D.)--University of Hawaii at Manoa, 2004. / Includes bibliographical references (leaves 174-184).

A dissertation submitted in partial fulfillment of the requirements for the degree of Masters of Arts (Clinical Psychology) in the Department of Psychology, University of Zululand, 2007. / The study investigated the impact of the HIV/AIDS peer education program on behaviour change of students at the University of Zululand main campus. The sample (N = 40) consisted of male (N - 20) and female (N = 20) students whose ages ranged between 21-40 years. Findings indicated a significant change in behavioural practices of the participants post exposure to the program. Based on these findings it is indicated that the program is effective in providing necessary information about HIV/AIDS and to change students sexual behavioural patterns towards HIV/AIDS prevention.

To prevent unwanted pregnancies and sexually transmitted infections, sexually active individuals should practice safer sex (World Health Organisation 2008). This is important across the lifespan (Nusbaum and Rosenfeld 2004). But older and heterosexual populations are typically overlooked in safer sex interventions (Bodley-Tickell et al. 2008; Bowleg 2011). The Theory of Planned Behaviour (TPB) has been used to predict behaviour, and develop safer sex interventions (Fishbein and Ajzen 2010). But a criticism of the TPB is that it fails to recognise the emotional aspect of safer sex (Norton et al., 2005). Extending the TPB to include affective attitudes has enhanced the effectiveness of safer sex interventions (Ferrer et al. 2011). Furthermore, safer sex typically involves a series of five condom-related behaviours; accessing, carrying, negotiating, using and disposing (Moore et al. 2006). Yet most interventions promote only one condom-related behaviour. In addition, the internet is now being used more as a platform for delivering interventions (Kraft and Yardley 2009). For safer sex interventions, online delivery may help reduce the embarrassment individuals often report when discussing sexual health (Qulliam 2011). Therefore, the aim of this thesis was to develop and evaluate an online safer sex intervention to promote performance of multiple condom-related behaviours in a broad population. A series of studies were conducted in order to develop the intervention. Study 1, an online elicitation study with 26 individuals, used an extended TPB framework to explore attitudinal, normative and control beliefs toward performing five condom-related behaviours. Findings suggested that individuals hold a range of attitudinal, normative and control beliefs toward performing these condom-related behaviours. Study 2, an online questionnaire study with 363 individuals identified beliefs and behaviours for intervention target. Findings suggested that three condom-related behaviours should be promoted; carrying, negotiating and using. In addition, analysis showed that affective and moral norm beliefs were most predictive of intention to perform these three condom-related behaviours, and should be the intervention targets. Study 3 was an online intervention with 439 individuals. Individuals were randomised to one of three conditions; control message, positively- or negatively-framed persuasive message. TPB and self-report behaviour measures were taken pre-, immediately post-intervention and three months later. Findings demonstrated that performance of condom-related behaviours did not significantly increase from participation in the intervention. However, intention to carry and use condoms increased over time regardless of intervention condition in all populations sampled. Overall, findings from this thesis support the development of safer sex interventions that promote multiple condom-related behaviours in a broad population. However, findings suggested that persuasive messages targeting psychological constructs of the TPB do not change intentions better than a control message in a broad population. From a public health perspective, these findings suggest that highlighting the benefits of performing condom-related behaviours may be sufficient to strengthen intentions. These strengthened intentions may be protective in the future if the situation arises for an individual which requires the performance of these behaviours. Recommendations for future safer sex research are considered.

Heterosexual adult men have been a neglected population that is at risk for HIV infection. In an era burdened by the devastation caused by HIV, it is alarming that risky sexual behavior continues to be a problem among heterosexuals. Heterosexual sexual behavior has contributed to a growing trend of HIV transmission in the Caribbean where the average prevalence in the adult population is 5%. Despite the availability of condoms and HIV prevention efforts of many Caribbean public health departments to reduce the spread of the disease, there appears to be barriers to safer sex practices. Guided by the theory of planned behavior, a descriptive correlational design was used with 185 Bahamian men ages 18 years and older to (a) examine the relationships among select demographics, masculine ideology, condom attitudes, self-efficacy for condom use, and safer sex behaviors; and (b) identify select predictors of condom use among Bahamian men. Data were collected using four standardized instruments and a demographic questionnaire. The results of this study suggest that masculine ideology, condom attitudes, and condom use self-efficacy are important in explaining 33% variance in safer sex behaviors among Bahamian men. Income (β = -.15, p < .01), masculine ideology (β = -.24, p < .01), condom attitudes, (β = .36, p < .01), and condom use self-efficacy (β = .1, p < .01) were significantly associated with safer sex behaviors. The empirical knowledge obtained from this study will be used to provide a rationale for nurses and policy makers to design and conduct culturally sensitive interventions with an aim of achieving an increase in safer sex behaviors among Bahamian men.

No description available.

Older African American (AA) women are at increased risk for HIV and STDs. The purpose of this quantitative study was to examine the influence of provider-initiated condom use education on condom use among unmarried, heterosexually active AA women aged 50 and over using the constructs of self-efficacy and attitudes of the health belief theoretical model. The relationships between provider education on condom use, condom use self-efficacy, condom use attitudes, and actual condom use were tested individually, and provider education on actual condom use was tested after controlling for condom use self-efficacy and attitudes among 95 study participants recruited primarily from Raleigh-Durham, NC. A 2-tailed sample t test or analysis of covariance was used for analysis. Provider education on condom usage failed to show a benefit with regard to condom usage, condom use self-efficacy, and attitudes toward condom usage. Additionally, women who received provider education on condom use were less likely to use condoms. Possibly these women had a low perception of risk and vulnerability to HIV and STDs, which correlated with lower condom use. The counter intuitive findings could also be related to another variable that was not tested and should spur more research. Results could be used to contribute to the design of an intervention model that specifically addresses the sexual behaviors of older AA women. Results of this study, combined with previous research, can help emphasize the need for improved patient-provider communication so that provider communication produces a more positive outcome and helps limit the spread of HIV and STDs, a limitation that would benefit individuals, whole communities, and the nation.