Thesis (DPhil)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Disabled adolescents are vulnerable to HIV infection particularly in countries like South Africa which has one of the largest HIV epidemics in the world. Like able-bodied adolescents, adolescents with disabilities are at a critical stage of their psychosocial and sexual development. They may be at risk of sexual abuse as perpetrators may believe that they are incapable of defending themselves or reporting the crime to the authorities. Deaf or hard of hearing adolescents are vulnerable to HIV/AIDS due to similar risk factors to other disabled adolescents. They also face difficulties in communicating with hearing people and receiving information in sign language, and they share characteristics with minority ethnic groups, which make them hard to reach for HIV prevention campaigns. There is a paucity of research in South Africa investigating the role of schools for Deaf and hard of hearing adolescents in delivering appropriate HIV and sexuality education to their learners. This thesis is an exploratory study and investigates HIV prevention issues for Deaf or hard of hearing adolescents in South Africa. More specifically, I aim to determine the ways in which participants believe schools, health systems and other organizations contribute or fail to contribute to the HIV/AIDS prevention needs of Deaf and hard of hearing adolescents. The study includes qualitative interviews with employees of Deaf organizations, educators of Deaf and hard of hearing adolescents, parents of Deaf and hard of hearing adolescents and Deaf and hard of hearing adolescents themselves in relation to sexuality and HIV related issues. Results indicate that Deaf organizations have an interest in the HIV prevention needs of the Deaf community and in Deaf schools. However they have experienced obstacles in delivering HIV education to learners. These obstacles include communication barriers as well as the fact that religious environments in some of the schools may not always be experienced as conducive to HIV education. Although all educators of Deaf and hard of hearing adolescents interviewed in the previous phase of the study were aware that their learners are at risk of HIV/AIDS, some educators of Deaf and hard of hearing adolescents were constrained by the same issues of morality and religious conviction discussed in the first phase. Some participants had made efforts to produce appropriate HIV and sexuality materials for Deaf learners. Parents of Deaf and hard of hearing adolescents were affected by communication barriers with their children but seemed unaware of the religious ethos of many of the schools their children attended. The Deaf and hard of hearing adolescents knew they could be at risk of HIV/AIDS. Some displayed poor knowledge of HIV transmission. There are a number of issues to be addressed if schools for Deaf and hard of hearing learners are to provide adequate HIV/AIDS prevention information to their learners. / AFRIKAANSE OPSOMMING: Gestremde adolessente is kwesbaar vir MIV-infeksie veral in lande soos Suid-Afrika wat een van die grootste MIV-epidemies ter wêreld het. Soos nie-gestremde adolessente is gestremde adolessente in 'n kritieke stadium van hul psigososiale en seksuele ontwikkeling. Oortreders van seksuele misbruik mag gestermde adolessente beskou as sagte teikens aangesien daar die persepsie is dat hulle minder in staat is om hulself te verdedig of minder geneig is om `n misdaad by die owerhede te rapporteer. Dowe of hardhorende adolessente is kwesbaar vir MIV / VIGS vir redes war soortgelyk is aan die van ander gestremde adolessente. Dowe of hardhorende adolessente vind dit problematies om met horende (nie-gestremde) mense te komminikeer, inligting in gebaretaal te ontvang, en deel eienskappe met etniese minderheidsgroepe wat dit moeilik maak om hulle deur middel van MIV voorkomingsveldtogte te bereik. Daar is 'n gebrek aan navorsing in Suid-Afrika oor die rol wat skole vir dowe en hardhorende adolessente speel in die lewering van geskikte MIV en seksualiteitsopvoeding. Hierdie proefskrif verken en ondersoek kwessies met betrekking tot MIV-voorkoming onder dowe en hardhorende adolessente in Suid-Afrika. Meer spesifiek was die doel van hierdie studie om vas te stel wat deelnemers se persepsies is oor die bydrae of gebrek aan bydrae van skole, gesondheids-en ander organisasies tot die behoeftes van dowe en hardhorende adolessente wanneer dit kom by die voorkoming van MIV/ VIGS. Gedurende die studie is kwalitatiewe onderhoude met die volgende deelnemers gevoer: die werknemers van organisasies vir dowes; die onderwysers van dowes, ouers van dowe en hardhorende adolessente. Die onderhoude het hoofsaaklik gehandel oor seksualiteit en MIV-verwante kwessies onder gehoor gestremde adolessente. Die studie het bevind dat organisasies vir dowes `n belangstelling toon in die behoeftes van dowe gemeenskappe en skole vir dowes wanneer dit kom by MIV-voorkomming. Hulle het dit egter met tye problematies gevind om leerders op te voed oor MIV weens verskeie hindernisse. Hierdie hindernisse sluit in kommunikasie-hindernisse sowel as die godsdienstige etos wat wat in sommige skole teenwoordig is en wat nie altyd bevorderlik is tot MIV-onderrig nie. Alhoewel al die opvoeders van dowe en hardhorende adolessente gedurende die vorige fase van die studie aangedui het dat hul wel bewus is van leerders se risiko vir MIV/VIGS word sommige van hulle beperk deur bogenoemde kwessies van moraliteit en godsdienstige oortuiging. Sommige deelnemers het daarop gedui dat hul pogings aangewend het om geskikte materiaal te produseer wat spreek tot MIV en seksualiteit onder dowe leerders. Ouers van dowe en hardhorende adolessente was bewus van en word beïnvloed deur kommunikasie-hindernisse, maar was nie bewus van die godsdienstige etos van die skole wat hul kinders bywoon nie. Dowe en hardhorende adolessente was bewus daarvan dat hulle die risiko loop om MIV / vigs op te doen, maar dit blyk dat sommige min kennis dra oor MIV-oordrag. Daar is 'n aantal kwessies wat aangespreek moet word voordat skole vir dowes en hardhorendes instaat sal wees om geskikte MIV/VIGS voorkomingsprogramme aanbied te bied wat voldoen aan die behoeftes van leerders.

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.

In recent times the potential impact of preeclampsia on the cardiovascular health of offspring has been identified. This thesis explores the relationship between preeclampsia and offspring cardiovascular phenotype during the first three decades of life. A systematic review and meta-analysis provided evidence that there was increased blood pressure and BMI in the offspring of preeclamptic pregnancies (n = 45,249). There was however limited data on metabolic features and inadequate characterisation of the degree of prematurity or growth restriction in existing literature. I therefore studied data on two birth cohorts with up to 28 years of detailed prospective follow up (n = 2868 and n = 926). Those born very preterm to preeclamptic pregnancies had transient perinatal reductions in insulin and cholesterol, although extreme prematurity was the only determinant of variation in cardiovascular risk in later life, with changes in both metabolism and blood pressure. In those born closer to, or at term, gestation was no longer relevant and an independent impact of preeclampsia on blood pressure was evident, so that by age 20, those born at term to preeclamptic pregnancies were four and a half times more likely to demonstrate clinically-apparent hypertension. I then investigated whether there were changes in other features of cardiovascular phenotype, independent of blood pressure, in preterm neonates born following preeclampsia (n = 46). At 3 months of age preterm infants born to hypertensive pregnancies had subclinical alterations in cardiac strain, independent of gestation or birth weight but not differences in blood pressure, or microvascular structure. These findings highlight preeclampsia and prematurity as key, independent perinatal factors, important in determining cardiovascular phenotype and risk during early life. Preeclampsia is associated with a specific lean, hypertensive phenotype, associated with cardiac functional alterations; these findings begin to define a distinct at risk population who may require targeted preventative interventions.

Thesis (MScMed)--Stellenbosch University, 2008. / ENGLISH ABSTRACT: It has recently been observed that the application of multiple short cycles of reperfusion and ischaemia, at the onset of reperfusion, elicits cardioprotection against injury due to prior sustained ischaemia. This phenomenon has been termed “postconditioning” (postC) and is of special interest due to its clinical applicability. Although much work has been done to delineate the mechanism of protection, there is still controversy regarding the precise algorithm of postC, the importance of the reperfusion injury salvage kinases (RISK), as well as uncertainty about the possible role of p38 MAPK and the protein phosphatases in postC cardioprotection. The aims of this study were therefore: I. To develop and characterise a cardioprotective postC protocol in the ex vivo rat heart, using both the retrogradely perfused and working heart models. II. To characterise the profiles of PKB/Akt, ERK p42/p44 and p38 MAPK associated with the postC intervention. III. To investigate the possible role of the serine/threonine protein phosphatases type 1 and type 2A (PP1 and PP2A) in the mechanism of postC. Hearts from male Wistar rats were perfused in both the retrograde Langendorff (at a perfusion pressure of 100 cmH2O and diastolic pressure set between 1 and 10 mmHg) and working heart models (preload: 15 cmH20 and afterload: 100 cmH20). Several different postC protocols were tested for their cardioprotective effect, as analysed by infarct size (IFS; determined by triphenyltetrazolium chloride (TTC) staining) and functional recovery. Experimental parameters tested were the number of cycles (3,4 or 6), the duration of the cycles (10, 15, 20 or 30 seconds), the method of application (regional or global) and temperature during the intervention (36.5 or 37 °C). Different sustained ischaemic insults were also utilised: 35 minutes regional (RI) or 20, 25, 30 and 35 minutes global ischaemia (GI). Hearts treated with a cardioprotective postC intervention or standard reperfusion after sustained ischaemia, were freeze-clamped at 10 and 30 minutes reperfusion in both perfusion models. Tissue samples were then analyzed using Western blotting, probing for total and phosphorylated PKB/Akt, ERK p42/p44 and p38 MAPK. The contribution of PKB/Akt and ERK p42/p44 activation to cardioprotection was also investigated by administration of inhibitors (A6730 and PD098059 respectively) in the final 5 minutes of ischaemia and the first 10 minutes of reperfusion, in the presence and absence of the postC intervention. The effect of these inhibitors were analyzed in terms of IFS and kinase profiles. The possible role of the phosphatases in postC was investigated by observing the effect of cantharidin (a PP1 and PP2A inhibitor) treatment directly before sustained ischaemia (PreCanth) or in reperfusion (PostCanth), in the presence and absence of postC, on IFS and kinase profiles. A postC protocol of 6x10 seconds global reperfusion / ischaemia, at 37°C, was found to give the best and most consistent reduction in infarct size in both the Langendorff (IFS in NonPostC: 47.99±3.31% vs postC: 27.81±2.49%; p<0.0001) and working heart (IFS in NonPostC: 35.81±3.67% vs postC: 17.74±2.73%, p<0.001) models. It could however only improve functional recovery in the Langendorff model (after 30 minutes GI: rate pressure product (RPP) recovery: NonPostC = 12.27±2.63% vs postC = 24.61±2.53%, p<0.05; and after 35 minutes GI: left ventricular developed pressure (LVDP) recovery: NonPostC = 28.40±7.02% vs postC = 48.49±3.14%, p<0.05). This protection was associated with increased PKB/Akt (NonPostC: 0.88±0.26 AU (arbitrary unit) vs postC: 1.65±0.06 AU; p<0.05) and ERK p42 (NonPostC: 2.03±0.2 AU vs postC: 3.13±0.19 AU; p<0.05) phosphorylation. Inhibition of PKB/Akt activation with A6730 (2.5 μM) abrogated the infarct sparing effect of postC. Administration of cantharidin, either before of after ischaemia, in the absence of postC, conferred an infarct sparing effect (IFS in PreCanth: 15.42±1.80%, PostCanth: 21.60±2.79%; p<0.05) associated with an increase in the phosphorylation of MAPK p38 (administration before ischaemia: NonCanth: 1.52±0.26 AU vs PreCanth: 2.49±0.17 AU, p<0.05; and administration after ischaemia: NonCanth: 5.64±1.17 AU vs PostCanth: 10.69±1.29 AU, p<0.05) and ERK p42 (when administered in reperfusion; NonCanth: 2.24±0.21 AU vs PostCanth: 3.34±0.37 AU; p<0.05). Cantharidin treatment combined with the postC intervention did not elicit an additive infarct sparing effect (postC: 17.74±2.72%, PreCanth-postC: 13.30±3.46% and PostCanth-postC: 15.39±2.67%). In conclusion: a postC protocol of 6x10 seconds global ischaemia / reperfusion, at 37°C, confers the best infarct sparing effect in both the Langendorff and working rat heart models. This protection is associated with ERK p42 and PKB/Akt phosphorylation, although only PKB/Akt is necessary for cardioprotection. We could not find evidence for PP1 and PP2A involvement in postC, although inhibition of these phosphatases per se does elicit an infarct sparing effect. The latter observation suggests that phosphatase activation during ischaemia / reperfusion is potentially harmful. / AFRIKAANSE OPSOMMING: Dit is onlangs waargeneem dat toediening van meervoudige siklusse herperfusie / iskemie, met die aanvang van herperfusie, die hart teen iskemie / herperfusie beskadiging beskerm. Hierdie verskynsel, bekend as postkondisionering (postC), geniet tans baie aandag vanweë die kliniese toepaslikheid van die ingreep. Ten spyte van intensiewe navorsing om die betrokke meganisme van beskerming vas te stel, is daar steeds kontroversie oor die presiese algoritme van die ingreep, asook die betrokkenheid van die sogenaamde iskemie herperfusie oorlewings kinases (RISK). Daar bestaan ook onsekerheid oor die rol van die stres-kinase, p38 MAPK, asook die proteïen fosfatases in die meganisme van beskerming teen iskemiese besering. Hierdie studie het dus drie doelstellings gehad: I. Ontwikkeling van ‘n postC protokol wat beskerming ontlok in die rothart ex vivo, deur gebruik te maak van beide die retrograad geperfuseerde ballon model, asook die werkhart model. II. Analiese van die profiele van die kinases PKB/Akt, ERK p42/p44 en p38 MAPK tydens herperfusie van postC en kontrole (NonPostC) harte. III. Ondersoek na die moontlike rol van die serien / treonien proteïen fosfatases tipe 1 en tipe 2A (PP1 en PP2A) in die meganisme van postC beskerming. Harte van manlike Wistar rotte is geperfuseer in beide die retrograad geperfuseerde ballon (d.i. die Langendorff) model (teen ‘n konstante perfusie druk van 100 cmH20 en ‘n diastoliese druk gestel tussen 1 en 10 mmHg), asook die werkhart model (teen ‘n voorbelading van 15 cmH20 en ‘n nabelading van 100 cmH20). Verskeie moontlike postC protokolle is getoets vir hul vermoë om kardiobeskerming te ontlok, in terme van funksionele herstel en infarktgrootte (IFS), soos bepaal deur trifenieltetrazolium chloried (TTC) kleuring. Die eksperimentele veranderlikes tydens die postC protokol wat ondersoek is, sluit in: die aantal siklusse (3, 4 of 6), die duur van die siklusse (10, 15, 20 of 30 sekondes), die wyse van postC toediening (streeks of globaal) en laastens die temperatuur tydens die ingreep (36.5 of 37 °C). Daar is ook gebruik gemaak van verskillende periodes iskemie: 35 minute streeks iskemie (RI), asook 20, 25, 30 en 35 minute globale iskemie (GI). Na 10 of 30 minute herperfusie is harte wat blootgestel is aan ‘n kardiobeskermende postC ingreep of gewone standaard herperfusie na iskemie, in beide perfusie modelle, gevriesklamp. Die weefsel proteïen-inhoud is verder geanaliseer deur van die Western blot tegniek gebruik te maak vir bepaling van die totale en fosforileerde vlakke van PKB/Akt, ERK p42/p44 en p38 MAPK. Die funksionele belang van PKB/Akt en ERK p42/p44 is verder ondersoek deur die effek van ‘n geskikte inhibitor (onderskeidelik A6730 en PD098059, toegedien tydens die laaste 5 minute van iskemie en die eerste 10 minute van herperfusie), in die teenwoordigheid en afwesigheid van die postC ingreep, op infarktgrootte en kinase aktiwiteit te monitor. Die moontlike rol van proteïen fosfatases in postC is ondersoek deur die effek van cantharidin (‘n PP1 en PP2A inhibitor) op infarktgrootte en kinase profiele te ondersoek. Cantharidin is óf onmiddelik voor iskemie óf tydens herperfusie toegedien, in die aan – en afwesigheid van die postC ingreep. Daar is bevind dat ‘n postC protokol van 6x10 sekondes globale iskemie / herperfusie, teen 37°C, die mees effektiewe en konstante verlaging in infarktgrootte teweeg gebring het in beide die ballon model (IFS in NonPostC: 47.99±3.31% vs postC: 27.81±2.49%; p<0.0001), asook die werkhart (IFS in NonPostC: 35.81±3.67% vs postC: 17.74±2.73%, p<0.001). Funksionele herstel kon egter slegs ontlok word in die ballon model (na 30 minute GI: tempo druk produk (RPP) herstel: NonPostC = 12.27±2.63% vs postC = 24.61±2.53%, p<0.05; en na 35 minute GI: linker ventrikulêre ontwikkelde druk (LVDP) herstel: NonPostC = 28.40±7.02% vs postC = 48.49±3.14%, p<0.05). Die infarkt-besparende effek van postC was geassosieer met ‘n toename in die fosforilasie van beide PKB/Akt (NonPostC: 0.88±0.26 AU (arbitrêre eenhede) vs postC: 1.65±0.06 AU; p<0.05) en ERK p42 (NonPostC: 2.03±0.2 AU vs postC: 3.13±0.19 AU; p<0.05). Inhibisie van PKB/Akt met A6730 (2.5 μM) het die infarkt-besparende effek van postC opgehef. Inhibisie van PP1 en PP2A opsigself, deur toediening van cantharidin óf voor óf na iskemie (in die afwesigheid van postC), het ‘n infarkt-besparende effek ontlok (IFS in PreCanth: 15.42±1.80%, PostCanth: 21.60±2.79%; p<0.05). Hierdie kardiobeskerming was geassosieer met ‘n toename in die fosforilasie van beide p38 MAPK (met toediening voor iskemie: NonCanth: 1.52±0.26 AU vs PreCanth: 2.49±0.17 AU, p<0.05; en toediening na iskemie: NonCanth: 5.64±1.17 AU vs PostCanth: 10.69±1.29 AU, p<0.05), asook ERK p42, indien cantharidin toegedien is tydens herperfusie (NonCanth: 2.24±0.21 AU vs PostCanth: 3.34±0.37 AU; p<0.05). Kombinasie van cantharidin behandeling met postC toediening kon egter nie ‘n kumulatiewe infarkt-besparende effek uitlok nie (postC: 17.74±2.72%, PreCanth-postC: 13.30±3.46% en PostCanth-postC: 15.39±2.67%). In samevatting: ‘n PostC protokol van 6x10 sekondes globale iskemie / herperfusie, teen 37°C, ontlok die mees effektiewe infarkt-besparende effek in beide die ballon, sowel as die werkhart modelle. Alhoewel hierdie beskerming geassosieer is met ‘n toename in die fosforilasie van beide PKB/Akt en ERK p42/p44 tydens herperfusie, is dit slegs PKB/Akt wat van funksionele belang is in die meganisme van kardiobeskerming. Ons kon geen bewyse vind vir die betrokkenheid van PP1 en PP2A in postC beskerming nie, alhoewel inhibisie van hierdie fosfatases opsigself infarkt-besparend is. Laasgenoemde waarneming toon dat fosfatase aktivering tydens iskemie / herperfusie skadelike gevolge mag hê.

Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: HIV/AIDS is considered as a global problem with the number of people living with HIV infection continuing to increase. At the end of 2007 HIV/AIDS had already claimed 25 million lives. Of all new HIV infections 71% were diagnosed in the Sub-Saharan region in 2008, remaining the worst affected region globally. UNAIDS (2008:43) indicated that heterosexual intercourse remained the main origin for HIV infection in the Sub-Saharan region. Therefore the researcher is of the opinion that prevention strategies should focus mainly on sexual transmission of the disease. HIV/AIDS affects mainly people between the ages 15-24 years, notably the age group of most of the learners in Higher Education Institutions (HEIs). Lesotho, a country in the Sub- Saharan region, presents with the third highest HIV adult prevalence (23.2%) in the world and in the region. In an attempt to address the prevailing situation, Lesotho has a number of programmes geared towards addressing HIV/AIDS in the country. However, all these attempts exclude the learners in HEIs, yet the majority of learners are found within the most affected age group. It is also to be noted that Higher Education provides the bedrock for socio-economic and political development in Africa. Some studies have identified insufficient knowledge as being at the root of the increasing HIV infections among youth. However, other studies have shown that there is adequate knowledge among the young people, but still a challenge remains and that is to facilitate changes in behavioural patterns as a component to be linked to the knowledge. Studies conducted in other African countries have shown that there are anti-AIDS programmes and clubs for learners in HEIs where learners are involved in the fight against HIV/AIDS. No publication indicating the same for Lesotho’s HEIs could be found, except for the National University of Lesotho (NUL) that only launched its HIV/AIDS policy for learners in 2009. The researcher is of the opinion that HEIs in Lesotho are not doing enough to combat HIV/AIDS and hence intends to focus on HEIs in Lesotho. This study had two objectives namely:  To determine the knowledge of learners in a specific HEI in Lesotho regarding HIV/AIDS prevention and care.  To explore the needs of learners in a specific HEI in Lesotho regarding HIV/AIDS prevention and care. This mixed method study was conducted, comprising of both quantitative and qualitative designs. Quantitative phase used a questionnaire for determining the knowledge of learners. The questionnaire was adopted from a study that was performed to determine knowledge of South African educators in public schools with some modifications. The qualitative phase was used to explore the needs of the learners through the focus group discussions with the leaders of the learners. Sample was drawn from the entire population using stratified random sampling for the quantitative phase. The qualitative phase used the purposive sampling to obtain in-depth information concerning learners’ needs. Quantitative data was analysed through the use of statistical package for social sciences (SPSS) and qualitative data was analysed using the thematic analysis and open-coding. All ethical principles were adhered to especially the principle of respect for persons. The findings from the quantitative phase of the study showed that learners had adequate knowledge regarding HIV/AIDS prevention and care and the findings from the qualitative phase showed the various needs of the learners with regards to prevention and care of HIV/AIDS in a specific HEI in Lesotho. Recommendations have been proposed based on the findings from the two phases of the study. Limitations observed by the researcher have also been identified. In conclusion the objectives of the study were met and the research questions had been answered. / AFRIKAANSE OPSOMMING: MIV/Vigs word as ‘n internasionale probleem erken, siende dat daar ‘n verhoging in die toename van MIVgeïnfekteerde indiwidue tans is . Einde 2007 het MIV/Vigs het reeds 25 miljoen lewens ge-eis . In 2008 is 71% van al die nuwe MIV-infeksies in die Sub-Sahara streek gediagnoseer, wat aandui dat die streek die mees geaffekteerde streek tans is. UNAIDS (2008:43) het aangedui dat heteroseksuele omgang die hoofoorsaak van MIV-oordrag in die Sub-Sahara-streek is. Laasgenoemde het daartoe gelei dat die navorser van mening is dat voorkomende strategieë meestal op seksuele oordrag van die siekte moet fokus. MIV/Vigs affekteer meestal mense in die ouderdomsgroep 15-24, opmerklik is dit die ouderdomsgroep waarby meesste leerders in Hoëronderwysinstellings (HOI) is. Lesotho, ‘n land in die Sub-Sahara-streek, het tans die derde-hoogste MIV-voorkoms (23.2%) in die wêreld en in die streek. Lesotho het verskeie programme ontlont om MIV/Vigs te bekamp in ‘n poging om die huidige situasie te beredder . Nieteenstaande sluit al die programme leerders in HOI uit, alhoewel die leerders in die ouderdomsgroep van die mees-geaffekteerde groep val. Dit is ook duidelik dat Hoëronderwys die fondasie vir sosio-ekonomiese- en politieke ontwikkeling in Afrika verskaf. Sommige studies het onvoldoende kennis as die wortel van die verhoging van MIV-infeksies onder die jeug geïdentifiseer. Ander studies, daarenteen, wys dat kennis voldoende is onder jeug, alhoewel veranderinge in gedragspatrone om by die kennis aan te sluit ‘n uitdaging bly. Studies uit ander Afrikalande dui daarop dat daar anti-Vigs programme en klubs is waarby HO leerders betrokke is om teen die verspreiding van MIV/Vigs te veg. Geen publikasies in hierdie verband word in Lesotho aangetref nie, behalwe ‘n MIV/Vigs-beleid wat in 2009 deur “National University of Lesotho’ (NUL) gepubliseer is. Dus is die navorser van mening dat HOI nie genoeg doen om MIV/Vigs te beveg nie, daarom fokus sy op HOI in Lesotho. Hierdie studie het twee doelstellings ten doel gehad, naamlik om die leerders in ‘n sekere HOI in Lesotho se kennis aangaande MIV/Vigs voorkoming en sorg te bepaal en die behoeftes van die leerders aangaande MIV/Vigs voorkoming en sorg te verken. ‘n Studie met beide kwantitatiewe- en kwalitatiewe metodes is gebruik om die doelstellings te verwesenlik. In die kwantitatiewe fase is ‘n vraelys gebruik om leerders se kennis te bepaal. Die vraelys is verkry uit ‘n vorige studie wat in RSA gedoen is, maar aangepas om in die Lesotho-konteks te gebruik. Gedurende die kwalitatiewe fase is fokusgroep besprekings met die leiers van die leerders gehou om die behoeftes indiepte te verken. Die steekproef was uit die totale populasie getrek deur van gestratifiseerde streekproefneming gebruik te maak in die kwantitatiewe fase en ‘n doelgerigte steekproefneming is in die kwalitatiewe fase te gebruik. Die navorser het ‘n kwantitatiewe data-analise sagteware (SPSS)gebruik om kwantitatiewe data te ontleed en tematiese- oopkodering is gedurende die kwalitatiewe fase gebruik. Etiese kode is ten volle gerespekteer, veral die respek vir mense gedurende navorsing. Bevindinge van die kwantitatiewe fase het bewys dat leerders voldoende kennis aangaande die voorkoming en sorg van MIV/Vigs besit en die kwalitatiewe bevindinge het die behoeftes van leerders met betrekking tot die voorkoming en sorg van MIV/Vigs in ‘n spesifieke HOI in Lesotho geopenbaar. Die aanbevelings is gemaak, gebaseer op die bevindinge uit die twee fases. Beperkinge in die studie is uitgelig. Ter afsluiting is die doelstellings in die studie bereik en die navorsingsvrae beantwoord.

Thesis (MTh)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: This thesis critically analyses the appropriateness and effectiveness of the ABC model in the HIV/AIDS prevention within the context of Swaziland. According to Louw (2008:423), the ABC model stands for the following: A = Abstinence, B = Be faithful and C = use Condoms. According to Green and Herling (2007:1) the ABC model has gained the attention of many countries. The attempt of this model in HIV prevention was to “aim at empowering people through value-based programs to basically abstain from sex as long as possible, to be faithful to one intimate partner and to use condoms correctly and consistently” (De la Porte 2006:79). The assessment of the HIV/AIDS virus in 1983-1984 came as a shock. It was difficult for the church to know at that time how to respond. Some of the responses pointed to the virus as punishment of God. Gradually the church started to become involved in the pandemic. From a Christian spirituality perspective it was argued that the so called ABC model could be viewed as a means of remedy within a prevention approach. The cultural issues as well as human sexuality factors have been discovered to be an obstacle in the ABC model in playing a progressive role in Swaziland. The cultural factors that prevent the ABC model from accomplishing effective results are listed in the final report of (Whiteside et al. 2006: 18-19): bunganwa (having multiple sexual partners; a cultural practice of male married and unmarried to have many girlfriends); kungenwa (levirate or wife inheritance); a widow is given in marriage to marry the brother of her deceased husband without the consent of the women which exposes women to the HIV virus. This practice is done without the consent of the women. Kujuma (occasional overnight visits between unmarried lovers); kuhlanta (a young girl bearing the children of her infertile sister); kushenda (extramarital relationships); kulamuta (a man having a sexual relationship with a younger sister of his wife); and sitsembu (polygamy, one man with more than one wife); this is a common cultural practice found in many African countries due to gender inequality (Chitando 2009:26). This has led to Swaziland being seriously affected by the HIV/AIDS virus (Rupiya 2006:66). The high rate of infection is frightening in a small country with a population of 1 million. As Bishop M, Mabuza, the Anglican bishop indicated, the nation‟s existence is threatened. (Rosenow 2011: 32). Therefore the researcher proposed a pastoral model which gives dignity to human and adds the spiritual dimension of healing in the pastoral care and counselling. There is an urgent need for church leaders to be empowered to face the HIV/AIDS with knowledge that the pandemic is not a punishment for promiscuous people. The theology of sexuality emphasises the responsibility in every sexual engagement for people to be conscious to whatever decision they take. / AFRIKAANSE OPSOMMING: In hierdie navorsing word die toepaslikheid en effektiwiteit van die ABC model in die voorkoming van MIV/Vigs binne die konteks van Swaziland krities ontleed. Volgens Louw (2008:423) staan ABC (in Engels) vir: A = Onthouding, B = Getrouheid aan een maat en C = Die gebruik van kondome. Die navorser, ‟n geordende predikant van die Evangeliese Lutherse Kerk, bespreek die erns van die voorkoms van die MIV/Vigs-infeksie in Swaziland. Empiries is bewys dat Swaziland een van die lande in Sub-Sahara en die wêreld is met die hoogste infeksiekoers (Rupiya 2006:66). Dit is ernstig in ‟n klein landjie soos Swaziland met ‟n bevolking van slegs 1 129 000. Die pandemie het ‟n impak op alle gemeenskappe in die land en bied‟n groot uitdaging vir die Kerk in Swaziland. Die vraag is hoe die Kerk, in haar pastorale bediening, die ABC model kan gebruik om die globale poging te steun om te verhoed dat MIV/Vigs versprei. Hoe kan die konsep van die ABC model toegepas word sodat die Kerk, as hulpgewende gemeenskap, kan sorg vir die siele van die gemeentelede (cura animarum) en effektief inligting omtrent die ABC model kan versprei en uitreik na MIV-positiewe mense? Die navorser stel voor dat daar verandering moet kom in die gesindheid van die Kerk en dat daar ‟n herkonseptualisasie van die voorkomingstrategie en die Skrifverklaring van menslike seksualiteit moet wees. Die Kerke in Swaziland moet hulle houding verander. Daar moet baie meer openlikheid wees sodat sosio-kulturele kwessies openlik bespreek kan word. Daar moet ‟n kritiese herbepaling wees van die tradisies en die kerkbeleid rondom menslike seksualiteit en hoe dit betrekking het op die MIV/Vigs-pandemie.

Thesis (M Social Work (Social Work))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: Young people between the ages of 15 and 24 have been identified as being the most significant target grouping affected by HIV and AIDS in the world. South Africa has one of the highest HIV and AIDS prevalence rates and has adopted two broad strategies to curb the HIV and AIDS pandemic. The first strategy is costly involving anti-retroviral treatment which the government has only been able to roll-out to a very few HIV positive people. Currently in a depressing global economy, international donors are finding it difficult to increase funding for HIV and AIDS, more particularly as the poor countries of Sub-Saharan Africa, particularly in Southern Africa have been mostly affected by the HIV and AIDS pandemic. The second strategy is an HIV and AIDS prevention strategy with the primary aim of keeping citizens free from contracting the HI virus. Although this strategy is a comprehensive strategy where governments embark on large-scale campaigns of raising HIV and AIDS awareness, there is very little scientific evidence that these campaigns have brought about a significant decrease of HIV and AIDS prevalence amongst young people. Raising awareness does not necessarily lead to positive behavioural change. Most young people in South Africa attend high schools where HIV and AIDS life-skills education has been made as a compulsory component of the life orientation curriculum. In South Africa, a National Aids Council has been established in South Africa to co-ordinate HIV and AIDS interventions and develops national HIV and AIDS policies aimed at curbing the spread of HIV and AIDS at a national level, yet the HIV and AIDS prevalence amongst young people has not significantly abated. On their own, governments cannot address all the socio-economic needs of their citizens. Partnership need to be formed with Non-government organisations and a broader range of stakeholders to address the spread of HIV and AIDS. Youth workers from NGOs currently implement HIV and AIDS preventative peer education programmes at high schools as part of the South African government’s broad strategy of HIV and AIDS prevention amongst young people. The purpose of this study was to explore and describe the experiences of youth workers who were employed at NGOs implementing HIV and AIDS preventative peer education programmes at high schools. The researcher used both qualitative and quantitative approaches in the research design. A literature review was conducted to research aspects of the study such as the features of NGOs, high schools as a setting and the role youth workers played when implementing HIV and AIDS preventative peer education programmes. Books, articles, journals, the internet and peer education manuals of NGOs all produced relevant information pertaining to the subject of HIV and AIDS prevention amongst young people. Twenty youth workers from three NGOs that is currently implementing HIV and AIDS preventative peer education programmes was purposively sampled, to be primary respondents of an empirical study. The researcher conceptualised and constructed an interview schedule with pertinent qualitative and quantitative questions based on the literature review. After the questionnaire was piloted with three youth workers, the interviewing process ensued. A considerable amount of time was spent on analysing and interpreting the data. Various themes emerged pertaining to different aspects of the programme. An empirical investigation was concluded with various results. Some of the research findings were in accordance with the literature review which supported the view of several authors that peer education programmes were an effective strategy for HIV and AIDS prevention amongst young people. Based on the literature study and the empirical study, various recommendations were made to improve the implementation of the HIV and AIDS preventative peer education programmes at high schools. One of the most significant revelations of the empirical study was how important the proper selection and recruitment of peer educators were to the success of the peer education programme. The research findings point to a strategy that encourages the nominations of learners from each classroom so that they could represent their classes and deliver lessons in a much more practical way than is currently being done. Another equally important finding was the management role that NGOs need to play in enabling the appropriate resourcing, monitoring, evaluating and improvement of the sustainability of the organisation and subsequently enriching the experience of youth workers who implement effective HIV and AIDS preventative peer education programmes at high schools as part of a broad strategy for HIV and AIDS prevention amongst young people in South Africa. / AFRIKAANSE OPSOMMING: Jong mense tussen die ouderdom van 15 en 24 is geïdentifiseer as die belangrikste groep wat deur MIV en VIGS geraak word. Suid-Afrika het een van die hoogste voorkomskoerse van MIV en VIGS en gebruik twee breë strategieë om die MIV en VIGS-pandemie te beteuel. Die eerste strategie is duur en behels teenretrovirale behandeling, wat die regering nog net aan klein aantal MIV-positiewe mense kon verskaf. In die huidige slegte globale ekonomie word dit vir internasionale skenkers toenemend moeilik om befondsing vir MIV en VIGS-behandeling te verhoog, veral omdat dit die arm lande van besuide die Sahara en veral Suidelike Afrika is wat die meeste deur die MIV en VIGS-pandemie geraak word. Die tweede strategie is MIV en VIGS-voorkoming, met die primêre doel om te keer dat landsburgers die HI-virus kry. Hoewel hierdie omvangryke strategie is waarvolgens regerings grootskaalse veldtogte onderneem om bewussyn van MIV en VIGS te verhoog, is daar min wetenskaplike bewyse daarvoor dat hierdie veldtogte tot noemenswaardige vermindering in die voorkoms van MIV en VIGS onder jong mense lei nie. ‘n Verhoogde bewussyn lei nie noodwendig tot positiewe verandering in gedrag nie. Verder is die meeste jong mense in hoërskole waar opvoeding in MIV en VIGS-lewensvaardighede verpligte komponent van die lewensoriënteringskurrikulum is. In Suid-Afrika is ‘n Nasionale Vigsraad geskep om MIV en VIGS-bekampingsprogramme te koördineer en om nasionale MIV en VIGS-beleide te ontwikkel wat gemik is op die bekamping van die verspreiding van MIV en VIGS op nasionale vlak. Nietemin het die voorkoms van MIV en VIGS onder jong mense nie noemenswaardig afgeneem nie. Regerings kan nie op hulle eie al die sosio-ekonomiese behoeftes van hulle burgers vervul nie. Vennootskappe met nieregeringsorganisasies (NRO’s) en ‘n breë reeks belanghebbers word benodig om die verspreiding van MIV en VIGS aan te spreek. Jeugwerkers van NRO’s implementeer tans voorkomende portuuropvoedingsprogramme by hoërskole as deel van die Suid-Afrikaanse regering se breë strategie van MIV en VIGSbekamping onder jong mense. Die doel van hierdie studie was om die ervaringe van jeugwerkers betrokke by NRO wat MIV en VIGS-voorkomende portuuropvoedingsprogramme in hoërskole implementeer, te ondersoek en te beskryf. Die navorser het kwalitatiewe en kwantitatiewe benaderings in die navorsingsontwerp gebruik. Literatuurstudie is onderneem om aspekte van die studie na te vors, soos die kenmerke van NRO’s, hoërskole as ligging en die rol van jeugwerkers in die implementering van MIV en VIGS-voorkomende portuuropvoedingsprogramme. Boeke, artikels, tydskrifte, die internet en portuuropvoedingsriglyne van NRO’s het almal relevante inligting verskaf oor die onderwerp van die voorkoming van MIV en VIGS onder jong mense. Twintig jeugwerkers van NRO wat tans MIV en VIGS-voorkomende portuuropvoedingsprogramme aanbied is deur doelgerigte steekproefneming vir empiriese ondersoek geselekteer. Die navorser het ‘n onderhoudskedule gekonseptualiseer en opgestel met pertinente kwalitatiewe en kwantitatiewe vrae wat op die literatuurstudie gebaseer is. Die vraelys is op drie jeugwerkers getoets, waarna daar met die onderhoudvoering voortgegaan is. Baie tyd is gebruik om die data te analiseer en interpreteer. Verskeie temas het na vore gekom wat met verskillende aspekte van die program verband hou. Empiriese ondersoek is onderneem, met verskillende resultate. Sommige van die navorsingsbevindings was in lyn met die literatuurstudie, wat die siening van verskeie skrywers ondersteun het dat portuuropvoedingsprogramme effektiewe strategie is vir die voorkoming van MIV en VIGS onder jong mense. Op die basis van die literatuurstudie en die empiriese studie is verskeie aanbevelings gemaak om die implementering van MIV en VIGS-voorkomende portuuropvoedingsprogramme in hoërskole te verbeter. Een van die belangrikste bevindings van die empiriese studie was hoe belangrik die behoorlike seleksie en werwing van portuuropvoeders in die sukses van portuuropvoedingsprogram is. Die navorsingsbevindings wys ook op strategie wat die nominasie van leerders in elke klaskamer aanmoedig sodat hulle die klasse kan verteenwoordig en lesse op baie meer praktiese manier aanbied as wat tans die geval is. Ewe belangrike bevinding was die bestuursrol wat NRO’s in die instaatstelling van gepaste hulpbronne moet speel, asook in die monitering, evaluering en verbetering van die volhoubaarheid van die organisasie en in die verryking van die ervarings van jeugwerkers soos hulle voortgaan om effektiewe MIV en VIGS-voorkomende portuuropvoedingsprogramme in hoërskole aan te bied as strategie vir die voorkoming van MIV en VIGS onder jongmense in Suid-Afrika.

published_or_final_version / Dentistry / Master / Master of Dental Surgery

published_or_final_version / abstract / Community Medicine / Doctoral / Doctor of Philosophy

This research study is a qualitative appraisal of the HIV and AIDS Prevention and Control Strategy of the Ethiopian Orthodox Tewahedo Church (EOTC). It critically analyses the strategy in order to ascertain its gender consciousness or gender sensitivity in the context of HIV and AIDS in Ethiopia. The basic motivation for this study is based on the idea that many if not most of the responses aimed at dealing effectively with the HIV and AIDS pandemic in Ethiopia have so far not addressed the underlying problems related to gender which are fuelling the spread of the HI virus. The study is guided by an overarching feminist ecclesiology, the gendered conceptual intervention to HIV and AIDS proposed by Geeta Rao Gupta, and Orthodox and feminist Trinitarian theology as a theoretical framework within feminist theology. These approaches were chosen because of their common focus on the unity and equality of humanity regardless of gender, social and religious differences. One of the major highlights of this study is that it has succeeded in bringing forth links between gender issues and HIV and AIDS; poverty and HIV and AIDS, and economic, social and cultural factors that fuel the spread of the HI virus; as well the historical, philosophical and cultural influences that perpetuate the oppression of women. Another important highlight of this study is the identification of theologies within EOTC that can help diffuse the tension created by the above mentioned negative influences. These theologies include the Trinitarian theology for example, and are life affirming for women because they transform and empower women to ensure their full humanity and equality, giving them the means to avoid being infected by the HI virus, and/or allowing those who are already infected and affected to live with dignity. / Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.