This ethnography explores the practice of sex tourism in Negril, Jamaica, and its sociocultural, economic, and health impacts on the popular tourist destination. Transactional sex with female tourists has become a popular income generator for some young Caribbean males who are excluded from formal employment in the region's leading industry. Like other resort locales, Negril draws both men and women from various parts of the country who choose to engage in sex work in order to benefit from the tourist dollars spent in Jamaica's third most popular resort area. Through the analysis of observations, interviews with residents, tourists, government officials, and health practitioners, as well as life histories of men involved in sex tourism, this study seeks to contribute to current literature on the practice and reveal its impact on the people of this particular locale. Additionally, relevant health data is utilized to examine the connection between sexual health and sex tourism locally, and to offer recommendations for effectively targeting male sex workers through risk reduction programs. This research takes a political economy perspective and applies relevant theoretical contributions from the anthropology of tourism, Caribbean gender theory, and gender performativity.

More than 25 years have passed since the first cases of HIV/AIDS were reported and a decade since highly active antiretroviral therapy (HAART) was introduced as part of the continuum of care for people living with HIV/AIDS (PLWHA). The introduction of HAART as a continuum of care for PLWHA positively changed the characteristics of HIV/AIDS epidemic, contributing for significant declines of HIV/AIDS-related morbidity and mortality rates. Thus, a new era began with HAART, often referred as the “HAART era”. However, HAART also brought with it new challenges and issues for researchers working in the field of HIV/AIDS. This thesis comprises several studies that were designed to gain understanding of some issues on prevention and management of HIV/AIDS that emerged in the current HAART era. The review of the literature points out for many emergent issues in HAART era, but only some issues were researched and presented in this thesis.

abstract: Female survivors of intimate partner violence (IPV) are at increased risk for negative sexual health outcomes, such as susceptibility to HIV/AIDS, other sexually transmitted infections, unintended pregnancy, miscarriage, and cervical cancer. Despite this known risk, HIV risk reduction interventions are lacking in IPV content, and little is known about women’s protective sexual health behaviors in this context. The purpose of this dissertation is to gain a deeper understanding of women’s sexual health within the context of a violent intimate relationship. Data were collected through semi-structured, in-person interviews with women who had experienced IPV (N = 28). Service-seeking women were recruited from a domestic violence shelter and a domestic violence counseling program; non-service-seeking women were recruited through a statewide coalition against domestic violence and online advertisements. Interviews were audio-recorded, transcribed, and then analyzed in NVivo Qualitative Software (Version 10). Detailed process notes, analytic memos, peer debriefing, and the use of visual analytic displays were used to increase the trustworthiness of findings. Results are presented in chapters two, three, and four. Chapter two explores women’s experiences of sexual violence in IPV relationships. Women described how their intimate partners used a combination of sexual abuse, sexual coercion, and sexual assault as a unique weapon of power and control. Chapter three examines women’s sexual risks across the levels of their ecological environment using an intersectional feminist framework. Women’s sexual risks went beyond sexual violence and were influenced by subtle yet pervasive cultural gender norms that reduced their power in relation to their male sexual partners. Chapter four focuses on understanding women’s protective sexual health behaviors in order to inform the development of an intervention that follows women’s natural pathway to care as they heal from victimization to surviving to thriving. / Dissertation/Thesis / Doctoral Dissertation Social Work 2016

Magister Public Health - MPH / Background: In Namibia, studies showed that HIV/AIDS affects youth, especially the under 24 years age group. At the same time the pregnancy rate is also high by age 19. Interestingly, in Andara district several reports from staff working in the reproductive services have indicated that adolescent girls, who would seem to be taking responsibility in one sphere of their sexual lives by protecting themselves against unwanted pregnancy, were however not using condoms to protect themselves from HIV infection. Study Aim and Objectives: To describe the knowledge, attitude and behaviour related to HIV/AIDS amongst female adolescents who are accessing the primary health care (PHC) services for contraception. Specific objectives were to describe the knowledge of female adolescents who are accessing the PHC services for contraception about the modes of transmission and prevention of HIV/AIDS, to assess their attitude with regards to condom use, abstinence and being faithful to one uninfected partner, also to determine the significance of association between age and knowledge, attitudes and behaviour, between their education level and knowledge, attitudes and behaviour and the significance of association between knowledge of HIV prevention strategies and behaviour of female adolescents accessing PHC services for contraception in the district. Setting: The study was conducted in Andara district, North East of Namibia. Methods: Descriptive cross-sectional KAB study. Sample: All female adolescents who are accessing PHC services for contraception selected from multistage simple random sampling in 5 facilities and systematic sampling at facility level in Andara. All married women within this age range were excluded in the study. Data collection tool: An interviewer-administered standardised questionnaire was used to collect the data. Data analysis and Interpretations: Epi Info software 2002 was used for data analysis. The results were presented using descriptive statistics including means, 95% confidence intervals and percentages and this information was shown in tables, bar and pie charts. Cross-tabulations of knowledge, attitude and behaviour scores against demographic variables were performed. P-values <0.05 were considered statistically significant. Results: 76.5% knew that unprotected sexual intercourse was the main way of getting HIV/AIDS, 77.3% knew that people could protect themselves by abstaining from sexual intercourse and 64.5% knew that people could protect themselves by having one uninfected faithful sexual partner. Out of 192 respondents who stated that unprotected sexual intercourse was the main way of HIV/AIDS transmission, 25.5% used condom every time they had sexual intercourse, 10.9% used condom almost every time they had sex, 41.1% used condom sometimes and 22.4% never used condom. Older girls and those who were in higher grades at school had more knowledge that could protect them from HIV infection. Later sexual debut is associated with increased condom usage at sexual debut. Conclusions: The general HIV knowledge of respondents and their knowledge of how to protect themselves from HIV infection were disappointing given that this study was conducted in health facilities. In this study we also see that knowledge does not always translate into the appropriate behaviour. The health services need to evaluate the targeting and effectiveness of their HIV educational messages and develop skills that will support behaviour change. / South Africa

Submitted in partial requirements for the degree of Doctor of Philosophy in the Department of IsiZulu namaGugu in the Faculty of Arts at the University of Zululand, 2002. / Lolu cwaningo lucubungula ulwazi lwesintu, amasiko, izinkolelo nemikhutshana yesizwe samaZulu neqhaza okungalibamba ekugwemeni izifo ezithathelwana ngokocansi, ikakhulukazi igciwane lesandulela ngculazi nengculazi uqobo lwayo. Luzama ukuthola ukuthi qhaza lini elingabanjwa umphakathi ekulweni nalesi sifo esesibhubhise izwe kangaka. Lucubungula izindlela zesintu ezazisetshenziswa ngempumelelo, esikhathini sakudala, ukunqanda izifo ezithathelwana ngokocansi. Luzama ukuthola ukuthi lezo zindlela ngeke yml zakhuthazwa ukuba zisetshenziswe esikhathini sanamuhla njengesikhali okungaliwa ngaso nalesi sifo esesiqede isizwe Lucubungula iqhaza elingabanjwa amasiko afana nokusokwa kwabesilisa nabesifazane, ukugwetshwa kwabesilisa nabesifazane, ukuhlolwa kwezintombi nezinsizwa, ukuthomba, ukusoma, ukuyobisa, umemulo, irnikhosi efana nomkhosi kaNomkhubulwane, umkhosi womhlanga, kanye neqhaza elingabanjwa amabandla ehlukene ekulweni nokusabalala kwegciwane lesandulela ngculazi, ingculazi uqobo lwayo, ezinye izifo ezithathelwana ngokocansi, ukukhulelwa kwentsha isikhathi singakafiki kanye nokufundiswa kwentsha ngokuziphatha ngenhlanzeko.

ABSTRACT The Ministry of Health in South Africa has launched massive campaigns to try and prevent the spread of HIV/AIDS. However, South Africa still has more people infected with HIV/AIDS than any other country in the world. This has led to government and health care planners re-evaluating neglected traditional health systems as potential contributors to health care delivery. This report highlights some areas where traditional healers can play a role in the prevention of HIV/AIDS as told by traditional healers themselves. In discussing these roles, the report raises the need for supportive government policy. Up to now government policies on HIV/AIDS have relied largely on biomedical explanations of illness and ignored other popular explanations. This poses a serious problem in a country like South Africa, where a large proportion of the population consults traditional healers first before consulting the medical sector. Such policies also impact on collaborative measures between the two sectors. Thus far, almost all prevention programmes are run by clinics with very little interaction with other sectors. The report then goes on to discuss the perceptions on HIV/AIDS as discussed by traditional healers. In so doing, the report begins to touch on the role of traditional practices that relates to sexual behaviour in HIV/AIDS prevention. As custodians of traditional culture, traditional healers have a huge role to play in re-inventing such practices in a manner that raises awareness about HIV/AIDS and at the same time preventing the spread of the disease.

No description available.

This study evaluated the efficacy of the Stages of Behavior Change (SBC) Model for use with Hong Kong Chinese. The SBC Model has demonstrated empirical support in a variety of health behaviors and across diverse populations. Further, the SBC has implications for the development of behavior change interventions. The SBC is composed of three components: stages of change, self-efficacy, and decisional balance. The stages of change are used to determine intention and time frames for behavior change. The SBC model applies Bandura's (1977) definition of self-efficacy and Janis and Manns’ (1968, 1977) conflict theory of decision making. The surveys used to measure these components have been validated and are predictive for condom acquisition. Survey data related to HIV/AIDS prevention (condom use) were collected from university students in Hong Kong and the United States. Comparisons were made across cultures (Hong Kong and the United States) and within the two cultural groups. Exploratory factor analyses using Principal Components Analysis revealed a single-factor model for self-efficacy and a 4-factor model for decisional balance (2 factors for advantages and 2 factors for disadvantages) concerning self (1) and others (we). Main effects for culture and staging were found for self-efficacy and the disadvantage component of decisional balance. Main effects for stage were found for advantages with a significant interaction. These data described an increase in self-efficacy across the stages of change for condom use and greater self-efficacy in HK then the US. The hypotheses for this study were supported with the exception of the advantages component of decisional balance within Hong Kong. Post hoc tests found no difference in self-efficacy in sexually active versus sexually non-active subjects in HK and the US and demonstrated differences in sexually active versus sexually non-active subjects in HK for advantages and disadvantages. Results offer support for using this model with Hong Kong Chinese as the data suggest more similarities than differences across two diverse cultures. These results have important implications for understanding behavior change mechanisms in diverse cultural groups and have significance for intervention planning in Hong Kong for AIDS risk reduction. / Ph. D.

A Síndrome da Imunodeficiência Adquirida (Aids), é uma pandemia com alto nível de letalidade. Os adolescentes no início da atividade sexual, podem se deparar com as Doenças Sexualmente Transmissíveis (DST), e entre estas a Aids. A gravidez na adolescência é uma epidemia no país, indicando que, se a prevenção para gravidez não está ocorrendo, também não está ocorrendo para as DST. Fazer um diagnóstico prévio da situação em que se deseja intervir, é uma conduta objetiva, utilizada por educadores na elaboração de programas de educação em saúde cientificamente elaborados. Neste sentido, este estudo têm o objetivo de obter dados que possibilitem identificar o perfil demográfico e os fatores que levam os estudantes do ensino médio a adotarem comportamentos de risco para a Aids. A população deste estudo foi constituída de 360 estudantes da primeira, segundo e terceira séries do ensino médio das duas escolas estaduais do município de Peruíbe, São Paulo, Brasil. Trata-se de um estudo exploratório - descritivo, para o qual foi aplicado um questionário estruturado. Os resultados demonstraram que 50,6% dos estudantes têm dúvidas de que a masturbação mútua seja uma prática sexual segura; a maioria tem conhecimentos corretos relacionados à Aids, porém 50,5% ainda acreditam, erroneamente, que a doação de sangue pode contaminar o doador; 62,3% referem utilizar o coito interrompido na prevenção da Aids e 30,4% a pílula anticoncepcional; 53,2% consideram não correr nenhum risco ou pequeno risco para a Aids; consideram como muito importante ou importante 87,7% a fidelidade do homem e 89,3% a fidelidade da mulher; 29,7% a virgindade do homem e 40,6% a virgindade da mulher; 23,5% a abstinência sexual masculina e 26,9% a abstinência sexual feminina na prevenção da Aids; 58,6% já tiveram relação sexual; 49,5% dos meninos iniciaram a atividade sexual entre os 10 e 13 anos e 70,0% das meninas entre os 14 e 17 anos de idade; 56,9% relataram atividade sexual nos últimos 30 dias; 48,3% afirmam fazer uso da camisinha todas as vezes que têm relação sexual; 38,3% algumas vezes e 11,0% nunca usam;45,1% afirmaram que fazem uso de bebidas alcoólicas; 95,2% não usam drogas injetáveis; 62,5% declararam que não têm plano ou seguro saúde ou convênio médico; 60,6% utilizam recursos da saúde pública; 45,3% dos estudantes trabalham; 63,3% ganham entre 1 e 2 SM; 25,8% das famílias dos estudantes têm renda mensal entre 1 a 4 SM; citaram como pessoas escolhidas para conversarem sobre HIV/Aids: 70,8% os amigos; 54,4% a mãe; 43,9% o (a) namorado (a); 40,3% os irmãos; 30,6% os professores; 29,7% o pai e 17,5% o profissional da saúde; 50,3% responderam seguir o que essas pessoas dizem; 30,8% seguem às vezes e 12,8% não seguem; 70,8% citaram a televisão como fonte de informação considerada mais importante na formação do conhecimento atual sobre a doença. Este projeto de pesquisa, tem a finalidade de obter dados que possam servir de subsídios, para que os setores responsáveis pela educação e saúde do município, construam programas preventivos de acordo com a realidade apresentada pelos seus próprios estudantes. / The Acquired Immunodeficiency Syndrome (Aids), is a pandemy with high level of lethality. Adolescents beginning their sexual activity, may get sexual diseases and among these Aids. Adolescence pregnancy is very common all around the country indicating that preventive mesures are not efficient; the same can be said do STD. A previous diagnosis of the situation where one intend to act is an objective way used by educators in education programs of health, scientifically elaborated. Based on these concepts, this study has the target to get information in order to make the demograph profile and identify the factors that make the students of high-school to have a behaviour of risk in relation to Aids. The sample studied was represented by 360 students of the first, second and third series of high-school, in two schools in the town of Peruíbe, São Paulo, Brazil. It was an exploratory and descriptive study in which was used an organized questionnaire. The results showed that 50,6% of the students have doubts on they safety of mutual masturbation as sexual practice; the majority has good knowledge in relation to Aids, but 50,5% believe that people who donate blood can be contaminated; 62,3% say that use interrupted coitus to prevent Aids and 30,4% anticonceptional drugs; 53,2% think that there is small or no risk to get Aids; 87,7% think that it is very important or important men\'s fidelity and 89,3% women\'s fidelity; for 29,7% and 40,6%, the virginity, respectively of men and women, is considerated important; 23,5% and 26,9% respectively men\'s and women\'s sexual abstinency are important in preventing Aids; 58,6% have already had sexual intercourses; 49,5% of boys began sexual activities around 10 and 13 years old and the girls between 14 and 17 years old; 56,9% had sexual intercourses on the last 30 days; 48,3% declare that use condoms in all sexual intercourses, 38,3% sometimes and 11,0% never; 45,1% declare that use alchoolic drinks; 95,2% say that don\'t use injected drugs; 62,5% don\'t have health insurance; 60,6% use the public health system; 45,3% work; 63,3% receive between 1 and 2 minimum salary; 25,8% of the student\'s family have a monthly income between 1 and 4 minimum salary; 70,8% talk about Aids with friends, 54,4% with the mother, 43,9% with boy/girl friends, 40,3% with brother or sister, 30,6% with teachers, 29,7% with the father, 17,5% with the health professional; 50,3% say that follow what these people say, 30,8% follow sometimes and 12,8% don\'t follow at all. 70,8% say that TV is the most important source of information. This study has the aim to obtain information to help the authorities responsible for education and heatlh in elaboration of preventive programs according to reality presented by the students.

A Síndrome da Imunodeficiência Adquirida (Aids), é uma pandemia com alto nível de letalidade. Os adolescentes no início da atividade sexual, podem se deparar com as Doenças Sexualmente Transmissíveis (DST), e entre estas a Aids. A gravidez na adolescência é uma epidemia no país, indicando que, se a prevenção para gravidez não está ocorrendo, também não está ocorrendo para as DST. Fazer um diagnóstico prévio da situação em que se deseja intervir, é uma conduta objetiva, utilizada por educadores na elaboração de programas de educação em saúde cientificamente elaborados. Neste sentido, este estudo têm o objetivo de obter dados que possibilitem identificar o perfil demográfico e os fatores que levam os estudantes do ensino médio a adotarem comportamentos de risco para a Aids. A população deste estudo foi constituída de 360 estudantes da primeira, segundo e terceira séries do ensino médio das duas escolas estaduais do município de Peruíbe, São Paulo, Brasil. Trata-se de um estudo exploratório - descritivo, para o qual foi aplicado um questionário estruturado. Os resultados demonstraram que 50,6% dos estudantes têm dúvidas de que a masturbação mútua seja uma prática sexual segura; a maioria tem conhecimentos corretos relacionados à Aids, porém 50,5% ainda acreditam, erroneamente, que a doação de sangue pode contaminar o doador; 62,3% referem utilizar o coito interrompido na prevenção da Aids e 30,4% a pílula anticoncepcional; 53,2% consideram não correr nenhum risco ou pequeno risco para a Aids; consideram como muito importante ou importante 87,7% a fidelidade do homem e 89,3% a fidelidade da mulher; 29,7% a virgindade do homem e 40,6% a virgindade da mulher; 23,5% a abstinência sexual masculina e 26,9% a abstinência sexual feminina na prevenção da Aids; 58,6% já tiveram relação sexual; 49,5% dos meninos iniciaram a atividade sexual entre os 10 e 13 anos e 70,0% das meninas entre os 14 e 17 anos de idade; 56,9% relataram atividade sexual nos últimos 30 dias; 48,3% afirmam fazer uso da camisinha todas as vezes que têm relação sexual; 38,3% algumas vezes e 11,0% nunca usam;45,1% afirmaram que fazem uso de bebidas alcoólicas; 95,2% não usam drogas injetáveis; 62,5% declararam que não têm plano ou seguro saúde ou convênio médico; 60,6% utilizam recursos da saúde pública; 45,3% dos estudantes trabalham; 63,3% ganham entre 1 e 2 SM; 25,8% das famílias dos estudantes têm renda mensal entre 1 a 4 SM; citaram como pessoas escolhidas para conversarem sobre HIV/Aids: 70,8% os amigos; 54,4% a mãe; 43,9% o (a) namorado (a); 40,3% os irmãos; 30,6% os professores; 29,7% o pai e 17,5% o profissional da saúde; 50,3% responderam seguir o que essas pessoas dizem; 30,8% seguem às vezes e 12,8% não seguem; 70,8% citaram a televisão como fonte de informação considerada mais importante na formação do conhecimento atual sobre a doença. Este projeto de pesquisa, tem a finalidade de obter dados que possam servir de subsídios, para que os setores responsáveis pela educação e saúde do município, construam programas preventivos de acordo com a realidade apresentada pelos seus próprios estudantes. / The Acquired Immunodeficiency Syndrome (Aids), is a pandemy with high level of lethality. Adolescents beginning their sexual activity, may get sexual diseases and among these Aids. Adolescence pregnancy is very common all around the country indicating that preventive mesures are not efficient; the same can be said do STD. A previous diagnosis of the situation where one intend to act is an objective way used by educators in education programs of health, scientifically elaborated. Based on these concepts, this study has the target to get information in order to make the demograph profile and identify the factors that make the students of high-school to have a behaviour of risk in relation to Aids. The sample studied was represented by 360 students of the first, second and third series of high-school, in two schools in the town of Peruíbe, São Paulo, Brazil. It was an exploratory and descriptive study in which was used an organized questionnaire. The results showed that 50,6% of the students have doubts on they safety of mutual masturbation as sexual practice; the majority has good knowledge in relation to Aids, but 50,5% believe that people who donate blood can be contaminated; 62,3% say that use interrupted coitus to prevent Aids and 30,4% anticonceptional drugs; 53,2% think that there is small or no risk to get Aids; 87,7% think that it is very important or important men\'s fidelity and 89,3% women\'s fidelity; for 29,7% and 40,6%, the virginity, respectively of men and women, is considerated important; 23,5% and 26,9% respectively men\'s and women\'s sexual abstinency are important in preventing Aids; 58,6% have already had sexual intercourses; 49,5% of boys began sexual activities around 10 and 13 years old and the girls between 14 and 17 years old; 56,9% had sexual intercourses on the last 30 days; 48,3% declare that use condoms in all sexual intercourses, 38,3% sometimes and 11,0% never; 45,1% declare that use alchoolic drinks; 95,2% say that don\'t use injected drugs; 62,5% don\'t have health insurance; 60,6% use the public health system; 45,3% work; 63,3% receive between 1 and 2 minimum salary; 25,8% of the student\'s family have a monthly income between 1 and 4 minimum salary; 70,8% talk about Aids with friends, 54,4% with the mother, 43,9% with boy/girl friends, 40,3% with brother or sister, 30,6% with teachers, 29,7% with the father, 17,5% with the health professional; 50,3% say that follow what these people say, 30,8% follow sometimes and 12,8% don\'t follow at all. 70,8% say that TV is the most important source of information. This study has the aim to obtain information to help the authorities responsible for education and heatlh in elaboration of preventive programs according to reality presented by the students.