Includes bibliographical references (p. 89-103). / This dissertation serves as a discursive exploration into the underdiscussed topic of heterosexual anal sex and pervading penile-vaginal heteronormativity. To understand the origins and character of the seemingly universal ambivalence towards heterosexual anal intercourse I attempt to situate it historically. There is general ignorance concerning the prevalence of this sexual behaviour, but there exist deep-seated taboos and undertones of immorality and abnormality associated with it. All these factors play a part in individual sexual decision making; an attempt is made at exploring the motivations and personal choices that culminate in an act of heterosexual anal intercourse.

Includes bibliographical references. / Do discourses of "hope" have real and practical consequences when it come to crucial issues such as policy, prevention, stigma, risk perception or funding? The following exploratory and treansdisciplinary study seeks to pull together a wide variety of the theoretical and analytical stances in order to examine the social construction of hope in the context of HIV/AIDS in South Africa. the theoretical framework is built from a base of cultural theory, discourse analysis and theology, and binds these together into a transdisciplinary argument.

Includes abstract. Includes bibliographical references (leaves 77-84).

Word processed copy. / Includes bibliographical references (leaves 84-98). / Until recently, the national implementation of a public sector Antiretroviral Therapy (ART) programme in South Africa seemed financially impossible. Drastically reduced prices for Antiretrovirals (ARVs) combined with substantial donor funding and the long-awaited adoption of a national treatment plan, have, however, shifted the debate. Now the question is not so much should universal ART be provided by government but, rather, is it possible to implement in severely resource-constrained environments and, if so, what are the best ways to deliver these services.

Incudes bibliographical references. / The thesis is based on the story of a 36 year old HIV positive middle class black Zimbabwean woman, Maidei Chivi (pseudonym). Maidei is well educated, financially secure and wields enormous power both within her family and at her workplace. She therefore, unlike many women, does not fall into the typical HIV victim category, characterised by poverty, coerced sex and desperation. Maidei's story demonstrates that economic security does not necessarily result in women taking decision making roles during sex.

Includes bibliographical references.

Testing is widely acknowledged to be a useful and necessary secondary tool of Human Immunodeficiency Virus (HIV) prevention. It is the method by which to identify people who are living with the virus, so that their behaviour may be modified and medical condition treated in order to prevent further infection. Unfortunately, many persons in South Africa (SA) remain undiagnosed and therefore unaware of their HIV-positive status. This thesis explores why it is necessary to test for HIV in SA, where the incidence of the virus remains the highest in the world. Voluntary Counselling and Testing (VCT) or the âopt-inâ approach has been adopted as the norm or âsine qua nonâ. The efficacy of this method will be interrogated and shortcomings identified. The most notable is that few people in SA undergo an HIV test in order to learn their status. When they do, it is often late in the progression of opportunistic infections, requiring hospitalisation that increases pressure on an already over-stretched healthcare system. Reasons for the poor uptake of VCT are explained, including pervasive stigma and deficiencies in leadership of SAâs HIV and AIDS response. The expansion of testing is a proposed response to the challenge of persons remaining undiagnosed, and includes the acceleration of âopt-outâ or routine HIV testing (RHT) among SAâs high prevalence population. This model offers an HIV test routinely to persons attending government healthcare settings with an illness or for a routine check-up. Although the provider initiates the test, consent is necessary in order to proceed and there is an option to decline. While the key focus of this thesis is routine HIV testing, other approaches are explored in brief, including mandatory testing, mobile clinics and wellness screening. The thesis argues that if SA is to achieve the HIV and AIDS and STI National Strategic Plan (NSP) target of increasing the number of adults who have ever had a test to 70 percent by 2011, new approaches to testing, and especially opt-out, will need to be explored and more widely adopted. Key words: HIV/AIDS; Voluntary Counselling and Testing (VCT); Routine HIV Testing (RHT); Routinely Recommended Testing (RRT); Opt-out Testing; Provider-Initiated Testing and Counselling (PITC).

Includes abstract. / Includes bibliographical references (leaves 86-91). / South Africa is a highly unequal society, comprised of a small, wealthy elite class and a large population living in deep, chronic poverty plagued with unemployment. Those suffering from the greatest poverty are unemployed women caring for children. In the context of a distinct underclass that has been historically marginalized from the labour market and a welfare system does not provide assistance for the unemployed, these women are left to cope with their own poverty. Additionally, the HIV/AIDS epidemic exacerbates existing vulnerabilities and compromises the capabilities of these women and children. Guided by a livelihood framework and based on a multi-dimensional definition of poverty, the study explored how women navigate within their difficult environment to respond to the poverty of their children.

Word processed copy. Includes bibliographical references (leaves 117-123).

This study explores the links between masculinity and the spread of HIV/AIDS by examining adolescents’ conceptions of manhood and the ways in which hegemonic masculinity manifests itself through peer pressure. The study employed qualitative methods, including in-depth interviews and focus group discussions. Interviews were conducted with fifteen adolescent males between the ages of twelve to sixteen, who live in areas with high levels of HIV prevalence outside Pietermaritzburg in KwaZulu-Natal.