The pathways to manhood for young adult African men in urban settings are based more on socio-economic demands than socio-cultural expectations of being a man. This study was a qualitative explorative research on the perceptions of HIV-prevention practitioners on the different pathways to manhood among young adult African men in urban settings in Gauteng, South Africa. From the findings it was clear that there are diverse socio-cultural and socio-economic pathways to manhood, including the media, older men, peers, religion and women. These pathways affirm, confirm, validate and value a man as a man and not a boy in urban settings such as cities and informal settlements in Gauteng. The research concluded that a great deal more could be done to ensure that men get involved in HIV-prevention programmes by ensuring dialogue on manhood and masculinities between men and men, and men and women. / Sociology / M. A. (Social Science)

Ce travail est réparti en deux parties différentes issues de deux études différentes.<p>La première partie décrit l’étude AMATA conçue en 2005 au Rwanda, étude prospective basée sur le suivi d’une cohorte répartie en deux groupes d’intervention postnatale. Cette étude avait pour objectif de tester l’hypothèse que l’allaitement maternel (AM) sous trithérapie antirétrovirale maternelle (HAART) pouvait être une prévention aussi efficace que le lait artificiel (LA) afin de réduire drastiquement la transmission du virus VIH de la mère à l’enfant avec une moindre mortalité infantile. Cette intervention permettait de préserver les avantages de l’AM, connue pour offrir une prévention naturelle minimisant les infections graves, en particulier les gastro-entérites et diminuant le taux de malnutrition protéino-énergétique (MPE). Dans la cohorte « AMATA », un groupe d’enfants était allaité exclusivement durant six mois, les mères étant sous trithérapie antirétrovirale systématique et un autre groupe d’enfants était nourri au LA durant les six premiers mois de vie. L’intervention débutait durant la grossesse à partir de la 28ème semaine d’âge gestationnel, une trithérapie antirétrovirale étaient donnée à toutes ces femmes enceintes infectées par le VIH participant à l’étude, quel que soit leur stade immunitaire ou clinique. Cette trithérapie était poursuivie à vie pour les femmes nécessitant cette combinaison de traitements antirétroviraux pour des raisons cliniques et/ou immunitaires et non poursuivie pour les autres femmes, avec un schéma d’interruption minimisant les résistances aux ARVs. <p>Les critères d’évaluation de comparaison des deux interventions postnatales étaient la survie à 9 mois des enfants non infectés, le taux d’infection par le VIH et la mortalité des enfants dans chaque groupe. La présence de facteurs confondants a été recherchée en effectuant une analyse de variance car la randomisation était impossible pour des raisons éthiques. <p> Dans l’étude AMATA, parmi les 532 enfants inclus, 227 (43%) étaient allaités et 305 (57%) recevaient du LA, 7 enfants furent infectés par le VIH (1,3%) dont 6 in utero (3 enfants par groupe). Un enfant fut infecté par l’AM correspondant à un risque cumulatif postnatal de 0,5% [IC95% 0,1–3,4%; P 0,24]. Ce taux de transmission reste parmi les plus bas dans un pays à ressources limitées même en comparant avec d’autres études où la trithérapie fut aussi utilisée durant l’AM. Ces études furent publiées après le début de l’enrôlement des patientes dans l’étude rwandaise AMATA en 2005. <p>La différence de mortalité à 9 mois n’était pas statistiquement différente dans les 2 groupes avec 3,3% (95% IC 1,6–6,9%) pour les enfants allaités et 5,7% (95% IC 3,6–9,2%) pour les enfants recevant du LA (P= 0,20). <p>Cette étude renforce la notion que l’AM sous trithérapie antirétrovirale (HAART) reste une approche à recommander dans les contextes où la mortalité infantile est élevée. Cette prévention postnatale permet non seulement de réduire très efficacement la transmission du VIH de la mère à l’enfant en préservant les avantages de l’AM et en évitant les risques du LA distribué dans des contextes d’hygiène précaire où un accès à l’eau potable est difficile. <p>Dans cette étude, l’efficacité de ces 2 interventions postnatales était comparable avec des taux de transmission et de mortalité semblables statistiquement.<p> <p> <p> La deuxième partie de ce travail, basée sur les résultats d’une cohorte d’enfants âgés de moins de 18 mois nés de mères infectées par le VIH permettait d’évaluer les signes cliniques présomptifs proposés par l’OMS en 2005. Ces signes <p>étaient créés afin de pouvoir effectuer le diagnostic clinique d’infection par le VIH chez les enfants exposés au virus VIH <p>dans les pays où les techniques moléculaires de PCR n’étaient pas accessibles. Les enfants nés de mères infectées par le <p>VIH gardent parfois des anticorps anti-VIH maternels jusqu’à l’âge de 18 mois sans être pourtant contaminés par le VIH/SIDA. Avant cet âge, la confirmation de l’infection par le VIH repose sur la démonstration de la présence d’ADN proviral ou ARN par la technique PCR. La mortalité précoce des nourrissons infectés par le VIH est élevée, il est important de pouvoir bénéficier d’ARVs dès le diagnostic précoce de l’infection.<p>Les signes cliniques de présomption d’infection par le VIH chez l’enfant exposé (sérologie VIH +) de moins de 18 mois ont été proposés en 2005 par l’OMS et modifiés en 2006 mais ne furent jamais évalués. <p>Cette étude transversale comprenant 236 enfants de moins de 18 mois ayant une sérologie VIH positive consistait à évaluer la sensibilité (76,6%) et la spécificité (52,7%) de ces signes cliniques en confirmant leur statut infectieux réel par le test PCR pour le VIH, test de référence. <p>Cette spécificité basse inquiétante était liée aux enfants présentant des signes cliniques similaires bien que non infectés par le VIH mais souvent carencés par manque d’apport calorique et/ou souffrant d’une forme avancée de tuberculose extra pulmonaire ou d’autres affections chroniques. Ces enfants cachectiques pouvaient présenter les mêmes signes cliniques que les enfants infectés par le VIH car ils avaient une baisse de leur immunité cellulaire due à la MPE. <p><p> Dans la première partie de ce travail, l’étude AMATA a montré 2 façons efficaces de diminuer la transmission du VIH de la mère à l’enfant.<p> Dans la deuxième partie, on a évalué une méthode de diagnostic clinique précoce proposé par l’OMS afin de détecter les enfants infectés par le VIH en l’absence de test virologique PCR mais la basse spécificité indique la nécessité d’améliorer cette méthode diagnostique.<p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

Between 1994 to 1998 the ANRS 049a DITRAME trial was conducted during which a short regimen of ZDV demonstrated for the first time acceptability, tolerance and efficacy on reduction of mother-to-child transmission (MTCT). Our major aim was to analyze certain virological characteristics of infected women in this cohort and their association to HIV-1 transmission. On the one hand, we analyzed the HIV-1 replication capacity in different physiological compartments :blood, vaginal fluids (VF) and breast milk (BM) related to MTCT were investigated by nested case control studies in the DITRAME cohort. We demonstrated the relationship between plasma viral load (VL), at 34 weeks of amenorrheae and at Day 8 post partum, and MTCT in Africa where the probability to be exclusively breastfed for an one year infant is 46.6%. We also analyzed relationship between plasma VL and ZDV treatment. Additionally, we demonstrated that MTCT is essentially the consequence of a high proviral load in VF in our context. Moreover, reduced levels of HIV-1 RNA in milk at Day 8 were observed in mothers receiving ZDV therapy rather than in mothers under placebo. For the first time, the association between BMVL and postnatal transmission has been studied. We observed a highly significative difference between BMVL of women who transmitted the virus and those who did not. Moreover, univariate and multivariate analyzes clearly indicated that early breastfeeding log10 HIV-RNA at Day8 is an independent factor significatively associated to MTCT. Decreased median BMVL from 1608 copies/mL (c/ml) at Day8 to 346 c/ml at Day45 were found for mothers who transmitted the virus during the postpartum and who received placebo. Nevertheless, for those who received ZDV, median BMVL increased from 56 c/ml at Day8 to 470.5 c/ml at Day45. This marked trend to a rebound effect of BMVL could be the consequence of the treatment withdrawal as observed for adults at HAART withdrawal. <p>On the other hand, we studied the variability of HIV and its association with MTCT. First, we analyzed HIV-1 diversity in African women in France and Burkina Faso. In a second step, we demonstrated that HMA was an adapted tool for co and super-infections studies for adults. By this way, we identified two superinfections among 147 women within our commercial sex workers cohort. Additionally, we used this tool to analyze children of the DITRAME cohort who were infected in utero and who could be superinfected during the delivery or later by breastfeeding. We identified seven children, among 18 who were infected in utero, displaying HMA profiles suspicions for co-infections, and who had a more important mortality rate than normally. Their proviral env sequences are currently analyzed. <p>Moreover, we confirmed the fact that the rate of vitamin A has no influence on MTCT.<p><p>De 1994 à 1998, s’est déroulé l’essai clinique DITRAME ANRS 049a qui a démontré, pour la première fois, l’acceptabilité, la tolérance et l’efficacité d’un traitement court de zidovudine (ZDV) sur la diminution de la TME. Notre travail s’est inscrit dans le cadre de cet essai et a eu pour but d’en analyser certains des aspects virologiques et leur rapport avec la transmission de la mère à l’enfant du VIH (TME). D’une part, nous avons analysé les niveaux de réplication virale dans différents compartiments physiologiques :le sang, les sécrétions cervico-vaginales (SCV) et le lait maternel (LM) et leur rapport avec la transmission, par des études cas-témoins nichées dans la cohorte DITRAME. Nous avons démontré le rapport entre la charge virale libre (CV) dans le plasma à 34 semaines d’aménorrhée et à J8 postpartum et la TME dans le contexte africain où la probabilité d’avoir un allaitement exclusif à un an est de 46,6%, et analysé leur rapport avec le traitement ZDV. Nous avons également démontré que la TME est essentiellement due à une charge provirale plus élevée dans les SCV dans notre contexte. De plus, grâce à la mise au point d’une technique, nous avons démontré que la ZDV avait un effet global marqué sur la diminution de la CV libre dans le LM. Il s’agit de la première étude mettant en relation la CV dans le lait avec la transmission postnatale. De même, nous avons observé une différence très hautement significative entre les charges virales libres des femmes ayant transmis le VIH et les non transmettrices. De plus, nos analyses univariée et multivariée démontrent que la CVlm mesurée en log10 de la lactation précoce (J8) est un facteur indépendant très significativement associé à la TME. Chez les femmes ayant transmis le virus durant le post-partum et non traitées à la ZDV, la CVlm médiane a décru de 1608 copies/mL (c/ml) à J8 à 346 c/ml à J45. Par contre, chez les femmes ayant transmis le virus mais ayant reçu un traitement ZDV, la CVlm médiane évolue de 56 c/ml à J8 à 470,5 c/ml à J45. Cette tendance marquée à un effet rebond de la CVlm à J45 laisse penser que la TME qui a lieu chez les femmes traitées à la ZDV pourrait être une conséquence de l’arrêt de ce traitement, comme observé chez les adultes après arrêt du traitement HAART.<p><p>D’autre part, nous avons étudié la variabilité du VIH en fonction de la TME. Dans un premier temps, nous avons analysé la diversité du VIH-1 chez des mères africaines vivant en France, et par après au Burkina Faso. Ensuite, grâce à l’élaboration d’une nouvelle technique, nous avons démontré que le HMA pouvait être un outil adapté à l’étude des co- et sur-infection chez l’adulte. Nous avons identifié de cette manière deux surinfections parmi 147 femmes analysées au sein d’une cohorte de femmes à haut risque de surinfection. Nous avons ensuite utilisé ce moyen pour étudier des enfants de la cohorte DITRAME infectés in utero qui auraient pu se surinfecter durant le peripartum ou ensuite par l’allaitement. Sept enfants parmi 18 analysés, présentant des profils HMA à suspicion de coinfection et qui présentaient un taux de mortalité plus élevé que la normale, ont été identifiés. Leurs séquences provirales env sont en cours d’analyse actuellement. <p><p>Par ailleurs, nous avons confirmé le fait que le taux de vitamine A n’a pas d’influence sur la TME.<p> / Doctorat en Sciences agronomiques et ingénierie biologique / info:eu-repo/semantics/nonPublished

Summaries in English and Shona / Introduction Despite wide spread information and knowledge of HIV and AIDS transmission, High school teenage girls continued to engage in risky sexual behaviour in Tshwane, a District of Gauteng Province of South Africa. Age-parity relationships between High school teenage girls and older men known as “Sugar Daddies” or “Blessers”, who showered High school teenage girls with money and expensive gifts, were believed to be spreading HIV. High school teenage girls failed to negotiate condom use due to lack of autonomy, coupled with sexual violence, resulting in HIV transmission. Consequently, Tshwane became one of the highest HIV burdened cities in South Africa. Purpose of the study This study explored and described the High school teenage girls’ knowledge and perceptions of the risks of human immunodeficiency virus and acquired immune deficiency syndrome in Tshwane, a District of Gauteng Province of South Africa. Method The study used a quantitative approach. The data were collected using questionnaires. The population comprised of all girls aged 15 to 19 at a selected High school. The sample consisted of 109 girls. Systematic sampling was used. The study was conducted in the school hall of a selected High school. Data were analysed using SPSS version 23 program. Results Generally, the High school teenage girls’ HIV knowledge was very high (84.4%) as compared to their knowledge on AIDS (3.7%). Only 10.1% of the High school teenage girls knew what the window period entailed. They were aware of HIV preventive measures evidenced by abstinence ranking first (1) and had the highest score of five (5). 17.4% of the High school teenage girls doubted the usefulness of the condom in combating HIV infection. Health care workers were easily accessible (30.3%). The television was the most available mass media (92%). The radio was most preferred (31%). High school teenage girls preferred to discuss HIV related information with their peers and friends (50%). 42% of the High school teenage girls preferred to discuss sex related topics with parents or guardians. Those who were below 18-years were 7.2 times less likely to have sex. 90% of the 19-year-old girls had had sex. Therefore, High school teenage girls’ perception of HIV risk was low because they continued to be involved in concurrent multiple relationships although 90% of those involved were using condoms. Conclusion Although High school teenage girls proved that they had knowledge of HIV and AIDS, they still had a low perception of HIV risk because they were involved in concurrent multiple sexual relationships with older men. / Habedi, Debbie Kgomotso / Kunyangwe vane ruzivo rwechirwere cheshura matongo, vasikana vane makore ari pakati pegumi nematatu negumi nemapfumbamwe vari kuenderera mberi nekuita unhu unoita kuti vabatwe nechirwere cheshuramatongo (AIDS). Vasikana ava vari kudanana nevarume vakuru kuvadarika vamwe masadzimba zvinoita kuti vatapurirwe utachiona hweHIV zvinoita kuti vasikana vane hutachiona uhwu vawandise muguta reTshwane, mudunhu reGauteng munyika yeSouth Africa. Vanasikana ava vanopuwa mari nekutengerwa mbozhanhre nenguvo zvinodhura nekudya tunonaka. Nekuda kwekuti varume vanesimba rehudzvinyiriri nekuvarwisa, muAfrica, vasikana ava havakwanisi kushandisa makondomu kuzvidzivirira kubva kuhutachiona hweHIV. Ndosaka guta reTshwane raita mukurumbira munyika yeSouth Africa nekuti vanasikana vane hutachiona hweHIV vari kuwandisa. Gwaro iri rinoongorora nekutsanangura ruzivo uye maonero evanasikana huipi hwechirwe cheshuramatongo muguta guru reTShwane, mudunhu reGauteng. Munyika yeSouth Africa. Mafambiro Egwaro Gwaro iri riri kuongorora nekutsanangura ruzivo nemaonerwo anoitwa hutachiona hweHIV nechirwere cheshuramatongo nevasikana vari pakati pemakore gumi nemakore matatu nevanegumi nemakore mapfumbamwe pachikoro chesekonari chakasarudzwa mugutu guru reTshwane, mudunhu reGauteng, munyika yeSouth Africa. Vasikana vaka pindura mibvunzo pamusoro peruzivo rwavaiva narwo uye zvakanyangara zvinoita kuti vabatwe nehutachiona hweHIV. Vasikana zana nevapfumbamwe ndivo vakapindura mibvunzo. Vasikana vakapindura mibvunza yaiva pamapepa muhoro yepachikoro pavo. Zvakabuda Muchidzidzo Zvakaonekwa kuti vasikana vane ruzivo rwechirwere cheshuramatongo asi vane zvimwe zvinhu zvavasinga nzwisisi pamusoro pechirwere ichi zvekuzvidzivirira. Vasikana havakwanisi kupa mutsauko wehutachiona (HIV) nechirwere cheshuramatongo (AIDS). Vanasikana vazhinji vanofunga kuti hutachiona hweHIV hunotapurirwana pakutsvodana uye pakushandisa zvimbuzi. Vasikana vazhinji havakwanisi kutsanangura nguva inogara hutachina hweHIV mumuviri hwusati hwaonekwa kuti hurimo. Vasikana havana chokwadi chekuti makondomu anogona kudzivirira hutachiona hweHIV kuti hwusapinda mumuviri nguva dzebonde. Vadzidzisi vechikoro ndivo vakasarudzwa kuti vane ruzivo rwechirwere cheshuramatongo. Vasikana havafariri kudzidziswa nezve chirwere cheshuramatongo nevabereki vavo. Vanofarira kukurukura nezvechirwere ichi nevanhu vezera ravo. Vasikana vasingagari nevabereki vavo vanoita bonde kudarika vanogara nevabereki vavo uye vanoita bonde nevadiwa vazhinji vamwe vacho varume vakuru madzisaimba. Vasikana vanotaridza kusatya kubatwa nechirwere chishuramatongo nemhaka yehunhu wawo hwakashata hweku danana nevarume vazhinji uye kusashandisa makondomu nguva dzebonde. Mhendero Zvidzidzo zvinopiwa vasikana zvinechekuita nezvepabonde zvinofanira kuongororwa zvipamhidzirwe kuti vasikana vagone kuzvidzivirira kuchirwere cheshuramatongo. Madzimudzangara netelevhizhoni zvino kurudzirwa kudzidzisa mitambo nedzimbo dzinodzidzisa pamusoro pekudzivirira chirwere cheshuramatongo. Vabereki vanofanira kudzidziswawo kuti vagone kudzidzisa vana vavo kuti vagone kuzvidzivirira kuti vasabatwa nechirwere ichi. Vanasikana vanofanirwa kudzidziswa kushandisa makondomu pese pavanoita bonde. Makondomu anofanira kuiswa pachena paano kwanisa kuwonekwa nevasikana. / Health Studies / M.P.H. (Health Studies)

Recognizing that a parent is a key role player in fighting HIV/AIDS, the researcher conducted a study to examine and describe the knowledge parents have of this disease and its virus. The study was conducted among a sample of 100 parents/guardians, using a questionnaire to examine the respondents' conceptual, episodic, descriptive, procedural and declarative knowledge of HIV/AIDS. The study found that the respondents lacked especially conceptual and declarative knowledge and that the main factor contributing to knowledge is the level of education. / Health Studies / M.A. (Health Studies)

A qualitative study following a phenomenological approach was undertaken to explore voluntary counselling and testing nurses' perception of educating HIV+ people about ARVs. Non-probability convenience sampling was used and in-depth semi-structured face-to-face interviews were conducted to collect data from 12 participants. The most important results were: &#61623; The need for extensive education on ARVs since it is a new technology used to curb the infection therefore clients need the information in order to use them effectively. &#61623; Stumbling blocks encountered when educating HIV+ people about the drugs. The problems are mainly due to the nurses lack of current knowledge about the drugs; patients' low economic status; severe side effects; difficulties in behaviour change; poor quality of life on ARVs and medical terminology. &#61623; Inability of clients to comply to the regimen because of severe side effects, complex regimen, lack of support from family and friends, lack of motivation, depression, cultural beliefs, lack of knowledge on how to use them and financial constraints. &#61623; Challenges for continuous education because of current nursing shortage, negative attitudes of some nurses, demotivation and inadequate funding for such activity. Recommendations include provision of continuing education and the incorporation of ARV therapy knowledge in the basic nursing curriculum in nursing education. / Health Studies / MA (HEALTH STUDIES)

The HIV/AIDS epidemic is described as a crisis by the Global Report (UNAIDS 2004:13). Swaziland¡¦s King Mswati III also declared the HIV/AIDS epidemic as a disaster when the HIV/AIDS prevalence rate increased from 3.9% in 1992 to 42.6% in 2004 (MOHSW 2004:3). In responding to the increasing numbers, the Government of Swaziland established various programmes; one of them being the Voluntary Counselling and Testing (VCT) services to meet societal needs. The MOHSW designed guidelines to be utilized when training nurses to be pre and post HIV test counselors (TASC 2003:2). The period of training ranges between 1 to 2 weeks, after which they are deployed to the VCT centres where nurses provide counseling and testing, treatment of opportunistic infections and distributing antiretroviral drugs. Much research has been done in Swaziland on HIV/AIDS however; there is insufficient knowledge on the impact of HIV/AIDS on nurses working at the VCT services. The objectives of the study were to: ,,« Explore and describe the experiences of nurses working in the VCT services. ,,« Explore and describe the experiences of clients receiving VCT services. ,,« Design and develop an empowerment programme for nurses working in the VCT services in Swaziland. ,,« Formulate and describe guidelines for the implementation of the programme. In this qualitative study, the exploratory descriptive and contextual methodology was utilized to look into lived experiences of nurses and clients. This was done within the adaptation of the intervention Design and Development genre proposed by Rothman and Thomas (1994). Data was collected through purposive sampling and analysed according to Tesch¡¦s methods (Tesch 1990:890) The study revealed one major theme; constant experience of stress that was related to psychological and physical factors (categories). Nurses identified the complexity of HIV/AIDS, shortage of staff, lack of social support, lack of a supportive working environment, and a need for staff development under psychological factors. Clients identified stigma and discrimination. Constant exhaustion and development of medical conditions were identified as physical factors that led to constant experience of stress. Conclusions drawn from the data analysis revealed that nurses were stressed and felt disempowered at working in the VCT services. An empowerment programme was designed and developed to enable these nurses to deal with issues and VCT services for rendering quality care and enjoy the work they do. Guidelines were formulated to implement the empowerment programme. The study concluded with the identification of limitations and recommendations for future endeavours. / Health Studies / D.Litt. et Phil.

Breast-feeding by Human Immunodeficiency Virus (HIV) positive mothers poses a risk of transmitting HIV infection from the mother to the baby. This study attempted to describe and explore the knowledge of antenatal women in Gaborone, Botswana on the transmission of HIV through breast-feeding. The research results, obtained from interview schedules, revealed that the respondents had: a greater knowledge of transmission of HIV in adults than mother-to-child-transmission (MTCT); a moderate understanding of infant feeding methods; poor understanding of the risk of HIV transmission through different infant feeding methods and feelings that infant feeding method reveals ones HIV status, which indicate stigma and discrimination. The study findings may assist health care providers to intensify educational programmes and counselling in the antenatal clinics and communities to reduce MTCT. / Health Studies / M. A. (Health Studies)

The phenomenon of HIV discordance has been in existence for a long time along with HIV. However, very limited attention has been given to HIV discordance. This phenomenological study aimed at gaining a deeper understanding on the lived experiences of sero-discordant couples in Botswana. Reports show that discordance in Botswana is around 17%. The main objectives of this study were to identify HIV discordant couples living in Botswana and explore their knowledge and understanding of the situation, explore the psychological, social and sexual experiences of the HIV discordant couples and determine its impact in their lives, and examine the meaning they attach to such experiences and challenges they face as well as their coping strategies. A qualitative phenomenological approach using face to face in-depth interviews was used to explore and describe meanings and experience as lived by the HIV discordant couples. The study sample consisted of forty-six (N=46) (twenty-nine (n=29) females and seventeen (n=17) males) participants selected using purposive sampling from three cities in Botswana. The Inclusion criteria were that participants should be aged 21 years and above; with no known diagnosis of mental illness; having been in a discordant relationship for at least six months at the time of data collection; living in Botswana and willing to participate in the study. The findings were that there are three forms of discordance, which are: discordant unaware which are couples who went into the relation unaware of their HIV status. Discordant aware; those who got into the relationship already knowing each other’s HIV status and discordantly discordant which are those with differing HIV status and differing motives of going into the relationship. These are the couples that conceal their status from one another. The results revealed intense emotional/psychological, sexual and social stresses as experienced by couples. HIV discordant goes through three phases of initial shock, conflict and resolution. The researcher recommends the OPEN DESK MODEL to be integrated in the health facilities to encompass the concept of a family or couple and as a unit. / Health Studies / D. Litt. et Phil. (Health Studies)

Submitted in fulfillment of the requirements for the Degree of Doctor of Technology: Education, Durban University of Technology, 2013. / This thesis focuses on the alarming situation of the rate of HIV infection which is escalating every day in South Africa, and what can be done to address the rate of HIV infection. Much has been tried to curb this escalation, but all efforts have had little effect. This concerns me deeply. So I have looked at the problem from the perspective of education. I have personally experienced how Zulu indigenous knowledge, in the form of traditional modes of Zulu sexuality education, was used in the past to address the problems of sexually transmitted diseases, and pregnancy before it was sanctioned. I have seen that the rituals performed as part of traditional Zulu sexuality education have been effective. I believe that indigenous knowledge systems in the South African context refer to a body of knowledge embedded in African philosophical thinking and social practices that have evolved over thousands years. Indigenous knowledge systems acknowledge the rich history and heritage of the people as important contributors to nurturing the values and norms in society, and so form the basis of education for the people. I believe that our indigenous knowledge systems according to the dictates of rites and rituals observed by our forefathers can play a major role in the (sexuality) education of our youth, and can optimise our efforts to fight against the HIV and AIDS pandemic. This study focuses on the adolescent stage. Adolescence is a phase of discovery and experimentation in which young people develop new feelings, which (coupled with physical maturing) lead to exploring new behaviors and relationships, including sexual behaviours and sexual relationships. Therefore, I believe that adolescents should be targeted because they are just beginning to face social situations in which their decisions and actions about their sexual behaviours and sexual relationships will determine their future. In addition, adolescents are – or should be – school going, so they can be influenced by what is in their school curriculum. I have made suggestions about how the Life Orientation Grades 10—12 curriculum can be used to include traditional sexuality education for this purpose. In doing so, I do not suggest that all South African school going teenagers should perform the traditional Zulu rituals, but I am suggesting that the revival and adaption of traditional modes of sexuality education in all cultures could be helpful in the fight against the HIV and AIDS pandemic. I use the Zulu traditions because they are the traditions with which I am familiar. I have carried out this study to promote the use of Zulu traditional sexuality education to curb the rate of HIV infection among young Zulu people. I believe that this traditional method, if it is used optimally, can reduce the rate of infection and the speed of mortality, as well as the problem of early pregnancy among our Zulu youth, in South Africa. / National Research Foundation