With increasing rates of HIV prevalence in South Africa, research focus is on examining factors that may affect HIV-related sexual risk behaviour, especially in adolescents. Two such factors, parenting styles and socio-economic status (SES) have been highlighted. Despite remarkable consistence in parenting style research, with the authoritative parenting style reliably associated with positive outcomes, the applicability of this model in diverse contexts is questioned given that the majority of this research was conducted in White, middle-class populations. Both parenting practices and SES have produced some inconsistent results in relation to sexual risk behaviours; where results have been dependable, they have failed to account for the mechanisms influencing such relationships. The current study aimed to determine if the documented parenting styles – and SES - sexual risk behaviour relationships could be found in 366 South African adolescents. The study also explored parenting style as a moderator and/or a mediator in the SES – sexual risk behaviour relationship, and SES as a moderator on the parenting style – sexual risk behaviour model. The participants completed adapted self report questionnaires (Parenting Style Index (PSI) and Adolescent Sexual Risk Behaviour Questionnaire) and a self-developed biographical questionnaire. Both the parenting styles – sexual risk behaviour and the SES – sexual risk behaviour relationships were found (r =-.21 and -.24 respectively, p <.0001). While the mediation model was disproven, SES and parenting style were both found to act as moderators (F6, 363=2.15, p=.0469). These results are valuable in terms of providing knowledge that may help to develop relevant and effective sexual risk behaviour intervention programmes, as well as adding richness to the current fields of parenting style, and sexual risk behaviour research.

Thesis (MTech (Tourism and Hospitality Management))--Cape Peninsula University of Technology, 2006. / The HIV/AIDS pandemic poses one of the greatest challenges to business development in South Africa. The hotel industry is growing rapidly and will be . significantly affected by the HIV/AIDS pandemic. The purpose of this study was to determine the Knowledge, Attitudes and Practices (KAP) regarding HIV/AIDS of staff from nine Protea group hotels in Cape Town. A sample of 200 hotel staff was randomly selected to participate. A structured self-administered anonymous questionnaire was the instrument used to collect the data. The response rate was 81%. There were more females than males, and the majority of the respondents were between the ages of 21-30 years. More than half of the respondents were single, hotel managers and with matriculation as the highest qualification. The respondents demonstrated a reasonably good knowledge on the transmission of HIV/AIDS. Almost half of the respondents believed that HIV/AIDS would not affect the hotel industry. The survey revealed conflicting results on whether HIV-infected staff should be involved in food preparation, and whether staff should serve food to HIV positive hotel guests. There were also concerns of the risk of infection when handling dirty linen used by HIV-infected hotel guests. More males than females were currently sexually active and reported having more than one partner in the past three years. The majority of the respondents believed that condoms were effective, but only one third reported the use of a condom every time they had a sexual encounter. There was a significant relationship between knowledge and attitudes (p-value<0.05, but none between knowledge and practice and attitude and practice. It is recommended that the hotel industry develop effective workplace policies and supportive environments, and that on-going HIV/AIDS education and prevention programmes be implemented to change high risk sexual behaviour and practices.

The world has entered the third decade of the HIV and AIDS epidemic under different times in which the epidemic is treatable. The International Labour Organisation (ILO) (2005) declares HIV and AIDS a developmental crisis destroying developmental gains over generations. Since HIV and AIDS affect the most productive segment of the labour force, it is therefore not only a threat to development but also to the world of work without which development will be sacrificed (ILO, 2001). Collaborative response efforts that seek to mitigate the HIV pandemic by government, business and higher education institutions have been fraught with challenges. The main challenge that beset these efforts is that, in the absence of an HIV vaccine, voluntary counselling and testing remains the gateway to access treatment and care. Regrettably, participation in VCT has been confronted by challenges of low utilisation. This precedes the objectives of this study, which were to explore and describe factors that serve as barriers and facilitators of workplace VCT programmes with the objective to improve participation in these programmes. The current study was a product of a qualitative and exploratory-descriptive research design. A nonprobability convenience sampling method was used to sample participants for this study. The targeted population in this study were the non-academic employees of an academic institution in the Eastern Cape. Data was collected by means of focus group discussions and by using semi-structured interviews. The focus group samples comprised of an equal number of men and women with an overall participation of fifty-six participants. Data obtained was transcribed, thematically analysed and coded using Henning, Van Rensburg, and Smit's (2004) qualitative analysis and interpretation method. Findings of this research revealed that factors that facilitate and inhibit voluntary counselling and testing are psychosocial and cultural by nature. At psychosocial level, participants reported factors that facilitate voluntary counselling and testing to include psychological readiness to go for HIV testing, reassurances of confidentiality of HIV test results and normalising HIV testing (making the process more like that for screening and diagnostic testing). Cultural factors included cultural practices and beliefs such as "intonjane" and traditional circumcision - positive cultural nurturers that could facilitate VCT participation. Results of this study showed a lack of basic knowledge about VCT and fear of knowing one's status, fear of breach of confidentiality, fear of being stigmatised and a lack of trust towards health professional as the major psychosocial factors that serve as barriers to VCT participation. The cultural barriers to VCT pointed to hegemonic masculinity as a socially constructed gender identity that encourages gender inequalities and undermines efforts to improve HIV testing. The study suggested that strategies to increase VCT participation should consider leadership support of VCT programmes, incentivisation of VCT programmes, institutionalisation of HIV and AIDS education and the establishment of integrated wellness services for employees.

Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2016. / IntroductionMale circumcision refers to the surgical removal of all or parts of the prepuce of the penis. This procedure is undertaken for religious, cultural, social, hygiene or medical reasons (Maibvise and Mavundla 2013: 139). The number of people living with Human Immunodeficiency Virus (HIV) rose from approximately 8 million in the year 1990 to 33 million infections now. Sub-Saharan Africa is the region in the world most affected by HIV/AIDS with 22.4 million people living with the virus in the year ending 2008 (Naidoo et al. 2012: 2). The use of male and female condoms remains a challenge despite decades of promotion. There is evidence that medical male circumcision (MMC) is effective in preventing HIV sexual transmission. Medical male circumcision is a drive that was initiated by the National Department of Health as a strategy to curb HIV infection in South Africa in 2010. Aim of the Study The purpose of the study was to investigate and describe knowledge, attitudes and perceptions of males with regard to medical male circumcision. Methodology A quantitative descriptive survey research method was used to describe the knowledge, attitudes and perceptions of males attending the community health care centers (CHCs) in eThekwini district regarding medical male circumcision. Results Displayed posters motivated 71.4% (n = 329) to have circumcisions. While 65.1% (n = 300) respondents had knowledge about circumcision and HIV, 27.8% (n = 280) perceived that circumcision would interfere with their sexual function and reproduction. A total of 38.8% (n = 179) of respondents indicated that it is good for children to be circumcised. There is a significant positive correlation between age and knowledge (r = 0.135, p = .004). Higher age is correlated with more knowledge. Conclusion This study found that knowledge plays a major role in changing attitudes and perceptions. The more knowledgeable an individual is, the more the chance is of them having a positive attitude towards MMC which could also influence a positive perception of MMC. In order to strengthen male circumcision as an HIV prevention strategy, it is imperative to provide the population that reflected low knowledge and negative attitude with information, education and counselling services. This may help them to change their attitudes and acquire a positive perception of MMC. / M

The socio-economic impact of HIV/AIDS on South Africa has resulted in lower gross domestic product, loss of skills in key sectors such as education, and increased health-care costs in providing access to treatment. Currently active pharmaceutical ingredients (API’s) such as stavudine (d4T) and azidothymidine (AZT) are imported from India and China, while formulation is conducted locally. A strategy was initiated between CSIR Biosciences and LIFElab under the auspices of Arvir Technologies to investigate the feasibility of local antiretroviral manufacture (d4T and AZT) or the manufacture of a key intermediate such as β- thymidine (dT). Several advantages associated with successful implementation of this strategy include ensuring a local supply of API’s, thus reducing reliance on procurement from foreign sources and reducing the effect of foreign exchange rate fluctuations on providing cost effective access to treatment. A local supply source would also reduce the imports and thus aid the balance of payments deficit, and in addition to this, provide stimulus in the local pharmaceutical manufacturing industry (which has been in decline for several decades), resulting in increased skills and employment opportunities. This thesis describes the development of a superior chemo-enzymatic process for the production of β-thymidine (72 percent yield, prior to isolation), a key intermediate in the preparation of anti-retrovirals. Alternative processes based purely on chemical or bioprocess transformations to prepare either 5-methyluridine (5-MU) or dT suffer from several disadvantages: lengthy transformations due to protection/deprotection strategies, low selectivties and product yields (30 percent in the chemical process) and isolation of the product from dilute process streams requiring the use of large uneconomical reactors (bioprocesss). This contributes significantly to the cost of d4T and AZT manufacture. Our novel chemoenzymatic process comprises of a biocatalytic reaction for the production of 5-MU, with subsequent chemical transformation into dT (3 steps) negating and circumventing the limitations of the chemical or bioprocess routes. During the course of this project development, the β-thymidine selling price declined from 175 $/kg (2005) to 100 $/kg (2008). However, the process described in this work is still competitive based on the current β- thymidine selling price of 100 $/kg. The process economics show that with further optimization and increasing the isolated dT yield from 70 percent to 90 percent, the variable cost decreases from 136 $/kg to 110 $/kg. The increase in isolated yield is highly probable, based on solubility data of β-thymidine. The decrease in β-thymidine selling price and technological improvement in dT manufacture should translate into lower API manufacture costs and more cost effective access to treatment. Our novel biocatalytic process producing 5-MU uses a coupled enzyme system employing PNP, Purine Nucleoside Phosphorylase and PyNP, Pyrimidine Nucleoside Phosphorylase. The overall transglycosylation reaction may be decoupled into the phosphorolysis reaction (PNP) and synthesis reaction (PyNP). During the phosphorolysis reaction, guanosine is converted into guanine and ribose-1-phosphate (R-1-P) in the presence of PNP enzyme. The reaction intermediate R-1-P is then coupled to thymine in the presence of PyNP enzyme during the synthesis reaction, producing 5-MU. The process was scaled up from lab-scale to bench-scale (10 - 20 L) and demonstrated to be robust and reproducible. This is evident from the average guanosine conversion (94.7 percent ± 2.03) and 5-MU yield (88.2 percent ± 6.21) and mole balance (104 percent ± 7.61) which were obtained at bench-scale (3 replicates, 10 L). The reaction was carried out at reactor productivities of between 7 – 11 g.L-1.h-1. The integration of the biocatalytic process and chemical processes was successfully carried out, showing that 5-MU produced using our novel biocatalytic process behaved similarly to commercially available 5- MU (ex. Dayang Chemicals, China). A PCT patent application (Ref. No. P44422PC01) on this chemo-enzymatic process has been filed and currently public private partnerships are being explored through Arvir Technologies to evaluate and validate this technology at one ton scale.

Dissertation (DPhil)--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: The aim of this study was to develop a HIV intervention programme tailored for South African adolescents with visual impairments. A further aim was to pilot and evaluate this tailored programme. This investigation was deemed necessary in the light of the growing HIV pandemic in South Africa, which has proliferated over the last 10 years. Adolescents and young adults are among the most vulnerable to HIV infection, and this does not exclude adolescents with visual impairments. Despite the perceptions among sighted people of asexuality in adolescents with visual impairments, they are a vulnerable group for HIV infection. The motivation for this study is the fact that very little literature is available on HIV/AIDS and people with visual impairments, and that this vulnerable group is marginalized in HIV/AIDS campaigns internationally. As far as we could ascertain, there have been three HIV prevention initiatives for people with visual impairments in South Africa, none of which was fully researched and evaluated, and all of which used existing generic interventions but transcribed into Braille and large print format. The reality is, many adolescents with visual impairments, as is the case with sighted youths, are sexually active, and the absence of research on HIV prevalence and HIV prevention needs in this sector, is conspicuous. An urgent need exists to tailor HIV preventative programmes for this vulnerable sector. The dearth of research on HIV/AIDS and people with visual impairments motivated the choice of a key informant study to investigate the effects that HIV/AIDS and other concomitant issues have on persons with visual impairments, prior to the design of any intervention. A purposive sample of key informants who are working among people with visual impairments on a daily basis, most of whom had visual impairments themselves, was selected. Information gathered from the key informant study was combined with the lessons from a review of available literature on health promotion programmes and HIV prevention programmes in particular to develop an HIV/AIDS intervention programme to be piloted and evaluated for its effectiveness. The design of the programme took account, in addition, of broader contextual issues such as power and gender issues, and the marginalization and stigmatization of disabled people. The theoretical framework which forms the basis of the programme was informed by elements of a number of cognitive theories in the health promotion field, and especially the Informational-Motivational-Behavioural model (IMF). The programme was designed to empower participants and to create an environment of reallife experiences in which they could acquire important negotiation skills, decision-making skills, and practical skills to use condoms and HIV/AIDS knowledge to facilitate attitude and behaviour change. The next objective of this research was to implement the intervention programme of eight sessions designed for adolescents with visual impairments and to investigate the outcome on participants in this study. For this purpose an experimental design, one experimental group and three control groups (n= 56), not randomly assigned, was used to test the effect of the programme on participants in the intervention group compared to the control groups, who received a health promotion programme of four sessions. All participants were learners at the only two schools for learners with visual impairments in the Western Cape Province of South Africa, and they were allocated into treatment or control conditions on the basis of the school grades in which they were already placed. The empirical investigation utilized a questionnaire that was developed and transcribed into Braille as well as large print. Following a small pilot study, the questionnaire was finalized and administered to all four groups (pre-test, to determine baseline differences; post-test, to determine the immediate effect of the programme; and follow-up [3 months later] to determine longer term effectiveness). An analysis was done to assess the internal consistency of the measuring constructs of the questionnaire, and satisfactory internal consistency was found, with Cronbach’s alpha scores ranging between 0.72 and 0.92. Quantitative data were analyzing using multivariate techniques, beginning with a repeated measures MANOVA analysis and, once an overall significant F ratio between variables, time and groups (F=2.009, p<0.05); a significant F ratio between groups and variables (F=4.211, p<0.01), and significant F ratio between time and groups (F=2.611, p<0.01), had been found, we continued with more focused analyses. Baseline results revealed no statistical differences between the four groups. There were statistically significant improvements in knowledge of HIV/AIDS for both the experimental group and two of the control group, but these differences were not maintained at follow up. Significant differences in attitudes towards HIV/AIDS were found for the experimental group and for one of the control groups. Though there were significant changes in both knowledge and attitudes, therefore, it cannot be claimed that the intervention itself was responsible for knowledge and attitudinal change. There was some evidence for diffusion of innovation in terms of HIV knowledge from the experimental group and the control group situated at the same school. Changes in reported HIV risk behaviour were not recorded to a significant degree, a fact which may have been attributable in part to small sample size. Qualitative process information was used to get a sense of the experiences of participants and the concomitant issues they discussed during the intervention. The qualitative data revealed a host of contextual factors relevant to issues of HIV/AIDS and sexuality in this group, including experiences of stigmatization as people with visual impairment, negotiating masculinity in the context of visual impairment, gender oppression of women and resistance to this, and a general atmosphere of myths and silences around HIV/AIDS in particular and sexuality in general. Despite the limited impact of the programme, this pilot study revealed important issues for adolescents with visual impairments regarding HIV prevention which require further investigation. Participants in the experimental group indicated that they learned a lot from this programme and suggested that it be given to younger adolescents to enable them to acquire these vital skills prior to active sexual engagement and the involvement in any form of unprotected sex. A number or recommendations are made for further well-documented and evaluated research in this field. / AFRIKAANSE OPSOMMING: Die doel van die studie was om ’n MIV-intervensieprogram te ontwikkel wat op Suid- Afrikaanse adolessente met gesigsgestremdhede gemik is. ’n Verdere doel was om ’n proeflopie van die pasgemaakte program te doen en dit te evalueer. Hierdie ondersoek is nodig geag in die lig van die groeiende MIV-pandemie in Suid-Afrika, wat oor die afgelope tien jaar vinnig versprei het. Adolessente en jong volwassenes tel onder die kwesbaarstes vir MIV-infeksie, en dit sluit nie adolessente met gesigsgestremdhede uit nie. Ongeag die persepsies omtrent aseksualiteit in adolessente met gesigsgestremdhede onder diegene wat nie gesigsgestremd is nie, is eersgenoemde ’n kwesbare groep vir MIV-infeksie. Die motivering vir hierdie studie is die feit dat baie min literatuur vir mense met gesigsgestremdhede beskikbaar is, en dat hierdie kwesbare groep wêreldwyd in MIV/VIGSveldtogte gemarginaliseerd is. Sover ons kon vasstel, was daar drie MIV-voorkomingsinisiatiewe vir mense met gesigsgestremdhede in Suid-Afrika, waarvan nie een ten volle nagevors en geëvalueer is nie, en wat almal bestaande generiese intervensies gebruik het wat in Braille en grootdruk-formaat omgesit is. Die werklikheid is dat baie adolessente met gesigsgestremdhede – nes die geval is met jeugdiges sonder gesigsgestremdhede – seksueel aktief is en dat die afwesigheid van navorsing oor MIV-voorkoms en MIVvoorkomingsbehoeftes in hierdie sektor opvallend is. Daar is ’n dringende behoefte aan pasgemaakte MIV-voorkomende programme vir hierdie kwesbare sektor. Die gebrek aan navorsing oor MIV/vigs en mense met gesigsgestremdhede het die keuse van ’n sleutelinformantstudie gemotiveer om die invloed wat MIV/vigs en ander gepaardgaande kwessies op mense met gesigsgestremdhede het, voor die ontwikkeling van enige intervensie te ondersoek. ’n Doelgerigte steekproef van sleutelinformante wat op ’n daaglikse grondslag onder mense met gesigsgestremdhede werk, waarvan die meeste self gesigsgestremd is, is gekies. Inligting wat van die sleutelinformantstudie verkry is, is gekombineer met die lesse uit ’n oorsig van die bestaande literatuur oor gesondheidsbevorderingsprogramme – in die besonder MIV-voorkomingsprogramme – om ’n MIV/vigs-intervensieprogram te ontwikkel wat as loodsprojek kon dien en wat vir doeltreffendheid geëvalueer kon word. Die ontwerp van die projek het, daarbenewens, ag geslaan op breër kontekstuele kwessies soos mags- en genderkwessies en die marginalisering en stigmatisering van mense met getremdhede. Die teoretiese raamwerk wat die grondslag vir die program vorm, is op elemente van ’n aantal kognitiewe teorieë op die gebied van gesondheidsbevordering, en spesifiek die inligtingmotivering- gedragsmodel geskoei. Die program is ontwerp om deelnemers te bemagtig en om ’n omgewing van lewenservaringe te skep waarbinne hulle belangrike onderhandelings-, besluitnemings- en praktiese vaardighede kon ontwikkel om kondoomgebruik te bevorder, asook kennis omtrent MIV/vigs om houdings- en gedragsverandering te fasiliteer. Die volgende doelwit van hierdie navorsing was om die intervensieprogram van agt sessies wat vir adolessente met gesigsgestremdhede ontwerp is, te implementeer en om die resultate ten opsigte van die deelnemers aan die studie te ondersoek. Met hierdie doel voor oë is ’n eksperimentele ontwerp – een eksperimentele groep en drie kontrolegroepe (n=56), wat nie ewekansig toegewys is nie – gebruik om die invloed van die program op deelnemers in die intervensiegroep te toets teenoor dié op die kontrolegroepe, wat aan ’n gesondheidsbevorderings-program van vier sessies deelgeneem het. Alle deelnemers was leerders by die enigste twee skole vir leerders met gesigsgestremdhede in die Wes-Kaap, Suid-Afrika. Hulle is op grond van die skoolgraad waarin hulle reeds geplaas is, aan behandelings- of kontroletoestande toegewys. Die empiriese ondersoek het ’n ontwikkelde vraelys gebruik wat sowel in Braille getranskribeer is as in grootdruk gedruk is. Ná afloop van ’n klein loodsstudie is die vraelys gefinaliseer en aan al vier groepe toegedien (voortoets, om die basisverskille vas te stel; na-toets, om die onmiddellike invloed van die program vas te stel; en opvolg [3 maande later] om doeltreffendheid op langer termyn vas te stel). ’n Ontleding is gedoen om die interne konsekwentheid van die meetkonstrukte van die vraelys te assesseer: voldoende interne konsekwentheid is gevind, met Cronbach se alfapunte wat tussen 0.72 en 0.92 gewissel het. Kwantitatiewe data is met behulp van meervariaattegnieke ontleed. Eers is ’n herhaaldemeting- MANOVA-ontleding gedoen en daarna – nadat ’n algeheel beduidende F verhouding tussen veranderlikes, tyd en groepe (F=2.009, p<0.05); ’n beduidende Fverhouding tussen groepe en veranderlikes (F=4.211, p<0.01) en ’n beduidende F-verhouding tussen tyd en groepe (F=2.611, p<0.01) gevind is – is dit deur meer gefokusde ontledings gevolg. Basislynuitslae het geen statistiese verskille tussen die vier groepe getoon nie. Daar was statisties beduidende verbeteringe in kennis oor MIV/vigs in sowel die eksperimentele groep as die twee kontrolegroepe, maar hierdie verskille is nie met die opvolgtoets volgehou nie. Beduidende verskille in houding jeens MIV/vigs is by die eksperimentele groep en een van die kontrolegroepe gevind. Hoewel daar beduidende veranderinge in sowel kennis as houdings gevind is, kan daar nie beweer word dat die intervensie self vir die kennis- en houdingsveranderinge verantwoordelik was nie. Daar was ’n mate van bewys vir diffusie van innovering wat betref kennis oor MIV van die eksperimentele groep en die kontrolegroep by dieselfde skool. Veranderinge in aangemelde MIV-risikogedrag is nie in ’n beduidende mate aangeteken nie, ’n feit wat gedeeltelik aan die beperkte grootte van die steekproef te wyte kan wees. Inligting uit ’n kwalitatiewe proses is gebruik om ’n indruk te skep van die ervaringe van deelnemers en gepaardgaande kwessies wat hulle tydens die intervensie bespreek het. Die kwalitatiewe data het ’n reeks kontekstuele faktore blootgelê wat vir kwessies van MIV/vigs en seksualiteit in hierdie groep tersaaklik is, met inbegrip van ervaringe van stigmatisering as mense met gesigsgestremdhede, die hantering van manlikheid binne die konteks van gesigsgestremdheid, genderonderdrukking van vroue en weerstand hierteen, asook ’n algemene atmosfeer van mites en stilswye oor MIV/vigs in die besonder en seksualiteit in die algemeen. Ten spyte van die beperkte impak van die program het hierdie loodsstudie belangrike kwessies vir adolessente met gesigsgestremdhede betreffende MIV-voorkoming blootgelê wat verdere ondersoek noodsaak. Deelnemers in die eksperimentele groep het aangedui dat hulle baie uit hierdie program geleer het en het voorgestel dat dit aan jonger adolessente aangebied word om hulle in staat te stel om hierdie noodsaaklike vaardighede te ontwikkel voordat aktiewe seksuele betrokkenheid en betrokkenheid by enige vorm van onbeskermde seks plaasvind. ’n Aantal aanbevelings vir verdere goed gedokumenteerde en geëvalueerde navorsing op hierdie gebied word gemaak.

A research report submitted to the Faculty of Humanities, School of Social Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Arts in the field of Demography and Population Studies. November 2016. / Introduction: South African men practice both traditional and voluntary medical male circumcision. Voluntary Medical Male Circumcision (VMMC) was introduced as a health intervention strategy against HIV/AIDS. On the other hand, traditional male circumcision (TMC) is a ritual that marks the rite of passage into manhood. TMC has been identified as a public health hazard associated with high numbers of complications and even deaths. The South African government has launched and promotes the VMMC programme. The programme aims to reach a target of 80% coverage in order to effectively reduce HIV infections in the country. However, TMC remains a popular practice. In 2009, the National HIV Community Survey reported that 67% of men were traditionally circumcised, while 33% had been circumcised medically. This study aims to identify factors associated with VMMC, in order to inform the current programme. Furthermore, this study will add to the body of knowledge regarding VMMC and TMC, as previous literature has focused on identifying factors associated with circumcision status rather than the choice of circumcision type (VMMC vs TMC). Objective: The aim of this study was to the identify levels of circumcision status and circumcision types (VMMC vs TMC). Furthermore, this study aimed to examine the relationship between demographic, socio-economic, cognitive and environmental factors associated with VMMC and TMC in South Africa. Methodology: The study used data from the Third National HIV Communication Survey, 2012. The study sample is 6 828 473 males aged 16-55 years who underwent VMMC or TMC. The first step of the analysis was descriptive, using cross tabulations and graphs. Finally, multivariate analysis was employed using binary logistic to examine the relationship between VMMC and TMC with demographic, socio-economic, cognitive and environmental factors. Results Fifty-one percent (51%) of circumcised males were circumcised medically, while 49% were traditionally circumcised. As expected; ethnic groups known to practice TMC were less likely to choose VMMC. In terms of socioeconomic variables, education was significantly associated with whether males were medically circumcised (p<0.05; CI1.66=5.11). Availability of VMMC at the health facility significantly influenced the males choice of selecting VMMC as the type of circumcision to undergo (p<0.05; CI 0.43=0.79). / GR2017

The importance of partnerships between marginalised communities and support agencies (from the public sector, private sector and civil society) is a pillar of HIV & AIDS management policy. Such alliances are notoriously difficult to promote and sustain. The thesis presents the findings from a longitudinal, qualitative case study of a project seeking to build partnerships to facilitate local responses to HIV & AIDS in a remote rural community in South Africa. The partnership aimed to empower community stakeholders to lead HIV-prevention and AIDS-care efforts through the support of local government departments, NGOs and the private-sector, and make public services more responsive to local needs. I highlight the value of building longterm relationships with, and ownership of the project by community stakeholders, i/ by involving community stakeholders in partnership building and facilitation from the very beginning of the process, and; ii/ through a compliance with, and respect for community protocols and norms in the process of entry, community engagement, and partnership facilitation. I illustrate how features of the local public sector environment have actively worked against effective community empowerment and partnership. These include a rigid hierarchy, poor communication between senior and junior health professionals, lack of accountability, limited social development skills, and the demoralisation and/or exhaustion of public servants dealing with multiple social problems in under-resourced settings. I outline the obstacles that have prevented private-sector involvement, suggesting a degree of scepticism about the potential for private-sector contributions to development in remote areas. The most effective partners have been the NGOs — run by committed individuals with a keen understanding of social-development principles, flexible working styles and a willingness to work hard for small gains. Despite the challenges, the partnership has achieved many positive outcomes, including the formalization of the partnership and its institutionalization within a permanent government structure. I outline these achievements and discuss the essential role played by an external change agent in facilitating the process of partnership building. I conclude with eight key lessons learnt and recommendations which emerged out of the research. Firstly, partnerships are embedded in and influenced by the contexts within which they are located; secondly, stakeholder organizations must create an enabling environment to encourage and sustain partnership participation; thirdly, capacity building and empowerment of partners is crucial for ensuring ownership and sustainability of the partnership; fourthly, partnerships within resource (human and physical) poor contexts like Entabeni, where skills and resources are scarce, require the services of a dedicated, skilled facilitator or external change agent; fifth, partnership building needs to be guided by regular monitoring and evaluation and a systematic documentation of the process; sixth, relationships based on trust are a central pillar of partnerships; seventh, partnerships are as much about individuals as they are about communities and organizations, and; finally, partnerships can and do work, in-spite of the many challenges that may be encountered. of partnerships between marginalised communities and support / Thesis (Ph.D.)-Universtiy of KwaZulu-Natal, Durban, 2008.

No abstract available. / Thesis (M.A.)-University of Natal, Durban, 2003.

Zimbabwe is one of the priority countries nominated by the World Health Organisation and the Joint United Nations Programme on HIV and AIDS to adopt and implement voluntary medical male circumcision (VMMC) because of its high rate of HIV prevalence and its low level of male circumcision. VMMC, which was introduced in Zimbabwe in 2009, is a new HIV prevention method which reportedly offers partial protection of about 60 percent for circumcised males with respect to contracting HIV through sexual relations. The other key prevention method, namely the use of condoms consistently and correctly, has a protection rate of up to 95 percent. As a result, because of only partial protection, medically-circumcised men are encouraged to use condoms to decrease the chances of HIV infection. Concerns though have been raised about the possibility of risk compensation by circumcised males by way of increases in unsafe or risky sexual practices subsequent to circumcision and arising from perceptions of reduced risk through VMMC. This compensation may take the form of condom use aversion including when involved with concurrent sexual partners. If risk compensation does take place, this would lead to increases in HIV transmissions affecting not only the circumcised men but their sexual partners as well. The supposed effectiveness of VMMC as a HIV prevention method has been subjected to significant criticism and, as yet, no significant study has been undertaken in Zimbabwe on the relationship between VMMC, condom use, concurrent sexual partners and risk compensation. Based on a study of twenty-five medically-circumcised males in Harare, the capital of Zimbabwe, this thesis seeks to understand and explain the relationship between voluntary medical male circumcision and risky sexual practices with particular reference to condom use amongst men engaged in concurrent sexual partnerships. While the thesis finds evidence of risky sexual practices subsequent to circumcision, risk compensation does not seem to be particularly prevalent.