Thesis (MSc)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Adolescents are regarded as a high risk group in South Africa with the highest human immunodeficiency virus (HIV) incidence occurring in this group. Prevention among adolescents is therefore a key in decreasing the HIV burden. This thesis aims to assist in the design of trials by simulating the potential outcomes of a combination prevention trial in adolescents. We develop a stochastic individual-based model stratified by sex and age. We then use this model to determine the impact of various prevention packages on HIV incidence among adolescents participating in a hypothetical trial over a three year period. The trial that is simulated involves an intervention arm, in which adolescents are offered a choice of a prevention methods (including medical male circumcision (MMC), oral pre-exposure prophylaxis (PrEP) and antiretroviral-based vaginal microbicides (ARV-VM)), and a control arm. We predict that the impact of a full prevention package on HIV incidence would be a 46% per personyear( PPY) (95% CI 45–47%) risk reduction. The combination of MMC and PrEP has a substantial impact on HIV incidence in males, with a 51% PPY (95% CI 49–53%) relative risk of HIV infection. Offering women the choice of PrEP, a microbicide gel or a microbicide in the form of a vaginal ring would be less effective, with a 57% PPY (95% CI 56–58%) relative risk of HIV acquisition. This is not substantially different from the relative risk estimated when the vaginal ring alone is offered, as the ring is assumed to be the most accept able of the three prevention methods. We determine a sample size requirement of approximately 1013 in each arm of a trial would achieve 80% power to detect a statistically significant reduction in HIV risk. We find that the relative risk is sensitive to the assumed degree of correlation between condom use and the acceptability of the prevention method. We also find that the most efficient trial design may be to offer both MMC and PrEP to males but to offer only a microbicide ring to females. Further work is required to better understand the processes by which adolescent prevention method choices are made. / AFRIKAANSE OPSOMMING: Adolessente word beskou as ‘n hoe risiko groep in Suid Afrika, met die hoogste menslike immuniteitsgebrekvirus (MIV) insidensie in hierdie groep. Voorkoming van MIV onder adolessente is daarom noodsaaklik om die MIV las te verminder. Die doel van hierdie tesis is om te help met die ontwerp van studies deur die moontlike uitkomste van ‘n kombinasie-voorkoming studie in adolessente te simuleer. Ons het ‘n stogastiese individu-gebaseerde model, gestratifiseer met betrekking tot seks en ouderdom, ontwikkel. Ons het toe die model gebruik om die impak van ‘n verskeinheid van voorkomingspakette op MIV insidensie onder adolessente wat deelneem aan ‘n hipotetiese proef oor ‘n drie jaar periode, te bepaal. Die proef wat gesimuleer word behels a intervensie groep, waarin die jong volwassenes ‘n keuse van voorbehoedings metodes (insluitende mediese manlike besnydenis (MMB), pre-blootstelling profilakse (PrBP) en anti-retrovirale vaginale mikrobisiedes (ARV-VM)) aangebied word, en ‘n kontrole groep. Ons voorspel dat die impak van ‘n volle voorkomingspaket op MIV insidensie ‘n 46% per persoon-jaar (PPJ) (95% VI 47–47%) risiko vermindering sal wees. Die kombinasie van MMB en PrBP het ‘n substansiele impak op MIV insidensie onder mans, met ‘n relatiewe risiko van MIV infeksie van 51% PPJ (95% VI 49–53%). Om die keuse van PrBP, ‘n mikrobisiede gel of ‘n mikrobisiede in die vorm van ‘n vaginale ring aan vrouens te bied, is minder effektief, met ‘n relatiewe risiko van MIV infeksie van 57% PPJ (95% VI 56%–58%). Hierdie verskil nie substansieel van die beraamde relatiewe risiko in die geval waar slegs die vaginale ring gebied word nie, aangesien daar aanvaar word dat die ring die mees aanvaarde van die drie voorkomingsmetodes is. Ons het bepaal dat ‘n steekproef van ongeveer 1013 individue in elke arm van die proef nodig is om ‘n 80% kans te he om ‘n statisties betekenisvolle afname in MIV-risiko te bespeur. Ons vind dat die relatiewe risiko sensitief is tot die aanvaarde graad van die korrelasies tussen kondoom-gebruik en die aanvaarding van die voorkomings metodes. Ons het ook gevind dat dit mag wees dat die mees doeltreffende proef ontwerp is om beide MMB en PrBP vir mans en slegs ‘n mikrobisiede ring vir vrouens te bied. Verdere werk word benodig om die prosesse waarby jong volwassenes keuses maak oor voorkomingsmetodes te verstaan.

Thesis (MScMedSc)--Stellenbosch University, 2013. / Bibliography / The efficiency in which HIV-1 can infect, spread and evade the attack of therapeutic agents can be attributed to a high mutation rate and frequent recombination events. These factors have collectively contributed to the diversity observed in HIV-1 and resulted in a multitude of subtypes, sub-subtypes, circulating recombinant forms (CRF’s) and unique recombinant forms (URF’s). The aim of this study was to investigate HIV-1 diversity in Cape Town using a small cohort of treatment naive patients being investigated for HIV Associated Neurocognitive Disorders (HAND). Four different genomic domains: gag, pol, accessory and gp41 genes were sequenced to subtype the virus. HIV-1 tat was further investigated because the dicysteine motif has been reported to play a role in HAND. Viral RNA and proviral DNA was extracted from 64 patients and used for the amplification and sequencing of the genes. Rega and jpHMM online tools were used to identify HIV-1 subtypes and recombinants while Neighbor-joining phylogenetic trees were constructed for phylogenetic analysis. The pol gene was further investigated using SCUEAL to detect possible intra-subtype recombination and was also screened for the presence of transmitted drug resistance. In addition tat sequence datasets retrieved from the Los Alamos sequence database were investigated and compared with the newly generated sequences for the detection of point mutations and amino acid signature patterns. Sequencing identified most of the samples as subtype C; however six inter-subtype recombinants (AE, A1G, A1CU and two BC) and 9 intra-subtype C recombinants were identified. In addition 13% of pol sequences were identified with resistance mutations. Signature pattern analysis identified a high level of variability in the tat sequences: 68% were identified with C30S31; 29% with the C30C31 mutation and a single sequence with a novel mutation C30A31. Functional analysis of these mutations indicated that all mutations investigated were capable of inducing apoptosis in cell culture. The C30C31 mutation generated the highest level of apoptosis, closely followed by the C30A31 mutation. However no statistical significance could be detected between tat mutations and the observed levels of apoptosis.

HIV/AIDS is an epidemic that is in one way or another affecting humankind and particularly the African continent. Due to its devastating nature, many strategies and interventions are being employed at different levels and by different groups of people to fight it. Evaluation has been a component of these projects, but few have been subjected to systematic monitoring and evaluation that provides a foundation for the development and implementation of further projects. This is partly due to the fact that project implementation and evaluation can be rendered complex by several factors, such as the choice of methodologies, donor satisfaction and the very nature of interventions and evaluations themselves. Taking a situation where the aim of a project and its evaluation is to bring about social change, as is the case with many HIV/AIDS interventions, this study sought to investigate approaches that could be considered meaningful, useful and valuable. In order to carry out the investigation of this study, the approach taken was an in-depth analysis of a few cases (in anticipation of greater achievement of insight), rather than broader survey types of perspectives. The study also concentrated on a review of the literature and on validation of documentary and interview evidence provided by beneficiaries, managerial staff and evaluators of communication-based HIV/AIDS. Results of the study highlighted the fact that community-based factors, such as education, poverty, culture, beliefs, gender, crime and age, influenced social change (with respect to HIV/AIDS) in varying ways and depending on the communities concerned. The different ways in which these factors influenced social change within specific communities were noted to have implications on interventions dealing with them. As such, an in-depth assessment of these different ways with respect to specific groups of people was encouraged in order to have a meaningful, useful and valuable HIV/AIDS intervention. The theory of active participation of targeted communities was also propagated in an HIV/AIDS intervention. It was noted that when active participation is encouraged in a project at both implementation and evaluation, taking the example of an HIV/AIDS project that intended achieving group knowledge acquisition, awareness, attitude change, skills acquisition, effective functioning and sustainability, such participation would contribute to: • Override to a great extent, limitations arising from socio-demographic differences (project locations and gender, language, age and race of implementers, evaluators and beneficiaries), in the attainment of project objectives. • Override to a great extent, limitations arising from differences in forms of evaluation (internal versus external evaluators), in the assessment of project objectives. • Create an enabling environment for higher attainment of project objectives in comparison to a situation where active participation is encouraged only at implementation (and not at evaluation). It was further discovered from this study that when beneficiaries are excluded from participating in the planning, action-planning and result-feedback stages of a project and its evaluation, dissatisfaction is experienced on the part of these beneficiaries as well as missed opportunities for useful contributions. The degree and quality of beneficiary involvement in project implementation and evaluation was seen to generate beneficiary excitement and a general sense of project acceptance: all of which was noted to create an enabling environment for the making of proper choices and decisions. Finally, difficulty in accessing traditional evaluations and people's feeling of shame and ineffectiveness was noted in the work (in the area of collecting data pertaining to traditional evaluation). This pointed to possible compromise of meaningfulness, usefulness and value of traditional evaluations. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2004.

Thesis (MPhil)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: HIV/AIDS has been seen as a thorn in the Corporate World's flesh. It is destroying the workforce like a swarm of locust on a wheat field. The Government Departmental Sectors are no exceptions. This paper has been written after a through project that was undertaken at the Department of Transport and Public Works in Cape Town. It was found that there is a great need for HIV/AIDS Education and Life skills Training amongst all Government Departments. The objectives of the researcher were also based on the ILO's document and our South African Labour Law. The employees at 7 (Seven) District Offices were educated and workshoped on HIV/AIDS Education. It was impossible to have all three Employee Assistant Programmes conducted within 7 (Seven) months of the project. The programmes for HIV/AIDS Education and Training entailed Pre-Awareness, Awareness and Post-Awareness. Only the Pre- Awareness programme was completed with a bit of Awareness was covered. In the workplace situation, time means money and it seems as if less time is allocated to the health part of the employees. Common and better methods in facilitating for HIV/AIDS Education and Trainings were by "Cascade Model, On-Job-Training (OJT) or Front Line Training (FLT) and Workshop Sessions" seem to be more appropriate, yielding better communication skills between the employees and employers. A simple questionnaire was constructed on the basis that the sample group was workshopped. The response was great and constructive comments were received from the employees, for example a question was "Do you find it good to celebrate the 09th - 15th February: Condom Week; 16th May: International AIDS Candle Memorial Day and 01st December: World AIDS Day"? Answer: YES - It creates awareness and unites people for the same course. It became interesting to the researcher in noticing how HIV/AIDS Education and Life Skills Training(HAELST) is very much needed in both Corporate/Private Sectors and Government Departments. In conclusion, recommendations are suggested to all Government Departmental and Private Sectors in HIV/AIDS Education and Training. The ball remains in the Corporate World to apply them as a tool to avoid loosing well qualified and skilful employees because of HIV/AIDS. / AFRIKAANSE OPSOMMING: Die doel van hierdie navorsing was om die noodsaaklikheid van opleiding aan regeringsinstansies in MIV/Vigs en lewensvaardighede te beklemtoon. Die studie het op die Departement van Vervoer en Openbare Sake gefokus. Werknemers van 7 distrikskantore het werkswinkels in die verband bygewoon. Die werkswinkels het hoofsaaklik op voor-bewustheid, bewustheid en na-bewustheid van MIV/Vigs gefokus. Die data is deur middel van ‘n vraelys ingesamel wat die proefpersone na afloop van die werkswinkel voltooi het. Dit is bevind dat daar ‘n geweldige behoefte vir MIV/Vigs en lewensvaardigheid opleiding by privaat- sowel as regeringsinstansies is. Die aanbeveling is dat die instansies hul werknemers in die verband moet oplei op te verhoed dat hul gekwalifiseerde en vaardige werknemers as gevolg van MIV/Vigs verloor.

M.Ed. (Curriculum Studies) / The study's main focus was on the integration of the theme HIV/AIDS into Life Orientation by educators in the senior phase. The purpose of the study was to investigate to what extent HIV/AIDS is integrated into the Life Orientation Learning Area to help to curb the spread of this leprosy in farm communities. The study explored through in-depth interviews, observations and the knowledge of the educators, learners and parents. The transcripts were analysed. The key finding of this study was that the educators are able to integrate HIV/AIDS theme into Life Orientation albeit there are still uncertainties about the aims of LO and what role the educators have to play.

Thesis (LLM. (Development and Management Law)) -- University of Limpopo, 2019 / In South Africa, the concept of virginity testing has been under the spotlight because of the Children’s Act 38 of 2005 partially legalising it. Section 12 thereof, provides for the testing to be performed on both male and female children over the age of sixteen with their informed consent. It has also been revived as a Zulu custom which gained momentum in response to the HIV/AIDS pandemic. This custom is, however, in contrast to the approach highlighted in the Act, since it targets only the girl child and mostly without her informed consent. Although a girl’s virginity is said to bring honour to her family, it also comes with inherent risks, since, in African societies, the myth that sex with a virgin, or a girl-child can cure AIDS, is prevalent. This dissertation examines, from a human rights perspective, the concept of virginity testing and related procedures/ provisions, the role and function of the virginity testers, as well as expectations/experience of the participants (the girls tested). The study asserts that the practice of virginity testing is a violation of human rights, strips the girl of her dignity, represents an invasion of bodily privacy and leads to degradation and humiliation. Virginity testing, according to this study, leads to limitation of rights and unfairly discriminates against the girls tested and cannot be justified in terms of the limitation clause, as provided by section 36 of the Constitution of the Republic of South Africa, 1996. As part of the comparative study, the analysis of the position in Senegal, regarding the successful abolishment of a similar discriminatory cultural practice, provides lessons on how both the South African government and NGO’s can work towards law reform in order to address the problem of virginity testing.

Submitted in fulfillment of the requirements for the degree of Master of Technology, Information Technology, Durban University of Technology, Durban, South Africa, 2013. / This study reports on the application of decision making core technology adoption theory to empirically examine youth preferences for Human Immunodeficiency Virus (HIV) preventive actions. In order to contribute to the open discourse on whether technology adoption rate is higher for male or female, goal desire, goal intention, action desire and action intention elements of decision making core theory were tested. A mobile health information system was implemented as an HIV information disseminating tool and used for experimentation to determine adoption by youths. A dataset of 118 pupils from two high schools was used for pilot investigation. A dataset of 292 undergraduate youths aged 10-24 years from two universities in South Africa was generated to validate the research model. The Partial Least Square (PLS) analytic modelling technique was used to determine the predictive power of decision making core model from the input dataset. Results of experimentation show that regardless of the gender youth accepts to use mobile information system to access HIV information. The predictive power of the decision making core model was found to be independent of gender factor, which was also not found to moderate the relationship between Perceived Behavioural Control (PBC) and action intention. In addition, gender was not found to moderate the order of importance in factors that predict youth preferences for HIV preventive action. PBC, action desire and goal desire were selected as the most important predictors of HIV preventive actions. The factor of action desire was found to mediate the relationship between PBC and action intention such that the mediation effect was stronger for male youth (68%) than for female youth (19%). Finally, the decision making core model better predicted youth preferences for HIV preventive actions as compared to two models based on Theory of Reason Action (TRA) and Theory of Planned Behaviour (TPB).

Thesis (MA) -- University of Stellenbosch, 2004. / ENGLISH ABSTRACT: The relentless progression of HfV /AIDS epidemic has made it imperative that measures are put in place to minimise its impact on Small and Medium Enterprises (SME). mv is set to have a significant effect on every facet of the population, and SME is not immune. Business is likely to feel the impact ofmv/AIDS epidemic through reduced productivity, increased absenteeism, increased staff turnover, increased recruitment and training costs, increased cost of employee benefits and poor staff morale. One of the interventions is to implement a mv/AIDS policy and programme, yet a literature search showed that psychological studies of SME in implementing a mv/AIDS policy and programme are limited. The present study utilised the model of the theory of planned behaviour (Ajzen, 1985,1988, 1991), which is an extension of the theory of reasoned action (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980). Intention to implement a mv/AIDS policy and programme was predicted by the theory of planned behaviour constructs such as attitude, subjective norm and perceived behavioural control. The theory of planned behaviour was found to be useful in assessing behavioural intention of SME in implementing a mv/AIDS policy and programme. These findings indicate that implementing an intervention like a mv/AIDS policy and programme by SMES is a behavioural intention motivated by attitudes, subjective norms and perceived behavioural control. / AFRIKAANSE OPSOMMING: Die meedoënlose progressie van die HIVNIGS pandemie het dit gebiedend noodsaaklik gemaak om maatreëls daar te stelom die impak daarvan op klein en medium sakeondernemings te minimaliseer. HIVNIGS sal 'n beduidende uitwerking hê op alle vlakke van die bevolking. Klein en medium sakeondernemings is geen uitsondering nie. Die uitwerking van die HIVNIGS pandemie sal tot gevolg hê 'n afname in produktiwiteit; 'n toename in personeelafwesigheid, personeelomset, personeelwerwing en - opleidingskoste, personeelvoordele; en swak personeel moreel. Een manier om die probleem aan te spreek is om 'n HIVNIGS beleid en program te implimenteer. Ongelukkig toon literêre navorsing dat psigologiese studies van klein en medium sakeondernemings om 'n HIVNIGS beleid en program te implimenteer, beperk is. Dié navorsing steun op die teorie van planmatige gedrag (Ajzen, 1985; 1988; 1991), wat 'n verlenging is van die teorie van beredeneerde optrede (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980). Die oogmerk met die implimentering van 'n HIVNIGS beleid en program is bepaal deur die teorie van planmagtige gedrag soos waargeneem in geesteshouding, subjektiewe norme en waargenome beheerde gedrag. Daar is gevind dat die teorie van planmagtige gedrag nuttig is om die oogmerke en optrede van werknemers in klein en medium sakeondernemings te bepaal met die implimentering van 'n HIVNIGS beleid en program. Hierdie bevindings toon dat die implimentering en tussenkoms van 'n HIVNIGS beleid en program by klein en medium sakeondernemings'n gedragsoogmerk is wat gemotiveer word deur geesteshoudings, subjektiewe norme en waargenome beheerde gedrag.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: HIV counseling and testing (HCT) is a cornerstone of both HIV prevention and care in South Africa, but only one in five South Africans who are aware of HCT services have been tested for HIV and hence the uptake is reportedly low. This study investigated factors that prevent the uptake of HCT programme in the workplace. Specific factors that were looked at include: fear of learning about one‟s HIV status, HIV-stigma and discrimination and knowledge of and attitudes towards HCT. The study employed descriptive survey design; anonymous questionnaires were randomly distributed irrespective of age, gender, marital status, race, educational level, work position and experience. Closed and open-ended easy- to- answer questions which were written in English were asked; and they required fewer instructions. Ethical issues were considered and university guidelines followed. The results of this study showed that a great proportion of participants (93.8%) tested for HIV as compared to (6.2%) who had never tested. Of these, 59.4 % tested because they wanted to know their HIV status and, 43.8% of participants preferred using the workplace HCT programme for convenience; while 50% used private facilities for privacy and confidentiality. The study further established that fear of knowing one‟s HIV status, workplace discrimination, knowledge of and attitudes towards HCT were not associated with workplace HCT programme uptake. The results did however show that both participants who had tested and those who had not tested (68.8%) demonstrated significantly greater AIDS-related stigma. Supportive and collaborative efforts are necessary to create and promote an enabling and conducive environment in order to dispel workplace HIV-related stigma. In addition, it is imperative to develop and implement workplace stigma mitigation strategy putting in place interventions that aim to reduce all forms of stigma, as well as emphasizing on the benefits of testing. / AFRIKAANSE OPSOMMING: MIV/Vigs-voorligting en toetsing is die hoeksteen vir beide die voorkoming en versorging van MIV-pasiënte in Suid-Afrika. Ongelukkig is net ongeveer een uit elke vyf mense bewus van hulle MIV-status. Die doel van hierdie studie is 'n poging om vas te stel waarom so min mense gebruik maak van gratis toetsingsdienste in die werksplek. 'n Beskrywende studie-ontwerp is in hierdie navorsing gebruik met anonieme vraelyste wat ewekansig versprei is onder 'n steekproef waarin geen onderskeid ten opsigte van ras, geslag. opvoedkundige vlak, posisie in die werk en ervaring gemaak is nie. Geslote en oop-einde vrae is gebruik en Engels is as kommunikasiemedium gebruik omdat al die proefpersone dit verstaan het. Resultate van die studie het aangetoon dat beduidend meer mense hulle wel laat toets het teenoor die wat hulle nie laat toets het nie. Die studie het verder bevind dat faktore soos die vrees om status te weet; diskriminasie in die werksplek, kennis van en houding teenoor MIV/Vigs nie geassosieer kan word met die lae opname van vrywillige toetsing in die werksplek nie. Die studie het wel bevind dat diegene wat hulle . laat toets het, beduidend meer stigma in die werksplek ondervind. Ondersteunende dienste is uiters nodig ten einde stigma suksesvol in die werksplek te bestuur. Daar word voorgestel dat daar 'n volledige opleidingsprogram ,in die werksplek van die organisasie wat in die studie gebruik is, ontwikkel moet word ten einde die invloed van stigma tot 'n minimum te beperk.

Submitted in partial fulfillment of the requirements for the Degree of PhD (Community Psychology), Faculty of Arts, University of Zululand, 2008. / HIV and AIDS present a catastrophic public health threat that is reaching crisis proportions among adolescents and young adults. There is a need to educate pre adolescent female learners before they reach puberty, as females are especially at risk of contracting HIV because of the interplay of biological, economic and cultural factors. This study explored the nature and extent of the pre-adolescent female learner's knowledge, attitudes and skills regarding HIV and AIDS. An experimental research design, namely, a no-treatment group design with pre test and posttest was applied. An HIV and AIDS prevention intervention programme was designed and implemented. The objectives were to help learners acquire knowledge, attitudes and skills to make informed decisions and practice health promoting behaviours. Life skills, sex and sexuality education and HIV and AIDS as a gendered epidemic were addressed. The science and art of health education was used to frame the intervention and ensured that the learner not only received the correct message but also incorporated it into her repertoire of behaviour. The findings of the study highlighted five critical areas that were vital within an HIV and AIDS education intervention. Firstly, pre adolescent female learners were very interested in sex and sexuality and information on physiological changes during puberty must be disseminated. The issue of morality was attached to sex and sexuality and this reinforced the biopsychosocial and cultural factors that came into play. The importance of peer education was emphasised, as parents were reticent to address these issues. It was found that basic information on all dimensions of HIV and AIDS education was still a powerful tool. It was vital to incorporate more than the ABC messages and look at the social constructs of health promotion and focus on critical thinking and an education for liberation. A manual with a set of guidelines was formulated and presented to educators for use with preadolescent female learners. This would help reduce the casualties of HIV and AIDS, as early intervention would protect a vulnerable group in society.