Transition to motherhood is an on-going developmental process that requires adaptation or change in restructuring behavior and role identity. When living in a foreign culture, women's challenges are increased exponentially because of bi-cultural conflicts and the presence of limited support. The purpose of this study was to describe the essential structure of the lived experience of the childbirth experience in Hawaii for expatriate Japanese women who were transitioning to motherhood. The research design was descriptive, using a phenomenological approach reflected in Colaizzi's method. A sample consisted of 10 Japanese expatriate women. Major findings of this study consisted of four Theme Categories: Challenges Living Overseas, Challenges of Motherhood, Reaching the Goal of Motherhood, and Relationship with Others. In the essential structure of the lived experience ofthe childbirth in Hawaii, the expatriate Japanese women experienced difficulties in their childbirth process, but as a result they understood their parents' values and also identified themselves as worthwhile individuals through the separation from family during the childbearing process. The new contribution of this study to nursing knowledge was the importance of family for women giving birth in a foreign country. The results of this study reflected the conceptual orientation, transition: a middle-range theory. The experience provided an opportunity for them to reflect their lives and to find the direction needed for their growth and transformation to successful parents. The women rebuilt the relationships with their husbands and further deepened their marital bonds.

Securitisation theory has made significant contributions to security studies. However, the theory is not without theoretical and empirical shortcomings. Notably, a lack of operationalisation and differentiation has led to a binary classification of results as either ‘securitised or not’. In addition, the presence of Euro-centric assumptions has weakened the theory’s applicability in non-Western contexts. This thesis develops a new framework featuring a typology with eight branches of securitisation. The thesis then uses that framework to study HIV/AIDS securitisation in two Asian countries: China and India. The process of HIV/AIDS securitisation in both countries is illustrated chronologically. Following the international HIV/AIDS securitisation obtained in 2000, the study shows that HIV/AIDS has been fully securitised by both national governments since 2004. However, the Chinese government addressed HIV/AIDS through a stand-alone programme, whereas India’s national HIV/AIDS programme was integrated into its primary health care system. Six cities were included in the detailed empirical analysis: Beijing, Shanghai, and Kunming in China, and New Delhi, Mumbai, and Imphal in India. Semi-structured interviews were conducted amongst 62 individuals working in HIV/AIDS-related non-governmental organisations, and 10 officials working in government agencies. Chinese respondents were receptive to framing the threat and handling of HIV/AIDS, yet many grassroots organizations lacked opportunities to participate in the national HIV/AIDS programme. In contrast, such groups were strongly involved in national HIV/AIDS interventions; however, Indian government efforts in fully securitising HIV/AIDS were largely faded out. The thesis therefore responds to the major theoretical and empirical shortcomings identified by security scholars. The thesis also advances the existing knowledge of security studies in general, and HIV/AIDS securitisation processes in the non-Western world in particular. / published_or_final_version / Humanities and Social Sciences / Doctoral / Doctor of Philosophy

The way gender relations influence access to care and treatment particularly access to antiretroviral medicines is a challenge to HIV/AIDS programmes and to the individuals and families with HIV. Gender norms that push women and men to adhere to dominant ideals of femininity and masculinity may restrict women's access to economic resources, health care and fuel the spread of HIV. The aim of this study was to determine the role of gender relations in influencing decision-making for access to antiretroviral medicines between partners and in the family.

This research focuses on vulnerable children in Swaziland, the country with the highest level of adult HIV prevalence in the world, where nearly 25 percent of children will be orphaned by 2010. It investigates the experiences of relatively poor urban children growing up in the epidemic and the coping strategies the children and their adult carers adopt. Through the lens of both children and adult carers, it explores the ways sexual knowledge is gained and used by older children in the context of HIV/AIDS as well as the experience of coping with widespread bereavement. In this way, it adds to the literature on childhoods in the 'South' and the increasing recognition of the heterogeneity of children's lived experiences. Rather than being seen as passive, the agency of both vulnerable children and their adult carers emerges as they seek to improve their livelihoods. The way this agency connects with government, NGO and community structures is revealed by showing the opportunities for and constraints on gaining access to education and health-care. The interwoven roles of government, international donors, NGOs and civil society is explored by assessing the relative merits of supporting vulnerable children by either welfare assistance to poor families or new forms of 'community' care structures or institutionalised residential care. The critical importance of relationships and power relations between key actors in different organisations and the effect this has on implementation of interventions for children is discussed as well as the relevance of these findings to vulnerable children in other settings.

This dissertation examines the emergence of queer personhood among black publics and medical cultures in South Africa over the past century. Based on more than two years of fieldwork in South Africa, it contains both a historical and an ethnographic component. The historical research was comprised of archival research and 16 life history interviews exploring how black South Africans reference multiple cultural fields of sexual and gender identities to elaborate composite formations of sexual subjectivity and personhood. In the ethnographic component, I conducted participant-observation and 70 in-depth interviews among various groups, including a number of queer, non-governmental organizations and two global health, HIV-focused clinical sites. In these settings, I examined how social actors, in the context of community settings and global health and community development projects, address sexual and gender nonconformity. Existing scholarship on gender and sexuality in South Africa presumes the existence of only one cultural field of gender and sexual identities in this social field. In contrast, my dissertation argues that multiple cultural fields and sexual ideologies have emerged coevally here. One is a liberal field of sexual subjectivity consisting of globally diffuse concepts of sexual personhood that are historically rooted in a psychiatric style of reasoning, such as homosexual, heterosexual, etc.; the other fields are more localized and are based on ethnic cultural fields of sexual and gender identities. However, they have incorporated aspects of, a globally diffuse psychiatric and anatomical style of reasoning about sexuality. Whereas the `global' liberal sexual ideology dictates a strict alignment of sex and gender, and has done so for some time, the ethnic sexual ideologies I examine, until recently, have not. My work explores the interrelationship of these multiple cultural fields. It follows the enactment of composite sexual subjectivities that are produced when social actors call upon multiple cultural fields of meaning about gender and sexuality. The study demonstrates how race and class mediate the co-emergence of these multiple cultural fields, and how they are entwined with political and economic ideologies and global health knowledge systems. The introductory chapter maps the theoretical and empirical terrain as well as the main questions that are discussed and proposed through the rest of the monograph. The second chapter is a historical analysis of gendered and sexual personhood among black South Africans during the twentieth century. Chapter 3 maps how discourses about cultural authenticity are being used to both contest and constitute LGBTQ sexualities as African. As these cultures and sexual ideologies co-emerge, Chapter 4 examines how they have become entwined with particular political traditions and ideologies during the past century. Chapter 5 explores the ways that biomedicine and public health only reference the a liberal sexual ideology when producing knowledge about black queer bodies and populations in the context of global health HIV interventions. Specifically, I explore the enactment of the MSM and WSW epidemiologic risk categories within HIV science. In Chapter 6, the disjuncture between global health knowledge and everyday experiences of gender and sexuality are highlighted through an ethical case study of the implementation of the HIV intervention known as pre-exposure prophylaxis, or PrEP. The case study concretely demonstrates how the symbolic violence enacted by medical cultures, which only reference the liberal cultural field, conditions structural violence in the form of unjust distribution of health resources among queer groups. The analyses presented in this dissertation suggest new avenues for queer and feminist anthropological inquiry throughout the sub-Saharan African region. In particular, this scholarship contributes to a novel understanding of the political economy of global health and sexuality by exploring how knowledge production and circulation about sexuality within global health contributes to gendered health disparities.

Thesis (M.A.(Clinical Psychology))--University of the Witwatersrand, Faculty of Humanities, 2004 / The aim of the present study was to investigate the relationship between the four dimensions of health locus of control and behaviours that predispose South African youth to HIV infection (HIV risk behaviours). Health locus of control (HLC) represents people's perception regarding controllability of health outcomes; whether health outcomes are controlled by internal or personal factors, powerful others like health care professionals, and chance or fate. Both powerful others health locus of control (PHLC) and chance health locus of control (CHLC) form the fourth dimension of external health locus of control (EHLC). A sample of 84 (n=84) South African young adults, 44 females and 40 males, whose ages ranged from 18 to 24 years old were selected for the study. They were requested to complete two questionnaires: Multidimensional Health Locus of Control and HIV risk behaviour assessment scale. Correlational analyses were done to establish the relationship between HLC and HIV risk behaviour. The findings of the research indicate that participants who scored higher on internal health locus of control (IHLC) tended to score insignificantly lower on HIV risk behaviour scale (r = - 0.17 with p of 0.1242). Participants who scored higher on PHLC scored insignificantly higher on HIV risk behaviour scale (r = 0.17 with p of 0.1195). While participants who scored higher on both CHLC and EHLC tended score significantly higher on HIV risk behaviour scale (CHLC r = 0.40 with P of 0.0001 and EHLC r = 0.37 withp of 0.0005). These results suggest that when both CHLC and EHLC scores go high, the risk of HIV infection also increases. Therefore, youth who have greater CHLC and EHLC tendencies are more likely to engage in behaviour that may predispose them to HIV than those who are high in IHLC. The findings of this study could provide further clarity on why many South African youth continue to engage in behaviour that predispose them to HIV infection. And therefore, to curb the spread of HIV, intervention strategies need to be informed by the understanding of the relationship between HLC and factors that predispose youth to HIV.

Substantial empirical research has documented that HIV prevention and decision-making are heavily influenced by the knowledge and practice of values and beliefs regarding infection and behavior. Most HIV research is still concentrated among high-risk populations (IDU and FSW), leaving out women in long-term heterosexual marriage who have been considered “safe” and less at risk of infection. In addition, researchers have called for more comparative and cross-cultural studies focused on the interplay of health education, behaviors, context, and HIV risk perception. The objective of this dissertation is to advance understanding of the factors sexually experienced women in Postsocialist Georgia consider important when they assess HIV perceived risk of which they are made aware by messages emanating from the social environment. A conceptual framework that integrates concepts from traditional social psychological theory and the constructs of context-specific factors to guide research intervention is applied. Combined quantitative and qualitative approaches are used to achieve a better understanding of perceived HIV risk and its association with different factors. The testing of relationships from two national Reproductive Health Survey samples (1999 and 2005) demonstrate strong positive associations among increased HIV transmission knowledge, belief in accidental transmission, HIV testing practice, and HIV perceived risk, while controlling for sociodemographic factors. Characteristics associated with social norms and economic factors (including stigmatizing attitudes about the rights of PWAs, constrained attitudes concerning sexual control, and experienced migration) demonstrate a strong significant link with assessment of HIV risk perception. Qualitative research with women strengthens the argument of superficial health education and helps to explain variations in perceived risk assessment. Through the interviews, HIV prevention practice is examined in relation to a myriad of cognitive components. This study finds health knowledge, misconceptions, stigmatizing attitudes, and beliefs in sexual and gender norms among the major factors constraining successful HIV/AIDS prevention practices. An effective strategy for HIV/AIDS prevention will require enhancement of research, more emphasis on an integrated approach to target education efforts, training providers in information diffusion approaches, and promoting a general communication campaign. / text

The effects of the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV and AIDS)-related stigma in Ndweni preclude learning and the humane treatment of people living with HIV or AIDS (PL WHA). This is because stigma contributes to the isolation, marginalization and vulnerability, all of which do more harm than good to people infected and affected. Countering HIV and AIDS-related stigma implies addressing, among other things, the private contexts within which it occurs. While redress mechanisms may have effected systematic change, HIV prevention and AIDS-related education would interrupt the cycles of ignorance, prejudice, violence and sexism that exist at both school and community levels. This study of the Ndweni Primary School and the surrounding community focuses on the HIV and AIDS-related stigma and its effect on learners. The findings reveal that HIV prevention and AIDS-related education is being marginalized by both educators at Ndweni Primary and members of the community. Although the learners gained some knowledge from occasional interaction with personnel from Ndweni Child Welfare, Ndweni Clinic, and volunteers, they retained most of their parents' views on HIV and AIDS. Within Ndweni Community, people do talk about the epidemic, but this is always in secret hushed tones and indirectly to PL WHA, waiting for them to 'break the silence' and disclose their status. The findings reveal, furthermore, the interconnectedness between poverty, prejudice and ignorance, violence and gender politics to the HIV and AIDS stigma. I used social justice theories of oppression by Freire (1970), Hardiman and lackson (1970) and others that focus directly on marginalization of PL WHA as well as of HIV and AIDS information. My recommendations include research into foster care birth documentation for placement of orphans within the education system and a merging of both educational and social institutions to keep a documented track of children who get lost once they transfer from schools or relocate to other areas. This thesis can be regarded as a step forward in the empowering process of creating knowledge and an understanding of HIV prevention and AIDS- related education at both the school and community levels, not only in Ndweni, but for all communities like Ndweni. / Thesis (M.Ed.)-University of Kwazulu-Natal, 2005.

Introduction Youth is a group of people which has been greatly affected by HIV epidemic in Malawi. They are vulnerable to HIV infection because they are at a stage where they are beginning sexual exploration. Youth therefore, need a lot of information and support on HIV preventions, and voluntary counseling and testing. They should be encouraged and assisted to disclose their HIV status whether positive or negative for them to access necessary support system. Purpose: The purpose of the study was to explore youth's experiences in disclosing their HIV positive status Methodology: This is an exploratory study that adopted a qualitative approach utilizing the phenomenological design to explore the experiences of HIV positive participants in disclosing their HIV positive status. The study was conducted in Likuni urban and Nambuma areas in Lilongwe district, Malawi. Ten HIV positive participants five males and five females between the ages 19-25 years were purposively sampled half from each area. A qualitative approach to data collection was done through face to face individual in-depth interviews. All the interviews were audio taped and transcribed verbatim using qualitative content analysis. Findings: The following are the four major themes that emerged from the findings of the study: factors leading to and hindering HIV positive status disclosure, disclosure of HIV status, experiences of disclosing HIV positive status, consequences of HIV positive status disclosure. These themes are in line with the objectives and the conceptual framework of the study. The findings of the study have shown that disclosure of HIV positive status among HIV positive youth is difficult and still remains a challenge. The study established that the majority of participants disclosed their HIV positive status due to their deteriorating health status. Stigma and discrimination was found to be the major barrier to HIV positive status while the positive consequences which include: psychosocial care, accessing medical services, safer sex practices and positive living with HIV seemed to be more rewarding because it brought some relief in their lives. Conclusion: Stigma and other hindering factors were found to be the major barriers to disclosure. This therefore, necessitates the need for dealing with barriers to disclosure because the benefits of disclosing HIV positive status are rewarding and outweighs the negative consequences. This study has made some recommendations to promote disclosure of HIV positive status among youth through Ministry of Health, Ministry of Education, National Youth Council, National AIDS Commissions, the Community and further research. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

The way gender relations influence access to care and treatment particularly access to antiretroviral medicines is a challenge to HIV/AIDS programmes and to the individuals and families with HIV. Gender norms that push women and men to adhere to dominant ideals of femininity and masculinity may restrict women's access to economic resources, health care and fuel the spread of HIV. The aim of this study was to determine the role of gender relations in influencing decision-making for access to antiretroviral medicines between partners and in the family.