Introduction: Little guidance is given to health professionals over how to deal with HIV disclosure complexities in the biomedical setting. Given the paucity of related research in this context, there is also little consideration of the actual effect of HIV disclosure in a given context. Social constructionist theory is an important contribution to disclosure research because it shifts the focus from a biomedical perspective to one that incorporates an individual's experience with HIV infection in a specific context. The task of this study was to develop substantive theory, with the aim of providing a theoretical framework for public health and health care practitioners to better understand HIV disclosure dynamics in the PMTCT setting. Methods: This was a qualitative study which explored the experience of disclosure amongst HIV positive pregnant women in the PMTCT context. Between 5 June – 31 November 2008, a total of 62 participants were recruited from two urban-based PMTCT programmes located within the eThekwini District, KwaZulu-Natal, South Africa. Results: Participants disclosed to two main groups: sexual partners, and family/others. Structural and relationship network factors shaped transmission risk behaviour, subsequent disclosure behaviour and outcomes. The circumstances which placed participants at risk for HIV acquisition also affected the likelihood of disclosure and health behaviour change. HIV and pregnancy diagnoses often occurred concurrently which profoundly impacted on participant's social identities and disclosure behaviour. Current HIV testing protocols within PMTCT settings often recommend disclosure to sexual partners under the assumption that couples will engage in safer behaviours, yet findings from this study indicate that this assumption should be challenged. Discussion: The study findings are synthesized in a conceptual model which offers substantive new theory over the concepts and interrelated factors that were identified to shape HIV disclosure and outcomes in the PMTCT context. The model identifies the following domains: 1) social networks and social support; 2) identity; 3) risk behaviour; 4) HIV and pregnancy diagnoses; and 5) HIV disclosure process to partners and others. Recommendations: Assumed pathways to risk reduction and HIV prevention need to be relooked and reconsidered. The conceptual model provides a proposed framework for future research, intervention design and implementation planning in the PMTCT setting. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2011.

Voluntary counselling and testing, the cornerstone of HIV/AIDS prevention efforts worldwide, is at the centre of a policy debate rega rding its effectiveness. Informed by social constructionism and drawing on various tools from ethnomethodology and conversation analysis, a sample of twenty-seven vid eotaped simulated counselling interactions in South Africa was analysed. The aim was to assess how the interactional tasks of the voluntary counselling and testing sess ion were worked through by clients and counsellors, and how this was done against the publ ic health and counselling frameworks that inform voluntary counselling and testing pract ice. The goal of the analysis was not to examine practitioners’ competencies, but to exam ine their unfolding actions in the situation and to consider the interactional functio ns these actions might serve. The results show that of the three interactional ta sks of voluntary counselling and testing, information-giving lays the foundation upon which the advice and support goals are realised. It is constructed as critical to client a nd counsellor identities and is a powerful tool through which hope is dispensed. Both the info rmation-giving and support tasks of voluntary counselling and testing combine to manage client distress into more concrete and manageable terms that encourage client coping. Counsellors draw on a range of advice-giving strategies – those that place the onu s of responsibility on the client to those that view the counsellor as the moral guide able to direct client change – in order to encourage clients to reflect on their risk behaviou r. In general, voluntary counselling and testing is framed as a moral activity, and this is most evident in the advice-giving segments. The public health and counselling framewo rks that inform voluntary counselling and testing create a dilemma for counse llors. In practice, counsellors orient towards a directive and health-advising role rather than a non-directive, client-centred counselling role. The implication of this research is that voluntary counselling and testing needs to be defined and framed more clearly – i.e. as a public health intervention with preferred outcomes that draws on a set of client-centred skills. Reconceptualisations of voluntary counselling and testing need to acknowledge the mor al framework under which it operates. Clear implementation guidelines (and training) on what voluntary counselling and testing is and that define its goals more clearly will be useful in assisting counsellors to implement the policies that govern their practice. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2008.

The generation and preservation of community knowledge have emerged as key factors in how rural communities deal with the consequences and ramifications of HIV/AIDS. Community-Based Organisations (CBOs) are responding to the disease and have a significant role to play in strengthening community education. The Thokozani Support Group is a community-based organisation (CBO) operating in Richmond, KwaZulu-Natal, a rural town that was once the backdrop of a bitter and bloody political war. The town is now characterised by high levels of unemployment, widespread poverty and a spiralling HIV/AIDS epidemic. Many of Thokozani's members are people living with AIDS and they undertake volunteer community work involving outreach and education as well as home-based care. This research takes the form of a case study with its focus on the Thokozani Support Group's contribution to community learning. Anchored in a qualitative paradigm, the case study is bimodal in that it utilises both the life history and photovoice methodologies. The data, gathered from semi-structured in-depth interviews as well as participant interpretations of photovoice material, is approached and examined against the conceptual framework of community learning theories as espoused by Foley (1999) and Wenger (1998), and, in particular, examines issues and concepts including communities of practice, learning in social action, informal, non-formal and incidental learning. The research outcome provides a detailed understanding of how the Thokozani Support Group contributes to community learning in Richmond, which feeds into the broader discourse on the role and challenges faced by rural CBOs responding to the HIV/AIDS epidemic. / Thesis (M.Ed.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.

My study is an exploration of four women educators' experiences of living "openly" with HIV in their respective workplaces. All four women were from the different geographical demarcations ofthe Ethekweni region. I used in-depth interviews , as outlined by Seidman (1999), to learn more about the experiences of the four women. The key findings of my study were (l) the evidence of HIV/AIDS-related stigma and discrimination against people living with HIV, (2) the inclusion of people living with HIV, shown by employers and colleagues and (3) the emergence of a new generation that is better informed, receptive and supporti ve of people living with HIV. / Thesis (M.Ed.) - University of Kwazulu-Natal, 2005.

All over the world HIV/ AIDS has created a new stigma and discrimination, bigotry and ignorance that have resulted in a new class of outcasts. AIDS 2000 will break the silence on this affront to human dignity. This was the theme of the XIII Annual AIDS Conference held in Durban in 2000. Fours years later, there is little evidence of this reality. There are communities of people living with HIV/ AIDS that still live lives cloaked in secrecy. HIV/ AIDS is not losing momentum. HIV/ AIDS has infected 50 million, and killed 16 million since the epidemic began (The Mercury,19 May 2000). In Africa, HIV positive women now outnumber infected men by two million. Recognition of the potentially devastating effects the disease could have, took place very slowly, in Africa. It is only since the middle to late nineteen eighties that a general understanding has established itself in society of how imp ortant the fight against HIV/ AIDS will be. In South Africa the dramatic transition to democracy in the early nineteen nineties meant that political considerations had to be given priority. In 1997, the KwaZulu Natal (KZN) cabinet launched an initiative to bring public attention to the effects the epidemic would have on our society. In 1999 this was followed up with the Cabinet's AIDS Challenge 2000 strategy which was to have been be funded to the extent of R20 million per year (The Mercury, 19 May 2000). HIV / AIDS has established itself at pandemic levels in the province of KZN (The Mercury, 19 May 2000). Uno fficial figures of people living with HIV/ AIDS stand at 40%. This has huge implications for education as it is stated that there will be at least 750 000 orphans- children with no parents in KZN by 2010 (The Mercury, 19 May 2000). This means that educators who are already burdened with responsibility will have to respond in direct and indirect ways to the pandemic. The researcher in this study has lived in Umhlatuzana, a suburb on the outskirts of Chatsworth for the past twenty years. I teach History and Life skills at a secondary school in Chatsworth. Since the introduction of Outcomes Based Education in 2000, HIV/ AIDS has become a part of the Life Orientation programme. My interest in HIV/ AIDS grew with the launch of the Government initiated Tirisano project - an HIV/ AIDS awareness initiative . As HIV-AIDS coordinator, my duties included teaching learners about HIV/ AIDS awareness and about the causes and prevention of HIV/ AIDS through responsible behaviour. Accordingly, I have set up a school HIV/ AIDS committee made up of both learners and staff, drafted and implemented a School AIDS Policy and held workshops at school. As the HIV/ AIDS coordinator I have attended many training workshops and seminars in and around Chatsworth. This exposure to issues concerning HIV/ AIDS, together with available literature has led me to conclude that HIV/ AIDS is still very much a taboo subject, even among so called 'enlightened educators'. Due to the scarcIty of available literature regarding Indians! living with HIV/ AIDS and according to The Mail and Guardian, because media representations and billboards depict Black, White or Coloured but no Indian repr esentations of people living with HIV/ AIDS, many Indians still think that it is someone else's disease, or 'that sickness' (02 December 2003). While stud ying the module 'Diversity and Education' at Masters level, I began to understand that being an HIV/ AIDS coordinator was much more than teaching learners about HIV / AIDS awarene ss of prevention and modes of transmission. The module 'Diversity and Education' was designed to develop a deeper understanding of the critical issues and skills required to create safe and inclusive schools for learners and educators who are living with and are affected by HIV/ AIDS. Through the Diversity and Education module I developed a raised understanding of the negative impact of HIVism on the lives of people living with HIV/ AIDS. According to Francis, HIVism refers to the negativetreatment meted out to people living with HIV/ AIDS (2004). Altho ugh the Department of Education has to be applauded in creating an awareness of the epidemic, there is concern that an important area of HIV/ AIDS has been neglected: The issues regarding human rights and HIV/ AIDS. It was especially during the Diversity and Education sessions togeth er with related literature that I discovered that globally, many women have negative experiences of living with HIV/ AIDS. An article that appeared in the Sunday Tribune, Herald (07 December 2003) prompted my research . It was a stolY of an Indian woman, Theresa Naidoo, who was HIV positive. In her story she communicates her experiences of betrayal, prejudice and discrimination. Her sto ry has inspired the research er to explore the experiences of other Indian women living with HIV/ AIDS. The researcher contac ted the Chatswo rth HIV/ AIDS coordinator, Kogie David, who is based at the Chatsworth Child and Family Welfare Centre . She coordinates the HIV/ AIDS counselors in the Chatsworth district. The researcher explained the nature of her research study and was informed that there were many women like Theresa, living with HIV/ AIDS. / Thesis (M.Ed.) - University of KwaZulu-Natal, 2005.

No abstract available. / Thesis (LL.M.)-University of KwaZulu-Natal, Durban, 2012.

Background: Worldwide, it is poor women who are at greatest risk of cervical cancer. These patterns are resonated in South Africa where black women, particularly in rural areas are at heightened risk for cervical cancer. The rate of morbidity and mortality due to cervical cancer has increased and in the year 2000, deaths as a result of cervical cancer in South Africa exceeded maternal deaths. This increase in morbidity and mortality has been associated with the emergence of HIV and AIDS. Cancer of the cervix was listed as an HIV-related opportunistic infection and an AIDS defining illness by the Centers for Diseases Control in 1993. This research documents the challenges of implementing cervical cancer services in the context of HIV. It explores structural, gender, societal, social exclusion and practical barriers to implementing these services. Methodology: The study was conducted using qualitative methods of enquiry which employed in-depth interviews to collect data from participants. Interviews were held with government officials, Section Nine institutions, non -governmental organisations working in the fields of cervical cancer and HIV/AIDS. Results: The study found that South Africa does not have a comprehensive policy to address cervical cancer in women living with HIV neither does it have plans to enact such a policy. It found that cervical cancer was a marginalised disease. It also found that cervical cancer does not always form part of health priorities as it falls outside women as mothers‟ brackets. The study found that the social status and the level of participation and active citizenship of women living with HIV might be one of the reasons for lack of prioritisation of cervical cancer policies. Conclusion: Cervical cancer is a marginalised disease because it affects women outside of their reproductive roles, can be defined as an STI and it affects women who live in the margins of society. Cervical cancer marginalisation could be linked to the discourse of lack of political will, advocacy and action in relation to women‟s health. Policies need to be nuanced from the perspectives of women living with HIV. / Thesis (M.Dev.Studies)--University of KwaZulu-Natal, Durban, 2013.

By knowing the incidence of an infectious disease, we can ascertain the high risk factors of the disease as well as the e ectiveness of awareness programmes and treatment strategies. Since the work of Hugo Muench in 1934, many methods of estimating the force of infection have been developed, each with their own advantages and disadvantages. The objective of this thesis is to explore the di erent compartmental models of infectious diseases and establish and interpret the parameters associated with them. Seven models formulated to estimate the force of infection were discussed and applied to data obtained from CAPRISA. The data was agespeci c HIV prevalence data based on antenatal clinic attendees from the Vulindlela district in KwaZulu-Natal. The link between the survivor function, the prevalence and the force of infection was demonstrated and generalized linear model methodology was used i to estimate the force of infection. Parametric and nonparametric force of infection models were used to t the models to data from 2009 to 2010. The best tting model was determined and thereafter applied to data from 2002 to 2010. The occurring trends of HIV incidence and prevalence were then evaluated. It should be noted that the sample size for the year 2002 was considerably smaller than that of the following years. This resulted in slightly inaccurate estimates for the year 2002. Despite the general increase in HIV prevalence (from 54.07% in 2003 to 61.33% in 2010), the rate of new HIV infections was found to be decreasing. The results also showed that the age at which the force of infection peaked for each year increased from 16.5 years in 2003 to 18 years in 2010. Farrington's two parameter model for estimating the force of HIV infection was shown to be the most useful. The results obtained emphasised the importance of HIV awareness campaigns being targeted at the 15 to 19 year old age group. The results also suggest that using only prevalence as a measure of disease can be misleading and should rather be used in conjunction with incidence estimates to determine the success of intervention and control strategies. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.

This study on, ‘Facing HIV and AIDS: Understanding family support within a rural Kwazulu-Natal community’ aimed to explore how an HIV/AIDS diagnosis affects the family as a whole and to determine the role of the family as a primary support system. Although HIV and AIDS infects individuals, it also affects entire families. The researcher employed a qualitative research design to gain in-depth and rich data, and to hear the stories of all participants. The study is grounded in the systems theory and the risk and resilience theory framework. For purposes of clarity, much of the work was divided into the different levels of the systems theory. Risk and resilience aspects were identified in relation to the various themes. It was necessary to explore this topic, not only from the perspective of individuals living with HIV and AIDS, but also from the perspective of their family and community. Three sets of data were therefore utilised: interviews with individuals living with HIV and AIDS, interviews with family members of an individual living with HIV and AIDS, and a once-off focus group discussion to gain the perspective of community members. This helped to ensure sample and instrument triangulation. The type and amount of support that was offered affected the stigma experienced; and affected individual fears and goals, willingness to disclose and the utilisation of available services in the community. It was clear that receiving support reciprocally affected individuals, family and the community. The experience of not being supported resulted in aspects of risk – for example, being more vulnerable in the face of stigma and discrimination. The importance of family support was thus found to be vital in facing the HIV and AIDS journey with resilience. Recommendations are provided at micro, mezzo and macro levels. This study also hopes to assist service providers to provide the necessary services. / M.A. University of KwaZulu-Natal, Durban 2013.

There is no abstract available for this thesis. / School of Nursing