Student Number: 9408497V Faculty of Humanities, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree for Masters of Arts. / In this research report an analysis of the message of pre-marital sexual abstinence as a strategy for HIV prevention and its implications for development was carried out. The Christian Action Fellowship, a student Christian organization at the University of the Witwatersrand provided a case for the research study. The alternative development paradigm informed my discussion of the message of pre-marital sexual abstinence in relation to development. In particular, it is its emphasis on participatory development and on the fact that development focus should be given to particular localities that I drew from the paradigm. However, the paradigm falls short of capturing the religious dynamics pertaining to local realities. Thus the results of the research study I carried out are meant to contribute to the development of the paradigm by factoring in the religious dimension of local reality in discourse of development. In this study, the religious dimension of local reality was captured in my focus on the message of pre-marital sexual abstinence as advanced within the evangelical faith based movement in South Africa. Furthermore, this research study is meant to contribute to discourse of development by stimulating intellectual reflection on the message of pre-marital sexual abstinence as a strategy of prevention and its implications for development in South Africa. The study demonstrated involvement by the evangelical movement in the fight against the HIV/AIDS pandemic. The study further demonstrated the existence of particular methods employed to advance the message of pre-marital sexual abstinence as a prevention strategy against the HIV/AIDS pandemic. One such method is the strategy of identification. This method is employed to appeal to the targeted audience when ii presenting a case. Other methods employed are debate and argumentation as well as rhetoric. The deployment of these methods point to a religious construction of an identity that upholds pre-marital sexual abstinence as a lifestyle and a better HIV preventive option to other strategies of prevention. This research study is recommending further work in the areas where HIV prevention interventions and development interventions intersect within the local context (in all its dimensions) of identity construction.

Within the last ten years HIV rates in Central Asia have more than quadrupled amongst the general population. Labor migrants from the region who are working in Russia are considered at high risk of HIV infection due to risky sexual practices. Similar behavior has been documented among labor migrants in sub Saharan Africa. By reviewing medical data and literature written by international health professionals in both regions, I analyze the chain of sexual contact of labor migrants within female partners that contribute to the spread of HIV from Russia to the general population within Central Asia. I use Tajikistan as a case study. The findings of this study recommend that existing behavior modification strategies need to recognize existing gender structures when addressing at risk populations. They must also emphasize collaboration with community religious leaders and civil society organizations to promote effective and appropriate HIV/AIDS education efforts in order to curb the growing prevalence rates among male labor migrants in Central Asia. / text

Thesis (MPhil (Industrial Psychology))--Stellenbosch University, 2008. / The purpose of this research was to determine the efficacy of an innovation in HIV prevention programming in Ukraine, which leverages the culture of Ukrainian society by appreciating its values and incorporating them into the strategy. Analysis of the results indicates that positive changes in two of the questions of the Behavioural Models were significant among the participants of the Experimental Group. This was not seen in the Control Group. The number of respondents from the Experimental Group who spoke to their partner about HIV/AIDS in the past month increased during the month after the training. The number of people who were tested for HIV during the month after training also increased. Based on the results of this research, it can be concluded that participation of employees’ sexual partners in HIV prevention programs can influence Behaviour Models and lead to desired changes in this area changes in Behaviour Models, which are very important and as we can see depends much on participation of both sexual partners in training.

Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) are infectious diseases wreaking irreparable havoc on the lives of millions all around the world. Of those infected and affected by HIV in the United States, African Americans disproportionately bear the burden of this disease, which has resulted in a major crisis within the African American community. In 2010, African Americans accounted for approximately 44% of all new HIV infections among adolescents, 13 years of age and older, and adults [Centers for Disease Control and Prevention [CDC], 2012). These statistics become even more dismal when both race and gender enter the equation. In regards to global HIV/AIDS, the leading cause of death among women of reproductive age is AIDS-related illnesses (Joint United Nations Programme on HIV/AIDS [UNAIDS], 2012). According to the CDC (2012), 64% of estimated new HIV infections in women in the United States in 2010 were in African Americans. This study examined the effectiveness of increasing protective HIV behaviors through the use of the SAHARA program, a computer-based, gender-specific and culturally appropriate HIV behavioral intervention program. More specifically, the SAHARA intervention was created to encourage consistent condom use during penetrative vaginal sex through mediating components of the intervention such as HIV knowledge, condom use self-efficacy, barriers to condom use, and frequency of partner communication for a population of African American women living in areas of Kentucky and Georgia. Convenience sampling was used to recruit participants from college campuses and community areas. Fifty-two African American female study participants completed surveys through the use of a quasi-experimental non-randomized pretest-posttest design. Significant group differences were observed for scores on STD/HIV Risk Behavior Knowledge and Condom Barrier Scale. Results suggest that the SAHARA prevention intervention produced clinically significant changes in STD/HIV knowledge and perception of condom barriers in the SAHARA group compared to the control group.

Magister Scientiae - MSc / This thesis looks at the effect that the introduction of various techniques (weighting, bootstrapping and variable selection) has on the accuracy of the modelling process when using logistic regression. The data used in the modelling process is based on the sexual activity of entering first-year students at the University of the Western Cape, therefore, by constructing logistic regression models based on this data, certain predictor variables or factors associated with the sexual activity of these students are identified. The sample weighting technique utilized in this thesis assigned a weight to a student based on gender and racial representations within a sample when compared to the population of the entering first-year. The use of a sample weighting technique is shown to produce a more effective modelling process than a modelling process without weighting. The bootstrapping procedure is shown to produce logistic regression models that are more accurate. Utilizing more than 200 bootstrap samples did not necessarily produce logistic regression models that were more accurate than using a total of 200 bootstrap samples. It is, however, concluded that a weighted bootstrap modelling procedure will result in more accurate models compared to a procedure without this intervention. The forward, backward, stepwise, Newton-Raphson and Fisher variable selection methods are used. The Newton-Raphson and Fisher methods are found not to be effective when used in a logistic modelling process, whereas the forward, backward and stepwise methods are all shown to produce very similar results. Six predictor variables or factors are identified with respect to the sexual activity of the specified students: the age of the student; whether they consume alcohol or not; their racial grouping; whether an HIV test has been taken; the importance of religion in influencing their sexual behaviour; and whether they smoke or not.i i Conclusions are reached with respect to improvements that could be made to the HIV prevention programme at UWC with reference to the sexual activity of entering first-years.

HIV/AIDS continues to challenge prevention, care and treatment efforts and presents an increasingly urgent threat to population health. In the context of prevention, this fatal sexually transmitted infection (STI) underscores the importance of providing youth (the fastest growing risk group) with adequate information, motivation, behavioural skills, and access to resources that support the achievement and maintenance of sexual health across the lifespan. However, youth have proven to be a difficult audience to reach, particularly with educational programs that approach adolescent sexuality from an adult frame of reference, one that often stresses the negative aspects of human sexuality. Yet many of the tasks associated with a successful transition into adulthood and social integration depend upon the ability to initiate and maintain long-term, intimate sexual relationships. Using a case study methodology, this research—which was conducted in British Columbia, Canada—investigated the potential effects of an innovative theatre-based, peer-led HIV prevention/sexuality education program on four groups of high school students and the peer leaders. The potential of theatre-in-education was examined to determine if this format would engage youth audiences—and keep them engaged—and if it would have a positive impact on self-reported confidence in performing risk-reduction behaviours. The results from the four case studies strongly suggest that peer-led theatre presented in conjunction with peer-led discussion has the potential to not only engage youth between 12 and 17, but to also increase self-reported confidence in their ability reduce risk. In two of the cases, engagement was high and constant; while the two other cases demonstrated that the format has a strong potential for drawing more reluctant audiences into discussions over time. In all cases, confidence reportedly increased. Further to this, audiences reported gains in knowledge, improvements in behavioural and communication skills, and increased motivation to use condoms and to access sexual health care. In addition, and perhaps most importantly, there were reports of increased communication about sexual health issues, the development of greater compassion and tolerance, along with the desire to avoid stigmatizing HIV-positive individuals and sexual minorities. The peer leaders reported comparable effects. Given that stigma has been identified as the most persistent barrier to HIV/AIDS prevention, care and treatment, embedding peer-led theatre programs—focused on sexuality and HIV prevention—into currently existing theatre arts curricula within the public school system offers a powerful and cost-effective means of providing comprehensive sexual health education. It would be shrewd (from both a social and economic perspective) for education ministries and school districts to capitalize on the positive aspects of adolescent peer networks and youths’ natural tendency to learn from one another. This research, while based on informed judgment, adequacy and plausibility rather than on the gold standard of a randomized control trial, arguably provides initial evidence that the theatre-in-education format is worthy of implementation on a wider scale. Investing in the set-up, maintenance and rigorous evaluation of peer-led theatre-in-education programs which focus on sexuality has the potential to normalize safer sexual practices and improve population health, for this generation and generations to come.

Background: Social networks, norms, and discussions about sexual health may inform sexual practices, influencing risk of human immunodeficiency virus (HIV) or sexually transmitted infection (STI) acquisition. To better understand social networks of Peruvian men who have sex with men (MSM) and transgender women (trans women), we examined key social network members (SNMs), participant perceptions of these network members’ opinions toward sexual health behaviors, and associations between network member characteristics and condomless anal intercourse (CAI). Methods: In a 2017 cross-sectional study, a convenience sample of 565 MSM and trans women with HIV-negative or unknown serostatus was asked to identify three close SNMs; describe discussions about HIV and STI prevention with each; and report perceived opinions of condom use, HIV/STI testing, and partner notification of STIs. Generalized estimating equations evaluated relationships between SNM characteristics, opinions, and discussions and participant-reported CAI. Results: Among participants who identified as MSM, 42.3% of key SNMs were perceived to identify as gay. MSM “never” discussed HIV and STI prevention concerns with 42.4% of heterosexual SNMs, but discussed them “at least once weekly” with 16.9 and 16.6% of gay- and bisexual- identifying SNMs, respectively. Among participants who identified as trans women, 28.2% of key SNMs were perceived as heterosexual; 25.9%, as bisexual; 24.7%, as transgender; and 21.2%, as gay. Trans women discussed HIV/STI prevention least with cis-gender heterosexual network members (40.2% “never”) and most with transgender network members (27.1% “at least once weekly”). Participants perceived most of their close social network to be completely in favor of condom use (71.2% MSM SNMs, 61.5% trans women SNMs) and HIV/STI testing (73.1% MSM SNMs, 75.6% trans women SNMs), but described less support for partner STI notification (33.4% MSM SNMs, 37.4% trans women SNMs). Most participants reported CAI with at least one of their past three sexual partners (77.5% MSM, 62.8% trans women). SNM characteristics were not significantly associated with participant-reported frequency of CAI. Conclusions: Findings compare social support, perceived social norms, and discussion patterns of Peruvian MSM and trans women, offering insight into social contexts and sexual behaviors. Trial registration: The parent study from which this analysis was derived was registered at ClinicalTrials.gov (Identifier: NCT03010020) on January 4, 2017. / National Institutes of Health / Revisión por pares

Personalized cognitive counseling (PCC) is an evidence-based intervention designed to modify HIV-related risk behavior. We assessed the impact of PCC on sexual behavior, drinking expectancy, and incidence of sexually transmitted infections (STIs) in a 6-month randomized controlled trial among 153 HIV-uninfected men who have sex with men (MSM) and transgender women (TW) in Peru. Study retention was ≥ 90%, with three HIV infections (3 Control) and 19 cases of GC/CT (10 Control, 9 PCC) at 6 months. There was a decline in condomless receptive anal intercourse in the Control (0.74, 95% CI 0.60-0.91; p < 0.01) and PCC arms (0.72, 0.55-0.94; p = 0.02) at 6-month follow-up. There was a decrease in drinking expectancy at 6 months among participants endorsing alcohol use in the PCC arm (0.89, 0.83-0.96; p < 0.01), versus no change in the Control arm (0.98, 0.92-1.04; p = 0.54). PCC was efficacious in reducing drinking expectancy and HIV risk among MSM and TW in Peru. / National Institutes of Health / Revisión por pares

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / OBJECTIVE: Determine the impact of HIV-1 seroconversion on inflammatory cytokines in the rectal mucosa. SETTING: Secondary analysis of data from men who have sex with men and transgender women who participated in a HIV prevention trial Lima, Peru. METHODS: From July to December 2017, 605 men who have sex with men and transgender women were screened for rectal gonorrhea/chlamydia (GC/CT). Fifty GC/CT-positive cases were randomly selected and matched with 52 GC/CT-negative controls by age and number of receptive anal intercourse partners in the last month. All participants were HIV-negative at baseline and those with GC/CT at baseline and/or follow-up received appropriate antibiotic therapy. Participants underwent sponge collection of rectal secretions for the measurement of inflammatory cytokines (IL-1β, IL-6, IL-8, and TNF-α) and were screened for rectal GC/CT and HIV at baseline, 3 months, and 6 months. Wilcoxon rank-sum tests compared inflammatory cytokine levels between participants diagnosed with HIV during follow-up and persons who remained HIV-negative. RESULTS: Eight participants were diagnosed with HIV at the 3-month (n = 6) or 6-month (n = 2) visit. The median number of receptive anal intercourse partners in the month before HIV diagnosis was the same for those who acquired HIV and those who did not. There were no significant differences in inflammatory cytokine levels in rectal mucosa between participants who did and did not experience HIV seroconversion at any time point. CONCLUSIONS: Despite a surge in viral replication during acute infection, findings from this study suggest that there is no prolonged effect of HIV-1 seroconversion on inflammatory cytokine levels in the rectal mucosa. Copyright / National Institute of Allergy and Infectious Diseases / Revisión por pares

This phenomenological study was designed to understand the lived experiences of a purposive sample of 9 participants from local villages in Nairobi, Kenya, who had sexual behaviors that contributed to higher HIV risk exposure. Past studies have provided information about the increased rates of HIV infection; however, little has been done to identify the solutions for minimizing the negative impact of HIV among concurrent partnerships. The study investigated the role of high risk cultural practices among participants in married and cohabitating unions. The conceptual framework of the study was gender and power theory, which addresses the complex sexual relationships between men and women. Semi-structured, open-ended questions were used to obtain data from 4 males and 5 females between the ages of 28 and 46 who had been sexually active for more than 12 months. Data was collected on participants' cultural perspectives on condom use, HIV risk behaviors, and sexual morality. The interviews were transcribed and reviewed for consistent patterns of high risk sexual behaviors prior to coding. Through the use of NVivo, seven emergent themes were common among the participants. Findings from the small scale sexual risk behavioral data showed that among these participants, condom use and partner fidelity in unequal partnerships were low. The study also indicated the importance of developing an HIV intervention that focuses on gender and power in long-term sexual partnerships. The implications for positive social change included awareness that gender inequality exists among concurrent unions and formulating an effective cultural HIV prevention strategy for couples.