The purpose of this research study was to explore successes and challenges of Vhutshilo 2 HIV Prevention Programme in reducing HIV Infections amongst Adolescent Girls and Young Women [AGYW] in Alexandra. Qualitative, narrative research design was conducted to explore the experiences of the adolescent girls and young women in the Vhutshilo 2 programme. In order to obtain the data for this research the researcher used focus group interviews. Since the current study did not seek to generalize findings, a purposive sampling approach was seen as appropriate to use for this study. Two groups of respondents participated in the study. The first group of 7 participants were from Ratang Bana Organisation from Alexandra and the second group of 12 participants was from Friends for Life from the Mayibuye site. The data of this research project was analyzed using thematic analysis. Findings revealed that Vhutshilo was successful in achieving its desired results of helping adolescents to adopt healthy sexual behavior, developing positive values and behavior through exploring options, promoting assertiveness, understanding different influences on their lives and coming to their own views and decisions, rather than being told what to do. Recommendations made included taking the Vhutshilo 2 to other places like rural areas as the adolescent girls in the rural areas are at high risk of getting infected by HIV mostly due to cultural practices that expose them to such risks together with ignorance and limited access to health facilities. / Health Studies / M.P.H.

With the spread of the Human Immuno-Deficiency Virus and sexually transmitted diseases, it is extremely important for sexually active individuals to protect themselves properly if they decide to engage in sexual intercourse. Knowledge of HIV and the Acquired Immune Deficiency Syndrome has been associated with safer sexual practices, but knowledge alone does not totally explain risky sexual practices. This study examined how 154 college students' knowledge of HIV/AIDS, relationship status, perceptions of condom use, and perceptions of personal risk affect condom use during sexual intercourse. The impact of trust and love justifications along with the approval of peers were also examined. Perceptions of condom use and perceptions of personal risk were compared by gender and ethnicity; how perception of personal risk is related to condom use and condom use intentions was also examined. Condom use intention was found to be a significant predictor of condom use, and a significant difference of means for condom use intentions was reported between individuals who used condoms during their last experience with sexual intercourse and those who did not use condoms during their last sexual experience

In the context of decreasing mortality and increasing prevalence, prevention of HIV-transmission represents a public health priority. In the United States, the majority of infections are sexually-acquired, with men who have sex with men and minorities disproportionately affected. Although a number of promising biomedical prevention approaches have emerged over the past decade, a further 20 years could be needed before a suitable product becomes widely available. Evidence from vaccine and microbicide trials has shown that success in one population may not be replicated in another. To understand surprising or unexpected results, investigators need chronologically concordant evidence of both study product adherence and viral exposure. Since exposure to HIV cannot yet be independently verified, in seeking to measure this variable, investigators target the sexual behaviors through which it takes place deriving data for these surrogate measures from study participants' voluntary self-reports. Likely sources of reporting bias and efforts to minimize this phenomenon in the context of HIV-prevention research are critically reviewed in Chapter 1. Research describing the role of cognitive and affective functioning in the preparation of responses to potentially threatening questions is examined. Studies investigating techniques such as the use of colloquial language to facilitate comprehension, or variation in the length of the reference period to enhance recall are explored. Research comparing the effect of mode of administration on the amount of proscribed behavior reported - widely believed to correlate with validity - is reviewed. Contextual factors facilitating versus inhibiting disclosure of sensitive information are examined. Finally, risk-behavior measurement approaches used in selected HIV-prevention trials are inspected. Thereafter, the dissertation focuses on the properties of risk-assessment items, formulated specifically to elicit Global recall over six months, or Event-Specific (episodic) memory for selected recent episodes of limited duration, to capture sexual behaviors or temporally related activities. The capacity of the different questionnaire item formats to elicit responses with sufficient construct validity to serve as proxies for HIV-exposure is examined. Data for these studies are drawn from a large randomized controlled trial of a behavioral intervention to prevent HIV-transmission among men who have sex with men. Using a subset of 1295 cases and controls, models with good discriminant validity for HIV are derived separately for the Global and Event-Specific items. Thereafter, selected items from the two formats are combined to produce a single model with excellent discriminant validity, suggesting that these items can adequately represent true HIV-exposure. Next, a preliminary investigation of the contribution of psychosocial items to the predictive model based on exposure measures is undertaken. Specifically, interaction with exposure measures and the increase in discriminant validity obtained using data derived from constructs of partner type/relationship status, substance use, depressive symptoms and perceived self-efficacy is examined first in stratified analysis and then in logistic regression analysis using the case-control data. Effect-modification is observed for perceived relationship status and non-injection drug use. Evaluation of psychosocial items continues in a cohort study with prospective analysis of follow-up data from all trial participants who returned for at least one follow-up visit. Informed by the case-control study, a series of items representing psychosocial constructs known for their association with HIV-infection are tested for main effects and effect-modification. Evidence of the interaction observed in stratified analyses and confirmed in ordinary logistic regression persists in separate, topic-specific GEE analyses with assorted exposure measures, but abates in repeated measures analyses drawing on all available psychosocial items. Lastly, a single lagged variable indicating primary relationship status of the most recent partner (with respect to the preceding study visit) provides a significant addition to the model. Significant main effects for all except depressive symptoms and perceived self-efficacy and the increase in discriminant validity obtained for the multivariable model versus the `exposure-only' model are sufficient to warrant continued use of these risk-assessment items. Despite good predictive validity demonstrated for the sexual risk-behavior and psychosocial items, some inconsistent reporting between the Global and Event-specific formats is evident. Likely sources of this reporting bias are considered in light of the literature, and strengths and limitations of the overall study are discussed in the closing chapter.

For the first twenty-five years of Ghana’s national response to HIV/AIDS, the government, like most nations in Africa, did not include gay and bisexual—locally known as sasoi—and other men who have sex with men (MSM) as a high-risk group for HIV in its policies. In 2011, Ghana finally addressed this policy blind spot by acknowledging sasoi and other MSM as a key population at-risk for HIV and in need of policy and programmatic interventions—a shift that is occurring in many parts of Africa. Using Ghana as a case study of this policy shift on the continent, my dissertation examined: why sasoi and other MSM were not initially acknowledged in Ghana’s national AIDS policies; why and how the government decided to include MSM as a key population in its national AIDS policies and programs; what cultural, social, and political factors have affected the development, implementation, and reception of these policies and programs; how sasoi and other MSM perceive and experience these policy and programmatic efforts; and how sasoi and other MSM experience life in a country that criminalizes and stigmatizes same-sex sexual activities. Using ethnographic methods, I conducted a 12-month qualitative study in Ghana. I conducted: interviews with 43 state and non-state policymakers and stakeholders, HIV frontline workers, and sasoi and other MSM; focus group interviews with 18 peer educators; participant observations of policy and HIV prevention work, and meetings and other events related to the research scope; and archival research of media coverage of homosexuality. My findings indicate that Ghana’s MSM policy blind spot was due to: 1) the criminalization and stigmatization of same-sex sexualities in the country, 2) a construction of the Ghanaian epidemic as driven by migrant female sex workers, and 3) international AIDS researchers’ categorization of HIV in Africa as heterosexual, which informed donor policies and stipulations. However, in 2011, the government shifted to include MSM as a KP at risk for HIV in light of mounting epidemiological data on MSM HIV prevalence and risk, NGO advocacy efforts, and international donor policy changes that now recognize MSM as a KP in Africa. I conceptualize this change as a paradigm shift in Ghana’s national AIDS policies from a general population paradigm to a key populations paradigm that includes MSM as biomedical citizens at higher risk for HIV. The country’s progress in addressing HIV among sasoi and other MSM using evidence-based policies has earned it status as a model country in Africa in MSM HIV efforts. Stakeholders, however, face significant challenges rooted in the country’s sociocultural context, namely institutionalized homophobia and heterosexism, a dated and underfunded healthcare system, and inadequate HIV funding. Implementation of MSM HIV policies has come into conflict with the country’s legal and sociocultural realities in Ghana, where male same-sex sexual activities are criminalized and socially stigmatized. Moreover, stakeholders are strategically discreet in how they implement MSM HIV policies and programs and are hesitant to publicly push any advocacy efforts that might come across as supporting or promoting homosexuality, in fear of social and political retribution. Despite this strategy, I argue that MSM HIV efforts have attracted public attention and criticism and have constituted, in part, the politicization of homosexuality in Ghana, reshaping public representations and perceptions of homosexuality and presenting challenges to the ongoing efforts to address HIV among MSM. Stakeholders must evaluate these unintended consequences alongside the intended policy objectives and outcomes to strengthen efforts to reduce the burden of HIV among sasoi and other MSM in Ghana.

Since 1988 when the first HIV positive drug user was identified in Poland, for close to two decades, the predominant route of HIV transmission has been through injecting drug use. In mid 2000s, Polish officials reported that injecting drug use no longer contributed to incrasing HIV incidence. The consequences of such a statement are that many of the structural and personal risks associated with HIV infection go unaddressed, that drug users are neglected by HIV prevention efforts, that HIV treatment is not made available to drug users and that the policy environment does not adequately support effective public health initiatives. This case study is based on documentation, archival records, interviews, participant observation, and physical artifacts shows that these assertions were made, and continue to be repeated, in a highly political context. Poland is a post-socialist state with strong neoliberal leanings, and it is highly invested in successful integration with the European Union. Powerful Catholic Church serves as an important backdrop. While people considered "at risk" now have more freedom to conduct their lives, they also have a set of neoliberal expectations and religious pressures placed on them. Country's geographic location adds to this complexity - situated between "Old Europe" where HIV problem has been successfully contained and the former Soviet Union, where the HIV incidence among drug users is the highest in the world, Poland attempts to align itself with the success of the West. Furthermore, examination of the available data suggests that the assertions made by Polish officials omit numerous variables. My research shows that even though Polish leadership in the area of HIV and drug policy wishes to resemble Western Europe, Poland does not meet international standards for the prevention of HIV transmission. The interviews I conducted, as well as the review of the literature on drug and HIV policies and programs suggest that these services are scattered, often unavailable, and that their number is stagnating, at best, and in some cases, even decreasing. This maybe a direct result of lack of engagement of drug users in their design. Excluded from the discussion of risk, drug users are thus not the focus of prevention efforts. Based on gathered data, there are seven crucial issues that require immediate action if Poland is to manage HIV prevention and care for people who use drugs in a manner consistent with the international standards. The areas requiring action are: a change in the drug policy from the current very punitive approach, expansion of needle and syringe programs and other harm reduction services, improved data collection and an increase in the availability of HIV testing, scaled-up substitution treatment, improved quality of other forms of drug treatment, greater investment in civil society organizations, improved access to HIV treatment, and educational and training efforts that encourage greater attention to HIV related matters across disciplines.

Thesis (M. A. (Sociology)) --University of Limpopo, 2017. / Refer to document

Thesis (M. A. (Social Work)) -- University of Limpopo, 2004. / The aim of this study was to explore the impact of culture on the prevention and reatment of HIV/AIDS amongst people in low-resourced areas like Malamulele. he study focused on the lifestyles, beliefs, attitudes and perceptions around ultural elements and practices, which might impact negatively on the prevention nd treatment of the HIV/AIDS epidemic. There were three groups of research espondents namely: learners from three high schools in Malamulele, some arents of the learners and the traditional/cultural leaders. The researcher ollected both qualitative and quantitative data. The data was gathered through he use of an interview schedule (questionnaire), focus group discussions and ound-table discussion sessions. The data was presented, analysed and nterpreted by means of tables and charts. t was found that people in low-resourced (rural) areas have little knowledge about HIV/AIDS, causes, symptoms and how the disease is transmitted. Despite the fact that awareness and educational campaigns and programmes are being rendered, people in low-resourced (rural) areas have little knowledge and needed skills about prevention and treatment of the pandemic. Polygamy and extra-marital relations by men is still highly valued and viewed at high esteem. Religious structures seem to be detached to the issue of HIV/AIDS as they mentioned that talking about HIV/AIDS is immoral and against their principles. The study also tried to explore the extent to which people in low-resourced areas view and use condoms as a protective means.

This dissertation examines the political economy of HIV biomedical prevention research—largely designed in the global North but conducted in the global South—and its implications for people of diverse genders and sexualities. As a recognized global leader in HIV biomedical prevention research among people categorized as men who have sex with men (MSM) and transgender women, Peru offers a key site in which to explore the increasing focus on gender and sexual identity as a strategic area for extractive research practices. This phenomenon has become particularly visible in the epidemic’s 4th decade, which has emphasized the pursuit of biomedical prevention strategies. Building on nine years of previous experience working inside HIV biomedical prevention studies, this project involved 24 months of ethnographic research, including participant observation; 110 interviews with scientists, study staff, and research subjects; 10 focus groups; and analyses of relevant scientific publications. This study presents four key findings. First, US and Peruvian researchers’ historical and continued entanglement primed Peru to become a hotbed of HIV biomedical prevention research. In this context, population categories imported from the global North have served as powerful tools to sustain a booming local research market, which produces data that aligns with the global demands of the HIV industry. Second, on the ground, research begets more research rather than institutionalized HIV prevention technologies, creating a sustained enterprise in which issues of compensation, value, and labor shape the science. The commodification of gender and sexually diverse identities operates here in two ways: as a mechanism to access particular kinds of bodies and associated HIV risk data, and as a mechanism by which to claim expertise in the HIV prevention research industry for both researchers and community members. Third, Peruvians classified as MSM and transgender women are afforded only temporary access to cutting-edge strategies to prevent HIV, limited to study participation. The result is a sustained pool of people in need of HIV care primed to support the HIV biomedical research economy. Finally, this project illuminates a key paradox within the industry’s contemporary focus on gender and sexual diversity in HIV prevention science. This focus creates the impression that progressive health politics marked the field, while obscuring and absolving ongoing forms of exploitation and unequal gains embedded within it.

No description available.

No abstract available. / Thesis (M.PH.)-University of KwaZulu-Natal, 2004.