HIV and AIDS is one of the biggest challenges facing South African young people today (Govender, 2010). Young people are at risk, partly through their own behaviour and partly through the attitudes, expectations and limitations of the societies in which they grow up (Panos AIDS Briefing, 1996).The are many HIV prevention programmes developed globally and nationally, specifically for young people but the pandemic still escalates rapidly. The fourth decade now calls for multidimensional approaches when communicating HIV prevention for young people. This thesis explores how young people can contribute to this multidimensional approach through their active participation in the various phases of developing HIV projects. The study does this through a sample of eight youth-focused HIV organisations in KwaZulu-Natal and a sample of students from the University of KwaZulu-Natal, to gain more insight into participation of young people in the development of HIV programmes. Bodymapping, a visual and art-based method, was used to explore young people’s understanding of HIV, their perceptions of HIV programmes and the possibilities of their participation in the developing of further HIV projects. The study used a grounded approach and applied principles of participatory action research to collect data in four phases. The first phase used interviews and focus group discussions with eight sample organisations to give insight into the programmes offered to young people and how they engage and make sense of their participation within these programmes. The second phase draws on previous bodymapping workshops that have been conducted with students from UKZN and young people in various communities to explore the application and relevance of bodymapping. In the third phase, data is presented on two bodymapping workshops conducted, to engage with young people about their contribution to the development of HIV programmes. The final phase draws on two focus group discussions, conducted with bodymapping participants, to examine their experiences and interpretation of the bodymapping process. Some of the key findings indicate that a blanket approach to HIV programmes will not always work, as young people’s sexual behaviour needs to be explored within a wider socio-ecological framework that recognises the inter-relational and interconnected system in which they make their sexual choices. The data indicates that youth and organisations strongly support the importance of participation and the inclusion of participants when developing HIV projects. However, discussions about participation indicated that while young people could identify the importance of participation, they still lacked an understanding of how to participate and how they could learn more about their lived experiences through participation. This was evident in the data where there was a distinction in how participation was defined from those in the UKZN group and those from rural KZN. In understanding what constitutes participation, young people are better positioned to aid the process of developing effective HIV related projects that are participant specific. I argue that bodymapping can be used as a process to initiate and aid the participation of young people in the various phases of developing HIV projects. A three level model for applying bodymapping and planning processes has been developed to encourage participation with young people where the first step ensures that young people define what participation means to them. This becomes the foundation for how communication practitioners and academics make sense and theorise participation from a participant informed perspective. Bodymapping was pivotal in this process of engaging young people in self-reflection and introspection which encouraged a process of dialogue towards better understanding and defining participation from a participant perspective. Bodymapping in this way can be identified as a catalyst that encourages dialogue as part of communication for participatory development. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2013.

HN/AIDS in South Africa has grown to very serious proportions. An estimated number of 5.3million South Africans are infected with HIV and the majority of these infections are in the reproductive age group. Based on Annual Antenatal survey 2002,of the total 2.95 million were women aged 15-49, with an estimation of 91271 babies infected through mother to child transmission. Breastfeeding is said to be an ideal food for growth and development of a child. Given that HIV is transmissible through breastfeeding, the paper aims at examining patterns and attitudes towards breastfeeding in the era of HIV/AIDS. A total of 400 respondents drawn from Mafikeng district were interviewed. The majority were aged 20-39, never married, rural, unemployed with high school level of education. Areas of interest were knowledge about HIV/AIDS, patterns of breastfeeding and attitudes towards alternative methods of infant feeding for an HIV positive mother. Previous reports gave clarity to HIV transmission rates at various stages of life. Evidence has shown that rates of transmission are higher in early stages than late stages of life. Few weeks of life from 6-8 weeks may particularly be a period of high risk than ages above three months. Transmission might have occurred during pregnancy, labor or through breastfeeding, whereby data has shown that colostrums have high concentration of Human Immune Virus than mature milk. The study shows that breastfeeding is still regarded as an important infant feeding method that is ideal for child's growth and development but HIV infection is seen as a disturbing factor to successful breastfeeding. Fifty four percent of respondents did not breastfeed exclusively as promoted by UNICEF and WHO; mean duration for exclusive breastfeeding is two months, support is given by SADHS 1998, mean duration for complementary feeding is two months which gives an indication that more infants are at higher risk of contracting the virus should their mothers test positive which in turn gives rise to high infant /childhood morbidity and mortality rates. There is a need to strengthen and expand programmes such as VCT and PMTCT in all communities especially in rural setting where there is lack of pure water supply and proper sanitation. Efforts to reduce the risk of transmission should therefore be centered on promoting the understanding that mixed feeding or breastfeeding with supplementary feeding carries the highest risk of HIV transmission compared to exclusive breastfeeding or exclusive formula feeding. / Thesis (M.Soc.Sc. (Population Studies) North-West University, Mafikeng Campus, 2004

No abstract available. / Thesis (Ph.D.)-University of KwaZulu-Natal, Piertermaritzburg, 2010.

Magister Artium - MA / This study investigated the societal perception of refugee men as being a risk group, being polluted and the consequent risk of HIV infection they might face. It also determined the factors that could expose them to the risk of HIV infection while living in exile in South Africa. / South Africa

The present study presents three individual cases; all three clients had endured a traumatic event, namely rape, and all three met the criteria for PTSD. Despite the fact that each of the clients was initially assessed as being a suitable candidate for psychological treatment, none of the cases proceeded to the therapy phase of treatment. A number of obstacles, both personal and contextual, were encountered during treatment implementation, preventing or limiting a successful outcome of psychological treatment in each case. An examination of these cases highlights a few of the many obstacles frequently faced when delivering psychological treatment to the South African context. In so doing, this research provides an opportunity to consider the possible reasons for the limited documentation of treatment efficacy within the South African context, as well as to enhance our understanding of and sensitivity towards the cultural and contextual factors playing a role in psychological treatment.

Zimbabwe is one of the priority countries nominated by the World Health Organisation and the Joint United Nations Programme on HIV and AIDS to adopt and implement voluntary medical male circumcision (VMMC) because of its high rate of HIV prevalence and its low level of male circumcision. VMMC, which was introduced in Zimbabwe in 2009, is a new HIV prevention method which reportedly offers partial protection of about 60 percent for circumcised males with respect to contracting HIV through sexual relations. The other key prevention method, namely the use of condoms consistently and correctly, has a protection rate of up to 95 percent. As a result, because of only partial protection, medically-circumcised men are encouraged to use condoms to decrease the chances of HIV infection. Concerns though have been raised about the possibility of risk compensation by circumcised males by way of increases in unsafe or risky sexual practices subsequent to circumcision and arising from perceptions of reduced risk through VMMC. This compensation may take the form of condom use aversion including when involved with concurrent sexual partners. If risk compensation does take place, this would lead to increases in HIV transmissions affecting not only the circumcised men but their sexual partners as well. The supposed effectiveness of VMMC as a HIV prevention method has been subjected to significant criticism and, as yet, no significant study has been undertaken in Zimbabwe on the relationship between VMMC, condom use, concurrent sexual partners and risk compensation. Based on a study of twenty-five medically-circumcised males in Harare, the capital of Zimbabwe, this thesis seeks to understand and explain the relationship between voluntary medical male circumcision and risky sexual practices with particular reference to condom use amongst men engaged in concurrent sexual partnerships. While the thesis finds evidence of risky sexual practices subsequent to circumcision, risk compensation does not seem to be particularly prevalent.

The Department of Health in South Africa, as in many countries, has developed a policy guideline and recommendations for feeding of infants of HIV positive mothers. This is aimed at providing midwives with detailed and sound information about HIV and infant feeding practices based on current understanding of HIV and exclusive breastfeeding for the first six months of the infant’s life. The policy states that breastfeeding is a significant and preventable mode of HIV transmission to infants and there is an urgent need to educate, counsel and support women and families, so that they can make decisions about how best to feed infants in the context of HIV (http://www.doh.gov.za/aids/doc/feeding/html.2005-03-07). Speaking to midwives from the Provincial Hospitals in the Nelson Mandela Metropole, the researcher became aware of the midwives’ often-expressed unhappiness about the new policy from the Department of Health on exclusive breastfeeding. Midwives complained about the dilemma with which they are faced regarding infant feeding practices. They could not understand the advocacy of exclusive breastfeeding, when breastfeeding is recognised as one of the modes of Mother-to-Child Transmission (MTCT) of HIV. The aim of the study was to help, support and encourage midwives to implement the policy of exclusive breastfeeding. The objectives of the study were to: • Explore and describe the experiences and perceptions of midwives related to promoting exclusive breastfeeding in HIV positive first-time mothers. • Make recommendations to the Department of Health regarding the support and help that can be given to midwives to encourage their implementation of the exclusive breastfeeding policy. The researcher made use of a qualitative, phenomenological, descriptive, explorative and contextual design. Permission for conducting the research was iv obtained from relevant authorities, and participants were asked to sign a consent form before the researcher proceeded with the study. Collection of data was done by means of unstructured interviews using an audiotape recorder. Once data was saturated, the interviews were transcribed verbatim and analysed, using the steps described by Tesch’s (1990 in Creswell, 1994: 153) method of descriptive analysis. Field notes were also taken to record non-verbal communication during the interviews. In order to ensure trustworthiness of the study, the ethical principles of Guba’s model (in Krefting, 1991:215), namely truth-value, applicability, consistency and neutrality were used. The services of an independent coder were utilised and a consensus meeting was held between the researcher and the independent coder in order to discuss the identified themes. Prior to the consensus meeting, the independent coder was provided with interview transcripts and a protocol to guide the data analysis. Following the data analysis, a literature control was undertaken to highlight the similarities and differences found in the data analysis. Three themes with sub-themes were identified. The participants expressed positive views on the policy of exclusive breastfeeding in HIV positive first-time mothers. They were satisfied with the policy and viewed the policy of exclusive breastfeeding as an effective contribution to feeding options of babies born of HIV positive first-time mothers. However, the participants identified several factors hindering the effective implementation of the policy of exclusive breastfeeding in HIV positive first-time mothers. Factors identified were staffshortages, lack of cooperation among staff members regarding promotion of exclusive breastfeeding, lack of information regarding the CD4 count of patients on admission in the ward, cultural beliefs, lack of training among staff members and inadequate counseling facilities to ensure privacy and confidentiality for mothers. Participants also experienced a variety of emotions related to exclusive breastfeeding such as happiness, confidence, helplessness, frustration, worry and concern, stress and exhaustion. Based on the findings of the study, guidelines were developed and recommendations made concerning nursing practice, nursing education and nursing research.

This research report is submitted in partial fulfilment of the Master of Arts in Demography and Population Studies at the University of the Witwatersrand, March 2017 / Background: Evidence shows that circumcised men are less likely to be infected with HIV compared to their uncircumcised counterparts. However, critics have argued that adopting male VMMC as part of the comprehensive HIV prevention strategy might lead circumcised men to believe that they are completely protected against HIV. Consequently, this could cause them to neglect other HIV protective measures, such as consistent condom use. This study investigated the association between male circumcision and consistent condom use among sexually active men in South Africa. Methodology: The analyses were done using nationally representative cross-sectional secondary data drawn from the 2012 Third National HIV Communication Survey. The study sampled a total of 1899 single black men who were sexually active and were aged between 16-55 years. The management and analysis of the data were carried out using STATA version 14. Descriptive statistics were computed to describe the levels of male circumcision and consistent condom use in South Africa, and crosstabulations and a Pearson Chi-square test were used to assess associations between patterns of male circumcision and consistent condom use by selected variables. Bivariate and multivariate binomial logistic regressions were used to examine the socio-demographic determinants of male circumcision, as well as the association between male circumcision and consistent condom use. Results: The main findings showed that circumcised men were more likely (OR=1.18; C.I, 1.171 - 1.182) to consistently use condoms, compared to uncircumcised men. Furthermore, place of residence, education, occupation status and socioeconomic status were positively associated with consistent condom use. On the other hand, men who believed that they would get HIV, and those who were older than 24 years were less likely to consistently use condoms. While circumcision rates were lower in all the provinces compared to the Eastern Cape; Kwa-Zulu Natal and North West had the lowest odds of circumcision of all the provinces. However, both these provinces had the highest odds of consistent condom use compared to all the other provinces. Conclusion: This study found a positive association between male circumcision and consistent condom use. The findings revealed that, contrary to concerns that circumcised men may have a false sense of protection and therefore use condoms less consistently, circumcised men were more likely to consistently use condoms compared to uncircumcised men. There is, therefore, no evidence of risk compensation associated with circumcision. As a result, male circumcision should continue to be rolledout nationally, as part of an effective and comprehensive HIV prevention strategy. On the other hand, it is also evident that HIV prevention education targeting men is crucial, as men who believe that they will get infected with HIV and those older than 24 years need to be encouraged to practice safe sexual and HIV protective behaviours such as consistent condom use. / XL2018

The study sought to analyse the perception of HIV/AIDs by clients attending a community clinic in Mutale area in Limpopo province by interviewing them as they are attending the clinic. The study sought to determine ideas, beliefs or images clients have as a result of how they see or understand HIV/AIDS. The major inferences drawn from this study are that clients still need information on the rights of HIV/AIDS client and the immune system. Feedback from the study is indicative of culture and beliefs playing a major role in diseases epidemic. / Health Studies / MA (HEALTH STUDIES)

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.