Thesis (DTech. in the Dept. of Drama and Film Studies.)--Tshwane University of Technology, 2012. / When theatre officially was acknowledged as an interventionist tool in the fight against HIV/AIDS in South Africa in 1996, economic and political evils of apartheid of the past. Unfortunately, as statistics have revealed, this has not been the case, as HIV prevalence levels have continued to rise in all sections of society. In trying to understand the reasons for theatre's failed attempts at changing peoples' sexual behaviour, scholars have identified the non-centrality of cultural norms of target audiences as one of the principal causes.it was hoped that it would effectively and efficiently deal with raising the awareness levels of the South African population of the dangers of HIV, and the consequences of risky sexual behaviour given its immense contribution in creating awareness about the social Health communication experts have agreed that health intervention strategies seem to be controlled by people who do not understand the complexity of the behaviour of their target audiences. Health behaviour theorists have also indicated the need to re-examine intervention approaches by paying more attention to the culture of the target population. This study therefore, investigated the inclusion/non-inclusion of cultural norms of target audiences in the design of theatre's dramatic performances which serves as its intervention instrument. This was done through an examination of three theatre groups' HIV/AIDS campaigns in three provinces of South Africa. Using qualitative study methods, the study probed into whether the cultural values of the communities concerned are encapsulated in the plays performed by the groups to spread awareness of HIV/AIDS.

published_or_final_version / Community Medicine / Master / Master of Public Health

Not available / text

That the HIV and AIDS epidemic is fuelled by structural injustices is not a new discovery. Several studies reveal the link between the HIV transmission and the spread of the epidemic and the structural inequalities created by human beings themselves in terms of economic and political structures sustained by the patriarchal socio-cultural and religious beliefs systems. In most African rural contexts, faith communities have the potential to alter the course of the epidemic given their moral authority in community and their direct connection with people. However, they are seldom theologically equipped to address the structural inequalities that fuel the spread of HIV and AIDS. This study critically analyses the specific factors driving the HIV and AIDS epidemic in Burundian context and the challenge that they pose to the Burundian Pentecostal churches‘ theology of mission. The study argues that Burundian Pentecostal churches are not responding the epidemic as they should because their responses are informed by a theological framework of mission that was elaborated in the early years of the 20th century and which was responding to theological and social questions quite different to the questions raised by the current HIV context. To overcome this theological irrelevancy that has led to a failure to respond to the political, socio-economic, and cultural factors that fuel the spread of HIV infection, the study suggests that there is a need to adopt a theological framework rooted in a holistic understanding of the mission of the church in the world as defined by the concept of missio Dei. The practical implication of this theological framework is that it challenges faith communities in general and Burundian Pentecostals in particular to become transforming agents not only interested in right relationships between God and humans but also committed to the transformation of political, economic, socio-cultural and religious structures that sustain unequal relationships between humans and between humanity and the rest of creation. / Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2010.

The management of HIV-associated tuberculosis (TB) is complicated by the pharmacokinetic interactions between rifampicin (RMP) and co-administered protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors. Rifabutin (RBT) is an alternative rifamycin, preferred in patients requiring PIs. Recent studies suggest the current recommended dose of RBT in combination with boosted lopinavir (LPV/r) is suboptimal and there are insufficient pharmacokinetic data evaluating the interaction between RBT coadministered with efavirenz (EFV) and nevirapine (NVP). Pharmacogenomic studies have shown that RMP concentrations are lower in patients from sub-Saharan Africa with polymorphisms of the SLCO1B1gene but there is currently no data on the pharmacogenetic determinants of RBT exposure. The pharmacokinetics of RBT were evaluated at two different doses in HIV co-infected patients before and after the introduction of LPV/r, EFV and NVPbased antiretroviral therapy (ART). After six weeks of standard TB therapy, RBT 300 mg daily was started for four weeks. Thereafter patients were randomized to receive either RBT 150 mg daily or RBT 150 mg three times a week (TPW) with LPV/r, RBT 300mg or 450mg with NVP or RBT- 450mg or 600mg with efavirenz. After four weeks on the first RBT dose, patients switched to the alternate dose and continued until the end of TB treatment. Serial RBT and 25-O-desacetylrifabutin (dRBT) concentrations were measured during a dose interval before patients switched RBT doses. The median AUC0-24 and Cmax, of RBT in patients taking 150mg RBT TPW was significantly reduced when compared to the other treatment arms. 86% of patients whilst on this intermittent RBT arm had an AUC0-24 < 4.5 μg.h/mL, level that has been associated with acquired rifamycin resistance. Rifabutin exposure was maintained within the range of AUCs that have been shown to prevent acquired rifamycin resistance (ARR) with 150mg daily dosing in combination with LPV/r. In addition, the combination of RBT with NVP 300mg resulted in significantly increased exposure of RBT, with significantly higher exposure observed with 600mg RBT. However, the combination of RBT 450mg with EFV resulted in RBT exposure lower than 300mg RBT given alone in the same patients, whereas RBT 600mg plus NVP results in bioavailability of RBT equivalent to 300mg given alone. Rifabutin was well tolerated at all doses. Only three grade 4 laboratory toxicities, elevated transaminases, neutropenia, and uveitis, possibly related to RBT were reported in patients taking NVP. SLCO1B1 rs4149032 C>T polymorphism occurs frequently in African patients in Durban and may be associated with low RBT bioavailability. These findings support recommendations for the higher dose of RBT in combination with LPV and EFV but not with NVP. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2012.

In the wake of HIV and AIDS in Africa, culture has been identified as central to HIV prevention, care, and support. Therefore, scholars have argued that HIV intervention in communities should focus on cultural practices rather than just individual behaviour. Researchers have also taken note of the interconnectedness between religion and culture in Africa. Therefore the African theologian, Mercy Oduyoye, proposed the term ‘religioculture.’ In the light of this connection, it has become crucial to examine not just cultural practices but the response of religion to cultural practices in the context of HIV. Given that Zambia is a Christian country, this qualitative empirical study sought to examine the response of a church, the United Church of Zambia (UCZ), to traditional marriage practices that I consider to be harmful in the context of HIV. Traditional marriage practices such as child marriage and widowhood inheritance were analysed through gendered theological perspectives. The study was located in the United Church of Zambia in the towns of Mufulira and Kitwe in the Copperbelt Province of Zambia. The reason for choosing the practices of widowhood inheritance and child marriage as the areas of focus was twofold: first, throughout history and in the current context, the church and society’s perception of these two practices has been ambiguous. Depending on the time and event in history, the practices were seen as either a norm or a problem. In this study, I have questioned the extent to which this historical ambiguity towards these traditional marriage practices has contributed to the way in which the church today is responding to these culture practices. The second reason for choosing these two marriage practices was to highlight how the institution of marriage has been challenged in the context of HIV and AIDS. When marriage ceases to be a safe practice for couples, how should the church respond to the harmful cultural practices associated with marriage, especially in the context of HIV and AIDS? The question that this study posed, therefore, was: What role has the United Church of Zambia played in either promoting or discouraging harmful marriage practices in the context of HIV and AIDS? The methodology used to answer this question included: semi- structured interviews, openended in-depth interviews, Contextual Bible Study, and focus group discussions as forms of data collection from: church leaders, lay people, widows, girls involved in child marriage, and members of the Marriage Guidance Committee. Thereafter, the data was thematically ii analysed using the theory of African feminist cultural hermeneutics. The study is divided into eight chapters, each chapter answers one of the objectives of the study. Through the use of the tools for data collection stated above, the study drew a number of conclusions. Firstly, it was established that indeed child marriage and widowhood inheritance are contributing factors to the spread of HIV. Secondly, the Marriage Guidance Programme of the United Church of Zambia was identified as a point of entry in re-examining the theology of marriage that is contextual and holistic in the United Church of Zambia. Thirdly, the church’s ambivalence with regard to harmful marriage practices in the context of HIV and AIDS was attributed to people’s belief systems about their cultures which are embedded in their worldviews. Overall, the study has shown that there is a need for an analysis of culture within the church which can enable it to respond to harmful cultural practices in the context of HIV. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

Thesis (MTh)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The current situation around widowhood sexuality is unspeakably painful. It has been established through literature review in this study that widows are the most neglected group in many societies. In Zimbabwe the unprecedented rise in the number of widows has been caused by the proliferation socio-economic, political climate coupled with the devastating effects of HIV and AIDS pandemic. HIV and AIDS pandemic has caused unimaginable suffering among all segments of society in Zimbabwe but impacts more on women and girls. HIV has increased the number of young widows in the country. This is the group which is still sexual active and they are in the church in quest to find meaning in God. The study also explored how the patriarchal society and religious norms control and manipulate women‟s sexuality. The church and the community views sex and sexuality issues as private matters. Hence, the dilemmas of widowhood sexuality are created by widows‟ failure to publicly and or share their challenges with church leadership. However, it was made clear during the study that the quest for sexual meaning becomes a challenge due to the complexities caused by HIV and AIDS pandemic. The challenge shown in this study was how to do theology and be a church where we accept that all theological formulations and institutional designs are influenced by their context. Therefore, could it be moral for the church to teach that widows embrace other sexual alternatives that are less risk to contract or transmit HIV; such as masturbation, use of sex toys and vibrators? Can these help widows reduce their sexual tension and evoke pleasure? If such or more suitable means are availed by the church how should widows be enriched to live meaningful in their faith in God? For the church to teach widows to say “no” to sexual intimacy outside marriage sound irresponsible and unrealistic to prevailing statistics of widows and their ages in church. However, the dilemma is for them to engage in sexual intimacy without creating other existential issues leading them to live in guilt- feelings and in the process lose their meaning in their God. Is the church willing to look closely to widowhood sexuality in this era of HIV and AIDS pandemic? The HIV and AIDS pandemic challenges the church to formulate policies and reframe pastoral theology in a way that is relevant to allow widows discover a God who can be compassionate and trusted to give meaning in suffering. / AFRIKAANSE OPSOMMING: Die huidige situasie in verband met weduweeskap en seksualiteit is onbeskryflik pynlik. Dit het duidelik geword uit die literatuuroorsig in hierdie studie dat weduwees die mees afgeskeepte groep in baie gemeenskappe is. In Zimbabwe is die ongehoorde styging in die aantal weduwees te wyte aan die groei in die slegte sosio-ekonomiese en politiese klimaat tesame met die verwoestende gevolge van die MIV en VIGS pandemie. Die MIV en VIGS pandemie het ondenkbare lyding veroorsaak in alle areas van die gemeenskap in Zimbabwe, maar dit het 'n groter invloed op vroue en jong meisies. MIV het veroorsaak dat die getal jong weduwees in hierdie land gestyg het. Dit is ook die groep wat steeds seksueel aktief is en hulle kom na die kerk in 'n soeke om betekenis te vind in God. Hierdie studie ondersoek ook hoe die patriargale gemeenskap en sy godsdienstige norme vroue se seksualiteitbeheer en manipuleer. Die kerk en die gemeenskap beskou seks en seksualiteit as 'n private aangeleentheid. Die gevolg is dat die dilemma van weduweeskap en seksualiteit geskep word deur die weduwee se versuim om haar uitdagings in die openbaar of by die kerkleiers bekend te maak. Dit het egter gedurende hierdie studie duidelik geraak dat die soeke na seksuele betekenis 'n groot uitdaging is as gevolg van die kompleksiteite wat veroorsaak word deur die MIV en VIGS pandemie. Die uitdaging wat met hierdie studie beklemtoon word, is hoe om teologie toe te pas en 'n kerk te wees wat aanvaar dat alle teologiese formulering en institusionele ontwerpe ook deur hul konteks beïnvloed word. Is dit derhalwe 'n morele probleem vir die kerk om vir weduwees aan te beveel om seksuele alternatiewe te ondersoek wat minder risiko's inhou vir die opdoen of oordra van MIV; soos masturbasie, die gebruik van seksspeelgoed en vibrators? Kan hierdie alternatiewe metodes weduwees help om hul seksuele spanning te verminder en seksuele genot te ervaar? Indien hierdie, of ander geskikte metodes, deur die kerk benut word, hoe kan weduwees verryk word deur betekenisvol tot hul geloof in God te leef? Vir die kerk om weduwees te leer om “nee” te sê vir seksuele intimiteit buite die huwelik klink onverantwoordelik en onrealisties as die heersende getal weduwees in die kerk en hul ouderdomme in ag geneem word. Die dilemma is egter vir hulle om seksuele intimiteit te beleef sonder om ander eksistensiële vraagstukke te skep, wat hulle dwing om saam te leef met skuldgevoelens en in die proses betekenis in hul God verloor. Is die kerk bereid om noukeurig te kyk na weduweeskap en seksualiteit in hierdie era van die MIV en VIGS pandemie? Die MIV en VIGS pandemie daag die kerk uit om beleide te formuleer en pastorale teologie te herdefinieer op 'n manier wat relevant is tot die ontdekking van 'n God wat medelydend en betroubaar is en wat betekenis kan gee aan lyding.

This research study is a qualitative appraisal of the HIV and AIDS Prevention and Control Strategy of the Ethiopian Orthodox Tewahedo Church (EOTC). It critically analyses the strategy in order to ascertain its gender consciousness or gender sensitivity in the context of HIV and AIDS in Ethiopia. The basic motivation for this study is based on the idea that many if not most of the responses aimed at dealing effectively with the HIV and AIDS pandemic in Ethiopia have so far not addressed the underlying problems related to gender which are fuelling the spread of the HI virus. The study is guided by an overarching feminist ecclesiology, the gendered conceptual intervention to HIV and AIDS proposed by Geeta Rao Gupta, and Orthodox and feminist Trinitarian theology as a theoretical framework within feminist theology. These approaches were chosen because of their common focus on the unity and equality of humanity regardless of gender, social and religious differences. One of the major highlights of this study is that it has succeeded in bringing forth links between gender issues and HIV and AIDS; poverty and HIV and AIDS, and economic, social and cultural factors that fuel the spread of the HI virus; as well the historical, philosophical and cultural influences that perpetuate the oppression of women. Another important highlight of this study is the identification of theologies within EOTC that can help diffuse the tension created by the above mentioned negative influences. These theologies include the Trinitarian theology for example, and are life affirming for women because they transform and empower women to ensure their full humanity and equality, giving them the means to avoid being infected by the HI virus, and/or allowing those who are already infected and affected to live with dignity. / Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

Recent studies reflect increasing levels of HIV infection amongst married women in sub-Saharan Africa. The institution of marriage, which is highly revered within the church and society, is thus now regarded as a 'potential death trap' for many married women. This study examines the drivers of these increasing levels of HIV infection amongst married women in sub-Saharan Africa. It offers a critical reflection of the socio-cultural factors and gender-insensitive theological traditions that expose married women to the vulnerability of HIV infection. In order to observe the sacrosanctity of the marriage institution as well as preserving the dignity of life for many married women in sub-Saharan Africa, the study presents the imago Dei theological motif as a gender-sensitive theological response to the increasing levels of HIV infection among married women. The imago Dei theological motif argues that both men and women equally reflect the divine image of God. This theological motif also brings to the fore the realization that HIV and AIDS is fuelled by conditions of inequality, socio-economic and socio-cultural discrimination, hence the need to promote human dignity for both men and women within our communities in sub-Saharan Africa. Furthermore, emanating from the imago Dei theological motif, the study offers a bold community praxis through the transformation of gender-insensitive theological traditions; the transformation of hegemonic masculinities; and the transformation of gender-insensitive HIV prevention models as practical ways aimed at redressing the vulnerability of married women to the increasing levels of HIV infection. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

According to the Joint United Nations Programme against HIV/AIDS 2009 AIDS epidemic update, there were a total of 33.3 million (31.4 million–35.3 million) people living with HIV worldwide in 2009. The majority of the epidemic occurs in Sub-Saharan Africa. Of the 33.3 million people living with HIV worldwide in 2009, a vast majority of 22.5 million (20.9 million-24.2 million) were from Sub-Saharan Africa. There were 1.8 million (1.6 million-2.0 million) new infections and 1.3 million (1.1 million-1.5 million) AIDS-related deaths in Sub-Saharan Africa in 2009 (UNAIDS, 2009). Statistical models and analysis are required in order to further understand the dynamics of HIV/AIDS and in the design of intervention and control strategies. Despite the prevalence of this disease, its pathogenesis is still poorly understood. A thorough understanding of HIV and factors that influence progression of the disease is required in order to prevent the further spread of the virus. Modelling provides us with a means to understand and predict the progression of the disease better. Certain genetic factors play a key role in the way the disease progresses in a human body. For example HLA-B types and IL-10 genotypes are some of the genetic factors that have been independently associated with the control of HIV infection. Both HLA-B and IL-10 may influence the quality and magnitude of immune responses and IL-10 has also been shown to down regulate the expression of certain HLA molecules. Studies are therefore required to investigate how HLA-B types and IL-10 genotypes may interact to affect HIV infection outcomes. This dissertation uses the Sinikithemba study data from the HIV Pathogenesis Programme (HPP) at the Medical School, University of KwaZulu-Natal involving 450 HIV positive and treatment naive individuals to model how certain outcome biomarkers (CD4+ counts and viral loads) are associated with immuno genetic parameters (HLA-B types and IL-10 genotypes). The work also seeks to exploit novel longitudinal data methods in Statistics in order to efficiently model longitudinally measured HIV outcome data. Statistical techniques such as linear mixed models and generalized estimating equations were used to model this data. The findings from the current work agree quite closely with what is expected from the biological understanding of the disease. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.