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Reasonable trust : an analysis of sexual risk, trust, and intimacy among gay menBotnick, Michael R. 11 1900 (has links)
This thesis explores the psychosocial dynamics of sexual risk-taking in men who
have sex with men, with particular focus on the dilemmas that gay men face in
establishing trust in themselves and reasonable trust and intimacy with their
sexual partners. As well, the practical function of this study is to analyze past and
current social marketing efforts aimed at reducing the spread of HIV/AIDS, and
to offer suggestions for how to approach a strategy to reduce HIV incidence in
gay men and at the same time bolster efforts to assist men who have sex with
men (MSM) in adhering to safer sex guidelines.
In part, this thesis uses a sample of participants of the Vanguard Project cohort
(St. Paul's Hospital, Vancouver, British Columbia), in order to explore the social
meanings attributed by MSM towards sex, risk, intimacy, and attitudes toward
HIV/AIDS. Through the use of first-person narratives, this thesis examines the
concordance or discordance of MSM beliefs and behaviour with long-standing
theoretical models of harm reduction methods concerning sexual risk.
The study reveals that, in great measure, due to past life course events, many gay
men suffer from a lack of trust in themselves, which results in a tendency to
make irrational or unreasonable decisions concerning their long-term sexual
health, and a lack of trust in other gay men. As welL through the misguided and
often untruthful health models that advocate fewer sexual partners and rely upon
the false assumption that all potential sex partners are carriers of contagion, the
sense of mistrust has been reinforced. The lack of confidence in self and others
further translates into a suspicion of the motives and/or efficacy of social
institutions entrusted with community health development and maintenance,
rendering their efforts even less effective. Moreover, traditional harm reduction
messages, especially 'fear campaigns', often act as a deterrent, rather than as an
incentive, to harm reduction. Of more appeal are supportive harm reduction
messages delivered by someone whom the recipient trusts, especially when the
social meanings of sex, risk, trust and intimacy are, for many gay men, less fixed
and more contingent than for the population at large. This means that attempts
to modify risky behaviour must acknowledge and negotiate multiple meanings,
shifting values and changing social climates, as well as routine epidemiological
concerns.
The research identifies four key themes within a problematic of trust, risk and
intimacy, and delineates the harm reduction social complexities experienced by
gay men in the study group; these recurring themes deal with family and early
sociahzation, internalized homophobia, contingency and instability of meanings
of risk, trust and sex, and the toistworthiness of the messengers of harm
reduction strategies. Out of these recurring themes come a number of
recommendations for remedial programs aimed at both mid- and long-term
reductions in HIV incidence. The recommendations are grounded in the
recognition that homophobic and/or dysfunctional social conditions are, to a
great extent, implicated in sexual risk behaviour, and therefore must be eliminated
or ameliorated before meaningful harm reduction gains can be realized. The
discussions with the gay men in the study reveal their need for positive role
models and communal social support in their efforts to combat HIV infection,
suggesting a need to rethink the meanings of what it is to be gay, a need to
redevelop and revitalize what was once a vibrant and cohesive corrimunity, and
bearing in mind the lessons of the past, a need to re-approach the task of
sternming the tide of HIV infection in ways that are sensitive to the factors that
adduce high-risk sexual behaviour.
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An HIV/AIDS prevention intervention among high school learners in South Africa.Frank, Serena V. January 2008 (has links)
Introduction
Nearly half of all new HIV infections worldwide occur in young people aged 15-24 years.
Risky sexual behaviours may lead to the development of lifelong negative habits like having
multiple partners, thereby placing young people at risk of a broad range of health problems,
including HIV/AIDS. Prevention is therefore critical and includes changing behaviours that
are risky, such as the early age of sexual initiation, having many sexual partners and non-use
of condoms. The study aimed to evaluate whether a theory based HIV/AIDS intervention, 'Be
A Responsible Teenager' (B.A.R.T.), could produce behaviour change among high school
learners in South Africa.
Methods
A pre-test /multiple post-test intervention study was undertaken. All Grade 10 learners (n =
805) from all three public high schools in Wentworth were included in the study. Eleven
teachers were interviewed from these schools. Learners completed a questionnaire at baseline
(Tl), immediately post intervention 1 (T2), post intervention 2 (T3) and after a period of
seven months (T4). The B.A.R.T.intervention was implemented in the intervention schools
while the control group did not receive any intervention. Qualitative data was analyzed
according to themes, while quantitative data was analyzed cross sectionally and
longitudinally.
Results
Teachers reported many obstacles in implementing the HIV/AIDS Life Skills' curriculum,
including the poor quality of training and inadequate resources in schools. Further, learners
practised high-risk sexual behaviours. Gender differences in sexual behaviour were reported
with males predominately practising higher risk behaviours than females.The B.A.R.T.
intervention did show changes in behaviour for alcohol use at last sex and for the
determinants knowledge, attitudes, beliefs, self-efficacy and intentions to practise safer sex
respectively, over time. However, the intervention didnot positively impact abstinence
behaviours, condom use and the reduction in partners. Further, subjective norms did not
change.
Conclusion
The major obstacles to AIDS prevention include the current practices of risky sexual
behaviours including age mixing, early sexual initiation, multiple partners, forced sex and
receiving money or gifts for sex among others. Social norms as potrayed by parents, peers and
religious groups play a pivotal role in promoting protective sexual behaviours. The role of
gender and the gaps in LHAP (Life Skills' HIV/AIDS programme) also require urgent
attention. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2008.
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The perceptions of HIV negative pregnant women towards HIV preventative sexual behaviour in one of the regional hospitals in Durban.Msebeni, Sibongile. January 2005 (has links)
The aim of the study was to explore the perceptions of the HIV negative pregnant women, after their hiv negative results, towards preventive sexual behaviour. Methodology: A qualitative approach was used in exploring the perceptions of hiv negative pregnant women and describing their behaviour according to the findings. Fifteen participants were interviewed. Two semi - structured interviews were conducted with each participant, an initial interview and a verifying interview, for the purpose of saturation and verification. Each interview lasted for 20 - 30 minutes. The interviews were recorded and transcribed. Manual data analysis was used to identify categories and themes. Findings: The study revealed that the participants knew what the negative status entailed. They were also aware that there is a chance of hiv negative person being infected by hiv virus if they do not engage in preventive sexual behaviour. Furthermore, they had also disclosed their hiv negative status to their partners and most of the partners refused to go for testing. Though the participants believed that it was necessary to use condoms even if they were hiv negative, most of them had not use condoms during their last sexual intercourse. Reasons for not engaging in preventive sexual behaviour were revealed by the study. Recommendations were suggested for clinical practice, nursing education, management and research. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2005.
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TB and HIV community-outreach training project in a higher education institutionLourens, Guinevere Margaretha Attilla January 2009 (has links)
Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2009. / At the request of the South African Department of Health's Western Cape Provincial
Tuberculosis Control Directorate, the Cape Peninsula University of Technology, a
Higher Education Institution, developed and implemented a Tuberculosis and Human
Immunodeficiency Virus community outreach train the trainer project to train
community members about Tuberculosis and Human Immunodeficiency Virus. This study aimed to provide a historical overview of the Cape Peninsula University of
Technology Tuberculosis and Human Immunodeficiency Virus project and describe
the experiences of the trainers involved. A descriptive case study design, using a qualitative approach was applied during this
study. The historical overview of the project showed the need for a broad base of
networking, securing funding and a project facilitator from the outset of such a
project. This study found that trainers had experienced self-development in terms of
knowledge, skills and self confidence and that the training had far reaching effects by
spreading Tuberculosis and Human Immunodeficiency Virus information in diverse
community settings, despite notable challenges experienced in the community
settings. Community outreach training projects from a recognized training institution have a
positive impact at community level. However, political commitment and development
of the course content into a registered learnership are required for sustainability.
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The promotion of voluntary HIV testing among hostel dwellers by community nursesMakwakwa, Eliam 06 December 2011 (has links)
M.Cur. / The Sub-Sahara region is riddled with HIV/AIDS to such an extent it has became a pandemic. The challenge to control or to minimize further infections has been left to the community nurses. The community nurses' primary aim is to promote and prevent the spread of infection, especially HIV I AIDS, amongst vulnerable groups (Clemen-Stone, 2002-134 ). The under-utilisation of the voluntary HIV -testing facility by hostel dwellers is a cause of concern among nurses in this Southern Metropolitan Health Care Centre. Clinic statistics for the year 2002 indicate that only sixty-six hostel dwellers used the voluntary HIV -testing. This number is low compared to the approximate population of twelve thousand hostel dwellers of the three hostels. The purpose of the research is to describe strategies to promote voluntary HIV -testing in the Southern Metropolitan Health Care Centre by community nurses. To realise the purpose of the research, the following research objectives are stated: To explore and describe factors that influence hostel dwellers not to utilise voluntary HIV -testing by community nurses in the Southern Metropolitan Health Care Centre. To explore and describe the community nurses' response to the factors that influence hostel dwellers not to utilise voluntary HIV -testing in the Southern Metropolitan Health Care Centre. To describe strategies for community nurses to promote the utilisation of the voluntary HIV -testing. The research design for this study is qualitative, descriptive and contextual in nature, (Mouton, 1996:102-103, 10, 133). The research in phase one was conducted in two steps. Step one focused on the exploration and description of the factors that influence hostel dwellers not to utilise the voluntary HIV -testing in health care centers. Step two dealt with the responses of community nurses as to how to address these factors in the health care centre.
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Reasonable trust : an analysis of sexual risk, trust, and intimacy among gay menBotnick, Michael R. 11 1900 (has links)
This thesis explores the psychosocial dynamics of sexual risk-taking in men who
have sex with men, with particular focus on the dilemmas that gay men face in
establishing trust in themselves and reasonable trust and intimacy with their
sexual partners. As well, the practical function of this study is to analyze past and
current social marketing efforts aimed at reducing the spread of HIV/AIDS, and
to offer suggestions for how to approach a strategy to reduce HIV incidence in
gay men and at the same time bolster efforts to assist men who have sex with
men (MSM) in adhering to safer sex guidelines.
In part, this thesis uses a sample of participants of the Vanguard Project cohort
(St. Paul's Hospital, Vancouver, British Columbia), in order to explore the social
meanings attributed by MSM towards sex, risk, intimacy, and attitudes toward
HIV/AIDS. Through the use of first-person narratives, this thesis examines the
concordance or discordance of MSM beliefs and behaviour with long-standing
theoretical models of harm reduction methods concerning sexual risk.
The study reveals that, in great measure, due to past life course events, many gay
men suffer from a lack of trust in themselves, which results in a tendency to
make irrational or unreasonable decisions concerning their long-term sexual
health, and a lack of trust in other gay men. As welL through the misguided and
often untruthful health models that advocate fewer sexual partners and rely upon
the false assumption that all potential sex partners are carriers of contagion, the
sense of mistrust has been reinforced. The lack of confidence in self and others
further translates into a suspicion of the motives and/or efficacy of social
institutions entrusted with community health development and maintenance,
rendering their efforts even less effective. Moreover, traditional harm reduction
messages, especially 'fear campaigns', often act as a deterrent, rather than as an
incentive, to harm reduction. Of more appeal are supportive harm reduction
messages delivered by someone whom the recipient trusts, especially when the
social meanings of sex, risk, trust and intimacy are, for many gay men, less fixed
and more contingent than for the population at large. This means that attempts
to modify risky behaviour must acknowledge and negotiate multiple meanings,
shifting values and changing social climates, as well as routine epidemiological
concerns.
The research identifies four key themes within a problematic of trust, risk and
intimacy, and delineates the harm reduction social complexities experienced by
gay men in the study group; these recurring themes deal with family and early
sociahzation, internalized homophobia, contingency and instability of meanings
of risk, trust and sex, and the toistworthiness of the messengers of harm
reduction strategies. Out of these recurring themes come a number of
recommendations for remedial programs aimed at both mid- and long-term
reductions in HIV incidence. The recommendations are grounded in the
recognition that homophobic and/or dysfunctional social conditions are, to a
great extent, implicated in sexual risk behaviour, and therefore must be eliminated
or ameliorated before meaningful harm reduction gains can be realized. The
discussions with the gay men in the study reveal their need for positive role
models and communal social support in their efforts to combat HIV infection,
suggesting a need to rethink the meanings of what it is to be gay, a need to
redevelop and revitalize what was once a vibrant and cohesive corrimunity, and
bearing in mind the lessons of the past, a need to re-approach the task of
sternming the tide of HIV infection in ways that are sensitive to the factors that
adduce high-risk sexual behaviour. / Arts, Faculty of / Sociology, Department of / Graduate
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Male circumcision as a bio-medical HIV intervention targeting male heterosexual sexually transmitted disease (STD) patients in China: an acceptability study and a single-arm test-of-concept trial. / 應用包皮環切手術作為預防中國男性性病患者HIV感染的生物醫學干預手段: 一項可接受性研究及一項測試概念的臨床實驗 / CUHK electronic theses & dissertations collection / Ying yong bao pi huan qie shou shu zuo wei yu fang Zhongguo nan xing xing bing huan zhe HIV gan ran de sheng wu yi xue gan yu shou duan: yi xiang ke jie shou xing yan jiu ji yi xiang ce shi gai nian de lin chuang shi yanJanuary 2013 (has links)
Wang, Zixin. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 215-223). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract and appendixes also in Chinese.
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Expression of anti-HIV peptides in tobacco cell culture systemsMoodley, Nadine January 2009 (has links)
Submitted in fulfillment of the requirements for the Degree of Master of Technology: Biotechnology, Department of Biotechnology and Food Technology, Faculty of Applied Sciences, Durban University of Technology, South Africa,2009. / Nearly half of all individuals living with HIV worldwide at present are woman and
the best current strategy to prevent sexually transmitted HIV is antiretrovirals (ARVs).
Microbicides are ARV’s which directly target viral entry and avert infection at mucosal
surfaces. However, most promising ARV entry inhibitors are biologicals which are costly
to manufacture and deliver to resource-poor areas. Microbicides formulated as simple
gels, which are currently not commonly used in ARV therapy, show immense potential
for use in prevention and treatment of multidrug-resistant viral infections in developing
countries.
Among the most potent HIV entry inhibitory molecules are lectins, which target the
high mannose N-linked glycans which are displayed on the surface of HIV envelope
glycoproteins. Of the microbicides, the red algal protein griffithsin (GRFT) has potent
anti-HIV inhibitory activity and is active by targeting the terminal mannose residues on
high mannose oligosaccharides. It has a total of 6 carbohydrate binding sites per
homodimer, which likely accounts for its unparalleled potency. The antiviral potency of
GRFT, coupled with its lack of cellular toxicity and exceptional environmental stability
make it an ideal active ingredient of a topical HIV microbicide.
v
Scytovirin (SVN) is an equally potent anti-HIV protein, isolated from aqueous
extracts of the cyanbacterium, Scytonema varium. Low, nanomolar concentrations of
SVN have been reported to inactivate laboratory strains and primary isolates of HIV-
1. The inhibition of HIV by SVN involves interactions between the protein and HIV-1
envelope glycoproteins gp120, gp160 and gp41.
Current recombinant production methods for GRFT and SVN molecules are
unfortunately hampered by inadequate production capacities. This project therefore
aimed to determine if these molecules can be produced in plant cell culture systems.
The transgenic tobacco cell culture system was evaluated to determine if it can be an
alternative, cost effective production system for these molecules.
Results of the study show that the microbicide genes can be cloned into plant
transformation vectors, used to successfully transform SR1 tobacco cell lines and
adequately produce 3.38ng and 10.5ng of GRFT and SVN protein respectively, per
gram of SR1 tobacco callus fresh weight.
The promising results attained in this study form the basis for further work in
optimising plant cell based production systems for producing valuable anti-HIV
microbicides, a possible means to curbing the elevated HIV infection rates worldwide. / CSIR
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Narratives around sexual behaviour and decisions regarding treatment-seeking of adolescent females who contracted a sexually transmitted infection: Birth to Twenty cohortQuan, Vanessa Cecilia January 2012 (has links)
Degree of Masters in Public Health by coursework and research report
Maternal and Child
Johannesburg, March 2012 / Adolescent sexual behaviour related to low condom-use and early sexual debut has
been a concern in the transmission of sexually transmitted infections (STIs) and HIV.
Treatment-seeking behaviour is a problem in adolescents due to embarrassment and
unfriendly health care services. The Birth to Twenty study group (Bt20) is a cohort of
singletons born in 1990 with approximately 10% having tested positive for STIs at an
early age. Their sexually activity and unprotected sex practices have increased their risk
for HIV infection. The objectives of this study were to explore the perceptions, sexual
behaviour and treatment-seeking behaviour of a sample of girls who had a previous STI,
through their narratives.
One-on-one narrative interviews were done on 19 girls with the aid of an interview
schedule. A life history of their sexual encounters was documented. The interviews were
taped and transcribed. Thematic analysis was performed.
The majority of the girls had no knowledge of STIs before they were counselled by the
Bt20 nurses yet 50% of the girls used condoms in their first sexual experiences. Once
counselled, almost all the girls went on to seek treatment for their STI. A third of the girls
reported poor service at the clinic and would prefer to be treated either privately or at
Bt20 if possible. Information regarding the role of STIs in the transmission of HIV seems
to be unclear. Improving the life orientation programme at schools with a focus on STIs
and pregnancy would positively impact on HIV transmission. One-on-one counselling is
effective but may not be feasible in under-resourced communities and the continued
education of nurses in clinics, whilst increasing the number of adolescent friendly clinics,
must be prioritised.
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Synthesis of peptidomimetic compounds as potential anti HIV and malaria agentsZimuwandeyi, Memory 14 May 2015 (has links)
A thesis submitted to the Faculty of Science University of the Witwatersrand
Johannesburg in fulfillment for the requirements of the degree of Master of Science.
14 May 2015. / Peptidomimetic compounds have been shown to exhibit both anti-HIV and anti-malarial activity. A multicomponent reaction was used to create a library of peptidomimetic compounds with an α-hydroxy-β-amino acid unit. The Passerini reaction between an aldehyde, carboxylic acid and isocyanide was used to prepare compounds containing both ester and amide functionalities. These compounds were then subjected to a deprotection-acyl migration strategy giving rise to the target compounds. This approach, known as the Passerini Amine Deprotection Acyl Migration (PADAM) sequence was successfully used to create a library of novel peptidomimetic compounds. From this library, 22 compounds were tested for activity against HIV and malaria.
The Passerini reaction gives rise to a product containing a new stereogenic centre, and as the starting aldehyde used (N-Boc-phenylalaninal) has a stereogenic centre, the products were isolated as a mixture of diastereomers. Our research was also focused on finding ways of influencing the stereoselectivity of the reaction and the separation of the resulting diastereomers. The diastereomeric ratio of the Passerini products was found to be approximately 2:1 for all the reactions performed. This ratio could be modified slightly when using certain carboxylic acids and isocyanides that were either very bulky or had a stereogenic centre.
Attempts to enzymatically resolve the diastereomeric products were not successful after trials using a library of 25 lipase enzymes. However, use of preparative HPLC enabled the successful separation of most of the diastereomeric mixtures, affording compounds with high purity. X-ray crystallography enabled us to identify the major diastereomers as having the R,S configuration, whilst the minor diastereomers had the S,S configuration at the two stereogenic centres.
A possible explanation for the observed stereoselectivity is based on the Felkin-Anh chelation control model. It suggests that mono-protected amino aldehydes follow a chelation controlled mechanism in nucleophilic addition reactions. Chelation occurs, albeit in the form of hydrogen bonding, between the NH and carbonyl oxygen.
The library of compounds was tested for activity against both HIV-1 and malaria. Only three compounds showed moderate activity against the malaria parasite, inhibiting parasitic growth by 37-42% at 5 μM respectively. Significantly, all of the active compounds contained an adamantyl moiety. Unfortunately no anti-HIV activity was seen for any of the compounds tested in the HIV-assay.
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