Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: This study sought to establish the level of knowledge of people on the medical benefits of male circumcision, especially the protective effect against HIV, with the aim of gathering baseline information on the subject for future health promotion programmes. A cross-section survey was conducted at Border Timbers Limited forest management units with 220 respondents that were conveniently selected into the study, and of these 49% were males and the reminder females. The data were collected using two questionnaires; one for females and the other for males. The data was analyzed using an Epi Info programme. The findings showed that, there was little knowledge on the benefits of male circumcision as they scored an average score of three out of eight, and 66% scored less than 50%. Striking was that that females were more knowledgeable than their male counterparts. Less than 20% knew of the protective effect of male circumcision against HIV. Fifty eight percent of the respondents had negative perceptions of the procedure, and 55% of the respondents were of the opinion that, male circumcision should be stopped with as little as twenty percent of the uncircumcised men willing to be circumcised. Under a third of the total respondents (26.7%) expressed their willingness to circumcise their male children. Medically conducted circumcision was preferred by 95% of the respondents over traditionally conducted circumcision. Based on the above; the study concluded that, raising people's knowledge on benefits of male circumcision would help in changing people's perceptions and increase the acceptability of the procedure. It is recommended that the government together with the private sector urgently need to carry awareness campaigns to raise workplace on how male circumcision can reduce chances of getting HIV. Furthermore, traditional circumcision practice should be encouraged and the practitioners trained to carry the procedure in a safe way. Further studies are recommended to assess the impact of stigma on the already circumcised in order to effectively plan and overcome societal barriers for the recommended strategies to make an impact. / AFRIKAANSE OPSOMMING: Hierdie studie poog om die vlak van kennis van mense rakende die mediese voordele van manlike besnyding te vestig, veral die voorkomende effek teen MIV met die doel om basislyn inligting oor die onderwerp van toekomstige gesondheidsbevoordelings programme te bevorder. 'n Proefopname is uitgevoer by die Border Timbers Beperk bosbestuur eenhede met 220 respondente wat gerieflik gekies is, waarvan 49% mans en die res vroue is. Data is ingesamel met behulp van twee vraelyste vir vrouens en mans onderskeidelik. Die data was ontleed deur gebruik te maak van die Epi Info program. Die bevindinge het getoon dat daar min kennis oor die voordele van manlike besnyding is, aangesien 'n gemiddelde telling van drie uit agt behaal is en 66% respondente het minder as 50% behaal. Wat opvallend was, is dat vroue meer kennis as hul manlike eweknieë oor die onderwerp gehad het. Minder as 20% het geweet van die beskermende effek van manlike besnyding teen MIV. Agt en vyftig persent van die respondente het negatiewe persepsies oor die proses en 55% van die respondente was van mening dat manlike besnyding gestop moet word en so min as twintig persent van die onbesnyde mans is bereid om besny te word. Minder as 'n derde van die totale respondente (26,7%) was bereid om hul manlike kinders te besny. Medies uitgevoerde besnyding was verkies deur 95% van die respondente teenoor tradisionele besnyding. Gegrond op bogenoemde, het hierdie studie bevind dat die verhoging van mense se kennis oor die voordele van manlike besnyding sal help om mense se persepsies asook die verhoging van aanvaarbaarheid van die proses te verander. Daar word aanbeveel dat die regering, tesame met die privaatsektor dringend bewusmakingsveldtogte moet uitvoer om die werksplek op te voed oor hoe manlike besnyding die kanse om MIV te verminder. Verder moet tradisionele besnydingspraktyke aangemoedig word en praktisyne moet opgelei word om die prosedure op „n veilige manier uit te voer. Verdere studies word aanbeveel om die impak van stigma op die reeds besnydes te assesseer om doeltreffend te beplan en om maatskaplike hindernisse te oorkom vir die aanbevole strategieë om 'n impak te maak.

Thesis (MPhil)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: NACOSA had an eventful history spanning 22 years. The first phase between 1992 and 2001 is labeled Great Expectations as the composite multi-sectoral structure started a groundbreaking initiative on HIV and AIDS in South Africa and believed that the first AIDS plan drafted by them would be implemented as planned. Expectations came to nothing as government struggled to find its feet through a decade of blunders leading to the demise of the structure by end 2001. The next phase between 2001 and 2010 is labeled Starting Over as the Western Cape branch of NACOSA reinvented itself as a community mobilisation network for the province. Within a period of ten years Western Cape NACOSA developed into a successful national network with a large membership fully involved through its networking, capacity building and promoting dialogue functions. The third phase between 2010 and 2015 is labeled Rapid Growth as NACOSA developed into a large training and grant management agency with strong systems providing funding to its members through sub-granting. Networking continued at a slower pace but is still highly important for the organisation. The network contributes to localised social capital through shared learning and collaboration. NACOSA‟s sustainability has been developed through the ability to raise long-term funds for network activities, capacity building of members and coordinated service delivery on the ground. NACOSA also has a culture of identifying and acting fast on opportunities and adapting to change when it is needed. Strategic factors attributing to the success of NACOSA are a sector based approach promoting diversity in its membership; a consistently focused and shared purpose throughout the years; a community agent approach believing in and advocating for community systems strengthening; obtaining a mandate from network members for main strategy changes; strategic partnerships; a strong capacity building approach focussing on organisational and programmatic competencies; not competing with network members but acting as main weaver; creating specialist networks for specific HIV-related causes; a committed representative executive committee and skilled staff; bringing groups together on a regular basis for discussions and strategising; a variety of social media; and a network mindset intent on a culture of learning and building trust between member organisations. / AFRIKAANSE OPSOMMING: NACOSA het 'n gebeurtenisvolle geskiedenis wat strek oor 'n periode van 22 jaar. Die eerste fase tussen 1992 en 2001 word genoem Groot Verwagtinge, verwysende na die saamgevoegde multi-sektorale struktuur wat ontstaan het as die eerste groot MIV en VIGS inisiatief in Suid-Afrika. Hulle het verwag dat hul eerste VIGS-plan geïmplementeer sou word soos wat hulle dit beplan het. Hul verwagtinge het egter skipbreuk gely as gevolg van die regering wat oor die dekade heen hul voete gesleep en foute gemaak het wat uiteindelik gelei het tot die struktuur se ondergang in 2001. Die volgende fase tussen 2001 en 2010 word genoem Oorbegin verwysende na die Wes-Kaap tak van NACOSA wat hulself herskep het as „n gemeenskapsmobiliseringsnetwerk. Wes-Kaap NACOSA het binne tien jaar weer ontwikkel in 'n suksesvolle nasionale netwerk met 'n groot ledetal wat volledig ingeskakel is by die organisasie se netwerk, kapasiteitsbou en bevordering van dialoogaktiwiteite. Die derde fase tussen 2010 en 2015 word genoem Snelle Groei verwysende na NACOSA se ontwikkeling in 'n groot opleidings- en fondsbestuursagentskap met sterk stelsels wat befondsing aan hul lede verskaf. Netwerkskakeling het voortgeduur teen 'n stadiger pas maar is steeds baie belangrik vir die organisasie. Die netwerk dra by tot die bou van plaaslike sosiale kapitaal deur middel van samewerking en saam leer. NACOSA se volhoubaarheid het ontwikkel deur hul vaardigheid om langtermynfondse in te samel vir netwerkaktiwiteite, kapasiteitsbou en gekoördineerde dienslewering op grondvlak. NACOSA het ook 'n kultuur om geleenthede vinnig te identifiseer en daarop te reageer, asook om aan te pas by veranderinge wanneer nodig. Strategiese faktore wat bygedra het tot NACOSA se sukses sluit in 'n wye sektorbenadering met diverse lidmaatskap; 'n konsekwente gedeelde doelwit oor die jare; die bevordering van sterk gemeenskapstelsels; die verkryging van 'n mandaat by netwerklede vir strategie-veranderinge; strategiese vennootskappe; 'n sterk kapasiteitsboubenadering wat fokus op organisatoriese en programmatiese vaardighede; geen kompetisie met lede-organisasies maar eerder die rol van “hoofwewer”; skep van spesialisnetwerke vir spesifieke MIV-verwante kwessies; 'n toegewyde raad en vaardige personeel; gereelde bymekaarbring van groepe vir dialoog en strategie bou; 'n verskeidenheid van sosiale media; en 'n netwerk denkpatroon gefokus op 'n leerkultuur en die bou van vertroue tussen lede.

ENGLISH ABSTRACT: This research study examines the beliefs related to HIV/AIDS risks and the perceived effectiveness of preventative measures among men who have sex with men (MSM) in the Philippines. Using a questionnaire developed using the Health Belief Model (HBM), this study endeavors to understand beliefs and thus improve counseling guidelines for MSM who continue to engage in risky sexual behaviors following VCT and a negative HIV test. The impact of HIV/AIDS on the Philippines is beginning to increase, affecting men and their partners. The rapid growth of HIV/AIDS among Filipino MSM indicates that more attention must be paid to the barriers and benefits of condom use within this high-risk population. A background of the presence and prevalence of HIV/AIDS is presented. This study aims to answer the question of why MSM choose to have unprotected sex despite the risk of HIV/AIDS. Multiple barriers to condom use are identified, including the availability of condoms, partner resistance, and reduced pleasure. The impacts of culture and society, the media, role models, social networking, drug use, and riskseeking behavior on safer sex are assessed. Currently, supplying condoms and providing voluntary testing and counseling is the primary mode of preventing the spread of HIV/AIDS, but this study sheds light on the critical issues of condom availability, perceived benefits and barriers to condom use, and the disconnect between belief and behavior regarding HIV/AIDS and unprotected sex among MSM in the Philippines. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie is ‗n ondersoek na die gelowe (beliefs) teenoor MIV/Vigs van mans wat seks het met mans. Die studie poog verder om ondersoek in te stel na moontlike voorkomende maatreëls wat ingestel kan word om die pandemie te bekamp. Vir die doel van hierdie studie is ‗n vraelys ontwikkel , deur gebruik te maak van die Health Belief Model, met die doel om ‗n beter begrip te kry van die redes vir risikogedrag onder mans wat seks het met mans in die Fillipyne. Die voorkoms van MIV/Vigs by mans wat seks het met mans is steeds aan die toeneem in die Fillipyne en dringende maatreëls is nodig om die groei van die pandemie te beperk. Die studie gee ‗n agtergrond tot MIV/Vigs in die Fillipyne. Die ondersoek gaan dan voort om te probeer bepaal waarom risikogroepe steeds voortgaan om aan onbeskermende seksuele aktiwiteite deel te neem. Resultate van die studie toon aan dat daar verskeie faktore is wat die gebruik van kondome ontmoedig in die risikogroep wat in hierdie studie aangespreek word. Kondome is nie altyd beskikbaar nie; seksuele vennote wil nie kondome gebruik nie en die vermindering in seksuele plesier word as redes aangevoer. Hierdie studie maak ‗n betekenisvolle bydrae tot die kennisbasis van die gelowe en houdings van mans wat seks het met mans ( en dan MIV-positief raak) en sal na alle waarskynlikheid betekenisvol bydra tot die meer suksesvolle bestuur van hierdie risikogroep in die Fillipyne.

Exclusive breastfeeding is one of the infant feeding methods recommended by the World Health Organisation (WHO) in the prevention of mother-to-child transmission of Human Immunodeficiency Virus (HIV), especially to HIV positive women of low socio economic status. The purpose of the study was to determine and describe the HIV positive mothers’ perceptions towards exclusive breastfeeding in postnatal ward at a particular hospital in Limpopo Province, South Africa. Qualitative exploratory research design was used to explore and describe the HIV positive mothers’ perceptions towards exclusive breastfeeding. A grand tour question in an unstructured interview was used to collect data, followed by probing questions according to participants’ responses. Data were collected from 15 HIV positive mothers aged 18 years and above. They opted for exclusive breastfeeding, and voice recorder and field notes were used to capture data. The seven steps of data analysis, adapted from Colaizzi were used. The findings: Although the benefits of exclusive breastfeeding was known by mothers, some participants had limited knowledge on the importance of exclusive breastfeeding. Some health care providers lack up-to-date information on exclusive breastfeeding. Religious and cultural practices interfere with exclusive breastfeeding. Coping strategies with the feeding options emerged as well. / Health Studies / M.A. (Nursing Science)

M.Ed. / This study was conducted with the main aim to inquire into the possibilities of the integration of themes on HIV/AIDS into the Natural Sciences (Grades 7-9) and Life Sciences (Grades 10-12) curriculum in such a way that learners can become aware of the danger of an epidemic such as caused by HIV/AIDS, and start to take care of themselves. The researcher also wanted to explore the views of educators as stakeholders’ perseverance and strategies for combating the pandemic spread of the HIV/AIDS amongst our youth and everyone else. It is generally accepted that many schools are already experiencing the effects of the disease as teachers, learners and members of their families fall ill and even die. This often results in the disruption of the normal school programme. At present, the assumption can be made that there is no integration of themes, knowledge and life skills on HIV/AIDS and the Natural Sciences (Grade 7-9) and Life Sciences (Grade 10-12) curriculum, and no teaching about the consequences of this disease. It is clear that HIV/AIDS, Natural Sciences (Grade 7-9) and Life Sciences (Grade 10-12) programmes should be designed to enable young learners to develop the skills, knowledge, attitudes and values that will prepare them to identify and solve problems and make decisions for their own benefit. At the same time, Natural Sciences (Grade 7-9) and Life Sciences (Grade 10-12) help learners to develop basic personal and community health knowledge and skills that would benefit the whole community. They will also learn about their rights and responsibilities and the causes and impact of problems that may affect their health and safety because the HIV/AIDS programmes can also be incorporated into the Natural Sciences (Grade 7-9) and Life Sciences (Grade 10-12) curriculum. Natural Sciences (Grade 7-9) and Life Sciences (Grade 10-12), and themes on HIV/AIDS, link closely to the knowledge and experiences the learners bring with them to school. The programmes should affirm both this prior knowledge and experience, and assist in the development of new life skills out of it. The Department of Education is expecting that the issue of HIV/AIDS should be taught in school. The problem that arises is HOW TO link or integrate HIV/AIDS and Natural Sciences (Grade 7-9) and Life Sciences (Grade 10-12). The educators need to be capacitated through in-service training and workshops to enable them to handle the issue of HIV/AIDS with all the sensitivity it deserves. Where teachers can draw on their relevant professional experiences and expertise to integrate and strengthen their Natural Sciences (Grade 7-9) and Life Sciences (Grade 10-12) skills, they should do so without hesitation. At the same time they should address the development of appropriate life skills and knowledge on HIV/AIDS to deal with the consequences of the disease and how to fight it. / Dr. M.C. van Loggerenberg

The following treatise first frames the role of CBOs in responding to the HIV/Aids crisis in relation to their position in the global health governance system through a literature survey that moves from an analysis of the global structures down to the local. The survey covers the role of international organisations, international NGOs (INGOs), national governments, local NGOs and CBOs and outlines the context in which Masizakhe is working within the global health governance structure. Secondly the research design and methodology are outlined focusing on the longitudinal, case study and participant--‐observation approaches. Hypotheses, conceptualisation, definitions, key variables are described and data collection methods and fieldwork practice extrapolated upon. Following that data capturing, editing and analysis are discussed in conjunction with shortcomings and sources of error. In the fourth chapter the research discusses the history, structure and outlines the research findings by comparing what has changed within the organisation over time, presenting and discussing the results. The outcomes of this research have shown that existing problems in this particular CBO are very difficult to overcome without committed, sustained support from donors, government, community and the organisation’s members. CBOs are often hamstrung by a series of intersecting factors which hamper their ability to problem--‐solve, even when the route to overcoming the problem is clear, particularly when the capacity and will to do so is not always present from both within the organisation and from outside support systems. These challenges then impact on the overall quality of and ability to deliver the services the organisation is structured to deliver. The major challenge for the organisation remains the inconsistent donor cycle and resultant instability thus created within an organisation already working in a highly volatile, unstable situation marked by poverty and disease. Thus the title, The Aids of Aid?, captures the essence of Masizakhe’s struggle with its own syndrome of problems. It summarises a comment made by the project secretary said that: “Sometimes it feels like we are not only fighting for the health of our people – We are fighting for the health of our organisation. We are a sick organisation trying to help sick people. All we need is donors and funding –we can’t live without them, and when they don't give, we get sick” (Stamper, Pers Comm, 2011). The other emergent challenges were a battle internally with ‘founder syndrome’, lack of management transparency and a dysfunctional board.

Research has identified the important role that effective parent-adolescent communication about sex and relationships signifies in reducing the chances of adolescents engaging in risky sexual behaviour. However, many parents find it difficult to discuss issues related to HIV prevention at family level because HIV prevention is inherently linked to sex, which is still regarded as a taboo in some countries, including the country of the study, Swaziland. In addition to cultural barriers related to effective parent-adolescent communication, parents seem to lack the knowledge, approach as well as the confidence regarding communication about sex and relationships. The purpose of the study was to use appreciative inquiry (AI) to engage parents of adolescents in the design of interventions to prevent HIV among adolescents in Swaziland. Non-probability, purposive sampling was used to select parents of adolescent children (10-19 years) attending school at the two purposively selected high schools in Manzini. Twenty-four (24), 23 female and 1 male parents took part in AI. Participatory action research was conducted to involve participants actively in the process of initiating interventions for preventing HIV among adolescents. The process was guided by appreciative inquiry. Data was collected by means of appreciative interviews, comprising paired and focus group interviews according to different phases of the 4-D cycle of AI. Thematic analysis of data was done throughout the 4-D cycle of AI. The themes that emerged from appreciative stories of exceptional experiences shared during the discovery phase were perceived gains and open communication. The findings of the dream phase included expressed wishes for open parent-adolescent sexual health communication, support for parents and a community of HIV free adolescents. In the design phase, parents constructed and initiated interventions for effective parent-adolescent sexual health communication and parental comfort with communication about sex. In the destiny phase, parents made statements, which were based on what they committed to do to prevent HIV among adolescents. / Lucwaningo lukhombisa bumcoka bekukhumisana kahle kwemtali nemtfwana loyinsha ngetindzaba tebundlelwane bebantfu labatsandzanako netekulalana kuze kutsi kunciphe kutsi intsha ingabi sengotini yekutfola ligciwane HIV. Kodvwa kubatali labanyenti kulukhuni kukhulumisana nentsha ngetindzaba tekutivikela kuHIV emakhaya ngoba kukhuluma ngalendzaba kufaka ekhatsi tekulalana lokuselichilo kukhuluma ngako emaveni lamanyeti lokufaka ekhatsi leSwatini lapho kwetiwa khona lolucwaningo. Lokunye lokuvimbela kutsi batali bangakhulumi ngalendzaba ngaphandle kwekutsi kulichilo, kutsi batali baswele lwati nekutsi abati kutsi bangayingena njani intsha, kanye nekutsi abatetsembi kutsi bangakhona kukhuluma ngebudlelwane bebantfu labatsandanako kanye nekulalana. Injongo yalolucwaningo bekukusebentisa indlela yekubuketa lokuhle kubatali labakwentako mayelana nekukhulumisana nentsha kuze kutsi bakhe tindlela letingito tokutivikela intsha kuHIV Eswatini. Indlela labakhetfwe ngayo batali labangene lolucwaningo bakhetfwe ngokutsi banebantfwana bentsha labaneminyaka lelishumi kuya kulabo labanelishumi nemfica labafundza etikolweni letimbili letiphakeme letikhetsiwe kaManzini. Babangemashumi lamabili nesine batali labatfolakala kungenela lolucwaningo. Batali babamdzibi munye nebacwaningi kuloluhlelo lokuhlela tindlela tekuvikela iHIV kubantfwana labayintsha. Kwakusetjentiswa tindlela letibuka lokuhle lokwetiwe batali. Imibuto beyihlose kubuta ngalokuhle kodvwa. Imivo yebatali yatfolakala nekutsi bacale babutana bodvwana besebakhulunyiswa baticagogwana ngekwehlukana kwaletigaba letine talolucwaningo. Kuhlanganisa kwemivo kwentiwa ngekutsi kubuketwe tingcikitsi kutotonkhe tigaba talolucwaningo. Tingcikitsi letaphuma kuletingcoco esigabeni sekucala lapho bebakhuluma ngetikhatsi letinhle letabayimphumelelo lapho bebakhumisana nentsha ngekulalana nangeHIV, batsi bevakunemphumelelo nekubhobokelana ekhatsi kwebatali nebantfwana. Ngalesikhatsi sesigaba sekubeka emaphupho abo basho batsi bafisa kube nekubhobokelana phakatsi kwebatali nentsha mayelana nekulhulumisana ngekulalana. Lokunye labakufisile kutsi basekelwe basitwe ngekutsi intsha ikhulunyiswa njani. Ngesikhatsi sesigaba sesitsatfu sekubuketwa kutsi kungentiwani kutsi batali nebantfwana bakhulumisana ngetindzaba tekutsandzana kanye nekulalana batali babhala imivo labo. Ngemuva kwaloko benta tivumelwano tekutsi batakwentanjani uma sebabuyela emakhaya kuze bakhone kuvikela bantfwana bentsha kuHIV. / Health Studies / D. Litt. et Phil. (Health Studies)

Thesis( MPH.) -- University of Limpopo, 2021 / Title: The Perceptions of Postgraduate Students About Female Condoms at The University of Limpopo Background: The female condom is one of the safest and effective female-initiated methods of contraceptives that has been promoted as an integral part of inventions that provide protection against the widespread of Human Immunodeficiency Virus and other Sexual Transmitted Infections among the youth, including at institutions of higher learning. A number of university students in South Africa are at risk of contracting HIV because of their risky sexual behaviours. How one perceives the female condom can have greater potential to influence its use. There is a gap in literature about this condom. Therefore, this study seeks to understand and document perceptions of postgraduate students about the female condom at the University of Limpopo. Objectives: To explore demographic characteristics of postgraduate students at the University of Limpopo regarding female condoms. To describe perceptions of postgraduate students at the University of Limpopo about female condoms. Methods: The study used the qualitative research approach. Participants of the study were full-time male and female postgraduate students at the University of Limpopo. Data was collected through semi-structured interviews, participants were interviewed one by one using an interview guide. The sample size of the study was 10 participants which was determined by saturation of data. An audiotape was also used to record interviews with participants, and field notes were also taken during the interview. Data was analysed through Thematic Content Analysis. Results: Literature suggests that students are aware of the female condom and its potential to reduce the risk of contracting HIV and STI but are still reluctant to use it in preference of the MC which is well marketed and promoted. The observed discarding and misuse of female condoms among students is associated with lack of knowledge and their perceptions of it. Although this study does not generalise the overall students’ perceptions regarding the female condom, but as a qualitative research, the study provides a useful qualitative enquiry of postgraduate students at the University of Limpopo about the female condom. Conclusion: Many studies have concluded that a female condom is a female-initiated method that is developed to empower and educate women to take control of their sexual health issues as well as to develop other programmes that prioritise women against HIV/AIDS and other STI. There is a need for effective interventions and campaigns to improve student knowledge in order to minimise wasteful expenditure in the process of the procurement and distribution of female condoms. There is also a need to increase the availability and accessibility of these condoms at institutions of higher learning.

Donor country initiatives for the prevention and mitigation of HIV/AIDS are not a matter of simple burden sharing. Instead, they have brought in their wake many of the complexities and unforeseen effects that have long been associated with more general overseas development assistance. In the case of funding directed toward HIV/AIDS, these effects are by no means either secondary or easily calculable. It is widely acknowledged that there is no consensus framework on how these impacts may be defined, no framework/toolkit for the evaluation of impacts and no longitudinally significant data that could provide the substance for those evaluations. The subject of this study focuses not on the health outcomes of funding but on how donor-recipient relations could be better deliberated, negotiated and coordinated. We argue that effective leadership and governance of developing country health systems for HIV/AIDS work requires a reconfiguration of how donor-recipient relations are conceived and contracted, and for this purpose, we propose an adaptation of the Organisation for Economic Co-operation and Development Paris Declaration principles of aid effectiveness.

BACKGROUND:In Eastern and Southern Africa (ESA), adolescent girls’ and young women’s (AGYW, aged 15-24 years) disproportionate HIV risk is fueled by age-disparate sex (partners >5 years older). Older men typically acquire HIV from same-aged partners; they then transmit HIV to AGYW, who then transmit HIV to older men as they age, creating a cycle of transmission. Adolescent boys and young men (ABYM, aged 15-24 years) have lower HIV incidence rates, and their risk starts increasing around age 20 due to same-aged partners and age-disparate sex. Developing ABYM’s preventative behaviors may proximally and distally reduce their and AGYW’s HIV risk. HIV risk perception (HIV RP) is a theoretical motivator for initiating and using risk-reduction strategies. However, this relationship remains temporally and empirically equivocal in AGYW and ABYM, who are in a developmentally and socially dynamic stage of life. To increase and improve HIV risk-reduction strategies among AGYW and ABYM in ESA, this dissertation aimed to elucidate temporal trends, determinants, and effects of HIV RP. METHODS:This dissertation employed three aims to examine 1) longitudinal HIV RP literature, 2) HIV RP trajectories and predictors, and 3) HIV RP’s association with health outcomes. Secondary analyses used data collected (2010 [T1], 2011 [T2], 2012 [T3]) from the control arm (714 AGYW, 635 ABYM) of a school-based trial in KwaZulu-Natal, South Africa. Aim 1 evaluated longitudinal quantitative studies examining HIV RP among AGYW and ABYM in ESA. A scoping review synthesized data from peer-reviewed articles published between 1995-2022 to elucidate studies’ geo-spatial distributions, temporal data patterns, sample characteristics, and HIV RP definitions, analytic findings, and theoretical underpinnings. A proposed HIV RP conceptual framework was created by synthesizing findings and theories. Aim 2 described gender-specific patterns and determined predictors of HIV RP in AGYW and ABYM. Trajectories were created based on cumulative reports of high HIV RP. After, these trajectories were characterized using sociodemographic, knowledge, attitudinal/perceptual, biological, experiential, and behavioral factors. Using models stratified by ever-sex status, overall predictive analyses explored factors prospectively associated with high HIV RP. Aim 3 tested the hypothesis that high HIV RP increased chances of HIV testing and decreased cumulative acquisition of HIV/HSV-2. Directed acyclic graphs identified potential confounders using current literature. Predictive analyses estimated high HIV RP’s gender-specific confounder-adjusted association with HIV testing and HIV/HSV-2 incidence over 1-year periods. RESULTS:In Aim 1, synthesis of 38 longitudinal studies offered limited insights on AGYW’s and ABYM’s HIV RP due to geographic homogeneity, abundance of intervention-related studies, and minimal reporting of RP definitions and HIV status. Most (~75%) studies analyzed data collected before 2015, highlighting the evidence gap of HIV RP in current epidemic conditions or prevention options. Studies assessed AGYW when their risk is peaking and provided little detail on pre-risk periods; ABYM were rarely included in analyses. Elevated HIV RP was mostly positively associated with AGYW’s self-initiated outcomes, but HIV RP’s formulation was understudied. Aim 2 found HIV RP was temporally dynamic, as most (60% AGYW, 65% ABYM) changed their level of HIV RP at least once. AGYW’s and ABYM’s Persistent (high HIV RP at all timepoints) trajectories were primarily differentiated by negative prevention attitudes. While sexual risk behaviors were relatively high in AGYW’s and ABYM’s Persistent trajectories, HSV-2 and becoming/getting others pregnant increased in lower RP trajectories, implying potential contradictions between actual and perceived risk. Analyses showed sociodemographic factors (grade repetition, mother-led households) mostly predicted high HIV RP in AGYW, while prevention attitudes differentially (i.e., attitudes and associations largely shifted from negative to positive over time) affected ABYM’s high HIV RP. Behaviors (transactional sex, not knowing partners’ status, older partners, alcohol use [ABYM only]) predicted high HIV RP in both groups. Aim 3 highlighted that age, grade, financial insecurity, HIV/pregnancy-related knowledge, attitudes, perceptions, experiences, and service-seeking and risk-taking behaviors potentially confounded relationships between HIV RP and outcomes (HIV testing, HIV/HSV-2 acquisition). AGYW with high HIV RP at T1 were more likely to HIV test (aRR=1.48 [1.12-1.95]) and acquire HIV/HSV-2 (aRR=1.83 [1.03-3.25]) by T2, associations that did not persist in T2-T3’s analyses. There were no significant associations between any factor and HIV RP in ABYM. CONCLUSION:This dissertation highlights the temporal and associative complexities of HIV RP among AGYW and ABYM in ESA. HIV RP in these groups was variable and primarily predicted by sociodemographic (AGYW), attitudinal (ABYM), and behavioral factors, elucidating need and opportunities for multi-level, age- and risk-appropriate interventions. Structural insecurities and age- and gender-driven power differentials may inhibit AGYW’s prevention behaviors. For both groups, earlier intervention would reach AGYW before their risk escalates and reinforce and/or instill ABYM with potentially lasting assets. Additional high-quality, detailed studies are needed to combat the current evidentiary dearth, optimize prevention interventions, and increase the likelihood of ending HIV/AIDS by 2030.