HIV-positive men face multiple challenges when deciding whether or not to disclose their serostatus to sex partners. This survey design using repeated measures examined disclosure of HIV-positive serostatus to sex partners in an ethnically diverse population of men (N= 93) recruited from the community in O'ahu, Hawai'i. The framework guiding the research was Social Cognitive Theory (Bandura, 1987), with a specific focus on self-efficacy for disclosure decision-making and for negotiating safe sex. The aims of the research were to: 1) describe HIV serostatus disclosure to sex partners; 2) describe self-efficacy for disclosure to sex partners and self-efficacy for negotiating safer sex; 3) determine the relationships between demographic, HIV-illness, drug use history, self-efficacy and sex partner variables (relationship status, serostatus), and self-disclosure, and; 4) determine the relationships between demographic, HIV-illness, drug use history, self-efficacy, sex partner variables, self-disclosure, and condom use by the men in the sample. A convenience sample of HIV-seropositive men was enlisted through both active outreach and passive recruitment (posters and public advertisement). Survey responses were anonymous, as the subject matter being asked was sensitive in nature. Results reveal that self-disclosure to sex partners varied based on sex partner serostatus and relationship status, and was significantly influenced by perceived self-efficacy, by income, education, years since diagnosis and contextual factors including cocaine use before sex. Subjects were least likely to disclose to a sex partner whose serostatus was not discussed. An unknown partner serostatus was also significantly associated with less disclosure. The more committed the relationship, the greater the likelihood that a subject would self­ disclose. The longer the time since initial HIV diagnosis the more likely a subject was to disclose to sex partners. High self-efficacy scores were associated with self-disclosure, and with condom use. Cocaine use before sex was associated with less disclosure and less condom use. Self-disclosure was significantly associated with condom use as well. Although a causal relationship is not implied, self-disclosure practices did influence safe sex behavior. Implications for nursing and for future research are discussed.

This study focuses on the process and complexities of disclosure and decision-making amongst HIV-positive ex-offenders. In addition, this study highlights the history and circumstances of HIV infection and how this influences disclosure. The process of disclosure was explored amongst seven HIV positive male ex-offenders who fell in the African racial category. Data was collected through qualitative in-depth interviews and analyzed using thematic analysis. Results revealed that within this target group disclosure initially occurred within prison and thereafter upon release from prison, continues depending on the contextual factors. Because disclosure initially took place within prison, the prison environment was a defining feature during the process of disclosure. Factors that enabled ex-offenders to disclose their HIV status included social support, witnessing of HIV – related deaths amongst other offenders, as well as the challenging nature of the prison environment. Factors that compromised the disclosure process included their access to treatment and a more nutritional diet. Upon release from prison, access to financial and material support and responsibility to significant others were reasons that facilitated the process of disclosure. Overall, stigma was a main barrier that contributed to non - disclosure. These findings highlight that the process of disclosure is a relational factor as it depends largely on the availability and accessibility of significant others. The conclusion that can be drawn from this study is that HIV disclosure is a process that occurs on a continuum whereby there is no clear end-point as ex-offenders weighed up the enabling factors against the barriers before disclosing. Once disclosure had occurred, ex-offenders had to integrate the outcomes and reactions from significant others into their lives. The process of HIV disclosure is also a never – ending process as there are always significant others to disclose to. It is recommended by this study that more research is conducted regarding how prison conditions influence HIVpositive offenders, how HIV-positive ex-offenders can be better re-integrated into the community and how significant others deal with the ex-offenders HIV disclosures.T / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010

D.Phil. / The aim of this study is to critically analyse representations of gender and sex in newspaper reports on HIV and AIDS in the hope of improving messaging around HIV and AIDS. Within the scope of this study observations are made at the conclusion of each case study so as to inform prevention campaigns and media on more appropriate ways of representing gender and sex and HIV and AIDS. These observations serve as guidelines to inform journalists and civil society on how better to message HIV and AIDS and sexuality. Mutual recognition is used as the theoretical standpoint for understanding sexuality by emphasizing the premise of respect for self and other. Mutual recognition is used as the critical lens to rethink gender beyond constructions of masculinity and femininity, race, class and sexuality; looking for the moments and opportunities for recognition between both masculine and feminine subjects as well as for narratives on sameness and difference beyond race, class and sexuality. Mutual recognition is also the way forward for resisting phallogocentrism and shifting representation away from the workings of male hegemony. The theoretical framework used in this study is based on feminist psychoanalysis and feminist media interpretation. Special mention is given to the work of Jessica Benjamin, Donna Haraway and Jane Flax; on account of their reception of Freudian theory of the oedipal complex showing ways of rethinking the oedipal complex and gender differentiation. Foucault’s work on representation shows how we can rethink language to better serve the notion of mutual recognition, placing importance on concepts such as respect, responsibility and caring for self and other in ways that go beyond race/ethnicity, class, sex/gender or sexuality. Eros and thanatos (life and death drives) is nuanced to highlight how jouissance or the ‘little death’ (orgasm) is a way of resolving the tension between these opposing drives by shifting discourse away from sex and taboo or death towards sex and pleasure and thus emphasizing eros and mutual recognition. The study is concluded with a set of guidelines for representing gender and sex in relation to HIV and AIDS. It is significant to note that this is a qualitative study that, which makes use of textual analysis and seeks to offer a measure of transparency and accountability to the interpretation of selected texts.

Mode of access: World Wide Web. / Thesis (Ph. D.)--University of Hawaii at Manoa, 2005. / Includes bibliographical references (leaves 207-219). / Electronic reproduction. / Also available by subscription via World Wide Web / xiii, 219 leaves, bound 29 cm

Thesis (MSc)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Successful antiretroviral therapy (ART) depends on appropriate use of antiretroviral agents; which ultimately prevents replication of Human Immunodeficiency Virus (HIV) thus delaying clinical progression of the disease. This study explored how HIV status disclosure affects adherence to antiretroviral therapy at Mamelodi Hospital, using a convenience sampling method with a sample size of 50 adults above 18 years who were on treatment for a minimum of two years prior to the study. An interview protocol was used to uncover patients’ demographics, sexual orientation, and HIV status disclosure, adherence to antiretroviral drugs, drug side effects, how often they missed their doses and how HIV status disclosure / non-disclosure affected their adherence to treatment. Patients’ medical records were assessed to validate and correlate the information obtained from the interviews. The scientific test results used were the CD4count and Viral loads which are used to monitor the HIV/AIDS disease progression. All partakers involved in the study made their HIV status known and reported taking their medicines regularly. The patients’ CD4 count and VL were verified, the CD4 count has shown an upward trend while the VL load showed a downward trend in keeping with patients who are adhering to ART. The majority of participants (54% or 27 patients) reported they had never skipped taking their medication. The participants also reported they had taken their medicine in front of other people and they constituted 74% (37) of the group. Of this 74%, 78.38% (29 patients) said it was because they had disclosed their status. This observation supports the fact that if you have disclosed your HIV status, you have better chances of adhering to prescribed medication. Findings from the study at Mamelodi Hospital revealed that for as long as one has disclosed their HIV status, the outcome of treatment adherence will be better. The only shortfall noted was lack of partakers who did not divulge their HIV status thus a comparison could not be done. It was acknowledged that some participants in the study might have reported disclosure of their HIV status to be in good favour of the researcher to create an impression that they are adhering to their medication. The study has confirmed the existence of a relationship between HIV status disclosure and adherence to ART. / AFRIKAANSE OPSOMMING: Suksessvolle antiretrovirale terapie (ART) hang af van die toepaslike gebruik van antiretrovirale middels, wat replikase van die MI-virus verhoed, en dus die kliniese vordering van die siekte vertraag. Hierdie studie het ondersoek hoe die bekendmaking van MIV-status die gehoorsaamheid tot ART beïnvloed het by die Mamelodi Hospitaal. ‘n Gerieflikheid-streekproef met ‘n groote van 50 volwassenes bo 18 jaar is gebruik en die deelnememers moes ten minste vir twee jaar voor die studie reeds op behandeling gewees het. Data is deur middel van onderhoude ingesamel, met die doel om pasiënte se demografiese inligting, seksuele orientasie, MIV-status, gehoorsaamheid tot ART en newe-effekte van ART in te samel. Pasiënte se mediese rekords is nagegaan om die inligting wat uit die onderhoude verkry is te bevestig. Die wetenskaplike toetse wat gebruik is, was die CD4-telling en virale lading wat gebruik word om MIV/Vigs te monitor. Al die deelnemers het hul MIV-status bekend gemaak en aangedui dat hul hul medikasie gereeld gebruik. Die pasiënte se CD4-tellings en virale lading is bevestig, die CD4-tellings het ‘n opwaartse neiging getoon terwyl die virale lading ‘n afwaartse neighing getoon het. Die meerderheid van die deelnemers (54%) het aangedui dat hul nog nooit hul medikasie oorgeslaan het nie. 74% van die deelnemers het aagedui dat hul hul medikasie voor ander mense neem - hul noem dat dit as gevolg van die feit is dat hul hul status bekend gemaak het. Dit ondersteun die feit dat mense wie hul status bekend maak beter kanse het om gehoorsaam hul medikasie te gebruik. Die studie by die Mamelodi Hospitaal toon dat solank mense hul MIV-status bekend maak, hul meer gehoorsaam is teenoor die gebruik van hul medikasie. Die studie bevestig dus die verband tussen bekendmaking van MIV-status en gehoorsaamheid tot ART.

A quantitative, explorative, descriptive research approach was used to investigate why HIV positive people have a problem with disclosing their status. The HIV infection spread is increasing globally, nationally and locally and disclosing would help reduce the spread of infection through preventive measures. Interviews were conducted with 106 respondents at Kagiso primary health care clinics in the West Rand Health Region. Reasons given by the respondents for non-disclosure of the HIV status were: discrimination, stigma to the HIV positive person and the family by the community, isolation and rejection by the family members, discrimination and possible dismissal at the workplace, fear of losing a partner. The findings illustrate that a large percentage of the population know about HIV and its spread and know that by disclosing, one can get support from health resources and family, but people will not make their status public unless stigmatisation is addressed / Health Studies

A quantitative, explorative, descriptive research approach was used to investigate why HIV positive people have a problem with disclosing their status. The HIV infection spread is increasing globally, nationally and locally and disclosing would help reduce the spread of infection through preventive measures. Interviews were conducted with 106 respondents at Kagiso primary health care clinics in the West Rand Health Region. Reasons given by the respondents for non-disclosure of the HIV status were: discrimination, stigma to the HIV positive person and the family by the community, isolation and rejection by the family members, discrimination and possible dismissal at the workplace, fear of losing a partner. The findings illustrate that a large percentage of the population know about HIV and its spread and know that by disclosing, one can get support from health resources and family, but people will not make their status public unless stigmatisation is addressed / Health Studies / M.A. (Health Studies)

Thesis (MPhil)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: This work provides a comprehensive overview of the South African HIV/AIDS epidemic. It examines the historical and social background of the HIV/AIDS situation and looks at the importance of the media and science communication in combating the effects of the epidemic on society. This research explores the different forms of health communication and the varied benefits of each. Overall, it highlights positive media efforts that have helped redirect the HIV/AIDS epidemic within the social and political context of the HIV epidemic in South Africa. The second half of this work covers the challenges experienced in gaining publicsector antiretroviral treatment and the roles the media have played in informing and mobilizing society for these efforts. Through a community clinic ethnographic case study this work explores the current state of treatment clinics, social challenges experienced in the Usapho Lwethu Clinic of Gugulethu and the future of the HIV/AIDS epidemic in South Africa. / AFRIKAANSE OPSOMMING: Hierdie werk verskaf ‘n omvattende oorsig van die Suid-Afrikaanse HIV/VIGS epidemie. Dit ondersoek die historiese en sosiale agtergrond van die HIV/VIGS toestand en belig die belangrikheid van media en wetenskaplike kommunikasie in die bestryding van die effek van hierdie epidemie op die samelewing. Hierdie navorsing verken die verskillende vorms van gesondheidskommunikasie en die onderskeie voordele van elk. In sy geheel beklemtoon dit die positiewe pogings van die media wat gehelp het met die herkanalisering van die HIV/VIGS epidemie binne die sosiale en politieke konteks in Suid-Afrika. Die tweede helfte van die werk gee 'n oorsig van die rol wat die media speel in die beskikbaarstelling van inligting en die mobilisasie van die publiek en die stryd rondom die verkryging van antiretrovirale behandeling vir die algemene publiek. ‘n Etnies-grafiese gevallestudie van ‘n plaaslike gemeenskapskliniek word gebruik om die huidige toestand in behandelingsklinieke toe te lig asook die sosiale uitdagings in die Usapho Lwethu Kliniek in Gugulethu en die toekoms rondom die HIV/VIGS epidemie in Suid-Afrika.

This research focused on the experiences of HIV disclosure to significant others amongst people living with HIV. The aim of the research was to explore how people living with HIV experience disclosure of their HIV positive status to their significant others. The social constructionist perspective was utilized to gain a deeper understanding of the experience of HIV positive status disclosure to significant others. The study’s sample comprised of five participants who were recruited using purposive sampling strategy. Data was collected with using face to face semi structured interviews. Themes were extracted and analysed using thematic content analysis. An analysis was made as to whom participants choose to disclose to, the reaction of the people they disclosed to, as well as their reasons for disclosing. Results were reported as the participants’ experiences and noted as is or unadulterated. / Psychology / M.A. (Psychology)

The purpose of this study was to develop a laboratory based Comprehensive Care, Management and Treatment of HIV and AIDS (CCMT) programme status reporting system using a methodological research study design. Quantitative data was collected using a request form and qualitative data was collected using structured questionnaires. For the study 1190 eligible CD4 samples were received, of which 1004 (84%) had a valid CCMT programme status. Overall 32% of the CD4 samples had a pre-ART status (n=383) and 52% had an ART status (n=621). The remaining 16% of CD4 samples (n=186) did not have a valid CCMT programme status. A pre-ART register was generated and assessed using a structured questionnaire. Based on the study findings a recommendation has been made to adopt the two-tick design for all NHLS request forms where programmatic data is collected. Additionally the CCMT programme status reporting system is recommended for rollout to other health districts / Health Studies / M.A. (Public Health with specialisation in Medical Informatics)