HIV incidence rates have been on the decline globally, yet certain sub-populations have seen their incidence rates increase, bearing an extraordinary share of the HIV disease burden. In Eastern and Southern Africa, the rate of new HIV infections disproportionately affects adolescent girls and young women (AGYW) with up to three times as many young women ages 15-24 living with HIV as compared to their male peers. These statistics make AGYW a key demographic for action in order to realize an AIDS-free generation. To most effectively intervene, researchers must examine the rationale for higher infection rates among young females. Recent studies have found positive correlation between economic strengthening interventions (such as cash transfers, savings accounts, or financial literacy) and HIV sexual risk among AGYW, however, the majority of the literature to date understands these economic strengthening interventions at the household level, as a mechanism for providing insurance against economic shocks and as an incentive for keeping girls in school, a key predictor of reduced HIV. Fewer studies have sought to understand how increased resources, and power over those resources, affects the thoughts and behaviors of AGYW at the individual level. Does this enhanced agency translate into greater power in intimate relationships? Does she feel more entitled to make decisions over her own body once she has the power to meet her own basic needs? And does agency over her body inevitably translate to fewer HIV risk behaviors? This three-paper dissertation examines data collected with AGYW living in two urban areas, characterized by HIV prevalence. These areas are the sites of a multi-sectoral DREAMS program, a public-private partnership to reduce HIV incidence in ten countries within sub-Saharan Africa. Paper 1 examined the construct of financial agency through the development of a scale, finding variations in experience of financial autonomy between age cohorts with younger adolescents’ autonomy correlated to a higher likelihood of being sexually active and exposure to partner violence. Financial agency was not strongly associated with HIV risk reduction variables at any age. Paper 2 sought to understand the correlational relationships between personal financial agency, sexual relationship power (SRP), and reduced sexual HIV risk for AGYW in Zambia in order to determine if SRP may be a potential mediator between financial agency and sexual HIV risk reduction. Paper 2 found that SRP within sexual relationships did convert to HIV protective behaviors and that while financial agency did correlate with SRP for the oldest cohort, financial agency on its own was not sufficient to reduce sexual HIV risk. Paper 3 explored how AGYW in Zambia understand financial agency as a construct and how it does or does not affect their power in intimate relationships. This study demonstrated that financial independence is an aspiration of AGYW, however, that autonomy is tied up with negative community-based perceptions about what it means to be a woman earning and with control over her own income. Financial independence has promise as a mechanism for sexual HIV risk reduction, specifically the reduction of transactional sex; however, the realities of male sexual privilege may remain an obstacle to risk reduction irrespective of financial decision-making power. Women’s sexual agency was viewed as far greater in non-martial relationships as opposed to within marriage, where religious mores on headship created a power imbalance. Overall, findings from this dissertation contribute empirically to the literature on economic strengthening and HIV prevention for AGYW, providing new insights on the influence of individual financial agency. Findings suggest a nuanced relationship between financial agency and sexual HIV risk reduction, one that is not necessarily linear or positively correlated. HIV prevention programs that wish to incorporate economic strengthening into their multi-sectoral models should consider the influence of gender norms and sexual relationship power which could continue to keep AGYW in positions of vulnerability regardless of their financial autonomy.

Thesis (Ph. D.)--University of Hawaii at Manoa, 2004. / Includes bibliographical references (leaves 174-184). / Also available by subscription via World Wide Web / xv,184 leaves, bound ill. 29 cm

Refugees are not a new phenomenon and their plight has been felt the world over. Africa continues to see large numbers of people displaced through armed conflict, producing more refugees on the worlds&rsquo / most poverty stricken continent than any other.<br /> The implications of these displacements of people dislocated from their places of habitual residence create much concern, particularly in the wake of the HIV/AIDS pandemic. Such dislocations and displacements imply separation from family and communities, including socio-economic benefits that accrue to them. There is an apparent problem of accessing health services, educational services, sources of livelihood and protection from sexual and emotional abuse. Refugee children and women are said to be the most vulnerable, although until recently adolescents in armed conflict were not considered as a<br /> special group of children requiring special attention. The main objective of this research was to investigate levels of risk for HIV among refugee adolescents in Zambia and to determine how location relates to risk. Of particular interest was the difference in risk experienced in rural and urban areas. The researcher&rsquo / s hypothesis was that refugee adolescents in rural camps of Zambia are at greater risk because they lack adequate sources of income, health, and education in comparison to urban areas. The research was located within two theoretical underpinnings namely the social cognitive theory and the AIDS Risk Reduction Model (ARRM). The theory posits that a reciprocal relationship exists between environmental contexts, personal factors and behavior. The model explains how people change behavior that reduces risk for HIV by changing perceptions on sexual activity and when they enact the knowledge obtained from HIV preventive programmes. The methodology was located within both the qualitative and quantitative research<br /> approaches. Qualitative because firstly, the research is a comparative case study and secondly, it is the first time such a study is being conducted. The researcher also made use of the quantitative through the survey and secondary HIV/AIDS statistical data.

This dissertation examines how Black and Latino men who have sex with men (MSM) are making sense of the contemporary HIV/AIDS epidemic and their relation to it. Black and Latino MSM in the United States are disproportionately impacted by HIV. Interdisciplinary scholarship on the matter has conceptualized risk as an intrinsic facet of HIV. However, this research has paid little attention to the process by which Black and Latino MSM form their HIV risk perceptions. In this dissertation, I advance the “risk ecology framework” as a novel socioecological approach for understanding risk perception. This framework conceives of HIV risk perception as emerging from individuals’ relationship to HIV as shaped by the intersecting influences of the broader social environment. I base my analysis on 40 in-depth semi-structured interviews with HIV-negative Black and Latino MSM in New York City, as well as a year of participant-observation with a health advocacy group that serves this community. I find respondents form their risk perceptions by reflecting on HIV vis-à-vis their respective and distinctive social locations. The intersections of race, class, and sexuality come to be associated with HIV risk across the ecological levels of an individual’s lived experience, revealing a risk ecology, or a set of interrelated potential threats posed by HIV. I find this risk ecology to be reflected in Black and Latino MSM’s framing of HIV as a risk to their bodily health and social wellbeing, on the one hand. Or, its framing as personally irrelevant, on the other. Relationships and interactions with family, friends, and romantic/sexual partners inform what Black and Latino MSM understand HIV to potentially threaten. Respondents and the people in their lives draw upon culturally-available discourses, rhetoric, and beliefs concerning HIV that reflect how the institutionalization of racial, social, and sexual inequalities structure risk perception. With respect to health-relevant behaviors, I demonstrate how the analysis of risk perception formation clarifies the ways in which Black and Latino MSM make use of preventative tools and construct meanings about sex. I conclude with a discussion of the broader implications of the risk ecology framework for future health policy and further sociological research. By interrogating what it means to be at-risk, this dissertation lends crucial insight into the persistence of the HIV epidemic at a time when the means to end it are available, and also enriches sociological understandings of risk both within and beyond the public health domain.

By gathering information from a volunteer sample of men who sleep with men (MSM) in the Johannesburg inner city, the study aimed to discover those decisions and behaviour that influence their health decision-making and health-seeking behaviour, particularly as far as HIV and their sexual health was concerned. Eleven in-depth interviews were conducted by three interviewers using a semistructured interview guide which asked questions on demographics, health-seeking behaviour, sexual orientations and behaviour, knowledge of HIV/AIDS and community support. During analysis, collected data was classified into the themes of access to health care, personal and general MSM HIV risk perceptions, sexual behaviour, alcohol and unprotected sex, prostitution, religion and stigma, violence and discrimination. This study was the first qualitative study researching MSM in the Johannesburg inner city and provides useful baseline information for further qualitative MSM studies in the geographical area and for the development of MSM aligned interventions. / Sociology / M.A. Sociology

Thesis (MPhil)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: While there has been several studies that have been conducted targeting university students at state owned universities in South Africa, specifically on the impact of HIV/AIDS epidemic, no extensive study was conducted to establish what informs adoption of high risk sexual behaviour among university students in the context of HIV, STI and unplanned pregnancy epidemics at any of the state owned South African universities, let alone private universities. In order to address this identified gap in the body of knowledge, a cross-sectional study underpinned by the ‘social norms’ theory was undertaken at a private university in the Gauteng Province, South Africa to establish why undergraduate students engage in high risk sexual behaviour that puts them at risk of contracting HIV, STIs and unplanned pregnancy. Quantitative data was collected from 342 students through a questionnaire and qualitative data was collected from 38 students through the focus group discussions. Findings revealed that early sexual debut, intergenerational sex, multiple and concurrent partners, unprotected sex, sex under the influence of alcohol and illegal drugs and transactional sex constitute high risk sexual behaviour. The study concluded that peer pressure, independence, financial needs, drug and alcohol abuse, fear of being an outcast, need to identify with modernity, lack of individual perception of risk, campus culture and sexual partner influence are the factors influencing the adoption of high risk sexual behaviour on campus. Based on the findings and conclusions, recommendations are provided for the development of an HIV prevention programme on campus that is aimed at mitigating the negative consequences of the HIV/AIDS, STIs and unplanned pregnancy epidemics. / AFRIKAANSE OPSOMMING: Die literatuur toon aan dat daar alhoewel daar wel studies onderneem is ten einde die impak van die MIV epidemie onder studente aan openbare universiteite te bepaal onderneem is, daar nog steeds baie min kennis in hierdie verband bestaan. Die faktore wat ‘n rol vervul in hoërisiko seksuele gedrag onder studente aan hierdie universiteit is grootliks onbekend. Ten einde hierdie gaping te probeer oorbrug is hierdie studie onderneem aan ‘n privaat universiteit in Gauteng provinsie in Suid-Afrika. Die doel van die studie was om vas te stel wat voorgraadse studente motiveer om hoë seksuele gedrag te beoefen, wetende dat hulle hulleself blootstel aan MIV-infeksie en onbeplande swangerskappe. ‘n Steekproef van 342 student is in die studie gebruik en ‘n vraelys is deur hulle voltooi. ‘n Verdere 38 student het deelgeneem aan ‘n fokusgroepbespreking. Resultate toon aan dat studente dikwels meer as een seksuele maat het; dat seks beoefen word terwyl studente onder die invloed van alkohol is; dat seks dikwels onbeskermend plaasvind en dat alle hierdie faktore bydraend is tot hoë blootstelling aan MIV-infeksie. Die studie het verder gevind dat groepsdruk, finansiële probleme, dwelm- en alkoholmisbruik en groepsdruk verdere bydraende faktore tot hoë-risiko gedrag onder studente is. Resultate van die studie is gebruik om aanbevelings te maak vir die ontwikkeling van ‘n MIV-voorkomingsprogram wat daarop gerig is om die oordrag MIV en onbeplande swangerskappe aan die universiteit ( wat in die studie ondersoek is ) te bekamp.

By gathering information from a volunteer sample of men who sleep with men (MSM) in the Johannesburg inner city, the study aimed to discover those decisions and behaviour that influence their health decision-making and health-seeking behaviour, particularly as far as HIV and their sexual health was concerned. Eleven in-depth interviews were conducted by three interviewers using a semistructured interview guide which asked questions on demographics, health-seeking behaviour, sexual orientations and behaviour, knowledge of HIV/AIDS and community support. During analysis, collected data was classified into the themes of access to health care, personal and general MSM HIV risk perceptions, sexual behaviour, alcohol and unprotected sex, prostitution, religion and stigma, violence and discrimination. This study was the first qualitative study researching MSM in the Johannesburg inner city and provides useful baseline information for further qualitative MSM studies in the geographical area and for the development of MSM aligned interventions. / Sociology / M.A. Sociology

Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2018 / Health risks are continuing to be a challenge worldwide. Globally, young people aged 15-24 are amongst the most vulnerable groups. It was revealed that between 2007 and 2010, the rate of HIV infection increased in this age group. In sub-Saharan Africa, three out of four new HIV infections are amongst girls aged 15 to 19 years of age. Young women aged 15 to 24 are twice more likely to live with HIV than men in 2019. South Africa is the country with the largest human immunodeficiency virus (HIV) infected population in the world, with an estimated 7 million people living with HIV and 380 000 new HIV infections in 2015. University students are a very important group of young people because they are being prepared for the world of work and to assume leadership roles. However, they are the group most exposed to a range of health risks, particularly regarding sexuality and HIV/AIDS. The aim of this study was to explore potential health risk factors amongst students at a Higher Education Institution (HEI) in the Western Cape with regard to sexuality and HIV/AIDS. The objectives of the study were to explore the factors that may increase health risk behaviours amongst students at an HEI and to discover and describe the knowledge university students have regarding potential health risks related to sexuality and HIV/AIDS. A qualitative research design was employed. Focus group interviews were done to collect data and a thematic content analysis was employed to analyse the data. Results revealed that the university students engaged in high-risk sexual behaviours, such as transactional sex, casual sex, multiple partner sexual relationships and unprotected sex. Such behaviours lead to a high-risk of contracting STIs and HIV/AIDS. Among the factors that were found to be contributing to these risky behaviours, was the new-found freedom of being away from the supervision of parents. Peer pressure at HEIs, as well as abuse of alcohol and drugs, also contribute to risky behaviours. Recommendations were that there should be organised and measured approaches to expose both lecturers and the students to HIV/AIDS education through an integrated curriculum design. There should be teamwork amongst lecturers, support staff and students to create powerful discussions and an exchange of ideas to clarify issues regarding HIV/AIDS, sexuality and other related topics to reduce high-risk behaviours and promote solid constructive attitudes amongst the university community.

This study examined relationships among ethnic identity, gay identity, sexual sensation seeking, and HIV risk-taking behaviors among 302 men of color recruited from gay bars, bathhouses, community agencies, and the 1998 United States Conference on AIDS. The sample included 24% African American, 28% Latino, 25% Asian/ Pacific Islander, 19% Caucasian, 1% American Indian, and 3% other ethnicity. Logistic regression analysis identified sexual sensation seeking, having an undefined gay identity, being in a sexually exclusive relationship, not being HIV seronegative, and length of stay in the country (for those born overseas) as significant predictors of unprotected anal intercourse (insertive and penetrative) among men of color who have sex with men.

This study explored preparatory students’ perceptions of the risk of contracting the Human Immuno-deficiency Virus (HIV) and sexually transmitted infections (STIs) in Ethopia. It utilised a non-experimental exploratory survey methodology. A range of findings was revealed. Most respondents (67.14%) were knowledgeable about HIV/AIDS and more than half of the respondents knew about STIs. A significant number of respondents (67.1%) were able to describe HIV transmission prevention methods. Twenty one percent of respondents were sexually active and 17.0% of these reported to have used condoms. Twenty nine percent and 4.25% of the respondents had selfperceived risk of contracting HIV infection and STIs respectively. In spite of increased awareness of HIV/AIDS, school youths still engage in high-risk sexual activities and believe that they are unlikely to contract the disease. The study findings have implications for practice, and recommendations are offered for further research / Health Studies / M.A. (Public Health)