Text in English / The aim of the study was to describe the competencies of midwives during the provision of immediate postnatal care (PNC) with the intention of adapting and linking international best practice guidelines as well as a conceptual framework for the implementation of PNC in Swaziland. A quantitative cross-sectional design study was conducted to investigate the competencies of midwives during the provision of immediate postnatal care services to mothers and their infants. A systematic random sampling technique was used to select eighty-eight (88) midwives and six (6) senior midwives to participate in the study. Data collection was done using structured questionnaires. Quantitative data was complemented by data that was generated from open-ended questions at the end of the questionnaires. Data analysis was conducted using IBM SPSS Statistics version 22.0 software. The study highlighted that all the midwives who participated in this study had the relevant qualification. Of the respondents, 70.5% were state-certified midwives with a second registered certificate, 27.3% had bachelor’s degrees, while 2.3% had an advanced midwifery certificate. The study found no difference between the type of qualification of midwives and the knowledge of PNC interventions to be offered to mothers immediately post-delivery across different qualifications held by the midwives (Kruskal-Wallis test: x2=5.498, df=2, p=0.064). Gaps were identified in their knowledge and practices. There were discrepancies in the level of knowledge and practices regarding maternal vital sign assessment immediately after delivery (within 30 minutes). It was noted that these vital signs, i.e. blood pressure (12.5%), temperature (50.0%), pulse (54.5%), respiration (63.6%) were not taken after delivery. It was also noted that 15.0%, 58.0%, 64.8% of the respondents were not aware of the importance of assessing newborns for APGAR, skin-to-skin contact and drying the neonate. The study found that there were no postnatal care guidelines in Swaziland. The findings of the study led to the adaption and linkage of the latest international evidence-based guidelines and a conceptual framework for the implementation of immediate PNC to mothers and their infants in Swaziland. / Health Studies / D. Litt. et Phil. (Health Studies)

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)

HIV and AIDS still challenges the best efforts of public health and medical establishments and continues to ravage communities around the world. While measures have been put in place to preclude it from further spread, recent studies in the field of HIV and AIDS prevention intimate that for more efficacious intervention to be realized, it is critical to understand and address the social and cultural practices which influence sexual behavior, particularly understanding how issues of masculinity plays a role in the perpetuation of these behavior. Relying on Bourdieu’s theory of social practice, this study explores the inherent enduring nature of habitus and its role in the production and maintenance of masculine and sexual identities that predispose young men to HIV and AIDS. The study was conducted in Rundu Urban Constituency in Kavango Region of Namibia to gain insight into male youth’s masculinity and conceptions of risk and vulnerability to HIV and AIDS. The study design was qualitative and interpretive in nature. Data collection strategies included focus group discussions and individual interviews. Twelve male youth aged 17-20 years in two secondary schools (six in each) were selected to participate in the study. Four focus group discussions and fourteen individual interviews were conducted. Institutional ethical clearance from both regional education office and the schools were obtained before undertaking the study. Participants also signed written consent forms before interviews started. The findings of this study revealed that young men from this community were under constant pressure to conform to dominant masculine norms and values. Key in the case of youth in the study was the need to procreate as a dominant marker of one’s masculine and sexual identity because it represented a primary source of a ‘real’ man’s social identity in this community. This masculine and sexual identity seemed in itself to be constructed along paternal lines and cultural beliefs, which youth preserved by not only complying, but also reproducing. The sexual activities they reported that would secure their position as `real` men were often those that put them at risk and made them vulnerable to the epidemic.

Racial minority men who have sex with men (MSM) experience greater levels of discrimination and higher rates of HIV infection. However, little is known about the associations between racial and heterosexist discrimination and HIV risk behavior. Further, little is known about the mechanisms of the association between racial and heterosexist discrimination and HIV risk behavior. There is some evidence to suggest that depression may be a mechanism that mediates the relationship between racial and heterosexist discrimination and HIV risk behavior. Thus, one purpose of this study was to investigate the extent to which discrimination based on both race and sexual orientation, alone and in combination, are associated with HIV risk behavior. A secondary purpose of this study was to examine whether the relationship between discrimination and HIV risk behavior is mediated by depressive symptoms. Lastly this study sought to examine whether the relationships between discrimination, depressive symptoms, and HIV risk behavior were mediated by social support, LGBT and Native identity, and LGBT and Native community participation. This study analyzed data from the HONOR project, the first national study of two-spirit individuals, which included 221 American Indian and Alaska Native MSM. Logistic regression analyses were conducted to determine the extent to which experiences of racial and heterosexist discrimination were associated with HIV risk behavior. Results indicate that heterosexist discrimination was associated with HIV risk behaviors, whereas racial discrimination was not. Conversely, results indicate that racial discrimination was associated with depressive symptoms, whereas heterosexist discrimination was not. This study found no association between depressive symptoms and HIV risk behavior, even when accounting for alcohol and substance use. Results indicate that depressive symptoms are not a mechanism that explains the association between discrimination and HIV risk and perhaps the better mechanism to examine in future studies is substance use. Finally, LGBT community participation was shown to have protective effects against HIV risk behaviors. These findings have the potential to guide development of mental health and HIV prevention interventions for Native MSM, with special attention to LGBT community participation and social support. Future research should examine attributes such as types, sources, and frequency of heterosexist discrimination and LGBT community participation.

Aims: The study was aimed at exploring adolescents‟ level of knowledge of HIV/AIDS and the influence this knowledge has on their sexual behaviour. Methods: In total, 20 in- depth interviews were conducted from a group of 20 (both males and females) secondary school learners. The interviews were audio taped with consent from participants. Results: The results of the study showed that participants possess basic knowledge of HIV/AIDS, including methods of prevention and transmission. No serious misconceptions about modes of transmission of HIV were found in this study. Although, participants reported condom use, no sexual intercourse with multiple concurrent partners and no intergenerational sexual relationships, the findings revealed some risk factors such as early sexual debuts, early dating, multiple sexual partnerships. Conclusions: The aforesaid sexual behaviours and the sexual activeness among learners is a cause for angst. Thus, these findings highlighted the need for a comprehensive approach to sexual reproductive health education by all interested parties in order to enhance and sustain behaviour change among young people. / Health Studies / M.A. (Public Health)

Thesis (Mphil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Political instability involving civil wars which had been prevailing mostly within the African Great Lakes Region caused great numbers since the 1990s of civilian populations to move to and fro within the borders and sometimes beyond its frontiers in search of both safer homes and better living conditions. Socio-economic hardships experienced by these people constrained them to engage in various migration movements, thus making them more vulnerable to a variety of diseases and pandemics, among which Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). Sub–Saharan Africa has been bearing the brunt of HIV pandemic, and South Africa is believed to have the highest HIV prevalence. The present study was a quantitative survey exploring personal perception of HIV infection risk among African émigré communities of the Cape Metropolitan area. Only thirty four heterosexual active participants, who had joined their partners in South Africa after a certain period of temporary separation, were considered for final analysis using descriptive statistics. A relatively high perception of HIV infection risk was found among both males and females. However, the perceived risk did not necessarily determine sexual behaviour. No significant reciprocal relationship was found between the perceived risk and one important sexual risk behaviour. HIV and AIDS related stigma was found to be relatively high and the use of condoms prejudiced by tendencies of personal moralistic values. The present study has made relevant recommendations as to promote more preventive behaviours among the present African émigré community. / AFRIKAANSE OPSOMMING: Politieke onstabiliteit wat burgeroorloë meebring kom sedert die 1990’s meestal in die Groot Mere-streek van Afrika voor en het veroorsaak dat groot groepe van burgerlike bevolkings heen en weer tussen grense beweeg en soms grense oorsteek op soek na beter en veiliger tuistes en beter lewensomstandighede. Die sosio-ekonomiese ontberings wat deur hierdie mense ervaar is het hulle verplig om by verskeie migrasiebewegings betrokke te raak. Dit het hulle kwesbaar gemaak vir ’n verskeidenheid siektes en pandemies, waaronder die menslike immuniteitsgebreksvirus (MIV) en verworwe immuniteitsgebreksindroom (Vigs). Sub-Sahara-Afrika het die ergste van die MIV-pandemie getrotseer en Suid-Afrika het na bewering die hoogste MIV-voorkoms. Hierdie studie is ’n kwantatiewe opname wat die persoonlike persepsie van die risiko van MIV-infeksie onder Afrika-uitgeweke gemeenskappe in die Kaapse Metropoolgebied ondersoek het. Slegs 34 heteroseksuele, seksueel aktiewe deelnemers wat na ’n tydperk van tydelike skeiding by hul (lewens) maats in Suid-Afrika aangesluit het, is vir die finale analise oorweeg met behulp van beskrywende statistiek. Onder mans sowel as vroue is ’n relatief hoë persepsie van infeksierisiko gevind. Die waargenome risiko het egter nie noodwendig seksuele gedrag bepaal nie. Geen beduidende omgekeerde verhouding is tussen die waargenome risiko en een belangrike seksuele risikogedragsaspek gevind nie. Daar is bevind dat MIV en Vigsverwante stigma relatief hoog is en dat daar weens tendense van persoonlike moralistiese waardes vooroordeel teen die gebruik van kondome bestaan. Hierdie studie het relevante aanbevelings gedoen om meer voorkomende gedragspatrone onder die huidige Afrika-uitgeweke gemeenskap te bevorder.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: This study attempts to identify HIV/AIDS knowledge gaps and the factors which influence the perceptions of the risks of contracting of HIV/AIDS, in relation to the sexual behavior of high school learners in Port St Johns Municipality. In order to do this, a close ended questionnaire was administered to 116 learners from three senior secondary schools in Port St Johns Municipality. Frequency table counts and percentages were used to describe HIV/AIDS knowledge, the perceptions of the risks of contracting of HIV/AIDS and the risky sexual behaviors by learners. The Pearson Product Moment Correlation was used in the inferential analysis. From the data, it was clear that a significant proportion of learners had gaps in their knowledge of HIV/AIDS. Female senior secondary school learners were slightly more knowledgeable than their male counterparts, in that 60% of the female learners were correct in their knowledge of HIV/AIDS, compared to 57 % of males. According to the data, 58 % of male high school learners correctly interpreted the perceptions of the risks of contracting HIV/AIDS, compared to 56% of their female counterparts. These low percentages suggest that the high school learners have inadequate skills in interpreting the perceptions of the risks of contracting of HIV/AIDS. Another finding was that 74 % of female learners do not engage in risky sexual behaviors which might lead to a contraction of HIV/AIDS, compared to 67 % of male learners. Male learners, as well as the female learners, had a Pearson Product Moment Correlation coefficient: r=0.522 for males and r= -0.268 for females, in terms of perceptions of risks of contracting of HIV/AIDS and engaging in risky sexual behavior. In other words, the results indicate that if males perceive the risks more acutely, they will not take such risks, whereas females are not easily influenced by the perceptions of risks and the way in which they behave. The study recommends that stakeholders of the schools craft HIV/AIDS programmes and policies that bridge the knowledge gaps and reduce or eliminate inaccurate perceptions of the risks of contracting HIV/AIDS, so as to enable learners to adopt safer sexual behaviors. / AFRIKAANSE OPSOMMING: Hierdie studie poog om gapings in MIV/Vigs kennis te identifiseer en die faktore wat die persepsies van die risiko's van die kontraktering van MIV, met betrekking tot die seksuele gedrag van hoërskoolleerders in Port St Johns Munisipaliteit beïnvloed. Ten einde dit te doen, is 'n vraelys geadministreer onder 116 leerders van drie senior sekondêre skole in Port St Johns Munisipaliteit. Frekwensietabel-tellings en persentasies is gebruik om MIV/Vigs kennis te beskryf, die persepsies van die risiko's van die kontraktering van MIV en die riskante seksuele gedrag deur leerders. Die Pearson Produk Oomblik korrelasie is gebruik in die inferensiële analise. Die data toon dat ‘n aansienlike persentasie van die leerders ‘n tekort aan kennis het rakende MIV/Vigs. Vroulike senior sekondêre leerders toon effens meer kennis as hul manlike eweknieë, 60% van die vroulike leerders korrek was in hul kennis van MIV/Vigs, in vergelyking met 57% van die mans. 58% van die manlike hoërskoolleerders het die persepsies van die risiko's van MIV/Vigs korrek geïnterpreteer, in vergelyking met 56% van hul vroulike eweknieë. Hierdie lae persentasies dui daarop dat die hoërskoolleerders onvoldoende vaardighede het in die interpretasie van die persepsies van die risiko's van die kontraktering van MIV. Nog 'n bevinding was dat 74% van vroulike leerders nie betrokke is in riskante seksuele gedrag wat kan lei tot MIV-infeksie nie, in vergelyking met 67% van die manlike leerders. Manlike leerders, sowel as die vroulike leerders, het 'n Pearson Produk korrelasiekoëffisiënt: r = 0,522 vir mans en r = -0,268 vir vroue, in terme van die persepsies van risiko's van kontraktering van MIV/Vigs en betrokke te raak in riskante seksuele gedrag. Die studie beveel aan dat belanghebbendes van skole MIV/Vigs-programme en beleide ontwikkel wat die kennisgapings oorbrug en onakkurate persepsies verminder rakende die risiko van MIV-infeksie, met die doel dat leerder veiliger seksuele gerag sal toon.

Technical and Vocational Education and Training (TVET) colleges have become institutions of choice in the Department of Higher Education and Training (DHET) attracting youth between 15 and 24 years of age. College campuses are an opportune space for mixing of students with Grade 10 equivalence up to students with post-matriculation level. Students who enrol at TVET colleges for the first time are vulnerable to Human Immunodeficiency Virus (HIV) and Acquired Immuno Deficiency Syndrome (AIDS) since they mingle with students of different ages and diverse experiences. Sometimes they can be taken advantage of as the environment is inviting for transactional sex practices, casual and multi-partner sexual relationships with benefactors / “blessers”, promising them the world as angel babies, sugar pups and tuition babies in the sugar bowl of dating scene, hence risky sexual behaviours make college first year students vulnerable to HIV and AIDS. A qualitative research approach was followed underpinned by constructivism as a research paradigm. The theoretical framework followed in this study was the Social Cognitive Theory (SCT). A purposive sampling technique was used and six students who had enrolled in a TVET college as first year students for National Certificate Vocational (NCV) level 2 and were sexually active and willing to talk about the risky sexual behaviours they engaged in, participated during focus group interviews. Three students selected from the six were interviewed individually. The thematic analysis approach was used to identify patterns and themes which were considered for major findings. Findings of the study revealed that TVET college students who are enrolled as first year students in the NCV programme engage themselves in risky sexual behaviours such as transactional sex, casual and multi-partner sexual relationships, not using condoms, putting themselves at risk of contracting HIV. Among factors that were found to be contributing to risky behaviours were that students are away from the supervision of parents, peer pressure, partying, poverty, sugar daddy and sugar mummy (cougar) / Ben 10 with dating life style. / Psychology of Education / M. Ed. (Guidance and Counselling)

The study investigates the influence of online and social media in HIV prevention, with a focus on young women and HIV risk perception related to age-disparate relationships. The study was conducted using an existing online prevention HIV prevention platform by means of a self-administered online questionnaire. Convenience sampling was used to recruit between 250 and 500 users between the ages of 18 to 24 years. The results revealed poor HIV risk perception in 46% of respondents, which seemed influenced by their perception (38%) that older men are safer sexual partners than younger men. In addition, this poor risk perception is seemingly influenced by the fact that many young women (77%) involved in these relationships, viewed these as primarily based on love and affection and as being “safe”, challenging the commonly held perception that these are primarily transactional in nature. Further respondents reported at rates of between 38% and 44% that the platform had improved their HIV risk perception related to these relationships. In summary, the research resulted in several recommendations to improve the platform, including improving ways of getting more and on-going feedback from users on their HIV risk perceptions and designing content and engagement strategies to address these. / Sociology / M. A. (Social Behaviour Studies in (HIV/AIDS)

Aims: The study was aimed at exploring adolescents‟ level of knowledge of HIV/AIDS and the influence this knowledge has on their sexual behaviour. Methods: In total, 20 in- depth interviews were conducted from a group of 20 (both males and females) secondary school learners. The interviews were audio taped with consent from participants. Results: The results of the study showed that participants possess basic knowledge of HIV/AIDS, including methods of prevention and transmission. No serious misconceptions about modes of transmission of HIV were found in this study. Although, participants reported condom use, no sexual intercourse with multiple concurrent partners and no intergenerational sexual relationships, the findings revealed some risk factors such as early sexual debuts, early dating, multiple sexual partnerships. Conclusions: The aforesaid sexual behaviours and the sexual activeness among learners is a cause for angst. Thus, these findings highlighted the need for a comprehensive approach to sexual reproductive health education by all interested parties in order to enhance and sustain behaviour change among young people. / Health Studies / M.A. (Public Health)