MPH / Department of Public Health / Background: Human Immunodeficiency virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) is one of the major public health problems that has negatively impacted mostly orphans leaving in child-headed families in the world. A child- headed family is defined as a family, living under the same roof, which is headed by a person under the age of 18 years. Many of these children have become heads of households and they are obliged to look after themselves and siblings. As a result, some children drop out from school while looking for jobs to sustain the family. Purpose: The purpose of the study is to explore and describe the experiences of children in HIV/AIDS-affected child-headed families in Zimbabwe. Methodology: The researcher employed qualitative approach with explorative, descriptive, contextual and phenomenological designs. Nonprobability purposive sampling was used to select the participant. Children aged between 12-18 years were selected as they were able to narrate their life experiences. In-depth face to face individual interviews were used to collect data pertaining to experiences of children in HIV/AIDS child-headed families. Data was transcribed verbatim, and then translated from Shona to English. The data was then analysed following Tesch’s eight steps model. Findings: The findings of the study revealed that children in HIV/AIDS-affected child-headed families were lacking basic commodities such as food, clothing, shelter and clean water. The findings also revealed that children living in HIV/AIDS-affected child-headed families were being abused physically, sexually, emotionally and verbally. The findings of the study also revealed that children living in HIV/AIDS-affected child-headed families received support from the government, non-governmental organisations, community and relatives. / NRF

Antiretroviral drugs were introduced into Uganda during the past decade and have revolutionised the treatment of AIDS. However, in as much as success was recorded, new challenges emerged. One such challenge was the continued use of condoms. This study investigated existing knowledge, attitudes and practices of condom use in a time of highly active antiretroviral therapy in a rural area. A quantitative, cross sectional design, with probability sampling form the general population was utilised. A self-designed questionnaire was used to collect data which was then analysed at the descriptive statistics level. The results indicated that: knowledge of HIV, its transmission, condoms and antiretroviral drugs were high among the respondents; condom acceptance and use were low; and respondents would not intentionally engage in unprotected sexual intercourse because of availability of ARVs. However it was acknowledged that some people taking ARVs have engaged in risky sexual behaviours that would expose others to infection. / Health Studies / M.A. (Public Health)

Antiretroviral drugs were introduced into Uganda during the past decade and have revolutionised the treatment of AIDS. However, in as much as success was recorded, new challenges emerged. One such challenge was the continued use of condoms. This study investigated existing knowledge, attitudes and practices of condom use in a time of highly active antiretroviral therapy in a rural area. A quantitative, cross sectional design, with probability sampling form the general population was utilised. A self-designed questionnaire was used to collect data which was then analysed at the descriptive statistics level. The results indicated that: knowledge of HIV, its transmission, condoms and antiretroviral drugs were high among the respondents; condom acceptance and use were low; and respondents would not intentionally engage in unprotected sexual intercourse because of availability of ARVs. However it was acknowledged that some people taking ARVs have engaged in risky sexual behaviours that would expose others to infection. / Health Studies / M.A. (Public Health)

Employee involvement and participation in HIV-prevention interventions at the workplace remains a barrier to effective programme implementation, which contributes significantly to programme failure and the consequent continued spread of HIV among employees at the workplace. This study explores employee involvement and participation in HIV-prevention interventions at a Bulawayo tyre manufacturing firm. It assesses factors affecting employee involvement and participation in these interventions, and examines the implications of these findings for programme implementation. I used a semi-standardised interview schedule to conduct in-depth, face-to-face qualitative interviews and a self-administered questionnaire to collect quantitative data. The responses showed the nature of employee involvement in HIV-prevention at the firm was at a co-option level, and the type of participation was mere token participation. I recommended that the firm should develop a clear understanding of the importance of stakeholder involvement in HIV-prevention programmes. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

This study was an attempt to investigate the influence of socio-cultural factors on HIV prevention strategies among HIV discordant couples in Harare, Zimbabwe. HIV sero-discordance is a scenario whereby one partner is HIV-positive and the other is HIV-negative. HIV sero-discordant couples are a unique and vulnerable population that encounters many peculiar challenges. When dealing with this population, researchers have to deal with contradictory ideas and perceptions presented by each partner making up the couples and also understand the relationship in the context of cultural values, norms and the dynamic of power and oppression. In addition to this, the concept of HIV sero-discordance and the frequency of its occurrence are poorly understood in most African communities. Despite the growing evidence of HIV discordance, HIV prevention strategies have largely focused on clinical aspects at the expense of socio-cultural issues that impact on HIV prevention strategies targeted at HIV sero- discordant couples. The study seeks to contribute to the conceptualization and design of intervention programs dealing with sero-discordance. The study is underpinned by the symbolic interactionism theory and was qualitative in design involving 13 HIV discordant couples in heterosexual relationships enrolled in the HIV Preventions Trials Network 052 Study (HPTN 052 Study) being undertaken by the University of Zimbabwe’s department of medicine. The study utilized 2 Focus Group Discussions (FGD) and 10 in-depth interviews (IDI) to collect data. The study’s findings indicate that discordant couples are in fact critical stakeholders in the uptake of all the available HIV prevention strategies. Failure to acknowledge this tenet is self-defeating as evidenced by the perception of viewing condom use within a marriage as humiliating for a woman. The study further noted that practitioners in the HIV prevention domain must guard against over-relying on the scientifically demonstrated efficacy of the strategies. The study recommends that HIV prevention strategies must be socially and culturally acceptable and embedded for them to be more efficacious. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)

The study examined the sexual and reproductive health needs of adolescents infected with HIV and AIDS. This was a qualitative study that involved semi-structured interviews and observation. The sampling method used was purposive and it entailed 10 adolescents (4 boys and 6 girls) who are living with HIV at Chiedza Child Care Centre in Zimbabwe. This study revealed that adolescents’ sexual and reproductive health needs are the desire to have sex, desire to have children, the need for prevention of unwanted pregnancy and care and treatment support. However, their knowledge of HIV and AIDS was inadequate. Adolescents also revealed their lack of proper information regarding their health care and treatment needs. However, adolescents illustrated an adequate knowledge of the services available for them for their health, treatment and care needs. The study recommended that there is need to strengthen the provision of information and services on adolescents’ sexual and reproductive health issues. The study also recommended that counsellors should improve their counselling skills so that they can empower adolescents living with HIV to be able to negotiate condom usage, matters of dating and handling relationships. / Sociology / M. A. (Social Behaviour Studies in HIV and AIDS)

This study was an attempt to investigate the influence of socio-cultural factors on HIV prevention strategies among HIV discordant couples in Harare, Zimbabwe. HIV sero-discordance is a scenario whereby one partner is HIV-positive and the other is HIV-negative. HIV sero-discordant couples are a unique and vulnerable population that encounters many peculiar challenges. When dealing with this population, researchers have to deal with contradictory ideas and perceptions presented by each partner making up the couples and also understand the relationship in the context of cultural values, norms and the dynamic of power and oppression. In addition to this, the concept of HIV sero-discordance and the frequency of its occurrence are poorly understood in most African communities. Despite the growing evidence of HIV discordance, HIV prevention strategies have largely focused on clinical aspects at the expense of socio-cultural issues that impact on HIV prevention strategies targeted at HIV sero- discordant couples. The study seeks to contribute to the conceptualization and design of intervention programs dealing with sero-discordance. The study is underpinned by the symbolic interactionism theory and was qualitative in design involving 13 HIV discordant couples in heterosexual relationships enrolled in the HIV Preventions Trials Network 052 Study (HPTN 052 Study) being undertaken by the University of Zimbabwe’s department of medicine. The study utilized 2 Focus Group Discussions (FGD) and 10 in-depth interviews (IDI) to collect data. The study’s findings indicate that discordant couples are in fact critical stakeholders in the uptake of all the available HIV prevention strategies. Failure to acknowledge this tenet is self-defeating as evidenced by the perception of viewing condom use within a marriage as humiliating for a woman. The study further noted that practitioners in the HIV prevention domain must guard against over-relying on the scientifically demonstrated efficacy of the strategies. The study recommends that HIV prevention strategies must be socially and culturally acceptable and embedded for them to be more efficacious. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Medical male circumcision (MMC) has emerged as one of the Human Immunodeficiency Virus (HIV) prevention methods for HIV negative men engaged in heterosexual contact. Many studies have documented its efficiency in reducing the risk of contracting HIV infection in men. Because of that, Zimbabwe like other countries in the Southern Africa region, with generalised HIV infections is finding ways to scale-up MMC in non-circumcised communities. This study searched for knowledge, perceptions and attitudes of males in Bindura urban towards MMC. Bindura is the capital city of the Mashonaland Central Province of Zimbabwe. This town has diverse people with different social backgrounds who economically depend on the surrounding mines and commercial farms. Given the enormous differences in culture, religion, social and value systems among these people it was of particular importance to understand how they perceive medical male circumcision. Methodology: The study was conducted using quantitative data collection method. Random selection was done to choose respondents and age was used to determine eligibility to the study. The qualifying age was 18-49 and a sample size of 60 was considered to be appropriate taking into consideration financial and time associated with large samples. Structured questionnaire with open-ended and closed questions were used to gather data. Likert scale was used on some questions to determine perceptions and attitudes of respondents. The questionnaires used to solicit information did not require respondent to provide his name for purposes of maintain confidentiality but contained identification number. In some cases, Chi-square test for independence was conducted to test for associations between demographic characteristics and observed responses. Comparison of responses between the age groups 18-29 and 30-49 years were also done to determine if there were some differences in representations of respondents in observed responses. Results: The study aimed to assess knowledge, perceptions and attitudes of males in Bindura urban towards MMC and barriers they were confronting in accessing MMC. Respondents showed high level of awareness about HIV/AIDS intensity in Zimbabwe. Male circumcision (MC) was perceived by the majority of respondents as important in curbing HIV infections. A significant proposition of respondents regarded medical reasons as the most common reason why people undergo MC. However respondents demonstrated poor knowledge or understanding of other strategies that must be used in conjunction with MC. Risks associated with operation, its cost and protection of confidentiality and consideration of family concerns were considered by respondents as barriers to MMC. Availability of accurate information about MMC and easing of access to MMC services were considered to be very important facilitating factors. Religious and cultural reasons and stigma from peers and friends were considered non barriers. Statistically significant associations were only detected between MMC being motivated by medical reasons and demographic characteristics of age and marital status and also an association between education level and stigma as a barrier for MMC. The study failed to show a significant association between other observed responses and demographic characteristics. / AFRIKAANSE OPSOMMING: Agtergrond: Mediese manlike besnyding (MMB) het na vore gekom as een van die metodes vir die voorkoming van die oordrag van die menslike immuniteitsgebreksvirus (MIV) deur MIV-negatiewe mans betrokke by heteroseksuele kontak. Baie studies het reeds die doeltreffendheid daarvan ten opsigte van die vermindering van die risiko van MIV-infeksie by mans gedokumenteer. As gevolg daarvan is Zimbabwe, soos ander lande in die Suider-Afrika-streek met algemene MIV-infeksies, op soek na maniere om MMB by onbesnyde gemeenskappe uit te brei. Hierdie studie wou kennis, persepsies en gesindhede van manlike persone in die Bindura-stadsgebied ten opsigte MMB bepaal. Bindura is die hoofstad van die sentrale provinsie Masjonaland in Zimbabwe. Hierdie stad word bewoon deur diverse mense met verskillende maatskaplike agtergronde wat ekonomies van die omliggende myne en kommersiële plase afhanklik is. Gegewe die groot verskille in kultuur, godsdiens, maatskaplike en waardestelsels onder hierdie mense, was dit van besondere belang om te begryp hoe hulle mediese manlike besnyding verstaan. Metodologie: Die studie het van die kwantitatiewe data-insamelingsmetode gebruik gemaak. Ewekansige seleksie is gebruik om respondente te kies en ouderdom is gebruik om geskiktheid vir deelname aan die studie te bepaal. Die kwalifiserende ouderdom was 18-49 jaar en ʼn monstergrootte van 60 is geskik beskou in ag geneem finansiële beperkinge en tyd verbonde aan groot monsters. ʼn Gestruktureerde vraelys met oop en geslote vrae is gebruik om data in te samel. ʼn Likert-tipe skaal is by sommige vrae gebruik om persepsies en gesindhede van respondente te bepaal. Die vraelyste wat gebruik is om inligting te ontlok, het dit nie vir respondente nodig gemaak om hulle name te verskaf nie ten einde vertroulikheid te verseker, maar het ’n identifikasienommer bevat. In sommige gevalle is die chi-kwadraattoets vir onafhanklikheid gedoen om te toets vir verbande tussen demografiese eienskappe en response wat waargeneem is. Vergelyking van response tussen die ouderdomsgroepe 18-29 en 30-49 jaar is ook gedoen om te bepaal of daar enige verskille in verteenwoordigings van respondente in die waargenome response was. Resultate: Die studie wou kennis, persepsies en gesindhede ten opsigte van MMB by manlike persone in die Bindura-stadsgebied en hindernisse waarvoor hulle te staan kom ten einde toegang tot MMB te verkry, bepaal. Respondente het ʼn hoë vlak van bewustheid omtrent die intensiteit van MIV/VIGS in Zimbabwe getoon. Manlike besnyding (MB) is deur die meerderheid respondente as belangrik by die beperking van MIV-infeksies beskou. ʼn Beduidende aantal respondente het mediese redes gesien as die algemeensien rede waarom mense MB ondergaan. Respondente het egter swak kennis of begrip van ander strategieë wat tesame met MB gebruik moet word, getoon. Risiko’s geassosieer met die operasie, die koste daarvan en beskerming van vertroulikheid en agting vir die familie se bekommernisse is deur respondente as hindernisse met betrekking tot MMB beskou. Beskikbaarheid van akkurate inligting omtrent MMB en vergemakliking van toegang tot MMB-dienste is gesien as baie belangrike fasiliterende faktore. Godsdienstige en kulturele redes en stigmatisasie deur portuurs en vriende is nie as hindernisse beskou nie. Statisties beduidende verbande is slegs tussen MMB gemotiveer deur mediese redes en demografiese eienskappe van ouderdom en huwelikstatus bespeur en ook ʼn verband tussen opvoedingspeil en stigma as ʼn hindernis vir MMB. Die studie het nie daarin geslaag om ʼn beduidende verband tussen ander waargenome response en demografiese eienskappe aan te toon nie.

Non-timber forest products (NTFPs) constitute an important source of livelihood for most poor rural households and communities in Zimbabwe. NTFPs also serve as a vital livelihood safety net in times of hardship. An important feature of this dependence is that almost all NTFPs are deemed to have ‘public good’ characteristics, with no exclusive property rights. Consequently, extraction is often intense and exhaustive because of lack of alternative income sources, unreliable productivity and weak enforcement of institutional arrangements governing NTFPs use. In recent years, with HIV/AIDS rampant in Zimbabwe, there are indications of a rapid increase in the extraction of NTFPs, mostly from common property resources. Appropriate natural resources policies need to be based on comprehensive research, yet to date scant attention has been paid to understanding the role of NTFPs in mitigating the predicaments of HIV/AIDS-affected households in Zimbabwe. The main objective of this study was to determine the types of and need for natural resource management interventions to help ensure the sustainability of local responses to HIV/AIDS. The research focused on five communities of Sengwe Communal in the Chiredzi district, Zimbabwe. Multistage cluster sampling was used to select ten villages and households for the survey. Two villages from each community, representing the most and the least affected by epidemic were selected for each community using stratified random sampling. A cluster analysis was used to improve understanding of the challenges of rural livelihoods and how households diversify their livelihood strategies to cope with the various constraints. Five dominant groups based on their livelihood diversification patterns were identified : (1) smallholders/unskilled workers; (2) subsistence smallholder/non-timber forestry products harvesters; (3) crop production and non-timber forestry products extraction integrators; (4) commercial smallholders with regular off-farm employment; and (5) specialised commercial livestock producers. Multinomial logit model results showed that the level of education of the household head, the value of physical assets, cattle numbers and income, remittances, NTFPs income and economic shocks were the main determinants of these livelihood choices. Empirical evidence also revealed that households that were statistically significantly affected by HIV/AIDS economic shocks practised ‘distress-push’ diversification by extracting NTFPs. These results suggest that policy makers need to advise rural households on how to improve their risk management capacities and move from geographically untargeted investments in livelihood assets to a more integrated approach adapted to the asset base of individual households. Using panel data from 200 households in 2008 and 2009, regression models revealed that NTFPs extraction is an important ex-post coping mechanism for many HIV/AIDS-afflicted households. The results also revealed that the main determinants of livelihood strategy choices were differences in asset endowment, especially education, land and livestock and the impact of the shock. Asset constraints compelled diversification into lower-return activities such as NTFPs extraction. Findings from a comparative analysis of HIV/AIDS-afflicted and non-afflicted households showed that HIV/AIDS-afflicted households were relatively young, with relatively few physical and livestock assets. A fixed-effect Tobit model indicated a positive significant relationship between HIV staging and quantity of NTFPs extracted. The relatively young, poorly educated households with low household coping capacity in terms of livestock value relied more on the natural insurance of forests in buffering HIV/AIDS economic shocks. These results have important policy implications for development planners, conservationists and non-governmental organisations working in the region. There is a need for programmes that reduce pressure on forest resources, and improved access to education and health care, thus helping the poor to cope with the HIV/AIDS economic crisis. This study also examined the extent to which forest degradation is driven by existing common property management regimes, resource and user characteristics, ecological knowledge and marketing structure. A Principal Component Analysis indicated that the existence of agreed-upon rules governing usage (including costs of usage), enforcement of these rules, sanctions for rule violations that are proportional to the severity of rule violation, social homogeneity, and strong beliefs in ancestral spirits were the most important attributes determining effectiveness of local institutions in the management of Common Pool Resources (CPRs). Empirical results from an ordinary least regression analysis showed that resource scarcity, market integration index, and infrastructural development lead to greater forest resource degradation, while livestock income, high ecological knowledge, older households, and effective local institutional management of the commons reduce forest resource degradation. The results suggest that there is a need for adaptive local management systems that enhance ecological knowledge of users and regulates market structure to favour long-term livelihood securities of these forest-fringe communities. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2010.

Employee involvement and participation in HIV-prevention interventions at the workplace remains a barrier to effective programme implementation, which contributes significantly to programme failure and the consequent continued spread of HIV among employees at the workplace. This study explores employee involvement and participation in HIV-prevention interventions at a Bulawayo tyre manufacturing firm. It assesses factors affecting employee involvement and participation in these interventions, and examines the implications of these findings for programme implementation. I used a semi-standardised interview schedule to conduct in-depth, face-to-face qualitative interviews and a self-administered questionnaire to collect quantitative data. The responses showed the nature of employee involvement in HIV-prevention at the firm was at a co-option level, and the type of participation was mere token participation. I recommended that the firm should develop a clear understanding of the importance of stakeholder involvement in HIV-prevention programmes. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)