Thesis (M. A. (Social Work)) -- University of Limpopo, 2004. / The aim of this study was to explore the impact of culture on the prevention and reatment of HIV/AIDS amongst people in low-resourced areas like Malamulele. he study focused on the lifestyles, beliefs, attitudes and perceptions around ultural elements and practices, which might impact negatively on the prevention nd treatment of the HIV/AIDS epidemic. There were three groups of research espondents namely: learners from three high schools in Malamulele, some arents of the learners and the traditional/cultural leaders. The researcher ollected both qualitative and quantitative data. The data was gathered through he use of an interview schedule (questionnaire), focus group discussions and ound-table discussion sessions. The data was presented, analysed and nterpreted by means of tables and charts. t was found that people in low-resourced (rural) areas have little knowledge about HIV/AIDS, causes, symptoms and how the disease is transmitted. Despite the fact that awareness and educational campaigns and programmes are being rendered, people in low-resourced (rural) areas have little knowledge and needed skills about prevention and treatment of the pandemic. Polygamy and extra-marital relations by men is still highly valued and viewed at high esteem. Religious structures seem to be detached to the issue of HIV/AIDS as they mentioned that talking about HIV/AIDS is immoral and against their principles. The study also tried to explore the extent to which people in low-resourced areas view and use condoms as a protective means.

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 Montana, 2007. / Title from title screen. Description based on contents viewed Apr. 2, 2007. Includes bibliographical references (p. 87-92).

No description available.

Background AIDS as a burden to all over the world caused serious problems in some developing regions by threatening health of the population and stability of the society, especially in cross-border areas that have a complex crowd with many migrants. The HIV/AIDS situation of cross-border FSWs in China-Burma border region is not comprehensively known so far. Only have a clearly understanding of their circumstances, can health workers provide target health services for them. Objectives In view of the increasing HIV epidemic in China-Burma border areas in the past several years, this study tries to understand the HIV prevalence among two groups of cross-border FSWs; further describe socio-demographic characteristics in each group; identify risk behaviours related to consistent condom use; interpret HIV risk factors that contribute to HIV infection in each group of FSWs; describe health services currently being provided and particular health services needs of these FSWs. Methods This cross-sectional research design comprises two parts. Part one is a questionnaire based face-to-face interview to obtain self-reported information. A total of 142 cross-border FSWs were recruited from Ruili City, China (Burmese FSWs) and Laukkai City, Burma (Chinese FSWs). Convenience sampling method was used. Risk factors that mutually adjusted were analysed in two logistic regression models regarding condom use and HIV infection in each group and odds ratios (ORs) were obtained with 95% confidence intervals (CI). Part two of this study is voluntary venous blood drawing and testing for HIV infection. 136 cross-border FSWs [6 of part one (questionnaire interview) participants refused] attended part two study. Results In general, Burmese cross-border FSWs tended to be older, lower educated and married and had higher HIV prevalence (18.8%) compared with Chinese women (5%). Frequency of condom use with the paying clients was higher than with the regular partners in both groups. After adjustment, drug users had statistically significant OR of 6.89 (95% CI: 1.12 to 42.38) for condom use frequency in last sex behaviour compare to non-users in Burmese FSWs; based on Chinese FSWs’ condom use model, the more paying clients, the higher frequency of condom use they had (OR: 0.63 with 95% CI: 0.45 to 0.9). Age (year of birth) had a significant impact with two opposite direction on HIV infection in both Burmese group and the whole study population: positively relate to HIV infection in Burmese model (OR: 1.20 with 95% CI: 1.02 to 1.41); nevertheless, when Chinese ones were added, year of birth negatively related to HIV infection with OR of 0.84 (95% CI: 0.74 to 0.96). Generally, Burmese women had proportionally higher health services acceptance proportion to Chinese women. “HIV/AIDS awareness” and “HIV counselling and testing” were the most widely provided services in Burmese and Chinese group, respectively, and “free condom distribution” was the most needed health services of both cross-border FSWs. Conclusion This study provides better understanding about cross-border FSWs working in China-Burma border areas in which little information about their demographics, HIV infection, and high-risk behaviour has been known. From public health perspective, development and implementation of public health interventions and policies can get inspiration and support from this study. / published_or_final_version / Public Health / Master / Master of Public Health

Multilevel models account for different levels of aggregation that may be present in the data. Researchers are sometimes faced with the task of analysing data that are collected at different levels such that attributes about individual cases are provided as well as the attributes of groupings of these individual cases. Data with multilevel structure is common in the social sciences and other fields such as epidemiology. Ignoring hierarchies in data (where they exist) can have damaging consequences to subsequent statistical inference. This study applied multilevel models from frequentist and Bayesian perspectives to the Swaziland Demographic and Health Survey (SDHS) data. The first model fitted to the data was a Bayesian generalised linear mixed model (GLMM) using two estimation techniques: the Integrated Laplace Approximation (INLA) and Monte Carlo Markov Chain (MCMC) methods. The study aimed at identifying determinants of HIV in Swaziland and as well as comparing the different statistical models. The outcome variable of interest in this study is HIV status and it is binary, in all the models fitted the logit link was used. The results of the analysis showed that the INLA estimation approach is superior to the MCMC approach in Bayesian GLMMs in terms of computational speed. The INLA approach produced the results within seconds compared to the many minutes taken by the MCMC methods. There were minimal differences observed between the Bayesian multilevel model and the frequentist multilevel model. A notable difference observed between the Bayesian GLMMs and the the multilevel models is that of differing estimates for cluster effects. In the Bayesian GLMM, the estimates for the cluster effects are larger than the ones from the multilevel models. The inclusion of cluster level variables in the multilevel models reduced the unexplained group level variation. In an attempt to identify key drivers of HIV in Swaziland, this study found that age, age at first sex, marital status and the number of sexual partners one had in the last 12 months are associated with HIV serostatus. Weak between cluster variations were found in both men and women. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

No abstract available. / Thesis (M.A.)-University of Natal, Durban, 2003.

By knowing the incidence of an infectious disease, we can ascertain the high risk factors of the disease as well as the e ectiveness of awareness programmes and treatment strategies. Since the work of Hugo Muench in 1934, many methods of estimating the force of infection have been developed, each with their own advantages and disadvantages. The objective of this thesis is to explore the di erent compartmental models of infectious diseases and establish and interpret the parameters associated with them. Seven models formulated to estimate the force of infection were discussed and applied to data obtained from CAPRISA. The data was agespeci c HIV prevalence data based on antenatal clinic attendees from the Vulindlela district in KwaZulu-Natal. The link between the survivor function, the prevalence and the force of infection was demonstrated and generalized linear model methodology was used i to estimate the force of infection. Parametric and nonparametric force of infection models were used to t the models to data from 2009 to 2010. The best tting model was determined and thereafter applied to data from 2002 to 2010. The occurring trends of HIV incidence and prevalence were then evaluated. It should be noted that the sample size for the year 2002 was considerably smaller than that of the following years. This resulted in slightly inaccurate estimates for the year 2002. Despite the general increase in HIV prevalence (from 54.07% in 2003 to 61.33% in 2010), the rate of new HIV infections was found to be decreasing. The results also showed that the age at which the force of infection peaked for each year increased from 16.5 years in 2003 to 18 years in 2010. Farrington's two parameter model for estimating the force of HIV infection was shown to be the most useful. The results obtained emphasised the importance of HIV awareness campaigns being targeted at the 15 to 19 year old age group. The results also suggest that using only prevalence as a measure of disease can be misleading and should rather be used in conjunction with incidence estimates to determine the success of intervention and control strategies. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.

No abstract available. / Thesis (Ph.D.)-University of KwaZulu-Natal, Piertermaritzburg, 2010.

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