<p>This mini-thesis seeks to provide a substantiation for the need for a new legal framework for South Africa in order to address prostitution. It will argue that the current legal framework has failed in its desired aims and in addressing prostitution effectively. This mini-thesis critically analyses the underlying reasons for prostitution in South Africa and discovers that it is influenced by a myriad of interrelated factors. The current level of poverty and the prevailing socio-economic paradigm in South Africa have contributed to its complex nature. The demand for prostitution acts as a catalyst for both the further exploitation of prostitutes and women, while making them vulnerable to sexually transmitted diseases. I establish that criminalisation alone is not sufficient to address prostitution, especially given the HIV/AIDS epidemic.</p>

Abstract Bakgrund: Totalt har nästan 30 miljoner avlidit sedan första AIDS- fallet diagnostiserades år 1981. Ovissheten och hotet om sjukdom och för tidig död innebär stora psykiska påfrestningar på individen. Sjuksköterskans attityder och sätt att vara spelar en viktig roll för etablering av en terapeutisk relation. Syfte: Syftet var att belysa sjuksköterskans attityder till patienter med HIV- infektion. Metod: Genom en litteraturstudie av tidigare forskning har 16 vetenskapliga artiklar granskats. Dessa fann vi på databaserna PubMed och Cinahl. Resultat: Sjuksköterskor upplevde rädsla vid omvårdnad av patienter med HIV/AIDS på grund av dess smittrisk. De ansåg att de behövde mer utbildning och support och professionell support mellan kollegor för att orka med sitt arbete. Från forskarnas observationer sågs ett fysiskt undvikande av patienter, som att vårdpersonalen inte svarade på patientens ringningar, de undvek att gå in till patienten. Sjuksköterskestuderande som hade en rädsla för HIV/AIDS har mer homofobier, de ansåg att det var ett straff för deras oordnade sexliv och att de förtjänade sitt öde. Slutsats: Vi anser att många av dessa attityder skulle kunna undvikas om personalen får mer kunskap om smitta, sexuallitet och droger, hur sjukdomsförloppet ser ut, och vilka funderingar en HIV/AIDS smittad kan ha. Detta skulle bidra till att sjuksköterskor/vårdpersonal vågar möta patienten och utveckla en god relation till denne.

HIV (humant immunbristvirus) är en sjukdom som bryter ned kroppens immunförsvar och utan bromsmedicin är risken stor att drabbas av den sekundära fasen, AIDS. Sjukdomen, som globalt innefattar cirka 33 miljoner virusbärare, har inget botemedel, vilket leder till att många människor avlider av sjukdomen. Eftersom det finns så många HIV-smittade människor, är sannolikheten stor att sjukvårdspersonalen möter dessa patienter inom de olika delarna av sjukvården. Förståelsen för hur dessa patienter upplever en vårdrelation med sjukvårdspersonal är viktig för att kunna ge dessa patienter en god vård. Syftet med studien är att beskriva HIV/AIDS-positiva patienters upplevelser av vårdrelationen med sjukvårdspersonal. I detta examensarbete inom vårdvetenskap gjordes en systematisk litteraturstudie efter Evans (2002) modell, där vetenskapliga artiklar av kvalitativ design analyseras vilket är en metod för att finna ny kunskap som besvarar syftet. Resultatet kan delas in i tre olika teman; upplevelser av trygghet, upplevelser av att inte bli bekräftad och upplevelser av att känna avvisning och skam. Det förekommer att HIV-positiva patienter antingen blir vägrade vård eller att de själva väljer att inte söka vård på grund av sjukdomen och att sjukvårdspersonal undviker fysisk kontakt. Alla HIV-positiva patienter är inte missnöjda med vården, vilket redovisas i studien. Diskussionen utgår från Katie Erikssons (1987; 1990; 1994; 1995) teori om vårdlidande och tar upp olika orsaker till varför vårdlidande uppstår med fynden i resultatet som utgångspunkt. Författarna föreslår att ökad kunskap ska införas på alla vårdnivåer för att ge en ökad medvetenhet, vilket ger patienterna trygghet.

The spreading of HIV/AIDS has a gendered dimension. In this essay I focus on the gender roles that create different spheres for the sexes and how they are connected to the spreading of HIV/AIDS. The construction of masculinity hinders the HIV preventing efforts due to the social demands of having several partners and the dislike of using condoms. Sometimes it also results in gender-based violence. The female gender role narrows the possibilities for women to protect themselves. The women are struck harder by the disease because they are in a disadvantageous position in society where they have few means of economic independence and no control over their own bodies in their sexual relationships. The key is to change the gendered domain and the attitudes toward both men and women.

Background: HIV/AIDS is one of the world’s most serious health challenges. Sub-Saharan Africa remains the region most heavily affected by HIV, with 69% of the people living with HIV in the world. Côte d'Ivoire has a high HIV prevalence rate and Senegal a low prevalence rate. The main research question is whether or not the HIV risk behavior of Ivorian differs from the HIV risk behavior of Senegalese in terms of selected categorical and continuous variables. In other words, if using condoms at last sexual intercourse differs between Côte d’Ivoire and Senegal. Methods: Cross-sectional data from the Measure Demographic and Health Survey (MDHS) involving 9,686 Ivorian and 18,363 Senegalese from 2005 were used. The Pearson Chi-square test were performed to determine any significant relationship between the variables across the two countries with respect to socio-demographic and HIV risky behaviors status. Univariate and multivariate analyses were performed to test the significance of any association between the independent and the dependent variables (Condoms used at last sexual intercourse). Throughout all the analysis performed, a p-value of 0.05 and confidence interval of 95% were used to determine any statistical significance. Results: Logistic regression models showed that Côte d’Ivoire respondents had decrease odds of using condoms during their last sexual intercourse (OR=0.7; 95% CI 0.62 - 0.79) as compared to Senegal and the difference was statistically significant at p < 0.05. In Côte d’Ivoire and Senegal, wealth and education have been consistently found to be positively associated with condoms used at last sexual intercourse. Conclusion: HIV risk behaviors seem to be associated with condoms used and marital status. The results in our study suggest a possible relation with condoms used, HIV prevalence and polygamy in Senegal, so men use condoms less frequently with marital partners. More studies need to assess the role of polygamy in the transmission and/or acquisition of HIV in Sub-Saharan Africa. Key words: HIV/AIDS, Risky behaviors, Condoms used, Côte d’Ivoire, Senegal

Black-Canadian populations are disproportionately affected by HIV/AIDS. In particular, Black-Canadian youth are noted to be at a greater risk of HIV infection due to their sexual risk behaviours. Many international studies indicate that open parent-youth sex communication may counter the potentially negative impact of peers, mass media and inadequate sexual health education programs on youth sexual risk behaviour. However, there is a paucity of Canadian studies on Black-Canadian parent-youth sex communication and ways to enhance this communication. As such, a qualitative based exploratory study was conducted using a community based research approach to determine the state of Black-Canadian parent-youth sex communication in Toronto, Ontario. Data was collected through 17 Key Informant interviews; that is individuals who work in Black Toronto communities and are knowledgeable about the subject matter. The results noted several factors which affect Black-Canadian parent-youth sex communication such as religion and cultural taboos surrounding the discussion of sexual health. The impact of these factors along with potential implications of this study on Black-Canadian populations and recommendations to enhance Black-Canadian parent- youth sex communication are discussed. / UOIT

The Men, Internet, and Sex with Men Study was a qualitative inquiry into how men who have sex with men (MSM) use the Internet in their sexual lives. The study responds to calls for HIV prevention to become more resonant with men’s online experiences. Men’s use of the Internet in their sexual lives was explored through structural interactionist and social risk theories. The study was a focused ethnography, drawing on semi-structured interviews with 23 MSM from the Greater Toronto Area. The sample included men aged 20 to 61, from a variety of sexual orientations (gay, bisexual, and heterosexual) and HIV statuses. Data analysis focused on the contextual aspects of men’s use of the Internet for sexual purposes and their sexual risk behaviour. This study focused on how men’s use of the Internet for sexual purposes was situated within and influenced by the contexts of their use. The participants’ online experiences were socially-situated from the outset: men saw the Internet as a “solution” to challenges in their sexual lives; their online interactions were structured by online rules of engagement and discourse from the offline gay community; and their sexual risk behaviour was mediated by social context and sexual interactions. The participants’ stories revealed the existence of an online subculture for sex seeking. Men also talked about the links between their online and offline experiences, where the Internet played a role in developing their sexuality but could also foster isolation and addiction. The men emphasized the importance of online HIV prevention and offered suggestions on how prevention more generally might be improved. The Internet holds both promise and pitfalls for HIV prevention. The findings from this study underline the need for prevention efforts that focus on individual- and structural-level prevention which can respond to men’s experiences both online and offline.

The field of survival analysis has experienced tremendous growth during the latter half of the 20th century. The methodological developments of survival analysis that have had the most profound impact are the Kaplan-Meier method for estimating the survival function, the log-rank test for comparing the equality of two or more survival distributions, and the Cox proportional hazards (PH) model for examining the covariate effects on the hazard function. The accelerated failure time (AFT) model was proposed but seldom used. In this thesis, we present the basic concepts, nonparametric methods (the Kaplan-Meier method and the log-rank test), semiparametric methods (the Cox PH model, and Cox model with time-dependent covariates) and parametric methods (Parametric PH model and the AFT model) for analyzing survival data.<p> We apply these methods to a randomized placebo-controlled trial to prevent Tuberculosis (TB) in Ugandan adults infected with Human Immunodificiency Virus (HIV). The objective of the analysis is to determine whether TB preventive therapies affect the rate of AIDS progression and survival in HIV-infected adults. Our conclusion is that TB preventive therapies appear to have no effect on AIDS progression, death and combined event of AIDS progression and death. The major goal of this paper is to support an argument for the consideration of the AFT model as an alternative to the PH model in the analysis of some survival data by means of this real dataset. We critique the PH model and assess the lack of fit. To overcome the violation of proportional hazards, we use the Cox model with time-dependent covariates, the piecewise exponential model and the accelerated failure time model. After comparison of all the models and the assessment of goodness-of-fit, we find that the log-logistic AFT model fits better for this data set. We have seen that the AFT model is a more valuable and realistic alternative to the PH model in some situations. It can provide the predicted hazard functions, predicted survival functions, median survival times and time ratios. The AFT model can easily interpret the results into the effect upon the expected median duration of illness for a patient in a clinical setting. We suggest that the PH model may not be appropriate in some situations and that the AFT model could provide a more appropriate description of the data.

The present study explored the influence of social support and psychological resources on depression in people living with HIV/AIDS. The mediating role of mastery and self-esteem was examined. Factor analysis of the MOS-SSS supported three dimensions of social support. Findings from a predominantly gay male sample of unemployed individuals living with HIV/AIDS in the Toronto-area indicated high levels of depressive symptomatology, which were negatively related to emotional/informational support, tangible support, and affectionate/interpersonal support. Mediation analyses indicated partial support of the Cognitive Adaptation Model, revealing significant mediating effects of mastery on the relationship between social support and depressive symptomatology. Self-esteem was not found to be a significant mediator of this relationship. Findings suggest the need for social support interventions that help to strengthen mastery in individuals living with HIV/AIDS in order to reduce depression. Attention should be paid to self-esteem and its relationship with gender and employment status in this population.

The present study explored the influence of social support and psychological resources on depression in people living with HIV/AIDS. The mediating role of mastery and self-esteem was examined. Factor analysis of the MOS-SSS supported three dimensions of social support. Findings from a predominantly gay male sample of unemployed individuals living with HIV/AIDS in the Toronto-area indicated high levels of depressive symptomatology, which were negatively related to emotional/informational support, tangible support, and affectionate/interpersonal support. Mediation analyses indicated partial support of the Cognitive Adaptation Model, revealing significant mediating effects of mastery on the relationship between social support and depressive symptomatology. Self-esteem was not found to be a significant mediator of this relationship. Findings suggest the need for social support interventions that help to strengthen mastery in individuals living with HIV/AIDS in order to reduce depression. Attention should be paid to self-esteem and its relationship with gender and employment status in this population.