As Africa faces the challenges of its renewal or renaissance, the HIV/AIDS epidemic poses the greatest potential barrier to the attainment of this vision (Makgoba, 2001 in Dorrington, Bourne, Bradshaw, Laubscher & Timaeus, 2001). The development of an HIV vaccine that is safe, effective and affordable, has been widely contemplated as a necessary supplement to already established interventions. In preparation for HIV vaccine trials in South Africa the current project aimed to assess students' understanding (knowledge and perceptions) and experiences of vaccination in general, and to explore if these were associated with demographics such as motherhood and gender. A parallel aim was to assess students' knowledge and expectations of HIV vaccination and trial participation. A sample of 33 students was recruited from university residences at the University of Natal, Pietermaritzburg. Participants were interviewed via a semi-structured interview schedule. The data collected was then coded and analysed using content analysis, while Chi - square analysis was used to evaluate if demographics such as gender and motherhood were systematically associated with various responses. The results revealed that the vast majority of participants (97%) knew the purpose of vaccination, stating that it was to promote health and prevent illness. Most participants (67%) knew that vaccination works by mobilising the immune system (vaccination mechanism). The vast majority of participants (91%) could name at least one vaccine preventable disease. Uptake of childhood immunisation was reportedly high (88%) while adult uptake of immunisation was low (33%). A significant minority (36%) reported that they had experienced side effects but understood these to be an integral part of vaccination. Thirty percent of participants stated they were willing to participate (WTP) in a hypothetical vaccine trial, 33 % of participants were not WTP and 15% were not sure. Motivations for trial participation were reportedly influenced most by personal incentives of altruism (39%) and barriers such as perceived significant physical risk (61%). In general, knowledge and experiences of vaccination were not associated with gender or with motherhood. The results suggest that more awareness of HIV vaccine trials is needed. In this regard education should emphasise that the prospective vaccine will be preventive, that only healthy people can volunteer and that the HIV vaccine will not guarantee immunity to HIV infection. Suggestions are made for future research into motivations, barriers and incentives to facilitate an ethical process of vaccine trial participation. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2004.

This research examines men’s talk around abortion using critical discourse analysis. Current literature indicates a dearth of studies addressing the topic of men and abortion in various domains. An understanding of men’s relationship to abortion, however, is crucial to understanding abortion as a social phenomenon. This study utilises the work of Foucault around discourse and power, as well as Butler’s work on gender to create a theoretical framework to approach data. Data were collected in the form of interview groups made up of men, as well as newspaper articles and on-line forum discussions that featured men as the author. What emerged from theses texts was a ‘Familial Discourse’ which posits the nuclear, heterosexual family as a long term relationship between a mother and father, which forms the ideal site to raise children. Discourses that support the family are a discourse of ‘Equal Partnership’ which establishes the man and the woman as being in a heterosexual relationship where each partner is seen to have equal power, and a discourse of ‘Foetal Personhood’ which constructs the foetus as a child in need of a family. Related to the heterosexual matrix, the formation of a family unit comes to be constructed as ‘natural’. Abortion acts as a disruptor to these discourses. By disrupting the formation of the family unit, abortion negatively affects the individuals involved. A relationship where a formation of a family unit was disrupted cannot survive. If the female partner has an abortion without her partner, it is seen as disrupting the equal partnership between the man and the woman. Men in this case see themselves as ‘powerless’ compared to women. From this point a ‘New Man’ discourse emerges, where men position themselves as loving and responsible in the context of a nuclear, heterosexual family unit. Abortion disrupts ‘Foetal Personhood’ and is constructed as murder. In the case of rape the ‘Familial Discourse’ can be invoked either to justify abortion or resist abortion, based on whether or not a family unit can be formed. These discourses reproduce patriarchy.

This study applied the theory of reasoned action (TRA) and its extension, the theory of planned behaviour (TPB) to the design of a workplace HIV/AIDS health promotion programme. The purpose of the study was to determine if the variables of the TRA and TPB would predict intentions to change HIV/AIDS health behaviour, whether a theory-based intervention would result in health behaviour change over time and if there would be any significant health behaviour differences among participants who received a theory-based intervention and those who received an information-only intervention. In a longitudinal, quasi-experimental study, 170 government employees were divided into two groups. One group comprised 92 employees who participated in a HIV/AIDS health promotion workshop based on the theories of reasoned action and planned behaviour. The other group comprised 78 employees who took part in an educational information session about HIV and AIDS. An elicitation study was conducted with a sample of 38 employees from the research population two months prior to the commencement of the study. The findings of the elicitation study informed the design of research questionnaires and an intervention workshop. Both groups of participants (theory-based workshop and information-only workshop) were measured on HIV/AIDS health behaviour intentions and HIV/AIDS health behaviour (condom use, seeking HIV testing and monogamy) across three measurement periods over a six month period. The results of the study showed that the combined theoretical variables predicted intentions to use condoms and to seek HIV testing, with attitudes having the main effect on intentions. There was, however, no significant health behaviour change across the three measurement periods. There were also no health behaviour differences between the two intervention conditions at one month and six months post-intervention. The study concludes that the intervention based on the theories of reasoned action and planned behaviour did not produce health behaviour change. The study also identified barriers to AIDS health behaviour in the South African context that the theories of reasoned action and planned behaviour cannot explain. Ways in which the theories of reasoned action and planned behaviour can be adapted to HIV/AIDS education in collectivist cultures are proposed. / Psychology / Thesis (D. Phil. (Psychology))

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The HIV pandemic threatens the social, emotional, and physical development of all persons, especially the youth. Adolescents are more at risk of contracting HIV as their lifestyle often involves sexual exploration and experimentation. Effective educational interventions are central to HIV prevention in South Africa. Being a clinical nurse practitioner in a primary health care (PHC) facility, the principal investigator observed that school learners failed to practice safe sex and demonstrated little knowledge about HIV/AIDS prevention. The aim of the study was to investigate the reported level of HIV knowledge and sexual risk behaviour of grade 12 school learners in the Eastern Sub-District of the Cape Metropole, Cape Town. A descriptive, non-experimental, research design was employed with a primarily quantitative approach. The study population comprised grade 12 learners from high schools in the Eastern Sub-District of the Cape Metropole in Cape Town (N=7940). A total of 92 participants from four schools (2 public and 2 private) were included in the sample by using a cluster sampling method. A self-completion semi-structured questionnaire was used to collect the data. Data was collected by the principal investigator and a trained field worker. Ethical approval was obtained from the Health Research Ethics Committee of the Faculty of Health Sciences, Stellenbosch University (N11/07/225). Permission to conduct the research was obtained from the Department of Education. Reliability and validity were assured by means of a pilot study and the use of experts in the field of nursing research and statistics. Descriptive statistics were used to analyse data. Statistical associations were determined using ANOVA and the Mann-Whitney U tests. The qualitative data was analysed thematically and then quantified. The results show that the average HIV/AIDS knowledge score of participants was 60.73%. However, many gaps in HIV/AIDS knowledge were identified. Only 77.2% (n=71) of participants knew the meaning of HIV, 80.4% (n=74) did not know all the ways in which HIV can be transmitted and only 8.7% (n=8) knew how to safely use a condom. The majority of participants (67.4%; n=62) believed in the myth that HIV can be cured and 18.5% (n=17) reported that a traditional healer can cure HIV. With regard to risky behaviour, half of the participants at the time of the study (51%; n=47) reported sexual engagement and 20% (n=9) of these respondents did not use condoms. Furthermore, 25% (n=23) had used alcohol before having sex. There were no association found between the knowledge about HIV/AIDS of participants and their sexual risk behaviour. In view of these study findings, participants are exposing themselves to high risk sexual behaviour that may increase their chances of acquiring sexually transmitted infections including HIV. Several recommendations were identified, including the strengthening of HIV and STI education linked to sexual risk reduction, open communication and additional information sources, availability of condoms at schools and improved access to HIV testing at schools. / AFRIKAANSE OPSOMMING: Die jeug se sosiale, emosionele en fisiese ontwikkeling word deur die MIV-pandemie gekortwiek. As gevolg van hulle seksuele eksperimentering, word adolessente as ʼn hoë risikogroep beskou, sover dit die ontwikkeling van MIV aangaan. Gevolglik speel onderrig ʼn belangrike rol in MIV voorkoming. Die beoefening van onveilige seks, en onvoldoende kennis rakende MIV/VIGS-voorkoming, is deur die primêre navorser, ʼn kliniese verpleegpraktisyn in die primêre gesondheidsorg omgewing, waargeneem. Die studie het dit ten doel om te bepaal wat die MIV-kennis vlakke, en die seksuele gedrag risiko van Graad 12 leerders in die Oostelike sub-distrik van die Kaapstadse Metropool is. ʼn Beskrywende, nie-eksperimentele navorsingsontwerp is gebruik, met ʼn hoofsaaklike kwantitatiewe benadering. Uit die studie populasie van Graad 12 leerders in die Oostelike sub-distrik van die Kaapstadse Metropool hoërskole (N=7940), is ʼn steekproef van 92 deelnemers uit vier hoërskole (twee staatskole en twee privaatskole) gekies – die trossteekproefnemingsmetode is gebruik. Data is versamel deur middel van ʼn semi-gestruktureerde vraelys wat deur die deelnemers self voltooi is. Toestemming vir die uitvoer van die studie is verkry van die Etiese Komitee van die Mediese Fakulteit van die Universiteit van Stellenbosch (N11/07/225), asook die Wes-Kaapse Departement van Onderwys. Die betroubaarheid en geldigheid van die studie is verseker deur die uitvoer van ʼn voorstudie, en is verder versterk deur gebruik te maak van kundiges in die veld van statistiek en verpleegnavorsing. Data is ontleed deur middel van beskrywende statistiese metodes en assosiasies is bepaal deur gebruik te maak van variansie-analise (“ANOVA”) en Mann-Whitney U toetse. Die bevindinge is in frekwensie tabelle en histogramme vervat. Die kwalitatiewe data is gekodeer en gekategoriseer, waarna temas geïdentifiseer is. Alhoewel die studie-bevindinge aangedui het dat die deelnemers ʼn gemiddelde MIV/VIGS-kennis telling van 60.73% behaal het, is verskeie leemtes in hulle bestaande kennis geïdentifiseer. Slegs 77.2% (n=71) van die deelnemers het geweet wat MIV beteken, terwyl 80.4% (n=74) nie geweet het hoe MIV oorgedra word nie. Slegs 8.7% (n=8) van die deelnemers het kennis gehad rakende veilige kondoom gebruik. Die meerderheid van die deelnemers (67.4%; n=62) glo dat MIV genees kan word en 18.5% (n=17) het aangedui dat MIV deur ʼn tradisionele geneesheer genees kan word. Hoë-risiko gedrag, spesifiek seksuele aktiwiteit (51%; n=47%) sonder kondome (20%; n=9) is rapporteer. ʼn Verdere 25% (n=23) van die deelnemers het rapporteer dat hulle alkohol gebruik voor seks, maar daar was geen assosiasie tussen die vlak van MIV/VIGS-kennis en hoë-risiko gedrag nie. Die bevindinge dui daarop dat die deelnemers hulself blootstel aan hoë-risiko seksuele gedrag met die gevolg dat hul kans om MIV te kry verhoog. Die aanbevelings, gegrond op die bevindinge, sluit in: ʼn groter fokus op onderrig wat verband hou met MIV en seksueel oordraagbare infeksies wat gekoppel is aan ʼn verlaging in hoe-risiko seksuele gedrag, openhartige kommunikasie en bykomende inligtingshulpbronne, beskikbaarheid van kondome by skole, asook verbeterde toegang tot MIV toetsing by skole.

This study applied the theory of reasoned action (TRA) and its extension, the theory of planned behaviour (TPB) to the design of a workplace HIV/AIDS health promotion programme. The purpose of the study was to determine if the variables of the TRA and TPB would predict intentions to change HIV/AIDS health behaviour, whether a theory-based intervention would result in health behaviour change over time and if there would be any significant health behaviour differences among participants who received a theory-based intervention and those who received an information-only intervention. In a longitudinal, quasi-experimental study, 170 government employees were divided into two groups. One group comprised 92 employees who participated in a HIV/AIDS health promotion workshop based on the theories of reasoned action and planned behaviour. The other group comprised 78 employees who took part in an educational information session about HIV and AIDS. An elicitation study was conducted with a sample of 38 employees from the research population two months prior to the commencement of the study. The findings of the elicitation study informed the design of research questionnaires and an intervention workshop. Both groups of participants (theory-based workshop and information-only workshop) were measured on HIV/AIDS health behaviour intentions and HIV/AIDS health behaviour (condom use, seeking HIV testing and monogamy) across three measurement periods over a six month period. The results of the study showed that the combined theoretical variables predicted intentions to use condoms and to seek HIV testing, with attitudes having the main effect on intentions. There was, however, no significant health behaviour change across the three measurement periods. There were also no health behaviour differences between the two intervention conditions at one month and six months post-intervention. The study concludes that the intervention based on the theories of reasoned action and planned behaviour did not produce health behaviour change. The study also identified barriers to AIDS health behaviour in the South African context that the theories of reasoned action and planned behaviour cannot explain. Ways in which the theories of reasoned action and planned behaviour can be adapted to HIV/AIDS education in collectivist cultures are proposed. / Psychology / Thesis (D. Phil. (Psychology))

The aim of this research project was to assess and compare cardiovascular disease (CVD) risk in black males and females from an urban, working population in the Makana (Grahamstown) region of the Eastern Cape, South Africa. Two-hundred and ninety one individuals (males: n = 143, females: n = 148) with a mean age of 42.6 (±8.1) years were voluntarily recruited from the greater urban Makana (Grahamstown) area. Eight Cardiovascular disease (CVD) risks were assessed: stature and mass were obtained in order to calculate body mass index (BMI) (mass/stature2). Obesity, defined as a morphological risk, was classified according to the World Health Organisation (WHO) BMI criteria (BMI>30kg.m-2), as well as according to measures of waist circumference (WC) and body composition. Hypertension, hypercholesterolemia and type II diabetes, were grouped as cardiovascular (CV) risks. Hypertension was defined as a blood pressure greater than 140/90mmHg (JNC-7); hypercholesterolemia, as total cholesterol greater than 6.2mmol.L-1 (NCEP); and type II diabetes, as total glucose greater than 12mmol.L-1 (WHO). Physical activity, diet, tobacco use, and alcohol consumption and dependence were grouped as lifestyle-related risks. These were assessed by means of self-reporting through the use of various validated questionnaires. Finally, self-reporting of obesity, hypertension, hypercholesterolemia and type II diabetes was assessed, in addition to perception questions on individuals’ perceived body shape and size (Ziebland figures). Self-reported and perceived responses were then compared to actual measures. Females were significantly (p<0.001) heavier than the males (92.7kg compared to 72.1kg) and had significantly (p<0.001) higher BMIs than their male counterparts (37.6kg.m-2 compared to 25.7 kg.-2). They also recorded significantly (p<0.001) higher waist circumference (WC) values and had significantly (p<0.001) higher percentage and total body fat. Significantly (p<0.001) more females were obese (81%) compared to males (17%). While a higher percentage of males (25 % compared to 22%) presented with stage I hypertension (≥140/90mmHg, <160/95mmHg), significantly (p<0.05) more females (14% compared to 8%) presented with stage II hypertension (>160/95mmHg). The prevalence of hypercholesterolemia at a high level of risk (>6.2mmol.L-1) was relatively low (2.1 % of males, 3.4% of females), but notably more participants (22% of males and 26% of females) presented with the condition at a moderate level of risk (>5mmol.L-1). Type II diabetes was the least prevalent CV risk factor, with no males and only 3% of females presenting with the condition. Males consumed significantly (p<0.05) more in terms of total energy intake (9024 vs. 7234 kJ) and were significantly (p<0.05) more active (3315 compared to 2660 MET-mins.week). A significantly (p<0.05) higher percentage of males smoked (51.1% compared to 3.4%), consumed alcohol (73.4% compared to 46.6%) and were alcohol dependent (40% compared to 33.5%). Both males and females tended to be ignorant of their health status, with both samples under-reporting obesity, hypertension and hypercholesterolemia, while over-reporting type II diabetes. Furthermore, obesity was significantly (p<0.05) underestimated, with both male and female individuals perceiving themselves to be notably smaller than they actually were. Physical activity and diet were important determinants of CVD risk in this black urban sample of individuals. Obesity, in particular central adiposity, was the most notable risk (particularly in females), followed by hypertension (particularly in males). Although some risks presented at a moderate level of risk, a clustering of risk factors was evident in both samples, with 12.6% and 41.2% of males and females presenting with two risk factors, and 2.8% and 8.1% of males and females respectively presenting with three risks.

The purpose of the study was to investigate the cardiovascular disease (CVD) risk profile of black African females in the Makana region, Eastern Cape, South Africa. Baseline measures from 40 participants, who met the criteria, were compared against the 2003 South African Demographic and Health Survey (SADHS) and the 2013 South African National Health and Nutritional Examination Survey (SANHANES-1). The risk factors measured were anthropometric (stature, body mass and body mass index (BMI)), morphological (waist circumference (WC), fat mass and lean mass), cardiovascular (heart rate and blood pressure (BP)), physical activity (step count and energy expenditure), biochemical (glycated haemoglobin and full blood lipid profile) and behavioural (alcohol and tobacco use). Results showed significantly higher (p≤0.05) values for overweight/obesity (BMI 37.60 kg.m⁻²; WC 1130.58 mm; fat mass 45.23%) and high BP (130/88 mmHg) compared to the previous national surveys, highlighting these CVD risk factors as problematic. The subsequent sub-study aimed to assess the efficacy of a pedometer-based walking intervention on high BP. The walking programme (n=25) was based on individual step goals to be completed at a moderate-intensity on five days.week⁻¹ for 12 weeks. The same measurements were taken at monthly intervals, Week 0, Week 4, Week 8 and Week 12, with the addition of dietary intake and fitness level, and the exclusion of the behavioural variables. There were no significant differences (p≤0.05) in systolic and diastolic BP with the exercise intervention, although there was a strong, negative relationship with time for diastolic BP (r²=0.9857). This trend suggests that the lack of significance may be a result of poor compliance and/or the small sample size. Individual results, however, showed no compliance-result relationship for the two risk factors of interest: overweight/obesity and high BP. Future recommendations include supervised or group-based exercise interventions to improve compliance, and the addition of resistance training to the aerobic programme.

Cultural factors have been shown to play a role in human decision making and behaviour. The main objective for this research was to identify and evaluate the possible influence of Shangaan cultural beliefs, myths and behaviours, on the spread of HIV within the Mnisi tribe. A qualitative method of investigation was followed; interviews with three participants and observations of the Mnisi culture were used in the construction of the investigation and findings. Through the information obtained two cultures influencing the spread of HIV in the Mnisi tribe were identified, they are (1) The culture of power-rule and fear, and (2) The culture of poverty. / Psychology / M.Sc. (Psychology)

Cultural factors have been shown to play a role in human decision making and behaviour. The main objective for this research was to identify and evaluate the possible influence of Shangaan cultural beliefs, myths and behaviours, on the spread of HIV within the Mnisi tribe. A qualitative method of investigation was followed; interviews with three participants and observations of the Mnisi culture were used in the construction of the investigation and findings. Through the information obtained two cultures influencing the spread of HIV in the Mnisi tribe were identified, they are (1) The culture of power-rule and fear, and (2) The culture of poverty. / Psychology / M.Sc. (Psychology)