The Isipingo River and Estuary system located in the province of KwaZulu-Natal, although relatively small, has been subjected to the impacts of intense development within the catchment. The catchment is characterized by informal and formal dwellings and intensive industrial activities in the lower catchment and in close proximity to the estuary. Significant modifications to the hydrology of the system has occurred as a result of the diversion of the Umlazi River (which previously merged with the Isipingo River at the estuary mouth), canalization of the lower portion of the Isipingo River flowing through the Prospecton Industrial Area and the development of the Diversion Works system (to regulate flows to the lower Isipingo River), removal of riparian vegetation, encroachment onto the river and estuarine floodplain, and land reclamation through the infilling of wetlands all of which has culminated in a deterioration of the functionality and health of this system. The main aspects of this study focus on water and sediment quality, material flux between the estuary and the sea and the management of the system. The water quality variables covered as part of this dissertation include physical, chemical (nutrients and heavy metals) and microbiological (faecal coliforms) components. The water quality of the river and estuary presents a risk to human health and the concentrations of heavy metals generally exceeded the South African Water Quality Guidelines that prescribes target levels, implying potential negative impacts to aquatic health. The Isipingo system exhibited signs of eutrophication with phosphorus concentrations in excess of the target level to prevent eutrophication. Excessive water hyacinth growth was visible during most of the field surveys. A geochemical assessment of heavy metals in surface sediments of the river and estuary was also undertaken. The results indicate that although the presence of several metals were undetectable at certain river sites, the concentrations of those heavy metals present increased in a longitudinal direction from the river to the estuary. The contamination factor analysis for all metals indicated low contamination except for selenium. The riverine sites yielded moderate enrichment by some heavy metals in both seasons. The degree of contamination for each site with the exclusion of selenium was low. The inclusion of selenium in the assessment raises the estuary to a considerably contaminated status in the wet season. The analysis suggests that the enrichment of the system by selenium is due to an anthropogenic source. The Geo-accumulation Index places the sediment in an overall unpolluted category. The study conducted on the net exchange of heavy metals and nutrients between the Isipingo Estuary and the adjacent marine environment (i.e. Indian Ocean) demonstrates that significant quantities of the suite of heavy metal analysed are exported on an annual basis while copper, nickel and zinc are imported into the estuary. Significant quantities of ammonia and nitrates are exported annually from the Isipingo Estuary while a net annual import of phosphorous is observed. The variation in the quantity and concentration of nutrients exported during the seasons may be attributed to anthropogenic source. The import of nutrients from marine sources can accumulate in the estuary and contribute to eutrophication of the Isipingo Estuary. This study also demonstrated that although the ebb flow has a much longer duration than the flood flow, the flood velocities observed were generally greater than the ebb velocities. The final part of this research identifies other environmental problems experienced in the Isipingo catchment. The following issues are identified as directly or indirectly contributing to stress and deterioration of the water quality of the Isipingo system: reduction in water quantity, poor water quality, moderate enriched sediment, loss of habitat integrity, species diversity and invasive alien vegetation and uncontrolled solid waste. A Water Quality Management Plan including management objectives, strategies and action plans to address the direct and indirect factors influencing the system are proposed. A water quality monitoring program is also proposed for the Isipingo River and Estuary. The adoption and execution of the water quality management plan and monitoring program will assist in the prevention of further degradation of the system and will be a stepping stone toward improvement. / Thesis (M.Sc.)-University of KwaZulu-Natal, Westville, 2013.

In recent years several regions in South Africa including KwaZulu-Natal (KZN) have experienced a significant shift in their farming practice, moving away from conventional commercial farming to the apparently more lucrative private game farming. This is clearly evident in the northern parts of KZN, where most Private Game Reserves (PGRs) occur in semi-arid areas, which are poorly suited to agriculture or livestock farming. These conversions of land cover or change in land use (i.e. from conventional commercial farming to private game farming) is occurring fairly swiftly even though the extent (area of change), impacts and implications of this trend have not been established. Very limited scientific research has been carried out on the environmental effects, impacts and implications of these land cover/use changes related to PGRs. In an attempt to document these changes as well as the environmental implications, three PGRs i.e. Kube Yini, Thanda and Phinda and the Mkhuze Game Reserve within northern KZN were selected for in-depth study. Mkhuze, which is owned and managed by the state, was selected as the control for this study, as it has remained relatively undisturbed for a long period of time. A comparison between the PGRs and Mkhuze was carried out to compare the land cover/use changes within the study area since the establishment of the PGRs. Remote sensing software was used to achieve the aim and objectives of this study. Using satellite images from 1990 and 2007, a change detection analysis was performed to determine the land cover/use changes that occurred within the study area during the period 1990-2007. Sixty-four land cover/use classes were generated from the analysis. These sixty-four classes were reclassified into five broad land cover/use classes which were identified as (1) water and riverine vegetation, (2) sand forest, forest and rock faces, (3) woodlands, (4) old fields and disturbed areas, (5) and grasslands. The results illustrated that during the period 1990 to 2007, the land cover/use of the entire study area changed significantly, with the overall land cover/use changes illustrating a decrease in the water bodies and riverine vegetation (6 percent to 3 percent); sand forest, forest and rock faces (19 percent to 16 percent); woodlands (26 percent to 25 percent); and old fields and disturbed areas (26 percent to 25 percent) whilst an increase in the grasslands (23 percent to 31 percent) was evident. Within each individual PGR, significant land cover/use changes related to private game farming were evident. In Kube Yini PGR, a decrease in the water bodies and riverine vegetation (4 percent to 1 percent); old fields and disturbed areas (23 percent to 11 percent); and grasslands (6 percent to 5 percent) were observed whilst an increase in the sand forest, forest and rock faces (31 percent to 47 percent); and grasslands (6 percent to 5 percent) land covers were seen. There has been no change in the woodlands cover (i.e. remains 36 percent). Old fields and disturbed areas have decreased due to the clearing programme that was implemented by Kube Yini, which has also contributed to the increased sand forest, forest and rock faces; and grassland land covers. At Thanda PGR, water bodies and riverine vegetation remained the same overall, while an increase in the grasslands cover (19 percent to 49 percent) was clearly evident. A decrease in the sand forest, forest and rock faces (13 percent to 4 percent); woodlands (29 percent to 18 percent); and old fields and disturbed areas (38 percent to 28 percent) was also noted. This was due to Thanda‟s Management Plan, whereby management had cleared the old fields and disturbed areas to accommodate the increased tourist accommodation, increased game species as well as the increased space that is required for these species. Furthermore over the recent years, Thanda has been practicing bush clearing and thinning of vegetation, which has resulted in the creation of a grassland landscape. A grassland landscape was required for viewing the game species, which resulted in a decreased sand forest, forest and rock faces; woodlands; and old fields and disturbed areas. In Phinda too, the water bodies and riverine vegetation remained the same (i.e. 1 percent). The sand forest, forest and rock faces (32 percent to 19 percent); and woodlands (43 percent to 41 percent) decreased whilst an increased old fields and disturbed areas (15 percent to 26 percent); and grasslands (9 percent to 13 percent) were observed. Sand forests are sensitive and decrease in extent rather easily as a result of disturbances experienced in the area. The decrease in sand forest, forest and rock faces during this period may be due to the increased wildlife and especially elephant population experienced on this reserve. The woodlands land cover decreased in size as a result of clearing to accommodate tourist infrastructure as well as creating a grassland landscape i.e. open space and clear viewing for the game species. The changes in Phinda‟s land cover resulted can be explained by the different management practices that were practised on the reserve. The results from the PGRs were compared against Mkhuze so as to determine whether private game faming was in fact changing the landscape of the study area. During this period 1990 to 2007, Mkhuze experienced only slight changes within it‟s land cover/use classes: water and riverine vegetation (2 percent to 1 percent); sand forest, forest and rock faces (16 percent to 15 percent); and grasslands (29 percent to 26 percent) decreased whilst an increase in the woodlands (27 percent to 30 percent); and old fields and disturbed areas (26 percent to 28 percent) were noted. Since Mkhuze is managed by the state with its priority being conservation first and not increased monetary gain, competition between species and habitants occurred with the least amount of human influence. It is most likely that the water and riverine vegetation; and grasslands decreased due to the drought experienced in the area between 2001-2006, which may have led to the increased old fields and disturbed areas. In addition woodlands may have increased due to its resistance to harsh conditions. Also contributing to the increased old fields and disturbed areas could be the increased wildlife numbers experienced in the reserve. The slight drop in the sand forest, forest and rock faces land cover most likely resulted due to natural competition between the vegetation species as well as management realising the significance of the sand forest, thus assisting in the preservation of the sand forest, forest and rock faces cover. An accuracy assessment was carried out to determine the accuracy of the image classification, and a 75 % accuracy was achieved for the overall analysis. The results illustrate that during the period 1990-2007, the study area‟s land cover changed significantly and that this was mostly like due to the changes within the land cover of the individual PGRs. Climatic data for this period was also taken into consideration to see whether climate variations had occurred and whether this had impacted the change in land cover/use of the study area. The results from the PGRs were compared against the state reserve results as well as the climatic data. The results suggest that the majority of the land cover/use changes within the study area had occurred largely due to private game farming rather than natural processes. The climatic variables such as temperature of the area remained fairly unchanged whilst humidity remained fairly high. With the exception of the drought experienced in the area between the period 2001-2006, it is most likely that the changes in the area are the result of the change to private game farming. Private game farming is having a significant effect on the landscape of the study area and this is largely due to the different management practices practised on each individual PGR. It is recommended that PGRs be monitored and regulated consistently in order to prevent the degradation of the environment and its ecosystem. The study exhibits the value and usefulness of satellite imagery in detecting land cover/use changes related to private game farming. Landsat 5 TM imagery was the most suitable and accurate in identifying and mapping broad scale land cover/use changes related to private game farming. If a more detailed level of investigation is required, the use of higher resolution imagery (e.g. Spot/Landsat 7) is advised. / Thesis (M.Sc.)-University of KwaZulu-Natal, Westville, 2010.

To assist in developing a more precise understanding of past climatic changes in southern Africa, further pollen analytical research is required. In the past, pollen sites in the subregion have been restricted to swampy areas such as permanent springs and peat deposits. While such sites are often rare as a consequence of the aridity of the country, rich polliniferous deposits can be found in the peatlands surrounding coastal lakes in the Maputaland Coastal Plain. The Mfabeni peatland, situated on the eastern shores of St. Lucia, contains relatively old sediments dating back to >45000 years bp at a depth of 7.80m. A multi-proxy approach, comprising radiocarbon, stable carbon isotope (513C) and palynological analysis, was applied in the investigation of Late Quaternary climatic conditions and vegetation changes along the Maputaland Coastal Plain. A single 10 m sediment core, dating back to >45000 years bp, was extracted from the Mfabeni Peatland. A detailed fossil pollen analysis of Mfabeni sediments indicated the existence of extensive Podocarpus-abundant coastal forests before ca. 44500 years bp. The onset of wetter local conditions after this time is inferred from forest retreat and the development of swampy conditions, which prevailed until ca. 25000 Cal years BP. Conditions during the Last Glacial Maximum (LGM; 18000 years BP) are inferred to have been generally colder and drier, as evidenced by forest retreat and replacement of swampy reed/sedge communities by dry grassland. A significant depletion in 813C values at ca. 18200 Cal years BP indicates the dominance of C3 vegetation during the LGM, reflecting considerably colder conditions. This is in agreement with palaeoenvironmental indications from elsewhere in the Transvaalian Ecozone, although conditions at Mfabeni were more moderated in their manifestation, which can be attributed to the proximity of this site to the ocean. Cool, relatively moist conditions are inferred for the Holocene Altithermal (ca. 8000-6000 years BP), as evidenced by forest growth and expansion during this time. Warm, dry conditions are inferred for the Late Holocene, with the establishment of grassland/savanna type vegetation in the area after ca. 2000 Cal years BP. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.

The thesis examines the genesis and implementation of integrated conservation development and associated projects in northern Maputaland during the 1980s and 1990s. The premise upon which this study is based is that there has been a worldwide paradigmatic shift in conservation policies and practices during the 1980s and 1990s. The extent to which initiatives in Maputaland reflected these trends is examined. In formulating a conceptual and theoretical framework for the study, the developments within the discipline of geography as well as the paradigmatic shifts within the broader sphere of conservation and development thinking, are discussed. Traditionally geography focuses on the nature of the relationship between human beings and their environment. Working within this tradition, the relationship between geography and conservation policy and practice is identified and applied to South Africa. Analysis of the process of integrating conservation and development in Maputaland is informed by both the broader international debate surrounding conservation and development and by local history and place specific conditions. The key geographical concepts of process and place are viewed as interdependent factors influencing one another. Within this framework and drawing on the concept of sustainable development, the experience of implementing the new conservation paradigm in Maputaland is recorded and analysed. The case study examples are associated with Ndumo Game Reserve. Sources of data and methodologies include primary sources (published books and journals), secondary sources (unpublished reports), participant-as-observer status with conservation liaison committees and the Ndumo Environmental Education Centre, key informant and focus group interviews and Participatory Rural Appraisal with the Ndumo Environmental Education Centre Management Committee. The study indicates that the Maputaland initiative did represent a considerable paradigm shift in the conservation policies guiding the general practice of conservation in Maputaland. The conservation agency did attempt to initiate Integrated Conservation Development Projects (ICDPs) during the 1990s, but this has been a complex process, fraught with tensions and suspicions. The practise fell short of the ideals and there is a long road to be travelled before reconciliation between conservation and community development is reached. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2001.

This study examines foredune evolution along a 2100 m section of coast adjacent to the Tugela River. The foredunes vary in both height and shape along the study area and form the southern most extension of the Tugela foredune-ridge plain. Sand accumulation and erosion was measured at regular intervals over a 30 month period by tacheometric surveys. The foredunes and beaches are comprised of over 99 % sand. The sediment was predominantly composed of quartz and feldspar with subordinate lithic fragments. The quartz grains display conchoidal fractures and mechanical v-shaped pits and curved grooves. The beach and dune sand is well sorted and slightly negatively skewed with a mean grain size of 1.62 ф. The vegetation structure and floristic composition of the foredunes are explored. A range of factors influencing foredune morphology and evolution, including canopy density, height and distribution, wind velocity and a variety of ecological and environmental processes are examined. Ridge and swale morphology as well as alongshore variation in the dunefield could not be related to biological processes. The development of a foredune-ridge topography depends on a large sediment supply from the Tugela River over the long-term. Periods of high discharge introduce a fresh source of sediment to the littoral zone. Reworking of fluvial sediment landwards results in wide beaches. Onshore winds transport the sand from the beaches to the foredunes. Scaevola thunbergii encourages rapid vertical accretion and hummock dunes are formed. Lateral extensive invasion by seedlings may result in the hummock dunes joining to form coast parallel foredunes. Under periods of reduced sediment discharge erosion of the shoreline results in steep narrow beaches. Despite a negative beach budget foredunes continue to accrete vertically. Marine erosion results in either the complete destruction of embryo foredunes or their landward shift. Natural breaks in the dune crestline were attributed to changes in the delivery of sediment to the beaches. The processes operating in the study area conform to Psuty's (1988,1989) sediment budget model of foredune development. Sediment availability to the coastline produces characteristic morphologies. / Thesis (M.Sc.)-University of Natal, Durban, 1998.

The purpose underpinning the study was to establish the prospect of developing a supplementary Internet-based information exchange system for the Natal Midlands Rural Development Network (MIDNET) and to propose a model of operation for the anticipated system. The study intended to propose, based on findings, steps and strategies that need to be taken on how best to integrate an Internet based information exchange system into the requirements and capacity of MIDNET members. To accomplish the objectives of the study, both primary and secondary sources of data were used. Literature on cooperation and networking and application of the Internet for information exchange networking were reviewed, analyzed and conceptualized to establish feasibility dimensions for an Internet-based information exchange system in a network environment and to plan a model of operation for the system. Original research was carried out using a self-administered questionnaire to MIDNET members during July through November 2001. Out ofthe questionnaires distributed to all 32 members, 18 (56.8%) were returned and used. Data collected was related to current information exchange activities; general information needs; availability of information resources in terms of ICTs infrastructure, organization and human resources and funding; and opinions on establishing an Internet based information exchange system. Supplementary information was also collected through observation of some aspects of the information exchange and dissemination activities of MIDNET members. Document analysis was done mainly to establish the contents ofthe information products of MIDNET members, MIDNET and interest groups of MIDNET. Based on general information needs established in the present study, MIDNET members were found to have similar objectives, activities and disciplines of work geared toward similar goals within rural development, the thematic boundary of the network. MIDNET was found to draw in, within its membership, geographical and thematic boundary, like-minded organizations and individuals that have similar information seeking behavior. Members, when motivated by five reasons, were found to exchange information using nine kinds ofcommunication media and mechanisms and 16 categories ofinformation products and activities which reflected 27 information content categories. The information products of members, MIDNET and interest groups of MIDNET were largely in the category of grey literature. Most members were found to have a good state oflCTs infrastructure in terms of owning computers, computer networks, Internet connectivity and development of Internet-based information exchange and dissemination systems. Most members do not have information support services backed by conventional information units and professionals. Ad hoc arrangements of responsibility for information work were used in most instances. Findings concerning funding infonnation exchange activities were inadequate to examine the trend in funding. Findings concerning problems and factors that impeded current information exchange activities and solutions suggested by members reflected the need to improve current communication and information delivery interfaces and to establish an Internet-based information system as a supplementary interface. Members indicated an overwhelming desire to participate in and contribute to the anticipated system, although there was a reluctance in terms of system inputs other than information. Analysis of the study findings in terms of fundamental feasibility dimensions showed that the Internet, if appropriately and effectively used, has the prospect to facilitate communication and information exchange in MIDNET by way of replicating current interfaces. The study proposes a model plan for the establishment of an Internet-based information exchange system that would suit the requirements and capacity of members. The plan is proposed based on findings of the present study and valid reflections from a review of the literature in terms of prerequisites for networking, basic requirements and general principles. Other aspects considered were models of cooperation on the Internet and methodological approaches for the development and impact assessment ofan Internet-based information exchange system in the development sector. / Thesis (M.I.S.)-University of Natal, Pietermaritzburg, 2002.

Long-term trends in rangeland sward dynamics (species composition, structure, productivity) were examined on three trials established between 1989 and 1996 at Kokstad Research Station in the Highland Sourveld, while animal performance (average daily gain and gain per hectare) was examined on two of the trials. The region enjoys moderate rainfall of 782mm per annum, with hilly topography, and soil depths ranging from >1m to <20cm. The first trial was labelled the simulation trial, as it simulated a four-paddock rotational grazing system, in which animals spent two weeks in each of three paddocks while the fourth was rested for the entire season. The rested paddock was rotated each year. The trial tested two stocking rates (0.5 and 1.0 AU.ha-1) at five ratios of cattle to sheep, ranging from cattle only to sheep only. The trial was unreplicated, and was established in 1989 on flat topography with deep soils. The second trial (labelled the flat two-paddock trial) was established in 1992 adjacent to the simulation trial. The trial examined two stocking rates of sheep weaners (0.5 and 1.0 AU.ha-1 seasonally) in a continuous grazing two-paddock system, in which one paddock of each treatment was burned and grazed continuously while the second paddock was rested, to be burned and grazed in the following season. The trial was replicated twice. The third trial (labelled the steep two-paddock trial) mimicked the grazing system of the flat trial, but was located on a steep (c. 20%) West-facing slope with shallow soils. The trial incorporated two additional treatments: an intermediate stocking rate of 0.7 AU.ha-1 and an ungrazed treatment. Species composition of the sward was recorded biennially on all trials using the nearest plant-point technique with between 200 and 800 points per paddock. Sward standing crop was measured in the rested seasons of the simulation trial and at the beginning, middle and end of each season in one paddock of each two-paddock treatment of the two-paddock trials. In the two-paddock trials, sward standing crop was measured within and outside permanently placed exclosure cages. Animals were weighed fortnightly. The response of species to grazing pressure or animal type was mediated by soil depth and slope, as well as the grazing system. Tristachya leucothrix declined on all grazed treatments. The ungrazed treatments remained relatively stable over ten years. On the low stocking rate treatments of the steep trial, unpalatable species increased, but so did Themeda triandra. The heavily grazed treatment of the steep trial was surprisingly stable, with little significant change in relative abundance of key species other than an increase in the unpalatable Alloteropsis semialata and decline in T. leucothrix. The medium stocking rate treatment on the steep trial showed significant shifts in relative abundance of key species, with declines in T. triandra and T. leucothrix and increases in A. semialata and the unpalatable wiregrass D. filifolius. These trends were not repeated on the flat trial, however, with T. triandra and A. semialata increasing and all other key species declining or remaining stable. On the simulation trial, species responded largely unpredictably with species abundances often fluctuating considerably over time. Microchloa caffra and A. semialata increased substantially in both the low and high stocking rate sheep-only treatments, with a concurrent decline in T. triandra in the high stocking rate but not the low. Changes in composition over time, as measured by Euclidean distance, showed that shallow soils, high stocking rates and a high proportion of sheep caused greater shifts in species composition over time than deep soils, low stocking rates or more cattle. Three treatments, the sheep-only treatments on the simulation trial and the high stocking rate on the steep trial, showed an initial rapid shift in composition over about 6 years, before stabilising in subsequent seasons. The flat trial showed no substantial shift in composition over time. This general pattern of change was confirmed by Non-Metric Multidimensional Scaling. On the simulation trial, total standing crop was influenced by stocking rate and by the proportion of sheep in most seasons. On the two-paddock trials, increasing stocking rate significantly reduced sward vigour, and vigour declined over time. Stocking rate reduced total standing crop on both trials at the end of the 2004/05 seasons and the crop of unpalatable species on the steep trial. Total palatable plants were unaffected by stocking rate on both trials. The classic Jones-Sandland model of animal performance as influenced solely by stocking rate was not supported. Sheep performance was influenced by stocking rate and the interaction of stocking rate and seasonal rainfall. There was no difference in average daily gain between treatments over time, and hence cumulative animal production per hectare increased with increasing stocking rate. Animal performance was possibly influenced by many factors beyond the scope of this study, including the effect of predator attacks on surviving animals, and resource availability such as shade and shelter and high-production patches in some paddocks and not others. Scale effects on ecology are being increasingly investigated and a meta-analysis of this type shows that, even in one research farm, slight differences in management and environment can have significant effects on plant and animal responses to grazing. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2010.

Title: Exploring the lived experiences of nurses caring for the terminally ill patients with AIDS in selected wards in a level one district hospital. Aim: The purpose of this study was to explore and describe the experiences of nurses caring for dying patients with AIDS in the context of palliative care. Methodology: The study explored the meaning of caring and terminal illness and the lived experiences of nurses in the context of AIDS in palliative care. A constructivist paradigm underpinned this study. A qualitative research approach was used and Giorgi’s five steps of analysis were aligned to the Husserlian phenomenology method to make sense of the data. Individual in-depth interviews were conducted with ten of the operational nurses who were caring for patients suffering from AIDS in the palliative care wards of a level one state-aided district hospital. These included professional nurses, enrolled nurses and enrolled nursing assistants. The interviews were audio-taped. Findings: The findings of the study were presented and discussed according to the two categories that emerged during the data analysis, namely, conceptualization of the core concepts of caring and terminal illness and the experiences of caring in the context of palliative care. Each of these categories had themes and sub-themes that were presented and discussed. The conceptualization of the core terms influenced the nurses’ actions, behaviors and opinions as they described their experiences of taking care of terminally ill patients who suffered from AIDS. The nurses’ lived experiences were conceptualized into three main themes: the social networking that enabled the nurses to collaborate with colleagues in the interdisciplinary teams and share knowledge, skills and support within the palliative care team to optimize patient outcomes; factors hindering the nurses abilities to provide quality care to their patients and the internal and external mechanisms that enabled the nurses to provide care within palliative care contexts despite the encountered challenges. Conclusion: Nurses are exposed to increasing work-load in the context of HIV/AIDS, particularly in the care of terminally ill patients suffering from AIDS as they deal with complex emotional aspects of the diseases. Routine exposure to suffering and death accustom the nurses to dealing with death, resulting in situations where they display lack of care and respect for the terminal patients. Therefore, the antecedents that alter the nurses’ level of caring augmented by the emotionally taxing contexts are an agenda that needs to be addressed in order to achieve emotional work through improved nurse-patient relationships. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2012.

South Africa has one of the highest prevalence of HIV infections in the world. Sexual transmission is the primary mode of transmission across the country’s population. Misinformation about AIDS, negative attitudes to HIV testing and AIDS’ stigmatizing beliefs represent potential barriers to seeking HIV testing. Youth between 15-24 years have the greatest risk of HIV infection but only 37% of students at the University of KwaZulu-Natal (UKZN) had undertaken HIV counselling and testing (HCT) according to the HEAIDS (2008) report. Prevention of HIV and behaviour change includes knowledge about, and adequacy of, HIV counselling and testing (HCT) resources on campuses. The aim of this study was to investigate students’ perceptions about HCT at UKZN and make recommendations regarding improvements. An observational, analytical, cross-sectional study of UKZN undergraduate students on the five campuses was conducted. Participants completed anonymous self-administered questionnaires. Of 965 surveyed students, 663 (71%) had tested for HIV among whom 545 (58%) were females and 501(52%) were 20-25 years. Fear of positive results, perceived low risk of acquiring the infection and having confidence in his/her partner influenced student HIV testing behaviour (p<0.001). A significant difference was also found in positive attitudes towards HCT on campus between people who had tested (median score 20) and people who had not tested (median score 18) (p < 0.05). Since one third of students at UKZN had not tested for HIV, HCT at UKZN needs to be advertised more effectively so as to increase HIV testing by students on campuses. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2013.

Addiction to drugs is a widely acknowledged problem in South Africa. Newer developments in the study of addiction include behaviours such as gambling and sex as part of a broader syndrome. International research has established that most people with one addiction are at risk for co-occurring addictions which are frequently undiagnosed and untreated. Multiple addictions (MA) have been shown to combine in specific patterns to produce addiction interaction disorder (AID) resulting in a more complex, treatment- resistant illness. This was the first study South Africa to investigate if people with substance use disorders had other addictions. The research had three aims: to establish if in-patients admitted to three drug rehabilitation centres had other addictions, to investigate the extent of the MA and AID and to determine whether the treatment programmes managed them appropriately. The study employed the mixed methods research design and was located at three in-patient facilities in Durban, KwaZulu-Natal. During the first phase, discussion groups were held with professionals that explored their perceptions of MA, AID and current treatment programmes. The second phase involved a survey of 123 participants screened for poly-substance abuse, sex (including internet) addiction and problem gambling. The third phase utilised in-depth interviews with 25 participants displaying MA to understand the development of addiction, AID and treatment received. The data were analysed utilising descriptive and statistical analysis for the survey data, and thematic analysis for the in-depth interviews and discussion groups. The study found a high incidence of MA within the survey population of 54%; 37% of participants tested positive or at risk for problem gambling and 41% tested positive for sex addiction with 24% of the participants being positive for both. In-depth interviews revealed high rates of trauma, especially for the female participants and demonstrated the complex interrelationship between addictions. AID was identified in all 25 participants. In KwaZulu- Natal, it appears that MA and AID are currently not being assessed or treated. The study highlights the need for a broader conceptualisation of addiction which would improve current assessment and treatment and has implications for further training of professionals and addiction policy in South Africa. / Ph.D. University of KwaZulu-Natal, Durban 2013.