Doctor of Philosophy / Department of Family Studies and Human Services / Karen S. Myers-Bowman / The purpose of this study was to conduct a phenomenological inquiry into the impact HIV/AIDS-related stigma has on People Living with HIV/AIDS (PLHA) and their family members in Ghana and the overall relationship family members have with PLHA. The study explored the concept of stigma in the Ghanaian context, ways in which it is expressed, factors influencing HIV- related stigma and its consequences on both PLHA and their family members. Strategies that PLHA and their family members consider for effective HIV- related stigma prevention were also explored. The study further explored some of the gender- biased nature of HIV- related stigma in Ghana. Data was gathered qualitatively through interviews with five PLHA and their discordant family members. Interviews were transcribed and translated into English, coded and analyzed. After inductively establishing themes and categories, final confirmatory analysis was deductively established, by using the Bronfenbrenner’s ecological model and Symbolic interaction theory to affirm the authenticity and appropriateness of the inductive content analysis. The study found that HIV- related stigma begins with serostatus disclosure. Stigma is manifested in myriad contexts including the family, community, healthcare institutions and gender. The major factors influencing stigma are insufficient knowledge of HIV transmission, fear and misconception of HIV created by the media, cultural and religious factors as well as poverty. Family members experienced similar stigma as PLHA, such as loss of jobs, loss of social network, loss of identity and self stigma. However extreme impacts such as suicidal thoughts were only experienced by PLHA. The impact of HIV- related stigma is worst for women because of beliefs and values relating to gender- role expectations. While women accept and support their husbands when they have HIV/AIDS, women are often neglected and abandoned by their husbands. To address this stigma, participants suggested house to house education, financial support from the government, revision of educational content especially discontinuation of negative images of HIV/AIDS used by the media. Implications for this study in the areas of research, practice and policy are provided.

This quantitative study sought to identify and describe factors influencing HIV disclosure and sexual practices among 340 PLWHA on ART at Mbabane National Referral VCT/ART Centre, Swaziland. Data were collected using a structured questionnaire. A high general HIV disclosure rate (94.1%; f=320; N=340) was observed of which 57.5% (f=184; n=320) was to sexual partners. X2 procedures indicate an association with gender, residential region, religion, and period of being on ART. The majority (70.2%; f=179; n=255) of the respondents used condoms all the time to avoid infecting their sexual partners (99.2%; f=243; n=245) and to avoid contracting STIs (99.2%; f=243; n=245). X2 procedures indicate an association with gender, residential region, marital status, number of sexual partners, knowledge of the HIV status of sexual partners and period of being on ART. The single leading reason for not using the condom was sexual partners’ refusal to use condoms (85.7%; f=54; n=63). / Health Studies / M.A.(Health Studies)

The purpose of this study is to investigate the right to confidentiality in the context of HIV/AIDS through an interdisciplinary lens. This study indicates that whilst confidentiality is important and should be preserved in order to protect persons living with HIV/AIDS against stigmatisation, discrimination and victimisation, this should be balanced by other equally important interests, such as the protection of public health and individual third parties who may be affected by the intentional or negligent infection of others with HIV. As the consideration of the legal issues relating to confidentiality and privacy cannot be divorced from the social context in which HIV/AIDS plays out in South African communities, the study will examine, amongst others, the victimisation, discrimination and stigmatisation experienced by persons living with HIV/AIDS, followed by a critical exploration of the present legal and ethical framework governing privacy and confidentiality, including medical confidentiality, as well as the duty to disclose a positive HIV-status, in the context of HIV/AIDS. Possible limitations on the right to privacy in this context are also examined, which include, amongst others, a consideration of making HIV/AIDS notifiable diseases in South Africa. The study suggests that it is imperative that legal interventions aimed at curbing the spread of HIV will need to be mindful of the unique social, cultural and economic forces that impact on the duty to disclose a positive HIV-status to partners and other affected third parties. Insights gained from philosophical theories relating to Africanism, individualism, communitarianism and utilitarianism are valuable tools in facilitating a clearer understanding of relevant social and cultural factors that keep South African society locked in the present stalemate with regard to the disclosure of HIV status. / Public, Constitutional, & International law / LLD

This quantitative study sought to identify and describe factors influencing HIV disclosure and sexual practices among 340 PLWHA on ART at Mbabane National Referral VCT/ART Centre, Swaziland. Data were collected using a structured questionnaire. A high general HIV disclosure rate (94.1%; f=320; N=340) was observed of which 57.5% (f=184; n=320) was to sexual partners. X2 procedures indicate an association with gender, residential region, religion, and period of being on ART. The majority (70.2%; f=179; n=255) of the respondents used condoms all the time to avoid infecting their sexual partners (99.2%; f=243; n=245) and to avoid contracting STIs (99.2%; f=243; n=245). X2 procedures indicate an association with gender, residential region, marital status, number of sexual partners, knowledge of the HIV status of sexual partners and period of being on ART. The single leading reason for not using the condom was sexual partners’ refusal to use condoms (85.7%; f=54; n=63). / Health Studies / M.A.(Health Studies)

The purpose of this study is to investigate the right to confidentiality in the context of HIV/AIDS through an interdisciplinary lens. This study indicates that whilst confidentiality is important and should be preserved in order to protect persons living with HIV/AIDS against stigmatisation, discrimination and victimisation, this should be balanced by other equally important interests, such as the protection of public health and individual third parties who may be affected by the intentional or negligent infection of others with HIV. As the consideration of the legal issues relating to confidentiality and privacy cannot be divorced from the social context in which HIV/AIDS plays out in South African communities, the study will examine, amongst others, the victimisation, discrimination and stigmatisation experienced by persons living with HIV/AIDS, followed by a critical exploration of the present legal and ethical framework governing privacy and confidentiality, including medical confidentiality, as well as the duty to disclose a positive HIV-status, in the context of HIV/AIDS. Possible limitations on the right to privacy in this context are also examined, which include, amongst others, a consideration of making HIV/AIDS notifiable diseases in South Africa. The study suggests that it is imperative that legal interventions aimed at curbing the spread of HIV will need to be mindful of the unique social, cultural and economic forces that impact on the duty to disclose a positive HIV-status to partners and other affected third parties. Insights gained from philosophical theories relating to Africanism, individualism, communitarianism and utilitarianism are valuable tools in facilitating a clearer understanding of relevant social and cultural factors that keep South African society locked in the present stalemate with regard to the disclosure of HIV status. / Public, Constitutional, and International law / LLD

Against the background of evidence that HIV-AIDS has had and continues to have an enormous impact on all South African schools, a need has arisen for HIV -AIDS policies and programmes to be effectively implemented in all schools. In this study, a qualitative methodology was used to evaluate policy implementation in the North West province. Data was gathered by means of field notes, observation and interviews with management and educators. The study found that although principals and educators are knowledgeable about HIV -AIDS, there is a tendency to discriminate against infected educators, particularly in terms of educator workload. This study also revealed that educators fear being accidentally exposed to HIV -AIDS infected blood, despite the guidelines given in the National HIV -AIDS policy and the availability of emergency first aid kits. The key thought emerging from this study is that not all schools are able to deal effectively with HIV -AIDS and that schools urgently need to plan or implement their own policies in this regard. School-based HIV-AIDS policies can only be successful if they take cognisance of local contextual issues and involve the three spheres of influence in the lives of educators and learners, namely, the sphere of the school, the sphere of family life and the sphere of the community. / Sociology / M.A.(Social and Behavioural Studies in HIV-AIDS)

Against the background of evidence that HIV-AIDS has had and continues to have an enormous impact on all South African schools, a need has arisen for HIV -AIDS policies and programmes to be effectively implemented in all schools. In this study, a qualitative methodology was used to evaluate policy implementation in the North West province. Data was gathered by means of field notes, observation and interviews with management and educators. The study found that although principals and educators are knowledgeable about HIV -AIDS, there is a tendency to discriminate against infected educators, particularly in terms of educator workload. This study also revealed that educators fear being accidentally exposed to HIV -AIDS infected blood, despite the guidelines given in the National HIV -AIDS policy and the availability of emergency first aid kits. The key thought emerging from this study is that not all schools are able to deal effectively with HIV -AIDS and that schools urgently need to plan or implement their own policies in this regard. School-based HIV-AIDS policies can only be successful if they take cognisance of local contextual issues and involve the three spheres of influence in the lives of educators and learners, namely, the sphere of the school, the sphere of family life and the sphere of the community. / Sociology / M.A.(Social and Behavioural Studies in HIV-AIDS)