A dissertation submitted to the Faculty of Humanities, in fulfilment of the requirements for the degree of Masters of Arts in Journalism and Media Studies at the University of the Witwatersrand in 2016 / The research set out to investigate how the Voluntary Medical Male Circumcision (VMMC) programme in South Africa facilitated stakeholder participation in its communication processes to improve the uptake of services in the context of national targets. Studies reviewed have highlighted challenges in the implementation of the participatory model to achieve communication goals. This qualitative study used document analysis, in-depth interviews and Focus Group Discussions (FGDs) for data collection. The research has revealed other limiting factors including unequal opportunities to influence decisions as a result of varying levels of authority and access to mediated public spheres. While those with power end up being further empowered through participatory approaches in terms of voice and visibility, the representation of the inputs of the lower level stakeholder group is limited to head count. A five-day visit to a VMMC clinic in Alexandra Township attributes marginalisation by exclusion from decision-making processes as one of the reasons for people’s inability to translate knowledge into the positive public response. The study was inconclusive about the influence of the model on the actual service uptake because the purpose was to provide a textual description of the participants’ experiences and not the impact. / XL2018

The practise of male traditional circumcision is severely challenged with enormous problems ranging from hospitalisation of the initiates as well as deaths of the initiates. The background of the problem is focused in the Eastern Cape Province where the researcher has noted several initiates being treated in hospitals for physical and as well for psychological problems. The objective of this study was to explore and describe newly initiated Xhosa men's experiences of traditional circumcision rites at East London in the Eastern Cape Province and to describe the guidelines for support of these newly initiated Xhosa men by public health professionals. A qualitative explorative, descriptive contextual and phenomenological design was followed. Purposive sampling technique was used to select the participants. Fourteen participants volunteered to participate in the study after they met the eligible criteria. Focused group interviews were used as a method for data collection. Data analysis of the study showed that there are several factors affecting newly initiated men whilst undergoing circumcision rites. These factors can present at any of the three circumcision stages i.e. pre-circumcision, peri-circumcision and post-circumcision. The recommendations of the study strongly suggest a cultural competence in rendering effective health care services to culturally and ethnically diverse clients. All the five constructs of cultural competence are entailed in the support guidelines that have been developed by the researcher. They are cultural awareness, cultural knowledge, cultural skill, cultural encounter and cultural desire. Finally limitation of the study and the need for a further research has been clearly stated. / Health Studies / M.A.

Evidence of male sex work has a history as long as female sex work. There is century old evidence of male Sumarians and Greeks selling sex to other men. Men are today still selling sex to other men. This study showed that the elimination of sex work is practically impossible, and could only be accomplished by the gross denial of basic human rights. Male sex workers have not received the same attention from researchers as have their female counterparts. This is so despite the large numbers of male sex workers in cities all over the world who potentially contribute to the worldwide sexually transmitted infection rates. It is known that wherever indiscriminate sexual activities take place, the risk of transmission of infections are greater. The activities between the male sex worker and his client(s) determine the health problems they are exposed to. The purpose of this research was to determine what transpires between male sex workers and their client(s) in order to provide the sex workers with knowledge to better take care of their own health as well as the health of their clients. A qualitative research design was used to collect data by means of in-depth interviews and participant observation sessions. Research strategies that were also used included: description, ethnography, phenomenology, and the biographic methods of qualitative research. The research revealed that men who have sex with men (MSM) were exposed to forty-nine different preventable sexually transmitted infections including HIV/AIDS, trauma, violence, and alcohol and drug abuse. All these conditions relate to the lifestyle and activities of male sex workers. Recommendations were made regarding the removal of factors that hinder the delivery of programmes on safer sex to MSM. A booklet on safer sex for MSM was compiled by the researcher and distributed to all informants upon completion of the research. The neglected topic of male sex work was highlighted and health practitioners and other decision makers can now use the information in this thesis to make a contribution towards the better management of male sex work in South Africa in the interest of public health. / Health Studies / D.Litt et Phil. (Health Studies)

The study has two separate but related aims, which are to explore the social and health experiences of men who are in polygynous relationships and to develop holistic health and social strategies to support men who are in polygynous relationships. Objectives of the study were to identify the different permutations of polygynous relationships that related to health and social issues; to clarify the social status of men who are in polygynous relationship; to explore and describe the health experiences of men in polygynous relationship; to explore and describe the social experiences of men in polygynous relationship; to explore the spiritual experiences of men who are in a polygynous relationship; to describe and to generate holistic strategies to support men who are in a polygynous relationships. Method: In this study, the researcher used descriptive and interpretive phenomenological processes to develop a range of holistic strategies to support men who were in polygynous relationships. The researcher described the experiences and developed interpretations based on the lived experiences that the men reported. Findings: Polygyny remains the reality within the Bapedi tribe in Sekhukhune area. The practice of polygyny is not only for the affluent as indicated in most literature but is also practiced as a corrective strategy for families who are experiencing marital problems. Polygyny is not viewed as abusive to the women and children but rather beneficial to the women. It helps to reduce the risks of the development of cervical cancer that is predisposed by frequency of sexual intercourse. Polygyny promotes the morals within the communities, as children grow up within the two parents’ environment as opposed to the rising numbers of single parent families. Polygyny practice in the Sekhukhune areas is a voluntary choice and not a forced marital arrangement. Conclusions and recommendations: The researcher recommended policy guidance to support health practitioners with strategies to assist members of polygynous families in need of help. The policy also guides employers to recognise and to register the second or third wife as beneficiaries of the working husband. / Health Studies / D. Litt. et Phil . (Health Studies)

In English / The purpose of this study was to establish factors affecting the participation of men working in the informal sector economy of South Africa in HIV counselling and testing (HCT) or voluntary counselling and testing (VCT). This includes the exploration of reasons for acceptance and non-acceptance of HIV testing, knowledge and perceptions about HIV testing and behaviours and attitudes towards HIV testing. Data was collected through a structured questionnaire and a sample of fifty (50) men was purposively selected. It was found that the reasons for acceptance of HIV testing are satisfactory and reasons for non-acceptance are still a concern, and that several issues such as education about HIV testing and HIV in general still need to be addressed. Most of the respondents had undergone testing for HIV, but there is still a stigma attached to HIV testing. / Sociology / M. A. (Social Behaviour Studies in HIV/AIDS)

The study has two separate but related aims, which are to explore the social and health experiences of men who are in polygynous relationships and to develop holistic health and social strategies to support men who are in polygynous relationships. Objectives of the study were to identify the different permutations of polygynous relationships that related to health and social issues; to clarify the social status of men who are in polygynous relationship; to explore and describe the health experiences of men in polygynous relationship; to explore and describe the social experiences of men in polygynous relationship; to explore the spiritual experiences of men who are in a polygynous relationship; to describe and to generate holistic strategies to support men who are in a polygynous relationships. Method: In this study, the researcher used descriptive and interpretive phenomenological processes to develop a range of holistic strategies to support men who were in polygynous relationships. The researcher described the experiences and developed interpretations based on the lived experiences that the men reported. Findings: Polygyny remains the reality within the Bapedi tribe in Sekhukhune area. The practice of polygyny is not only for the affluent as indicated in most literature but is also practiced as a corrective strategy for families who are experiencing marital problems. Polygyny is not viewed as abusive to the women and children but rather beneficial to the women. It helps to reduce the risks of the development of cervical cancer that is predisposed by frequency of sexual intercourse. Polygyny promotes the morals within the communities, as children grow up within the two parents’ environment as opposed to the rising numbers of single parent families. Polygyny practice in the Sekhukhune areas is a voluntary choice and not a forced marital arrangement. Conclusions and recommendations: The researcher recommended policy guidance to support health practitioners with strategies to assist members of polygynous families in need of help. The policy also guides employers to recognise and to register the second or third wife as beneficiaries of the working husband. / Health Studies / D. Litt. et Phil. (Health Studies)

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Men might benefit from opportunities specific to their needs in improving access to HIV care. This is a group vulnerable to higher morbidity and mortality than their female counterparts, due not only to poor or delayed health seeking behaviour and the culture of blame for the transmission of HIV, but probably due to neglect, inadequate or poor support by the current policies, by a gender biased research agenda, by the international research community and global health funders. Objectives: The objectives of this current study were: - to explore the reasons for poor health seeking behaviour amongst African men seeking HIV care in KZN; - to establish the health care practitioners’ views about the reasons for the perceived poor health seeking behaviour amongst African men accessing HIV services in KZN; - to inform guidelines in improving access to HIV services by African men Methodology In-depth interviews were employed as the method of obtaining lived experiences, perspectives and opinions of men living with HIV and that of their health care practitioners. Results It was found that men still feared the diagnosis of being HIV positive, even with the advent of highly active anti-retroviral therapy (HAART) and the advances in managing this disease. Several reasons for this fear emerged with the common theme being the doom of impending death, social stigma and fear of abandonment as well as social marginalization. Conclusions We cannot expect to attract men to predominantly female orientated settings within health faculties. Special attempts need to be made to reach out to men in places they are comfortable being in. Messages should be clear and concise about the effectiveness of low cost, available treatment for HIV; and that early diagnosis improves health outcomes. Cultural sensitive interventions are needed that are suitable, in generating a clearer understanding of health management options and motives. / AFRIKAANSE OPSOMMING: Mans kan voordeel trek uit geleenthede wat spesifiek op hul behoeftes in die verbetering van toegang tot MIV-sorg. Dit is 'n groep kwesbaar vir hoër morbiditeit en mortaliteit as hul vroulike eweknieë, nie net die gevolg swak of vertraagde gesondheid gedrag en die kultuur van die blaam vir die oordrag van MIV, maar waarskynlik as gevolg van verwaarlosing, onvoldoende of swak ondersteuning deur die huidige beleid , deur 'n geslag bevooroordeeld navorsing agenda, deur die internasionale navorsing gemeenskap en globale gesondheid-befondsers. Doelstellings: Die doelwitte van die huidige studie was: - die gesondheidsorg-praktisyns se siening oor die redes vir die waargenome swak gesondheid gedrag onder-Afrikaanse mans toegang tot MIV-dienste in KZN tot stand te bring; - die redes vir swak gesondheid gedrag onder-Afrikaanse mans wat MIV-sorg in KZN te verken en - riglyne te stel in die verbetering van toegang tot MIV-dienste deur swart mans Metodes In-diepte onderhoude is gebruik as die metode van die verkryging van geleefde ervarings, perspektiewe en menings van mense wat met MIV en dié van hul gesondheidsorg praktisyns. Bevindings Daar is bevind dat mans nog bang was vir die diagnose van MIV-positief is, selfs met die koms van hoogs aktiewe antiretrovirale terapie (HAART) en die vooruitgang in die bestuur van hierdie siekte. Verskeie redes vir hierdie vrees na vore gekom met die gemeenskaplike tema synde die straf van die naderende dood, sosiale stigma en vrees vir verlating, sowel as sosiale negatief. Gevolgtrekkings Ons kan nie verwag om mense te lok om oorwegend vroulike georiënteerde instellings in gesondheid fakulteite. Spesiale pogings moet aangewend word om uit te reik na die mans in plekke waar hulle gemaklik is. Boodskappe moet duidelik en bondig oor die doeltreffendheid van lae koste, beskikbare behandeling vir MIV, en dat die vroeë diagnose verbeter gesondheid uitkomste. Kulturele sensitiewe intervensies word benodig wat geskik is, in die skep van 'n beter begrip van gesondheid opsies en motiewe.

The practise of male traditional circumcision is severely challenged with enormous problems ranging from hospitalisation of the initiates as well as deaths of the initiates. The background of the problem is focused in the Eastern Cape Province where the researcher has noted several initiates being treated in hospitals for physical and as well for psychological problems. The objective of this study was to explore and describe newly initiated Xhosa men's experiences of traditional circumcision rites at East London in the Eastern Cape Province and to describe the guidelines for support of these newly initiated Xhosa men by public health professionals. A qualitative explorative, descriptive contextual and phenomenological design was followed. Purposive sampling technique was used to select the participants. Fourteen participants volunteered to participate in the study after they met the eligible criteria. Focused group interviews were used as a method for data collection. Data analysis of the study showed that there are several factors affecting newly initiated men whilst undergoing circumcision rites. These factors can present at any of the three circumcision stages i.e. pre-circumcision, peri-circumcision and post-circumcision. The recommendations of the study strongly suggest a cultural competence in rendering effective health care services to culturally and ethnically diverse clients. All the five constructs of cultural competence are entailed in the support guidelines that have been developed by the researcher. They are cultural awareness, cultural knowledge, cultural skill, cultural encounter and cultural desire. Finally limitation of the study and the need for a further research has been clearly stated. / Health Studies / M.A.

Evidence of male sex work has a history as long as female sex work. There is century old evidence of male Sumarians and Greeks selling sex to other men. Men are today still selling sex to other men. This study showed that the elimination of sex work is practically impossible, and could only be accomplished by the gross denial of basic human rights. Male sex workers have not received the same attention from researchers as have their female counterparts. This is so despite the large numbers of male sex workers in cities all over the world who potentially contribute to the worldwide sexually transmitted infection rates. It is known that wherever indiscriminate sexual activities take place, the risk of transmission of infections are greater. The activities between the male sex worker and his client(s) determine the health problems they are exposed to. The purpose of this research was to determine what transpires between male sex workers and their client(s) in order to provide the sex workers with knowledge to better take care of their own health as well as the health of their clients. A qualitative research design was used to collect data by means of in-depth interviews and participant observation sessions. Research strategies that were also used included: description, ethnography, phenomenology, and the biographic methods of qualitative research. The research revealed that men who have sex with men (MSM) were exposed to forty-nine different preventable sexually transmitted infections including HIV/AIDS, trauma, violence, and alcohol and drug abuse. All these conditions relate to the lifestyle and activities of male sex workers. Recommendations were made regarding the removal of factors that hinder the delivery of programmes on safer sex to MSM. A booklet on safer sex for MSM was compiled by the researcher and distributed to all informants upon completion of the research. The neglected topic of male sex work was highlighted and health practitioners and other decision makers can now use the information in this thesis to make a contribution towards the better management of male sex work in South Africa in the interest of public health. / Health Studies / D.Litt et Phil. (Health Studies)

In English / The purpose of this study was to establish factors affecting the participation of men working in the informal sector economy of South Africa in HIV counselling and testing (HCT) or voluntary counselling and testing (VCT). This includes the exploration of reasons for acceptance and non-acceptance of HIV testing, knowledge and perceptions about HIV testing and behaviours and attitudes towards HIV testing. Data was collected through a structured questionnaire and a sample of fifty (50) men was purposively selected. It was found that the reasons for acceptance of HIV testing are satisfactory and reasons for non-acceptance are still a concern, and that several issues such as education about HIV testing and HIV in general still need to be addressed. Most of the respondents had undergone testing for HIV, but there is still a stigma attached to HIV testing. / Sociology / M. A. (Social Behaviour Studies in HIV/AIDS)