There are two dominant approaches to counselling for sexual risk reduction In South Africa. The TASO model which is based on client centred principles, informs much of vCT counsellors' training. More recently, the (ARRM) AIDS Risk Reduction Model which includes a cognitive behavioural component to counselling for sexual risk reduction has been introduced. A sample of vCT counsellors who have been trained using the ARRM were interviewed to develop an understanding of their experiences of using this approach. These participants provide a vCT service to clients in the midlands of the province of KwaZulu-Natal. A central finding was that although counsellors experienced the cognitive behavioural approach as having good potential for effecting sexual behaviour change, numerous barriers were identified to applying the approach within the South African context. Counsellors were also critical of the TASO model as a model for counsell ing for sexual risk reduction. Elements of the cognitive behavioural approach they experienced as useful included its potential for changing cognitions (misconceptions and myths in communities), the collaborative nature of the approach, negotiating strategies for risk reduction, use of a problem solving approach, follow-up and monitoring of behaviour. Barriers identified included contextual constraints such as poverty, gender power differentials and cultural practices. Also identified as a barrier was the dominance of the biomedical approach within the health care system. Despite identifying barriers to the application of this approach, counsellors remained optimistic that cognitive behavioural approaches could be adapted to the life context of their clients and that this could be facilitated through further training and mentoring. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2007.

Introduction: The high prevalence of HIV in South Africa was confirmed by Department of Health (2005) which reported an HIV prevalence rate of 40.7 percent amongst antenatal clinic attendees at public facilities in KwaZulu-Natal in 2004. Abstinence is one of the strategies used by many different cultures where young unmarried people are encouraged to abstain from sex until marriage, to prevent young girls from getting pregnant and acquiring sexually transmitted infections (STIs). Aim: The aim of this study was to investigate African rural high school learners' choice of sexual abstinence and to compare abstinent versus non-abstinent African rural high school learners in order to be able to develop tailored educational messages. Abstinence was defined as not having penetrative sex, since this is the accepted definition of abstinence in Zulu culture. Objectives: a) To investigate the prevalence of abstinence from sexual intercourse amongst African rural high school learners, b) To assess demographic, psychosocial, and economic determinants of abstinence from sexual intercourse, c) To make recommendations about abstinence interventions. Method: A descriptive cross-sectional study was carried out in a rural area (Ugu District in southern KwaZulu-Natal). One class of Grade 9 learners, ages 14-20 years, was selected from each often randomly selected rural high schools. An anonymous selfreporting semi-structured questionnaire used the I-Change model to investigate demographic and economic information, attitudes, social influences, self-efficacy and intentions towards sexual abstinence. Chi square and T-tests were used for bivariate analysis and Logistic regression was used to develop a model for abstinence from sexual intercourse. Results: A total of 454 learners participated with a mean age of 16.76 years (SD 1.41) age range 14-20 years. Of the sample 208 (45.8%) were male and 246 (54.2%) female. The majority were Christian (84.6% (n=384)) and of this population, 28.3% (n=127) reported that they had 'ever had sex'. Furthermore, 24.5% (n=91) of learners reported that they were currently sexually active. Fifty six percent (n=252) of learners reported that they abstained from sex. When comparing learners reporting abstinence (n= 252) with those not abstinent (n= 202), abstinent learners were significantly more often females, who had never had sex (p / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2007.

This study describes how AIDS prevention education programs were constructed, delivered, and implemented in Vancouver between 1983 and 1994. Biodeterministic models of disease are examined through a historical analysis of documents that include newsletters, minutes of board meetings, policy reviews, annual reports, and personal journals. This study assumes that AIDS is as much a sociocultural phenomenon as it is biological. The findings suggest that present educational guidelines for AIDS prevention are unable to identify what messages should be communicated and fail to identify to whom they should be conveyed. This study does not recommend the use of biodeterministic models of AIDS prevention education which reflect plague metaphors. Instead, culturally relevant strategies need to be developed throughout all aspects of AIDS prevention curricula.

Research on AIDS and women is recent and focuses almost exclusively on the heterosexual population. Despite research on the sexual behavior of young women which asserts that lesbians are at low risk for exposure to HTV, many lesbians engage in high risk practices and are therefore at risk for infection. In order for AIDS education for this population to be effective, it must be designed spedfically to meet identified needs. [...]

This study surveyed the sexual behaviors and knowledge of Acquired Immunodeficiency Syndrome (AIDS) among 117 undergraduate students from McGill University, Montreal. The sample consisted of 32 men and 85 women ranging from 18 up to 24 years of age. The total sample was split into three knowledge groups, Low, Medium, and High, based on answers provided to questions about AIDS. The data were analyzed separately for the total sample, men, women, and the three knowledge groups. The findings indicated that these students were relatively knowledgeable about AIDS (73.23% correct responses out of 21 items), but were engaging in high risk sexual activities. It appears that personal concern about contracting AIDS, not knowledge of this disease, is related to behavior change among undergraduate students. It was recommended that AIDS education programs focus more on increasing the personal concern than the AIDS knowledge of adolescents.

The challenge that confronts South Africa 's emerging democracy is that an increasing percentage of its population is being infected with HIV/AIDS daily . The socio-political impact of the disease has resulted in the development of a variety of macro-level interventions. Despite these initiatives, there has been no decline in the spread of the epidemic. The increasing prevalence of HIV infection among young South Africans in particular, has necessitated an exploration into their risky sexual behaviour. A closer study of the social fields of practice, where knowledge is not only produced, but is constantly contested, negotiated, reproduced and embedded, is suggested. This study uses the principles of feminist theory to focus on gender roles and the related issues of power and risky behaviour. The central argument of this work is that the traditional construction of sexuality, which encourages sexual aggression and promiscuity among young men, alongside female sexual passivity and ignorance, are gendered factors which fuel the spread of HIV/AIDS . In order to examine young peoples' perceptions of the role of gender and risky behaviour, I engaged young people, who were already in the field, to conduct the research. An exploration into the processes of enabling young people to conduct research, while linking the production of meaning to the possibility of human agency and transformative social action, formed an evolving methodology in this work. The research was designed to provide young people with a space for active engagement, participation, immersion and reflection, en route to becoming researchers. Young researchers who conducted research in their youth communities served as deep insider researchers, who possessed an awareness of the slogan systems and semiotics which operated within the cultural norms of the community. The young researchers conducted the inquiry by using a multiplicity of methods, which included visual methodologies, individual interviews and questionnaires. They solicited most of the data from a wider group of 15 to 19 year old African and Indian learners . These learners, who were mainly from a lower socio-economic background, attended the co-educational school, in the province ofKwaZulu Natal in South Africa. The findings of this study reveal how young researchers become empowered by acquiring increased competence in doing research and achieving a greater understanding of the influences of gender and power on risky behaviour. The research report offers methodological insights into the training and enablement of young people as researchers. It reveals how catalytic validity enables a transformation in the young researchers, who, having achieved a heightened understanding of the purpose of the research , actively participated in the research process. The study is significant because it reveals the gradual effacement of the main researcher from the research process, as a natural consequence of engaging young researchers to solicit, generate and interpret data. These new insights evolved as a result of taking the risk of allowing oneself, as a main researcher, to "get off track" and to enter uneven social spaces by doing research differently. / Thesis (Ph.D.)-University of KwaZulu-Natal, 2006.

Multiple sexual partnerships play a very significant role in the spread of HN with epidemiologists suggesting that these partnerships possibly drive the epidemic. According to epidemiological evidence, a reduction of these partnerships would have a substantial impact on the epidemic. Like most countries in sub-Saharan Africa, Zambia is facing a crippling HIV epidemic with prevalence in the 15-20 percent range. In light of this, this study explored youth perceptions of multiple sexual partnerships in the contex,t of HIV/AIDS. The main aim of the study was to provide some insight on these partnerships with the hope that this will shed some light on why these partnerships exist and what barriers and opportunities for change exist given Zambia's high HIV prevalence. The findings of this study suggest that there are several social, cultural, economic and environmental factors that influence the existence of multiple sexual partnerships among the youth. In addition, the study also shows that while young people acknowledge the benefits of faithfulness in sexual relationships, there are several barriers that prevent the youth from being faithful. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2006.

In the global HIV/AIDS pandemic, men who have sex with men (MSM) have experienced high levels of infection. Consequently, this population is considered a crucial target for prevention, care, and treatment efforts. In sub-Saharan Africa, however, most HIV transmission occurs via heterosexual intercourse, and 60% of HIV cases are women. African HIV epidemics are thus classified as “heterosexual” phenomena, and MSM are rarely targeted by public health programming. Epidemiological studies now show that African MSM often have greater HIV prevalence than the general population. Behavioral research further indicates elevated sexual risk and low prevention-related knowledge levels among these men. Moreover, denial, stigmatization, and criminalization of male homosexual conduct across Africa have created social climates in which MSM remain “hidden,” fearing rejection or arrest. This has heightened their vulnerability to HIV infection. To counteract this trend, public health advocates call for prevention interventions adapted to the needs of African MSM. In a few countries, local NGOs have begun mobilizing around the “MSM issue.” However, little information exists about HIV prevention among MSM in sub-Saharan Africa and the associations undertaking it. Using a case study of one such association – Alternatives-Cameroun – this project aimed to explore the factors affecting design and implementation of HIV prevention interventions for MSM in Cameroon. Homosexual conduct is illegal in Cameroon, and MSM are frequently harassed and arrested. Nonetheless, Alternatives-Cameroun has launched prevention programming that reaches “hidden” MSM and addresses their unique characteristics. Through qualitative research involving stakeholder interviews and personal observation, this project found that local, national, and international factors all influence choices of intervention content and delivery formats. Interventions are designed by Cameroonian MSM, for Cameroonian MSM, but are also informed by empirical research and outreach principles drawn from other contexts. Implementation is a challenge in Cameroon’s hostile and resource-poor environment: stakeholders bear physical, emotional, and financial burdens during outreach. However, internal dynamics and foreign support help Alternatives-Cameroun mitigate these obstacles. This project reveals that understanding local realities and reinforcing multi-sectoral mobilization around MSM issues are important first steps towards launching HIV prevention interventions for MSM in sub-Saharan Africa. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

As we enter the third decade of a devastating worldwide epidemic, much has been done to stem the flow of HIV/AIDS, in particular within North American and Western European urban centres. Successful prevention campaigns in the 1980s had the immediate impact of lowering the rate of HIV infection among gay men, and anti-retroviral drug therapies in the mid-1990s have literally brought thousands of gay men back from the brink. However, by the middle to late 1990s, epidemiological and anecdotal evidence has strongly suggested that gay men have begun to move away from the safer sex orthodoxy of the 1980s. / Forty gay men ranging in age from 21 to 55 were interviewed for this study in order to determine if they have changed their approach to safer sex strategies implemented in the mid-1980s. In contrast to approaches to risk behaviour that emphasize the Health Belief Model, with its focus on the rational individual, this dissertation focused on the social contexts that shape gay men's decisions. / This study found a number of factors that influenced gay men's sexual choices, including age and the changing role of community. Younger gay men, those who have come of age during the 1990s, have taken a different approach to the AIDS epidemic. None of the younger participants in this study had lost anyone to HIV. Furthermore, they were now part of a group of men who no longer considers a HIV diagnosis to be immediately fatal. New medications have definitely shifted their approach to AIDS. Finally, this group of gay men no longer feels defined by a gay community like older gay men interviewed for this study. They believe they are coming of age in a time and place where they have more choices in how they will define themselves as gay men. For older gay men, those who lost many lovers, friends, and acquaintances during the HIV epidemic, changes in gay men's sexual risk-taking are both surprising and inevitable. These men are dealing with issues of ageism, loss and lack of visibility in a changing gay community. / Although there are different age-related arguments for abandoning safer sex strategies, this study helps to explain why there is a definite shift in risk-taking behavior underway as we enter the third decade of HIV/AIDS. It suggests new challenges and approaches for AIDS service organizations to deal with a substantive change in gay men's sexual behaviour.

Thesis (M.P.H.M.)--Mahidol University, 1999.