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))

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 pathways to manhood for young adult African men in urban settings are based more on socio-economic demands than socio-cultural expectations of being a man. This study was a qualitative explorative research on the perceptions of HIV-prevention practitioners on the different pathways to manhood among young adult African men in urban settings in Gauteng, South Africa. From the findings it was clear that there are diverse socio-cultural and socio-economic pathways to manhood, including the media, older men, peers, religion and women. These pathways affirm, confirm, validate and value a man as a man and not a boy in urban settings such as cities and informal settlements in Gauteng. The research concluded that a great deal more could be done to ensure that men get involved in HIV-prevention programmes by ensuring dialogue on manhood and masculinities between men and men, and men and women. / Sociology / M.A. (Social Science)

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.

Thesis (MPhil)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: Theological positions are usually considered as coterminous with ethical considerations. That which the Church has earnestly considered in the light of what is believed to be God's will, as elucidated in religious texts and through prayerful contemplation, are considered to be ethical without contradiction. Recently the Roman Catholic Church adopted a position forbidding the use of condoms as protection from contracting HIV/AIDS. Instead, the Church has declared that the way to controlling the AIDS pandemic is via sexual abstinence for the unmarried and sexual faithfulness within marriage. It is acknowledged that it is not possible for all the church's theological positions to be driven by pragmatic concerns within society. Nor can a church easily be seen to be promoting sex outside of marriage by recommending the indiscriminate use of condoms. However, the Roman Catholic Church, by forbidding the use of contraception, puts itself in an ethically questionable light relative to other Christian churches. The Catholic Church needs to reconsider its stance on contraception from first principles, divorced from dogmatic beliefs and practices which were derived by men and which have endured beyond their usefulness or theological veracity. It is evident that a church should not adhere to dogmas that are ungodly in their impact and ethically questionable in their import. If a church needs to revise its dogmatic stance on such issues, it should have the courage to do so. This research considers whether the stance of the Catholic Church on condoms can be considered ethical. The position of the Catholic Church is considered critically from a variety of philosophical, empirical and ethical viewpoints. In so doing, it highlights the principled and practical problems of resolving differing moral positions that cross the religious and secular divide. The approach adopted is one of an applied ethical nature, given the probable effects of participating in unprotected sex. Pregnancy and contracting HIV/AIDS are the likely outcomes of not using condoms, and these conditions will create enormous problems for the individual concerned, her, or his, family, as well as for the greater society. The position taken in this research is that the Catholic Church's stand on abstinence before marriage and faithfulness in marriage, as the answer to the HIV/AIDS crisis, would be a realistic ethical position, if, and only if, it was at all feasible and realisable in practice. However, it is the contention of the author, based on empirical considerations, that the idealistic stance taken by the Catholic Church is out of touch with the realities in our contemporary South African society and is doomed to failure. Given this perspective, the Catholic stance is morally questionable, as, if sexual relationships continue to occur outside of marriage, and if condoms are not used, the result will be unwanted pregnancies, HIV infections of both mothers and their babies, crises for families and society at large, and ultimately widespread death from AIDS. Given the pandemic facing South Africa, the Catholic position in banning the use of condoms, is ethically questionable and morally suspect. The Church needs to be called to account for the implications of its dogmatic stance. The HIV/AIDS pandemic is simply too serious for a public institution, such as the Catholic Church, to be involved in perpetuating theological niceties and holding idealised positions. The Church is not divorced from the society it exists in and a realistic, responsible and accountable response is needed in the current context of hundreds of thousands of persons facing death from AIDS and its related diseases. / AFRIKAANSE OPSOMMING: Teologiese standpunte word gewoonlik beskou as gelyktermig met etiese oorwegings. Dit wat die Kerk met erns beskou het word sonder weerspreking as eties aanvaar in die geloof dat dit die wil van God is wat belig word in religieuse geskrifte en deur gebedsoordenking. Onlangs het die Rooms-Katolieke Kerk 'n standpunt aanvaar wat die gebruik van kondome verbied as beskermingsmiddel teen MIV/VIGS-besmetting. Daarteenoor het die Kerk verklaar dat die VIGS-pandemie beheer moet word via seksuele weerhouding vir ongetroudes en seksuele getrouheid binne die huwelik. Daar word toe gegee dat dit nie moontlik is om al die die kerk se teologiese standpunte aan pragmatiese kwellinge binne die gemeenskap te onderwerp nie. Daarmee saam kan die kerk ook nie buite-huwelikse seks aanmoedig deur aan te beveel dat kondome onoordeelkundig benut word nie. Relatief tot ander Christelike kerke plaas die Rooms- Katolieke Kerk homself egter in 'n etiese bevraagtekenbare posisie deur die gebruik van voorbehoedmiddels te verbied. Die Katolieke Kerk behoort sy standpunt oor geboortebeperking te heroorweeg in die lig van primêre prinsiepe - geskei van dogmatiese oortuigings en bedrywe wat deur mense bedink is en wat hulle bestaansreg as nuttigheid of teologiese waarheid oorskrei. Dit is duidelik dat 'n kerk nie dogmas behoort aan te hang wat onverantwoord in haar impak en eties bevraagtekenbaar in hulle belangrikheid is nie. Indien 'n kerk sy dogmatiese standpunte oor sulke sake moet hersien, behoort dit die moed te hê om dit te doen. Hierdie navorsing skenk oorweging aan die vraag of die Katolieke Kerk se standpunt oor kondome as eties beskou kan word. Die posisie van die Katolieke Kerk word krities beskou vanuit 'n verskeidenheid filosofiese, empiriese en etiese standpunte. Dit verlig die beginsels en praktiese probleme wat verband hou met die resolusie van die verskillende morele posisies wat die kloof tussen die religieuse en sekulêre moet oorbrug. Die benadering wat benut word is van 'n toegepas etiese aard, gegewe die waarskynlike gevolge van deelname aan onbeskermde seks. Swangerskap en besmetting met MIV /VIGS is die waarskynlike resultate indien kondome nie benut word nie. Dit lei gevolglik tot enorme probleme vir die betrokke individu, familie en die breër samelewing. Die aanspraak van hierdie navorsing is dat die Katolieke Kerk se standpunt - dat weerhouding van seks voor die huwelik en getrouheid binne die huwelik as antwoord dien vir die MIV /VIGS krisis - 'n realistiese etiese posisie verteenwoordig indien, en slegs indien, dit toepasbaar en haalbaar binne die praktyk is. Dit is egter die bewering van hierdie skrywer, gebaseer op empiriese oorwegings, dat die idealisriese standpunt van die Katolieke Kerk uit voeling is met die realiteite van ons kontemporêre Suid-Afrikaanse samelewing en dat dit gedoem is tot mislukking. Gege hierdie perspektief, word dit duidelik dat die Katolieke standpunt moreel verdag is, veral as in gedagte gehou word dat - indien seksuele verhoudings buite huweliksverband voortduur en kondome nie gebruik word nie - die resultaat onbeplande swangerskap, MIV besmetting van beide moeders en babas, krisisse vir families en die samelewing en uiteindelik wydverspreide sterftes as gevolg van VIGS sal wees. Gegewe die pandemie wat Suid-Afrika in die gesig staar word die Katolieke standpunt waarin die gebruik van kondome verbied word eties bevraagtekenbaar asook moreel verdag. Die Kerk moet tot verantwoording geroep word vir die implikasies van sy dogmatiese standpunt. Die MIV /VIGS'pandemie is eenvoudig te ernstig vir 'n openbare instansie soos die Katolieke Kerk om betrokke te bly in die voorsetting van teologiese kieskeurigheid en die verkondiging van geïdealiseerde standpunte. Die Kerk is nie los van die samelewing waarbinne dit bestaan nie en 'n realistiese, verantwoordelike en toerekenbare respons word benodig binne die huidige konteks waarbinne honderde duisende mense dood as gevolg van VIGS in die gesig staar.

The pathways to manhood for young adult African men in urban settings are based more on socio-economic demands than socio-cultural expectations of being a man. This study was a qualitative explorative research on the perceptions of HIV-prevention practitioners on the different pathways to manhood among young adult African men in urban settings in Gauteng, South Africa. From the findings it was clear that there are diverse socio-cultural and socio-economic pathways to manhood, including the media, older men, peers, religion and women. These pathways affirm, confirm, validate and value a man as a man and not a boy in urban settings such as cities and informal settlements in Gauteng. The research concluded that a great deal more could be done to ensure that men get involved in HIV-prevention programmes by ensuring dialogue on manhood and masculinities between men and men, and men and women. / Sociology / M. A. (Social Science)

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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)

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))