Although much research has been conducted on termination of pregnancy, there is a paucity of information regarding women’s sexuality after such a procedure, and in particular, how a woman understands her sexuality following a termination of pregnancy or what influences such an understanding. This research aimed to investigate how women understand their sexuality following a voluntary termination of pregnancy through the examination of the interaction between personal and broader social views on sexuality. Seven women who had undergone the procedure at two private termination clinics in Johannesburg were interviewed, using a semi-structured, open-ended interview schedule. The data was analysed according to thematic analytic methods. Based on the results, it was clear that the way in which women understand their sexuality following a termination of pregnancy is complex and multi-faceted. Particular themes emerged that were in line with the debates raised in the current literature. It became evident that these views were intricate and multi-faceted. Heteronormativity and heterosexuality proved particularly influential in how women understand their sexuality following a termination of pregnancy, and which further related to points raised throughout the literature. It was clear through the analysis that each theme could be seen to stand alone, or alternatively be represented through other themes and sub-themes.

A research report submitted in partial fulfilment of the requirements for the degree of Master of Science in Epidemiology in the field of Infectious Diseases School of Public Health, University of the Witwatersrand May 2014 / South Africa continues to grapple with the HIV/AIDS epidemic almost 30 years since the disease was first described. South Africa has 6.4 million people living with HIV thereby contributing 17% to the global burden of HIV/AIDs even though it makes up 0.7% of the world population translating to an HIV prevalence of 10.6% in the general population. . Multiple concurrent sexual partnerships (MCP) and inconsistent condom use are notably the major contributors to the spread or transmission of HIV in South Africa. The South African government has allocated massive financial resources to support HIV/AIDS interventions, however, the epidemic continues to amplify in South Africa and there is a growing need for targeted HIV prevention interventions which will address behaviour change. Objectives The objectives of the study were to determine the differences in sexual risk behaviour between self-identified HIV positive and HIV negative men and identify factors associated with sexual risk behaviour. Methodology This was secondary data analysis of a cross sectional design study called "Risk Perceptions of HIV Positive Men" and it was conducted in clinics from Soweto, Cape Town and the Cape Winelands from October 2010 to July 2011. The sample size was 451 and the study population comprised self-identified HIV positive and negative men between ages 18 - 60 years. Proportion of consistent condom use (CCU) and multiple concurrent partnerships (MCP) were calculated and difference between those self-identified HIV positive and negative were determined using Chi-square tests. Factors associated with MCP and CCU between the two groups was determined using univariable and multivariable logistic regression Results We analysed data for 451 men with a mean age of 39 years (std. dev. 11.30). Out of the 451 men 311 (69%) identified themselves as HIV positive and there was a statistical significant difference in baseline characteristics between HIV positive and HIV negative men (age, race, relationship status, employment status, education level, religion, area of residence, age at sexual debut, condom use at first sex, sexual orientation and circumcision status). HIV positive men were four times more likely to have used condoms consistently in the last six months compared to HIV negative men (AOR=3.72, CI: 1.95-7.11), however, HIV positive men were also four times more likely to have had Multiple Concurrent Partnerships in the last 12 months compared to HIV negative men (AOR=4.60, CI: 2.09- 10.12) . Other factors associated with sexual risk behaviour were; relationship status, age group, race, age at sexual debut, alcohol frequency, sexual orientation and perceptions about undetectable viral load reducing HIV transmission risk. Conclusion and recommendation There is a difference in sexual risk behaviour between men who identified themselves as HIV positive and those who identified themselves as HIV negative. Men who identified themselves as HIV negative were less likely to have used condoms consistently in the last six months. Though the HIV positive men are using condoms consistently they have multiple concurrent partners. There is need to strengthen post HIV test counselling coupled with targeted messages for both HIV positive and HIV negative men.

Introduction: Alcohol is an indirect contributor to HIV transmission in sub-Saharan Africa. Alcohol users in general, and heavy, episodic drinkers in particular, are more likely to engage in risky sexual behaviour. Interventions promoting the reduction of alcohol use in conjunction with sex are likely to enhance the HIV prevention response. However, little is known about the relationship between different dimensions of alcohol use and risky sexual behaviour in the general adult population in South Africa. The overall aim of this study was to examine the relationship between alcohol dependence, binge drinking and frequency of drinking in the past month and risky sexual behaviour among males and females aged 16-55 years in South Africa in 2012. Methods: This was a secondary analysis of data from a nationally representative cross-sectional study of males and females aged 16-55 years in 2012. Bivariate and multivariate analysis was conducted to investigate the relationship between alcohol use and risky sexual behaviour. Three nuanced measures of alcohol use were used – alcohol dependence, binge drinking, and frequency of drinking in the past month. The outcomes examined included multiple sexual partners (MSP) in the past 12 months, MSP in the past month, transactional sex, age-disparate sex and condom use at last sex. Results: Some 10,034 respondents (n=4,065 males and n=5,969 females) were interviewed. This study found that for males, there was no significant relationship between alcohol dependence and risky sexual behaviour. For females, those who were alcohol dependent were more likely to have received money/gifts in exchange for sex. Binge drinking and frequency of drinking in the past month were associated with risky sexual behaviour for both males and females. For males, binge drinking was associated with: MSP in the past 12 months (AOR: 1.93, 95% CI 1.37 - 2.72), providing gifts/money in exchange for sex (AOR: 1.53, 95% CI 1.01 - 2.33), and having a sexual partner five or more years younger than themselves (AOR 1.44, 95% CI 1.09 - 1.89). An interaction between binge drinking and self-efficacy for resisting MSP was positively associated with MSP in the past month. Frequency of drinking in the previous month was associated with all five outcome variables and a dose response relationship was present. An interaction between frequency of drinking and self-efficacy for resisting MSP was positively associated with MSP in the past month. For females, binge drinking was associated with: MSP in the past 12 months (AOR 1.93, 95% CI 1.37-2.72), MSP in the past month (AOR 1.79, 95% CI: 1.03 - 3.10), and receiving money/gifts in exchange for sex (AOR 3.10, 95% CI 1.45 - 6.62). An interaction between binge drinking and self-efficacy for resisting MSP was positively associated with MSP in the 12 past months. Frequency of drinking was associated with MSP in the past month. A dose response relationship was evident with females who drank more frequently in the past month being more likely to have had MSP in the past 12 months. This study found high levels of non-drinking (62.80%) but high levels of hazardous drinking among those who drank. Males were more likely to drink and to display hazardous drinking patterns. In general males were more likely to engage in risky sexual behaviour, although males were more likely to have used a condom at last sex. Conclusions: Overall this study has described the patterns and prevalence of alcohol use and risky sexual behaviour in the general population in South Africa. It has demonstrated gender-specific relationships between various types of alcohol use and risky sexual behaviour and has new insights into the complex relationship between these two phenomena. Results suggest that the drinking environment facilitates high-risk sexual encounters. Findings from this study can be used to design and implement future interventions to address this important risk factor for HIV.

Background Risky sexual behaviour, especially among 15-24 year olds, is a public health concern in South Africa since this age group is the most at risk of contracting HIV. The concern is to what extent youth are indulging in risky sexual behaviour. In 2002, the Department of Health conducted a nationally representative survey on issues surrounding HIV/AIDS. A mass media intervention was launched in the same year, i.e. the Khomanani Campaign, and a year later, in 2003, a survey was conducted to assess the impact of the Khomanani Campaign. Objectives The main question being asked is, “What are the factors associated with risky sexual behaviour amongst the young people of South Africa”. The indicators of risky sexual behaviour being explored are age of sexual debut, condom use at last sexual encounter, condom use in the past year and use of condoms consistently over the entire sexual lifetime. The three objectives of the research report are to describe the cohort of the youth in the sample under investigation, to describe the indicators of risky sexual behaviour among youth that are deemed at risk, and to investigate the factors associated with these indicators of risky sexual behaviour. Data The research uses the Khomanani Survey Findings of the Khomanani survey which was conducted in 2003, a year after the Khomanani Campaign. Only youth aged 15-24 years old who indicated that they were sexually active were included in the sample. Method The research is a cross sectional, secondary analysis of existing data, i.e. the Khomanani Survey Findings. Descriptive statistics were carried out and Chi-squares or Fisher’s exact tests were used for the initial bivariate analysis testing for associations between the indicators of risky sexual behaviour and the factors deemed to affect such behaviour. Factors such as media, self-esteem, self-efficacy, beliefs and accessibility of condoms which were deemed to be associated with risky sexual behaviours were explored in this report. Multiple logistic regression models were carried out with variables which were significant at p<0.20 in the bivariate analysis being included in the models. Factors that were significant in the multiple regression models were regarded as the most important variables to be associated with risky sexual behaviour. Results The final sample comprised 481 sexually active respondents with slightly more girls than boys (55% vs. 44% with 1% not indicating the gender); 48% of respondents were aged 15-19 years compared with 52% of respondents in the 20-24 age group. The majority of the youth had a partial secondary education. Only 5% of the youth were reported as married. The proportion of youth that had used a condom at last sexual encounter was 57%. The proportion of youth reporting that they used condoms consistently in the past year was 39% and some 28% of youth had used condoms consistently during the entire sex life. Of the 481 youth in the sample, 31% reported their first sexual encounter as before 16 years (“early sexual debut”). In the final regression model for condom use at last sex, females were 48% (aOR=0.52; 95% CI=0.34, 0.78) less likely to have used a condom at last sexual encounter compared with males. Being a youth from metropolitan areas was associated with condom use at the last sexual encounter (aOR=2.60; 95% CI=1.47, 4.57). Youth who have heard the term ‘safe sex’ were twice (aOR=1.98; 95% CI=1.10, 3.56) as likely to have used a condom at the last sexual encounter as to those who hadn’t heard the term “safe sex”. Being comfortable talking about using condoms with partners was also associated with use of condoms at last sex (aOR=3.86; 95% CI=1.74, 8.53). Concerns over the quality of government issued condoms were postulated to have an impact on condom use. Therefore respondents were asked whether they thought that government condoms differed from those purchased from shops. Respondents who indicated that condoms were the same were 2.71 times (aOR=2.71; 95% CI=2.28, 5.73) as likely to have used condoms consistently in the past year as those who indicated that government condoms were better than the ones from shops. Respondents who indicated that government condoms are of poor quality were 2.18 times (aOR=2.18; 95% CI=1.04, 4.58) as likely to have used condoms consistently in the past year as those who indicated that government condoms were better than the ones from the shops. Consistency in using condoms since being sexually active was associated with being from a metropolitan area (aOR=1.99; 95% CI=1.12, 3.51) and also respondents who had the opinion that condoms are the same (aOR=3.04; 95% CI=1.33, 7.07) whether they are government issued or from the shops.. The age of the respondent and also the belief that one should have sex with a partner to show their love were the only factors associated with early sexual debut. Respondents who were older (20-24 years) were 61 %( OR=0.39; 95% CI=0.23, 0.65) less likely to have had early sexual debut below the age of 16 compared to their counterparts aged 15-19 years. Respondents who did not believe that a person should have sex with their partner to show their love were 41 %( OR=0.59;95% CI=0.37,0.94) less likely to have had early sexual debut to those who believed that a person should have sex with their partner to show their love controlling for gender, area of stay, age group and employment. Conclusions The findings from the survey point out that more than half of the youth are using condoms at most recent activities, with differences between men and women. Some youth are consistently using condoms and not only using at last sex. Hence programs targeting youth should continue taking into account issues that may be contributing to youth not using condoms and not using them consistently. Messages on safe sex, messages encouraging youth to communicate with partners on sexuality issues, as well as the government making condoms accessible in all areas, should continue to be reinforced. Future research should also focus on development and evaluation of interventions to delay sexual debut with issues of beliefs, and community beliefs being discussed.

A velhice se constitui de uma importante etapa da vida que é extremamente significativa, merecendo atenção e cuidados especiais, com possibilidades de continuidade das fontes de prazer, alegria e de felicidade. Assim, atingir a velhice implica nas diversas superações de etapas, obstáculos, percalços e momentos que conduzem a um amadurecimento maior, dadas as experiências vivenciadas. Embora podendo ser considerada, biologicamente, como uma regressão morfofuncional, esse processo afeta todos os sistemas fisiológicos principais, de forma variável. Entretanto, os sentimentos e as sensações não sofrem deterioração. Não impede o indivíduo de desfrutar a vida, de forma ativa e saudável, possibilitando também a praticar a sexualidade como pode e como queira. Mas, os preconceitos sofridos neste sentido, são muitos. A sociedade, sustenta o mito da fase assexuada, excluindo do imaginário, qualquer vivência da sexualidade entre eles, que por vezes, acreditam que a sexualidade nessa fase da vida já não faz mais sentindo. Assim, sentimos a necessidade de estudar e entender como os idosos percebem a sua própria sexualidade. Para desmitificar esse assunto que perpassa por preconceitos, mitos, tabus e crendices populares, é preciso analisar e depreender os pontos que devem ser trabalhados na perspectiva dessa população, a fim de desenvolver ações educativas mais eficientes e eficazes, nesse contexto. Portanto, propusemos, neste estudo, explorar, recolher, organizar, sintetizar e compartilhar, por meio da revisão sistemática da literatura, os resultados de artigos primários, referentes à percepção dos idosos em relação a sua sexualidade. Assim sendo, esta pesquisa basea-se em um estudo descritivo- analítico e documental, fundamentado em uma revisão sistemática da literatura científica sobre o tema central do presente estudo. Por meio da síntese das ideias principais dos estudos selecionados, identificamos as situações -limite e a partir disso, elencamos 04 Categorias e 02 desdobramentos ou subcategorias: -A falta de informação sobre a sexualidade; -Idoso não pode ter atividade sexual; - As questões de gênero no contexto social e suas influências na sexualidade do idoso; - Fatores como as doenças, a falta de um parceiro e a influência da família, são motivos que interferem na vivência da sexualidade. Como desdobramentos- A religião e suas influências na sexualidade do idoso; - As mudanças físicas e hormonais dificultam a vivência da sexualidade. Após os resultados obtidos e analisados, verificou-se que a percepção do idoso sobre a sua sexualidade é manifesta de maneira ingênua, limitada e simplista. Daí, torna-se evidente haver necessidade de efetivo investimento sobre esse assunto visando a desmistificação frente à sexualidade nesta faixa etária, compreendendo a importância do papel da Educação para a Saúde neste sentido, destacando a relevância do trabalho multiprofissional nesta lógica, relevando o do (a) enfermeiro (a) na promoção da saúde sexual e na qualidade de vida do idoso. Vale destacar a importância de se atentar para a prevenção da Aids a esse contingente no cenário nacional e internacional / Old age is a stage of life, which is extremely significant, deserving special attention and care, with great possibilities of continuing sources of pleasure, joy and happiness . However , to reach old age involves several exceedances of obstacles , setbacks and moments that bring us into maturity . Can be considered biologically functional morphology as a regression that affects all major physiological systems to varying degrees . However , the feelings and sensations are stable . Does not prevent the individual from enjoying life active , healthy and happy way, sexuality can be lived to the end. However , prejudice against sexuality of the elderly are diverse . The company maintains the myth of the asexual phase , excluding any of the imaginary experience of sexuality among the elderly , which in turn , believe that sexuality at this stage of life is no longer feeling . Therefore , we feel the need to study and understand how the elderly perceive sexuality . We know that to demystify this subject that permeates prejudices , myths , taboos and erroneous beliefs , it is necessary that health professionals understand the points that should be better worked at the prospect of this population in order to achieve more efficient educational activities in this context . We proposed , in this study , explore , collect , organize , synthesize, and share , through the systematic literature review , the results of primary articles relating to the perception of older people in relation to their sexuality . This is a search based on a descriptive - analytical and documentary study, based on a systematic review of scientific literature on the central theme of this study. By summarizing the main ideas of the selected studies , we identify the extreme situations and from this, we list 04 categories and 02 subcategories or developments : a lack of information about sexuality ; - Aged can not have sexual activity ; - The issues gender in the social context and its influence on the sexuality of the elderly; - factors such as disease , lack of a partner and family influence are reasons that interfere with the experiences of sexuality . Developments as a religion and its influences on sexuality of the elderly; - The physical and hormonal changes complicate the experiences of sexuality . After the results obtained from the research , it appears that the perception of the elderly on sexuality is still confusing , which contributes to a negative view . Becomes evident that there is a gap on the subject and lacking information for debunking that permeate our cultural scene with myths and taboos that hinder the experience and authentic perception of the elderly with regard to sexuality. We understand that only education , along with health professionals such as nurses , can and should assist in demystifying and transforming the repressive gaze of the elderly who deny sexuality , as well as the forerunners of own prejudices that permeate the subject

Typescript (photocopy). / Digitized by Kansas Correctional Industries

Photocopy of typescript. / Digitized by Kansas Correctional Industries

Increasingly the Internet has been used by men who have sex with men (MSM) to facilitate social and sexual relationships. Finding from studies investigating the relationship between sexual risk and MSM who meet sex partners on the Internet in either venue-based (offline) and Internet-based (online) settings have been mixed. In an effort to contribute to the knowledge base on this topic, this study analyzed data from two samples of MSM recruited in New York City: Web-based HIV Behavioral Surveillance (WHBS) and National HIV Behavioral Surveillance (NHBS). The relationship between sexual risk behaviors including unprotected anal intercourse (UAI), drug use, number of sexual partners, use of performance enhancing drugs (also known as erectile dysfunction drugs or PDE5 inhibitors), and group sex participation and mode of sex partner recruitment are examined. Univariate, bivariate, and multivariate analysis were used to examine the research questions and hypothesis.

New world crocodilians constitute a monophyletic group comprising four species: Crocodylus rhombifer (Cuban crocodile), Crocodylus acutus (American crocodile), Crocodylus intermedius (Orinoco crocodile), and Crocodylus moreletii (Morelet’s crocodile). All of these are in the IUCN Red list of Threatened Species and exhibit geographic distributions covering small to widespread ranges across the Americas and insular Caribbean. With the overarching goal of generating relevant information for the conservation of endangered new world crocodilians, this dissertation integrates genetic and ecological information to provide a context spanning a scale from the species level to specific populations, to analyses of mating systems and breeding strategies in Crocodylus. In addition, my research applies tools of ecological inference to model the influence of environmental factors and natural habitat disturbances in the reproductive success of Crocodylus using a long-term dataset. This work uses C. intermedius and C. acutus as model species to explore four focal questions organized in distinct chapters related to the biology and ecology of crocodilians. In Chapter I, I compare previously reported reproductive traits among C. acutus populations across its geographic range. This comparative analysis reveals a high degree of variability in reproductive traits across C. acutus range and provides potential adaptive explanations for the patterns observed. Crocodylus acutus appears to be one of the most adaptable of crocodilians in terms of nesting requirements, total nests per breeding season, nest mode (hole vs. mound), timing of egg-laying, female minimum reproductive size, clutch size, female nest defence behavior, and female parental care. Besides regional comparisons, this chapter focuses on the largest nesting population of C. acutus located in southeastern Cuba, where the species still occurs at its natural population numbers. In Chapter II, I use molecular tools to elucidate the mating system of the Orinoco crocodile in a reintroduced population in the Llanos of Venezuela. Analyzing 17 polymorphic microsatellite loci from 20 clutches I found multiple paternity in C. intermedius, with half of the clutches fathered by two or three males. Sixteen mothers and 14 fathers were inferred by reconstruction of multilocus parental genotypes. Results showed skewed paternal contributions to multiple-sired clutches in four of the clutches (40%), leading to an overall unequal contribution of offspring among fathers with six of the 14 inferred males fathering 90% of the total offspring, and three of those six males fathering more than 70% of the total offspring. Results of this chapter provide the first evidence of multiple paternity occurring in the Orinoco crocodile and confirm the success of reintroduction efforts of this critically endangered species in Venezuela. In Chapter III, I apply generalized linear mixed models to infer the effect of tropical cyclones and environmental variability on the nesting success of C. acutus in the largest nesting population of the species in southeastern Cuba for a period of 21 years. Results of this chapter report the highest-density nesting for the species documented to date, and one of the highest densities of nesting in relation to other crocodilian species, with an average of 164 nests per year and a density of 17 nests per hectare. Two of the five analyzed nesting sites had consistently higher nests and higher nesting success for the whole 21-year period. Much of the temporal variation in nesting success could be explained by the occurrence of tropical cyclones. I found that occurrence of tropical cyclones within a nesting season negatively affected nesting success, whereas the occurrence of tropical cyclones one or two years before the nesting season positively affected nesting success. Additionally, results of this chapter suggest that higher ambient temperature negatively affected nesting success. Higher-intensity tropical cyclones are expected to strike the coasts of Cuba due to climate change, potentially devastating C. acutus nests if they occur during the nesting season. As the recruitment of C. acutus populations in Cuba heavily rely on nesting success, we propose incorporating information on crocodilian’s nesting success and density, as well as the impact of tropical cyclones on the latter, as key components of coastal resilience when designing plans for coastal adaptation in the context of climate change. In the last chapter, I employed data on mitochondrial DNA (mtDNA) control region and 12 nuclear polymorphic microsatellite loci to assess the degree of population structure of C. acutus between and among localities in South America, North America, Central America and the Greater Antilles. All analyses for both mtDNA and nuclear markers show evidence of strong population genetic structure in the American crocodile, with unique populations in each of the sampling localities. My research results reinforce previous findings showing the greatest degree of genetic differentiation between the continental C. acutus and the Greater Antillean C. acutus. Three new haplotypes unique to Venezuela were reported. These were considerably less distant from Central and North American haplotypes than Greater Antillean haplotypes. Overall evidence of this chapter suggests that Cuban and Jamaican C. acutus share a mtDNA haplotype but currently represent at least two different genetic populations when using nuclear, faster evolving, microsatellite markers. Findings of this chapter offer the first evidence of genetic differentiation among the populations of Greater Antillean C. acutus, the first ever reported haplotypes for the species in Venezuela, and provide important information for the regional planning and in-situ conservation of the species. In conclusion, research findings of my dissertation are the product of combining ecological data collected in the field, genetic data generated in the lab, and the use of a suite of classic and inference-based methodological approaches to gain a better understanding of the behavior and evolution of crocodilians. The dissertation presents the first genetic research on C. intermedius, shows the importance of coastal mangrove conservation for the persistence of C. acutus in Cuba, and depicts phylogeographic linkages among distinct C. acutus populations across the Americas and Greater Antilles. The outcomes of this research provide science-based information to influence decision-making processes for the conservation of threatened crocodilians and their habitats across the study areas.

by Siu Pik-ngan. / Questionnarie in Chinese. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 74-79). / List of Tables --- p.v / List of Figures --- p.vi / List of Appendices --- p.vii / Introduction --- p.1 / Method --- p.28 / Results --- p.36 / Discussion --- p.55 / References --- p.74 / Appendices --- p.80