M.Ed.

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MMed, Epidemiology and Biostatistics,University of the Witwatersrand, 2009 / Background: South Africa is one of the countries with the highest Human Immunodeficiency Virus (HIV) prevalence in the world. The main mode of transmission in South Africa is via heterosexual intercourse. Thus there is the need to identify factors associated with HIV high risk sexual behaviour to inform future intervention programmes. Objective: To determine the association between alcohol consumption and high risk sexual behaviour in South African adults in 2006. Methods: Secondary data analysis of cross sectional study involving 1544 adult males and females, between 16-65 years interviewed in the Soul City National Survey. A multi-stage, stratified and clustered probability sampling technique was used. Univariate and multivariate analysis was done using student t test, chi square test and logistic regression models. Results: The prevalence of alcohol consumption in the week prior to the survey was 24.4% (95%CI: 22.2-26.6). The prevalence of heavy episodic drinking in last one month was 17.5% (95%CI: 15.5-19.4). There was an association between broad socioeconomic conditions and sexual behaviour particularly age, sex and race (P<0.05). The mean age at sexual debut was 17.13 (SD 2.61) years in the males and 17.91 (2.45 SD) years in females (P<0.001). Of the sexually active respondents, 12.7% and 4.2% of the men and women respectively had multiple partners currently (P<0.001). Generally consistent condom use was more in men although, only 10.3% of the men and 5.6% of the women used the condoms consistently with their casual partners (P=0.28). Multivariate regression showed that alcohol use predicted having multiple partners (AOR 2.37; 95%CI 1.19-4.69 and AOR 4.15; 95%CI 1.37-11.97) for moderate and problem drinkers respectively. Also, heavy episodic drinking predicted having multiple partners by three times (AOR 3.21; 95%CI 1.69-6.39). There was a significant dose response relationship for having multiple partners (P<0.05). As regards unprotected sexual intercourse, although not significant, female drinkers were found to be protected from inconsistent condom use with a casual partner. Male drinkers on the other hand, were found to be at a higher risk of having unprotected sex with casual partners. Perceptions of susceptibility to HIV (AOR 0.31; 95%CI 0.17-0.56), and alcohol related harm (AOR 0.17; 95%CI; 0.22-0.71) influenced consistent condom use with casual partners. Also regards gender differences, women who drank alcohol (AOR 9.68; 95%CI 1.31-17.45 vs. 1.17; 0.28-4.89) or were heavy episodic drinkers (AOR 4.45; 95%CI 1.46-3.55 vs. 2.43; 1.03-5.92) had a higher probability of having multiple partners than men. Conclusion: There is a strong association between risky alcohol use and high risk sexual behaviours. HIV prevention programmes need to address reduction in alcohol intake and changes in drinking pattern. Further research to disentangle the relationship between condom use and alcohol use is needed.

Sexual arousal is a complex and dynamic element of women’s sexuality. Accounts vary, however most multidimensional models highlight the cognitive, affective and physiological components of the female sexual arousal response. While literature examining the peripheral physiological changes that occur during female sexual arousal abounds, there has been a dearth of literature pertaining to the cognitive and affective components. Thus, while many authors have included cognitive and emotions as independent components of the female sexual arousal response, there has been little empirical research to validate this approach. The aim of the current thesis was to examine the cognitive and affective components of female sexual arousal in more depth, investigating the nature of the relationship between these components under various experimental conditions. In order to do so, two integrated studies were conducted, each highlighting the effects of either external or internal variables on women’s subjective sexual arousal, absorption, positive affect and negative affect. Study One was designed to evaluate women’s emotional and cognitive processing of two elements of erotic film – foreplay and erotic context. 60 women were asked to report their subjective sexual arousal, absorption, positive affect and negative affect in response to one of four erotic film excerpts. The erotic excerpts varied in accordance with the degree of foreplay (low vs. high) depicted and the context in which the sexual activities took place (novel vs. habitual context). Women in the study responded more favourably to the high foreplay erotic film excerpt, subsequently reporting higher degrees of subjective sexual arousal, absorption and positive affect. Women also responded favourably to the erotic excerpt filmed in a novel context, reporting greater subjective sexual arousal as a result. The environment in which the sexual encounters were filmed failed to have an effect however, on women’s absorption or their positive or negative affect. The results of Study One suggest that stimulus specific variables, such as the degree of foreplay depicted, have a significant influence on female cognitive and emotional processing of erotic film. The results also suggest that a relationship exists between absorption, subjective sexual arousal and positive affect, albeit a correlational one. Specifically, there was evidence of parallel processing during sexual arousal, as participant reported sexual arousal, absorption and positive affect all increased and decreased in unison. Based on the results it was suggested that future research attempt to experimentally manipulate one of these variables, to examine its direct effect on the remaining variable. Thus, Study Two aimed to examine the effects of absorption on women’s cognitive and emotional processing of erotica. Study Two manipulated absorption at two levels (high vs. low), examining the impact of these states on participants’ subsequent absorption, subjective sexual arousal and positive and negative affect. 62 women were asked to read one of two sets of test session instructions. The first, participant-oriented instruction set, instructed participants to immerse themselves in the erotic film excerpt, as if they were active participants in the sexual exchange. The second, spectator-oriented instruction set, directed participants to observe and evaluate the erotic film. These instructions were designed to elicit high and low degrees of absorption, respectively. The utility of this approach when manipulating female absorption, was demonstrated by self reported ratings of absorption, given at the conclusion of the film presentation. Participants were also asked to report their subjective sexual arousal and positive and negative affect at the conclusion of the erotic film presentation. The findings of this study suggest that the adoption of a participant-oriented (high absorption) perspective elicits more favourable responses from participants than a spectator-oriented (low absorption) perspective, with participants in the former experimental group reporting greater degrees of subjective sexual arousal and positive affect. Negative affect was equivalent across experimental conditions, with the participants reporting that they experienced little to no aversive feelings during either of the experimental conditions. The results suggest that the degree to which a women immerses and absorbs herself in a sexual stimulus has a significant impact in her subsequent cognitive and affective processing of that stimulus. More specifically, it appears that women respond more favourably when they are highly absorbed and immersed in a stimulus, reporting greater subjective sexual arousal and positive affect. Overall, the results of Studies One and Two highlight the dynamic and complex nature of female sexual arousal. It appears that women have definite cognitive and affective responses to sexual stimuli. The magnitude of these responses may be mediated by a number of factors however, including the intrinsic qualities of the stimulus and the degree to which the woman attends to the stimulus. Both these variables act to either enhance or inhibit the sexual arousal response. There results have important implications for current sexuality literature. While women’s cognitions and emotions in response to erotic film were generally highly correlated, in some instances they differed, warranting their inclusion as separate elements in models of female sexual arousal. Furthermore, it might be suggested that the inclusion of an additional variable – absorption – into current models of female sexual arousal would prove beneficial, aiding researchers to better understand and predict the arousal process. As such, recommendations are made for a revised model of female sexual arousal. In terms of future directions, the results of the present thesis have implications for the treatment of sexual dysfunctions, suggesting that clinicians need to understand the internal and external variables that might contribute to the aetiology and maintenance of their presenting problems.

University and government authorities in Zimbabwe, and indeed in many African countries, have tended to downplay the presence of HIV and AIDS on university campuses. The general belief seems to be that university students’ high levels of schooling somehow protect them from HIV infection, even though existing evidence suggests otherwise. Consequently, very little is known about university students’ specific vulnerabilities to HIV infection. The few interventions that are being implemented in university campuses are often based on generic models of ‘youth sexual behaviour’ that fail to take into account the many ways that university students’ experiences are different from those of other young people. Through the use of ethnography, the thesis examines how institutional factors and ‘campus cultures’ shape students sexual behaviour at the University of Zimbabwe, as well as students’ expectations from intimate relationships and the meanings that they attach to sex, sexuality, love and romance. A key point I make throughout the thesis is that where individuals are located - both spatially and temporally - is just as important for understanding youth sexuality and the HIV epidemic as are other ‘risk’ factors, such as socio-cultural beliefs and poverty. The thesis also explores how ‘HIV risk’ is constituted, understood, deployed and avoided by university students. I argue here that ‘HIV risk’ behaviours such as transactional sex, multiple and concurrent partnerships and the non-use of condoms take on vastly different meanings when they are practiced by university students and within the context of a university campus. It is therefore incorrect to abstract ‘HIV risk’ behaviours from their immediate contexts as many interventions do. / Thesis (DPhil)--University of Pretoria, 2011. / Anthropology and Archaeology / unrestricted

MPH / Department of Public Health / See the attached abstract below

<p>the motivation of this study is to assess the high risk behaviors that contribute to the spread of HIV and AIDS among the youth. The most influential high risk behaviours that contribute to the spread of HIV and AIDS are unprotected sexual intercourse and having more than one sexual partner.The population for this study includes all full time first year students who registered for the first time in 2006 that attended the orientation week. A stratified, sequential random sample was drawn from the students attending the orientation.</p>

<p>the motivation of this study is to assess the high risk behaviors that contribute to the spread of HIV and AIDS among the youth. The most influential high risk behaviours that contribute to the spread of HIV and AIDS are unprotected sexual intercourse and having more than one sexual partner.The population for this study includes all full time first year students who registered for the first time in 2006 that attended the orientation week. A stratified, sequential random sample was drawn from the students attending the orientation.</p>

Thesis (MTh)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: This study examines the value that body theology can add to an inclusive understanding of sexuality in adolescence. Sexuality was understood differently throughout different periods in time, but even today there is still no real clarity on what is meant by the term sexuality. Sexuality is a difficult term to define and its meaning plays an important role in the way people treat each other. Throughout the different periods the church has largely been either silent about sexuality or considered it a sin. As a result the church would not necessarily be seen as a good resource for advice on sexual matters. Adolescents go through a dramatic period of developing on a physical, cognitive and moral level, which all occur simultaneously, but sexual development is the most prominent. Sexual development prepares adolescents on a physical level to reproduce and to enter into sexual relationships, but cognitive and moral development also takes place; these two processes are supportive for the adolescent to understand and process the sexual development. These developing processes, together with the context in which an adolescent is growing up, has an impact on the type of moral value system compiled by adolescents, which determines how they behave. As already mentioned, the church is not necessarily involved in these discussions, and therefore this study challenges the churches to become involved again by making use of body theology. The research question can be formulated as follows: What contribution can body theology make to promote an inclusive understanding of sexuality during adolescence? To answer the research question, the first objective is discussed in chapter 2, namely to give a historical overview to obtain an understanding of sexuality and see how the understanding of sexuality changed over the different periods, but also to see that there were certain times when the understanding of sexuality was the same. The second objective is discussed in chapter 3, where the focus is on a historical overview of the understanding of the body. This historical overview is discussed to understand that the body often stood in an ambiguous position and dualisms formed part of the understanding of the body, but it also affects a deeper understanding of life. In chapter 4, the third objective is discussed by examining the centrality of sexual development during adolescence to understand the important role that sexual development plays in the adolescent's life, but also to realise that it affects other aspects of life. The fourth objective is discussed in chapter 5, which contains the discussion of body theology to indicate how it can promote an inclusive understanding of sexuality. This chapter also discusses how body theology developed and the importance of the body in body theology. Chapter 6 includes conclusions and recommendations, such as that youth workers and church leaders need to recognise their own understanding of sexuality and the body, but that body theology can promote an inclusive understanding of sexuality if youth workers and church leaders are able to make a theological shift and use body theology as a theological lens. / AFRIKAANSE OPSOMMING: Hierdie studie ondersoek die waarde wat liggaamsteologie tot ʼn inklusiewe verstaan van seksualiteit tydens adolessensie kan byvoeg. Seksualiteit is deur verskillende tydperke verskillend verstaan, maar daar is selfs vandag nog nie werklik uitsluitsel van wat met die term seksualiteit bedoel word nie. Seksualiteit is ʼn moeilike term om te definieer en die verstaan daarvan speel ʼn belangrike rol in die wyse waarop mense mekaar hanteer. Die kerk was grootliks deur die verskillende tydperke óf stil oor seksualiteit óf het dit as ʼn sonde beskou, met die gevolg dat die kerk nie noodwendig as ʼn goeie hulpbron vir raad rakende seksuele sake beskou word nie. Adolessente gaan deur ʼn dramatiese tydperk waar alle ontwikkelingsprosesse, waarvan die seksuele ontwikkeling die prominentste is, gelyktydig plaasvind. Die seksuele ontwikkeling berei adolessente liggaamlik voor om voort te plant en in seksuele verhoudings te tree, maar kognitiewe en morele ontwikkeling vind ook plaas; hierdie twee prosesse is ondersteunend vir die adolessent om die seksuele ontwikkeling te kan verstaan en verwerk. Hierdie ontwikkelingsprosesse, tesame met die konteks waarin ʼn adolessent groot word, het ʼn invloed op die tipe morele waardestelsel wat adolessente saamstel, en wat bepaal hoe hulle optree. Soos reeds genoem, is die kerk nie noodwendig betrokke by hierdie gesprekke nie, en daarom stel hierdie studie voor dat kerke weer betrokke moet raak deur gebruik te maak van liggaamsteologie. Die navorsingsvraag kan soos volg geformuleer word: Watter bydrae kan liggaamsteologie maak tot die bevordering van ʼn inklusiewe verstaan van seksualiteit tydens adolessensie? Om die navorsingsvraag te beantwoord word die eerste doelstelling, om ʼn historiese oorsig oor die verstaan van seksualiteit te kry, om te sien hoe die verstaan van seksualiteit oor verskillende tydperke verander het, maar ook op sekere tye dieselfde verstaan van seksualiteit gehandaaf is, in hoofstuk 2 bespreek. Die tweede doelstelling word in hoofstuk 3 bespreek, waar die fokus op ʼn historiese oorsig van die verstaan van die liggaam val. Die historiese oorsig oor die verstaan van die liggaam word bespreek om ook te verstaan dat die liggaam baie keer in ʼn dubbelsinnige posisie gestaan het en dat dualismes deel gevorm het van die verstaan daarvan, maar dat dit ook verdere verstaan van die lewe beïnvloed het. In hoofstuk 4 word die derde doelstelling bespreek deur die sentrale rol van seksuele ontwikkeling tydens adolessensie te ondersoek om te verstaan watter belangrike rol seksuele ontwikkeling in die adolessent se lewe speel, maar ook dat dit ander aspekte van die lewe beïnvloed. Die vierde doelstelling word bespreek in hoofstuk 5, wat die bespreking van liggaamsteologie bevat om aan te dui hoe dit ʼn inklusiewe verstaan van seksualiteit kan bevorder. In hierdie hoofstuk word daar ook bespreek hoe liggaamsteologie ontstaan het en wat die belangrikheid van die liggaam in liggaamsteologie is. Hoofstuk 6 sluit die studie af met gevolgtrekkings en aanbevelings soos dat jeugwerkers en gemeenteleiers bewus moet word van hulle eie verstaan van seksualiteit en die liggaam, maar ook dat liggaamsteologie ʼn inklusiewe verstaan van seksualiteit kan bevorder, indien jeugwerkers en gemeenteleiers ʼn teologiese skuif maak en liggaamteologie as ʼn teologiese lens gebruik.