Dating and sexual relations are basic processes in the lives of most human beings. However, dating and sexual relationships in HIV positive peoples’ lives are fraught with challenges. Limited knowledge of these challenges is recorded. Studies focusing on the challenges of serodiscordance, ARVS, adherence, side effects of ARVS, condoms, reproduction, disclosure and stigma are plentiful, however studies addressing dating and sexual challenges of HIV positive people are sadly lacking. The study described and explored the dating and sexual challenges faced by HIV infected people. The systems and ecosystems approach provided the theoretical framework for the study. A descriptive and exploratory design was chosen for this study. Purposive and snowball sampling was utilised to access respondents for this study. Data was collected qualitatively, using semi-structured interviews with 12 HIV positive respondents. The interviewed lasted between 1 to 2 hours. This study found that People living with HIV (PLHIV) experience many challenges in their dating and sexual lives. The challenges varied amongst the respondents. The challenges were divided into the following themes: disclosure; stigma; rejection and discrimination; dating options to pursue; serosorting or abstaining; guilt; anger; blame; social disconnection; negative self esteem and fear; physical, medical and psychological factors; impact of ARVS; sexual changes/sexual dysfunction; reproduction; community/society; the media; counselling, awareness and education about dating and sexual relationships; government and the consequences of relationships ending. The study encouraged further research on the topic. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.

High adolescent childbearing in South Africa has been sustained over several decades (Kaufman, De Wet and Stadler, 2001:149). Findings from the South African Demographic Health Survey (1998) show that 35 percent of 19-year-old girls had given birth at least once (DoH, 1999). Early childbearing can affect the economic, social and physical well-being of the mother and child. In addition young women who are sexually active are also at high risk of HIV infection and other STIs (Rutenberg, Kaufman, McIntyre, Brown and Karim, 2003). Apart from the health risks, there are also social consequences of early childbearing. Studies that have examined the factors influencing early childbearing show that there is a variation in the prevalence of early childbearing that is by place of residence (rural vs. urban), educational attainment, socio-economic status and population group (Palmuleni, Kalule-Sabiti.and Makiwane, 2007; Dickson, 2003). However, there have been few studies that explore the influence of family structure on early childbearing and sexual intercourse. In an attempt to tease out family influences on teenage sexual behaviour, recent literature explores the correlation of timing of sexual activity and childbearing among sibling pairs. Findings confirm that a sister’s sexual initiation and timing of childbearing and other forms of family formation have an independent strong effect on the timing of family formation for a younger sibling (East, 1996). Exploring a sister’s influence in the context of high early childbearing, such as one observed in South Africa, could contribute in understanding escalating teenage pregnancies and childbearing. The 1998 South African Demographic Health Survey will be used to analyse the sexual behaviour patterns of young women between 15 and 24 years of age, focusing specifically on their age at sexual debut, and age and the covariates associated with teenage pregnancy. These results show that having an older sister who has given birth to a child during adolescence could influence the age at which a younger sister has a child and her age at sexual debut. From the results sisters could be a strategic population to target for pregnancy prevention, which would help reduce early childbearing and also the spread of HIV and AIDS in Africa. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

This study explored Black women’s perceptions of the impact of women’s changing socio-economic status on their intimate relationships. The study used the theoretical resources of social constructionism and feminism. Seven Black women (African, ‘Coloured’, and Indian) were recruited from a banking and an academic institution using convenience non-probability sampling technique. Semi-structured interviews were used to collect the data which was analysed using thematic analysis. The study found that participants viewed the change in women’s socio-economic status and roles as rendering some women more vulnerable to abuse. The participants reported that women’s shift in socio-economic status imposes a threat to masculinity leaving some men feeling intimidated, insecure, and emasculated. Most men were seen as responding to their feelings of intimidation by leaving their partners for a less financially independent woman, or by abusing their current partners. Some men were considered to use domestic violence to exert their power and control over women, express their authority, as well as police and maintain the boundaries of femininity and masculinity. Analysis indicated that for a number of reasons women continue to remain vulnerable to experiencing domestic violence irrespective of their socio-economic status. It was also evident in the study that some working women find themselves in a dilemma of choosing between their careers and family. Some self-reliant wives were seen as having to forfeit senior occupational ranks due to the expectation that their husbands would be disapproving and unsupportive. The respondents stated that other financially stable women are reluctant to marry because they fear being controlled, losing their sense of autonomy, and the ability to make their own decisions without seeking their husbands’ approval. However, it also revealed in this study that women’s changing financial status was seen as entitling them with power and control of their sexuality. As the result, women seem to perceive men as being under pressure to be romantic and satisfy their partners’ sexual needs so as to maintain the relationship. This study highlights an important area for further research as it is likely that the shift in Black women’s socioeconomic status will continue to impact and shape heterosexual relationships in particular ways. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Today’s youth grow up in a world riddled by HIV/AIDS and its devastating effects. In order to prevent HIV infection in youth, there is an ongoing need to understand the influences that place them at risk in order to develop programmes to mediate these influences towards healthy outcomes. Sexual risk behaviors are influenced by various factors ranging from intrapersonal to social normative and contextual/environmental factors. This study focuses on the social normative contextual influences on adolescent sexual risk behaviours in an attempt to understand sexual behaviours, in a sample of school going adolescents from grades nine, ten and eleven, in the Durban Metropolitan area (N=259). This study aimed to examine the relationship, if any, between protective peer norm influences and adolescent sexual behaviour, including sexual risk-taking behaviours, measured by the dimensions of condom use at last sexual encounter, number of sexual partners and age of sexual debut. The findings showed no significant difference in levels of protective peer norms between those who have never engaged in sexual intercourse (primary abstinence) and those that had. The findings did, however, show significantly higher levels of protective peer norm influence regarding safe sexual practices, particularly condom use, among those who reportedly used condoms at their last sexual encounter, confirming that those who practiced safer sex had higher levels of protective peer norm influence. The findings of this study suggest the need for lifeskills programmes to empower youth to challenge social norms that place youth at risk of HIV infection, and further to include interventions to facilitate the renegotiation of peer norms towards health enhancing alternatives, to protect adolescents against sexual risk behaviours. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Therapist-client sexual involvement has been shown to have damaging effects on clients, therapists and the mental health professions. As sexual attraction necessarily precedes sexual involvement, the incidence, experience and management of sexual attraction to clients was investigated in a sample of 485 South African clinical psychologists (return rate 23%). Evaluation of training and attitudes to sexual involvement with current and former clients and to other forms of touch in therapy were also investigated. Survey data from 111 psychologists reveal that 63.1% (79.1% of men and 52.9% of women) have been sexually attracted to clients, at least on occasion, while 97.1% have never become sexually involved with a client. Most (61.4%) do not feel anxious, guilty or uncomfortable about the attraction, although more women (50%) than men (26.5%) do. More than half (58.2%) felt that their sexual attraction had benefited the therapy process, while 76.1% believed that it had never been harmful. Men reported significantly more frequent benefit than women. In managing their sexual attraction, 60.8% sought support from supervisors, peers and their own therapists, while 31.9% worked through the feelings on their own. Ethical practice and welfare of clients were more important reasons for refraining from acting on sexual attraction than fear of legal or professional censure. Ethics codes consulted reflect the lack of nationally endorsed guidelines. Almost half (45.7%) had received no education about therapists' sexual attraction to clients, while only 10.6% had received adequate education. Education about the ethics of therapist-client sexual involvement was rated as significantly more adequate than training about therapists' sexual attraction to clients. Most (74.2%) said that their training was useful in helping them to make informed decisions about sexual involvement with clients. The majority (92.5%) felt that education on these issues should be a required part of training for clinical psychologists. Sexual involvement with former clients was considered less unethical than with current clients (65.2% vs 98.9%). 55.9% believe that there are circumstances in which sexual involvement with former clients might not be unethical, particularly depending on time since termination. Appropriate time between termination of therapy and sexual involvement ranged from immediately (1.8%) to never (44.1 %). Certain forms of touch are considered ethical, although attitudes varied depending on context and form. A handshake was rated to be always ethical by 66.3%, while 83.2% believe kissing is never ethical. There was lack of consensus about hugging and holding hands. Implications of findings and directions for future research are discussed. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 1999.

Any form of sexual interaction contains risk, for example the risk of pregnancy and/or STI transmission. There are a range of measures that can be used to prevent the above mentioned risks, namely contraceptive practices. However, condom use is the best method to prevent all risks related to sex. Although South Africa has the highest number of people living with HIV (Shisana et al., 2009), it has been found that the HIV prevalence is low amongst students in comparison to nationwide statistics (HEAIDS, 2010). Additionally condom use amongst students at last sex is reportedly high (HEAIDS, 2010). However there are many reasons why students in particular do not engage in protective sexual practices such as condom use. The question that guided this research study was what motivates students to engage or not engage in condom use? The study explored dynamics of condom use amongst heterosexual students at the University of KwaZulu-Natal, Pietermaritzburg. This qualitative study used Hollway (1984) and Willig’s (1995) discourses to examine the ways in which men and women relate to each other in engaging in sex, relationships and protective sexual practices. Information was gathered using two focus groups (one female and one male group) and five individual interviews. Students saw the risks related to pregnancy and HIV differently which impacted on their preferred method of contraceptive use and the ways in which they viewed condom use. Students seem to draw on Hollway’s (1984) “male sexual drive discourse” and “have/hold discourse”, and Willig’s (1995) “marital discourse”, to position themselves with regards to each other and their sexual activities. This suggests a need to redirect health promotion strategies.

This study investigated communicative parameters in parent-adolescent and peer discussions about sex. While most sexual health interventions rely on communication and the dissemination of information, little research has sought to elucidate how talk about sex is mediated by the social and cultural context in which it occurs. This study was undertaken with the purpose of obtaining a better understanding of the way in which contextual factors mediate talk. In order to do this, oral histories of participants' first knowledge of sex and first sex experiences were accessed. Participants of different ages were interviewed with a view to exploring how social and cultural factors mediating talk changed over time. / Thesis(M.A.)-Universityof KwaZulu-Natal, Pietermaritzburg, 2006.

South Africa is one of the six southern African countries where the HIV levels for childbearing women are 20% or higher. In South Africa, like most countries, behaviours such as multiple sexual partners, unprotected sex and drug use expose individuals to the risk of HIV infection and drive the HIV epidemic. Thus, research on sexual risk behaviours associated with HIV/AIDS is vital in identifying target groups at risk for HIV. Previous research has shown a link between substance use and sexual risk behaviour however in South Africa research within this field is still evolving. Furthermore, research on substance abuse among women in South Africa is limited. In the light of increasing HIV infection in women and the possible influence substance use has on sexual risk behaviours including HIV, exploring the association between substance use and sexual risk behaviours among women would provide valuable information. Socio-cultural and situational factors are explored within substance use and sexual risk behaviours as women's lives occur with realm of individual, family and community. The sample was drawn from an Alcohol and Drug Rehabilitation Centre situated in the Durban area. Study participants included Black/African, White, Indian and Coloured women who were admitted to the treatment centre for alcohol abuse. One focus group discussion and six in-depth interviews were conducted with women to understand the socio-cultural and situational context of substance abuse and sexual risk-taking behaviours (including HIV/AIDS). Substance abuse emerged from women's lack of coping mechanisms to deal with poor relationships and lack of employment which led to financial dependence on their partners. Women reported that within their settings, alcohol can be related to sexual risk behaviours because alcohol tends to lead to unsafe sexual behaviours. Women reported that alcohol use facilitates intimacy and rapport between couples thus some women tended to consume alcohol. Women reported that knowledge of safe and unsafe sex is known however implementation is difficult because condom use requires her partner's co-operation. Women were financially and emotionally dependent on their partners, social norms which determine women's role in society and sexual relationships governed their behaviour. Partner violence was a common feature among women which impacted on women's ability to negotiate condom use. The paper discusses the intrapersonal, interpersonal and contextuall situational factors that influence substance use and sexual risk behaviours in these women's lives. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2008.

Introduction: Oil/gas communities across Northeastern British Columbia are experiencing rapid in-migration of young, primarily male workers in response to an economic ‘boom’ in the oil/gas sectors. Accompanying the ‘boom’ has been a rise in rates of sexually transmitted infections (STIs) among young people, with Chlamydia rates among youth in the Northeast exceeding the provincial average by 22%. Previous research indicates that socio-cultural and structural determinants of youth sexual behaviour and access to STI testing are important for understanding youth sexual health disparities – and represent key targets for STI prevention efforts. No other research has explored STIs in this rapidly developing, under-resourced context. Therefore, objectives of this thesis were to: (1) Examine how socio-cultural and structural features related to the oil/gas ‘boom’ affect the sexual behaviour of young people in Fort St. John (FSJ), BC; (2) Gather the perspectives of youth and their service providers on the socio-cultural and structural barriers to STI testing in FSJ; (3) Develop recommendations to improve the accessibility of STI testing. Results: Participants identified 4 main ways in which the socio-cultural and structural conditions created by the ‘boom’ affect sexual behaviours, fuelling the spread of STIs in FSJ: mobility of oil/gas workers; binge partying; high levels of disposable income; and gendered power dynamics. As well, 5 key barriers to STI testing among youth were identified: limited opportunities for access; geographic inaccessibility; local social norms; limited information; and negative interactions with providers. Discussion: These data indicate that the conditions fostered by the ‘boom’ in FSJ exacerbate sexual health inequalities among young people. They can be more widely contextualized as an example of the unintended – but not unexpected – health and social implications of a resource-extraction ‘boom’, illustrating the fallacy of ‘development’ as representing uniformly positive ‘progress’. Recommended actions include STI prevention and testing service delivery models that incorporate a locally tailored public awareness campaign, outreach to oil/gas workers, condom distribution, expanded clinic hours and drop-in appointments, specialized training for health care providers, and intersectoral partnerships between public health, non-profit organizations, and industry. An ongoing knowledge translation internship has been undertaken to implement some of these recommendations.

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