Philosophiae Doctor - PhD / HIV/AIDS has made a huge impact on human development and sexual reproductive habits in this century in the world and especially in sub-Saharan Africa. It has only recently been acknowledged that HIV/AIDS has an equal if not greater effect on or threat to people with disabilities. Survivors of traumatic spinal cord injury (TSCI) with resultant disability are incorrectly believed to be sexually inactive, unlikely to use drugs or alcohol and at less risk of violence or rape than their non-disabled peers. This group can thus be described as economically, educationally and socially disadvantaged, which in itself, suggest that they are a high-risk group for HIV infection. The overall aim of this study is to examine the factors that could contribute to the risk and vulnerability to HIV/AIDS among individuals with spinal cord injuries in South Africa. The specific objectives of the study are to assess the behavioral and protective factors that could contribute to risk and vulnerability to HIV infection among individuals and spinal cord injuries; and to explore the socio-cultural issues that might increase individuals with spinal cord injuries’ vulnerability to HIV/AIDS. The design of this study was a mixed methods design, particularly the sequential explanatory strategy was used will used in this study. The study was conducted in four (4) conveniently selected provinces (highest prevalence of SCI). The Quad-Para Association of South Africa’s (QASA) provincial databases was used to invite individuals with SCI to participate in the study. Data for quantitative part of the study was collected by means of self-administered questionnaires. The questionnaire consisted of various sections requesting for information on: Demographics; HIV-Knowledge (HIV- KQ-18); Sexual behaviours; Sexual communication and negotiation skills; Self-efficacy to refuse sex. Separate binary logistics analysis was done to assess which of the selected factors are associated with risky sexual behaviour. The forced entry method approach was used to determine which of these factors have the greatest productive power to predict sexual risk behaviour. No “a priori” sample size was developed for the qualitative part, but participants were recruited until saturation has been reached of all the categories. Consenting participants were visited by the researcher for data collection in the environment indicated by the participant. Permission to conduct the study was obtained from the Research Ethics Committee at the University of the Western Cape (UWC). The study was conducted according to ethical practices pertaining to the study of human subjects as specified by the UWC and Faculty of Community and Health Sciences Research Ethics Committee of the UWC.

This quantitative descriptive cross sectional study explored factors influencing sexual risk behaviours among youths in senior secondary schools in Ethiopia. Data were collected using structured questionnaires. Religious attachment, living with friends, living alone, parental control, level of parental education, peer pressure and number of friends who had experienced sex were some of the factors noted to influence youths to engage in sexual risk behaviours. The findings of this study have implications for both practice and policy development. They will enable healthcare workers to identify youths at risk of engaging in sexual risk behaviours and subsequently motivate them using health promotion strategies to engage in safe sexual practices. Adopting such an approach will prevent or at least minimise risk of youths being infected with sexually transmitted diseases, such as HIV/AIDS. / Health Studies / M.A. (Health Studies)

Today, 1.2 billion adolescents stand at the challenging crossroads between childhood and the adulthood. Driven by a combination of biological, psychological and social forces, adolescence is a period of “stress and storm” for many adolescents predisposing them to risky behaviours with long term consequences. Adolescence is not only a time of vulnerability; it is also an age of opportunity for investment in sustained health and wellbeing through education and preventive efforts to help them navigate risks and vulnerabilities. Evidence-based sexuality education programmes are a cornerstone in reducing adolescent sexual risk behaviours and promoting sexual health. A qualitative, grounded theory study was undertaken to explore and describe experiences of adolescents, teachers and perceptions of parents of school-based sexuality education (SBSE). An indepth literature review through concept analysis on the phenomenon was conducted to assist the researcher with theoretical sensitivity and theoretical saturation. In-depth Individual interviews and focus group interviews were conducted to generate data. Interviews were audio-taped and transcribed by the researcher verbatim. The direct quotes of participants were coded and arranged into meaning units for analysis. A constant comparison method of data analysis was applied by following a Strauss and Corbin (1998) analysis process of open, axial and selective coding to analyse textual qualitative data until themes, categories and sub-categories were identified and developed. Data analysis revealed that adolescents benefitted from SBSE but the implementation of programme was undermined by challenges at national, institutional, community, family and individual levels enshrined in the physical. There were also challenging contextual factors at various levels that influenced the benefits of the SBSE. It is recommended that there is need to review the teaching and learning resources and to fully integrate sexuality education into the formal curriculum. The ministry of education in Uganda should take a leadership role in fostering engagement and participation of major stakeholders, particularly teachers, parents and other community groups in delivering school-based sexuality education that addresses the needs of the schoolgoing children / Health Studies / D. Litt. et Phil. (Health Studies)

Today, 1.2 billion adolescents stand at the challenging crossroads between childhood and the adulthood. Driven by a combination of biological, psychological and social forces, adolescence is a period of “stress and storm” for many adolescents predisposing them to risky behaviours with long term consequences. Adolescence is not only a time of vulnerability; it is also an age of opportunity for investment in sustained health and wellbeing through education and preventive efforts to help them navigate risks and vulnerabilities. Evidence-based sexuality education programmes are a cornerstone in reducing adolescent sexual risk behaviours and promoting sexual health. A qualitative, grounded theory study was undertaken to explore and describe experiences of adolescents, teachers and perceptions of parents of school-based sexuality education (SBSE). An indepth literature review through concept analysis on the phenomenon was conducted to assist the researcher with theoretical sensitivity and theoretical saturation. In-depth Individual interviews and focus group interviews were conducted to generate data. Interviews were audio-taped and transcribed by the researcher verbatim. The direct quotes of participants were coded and arranged into meaning units for analysis. A constant comparison method of data analysis was applied by following a Strauss and Corbin (1998) analysis process of open, axial and selective coding to analyse textual qualitative data until themes, categories and sub-categories were identified and developed. Data analysis revealed that adolescents benefitted from SBSE but the implementation of programme was undermined by challenges at national, institutional, community, family and individual levels enshrined in the physical. There were also challenging contextual factors at various levels that influenced the benefits of the SBSE. It is recommended that there is need to review the teaching and learning resources and to fully integrate sexuality education into the formal curriculum. The ministry of education in Uganda should take a leadership role in fostering engagement and participation of major stakeholders, particularly teachers, parents and other community groups in delivering school-based sexuality education that addresses the needs of the schoolgoing children / Health Studies / D. Litt. et Phil. (Health Studies)

This quantitative descriptive cross sectional study explored factors influencing sexual risk behaviours among youths in senior secondary schools in Ethiopia. Data were collected using structured questionnaires. Religious attachment, living with friends, living alone, parental control, level of parental education, peer pressure and number of friends who had experienced sex were some of the factors noted to influence youths to engage in sexual risk behaviours. The findings of this study have implications for both practice and policy development. They will enable healthcare workers to identify youths at risk of engaging in sexual risk behaviours and subsequently motivate them using health promotion strategies to engage in safe sexual practices. Adopting such an approach will prevent or at least minimise risk of youths being infected with sexually transmitted diseases, such as HIV/AIDS. / Health Studies / M.A. (Health Studies)