The purpose of the study was to investigate Grade 12 learners’ perceptions of their vulnerability to HIV infections in order to gain insight of their experiences on HIV and AIDS at schools in the Eastern Cape. This was done by using a mixed method approach where focus-group discussions and questionnaires were used to gather data. This study found that the teaching of HIV and AIDS or Life Skills is not adequate. It is possible that the lack of learner involvement in the design and implementation of the programmes could be one of the reasons why there is low participation by learners in intervention programmes in schools, as noted in this study. There is need for strong advocacy on the use of condoms as a preventive measure against unwanted pregnancies, and sexually transmitted diseases (STIs) including HIV. More involvement in extra-curricular activities would help learners to develop self-esteem and the ability to resist drugs and other risky sexual behaviours. / Social Work / M.A. (Social Behaviour Studies in HIV & AIDS)

OBJETIVO: O objetivo deste estudo foi analisar a concordância entre o esfregaço anal e a biópsia guiada por anuscopia de alta resolução no diagnóstico da displasia anal em pacientes infectados pelo HIV. MÉTODO: Conduzimos uma análise transversal de pacientes infectados pelo HIV submetidos a rastreamento de displasia anal rotineiro. A concordância entre mensurações foi estimada por índice de kappa ponderado através de sistema de avaliação citológica e histológica de três categorias (normal, displasia de baixo grau, e displasia de alto grau). Estimativas de sensibilidade, especificidade e valores preditivos foram calculados através de sistema de avaliação citológica e histológica de duas categorias (ausência de displasia e displasia de qualquer grau). Estimativas foram calculadas também para a detecção de displasia de alto grau. RESULTADOS: No decorrer de um ano, 222 pacientes foram submetidos a 330 esfregaços anais seguidos de biópsias guiadas por anuscopia de alta resolução. Trezentos e onze (311) esfregaços com biópsias concomitantes foram satisfatórios. Considerando-se a histologia como padrão, a freqüência de displasia anal foi de 46%. O índice kappa ponderado para concordância entre o esfregaço anal e a biópsia foi de 0,20. Para detecção de displasia anal de qualquer grau, o esfregaço anal demonstrou sensibilidade de 61%, especificidade de 60%, valor preditivo positivo de 56% e valor preditivo negativo de 64%. Para displasia de alto grau, o esfregaço anal demonstrou sensibilidade de 16% e especificidade de 97%. CONCLUSÃO: Os resultados obtidos no presente estudo, em que comparamos os achados da citologia dos esfregaços com os achados histológicos das biópsias dirigidas pela anuscopia de alta resolução em pacientes infectados pelo HIV permitiram concluir que houve baixa concordância entre eles / Purpose: To analyze the agreement between anal Pap smear and high resolution anoscopy guided biopsy to diagnose anal dysplasia in HIV-infected patients. Methods: Cross sectional analysis of HIV-infected patients receiving anal dysplasia screening as part of routine care. Agreement between measures was estimated by weighted kappa-statistics, using 3-tiered cytologic and histologic grading system (normal, low grade dysplasia, and high grade dysplasia). Estimates of sensitivity, specificity, and predictive values were calculated using a 2-tiered cytologic and histologic grading system (without dysplasia, and with dysplasia of any grade). Estimates were also calculated for the detection of high grade dysplasia. Results: Two hundred and twenty-two patients underwent 330 anal Pap smears followed by high resolution anoscopy guided biopsies in one year period. There were 311 satisfactory Pap smears with concurrent biopsy. Considering histology the standard, the frequency of anal dysplasia was 46 percent (95 percent confidence interval: 40-51 percent). Kappa-agreement between anal Pap smear and biopsy was 0.20 (95 percent confidence interval: 0.10 0.29). Anal Pap smear showed sensitivity of 61 percent, specificity of 60 percent, positive predictive value of 56 percent, and negative predictive value of 64 percent for detection of anal dysplasia of any grade. For high grade dysplasia, anal Pap smear showed sensitivity of 16 percent, and specificity of 97 percent. Conclusion: The present study showed a low concordance between anal Pap smears and high resolution anoscopy-guided biopsy

The study aim to investigate perceptions of military personnel with regard to HIV/AIDS in the SANDF in some military Units of Bloemfontein. The military personnel includes all males and females whose ages range between 19 - 47 years, were included in the sample. The approach utilised were both qualitative and quantitative. The data collection technique were: Closed and open-ended questionnaires were distributed to 548 respondents. ~ Participant observation. ~ Review of documents. • Unstructured observations. .. Unstructured interviews. This different data collection techniques to gather valid and reliable information with regard to HN/AJDS in the SANDF were triangulated. The findings revealed poor perception with regard to HIV/AIDS in the workplace, health education, lack of privacy, and discrimination on the benefit of HIV/AIDS. The recommendations of this project deals with aspects which include HIV/AIDS education, inclusion of HIV/AIDS in all military courses, distribution of policy on HIVIAIDS to all military personnel, and involvement in HIV/AIDS awareness. / Health Studies / M. Cur. (Health Studies)

Farm workers in South Africa have limited access to health care and health-related information. In this qualitative study, the implementation of a workplace HIV/AIDS policy was evaluated using data gathered through interviews and observation. It was found that, although the farm workers were knowledgeable about HIV and AIDS, this knowledge was insufficient. It was found that the lives of farm workers are deeply affected by HIV and AIDS. It is also suggested that the agricultural sector is not yet able to deal effectively with HIV and AIDS and that, in this regard, urgent planning is needed in respect of HIV and AIDS policies and interventions / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

The study aim to investigate perceptions of military personnel with regard to HIV/AIDS in the SANDF in some military Units of Bloemfontein. The military personnel includes all males and females whose ages range between 19 - 47 years, were included in the sample. The approach utilised were both qualitative and quantitative. The data collection technique were: Closed and open-ended questionnaires were distributed to 548 respondents. ~ Participant observation. ~ Review of documents. • Unstructured observations. .. Unstructured interviews. This different data collection techniques to gather valid and reliable information with regard to HN/AJDS in the SANDF were triangulated. The findings revealed poor perception with regard to HIV/AIDS in the workplace, health education, lack of privacy, and discrimination on the benefit of HIV/AIDS. The recommendations of this project deals with aspects which include HIV/AIDS education, inclusion of HIV/AIDS in all military courses, distribution of policy on HIVIAIDS to all military personnel, and involvement in HIV/AIDS awareness. / Health Studies / M. Cur. (Health Studies)

Resumé<p><p>Dans le présent travail de recherche, nous présentons un cadre d’analyse, de planification et de mise en œuvre d’une recherche-action portant sur l’apport de l’éducation sexuelle participative comme démarche de la communication stratégique, et ses effets sur le public d’adolescents en milieu scolaire. Le but ultime étant de proposer une meilleure alternative à l’amélioration de la double prévention des IST/VIH/SIDA et des grossesses non désirées chez les adolescents scolarisés de 15-19 ans à Kinshasa, RDC.<p>Les principaux objectifs fixés à la présente recherche étaient :i) d’évaluer l’ampleur de la situation épidémiologique et sociale liée à la santé de reproduction y compris la prévention du VIH/SIDA chez les jeunes adolescents (15-19 ans) ;ii) d’identifier les besoins ainsi que les préoccupations spécifiques des adolescents et jeunes notamment en terme de vie sexuelle et affective ;iii) de projeter les axes de communication stratégiques susceptibles d’influencer positivement les comportements en vue d’améliorer la prévention des IST/VIH/SIDA et des grossesses précoces des adolescents et jeunes en milieu urbain ;iv) de construire sur base des observations et analyses précédentes, une approche de communication stratégique fondée sur l’éducation sexuelle participative; iv) et mesurer au point de vue cognitif et comportemental, l’écart attribuable à l’éducation sexuelle sur l’amélioration des connaissances, des attitudes et des pratiques favorables à la double prévention des IST/VIH/SIDA et des grossesses précoces chez les adolescents de 15-19 ans en milieu urbain de la RDC.<p>Réalisée dans une perspective de la promotion de la santé, son cadre théorique chemine avec celui de l’évidence des liens entre les IST/VIH/SIDA et la santé sexuelle et de reproduction. La combinaison du modèle d’analyse PRECEDE avec l’outil de planification PROCESSUS-P, a servi de fil conducteur de ce travail.<p>Cette étude confronte également la théorie de la communication avec les modèles de changement de comportement. En effet, les messages sur la sexualité émis par un émetteur, permettent à l’individu qui les reçoit, de se persuader à amorcer le changement de comportement qui passe par différents étapes. Mais au delà de la volonté individuelle, les relations de sexualité se vivent dans une interaction sociale dont il faudra tenir compte. <p>La construction de cette recherche a fait appel aux disciplines des sciences sociales, comportementales, de l’éducation, et de l’épidémiologie.<p>Nous avons combiné quatre approches différentes pour cerner nos hypothèses de recherche :i) la revue documentaire, ii) l’approche socio-anthropologique (qualitative) par des focus groups, entretiens semi dirigés, observations directes, iii) l’approche socio-épidémiologique (quantitative) par des enquêtes transversales et iv) l’approche opérationnelle par l’introduction d’une approche innovante utilisant le téléphone et la radio comme moyen pour identifier et orienter des messages à diffuser en milieu scolaire sur la prévention des IST/VIH/SIDA et les grossesses précoces.<p>Ce travail propose deux formats de résultats :les articles publiés ou en cours de l’être et les résultats complémentaires synthétisés dans différents tableaux. <p>Les articles abordent successivement :i) le profil de risque et de vulnérabilité lié au VIH/SIDA et à la santé des adolescents ;ii) la perception des adolescents en matière de santé sexuelle et reproductive ;iii) l’ analyse de l’intégration de l’éducation sexuelle dans les médias ;iv) l’utilisation du téléphone portable et de la radio pour identifier les préoccupations sexuelles des adolescents, v) les déterminants associés à la pratique de la double prévention des IST/VIH/SIDA et des grossesses précoces et vi) les effets cognitifs et comportementaux de l’éducation sexuelle participative sur la double prévention des IST/VIH/SIDA et des grossesses précoces en milieu scolaire de Kinshasa.<p>Les données synthétisées dans différents tableaux rendent compte de l’analyse de la réponse nationale sur la santé de la reproduction des adolescents et des différents aspects du cadre théorique d’analyse et de planification d’une communication stratégique pour la prévention des IST/VIH/SIDA et des grossesses précoces.<p>L’ensemble des résultats de cette recherche peut se résumer en dix points importants ci-après :<p>1.\ / Doctorat en Sciences de la santé publique / info:eu-repo/semantics/nonPublished

La question des infections sexuellement transmissibles (IST) en Afrique a longtemps été<p>négligée par des chercheurs africains spécialistes en sciences sociales, en raison notamment du tabou<p>qui entoure la sexualité dans ce continent. Toutefois, les dernières décennies ont donné lieu à plusieurs<p>recherches menées principalement par les Européens africanistes sur ces pathologies grâce à<p>l’émergence de la pandémie actuelle du Sida. La plupart des travaux réalisés sont axés sur les facteurs<p>de risque, les mécanismes de diffusion, les croyances et les attitudes populaires face à ces maladies, les<p>politiques de lutte, etc. Mais les études historiques consacrées aux IST sont très rares. Celles qui<p>existent ont surtout mis en évidence la dimension démographique axée sur le problème de la dénatalité<p>en laissant dans l’ombre le contexte socio-historique et les conditions socio-épidémiologiques de<p>propagation de ces affections. Au moment où le Sida fait des ravages dans le monde et tout<p>particulièrement en Afrique subsaharienne, l’intérêt d’une réflexion historique sur les IST au Congo<p>n’est plus à démontrer.<p>Contrairement à une affirmation classiquement admise dans la littérature, selon laquelle la<p>lutte contre les IST au sein de la population congolaise fut un franc succès pour les autorités coloniales<p>surtout après la Deuxième Guerre mondiale, cette thèse montre plutôt l’augmentation de la prévalence<p>des IST dans le temps. Les archives inédites et l’analyse des données révèlent que cette progression<p>continue est la conséquence de l'urbanisation accélerée et de la monétarisation de la société et de la sexualité entraînant des modes de vie propres à la société coloniale urbaine. Les villes issues de ce processus deviendront non seulement des espaces<p>d’acculturation et de modernité, mais aussi des lieux d’expansion de ces maladies. Le développement<p>de la prostitution et la multiplicité des partenaires sexuels, à travers les unions plus libres et<p>momentanées, sont les principaux facteurs explicatifs de cette observation.<p>On présente généralement de manière panégyrique l’oeuvre sanitaire coloniale de la Belgique<p>au Congo comme ‘‘modèle’’. Pourtant, aucune étude n’a déjà été menée pour examiner, de manière<p>chiffrée, les aspets liés aux différences de santé entre les Congolais et les Blancs. Cette<p>dissertation vient combler les lacunes existantes dans ce domaine. De ce point de vue, il en résulte de<p>fortes inégalités et des déséquilibres persistants de santé entre ces deux types de populations. Les Congolais beaucoup plus<p>nombreux, socialement défavorisés, ne bénéficient que d’une situation peu ou moins favorable ;tandis<p>que les Blancs, socialement plus favorisés, bénéficient en général d’une meilleure situation sanitaire.<p>Plusieurs indicateurs élaborés dans ce travail sont révélateurs de cette réalité coloniale, en termes<p>d’équipements sanitaires, d’accès et d’utilisation de soins et d’état de santé différencié./<p><p><p><p>The issue of sexually transmitted infections (STI) in Africa has long been neglected by<p>researchers African social scientists, particularly because of the taboo surrounding sexuality in Africa.<p>However, recent decades have resulted in several research conducted mainly by the European<p>Africanists on these diseases through the emergence of the current pandemic of AIDS. Most of studies<p>are focused on risk factors, distribution mechanisms, the popular attitudes about these infections,<p>control policies. But historical studies on STI are seldom examined. Those that exist are mainly<p>concerning the demographic dimension focuses on the problem of declining birth, leaving the socio-historical<p>and socio-epidemiological spread of such diseases. While AIDS is ravaging the world and<p>especially in sub-Saharan Africa, one thing to mention is that the interest of historical reflection on<p>STI in the Congo is obvious.<p>Contrary to an assertion conventionally accepted in the literature, that the fight against<p>gonorrhea and syphilis among the Congolese population was a success for the colonial authorities,<p>especially after the Second World War, our thesis shows rather the increasing prevalence of STI. The<p>archives and analysis of data indicates this continued progress is the result of special conditions of<p>industrialization and urbanization colonial that make people vulnerable. Cities from this historical<p>process will not only areas of acculturation and modernity, but also places for expansion of these<p>diseases. The development of prostitution and multiple sexual partners through free and temporary<p>unions are the main factors explaining this observation.<p>It has generally praises how the actions of Belgian colonial health in the Congo as 'model'.<p>However, no study has been conducted to establish or to compare quantitatively the health status<p>between Blacks (Congolese) and Withes (Europeans in majority). This essay shows the social health<p>inequalities among these two populations. The Congolese many in number, but more socially<p>disadvantaged have only less favorable conditions to health. While the white people, socially<p>privileged, generally have better health status. Several indicators developed in this study are revealing<p>of the colonial reality in terms of sanitation, access and use of care and health status differential. / Doctorat en Histoire, art et archéologie / info:eu-repo/semantics/nonPublished

Farm workers in South Africa have limited access to health care and health-related information. In this qualitative study, the implementation of a workplace HIV/AIDS policy was evaluated using data gathered through interviews and observation. It was found that, although the farm workers were knowledgeable about HIV and AIDS, this knowledge was insufficient. It was found that the lives of farm workers are deeply affected by HIV and AIDS. It is also suggested that the agricultural sector is not yet able to deal effectively with HIV and AIDS and that, in this regard, urgent planning is needed in respect of HIV and AIDS policies and interventions / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

Against the background of evidence that HIV-AIDS has had and continues to have an enormous impact on all South African schools, a need has arisen for HIV -AIDS policies and programmes to be effectively implemented in all schools. In this study, a qualitative methodology was used to evaluate policy implementation in the North West province. Data was gathered by means of field notes, observation and interviews with management and educators. The study found that although principals and educators are knowledgeable about HIV -AIDS, there is a tendency to discriminate against infected educators, particularly in terms of educator workload. This study also revealed that educators fear being accidentally exposed to HIV -AIDS infected blood, despite the guidelines given in the National HIV -AIDS policy and the availability of emergency first aid kits. The key thought emerging from this study is that not all schools are able to deal effectively with HIV -AIDS and that schools urgently need to plan or implement their own policies in this regard. School-based HIV-AIDS policies can only be successful if they take cognisance of local contextual issues and involve the three spheres of influence in the lives of educators and learners, namely, the sphere of the school, the sphere of family life and the sphere of the community. / Sociology / M.A.(Social and Behavioural Studies in HIV-AIDS)

Against the background of evidence that HIV-AIDS has had and continues to have an enormous impact on all South African schools, a need has arisen for HIV -AIDS policies and programmes to be effectively implemented in all schools. In this study, a qualitative methodology was used to evaluate policy implementation in the North West province. Data was gathered by means of field notes, observation and interviews with management and educators. The study found that although principals and educators are knowledgeable about HIV -AIDS, there is a tendency to discriminate against infected educators, particularly in terms of educator workload. This study also revealed that educators fear being accidentally exposed to HIV -AIDS infected blood, despite the guidelines given in the National HIV -AIDS policy and the availability of emergency first aid kits. The key thought emerging from this study is that not all schools are able to deal effectively with HIV -AIDS and that schools urgently need to plan or implement their own policies in this regard. School-based HIV-AIDS policies can only be successful if they take cognisance of local contextual issues and involve the three spheres of influence in the lives of educators and learners, namely, the sphere of the school, the sphere of family life and the sphere of the community. / Sociology / M.A.(Social and Behavioural Studies in HIV-AIDS)