The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic has surpassed forty years with many medical advancements in prevention and treatment. Often believed to be at negligible or low risk by society at large, sexual minority women have remained understudied regarding their risk of HIV and other sexually transmitted infections (STIs), leaving their sexual health inadequately understood and supported in healthcare and social services. The sexual health of young South Asian sexual minority women, who are multiply minoritized due to their intersecting identities, has been entirely overlooked. This qualitative study aimed to understand the knowledge, attitudes, and practices of young South Asian sexual minority women as it pertains to their HIV/STI risk. Barriers and facilitators to accessing community-based sexual health supports and services were also investigated. A community-engaged approach was taken to develop this study in partnership with the Alliance for South Asian AIDS Prevention to investigate the HIV/STI risk context and sexual health needs of this group residing in the Greater Toronto Area. A maximum variation sampling strategy was used to recruit six young South Asian sexual minority women and semi-structured in-depth interviews were conducted to collect narrative data. Narrative analysis of the data found socio-cultural and structural influences which guide the HIV/STI risk context for this group. The participants illuminated an inadequate understanding of sexual health when engaging in sex with women, an overall low HIV/STI risk perception, barriers to adequate sexual healthcare and health promotion resources, and multiple minority stressors which impacted their access to safe sex. These findings have major implications for school-based sexual health education, medical training for healthcare practitioners, and sexual health support and services provided by community-based sexual health organizations in the Greater Toronto Area. / Thesis / Master of Public Health (MPH)

This dissertation has two overall aims; to explore and develop the use of SNA in sociology, and to demonstrate that sociology has much to give to other sciences. Interdisciplinary collaboration is necessary because we do not live in a world in which subject areas are strictly isolated. Human beings are social animals, and a sociological understanding is crucial in all human-related science. The examination in this thesis of different kinds of social networks and how they affect the lives of individuals (and vice versa) will provide knowledge both in the development of methods for analyzing social networks, and in their areas specific scientific areas. Paper I-III investigates sexual networks and how the number of sexual encounters involving intercourse in combination with the number of sexual partners affects the dynamics of sexually transmitted infections (STIs). The results show that this relationship is non-linear, indicating that it may not be the individuals with the largest number of partners who have the most impact on the spread of STIs. One might also have to focus interventions on individuals who have a large number of sexual encounters involving intercourse per partner, and who have several (but not necessarily a very large number of) partners. In the fourth paper, we apply the theoretical concept of so-called small worlds to a sexual network. The spread of epidemics can be difficult to stop in such networks, and we show that the sexual network of individuals infected with chlamydia can be characterized as such. The fifth and last paper differs from the four first. In this paper, we focus on how individuals who committed suicide in Stockholm during the 1990s where connected to each other. The social-interaction exposure effect is larger for the individual within the family than at the workplace; yet work-domain exposure is more important for the overall suicide rate because individuals are more often exposed to suicides of co-workers than family members.

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No. of bitstreams: 1 Danielle Albuquerque Pires Rocha.pdf: 1640322 bytes, checksum: 517abde36a5e28961792c6d782a3d48b (MD5) Previous issue date: 2012-06-25 / FAPEAM - Fundação de Amparo à Pesquisa do Estado do Amazonas / The lack of precision and speed in the laboratory diagnosis of some sexually transmitted infections (STI) are commom problems faced by professionals working in this area. Additionally, the lack of some of them in the public health system become more difficult to elucidate the diagnosis. Because of these difficulties, the STI are underdiagnosed, being treated indiscriminately, using only clinical diagnosis. The molecular diagnostic methods have arisen in recent years as an excellent alternative to fill some of the gaps left by traditional methods. The aim of this research was to study the epidemiology of some sexually transmitted pathogens at molecular level, using molecular biology techniques in women attended in public health system in the city of Coari, Amazonas, Brazil. Samples were collected from 361 women for cervical cytology (Pap Smear) and molecular examination. We carried out molecular diagnosis using the technique of Polymerase Chain Reaction (PCR) and real-time PCR for some sexually transmitted pathogens, which were: Human Papillomavirus, Herpes Simplex Virus 2, Human Cytomegalovirus, Chlamydia trachomatis, Neisseria gonorrhoeae and Thichomonas vaginalis. The results showed that 47.8% of these women were infected by any of the pathogens. There was a high prevalence of infection with Human Papilomavirus (29.1%), followed by T. vaginalis (12.7%), Human Cytomegalovirus (8.3%), C. trachomatis (6.4%), N. gonorrhoeae (1.4%) and Herpes Simplex Vírus 2 (0.6%). The prevalence of HPV type in the infected women was HPV 16 (58.1%), followed by HPV 58 (20.0%). The satisfactory slides for cytological diagnosis (n=321) showed that 7 women (2.1%) showed abnormal cytology (ASCUS, LSIL and HSIL), 5 of them being infected by HPV. There were no statistically significant associations between sexually transmitted infections and the variables related to socio-demographics, medical history and sexual behavior. / A falta de precisão e rapidez no diagnóstico laboratorial de algumas doenças sexualmente transmissíveis (DST) são problemas enfrentados pelos profissionais que atuam nesta área. Além dessas dificuldades inerentes aos testes, a falta de alguns deles na rede pública de saúde dificultam ainda mais a elucidação de diagnósticos. Por causa dessas dificuldades, as DST são subdiagnosticadas, sendo tratadas indiscriminadamente, valendo-se apenas do diagnóstico clínico. Os métodos moleculares de diagnóstico têm surgidos nos últimos anos como uma excelente alternativa para preencher algumas dessas lacunas deixadas pelos métodos tradicionais. Esta pesquisa teve como finalidade estudar a epidemiologia de alguns patógenos sexualmente transmissíveis a nível molecular, valendo-se para isso de técnicas de biologia molecular, em mulheres atendidas na Atenção Primária à Saúde do Município de Coari, Amazonas (AM). Foram colhidas amostras cervicais de 361 mulheres para exame citológico (Papanicolaou) e exame molecular. Foi realizado o diagnóstico molecular através da técnica de Reação em Cadeia da Polimerase (PCR) e PCR em tempo real para alguns patógenos sexualmente transmissíveis, que foram: Papilomavírus Humano, Herpes Vírus Simples 2, Citomegalovírus Humano, Chlamydia trachomatis, Neisseria gonorrhoeae e Trichomonas vaginalis. Os resultados obtidos mostraram que 47,8% dessas mulheres estavam infectadas por algum dos patógenos estudados. Constatou-se alta prevalência de infecção por Papilomavírus Humano (29,1%), seguida pelo T. vaginalis (12,7%), Citomegalovírus Humano (8,3%), C. trachomatis (6,4%), N. gonorrhoeae (1,4%) e Herpes vírus Simples 2 (0,6%). O tipo prevalente de HPV nas mulheres infectadas foi o HPV 16 (58,1%), seguido pelo HPV 58 (20,0%). As lâminas citológicas satisfatórias para diagnóstico (n=321) mostraram que 7 mulheres (2,1%) exibiram alterações citológicas (ASCUS, LSIL e HSIL), estando 5 delas contaminadas pelo HPV. Não foram encontradas associações estatisticamente significativas entre as infecções por patógenos sexualmente transmissíveis e variáveis relacionadas à condições sócio-demográficas, história clínica e comportamento sexual.

MAAS / Centre for African Studies / Zimbabwe launched the Voluntary medical male circumcision programme (VMMC) in November 2009, with the primary aim of curbing sexual transmitted infections (STI’s). In 2010, the district of Mazowe managed to adopt voluntary medical male circumcision programme to curb sexual transmitted infections. It is of concern that the voluntary medical male circumcision programme has been below expectations in Mazowe district. Hence, the aim of the study was to explore the effectiveness of the voluntary medical male circumcision programme among secondary school learners in Mazowe district. Furthermore, the primary goals of the study were firstly check the levels of understanding about the voluntary medical male circumcision programme among secondary school learners in Mazowe district. Secondly, explore the reasons behind the low rate of the voluntary medical male circumcision programme among secondary school learners. Thirdly, investigate whether cultural beliefs influence the learners’ choice. Lastly, recommend possible ways of improving the uptake of the voluntary medical male circumcision programme among secondary school learners in Mazowe district. A qualitative research method used in the study. Also, un-structured interviews and focused group discussions. The researcher conducted interviews using purposeful sampling method on three secondary schools in Mazowe district, Zimbabwe and about forty respondents participated in the study. The study adopted a planned behaviour and person/client centered approaches. The thesis’s conclusions deduced that most of the male respondents are not ready or willing to receive circumcision due to fear of being screened for HIV/AIDS, the cost of the procedure, pain, bleeding, to mention but a few. Furthermore, the researcher identified that in the Shona culture, medical male circumcision is rarely unknown. In addition, the Ministry of Health and Child Welfare must introduce new ways of circumcision to avoid bleeding, pain and must remove the screening of the HIV testing procedure before one is circumcise. Therefore, by these outcomes the Ministry of Child and Health Care Centre will try to find strategies in which they can scale the programme, since the study highlighted that most males are not going for circumcision, hence their lives are in predicament. More so, the study recommends v that researchers must obtain consent and ethical clearance from different relevant place so that data there will not be harm to respondents. Also, there is a need to look for policies in which the government will use to assess strategies to scale the programme, since it is of paramount importance to test the VMMC programme about the impact that it is giving to the community and to find out whether it is helpful or not. More so, in terms of future researchers, there is a need to reconnoiter barriers that hinders males from circumcised. Hence, fourth, this will motivate number of District schools to bring awareness towards males to take part in the programme and prevent males from being susceptible to the infections as recommended by the WHO in 2007. In addition, decentralizing the programme to the community, stakeholders would be able to work hand in hand with the District to make sure that the rate of the VMMC is up and those males take part in the programme willingly. Hence, this will create an efficacy of the programme since all stakeholders and the community will scale up the programme since the priority of all sides will be to scale the programme. Furthermore, clearing misconceptions associated with male learners (witchcraft, pain, bleeding, and religion, to mention but the few), providing them with right mentality about the good side of the programme. In addition, there is a need for the Ministry of Health and Child Welfare to amend new polices that allows free male circumcision, especially in public hospitals, hence, through these amendments, males might be willing to get the services. Lastly but not least, the Department of Education in Zimbabwe must set up tight mechanism for assessment for the programme, especially at secondary and high schools. This will in turn, develop an effective assessment system to see how effective the programme is in the districts. Finally, it is of paramount importance that the National HIV/AIDS council collaborates with the Ministry of Health and Child Welfare in decentralizing the service of the VMMC, since some respondents were concerned that the distance to the service centers were a hindrance for circumcision. / NRF

MA (Youth in Development) / Institute for Gender and Youth Studies / Commercial sex work (CSW) has turned out to be a subject of concern in most societies. CSW occurs in most countries of the world, and has existed since ancient times. Different nations have different viewpoints with regards to prostitution. In some nations it is illegal while in others it is legal. Prostitution is regarded as a social problem that offends culture, societal morals and values and leads to the spread of Sexually Transmitted Infections (STIs). In most studies about sex work, male counterparts receive little attention but they play a role in the industry. In light of the profiled background context of the problem, this study explored the experiences of female sex workers (FSWs) at Ngundu Growth Point in Zimbabwe. This study endeavored to examine the circumstances that drive women into CSW and the impact of prostitution on the wellbeing of FSWs. The study further examined the role played by government, Non-Governmental Organizations (NGOs) and health professionals towards service delivery to CSWs. In order to understand the experiences of sex worker intersectionality and feminist standpoint theories were deployed. A case study approach involving Ngundu growth point in Masvingo was utilized. The choice of Ngundu emanated from the fact that it is located along the highway that connects South Africa with Zimbabwe, Zambia and Democratic Republic of Congo and as a result, it experiences varying prostitution encounters. Methodologically, the study followed a qualitative research path involving the use of open-ended interviews as data collection methods. A total of nine participants were interviewed that includes sex workers as well as the key informants. Data analysis was done using thematic analysis. The overall study finding was that prostitution at Ngundu is proliferating due to economic hardships where most people are unemployed and living in poverty. From the field interviews with those involved in the prostitution business, it emerged that the socioeconomic situation in the country is forcing women to be in the sex industry. The recommendation proffered is that is that the government should create employment opportunities for the people, open vocational training centres and there should be awareness campaigns targeting sex workers. / NRF