Women throughout the world are suffering the brunt of HIV/AIDS. They carry the unenviable tag of being the suffering group who are at risk. Women's vulnerability to HIV/AIDS is a subject that has not received adequate attention to date. This empirical study examines the socio-cultural factors and practices that impede upon behavioural change of Zimbabwean women in an era of HIV/AIDS. Firstly, a sample of 1002 women respondents is purposefully drawn from the six major Zimbabwean ethnic groups to participate in this research study. A survey questionnaire is administered to respondents in the age group 18 to 59 years to quantify the levels and magnitude of the HIV/AIDS problem among women. Secondly, fifty in-depth interviews with key informants are conducted to assess the nature of the problem confronting and impeding upon women's quest to attain good reproductive health. Thirdly, six focus group discussions for each of the respective six ethnic groups are conducted with forty-eight mature women to understand broadly the concepts of the study. This study employs a combination of mainly qualitative and some quantitative methods of data collection and analysis, which is called triangulation. Underlying the methodology of this study is an overarching functionalist theoretical perspective, also referring to gender development theory which serves as the basis for data analyses. The main findings of this study include the view that power dynamics, gender roles and cultural practices have impacted negatively on women's quest to attain safe sexual behaviour. The problem of HIV/AIDS remains a complicated and awesome one among Zimbabwe's ethnic groups. For Zimbabwean women the HIV/AIDS problem begins with a total lack of control over sexual lives and behaviour of their husbands especially outside marriage. The women have noted that the majority stay faithful to their husbands and partners according to cultural prescriptions and roles, while their husbands do not comply. Women noted that cultural prescriptions in their various ethnic settings condone male infidelity but expect women to stay faithful to their partners. As a result it is found that women sometimes contract HIV/AIDS straight on their matrimonial beds. / SOCIOLOGY / Thesis (D. Phil. (Sociology))

Women face a greater risk of HIV infection worldwide than men. This study explored socio-economic, cultural and environmental factors influencing young women’s vulnerability to HIV. A quantitative explorative study was conducted among young women in Sunnyside, Pretoria. A sample of 158 young women in the age group 18 to 24 years from all language groups was randomly selected to participate in this study. The findings showed that poverty, peer pressure and multiple sexual partners were the main factors that influenced young women in Sunnyside’s vulnerability to HIV. Behavioural change and social change were recommended as long-term processes, which need to be taken into consideration. Findings from the Sexual Relationship Power Scales show that young women between 18 and 21 years experience physical abuse, emotional abuse, sexual abuse and forced sex in their relationships. The study concluded with specific recommendations for the successful implementation of policy makers and planners to protect women. / Health Studies / M.A. (Social Behaviour Studies in HIV/AIDS)

This study focussed on determining the knowledge and understanding of Angolan women pertaining to the causes and consequences of HIV/AIDS with the aim of developing an information leaflet about HIV/AIDS for disseminating information to the vulnerable community. A quantitative approach was applied using an exploratory and descriptive design, utilising a self-developed questionnaire to collect the data, from 100 females who accompanied sick children to a specific hospital in Luanda. The findings indicated that even though the respondents were aware of certain key issues in the transmission and consequences of the HIV infection, there were many areas in which a great measure of uncertainty existed such as the causes of the disease, prevention methods, risk factors and precautions to take when living with an HIV positive person. Recommendations were made in view of enhancing the distribution of information regarding the causes and consequences of HIV and AIDS by means of different structures. / HEALTH STUDIES / MA (HEALTH STUDIES)

Background: Herpes Simplex Virus Type 2 (HSV 2) is one of the most common sexually transmitted infections (STIs) worldwide. HSV 2 infection is a risk factor for the acquisition and transmission of other STIs. Aim: The aim of this study is to determine prevalence and predictors of HSV 2 infection in Durban, South Africa by using available data that has not been previously analysed for the purpose of adding scientific evidence to the existing body of knowledge relating to HSV 2. Method: The study involves secondary analyses of data collected as a prospective study which enrolled women who participated in a clinical trial. A total of 3472 sexually active women were screened in the primary study from two clinics in Durban. All consenting participants were tested for HIV, HSV 2, Trichomonas vaginalis (TV), Neisseria gonorrhoea (NG) and Chlamydia trachomatis (CT) infection. Results: There were 2532 women who had HSV 2 giving a prevalence of 73%. Of these, 53% also tested positive for HIV infection. In univariate analysis, co-infection with HIV was strongly associated with HSV2 (Odds Ratio (OR): 7.4, 95% Confidence Interval (CI): 6.0, 9.1, p<0.001). There was also an association between other STIs, such as CT, NG and syphilis and HSV 2, although only NG was significantly associated with prevalent of HSV 2 (OR: 2.3, 95% CI: 1.3, 4.1, p=0.005). Women older than 25 years of age more likely to have HSV 2 (OR: 2.4, 95% CI: 2.0,2.8, p<0.001). A risk of being infected with HSV 2 increased with the number of reported lifetime sexual partners Those with two and three or more were 2,5 and 4.6 times more likely to have HSV2 respectively (OR: 2.5, 95% CI: 2.1,3.1, p<0.001 and OR: 4.6, 95% CI: 3.8, 5.6, p<0.001 respectively). Women who had less than high school education were also found to have higher risk for HSV 2. Conclusion: The secondary analysis showed a high prevalence of HSV 2 infection and a strong association of HSV 2 and HIV. A significant association of HSV 2 was noted in women having more than two sex partners and lower high school education. Therefore, it is recommended that screening for HSV 2 among high risk populations be incorporated into the STI screening and treatment packages. / Prevalence and risk factors associated with HSV 2 / Herpes Simplex Virus Type 2 / HSV 2 / Department of Health Studies / M. (Public health)

Reproductive health is very important as it shapes a woman's whole life. Currently there are a lot of obstacles which deny women their rights to reproductive health. The aim of this research was to find out what obstacles deny women the freedom to enjoy their reproductive health in order to establish a contribution which can be used by the Department of Health to improve their services. Descriptive research was conducted, using a survey approach. Convenience sampling was utilized. Participants were selected from a sample of people attending the reproductive health clinic at a hospital and a clinic in the Northern Province. The findings indicate that women are not enjoying reproductive health rights due to low educational level, cultural and societal constraints, low socio economic status and the negative attitude of the providers, of reproductive health services. / Contraceptives / Family planning / Health and gender / Health rights / Reproductive choice / Reproductive health / Reproductive rights / Reproductive health care / Women's rights / Rural women / Health Science / M.A.Cur.(Nursing Science)

Human Immunodeficiency Virus is the leading cause of death among women of reproductive age worldwide. It is also a major contributor to infant mortality. The effective application of prevention of mother-to-child transmission strategies effectively reduces the risk of mother-to-child transmission. The intent of this study was to determine the availability and accessibility of the PMTCT programme in one district of the North West Province of South Africa. A qualitative, explorative, descriptive and contextual design was utilised to gain better understanding of the experiences of both the HIV positive pregnant women and the Health Care Workers regarding the availability and access to the PMTCT programme. The study population consisted of HIV positive pregnant women between 18 and 49 years of age and Health Care Workers aged between 21 to 60 years of age. The non-probability purposive sampling technique was utilised to identify potential research participants. Data were collected by means of individual semi-structured interviews with HIV positive pregnant women and focus group discussions with the Health Care Workers. Adherence to Tesch’s eight descriptive methods was utilised as the primary form of data analysis, organisation and interpretation. The findings of the study revealed that availability and accessibility of PMTCT services are still problematic. Distance, waiting periods, and long queues were among the few mentioned as problematic. There were also few positives such as communication, counseling and health education. Strategies for facilitation of the availability and accessibility of the PMTCT programme were developed based on the findings. Themes emerged from the HIV positive pregnant women’s data included: acceptance of one’s sero positive status, maternal concerns, stressors about HIV status, as well as lack and shortage of resources and support by health care professionals and family; while emerging themes from the Health Care Workers included: fear of disclosure by HIV positive pregnant women, child feeding, formal trainings and workshops on PMTCT programme, as well as lack and shortage of resources and loss to follow-up activities / Health Studies / D. Litt. et Phil. (Health Studies)

Text in English / Intimate Partner Violence (IPV) is a major problem among women of child-bearing age in Uganda. This study explored the IPV experiences of women living in urban slums and their health needs in order to assist in developing strategies to prevent and respond to IPV. This was a cross-sectional explanatory study using a mixed methods approach among women aged 20-45 years in Kabalagala slums, Kampala, Uganda. The quantitative survey data was collected using a structured questionnaire while qualitative data was collected using in-depth interviews. Quantitative data were collected from a random sample of 372 women and qualitative data from a purposive sample of 48 women with IPV experiences. The quantitative data was analysed using STATA (version 11), and the qualitative data was coded and analysed manually into thematic content. The study revealed a high overall lifetime prevalence of IPV. The different IPV forms prevalent in the study population included psychological (99.7%), economic (93%), physical (92%) and sexual (88%). Physical violence in the last one year was 91%. The qualitative findings revealed the manifestations of IPV in this context. Furthermore, the physical and psychological health impacts of IPV included but were not limited to injuries; chronic pain and complications; HIV infection; low self-esteem; stress and fear of death, and loss of relationships. The researcher proposed three strategies to prevent and respond to IPV, namely implementing economic empowerment and poverty reduction programmes for women; strengthening the legal and justice system to respond appropriately to the problem of IPV, and improving the social and institutional support including training of health workers to prevent and respond to IPV. The proposed regulation of substance and alcohol use would also contribute to reducing IPV prevalence and scaling-up the response. / Health Studies / D. Litt. et Phil. (Health Studies)

Text in English / Malaria is endemic throughout Uganda and the leading cause of morbidity and mortality. Malaria causes complications in 80.0% of all pregnancies in Uganda. This study attempted to identify factors that influence pregnant women’s utilisation of anti-malaria services in the Buikwe district of Uganda. These factors were contextualised within the Social Learning Theory’s major concepts. The target populations comprised pregnant women attending antenatal clinics (phase 1) and midwives providing antenatal services (phase 2) at 16 clinics in the Buikwe district of Uganda during the data collection phase of the study. Structured interviews were conducted with a sample of 400 randomly selected pregnant women and with the accessible population of 40 midwives. Pregnant women, who had progressed beyond primary school level education, were more likely to take intermittent preventive treatment (IPT) drugs and to use long lasting insecticide treated nets (LLINs) to prevent malaria. Pregnant women were more likely to implement malaria-preventive actions if they lived within five kilometres of clinics, were satisfied with available health services, were knowledgeable about the malaria preventive measures and had used IPT during previous pregnancies. Pregnant women who implemented one malaria-preventive action were likely to implement other actions as well (Pearson’s correlation coefficient was 0.65; p<0.05). Midwives’ provision of malaria-preventive services to pregnant women were influenced by the availability of IPT drugs, accessibility of safe drinking water, frequency of giving health education to pregnant women, cooperation with village health teams, malaria-related in-service training, midwives’ education level and experience. Although 97.9% of the pregnant women had taken IPT and 84.2% of those who had received LLINs, utilised these nets, malaria prevention during pregnancy could be improved. All pregnant women should attend antenatal clinics at least four times during each pregnancy, commencing during the first trimester of pregnancy to receive adequate health education and prenatal services, including IPT and LLINs. All midwives should receive malaria-related in-service training. Regular audits of midwives’ records should identify and address strengths and weaknesses related to the prevention and management of malaria during pregnancy. Such actions could enhance the prevention and management of malaria, estimated to affect 80% of pregnant women in Uganda. / Health Studies / D. Litt. et Phil. (Health Studies)

Background Plasmodium falciparum malaria during pregnancy poses a substantial risk to mother and foetus. In recent years, convincing evidence has shown that preventive methods such as the use of insecticide treated bed nets (ITNs) and intermittent preventive treatment (IPT) in pregnancy with sulphadoxine-pyrimethamine (IPTp-sp) can greatly reduce the adverse effects of malaria during pregnancy. Purpose The main purpose of the study was to assess the knowledge and use of Intermittent Preventive Treatment of Malaria among pregnant women receiving Antenatal Care at the primary health centers of the Federal Capital Territory, Abuja Nigeria. Methods A quantitative, descriptive, cross-sectional study was conducted Structured questionnaires were administered to 300 pregnant women aged between 18 and 49 years. Data was analysed using Statistical Package for Social Sciences (SPSS) 22. Results The results revealed that most of the respondents had knowledge about IPT, majority of the respondents had received IPT drugs, in the clinic, but unfortunately none of them were supervised by a health worker during taking of the drug. Few of the respondents did not take the drugs at all for fear of complication, some of them did not know exactly how many tablets were given to them and there was poor adherence to the Directly Observed Therapy (DOT) scheme. Conclusion Knowledge of malaria and IPT was good and many pregnant women received the drugs and used it, but some of them had challenges and did not use the drugs. / Health Studies / M.P.H.

Background: Group B streptococcus (GBS) is regarded as one of the most important causes of maternal and neonatal morbidity and mortality in many parts of the world. GBS recto-vaginal colonization is important in the health of a mother and her neonate, especially in developing countries. Maternal vaginal colonization with GBS at the time of delivery can cause vertical transmission to the neonate. Multilocus sequence typing (MLST) is a technique used to characterize microbial isolates by means of sequencing internal fragments of housekeeping genes and has the advantage of reproducibility and has been shown to correlate with the other typing techniques and thus has emerged as the standard for delineating the clonal population of GBS. The study aimed to investigate the epidemiology of GBS colonization among pregnant women and their neonates, and to characterize the isolates by multilocus sequence typing technique at Dr George Mukhari Academic Hospital, Pretoria. Methodology: A total of 413 pregnant women who visited the antenatal clinic were recruited and screened. Participants were interviewed using a questionnaire to gather demographic and other relevant information such as history of current pregnancy, previous miscarriages and still births. Samples from maternal rectum and vagina as well as neonate ear and umbilical cord were taken for culture using colistin and nalidixic acid (CNA) blood agar and incubated for 24-48 hours. If negative after 48 hours, Todd-Hewitt broth was subcultured after 18-48 hours onto sheep blood agar. Multilocus sequence typing (MLST) was used to characterize seven group B streptococcus isolates collected at Dr George Mukhari academic hospital. Fragments of seven housekeeping genes were amplified by polymerase chain reaction (PCR) for each strain and sequenced. CLC bio software (Inqaba biotech, South Africa; Pretoria) was used to analyse sequenced loci and UPGMA dendrogram was constructed. Results: The colonization rate for GBS in pregnant women and their neonates was 30.9% and 0%, respectively. A higher proportion of GBS were isolated from the rectum (37.9%) as compared to the vagina (20.6%). Most socio-economic, demographic and obstetric factors analysed were not significantly associated with.GBS colonization. On 128 positive samples, the results of Todd-Hewitt enrichment broth and direct plating method using CNA were compared. A total of 45.3% of colonised were positive on direct selective agar (CNA); an additional 54.7% samples were recovered from Todd-Hewitt broth. Three genes (adhP, glnA and tkt) were sequenced successfully for six samples (1, 2. 4,6,12 and 65). The UPGMA tree with 1000 bootstrap showing the relationship between six samples was drawn.Conclusion: This study revealed that pregnant women of all ages are at risk of group B streptococcus colonization. Group B streptococcus was common among pregnant women at Dr George Mukhari Academic Hospital. No socio-economic risk factor was associated with group B streptococcus colonization. Results confirm that the combination of Todd-Hewitt broth and CNA agar plate is a time saving and sensitive method. The allelic profile, characteristics such as G+C (guanine+cytosine) content and dN/dS ratio were not analysed because of the smaller sample size used in this study, which shows that the MLST method was unsuccessful in this study. The UPGMA tree based on differences in consensus of the isolates showed that all group B streptococcus isolates are clustered and descend from a single node. / Life Sciences / M.Sc. (Life Sciences)