Thesis (MPhil)--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: This reflexive study of responses to the HIV/AIDS pandemic was set in Stellenbosch, a town in the Cape Winelands that, with its diverse but disjointed population, in many ways is a microcosm of South African society. My question was what happens when the experience of HIV/AIDS, with its personal impacts and global connections, reaches a particular locality in South Africa. I worked on the assumption that the reach of the disease in this specific locality reflects the disconnectedness of people through historical, political, social and economic processes, and that responses to the disease attempt to repair ruptures through integrating people into caring systems of support. By tracking and interrogating responses at public health and service organisation levels as a participant observer, I noted recurrent references to the importance of engaging patients in the treatment process. My observations revealed a transformation in the dyadic relationship between doctor and patient, as well as an embracing reach of networked service organisations, both initiatives striving to render more effective services. In the process relationships developed between patients and service providers at health and social levels, and between providers themselves. Much of the impetus for these local developments was derived from global inputs as local players draw down packaged practices and funds from the global assemblage that Nguyen refers to as the “AIDS industry” (2005a). Thus, I suggest that HIV/AIDS becomes a catalyst for local innovation within globally standardised structures, such innovation being driven principally by building social relationships. / AFRIKAANSE OPSOMMING: Hierdie reflektiewe studie aangaande die response tot die MIV/VIGS pandemie is in Stellenbosch, ‘n dorp in die Kaapse Wynlande, gedoen. Stellenbosch se diverse, maar tog onsamehangende, populasie is in verskeie maniere ‘n mikrokosmos van die Suid- Afrikaanse samelewing. My vraag het gevra wat gebeur as die ondervinding van MIV/VIGS, wat persoonlike impakte en globale konneksies insluit, ‘n spesifieke lokaliteit in Suid-Afrika bereik. Ek het gewerk volgens die aanname dat die omvang van die siekte in dié spesifieke lokaliteit die uitskakeling van mense deur historiese, politieke, sosiale en ekonomiese prosesse reflekteer, en dat response tot die siekte poog om ontwrigtings te herstel deur die integrasie van mense in versorgende ondersteunings sisteme. Deur response, op publieke gesondheid en dienslewerings organisasie vlak, as deelnemende waarnemer op te volg en te ondersoek, het ek herhaaldelike verwysings gekry na die noodsaaklikheid om pasiente te betrek in die behandelings proses. My observasies het ’n transformasie in die wederkerige verhouding tussen dokters en pasiente ontbloot, sowel as ’n omvattende omvang van netwerke van dienslewerings organisasies. Beide inisiatiewe streef daarna om meer effektiewe dienste te lewer. In die proses ontwikkel verhoudings tussen pasiente en diensverskaffers op gesondheids and sosiale vlakke, asook tussen diensverskaffers. ’n Groot gedeelte van die dryfkrag agter hierdie plaaslike ontwikkelings spruit uit globale insette namate plaaslike spelers verpakte praktyke en fondse ontvang/trek van die globale groep, wat Nguyen na verwys as die ’VIGS industrie’ (2005a). Daarvoor, stel ek voor dat HIV/VIGS ’n katalisator vir plaaslike innovasie binne globaal gestandardiseerde strukture word, en dat inovasies van die aard hoofsaaklik deur die bou van sosiale verhoudings gedryf word.

In many South African communities, socially constructed masculinity norms that promote unequal gender relations and high risk sexual behaviour are key contributing factors to HIV transmission. Following a qualitative approach, using in-depth interviews, this study engaged graduates of the Tavern Intervention Programme (TIP) in Gauteng to explore and describe their perceptions of traditional and modern masculinities, as well as their experience of the TIP. The findings indicated that, while there are differences between traditional and modern men, several masculinity practices, such as unequal gender relations, inconsistent use of condoms, infrequent accessing of HIV testing opportunities and entitlement to multiple partners endure as potential barriers to HIV prevention. Additionally, peer groups reinforce and reward HIV risk behaviour among modern men. Participants did, however, report changes in perceptions and behaviour regarding gender relations and HIV prevention as a result of their participation in the TIP. This study concluded that the role the TIP played in providing these men with an environment where alternative masculinity behaviour could be explored and supported was of particular value in terms of changes in their perceptions of masculinities, gender relations and HIV prevention. / Sociology / M. A. (Social Behaviour Studies in HIV/AIDS)

The purpose of this study was to explore and describe the positive values of masculinity and the role of a man in the prevention of HIV and AIDS and teenage pregnancy in order to develop a health education handbook for young Zulu men. The objectives of this study were to  identify expectations of a man of essence  describe the man’s role in the prevention of HIV and AIDS and teenage pregnancy  develop a health education handbook for young men in developing positive values of masculinity Continuing transmission of HIV and high teenage pregnancy causes concern about the effectiveness of risk reduction measures. Masculinity is associated with risky sexual behaviour. A qualitative, descriptive, exploratory and contextual study explored the positive values of masculinity and the role of a man of essence in the prevention of HIV/AIDS and teenage pregnancy. Semi-structured interviews with interview guides were conducted to collect data among Zulu men aged 18-24 years residing in Nquthu sub-district in northern KwaZulu-Natal. Twenty-one participants from three villages of Tribal Authority 8, namely villages 3, 7 and 9, were interviewed. Data were analyzed thematically and manually. Follow-up interviews were conducted with participants who had committed to a plan of action to prevent HIV infection and teenage pregnancy. The study found that a man of a kind embraced gender equality and the education of women; treated women well, and used traditional/cultural or religious and modern methods to prevent HIV and teenage pregnancy. According to social norms, the participants were expected to have sex with or without a condom. Social support came from parents, grandparents, teachers and health care workers. The participants appeared to lack role models; some preferred to buy condoms, and some used condoms inconsistently. Some experienced problems such as pressure to have sex or girlfriends. A contribution of this study was the development of a health education handbook for young men to develop into men of essence through positive values of masculinity and prevent HIV/AIDS and teenage pregnancy. / Health Studies / Ph. D. (Nursing)

The study was about the process evaluation of the development of the YOUNG WORKERS CAMPAIGN (YWC) Programme to document and analyses the involvement and participation of stakeholders in the development process. The purpose of the study was on the assessment of stakeholder participation and involvement in the development of the YWC to maximise the effectiveness, acceptability and sustainability of the intended programme. Informant interviews, focus group interviews and document analysis were the primary means of collecting data for this research study. The main findings are as follows: Few of the stakeholders were involved in the conceptualisation phase of the YWC Programme and their roles in the development process were not clearly described. Stakeholder analysis was not done and their involvement in decision-making was limited. In order to address the problem of participation, YWC stakeholders should pass through a process of stakeholder analysis, that is, they should be assessed in terms of contribution and value-adding to the development process. / Sociology / M.A. (Social Behaviour Studies HIV/AIDS)

The researcher investigated the knowledge, attitudes and experiences of people living with the Human Immunodeficiency Virus (HIV) towards antiretroviral treatment (ART) and who are accessing antiretroviral treatment at a public health clinic in Limpopo, South Africa. A qualitative method was used. The research findings revealed five themes: experiences, social support, knowledge, attitudes, unemployment and economic themes of the study. Factors reported influencing optimum adherence were the inability of the patients to take medication at work, laziness of the patients to collect medication, unemployment, economic hardship, poverty and lack of knowledge of employers regarding HIV/AIDS. / Health Studies / M.A. (Social Behaviour Studies in HIV and AIDS)

The purpose of the study was to explore and describe the perceptions of adolescents about sexuality and sexually transmitted infections, which probably contribute towards the high incidence of sexually transmitted infections amongst this group.The study was designed as a qualitative, exploratory and descriptive research. A focus group interview and unstructured observation were used to collect data, using a nonprobability snowball sample. The group consisted of 12 male and female adolescents residing in a specific geographical area in Pretoria and attending different high schools. Recommendations made focus on: the approach to sex education programmes factors that need to be addressed in order to improve adolescent sexual health empowerment strategies of teachers, parents and community leaders on adolescent sexuality and sexually transmitted infections so that in turn, they should be able to empower adolescents on their sexual roles and thus make informed choices The impact of implementing the recommendations will benefit individuals, families and communities. / Health Studies / M.A.(Health Studies)

The purpose of this study was to investigate the role of food gardens in influencing the vulnerability of women in rural communities to HIV-infections. The study was conducted at the Makotse Women's Club in rural Limpopo. Qualitative field research was used and five participants were purposefully selected for participation in face-to-face interviews. The study found that the women's involvement in the food gardens enabled them to take responsibility for their own lives. Participation in food gardens gave these women an opportunity for income generation, the chance to access healthy food sources to improve their and their families' diets and a sense of meaning and purpose in their lives. Financial independence from husbands and male partners freed them from poverty and male domination. Through exposure to HIV and AIDS education programmes offered at the food gardens the women were empowered with knowledge about sexual health, hence reducing their vulnerability to HIV-AIDS. / Sociology / M. A. ((Social Behaviour Studies in HIV/AIDS))

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)

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 / This study sought to evaluate the implementation of an HIV and AIDS workplace policy at Sappi-Ngodwana mill. Employing process evaluation, and adopting a qualitative approach, the study evaluated the intervention process, the perceptions of the policy implementers, the strengths and weaknesses of the policy implementation, and suggests possible strategies for addressing the challenges. A systems approach was the theoretical point of departure and guiding framework of the research study. Research data was gathered through in-depth interviews with key informants and theory-driven and data-driven inductive reasoning was adopted in analysing the data. The general findings were that although the Sappi-Ngodwana mill implements a comprehensive HIV and AIDS programme that are in line with national and international benchmarks, there were challenges identified. Recommendations are that the company redesign the HIV and AIDS policy implementation plan with a specific focus on improving the peer educators` system. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)