Thesis (Ph. D.)--University of Texas at Austin, 2007. / Vita. Includes bibliographical references.

In the past three decades, the HIV pandemic has struck sub-Saharan Africa and resulted in devastating consequences. Increasingly studies have shifted from applying a bio-medical approach to HIV to applying a social approach. This study focuses on applying a social approach. One of the major factors that contributes to the high HIV prevalence is women’s inferior social status. Women are unable to challenge their partners in situations of sexual intimacy and as such they are often at risk of contracting HIV. In Malawi, patriarchyis the dominant ideology structuring gender roles. These gender roles reinforce social hierarchies where women’s capacity to practice agency is significantly decreased. The domestic responsibilities female scholars carry often leads to their drop-out from school. Their lack of formal education, as a result, decreases their ability to pursue income generating activities. Furthermore their inability to acquire income increases their dependence on their partners. It is in part this dependence that perpetuates women’s vulnerability and ultimately increases their risk of contracting HIV. This study focused on how women are socialised to perform certain gendered roles and how this socialisation ultimately affects their capacity to negotiate safe sex.Various institutions and organisations have driven intervention programmes in communities in Malawi in order to address the issue of HIV/AIDS. This study looks at how socialisation of young women living in a peri-urban community in Malawi has changed and how this change has influenced their capacity to negotiate safe sex. The study found that although socialisation had changed and had some impact on increasing female scholars efficacy with regard to their education, they still remain constrained by their social status in a patriarchal context. Through the adapting of the curriculum, schools address issues of gender inequality and the changing roles of women. However, these institutions continue to remain male dominated. This poses an obstacle as they reinforce gender roles of subordinate women and in doing so diminish the impact of the new curriculum. Gender roles continue to make it difficult for women to practice agency in particular with regard to negotiating safe sex. In instances where women have suggested condom use, they have been subjected to domestic abuse or faced the withdrawal of financial support for a given period. This study proposes a continuum of agency ranging from submissive to autonomous. It suggests that women are never entirely submissive or autonomous. They either practice agency by manipulating their boundaries or pushing their boundaries. This study revealed that although there have been significant changes in the process of socialisation, women’s ability to practice agency is considerably limited. Where it is exercised, it often results in separating from their spouses. However, in spite of all the difficulties, women do practice agency on various levels. It also revealed that scholars are developing agency with regards to education. However, social structures continue to reinforce patriarchy. This creates contradictory messages which the scholars are not always able to negotiate. / Dissertation (MSocSci)--University of Pretoria, 2013. / Sociology / unrestricted

This study describes how AIDS prevention education programs were constructed, delivered, and implemented in Vancouver between 1983 and 1994. Biodeterministic models of disease are examined through a historical analysis of documents that include newsletters, minutes of board meetings, policy reviews, annual reports, and personal journals. This study assumes that AIDS is as much a sociocultural phenomenon as it is biological. The findings suggest that present educational guidelines for AIDS prevention are unable to identify what messages should be communicated and fail to identify to whom they should be conveyed. This study does not recommend the use of biodeterministic models of AIDS prevention education which reflect plague metaphors. Instead, culturally relevant strategies need to be developed throughout all aspects of AIDS prevention curricula. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

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No description available.

No description available.

Teng, Yue. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (p. 33-38). / Abstract also in Chinese.

Com o advento da terapia antiretroviral houve um aumento significativo na sobrevida e qualidade de vida dos portadores do HIV/aids. Esta nova realidade traz novas possibilidades de conviver com a aids, sendo a sorodiscordância uma delas. Este estudo teve como finalidade descrever e analisar o impacto da sorodiscordância na vida afetivo-sexual de portadores do HIV/aids que convivem com parceria heterossexual com status sorológico discordante. Como referencial teórico utilizou-se o conceito da vulnerabilidade. O local de estudo foi o ambulatório especializado no atendimento do HIV/aids do Hospital das Clínicas da Faculdade de Medicina da Ribeirão Preto-SP. Os dados foram coletados através de entrevista individual gravada e organizados e analisados com base na Análise de Prosa de André (1983). A partir dos dados emergiram nove temas: A percepção da invulnerabilidade, A descoberta da soropositividade ao HIV, Via de Infecção, Revelação do diagnóstico para o parceiro, A sexualidade, Vulnerabilidade da parceria sexual, Uso do preservativo, Saúde Sexual e Reprodutiva, A convivência. Os casais sorodiscordantes enfrentam inúmeros desafios após a descoberta de soropositividade em um dos parceiros, precisando desenvolver estratégias para o manejo de dificuldades para a vivência da sexualidade, para a manutenção do sexo seguro até a convivência com o parceiro soronegativo. Estas dificuldades não são de responsabilidade exclusiva do casal, cabendo aos profissionais de saúde assumirem a sua responsabilidade social no enfrentamento destes desafios impostos pela sorodiscordância. Ficou evidente que a necessidade de acolher também o parceiro soronegativo no atendimento e que os casais sorodiscordantes merecem atenção específica dos serviços de saúde. A falta de serviços de saúde específicos a casais sorodiscordantes é um dos fatores que aumenta a vulnerabilidade do parceiro soronegativo, quando este não é evidenciado no atendimento e quando as questões trazidas pela sorodiscordância não são abordadas adequadamente. Apontamos a necessidade de alternativas assistenciais, promovendo uma mudança na prática assistencial vigente, centrada no modelo biológico. A assistência a estes indivíduos deve ser realizada por equipes interdisciplinares que contemple os aspectos da dimensão afetivo-sexual trazidos pela sorodiscordância, sendo necessária capacitação e sensibilização dos profissionais de saúde envolvidos no atendimento. A equipe de enfermagem ocupa um importante papel na assistência ao portador do HIV/aids e suas ações devem transcender os aspectos clínicos e terapêuticos, incluindo a sexualidade, a prevenção e manutenção de sexo seguro, que se apresentam como expressivos componentes de risco entre parceiros sorodiscordantes. / The appearance of antiretroviral therapy brought about a significant increase in the survival and quality of life of HIV/aids patients. This new reality entails new possibilities for living with aids, one of which is serodiscordance. This study aimed to describe and analyze the impact of serodiscordance on the affective and sexual life of HIV/aids patients whose heterosexual partner has a different HIV status. The concept of vulnerability was used as a theoretical reference framework. This study was carried out at the specialized HIV/aids care clinic of the University of São Paulo at Ribeirão Preto Medical School Hospital das Clínicas, Brazil. Data were collected through individual interviews, which were recorded. Data organization and analysis was based on Prose Analysis by André (1983), which gave rise to nine themes: perception of the invulnerability, the discovery of HIV seropositivity, infection way, revealing the diagnosis, sexuality in mixed-status couples after discovering HIV/aids infection, vulnerability of the seronegative partner, use the condom; reproductive health, relationship. After discovering seropositivity in one of the partners, mixed-status couples face countless challenges and need to develop coping strategies for difficulties related to sexual activities, maintaining safe sex and living with a seronegative partner. Not only the couple is responsible for these difficulties. Health professionals should assume their social responsibility in facing the challenges imposed by serodiscordance. We observed that seronegative partners have to be included in care activities, and that mixed-status couples deserve specific attention from health services. The lack of specific health services for mixed-status couples is one of the factors responsible for increased vulnerability of the seronegative partner, when (s)he does not appear in care and no adequate treatment is given to serodiscordance-related issues. We point towards the need for care alternatives with a view to promoting a change in current care practices, which focus on the biological model. Care for these persons has to be realized by interdisciplary teams and consider the affective and sexual aspects caused by serodiscordance, which leads to the need for increased training and awareness of the health professionals involved. The nursing team plays an important role in HIV/aids care and its actions have to go beyond clinical and therapeutic aspects and including sexuality, prevention and safe sex maintenance, which reveal to be important risk components in mixed-status couples.

Com o advento da terapia antiretroviral houve um aumento significativo na sobrevida e qualidade de vida dos portadores do HIV/aids. Esta nova realidade traz novas possibilidades de conviver com a aids, sendo a sorodiscordância uma delas. Este estudo teve como finalidade descrever e analisar o impacto da sorodiscordância na vida afetivo-sexual de portadores do HIV/aids que convivem com parceria heterossexual com status sorológico discordante. Como referencial teórico utilizou-se o conceito da vulnerabilidade. O local de estudo foi o ambulatório especializado no atendimento do HIV/aids do Hospital das Clínicas da Faculdade de Medicina da Ribeirão Preto-SP. Os dados foram coletados através de entrevista individual gravada e organizados e analisados com base na Análise de Prosa de André (1983). A partir dos dados emergiram nove temas: A percepção da invulnerabilidade, A descoberta da soropositividade ao HIV, Via de Infecção, Revelação do diagnóstico para o parceiro, A sexualidade, Vulnerabilidade da parceria sexual, Uso do preservativo, Saúde Sexual e Reprodutiva, A convivência. Os casais sorodiscordantes enfrentam inúmeros desafios após a descoberta de soropositividade em um dos parceiros, precisando desenvolver estratégias para o manejo de dificuldades para a vivência da sexualidade, para a manutenção do sexo seguro até a convivência com o parceiro soronegativo. Estas dificuldades não são de responsabilidade exclusiva do casal, cabendo aos profissionais de saúde assumirem a sua responsabilidade social no enfrentamento destes desafios impostos pela sorodiscordância. Ficou evidente que a necessidade de acolher também o parceiro soronegativo no atendimento e que os casais sorodiscordantes merecem atenção específica dos serviços de saúde. A falta de serviços de saúde específicos a casais sorodiscordantes é um dos fatores que aumenta a vulnerabilidade do parceiro soronegativo, quando este não é evidenciado no atendimento e quando as questões trazidas pela sorodiscordância não são abordadas adequadamente. Apontamos a necessidade de alternativas assistenciais, promovendo uma mudança na prática assistencial vigente, centrada no modelo biológico. A assistência a estes indivíduos deve ser realizada por equipes interdisciplinares que contemple os aspectos da dimensão afetivo-sexual trazidos pela sorodiscordância, sendo necessária capacitação e sensibilização dos profissionais de saúde envolvidos no atendimento. A equipe de enfermagem ocupa um importante papel na assistência ao portador do HIV/aids e suas ações devem transcender os aspectos clínicos e terapêuticos, incluindo a sexualidade, a prevenção e manutenção de sexo seguro, que se apresentam como expressivos componentes de risco entre parceiros sorodiscordantes. / The appearance of antiretroviral therapy brought about a significant increase in the survival and quality of life of HIV/aids patients. This new reality entails new possibilities for living with aids, one of which is serodiscordance. This study aimed to describe and analyze the impact of serodiscordance on the affective and sexual life of HIV/aids patients whose heterosexual partner has a different HIV status. The concept of vulnerability was used as a theoretical reference framework. This study was carried out at the specialized HIV/aids care clinic of the University of São Paulo at Ribeirão Preto Medical School Hospital das Clínicas, Brazil. Data were collected through individual interviews, which were recorded. Data organization and analysis was based on Prose Analysis by André (1983), which gave rise to nine themes: perception of the invulnerability, the discovery of HIV seropositivity, infection way, revealing the diagnosis, sexuality in mixed-status couples after discovering HIV/aids infection, vulnerability of the seronegative partner, use the condom; reproductive health, relationship. After discovering seropositivity in one of the partners, mixed-status couples face countless challenges and need to develop coping strategies for difficulties related to sexual activities, maintaining safe sex and living with a seronegative partner. Not only the couple is responsible for these difficulties. Health professionals should assume their social responsibility in facing the challenges imposed by serodiscordance. We observed that seronegative partners have to be included in care activities, and that mixed-status couples deserve specific attention from health services. The lack of specific health services for mixed-status couples is one of the factors responsible for increased vulnerability of the seronegative partner, when (s)he does not appear in care and no adequate treatment is given to serodiscordance-related issues. We point towards the need for care alternatives with a view to promoting a change in current care practices, which focus on the biological model. Care for these persons has to be realized by interdisciplary teams and consider the affective and sexual aspects caused by serodiscordance, which leads to the need for increased training and awareness of the health professionals involved. The nursing team plays an important role in HIV/aids care and its actions have to go beyond clinical and therapeutic aspects and including sexuality, prevention and safe sex maintenance, which reveal to be important risk components in mixed-status couples.

<p>The aims of this thesis were to expand the knowledge about sexual and reproductive health among urban Ugandan youths, living in a slum, and to evaluate the national flow-chart for management of the abnormal vaginal discharge (AVD) syndrome in adolescent girls. Data collection included individual interviews, focus-group discussions and clinical investigations with tests for chlamydia trachomatis (CT), neisseria gonorrhoea (NG), trichomonas vaginalis (TV), syphilis, and HIV infection. Poverty, peer pressure and gender power imbalance were obstacles to safe sexual practices: to abstain from sex, be faithful or to use condoms. Prevalence among the 199 female and 107 male adolescents for CT, NG, TV, syphilis and HIV was 4.5%, 9.0%, 8.0%, 4.0% and 15.2% for females and 4.7%, 5.7%, 0%, 2.8% and 5.8% for males. The national AVD flow-chart had a sensitivity of 61%, a specificity of 38.5% and a positive predictive value (PPV) of 11.6%. A flow-chart using risk factors, rather than symptoms, implicated a sensitivity/specificity and PPV of 82.6%/47% and 17.3% respectively. Socially disadvantaged females had a high risk to be HIV infected and HIV infection was associated to other STIs. Females were more likely than males to have any of the infections studied. Voluntary counselling and testing (VCT) for HIV was considered as helpful in preventing the spread of HIV. Obstacles for testing were: lack of time and money, fear of stigmatisation and fear that the knowledge of HIV positive status could shorten someone's life. An alternative flow-chart for management of AVD among adolescent girls should be evaluated. Girl's opportunities for education and income generating work should be a priority. VCT services for young people should be made accessible in terms of cost, time and quality of counselling.</p>