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)

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)

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)

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This phenomenological study examined the experiences of women in midlife. The primary purpose of the study was to develop and describe a model of health promotion that will facilitate self-care of women in midlife to support them in the attainment of wholeness. A theory-generative, qualitative, explorative, descriptive and contextual design was utilized to achieve the objectives of the study, namely to explore and describe women's experience of midlife transition; classify concepts of the model; describe the structure and process of a model for support of women during midlife transition, and develop guidelines for operationalization of the model. The study was undertaken in one of the northwest states of the United States of America. Purposive sampling of eight women included women between the ages of 40 and 55 years of age. Women who had undergone surgical menopause were excluded as the influence of prolonged hormone replacement therapy was seen as a bias. Data was collected by using an unstructured interview technique. Data was analyzed according to Tesch's protocol (in Cresswell, 1994:155). Guba's model (in Krefting 1991:215) was utilized to ensure the trustworthiness of the study. Ethical issues were considered throughout and these are reflected in chapter one of the thesis. The study identified two themes: (1) how the women experienced midlife and (2) how they managed it. The experiences of midlife were expressed in physical, psychosocial and spiritual changes while the management of the process was accomplished in two ways, namely self-care and the services of healthcare professionals. The researcher identified that health promotion was essential to facilitate the self-care practices of women in midlife. Essential and related attributes of health promotion were identified, analyzed and synthesized to define health promotion. The process of health promotion was then defined with a description of the structure and process of the model. Concepts identified were classified, defined and placed into relationship statements after which the model was described and evaluated. Guidelines to operationalize the model were then formulated to assist health professionals to support women in self-care for the attainment of wholeness. / Health Studies / D.Litt et Phil (Health Studies)

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)

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))

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)