Dissertations / Theses on the topic 'AIDS (Disease) Treatment Moral and ethical aspects'

Thesis (M.Phil.)--Stellenbosch University, 2000.
ENGLISH ABSTRACT: AIDS is the most important threat to world health. Recent years have seen a dramatic spread of HIVand AIDS in South Africa. Health education directed at modifying risk behaviour appears to be the only way in which the disease can be contained. Controlling AIDS is not only by controlling the virus, but also involves tackling social, economic and political issues and putting AIDS into the broader context of sexuality and gender roles. This requires a broader understanding of this aspect of HIV-AIDS ranging from population dynamics, through to research on individual behaviour and its socio-economic impact; so that we can dispel the myths and rumours that surround AIDS and answer searching questions that will be asked by the community. In South Africa, HIV-AIDS remains a stigmatized disease. There have been calls from courageous and influential people for those who are living with HIV-AIDS to be open about their status and to destigmatise the disease. Institutions too have been drawn into the controversy about whether to remain silent or speak out. Southern African Anglican bishops, as well as some politicians declared their intention to undergo testing for HIV status in order to sensitise the public to the seriousness of the epidemic. Were AIDS not regarded as intolerable, the entire issue of confidentiality would fall away. Calls to destigmatise the disease through openness cannot stand alone. Government must put effective treatment programmes in place. In the absence of treatment, AIDS may represent only frustration and hopelessness to those who test positive; and fear, danger and resultant animosity to those who are HIV negative. The text is in four chapters. Chapter 1 focuses on confidentiality as an important principle in the management of disease. In HIV -AIDS, confidentiality is a more sensitive issue as AIDS is particularly viewed as a social stigma, accompanied by discrimination and harassment. The chapter also addresses HIV infection, transmission, counseling and screemng. Chapter 2 deals with the principles of biomedical ethics namely, autonomy, to enable the patient to determine his/her course of treatment; informed consent, designed to protect the interests of patients from exploitation and harm, and encourage health professionals to act responsibly; beneficence and nonmaleficence, to protect the welfare of others; and justice, to ensure access to health care for all. It also highlights the aspects of and limitations to confidentiality. Chapter 3 discusses broadly the ethical dilemmas pertammg to professional-patient relationships, women and HIV-AIDS, religion, prisoners and employer-employee relationships. When the AIDS epidemic started, very few people suffered from the disease, and the disease was treated with great caution and confidentiality. Today, AIDS is a pandemic and emphasis should shift from the ethic of autonomy and confidentiality, to a social ethic, which emphasizes the responsibility of minimizing the risk of spread of infection. The chapter also examines the role of the Department of Health, the participation of health professional bodies and the legal aspects relating to confidentiality in HIV-AIDS. Chapter 4 attempts to construct an argument to destigmatise HIV-AIDS by arguing the responsibility of the government to make sufficient resources available for the treatment and control of the pandemic. Health professionals are challenged to engage their expertise and skills in the service of the sick with dignity and respect. The community is encouraged to support the drive towards controlling the spread of HIV infection and enable people living with AIDS to disclose their status without fear of harassment.
AFRIKAANSE OPSOMMING: Vigs is die gevaarlikste bedreiging van wéreldgesondheid. Die afgelope paar jaar het 'n dramatiese verspreiding van mv en VIGS in Suid-Afrika plaasgevind. Gesondheidsopvoeding wat gemik is op die verandering van risiko-gedrag is skynbaar die enigste metode wat die siekte kan beheer. Die kontrolering van VIGS is nie net die kontrolering van die virus nie, maar dit betref ook herbesinning oor sosiale, ekonomiese en politiese en geslagsrolle. Dit vereis 'n omvattender verstaan van hierdie aspek van HIV-VIGS, wat strek vanaf van bevolkingspatrone tot by die navorsing oor individuele gedrag en die sosio-ekonomiese impak van 19. So kan ons hopelik help om die mites rondom VIGS te besweer. In Suid-Afrika bly mV-VIGS 'n gestigmatiseerde siekte. Daar rus 'n veranbtwoordelikheid op invloedryke mense wat met mV-VIGS leef en wat as rolmodelle sou kon dien, om hul mv -status te openbaar en sodoeonde te help om die siekte te destigmatiseer. Instansies is ook by hierdie twispunt betrek om vas te stelof die mense moet praat of swyg. Suider-Afrikaanse Anglikaanse Biskoppe, asook somige politici het hulle intensies aangekondig om die mv -toets te ondergaan om sodoende die publiek te help opvoed oor die gevaar van hierdie epidemie. Oproepe om die siekte te destigmatiseer deur openbaarheid kan nie in isolasie funksioneer nie. Die staat moet effektiewe kuratiewe en voorkomingsprogramme hier rondom loods en kontinueer. In die afwesigheid van 'n geneesmiddel, sal VIGS slegs frustrasie, hopeloosheid, en vrees skep by diegene wat positief getoets is, sowel as vyandigheid onder diegene wat nie mv positief is nie. Die teks het vier hoofstukke. Hoofstuk 1 fokus op vertroulikheid as 'n belangrike beginsel in die bestuur van die siekte. In mV-VIGS is vertroulikheid 'n meer sensitiewe beginsel aangesien VIGS in die besonder as 'n sosiale skandvlek, aangevreet deur diskriminasie, gesien word. Die hoofstuk bespreek ook mv -infeksie, transmissie, raadgewing en toetsing. Hoofstuk 2 gaan oor die beginsels van die biomediese etiek, naamlik, outonomie, waaronder ingeligte toetstemming, ontwerp om die belange van die pasiente te beskerm teen eksploitasie en gevaar: om gesondheids professionele aan te moedig om hulle op 'n verantwoordelike manier te gedra. Ander beginsels is goedwilligheid en niekwaadwiligheid om die welsyn van ander te beskerm, asook geregtigheid, om toegang tot gesondheidshulp vir almal te verseker. Dit beklemtoon ook die aspekte verwant aan beperkinge tot vertroulikheid. Hoofstuk 3 bespreek breedweg die etiese dilemmas met betrekking tot die verhouding tussen pasiënye en professionele gesondheidswerkers, vrouens en mV-VIGS, godsdiens, gevangenes en werkgewer-werker verhoudings. Toe die VIGS-epidemie begin het, het min mense aan die siekte gely, en die siekte is met groot sorg en vertroulikheid behandel. Vandag is VIGS 'n pandemie en die klem moet geskuif word vanaf outonomie en vetrouilikheid na 'n sosiale etos wat verantwoordlikheid en die vermindering van die risiko van die verspreiding van die infeksie beklemtoon. Die hoofstuk kyk ook na die rolle van gesondheidsdepartmente, deelname van gesondheids professionele organisasies en die juridiese aspekte met betrekking tot vertroulikheid van HIV-VIGS. Hoofstuk 4 poog om 'n argument te ontwikkel wat daartoe sou kon bydra dat HIV-VIGS gedestigmatiseer sal word. Klem word gelê op die verabtwoordelikheid van die staat om soveel moontlike bronne beskikbaar te stel vir die behandeling van en beheer oor hierdie pandemie. Gesondheids professionele word uitgedaag om hulle deskundigheid en bekwaamheid in die diens van die siekes met waardigheid en respek te gebruik. Die gemeenskap word aangemoedig om die poging tot die beheer van die verspreiding van die HIV -infeksie te ondersteun en om die mense wat met VIGS leef in staat te stelom hul status sonder die dreigement van stigmatisering bekend te maak.

This thesis explores the relationship between law and society and various forms of causality: (1) legal change leading to social change; (2) social change leading to legal change; and (3) the interdependent interaction between social change and legal change. It is proposed that a multi-directional approach would be the most useful in examining the moral boundaries exemplified in the law identified with legal and social changes that have resulted in response to the AIDS epidemic.

Thesis (MPhil)--Stellenbosch University, 2003.
ENGLISH ABSTRACT: When South Africa's President, Thabo Mbeki, began doubting that HfV was the cause of AIDS in the late nineties, the debate he introduced in his country was not new; it had raged in the United States as far back as a decade ago. But, even prior to that, there had been numerous controversies pertaining to the discovery of the Ill-virus. This thesis argues that those contentions created such a heated atmosphere that the causal debates that were to follow, however incredible they were, were largely unavoidable. In its coverage of the epidemic, the media were immersed in its own politics. During the early eighties, the gay newspapers in the US felt a personal responsibility to find the cause of a disease that was rapidly killing many of its readers. But, in the process, the often promoted unscientific and dangerous approaches. By the time the AIDS dissident debate had unraveled in the US, the gay media was so suspicious of the anti-gay Reagan government that they frequently advanced dissident arguments. The mainstream and scientific media, on the other hand, were perceived as rigidly supporting government institutions, excluding critical voices. When the dissident debate reached South Africa ten years later, the South African media was completely unprepared. Most journalists had never heard of AIDS dissidents; some had not even heard of HfV or the anti-AIDS drug AZT, that the President had labeled toxic. Begin a new democracy, with a history of white oppression, the black and white media differed immensely on how to cover 'the President's debate'. Criticism of the newly elected ANC government's arguments were often branded racist and unpatriotic, with journalists suffering regular intimidation at the hands of state officials and governmentaligned editors. This thesis examines the development of the politics surrounding the science of AIDS, from the discovery of'HfV up until Thabo Mbeki's controversial contentions. To an equal extent, it looks at the news media's coverage of the process, focusing on the approaches to the debate of various media outlets and individual journalists. It also raises ethical issues, particularly in South Africa, that emerged during one of the most widely reported debates in the country's history. It in no way attempts to provide a quantitative analysis of media coverage and, in the case of the US media, draws heavily on analytical studies conducted at the time. NOTE: In the analysis of the South African media's coverage of the AIDS dissident debate in Part Three: B, issues pertaining to the country's public broadcaster, the South African Broadcasting Corporation (SABC), were not discussed The reason was that the author was the Corporation's Health Correspondent at the time, and therefore too closely involved in the institution in order to provide an objective perspective.
AFRIKAANSE OPSOMMING: Toe Suid-Afrika se president, Thabo Mbeki, in die laat jare negentig begin het om die oorsaak van VIGS in twyfel te trek, was die debat wat hy in sy land ingelei het, nie nuut nie; dit reeds 'n dekade tevore in die VSA gewoed. Maar, selfs voor daardie debat, was daar 'n hewige omstredenheid wat met die ontdekking van die MI-virus verband gehou het. Hierdie tesis argumenteer dat daardie omstredenheid so 'n driftige atmosfeer geskep het, dat die debat oor die oorsaak van VIGS wat sou volg, hoe ongeloofwaardig ook al, grootliks onvermydelik was. Met die dekking van die epidemie was die media in hul eie politiek gedompel. Tydens die vroeë jare tagtig het gay-koerante in die VSA 'n persoonlike verantwoordelikheid gevoel om die oorsaak te vind van 'n siekte wat baie van hulle lesers vinnig laat sterfhet. Maar, in die proses het hulle dikwels onwetenskaplike en gevaarlike benaderings bevorder. Teen die tyd dat die 'oorsaak-debat' in die VSA begin posvat het, was gay-koerante so agterdogtig oor die anti-gay Reagan-regering dat hulle dikwels 'afvallige' argumente aangemoedig het. Die hoofstroommedia en wetenskaplike joernale is aan die ander kant weer gesien as rigiede ondersteuners van regeringsorganisasies, wat kritiese stemme wou stilmaak. Toe die 'oorsaak-debat' Suid-Afrika tien jaar later bereik het, het dit die plaaslike media geheel en alonkant betrap. Die meeste joernaliste het toe nog nooit van 'VIGS-afvalliges' gehoor nie; party nie eens van MIV of die teenvigsmiddel AZT, wat die president as giftig geëtiketteer het nie. Daarby was die land 'n jong demokrasie met 'n geskiedenis van wit onderdrukking, wat meegebring het dat wit en swart media-instansies grotendeels verskil het oor hoe die 'president se debat' gedek moes word. Kritiek teen die nuut verkose ANC-regering se argumente is dikwels as rassisties of onpatrioties afgemaak, en regeringsamptenare of regeringsgesinde redakteurs het gereeld probeer om joernaliste te intimideer. Hierdie proefskrif ondersoek die ontwikkeling van die politiek rondom die wetenskap van VIGS, van die ontdekking van MIV tot en met Thabo Mbeki se omstrede argumente. Dit kyk ook na die nuusdekking van die proses, deur op die benaderings van verskeie media-instansies asook individuele joernalistse te fokus. Dit bespreek ook etiese kwessies wat tydens nuusdekking na vore gekom het, veral in Suid-Afrika, waar hierdie debat van die wydste nuusdekking óóit in die geskiedenis van die land geniet het. Dit poog geensins om 'n kwantitatiewe analise van mediadekking te verskaf nie, en waar die Amerikaanse media beskou word, word daar sterk gesteun op analitiese studies wat tydens die duur van die debat uitgevoer is. NOTA: In die analise van die Suid-Afrikaanse media se dekking van die 'oorsaak-debat' in Deel 3:B word kwessies wat met die nuusdekking van die land se openbare uitsaaier, die Suid-Afrikaanse Uitsaaikorporasie (SA UK), verband hou, nie bespreek nie. Die rede is dat die outeur die korporasie se gesondheidskorrespondent was, en was daarom te nou verbind aan die korporasie om 'n objektiewe perspektiefte verseker.

Thesis (MPhil)-- University of Stellenbosch, 2000
ENGLISH ABSTRACT: It is a well-known fact that the sub-Saharan Africa is a continent most affected by HIV/AIDS. The HIV/AIDS pandemic has in other words become our disease. For many of us, this fact may be difficult to fully accept. There are elements of prejudice in our reactions. Ignorance and intolerance can be found around the world. Therefore, by presenting the facts about HIV/AIDS, this assignment challenges the misconceptions and focuses on the profound dilemmas confronting society. I think the success in combating the HIV/AIDS pandemic could be found in President Thabo Mbeki's terminology "Partnership against HIV/AIDS". In his speech, the President appealed to both the private and public sectors and all South Africans to work together with greater determination than before to fight against HIV infection and AIDS. Arguably, this was the best speech President Thabo Mbeki ever made on HIV/AIDS on October 9, 1998. Back then, the government seems to have had a direction and led from the front in the battle against HIV/AIDS. The title of this thesis reads: "Ethical perspectives on surveillance and preventive strategies for HIV/AIDS in South Africa". Presently, the South African Government through the Ministry of Health is seriously considering making AIDS a notifiable medical condition. This is a serious and a controversial move that has serious ethical and legal implications that will be discussed. Should partners of HIV-infected individuals be informed? If the answer is on the affirmative, who should inform them? I am also looking at the ethical obligation of health care workers to treat HIV/AIDS patients despite the fear of being accidentally infected. Tough questions need to be asked. Should health workers be informed of the HIV status of every patients they treat? On the other hand, some patients have some fears too that HIV-infected health professionals may infect them. Again, the fundamental ethical concerns related to confidentiality, privacy, the right to treatment will also be discussed. The country is divided on this issue. Ethical principles are directly involved in such a decision, for instance, the principle of confidentiality, respect for autonomy and informed consent. How can the government go about implementing this without disregarding these fundamental ethical requirements?Another ethical issue that comes to mind regarding HIV/AIDS concerns AIDS vaccine trials, which are so far dominantly manufactured in 'developed countries' while subjects of these trials are from 'third world' or 'developing countries '. The ethical concerns here are: How will informed consent be protected, especially where subjects of the trials are not educated and do not understand the terms used? What are the cost-effects or benefits of such trials? What are the risks involved? Together with this, other issues include ethical debates concerning market prices of drugs, which are too expensive for poorer countries and affordable for richer countries. Finally, this work does not treat everything that needs to be dealt with insofar as HIV/AIDS is concerned. However, I hope that this thesis will contribute (in a small way) in making people appreciate the ethical dilemmas that are presented by HIV/AIDS.
AFRIKAANSE OPSOMMING: Dit is algemeen bekend dat Afrika suid van die Sahara die gebied is met die hoogste voorkoms van MIV/vIGS. Die MIV/VIGS-pandemie het dus ons siekte geword. Dit is vir baie van ons moeilik om hierdie feit te aanvaar, en ons reaksies is dikwels bevooroordeeld. Onkunde en onverdraagsaamheid oor MIV/vIGS word trouens wereldwyd aangetref. Hierdie verhandeling Ie klem op die feite van MIV/VIGS, en konfronteer sodoende hierdie wanopvattings terwyl daar gefokus word op die diepgaande dilemmas waarmee die samelewing gekonfronteer word. President Thabo Mbeki se woorde "Vennootskap teen MIV/VIGS" verwoord myns insiens die enigste oplossing vir die MIV/VIGS-pandemie. Die President doen in sy toespraak 'n beroep op al1e Suid-Afrikaners, in private en openbare sektore, om met groter determinasie saam te veg teen MIV-infeksie en VIGS; Hierdie toespraak, gelewer op 9 Oktober 1998, toe die regering klaarblyklik nog rigting gehad het en op die voorfront was in die styd teen MIV/VIGS, was moontlik President Thabo Mbeki se beste ooit oor die onderwerp MIV/VIGS. Die titel van hierdie verhandeling is "Etiese perspektiewe ten opsigte van waarnemende en voorkomende strategiee vir MIV/VIGS in Suid-Afrika". Die Suid-Afrikaanse regering, by monde van die Ministerie van Gesondheid, oorweeg dit tans sterk om VIGS 'n aanmeldbare mediese kondisie te verklaar. Die ernstige etiese en regsimplikasies van so 'n daadwerklike en kontroversiele stap sal in die verhandeling bespreek word. Behoort die rnetgesel1e van MIV-positiewe persone ingelig te word? Indien wei, wie moet hulle in kennis stel? Daar sal ook gekyk word na die etiese verpligting van gesondheidsorgwerkers om MIV/VIGS-pasiente te behandel ten spyte van hul1e vrees om per ongeluk besmet te word. Indringende vrae moet gevra word. Behoort gesondheidsorgwerkers ingelig te word oor die MIV-status van elke pasient wat hul1e behandel? Aan die ander kant vrees sornmige pasiente dat hul1e deur MIV-positiewe gesondheisorgwerkers besmet kan word. Die fundamentele etiese aangeleenthede rakende vertroulikheid, privaatheid en die reg tot mediese behandeling sal ook bespreek word. Suid-Afrika is verdeeld oor hierdie kwessies. Etiese waardes, soos die beginsel van vertroulikheid, respek vir outonomie en ingeligte goedkeuring is direk betrokke by besluite oor etiese kwessies. Die regering kan nie hierdie aangeleenthede implementeer sonder om die fundamentele etiese vereistes in ag te neem nie. VIGS-entstofproefnemings is'n verdere etiese kwessie wat ter sprake kom. Hierdie proefnemings word grotendeels deur "ontwikkelde" lande uitgevoer, tewyl die proefpersone van "derdewereldse" of "ontwikkelende" lande afkomstig is. Die etiese kwessies hierby betrokke is: hoe sal ingeligte goedkeuring beskerm word, veral wanneer proefpersone onopgevoed is en nie die tersaaklike terme verstaan nie? Wat is die kosteeffektiwiteit of voordele van hierdie proefnemings? Watter risiko's is betrokke? Die etiese debat oor die markprys van medisyne, wat heel bekostigbaar vir ryk lande, maar duur vir armer lande is, word ook aangeraak. Hierdie verhandeling dek nie alle relevante kwessies wat betref MIV/VIGS nie. Tog hoop ek dat dit 'n bydrae sal lewer tot mense se bewuswording van die etiese dilemmas wat MIV/VIGS inhou.

Thesis (MA)--Stellenbosch University, 2005.
ENGLISH ABSTRACT: Religion plays a significant role in the structuring of people's identities and perceptions and also has the potential to playa fundamental role to determine how communities respond to HIV/AIDS. Faith-based organisations are respected in their communities and have existing resources, structures and systems in place. People who are diagnosed with HIV often turn to the church where they receive emotional and spiritual support. The primary objective of this study was to determine the knowledge of religious leaders about HIV/AIDS and their attitudes towards people living with it. A non-experimental quantitative research design was used in this study and the data was gathered through a structured questionnaire. The respondents were not exceptionally informed about the transmission of the HI-virus, but their knowledge around the risk of specific sexual behaviour was high and their attitudes towards PLHA generally positive.
AFRIKAANSE OPSOMMING: Geloof speel "n belangrike rol in die vorming van "n mens se identiteit en persepsies en het ook die potensiaal om gemeenskappe se reaksie rakende MIV/Vigs te bepaal. Geloofsorganisasies word in hul gemeenskappe gerespekteer en het bestaande hulpbronne en stelsels in plek. Mense wat MIV postitef gediagnoseer word, wend hul dikwels na hierdie organisasies waar hul emosionele en geestelike ondersteuning ontvang. Die doel van hierdie navorsing was om die kennis en houdings van geloofsleiers rondom MIV/Vigs en die mense wat daarmee leef te bepaal. "n Nie-eksperimenteel kwantitatiewe navorsingsontwerp is gebruik, en die data is deur middel van "n gestruktureerde vraelys ingesamel. Hoewel die respondente se kennis omtrent die oordrag van die MI-virus nie voldoende was nie, het hul die nodige kennis rondom die risiko van spesifieke seksuele gedrag gehad. Hul houdings rondom MIV/Vigs en mense wat daarmee leef was positief.

This research critically analysed Muslim approaches to five women with HIV/AIDS in Cape Town focussing particularly on the approach of 'Positive Muslims' - an awareness-raising and support group for Muslims living with HIV/AIDS. The central question of this thesis dealt with the impact of the norms, values and practices of Cape Muslims on the approach of Positive Muslims to women living with HIV/AIDS. It is suggested that while norms and values articulated in religious texts inform the ideological approach of the organisation's AIDS prevention model. This is due to the pragmatic approach adopted by Postive Muslims which recognises that the articulated norms and values do not always conform to the practices of Cape Muslims.

South Africa has the largest percentage of people living with HIV/AIDS in the world. However, the response against the further spread of HIV/AIDS in the country is being hindered by stigma and discrimination. In order to develop effective intervention programmes to control and reduce the further spread of the disease, it is first important to understand the nature of HIV/AIDS-related stigma and especially how people construct it. In the present study, the social construction of HIV/AIDS-related stigma among Muslims was investigated because high levels of stigma were found in this group. This was fuelled partly by the belief that HIV/AIDS was not a serious problem amongst Muslims. Two focus groups were conducted, one among Muslim women only and the second among Muslim men only. The main aim of the study was to examine the perceptions of HIV/AIDS-related stigma among Muslims. The transcripts were analyzed using thematic content analysis to determine the themes that emerged from the research material. The main findings of the study included that Muslims&rsquo
religious identity/positioning was the most salient discourse that informed how they understood, made meaning of, and responded to HIV/AIDS. They engaged in various forms of stigma such as &lsquo
othering&rsquo
, and mediating factors of stigma included religious positioning. Stigma also served as a social barrier to VCT and disclosure of HIV status. However, supportive attitudes and behaviours were also evident. The findings yielded useful insights into possible elements of intervention programmes, both to reduce HIV/AIDS-related stigma, and also to encourage behavioural change in order to control and reduce the spread of HIV/AIDS in this community.

The HIV and AIDS crisis can be presented as a socio-ecological issue, with an ever-increasing impact on both human beings and the environment. Teaching about socio-ecological issues and the consideration of individual capabilities has become crucial within HIV and AIDS education programmes. Issues of deforestation, land degradation and other environmental problems have worsened since the advent of HIV and AIDS, especially in developing countries. The My Future is My Choice (MFMC) programme has been identified as an important HIV and AIDS education initiative that caters for young people in Namibian secondary schools (Grades 8-12). One of the themes within the programme (Facing HIV and AIDS) is highlighted in this study. This study was constituted as a case study of one school in rural Omuthiya, in the Oshikoto region. The study investigated the opportunities for the integration of a focus on socio-ecological issues and risks, within the MFMC education programme. The study also investigated the way in which the program develops learners‟ capabilities to respond to HIV and AIDS related socio-ecological issues and risks/vulnerabilities. The study also presents the constraints and enabling factors influencing the implementation of the programme. This study used a qualitative, interpretive case study methodology. The research methods included the analysis of eight documents and nineteen semi-structured interviews, with the Programme Coordinator, the Programme Facilitator, the School Principal and with the programme participants. The analysis also included two focus group discussions with a group of learners; and two classroom observations; and the learners' submissions (reflection sheets). Convenience sampling was used, and ethical issues were taken into consideration throughout the study. The study revealed the following as key findings:  The aims and objectives of the HIV and AIDS education programme can enhance and constrain the development of capabilities, as well as opportunities and challenges for the integration of a focus on socio-environmental issues and risks as additional learning content.  Teaching and learning methods that are participatory and rooted within the learner centered approach can make the integration of HIV and AIDS inherent socio-environmental issues and risks into the MFMC education programme possible.  The values and beliefs inherent within the MFMC education programme stand as opportunities for the successful development of capabilities in the education programme. The study concluded by recommending that capabilities within the MFMC programme be developed through teaching learners about their rights, respect for human dignity, and the right to health and to living the life free from discriminatory practices, as a moral entitlement of each and every individual. While teaching learners about their right to health and the importance of healthy diets, this study found that the programme could include learning about food production and handling practices for the benefit of those living with HIV and AIDS, while caring for the environment. Another recommendation was that future research should consider actively involving young people in decision-making with regard to the programme, as this will allow them to choose and decide on what knowledge and skills they need and want to acquire. The study further explained that this will promote the programme participants‟ sense of agency, and their freedom to choose what they value being and doing as an important element in enhancing learner capabilities. Ultimately, this will also enable the learners to acquire the necessary skills and knowledge they need in order to respond to the socio-ecological problems they face in their communities.

Thesis (MPhil)--University of Stellenbosch, 2004.
ENGLISH ABSTRACT: Several studies have reported that thirty million people are living with HIV/AIDS in sub-Saharan Africa. Fifty percent of the infected adults are women aged between 15 and 49 years. In Lesotho, HIV/AIDS has also been declared a national emergency and an estimated 180,000 women out of 330,000 adults, and 27,000 children are living with HIV/AIDS. Statistics have shown that the majority of AIDS cases occur in adults aged 15 and 49 years in Lesotho. Presently women are the fastest growing infected population in Lesotho. Regardless of the growing numbers of women infected with HIV/AIDS, experiences of women living with HIV/AIDS have received little attention in Lesotho. Qualitative research in this area is necessary to gain access to women's perceptions of their HIV positive status. In this study, the experiences and coping strategies of Basotho women living with HIV/AIDS were investigated. The study used a feminist approach to research. Feminist research stresses the multiplicity of knowledge and it is useful to understand the subjective experiences of women. Indepth, face-to-face interviews were conducted with five women ranging between 29 and 46 years, purposefully drawn from Positive Action Society Lesotho (PASL). Grounded theory was used to analyse the data. Findings indicate that women's risk for exposure to HIV is related to their ability to protect themselves by negotiating a safe sexual relationship. Women who feel powerless in their relationships are less likely to protect themselves against HIVexposure. These perceptions of powerlessness are the result of a broad array of experiences that may include exposure to gender-based violence and restricted economic opportunities. The results show that it is common for women to be shocked, depressed, and discouraged when they find that they are living with HIV/AIDS as can be expected. It is also difficult for women to disclose their HIV positive status to family, friends and community members because of stigma attached to HIV/AIDS. Participants developed different ways of coping with their status such as religion, healthy life style, AIDS counselling and social networks. There was a profound sense of anxiety about the future care of children. The study concludes with a number of recommendations to promote an environment that will make it possible for women living with HIV/AIDS to cope with their illness.
AFRIKAANSE OPSOMMING: Studies het bevind dat daar ongeveer dertig miljoen mense in sub-Sahara Afrika is wat met MIVNIGS leef. Vyftig persent van geinfekteerde volwassenes is vroue tussen die ouderdom van 15-49 jaar. In Lesotho is MIVNIGS as 'n nasionale ramp verklaar en daar word beraam dat 330,000 volwassenes, 180,000 vroue en 27,000 kinders MIVNIGS het. Statistiek het ook getoon dat die meerderheid VIGS gevalle in Lesotho voorkom by volwassenes in die ouderdomsgroep 15-49 jaar. Vroue is tans die vinnigste groeiende groep. Ten spyte van die groeiende getalle vroue wat met MIVNIGS geinfekteer is, het die ervaringe van vroue in Lesotho wat met MIVNIGS saamleef tot dusver relatief min aandag geniet. Kwalitatiewe navorsing in hierdie verband is nodig om toegang tot vroue se persepsies te verkry rakende hul eie MIV positiewe status. In hierdie studie is die ervaringe en hanteringsmeganismes van Basoetoe vroue wat MIVNIGS het, ondersoek. Die studie het 'n feministiese benadering gebruik, wat die multiplisiteit van kennis en die subjektiewe ervaringe van vroue beklemtoon. In-diepte aangesig-tot-aangesig onderhoude is met vroue tussen 29-46 jaar gevoer. Gegronde teorie is gebruik om die data te analiseer. Bevindinge dui aan dat vroue se risiko vir blootstelling aan MIV verband hou met hul vermoë om hulself te beskerm deur te onderhandel vir 'n veilige seksuele verhouding met 'n maat. Vroue wat magteloos in hul verhoudings voel, is waarskynlik minder suksesvol om hulself teen MIV blootstelling te beskerm. Hierdie persepsies van magteloosheid is die resultaat van 'n breë spektrum ervaringe wat sekondêre status, blootstelling aan geweld, en beperkte ekonomiese geleenthede insluit. Soos wat verwag word, toon die bevindinge dat dit algemeen vir vroue is om geskok, deppressief en ontmoedig te wees wanneer hulle uitvind dat hul MIVNIGS het. Dit is ook moeilik vir vroue om hul MIV status aan familie, vriende en gemeenskapslede bekend te maak weens die stigma wat aan MIVNIGS kleef. Respondente het verskeie wyses ontwikkelom hul status te hanteer, soos godsdiens, 'n gesonde leefstyl, VIGS raadgewing en sosiale netwerke. Daar was ook 'n intense bekommernis by vroue oor die toekomstige sorg vir hul kinders. Die studie sluit af met 'n aantal aanbevelings om 'n omgewing te promoveer wat dit vir vroue wat met MIVNIGS leef moontlik sal maak om hul siekte te hanteer.

Thesis (MPhil)--Stellenbosch University, 2003.
ENGLISH ABSTRACT: Theological positions are usually considered as coterminous with ethical considerations. That which the Church has earnestly considered in the light of what is believed to be God's will, as elucidated in religious texts and through prayerful contemplation, are considered to be ethical without contradiction. Recently the Roman Catholic Church adopted a position forbidding the use of condoms as protection from contracting HIV/AIDS. Instead, the Church has declared that the way to controlling the AIDS pandemic is via sexual abstinence for the unmarried and sexual faithfulness within marriage. It is acknowledged that it is not possible for all the church's theological positions to be driven by pragmatic concerns within society. Nor can a church easily be seen to be promoting sex outside of marriage by recommending the indiscriminate use of condoms. However, the Roman Catholic Church, by forbidding the use of contraception, puts itself in an ethically questionable light relative to other Christian churches. The Catholic Church needs to reconsider its stance on contraception from first principles, divorced from dogmatic beliefs and practices which were derived by men and which have endured beyond their usefulness or theological veracity. It is evident that a church should not adhere to dogmas that are ungodly in their impact and ethically questionable in their import. If a church needs to revise its dogmatic stance on such issues, it should have the courage to do so. This research considers whether the stance of the Catholic Church on condoms can be considered ethical. The position of the Catholic Church is considered critically from a variety of philosophical, empirical and ethical viewpoints. In so doing, it highlights the principled and practical problems of resolving differing moral positions that cross the religious and secular divide. The approach adopted is one of an applied ethical nature, given the probable effects of participating in unprotected sex. Pregnancy and contracting HIV/AIDS are the likely outcomes of not using condoms, and these conditions will create enormous problems for the individual concerned, her, or his, family, as well as for the greater society. The position taken in this research is that the Catholic Church's stand on abstinence before marriage and faithfulness in marriage, as the answer to the HIV/AIDS crisis, would be a realistic ethical position, if, and only if, it was at all feasible and realisable in practice. However, it is the contention of the author, based on empirical considerations, that the idealistic stance taken by the Catholic Church is out of touch with the realities in our contemporary South African society and is doomed to failure. Given this perspective, the Catholic stance is morally questionable, as, if sexual relationships continue to occur outside of marriage, and if condoms are not used, the result will be unwanted pregnancies, HIV infections of both mothers and their babies, crises for families and society at large, and ultimately widespread death from AIDS. Given the pandemic facing South Africa, the Catholic position in banning the use of condoms, is ethically questionable and morally suspect. The Church needs to be called to account for the implications of its dogmatic stance. The HIV/AIDS pandemic is simply too serious for a public institution, such as the Catholic Church, to be involved in perpetuating theological niceties and holding idealised positions. The Church is not divorced from the society it exists in and a realistic, responsible and accountable response is needed in the current context of hundreds of thousands of persons facing death from AIDS and its related diseases.
AFRIKAANSE OPSOMMING: Teologiese standpunte word gewoonlik beskou as gelyktermig met etiese oorwegings. Dit wat die Kerk met erns beskou het word sonder weerspreking as eties aanvaar in die geloof dat dit die wil van God is wat belig word in religieuse geskrifte en deur gebedsoordenking. Onlangs het die Rooms-Katolieke Kerk 'n standpunt aanvaar wat die gebruik van kondome verbied as beskermingsmiddel teen MIV/VIGS-besmetting. Daarteenoor het die Kerk verklaar dat die VIGS-pandemie beheer moet word via seksuele weerhouding vir ongetroudes en seksuele getrouheid binne die huwelik. Daar word toe gegee dat dit nie moontlik is om al die die kerk se teologiese standpunte aan pragmatiese kwellinge binne die gemeenskap te onderwerp nie. Daarmee saam kan die kerk ook nie buite-huwelikse seks aanmoedig deur aan te beveel dat kondome onoordeelkundig benut word nie. Relatief tot ander Christelike kerke plaas die Rooms- Katolieke Kerk homself egter in 'n etiese bevraagtekenbare posisie deur die gebruik van voorbehoedmiddels te verbied. Die Katolieke Kerk behoort sy standpunt oor geboortebeperking te heroorweeg in die lig van primêre prinsiepe - geskei van dogmatiese oortuigings en bedrywe wat deur mense bedink is en wat hulle bestaansreg as nuttigheid of teologiese waarheid oorskrei. Dit is duidelik dat 'n kerk nie dogmas behoort aan te hang wat onverantwoord in haar impak en eties bevraagtekenbaar in hulle belangrikheid is nie. Indien 'n kerk sy dogmatiese standpunte oor sulke sake moet hersien, behoort dit die moed te hê om dit te doen. Hierdie navorsing skenk oorweging aan die vraag of die Katolieke Kerk se standpunt oor kondome as eties beskou kan word. Die posisie van die Katolieke Kerk word krities beskou vanuit 'n verskeidenheid filosofiese, empiriese en etiese standpunte. Dit verlig die beginsels en praktiese probleme wat verband hou met die resolusie van die verskillende morele posisies wat die kloof tussen die religieuse en sekulêre moet oorbrug. Die benadering wat benut word is van 'n toegepas etiese aard, gegewe die waarskynlike gevolge van deelname aan onbeskermde seks. Swangerskap en besmetting met MIV /VIGS is die waarskynlike resultate indien kondome nie benut word nie. Dit lei gevolglik tot enorme probleme vir die betrokke individu, familie en die breër samelewing. Die aanspraak van hierdie navorsing is dat die Katolieke Kerk se standpunt - dat weerhouding van seks voor die huwelik en getrouheid binne die huwelik as antwoord dien vir die MIV /VIGS krisis - 'n realistiese etiese posisie verteenwoordig indien, en slegs indien, dit toepasbaar en haalbaar binne die praktyk is. Dit is egter die bewering van hierdie skrywer, gebaseer op empiriese oorwegings, dat die idealisriese standpunt van die Katolieke Kerk uit voeling is met die realiteite van ons kontemporêre Suid-Afrikaanse samelewing en dat dit gedoem is tot mislukking. Gege hierdie perspektief, word dit duidelik dat die Katolieke standpunt moreel verdag is, veral as in gedagte gehou word dat - indien seksuele verhoudings buite huweliksverband voortduur en kondome nie gebruik word nie - die resultaat onbeplande swangerskap, MIV besmetting van beide moeders en babas, krisisse vir families en die samelewing en uiteindelik wydverspreide sterftes as gevolg van VIGS sal wees. Gegewe die pandemie wat Suid-Afrika in die gesig staar word die Katolieke standpunt waarin die gebruik van kondome verbied word eties bevraagtekenbaar asook moreel verdag. Die Kerk moet tot verantwoording geroep word vir die implikasies van sy dogmatiese standpunt. Die MIV /VIGS'pandemie is eenvoudig te ernstig vir 'n openbare instansie soos die Katolieke Kerk om betrokke te bly in die voorsetting van teologiese kieskeurigheid en die verkondiging van geïdealiseerde standpunte. Die Kerk is nie los van die samelewing waarbinne dit bestaan nie en 'n realistiese, verantwoordelike en toerekenbare respons word benodig binne die huidige konteks waarbinne honderde duisende mense dood as gevolg van VIGS in die gesig staar.

Thesis (MEdPsych))--University of Stellenbosch, 2010.
Bibliography
ENGLISH ABSTRACT: Teachers have been strategically positioned to mediate information that might lead to increased HIV and AIDS knowledge and preventative measures among school-based youth. This study attempted to understand such teachers' knowledge and attitudes within a particular social context using the Bio-ecological systems model of Bronfenbrenner. The systems model provided the framework for understanding teachers' knowledge and attitudes of HIV and AIDS given their choices in terms of background, knowledge, attitude, and their links with multiple systems. The study was conducted within the qualitative paradigm. Semi-structured interviews were conducted with thirteen intermediate phase primary school teachers from seven primary schools in Phillipi, Cape Town. This study showed that teachers were aware of being part of complex systems. They expressed their difficulties with teaching HIV and AIDS education in the classroom, particularly conditioned by cultural taboos. This study further showed that teachers. interactions, particularly with people living with HIV and AIDS, changed their knowledge of, and attitudes towards, HIV and AIDS and the teaching thereof. It also pointed to the dissonance between teachers' beliefs and behaviours in serving people living with HIV and AIDS. For some teachers, religious beliefs provided the means with which to deal with the HIV and AIDS pandemic. For others, particularly some female teachers, unequal gendered roles and expectations with regard to sex and sexuality in their communities had a direct impact on the spread of HIV and AIDS and safe-sex practices (knowledge) in their communities. Finally, teachers were actively and critically engaged with systems that impact upon them; particularly, the Macrosystem of the Education Department (in this case, the Western Cape), and the Microsystems of the societies and communities within which their schools were located. In summary, the study showed that a contextual, system-related approach to teachers in the classroom highlighted how they related to HIV and AIDS. Such complex, and inter-connected relations cannot be ignored by teachers, educators, policy-makers, material developers and trainers. More studies will give us a better model of the challenges and opportunities facing those who are helping stem the tide of the pandemic.
AFRIKAANSE OPSOMMING: Onderwysers is in 'n strategiese posisie om inligting oor te dra aan jong leerders wat sal lei tot meer kennis van MIV en ook sal voorkom dat dit versprei. In hierdie studie is onderneem om onderwysers se kennis en denkwyse in 'n besondere sosiale verband te verstaan, deur gebruik te maak van die Bio-ekologiese stelsels-model van Bronfenbrenner. Die stelsels-model voorsien die raamwerk om onderwysers se kennis en houdings van MIV/VIGS te verstaan, aangesien hulle keuses maak in terme van hulle agtergrond, kennis, denkwyse en hulle kontak met meervoudige stelsels. Hierdie studie is uitgevoer in die kwalitatiewe paradigma. Halfgestruktureerde onderhoude is uitgevoer met dertien intermediêre fase primêre-skool onderwysers by sewe primêre skole in Philippi, Kaapstad. Hierdie studie het bewys dat onderwysers bewus is daarvan dat hulle deel vorm van ingewikkelde stelsels. Hulle het te kenne gegee dat hulle dit moeilik vind om MIV/VIGS opvoeding te gee in die klaskamer, veral as gevolg van kulturele taboes. Hierdie studie het ook bewys dat onderwysers se interaksie, veral met mense wat met MIV/VIGS saamleef, hulle kennis van en houding teenoor MIV/VIGS, en die onderrig daarvan, verander het. Dit het ook die verskil tussen onderwysers se godsdienstige oortuigings en houdings uitgewys wanneer hulle in kontak kom met mense wat met MIV/VIGS saamleef. Sommige onderwysers het hulle godsdienstige oortuigings gebruik wanneer hulle met die MIV/VIGS pandemie gewerk het. Sommige onderwyseresse veral, het gevind dat ongelyke geslagsrolle en verwagtinge ten opsigte van seks en seksualiteit in hulle gemeenskappe 'n direkte invloed gehad het op die verspreiding van MIV/VIGS en veilige sekspraktyke in hulle gemeenskappe. Onderwysers was aktief betrokke by stelsels wat 'n invloed op hulle gehad het, veral die Makrostelsel van die Onderwysdepartement (in hierdie geval die Wes-Kaap), en die Mikrostelsels van die samelewings en gemeenskappe waar die skole hulself bevind. In opsomming, het hierdie studie bewys hoedat 'n kontekstuele, stelsel- verwante benadering tot onderwysers in die klaskamer in verhouding staan met kennis en houdings teenoor MIV/VIGS. Sulke komplekse en onderlinge verhoudings kan nie deur onderwysers, beleidmakers, materiële ontwikkelaars en afrigters geïgnoreer word nie. Verdere navorsing en studies sal vir ons 'n meer effektiewe model bied van die uitdagings en geleenthede wat onderwysers in die gesig staar en wat sal help om die pandemie hok te slaan.

Condom use is promoted as an effective method for prevention and contraception for people who practice or are at risk of practicing high-risk sexual behaviors. According to the UNAIDS (2009) report, condoms are the only resource available to prevent the sexual spread of the HI-Virus; and with regard to family planning, the same report proposes that condoms expand the choices, have no medical side effects, and thus provide dual protection against pregnancy and disease. However, in Africa as elsewhere in the world, condom use has been fiercely debated. The debates on the accessibility, availability and distribution of condoms in schools are not new nor are they uncontested. In Namibia, the HIV and AIDS policy in education does not explain how, when and by whom condoms should be made available to learners. This leaves it to schools to decide on how (and whether) to make condoms available to learners. As a result, individual school‘s choices not only vary, but are mediated by different factors that are not always in the best interest of learners who, as the foregoing discussion suggests, continue to participate in behaviour that, amongst other things, puts them at risk of HIV infection and falling pregnant. Relying on Foucault‘s theory of discourses, this study investigated the dominant discourses that shape learner, teacher, parent religious and traditional leader and traditional healer perspectives, responses, and experiences with regard to the accessibility, availability, and distribution of condoms in school. The study was conducted in nine schools in Kavango Region in Namibia using a mixed methods approach. The study used triangulation in the data collection process through the use of questionnaires where 792 learners participated in this component, and focus group discussions and individual interviews targeting four groups namely, learners, teachers, parents and religious leaders, traditional leaders and traditional healers. The quantitative data were analyzed using the Statistical Packages for Social Sciences (SPSS), and findings from the focus group discussions and individual interviews were analyzed identifying themes and patterns and then organizing them into coherent categories with sub-categories. The study revealed that the majority of adult participants opposed the idea of making condoms available in schools; advocating abstinence instead. This was despite evidence on the prevalence of sexual activity amongst youth in the community. Reasons had to do with various competing and hierarchized discourses operating to shape participant beliefs, perspectives, and responses in a highly regulated and surveilled social and cultural context. Put differently, the dominant discourses invoked a particular sexual subject; authorized and legitimated who invoked such a subject; who was and was not allowed to speak on sexual matters; as well as how sexual matters were brought into the public space of schools. Such authorization and legitimation regulated the discursive space in which discussions on sexual health, safe sex, and resources such as condoms were permitted; with negative consequences for the sexual well-being of youth in Kavango Region. The study also highlighted the tension between freedom, choice, and rights, showing how complex in fact is decision to make condoms available in school. On the one hand, teenagers positioned themselves as capable subjects who had the right to exercise choice over their sexual lives. Requesting parent consent was thus viewed as a violation of this right to choose. Such a position displayed authority and agency by learners that was pitted against views amongst adults in this study that positioned youth as having no agency. In their view, youth (a) were still children and thus innocent and pure, (b) ought to abstain, and (c) were difficult to control given the modern context. Adults believed that early sexual involvement by learners did not result from lack of vigilance and control on their part, but rather from exposure to modern social mores. The study concluded that (a) schools remain difficult spaces not only for mediating discussions of sex and sexuality, but also for providing resources to mitigate sexual risk amongst leaners, (b) in highly regulated societies, dominant religious discourses are produced and reproduced in and through existing institutions such as family, church, and schools; highlighting how these serve to normalize beliefs and perspectives, (c) the dominant discourses shaping communities in which schools find themselves remain inconsistent with school discourses that are shaped by modernist conceptions of childhood and youth, and (b) adult choices to sanction and obstruct schools from making condoms available (and in the case of teachers, not accessible and distributable) put the very children at risk that they propose to be protecting.

M.Phil. (Labour Relations)
The aim of this study was to investigate the impact of Aids in the workplace from a legal point of view and to isolate some of the most important areas where legal regulation could become problematical. In general it was found that the best way to deal with Aids is to try and prevent it by eliminating ignorance as far as .possible and to bring the disease into the open by means of the early distribution of facts through proper education and counselling and especially the formulation and implementation of a sympathetic Aids policy. This should prevent litigation on the basis of the unfair labour practice concept in the industrial court to a large extent. The legal position regarding problem areas such as confidentiality, testing, the value and regulation of screening, the freedom to employ, dismissal, termination and safety was analysed both in terms of existing South African law and also by comparison with developments internationally. It was found that a high premium is placed on security of employment and that Aids victims should not be discriminated against, but treated objectively like other cases of serious illness.

A dissertation submitted in partial fulfillment of the requirements for the Degree of Applied Master of Arts in the Department of Psychology, Faculty of Arts at the University of Zululand, 2000.
This study was aimed at describing levels of AIDS knowledge, HIV infection and risk reduction, attitudes towards AIDS and people with AIDS (PWAs), sexual behaviour, condom use as well as attitudes, beliefs and perceptions about condoms, the impact which perceived norms and self-efficacy have on condom use, sexual behaviour and AIDS preventative behaviour(APB). Results of the study have shown that knowledge levels were high among Zululand university students. A comparison of the different sexes shows that females had a slightly higher level of knowledge than males. The three most popular choices identified as sources of AIDS knowledge were campus health, clinic/doctor and a friend. The majority of the sample was negative, rejecting and intolerant with regard to the proximity to PWAs. Many also held judgemental, fatalistic and moralistic attitudes with regard to AIDS and PWAs. Half of the respondents showed compassion with regard to the legal and social welfare of PWAs. The majority of the sample was sexually active, with a substantial number of subjects engaging in sexual intercourse with multiple partners. Condoms were least used among this latter group and only a third used condoms consistently. However, the majority intended to use condoms in future sexual encounters and this intention was stronger among students with one sexual partner. The Pearson product moment correlation revealed that attitudes, perceived norms and self-efficacy were associated with condom use and sexual behaviour. Knowledge of AIDS per se had no impact on sexual behaviour and condom use. The multiple regression analysis showed that attitudes and self-efficacy are the strongest predictor variables of condom use. Finally gender had no effect on sexual activity, number of sexual partners, condom use, perceived norms and self-efficacy.

M.A. (Counselling Psychology)
The Psychological Association of South Africa (PASA) is, at present, in a transition phase in that the profession is striving to unite under one single controlling body. As a consequence, the Association is seeking to establish a set of inclusive, scientific, academic and ethical standards that will be recognised by all psychologists. with this purpose in mind, the Association is currently revising its ethical code. Since the Association commits itself to both the prevention and treatment of AIDS, part of its agenda is to include the handling of the disease in this code. The purpose of this study is to make a contribution to the revision of the ethical code by exploring the ethics surrounding the handling of the AIDS-dilemma by psychologists, and to make recommendations in this regard. AIDS should therefore be handled responsibly in the ethical code in such a way that it is acceptable to all practicing psychologists in South Africa. The nature of the study is a qualitative exploratory analytical study that relies on rational cognitive processes. Literature concerning ethics in psychology was explored together with the way in which it is translated in the ethical code. Ethical dilemmas that result from the handling of the AIDS-phenomenon are identified and grouped together by describing both real and hypothetical ethical problems. A critical rational analysis of the ethical code then follows. Finally, logically argued proposals are made in order that identified shortcomings be eliminated.

The overall objectives of the study are to analyse the economic impact of HIV/AIDS on income-earning urban households and in so doing to develop a methodology for HIV/AIDS household surveys. The study started with 125 households in the first wave. Of these, 113 households were followed over 4 waves (2), over a 12-month period, and across two cohorts referred to as affected (3) and non-affected (4) households. Data on the household were collected from the financial head (5) using the diary method. The methodology for this study was done after a review of 33 HIV/AIDS economic studies conducted around the world. The study obtained buy-in and support from various stakeholders in government, nongovernment organisations, community, academic and funding institutions as from people living with HIV/AIDS. Due to the comprehensive design of the research instrument, the study is able to draw relationships between the various facets of the household and the possible influence that HIV/AIDS has on them. Methodologically, the study found that there are "hidden" costs of morbidity and mortality that needs to be quantified. The costs of health care and funerals are higher in the affected cohort, as expected, due to the frequency of illness or death and not necessarily because there are cost differences as a result of whether a household member has HIV/AIDS or not. The key finding is that affected households re-organise themselves in terms of household size, composition and structure as well as through transfers in, income from grants and other non-market sources, especially to pay for funeral costs. Surviving members are affected not only socially and economically but also psychologically and the needs of this group should not be ignored. (2) Each visit is referred to as a wave (3) Affected household is a household where at least one person is HIV positive (4) Non-Affected household is a household where the index case is HIV negative and no other members presented with an HIV/AIDS-related symptom (5) The person responsible for the finances in the household.
Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2004.

M.A.
The focus of this dissertation is based on the New Testament concept of life, within the framework of the reign of God. The message of the reality and concrescence of the reign of God in human history was articulated by Jesus Christ, both in his ministry and his consciousness as the Son of God. It was Jesus of Nazareth who declared that he was sent from above to bring about reconciliation between God and mankind. Jesus Christ in his prophetic role taught and challenged his audience to make radical decisions for God, by appropriating and aligning their everyday lives with the claims and the demands of the Kingdom of God, through repentance and by seeking God's will. Therefore, the death and the resurrection of Jesus Christ signifies a purposive, deliberate and redemptive intervention of God in human history. This christological event of God's intervention in human history inaugurates a new age accompanied by a newness of life. The message of the reign of God places serious ethical and moral demands upon all humanity. It affirms the fact that in Jesus Christ God has a Sovereign claim upon life itself, and that there is no area in human life which cannot be radically transformed by the salvific acts of God in the person and the work of Jesus Christ. The objective of this dissertation therefore, is to show how human life, particularly when affected by sickness and disease can be re-oriented by the "transformative purpose" of God in Jesus Christ. We therefore conclude by giving recommendations on how the Church can witness to the people suffering with the HIV-AIDS disease and how the kingdom ethics re-directs the lives of the sufferers themselves.

In the history of public health vaccines have proven to be among the most effective disease prevention tools. It is clear that in the fight against HIV that new and powerful preventive technology such as a vaccine is badly needed. Ethically, however the processes of developing a vaccine against HIV have been distinctly different from that of any previous pharmaceutical products. HIV vaccine trials can be ethically complex for a number of reasons. In 2004 the HIV I AIDS Vaccine Ethics Group undertook a research initiative that aimed to collect data from various South African stake holders of HIV vaccine trials to ascertain what they perceived as the ethical challenges related to HIV vaccine trials. A quantitative content analysis on the data from 31 semistructured interviews revealed that the ethical issue listed spontaneously by most of the respondents was that of informed consent. Further probing and discussion on informed consent identified a number of sub issues which the respondents thought would pose important challenges to HIV vaccine trials in the South African context. This study undertook to do a more in-depth qualitative analysis of the data to ascertain whether the challenges and concerns the stakeholders have are consistent with or different to those already identified in the literature and ethical guidelines on informed consent in medical research. What variables may be impacting on the position stakeholders take was also of interest. Results indicated that many concerns relating to the substantive and procedural elements of informed consent were consistent with those debated in the literature. These issues related to first person consent, the voluntariness of participants' consent, practicing cultural sensitivity, dealing with language issues, promoting and assessing understanding of material disclosed, issues around the vulnerability of .. participants, children and adolescents' capacity to consent and the role of the media. More specific to the South African context, stakeholders were concerned about the legal framework under which the trials take place, the general lack of education and training about HIV vaccine trials, a lack of communication and coordination between stakeholder groups, and the historical influences of apartheid on black South African participants' capacity to consent. The main variables that appeared to impact on the position stakeholders took related to the role the stakeholders play within the trials, the philosophical position underpinning their ethical viewpoints, stakeholders' understanding of vulnerability and capacity to consent, and how they view the universality or relativity of ethical issues.
Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2008.

This study investigated the Ethic, Law, and Human rights (ELH) dilemmas of researchers involved in preparing for and/or conducting HVTs in African countries. Furthermore it investigated availability of ELH material resources and infrastructure necessary for the successful conduct of HVTs. The study employed both qualitative and quantitative research methods. The main ethical challenges that researchers face when conducting HVTs include; high seroconversion rates, determining social value, working collaboratively with participants and communities, and paying trial participants. Legal challenges faced by researchers included; termination of participants who meet study inclusion criteria due to demands to do so from their parents and/or male partners, and in some countries lack of support from health care service providers when it comes to caring form trial participants. Understanding of consent age in African countries by communities was reported as a human right concern for researchers. The study concludes that researchers conducting or preparing to conduct HVTs in African countries face different ethics, law and human rights challenges when conducting HVTs at their sites and these challenges need to be addressed in order to improve the conduct of HVTs in Africa.

AIDS has had a negative impact on developing countries. Because most developing countries cannot afford the new antiretroviral drug therapies, it has been suggested that preventive vaccines might reduce the spread of the HIV/AIDS epidemic (Bloom, 1998). The clinical trials of AIDS vaccines do, however, present with complex ethical issues such as informed consent. Informed consent is primarily grounded on the Western principle of respect for individuals as autonomous agents. This may be at variance, however, with African societies' emphasis on the social embeddedness of the individual. The current study forms part of the HIVNET vaccine trials to be conducted in Hlabisa, in Northern Zululand, under the auspices of the South African Medical Research Council. The main aim of the study was to explore key informants' cultural conceptions of research and informed consent in order to facilitate community consultation and cultural sensitivity. Maximum variation sampling was used to select twenty-three key informants, who are in leadership positions within Hlabisa. An interview guide was used to facilitate narrative disclosure of cultural conceptions of research and informed consent. Perceptions of research, conceptions of the informed consent process, and projected motivations for why individuals agree to participate in studies were explored during interviews. Results suggest that members of the Hlabisa community have a limited understanding of the Western research process. Community education about research is therefore warranted. Informants indicated that community members would value the establishment of a relationship characterised by mutual respect for cultural differences between researchers and participants. This was perceived as likely to facilitate shared decision-making, and the reduction of the power differentials that exist between researchers and participants. While the involvement of key community leaders and family members was recommended by most informants, a few informants felt that participants could also make individual decisions about participation. The theoretical implications of the study are considered last.
Thesis (M.A.)-University of Natal, Pietermaritzburg, 1999.

This thesis explores the history of AIDS activism 'from both sides of the bed', by doctors and gay patients, in the 1980s and early 1990s. Such AIDS activism was formed in opposition to dominant racist and homophobic framings of the epidemic and the AIDS-related discrimination that these representations caused. Moreover, links between both groups of AIDS activists have their origins in this period. This history has emerged through oral interviews conducted with AIDS activists and an analysis of archival material held at the South African History Archive and the Centre for Health Policy at the University of the Witwatersrand. Evidence reveals that AIDS activism was politically overshadowed in the 1980s by the overwhelming need to respond to apartheid. Although the Gay Association of South Africa (GASA) resisted AIDS-related homophobia, it was politically conservative, which later led to its demise, and then the creation of new, more militant anti-apartheid gay AIDS activism. By contrast, the anti-apartheid doctor organisations such as the National Medical and Dental Association (NAMDA) and the National Progressive Primary Health Care Network (PPHC) were militantly anti-apartheid, but did not seriously address AIDS in the 1980s. In the early 1990s, in the new transitional context, AIDS activists framed the epidemic in terms of human rights to combat AIDS-related discrimination in AIDS policy. Simultaneously, doctor activists in NAMDA and PPHC mobilised around AIDS in the early 1990s, but both organisations disbanded after 1994. Meanwhile, gay AIDS activists remained prominent in AIDS activism, as some who were living with HIV adopted the strategy of openness about their HIV status. On the other hand, AIDS-related stigma remained widespread in the transition era with important implications for post-apartheid AIDS activism and policy-making. Ultimately, this history has significantly shaped post-apartheid, rights-based AIDS activism and its recent disputes with the government over AIDS policy.
Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2004.

This ethnographic study explored and described practices and beliefs that may have an impact on the management of HIV and AIDS among Tsonga people in Bushbuckridge. Data was collected through face to face in-depth individual interviews with 19 key informants who are highly knowledgeable about the Tsonga culture. The researcher used ethnographic content analysis to analyse data. Findings indicated that language, rituals, beliefs related to the origin of diseases, traditional healers, and tattoos are among Tsonga cultural practices and beliefs that have an impact on management of HIV and AIDS. Some of the practices increase the risk of HIV infection while some assist in the reduction of the risk of HIV infection. Based on the findings of the study and literature, the researcher managed to develop a contextual, cultural approach model for HIV and AIDS management for Tsonga people in Bushbuckridge. The model development was guided by Leininger theory of culture, care, diversity, and universality. To organise the model, the researcher used CIPO model to guide the elements of the cultural approach model. Though the model takes into consideration global and national context, the main focus was the local context in particular Bushbuckridge. The success of this model is dependent on the availability of knowledgeable healthcare practitioners, relevant resources and engaged community structure. The process of the model includes Cultural Care Preservation, Cultural care Accommodation, and Cultural care Re-patterning. The expected output of the model is modification of HIV risky cultural practices, improved health-seeking behaviour, reduction of new HIV infections and reduction of HIV and AIDS-related deaths. Based on the study outcomes, the researcher makes several recommendations in relation to implementation of the model, Nursing Practice and Education, and further research. The study has contributed to the body of knowledge in relation to cultural practices and management of HIV and AIDS. The model can be utilised to enhance nursing education and practice and further research.
Health Studies
Ph. D. (Health Studies)

This dissertation examines the legal position relating to the participation of children in research, especially in HIV preventive clinical research in South Africa. HIV/AIDS presents a real threat to humanity and particularly to the welfare of children. The participation of children in this type of trials is therefore vital. Children, as vulnerable participants, must also be protected from harm resulting from research. The study also considers the nature of HIV preventive clinical research, pointing to the inconsistencies in the legislation governing children’s participation in HIV preventive vaccine trials. The dissertation concludes that the question of the participation of children in HIV preventive clinical research poses many challenges, as the position in the South African law and relevant ethical guidelines are inconsistent and contradictory. The study recommends in the final instance that the relevant statutory provisions and ethical guidelines be harmonised in order to clear up the inconsistencies.
Jurisprudence
LL.M. (Legal Aspects of HIV/AIDS)

Background. An inherent challenge in HIV prevention studies is making sure that trial participants understand the information. This study explored trial participants’ perceptions and comprehension of the informed consent process in a pre-exposure HIV prevention study. Method. Face-to-face in-depth interviews, using a study guide, were held with twenty interviewees purposively selected from ex-participants of an HIV prevention study. Audio-recorded data were transcribed, translated, coded using NVivo 8, and analysed according to themes. Results. The participants were all women between the ages of 18 and 40. Participants felt that key information had been given during the informed consent process. Most felt that the process of obtaining informed consent was rushed with some participants citing a need for more time to make a decision regarding participation. Some participants felt pressured to sign consent forms. Some found it difficult to ask questions and mixed feelings existed on male partner involvement in the decision-making process. Conclusions: Participants experienced the consent process as rushed and most only fully comprehended study concepts with time. Their concerns necessitate the reassessment of informed consent processes in a developing world setting.
Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

The objective of this research is to explore the perceptions of rural Samburu women in Kenya with regard to HIV/AIDS in terms of their knowledge, attitudes, beliefs and opinions; to examine several HIV/AIDS awareness channels that have been used to communicate HIV/AIDS messages to the Samburu women to determine how effective they have been in effecting behaviour change.This study is an example of how a communication audit can be carried out on a certain sub-group of a community in order to suggest a tailor-made communication strategy in an effort to stop the spread of HIV among the Samburu women. This study is also a confirmation that the prevention strategies that have been in use to communicate to Samburu women have been inadequate and need to be revised to address the knowledge gaps that exist. The study is located within a relatively new field of health communication where health messages are evaluated to determine whether target audiences are receiving these messages and changing their behaviour in order to live healthier lives. This area of study is also supported by behaviour change models such as the Health Belief Model (HBM), the Social Cognitive Theory (SCT), Diffusion of Innovations Theory, Cultural Models, and Strategic Communication. A qualitative study was undertaken in 2008 by way of ten focus group discussions with Samburu women and eleven in-depth interviews with professionals who ran HIV/AIDS programmes in the Samburu district. The focus groups were constituted by means of convenience sampling whereas the snowball strategy was utilised for the selection of participants for in-depth interviews. The questioning route for the focus group discussions for the Samburu women was guided by five themes namely: knowledge levels of the women; cultural aspects that made the women vulnerable to HIV/AIDS; beliefs about HIV/AIDS; attitudes towards HIV/AIDS; and the different channels of communication used to convey HIV/AIDS messages. The interview schedule for the professionals consisted of open-ended questions and face-to-face interviews were carried out using this schedule.
Communication Sciences
D. Litt. et Phil. (Communication)

This dissertation has made an attempt at exploring the psychological factors that motivates individuals into opting for or against undertaking an HIV-test. The Health Belief Model is used to ascertain its predictive powers towards the motivation for undertaking such a test. Literature on HIV-testing indicates non-exploration of voluntary HIV-testing, as opposed to massive reporting on mandatory HIV-testing. Therefore, the focus of this dissertation is on voluntary HIV-testing. The sample used for the study. comprised of antenatal mothers who were offered HIV/Aids education and then presented with an option of either undertaking the HIV-test, or not. The results of the study indicate that the Health Belief Model has failed in its predictive powers towards motivations for or against HIV-testing. However, the study provided valuable psychological factors that are associated with the decision to undertake the HIV-test, which will be important for future research on HIV/Aids and on the control in the spread of the disease.
Thesis (M.A.)-University of Natal, Pietermaritzburg, 1999.

This study examined the role of the Anglican Church in the prevention of the spread of HIV and AIDS in the Limpopo Province, South Africa, using a random sample of 51 members of the Zoutpansberg parish. The study found that the Church currently contributes to the prevention of the spread of HIV among its congregation through HIV-related activities to reduce stigma, prejudice and discrimination against people living with HIV and AIDS (PLWHA). At the same time, however, much still needs to be done in the areas of cultural perception, sexual practices, and myths surrounding HIV and AIDS. Most of the respondents indicated that they would like to see the Church play an active role in voluntary counselling and testing (VCT), marital counselling, and encouraging openness with regard to HIV and AIDS. It is recommended that the Church should extend its activities to include members of the community outside the congregation in the prevention of the spread of HIV and AIDS.
Health Studies
M.A. (Health Studies)

The limited success of HIV-testing facilities in South Africa means that many people are not accessing necessary antiretroviral treatment services. This study investigates the practical implications of HIV exceptionalism inherent in Voluntary Counselling and Testing (VCT). A semi-structured interview schedule was used to survey participants for their perspectives on barriers to HIV-testing uptake as well as the effects of exceptionalist practices at VCT clinics. Responses showed marked perceptions of gender differences in people's willingness to test and several important barriers including problems of access to services. Significantly, exceptionalism displayed in certain clinic procedures was thought to contribute to stigma, and attempts to normalise HIV practice in order to combat the effects of stigma were being informally implemented. Participants' views on routine opt-out testing were explored. The researcher recommended further investigation on how HIV testing and treatment policies can be normalised so as to reduce stigma and increase testing uptake.
Social Work
M.A. Sociology (Social Behaviour Studies in HIV/AIDS)

With an estimated 500 infections everyday, the country is beset with a galloping HIV and AIDS epidemic. With these accelerating numbers, it is no longer possible to ignore people living with HIV and AIDS, as they will inevitably form a more and more significant volume of the workforce. A key aspect of this phenomenon, that needs dedicated attention, is the issue of their stigmatisation in the workplace. The intent is to present the voice of the stigmatised. The dissertation attempts to understand how a stigmatised identity affects a productive member of society. It tries to capture the perspective of sero-positive persons as productive members of society and not as `victims' or `threats'. The ultimate objective is to influence policy in the workplace in order to provide a nurturing and productive work environment. The key thought emerging from the research is: driven by the inescapable structural stigma of the workplace, the virus fundamentally influences the self-definition of the sero-positive person.
Sociology
M.A.

Educators play an essential role within the education system as role models. Many educators, in addition to being affected by learners living with HIV and AIDS, are themselves living with HIV and struggle to cope. SMTs have to play a role in the provision of psychosocial services. The purpose of this study was to explore the types of psychosocial services provided to ELWHIV by their SMTs in order to gain insight and understanding and to make suggestions on how psychosocial services can be improved. A qualitative study was undertaken in 2008. Fifteen interviews were conducted with ELWHIV and members of SMTs at four primary schools in Bela-Bela, Limpopo Province. The findings reveal that SMTs are failing to implement government policies and are not providing adequate support for ELWHIV. None of the participating schools had a functional AIDS policy. Support structures were found to be inadequate and ineffective. Disclosure was identified as one of the major obstacles to the provision of effective services.
Sociology
M.A. (Social Behaviour Studies in HIV/AIDS)

Educators play an essential role within the education system as role models. Many educators, in addition to being affected by learners living with HIV and AIDS, are themselves living with HIV and struggle to cope. SMTs have to play a role in the provision of psychosocial services. The purpose of this study was to explore the types of psychosocial services provided to ELWHIV by their SMTs in order to gain insight and understanding and to make suggestions on how psychosocial services can be improved. A qualitative study was undertaken in 2008. Fifteen interviews were conducted with ELWHIV and members of SMTs at four primary schools in Bela-Bela, Limpopo Province. The findings reveal that SMTs are failing to implement government policies and are not providing adequate support for ELWHIV. None of the participating schools had a functional AIDS policy. Support structures were found to be inadequate and ineffective. Disclosure was identified as one of the major obstacles to the provision of effective services.
Sociology
M.A. (Social Behaviour Studies in HIV/AIDS)