Rozprawy doktorskie: „HIV infections – Australia – Prevention”

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Petoumenos, Kathy Public Health &amp Community Medicine Faculty of Medicine UNSW. "Treatment experience and HIV disease progression: findings from the Australian HIV observational database". Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/24937.

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The Australian HIV Observational Database (AHOD) is a collaboration of hospitals, sexual health clinics and specialist general practices throughout Australia, established in April 1999. Core data variables collected include demographic data, immunological and virological markers, AIDS diagnosis, antiretroviral and prophylactic treatment and cause of death. The first electronic data transfer occurred in September 1999 followed by six monthly data transfers thereafter. All analyses included in this thesis are based on patients recruited to AHOD by March 2004. By March 2004, 2329 patients had been recruited to AHOD from 27 sites throughout Australia. Of these, 352 (15%) patients were recruited from non-metropolitan clinics. The majority of patients were male (94%), and infected with HIV through male homosexual contact (73%). Almost 90% of AHOD patients are antiretroviral treatment experience, and the majority of patients are receiving triple therapy as mandated by standard of care guidelines in Australia. Antiretroviral treatment use has changed in Australia reflecting changes in the availability of new treatment strategies and agents. The crude mortality rate was 1.58 per 100 person years, and of the 105 deaths, more than half died from HIV-unrelated deaths. The prevalence of HBV and HCV in AHOD was 4.8% and 10.9%, respectively. HIV disease progression in the era of highly active antiretroviral treatment (HAART) among AHOD patients is consistent with what has been reported in developed countries. Common factors associated with HIV disease progression were low CD4 cell count, high viral load and prior treatment with mono or double therapy at the time of commencing HAART. This was demonstrated in AHOD in terms of long-term CD4 cell response, the rate of changing combination antiretroviral therapy and factors predicting death. HBV and HCV coinfection is also relatively common in AHOD, similar to other developed country cohorts. Coinfection does not appear to be serious impediments to the treatment of HIV infected patients. However, HIV disease outcome following HAART does appear to be adversely affected by HIV/HCV coinfection but not in terms of HIV/HBV coinfection. Patients attending non-metropolitan sites were found to be similar to those attending metropolitan sites in terms of both immunological response and survival.

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Hou, Wei Wei. "Effectiveness of HIV preventive intervention programs in China: a systematic review of most recentevidences". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46937183.

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Guo, Jia, i 郭佳. "Distinct vaccine-induced antibody responses and bispecific neutralizing immunoadhesins against SIV/HIV infection". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/196479.

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Our research laboratory has recently reported that mucosal priming with a replicating modified vaccinia Tiantan virus (MVTTgpe)-based vaccine elicits durable protection against pathogenic SIVmac239 infection in rhesus monkeys. However, the protective role of vaccine-elicited antibody responses remains poorly understood. Here, a novel yeast surface displayed (YSD) antigen library was established to quantitatively map the antigenic determinants presented by MVTTgpe-based and control vaccines as well as by SIVmac239 infection. The YSD-library allows the mapping of linear and some conformational epitopes as a major technical innovation, as validated by testing SIV-specific mAbs KK65, KK8 and VM-18S. While eight antigenic domains are characterized covering the entire SIVmac239 gp160, the MVTTgpe/Ad5gpe regimen uniquely induces antibody responses against a distinct major antigenic determinant (MAD) in V2 region as compared with the Ad5gpe/Ad5gpe vaccination and SIV infection. This MAD is associated with a higher titer of anti-V2 antibody responses, which inversely correlates with peak viral load. Unexpectedly, the MVTTgpe/Ad5gpe vaccine- challenge. The results showed that instead of recalling B cell memory response to V2, viral infection presents a distinct set of antigenic determinants with anti-V1V2 antibodies primarily directed to V1 region. Moreover, the anti-V1V2 antibody responses disappear in two infected macaques after they enter the stage of simian AIDS. SIVmac239 infection, therefore, can modulate vaccine-elicited B cell immunity by diminishing anti-V2 antibody memory responses in rhesus monkeys. These findings implicated that vaccine efforts with focus on V2 region would require periodic vaccinations to maintain a long-lasting high level of antibody responses for protection. In the absence of an effective vaccine for eliciting HIV-1-specific broadly neutralizing antibodies (bNAbs), passive immunization with bNAbs or Ab-like agents (e.g. immunoadhesin) becomes an attractive alternative for HIV-1 prevention. In this study, we aimed to design, optimize and produce secretory immunoadhesins (IAs) based on gene engineering of existing HIV-1 specific bNAbs for potency and production improvements. IAs are chimeric, antibody-like molecules that combine the functional domain of bNAb with immunoglobulin constant domains, including the hinge and Fc regions. We found that the modified secretory IAs not only preserved the neutralization activity of the parental bNAbs, but also had enhanced expression and smaller molecular size that is suitable for antibody gene-based in vivo delivery. Furthermore, we defined the synergistic effects of five IAs against HIV-1 infection and subsequently engineered two types of bi-specific IAs by combining the functional domains of Hu5A8, a humanized anti-CD4 antibody, and the bNAb PGT128. Significantly, one of the bi-specific IA, namely Bi-IA-Mono, neutralized 100% of the 33 viruses tested, including the transmitted/founder viruses and viruses resistant to both parental IAs. The remarkably enhanced neutralization activity of Bi-IA-Mono, either in potency and breadth, indicated the great potential of modified bi-specific IA to provide complete or nearly complete protection against major HIV-1 subtypes. Overall, our results demonstrated that the engineering of IA and bi-specific IA is an attractive way to improve anti-HIV-1 properties of existing bNAbs, which have significant implications for antibody-based prophylactics in blocking diverse HIV-1 transmissions and infections.
published_or_final_version
Microbiology
Doctoral
Doctor of Philosophy

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Chigali, George M. "Assessment of the factors associated with HIV risk behaviours amongst women in Livingstone, Southern Province, Zambia". Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_2551_1189600940.

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The aim of this study was to assess the factors associated with HIV risk behaviours in women in Livingstone, Zambia. A cross-sectional analytical survey using a structured questionnaire was carried out in two sites in Livingstone, which were selected on the basis of differences in socio-economic status. Married women and women in the urban community are at high risk of contracting HIV and every effort should be made to ensure that HIV/AIDS programmes help to reduce their vulnerability to HIV infection.

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Cunningham, Nancy Mae. "An assessment of the HIV prevention needs of injection drug users in Montana". CONNECT TO THIS TITLE ONLINE, 2007. http://etd.lib.umt.edu/theses/available/etd-03292007-102609/.

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Hutchinson, Angela Blair. "A health technology assessment of HIV counseling and testing technologies". Diss., Georgia Institute of Technology, 2004. http://hdl.handle.net/1853/8077.

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Keen, Barbara. "The role of parents in HIV/AIDS primary prevention education /". Title page, contents and abstract only, 1992. http://web4.library.adelaide.edu.au/theses/09PM/09pmk26.pdf.

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Ailing, Wang Luechai Sringernyuang. "Uses of prevention of mother-to-child transmission of HIV Services : a study of HIV-positive women in Yining, Xinjiang, China /". Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd388/4737914.pdf.

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Wang, Ya-Chien. "A systematic evaluation of culturally sensitive HIV/AIDS prevention interventions in the US, 1996--2007". Diss., Connect to online resource - MSU authorized users, 2008.

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Lufuluabo, Ngeleka Albert. "Role of contraception in HIV prevention". Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/79936.

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Thesis (MPhil)--Stellenbosch University, 2013.
ENGLISH ABSTRACT: Reproductive health of people living with HIV/AIDS is a significant public health issue because of its associated risks of HIV transmission to both, the baby and the sexual partner. Provision of effective contraceptive to HIV-positive women is a proven prevention strategy, and can help prevent unintended pregnancy and other sexually transmitted infections. Unmet need for contraception in developing world and rates of unintended pregnancies among women living with HIV remain highly prevalent. The objectives of this study were to identify the current knowledge of HIV-positive women on existing contraceptive methods, determine their current contraceptive practices, identify barriers to contraception use, and provide recommendations on how contraception uptake can be improved among these women in Kasane. A cross-sectional study using qualitative technique was used among twenty five (25) participants at Kasane Primary Hospital. In-depth interviews were conducted with the help of research assistants for data collection. Excel Microsoft Office Software was used for socio-demographics data entry and analysis, and qualitative data were analysed manually using descriptive statistics. Main reasons for low uptake of contraception were desire for children, partner refusal, side effects, and socio-cultural and religious factors. Contraception prevalence was 56 % and condom was the most used contraceptive method (36%). whereas the rate of unintended pregnancies was 60% . Knowledge of contraception was high (100%) but limited proportion of participants (12%) had an expended understanding of contraception as a HIV prevention strategy. Most women living with HIV prefer to space, limit or stop childbearing but do not use any contraceptive method and found themselves with unintended pregnancy. Despite the good knowledge about contraception among participants, the uptake remained low. About half (44%) of the women interviewed were not on any contraceptive method. The choice to use contraception interferes with many factors and the desire to fulfil the primary reproductive intention of men and women, including those living with HIV, mostly override this choice. There is need for a strategic integrated approach that conveys HIV prevention messages and discusses the importance of planning a pregnancy. Thus promoting dual protection among women living with HIV.
AFRIKAANSE OPSOMMING: Die voortplantingsgesondheid van mense wat met MIV/vigs leef, is ‘n belangrike openbaregesondheidskwessie, aangesien voortplantingsgesondheid verband hou met die gevaar van MIV-oordrag na babas sowel as seksmaats. Daar is al bewys dat ander seksueel oordraagbare siektes sowel as onbeplande swangerskappe voorkom word as doeltreffende voorbehoedmiddels verskaf word aan vroue wat MIV-positief is. Dit behoefte aan voorbehoeding in ontwikkelende lande bly egter baie dikwels agterweë, en ‘n groot persentasie vroue wat met MIV leef, raak onbepland swanger. Die doel met hierdie ondersoek is om vas te stel wat vroue wat MIV-positief is, tans oor bestaande voorbehoeding weet, watter voorbehoedingsmetodes hulle tans gebruik en watter struikelblokke daar vir die gebruik van voorbehoeding is, en om voorstelle te maak oor hoe ŉ groter persentasie van hierdie vroue in Kasane oortuig kan word om voorbehoedmiddels te gebruik. ‘n Deursnee-studie wat met behulp van kwalitatiewe tegnieke by die Kasane Primêre Hospitaal uitgevoer is, het vyf en twintig (25) deelnemers betrek. Met die hulp van navorsingsassistente is diepte-onderhoude gevoer om inligting in te samel. Microsoft Office se Excel-sagteware is gebruik om sosio-demografiese inligting in te voer en te ontleed, en kwalitatiewe inligting is met verwysing na beskrywende statistiek met die hand ontleed. Die vernaamste redes vir die trae gebruik van voorbehoeding was die begeerte na ‘n kind, die teenstand van seksmaats, die newe-effekte, en sosio-kulturele en godsdienstige oorwegings. Daar is bevind dat 56% van die deelnemers voorbehoeding gebruik, dat kondome die algemeenste voorbehoedmiddel is (36%) en dat 60% van alle swangerskappe ongewens was. Die deelnemers was almal oor voorbehoeding ingelig (100%), maar slegs ‘n klein persentasie (12%) het ook geweet dat voorbehoedmiddels ‘n voorkomingstrategie vir MIV-infeksie is. Die meeste vroue wat met MIV leef, verkies om swangerskappe te versprei, te beperk of te verhoed, maar gebruik geen voorbehoedmiddels nie en het dus onbepland swanger geraak. Hoewel die deelnemers goed ingelig was oor voorbehoeding, het min van hulle dit gebruik. Ongeveer die helfte (44%) van die vroue met wie onderhoude gevoer is, het geen voorbehoeding gebruik nie. Die keuse om ‘n voorbehoedmiddel te gebruik, word beïnvloed talle ander faktore, en mans en vroue se primêre begeerte om voort te plant – ook al leef hulle met MIV – weeg gewoonlik swaarder as hierdie keuse. Daar is ‘n behoefte aan ‘n strategiese, geïntegreerde benadering wat boodskappe oor MIV-voorkoming oordra en wat tuisbring hoe belangrik dit is om swangerskappe te beplan. Sodoende sal vroue wat met MIV leef, tweedoelige beskerming kry.

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Jusayo, Nomonde. "Factors affecting the utilisation of a workplace voluntary counselling and testing programme in the Eastern Cape". Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1010273.

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The world has entered the third decade of the HIV and AIDS epidemic under different times in which the epidemic is treatable. The International Labour Organisation (ILO) (2005) declares HIV and AIDS a developmental crisis destroying developmental gains over generations. Since HIV and AIDS affect the most productive segment of the labour force, it is therefore not only a threat to development but also to the world of work without which development will be sacrificed (ILO, 2001). Collaborative response efforts that seek to mitigate the HIV pandemic by government, business and higher education institutions have been fraught with challenges. The main challenge that beset these efforts is that, in the absence of an HIV vaccine, voluntary counselling and testing remains the gateway to access treatment and care. Regrettably, participation in VCT has been confronted by challenges of low utilisation. This precedes the objectives of this study, which were to explore and describe factors that serve as barriers and facilitators of workplace VCT programmes with the objective to improve participation in these programmes. The current study was a product of a qualitative and exploratory-descriptive research design. A nonprobability convenience sampling method was used to sample participants for this study. The targeted population in this study were the non-academic employees of an academic institution in the Eastern Cape. Data was collected by means of focus group discussions and by using semi-structured interviews. The focus group samples comprised of an equal number of men and women with an overall participation of fifty-six participants. Data obtained was transcribed, thematically analysed and coded using Henning, Van Rensburg, and Smit's (2004) qualitative analysis and interpretation method. Findings of this research revealed that factors that facilitate and inhibit voluntary counselling and testing are psychosocial and cultural by nature. At psychosocial level, participants reported factors that facilitate voluntary counselling and testing to include psychological readiness to go for HIV testing, reassurances of confidentiality of HIV test results and normalising HIV testing (making the process more like that for screening and diagnostic testing). Cultural factors included cultural practices and beliefs such as "intonjane" and traditional circumcision - positive cultural nurturers that could facilitate VCT participation. Results of this study showed a lack of basic knowledge about VCT and fear of knowing one's status, fear of breach of confidentiality, fear of being stigmatised and a lack of trust towards health professional as the major psychosocial factors that serve as barriers to VCT participation. The cultural barriers to VCT pointed to hegemonic masculinity as a socially constructed gender identity that encourages gender inequalities and undermines efforts to improve HIV testing. The study suggested that strategies to increase VCT participation should consider leadership support of VCT programmes, incentivisation of VCT programmes, institutionalisation of HIV and AIDS education and the establishment of integrated wellness services for employees.

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Simpson, Malcolm Robert. "Knowledge of safe sex practices and HIV transmission, propensity for risk taking, and alcohol/drug use in the aetiology of unprotected sex". Thesis, Rhodes University, 1997. http://hdl.handle.net/10962/d1007421.

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Second year psychology students (N=176) from Rhodes University were surveyed using an anonymous questionnaire to obtain information on sexual behaviour and knowledge of the acquired immunodeficiency syndrome (AIDS) among young people. The following information was obtained: Knowledge of safe sex practices and HIV transmission was high although a number of misconceptions were noted. Only fifty six percent of students viewed oral sex with a condom as safe and thirty one percent do not consider mutual masturbation with a condom safe. Thirteen percent and twenty five percent respectively identified insects and saliva as being routes of HIV transmission. Magazines (96%), informal discussions with friends (95%), public pamphlets (86%) and public television (79%) were preferred sources of information. The students' knowledge did not appear to significantly affect sexual behaviour. Eighty percent of respondents were intimately involved with another person during the past twelve months, and only fifteen percent always made use of a latex barrier when being sexually intimate. Despite high rates of alcohol and/or drug consumption (80% of students use such substances), and the belief by the majority of respondents that alcohol and/or drugs facilitate higher risk behaviours, no support for the alcohol/risky sex hypothesis was found. Students were found to score highly on proneness to psychological and behavioural risk taking, and no significant relationship between this and unprotected sex was found. It can be concluded that educational programmes need to focus on what constitutes safe sexual practices in order to equip young adults with the knowledge they need to make informed choices regarding the relative risks of various sexual activities.

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Pokharel, Ubin. "Factors Associated with Sexually Transmitted Infections (STIs) and Multiple STI Co-infections: Results from the EVRI HIV Prevention Preparedness Trial". Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6131.

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Objective: The objective of this study was to describe the prevalence of sexually transmitted co-infections and assess factors associated with a single infection and co-infections. Methods: A total of 388 women were included in this study. At enrollment of the EVRI trial women were tested for five STIs: Human papilloma virus (HPV), Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus-2 (HSV-2) and Treponema pallidum. Prevalence of STI infections and proportion of women with different combinations of co-infections were calculated. Factors associated with single infection and STI co-infection were assessed using a polytomous logistic regression model and odds ratio (OR) and 95% confidence intervals (95% CI) were reported as the measure of association. Results: Prevalence of a single STI and concurrent STI co-infections were high. Prevalence of chlamydia was 33%, syphilis 6%, HSV-2 46% and HPV 71%. The most common STI co-infection pattern was HPV-HSV (32%), followed by HPV-chlamydia (17%). The odds of single STI compared to no STIs was significantly lower for women who had education level of grade 7 compared to women who had some college or technical education (OR 0.16, 95% CI: 0.03-0.79).The odds of a single STI compared to no STIs were significantly higher (OR 3.02, 95% CI: 1.05-8.64) and the odds of concurrent STIs compared to no infection were significantly higher (OR 3.86, 95% CI: 1.42-10.48) for women with three or more lifetime partners compared to one life time partner. Conclusions: STIs, single and multiple concurrent infections, are common among this cohort of South African women. These results strengthen the recommendation that STI screening and treatment needs to be a component of multiple intervention strategies among high-risk women residing in communities with high STI prevalence.

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Ngamvithayapong-Yanai, Jintana. "Challenges and opportunities for tuberculosis prevention and care in an HIV epidemic area, Chiang Rai, Thailand /". Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-440-2/.

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Matengu, Barbara. "The importance of STI treatment in HIV prevention: knowledge and behaviours of secondary school students in Tsumeb, Namibia". Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_8923_1182746437.

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Curricula should be strengthened by teaching the curability of STIs and the importance of STI treatment to prevent HIV transmission. This study focused on the control of sexually transmitted infections as a key HIV prevention strategy. Sexually transmitted infections act as a strong cofactor in the sexual transmission of HIV. Effective STI management can limit the spread of HIV.

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Mohammed, Amina. "Knowledge, attitudes and practices regarding HIV/AIDS of hotel staff from a selected hotel group in Cape Town". Thesis, Cape Peninsula University of Technology, 2006. http://hdl.handle.net/20.500.11838/1589.

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Thesis (MTech (Tourism and Hospitality Management))--Cape Peninsula University of Technology, 2006.
The HIV/AIDS pandemic poses one of the greatest challenges to business development in South Africa. The hotel industry is growing rapidly and will be . significantly affected by the HIV/AIDS pandemic. The purpose of this study was to determine the Knowledge, Attitudes and Practices (KAP) regarding HIV/AIDS of staff from nine Protea group hotels in Cape Town. A sample of 200 hotel staff was randomly selected to participate. A structured self-administered anonymous questionnaire was the instrument used to collect the data. The response rate was 81%. There were more females than males, and the majority of the respondents were between the ages of 21-30 years. More than half of the respondents were single, hotel managers and with matriculation as the highest qualification. The respondents demonstrated a reasonably good knowledge on the transmission of HIV/AIDS. Almost half of the respondents believed that HIV/AIDS would not affect the hotel industry. The survey revealed conflicting results on whether HIV-infected staff should be involved in food preparation, and whether staff should serve food to HIV positive hotel guests. There were also concerns of the risk of infection when handling dirty linen used by HIV-infected hotel guests. More males than females were currently sexually active and reported having more than one partner in the past three years. The majority of the respondents believed that condoms were effective, but only one third reported the use of a condom every time they had a sexual encounter. There was a significant relationship between knowledge and attitudes (p-value<0.05, but none between knowledge and practice and attitude and practice. It is recommended that the hotel industry develop effective workplace policies and supportive environments, and that on-going HIV/AIDS education and prevention programmes be implemented to change high risk sexual behaviour and practices.

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Jackson, Glenda Joy. "Professional development in HIV prevention education for teachers using flexible learning and tutor support". Curtin University of Technology, School of Public Health, 2004. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=15246.

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HIV prevention programs in schools are acknowledged as one of the best prospects for controlling the world HIV epidemic. Epidemiological evidence indicates that deaths world-wide from AIDS are yet to peak. Although HIV notifications and AIDS deaths in the total Australian population have decreased', there has been an increase in rates in the Australian Indigenous population. There is also some evidence of complacency in HIV prevention vigilance in Australia which indicates a need for continued focus on prevention programs. The knowledge levels, attitudes toward HIV risk, and risk-taking behaviours of young Australians place them at risk of exposure to HIV. Appropriate prevention programs can be delivered to these vulnerable young people through the school setting. Programs delivered in schools have been shown to have a positive effect and teachers are vital to the delivery of these education programs. Without appropriate training, however, teachers may not optimise the outcomes of these programs. While it would be desirable for teachers to be trained in HIV prevention education in pre-service training this has not been the case in Western Australia (WA). When there is not an opportunity for pre-service training, professional development programs can be implemented to provide additional training required by teachers. Traditionally this professional development has been provided through workshops. These face-to-face delivery methods, however, do not always adequately serve the needs of all teachers, and in particular the needs of teachers in rural and remote areas. In an attempt to address the needs of these teachers, alternate methods of professional development delivery may be appropriate. The aim of this study was to test an alternate method of delivery.
The study designed, disseminated and evaluated the implementation of a flexible learning professional development program for teachers of HIV education. The program was based on print-based distance learning, supported by a video and tutors. Five objectives were developed for the study. These objectives were: Objective One - To determine factors associated with teachers' enrolment in the Protect Yourself Program (PYP). Objective Two - To determine the association between factors related to entry characteristics, social integration, external attribution, academic integration and incompatibility and amount of PYP completed. Objective Three - To determine the association between amount of PYP completed and factors related to the teaching of HIV lessons. Objective Four - To examine the context in which intervention and comparison group teachers were operating for this study. Objective Five - To evaluate the process of teacher recruitment to PYP, satisfaction with the flexible learning methodology, satisfaction with the PYP materials and completion of PYP. A comprehensive theoretical framework was constructed to guide the development of the empirical study and the professional development program, as little evidence was found in the literature of similar empirically evaluated studies. This framework incorporated: Adult Learning Theory; the Model of Student Progress; the PRECEDEPROCEED Model; the Health Promoting Schools Framework; Diffusion of Innovation and the Communication Behaviour Change Model. The study was conducted in two parts. Firstly, an exploratory study was conducted which provided a basis upon which to implement the second, larger empirical study.
A quasi-experimental study design was implemented due to restrictions placed upon the study by the WA Department of Health, the funding agency. The study sample was made up of teachers from government and independent, primary and second schools in WA. In total, 126 teachers were recruited to the intervention group and enrolled in the professional development program, and 128 to the comparison group, who completed some of the evaluation instruments, but did not participate in a professional development program. The professional development intervention program incorporated four comprehensive work modules, which were delivered in print form. A video and tutorial support supplemented the print materials. To evaluate the professional development program, seven instruments were developed. From these instruments five categories of variables were created, namely demographic, contextual, teacher characteristics, process and dependent. These variables were developed as single item variables, scales or indices. Quantitative data were analysed using the Statistical Package for the Social Sciences and a combination of univariate, bivariate, and multivariate techniques (logistic regression and analysis of covariance) were conducted. Qualitative data were analysed for themes. A binary logistic regression was conducted to evaluate Objective One: to determine factors associated with teachers’ enrolment in PYP. The analysis identified four factors which were associated with enrolment in PYP.
The teachers most likely to enrol in PYP had no pre-service training in health education and did not consider themselves to be a specialist or coordinator of health education. The majority of program participants had been teaching health education for between three and seven years and displayed a high level of acceptance of the flexible learning methodology. Objective Two: to determine the association between factors related to entry characteristics, social integration, external attribution, academic integration and incompatibility and amount of PYP completed was evaluated using a nominal logistic regression analysis with the intervention group sample only. Completion of the PYP program by participants was related to circumstances which were often beyond the control of the program, such as events occurring in a teacher’s personal life. However, teachers who showed a preference for flexible learning were found to be more successful in completing the program. The effects of PYP were measured by Objective Three: to determine the association between amount of PYP completed and factors related to the teaching of HIV lessons. Three of the six factors considered by this objective returned a significant association with program dose. Teacher perceived access to HIV education resources was found to be positively related to the dose of materials a participant completed.
Participants who completed a high dose of the program considered HIV resources to be relatively easier to access than participants completing a low dose. Teachers who completed a high dose of PYP reported being more comfortable to teach HIV lessons than teachers completing a mid dose. In addition, intervention group teachers showed a significant change in comfort with their ability to teach HIV lessons and specified HIV topics to Years 8, 9, and 10 classes and intervention group teachers of Year 8 students thought the HIV topics were less important for this level of students. The final variable to show a significant change over time when dose of the program was considered was teacher sexual conservativeness. Both high and mid dose participants reported being less sexually conservative than low or no dose participants from pre to midtest. The context of the teachers participating in the PYP study was investigated through Objective Four: to examine the context in which intervention and Comparison group teachers were operating for this study. Two factors were found to be associated with gender, six with school location and eleven with level of teaching. These associations provided important contextual information for interpreting the findings of the study. Objective Five evaluated the process of teacher recruitment to PYP, satisfaction with the flexible learning methodology, satisfaction with the PYP materials and completion of PYP. The recruitment strategies implemented for PYP were effective in having teachers from government and independent schools in WA recruited to PYP.
However, more than 90% of the intervention group were from government schools. Schools encouraged more than one teacher from a school to enrol, with nine primary schools, four district high schools, one community high school, one secondary college, four senior high schools and one combined independent primary and high school enrolling more than one teacher in the program. The flexible learning methodology was reported to be suitable for the needs of teachers who enrolled in PYP, as they felt comfortable with the learning methodology and appreciated the opportunity to choose when and where they completed the program. The opportunity for face-to-face contact, however, was still preferred by some teachers. The materials within the program were considered to be appropriate and useful. The writing style and activities were well received and the efforts of the tutors were welcomed by the majority of the intervention group. One third of teachers who enrolled in PYP completed at least some of the materials, but less than 10% completed the entire program. The most frequent suggestions made for increasing program completion rates were to set dates for completion of the program modules and to allow time release to complete the program. At baseline, this research showed that teachers considered it important for their students to have access to HIV education, but many of these teachers did not feel comfortable providing HIV education for their students.
As positive effects were observed in the PYP program of impact of program dose on factors affecting the implementation of HIV education, it would appear that flexible learning professional development was a suitable alternative to face-to-face professional development. Teachers' acceptance of flexible learning professional development as an alternate methodology, however, appears to be in its infancy and will require more empirical research. Future research, study design improvements and intervention design improvements can be informed by the following recommendations. Future research Recommendation 1: There be more rigorous investigation of flexible learning as a methodology for provision of professional development for teachers of health education. Recommendation 2: The status of claiming credit for professional development toward postgraduate qualifications for teachers continue to be investigated. Recommendation 3 : Further research be undertaken to evaluate available technologies and their acceptance by teachers as a delivery method for flexible learning professional development. Study design improvements Recommendation 4: design limitations of the PYP study. Future research be designed to overcome the study Intervention design improvements Recommendation 5: The findings of the PYP study and suggestions made by PYP participants be used to improve future health education professional development programs.

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Gordon, Gregory Ernest Robert. "A chemo-enzymatic process for the production of beta-thymidine, a key intermediate in antiretrovirol manufacture". Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/d1016217.

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The socio-economic impact of HIV/AIDS on South Africa has resulted in lower gross domestic product, loss of skills in key sectors such as education, and increased health-care costs in providing access to treatment. Currently active pharmaceutical ingredients (API’s) such as stavudine (d4T) and azidothymidine (AZT) are imported from India and China, while formulation is conducted locally. A strategy was initiated between CSIR Biosciences and LIFElab under the auspices of Arvir Technologies to investigate the feasibility of local antiretroviral manufacture (d4T and AZT) or the manufacture of a key intermediate such as β- thymidine (dT). Several advantages associated with successful implementation of this strategy include ensuring a local supply of API’s, thus reducing reliance on procurement from foreign sources and reducing the effect of foreign exchange rate fluctuations on providing cost effective access to treatment. A local supply source would also reduce the imports and thus aid the balance of payments deficit, and in addition to this, provide stimulus in the local pharmaceutical manufacturing industry (which has been in decline for several decades), resulting in increased skills and employment opportunities. This thesis describes the development of a superior chemo-enzymatic process for the production of β-thymidine (72 percent yield, prior to isolation), a key intermediate in the preparation of anti-retrovirals. Alternative processes based purely on chemical or bioprocess transformations to prepare either 5-methyluridine (5-MU) or dT suffer from several disadvantages: lengthy transformations due to protection/deprotection strategies, low selectivties and product yields (30 percent in the chemical process) and isolation of the product from dilute process streams requiring the use of large uneconomical reactors (bioprocesss). This contributes significantly to the cost of d4T and AZT manufacture. Our novel chemoenzymatic process comprises of a biocatalytic reaction for the production of 5-MU, with subsequent chemical transformation into dT (3 steps) negating and circumventing the limitations of the chemical or bioprocess routes. During the course of this project development, the β-thymidine selling price declined from 175 $/kg (2005) to 100 $/kg (2008). However, the process described in this work is still competitive based on the current β- thymidine selling price of 100 $/kg. The process economics show that with further optimization and increasing the isolated dT yield from 70 percent to 90 percent, the variable cost decreases from 136 $/kg to 110 $/kg. The increase in isolated yield is highly probable, based on solubility data of β-thymidine. The decrease in β-thymidine selling price and technological improvement in dT manufacture should translate into lower API manufacture costs and more cost effective access to treatment. Our novel biocatalytic process producing 5-MU uses a coupled enzyme system employing PNP, Purine Nucleoside Phosphorylase and PyNP, Pyrimidine Nucleoside Phosphorylase. The overall transglycosylation reaction may be decoupled into the phosphorolysis reaction (PNP) and synthesis reaction (PyNP). During the phosphorolysis reaction, guanosine is converted into guanine and ribose-1-phosphate (R-1-P) in the presence of PNP enzyme. The reaction intermediate R-1-P is then coupled to thymine in the presence of PyNP enzyme during the synthesis reaction, producing 5-MU. The process was scaled up from lab-scale to bench-scale (10 - 20 L) and demonstrated to be robust and reproducible. This is evident from the average guanosine conversion (94.7 percent ± 2.03) and 5-MU yield (88.2 percent ± 6.21) and mole balance (104 percent ± 7.61) which were obtained at bench-scale (3 replicates, 10 L). The reaction was carried out at reactor productivities of between 7 – 11 g.L-1.h-1. The integration of the biocatalytic process and chemical processes was successfully carried out, showing that 5-MU produced using our novel biocatalytic process behaved similarly to commercially available 5- MU (ex. Dayang Chemicals, China). A PCT patent application (Ref. No. P44422PC01) on this chemo-enzymatic process has been filed and currently public private partnerships are being explored through Arvir Technologies to evaluate and validate this technology at one ton scale.

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Lourens, Guinevere Margaretha Attilla. "TB and HIV community-outreach training project in a higher education institution". Thesis, [S.l. : s.n.], 2009. http://dk.cput.ac.za/cgi/viewcontent.cgi?article=1021&context=td_cput.

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Links, Nomvuyiseko. "Postnatal women's experiences of the prevention of mother-to-child transmittion of HIV programme". Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/545.

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This research study endeavoured to explore and describe the experiences of women who participated in the Prevention of Mother-To-Child Transmission (PMTCT) of HIV Programme. Data relating to evaluation of the PMTCT Programme in the piloted sites compiled by other researchers in the Department of Health focus on the process, progress and extent of service implementation. There appears to be a dearth of information available from women participants in the PMTCT Programme. The objectives of the study were to: · Explore and describe postnatal women’s experiences of the PMTCT Programme offered in the East London Hospital Complex. · Propose recommendations into the existing guidelines for midwives who implement the PMTCT Programme in the health services to ensure optimal implementation of this programme. The research population included postnatal women who participated in the PMTCT of HIV Programme at the East London Hospital Complex (Frere site). Permission to conduct the research was obtained from the Eastern Cape Department of Health Ethics Committee, Chief Executive Officer of the hospital complex and the Advanced Degrees Committee and Human Ethics Committee at the Nelson Mandela Metropolitan University. The research study was qualitative, exploratory, descriptive and contextual in design. Data collection was carried out by face-to-face semi-structured interviews with postnatal women at the East London Hospital Complex (Frere site). The tape-recorded interviews were transcribed verbatim with the aid of field notes. Data analysis was done according to Tesch’s method of data analysis (in De Vos et al, 2000:343). Themes were identified from the transcriptions and finalised after consensus discussions with an independent coder who was experienced in qualitative research. Literature control, guided by the themes identified in the interviews, was carried out to compare and verify the findings of the study. Three major themes with sub-themes were identified during data analysis. The major themes were identified as follows: · The participants expressed feelings of being devastated by the results that confirmed their HIV positive status. · The participants expressed a thirst for knowledge on how to live with the diagnosis and on how to continue with the PMTCT Programme. · The physical environment where counselling and testing were done, as well as the practical arrangements, were not conducive to the full implementation of the PMTCT Programme at the antenatal clinic. Conclusions were drawn and recommendations were made in the form of additional guidelines for midwives implementing the PMTCT Programme in the antenatal clinic health services. Guidelines for further midwifery-related research were formulated.

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Makhubele, Jabulani Calvin. "The impact of culture on the prevention and treatment of HIV/AIDS amongst people in low-resourced areas :a social work perspective". Thesis, University of Limpopo, 2004. http://hdl.handle.net/10386/2027.

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Thesis (M. A. (Social Work)) -- University of Limpopo, 2004.
The aim of this study was to explore the impact of culture on the prevention and reatment of HIV/AIDS amongst people in low-resourced areas like Malamulele. he study focused on the lifestyles, beliefs, attitudes and perceptions around ultural elements and practices, which might impact negatively on the prevention nd treatment of the HIV/AIDS epidemic. There were three groups of research espondents namely: learners from three high schools in Malamulele, some arents of the learners and the traditional/cultural leaders. The researcher ollected both qualitative and quantitative data. The data was gathered through he use of an interview schedule (questionnaire), focus group discussions and ound-table discussion sessions. The data was presented, analysed and nterpreted by means of tables and charts. t was found that people in low-resourced (rural) areas have little knowledge about HIV/AIDS, causes, symptoms and how the disease is transmitted. Despite the fact that awareness and educational campaigns and programmes are being rendered, people in low-resourced (rural) areas have little knowledge and needed skills about prevention and treatment of the pandemic. Polygamy and extra-marital relations by men is still highly valued and viewed at high esteem. Religious structures seem to be detached to the issue of HIV/AIDS as they mentioned that talking about HIV/AIDS is immoral and against their principles. The study also tried to explore the extent to which people in low-resourced areas view and use condoms as a protective means.

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Mamudu, Rashidat Amanosi. "Knowledge, attitude and practices of prevention of mother to child transmission of HIV(PMTCT) among women of child bearing age, in Karu Village, Abuja, Nigeria". Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86249.

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Thesis (MPhil)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: An estimated 34 million people worldwide are infected with HIV with 52% of them being women (UNAIDS, 2011), of this figure, an estimated 3.4 million are said to be children below the age of 15years. Sub Saharan Africa accounts for up to 90% of this burden in children. Nigeria, the most populous nation is Saharan African still contributes up to 30% of the global burden of mother to child transmission of HIV which is a major source of infection in children. According to the Federal ministry of health 2010 ANC survey report, the country has a prevalence of 4.1%. The Federal Capital Territory (FCT) where Karu village is located ranked 5th among the 36 states and Federal capital territory in Nigeria with a prevalence of 8.7%. Urban prevalence is 8.6% while the rural prevalence is 8.2%. An exploratory descriptive study was conducted among women of child bearing age (18 to 49years) living in Karu village, Abuja, FCT, North central Nigeria. A semi structured questionnaire designed to assess the knowledge, attitude and practices of prevention of mother to child transmission of HIV was administered by the researcher on 120 women of child bearing age living in Karu village after obtaining their consent. The study received an ethical review and approval from FCT human research ethics committee at the Health Department of the Federal capital development agency and Stellenbosch University, ethic committee. Findings from the 120 women who gave consent to participate showed that 28.33% had sufficient knowledge of how MTCT can occur with 77% having insufficient knowledge of how MTCT occur, 51.67% of them have sufficient knowledge of how PMTCT can be achieved while 48.33% do not. Of the participant surveyed, 89.17% of them have ever been pregnant while 24.17% were pregnant at the time of the survey, the bulk of the participants were between the ages of 18 to 34 with only 22.5% of them within the age of 35 – 49 years. From this study, women in Karu village were identified to have high level of general knowledge regarding MTCT and PMTCT of HIV but in-depth knowledge of both is still insufficient among a large group of women. Health workers and mass media were identified as key sources of information regarding MTCT and PMTCT of HIV and majority of women have favourable attitude towards PMTCT interventions but practices of these interventions is still relatively low.
AFRIKAANSE OPSOMMING: Ongeveer 34 miljoen mense is wêreldwyd aangetas deur MIV, waarvan 52% vroue is (UNAIDS, 2011). Hiervan is ongeveer 3.4 miljoen na bewering kinders onder die ouderdom van 15 jaar. Tot 90% van hierdie infeksie by kinders kom in sub-Sahara-Afrika voor. Nigerië, die digsbevolkte staat in sub-Sahara-Afrika, dra tot 30% van die globale las van moeder-tot-kind-oordrag van MIV, wat ’n groot bron van infeksie onder kinders is. Volgens die Federale Ministerie van Gesondheid 2010 ANC-opnameverslag het die land ’n voorkomssyfer van 4.1%. Die Federal Capital Territory (FCT), waar die dorp Karu geleë is, is as 5de van die 36 state in Nigerië geklassifiseer met ’n voorkomssyfer van 8.7%. Die stedelike voorkomssyfer is 8.6% teenoor die landelike voorkomssyfer van 8.2%. ’n Ondersoekende, beskrywende studie is uitgevoer onder vroue van vrugbare leeftyd (18 tot 49 jaar) wat in die dorp Karu, Abuja, FCT, Noord-sentrale Nigerië, woon. ’n Halfgestruktureerde vraelys is ontwerp om die kennis, houdings en voorkomingspraktyke van moeder-tot-kind-oordrag (MTCT) van MIV te beoordeel. Dit is deur die navorser toegepas op 120 vroue van vrugbare leeftyd wat in die dorp Karu woon nadat hul toestemming daartoe verkry is. Die studie het ’n etiese oorsig en goedkeuring van die FCT mensenavorsing-etiekkomitee by die Departement van Gesondheid van die federale hoofstad se ontwikkelingsagentskap en die Universiteit Stellenbosch se etiekkomitee ontvang. Bevindings van die 120 vroue wat ingestem het om deel te neem het getoon dat 28.33% toereikende kennis gehad het van hoe MTCT kan voorkom, met 77% wat onvoldoende kennis gehad het van hoe MTCT voorkom. Van hulle het 51.67% genoegsame kennis gehad van hoe PMTCT verkry kan word, terwyl 48.33% nie oor hierdie kennis beskik het nie. Van die deelnemers wat waargeneem is, was 89.17% al swanger, terwyl 24.17% tydens die opname swanger was. Die meerderheid van die deelnemers was tussen 18 en 34 jaar oud, met slegs 22.5% wat in die ouderdomsgroep 35 – 49 jaar geval het. Uit hierdie studie het geblyk dat vroue van die dorp Karu geïdentifiseer is as mense wat ’n hoë vlak van algemene kennis omtrent MTCT en PMTCT van MIV gehad het, maar dieptekennis van albei sake is steeds ontoereikend by ’n groot groep vroue. Gesondheidswerkers en die massamedia is geïdentifiseer as sleutelbronne van kennis oor MTCT en PMTCT van MIV en die meeste vroue het ’n gunstige houding teenoor PMTCT-intervensies, maar die toepassing van hierdie intervensies is nog betreklik laag.

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Eason, Yoshika Shajuan. "Exposure to HIV Prevention Messages on Social Media and Behavior Change Intent". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3876.

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African Americans living in the Southeastern region of the United States disproportionately contract sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Facebook and other social media sites are becoming a way to deliver health-related messaging to targeted populations. The purpose of this quantitative, cross-sectional study was to examine the association between selected demographic factors and impact of social media on intent to change sexual behaviors among 112 African Americans between the ages of 18 and 49 in the Southeastern United States who viewed STI/HIV prevention materials on Facebook within 1 year prior to the study. The theory of planned behavior was used to help understand and interpret the findings. Participants completed an online self-report survey containing questions about their exposure to sexual health messages on Facebook and their intent to change behavior. Results of the multiple logistic regression analyses indicated that gender (p =.462), age (p =.122), education (p =.593), and income (p =.200) were not statistically associated with the dependent variable, intent to change risky sexual behaviors. A majority of respondents indicated the intention to change their sexual behaviors as a result of viewing HIV prevention messages on Facebook, and that the messages were the most important factor in their decision to change behavior. Facebook messaging may be an effective platform for reaching African Americans and influencing behavior; however more research is needed to fully understand the use of social media for STI prevention. The social change implication of this research is the potential to decrease HIV/STI associated morbidity and mortality among this population.

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Alexander-Terry, Jennifer. "Organizational legitimacy of nonprofit service organizations engaged in HIV prevention among women". Diss., Virginia Tech, 1993. http://hdl.handle.net/10919/37896.

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All organizations are concerned with survival and effectiveness, but for third sector and public organizations these issues are acute; they hinge on the organization’s ability to establish and sustain its legitimacy. Legitimacy has been defined as a manifestation of value congruence between an organization’s activities and the social system within which it functions (Dowling and Pfeffer, 1975). This study oxamines the multi-dimensionality of organizational legitirnicy in a comparative case study of nonprofit service organizitions (NSO’s) which provide HIV education and support services for women. Processes of seeking organizational legitirnacy are identified and organizational relationships analyzed within the environmental networks of clientele and the interorganizational network. The study also seeks to identity tte focus and progression of legitimating efforts over tho course of the organization’s existence. Tw. Community based organizations are included; one in the United States and one in the Spanish-speaking Caribbean. The organizations studied are directed to women in a variety of circumstances: sex workers, drug users, and women who self-identify as being at risk. The majority of clients were Hispanic, although a few were Caucasian and African-American. The study is intended to generate theory as to how organizations address legitimacy in a multidimensional environment, and how this challenge has been confronted in the case of NSO’s serving women at risk for HIV. The study identifies strategies for preserving the organization’s internally defined objectives and processes and its active relationship with the client community.
Ph. D.

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Bwesigye, Akankunda Denis Amara Soonthorndhada. "The practice of ABC in the prevention of HIV/AIDS : case study of Uganda /". Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd381/4738664.pdf.

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Carney, Patricia Anne. "Using unannounced standardized patients to assess HIV prevention in primary care : a study of clinical performance /". Thesis, Connect to this title online; UW restricted, 1994. http://hdl.handle.net/1773/7258.

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Decoste, Anthony. "HIV/AIDS beliefs among MSM in the Philippines". Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97043.

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ENGLISH ABSTRACT: This research study examines the beliefs related to HIV/AIDS risks and the perceived effectiveness of preventative measures among men who have sex with men (MSM) in the Philippines. Using a questionnaire developed using the Health Belief Model (HBM), this study endeavors to understand beliefs and thus improve counseling guidelines for MSM who continue to engage in risky sexual behaviors following VCT and a negative HIV test. The impact of HIV/AIDS on the Philippines is beginning to increase, affecting men and their partners. The rapid growth of HIV/AIDS among Filipino MSM indicates that more attention must be paid to the barriers and benefits of condom use within this high-risk population. A background of the presence and prevalence of HIV/AIDS is presented. This study aims to answer the question of why MSM choose to have unprotected sex despite the risk of HIV/AIDS. Multiple barriers to condom use are identified, including the availability of condoms, partner resistance, and reduced pleasure. The impacts of culture and society, the media, role models, social networking, drug use, and riskseeking behavior on safer sex are assessed. Currently, supplying condoms and providing voluntary testing and counseling is the primary mode of preventing the spread of HIV/AIDS, but this study sheds light on the critical issues of condom availability, perceived benefits and barriers to condom use, and the disconnect between belief and behavior regarding HIV/AIDS and unprotected sex among MSM in the Philippines.
AFRIKAANSE OPSOMMING: Die doel van hierdie studie is ‗n ondersoek na die gelowe (beliefs) teenoor MIV/Vigs van mans wat seks het met mans. Die studie poog verder om ondersoek in te stel na moontlike voorkomende maatreëls wat ingestel kan word om die pandemie te bekamp. Vir die doel van hierdie studie is ‗n vraelys ontwikkel , deur gebruik te maak van die Health Belief Model, met die doel om ‗n beter begrip te kry van die redes vir risikogedrag onder mans wat seks het met mans in die Fillipyne. Die voorkoms van MIV/Vigs by mans wat seks het met mans is steeds aan die toeneem in die Fillipyne en dringende maatreëls is nodig om die groei van die pandemie te beperk. Die studie gee ‗n agtergrond tot MIV/Vigs in die Fillipyne. Die ondersoek gaan dan voort om te probeer bepaal waarom risikogroepe steeds voortgaan om aan onbeskermende seksuele aktiwiteite deel te neem. Resultate van die studie toon aan dat daar verskeie faktore is wat die gebruik van kondome ontmoedig in die risikogroep wat in hierdie studie aangespreek word. Kondome is nie altyd beskikbaar nie; seksuele vennote wil nie kondome gebruik nie en die vermindering in seksuele plesier word as redes aangevoer. Hierdie studie maak ‗n betekenisvolle bydrae tot die kennisbasis van die gelowe en houdings van mans wat seks het met mans ( en dan MIV-positief raak) en sal na alle waarskynlikheid betekenisvol bydra tot die meer suksesvolle bestuur van hierdie risikogroep in die Fillipyne.

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Dietrich, Janan Janine. "Adapting a Psychosocial Intervention to reduce HIV risk among likely adolescent participants in HIV biomedical trials". Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97046.

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Thesis (PhD)--Stellenbosch University, 2015
ENGLISH ABSTRACT : In 2010, young people aged 15–24 years accounted for 42% of new HIV infections globally. In 2009, about five million (10%) of the total South African population was estimated to be aged 15–19 years. Current South African national sero-prevalence data estimate the prevalence of HIV to be 5.6% and 0.7% among adolescent girls and boys aged 15–19 years, respectively. HIV infections are mainly transmitted via sexual transmission. Adolescent sexuality is multi-faceted and influenced at multiple levels. In preparing to enroll adolescents in future biomedical HIV prevention trials, particularly prophylactic HIV vaccine trials, it is critical to provide counseling services appropriate to their needs. At the time of writing, there was no developed psychosocial intervention in South Africa for use among adolescent vaccine trial participants. Thus, the aim of the present study is to adapt and pilot-test a psychosocial intervention, namely, the Centers for Disease Control and Prevention (CDC) risk reduction counseling intervention of Project Respect, an intervention tasked at being developmentally and contextually appropriate among potential adolescent participants in HIV biomedical trials in the future. To achieve this overall aim, I qualitatively explored adolescent sexuality and risk factors for HIV among a diverse sample of participants aged 16–18 from Soweto. Thereafter, I developed a composite HIV risk scale in order to measure the variance in HIV risk among the sample of adolescents studied. The study followed a two-phased, mixed method research design and was informed by ecological systems theory and integrative model of behavioral prediction. The aim of Phase 1, split into phases 1a and b, was to conduct focus group discussions (FGDs) and to undertake a cross-sectional survey, respectively, to determine psychological (for example, self-esteem and depression), behavioral (specifically, sexual behavior) and social (specifically, social support, parent-adolescent communication) contexts that placed adolescents at risk for HIV infection. Phase 1a was qualitative, with data collected via nine FGDs: three involved parents of adolescents, four involved adolescents aged 16–18 years and two counselors. Nine key themes related to adolescent sexuality and risks for HIV acquisition were identified, namely: (1) dating during adolescence; (2) adolescent girls dating older men; (3) condom use amongst adolescents; (4) teenage pregnancies; (5) views about homosexuality; (6) parent-adolescent communication about sexual health; (7) the role of the media; (8) discipline and perceived government influence; and (9) group sex events. Phase 1b was quantitative and the data were collected via a cross-sectional survey to investigate the variance of risk for HIV. For Phase 1b, the sample consisted of 506 adolescents with a mean age of 17 years (interquartile range [IQR]: 16–18). More than half the participants were female (59%, n = 298). I used a three-step hierarchical multiple regression model to investigate the variance in risk for HIV. In step 3, the only significant predictors were “ever threatened to have sex” and “ever forced to have sex”, the combination of which explained 14% (R2 = 0.14; F (12, 236) = 3.14, p = 0.00). Depression and parentadolescent communication were added to steps 2 and 3, respectively, with both variables insignificant in these models. In Phase 2, I adapted and pilot tested the CDC risk reduction counseling intervention. The intervention was intended to be developmentally and contextually appropriate among adolescents from Soweto aged 16–18 years, viewed as potential participants in future HIV biomedical trials. Participants in Phase 2 were aged 16–18 years; the sample was mainly female (52%, n = 11) and most (91%, n = 19) were secondary school learners in grades 8 to 12. Participants provided feedback about their experiences of the adapted counseling intervention through in-depth interviews. I identified three main themes in this regard, namely: benefits of HIV testing services, reasons for seeking counseling and HIV testing services, and participants’ evaluation of the study visits and counseling sessions. The adapted CDC risk reduction counseling intervention was found to be acceptable with favorable outcomes for those adolescents who participated in the piloting phase. This study adds to the literature on risks for HIV among adolescents in Soweto, South Africa, by considering multiple levels of influence. Reaching a more complete understanding of ecological factors contributing to sexual risk behaviors among adolescents in the pilot-study enabled the development of a tailored counseling intervention. The findings showed the adapted CDC risk reduction counseling intervention to be feasible and acceptable among adolescents likely to be participants and eligible to participate in future HIV biomedical prevention trials. Thus, this study provides a much needed risk reduction counseling intervention that can be used among adolescents, an age group likely to participate in future HIV vaccine prevention research.
AFRIKAANSE OPSOMMING : In 2010 het jongmense tussen die ouderdomme van 15 en 24 jaar 42% van nuwe MIV-infeksies wêreldwyd uitgemaak. In 2009 was omtrent 5 miljoen mense (10%) van die Suid-Afrikaanse bevolking tussen 15 en 19 jaar oud. Volgens data oor die huidige Suid-Afrikaanse nasionale sero-voorkoms, word die voorkoms van MIV onderskeidelik op 5.6% en 0.7% onder tienermeisies en -seuns tussen die ouderdomme van 15 tot 19 jaar beraam. MIV-infeksies word hoofsaaklik deur seks oorgedra. Adolessente seksualiteit het baie fasette en word op verskeie vlakke beïnvloed. Ter voorbereiding van die werwing van adolessente vir toekomstige biomediese proewe, veral proewe oor profilaktiese MIVentstowwe, is dit van kritiese belang dat beradingsdienste verskaf word wat geskik is vir hul behoeftes. Op die tydstip wat hierdie tesis geskryf is, het daar nog geen psigososiale intervensie in Suid-Afrika bestaan vir gebruik onder adolessente deelnemers aan entstofproewe nie. Daarom is die doel van hierdie studie om ʼn psigososiale intervensie ‒ die Centers for Disease Control and Prevention (CDC) se Projek Respek, ʼn beradingsintervensie vir die vermindering van risiko ‒ aan te pas en met ʼn loodsprojek te toets. Hierdie intervensie is geskik vir die ontwikkelings- en kontekstuele vlak van adolessente deelnemers aan toekomstige MIV- biomediese proewe. Ten einde hierdie oorkoepelende doelwit te bereik, het ek adolessente seksualiteit en die risikofaktore vir MIV onder ʼn diverse steekproef deelnemers tussen die ouderdomme van 16 en 18 jaar van Soweto kwalitatief ondersoek. Daarna het ek ʼn saamgestelde MIV-risikoskaal ontwikkel om die variansie van MIV-risiko onder die groep adolessente te meet. Die studie se navorsingsontwerp het uit twee fases en gemengde metodes bestaan, en is gebaseer op ekologiesestelsel-teorie en die integrerende gedragsvoorspellingsmodel. Die doel van fase 1, wat in fases 1a en 1b verdeel is, was om onderskeidelik fokusgroepbesprekings te hou en om ʼn deursnitopname te doen om die sielkundige kontekste (byvoorbeeld elemente van selfbeeld en depressie), gedragskontekste (spesifiek seksuele gedrag) en sosiale kontekste (spesifiek sosiale ondersteuning en ouer-adolessent-kommunikasie) te bepaal waarin adolessente die risiko loop om MIV-infeksie op te doen. Fase 1a was kwalitatief en data is deur middel van nege fokusgroepbesprekings ingesamel: drie met die ouers van adolessente, vier met adolessente tussen 16 en 18 jaar oud en twee met beraders. Nege sleuteltemas is geïdentifiseer wat verband hou met adolessente seksualiteit en risiko’s om MIV op te doen: (1) verhoudings tydens adolessensie, (2) tienermeisies wat verhoudings met ouer mans het, (3) die gebruik van kondome onder adolessente, (4) tienerswangerskappe, (5) sienings oor homoseksualiteit, (6) ouer-adolessent-kommunikasie oor seksuele gesondheid, (7) die rol van die media, (8) dissipline en die ervaarde regeringsinvloed en (9) groepseksgeleenthede. Fase 1b was kwantitatief en data is deur middel van ’n deursnitopname ingesamel om die variansie van risiko vir MIV te ondersoek. Vir Fase 1b het die steekproef bestaan uit 506 adolessente met ’n gemiddelde ouderdom van 17 jaar (interkwartielwydte [IKW]: 16–18). Meer as die helfte van die deelnemers was vroulik (59%, n = 298). Ek het ’n hiërargiese meervoudige regressiemodel met drie stappe gebruik om die variansie van risiko vir MIV te ondersoek. Die enigste beduidende voorspellers in stap 3 was “ooit gedreig om seks te hê” en “ooit geforseer om seks te hê”. Die kombinasie hiervan het 14% (R2 = 0.14; F (12, 236) = 3.14, p = 0.00) verklaar. Depressie en oueradolessent- kommunikasie is onderskeidelik in stappe 2 en 3 bygevoeg, en albei veranderlikes was onbeduidend in hierdie modelle. In Fase 2 het ek die CDC se intervensie vir die verlaging van risiko aangepas en met ’n loodsprojek getoets. Die intervensie was bedoel om geskik te wees vir die ontwikkelings- en kontekstuele vlakke van 16- tot 18-jarige adolessente van Soweto wat beskou is as potensiële deelnemers aan toekomstige MIV- biomediese proewe. Deelnemers in Fase 2 was 16 tot 18 jaar oud, die steekproef was hoofsaaklik vroulik (52%, n = 11) en die meeste van die deelnemers (91%, n = 19) was in grade 8 tot 12 op hoërskool. Deelnemers het tydens indringende onderhoude terugvoering oor hulle ervarings van die aangepaste beradingsintervensie verskaf. Ek het drie hooftemas in hierdie verband geïdentifiseer, wat die volgende insluit: voordele van MIV-toetsingsdienste, redes waarom berading en MIV-toetsingsdienste verlang word, en die deelnemers se evaluering van die studiebesoeke en beradingsessies. Daar is bevind dat die aangepaste beradingsintervensie van die CDC aanvaarbaar was en gunstige uitkomste gelewer het vir die adolessente wat aan die loodsfase deelgeneem het. Hierdie studie dra by tot die literatuur oor MIV-risiko’s vir adolessente in Soweto, Suid-Afrika, deur meervoudige invloedsvlakke te oorweeg. Die feit dat ’n meer volledige begrip tydens die loodsondersoek verkry is van die interaksie van die ekologiese faktore wat tot seksuele risikogedrag onder adolessente bydra, het die ontwikkeling van ʼn doelgemaakte intervensie deur berading moontlik gemaak. Die bevindings het getoon dat die aangepaste beradingsintervensie van die CDC lewensvatbaar en aanvaarbaar is vir gebruik onder adolessente wat waarskynlik geskikte deelnemers aan toekomstige biomediese proewe oor MIV-voorkoming kan wees. Hierdie studie verskaf dus ʼn noodsaaklike beradingsintervensie om die MIV-risiko onder adolessente ‒ ʼn ouderdomsgroep wat waarskynlik aan toekomstige biomediese navorsing oor MIV-voorkoming sal deelneem ‒ te verminder.

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Larios, Sandra Erika. "Using the social ecological model to understand the contextual factors associated with HIV risk in commercial sex workers at high risk for contracting HIV". Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2008. http://wwwlib.umi.com/cr/ucsd/fullcit?p3298343.

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Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2007.
Title from first page of PDF file (viewed March 18, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 86-98).

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De, Vos Marieta. "Critical factors in NACOSA’s success as a network organisation in the HIV and AIDS sector". Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96802.

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Thesis (MPhil)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: NACOSA had an eventful history spanning 22 years. The first phase between 1992 and 2001 is labeled Great Expectations as the composite multi-sectoral structure started a groundbreaking initiative on HIV and AIDS in South Africa and believed that the first AIDS plan drafted by them would be implemented as planned. Expectations came to nothing as government struggled to find its feet through a decade of blunders leading to the demise of the structure by end 2001. The next phase between 2001 and 2010 is labeled Starting Over as the Western Cape branch of NACOSA reinvented itself as a community mobilisation network for the province. Within a period of ten years Western Cape NACOSA developed into a successful national network with a large membership fully involved through its networking, capacity building and promoting dialogue functions. The third phase between 2010 and 2015 is labeled Rapid Growth as NACOSA developed into a large training and grant management agency with strong systems providing funding to its members through sub-granting. Networking continued at a slower pace but is still highly important for the organisation. The network contributes to localised social capital through shared learning and collaboration. NACOSA‟s sustainability has been developed through the ability to raise long-term funds for network activities, capacity building of members and coordinated service delivery on the ground. NACOSA also has a culture of identifying and acting fast on opportunities and adapting to change when it is needed. Strategic factors attributing to the success of NACOSA are a sector based approach promoting diversity in its membership; a consistently focused and shared purpose throughout the years; a community agent approach believing in and advocating for community systems strengthening; obtaining a mandate from network members for main strategy changes; strategic partnerships; a strong capacity building approach focussing on organisational and programmatic competencies; not competing with network members but acting as main weaver; creating specialist networks for specific HIV-related causes; a committed representative executive committee and skilled staff; bringing groups together on a regular basis for discussions and strategising; a variety of social media; and a network mindset intent on a culture of learning and building trust between member organisations.
AFRIKAANSE OPSOMMING: NACOSA het 'n gebeurtenisvolle geskiedenis wat strek oor 'n periode van 22 jaar. Die eerste fase tussen 1992 en 2001 word genoem Groot Verwagtinge, verwysende na die saamgevoegde multi-sektorale struktuur wat ontstaan het as die eerste groot MIV en VIGS inisiatief in Suid-Afrika. Hulle het verwag dat hul eerste VIGS-plan geïmplementeer sou word soos wat hulle dit beplan het. Hul verwagtinge het egter skipbreuk gely as gevolg van die regering wat oor die dekade heen hul voete gesleep en foute gemaak het wat uiteindelik gelei het tot die struktuur se ondergang in 2001. Die volgende fase tussen 2001 en 2010 word genoem Oorbegin verwysende na die Wes-Kaap tak van NACOSA wat hulself herskep het as „n gemeenskapsmobiliseringsnetwerk. Wes-Kaap NACOSA het binne tien jaar weer ontwikkel in 'n suksesvolle nasionale netwerk met 'n groot ledetal wat volledig ingeskakel is by die organisasie se netwerk, kapasiteitsbou en bevordering van dialoogaktiwiteite. Die derde fase tussen 2010 en 2015 word genoem Snelle Groei verwysende na NACOSA se ontwikkeling in 'n groot opleidings- en fondsbestuursagentskap met sterk stelsels wat befondsing aan hul lede verskaf. Netwerkskakeling het voortgeduur teen 'n stadiger pas maar is steeds baie belangrik vir die organisasie. Die netwerk dra by tot die bou van plaaslike sosiale kapitaal deur middel van samewerking en saam leer. NACOSA se volhoubaarheid het ontwikkel deur hul vaardigheid om langtermynfondse in te samel vir netwerkaktiwiteite, kapasiteitsbou en gekoördineerde dienslewering op grondvlak. NACOSA het ook 'n kultuur om geleenthede vinnig te identifiseer en daarop te reageer, asook om aan te pas by veranderinge wanneer nodig. Strategiese faktore wat bygedra het tot NACOSA se sukses sluit in 'n wye sektorbenadering met diverse lidmaatskap; 'n konsekwente gedeelde doelwit oor die jare; die bevordering van sterk gemeenskapstelsels; die verkryging van 'n mandaat by netwerklede vir strategie-veranderinge; strategiese vennootskappe; 'n sterk kapasiteitsboubenadering wat fokus op organisatoriese en programmatiese vaardighede; geen kompetisie met lede-organisasies maar eerder die rol van “hoofwewer”; skep van spesialisnetwerke vir spesifieke MIV-verwante kwessies; 'n toegewyde raad en vaardige personeel; gereelde bymekaarbring van groepe vir dialoog en strategie bou; 'n verskeidenheid van sosiale media; en 'n netwerk denkpatroon gefokus op 'n leerkultuur en die bou van vertroue tussen lede.

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Arenth, Jutta Boonyong Keiwkarnka. "Safe sex intention for HIV/AIDS prevention among male vocational students in selected school Nakhonpathom province, Thailand /". Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-JuttaA.pdf.

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Iyiani, Christian, i n/a. "A case study of HIV/AIDS prevention in Nigeria : assessment and recommendations". University of Otago. Department of Social Work and Community Development, 2008. http://adt.otago.ac.nz./public/adt-NZDU20080213.112805.

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This is a two-stage study of HIV/AIDS prevention. In Stage One, the study examines the HIV/AIDS approach of Western aid organisations (INGOs) and compares it to the lived realities of people who are most 'at risk', sex workers, unemployed street youth, and married low income families, in the poor migrant community of Ajegunle in Nigeria�s Lagos state. The study found that INGOs and their client NGOs emphasised Western medical models of HIV/AIDS for both intervention (e.g. testing and ARV drugs for management) and prevention (e.g. through education and behaviour change). In contrast, among 'at-risk' groups, the study revealed a high degree of knowledge about the transmission of HIV/AIDS (contrary to Western medical assumptions), but also detected strong feelings of powerlessness in being able to address it. INGOs and their client organisations were operating at the levels of tertiary or curative and secondary or behaviour change prevention, whereas the views of the local 'at-risk people' indicated relevance of the primary prevention level, the social structural conditions of the people. In analysing the results of the first stage of the study, the findings identified a process of 'talking past each other' by official aid agencies and those most at risk, thereby inhibiting effective prevention. The INGOs and NGOs used their financial power, based on the gross inequality in the world distribution of resources, to dictate their own agendas, omitting primary intervention and instead concentrating on secondary and tertiary prevention. The study suggests that new thinking about multi-sectoral responses with full community participation is necessary in order to engage in more effective preventive action. The study then sought out alternative sources of power that might permit that to happen, notably the strengths of the local Ajegunle community. As a poor community, they lacked financial resources and human capital, such as skilled workers, but they had significant knowledge capital about their own circumstances and the realities people faced. The community also had considerable cultural capital and local organisations with considerable relational capital around community links, broad based support and commitment to such action. This analysis suggests the need to identify and work through the power differentials using community development processes, especially seeking to empower local communities to take part in decision-making over prevention, if effective action is to take place. The process required is one of a negotiated, inclusive partnerships for sharing information, experience, and decision-making, involving all the relevant stakeholders - the International Organisations (INGOs), National NGOs, Community Groups and the community itself.

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Wu, Lucy Mimi. "Antiretroviral prophylaxis for prevention of mother to child transmission of HIV through breastfeeding: asystematic review and meta-analysis of infant treatment regimens". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48426581.

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A systematic review and meta-analysis was conducted to evaluate the efficacy of different infant antiretroviral (ARV) prophylaxis regimens for prevention of mother to child transmission (MTCT) of human immunodeficiency virus (HIV) infection in breastfeeding infants who were born to HIV positive mothers but were HIV uninfected at birth. The systematic review of the literature published during January 2000 to April 2012 resulted in ten randomized and controlled clinical studies which met the study inclusion criteria. Two datasets were identified from the ten selected clinical trials. One dataset contains six studies evaluating short-course ARV prophylaxis regimens, and the second dataset contains four studies evaluating short-course versus extended ARV prophylaxis regimens. The odds ratio was used as the effect size to measure the efficacy between two comparative infant ARV prophylaxis regimens. Meta-analyses were conducted to assess the overall (pooled) treatment effect of the two comparative infant ARV prophylaxis regimens of the two datasets. The pooled ARV treatment effect was calculated as a weighted average of the effect estimated in the individual studies. If no heterogeneity was identified, a fixed-effect meta-analysis by the Mantel-Haenszel method was used. The random-effects method was used when there was heterogeneity in the meta-analysis. The inverse-variance method was used in the random-effects method of meta-analysis. Heterogeneity in the meta-analysis was accessed by the Chi-squared (χ2) test and I2 test. The combined sample size of all ten clinical trials was a total of 10,316 breastfeeding infants, and the overall postnatal HIV transmission rate regardless of ARV regimens and the timing of HIV infection status was approximately 8.7%. The overall HIV transmission rates of the short-course ARV prophylaxis regimen groups were 10.3% at 4-8 weeks and 9.0% at 6-9 months, respectively. The overall late postnatal HIV transmission rate (at 6-9 months after birth) was 5.5% in the extended ARV prophylaxis regimen group. The first dataset contains six randomized and controlled studies to evaluate the efficacy outcome (defined as the unadjusted HIV infection status at 4-8 weeks after birth) of two short-course infant ARV prophylaxis regimens, the nevirapine (NVP) regimen and the zidovudine (ZDV) with or without combination of lamivudine (3TC) or NVP regimen. Due to the existence of substantial heterogeneity, a random-effects method was used to test for the overall treatment effect. The results show that there was no significant difference between the two short-course infant ARV prophylaxis regimens (odds ratio:1.07; 95% CI: 0.69-1.66; Z=0.31, p=0.76). The results of the meta-analysis of five comparative short-course versus extended infant ARV prophylaxis regimens from four randomized and controlled clinical trials, demonstrate a favorable efficacy outcome (defined as the unadjusted HIV infection status at 6-9 months after birth), of the extended ARV regimens. There was no heterogeneity found in this dataset. There was a highly significant difference in the overall effect between the two ARV prophylaxis regimens by a fixed-effect model (odds ratio: 1.72; 95% CI:1.45-2.04; Z=0.68, p<0.00001). In summary, there was no significant difference in the overall treatment effect in reducing the early postnatal MTCT of HIV infection by infant short-course regimens of ARV prophylaxis, which include NVP, ZDV and their combination regimens. In comparison with the short-course ARV regimens, the extended ARV prophylaxis further reduced the risk of the late postnatal MTCT of HIV infection in breastfeeding infants.
published_or_final_version
Public Health
Master
Master of Public Health

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Findlay, Racquel. "Changing behaviors : HIV prevention issues with African American women ages 19 to 27". Honors in the Major Thesis, University of Central Florida, 2003. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/316.

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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.
Bachelors
Health and Public Affairs
Social Work

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Malinowska-Sempruch, Kasia. "Hiv among drug users in poland; the paradoxes of an epidemic". Thesis, Columbia University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3610085.

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Since 1988 when the first HIV positive drug user was identified in Poland, for close to two decades, the predominant route of HIV transmission has been through injecting drug use. In mid 2000s, Polish officials reported that injecting drug use no longer contributed to incrasing HIV incidence. The consequences of such a statement are that many of the structural and personal risks associated with HIV infection go unaddressed, that drug users are neglected by HIV prevention efforts, that HIV treatment is not made available to drug users and that the policy environment does not adequately support effective public health initiatives. This case study is based on documentation, archival records, interviews, participant observation, and physical artifacts shows that these assertions were made, and continue to be repeated, in a highly political context. Poland is a post-socialist state with strong neoliberal leanings, and it is highly invested in successful integration with the European Union. Powerful Catholic Church serves as an important backdrop. While people considered "at risk" now have more freedom to conduct their lives, they also have a set of neoliberal expectations and religious pressures placed on them. Country's geographic location adds to this complexity - situated between "Old Europe" where HIV problem has been successfully contained and the former Soviet Union, where the HIV incidence among drug users is the highest in the world, Poland attempts to align itself with the success of the West. Furthermore, examination of the available data suggests that the assertions made by Polish officials omit numerous variables. My research shows that even though Polish leadership in the area of HIV and drug policy wishes to resemble Western Europe, Poland does not meet international standards for the prevention of HIV transmission. The interviews I conducted, as well as the review of the literature on drug and HIV policies and programs suggest that these services are scattered, often unavailable, and that their number is stagnating, at best, and in some cases, even decreasing. This maybe a direct result of lack of engagement of drug users in their design. Excluded from the discussion of risk, drug users are thus not the focus of prevention efforts. Based on gathered data, there are seven crucial issues that require immediate action if Poland is to manage HIV prevention and care for people who use drugs in a manner consistent with the international standards. The areas requiring action are: a change in the drug policy from the current very punitive approach, expansion of needle and syringe programs and other harm reduction services, improved data collection and an increase in the availability of HIV testing, scaled-up substitution treatment, improved quality of other forms of drug treatment, greater investment in civil society organizations, improved access to HIV treatment, and educational and training efforts that encourage greater attention to HIV related matters across disciplines.

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Nguyen, Thi Minh Tam Orapin Pitakmahaket. "Condom use related to HIV/AIDS prevention among female commercial sex workers (CSWs) in Quang Ninh province, Vietnam /". Abstract, 2004. http://mulinet3.li.mahidol.ac.th/thesis/2547/cd368/4638495.pdf.

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Mamba, Constance N. "Prevention within a pastoral strategy : assessing the ABC-model with reference to the HIV/AIDS pandemic in Swaziland". Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20297.

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Thesis (MTh)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: This thesis critically analyses the appropriateness and effectiveness of the ABC model in the HIV/AIDS prevention within the context of Swaziland. According to Louw (2008:423), the ABC model stands for the following: A = Abstinence, B = Be faithful and C = use Condoms. According to Green and Herling (2007:1) the ABC model has gained the attention of many countries. The attempt of this model in HIV prevention was to “aim at empowering people through value-based programs to basically abstain from sex as long as possible, to be faithful to one intimate partner and to use condoms correctly and consistently” (De la Porte 2006:79). The assessment of the HIV/AIDS virus in 1983-1984 came as a shock. It was difficult for the church to know at that time how to respond. Some of the responses pointed to the virus as punishment of God. Gradually the church started to become involved in the pandemic. From a Christian spirituality perspective it was argued that the so called ABC model could be viewed as a means of remedy within a prevention approach. The cultural issues as well as human sexuality factors have been discovered to be an obstacle in the ABC model in playing a progressive role in Swaziland. The cultural factors that prevent the ABC model from accomplishing effective results are listed in the final report of (Whiteside et al. 2006: 18-19): bunganwa (having multiple sexual partners; a cultural practice of male married and unmarried to have many girlfriends); kungenwa (levirate or wife inheritance); a widow is given in marriage to marry the brother of her deceased husband without the consent of the women which exposes women to the HIV virus. This practice is done without the consent of the women. Kujuma (occasional overnight visits between unmarried lovers); kuhlanta (a young girl bearing the children of her infertile sister); kushenda (extramarital relationships); kulamuta (a man having a sexual relationship with a younger sister of his wife); and sitsembu (polygamy, one man with more than one wife); this is a common cultural practice found in many African countries due to gender inequality (Chitando 2009:26). This has led to Swaziland being seriously affected by the HIV/AIDS virus (Rupiya 2006:66). The high rate of infection is frightening in a small country with a population of 1 million. As Bishop M, Mabuza, the Anglican bishop indicated, the nation‟s existence is threatened. (Rosenow 2011: 32). Therefore the researcher proposed a pastoral model which gives dignity to human and adds the spiritual dimension of healing in the pastoral care and counselling. There is an urgent need for church leaders to be empowered to face the HIV/AIDS with knowledge that the pandemic is not a punishment for promiscuous people. The theology of sexuality emphasises the responsibility in every sexual engagement for people to be conscious to whatever decision they take.
AFRIKAANSE OPSOMMING: In hierdie navorsing word die toepaslikheid en effektiwiteit van die ABC model in die voorkoming van MIV/Vigs binne die konteks van Swaziland krities ontleed. Volgens Louw (2008:423) staan ABC (in Engels) vir: A = Onthouding, B = Getrouheid aan een maat en C = Die gebruik van kondome. Die navorser, ‟n geordende predikant van die Evangeliese Lutherse Kerk, bespreek die erns van die voorkoms van die MIV/Vigs-infeksie in Swaziland. Empiries is bewys dat Swaziland een van die lande in Sub-Sahara en die wêreld is met die hoogste infeksiekoers (Rupiya 2006:66). Dit is ernstig in ‟n klein landjie soos Swaziland met ‟n bevolking van slegs 1 129 000. Die pandemie het ‟n impak op alle gemeenskappe in die land en bied‟n groot uitdaging vir die Kerk in Swaziland. Die vraag is hoe die Kerk, in haar pastorale bediening, die ABC model kan gebruik om die globale poging te steun om te verhoed dat MIV/Vigs versprei. Hoe kan die konsep van die ABC model toegepas word sodat die Kerk, as hulpgewende gemeenskap, kan sorg vir die siele van die gemeentelede (cura animarum) en effektief inligting omtrent die ABC model kan versprei en uitreik na MIV-positiewe mense? Die navorser stel voor dat daar verandering moet kom in die gesindheid van die Kerk en dat daar ‟n herkonseptualisasie van die voorkomingstrategie en die Skrifverklaring van menslike seksualiteit moet wees. Die Kerke in Swaziland moet hulle houding verander. Daar moet baie meer openlikheid wees sodat sosio-kulturele kwessies openlik bespreek kan word. Daar moet ‟n kritiese herbepaling wees van die tradisies en die kerkbeleid rondom menslike seksualiteit en hoe dit betrekking het op die MIV/Vigs-pandemie.

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Muwanguzi, Samuel. "The glocalization and acculturation of HIV/AIDS: The role of communication in the control and prevention of the epidemic in Uganda". Thesis, University of North Texas, 2005. https://digital.library.unt.edu/ark:/67531/metadc4949/.

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Grounded in the social constructivism tradition, this study examined the role of communication in the glocalization and acculturation of HIV/AIDS by a section of sexually active Ugandans then living in Rakai district during the advent of the epidemic in 1982. Sixty-four women and men participated in ten focus group discussions in Rakai and Kampala districts. Five themes emerged from the data highlighting how individuals and communities made sense of the epidemic, the omnipresence of death, how they understood the HIV/AIDS campaign, and how they are currently coping with its backlash. The study concludes that HIV/AIDS is socially constructed and can be understood better from local perspectives rather than from a globalized view. The study emphasizes the integration of cultural idiosyncrasies in any health communication campaigns to realize behavioral change.

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Grötzinger, Elsabé. "Employee knowledge, attitude and practices relating to HIV/AIDS at [a] mining company in Namibia". Thesis, University of the Western Cape, 2006. http://hdl.handle.net/11394/2284.

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Magister Artium (Social Work) - MA(SW)
A global prospecting and mining leader recognizes HIV/AIDS as a threat to the company and its employees. The management has committed them to have a proactive approach trying to minimize the impact of this killing disease by putting in place effective workplace programmes. However, programmes can only be successful if the employees’ needs regarding knowledge, attitudes and sexual practices have been thoroughly researched identified. The aim of this study was to do an explorative descriptive study of the knowledge, attitudes, perceptions and behaviours of the employees of a mining company in Namibia on HIV/AIDS. The objectives were: diams; To measure the overall knowledge levels as well as attitudes and sexual practices of DBMN employees on HIV and STD's. diams; To determine whether there was a difference in the knowledge levels, attitudes and sexual practices of employees in different job categories, age groups, marital status, religion and education level. diams; To measure risky sexual behaviours of participants. All employees (550) of this mining company were invited to participate in the survey and 226 employees responded. A self-constructed questionnaire was used to collect data administered in a group setting. The questionnaire was regarded as having content validity and the SPSS program was be utilized for descriptive statistics. Utilizing the ratio data developed through the indexes, an analysis of variance (ANOVA) was conducted to determine significant difference between the means of the groups in comparison. Because multiple comparisons were done, a post hoc test (Fisher LSD) was used to determine significant differences between group means.
South Africa

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Muheua, Adam. "A description of the perceptions and barriers that influence initial and consistent use of condoms amongst a sample of male and female students of the Polytechnic in Namibia". Thesis, University of the Western Cape, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_1401_1205410778.

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The purpose of this study is to gain a greater understanding of the perceptions and barriers that influence condom use amongst male and female students at the Polytechnic of Namibia (Technical Vocational Education &
Training Department). The specific objectives of this study include the following: To obtain a better understanding of knowledge amongst students about the correct use of condoms. To identify some of the problems students have in accessing condoms. To identify the common sources of information regarding condoms, the common perceptions that exist about condoms, and the extent to which students discuss condoms with others.

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Wang, Ying, i 王穎. "The effectiveness of school-based peer education on the risk of HIV/STD : a systematic review". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206926.

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Background HIV/AIDS has always been a concern since it first came up in 1981 in the field of medicine and public health. The trend of overall HIV epidemic has slow down through over 30 years fighting against the disease. Yet, being the largest population nowadays, young people still face high risk of HIV/AID. Sexual transmitted diseases, similar with HIV infection, are also a serious concern in young people. Peer education is widely used in the sexual education in young people. No review focused on the school-based peer education while most young people received their sexual education in schools. This systematic review aims to evaluate the effectiveness of school-based peer education on HIV/STD prevention and evaluate the factors that are likely to influence the effect of school-based peer education. Method Searching through PubMed and Cochrane Library, a literature review was carried out on the relevant articles about the evaluation of school-based peer education in developing and developed countries around the world from 2000-01-01 to 2014-05-31. Findings 10 experimental studies were chosen in this review, including 3 randomized controlled trials. Among 10 studies, 8 found significant improved about the general knowledge of HIV/STD and all studies showed positive change in attitude and risk perception in the peer-led education. However, no studies found significant effect of peer education on the behavioral change regarding condom use, postponing sexual intercourses and the reduction of sexual partners, etc. The interaction of peer education and the quality of peer-educators plus other demographical factors such as socioeconomic status and religions may influence the effect of school-based peer-led education. Conclusion School-based peer education was demonstrated to be effective on the prevention of HIV/STD in knowledge and attitude improvement, similar with other kinds of peer education. Peer educators and interactions between educators and educatees play important roles in the peer education. Yet, the effect of school-based education still requires long-term assessment.
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42

Nuwaha, Fred Ntoni. "Sexually transmitted infections in Uganda : implications for control /". Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4409-1/.

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Staflin, Emma, i Jennie Lundkvist. "Nurses’ counseling to mothers to prevent mother to child transmission of HIV through breastfeeding : A qualitative study". Thesis, Linköpings universitet, Omvårdnad, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-76743.

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Introduction: HIV is a serious problem in Namibia, 13.1% of the adult population is HIV-positive or is a carrier of AIDS. This is one of the highest numbers in the world. HIV is passed from mother to child during pregnancy, during labour or through breast milk. 18.8 % of the pregnant mothers in Namibia who is in contact with the maternity welfare have HIV. Aim: The aim of the study was to describe nurses’ counseling to mothers to prevent mother to child transmission of HIV through breastfeeding. Method: Eight nurses working with PMTCT of HIV were interviewed in Namibia. The interviews were transcribed and a content analysis was made. 18 sub-categories and seven categories were found. Findings: It is important that nurses provide individual counseling, are supportive and motivate the mothers. Poverty is an obstacle for the mothers, stigmatization occurs and cultural differences can have influence on the mothers. It is also important that nurses are updated in counseling and PMTCT. Conclusion: Nurses should provide mothers with the correct information in a pedagogical way. Nurses need to be aware of obstacles for the mothers and their families to be able to meet their different demands. Men are not involved in PMTCT-counseling and nurses think that partner involvement would benefit PMTCT of HIV.

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44

Yao, Dingming, i 姚丁銘. "Effectiveness of control measures against human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) in China : a systematic review". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193812.

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Background: Men who have sex with men (MSM) are a high risk group of human immunodeficiency virus (HIV) infection. Since 2003, HIV prevalence and incidence among MSM in China has increased alarmingly. And then numerous control measures targeting risk reduction of HIV infection among MSM have been implemented. However, previous studies varied in methodologies, prevention or interventions, and most studies only investigated one or several of control measures. Moreover, there are no existing systematic reviews on the effectiveness of integrated control measures against HIV infection. Therefore, this systematic review was conducted to assess the effectiveness of control measures against HIV infection among MSM in China, in terms of condom use, sexual behaviours, awareness of HIV knowledge, HIV counseling and testing, and HIV prevalence and incidence. Methods: A total of 154 articles were first retrieved from English database PubMed, and 114 articles from Chinese database CNKI. 19 English and Chinese articles that met the inclusion criteria were included in this systematically review. Results: The common control measures, including distribution and use of condoms and lubricant, high risk behavioural interventions, education of HIV knowledge, peer interventions, HIV testing and counseling, and MSM community or venue based interventions, are effective in increasing condom use in the anal sex, reducing risk sexual behaviours, improving awareness of HIV knowledge, and promoting the participation of HIV counseling and testing, which are all beneficial to prevent HIV infection among MSM. These findings may be influenced by the design of questions and the standard, and the response of MSM to questions. As for HIV prevalence and incidence, the effectiveness on them is uncertain, probably owing to inappropriate timing of conducting control measures, the short follow-up period, the small sample size or the scale of study. Future studies need to improve sampling method, and extend follow-up time and the study scale appropriately. Conclusion: Based on this systematic review, the control measures are effective in increasing condom use, reducing risk sexual behaviours, improving awareness of HIV knowledge and promoting the participation of HIV counseling and testing, while the effectiveness on HIV prevalence and incidence is uncertain among MSM in China. In future, more policy researches on HIV/AIDS burden, MSM and control measures are needed to provide an evidence base for policy change. In practice, policy makers and researchers need to promote structural control measures targeting different typologies of MSM. And the more effective way in conducting control measures needs the multi-sector cooperation, especially the cooperation between the governmental organizations and MSM community.
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45

Bue, Martine Eriksen. "Women's vulnerability, sexual power and prevention of stigma : what do prevention campaigns tell us". Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86385.

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Thesis (MA)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: The HIV-epidemic that is evident in South Africa today is infecting more women than men. This is mostly due to the vulnerability that women are facing in sexual relationships, where they are not able to negotiate the terms and conditions of their sexual engagement. Patriarchy, the culture of masculinity and a general male dominance influence women’s dependency on their man and agency inside and outside of the home, and contribute to the oppression of women both generally in society and sexually. Women have by this not the control over their own bodies and are for this reason in a high-risk position of contracting HIV. The vulnerability is further linked to the stigmatisation that women experience if they do try to negotiate preventative measures to reduce the risk of transmission. The fear of being stigmatised as ‘loose’ or HIV-positive by both men and women if suggesting condom use, inhibits women to propose the necessary actions for protection. Stigmatising behaviours also impact on a person’s fear of becoming HIV-positive and reduces the likelihood of getting tested, disclose one’s status to sexual partners and receive treatment. This thesis examines cultural and socio-economic issues that contribute to gender inequality in South Africa, and can generate stigma towards women on the basis of HIV and AIDS. This is done by using radical feminism as the theoretical framework for contextualising how women are situated in the South African society, in terms of general and sexual agency. Through the method of content analysis and the findings from the theoretical framework, the thesis further analyses how the three HIVprevention campaigns loveLife, Brothers for Life and TAC manage to address the issues related to stigma based on HIV/AIDS, which are directed towards women. Race, class and gender are all factors that influence the likelihood of becoming HIV-infected and of becoming stigmatised. Women’s low social status situates women in a position where they are more probable to be the object of stigmatisation since they already are considered lower in rank. If the women also are of colour, poor and low educated the chances of becoming stigmatised on the basis of HIV and AIDS are even more likely, the same is the chances of becoming HIV-infected. This indicates that poor, uneducated black women are the group that is most vulnerable towards stigmatisation as well as towards HIV-transmission. Socio-economic and cultural factors have a strong influence on the gender inequality in sexual relationships found in South Africa, which cause HIV to spread and can generate stigmatising behaviours. Stigmatisation on the basis of HIV/AIDS is therefore important to address in order to reduce the number of new HIV-infections. The three campaigns analysed for this thesis did neither directly address stigma on a general level nor directed towards women. The campaigns are therefore considered to be missing an important feature of HIV-prevention in South Africa.
AFRIKAANSE OPSOMMING: Die huidige Suid-Afrikaanse Vigsepidemie infekteer meer vroue as mans. Dit is die geval weens die kwesbaarheid wat vroue ervaar in seksuele verhoudings, waar vroue nie die mag het om die omstandighede van hul seksuele interaksies te onderhandel nie. Patriargie, die kultuur van manlikheid en ‘n algemene manlike dominansie beïnvloed vroue se mag en dra by tot die onderdrukking van vroue, beide in die samelewing in die algemeen en in seksuele verhoudings. Om hierdie rede het vroue nie beheer oor hul eie liggame nie en daarom ervaar hulle ‘n hoë risiko om MIV op te doen. Hierdie kwesbaarheid word ook verbind aan die stigmatisering wat vroue ervaar wanneer hulle probeer om voorkomende aksie te neem ten einde die risiko van Vigsoordrag te verminder. Die vrees om deur mans en ander vroue gestigmatiseer te word as iemand met ‘losse sedes’, of as iemand wat MIV-positief is wanneer hulle kondoomgebruik voorstel, weerhou vroue daarvan om die nodige voorkomende aksie vir selfbeskerming te neem. Stigmatiserende gedrag het ook ‘n impak op ‘n mens se vrees om MIV-positief te word en verminder die waarskynliheid dat jy jouself vir die virus sal laat toets, dat iemand hul status aan seksuele maats sal verklaar, of behandeling sal ontvang. Diegene wat reeds MIV onder lede het is bang om hul status te verklaar weens die gepaardgaande stigma. Hierdie tesis ondersoek kulturele en sosio-ekonomiese kwessies wat bydra tot geslagsongelykheid in Suid-Afrika, en wat stigma kan veroorsaak teenoor vroue met betrekking tot MIV and Vigs. Die studie analiseer dan of Vigsveldtogte hierdie stigma kan aanspreek. Dit word gedoen deur radikale feminisme toe te pas as ‘n teoretiese raamwerk om vroue se plek in die Suid-Afrikaanse samelewing te kontekstualiseer, beide in terme van algemene en seksuele mag. Die metode van inhoudsanalise word toegepas om drie Vigsvoorkomingsveldtogte (loveLife, Brothers for Life en TAC) te analiseer en vas te stel of en hoe hulle kwessies wat betrekking het op stigma teenoor vroue aanspreek. Sosio-ekonomiese en kulturele faktore het ‘n sterk invloed op die geslagsongelykeid in seksuele verhoudings in Suid-Afrika; dit lei daartoe dat MIV versprei word en kan stigmatiserende gedrag vererger. Om hierdie rede is dit belangrik dat MIV/Vigsvoorkomingsveldtogte stigmatisering aanspreek ten einde gedrag te wysig en om die getal nuwe Vigsbesmettings te laat daal. Die drie veldtogte wat in hierdie tesis geanaliseer is het beide nagelaat om stigma direk aan te spreek op ‘n algemene vlak, en was ook nie direk gerig op vroue nie. Die veldtogte kan daarom beskou word as ontoereikend deurdat hulle belangrike komponente van MIV-voorkomig in Suid-Afrika misgekyk het.

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Chen, Siyu, i 陈思宇. "A systematic review of interventions for HIV prevention among MSM (men who have sex with men) : what mainland China could learn from other countries?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193769.

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Background: The epidemic of HIV among MSM in China shows a hiking trend since 2003. The current intervention strategies in China lack effectiveness to curb the trend. It is imperative to review the interventions for HIV prevention among MSM in other countries to provide evidence for the future intervention design in China. Objectives: This study aimed to review the HIV prevention interventions among men who have sex with men(MSM) in order to identify appropriate intervention strategies and practices to be employed in China. Methods: Studies were searched in Pubmed database. Studies of interventions targeting MSM for HIV prevention among MSM in other countries were included in this systematic review. The search results were also filtered by the study type (i.e. RCT).The results and design of the studies were analyzed and discussed. Results: The studies in this review were analysed in terms of the study design, sampling method, retention and intervention strategies. High risk sexual activity, condom use, HIV testing and HIV knowledge were used as outcome measurements. The findings indicated that the interventions were in general effective in reducing the sexual risk behavior and increasing the intention to have a HIV test. The design of RCT offers stronger evidence of the intervention effects. The intervention strategies combined with internet were more personalized and confidential. Conclusions: Future intervention design in China could consider the strengths of interventions undertaken in other countries in order to improve the effectiveness and sustainability. In consideration of the context of China, this review made some suggestions for more effective implementation of interventions for HIV prevention among MSM in China.
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47

Tau, Nontobeko Sylvia. "An analysis of TalkBack, an interactive HIV and AIDS education programme on Botswana Television". Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/5043.

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The Republic of Botswana (2011a) recognises behaviour change as the only long term solution to the HIV and AIDS epidemic that has become a leading health and development challenge for the country. The study aimed to examine how Talk Back, an interactive HIV and AIDS educational programme on Botswana television, capacitates the school community to deal with challenges brought about by the HIV and AIDS epidemic. The study was based on recordings of 2014 Term One theme— ‘Paediatric care and support: challenges and implications in the teaching and learning environment. The study conducted a content analysis of Talk Back to determine behaviour change communication categories employed in producing the programme. All aspects of the Talk Back programme were also analysed to establish communication strategies employed in the presentation of content. Talk Back employed communication approaches such as panel discussions of matters related to HIV and AIDS by various specialists, video clips to present content, and viewers phoning in to interact with the panellists. A number of the callers identified challenges; the most common identified challenge was that parents tended not to disclose their children’s HIV status to the children due to the negative social stigma attached to HIV and AIDS. Although Talk Back provides a forum for interactive behaviour change communication, some listeners questioned the use of technical language.

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Mackie, Brent Donalson School of Arts UNSW. "Selling safe smut?? a research project exploring the effectiveness of sexually explicit HIV/AIDS prevention education campaigns in engaging Sydney gay men". 2008. http://handle.unsw.edu.au/1959.4/41461.

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This project critically examines the question Are HIV/AIDS prevention campaigns more effective at engaging gay men if they use colloquial language and sexually explicit imagery? by investigating the impact of sexually explicit campaigns on the Sydney gay community. The project approaches the question in three parts: 1. A review of literature exploring the circumstances in which and for what reasons sexually explicit HIV/AIDS campaigns are produced. 2. An analysis of seven interviews with producers of HIV prevention campaigns exploring how, why, where and for what reasons explicit campaigns are produced. 3. An analysis of eight interviews with homosexually active Sydney men exploring how HIV prevention campaigns are viewed, consumed and understood. The interviews were in-depth, semi-structured and conducted over one hour per interviewee. The findings are dominated by two interrelated and at times conflicting themes. First, that there is a strongly held belief by campaign producers that the most effective HIV prevention campaigns targeting gay men are produced by the community and reflect that community and as a result must at times be sexually explicit. Second, that it is no longer sufficient for HIV prevention campaigns to rely on explicit sex to attract attention. In an environment where visual images, and sexually explicit visual images especially, are becoming more accessible, and media and communication is more prevalent and complex, safe sex campaigns are forced to deliver ever more sophisticated and stimulating creative materials in order to maintain the engagement of gay men. The interviews revealed that both campaign producers and consumers participated in the production of a visual literacy of safe sex campaigns. This literacy was necessary to both effectively produce and comprehend the campaigns. The interviews showed that while HIV prevention campaigns that use sexually explicit language and imagery can be highly effective at engaging gay men, the success of sexually explicit campaigns is contextual that is, dependent on where, to whom and in what circumstances the materials are delivered. The audience??s accumulation of knowledge and cultural experience when viewing the campaigns, in other words their safe sex campaign literacy, significantly influenced their capacity to understand, appreciate and be engaged with sexually explicit HIV prevention campaigns.

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Nakhaee, Fatemeh Public Health &amp Community Medicine Faculty of Medicine UNSW. "Modelling survival following HIV and AIDS in Australia". 2007. http://handle.unsw.edu.au/1959.4/40661.

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To obtain more complete mortality data following HIV and AIDS diagnosis in Australia, HIV/AIDS diagnoses between 1980 and 2003 were linked to the National Death Index. Based on 6900 known deaths, and 1455 known non-deaths, sensitivity and specificity of the linkage was estimated to be 82% and 92% respectively. Mortality rates were compared by calendar period, pre-ART (<1990), pre- and early-HAART (1990-1996) and late-HAART (1997-2003). Mortality following AIDS decreased from 590.2/1000 person years pre-ART to 77.4 during the late-HAART period. Mortality following HIV diagnosis prior to AIDS increased from 9.7 to 20.2/1000 person years. The total number living with diagnosed HIV infection in Australia was estimated to have increased from 7873 at the end of 1989 to 12828 in 2003. Risk factors for survival following HIV and AIDS diagnosis were assessed using Cox regression. Age >40 years and certain HIV exposure results were associated with poorer survival following HIV. Predictors of poorer survival following AIDS were age >40 years, females exposed to HIV through receipt of blood, CD4 count <20 and certain AIDS illnesses. Parametric models of survival following HIV and AIDS diagnosis were assessed using likelihood based criteria. Goodness of fit was assessed by comparing observed with model predicted numbers of deaths. Weibull models were found to fit best to both survival following HIV and AIDS. Parametric survival models were used to project deaths after HIV and AIDS across three scenarios of HAART usage. Deaths following HIV were projected to remain low, but to increase from 223 in 2005 to 288, 292 and 282 in 2010 if the HAART usage remains stable at 2005 levels, increases to 70% of all people with diagnosed HIV by 2010 and decreases to 39% of all people with diagnosed HIV respectively. Deaths after AIDS diagnosis were projected to increase unless if HAART usage increases to 100% of AIDS diagnoses by 2010.

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Austin, Judith Florence. "Measuring HIV Exposure amongst Men who have Sex with Men in the USA: Implications for Risk Assessment in HIV Prevention Studies". Thesis, 2015. https://doi.org/10.7916/D8MG7NG7.

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In the context of decreasing mortality and increasing prevalence, prevention of HIV-transmission represents a public health priority. In the United States, the majority of infections are sexually-acquired, with men who have sex with men and minorities disproportionately affected. Although a number of promising biomedical prevention approaches have emerged over the past decade, a further 20 years could be needed before a suitable product becomes widely available. Evidence from vaccine and microbicide trials has shown that success in one population may not be replicated in another. To understand surprising or unexpected results, investigators need chronologically concordant evidence of both study product adherence and viral exposure. Since exposure to HIV cannot yet be independently verified, in seeking to measure this variable, investigators target the sexual behaviors through which it takes place deriving data for these surrogate measures from study participants' voluntary self-reports. Likely sources of reporting bias and efforts to minimize this phenomenon in the context of HIV-prevention research are critically reviewed in Chapter 1. Research describing the role of cognitive and affective functioning in the preparation of responses to potentially threatening questions is examined. Studies investigating techniques such as the use of colloquial language to facilitate comprehension, or variation in the length of the reference period to enhance recall are explored. Research comparing the effect of mode of administration on the amount of proscribed behavior reported - widely believed to correlate with validity - is reviewed. Contextual factors facilitating versus inhibiting disclosure of sensitive information are examined. Finally, risk-behavior measurement approaches used in selected HIV-prevention trials are inspected. Thereafter, the dissertation focuses on the properties of risk-assessment items, formulated specifically to elicit Global recall over six months, or Event-Specific (episodic) memory for selected recent episodes of limited duration, to capture sexual behaviors or temporally related activities. The capacity of the different questionnaire item formats to elicit responses with sufficient construct validity to serve as proxies for HIV-exposure is examined. Data for these studies are drawn from a large randomized controlled trial of a behavioral intervention to prevent HIV-transmission among men who have sex with men. Using a subset of 1295 cases and controls, models with good discriminant validity for HIV are derived separately for the Global and Event-Specific items. Thereafter, selected items from the two formats are combined to produce a single model with excellent discriminant validity, suggesting that these items can adequately represent true HIV-exposure. Next, a preliminary investigation of the contribution of psychosocial items to the predictive model based on exposure measures is undertaken. Specifically, interaction with exposure measures and the increase in discriminant validity obtained using data derived from constructs of partner type/relationship status, substance use, depressive symptoms and perceived self-efficacy is examined first in stratified analysis and then in logistic regression analysis using the case-control data. Effect-modification is observed for perceived relationship status and non-injection drug use. Evaluation of psychosocial items continues in a cohort study with prospective analysis of follow-up data from all trial participants who returned for at least one follow-up visit. Informed by the case-control study, a series of items representing psychosocial constructs known for their association with HIV-infection are tested for main effects and effect-modification. Evidence of the interaction observed in stratified analyses and confirmed in ordinary logistic regression persists in separate, topic-specific GEE analyses with assorted exposure measures, but abates in repeated measures analyses drawing on all available psychosocial items. Lastly, a single lagged variable indicating primary relationship status of the most recent partner (with respect to the preceding study visit) provides a significant addition to the model. Significant main effects for all except depressive symptoms and perceived self-efficacy and the increase in discriminant validity obtained for the multivariable model versus the `exposure-only' model are sufficient to warrant continued use of these risk-assessment items. Despite good predictive validity demonstrated for the sexual risk-behavior and psychosocial items, some inconsistent reporting between the Global and Event-specific formats is evident. Likely sources of this reporting bias are considered in light of the literature, and strengths and limitations of the overall study are discussed in the closing chapter.

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