Experiences of youths participating in combination social protection and HIV prevention programme in resource constrained settings of Gauteng Province in South Africa: a collective case study design
- Authors: Zibengwa, Enock
- Date: 2023-04
- Subjects: HIV infections -- Prevention , HIV (Viruses) , HIV infections -- Africa
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/27347 , vital:66944
- Description: South Africa continues to experience unacceptably high Human Immunodeficiency Virus HIV incidence rates among youths aged 15 to 24 years. Remarkably, this is despite the numerous youth HIV prevention programmes that have been implemented in the country. Unfortunately, the programmes have not significantly curbed the spread of HIV due to the partial and fragmented nature of their implementation. The programmes are also observed to be weak in addressing complex economic factors recognised as important structural drivers for vulnerabilities that put youths at risk of HIV infection. To address this challenge, there is increased adoption and implementation of the Combination Social Protection introduced in this research as the CSP by Non-Governmental Organisations NGOs. The CSP is a youth empowerment programming strategy whose critical foundations are entrenched in combining economic strengthening interventions and HIV prevention education. CSP could provide youths with a set of indispensable life skills that enhance their competencies and agency to make informed and effective decisions regarding their health and economic lives. Despite its growing traction, little is known regarding links between the CSP and its abilities to improve HIV prevention outcomes for youths. Given the paucity of research, this study aimed to explore the experiences of youths participating in the CSP and HIV prevention programme, with a particular focus on the resource-constrained settings of Gauteng Province in South Africa. This study employed a collective case study design, within the qualitative approach, and was exploratory. In-depth individual interviews were conducted with 30 youths from six established NGOs in the City of Johannesburg (CoJ). Qualitative thematic analysis was employed as a data analysis strategy. Focus groups were separately with six practitioners from the same six NGOs, and five officials from the Department of Social Development (DSD). Both phases of data collection were guided by interview themes, which were aligned with the objectives of the study. The findings of the study point to the fact that the CSP’s innovative and holistic approach offered numerous transformative and empowering benefits to youths. It equipped them with basic informational resources, capabilities, and social assets to safeguard their health and aid their economic advancement. The programme’s mixedgender sessions provided space, freedom, and support for youths to engage on issues of gender, differential access to health and socio-economic opportunities. Another major finding of the study was that improvement of economic aptitude (brought about by financial literacy education), employability, and entrepreneurship training stirred a sense of agency and purposefulness among youths, which in turn, prompted them to be more focused on achieving long-term objectives instead of indulging in risky sexual practices. Conversely, findings revealed that the programme had limited opportunities and did not create an adequate supportive environment for youths to develop successful entrepreneurial or income-generating projects. There was also no structure to assist youths to access apprenticeship and employment markets. The study specifically recognised that the programme’s efforts to develop youths’ entrepreneurship and employability capabilities were curtailed by a lack of mentorshipnand access to financial capital for start-up costs. With these findings in mind, recommendations are made for the creation of an enabling environment by purposefully engaging youths, establishing collaborative relations with communities, and building networks with businesses and financial institutions that can help youths with capital, mentorship, and linkages to internship and wage employment. Such collaborations could be fundamental in unravelling the impact of the programme on building livelihoods and reducing HIV among youths. Hence, this study proposes a model with strategies to support the successful implementation of economic strengthening interventions for youths. , Thesis (PhD) -- Faculty of Social Sciences and Humanities, 2023
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- Date Issued: 2023-04
Knowledge, attitude and perception of uninitiated adolescents towards customary male initiation practices in selected schools in Buffalo City Municipality, Eastern Cape
- Authors: Igaba, Nelson Kibiribiri
- Date: 2022-07
- Subjects: Circumcision , HIV infections -- Prevention , Initiation rites
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26896 , vital:66061
- Description: Background: Based on evidence that Voluntary Medical Male Circumcision (VMMC) significantly reduces the risk of human immunodeficiency virus- HIV transmission by 60percent, the World Health Organization (WHO) recommends implementing VMMC programs in countries with a high HIV prevalence, considering the unique sociocultural and economic dynamics of each setting. However, in South Africa (SA), multiple tribes including the AmaXhosa in the Eastern Cape (EC) province practice Customary Male Initiation (CMI) also known as Ulwaluko as a rite of passage of males from boyhood to manhood, and this involves circumcision. In recent years, this practice has been riddled with deaths of initiates, admissions to hospital, amputation of penis, assaults, drug and alcohol, and crime. Hence, this study aimed at understanding the knowledge, attitude, and perceptions of uninitiated adolescents towards the CMI practice in Buffalo City Municipality (BCM), EC to aid in developing strategies to solve current challenges. Methods: Between June and December 2021, this cross-sectional descriptive study was conducted in selected schools within BCM, in the EC, using a quantitative research approach. The study population included adolescent males aged 15 to 19 years who had not attended CMI. Applying a multistage random sampling technique, three (3)BCM towns (Bhisho, King William Town-KWT and East London-EL) and the Mdantsane township (MT) were selected and further the schools from which consenting pupils were enrolled into the study. Data was collected using a validated self-administered questionnaire which was captured on excel and analysed using STATA version 16.1. Categorical variables were summarized using percentages. Bivariate and multivariate regression was used to determine factors associated with a level of knowledge, attitude, and perception towards CMI and VMMC. The odds ratio with a 95percent confidence interval was calculated. A p–value of <0.05 was considered statistically significant. Results: Among 297 participants that responded 251 (84.51percent) were between the ages of 15-19 years and had not undergone circumcision or CMI. These were included in this analysis. Majority of participants 181 (72.11percent, 95percent CI 66.21-77.33) lacked knowledge on whether circumcision reduces risk of HIV acquisition. More than three quarters of participants 195 (77.69percent, 95percent CI 72.09-83.87) showed absence of knowledge on whether circumcision reduces risk of STIs. Close to all participants 244 (97.21percent, 95percent CI 94.25-98.67) indicated that they would choose CMI over VMMC due to cultural reason. More than three quarters of participants 193 (76.89percent, 95percent CI 71.24-81.72) agreed that CMI/Ulwaluko proves manhood. The presence of knowledge on the benefits of VMMC was positively dependent on the location where a participants lived (uOR 2.32, 95percent CI 1.09-4.97, p-value 0.029) and access to internet more than once a week (uOR 3.44, 95percent CI 1.14-10.43, p-value 0.029. The choice for CMI over VMMC was positively associated with participants living in Mdantsane Township than those living in urban areas (Coef. 1.55, 95percent CI 0.77-2.33, p-value 0.001). Conclusion: This study found lack of knowledge on benefits of VMMC, laws governing and on risks associated with CMI/Ulwaluko practices among uninitiated adolescents. The study further found that CMI/Ulwaluko was still highly regarded despite current challenges and most adolescents would choose CMI/Ulwaluko over VMMC. There is urgent need to integrate VMMC services into CMI/Ulwaluko to include health education on benefits of VMMC, infection prevention and control, male circumcision by trained medical personnel and education on laws governing CMI/Ulwaluko. These interventions should also target uninitiated adolescents. , Thesis (MPA) -- Faculty of Health Sciences, 2022
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- Date Issued: 2022-07
Formulation and evaluation of liposomal films for buccal delivery of antiretroviral drug
- Authors: Okafor, Nnamdi Ikemefuna
- Date: 2020
- Subjects: Liposomes , Highly active antiretroviral therapy , Antiretroviral agents , HIV infections -- Prevention
- Language: English
- Type: text , Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10962/117161 , vital:34485
- Description: The human immune deficiency virus (HIV) infection has been ranked as one of the most devastating microbial infections in the world. This status is a result of the HIV rapid genetic variation, which limits discovery of a vaccine. Use application of antiretroviral therapy (ARVT) in treatment of the disease caused by the HIV infection (known as acquired immunodeficiency syndrome, HIV-AIDS) is frequently compromised by several factors such as the low bioavailability and severe adverse effects associated with the existing antiretroviral drugs (ARVDs). This underlines the need for controlling the pharmacokinetics profiles of ARVD using effective vehicles that can modify drug biodistribution. The same is true for many other conditions, where delivery systems can determine the success or failure of treatment by controlling pharmacokinetic and dynamic properties. The mucosal linings of the oral cavities in addition offer adorable route of administration for systematic drug delivery, improving drug therapeutic performance and often preferred by clinicians and patients. Liposomes are tiny spherical sacs of phospholipid molecules enclosing water droplets, formed (artificially) to carry drugs or other substances into the tissues by crossing and targeting to specific organelles. This work therefore focused on preparation of liposomes and liposomal buccal films (BFs) for potential buccal delivery of efavirenz, an ARVD model endowed with poor solubility and several side effects. The liposomes were prepared by thin film hydration method using crude soybean lecithin (CL) and cholesterol. Efavirenz loaded liposomes were evaluated for particle size, Zeta potential (ZP), morphology, encapsulation efficiency (EE%) and release kinetics studies. The physiochemical properties of the liposomes were also evaluated using Differential Scanning Calorimetry (DSC), X-ray diffraction (XRD), energy dispersity spectroscopy (EDS), and Fourier transform infrared (FTIR), while the formulation with the best encapsulation efficiency was used as the solvent medium for the buccal film formation. The buccal films were prepared using solvent casting method, where the liposomal suspension was used as the dispersing medium. The films were optimized for physical properties (thickness, weight variation and folding endurance) using digital Vernier calliper and digital weighing balance. The physiochemical properties of the selected BFs films made of Carbopol (CP) and its combination with Pluronic F127 (PF127) were further characterized using XRD, DSC, FTIR, Transmission Electron Microscopy (TEM), EDS and Scanning Electron Microscopy (SEM). The permeation study of the selected BFs was investigated using Franz diffusion cell. The BFs composed of CP alone or its combination with PF127 demonstrated much better bio-adhesive properties than the films made of other polymers (like Hydroxyl propyl methyl cellulose, HPMC) alone or in combination with PF127. The developed liposome formulation showed high encapsulation 98.8 ± 0.01 % in CL to cholesterol mass ratio of 1:1 and total lipid to drug mass ratio of 2:1. The average particle size 104.82 ± 2.29 nm and Zeta potential -50.33 ± 0.95 mV of these liposomes were found to be attractive for targeted delivery to the HIV infected cells. The CP based BFs (without and with PF127) exhibited good film thickness 0.88 ± 0.10 and 0.76 ± 0.14 mm, with weight uniformity 68.22 ± 1.04 and 86.28 ± 2. 16 mg, satisfactory flexibility values 258 and 321, and slightly acidic pH 6.43 ± 0.76 and 6.32 ± 0.01. The swelling percentage was found to be 50 % for CP film alone and 78 % for CP film with PF127. The cumulative amount of drug that permeated through the buccal epithelium over 24 hours was about 66 % from CP film alone and 75 % from CP film with PF127. Since no evidence of the liposomal encapsulation of EFV have been reported to our knowledge, we find the insights from the present study valuable as a set of preliminary data to encourage further investigations of the encapsulation and delivery of EFV like antiretrovirals for enhanced solubility, site targeting and prolonged release using crude soybean lecithin and mucoadhesive polymers, which holds some added economical values as naturally occurring lipid and polymeric mixtures as a promising delivery systems for buccal delivery of ARVDs.
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- Date Issued: 2020
The assessment of the involvement of parents in imparting HIV/AIDS related information to their adolescents
- Authors: Lekonyana, Montseng Priscilla
- Date: 2015
- Subjects: Sex instruction for youth , Sexually transmitted diseases -- Study and teaching , HIV infections -- Prevention , Parent and teenager
- Language: English
- Type: Thesis , Masters , MPA
- Identifier: http://hdl.handle.net/10948/3225 , vital:20413
- Description: Human Immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is rapidly spreading in the whole world and many adolescents start relationships at a younger age without knowing the danger of the sexually transmitted diseases. Parents should involve themselves in imparting knowledge about HIV/AIDS related information. It is imperative that parents and adolescents should have that relationship of discussing about the dangers of HIV/ AIDS. Adolescents should be taught about the importance of relationships and how to protect themselves against the dreaded disease. The research took the form of a qualitative interpretive case study focusing on a study sample of twenty parents and twelve members of a focus group. Data was collected through semi-structured interviews, document analysis and observations. The study examined the hidden issues or underlying the involvement of parents in imparting HIV/AIDS related information to their adolescents. The study revealed that many parents are aware of the pandemic and they felt it is imperative to discuss with their adolescents. Family life education is very much important even if their adolescents are taught about the HIV/AIDS related information at schools. Government is also involved in ensuring that there are preventative measures against the killer disease. This should be a collective effort by both the parents and teachers. The study further recommends the establishment of a library in order to enhance the literacy levels of parents and educators. It will be very much significant to educate or train the trainers in order to educate even our future generation. HIV/AIDS is incurable, therefore, it is imperative for the Department of education to ensure the literacy levels so that even the department of Health contributes its information to inform everybody about the danger of incurable diseases more specifically HIV/AIDS.
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- Date Issued: 2015
Human rights implications of the compulsory HIV/AIDS testing policy: a critical appraisal of the law and practice in South Africa, Uganda and Canada
- Authors: Chiringa, Kudakwashe E M
- Date: 2013
- Subjects: HIV infections -- Prevention , HIV-positive persons -- Civil rights , AIDS (Disease) -- Patients -- Legal status, laws, etc. , AIDS (Disease) -- Law and legislation
- Language: English
- Type: Thesis , Masters , LLM
- Identifier: vital:11106 , http://hdl.handle.net/10353/d1017298 , HIV infections -- Prevention , HIV-positive persons -- Civil rights , AIDS (Disease) -- Patients -- Legal status, laws, etc. , AIDS (Disease) -- Law and legislation
- Description: HIV/AIDS has been an obstacle to socio-economic development and a major cause of loss of human life. It has also caused vast inequities and frustration to the public health sector. One of the significant efforts made by the public health sector to combat the epidemic is the implementation of a mandatory HIV/AIDS testing policy to scale-up HIV treatment. This dissertation examines the impact of this policy on the human rights of people infected with and affected by HIV/AIDS. Coercive government policies aimed at controlling the AIDS pandemic often infringe on the rights of individuals known to be or suspected of living with HIV/AIDS and this decreases the effectiveness of public health measures. The research methodology involved the study of written literature and a comparative literature study of the law and practice obtaining in South Africa, Uganda and Canada. It revealed that voluntary testing is effective and suitable in South Africa. This dissertation aimed to show that any public health approach that aims to achieve a comprehensive prevention strategy must be consistent with respect for human rights as enshrined in regional and international human rights law. Public health and human rights should, therefore, not be regarded as opposing forces; rather they should be seen as a unified system of protection of human welfare under the Bill of Rights and the Constitution. The solution to the crisis lies not only in testing every single person but also requires a shift of focus to more pressing issues that include gender equality, stigma and discrimination; prioritizing human rights, institutional capacity and resources; and an end to extreme poverty. A human rights-based approach to HIV/AIDS testing, such as the Voluntary Counselling and Testing (VCT) is recommended. Therefore, failure to adhere to the core principles of testing - which are informed consent, counselling and confidentiality of the test result - will only hinder the global fight against HIV/AIDS. The rights of those affected by HIV/AIDS need to be protected in order to address public health imperatives. This can be done through the use of the law as an instrument of social change as well as education and awareness. Key words, HIV/AIDS, mandatory testing, Voluntary Counselling and Testing, public health, human rights-based approach.
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- Date Issued: 2013
The AIDS of aid?: long-term organisation challenges of a CBO dealing with HIV/AIDS, poverty and donor aid
- Authors: Shelver, Amy
- Date: 2012
- Subjects: Communicable diseases -- Prevention , Public health -- International cooperation , Economic assistance, Domestic , Community-based social services , AIDS (Disease) -- Prevention , HIV infections -- Prevention , Nonprofit organizations
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9103 , http://hdl.handle.net/10948/d1012321 , Communicable diseases -- Prevention , Public health -- International cooperation , Economic assistance, Domestic , Community-based social services , AIDS (Disease) -- Prevention , HIV infections -- Prevention , Nonprofit organizations
- Description: The following treatise first frames the role of CBOs in responding to the HIV/Aids crisis in relation to their position in the global health governance system through a literature survey that moves from an analysis of the global structures down to the local. The survey covers the role of international organisations, international NGOs (INGOs), national governments, local NGOs and CBOs and outlines the context in which Masizakhe is working within the global health governance structure. Secondly the research design and methodology are outlined focusing on the longitudinal, case study and participant--‐observation approaches. Hypotheses, conceptualisation, definitions, key variables are described and data collection methods and fieldwork practice extrapolated upon. Following that data capturing, editing and analysis are discussed in conjunction with shortcomings and sources of error. In the fourth chapter the research discusses the history, structure and outlines the research findings by comparing what has changed within the organisation over time, presenting and discussing the results. The outcomes of this research have shown that existing problems in this particular CBO are very difficult to overcome without committed, sustained support from donors, government, community and the organisation’s members. CBOs are often hamstrung by a series of intersecting factors which hamper their ability to problem--‐solve, even when the route to overcoming the problem is clear, particularly when the capacity and will to do so is not always present from both within the organisation and from outside support systems. These challenges then impact on the overall quality of and ability to deliver the services the organisation is structured to deliver. The major challenge for the organisation remains the inconsistent donor cycle and resultant instability thus created within an organisation already working in a highly volatile, unstable situation marked by poverty and disease. Thus the title, The Aids of Aid?, captures the essence of Masizakhe’s struggle with its own syndrome of problems. It summarises a comment made by the project secretary said that: “Sometimes it feels like we are not only fighting for the health of our people – We are fighting for the health of our organisation. We are a sick organisation trying to help sick people. All we need is donors and funding –we can’t live without them, and when they don't give, we get sick” (Stamper, Pers Comm, 2011). The other emergent challenges were a battle internally with ‘founder syndrome’, lack of management transparency and a dysfunctional board.
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- Date Issued: 2012
Knowledge of safe sex practices and HIV transmission, propensity for risk taking, and alcohol/drug use in the aetiology of unprotected sex
- Authors: Simpson, Malcolm Robert
- Date: 1997
- Subjects: HIV infections -- Prevention , Safe sex in AIDS prevention
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3146 , http://hdl.handle.net/10962/d1007421 , HIV infections -- Prevention , Safe sex in AIDS prevention
- Description: 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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- Date Issued: 1997