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Item Posttraumatic Growth and Posttraumatic Stress Symptoms in People with HIV(Springer Nature, 2022-11) Chi D; de Terte I; Gardner DReceiving a diagnosis of HIV can be challenging. People with HIV (PWH) can experience high levels of distress, as well as some positive psychological changes associated with post-traumatic growth. However, the mechanisms which underlying the association of a highly stressful event (i.e., being diagnosed with HIV) and posttraumatic growth (PTG) and posttraumatic stress symptoms (PTSS) are under-explored, and this is the focus of the study. Cross-sectional survey data were provided by 77 PWH living in New Zealand. An analysis examined the roles of deliberate rumination and coping strategies as serial mediators of the associations between event centrality and PTG and PTSSs. The relationships between event centrality and PTG and PTSSs were found to be sequentially mediated by deliberate rumination and avoidance coping, but not by deliberate rumination and active coping. Further analyses explored active coping and deliberate rumination as parallel mediators, with avoidance coping as a subsequent mediator, between event centrality and PTG and PTSSs. However, these analyses were not supported. The findings indicate that the more participants appraised the HIV diagnosis as central, the greater PTG they perceived; however, the more they deliberately ruminated on it, and the more avoidance coping they adopted, the less PTG and greater PTSSs they perceived. Future studies need to explore the relationships of event centrality and coping and their associations with PTG and PTSSs.Item Baseline audiological profiling of South African females with cervical cancer: an important attribute for assessing cisplatin-associated ototoxicity(BioMed Central Ltd, 2021) Paken J; Govender CD; Pillay M; Ayele BT; Sewram VBackground Cisplatin is a popular antineoplastic agent used to treat cervical cancer in women from low and middle-income countries. Cisplatin treatment is associated with ototoxicity, often resulting in hearing loss. In light of this, it is crucial to conduct baseline audiological assessments prior to treatment initiation in order to evaluate the extent of cisplatin-associated-ototoxicity. Additionally, the identification of inherent risk factors and hearing patterns in specific patient cohorts is needed, especially in South Africa, a middle-income country characterized by the quadruple burden of disease (Human Immunodeficiency Virus (HIV), Tuberculosis (TB), Diabetes and Hypertension). Methods This study aimed to describe a profile of risk factors and hearing in a cohort of females with cervical cancer before cisplatin treatment commenced. A descriptive study design that included 82 cervical cancer patients, who underwent audiological evaluation prescribed for ototoxicity monitoring was conducted. Results All participants (n = 82) presented with risk factors (diabetes, hypertension, HIV, and antiretroviral therapy) for cisplatin ototoxicity and/or pre-existing sensorineural hearing loss. High-frequency tinnitus was the most common otological symptom experienced by 25 (31%) participants. Fifty-nine (72%) participants presented with normal hearing, twenty-two (27%) with a sensorineural hearing loss, and 36% were diagnosed with mild hearing loss. Abnormal Distortion Product Otoacoustic Emissions (DPOAE) findings were obtained bilaterally in two participants (2.4%), in the right ear only of another two (2.4%) participants and the left ear of three participants (3.7%). Most participants (94%) had excellent word recognition scores, demonstrating an excellent ability to recognize words within normal conversational levels under optimal listening conditions. Age was significantly associated with hearing loss at all thresholds. Among the co-morbidities, an HIV positive status significantly triggered hearing loss, especially at higher frequencies. Conclusion This study demonstrated that South African females with cervical cancer present with various co-morbidities, which may predispose them to develop cisplatin-associated -ototoxic hearing loss. Identification of these co-morbidities and hearing loss is essential for the accurate monitoring of cisplatin toxicities. Appropriate management of these patients is pivotal to reduce the adverse effects that hearing impairment can have on an individual’s quality of life and to facilitate informed decision-making regarding the commencement of cisplatin chemotherapy.Item Factors Associated with Bone Mineral Density and Bone Resorption Markers in Postmenopausal HIV-Infected Women on Antiretroviral Therapy: A Prospective Cohort Study(MDPI (Basel, Switzerland), 2021-06-18) Ellis C; Kruger HS; Viljoen M; Dave JA; Kruger MC; Weaver CThe study aimed to determine factors associated with changes in bone mineral density (BMD) and bone resorption markers over two years in black postmenopausal women living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART). Women (n = 120) aged > 45 years were recruited from Potchefstroom, South Africa. Total lumbar spine and left femoral neck (LFN) BMD were measured with dual energy X-ray absorptiometry. Fasting serum C-Telopeptide of Type I collagen (CTx), vitamin D and parathyroid hormone were measured. Vitamin D insufficiency levels increased from 23% at baseline to 39% at follow up. In mixed linear models serum CTx showed no change from baseline to end (p = 0.363, effect size = 0.09). Total and LFN BMD increased significantly over two years, but effect sizes were small. No significant change in spine BMD over time was detected (p = 0.19, effect size = 0.02). Age was significantly positively associated with CTx over time, and negatively with total and LFN BMD. Physical activity (PA) was positively associated with LFN BMD (p = 0.008). Despite a decrease in serum vitamin D, BMD and CTx showed small or no changes over 2 years. Future studies should investigate PA interventions to maintain BMD in women living with HIV.Item Male attitudes and behavioural change in Tanzania, in relation to HIV and AIDS : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Philosophy in Development Studies at Massey University, Palmerston North, New Zealand(Massey University, 2012) Lloyd-Jones, Timothy JohnAlthough there has been some encouraging progress towards combating the Human Immunodeficiency Virus (HIV) and the resulting Auto Immune Deficiency Syndrome (AIDS) in recent years, AIDS continues to cause premature death and hardship for many families. Sub-Saharan Africa accounts for 68 percent of the worldwide HIV infections, an estimated 22.5 million people (UNAIDS 2010:2). This thesis examines the relationship between men’s attitudes and behaviour in relation to HIV and AIDS. It is important to focus on men in the battle against HIV because men often control women’s sexual and reproductive health. Grieg (2005:1) and other commentators believe the socialization of boys and young men to be a major factor in the spread of HIV/AIDS. The ways in which boys and young men are socialised are strongly influenced by prevailing cultural norms. Fieldwork was carried out in the Iringa region of the United Republic of Tanzania during June 2008. Interviews and focus group discussions were conducted with men of different ages and socio-economic backgrounds. Results showed that culture and influential role models strongly influence men’s attitudes and behaviour in relation to HIV and AIDS. This thesis confirms other research for example Silberschmidt (2001), who argued that sub-Saharan Africa is undergoing an identity crisis as changes in society have eroded men’s traditional role as hunter and provider. Many men are facing feelings of inadequacy, inferiority, lack of self-esteem and depression. Faced with these feelings of disempowerment, many men often resort to alcohol and extra-marital relationships, which increase the prevalence of HIV. One of the challenges facing those involved in reducing the spread of HIV is to help men face up to these feelings of inadequacy and develop a healthy lifestyle, despite changing social and economic conditions in 21st century sub-Saharan Africa.Item Safe sexual freedoms : a new narrative for an age of risk : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Sociology at Massey University(Massey University, 1997) Ryan, Allanah Marie; Ryan, Allanah Marie'Safe sexual freedoms' is a theoretical and political project of some urgency and this thesis offers a perspective on how best to understand and develop that project. A common political response to the recognition of HIV risk has been to argue that sexual freedom is an inappropriate political and ethical goal. I maintain, on the contrary, that no real change in the sexual practice of individuals is possible outside a radical humanist model of sexual freedom. This perspective is pursued through two interconnected forms of critique. Firstly, I undertake an evaluation of a number of prominent theoretical constructions of sexual freedom in relation to the values which they espouse and the understanding of the self that they promote. In engaging with the meaning of sexual autonomy in the writings of Reich, Foucault, feminists, and gay and queer theorists, I defend a theorisation of the social, sexual self in terms of narrative identity and ethical authenticity. This formulation, I believe, offers a satisfactory synthesis between a previously hegemonic 'leftist' humanist project of the self and the influential postmodernist movement which came to dramatically overturn it. One of the primary consequences of the present analysis is the need to 'roll back' to an extent, the extraordinary - and deserved - place of Michel Foucault's work on issues of safe sex, liberation and human solidarity. The second moment of the thesis is rather different, though closely linked in conception. Drawing on research material which reveals how sexually active individuals construct their notions of sexual and personal autonomy, I explore the role of narrative identity in the sexual practice of individual gay men and heterosexual women. Through an analysis of eight case studies, I examine how individuals inhabit core sexual narratives that guide HIV risk assessment and sexual practice. These two levels of analysis (critique and lived experience) taken together, provide the means for developing a theoretical and political model of safe sexual freedom.Item Foreskin cutting beliefs and practices and the acceptability of male circumcision for HIV prevention in Papua New Guinea(2013) MacLaren D; Tommbe R; Mafile'O T; Manineng C; Fregonese F; Redman-Maclaren M; Wood M; Browne K; Muller R; Kaldor J; McBride WJBackground: Male circumcision (MC) reduces HIV acquisition and is a key public health intervention in settings with high HIV prevalence, heterosexual transmission and low MC rates. In Papua New Guinea (PNG), where HIV prevalence is 0.8%, there is no medical MC program for HIV prevention. There are however many different foreskin cutting practices across the country's 800 language groups. The major form exposes the glans but does not remove the foreskin. This study aimed to describe and quantify foreskin cutting styles, practices and beliefs. It also aimed to assess the acceptability of MC for HIV prevention in PNG. Methods. Cross-sectional multicentre study, at two university campuses (Madang Province and National Capital District) and at two 'rural development' sites (mining site Enga Province; palm-oil plantation in Oro Province). Structured questionnaires were completed by participants originating from all regions of PNG who were resident at each site for study or work. Results: Questionnaires were completed by 861 men and 519 women. Of men, 47% reported a longitudinal foreskin cut (cut through the dorsal surface to expose the glans but foreskin not removed); 43% reported no foreskin cut; and 10% a circumferential foreskin cut (complete removal). Frequency and type of cut varied significantly by region of origin (p <.001). Most men (72-82%) were cut between the ages of 10 - 20 years. Longitudinal cuts were most often done in a village by a friend, with circumferential cuts most often done in a clinic by a health professional. Most uncut men (71%) and longitudinal cut men (84%) stated they would remove their foreskin if it reduced the risk of HIV infection. More than 95% of uncut men and 97% of longitudinal cut men would prefer the procedure in a clinic or hospital. Most men (90%) and women (74%) stated they would remove the foreskin of their son if it reduced the risk of HIV infection. Conclusion: Although 57% of men reported some form of foreskin cut only 10% reported the complete removal of the foreskin, the procedure on which international HIV prevention strategies are based. The acceptability of MC (complete foreskin removal) is high among men (for themselves and their sons) and women (for their sons). Potential MC services need to be responsive to the diversity of beliefs and practices and consider health system constraints. A concerted research effort to investigate the potential protective effects of longitudinal cuts for HIV acquisition is essential given the scale of longitudinal cuts in PNG. © 2013 MacLaren et al.; licensee BioMed Central Ltd.Item Positive Women: A Community Development Response to Supporting Women and Families Living with HIV/AIDS in Aotearoa New Zealand(E-Press Unitec, 2016-10) Connor H; Bruning J; Napan K; Rennie, GThis paper reflects on Positive Women’s twenty five years as a successful community development response to supporting women and families living with HIV or AIDS. The paper focuses on the community development philosophical underpinning of Positive Women that have driven the organisation since its inception in 1991. Positive Women has actively advocated for social justice, human rights, collective responsibility and respect for diversities, all central to community development.