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    Beyond prevention : lived experiences of pre-exposure prophylaxis in Aotearoa New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy at Massey University, Albany, New Zealand
    (Massey University, 2021) Kolodziej, Jacek
    The prevailing research perspectives surrounding the use of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) revolve around public health aspects, offering less insights into the lived experiences of those who use it. This project aimed to expand this perspective and examine the experiences of PrEP users in Aotearoa New Zealand by contextualising them in the local social and cultural backgrounds. Ten individuals (nine men and one non-binary person) who identified as gay were interviewed individually, each on two separate occasions. A method of interviewing that followed the interpretive Gadamerian hermeneutical approach was used to elicit the deeper meanings of PrEP for its users. The theoretical lens of analysis included Bourdieu’s habitus theory and informed understanding of PrEP use and sexual behaviours as social practices. During the interviews, participants shared how their connection with the gay community gave them an informed and empowered status as they actively sought PrEP access. Participants pointed to pervasive heteronormativity in healthcare as a source of difficulties, and they reflected on their methods to challenge it. Many participants demonstrated resilience and were active advocates for themselves and their communities. PrEP was not only seen as one of the methods of HIV prevention, but primarily as an agent of personal and sexual liberation. PrEP also served as an enabler of what was seen as safe condomless sex as a carrier of new or recovered symbolic meanings signifying intimacy, connection, and ecstasy, as contrasted with fear and contagion. Condomless sex constituted an important part of the gay habitus that entailed subversive notions of social resistance contradicting the homonormative ideas of mainstream social acceptability. The use of PrEP enabled interrogation of moralised HIV prevention discourses, where condom use served as proxy for homonormative judgments. Differences were noted in ways participants were reconstructing the notions surrounding sexual liberation depending on their generational experiences of HIV/AIDS history. The new methods of HIV prevention may enable transformation of established discourses that can now allow agentic practices and offer safe ways of embodying desire. The changing notions of sexual risk and safety in previously forbidden practices need to be considered when analysing the impacts of HIV prevention methods and designing public health interventions.
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    The use of theatre for development in the prevention of HIV/AIDS : a dissertation presented in partial fulfilment of the requirements for the degree Master of Philosophy in Development Studies at Massey University
    (Massey University, 2000) Aldiss, Edmund Benet
    Over the last three decades development practitioners have begun to search for new theoretical approaches to the problems of underdevelopment. This has given rise to approaches that focus on the participation of people and their culture in development programs. The teachings of Paulo Freire, latterly developed by Augusto Boal, gave voice to theatre that is participatory, provides two-way communication and aims to raise the critical awareness of spectators. This form of theatre is known as Theatre for Development. It aims to promote awareness of political, social and economic issues. Theatre for Development goes beyond the theatrical event giving people skills to confront problems and solve them. The AIDS pandemic is a human tragedy that is threatening development in the world's poorest countries. In fact, 95 per cent of people with HIV or AIDS live in developing countries. HIV accentuates inadequacies that exist in health care infrastructures and highlights social and economic inequalities. There is no known cure for this disease but through systematic national programs that focus on preventing HIV transmission it is possible to significantly lower infection rates. Theatre should be part of any national HIV/AIDS program. Theatre for Development is effective in communicating HIV/AIDS related information and promoting attitude changes. Theatre has many advantages as an educational technique; it engages participants, is appropriate to the local situation, adapts to indigenous cultures, assists with skill development and encourages discussion about sensitive issues. In Vanuatu, Wan Smolbag theatre uses Theatre for Development to provide people with the knowledge and skills required to prevent HIV/AIDS infection. The mainstay of this Non Governmental Organisations' (NGO) work is short interactive theatre pieces of 20 to 50 minutes. In addition, WSB has created videos, radio dramas and educational materials. WSB's HIV/AIDS theatre is based on the Freiran concepts of participation and dialogue. As a consequence, the group's theatre reflects the lives of its participants and is proving that theatre can be a powerful tool for improving people's knowledge of HIV/AIDS.
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    Holes in the family : exploring a black African parents's HIV education to young people in the absence of extended family in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy, Massey University, Auckland, New Zealand
    (Massey University, 2015) Mhlanga, Fungai
    HIV and AIDS is a serious public health issue in New Zealand. As with other communities Black Africans may be exposed to HIV. There is a need to explore ways of reducing HIV exposure to this community. This study sought to generate information that could help in addressing the associated risk. Currently, such information is sparse in New Zealand scholarly work. Black African parents who settled in New Zealand face challenges when communicating HIV and sexual health messages to young family members. This is because, in many African communities, it is taboo for parents to discuss sexual matters with their teenage children. It is the responsibility of extended family members, aunties and uncles. However, advancements in other information sources have challenged the relevance and place for uncles and aunties in the mentoring of young people around sexual topics in the Black African Diaspora. The researcher used secondary data sources and explored how parents are bridging this gap in their families. The main findings from the present study showed that the dynamics in many African family structures have changed as a result of migration and settlement in New Zealand. There have been changes in values which have seen more young people taking up the host culture while a majority of the parents have retained their culture. The perception among some African community members that New Zealand is a low-risk country in terms of HIV transmission has contributed to complacency as regards adopting safer sexual behaviour. Parents are reluctant to have, and avoid, direct communication about sex with their children. Culture and religion have a strong influence on the Black African community beliefs around sex education. Sexual topics are still considered sensitive. African migrants bring strengths and resilience to New Zealand. The recommendations from this research include the need for HIV and AIDS Health Promoters to explore ways of increasing their relationship with religious leaders and further research into ways to develop the skills and confidence of parents around sex education.
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    When motherhood beckons : an exploration of the transition to motherhood for HIV positive women : a thesis presented in partial fulfillment of the requirements for the degree of Masters in Philosophy, Massey University, Manawatu, New Zealand
    (Massey University, 2010) Hinks, Amanda
    The aim of the research was to explore the transition to motherhood for women who have been diagnosed with HIV before pregnancy.Pregnancy is a time of adjustments for all women; socially psychologically and physically, the midwife has a fundamental role in supporting the woman to make a successful transition. HIV is increasing in New Zealand’s heterosexual population and with the national introduction of antenatal HIV testing midwives the diagnoses made will increase. Communities and health professionals need to hear about women’s experiences and recommendations from research about how best to provide individualised care for both mother and baby. This small research study was undertaken in 2008.Three women living in New Zealand with a positive HIV diagnosis were interviewed about their transition to motherhood. The babies of mothers in this study were aged between 3 and 18 months and the women knew their HIV diagnosis prior to pregnancy. The women spoke candidly about their experience of becoming pregnant, being pregnant and the transition to motherhood over the subsequent months of their babies’ lives. Three chapters present the themes from the women’s narratives; Chapter Four details the journey to becoming a mother. The themes identified were the desire to become a mother; “working hard for this baby”; maternal-infant attachment and “becoming a mother changes everything.” The themes in Chapter Five focus on how the women manage stigma and disclosure of their condition. The theme of managing disclosure in their personal world to family, friends and the child is identified. The maintenance of privacy and confidentiality is a theme arising from their step into the health service. In Chapter Six the theme of disempowering behaviours and perceived lack of evidence based care is discussed. The women describe how knowledge of HIV positive mothers was lacking as some health professionals queried “why aren’t you breastfeeding?” The women identified sources of support and knowledge which used to address the imbalance of power they felt whilst engaging with health professionals and wider society. In conjunction with midwives and other health professionals, the communities in which the women live are an integral component of supporting women to become mothers.