Browsing by Author "Vilakazi, Zinhle"

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Men, Masculinity, Aggression and Dominance: An Exploration of How Young Men are Socialized to Deal with Situations of Man-on-Man Aggression and Dominance
(University of the Witwatersrand, Johannesburg, 2019) Vilakazi, Zinhle; Davies, Nick
There is a considerable body of research placing young South African men at the core of interpersonal violence. Within these studies they are frequently positioned as both perpetrators and victims of extreme and homicidal modes of aggression. In light of this gendered nature of interpersonal violence, this study was directed at exploring how young men’s responses to a situation of man-on-man aggression and dominance might be linked to how society encourages or expects a certain masculine performance from men in such situations. This study’s secondary goal was to offer some ideas about how young men might establish a masculine identity through aggression and dominance. In the pursuing research aims, a total of 14 young adult men attending university participated in this qualitative study. From the analysis what became evident was the continuous pressure that young adult men experience in society, through various social institutions, to somehow fit into dominant or hegemonic constructions of masculinity. Within the context of this study, the proximal cause of aggression and dominance was attributed to broader concerns regarding presentation of a masculine identity, self-worth and social status.
Patterns of HIV Resistance in Children Attending an Antiretroviral Clinic in Soweto, South Africa: A Case-Control Study
(University of the Witwatersrand, Johannesburg, 2023) Vilakazi, Zinhle; Moore, David Paul; Sipambo, Nosisa; Steegen, Kim
Background: Exposure to suboptimal serum levels of antiretrovirals (ARVs) places resistance pressure on circulating human immunodeficiency virus (HIV), with consequent emergence of resistance. HIV resistance leads to treatment failure and adverse outcomes. We explored factors associated with the emergence of ARV resistance in children living with HIV (CLWH) attending a treatment clinic in Soweto. Methods: We reviewed the clinical and laboratory characteristics, and factors associated with ARV resistance in children aged 0 to 15 years of age that were treated at the clinic from 01 January 2011 through 31 December 2020. The Stanford HIV drug resistance database was used to identify HIV drug resistance mutations and generate resistance profiles. Characteristics of children that underwent drug resistance testing (DRT) were compared to those of children who remained virologically suppressed on fist-line ARVs. Results: During the study period, 7,029 children attended the clinic of which 425 (6.0%) underwent DRT (cases) and 953 (13.6%) remained suppressed on first-line ARVs (controls). The resistance dataset included 431 resistance tests that were done in 425 children and adolescents that were eligible for the study. Non-nucleoside reverse transcriptase inhibitor (NNRTI) mutations accounted for 50.8% of all mutations, followed by nucleoside reverse transcriptase inhibitor (NRTI) mutations (44.5%) and protease inhibitor (PI) mutations (4.6%). Cases were significantly older at ARV initiation (81.6 vs 45.2 months), had a higher prevalence of ever being diagnosed with tuberculosis (33.2% vs 27.4%), ever being orphaned (57.6% vs 50.6%) and ever experiencing severe acute malnutrition (SAM) (19.8% vs 11.7%). In all modelling approaches, SAM was consistently associated with ARV resistance adjusted odds ratios (aOR) ranging from 3.548 (95% confidence interval (CI) 1.979-6.359) to 6.383 (95% CI, 3.811-10.690)). Increasing baseline CD4 percentage was associated with significantly lower adjusted odds of case-status aOR ranging from 0.971 (95% CI, 0.953-0.989) to 0.951 (95% CI, 0.931-0.972)). Seventeen (5.6%) cases died, compared to two (0.3%) controls; P<0.001. Conclusions: Tenuous nutritional status was consistently and significantly associated with the requirement for DRT in this cohort of children and adolescents. Conversely, higher baseline CD4 percentage was associated with control status. Early ARV initiation, to preserve immunological status, and nutritional support throughout the course of clinic attendance may limit the emergence of drug resistance in CLWH.