School of Social Sciences (ETDs)

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A Philosophical Examination of Thomas Szasz on Mental Illness as a Myth
(University of the Witwatersrand, Johannesburg, 2024) Fenderico, Alex; Vice, Samantha
The field of psychiatry has encountered substantial scrutiny pertaining to its diagnostic and therapeutic modalities since the inception of the antipsychiatry movement in the 1960s. A prominent figure within this movement was Thomas Szasz, a Hungarian-American psychiatrist whose influence looms large. Szasz, inspired by the ideas of Michel Foucault, posited that psychiatry functions as a ‘locus of control’ designed to subjugate and pacify societal masses into compliance. His seminal work, "The Myth of Mental Illness," expressed the argument that the medicalisation of mental illness is inherently problematic, constituting a category error of profound significance and resulting in harmful stigmatisation. Szasz advocated for the extrication of mental illness, or as he preferred, 'problems in living,' from the view of the medical domain. Instead, he proposed a paradigm shift towards addressing these issues through social frameworks, particularly emphasizing psychotherapy or counselling as opposed to reliance on psychiatric medications. Szasz's perspectives yielded both enthusiastic support and strong criticism, and contemporary theorists, such as Gabor Maté, persist in echoing his sentiments to this day. The objective of this report is to critically examine Szasz's theoretical position, as well as to present a concerted effort to substantiate its enduring relevance in the current intellectual milieu.
A study of the psychometric properties of the Personality and Values Questionnaire in a sample of the South African Population
(University of the Witwatersrand, Johannesburg, 2024-03) Clack, Crystal; Laher, Sumaya
Personality assessment plays a crucial role in various domains in South Africa. Both personality traits and values dimensions have been shown to be reliable predictors of performance and behaviour. Research on personality in South Africa is lacking, as is research on values. Assessment use in South Africa is governed by legislation, requiring evidence of reliability, validity, fairness, and a lack of bias. Most objective, self-report personality assessments are based on the Five Factor Model (FFM), which is widely accepted in personality as being universal. However, evidence on personality in South Africa suggests that there are additional elements to these factors. This study explored the applicability of the Personality and Values Questionnaire (PVQ) for use in the South African context. This was done by investigating internal consistency reliability, construct validity, and aspects of construct bias as they pertain to the potential for adverse impact. A non probability convenience sample of 288 participants completed the PVQ. The study took the form of a non-experimental, cross-sectional design. From the results, it was evident that the scales of the PVQ demonstrated adequate internal consistency reliability. In assessing construct validity, the five factor structure replicated similarly with regards to the Extraversion and Neuroticism domains, but the domains of Agreeableness, Openness, and Conscientiousness loaded differently to that proposed by the FFM and the test developers and more in line with other research on personality in South Africa. Evidence for construct bias was found. Women were likely to be more considerate of others, and concerned with how they appear to others. Black participants appeared more inclined towards harmony in interpersonal relationships and traditionalism. The differences for the language subgroups were small. The results suggest that the PVQ would have some suitability for use in South Africa depending on the context and sample. More research with larger and more diverse samples is needed.
Appreciative Inquiry in the Context of Student Wellbeing
(University of the Witwatersrand, Johannesburg, 2024-02) Bondi, Cheryl; Milner, Karen
This study investigated the value of an Appreciative Inquiry intervention for enhancing the wellbeing of a sample of 46 first-year psychology students at a higher education institution. This is particularly important considering first-year students’ experience high levels of anxiety caused by this major transitionary phase which impacts their academic performance and overall wellbeing. Wellbeing was defined according to Seligman’s (2011) PERMA framework, including the elements of positive emotions, engagement, relationships, meaning and accomplishment. The investigation followed a mixed-methods approach by considering three distinct angles. Firstly, it considered students’ positive-orientated wellbeing perspectives and the promotion of their wellbeing at university. To achieve this, workshops were conducted, following the methodology of the first three phases of Appreciative Inquiry (Discover, Dream, Design). The workshops generated six overarching themes, which corroborate with previous research, namely: lecturers; small learning environments; support; identity and belonging; aesthetics; and personal growth. Secondly, it analysed students’ experiences of an Appreciative Inquiry workshop and their perspectives of the utility of the methodology. Students completed Appreciative Inquiry Assessment Questionnaires, immediately after attending the workshops. These questionnaires were analysed according to four key topics: students’ reflections of Appreciative Inquiry; students’ reflections of the value of positivity; whether and how Appreciative Inquiry inspired them; whether students would consider using the Appreciative Inquiry methodology in the future and in what context. Thirdly, it determined if an Appreciative Inquiry intervention can be considered a positive psychological intervention (PPI). Students completed the Scale of Positive and Negative Experience (SPANE) before and immediately after the workshop to test the hypothesis that students would experience an increase in positive emotions. Results from the paired-samples t-test indicated a statistically significant mean increase (µ = 5.18, t(43) = -6.384, p < .001), and a large effect size (d= -.962). These results support the hypothesis, however, considering the design limitations, they do not indicate causality. Future research, with a more rigorous design approach, is required. Overall, the research suggests the positive value of Appreciative Inquiry in enhancing student wellbeing, even in contexts of high levels of stress. Additionally, it underscores the value of following a recognised wellbeing framework, such as PERMA, in this regard
Decolonising Healthcare: Breathwork as a Traditional and Complementary Medicine
(University of the Witwatersrand, Johannesburg, 2023-10) Jardine-Lindberg, Zuraida; Steyn, Melissa; McEwen, Haley
This study investigates the potential for Breathwork as a traditional and complementary medicine to promote decolonisation in healthcare. The study utilised qualitative interviews with healthcare practitioners who integrate Breathwork into their practice, in order to explore their viewpoints on the potential therapeutic benefits of this modality. Colonisation has played a significant role in historically discriminating against indigenous knowledge systems when it comes to healthcare, leading to an epistemic ignorance around various healing modalities. To address this issue, a shift towards pluralistic healthcare systems that integrate traditional and complementary medicines is needed. This can provide patients with a wider range of medical options and a more holistic approach to healing, empowering the individual to take control of their own health. However, change needs to start at policy level, with a commitment to inclusivity and cultural sensitivity within healthcare systems. Academic institutions also have a critical role to play in transforming their healthcare curricula to be more inclusive of traditional, complementary, and alternative medicines. This involves recognising the extent to which Euro-western teachings still dominate healthcare education today and working towards greater diversity in curricular content. The observations made in this study suggest that socially constructed definitions of health require transformation, particularly in countries as diverse as South Africa. In conclusion, this study aimed to highlight the possible impact Breathwork as a traditional and complementary medicine may offer the healthcare sector. By acknowledging the historical discrimination against indigenous knowledge systems and embracing a more pluralistic approach to healthcare, South Africa can work towards building a more equitable and culturally sensitive healthcare system that not only meets diverse needs but offers empowerment for individuals to become active participants in their wellbeing.
Experiences of Community Health Workers (CHWs) and their wellbeing: A study of CHWs in Johannesburg Townships
(University of the Witwatersrand, Johannesburg, 2023-03) Mashinini, Lethiwe Yvonne; Carrasco, Lorena Nunez
Community Health Workers (CHWs) have become important role players in the provision of health and social services in many underprivileged communities around South Africa. Despite the role and impact of these cadres in many communities, few studies have focused on the impact of their work on their wellbeing. Hence, the study's interest in expanding its inquiry on the experiences of CHWs and their impact on the cadre's wellbeing. This research further inquired about the national CHWs policy and CHWs scope of practice facilitated through the WBPHCOTs strategy that resulted from the re-engineering of the PHC model. As an observer qualitative data was collected through non-participative observation. Drawing from in-depth interviews this study further examined and describes the self-reported experiences of CHWs and NGO managers. To frame the experiences of CHWs and the impact of these experiences on their wellbeing the research findings were theorized from the perspective of social constructionism. The fundamental concern was to understand how cadres define, describe, and think about different social aspects of their life as CHWs and how these experiences influence their reality. Specifically focusing on two NGOs situated in Johannesburg townships the study participants were composed of eight CHWs (six female and two male cadres) as well as two male managers who were consulted as key informants. Concerning the national CHWs policy and the guiding scope of practice in the functioning of CHWs, the research yielded interesting findings. The managers of the NGOs were unaware of the existence of the national policy framework dubbed the Ward-based primary healthcare outreach team’s strategy (WBPHCOTs) policy framework. Hence, the organizations had not adopted or aligned the work of CHWs with the WBPHCOTs strategy policy framework. Instead, the NGOs maintained their arrangement of CHWs programmes as multi-stakeholder projects. This raises concerns about the implementation of the WBPHCOTs policy framework as a national CHWs policy, particularly in the NGO sector. The research also revealed multifaceted findings about CHW's experiences, which were largely positive and influenced by altruistic sentiments. Cadres also felt a sense of self-development and the possibility of improvement in their lives, which had a positive impact on their social wellbeing. CHWs also encountered some negative experiences such as challenging working conditions and poor remuneration and this had adverse impacts on their physical, psychological, and economic wellbeing. Therefore experiences of CHWs impacted their wellbeing both positively and negatively.
Factors associated with Social Grant uptake In South Africa: A Closer Look at the Special Covid-19 Social Relief of Distress Grant among the Youth Aged 18 – 35 Years
(University of the Witwatersrand, Johannesburg, 2023-08) Mabala, Moyahabo Thomas; De Wet-Billings, Nicole; Godongwana, Motlatso
Background: Globally nearly 900 million people benefited from social assistance in 2017, most of them in the form of cash transfers, which accounts for 44% of the social assistance budget. During the same period, Sub-Saharan Africa was found to be far behind in terms of social assistance coverage, of those living in extreme poverty it is estimated that only 15% of them are receiving social assistance. In South Africa, with a population of 60 million people, it is estimated that 11.4 million of them received some sort of grant at the end of March 2021. When the Special COVID-19 Social Relief of Distress Grant (SCSRDG) was introduced, it received over 9.5 million applications of which only 6.5 million were approved with the youth aged 18 – 34 accounting for 70% of the applicants. As a result of the high number of applicants for the SCSRDG, this study wanted to gain an understanding of the profiles of the applicants. Objective: To explore the demographic, socio-economic, and household factors associated with the uptake of the Special COVID-19 Social Relief of Distress Grant (SCSRDG) among the youth aged 18 – 35 years in South Africa. Methodology: This study is a quantitative analysis of secondary data obtained from the National Income Dynamics Study – Coronavirus Rapid Mobile Survey 2020 wave 5. The survey interviewed 7074 youth aged between 18 – 35 years. The outcome variable of this study is the Special COVID-19 Social Relief of Distress Grant (SCSRDG) receipt status. To assess the uptake of the grant, descriptive statistics including tables and graphs were used. The predictor variables consist of demographic, socioeconomic and household characteristics, with age as the main predictor variable. To check for the association between the outcome and predictor variables, binary logistic regression was utilised. Where the odd ratio < 1.00, meant that the outcome was less likely in the index group when compared to the reference. Results: Using the weighted data, a total of 3 438 046 applicants who applied for the grants received it while 3 003 320 of them did not receive the grant. Among those who received the grant, the majority 1 223 192 of them are aged between 21- 25 years. Most of the applicants were male representing 63.58%. African/Black is the highest population group that applied for the grant accounting for 90.66% of the applicants while whites account for the least proportion of the applicants at 0.88%. For both that received and did not receive the grant, the African/black population group is the highest when compared to other population groups at 92.93% and 88.07% respectively, while whites are the lowest at 1.31% and 0.40% respectively. Most of the applicants 91.47% were unemployed. A total of 4 994 322 (77.54%) of the applicants reported their dwelling type as formal and 4 891 137 (75.93) reported that they had access to both water and electricity in their household. Most applicants 39.98% come from a household with between 4 – 6 family members. Out of the 14 independent variables included in this study only two variables, marital status, and multiple grants recipients, were statistically significant. Females have a lower likelihood of receiving the grant when compared to males with an odd ratio of 0.6431 and 0.55637 using the unadjusted and adjusted binary regression model, respectively. Conclusion: This study has found that marital status and multiple grants recipients are the two characteristics that are associated with the uptake of the Special COVID-19 Social Relief of Distress Grant among youth aged 18 – 35 years in South Africa. It found that males as compared to females are more likely to receive the SRD grant, this is because of the initial qualifying criteria that excluded a high number of females that were already receiving the Child Support Grant. This criterion was later changed to say that an applicant of the SCSRDG must not be entitled to a social grant for himself or herself.
Menstrual Hygiene and Management in Zamimpilo Riverlea Informal Settlement
(University of the Witwatersrand, Johannesburg, 2021-08) Khofi, Lucy; Manderson, Lenore
Managing menstrual hygiene in low- and middle-income countries is difficult, due to lack of proper facilities. With inadequate WASH (water, sanitation, and hygiene) services and infrastructure, such as proper working toilets and lack of access to sanitary materials, some women end up using unhygienic sanitary materials, such as rags, leaves, sand, tissues and so forth to manage menstruation. In this study, I used an anthropological approach to describe and analyse women’s understandings of menstrual health and hygiene in the informal settlement of Zamimpilo, Johannesburg. Firstly, I looked at how women understood menstruation and how this was influenced by community attitudes and social norms. Secondly, I identified what material, structural and normative factors hindered or enabled women to manage their menstruation and hygiene: shame, embarrassment, level of education, access to information, gender inequality, affordability of pads and soap, access to water, and access to sanitation and hygiene facilities. Thirdly, I explored women’s experiences of their bodies, and how menstruation influenced their decisions to go out, go to school, have sex, bathe with others, manage pain, and sleep. I looked also at the practices that women used to manage menstrual waste. As I illustrate, these practices are shaped by cultural, social, and religious factors. I have explored women’s creative ways to manage menstruation, menstrual waste, and hygiene under different conditions, and explored the extent to which they have internalised or resisted negative attitudes towards their bodies and bodily products. I emphasise women’s narratives. In theorising these questions, I have adapted ideas from Purity and Danger (1984) by Mary Douglas, and following her, I have analysed menstruation as something polluting and dirty that contributes to menstrual shame. I have also drawn on Emily Martin’s book The Woman in the Body (2001) and examined how social and cultural factors shape women’s understanding of themselves. The data on which this thesis was based is drawn from research using qualitative methods. Due to constraints in movement and social interactions associated with COVID-19, primary data were collected through telephonic semi-structured interviews. Twelve women – six young women between 18 and 25 years and six women between 25 and 40 years of age – were each interviewed twice, bringing the total number of in-depth interviews to 24. Participants were recruited through a key informant, using purposeful sampling for maximum variability to ensure diversity of age, ethnicity, religion, education background, among participants. This was significant given that the population of Zamimpilo was diverse and includes people from different provinces and communities: Xhosa, Zulu, Pedi and other South Africans all live in Zamimpilo, as well as people from other African countries including Mozambique, Zimbabwe, Zambia, and Nigeria. My findings suggest that women’s MHM (Menstrual Hygiene Management) in Zamimpilo is still a huge challenge. The environment is deeply compromised, and no residents have access to adequate housing, water and sanitation. These basic challenges, along with the lack of sanitary products, hinder women from managing their menstrual hygiene. However, I found that these women used alternatives to manage their MH (Menstrual Hygiene), including various herbs for menstrual hygiene purposes and to prevent urinary tract and reproductive tract infections. Women expressed various understandings of their bodies, menstrual blood and menstruation as a process. I describe how the South African Department of Women, Youth and Persons with Disabilities has tried to address ‘period poverty’ in the country with the collaboration of non-government, non-profit organisations, the private sector, and menstrual activists. However, the need is greater than available resources. In places like Zamimpilo, women still do not receive any assistance from community organisations or from the state, and so they must improvise to manage this most private, routine, mundane event.
Occupational Stress and Burnout among Clinical Officers at Public Hospitals in Malawi: Impact Shifting to the General Public
(University of the Witwatersrand, Johannesburg, 2023-08) Chinguwo, Paliani; Kenny, Bridget; Matshiditsho, Rajohane; Scully, Ben
In Malawi, there is a cadre of mid-level health workers called clinical officers who undertake duties conventionally designated for medical doctors in the wake of an acute shortage of the latter. The use of clinical officers as substitutes for medical doctors is one example of a strategy called task shifting that is implemented as a temporary remedy for the shortage of human resources in healthcare. This is a study on the experiences of clinical officers with occupational stress and burnout at public hospitals in Malawi. The study adopted a qualitative research design with a case study as a research strategy. The study was conducted at four district hospitals and one central hospital, all of which are state-owned. One shortcoming of the framing of occupational safety and health in Malawi is the narrow scope and coverage of the regulation on occupational safety and health. This narrow scope of the regulation of occupational safety and health is limited to physical, chemical, and biological hazards. The psychosocial hazards are therefore neglected by the regulation on occupational safety and health. Another shortcoming of the framing of occupational safety and health in Malawi is that the coverage of the regulation on occupational safety and health exempts service sectors like healthcare. This exemption, therefore, gives the impression that healthcare in Malawi is immune to occupational safety and health hazards. This study challenges the narrow scope and coverage of the regulation on occupational safety and health in Malawi that neglects psychosocial hazards and exempts healthcare. The overall aim of the study was to expose the impacts on public health that can be associated with the neglect of psychosocial hazards and the exclusion of healthcare from the regulation of occupational safety and health. This study demonstrates that there are psychosocial hazards at public hospitals that predispose clinical officers to occupational stress and burnout. These are excessive workload, long hours of work, poor interprofessional relations, restructuring, COVID-19 responses, and the absence of occupational and safety management systems. The study further illustrates that psychosocial hazards at public hospitals are a breeding ground for various health problems among clinical officers that emanate from occupational stress and burnout. These health problems include emotional and cognitive effects; injuries; high blood pressure (hypertension); muscle tension or pain; and severe headaches. These health problems negatively affect the quality of life among clinical officers and their performance on the job. The study, therefore, concludes that occupational stress and burnout among clinical officers ultimately affect health outcomes in the broader population. For instance, the study demonstrates how the consequences of OS and burnout among clinical officers are consequently externalised to patients and the general public through the poor quality of healthcare services. In this study, the externalisation of the negative effects of occupational stress and burnout on clinical officers to the patients and the general public, is referred to as impact shifting. This study conceptualises and proposes a theoretical framework for analysing occupational safety and health in Malawi, with a particular focus on psychosocial hazards at public hospitals. The theoretical framework comprises three theoretical perspectives, namely: attribution theory, job demands-resources model, and fundamental cause theory. This study, therefore, offers a theoretical foundation and empirical evidence drawn from the experiences of clinical officers with occupational stress and burnout. The theoretical foundation and empirical evidence can inform the reframing of the scope and coverage of the regulation on occupational safety and health. Finally, this study also conceptualises and proposes a framework for the formulation of a comprehensive policy on occupational safety and health for public health facilities in the context of Malawi.
Phenomena in the therapeutic setting when treating clients with gender-related Body dysphoria
(University of the Witwatersrand, Johannesburg, 2023) Coleman, David; Bain, Katherine
This study explored psychotherapists’ experiences of somatic phenomena, in relation to their own bodies, when treating clients with significant gender-related body dysphoria within the treatment setting. It also examined their experiences and deeper understandings of somatic transference and countertransference within the analytic frame when working with this particular client profile. The various resistance mechanisms deployed by such clients were also explored as well as the ways in which psychotherapists may be resistant to working more closely with their own somatic countertransference. A qualitative approach to research was in order to generate meaning and understanding through rich material. An interpretivist paradigm was employed whose ontology examines the perceptions and experiences of therapists who have treated clients with significant gender-related body dysphoria. Therapists’ experiences of somatic countertransference phenomena were varied and inconsistent. More than half of the therapists reported the experiencing of sensations including nausea, headaches, restriction of the chest and experiences of drowsiness. Some therapists could not recall any experiences of somatic countertransference and demonstrated a tendency to minimize, deny or disavow somatic phenomena.
Rethinking the “Idea of the University” Through Pandemic-Era Student Experiences
(University of the Witwatersrand, Johannesburg, 2023-05) Caine, Amber Rose; Hornberger, Julia
The COVID-19 pandemic resulted in the upheaval of “the university”, as we knew it, and a repositioning of higher education online. By mid-2022, third-year anthropology students at the University of the Witwatersrand (Wits) had experienced two years of online education, followed by a return to select in-person classes under the banner of “blended learning”. My research centred on in-depth interviews with fourteen students in order to grapple with, and learn from, this cohorts’ unique “university experience”. As the “Idea of the University”, conceptualised in academic texts, often contains lofty notions for an imagined future, I chose to retrospectively highlight “the university” as it was experienced, from early 2020 until mid-2022. Grounded in student narratives, I describe the pre-pandemic Liminal University; the Remote University as distance learning commenced and progressed; the Static University as education continued for a second year online; and the Interpersonal University as students returned to on-campus classes. I found that through destabilisation, the key elements that made an all-encompassing university education possible, came into focus – namely, campus infrastructure and student sociality. Despite the university’s dispersal of data and loan devices, students’ home environments could not mirror the layered infrastructure nor social connection that had shaped pre-pandemic university education. Yet, upon students’ return to the physical campus in 2022, small, in-person classes where discussion was facilitated led students to re-engage with their course material, educators, and each other. As such, I argue that the full university education, that students both desired and benefited from, requiresrobust on-campus infrastructure for living and learning, and facilitated in-person engagement.
The Impact of a Psychological Capital Micro-Intervention on Academic Burnout amongst First-year University Students
(University of the Witwatersrand, Johannesburg, 2023-10-23) Bonga, Bulelani; Siemers, Ian
Purpose – the aim of this study is to probe into whether psychological capital micro interventions impact upon burnout amongst first-year university students, in the psychology department, at the University of the Witwatersrand. Research Design and Methodology - This study used a quasi-experimental design, because it did not include random assignment, but did include a comparison group, and manipulation of the DV variables. The research was quantitative in nature, with a sample size of 319 first year students from Wits University.. Findings – There was an insignificant interaction effect between group and time on all the variables. Thus, the intervention was not successful. However, Psychological capital was significantly and negatively related to burnout, and it’s components. Research limitations/implications – The sampling approach may limit the generalizability of the study’s findings as the data was collected from just one South African university, where the primary focus was first-year students. Another limitation includes the 1% given to those who participated in the intervention. Although this is departmental policy, an allocation of this nature can be interpreted as an attempt to persuade or provide an incentive, which may have affected the way the students responded. The current study has highlighted the value and importance of administering psychological capital interventions, not only in universities, but South Africa at large.
The Moral and Legal Debates of Sexual Surrogacy Therapy in South Africa: Intimacy and Care
(University of the Witwatersrand, Johannesburg, 2023-10) Khutsoane, Keabetswe Brooke; Schuhmann, Antjie; Brown, Julian; Hassim, Shireen
The decriminalisation of sex work in South Africa is a highly controversial issue that has caused a great deal of debate in recent years. This study presents a survey of the possibilities of legalising sexual surrogacy therapy as a therapeutic option for gender and sexual minorities, particularly for people living with disabilities and those who have undergone gender affirming surgery. It investigates the potential benefits and drawbacks of a legalised system and whether certain regulations should be implemented in order to protect those involved. A survey of how sexual surrogacy therapy as a therapeutic option is shaped in terms of South Africa’s legal and political frameworks while considering socio-political implications. The study reviews existing literature to demonstrate the need for a legal and ethical consideration of sexual surrogacy therapy in South Africa’s healthcare system to address sexual exclusion and health inequalities. To do this, I outline the value of sex and argue that sex is an essential and fundamental aspect of a flourishing human life. I then bring attention to the necessity for the socialisation and institutionalisation of sexual surrogacy therapy through a discussion on sexual justice; sexual autonomy; and the rights and sexual citizenship of gender and sexual minorities. While this is not a study on the legal status of sex work in South Africa, I perform a constitutional test of Section 9 and 10 of the South African Constitution, 1996 and the Sexual Offences and Related Matters: Act No. 32 of 2007 with reference to the Sexual Offences Act 23 of 1957, to determine the legal grounds and limitations of the current laws around sex work towards a discussion on the feasibility of sexual surrogacy therapy in contemporary South Africa’s healthcare system. Finally, I conclude that the transformation of social attitudes towards sex and sex work is necessary and important for ensuring due process for sexual justice in South Africa.
The Socio-Demographic Factors Associated with Condom Consensus among Adolescents in South Africa
(University of the Witwatersrand, Johannesburg, 2022-07) Guambe, Malesedi Pokello; Frade, Sasha
Background: Evidence highlights that heterosexual condomless sex among adolescents aged 15 to 24 years is argued by the literature to be a contributor to the high HIV prevalence, STIs, and adolescent pregnancies. As South Africa seeks to reduce new HIV infections by approximately 80%, condom use is of paramount importance. This is due to the fact that condoms are a preventative method that can protect against HIV transmission, STIs and unwanted pregnancies. Previous studies have shown that mutual agreement about using a condom improves consistent condom use among sexual partners. This study therefore investigates the socio-demographic factors associated with condom consensus among adolescents in South Africa. Methodology: This is a cross-sectional study, conducted using secondary data from the South African National HIV Prevalence, HIV Incidence, Behavior and Communication Survey (SABSSM) collected from January to December 2017. The study sampled 2 995 adolescents aged 15 to 24 years in South Africa. The software STATA 14 has been used to manage and analyze data. Descriptive statistics were computed to describe the characteristics of the study population. Cross-tabulation and Pearson Chi2 test were computed to test for association between socio-demographic factors and condom consensus. In order to examine the relationship between socio-demographic factors and condom consensus, binary logistic regression was used. Key Results: The study found condom accessibility and frequency of condom use to be significantly associated with condom consensus. Findings show that condom consensus was 0.457 less likely for adolescents who reported that condoms were not easily accessible, compared to adolescent with easier access. Statistical significance for condom accessibility is p=0.031. Furthermore, the likelihood of condom consensus for frequency of condom use was more likely (AOR,1.931; CI, 1.185-3.145) for adolescents who reported using condoms almost every-time and less likely (AOR, 0.563, CI, 0.379-0.798) for adolescents who used condoms sometimes. Main conclusion: This study found association for condom accessibility and condom consensus, as well as for frequency of condom use and condom consensus. For other socio-demographic factors there was no statistical significance with condom consensus. This study suggests that exposure of Social and Behavioral Change Communication programs needs to be increased among adolescents in South Africa. Central to reducing HIV infections, STIs, and adolescent pregnancy are programs that will influence behavior change among adolescents. At the core of such programs, there is a need for counselling on condom consensus and encouragement about not consuming alcohol before sexual intercourse. Additionally, these programs should make condom accessibility adolescent friendly, so as to encourage using condoms all the time as this is central to reducing new HIV infections, STIs, and adolescent pregnancy.
The ‘Gay Plague’: Community responses to AIDS in South Africa 1982-1987
(University of the Witwatersrand, Johannesburg, 2023-08) Chernis, Linda; Glaser, Clive
South Africa became the epicentre of the HIV/AIDS pandemic in the 1990s, and still has the highest HIV rate in the world. Consequently, much has been written about HIV/AIDS in South Africa across a variety of academic disciplines, though with very little emphasis on the first five years (1982-1987) in which the epidemic first manifested in South Africa. This thesis explores these early years from the perspective of the “gay community” in which the virus was first identified, while also unpacking what is meant by community in this context. How did gay organisations, activists and individuals respond, rally and organised in a time of fear, oppression, ignorance and upheaval? Initial responses to AIDS fell on fledgling, mostly white, gay community organisations, and a few healthcare workers. By analysing the services and programmes initiated from this (admittedly disparate and problematic) group, and by placing these responses within the broader context of AIDS internationally, and apartheid locally, we can see a very specific and complex local response develop. This laid the groundwork for what was to become the much larger-scale gay and HIV/AIDS organising of the 1990s, which is generally where most researchers pick up the thread. Certainly, no previous research has sought to include all aspects of this organising, including fundraising, counselling, the gay press, public education initiatives, and caregiving. An intensive audit of the relevant material in the collections of the GALA Queer Archive in Johannesburg, including new additions, has contributed to a more in-depth understanding of this time period.
What are the reasons behind the poor access of Covid-19 vaccines in Africa?
(University of the Witwatersrand, Johannesburg, 2023-09) Xaba, Lumkile Thobile; Moore, Candice
Despite the pandemic and initiatives such as COVAX that were put in place for fair and equal distribution of vaccines, the African continent remains the least vaccinated continent in the world. Incorporating evidence from articles, journals and policies, this study demonstrates that the African continent had the least and poorest access to vaccines. This research paper aims to understand why Africa has received the least vaccines and is the least vaccinated continent. The paper looks at the availability of vaccines in Africa and the appropriate options available in healthcare settings to receive Covid-19 vaccines. Literature is used by various scholars to understand the reasons behind the poor access to vaccines which have resulted to low vaccine uptake in Africa. It aims to look at the various contributing factors to this phenomenon, “why has the African continent been the least vaccinated?” To respond to these issues, this study uses the theories of classical realism and institutional liberalism to discover why Africa was the least vaccinated continent. Data has been collected from March 2022 and subjected to discourse analysis to help further understand the reasons behind the poor access of vaccinations during Covid-19 in Africa. We find that there are both internal and external reasons behind the poor access in Africa and both national and international factors have contributed to poor vaccine access.

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