3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Effect of sexual behaviour on the spatial distribution of HIV among Kenyan youth in 2003 and 2008(2018) Oulo, Brenda AnyangoBackground: Kenya is among the fifteen countries contributing more than 75% of the global HIV prevalence and incidence. In these countries, clustering of risk behaviour across geographical space and population sub-groups such as young people contributes significantly to the disease burden. Low levels of knowledge on HIV and rejecting attitudes towards HIV infected people influence sexual risk behaviour among young people. Objectives: The primary aim of this research study was to determine and compare the relationship between sexual behaviour and the spatial distribution of HIV among young Kenyans across two-time periods, 2003 and 2008. The secondary aim was to investigate the direct and indirect determinants of HIV distribution. Methods: Secondary data analysis was performed using cross-sectional data obtained from two two-stage population based surveys conducted in Kenya. The main outcome investigated was HIV status among young people aged 15-24 years. The study employed Bayesian-based multivariable logistic regression models adjusting for both non-spatial and spatial random effects. A conceptual framework based on knowledge, attitudes and practices (KAP) was the basis of a generalised structural equation model (GSEM) fitted to investigate the complex relationship between sexual risk behaviour and HIV status. Results: Among 2,650 and 2,857 young people aged 15-24 years in 2003 and 2008 respectively, 3.6% and 2.9% were HIV positive with the majority being female. The level of comprehensive HIV knowledge increased from 42% to 78% between 2003 and 2008. In both years, there was county spatial variability in HIV prevalence among young Kenyan people. Having a partner with concurrent sexual partners had the greatest direct effect on the odds of HIV infection (adjusted OR 2.26; 95%CI 1.63-3.12), but this was indirectly affected by knowledge levels during the latter survey year. Conclusion: This study revealed significant spatial variability in the HIV prevalence among young Kenyan youth and significant association between HIV knowledge, high-risk sexual behaviour and HIV infection. Interventions targeting sexual behaviour in this age group should focus on the counties with the greatest disease burden before implementing a wider national approach. Keywords: HIV, young people, spatial analysis, GSEM, Kenya.Item Changes in sexual behaviour, following a diagnosis of HIV infection, in a group of South African males.(2013-01-25) Baraldi, EzioBackground: The inexorable spread of HIV infection across all continents is attributable to many factors, including male sexual behaviour. Such behaviour is often considered recalcitrant to change. Aim: The purpose of this study was to determine if sexual behaviour does or does not change after the diagnosis of HIV infection and to elucidate some of the psychosocial factors that may be operant in this context. Materials and Methods: The research consisted of a structured selfadministered questionnaire designed to measure ten psychosexual and sociosexual parameters in a group of HIV positive men. The questionnaire evaluated parameters at three different time points i.e. before HIV diagnosis, one year after HIV diagnosis and the present (2002). Participants were recruited from patients attending a private HIV treatment centre, in Pretoria, South Africa. Results: 53 participants completed the questionnaire. Descriptive statistics were used to elucidate trends. Statistically significant changes were seen in most studied domains, suggesting that beneficial change in sexual behaviour is possible after a diagnosis of HIV infection. These changes were seen, over time, in all the measured parameters, thus, change appears both possible and sustainable. This change was often detrimental to participants as it impacted negatively on some aspects of their personal and social functioning. Safer sex knowledge was weak in the studied group. Conclusion: The data indicate that change in behaviour is possible after a diagnosis of HIV infection and occurred in the studied population. Some changes were good for public health initiatives; many were detrimental to the psychosexual functioning of participants. Public health officials and other medical practitioners should include interventions aimed at reducing the negative psychosocial impact of HIV diagnosis at every patient encounter, as these changes do not resolve by themselves over time and are detrimental to the quality of life of patients.Item Knowledge of HIV/AIDS, related attitudes and participation in risky sexual behaviour among first and fourth year female students at the University of Botswana.(2012-02-16) Cavric, GordanaIntroduction Botswana still has the second highest HIV prevalence in the world with little indication of any significant decline. In Botswana, women are disproportionately affected: young women account for more than half (58 %) of the adults living with HIV thus indicating a significant gender disparity in HIV infection. University educated, urban young women aged 19-39 have been identified as group at particularly high risk of HIV infection. Aim This study aimed to assess knowledge and attitudes regarding HIV and AIDS and how such knowledge and attitudes have implications for participation in risky sexual behavior among female University of Botswana students in their first and fourth years of study. Methodology This study was conducted at the University of Botswana (UB) in Gaborone. Data was collected using a selfadministered questionnaire on Knowledge of HIV/AIDS and participation in Risky Sexual Behavior among female students in first and fourth year of studies at University of Botswana. Results The knowledge regarding the “window period” and infectivity during the window period was significantly lower for first year students compared to fourth years. Attitudes towards people with HIV were positive in both groups, while affirmative attitudes towards premarital sex are increasing as the students progress academically. The analyses highlight that the percentage of women who reported having been sexually active the proceeding year was significantly higher among fourth year students (82.6%) than their first year counterparts (56.9 %), (p<0.01), with the number of partners significantly higher among women in their fourth year. Significantly, 3% of first year female students stated that their partners did not want to use a condom while 7 percent of the participants themselves said that that was the case. Amongst fourth year UB female students responding, 4% said that their partners did not want to use a condom, yet 14% participant said that they themselves did not want to use one. Overall, the prevalence of self-reported STI’s was significantly higher among fourth year students when compared with first year students 19 of 155 [12.26% ]vs. 4 of 144 [2.78 %] p<0.01 . Conclusion This study explored the knowledge of HIV/AIDS and participation in risky sexual behavior amongst female students in their first and fourth years at the University of Botswana. The study supported the findings that higher levels of formal education are associated with better knowledge of how to protect oneself from HIV/AIDS transmission. Although many HIV/AIDS prevention campaigns might have contributed to educated women being knowledgeable about how to protect themselves from HIV/AIDS transmission and the importance from abstaining from risky sexual behavior, a small but significant proportion of women still do not use condoms consistentlyItem The effect of institutional shareholders on the level and mix of South African chief executive officers' compensation(2009-11-06T07:19:07Z) Surve, YaserAgency theory would predict that, given the presence of large or powerful shareholders in a company, agency costs would be reduced. Excessive executive compensation can be regarded as being an externality problem that stems from the agency problem. Agency theory would also then predict that executives in companies with large shareholders would receive less compensation and a larger proportion of long-term incentive-based compensation than companies with smaller shareholders. The validity of these two hypotheses has been tested using a unique cross-sectional, time series dataset and two statistical techniques. The first set of tests involve the construction of multiple regression models in order to provide evidence as to whether Chief Executive Officer (CEO) compensation is affected by institutional shareholders. The second method, using statistical tests of differences between means, involves separating the sample into two sub-samples, namely management- and owner-controlled firms, to ascertain whether these two groups remunerate their CEOs differently to each other, thus testing the hypotheses in an alternative manner to the regression models. This report examines whether the presence of institutional shareholders affects the level and mix of CEO compensation for 50 companies listed on the JSE Securities Exchange over the five-year period 2002-2006. Original findings on the value of share options awarded to CEOs are presented, along with the trends in the level and mix of CEO compensation. Further research findings also include trends in the level of institutional ownership of listed companies over this period. The results of both the regression models and tests for differences of means provide statistical evidence in support of the assertion that the presence of institutional shareholders do not have an effect on either the level or mix of CEO compensation. Suggested reasons for this result range from shareholder apathy, to not considering executive remuneration to be a significant enough issue for institutional shareholders, and finally to the suggestion that institutional shareholders perceive the level and mix of compensation paid to South African CEOs to be a fair reflection of their value to their company.