Browsing by Author "Van der Riet, Mary Boudine."

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Assessing an IsiZulu questionnaire with educators in primary schools in Pietermaritzburg to establish a baseline of knowledge of Autism Spectrum Disorder.
(2014) Hutton, Natalie K.; Mitchell, Carol Jean.; Van der Riet, Mary Boudine.
Autism Spectrum Disorder (ASD) is a significant childhood disorder and has a growing prevalence rate across the world. It has been identified in children from a wide range of racial groups, ethnicities and socio-economic groups, making it a globally relevant disorder. However, poorly developed research on ASD in Africa makes it difficult to determine the prevalence rate, presentation and level of knowledge regarding the disorder locally. Therefore, assessing knowledge of ASD amongst professionals is a useful starting point for research in countries where research on ASD is limited. Educators in particular are a vital resource due to the likelihood of their early identification of developmental delays in children of school going age. Awareness studies reveal that professionals have poor awareness of ASD and therefore what educators in South Africa know about ASD needs to be established. In order to do so, a culturally relevant measure is required. This study aimed to translate an established measure into isiZulu and then assessed its reliability as a measure of knowledge in the local context. This was done in a pilot study with postgraduate students at the University of KwaZulu-Natal, and then again in a larger sample of students and educators. The study then investigated the level of knowledge of ASD amongst educators in Edendale, Pietermaritzburg by using the isiZulu measure. The results suggested that the questionnaire was a reliable measure of knowledge amongst educators in Pietermaritzburg. Educators were found to have a good baseline knowledge of ASD but their knowledge was found to be lacking in specific detail. This indicated that there is an opportunity for further research and interventions to develop knowledge of ASD within the local context.
‘Auntie Stella: teenagers talk about sex, life and relationships’ : discursive constructions of gender and sexuality in the materials of a sexuality education programme.
(2020) Malan, Chantelle Therese.; Van der Riet, Mary Boudine.
Sexuality education in southern Africa has been relatively unsuccessful in engaging with young people in helpful ways. Gender inequalities have been highlighted as a significant contributor to poor adolescent sexual and reproductive health in the region. One of the major challenges for sexuality education has been the way in which interventions have largely reproduced, rather than challenged existing gender roles and hierarchies in society. The ‘Auntie Stella: Teenagers talk about sex, life and relationships’ intervention, developed by the Training and Research Support Center (TARSC) in Zimbabwe has experienced success in encouraging adolescent participation and engagement with their sexual and reproductive health. The materials of the intervention comprise forty two question and answer cards in an agony aunt format. However, to date, no research has undertaken a discursive analysis of the ways in which gender and sexuality are constructed in the materials. Given its widespread use across southern Africa this study set out to explore the constructions of gender and sexuality within the materials. The primary aims of this study were to identify the discourses in the Auntie Stella materials, to deconstruct them, to determine to what extent dominant discourses were present and to explore the social realities and identities which were produced. Using a Foucauldian discourse analysis, the research identified that the materials were largely constructed within a context of risk and responsibility which served to regulate adolescent sexuality in powerful ways. Adolescents were encouraged to take up responsibility in ways that were legitimated by Auntie Stella, who was constructed as an expert. Additionally, constructions of risk and responsibility were gendered in complex ways. Dominant discourses of gender and sexuality were prevalent throughout the materials. For instance, biological essentialism, gender difference and heteronormativity were produced as natural and normal. Despite overwhelming constructions of victimhood and vulnerability, young women were contradictorily expected to be responsible for regulating men’s’ desire. This uneven burden experienced by women in the materials represents a central conflict in the ways in which women’s agency was constructed and negotiated. While women’s sexuality was only notable by its absence in the materials, male sexuality was constructed in somewhat more complex ways. On the whole, the materials largely relied on dominant constructions of gender and sexuality which reproduced gender inequalities and offered limited discursive resources for adolescents to fashion their sexual subjectivities in complex and creative ways.
Balancing the role of student and motherhood : the experience of students at the University of KwaZulu-Natal.
(2016) Kubeka, Cebisile Clementine.; Van der Riet, Mary Boudine.
The conceptualisation of a mother’s role is often accompanied by various ideas about how and what should be done. Therefore, paying attention to the subjective experiences of this role in various contexts is of great importance. This understanding will add to the exploration of other roles played by women in society, such as being a student. It is evident in research that pursuing tertiary education and being a mother places great pressure on many women in South African universities. This study explored the experience of student mothers at the University of KwaZulu-Natal (on the Pietermaritzburg Campus) to understand their roles and how they balance being both a student and being a mother. This study provides a detailed account of the experience of student mothers, including the ways in which student mothers manage their dual roles, utilise available services and ultimately try to balance their dual roles. This study employed an interpretivist approach, which argues that people’s perspectives can be understood through their subjective experiences. Interpretivists assert that there is no specific route to knowledge and that there is no one reality. A qualitative approach was used with a purposive and convenience sampling strategy. One focus group discussion and eight individual interviews with student mothers were conducted and thematic analysis was used to analyse the data. The key themes from the study revealed that student mothers’ experience of motherhood is characterised by time constraints and the inability to find a balance between the two roles. Further, it was found that students’ plans changed after they became mothers. Other students also reported challenges that were related to managing time between the two roles. Concerning coping strategies, student mothers discussed the support that they anticipated from their institutions of higher learning as well as the actual support they received. Other themes highlighted the impact of motherhood on academic work. Lastly, student mothers expressed some guilt about their situation and this raised the need for reparation with their family members.
Being a ‘good mother’: examining the discourse of first-time breastfeeding mothers.
(2023) Bloch, Jennifer Leigh.; Sunjeevan, Kershia.; Van der Riet, Mary Boudine.
This study employs a qualitative research design, using a social constructionist approach to examine how first-time South African mothers position breastfeeding as an imperative of good mothering. Six first-time mothers participated in the study using purposive sampling from a private baby clinic site in KwaZulu-Natal. They were interviewed online due to the COVID-19 Pandemic. The interviews were transcribed in detail and analysed using discourse analysis. The research findings examined how mothers demonstrated good mothering through their commitment to breastfeeding. The mothers constructed breastfeeding as a project and positioned their bodies as sites that they needed to manage, to work to attain these good mothering standards. The findings showed that the mothers positioned experts as fundamental for breastfeeding success to receive advice, guidance, and reassurance, especially when they experienced difficulties. In the sample, three of the mothers introduced formula, which was positioned as the alternative to breastfeeding. This was accompanied by mothers constructing their failure to fulfil an exclusive breastfeeding ideal and they experienced feelings of guilt, shame, and inadequacy. These three mothers re-negotiated the standard of breastfeeding as an imperative of good mothering by drawing on a counter-discourse that positioned their babies as happy and healthy when using formula. The research concludes that the mothers in the study defined their motherhood identity through their socially constructed successes and failures in breastfeeding. Breastfeeding ideals considerably influenced them, and they constantly measured themselves against these medical and social standards. The impact is that these sociocultural norms position breastfeeding as an essential act of good mothering and contribute to a state of intensive mothering that renders mothers vulnerable to shame and guilt. The findings recommend challenging sociocultural infant feeding constructs and the discourses shaping modern-day motherhood.
Challenges in the process of HIV/AIDS disclosure: Perspectives of HIV positive students in a South African university.
(2020) Pillay, Gellinda Anna-Alicia Patience.; Van der Riet, Mary Boudine.
From the moment individuals are diagnosed as human immunodeficiency virus (HIV) positive, they are overwhelmed with various emotions. People living with HIV who have recently been diagnosed will usually search for comfort as they adapt to this unsettling life change. In addition, HIV-positive students may feel alienated because they live away from their source of support. This study explored HIV-positive students’ lived experiences of HIV disclosure. University students fall within the age group of South African youths who are most likely affected by HIV. Because of the social dynamics of university life, such as living away from home, it is of interest to study the disclosure patterns of these students. The objective of this study was to understand HIV-positive students’ process of disclosure, focusing on both the challenges and the facilitators of disclosure. A qualitative study was conducted at the University of KwaZulu-Natal, Pietermaritzburg, South Africa. In-depth individual interviews were conducted with five participants – two men and three women – who were on antiretroviral (ARV) treatment and who were recruited through the campus health clinic. The data were analysed using thematic analysis. The findings showed that the negative consequences of disclosure were that the participants were subjected to judgemental responses after disclosing; a positive consequence of disclosure was having access to support. The participants were afraid to disclose to friends and roommates at university because they feared the judgemental attitudes and stigma. However, the participants chose to disclose to close family members, owing to the support they would receive from them. The university was also seen as having a good support system for HIV-positive students. In this regard, the participants suggested that interventions geared at social support and the dissemination of information should be employed at the university.
Constructions of disability : an exploration of the embodied experience of blindness.
Michell, Marietjie.; Van der Riet, Mary Boudine.
It appears that disability is not always viewed or treated like other forms of discrimination. Even in South Africa where since the new constitution of 1994 the disability agenda is well established and firmly located within a human rights and development approach, the national psyche, because of a past of institutionalised racism, is still largely aware only of race as an oppressive marker of differentness. Disability is generally not linked with systematic discrimination, disadvantage, prejudice, exclusion and marginalisation. Instead it tends to be viewed in terms of impairment, an individual problem, a personal tragedy, and something that has little to do with society. This study explored the concept of disability in terms of its meaning, the social construction of the concept, but more specifically, the ‘real’ experience of disability. The latter includes paying attention to certain aspects of personal experience related to living with impairment, something previously neglected by the social model, the model generally subscribed to today. This model views disability as a form of social oppression, or a constructed category; therefore, scant attention has been paid to the experience of the body in living with disability. The experiences of impairment, embodiment and emotional life have thus emerged as features that need to be included on the agenda for future debate. In the study, the investigation took place from the perspective of how others’ understanding and treatment of blindness affect the lives of blind people. Responses to and treatment of blindness are explored via the accounts of nine blind people. A further focus of the study is the impact that living with blindness amidst a disablist society has on the emotional and social lives of blind people. The study makes use of a qualitative approach. It employs a largely realist method which reports experiences, meanings and the subjective reality of the participants, and to a lesser extent a constructionist method which examines the way in which events, realities, meanings and experiences are the effects of certain discourses operating within society. The sample consists of nine blind people who made their contributions via emails. The data was analysed using thematic analysis. It was found that interactions between blind people and the sighted world are largely informed by hidden assumptions. Further, people are unaware of such assumptions as they are largely unconscious and reflective of underlying societal discourses regarding disability, yet they influence the way people view and treat disability. In addition, it was concluded that the attitudes of sighted people regarding blindness and blind people are imbued with psychic investments. It transpired that living with blindness within such a disablist world impacts, in various areas, on the social and emotional well-being of blind people. Keywords: medical discourse, social model, social construction, embodied experience, loss and suffering, disablism, hidden assumptions, unconscious motivation.
Contradictions, tensions and dilemmas mitigating the adoption of risk reducing sexual behaviour in the rural Eastern Cape, South Africa.
(2015) Gabakaiwe, Tendani.; Van der Riet, Mary Boudine.
Despite considerable effort to prevent HIV and increase awareness about the HIV and AIDS epidemic, many South Africans continue to engage in risky sexual behaviours, putting themselves at a greater risk of HIV infection. This study explores this lack of sexual behaviour change. The study aims to understand sexual activity dynamics in Ematyholweni, a rural area in South Africa. It focuses on the tensions and dilemmas in the positions that men and women in Ematyholweni take in relation to safe sex practices. It also explored how these tensions and dilemmas relate to contradictions in the sexual activity system and the state of contradiction in the activity system. The study used a qualitative research design. It used existing data from a broader NRF funded project. A purposive sampling technique was used in order to meet the objectives of the study. The data was collected using semi-structured interviews and focus group discussions. Data collection was conducted from 2012 to 2013. This study sampled 47 interviews transcripts. This sample consists of 22 men and 25 women in the age range 18 to 60 years. It also sampled 6 male focus groups and 7 female focus groups also aged between 18 and 60 years old. The study used an activity theory framework to guide the development, analysis and interpretation of this study. This model helps with identification of tensions and contradictions in an activity system and therefore helps with understanding the potential for change and transformation within an activity system. It used thematic analysis and activity system analysis as complementary analytic tools. Data analysis highlighted that all participants were aware of the risk of HIV and HIV prevention measures. However, dilemmas that they experience in sexual activity, and the related tensions and contradictions do not lead to sexual behaviour change. Sexual activity was linked to a way of achieving gendered identity, making it problematic to effect behaviour change. However, the mediating artefact of the conceptual system of HIV risk is stronger for women than for men. The contradictions within women’s activity systems are at a mature stage and near crisis, while men’s activity systems are at an early stage of maturity and lack crisis. This lack of crisis in the activity system of men helps to understand lack of sexual behaviour change.
Dealing with a positive HIV diagnosis : a qualitative study exploring the lives of five people living with HIV in a rural Eastern Cape setting.
(2016) Mqedlana, Nasiphi.; Van der Riet, Mary Boudine.
Receiving an HIV diagnosis is a complex reality facing individuals. It alters life and its meaning for the infected individual, their family and the community. This study explored the experiences of five people infected with the Human Immunodeficiency Virus (HIV) in a rural South African community. The aim was to understand the challenges faced by those living with HIV and the role their environment played in the management of the virus. The focus was on uncovering the meaning that the individuals attach to being diagnosed with HIV and how they perceived themselves in relation to their community. A qualitative study that paid attention to the participant’s subjective experiences was implemented. In-depth interviews were conducted with five participants (two men and three women) who had self-reported living with HIV. Questions relating to management of the virus were posed to the participants, for example: why they decided to take an HIV test, the process they went through in accepting the diagnosis, their experience around disclosure, and around treatment. The interviews were transcribed and translated from isiXhosa to English by the researcher. Thematic analysis was used to analyse the transcribed data. The results of this study showed that participants experienced feelings of despair and helplessness upon diagnosis. The future of their children in the event of their inevitable death was a concern for the women in the study. While these fears were constantly present, the support of family members and close acquaintances helped the participants to accept their diagnosis. Disclosing their HIV status was a key decision for participants. Deciding to whom to disclose, and how to disclose was important. It was easier for the participants to disclose to females i.e. mothers, sisters or female friends. Disclosing to a sexual partner was difficult for those participants who were in relationships and in most of the relationships condom usage changed with the disclosure of the status. The participants experienced lack of acceptance within their community. Interventions to optimize perceptions of social support and community acceptance are needed.
Experiences of sex and contraception education in young women from semi-rural areas in Pietermaritzburg who have experienced early and unintended pregnancy.
(2021) Radebe, Sandile Innocent.; Van der Riet, Mary Boudine.
Early and unintended pregnancy (EUP) is a world-wide concern affecting both developed and developing countries. This study explored the experiences of sexual activity and contraceptive use in relation to early and unintended pregnancy. It aimed to understand young women’s experiences of sex and contraceptive education, in relation to early and unintended pregnancy. The data for this study was collected from individual interviews with four young women. This study took a qualitative approach to explore how young women made sense of their early and unintended pregnancy experiences. Simultaneously, this study used an interpretivist paradigm, which places importance on the notion that people’s experiences are better understood from within their immediate context. Thematic analysis was used to identify and report themes or patterns that were found in the data. Findings revealed that sexual reproductive health education and culture play a significant role in early and unintended pregnancy. The discovery of the pregnancy by young women further hinders their relationship with the baby’s father which may lead to the consideration of termination. Post-pregnancy experiences indicate that some women only use one contraceptive method which might be the pill or injection and not the condom, whereas some use the dual method. The study revealed that there is a need for parents to be taught about the importance of talking to their children about sex, and for sex education in schools to begin at a much earlier stage. The study further recommends possible steps that could be taken to ensure that early and unintended pregnancy can be better understood and supported.
An exploration of educators’ perceptions of social-emotional competencies in children beginning formal education.
(2020) Zondi, Nokubonga Immaculate.; Van der Riet, Mary Boudine.
The social and emotional competence of many South African children is inadequate to begin formal education. Entry into formal education is a vital developmental milestone. Developing children’s social-emotional skills provides a child with a better chance at succeeding in school. This study explored the often-neglected perspective of educators and what they think of children’s social-emotional competence. A qualitative study design was employed for this research study. Eleven grade 1 educators were interviewed individually. These educators came from three primary schools in KwaZulu-Natal. Convenience sampling was used to sample the schools and purposive sampling was employed to sample educators. Thematic analysis was employed to analyse the data in this study. The participants in this study argued that children’s social-emotional competence has declined over time, with behavioural regulation being of particular concern. Differences between children depended on their home environments and the schools they attended. Educators argued that social-emotional development was affected by low socioeconomic status, poor parenting skills, language issues and financial difficulties. School-based differences depended on each school’s socioeconomic background and pupil demographic factors. Further research on the decline in social-emotional competencies amongst children needs to be done to prevent further detriment to children’s academic achievement. Research on protective and risk factors for each school context would be useful.
An exploration of stigmatisation relating to the terms used to refer to HIV and AIDS amongst women in a rural area in the Eastern Cape.
(2016) Sutherland, Julie.; Van der Riet, Mary Boudine.
This thesis explores the terms used by women in a rural area of the Eastern Cape Province to reference HIV/AIDS. Exploring whether these terms are stigmatising and investigating and describing how they are stigmatising is at the heart of this study. Stigma is a barrier to HIV/AIDS related public health interventions. In order to understand HIV/AIDS stigma, this study considers the complex social and psychological processes that underpin the construction of HIV/AIDS stigma through an examination of the terms used to refer to HIV/AIDS. This project employs a qualitative research design and draws on an existing NRF Thuthuka project on sexual health, sexual risk behaviours and HIV. A purposive sampling technique was used to sample a total of 36 transcripts collected from interviews and focus groups. Thematic analysis was used to code and analyse the data. The findings of this study suggest that HIV/AIDS related fear propels an ‘othering’ response, a necessary psychological coping mechanism in the face of the overwhelming threat HIV/AIDS represents. This is fundamental to the generation and perpetuation of stigma. Cognisance of these processes is essential in rendering HIV/AIDS interventions increasingly effective.
Exploring challenges to safe sex for men in long-term relationships living in KwaZulu-Natal who have sex with both men and women.
(2020) Msweli, Sakhile.; Van der Riet, Mary Boudine.
Numerous research studies continue to show that HIV/AIDS is still a burden in South Africa. Although in recent years there have been breakthroughs in biomedical research, leading to the development and improvement of HIV treatment, a vaccine and a cure have yet to be found. Research has further suggested that people in long-term relationships are at a heightened risk of HIV infection owing to decreased condom use within these relationships. In addition, the majority of studies that investigated sexual safety in South Africa have focused on heterosexual relationships. This creates a problem, as international literature and some South African-based surveys have suggested that men who have sex with men (MSM) are at an increased risk of HIV infection when compared to men who have sex with women only (MSWO). This means that there is a gap in our current understanding of barriers to safe sex for MSM, particularly within the South African context. This gap is further problematised by the presence of homophobia and the persistent concealment of same-sex sexual activities within the South African context. This study focused on a subset of MSM, called men who have sex with men and women (MSMW), because even though in South Africa the burden of the HIV pandemic is still largely carried by women, there is reason to believe that MSMW could be at an intersection of HIV infection risk, which is yet to be understood fully. This study used a social constructionist approach as a theoretical lens that undergirded the study’s conceptual framework throughout the research process. Qualitative research methodology was selected as the method of inquiry, and 12 African MSMW were sampled for one-on-one interviews and seven MSMW for an online focus group discussion. The sampling of participants was conducted using convenience and non-random purposive sampling techniques, and the data were transcribed verbatim. Data analysis was conducted using a combination of inductive thematic analysis underpinned by social constructionism, and the sex script theory as contemporary analytical tools. The findings of this study showed that long-term romantic relationships were important in the lives of MSMW for varying reasons. The findings further showed that MSMW’s understanding of safe sex was related to condom use. This study adds to the already existing body of research, which highlights that condom use within long-term relationships is problematic. The findings indicated that the construction of these relationships relied heavily on the dynamic concept of trust, and, as such, MSMW within these relationships drew on the trusted partner is a safe partner script, which mediated condom use within the relationships. The main findings in this study suggested that challenges to safe sex for MSMW in long-term relationships are rooted in the nature of how gender norms are socially constructed. The current heteronormative gender norms affected the way the participants understood their same-sex sexualities and how they navigated these within a social context that still bore negative attitudes towards same-sex behaviours. The findings indicated that the participants’ understanding of their gender and sexuality led to the enactment of the desire script, the redefined traditional sex script, and the understanding male partner script. These scripts allowed for sexual agreements to exist between male partners that permitted a form of polyamorous sexual relationships. The risk of HIV infection thus seems to rest on the intersectional enactment of different scripts while the expectation to enact the trusted partner is a safe partner script remains. This trusted partner is a safe partner script was not abandoned even in the presence of HIV infection risk. This study highlighted the need for research to focus on diverse populations such as MSMW in the response to the HIV epidemic. Keywords: Men who have sex with men and women,social constructionism,sex script theory,HIV,sexual agreements.
The facilitation of participatory research techniques.
(2007) Boettiger, Merridy.; Van der Riet, Mary Boudine.
This study engaged in a micro-genetic analysis (Wertsch, 1984) of facilitation in participatory research (PR). The research conducted in this study explored the facilitation process of two facilitators using two participatory techniques (a 'road of life' technique and a ranking exercise) with children in a rural context. The facilitators' perceptions of facilitation and their experiences of facilitating a PR technique were examined through the use of individual interviews, and were analysed using a reading guide method (Mergendollar, 1989). Of particular concern was that in PR, there is no account of the mechanisms which bring about successful facilitation. This study exposed how some PR techniques, like the ranking exercise can simply be implemented through using a set of instructions, but other kinds of techniques such as the 'road of life' technique are inherently embedded in the principles of PR and are more difficult to implement. A lack of an understanding of the PR principles has major consequences for the implementation of PR processes, and whether or not PR processes achieve their aim i.e. critical reflection. The importance of training in PR was thus emphasised, and the importance of providing a theoretical framework of the facilitation process in PR was accentuated.
Female students’ concerns about, and management of, their sexual and reproductive health at the University of KwaZulu-Natal, Pietermaritzburg.
(2021) Masinga, Bonisiwe.; Van der Riet, Mary Boudine.
Literature on sexual and reproductive health concerns of university students is rare, and yet there is evidence that university students have concerns and misconceptions about sexual and reproductive health. The study presented two aims. Firstly, it aimed to investigate University of KwaZulu-Natal female students ‘concerns about sexual and reproductive health. It also aimed to investigate how female students manage their sexual and reproductive health while on campus. Four in-depth interviews and six focus groups discussions were conducted. The data were analysed using thematic analysis. The findings of the study indicate that female students had numerous concerns related to sexual and reproductive health. In the study many students were anxious about contracting sexually transmitted infections (STIs) such as gonorrhoea, chlamydia and syphilis. Their fear about contracting such STIs was that, they affect woman fertility. Further, some students were very scared of contracting HIV because they believed that their sexual partners would reject them if they were HIV positive. Students were also concerned about HIV related stigma that exists in their home community and on campus. Female students were not only worried about contracting STIs but also falling pregnant while they are students. Many female students reported using hormonal contraceptives such as birth control pills, injectable contraceptives and implants, to avoid pregnancy. However, some students had misconceptions about female contraceptives. They believed that hormonal contraceptives would affect their future fertility. Many students had a strong desire to have children in the future and linked their identity very strongly to childbearing. Another issue raised by students in the study was that of confidentiality at the campus health facilities, stating that their privacy was not sufficiently protected when accessing sexual and reproductive health services on campus and at their community clinics. Although many university students had some understanding about sexual and reproductive health, stigma and discrimination about accessing sexual health services such as testing as well as negative attitudes towards contraceptives, remain an issue. These can put students at risk of poor sexual and reproductive health. It is very important that young people understand what sexual and reproductive health means since such knowledge guides an individual’s own sexual behaviour and practices. Support programmes for sexual and reproductive health which include information and service provision, need to address all underlying issues faced by female university students.
The identities of transracially adopted adolescents in South Africa : a dialogical study.
(2006) Thomson, Robynne Leigh.; Van der Riet, Mary Boudine.
Using the theory of the dialogical self, this study aimed to understand the identities of a sample of transracially adopted South African adolescents. Particular attention was paid to the identity domains of race and adoption, as well as the impact of relationships on the formation of individual identity. In-depth interviews were conducted with four transracially adopted adolescents and their parents. The voice centred relational method (Brown and Gilligan, 1992) was used as the method of analysis. Results of this research support many assumptions of the theory of the dialogical self and suggest that there is a dynamic relationship between internal and external positions within the self. In addition, the results show that the participants have developed racial and adoptive identities characterized by conflicting positions within the self, which may be mediated by relationships with significant others. Issues specific to the South African context, including language and poverty, also appear to bear significant influence on the identities of the participants.
Key barriers to antiretroviral (ARV) treatment adherence : Experiences of health care workers (HCW) and antiretroviral therapy (ART) clients in the uThukela district of KwaZulu-Natal.
(2018) Cele, Jabulani Reginald.; Van der Riet, Mary Boudine.
In the fight against HIV and AIDS, the world managed to put more than 17 million people on anti-retroviral treatment (ART) in 2016. More than three million of the people on ART are in South Africa, and more than one million of them are in KwaZulu-Natal. South Africa is the epicentre of HIV and AIDS and has adopted the United Nations’ (UN) 90 90 90 strategy to end AIDS and the World Health Organization’s (WHO) Universal Test and Treat Policy for people living with HIV. All this could be challenged by the level of adherence to treatment by the individuals put on antiretroviral (ARVs). This study sought to identify barriers to adherence for people using ARVs in a rural area in South Africa. The main aim of this study was to identify key barriers that make HIV-positive people who are using ARVs fail on ART. In total, 14 research participants were purposefully sampled and interviewed using semi-structured questions. Of the 14 research participants, five were clients who are on ARVs (two men and three women), three facility lay counsellors, three facility community care givers (CCGs) and three Nurse Initiated and Management of Antiretroviral Therapy (NIMART) nurses. Data from interviews were analysed using thematic analysis to identify barriers to adherence for ART. In this study, 12 barriers to adherence for Injisuthi clients who were using ARVs were identified. The barriers identified included: 1) side effects, 2) pill burden, 3) no improvement while on ART, 4) use of alternative (traditional) medicine, 5) improved health, 6) communication with health care workers, 7) practical problems/socio-economic issues (poverty), 8) mobility and migration labour, 9) gender and social organisation (masculinity), 10) stigma and discrimination leading to fear of disclosure, 11) lack of community support, and 12) service delivery. In the rural context, it is critical for improved adherence to ART to establish interventions that tackle socio-economic, stigma and gender issues, together with providing appropriate continuous psychosocial support for clients using ARVs when they complain about side effects and pill burden.
Knowledge of contraceptives, attitudes towards contraceptive use, and perceptions of sexual risk, among university students at a South African university.
(2017) Chebitok, Betty.; Van der Riet, Mary Boudine.
University students form a high-risk group in relation to unplanned pregnancy and sexually transmitted infections such as chlamydia, gonorrhoea, hepatitis B, syphilis and HIV/AIDS, due to sexual exploration, unsafe sexual practices and involvement in risky behaviours in their environment. The use of contraceptives such as the male condom, the female condom, the contraceptive pill, the loop, implants, the injectable contraceptive, and contraceptive practices such as the rhythm method and withdrawal, potentially prevent conception; while proper use of the male condom and the female condom protect against the risk of sexually transmitted infections (STIs). An unplanned pregnancy can negatively impact on a student’s university education due to the challenges following childbirth. Students with children may find it difficult to attend to their studies and the needs of their young ones; while financial difficulties may constrain others. STIs, on the other hand, can severely damage a woman’s fallopian tubes leading to infertility, ectopic pregnancy and miscarriage. The STIs can cause genital cancers in both men and women and death of an infant following transmission of infection during pregnancy. Pregnant students and those with STIs are at higher risk of dropping out of college, becoming depressed or anxious. To inform interventions targeting change in behaviour, a qualitative study was conducted at the University of KwaZulu-Natal, on the Pietermaritzburg campus. The aim of the study was to understand students' knowledge of contraceptives, their attitudes towards contraceptive use, their perceptions of sexual risk, and factors influencing their decision-making processes about contraceptive use. The theory of planned behaviour was used to understand contraceptive use among university students. Convenience, purposive and snowball sampling techniques were used to access 25 sexually active students (13 men and 12 women) from all races, religions, levels of study and nationality. Ten in-depth interviews and four focus group discussions were conducted and, the findings were analysed using thematic analysis. The findings show that participants knew about the process of conception, the right time for contraceptive use, therapeutic benefits of contraceptive use, and sources of contraceptives on campus. The participants demonstrated knowledge of contraceptives such as the male condom, the female condom, the contraceptive pill, emergency contraceptives, injectable contraceptives, the loop, implants, and contraceptive practices such as the rhythm method, withdrawal and abstinence. There were inconsistencies and low use of contraceptives by the participants in the study, and contraceptives preferred were injectable contraceptives, emergency contraceptives and the male condoms. Participants knew about sexual risk and behaviours that can expose students to the risk of pregnancy and STIs. These behaviours were perceived to be mainly socially defined, like peer interaction, boredom, use of alcohol, drug abuse and watching pornographic movies. Contraceptive use was perceived as a woman’s responsibility because women are directly affected by pregnancy and they have access to more methods of contraception than men. Most of the participants were of the opinion that women have little say in negotiating safer sex practice and contraceptive use in relationships. Sexual activity was thought to be primarily for a man’s enjoyment. Men are not easily judged for their sexual behaviours if they are in possession of male condoms, while women are if they prepare for sexual activity. Peer interaction, parents’ expectations of their children’s behaviour and health care service providers’ attitudes towards sexual activity and contraceptive use influenced decisions about contraceptive use. The participants identified the cost of buying a good quality male condom and insufficient time to prepare for sexual activity as structural barriers to contraceptive use. This study concludes that contraceptive use is not a spur of the moment decision, but one guided by beliefs about likely outcomes of their use, beliefs held by significant others about their use, and availability of resources and opportunities that facilitate their use. Although knowledge of contraceptive use may be necessary for their use, it does not influence actual use. Knowledge is likely to influence the formation of intentions to contraceptive use by working mainly through attitudes towards their use. This information could help individuals in sexual and reproductive health centres in designing interventions to create awareness, change in sexual behaviours and promote contraceptive use. The study recommends interventions targeting men on attitudes change particularly in relation to condom use and responsibility for condom use in order to foster respect and shared responsibilities on reproductive health decisions; expansion of methods of contraception for men to widen their choices; and further national research on contraceptive use to inform new programming in higher institutions of learning.
Lesbian students' experiences of challenges faced at a South African university.
(2021) Leonard, Tarah Imelda.; Van der Riet, Mary Boudine.
Despite South Africa having one of the most progressive legal systems in the world, especially when it comes to the rights of sexual minorities, discrimination and violence against homosexual individuals remains a challenge. It appears that the social issues and prejudices present across South African society also permeate its tertiary education institutions, as South African universities tend to subscribe to the same homophobic ideologies present in South African society. Although the University of KwaZulu-Natal (UKZN) aims to provide a safe and protective environment for its student population, there are still numerous challenges for its homosexual student population on campus. This study aimed to explore the experiences of six lesbian students studying at the UKZN, Pietermaritzburg campus. Using Pryor and Reeder’s (2011) theoretical framework that delineates four manifestations of stigma (public stigma, self-stigma, stigma by association and structural stigma), this study sought to describe how lesbian students experience challenges due to their sexual orientation. Using a qualitative research design, a focus group was conducted with six participants who self-identified as lesbian. The research findings revealed that lesbian students face a variety of challenges on the UKZN campus, and that significant levels of homophobia were experienced by the participants. Homophobia on campus was experienced by the participants in the form of verbal abuse, physical and sexual violence, psychological harm, physical and sexual threat, and social exclusion. Campus social gatherings and events were positioned as being the main sites of concern for targeting homosexual students. University staff members were constructed as perpetuating homophobia on campus. Being identified as lesbian on campus produced high levels of stress for all participants. More research is recommended in order to more fully understand the challenges that student minority groups, such as the LGBT community, face on campus.
Mapping rural youth's experiences of school exclusion.
(2007) Maarschalk, Silvia.; Van der Riet, Mary Boudine.; Killian, Beverley Janet.
The South African context gives rise to a number of significant adversities that challenge the stability of the individual child and the survival of their families. The repercussions of these adversities are profound. Once risk begins to accumulate, the probability of a negative developmental trajectory increases. A group of South African children that are a particularly vulnerable, at risk, and marginalized group are those youth who are excluded from school. Access to the schooling system represents an important node of care and support with the potential of linking vulnerable children to key services. Eight youth from a town in a former homeland in rural KwaZulu Natal, who are excluded from the schooling system, participated in this research. The research aimed to map their experiences of school exclusion through a participatory photo interview technique. Using Bronfenbrenner's (1979) socio-ecological systems theory, this study has indicated that exclusion from school relates to risk factors present in the five contextual systems that a child functions within. From this research one can see how each risk factor adds to the web of exclusion that makes these youth hard to identify, access and help. The findings indicate that there is a need to further investigate the South African child care grant system and the impact it has on access to schooling, as well as to develop macrosystemic interventions to alleviate poverty.
Microfinance programmes : working towards empowering women living in a rural context?
(2012) Dhlamini, Sinelisiwe Lebohang.; Van der Riet, Mary Boudine.
This study aimed to investigate the experiences of women living in a rural area who participate in a microfinance programme called SaveAct. Microfinance programmes have been established to assist people, financially, living on a low income. Their primary focus is women because of the high level of poverty amongst them. Microfinance programmes seek to promote entrepreneurship in order for people to start income generating activities and to be more self-sufficient. This initiative intends to empower women by making funds available to them, so that these funds can transform into something more sustainable and help them in improving their lives. Semi-structured interviews were conducted with 16 female participants from the rural areas of Richmond and Obonjaneni, KwaZulu-Natal, in South Africa. A thematic analysis showed that women have experienced some change in their lives, as a result of getting access to funds and participating in SaveAct. Some of these changes included increased personal autonomy, self-confidence and business knowledge. These changes suggest that this sample of women has been empowered despite the backdrop of a patriarchal society. Women felt more in control of their lives and had gained some independence in their homes in terms of contributing to household income. Despite these changes more integrated services are still needed so that both genders are equipped with financial information as it affects the household, so that there is more equality in the household economically. More quality financial services are also needed in rural contexts in order for communities to be more knowledgeable about finances and to build businesses that will feed into the economy in the long term.