When you install PunBB there will already be a test forum setup for you. You create new categories and new forums through the administration interface which you reach via the administration link in the main menu. You can also edit the forum that was initially setup for you by changing its name and description. You can also setup user ranks through the administation interface.
You can delete, close or stick topics via the links which are the at the end of the forum and topic pages.
You may find the admin interface a little hard to use. It uses tables for layout and form controls are not as well marked up as they should be. Having said that, its probably easier than a lot of other forums.
You should be pleased to know that the next version of PunBB (including the admin interface) is aiming at compliance with accessibility priorty 2 checkpoints and has been tested on Jaws and Homepage Reader. You are the first screen reader user I've come across who has actually installed a forum from scratch which makes me think I might need to take a look at the installation procedure and the help that is available. Incidentally, do most Jaws users use Internet Explorer for ftp because it is linked to Jaws?