The objective of this study is to explore the impact of a social group work programme in the lives of adolescent orphans in foster care in the North–West province who are also affected by HIV and AIDS, and to enhance their social functioning. Keywords: Adolescent, foster care, foster parent, social work, social group work, empower, family, orphan, HIV and AIDS There are a growing number of children in need of care in South Africa who are placed with foster parents. The biggest reason for foster placement is due to the rising mortality rate of biological parents due to HIV and AIDS. Section A refers to the problem statement, research objectives, research procedures and research methodology. The limitations of the research are also investigated and the definitions of key words. The research was conducted in two phases. The needs assessment was conducted in phase one and the planning, implementation, and evaluation of the social group work programme in phase two. The problem statement in section A is based upon the following: It was found that insufficient research is being conducted on the problems and circumstances of adolescent orphans in South Africa. It is evident that the physical and emotional needs of adolescent orphans are not being fulfilled. The HIV and AIDS pandemic have a negative effect on the quality of daily life for orphans under foster care. The problem statement gave rise to five research aims. The overarching research design conformed to the Development and Utilization Research model. The model was divided into five phases that guided the research. The single–system design was used to gather quantitative and qualitative data. A literature study was conducted around the themes of foster care, foster parents, social group work, and circumstances of the foster care situation. Section B consists of the four articles that form the report on the research outcomes Each article is dealt with as a self–contained unit focusing on specific research objectives that were achieved via specific research methods. These methods were employed to collect the necessary data for the design and evaluation of the social group work programme. Article 1: The circumstances and needs of the adolescent orphan in foster care. The aim of this article is to identify the circumstances and needs through a self–designed and structured schedule. Thirty adolescent orphans in foster care from the researcher's case load were identified to take part in the research. Twenty adolescent orphans were selected by means of accidental sampling. Ten (N = 10) were selected for the experimental group and ten (N = 10) were selected for the control group. The results indicated the problems and needs experienced by adolescent orphans. These could be used for discussion during a social group work programme designed to provide knowledge, teach skills, and improve the social functioning of the group. Article 2: The role of the social worker during service delivery to adolescent orphans in foster care. The nature and extent of foster care in the North–West province was investigated by means of the completion of questionnaires. The role of the social worker regarding services to adolescent orphans in foster care was also investigated. A self–structured questionnaire was used for data collection purposes and 85 questionnaires were sent to social workers in the North–West province. The results show the state of existing programmes and the opinions of social workers on topics that could be included in a social group work programme. The data was used in Article 2. Article 3: A social work intervention programme for adolescent orphans in foster care. The programme was developed according to the data received from the 30 (N=30) adolescent orphans in foster care and the 85 (N=85) social workers in the North–West province. The programme was presented to 30 (N=30) adolescent orphans in foster care. Social group work was used as method to present the programme. The group gained knowledge and received skills training, both of which served to enhance their social functioning. Article 4: The evaluation of a social group work programme for adolescent orphans in foster care The purpose of this article is to evaluate the social group work programme. Three standardized measuring instruments were used. The Generalized Contentment Scale, the Index of Family Relations, and the Personal Self–esteem Profile were used. These instruments were used three times: once before intervention, once during intervention and once after intervention. The control group 10 (N=10) also completed the questionnaire three times but did not attend the social group. A self–developed questionnaire was completed before and after each session. A self–developed evaluation was completed after the final session to assess the effectiveness of the programme. Section C - Summary, conclusions and recommendations. Section D - contains the appendices with the results of the three standardized measuring instruments that were used for data collection. Section E - Contains the Bibliography. / Thesis (Ph.D. (Social Work))--North-West University, Potchefstroom Campus, 2012.

Text in Afrikaans / Weens die veeleisende aard van sorggewing aan VIGS-weeskinders, bevind die sorggewers hulle dikwels in 'n posisie waar hulle self sorg en ondersteuning nodig het. Die vraag het begin ontstaan op watter manier hierdie sorggewers ondersteun kan word. Dit het duidelik geword dat die kerk vanuit hul sosiale verantwoordelikheid sorg en ondersteuning aan die sorggewers kan bied. Sorggewers van een instansie wat aan die navorsingsreis deelgeneem het, het inderdaad nie genoeg sorg en ondersteuning van die kerk ontvang nie. Hierdie gebrek aan ondersteuning het 'n direkte invloed op die sorggewers se hantering van sorggewingseise. Sorggewers van die ander twee deelnemende instansies ontvang genoeg ondersteuning van lidmate, en dit maak 'n groot verskil aan hoe sorggewingspanning beleef word. In hierdie studie is daar krities gekyk na wyses waarop die kerk betrokke is en verder kan betrokke raak by die sorggewers van VIGSweeskinders. / Philosophy, Practical and Systematic Theology / M.Th. (Praktiese Teologie)

ENGLISH : The purpose of this study was to determine the role of fear for HIV/AIDs in adolescents’ sexual choices. Theories which informed the study included developmental theory, decisionmaking theory, as well as emotion theory. In this survey study a mixed-method questionnaire was designed, piloted and then implemented with 252 purposefully selected Grade 11, Afrikaans learners (127 boys and 125 girls), aged 16 to 17 years in one high school in Gauteng. Data was analysed quantitatively and qualitatively. It was found that adolescents link several emotions with HIV&AIDS: fear, concern and caution. Another finding was that adolescents reportedly made safe sexual choices. Therefore, it was concluded that adolescents fear for HIV&AIDS positively impacted on their safe sexual choices. AFRIKAANS : Die doel van hierdie studie was om te bepaal welke rol vrees vir MIV&VIGS speel in adolessente se seksuele keuses. Teorieë wat die studie ingelig het was ontwikkelingsteorie, besluitnemingsteorie en emosie-begronde teorieë. Die navorsingsontwerp van hierdie studie was ‘n opname studie. ‘n Gemengde metode vraelys is ontwerp, geloods, aangepas en geïmplementeer met. 252 graad 11, Afrikaanse leerders (127 seuns en 125 dogters), tussen die ouderdom van 16 en 17 jaar, wat doelgerig geselekteer is vanuit een hoërskool in Gauteng. Vraelysdata is kwantitatiewe en kwalitatiewe geanaliseer. Daar is bevind dat adolessente MIV/VIGS verbind met die emosies: vrees, bekommernis en versigtigheid. Verder blyk dit dat adolessente veilige seksuele keuses maak. Die gevolgtrekking is gemaak dat adolessente se vrees vir MIV&VIGS positief korreleer met hul veilige seksuele keuses. / Dissertation (MEd)--University of Pretoria, 2009. / Educational Psychology / unrestricted

No description available.

The effects of HIV/AIDS and subsequent opportunistic infections and/or associated conditions on the development of infected children are substantial. Considerable delays and/or disorders in communication development have been noted in the HIV/AIDS infected child, as well as the need for Early Communication Intervention (ECI) services for this population. A dearth of locally relevant data regarding the speech, language and hearing development of HIV/AIDS infected children within the South African context currently exists. The objective of this study was to describe the characteristics of a group of HIV/AIDS infected children being managed at an outreach clinic of regional hospital in Gauteng. A cross-sectional, retrospective, non-experimental, descriptive, quantitative research design was used in this study. The main objective was achieved by analysing the clinic records of 203 children infected with HIV/AIDS between the ages of 0 – 5 years 11months through the use of a pre-designed checklist. A questionnaire completed by four medical doctors practicing at the HIV/AIDS clinic within the hospital was also used. This allowed for the perceptions and practices of the medical doctors to be described. Results revealed that the majority HIV/AIDS infected children being managed at the outreach clinic were significantly immunocompromised and diagnosed with Stage III or Stage IV HIV/AIDS infection. Furthermore, results indicated the presence of several opportunistic infections and HIV/AIDS associated conditions (such as Tuberculosis, Candidiasis and Encephalopathy). A positive finding was that 76% of the HIV/AIDS infected children (n=153) were receiving Highly Active Antiretroviral Therapy (HAART) at the time of data collection. The most outstanding finding was that very few of the children with HIV/AIDS being managed at the outreach clinic were recorded as having speech, language and/or hearing delays and/or disorders. Similarly, referrals to other professionals as recorded in the children’s hospital records seemed to be limited to Social Workers and Dietitians, with only one child recorded as being referred to a Speech-Language Therapist and Audiologist for further management. It was unclear whether more children were in fact referred for additional intervention by other professionals and this was simply not recorded in the children’s records, or whether these referrals were in fact not made. Results from the questionnaires completed by the medical doctors working with the pediatric HIV/AIDS population within the outreach clinic were significant. Findings indicated that the majority of the respondents believed that HIV/AIDS infected infants were more at risk for developmental and communicative delays and/or disorders than the general population, and that this population would likely benefit from Speech-Language Therapy and/or Audiology intervention services. Respondents indicated that medical doctors working with the pediatric HIV/AIDS population were often not adequately informed regarding the effects of HIV/AIDS on communication development and that they would benefit from further training in this regard. The need for further research regarding the characteristics of the pediatric HIV/AIDS population, particularly on a larger sample, was described. This would assist in the development of a guideline for ECI service delivery for children infected with HIV/AIDS. The need for further training of other professionals regarding the effects that HIV/AIDS has on the communication development of the infected child, to assist with necessary referrals and teamwork, was also highlighted. AFRIKAANS : Suid-Afrika is een van die lande ter wêreld, wat die hoogste voorkoms van Menslike Immuniteitsgebrekvirus/ Verworwe Immuniteitsgebreksindroom (MIV/VIGS), toon - met die pediatriese populasie op die voorfront van hierdie epidemie. Die effek wat MIV/VIGS en opeenvolgende opportunistiese infeksies en/of ander geassosieerde toestande op die ontwikkeling van kinders het, is verreikend. Internasionale literatuur beskryf agterstande en/of akwykings in die kommunikasie ontwikkeling van kinders wat met MIV/VIGS geinfekteer is. Die behoefte vir Vroeë Kommunikasie Intervensie (VKI) vir hierdie populasie word ook gemeld. Daar bestaan egter slegs ‘n beperkte hoeveelheid relevante, plaaslike literatuur met betrekking tot die spraak-, taal- en gehoorontwikkeling van kinders met MIV/VIGS binne die Suid-Afrikaanse konteks. Die doelwit van hierdie studie was om die kenmerke van ‘n groep kinders, wat met MIV/VIGS besmet is en by ‘n streekshospitaal in Gauteng behandel word, te beskryf. ‘n Kwantitatiewe, nie-eksperimentele, terugwerkende, dwarsdeurige, beskrywende navorsingsontwerp is gebruik. Die hoofdoelwit was bereik deur die kliniekrekords van kinders wat met MIV/VIGS besmet is, te analiseer deur van ‘n vooraf-ontwerpte merklys gebruik te maak. Data is ook ingesamel deur middel van vraelyste wat deur mediese dokters, wat by MIV/VIGS klinieke binne die hospitale werk, voltooi is. Dit het toegelaat dat die persepsies en praktyke van die mediese dokters ook beskryf kon word. Resultate het getoon dat die meerderheid kinders met MIV/VIGS, wat by klinieke behandel word, se immuunsisteme ernstig onderdruk was en dat hulle met stadium III of stadium IV van MIV/VIGS gediagnoseer was. Die resultate het verder ook die voorkoms van verskeie opportunistiese infeksies en MIV/VIGS geassosieerde toestande aangedui. ‘n Positiewe bevinding was dat 76% van die kinders (n=153), wat met MIV/VIGS geinfekteer was, tydens die proses van data-insameling reeds Hoogsaktiewe Antiretrovirale Terapie (HAART) ontvang het. Die mees uitstaande bevinding was dat slegs ‘n geringe hoeveelheid kinders met MIV/VIGS by die kliniek, as met ‘n agterstand en/of afwyking in spraak, taal en/of gehoor, aangeteken is. Beperkte verwysings na ander professionele persone is ook in die kliniekrekords opgemerk. Verwysings was beperk tot Maatskaplike Werkers en Dieëtkundiges. Daar was slegs een aantekening van ‘n kind wat vir behandeling na ‘n Spraak- en Taalterapeut en Oudioloog verwys is. Dit is egter onduidelik of daar werklik meer verwysings na ander professionele persone gemaak is, maar net nie in die kinders se kliniekrekords aangedui is nie, of dat daar werklik min verwysings na ander professionele dissiplines gemaak is. Bykomend, was die resultate van voltooide vraelyste deur mediese dokters, wat met die pediatriese MIV/VIGS populasie in die kliniek werk, insiggewend. Bevindings dui aan dat die meerderheid proefpersone, wat aan die studie deelgeneem het, van mening is dat kinders wat met MIV/VIGS besmet is wel ‘n hoër risiko toon vir ontwikkelings- en kommunikasie agterstande en/of afwykings in vergeleke met die algemene populasie. Die proefpersone is verder ook van mening dat hierdie populasie wel van spraak- en taalterapie en/of oudiologiese intervensie sal baatvind. Proefpersone het verder aangedui dat mediese dokters, wat met die pediatriese MIV/VIGS populasie werk, nie ten volle ingelig is omtrent die effek van MIV/VIGS op kommunikasie ontwikkeling en dat hulle van verdere opleiding sal baatvind. Die behoefte vir verdere navorsing in die veld van pediatriese MIV/VIGS en kommunikasie ontwikkeling, binne die Suid-Afrikaanse konteks, word in hierdie studie beskryf. Dit sal as riglyn vir VKI dienslewering aan hierdie populasie dien. Daar is ook ‘n groot behoefte vir verdere opleiding van ander mediese professionele persone met betrekking tot pediatriese MIV/VIGS en die effek wat die op die kind se kommunikasie ontwikkeling het. / Dissertation (MCommunication Pathology)--University of Pretoria, 2010. / Speech-Language Pathology and Audiology / unrestricted

Text in Afrikaans / Die MIV/vigs-pandemie in Suid-Afiika- van die ergste in die wereld- toon geen tekens van afname nie. Miljoene kinders is reeds of wees gelaat of hewig geaffekteer deur die magdom impakte daarvan op gesinne en gemeenskappe. Die epidemie het voortdurend stygende sterftesyfers tot gevolg en die hewige las van die siekte rus swaar op MIV-positiewe sowel as MIV-negatiewe individue. Verder word tradisionele ondersteuningsnetwerke oorbelaai en/of gaan hulle tot niet. Gesinne en gemeenskappe verloor hul ekonomiese, sosiale en kulturele lewensvatbaarheid. Die pandemie hou, veral onder die armes, 'n geweldige bedreiging vir die gesondheid, welstand en regte van babas, kinders en jongmense in. 'n Groot gedeelte van die impak van MIV/vigs hou verband met die feit dat sommige kinders en hul gesinne beperkte toegang tot die elemente van 'n gesonde omgewing en goeie gesondheid het. Regerings, gemeenskappe en gesinne wat deur MIV/vigs geraak word, het minder tyd, energie en finansiële hulpbronne beskikbaar om op voorkomende gesondheidsorg te fokus. Benewens die impak op gesondheidstatus, word kinders se omstandighede ook as gevolg van MIV/vigsverwante probleme bemoeilik. Dit sluit verhoogde gesinsarmoede, 'n hoer risiko van verlating en weeslating, geforseerde migrasie, onterwing, sielkundige trauma, uitsluiting en diskriminasie, en fisiese en seksuele mishandeling in. Die derde vlaag van die epidemie, welke vlaag nou betree word, word gekenmerk deur 'n ontsettende hoe sterftesyfer, 'n ontploffing in die getal sorgbehoewende en weeskinders en 'n verhoging in menslike pyn en lyding. Die reg speel 'n baie belangrike rol in die beperking van hierdie impak van die MIV/vigs-pandemie op die lewens van alle kinders. MIV/vigs-reg is in die proses van evolusie of vorming en reeds bestaande teorieë kan aangewend word ten einde sekere vrae te beantwoord en probleme daaromtrent aan te spreek. Tog is daar 'n dringende behoefte aan MIV/vigs-spesifieke wetgewing en teorieë ten einde die impak van die pandemie op alle vlakke suksesvol te beheer. Verder het die Kinderreg so 'n mate van ontwikkeling bereik dat daar algemeen aanvaar word dat kinders 'n spesiale belangegroep binne die gemeenskap vorm. Die regsreëls met betrekking tot kinders verander gedurig en is ook nie geskik om volgens die tradisionele wyse, as privaat- of publiekreg, geklassifiseer te word nie. In die hieropvolgende proefskrif word die impak van MIV/vigs op sekere publiekregtelike, maar oorwegend privaatregtelike aspekte van die Suid-Afiikaanse kinderreg ondersoek, sowel as enkele metodes waarop die reg moontlik hierdie impak kan absorbeer en hanteer. Daar word ook in aparte hoofstukke na die impak van MIV/vigs op die lewens van kinders. sorgbehoewende kinders, egskeiding en die ouer-kind-verhouding verwys The HIV/aids pandemic in South Africa - one of the worst in the world - does not seem to be decreasing. Millions of children have already been either orphaned or heavily affected by the numerous impacts on families and communities associated with it. The epidemic brings on an ever-increasing mortality rate and the extreme burden thereof weighs down heavily on HIV-positive as well as HIV-negative individuals. Traditional support networks are further being heavily burdened or perish entirely. Families and communities lose their economical, social and cultural viability. The pandemic threatens, especially among the poorest, the health, wellbeing and rights of infants, children and young people. The impact of HIV/aids is to a great extent the result of the fact that some children and their families do not have sufficient access to a healthy environment and good health. Governments, communities and families affected by HIV/aids have less time, energy and financial resources available in order to enable them to focus on preventive healthcare. In addition to the impact on health status, children's circumstances are also being encumbered by HIV/aids-related problems, including family poverty, a higher risk of being abandoned or orphaned, forced migration, disinheritance, psychological trauma, ostracism and discrimination and physical and sexual abuse. The third wave of the epidemic, which wave is presently being experienced, is characterised by a high mortality rate, an increasing amount of children in need of care and orphaned children and an increase in human pain and suffering. The law plays an important role in the limitation of the impact of the HIV/aids pandemic on the lives of children. HIV/aids law is in the process of evolution or forming and existing theories can be used in order to answer certain questions and address certain issues relating to it. However, there is an urgent need for HIV/aids-specific legislation and theories in order to successfully manage the impact of the pandemic on all levels. Child law has also reached such an extent of development that children is now viewed as a special interest group within the community. The legal principles regarding children change constantly and cannot be classified in the traditional way, which is either as private or public law. In this thesis the impact of HIV/aids on certain aspects of the public and private law pertaining to children is examined. Ways in which the impact can be absorbed and managed by the law is also examined. The impact of HIV/aids on divorce, the parent-child relationship, children in need of care, and the impact of HIV/aids on the lives of children is examined in separate chapters. / Jurisprudence / LL. D.

Text in Afrikaans / Die MIV/vigs-pandemie in Suid-Afiika- van die ergste in die wereld- toon geen tekens van afname nie. Miljoene kinders is reeds of wees gelaat of hewig geaffekteer deur die magdom impakte daarvan op gesinne en gemeenskappe. Die epidemie het voortdurend stygende sterftesyfers tot gevolg en die hewige las van die siekte rus swaar op MIV-positiewe sowel as MIV-negatiewe individue. Verder word tradisionele ondersteuningsnetwerke oorbelaai en/of gaan hulle tot niet. Gesinne en gemeenskappe verloor hul ekonomiese, sosiale en kulturele lewensvatbaarheid. Die pandemie hou, veral onder die armes, 'n geweldige bedreiging vir die gesondheid, welstand en regte van babas, kinders en jongmense in. 'n Groot gedeelte van die impak van MIV/vigs hou verband met die feit dat sommige kinders en hul gesinne beperkte toegang tot die elemente van 'n gesonde omgewing en goeie gesondheid het. Regerings, gemeenskappe en gesinne wat deur MIV/vigs geraak word, het minder tyd, energie en finansiële hulpbronne beskikbaar om op voorkomende gesondheidsorg te fokus. Benewens die impak op gesondheidstatus, word kinders se omstandighede ook as gevolg van MIV/vigsverwante probleme bemoeilik. Dit sluit verhoogde gesinsarmoede, 'n hoer risiko van verlating en weeslating, geforseerde migrasie, onterwing, sielkundige trauma, uitsluiting en diskriminasie, en fisiese en seksuele mishandeling in. Die derde vlaag van die epidemie, welke vlaag nou betree word, word gekenmerk deur 'n ontsettende hoe sterftesyfer, 'n ontploffing in die getal sorgbehoewende en weeskinders en 'n verhoging in menslike pyn en lyding. Die reg speel 'n baie belangrike rol in die beperking van hierdie impak van die MIV/vigs-pandemie op die lewens van alle kinders. MIV/vigs-reg is in die proses van evolusie of vorming en reeds bestaande teorieë kan aangewend word ten einde sekere vrae te beantwoord en probleme daaromtrent aan te spreek. Tog is daar 'n dringende behoefte aan MIV/vigs-spesifieke wetgewing en teorieë ten einde die impak van die pandemie op alle vlakke suksesvol te beheer. Verder het die Kinderreg so 'n mate van ontwikkeling bereik dat daar algemeen aanvaar word dat kinders 'n spesiale belangegroep binne die gemeenskap vorm. Die regsreëls met betrekking tot kinders verander gedurig en is ook nie geskik om volgens die tradisionele wyse, as privaat- of publiekreg, geklassifiseer te word nie. In die hieropvolgende proefskrif word die impak van MIV/vigs op sekere publiekregtelike, maar oorwegend privaatregtelike aspekte van die Suid-Afiikaanse kinderreg ondersoek, sowel as enkele metodes waarop die reg moontlik hierdie impak kan absorbeer en hanteer. Daar word ook in aparte hoofstukke na die impak van MIV/vigs op die lewens van kinders. sorgbehoewende kinders, egskeiding en die ouer-kind-verhouding verwys The HIV/aids pandemic in South Africa - one of the worst in the world - does not seem to be decreasing. Millions of children have already been either orphaned or heavily affected by the numerous impacts on families and communities associated with it. The epidemic brings on an ever-increasing mortality rate and the extreme burden thereof weighs down heavily on HIV-positive as well as HIV-negative individuals. Traditional support networks are further being heavily burdened or perish entirely. Families and communities lose their economical, social and cultural viability. The pandemic threatens, especially among the poorest, the health, wellbeing and rights of infants, children and young people. The impact of HIV/aids is to a great extent the result of the fact that some children and their families do not have sufficient access to a healthy environment and good health. Governments, communities and families affected by HIV/aids have less time, energy and financial resources available in order to enable them to focus on preventive healthcare. In addition to the impact on health status, children's circumstances are also being encumbered by HIV/aids-related problems, including family poverty, a higher risk of being abandoned or orphaned, forced migration, disinheritance, psychological trauma, ostracism and discrimination and physical and sexual abuse. The third wave of the epidemic, which wave is presently being experienced, is characterised by a high mortality rate, an increasing amount of children in need of care and orphaned children and an increase in human pain and suffering. The law plays an important role in the limitation of the impact of the HIV/aids pandemic on the lives of children. HIV/aids law is in the process of evolution or forming and existing theories can be used in order to answer certain questions and address certain issues relating to it. However, there is an urgent need for HIV/aids-specific legislation and theories in order to successfully manage the impact of the pandemic on all levels. Child law has also reached such an extent of development that children is now viewed as a special interest group within the community. The legal principles regarding children change constantly and cannot be classified in the traditional way, which is either as private or public law. In this thesis the impact of HIV/aids on certain aspects of the public and private law pertaining to children is examined. Ways in which the impact can be absorbed and managed by the law is also examined. The impact of HIV/aids on divorce, the parent-child relationship, children in need of care, and the impact of HIV/aids on the lives of children is examined in separate chapters. / Jurisprudence / LL. D.

Globally an estimated 33.4 million people were living with HIV/AIDS by 2008 (UNAIDS, 2009a:7). One of the main challenges facing the Republic of South Africa (RSA) today is the HIV/AIDS epidemic (NSP, 2007:17). By mid-year 2011 an estimated 5.38 million people (10.6% of the total population) were living with HIV/AIDS in the RSA (Statistics South Africa, 2011:2). Currently South Africa has the largest number of people enrolled in the Highly Active Antiretroviral Treatment programme (HAART) in the world (WHO, 2008:59). The objective of this study was to determine retrospectively the medicine treatment patterns of HAART at a district hospital in the North West Province of South Africa. The study was conducted at Thusong hospital in the Ditsobotla sub-district of the North West Province of South Africa. A non-experimental, retrospective, cross-sectional, drug utilisation research methodology was used to obtain the data. The target population included patients of all ages who visited Thusong hospital pharmacy during the data collection period, which commenced on 01 February 2012 and ended on 31 March 2012. The data of three hundred and ninety nine (N=399) adult and one hundred and sixty one (N=161) paediatric patients on HAART were used. The adult female patients accounted for almost 70% (n=276, 69.17%) and the adult male patients for only 30% (n=123, 30.83%). The male paediatric patients represented just over 60% (n=97, 60.25%), whereas the female paediatric patients comprised less than 40% (n=64, 39.75%). The majority of adult patients were unmarried (n=323, 80.95%) and this group of patients were also the youngest group (μ=36.38 ± 8.98 years) on ARV treatment. Almost 86% (85.96%, n=343) of adult patients were registered as unemployed. Ninety two (n=92, 23.06%) adult patients and fifty eight (n=58, 36.03%) paediatric patients defaulted treatment during the defined period. The investigation into the adult medicine treatment patterns revealed that more than half (52.38%, n=209) of all the adult patients were receiving regimen 1atn (EFV, TDF and 3TC), followed by 20.80% (n=83) on regimen 1a (EFV, D4T and 3TC). Most paediatric patients (n=73, 45.34%) were on regimen P1c (EFV, D4T and 3TC) and the second most (n=45, 27.95%) were on regimen P1a (D4T, 3TC and LPV/r). The average weight of adult female patients was 57.18kg (± 15.78kg) and the average adult male patient weighed 55.87kg (± 10.17kg) on initiation of HAART. The average adult male patient was initiated on HAART with a CD4 count of 130cells/mm3 (± 99.45cells/mm3), while for adult female patients it was 160cells/mm3 (± 96.52cells/mm3). The average male child was initiated with a CD4 count of 509.1cells/mm3 and the average female paediatric patient with 477.3cells/mm3. The average viral load for adult female patients on initiation of HAART was 103046copies/mm3 (± 189146copies/mm3) and for adult male patients it was 416600copies/mm3 (± 439746copies/mm3). The difference between the viral load of adult female and male patients were described as statistically (p=0.0006) and practically (d=0.713) significant. The average viral load for female paediatric patients on initiation of HAART was 242207copies/mm3 (± 709133copies/mm3) and for male paediatric patients it was 329734copies/mm3 (± 674532copies/mm3). Adult patients that received HAART at more than 12 consultations revealed an average weight gain of 3.43kg (± 8.11kg) from initiation of treatment. This group also showed an average increase of 214.71cells/mm3 (± 248.24cells/mm3) in CD4 count and an average reduction in viral load of 170944copies/mm3 (± 191854.69copies/mm3) from the day they started HAART up to the last date of receiving treatment. The paediatric patients on treatment for more than 12 consultations showed an average weight gain of 6.56kg (± 3.75kg) from initiation of ARV treatmentup to the last date of receiving treatment. They also showed an average increase in CD4 count of 396.63cells/mm3 (± 594.53cells/mm3) and a very encouraging average decrease of 538369.37copies/mm3 (± 948634.46copies/mm3) in the viral load. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

Globally an estimated 33.4 million people were living with HIV/AIDS by 2008 (UNAIDS, 2009a:7). One of the main challenges facing the Republic of South Africa (RSA) today is the HIV/AIDS epidemic (NSP, 2007:17). By mid-year 2011 an estimated 5.38 million people (10.6% of the total population) were living with HIV/AIDS in the RSA (Statistics South Africa, 2011:2). Currently South Africa has the largest number of people enrolled in the Highly Active Antiretroviral Treatment programme (HAART) in the world (WHO, 2008:59). The objective of this study was to determine retrospectively the medicine treatment patterns of HAART at a district hospital in the North West Province of South Africa. The study was conducted at Thusong hospital in the Ditsobotla sub-district of the North West Province of South Africa. A non-experimental, retrospective, cross-sectional, drug utilisation research methodology was used to obtain the data. The target population included patients of all ages who visited Thusong hospital pharmacy during the data collection period, which commenced on 01 February 2012 and ended on 31 March 2012. The data of three hundred and ninety nine (N=399) adult and one hundred and sixty one (N=161) paediatric patients on HAART were used. The adult female patients accounted for almost 70% (n=276, 69.17%) and the adult male patients for only 30% (n=123, 30.83%). The male paediatric patients represented just over 60% (n=97, 60.25%), whereas the female paediatric patients comprised less than 40% (n=64, 39.75%). The majority of adult patients were unmarried (n=323, 80.95%) and this group of patients were also the youngest group (μ=36.38 ± 8.98 years) on ARV treatment. Almost 86% (85.96%, n=343) of adult patients were registered as unemployed. Ninety two (n=92, 23.06%) adult patients and fifty eight (n=58, 36.03%) paediatric patients defaulted treatment during the defined period. The investigation into the adult medicine treatment patterns revealed that more than half (52.38%, n=209) of all the adult patients were receiving regimen 1atn (EFV, TDF and 3TC), followed by 20.80% (n=83) on regimen 1a (EFV, D4T and 3TC). Most paediatric patients (n=73, 45.34%) were on regimen P1c (EFV, D4T and 3TC) and the second most (n=45, 27.95%) were on regimen P1a (D4T, 3TC and LPV/r). The average weight of adult female patients was 57.18kg (± 15.78kg) and the average adult male patient weighed 55.87kg (± 10.17kg) on initiation of HAART. The average adult male patient was initiated on HAART with a CD4 count of 130cells/mm3 (± 99.45cells/mm3), while for adult female patients it was 160cells/mm3 (± 96.52cells/mm3). The average male child was initiated with a CD4 count of 509.1cells/mm3 and the average female paediatric patient with 477.3cells/mm3. The average viral load for adult female patients on initiation of HAART was 103046copies/mm3 (± 189146copies/mm3) and for adult male patients it was 416600copies/mm3 (± 439746copies/mm3). The difference between the viral load of adult female and male patients were described as statistically (p=0.0006) and practically (d=0.713) significant. The average viral load for female paediatric patients on initiation of HAART was 242207copies/mm3 (± 709133copies/mm3) and for male paediatric patients it was 329734copies/mm3 (± 674532copies/mm3). Adult patients that received HAART at more than 12 consultations revealed an average weight gain of 3.43kg (± 8.11kg) from initiation of treatment. This group also showed an average increase of 214.71cells/mm3 (± 248.24cells/mm3) in CD4 count and an average reduction in viral load of 170944copies/mm3 (± 191854.69copies/mm3) from the day they started HAART up to the last date of receiving treatment. The paediatric patients on treatment for more than 12 consultations showed an average weight gain of 6.56kg (± 3.75kg) from initiation of ARV treatmentup to the last date of receiving treatment. They also showed an average increase in CD4 count of 396.63cells/mm3 (± 594.53cells/mm3) and a very encouraging average decrease of 538369.37copies/mm3 (± 948634.46copies/mm3) in the viral load. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Due to a lack of research, which, in turn, resulted in a shortage of applicable literature that focused on the experiences and socio-emotional needs of family members as carers of AIDS-patients, the researcher decided to undertake this research project. The aim of this was to investigate the experiences and socio-emotional needs of family members as AIDS care givers. To lead the research, the researcher made use of a qualitative research approach. Attention was also given to the description of HIV/AIDS, as well as the prevention and treatment of HIV/AIDS. The impact of HIV/AIDS was also given attention, and it was done from an ecological perspective. Within the qualitative research paradigm a phenomenological, explorative, descriptive and contextual research design was utilised. The boundaries for data collection were delineated to the George area. Semi-structured interviews were conducted with family members who acted as primary care givers of AIDS-patients who were recruited by means of purposive sampling and the snowball sampling technique. The data collected were analysed according to the steps for qualitative data analysis as proposed by Tesch (in Cresswell, 1994). To ensure the trustworthiness of the research findings, data verification was executed according to Guba’s model (in Krefting, 1991). The following twelve themes emanated from the process of data analysis: - Knowledge of the disease - Caring for people with AIDS - Risky behaviour - Other people’s reactions - Care givers’ feelings and reactions - Support that was received with the care giving - Effect of the care giving on the relationship between the care giver and the patient - Changes in the care givers’ life because of the care giving of AIDS patients - Experiences regarding the dying process - Needs regarding the caring of the patient - Services that are needed - Advice from the participants to other family members as AIDS care givers. The following recommendations were made based on the conclusions derived from the research findings: Information sessions by Social Workers in collaboration with the different clinics on certain days; a community based project to recruit volunteers to support family care givers on a regular basis; look at facilities, like old age homes and hospices, that can give respite for a week to three weeks; connect family care givers to support groups in the community; make use of the media to give information regarding HIV/AIDS to the broader community; a centralized food and clothes bank from which care givers can draw affordable food and clothes. An application for funding can be done at the Department of Social Development or the Department of Health. Another recommendation that is made is to investigate the possibility of a community based project that provides cleaning and washing services to family members as care givers, as well as the patients. This can even become a job creation project. Other recommendations are: to investigate an alternative form of transport that is wheelchair accessible and patient friendly; to train home based carers to help family members as AIDS care givers; to train home based carers to be of assistance with counseling of patients with regard to their medication; to train home based carers as AIDS care givers to help family members to reach out to other support services or groups; that care givers should be careful about expectations of other people and that they should be confident enough to verbalize their expectations; that Social Workers should investigate if the family member, as AIDS care giver, as well as the patient, gets the necessary support on all levels of the ecological perspective, and if not, he/she must look at ancillary sources and mobilize it to give support to the family care giver as well as to the patient; that professionals need to keep in mind the advice the participants was given to other family members as care givers when they are working with these families. A recommendation was also made to do a follow-up research on the same topic in the White, Indian and Black communities and especially that further emphasis should be placed on their needs, as participation by this population groups were scarce or could not be obtained at all. / AFRIKAANSE OPSOMMING: Weens ‘n gebrek aan navorsing, en gevolglik ook aan literatuur rakende die belewenisse en sosio-emosionele behoeftes van familielede as primêre VIGS-versorgers, het die navorser besluit om hierdie navorsingsprojek te onderneem. Die doel hiermee was om die belewenisse en sosio-emosionele behoeftes van familielede as primêre VIGS-versorgers te verken en te beskryf. Om die navorsing te rig, is ‘n kwalitatiewe navorsingsbenadering vir die doel gebruik. Aandag is ook gegee aan die beskrywing en voorkoms van MIV/VIGS, asook die voorkoming en behandeling van MIV/VIGS. Die impak van MIV/VIGS is ook breedvoerig bespreek en is dit vanuit ‘n ekologiese perspektief gedoen. Binne die kwalitatiewe navorsingsbenadering is daar van ‘n fenomenologiese, verkennende, beskrywende en kontekstuele navorsingsontwerp gebruik gemaak. Die grense vir data-insameling het binne die George-area geval. Semi-gestruktureerde onderhoude is gevoer met familielede wat as primêre VIGS-versorgers optree, en wat deur middel van ‘n doelgerigte steekproeftrekking en die sneeubaltegniek vir deelname aan die navorsing gewerf is. Die ingesamelde data is ontleed aan die hand van die agt stappe van kwalitatiewe data-ontleding van Tesch soos uiteengesit in Creswell (1994). Guba se model soos dit in Krefting (1991:214-221) uiteengesit is, is gebruik om die vertrouenswaardigheid van die navorsingsdata te verifieer. Twaalf temas het na aanleiding van die prosesse van data-ontleding na vore gekom, naamlik: - Kennis van die siektetoestand - Versorging van VIGS-lyers - Risiko-gedrag - Ander mense se reaksie - Versorger se gevoelens en reaksies - Ondersteuning wat ontvang is met die versorging - Effek van pasiënt se versorging op die verhouding tussen versorger en pasiënt - Verandering van versorger se lewe as gevolg van die versorging van die VIGS-lyer - Belewenisse ten op sigte van die sterwensproses - Behoeftes ten opsigte van die versorging van die pasiënt - Dienste wat benodig word - Raad deur deelnemers aan ander familielede as VIGS-versorgers. Voortspruitend uit die navorsingsbevindinge, is tot sekere gevolgtrekkings gekom waaruit die volgende aanbevelings gemaak is: dat inligtingsessies deur maatskaplike werkers in samewerking met die verskillende klinieke op sekere dae gehou sal word; dat ‘n gemeenskapsprojek van stapel gestuur word om vrywilligers te werf wat op ‘n gereelde basis aan VIGS-versorgers ondersteuning bied; dat daar gekyk word na respite by ouetehuise of ‘n hospice vir ‘n tydperk van ongeveer drie weke om aan versorgers ‘n ruskans te gee; dat versorgers betrek word by ondersteuningsgroepe in die gemeenskap; dat die media gebruik word om inligting oor VIGS aan die breë gemeenskap deur te gee; dat aandag gegee word aan ‘n gesentraliseerde voedsel- en klerebank waarvandaan versorgers voorraad kan onttrek. Aansoek vir befondsing kan gedoen word by Departement Maatskaplike Ontwikkeling of Departement Gesondheid. Verdere aanbevelings wat gemaak kan word, is: dat ‘n gemeenskapsprojek van stapel gestuur word om skoonmaakdienste en hulp met wasgoed was tot die beskikking van die VIGS-versorger te stel wat selfs as ‘n werkskeppingsprojek begin kan word; dat ‘n alternatiewe vorm van vervoer wat deur die familielid en pasiënt benut kan word, en wat geskik is vir pasiënt vervoer, ondersoek sal word; dat opleiding van tuisversorgers as hulp vir familielede as VIGS-versorgers aandag sal kry; dat opleiding van tuisversorgers om behulpsaam te wees met berading van pasiënte rakende hulle medikasie dringende aandag sal geniet; dat familielede as VIGS-versorgers uitreik na ander ondersteuningsbronne vir hulp; dat versorgers versigtig sal wees ten opsigte van verwagtinge van ander, maar dat hulle ook vrymoedigheid sal neem om hulle verwagtinge te verbaliseer; dat die maatskaplike werker sal ondersoek instel of die familielid as primêre VIGS-versorger, sowel as die pasiënt, vanuit al die vlakke van die ekologiese perspektief die nodige ondersteuning geniet, en indien nie, moet daar gekyk word na hulpbronne en dit moet gemobiliseer word ten einde hierdie noodsaaklike ondersteuning te bied; dat die raad wat deur die deelnemers aan die navorsing aan ander familielede as VIGS-versorgers voorsien is, in gedagte gehou sal word wanneer met hierdie families gewerk word. ‘n Aanbeveling is ook gemaak dat opvolg navorsing oor dieselfde onderwerp gedoen word onder die Wit, Indiër en Swart gemeenskappe, en dat veral klem gelê word op hulle behoeftes, aangesien deelname vanuit hierdie bevolkingsgroepe skraal was, of glad nie bekom kon word nie.