published_or_final_version / abstract / Medical Sciences / Master / Master of Medical Sciences

The study was conducted to identify the sources of HIV/AIDS information used by residential university students on the Pietermaritzburg campus of the former University of Natal. HIV/AIDS is one of the scourges that the world is faced with. South Africa, before the 1994 elections, was fighting the obvious enemy, apartheid. The enemy now is the silent killer, HIV/AIDS. The future leaders, the students of this country, need to be challenged to behave in a manner that will bring about a change in their sexual behaviour, so that no students are lost to the AIDS epidemic and neither are the skills that they have acquired. The research was conducted at the then University of Natal (now known as the University of KwaZulu-Natal). The researcher administered a questionnaire to residential students of Pietermaritzburg campus to determine the sources of HIV/AIDS information used by them. There were four residences included in the study, namely Denison, Malherbe Hall, Petrie Hall and William O'Brien Hall. The study argues that it is time for the university sector and its partners to take stock of a situation that might quickly outpace the institutions. AIDS has become an everyday reality in the university system . There is a need for a clearer, more forceful definition of roles and responsibilities amongst all the partners in response to the epidemic. Provision of relevant information in an appropriate format needs to be an integral part of the University's response to HIV/AIDS. The study found that the residential students were generally satisfied with the existing sources of HIV/AIDS information. They did encounter problems in finding information in some of the sources given in the study. The study revealed that some of the sources of HIV/AIDS information were used more than others. The study suggested that the sources that are most frequently used should be utilised by information providers or university information stakeholders to disseminate information on HIV/AIDS among students. This study should help the University of KwaZulu-Natal to improve the information - related aspect of its HIV/AIDS intervention strategies at a time when the HIV/AIDS epidemic is threatening the academic sphere and the whole community at large. / Thesis (M.I.S.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.

Social workers are faced with the huge challenge of HIV and AIDS. The increasing number of HIV infected people requires professional intervention. The National Integrated Plan is currently the strategy that social workers apply in service delivery. It offers a range of services such as soup kitchens, food parcels, homework supervision, administration of anti-retroviral drugs and foster care placement to children infected and affected by HIV/AIDS. The bulk of the work facing social workers includes orphans, infected and affected children and child headed households. HIV and AIDS affect the education system in the sense that school going children are infected and affected by AIDS. The life-skills HIV/AIDS programme offered in schools is the strategy that the education system can effectively use to deal with the scourge of HIV/AIDS. Lifeskills HIV/AIDS programme offers educators, children and parents the opportunity to learn about preventative measures, factors that contribute to HIV/AIDS and childhood development. Primary caregivers need to learn about basic facts of HIV/AIDS. This study was a qualitative descriptive study to understand the views of primary caregivers on life - skills HIV/AIDS offered in school. The conceptual framework, which underpinned the study, was the eco-systems approach. The data was collected via in depth interviews with 10 respondents where an interview guide questions was used. The interview sessions were tape-recorded and transcribed. The outcomes of the study revealed that most primary caregivers were of the idea that their children should be taught life-skills HIV/AIDS in schools. The primary caregivers felt that this programme would assist them in understanding numerous behaviours that their children exhibit that predispose them to HIV infections. The findings of this study are tentative in view of the limitations identified in the study. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2007.

This study investigated selected Christian denominations in the Durban Functional Region's response to HIV/AIDS and the extent of their involvement within the issues of HIV/AIDS. The study also explored how the churches viewed the development of holistic services and hence their involvement with social workers. Seven of the so-called mainline Christian churches participated in the study. Interviews were conducted with the head of each denomination and one other member of clergy from each of the seven denominations. The study was exploratory in nature. Data was collected using semi-structured interviews with the participants being selected utilising purposive and availability sampling. The literature review comprised theological reflection on what the church's role should be as well as literature exploring the necessity for holistic services in the ambit of HIV/AIDS. Some of the findings of this research included the lack of knowledge clergy have around HIV/AIDS, the lack of knowledge some clergy have about their denominational policies regarding HIV/AIDS, and the limited response of some congregations to the pandemic. There is also a sense of negativism amongst some clergy about HIV/AIDS. There is no hope of the promise the Christian faith gives. The recommendations that stemmed from this research are the training of clergy in HIV/AIDS, training of clergy regarding their denomination's policies and offering practical advice on how a church can respond, the need for the dissemination of this information to all role-players so that a holistic service can become a reality, and finally that more extensive research is done into the church and HIV/AIDS. / Thesis (M.A.)-University of Natal, Durban, 2003.

Background Patients infected with the human immunodeficiency virus (HIV), the causative agent of the acquired immunodeficiency syndrome (AIDS), have high rates of psychiatric morbidity. The effects of HIV on the Central Nervous System may lead to psychiatric morbidity even before the appearance of the full-blown AIDS syndrome. Sero-prevalence studies of patients with psychoses have found an estimated 5-20% to be HIV positive. However, sero-prevalence estimates vary from study to study due to the differences in sampling by geographic location, socio-economic class, race and ethnicity, and psychiatric-diagnostic composition. The Republic of South Africa has some of the highest prevalence rates in the world and research in this field is escalating rapidly. However research on HIV in patients with mental illness, particularly psychosis is very sparse. Aim of the study To determine the prevalence of HIV sero-positivity amongst patients admitted to Town Hill hospital presenting with first episode psychosis. Method All patients presenting to Town Hill hospital with first episode of psychotic symptoms were recruited to participate in the study. The treating doctor in collaboration with the multi-disciplinary team made the diagnosis of Psychosis. A total number of 63 patients participated in the study. Results. 23.8% of the patients tested positive for the human immunodeficiency virus. Conclusions. The prevalence of HIV sero-positivity is high amongst patients presenting with first episode psychosis. The HIV epidemic could have an important effect on the aetiology and clinical presentation of psychosis. Recommendations State mental health authorities should pursue the promotion of voluntary HIV testing programs, in patients presenting with first episode psychosis as soon as they are capable of giving informed consent. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2007.

People living with Human Immunodeficiency Virus (HIV) have been stigmatized since the epidemic began. Evidence suggests that stigma and discrimination contribute towards perpetuating the epidemic. South Africa has the largest number of people living with HIV in the world. Reducing stigmatization may therefore be an important factor in reducing new HIV infections. Studies in other countries have shown that people who possess inaccurate knowledge regarding the way HIV is transmitted have a greater tendency to stigmatize. Furthermore it was found that people who stigmatize are more likely to engage in risky sexual behaviour and to perceive themselves to be at low risk of contracting HIV. Wave 2 of the Transition to Adulthood study which took place in 2001 interviewed 4185 young people in KwaZulu-Natal on their sexual behaviour. This present study has linked respondent’s levels of HIV transmission knowledge to their stigmatizing attitudes. It was found that accurate knowledge had a significant impact on stigmatizing attitudes. Those respondents who possessed less knowledge were significantly more likely to stigmatize. Differences between levels of stigmatizing were also evident between race groups. Characteristics important to HIV prevention such as condom use and HIV testing were also linked to knowledge and stigmatizing. Respondents who had less knowledge and thus a greater tendency to stigmatize were more likely to have adverse attitudes towards using condoms. These respondents were therefore more likely to engage in risky sexual behaviour. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

The aim of the study was to explore nurses' experiences, attitudes and perceptions regarding the care of patients with the Acquired Immunodeficiency Syndrome (AIDS) before and after the introduction of Anti-Retroviral Therapy (ART) in a rural KwaZulu-Natal hospital .. A secondary aim was to investigate psychosocial stressors that nurses experience and the support they receive in this regard. A qualitative study was conducted and three focus group discussions were conducted before the introduction of ART and five individual interviews were used for in-depth exploration of the health care workers' perceptions of caring for AIDS patients after the introduction of ART. Special attention was paid to nurses' experiences with AI DS patient care and with attention to stress and coping. The AACN Synergy Model was used as a broad theoretical framework for the study to guide the exploration regarding the influence of both nurse and patient characteristics influence the care process within a rural South African context. The findings suggested that before the introduction of ARV-therapy most patients had limited knowledge and understanding of HIV/AIDS disease and its processes. They and other significant others who could be a family member or even friends were marginally involved in the care process. Voluntary Counseling and Testing (VCT) seemed to impact negatively on this situation, and patients were not willing to test and disclose their status to health workers. The knowledge around HIV/AIDS among nurses seemed to be inadequate due to the lack of support and training. They reported being inadequately equipped to deal effectively with caring for their AIDS patients. After the introduction of ARV-therapy, greater involvement of patients on ARV treatment was noted. The participation of significant others in patient management also improved possibly due to their involvement as treatment associates, a requirement of the ART programme. However, the nurses still reported inadequate knowledge not only around AIDS in general but also pertaining ART as well as in the provision of psychosocial support to their patients. The study also revealed that the Synergy Model for patient care, which compares the patient characteristics to nurse competencies can be used to gain insight into patient care and its demands. This model has also suggested weaknesses in nurses' training that need attention. Nurses are expected to use insight into patients needs to improve their competencies to meet the challenges of AIDS patient care and to fulfill their mandate as the key stakeholders on patient care. Lazarus and Folkman's (1984) views on stress and coping were useful in identifying the nurses' coping strategies. The study highlighted specific areas in need of intervention. Formal and informal teaching for both nurses and the patients on HIV and AIDS management needs to be introduced. Patients and families' involvement in decision making and HIV/AIDS disease management should be expanded. HIV counseling and all its components, which are pre- and post-counseling as well as on-going disease management counseling needs to be re-evaluated. There is a need to advocate for a more patient orientated counseling rather than test orientated counseling. Psychosocial support to nurses should be a priority to help them cope with their stressful AIDS caring work. Advocacy for a worker friendly Employee Assistance Program (EAP) should be encouraged by the managers of the institution. Intra-disciplinary and inter-disciplinary communication needs to be improved through innovative strategies. The address of the AI DS stigma within the healthcare system remains a priority and this aspect needs to be incorporated at different levels i.e. basic training, in counseling and within the psychosocial support efforts directed at nurses. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Voluntary Counselling and Testing (VCT) is known as the key component of HIVprevention and treatment programmes in workplace settings. The main objective of this study was to explore factors affecting the uptake of VCT amongst employees in the private sector. This study was also indirectly aimed in examining the effectiveness of HIV-prevention and treatment programmes in workplace settings. The Social cognitive theory (SCT) was adopted as the core theoretical framework in this study. The SCT explains behaviour change as a complex phenomenon and a product of multiple, complex factors embedded on the individual’s characteristic and his/her surrounding environment. This theory recognises the strength of other health promotion theories such as the health belief model (HBM), theory of reasoned action (TRA) in explaining behaviour change, but it mostly helps to provide a more holistic and coherent understanding of the complex factors affecting VCT uptake. This was a qualitative case study. Individual, semi-structured interviews were utilised to collect data from 6 male and 4 female participants, who are employees of a courier company operating around Durban. This company implemented an HIV/AIDS policy about 10 years ago, with an aim to introduce HIV-prevention and treatment initiatives, and to facilitate easy access to these initiatives within the workplace setting. Data was analysed using thematic analysis. Themes were analysed and discussed in relation to the topic of the study. Factors that affect VCT in the workplace were categorised thematically and critically discussed as findings of the study. Despite the convenient and easily accessible VCT and ART initiatives, rapid testing and onsite nature of VCT campaigns, the uptake of VCT appeared to be relatively poor within the compnay. The perceived lack of confidentiality regarding results, fears of stigma and discrimination, as well as organisational factors, were identified as barriers to the success of HIVprevention and treatment initiatives in this company. In light of these findings, the study recommends measures that might help improve service delivery. The study also contributes to the body of knowledge with respect to challenges facing HIV-prevention and treatment initiatives in workplace settings. / Thesis (M.Soc.Sci.)-University of KwaZulu-Natal, Durban, 2010.

This critical interpretivist case study explored students’ experiences of an HIV/AIDS service learning module run in the School of Psychology at the University of KwaZulu-Natal. The study was originally initiated in response to a request from CHESP to evaluate this module. It has since become an independent study with the purpose of exploring the kind of learning (HIV specific) that students gained from the module. A number of studies have attempted to explore students’ experiences of service learning through students’ evaluations, or have focused on the effects of the community intervention on the community. These are often of a quantitative nature and do not engage with students' experiences on a deeper level. They also tend to focus on measuring students’ knowledge and understandings of HIV/AIDS. The objective of this study was to qualitatively explore whether students had experienced a genuine engagement in the service learning module, focusing on their level of reflection on their identities, their understandings of self and other, and their understandings of their own location within the HIV/AIDS epidemic. Furthermore, there would need to be evidence of Freireian critical consciousness. Using the voicecentred relational method of analysis, reflective essays of the 20 students who completed the service learning module in 2006 were analysed. The findings of the study revealed that most of the students had engaged at this level and were able to reflect on a number of critical issues that are pertinent to the HIV/AIDS epidemic. This study provides the impetus for further research to be conducted in the field of service learning, as it is a valuable educational tool for getting students to engage critically and openly with issues around sexuality and HIV. Moreover, the findings of this study should be used to promote service learning with a focus on HIV/AIDS in other degree programmes, as well as other tertiary institutions. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Chantal Mouffe has proposed a theory of political engagement or “citizenship” that rejects fixed, essential definitions to “the political”. With her pluralistic, non-essentialized political subject, she hopes for a means by which different political struggles can be linked together rather than ordered hierarchically or exclusively. Here citizens are associated in distinct but related struggles, rather than by legal status or community membership. A crucial point in her argument is that political theorists must look for new “spaces” of politics. Since she never expands on this call, we are left with little more than spatial metaphors that fix the locations where citizenship might be found. Political theory typically plots three separate spheres to describe people’s lives: the state, civil society, and the family. By spatializing these metaphorical locations I have taken up her call and explored the emergence of citizenship across these spatialized social relations through an ethnography on AIDS politics in Vancouver, Canada. For each allegedly discrete space in political theory, I note an ongoing restructuring that affects and is affected by the articulation of citizenship with the changes in social relations in place. These restructurings suggest that fixed, essentialized characterizations of space must also be rejected. I sketch the considerable overlap between social relations of state, family, and civil society in locations across Vancouver’s AIDS politics. Radical civil disobedience failed because activists failed to understand the overlap of state and civil society through AIDS service organizations. Within those agencies, political engagement is caught between grassroots community orientations (civil society) and the emergence of a large, rapidly bureaucratizing service system attached to the state. Volunteers who provide all manner of support (from social work to kinship) for people living with AIDS likewise complicate any clearcut distinction between state and family. The overlap of the family with civil society is illustrated by the Vancouver display of the AIDS Quilt. It was at once a fundraising event held in civil society, yet it was also a familial space: allowing families and friends to grieve and mourn their dead. Spatial overlaps enabled (and also constrained) citizenship, as Mouffe defines it. These hybrid spaces articulate de-centered citizens with the ongoing restructurings of state, civil society, and family that are concurrent to the AIDS epidemic. Consequently, I conclude that future work on radical democratic citizenship consider the contexts in which the citizen engages in political struggle.