The dissertation seeks to investigate, examine, and critically analyse the reasons why Pietermaritzburg churches lack gender sensitivity in combating HIV/AIDS. The dissertation's focus is on Springs of Hope Support Group Project (SOH) - a support group that seeks to meet the felt needs amongst the HTV positive people around Pietermaritzburg. Amongst other motivations, the dissertation was undertaken as a contribution to the church in its fight against the spread of HIV/AIDS in South Africa. The methodology that was used involved field and library research as well as observations of other HIV/AIDS support groups. The primary source of this dissertation consists of interviews that were conducted among SOH members, NGOs workers, and Church ministers. Chapter one is an introduction to the whole dissertation and includes an introduction to chapter one, experiences of African women, the story of Ann Ntombela, the background of the study, statements of the problems and motivations, objectives of the study, research hypothesis/promises, significance of the study, the theoretical frameworks, critical reviews of existing literature, research methodology, research ethics, expected results, limitation of the study and a summary and conclusion. Chapter two deals with the negative effects of colonialism and failure of development on African women. Its objective is to unearth the factors behind the deplorable social, political, and economic position of African women before HIV was reported. It seeks to find out why the plight of African women has worsened since the coming of colonialism and the start of development efforts. Chapter three deals with gender. It relates the effects of development failure to the plight of African women. Matters of marginalization, exploitation and oppression of African women are dealt with at length. Chapter four focuses on HIV/AIDS infection, transmission, prevention, cure and treatment. It also tackles the matter of the vulnerability of African women to HIV/AIDS at length by relating chapter two to the realities that facilitates the infection of the virus especially on women. Chapter five deals with the field research and formulation of a gender sensitive approach to combating HIV/AIDS. It also seeks to formulate 'a church based gender sensitive approach' as the way forward in combating the spread of HIV/AIDS amongst African women in Pietermaritzburg. This chapter elaborates on how the church should reposition itself in order to be relevant and effective to women who are HIV positive. Chapter six is the conclusion of this dissertation. It includes a summary, a theological reflection and conclusion of the whole dissertation. / Thesis (M.Th.)-University of KwaZulu-Natal, PIetermaritzburg, 2004.

The spread of HIV/AIDS in South Africa has evoked many responses from the national government, Non-Governmental Organizations and the church. There are many reasons why the church should respond to this challenge of HIV/AIDS and join hands with the worldwide effort to provide care and support for people living with HIV/AIDS in our society. As the epidemic increases, many people in South Africa are falling sick, suffering physically, emotionally and spiritually and many are abandoned and desolate. Men, women, young people and children are dying; families and communities are severely affected socially and economically. This thesis examines the response of the Evangelical Lutheran Church in Southern Africa (ELCSA) to AIDS and suggests a more adequate strategy to deal with HIV/AIDS. First, it examines the incidence and· impact of HIV/AIDS, noting the emotional, physical and socio-economic impact of HIV/AIDS. Secondly, this thesis develops a theological response to AIDS. The involvement of ELCSA is examined via research into six parishes in the Umgeni circuit of the South Eastern Diocese (Kwa-Zulu Natal). It argues that a seven-fold framework best describes the sort of strategy needed to fight against the spread of HIV/AIDS. This seven-fold framework includes the following: AIDS education, AIDS counseling, Livelihood support for people living with HIV/AIDS, Advocacy for the people living with HIV/AIDS,Pastoral and practical care for people living with HIV/AIDS, Helping the bereaved families during funeral arrangements and providing grief counseling, and Support systems for AIDS orphans. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2001.

The essential question behind this thesis is: How can we respond to the pastoral needs of Christian Indians in Northdale/Raisethorpe, with regards to the HIV/AIDS pandemic, when there is this silence among those that are infected and affected and the lack of concern from the church ? This topic desires to research the silence among the Christian Indians of Northdale/Raisethorpe to look into the possibility that it is a myth that HIV/AIDS is not a threat to the Christian Indians of Northdale/Raisethorpe. Certain aspects of this problem need to be investigated to prove the myth and to open an avenue for pastoral counselling and care. In this investigation I intend to revisit and open a new dialogue with the clergy to set up combined structures that will alleviate the suffering in the Northdale/Raisethorpe community in regards to the HIV/AIDS pandemic. The interview collections and research findings support the hypothesis that it is a myth that HIV/AIDS is not a threat to Christian Indians of Northdale/Raisethorpe. / Thesis (M.Th.)- University of Natal, Pietermaritzburg, 2002.

Through the oral history approach, this study documents shifts in the pastoral agency of manyano leaders in the HIV and AIDS context of the KwaZulu-Natal Midlands from 1990-2000 and 2000-2010. The two time periods are significant as they mark changes in socio-economic and socio-political influences on HIV and AIDS in South Africa. The model used to investigate the agency of the manyano leaders has been drawn from James Scott’s (1990) theory of power relations between dominant and subordinate groups. Scott’s (1990) theory guided this study in analysing the agency of manyano leaders in two ways. Firstly, the theory guided the study’s analysis of the interviews beyond the superficial level to uncover discourses that in Scott’s (1990) terms operate in the public realm, hidden realm and in the realm of ‘infrapolitics’. Secondly, Scott’s (1990) theory helped uncover some of the shifts in the subversive agency of the manyano leaders’ response to the HIV and AIDS epidemic during the two time periods of 1990-2000 and 2001-2010. In both periods, the manyano leaders’ agency revealed that they opt for just and liberative responses on behalf of those that have been marginalised by the epidemic. The study revealed that in the first period, the agency of the manyano leaders’ faced more resistance in the public realm due to dominant political, religious and social attitudes that fuelled HIV and AIDS-related stigma and denial. As a result, much of their response to challenges raised by the epidemic took place in the hidden realm. In the second period, discourses of HIV and AIDS became more public and as a result, this study has argued, their agency has also become more public. From the results of this study, lessons have been drawn that contribute to a critical appreciation of manyano leaders’ pastoral agency in the context the HIV and AIDS epidemic in the KwaZulu-Natal Midlands. / Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

Background: Despite years of implementation, the program for PMTCT is not reaching the HIV positive pregnant women. Poor documentation as well as poor monitoring and evaluation for the program has contributed to the poor performance. This has led to South Africa being one of the 12 countries in the world with an increasing child mortality rate which is related to HIV/AIDS. Multi-steps and the complexity of the program and poor documentation have resulted in gaps in the provision of care. Objective: The aim of the study was to assess the documentation of the core activities of Prevention of Mother-to-Child Transmission of HIV program provided to pregnant women from antenatal, maternity and post-natal care at a selected Regional hospital in Ethekwini District. Methods: A non-experimental retrospective descriptive exploratory design informs the study. Provides a description of whether the activities of PMTCT are perfomed through the use of documented activities on patient’s charts. A data extraction tool was used to extract information, with the demographic information as well as the key activities of PMTCT. One hundred and thirty charts of women who had delivered in the hospital of study were sampled. Results: The study revealed gaps in the documentation of some activities, with dual therapy initiated at antenatal clinic documented to be n=98(75%), whilst NVP to the baby was 105/130 (80%). The results are in contrast with Horwood’s (2010) study which reported 91% receiving the Nevirapine prophylaxis. Although there are children missed by the program, it is interesting to note that more babies are receiving prophylaxis compared to women receiving NVP. The cd4 count, n=78(60%) uptake, seems not to be doing well, with only n=45(35%) , which is supported by Horwood’s (2010) study that showed much improvement in the cd4 uptake (70%) compared to the study results of 60%, but less cd4 results documented were reported by Horwood (2010), showing 33% respectively. Conclusion: The National strategic Plan’s (SADOH, 2007- 2011/2013) for South Africa, as well as the global Millennium Development Goals can only be achieved if all the activities for the PMTCT are improved. Documentation of activities remains the key to improved care. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

Background. People living with HIV/AIDS (PLWHA) are not always cared for by nurses who are competent to deal with mental health problems (MHP) in Blantyre district, Malawi. Little is known regarding nurses’ perceptions about their ability to provide mental health care in the district’s general settings. Purpose. The purpose of the study was to explore nurses’ perceptions about their provision of mental health care to PLWHA in Blantyre district. Methodology. A quantitative study was conducted to explore nurses’ perceptions about their provision of mental health care to PLWHA in Blantyre. Permission was granted by relevant authorities to conduct the study. Between March and April 2010, 165 nurses were randomly sampled from all wards and other departments at a central hospital and five selected health centres. They gave a written consent before joining the study. 151 questionnaires which were completed at participant’s convenient time were personally collected. Descriptive statistics were used to analyse data and nonparametric tests were also used to explore associations amongst variables. Findings. This study found that nurses’ perceptions about their provision of mental health care to PLWHA vary. Most nurses reported positive perceptions about caring for PLWHA who have MHP in general settings although some had negative perceptions. It was apparent that a relationship exists between nurses’ willingness to deal with MHP and perceptions about their knowledge, skills and access to support from mental health specialist. The perceived lack of knowledge, skills and support from mental health specialists were identified as reducing nurses’ ability to provide relevant mental health care to PLWHA. Conclusion. Conclusively, it is logical to say that the more support nurses receive from mental health specialists, the more knowledgeable and skilled they will become in dealing with MHP and, consequently, these nurses may demonstrate more willingness to deal with MHP of PLWHA. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2010.

This study was an investigation into the clinical judgments made by counseling psychologists when faced with a patient who had major depression and AIDS. Two hundred and eighty one counseling psychologists evaluated one of four vignettes depicting an individual with major depression. In three of the vignettes the individual also had AIDS but the vignette varied on how the virus was contracted (unprotected gay sex, IV drug abuse, hemophilia). In the fourth vignette (the control group) the individual did not have AIDS. Results of the study suggested, that the presence of AIDS overshadows the evaluation and treatment decisions made by counseling psychologists when their patient has major depression and AIDS. Three factors-counseling psychologists' general experience with people who have AIDS, their clinical experience with AIDS patients and how the AIDS virus was contracted-were investigated for possible moderating effects of the overshadowing bias. How the AIDS virus was contracted was used as an indirect measure of clinician attitude toward people with AIDS. Neither general or clinical experience with AIDS patients appeared to have an effect on the diagnostic or treatment decisions made by counseling psychologists when evaluating depressed patients with AIDS. As with experience, method of contracting the AIDS virus did not have a moderating effect on the overshadowing bias. Implications of these results for the evaluation and treatment of depression in AIDS patients, as well as future research are discussed. / Department of Counseling Psychology and Guidance Services

Studies on the impact of HIV/AIDS on health workers conducted in the health sector in different countries in Southern Africa have shown that health workers are affected and infected by HIV/AIDS. This has affected the provision of care rendered by nurses negatively. The high workload emanating from increased numbers of patients contributed to the situation. As a result, a number of nurses suffer from stress related illnesses caused by many factors such as fear of contracting the HIV virus. Low staff morale has also been observed among nurses. The aim of this study was to study nurses perceptions, views and suggestions on the impacts of HIV/AIDS on the provision of health care in terms of increased workload, stress, low morale and fear of contracting HIV/AIDS in two medical wards and a TB ward in one regional hospital in Namibia.

Each year approximately 600 000 infants, most of them in Sub-Saharan Africa are born with HIV infection as a result of mother to child transmission of HIV. Whereas significant progress has been made in reduction of mother to child transmission of HIV in developed countries, the situation remains desperate in developing countries. Progress has been hampered by shortage of staff, facilities, limited access to voluntary counselling and testing and lack of support for women by their partners and communities. The challenge is to increase voluntary counselling and testing uptake during antenatal care. Onandjokwe district in Northern Namibia is currently introducing the Prevention of Mother to Child Transmission Program (PMTCT). It has been found the previous PMTCT programs have failed because they adopted a top down approach where there was no community consultation. This study was conducted to explore the community perceptions, knowledge and attitudes regarding mother to child transmission of HIV through focus group discussions and in-depth interviews of key community members.

This thesis examines HIV disease natural history and response to antiretroviral treatment (ART) in patients from The TREAT Asia HIV Observational Database (TAHOD), a mulitcentre, prospective observational cohort of HIV-infected patients from countries in the Asia-Pacific region. By September 2005, 2979 patients have been recruited to TAHOD from 15 participating sites. The majority were male (73%), median age 37 years. Chinese (37%), Thai (25%) and Indian (17%) were the main ethnicities. Most patients reported HIV infection through heterosexual (59%) and homosexual contact (23%); 5% injecting drug use. At baseline, 41% of patients were diagnosed with AIDS defining illness, and 77% were being treated with highly active antiretroviral therapy (HAART). Baseline and retrospective data suggest that the overall response to HAART in TAHOD is similar to that seen in western cohorts, with mean CD4 count increase of 115 cells/μL and 69% achieving a viral load less than 400 copies/mL six-month after HAART initiation. Baseline CD4 count was the strongest predictor of short-term disease progression. Prognostic models based on routine clinical data and haemoglobin gave a good estimation of disease progression. The rate of new AIDS defining illness was 26% in the first 90 days after HAART initiation, which may partly be due to immune reconstitution syndrome occurring shortly after treatment. The most frequently used first-line ART combination was stavudine/lamivudine/nevirapine. Approximately 22% of patients receiving this treatment changed or stopped at least one drug in the first year, with adverse effect (including lipodystrophy, hepatitis, rash and peripheral neuropathy) the major reasons. The rates of discontinuation of efavirenz or nevirapine as part of HAART were similar (16 vs. 20/100 person years). Older age and positive HCV antibody were associated with an elevated liver function (ALT) test. Both prevalence of HBV and HCV coinfection with HIV were approximately 10%. The impact of hepatitis coinfection on immunological and virological responses to ART and HIV disease progression was not statistically significant. Both HBV and HCV remained independently associated with elevated ALT in the multivariate models. The overall HIV disease progression and response to ART in TAHOD patients were similar to those seen in the western countries.