Thesis (MSD (Play therapy))--University of Pretoria, 2003. / Includes bibliographical references.

Thesis (M.S. in human nutrition)--Washington State University. / Includes bibliographical references.

Thesis (PhD(Social Work))--University of Pretoria, 2009. / Includes bibliographical references.

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2003. / Vita. Includes bibliographical references.

Thesis (M.A. (Psychology))--Rhodes University, 2003. / Submitted in partial fulfillment of the requirements for the degree of Master of Arts.

published_or_final_version / Pharmacology and Pharmacy / Doctoral / Doctor of Philosophy

Thesis (MTech. degree in Public Management) -- Tshwane University of Technology, 2010.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

The vast majority of paediatric HIV occurs in sub-Saharan Africa and could be averted through implementation of effective Prevention of Mother to Child Transmission (PMTCT) strategies. At the United Nations General Assembly Special Session on HIV/AIDS in 2001, members committed themselves to the goal of reducing paediatric HIV by 20% by 2005 and by 50% by 2010. In South Africa, rates of HIV infection range between 28% in KwaZulu-Natal and 16% in the Western Cape. The South African National Department of Health has, over the past few years, phased in a comprehensive package for PMTCT of HIV. KwaZulu-Natal implemented its programme in 2002. The South African private healthcare sector follows guidelines of those of developed countries for PMTCT. Not much data is available of the outcome of infants born to HIV positive mothers managed in private practice. In view of this, the present study aimed to assess success or otherwise of PMTCT in private paediatric practice in South Africa. Eight of the 20 private paediatricians, in the central region of Ethekweni Metro of KwaZulu-Natal (Durban Central Area), agreed to participate in a retrospective study. Data for all their HIV exposed infants between January 2004 and June 2005 were reviewed. One hundred and one Black African infants were born to 100 HIV positive women aged 29.85 years (SD 5.38; range 18-44 years). The median CD4 count was 426 (IQR 244-613). The median viral load at first presentation was 3.97 logs (IQR 1.6-5.8) or 11 391 copies/ml (IQR 2 013-41 502). Eighty six women had HAART, nine had other antiretroviral therapy and five had no prophylaxis. Treatment started before 34 weeks in 72 women. There were 93 caesarean sections. There were 20 low birth weight neonates, 18 were preterm and all had been formula fed and received AZT for six weeks. Of the 92 tested, two (one preterm) were positive. Although caesarean deliveries, both these mothers had not adhered to the optimal treatment protocol. Of the rest, eight did not return for HIV testing and one died (the only neonatal death). This death was unlikely to have been HIV related. The transmission rate of less than one percent in those women who followed the protocol optimally is much better than that in the SA public sector, and is consistent with transmission rates in the developed world. / Thesis (M. Med.)-University of KwaZulu-Natal, Durban, 2009.

This thesis reports on a formative evaluation study conducted, firstly, to inform an adaptation of the Collaborative HIV Prevention and Adolescent Mental Health Program (CHAMP) so as to strengthen the adult protective shield in order to prevent high risk behaviour and HIV among children in the targeted community in Embo, Kwadedangendlale, KwaZulu-Natal (Study 1); and secondly, after a pilot intervention, to evaluate the adapted programme in order to understand the processes involved in strengthening the adult protective shield (Study 2). The research design for both Study 1 and Study 2 was qualitative in nature. More specifically, the two studies used a focused ethnographic case study approach. Thematic content analysis was used to analyse the data from both studies and three theoretical approaches facilitated the understanding of the data: Joffe’s psychoanalytic extension of social representation theory, Carpiano’s integrative theory of social capital, and Campbell and Murray’s critical approach to community health psychology. The participants in the first study were a volunteer convenience sample of parents of children aged 9-12 years from a school in the targeted community. Focus groups and in depth follow up interviews were conducted with the parents. Interviews were also conducted with key members of the community. At the community level, lack of containment emerged as an overarching theme, with splitting and lack of trust as subthemes interpreted as emerging to deal with anxiety. Anxiety was also linked to stigmatization of people suspected of being HIV positive or having AIDS. Coping mechanisms used to deal with stigmatization were silence and denial. Linked to the issue of stigmatization was that of death and bereavement. At the family level, disempowerment of caregivers emerged as an overarching theme creating anxiety for parents, one of the sources of which was the generational knowledge gap, with parents being generally less educated than their children. This was linked to two issues: that of children’s rights; and parents’ attempts to resort to severe forms of authoritarian parenting. In the second study, in-depth semi-structured interviews, based on the themes that had emerged from the pre-intervention focused ethnographic study, were conducted with a volunteer convenience sample of nine mothers who had been part of the CHAMPSA intervention. Two broad themes emerged: Individual empowerment, including the subthemes parental empowerment, women empowerment, and social support and social leverage; and collective empowerment, including the subthemes informal social control and community organisation, and HIV/AIDS stigma. The findings of the second study contributed to the development of a model showing how improved parent child communication and parental HIV knowledge at the individual level as well as renegotiated, empowered parental identities facilitated through the group process restored parental authority at the individual level as well as collectively, strengthening social capital and restoring the adult and community protective shields. / Theses (Ph.D.)-University of KwaZulu-Natal, Durban, 2011.