M.A. (Psychology) / The Acquired Immunodeficiency Syndrome not only threatens the world with hitherto unknown rates of mortality and economic ruin, but has also saddled the health sciences with an unprecedented challenge in curing and managing this disease. Herein, the health sciences have not found a cure, and the management of the disease is made extremely difficult because of the unpredictable nature of the interrelationships in biopsychosocial factors inherent in the disease. In order to attempt a description of the complex interrelationships between biopsychosocial factors in this disease, a group of twenty patients in a treatment programme comprising of an exercise and cognitive-behavioural intervention, were subjected to immunologic and psychological assessment before and subsequent to the intervention. The data obtained indicated that none of the interrelationships between psychological and immunological variables predicted by psychoneuroimmunological science existed prior to the intervention. It would appear that the interrelationships between these variables were in total disarray - defeating the object of systematic logical description of biopsychosocial factors in this condition. The post- intervention data suggested a pattern of interrelationships totally within the confines of predicted neuropsychoimmunologic patterns of a biopsychosocial interaction in a disease of immunologic origin. This pattern of predictability would then render possible a treatment programme of a multidisciplinary nature which would bear predictable fruit. It also underscores the necessity of psychological interventions as an adjunct in the treatment of AIDS.

M.Cur. (Psychiatric Nursing) / Please refer to full text to view abstract

Please read the abstract (Summary) in the section 00front of this document. Please note: The Errata list is included as last page of each chapter / Dissertation (MA (Clinical Psychology))--University of Pretoria, 2007. / Psychology / unrestricted

This pilot study aimed to contribute to the development of a methodology for researching various aspects of the relationship between HIV/AIDS and suicide in South Africa. To date, few systematic studies into this relationship have been conducted in South Africa. Specifically this study investigated the aspect of suicidal ideation in relation to HIV seroposivity, CD4 cell counts and social support. Although this study did not find increased suicidality in this sample of people living with HIV, the findings highlighted variables that may need to be studied in greater depth and outlined suggestions for further research methodology. Further research could indicate the extent to which suicide assessment and counselling is needed for people living with HIV/AIDS. This in turn could inform policy makers as to the inclusion of suicide assessment into the protocol for Voluntary Counselling and Testing (VCT). / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

This study explores the subjective experiences of persons who have been informed of a positive HIV antibody test and, from their point of view, explains the meaning and impact that HIV discovery has on their quality of life. In this qualitative narrative study, a racially specific, low-income sample of 10 HIV-infected men and women shared their stories of living with the virus during in-depth interviews. Findings of a multi-staged narrative analysis suggest that for people like those in this study, stigma associated with mv infection results in the concealment of the diagnosis by the individual for fear of being labeled as deviant from the rest ofthe community. Secondly, the tragic manner in which these respondents narrated HIV discovery signifies the negative impact the disease has on their quality of life. Lastly, there is evidence for the effectiveness ofthe primary health-care services on the HIV positive patients. Implications for these findings are elaborated. / Thesis (M.Soc.Sc.)-University of Natal, Pietermaritzburg, 2000.

D.Phil. / This thesis presents an intervention programme that aims to facilitate anger-expression and takes psychosocial and immunological variables into account. The present research argues that if the effects of the programme are validated, similar programmes may yield similar benefits for other participants in future intervention programmes in a South African context. The nature, course and effects of the HIV disease are described and include specific processes and mechanisms of influence in physical, mental and social terms. Biological processes that result from immunological deficiencies causing AIDS are analyzed and an explication of disease progression is offered. Psychological and social aspects related to immune-system deterioration carry implications for patients and influence their prognosis. The research was conducted in the context of a biopsychosocial conceptualization and was aimed at reducing levels of anger and helping establish recourses in the patients to manage infection and disease, as well as improve or at least retard decrements in immunological functioning. The goal of this intervention programme was to reduce levels of anger, anxiety, depression and social isolation. This would in turn increase the participant's personal sense of self-control, self-efficacy and self-esteem. Changes in these factors would help retard the overall HIV disease progression. An intervention programme was tailored to address the specific needs of HIV- infected patients. The group intervention was focused in such a way that relevant psychological, behavioural and social aspects were addressed. The programme borrowed and used aspects of different models and reformulated an intervention that would best address the specific needs of the participants. It was possible to isolate specific problems and focus the intervention on these specific areas, such as depression, anger, social isolation and hopelessness. For example, it was possible to take into account the participants' low self-efficacy and problems related to a lack of interpersonal coping skills and develop the participants' confidence and assertiveness (Antoni, 1991)

Thesis (DPhil (Psychology))—University of Stellenbosch, 2006. / Statistics show that young, heterosexual, low-income women are the fastest growing HIVinfected population in South Africa and in the rest of the world. Despite the rapidly growing numbers of women with HIV (human immunodeficiency virus) and AIDS (acquired immune deficiency syndrome), there is a scarcity of research that focuses primarily on how poor minority and disadvantaged women of colour experience being HIV-positive, how these women actually live and cope with their diagnosis. Furthermore, no research studies on minority groups, such as the Coloured women in the Western Cape, exploring these issues have been reported. Consequently, there is an urgent need for research studies in South Africa to explore the range of discourses revealed by low-income and minority women regarding their lives and experiences of HIV/AIDS, in order to generate understanding and knowledge which could contribute to possible interventions, support and care. The present study aimed to: 1) explore the psychosocial concerns and mental health needs of HIV-infected low-income Coloured mothers in everyday life; 2) construct a testable Grounded Theory regarding the illness experience of low-income Coloured mothers; and 3) recommend guidelines for health workers. The study was a systematic analysis and documentation of how the illness (HIV/AIDS) was constructed in narratives of one particular group of women in South Africa. Eleven suitable and willing HIV-infected Coloured mothers were recruited by means of convenience and theoretical sampling. The research study was conducted within a socialconstructionist framework where the focus was on how HIV-infected, low-income Coloured women make sense of their world and illness experience. Grounded Theory was applied within the framework of qualitative research to analyse the data and to explore the participants’ constructions of the illness. As qualitative measure, a semi-structured in-depth interview schedule was developed according to Grounded Theory protocol. To reach the aims of the present study, questions focused on specific behaviours, experiences, thoughts and feelings that related to living with a positive HIV-diagnosis. In the participants’ accounts of their illness experience, two dominant discourses were identified: a discourse of HIV/AIDS, within which the illness was constructed as an stigmatised, incurable and deadly illness; as a shameful illness that someone should be blamed for; and as being associated with secrecy, silence, separation, pain and suffering, loss, and loneliness, as well as a discourse of mothering, what it means to be a “good” woman/mother; constructed as someone that should primarily take care of her children and family, and not be separated from them, or neglect or abandon them through illness or death. It is suggested that the two dominant discourses found in the participants’ accounts of their illness experiences, namely the meaning of HIV/AIDS as an illness (a stigmatised, incurable, and deadly illness, a shameful and blameworthy illness, an illness of secrecy, silence, separation, pain and suffering, loss, and loneliness), and the imperatives of mothering, what it means to be a “good” woman/mother (the primary caregiver of children, someone who is connected, physically strong, healthy and productive, and someone who is able to cope with her caregiving responsibilities even when in distress herself) are irreconcilable. It seems that these distressing and disempowering experiences of being HIV-infected, while also being a primary caregiver and mother of children, caused the participants in the present study severe psychological distress and suffering. Given these discourses and the context of the participants’ lives within their specific socio-economic circumstances, namely their lack of emotional and social support from friends and family, abusive relationships, substance abuse, economic hardships, absence of treatment options, as well as their experience of an incapacitating, incurable, stigmatised illness causing them severe physical and psychological distress, it was argued that the majority of the participants in the present study were in some state of depression and were in need of psychosocial support and mental healthcare.

by Joe Chan Bing Hang. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 48-54). / Abstracts in English and Chinese; questionnaire in Chinese. / ABSTRACT --- p.i / ACKNOWLEDGEMENTS --- p.ii / TABLE OF CONTENTS --- p.iii / Chapter CHAPTER I - --- INTRODUCTION --- p.1 / Chapter CHAPTER II - --- METHOD --- p.23 / Chapter CHAPTER III - --- RESULTS --- p.29 / Chapter CHAPTER IV - --- DISCUSSION --- p.38 / REFERENCES --- p.48 / APPENDIX --- p.55

Thesis (MPhil)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: People diagnosed as being HIV positive or having AIDS develop depression as they attempt to cope with their daily lives. Some studies have indicated the prevalence of depression and anxiety in people living with HIV/AIDS is higher than in the general population. An evaluation of gender related factors that lead to depression after a diagnosis with HIV/AIDS will highlight the incidences and frequency of what individuals experience in their daily lives. The research is a descriptive study in which the factors that cause depression after HIV/AIDS diagnosis were identified and related to gender. Both quantitative and qualitative methods were used to analyse the responses elicited from the participants in the sample. Twenty five PLHAs who had been diagnosed with depression were selected from patients attending both Nthabiseng and Luthando Clinics at Chris Hani Baragwanath Hospital in Soweto, Johannesburg. A questionnaire was designed to gather demographic as well as information regarding family, social and economic history. A short interview was also conducted with selected patients to determine in their own words what causes their depression. The selected patient hospital charts were analysed to gain additional information to complete the equation. A semi structured interview was conducted with 13 selected health care professionals to gather information on how they see depression in the presence of HIV and whether they are adequately equipped to detect and manage this condition. The findings from this study supported the view depression is present or develops after a positive HIV diagnosis and a difference was detected in the causes of depression in women and that of men. Common causes of depression after HIV diagnosis were denial, fear of death and social insecurity. Women were more likely to attribute their depression to denial and worry about work and family responsibility. Men attributed their depression to failure to provide for their family and loss of social status. Recognising the causes of and gender differences in the causes of HIV-related depression may help in designing more effective counselling strategies and improve management and care of PLHAs. / AFRIKAANSE OPSOMMING: Daar is 'n aantal mense wat nie aan depressie ly voordat hulle met HIV gediagnoseer word nie. Meeste studies dui aan dat die voorkoms van depressie en angstigheid by mense wat lewe met MIV en VIGS heelwat hoër is as die algemene MIV populasie. Baie mense, insluitende gesondheidsorgwerkers, neem aan dat depressie 'n onontsnapbare newe-effek is van MIV/VIGS diagnose. Dus mag dit gebeur dat depressie ongesiens verby gaan, onbehandeld, met die gevolg van oneffektiewe behandeling, riskante optrede, swak bestuur van MIV/VIGS en 'n lae lewenskwaliteit vir hierdie pasiënte. Hierdie navorsingsartikel kyk na die geslags-verwante faktore wat lei tot depressie na die diagnosering van MIV/VIGS. Die navorsing is 'n beskrywende studie waarin faktore wat depressie in MIV/VIGS gediagnoseerde pasiënte veroorsaak identifiseer en gedifferensieer word afhangende van geslag. Kwantitatiewe asook kwalitatiewe metodes is gebruik. Dertig PLHAs wat met depressie gediagnoseer is, word behandel in Nthabiseng asook Luthando Kliniek by die Chris Hani Baragwanath Hospitaal in Soweto, Johannesburg. Nthabiseng is die MIV Kliniek en Luthando is die psigiatriese kliniek vir MIV/VIGS pasiënte. 'n Vraelys is saamgestel om demografiese asook familie, sosiologiese en ekonomiese inligting te verkry. 'n Kort onderhoud is ook met sommige pasiënte gehou om in hul eie woorde te hoor wat hul glo hul depressie veroorsaak. Die geselekteerde pasiënte se hospitaal kaarte is geanaliseer, met die doel om die dokter se insette of redes te kry oor die pasiënte se depressie. 'n Semi-gestruktureerde onderhoud was gedoen met gesondheidsorgwerkers in Luthando- en Nthabiseng klinieke om inligting te verkry oor hoe hierdie professionele gesondheidsorgwerkers depressie sien by MIV/VIGS pasiënte en of hul bevoegd is om dit te identifiseer en te behandel. Die studie het bevind dat daar 'n verskil is by oorsake van depressie by vroue en oorsake van depressie by mans. Mees algemene oorsake van depressie by MIV/VIGS pasiënte is ontkenning, vrees van dood en sosiale onstabiliteit. By die vroue het ontkenning en bekommernis oor werk- en familie verantwoordelikhede meestal bygedra tot hierdie depressie, en by die mans was dit meer asof daar 'n algemene terleurstelling geheers het in hul gemoed. 'n Terleurstelling deurdat hul nie vir hul families sal kan sorg nie asook die vernedering in die sosiale netwerk. Om die verskille in MIV-geassosieerde depressie gebasseer op geslag te kan herken mag bydra tot die ontwerp van meer effektiewe beradingstrategië.

Introduction: Stigma associated with HIV/AIDS creates a barrier to prevention, care and treatment of HIV/AIDS. It further restricts PLWHA from learning about their status, disclosing their status, adopting safe behaviour and accessing services such as antiretroviral treatment. Disclosure of HIV status and a reduction in stigma may contribute to the decrease in new HIV cases. Purpose: The purpose of the study was to develop a community-based framework that would encourage people living with HIV/AIDS to disclose their HIV status and reduce the stigma associated with the disease. Method: This study used the action research method to explore the experiences of stigma and disclosure of HIV status and to develop a community based framework with PLWHA who encouraged disclosure and promoted the reduction of stigma in a community-based setting. The research setting was Bhambayi, an informal settlement in the district of Inanda. Non-probability purposive sampling was used. In-depth interviews with PLWHA that had disclosed their HIV status and focus group discussions with family members, adult children and community members were conducted. Findings: The data was analyzed manually and the following categories and subcategories emerged. The categories were experience of disclosure, stigmatizing reactions, lifestyle changes after disclosure and supports to reduce stigma. Some of the sub-categories were ‘opens out the illness’, gossiping and pointing fingers, discrimination against PLWHA by family and community, changes in relationships, community awareness and formation of support groups. The findings revealed that PLWHA that had disclosed their HIV status had changed their lifestyles. Recommendations were made on the need for nurses to develop community engagement projects and establish partnerships in order to reach out to communities regarding HIV/AIDS. Incorporate HIV/AIDS stigma and discrimination into the current nurses’ curriculum. The need for research is expressed on the evaluation of the framework and conducting similar research in larger communities. Conclusion: PLWHA who had disclosed their HIV-status shared their experience of being HIV-positive and encouraged other people to get tested. The community-based framework to facilitate disclosure and reduce stigma among PLWHA can be operationalised in other informal community-settings. / Theses (Ph.D.)-University of KwaZulu-Natal, Durban, 2010.