This study using a quantitative, descriptive design with a questionnaire investigated cultural, religious and social factors that might impact on ARV treatment in HIV/AIDS-infected women in Botswana. The study found that the majority never missed any doses, a few missed doses once or twice, and a small minority missed more than three times. The respondents’ perception of cultural influence on treatment of HIV/AIDS in women revealed that the majority (70%) believe culture has an influence on the treatment. Social factors also impacted on ARV adherence. A few of the respondents indicated that side effects and the number of pills prevented ARV medication adherence. The main reason for non-adherence, however, was forgetfulness. There had been an improvement in the majority of the respondents’ health status and quality of life. Maximizing adherence is essential. Providers and patients both have responsibilities in this regard. / Health Studies / M.A.(Health Studies)

AIM: This study aimed to explore the factors influencing antiretroviral therapy patients` data quality at Princess Marina Hospital Pharmacy in Botswana. METHODS: A phenomenological approach was adopted in this study. Specifically, Interpretative Phenomenological Analysis qualitative design was used to explore the factors influencing antiretroviral therapy patients` data quality at Princess Marina Hospital Pharmacy in Botswana. Data were collected using a semi-structured interview format on 18 conveniently selected pharmacy staff. Data were analysed using Smith’s (2005) Interpretative Phenomenological Analysis framework. RESULT: Five thematic categories emerged from data analysis: data capturing: an extra task, knowledge and experience of IPMS, training and education, mentoring and supervision, and data quality: impact on patients’ care. The findings of this study have implications for practice, training and research. CONCLUSION: Pharmacy staff had limited knowledge of IPMS and its utilisation in data capturing. Such limitations have implications in the context of the quality of data captured / Health Studies / M.A. (Health Studies)

Submitted in fulfilment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, 2012. / Background : The current alarming growth of diseases and complications, especially in Africa, makes the integration of traditional and conventional health practices a priority in medical training, research and planning, and the funding of health services. Unplanned and/or unintended treatment non-compliance and unnecessary deaths from diseases like tuberculosis and Human Immunodeficiency Virus are escalating in spite of health information and/or education, support groups and awareness events. The World Health Organisation recommends Directly Observed Treatment Strategy for illnesses like tuberculosis, and suggests the inclusion of traditional health practitioners in the strategy because they are constantly in contact with the community and could therefore be utilized as reminders, support system, doctors and care givers. Therefore it is a high priority that traditional health practitioners be integrated into partnership with conventional medicine practitioners, as they are considered the entry point to primary health care programmes in South Africa. Aim of the study The aim of this study was to explore the nature of the partnership between the African traditional and conventional health care in the eThekwini District. Methodolody : A qualitative, multiple case study design was used to explore the partnership between African traditional and conventional health care within the South African health care system in the eThekwini district of KwaZulu-Natal Province. In attempting to explore and understand the extent to which both these health care systems work together, a qualitative research method was used. All ethical issues were considered after which individual interviews were conducted using an interview guide and a tape recorder. A cross-case synthesis was used to analyse data. Results : Results from the study suggest that a partnership is far from being implemented by both the Traditional Health Practitioners and Conventional Health Care Practitioners. It is apparent that they both do not share a common vision. The government has some responsibility and a major role to play in guiding such a partnership and making sure that the South African community is provided with best practices governed by policies and legislation that are transparent, fair and legally binding to everybody involved.

Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: HIV/AIDS is considered as a global problem with the number of people living with HIV infection continuing to increase. At the end of 2007 HIV/AIDS had already claimed 25 million lives. Of all new HIV infections 71% were diagnosed in the Sub-Saharan region in 2008, remaining the worst affected region globally. UNAIDS (2008:43) indicated that heterosexual intercourse remained the main origin for HIV infection in the Sub-Saharan region. Therefore the researcher is of the opinion that prevention strategies should focus mainly on sexual transmission of the disease. HIV/AIDS affects mainly people between the ages 15-24 years, notably the age group of most of the learners in Higher Education Institutions (HEIs). Lesotho, a country in the Sub- Saharan region, presents with the third highest HIV adult prevalence (23.2%) in the world and in the region. In an attempt to address the prevailing situation, Lesotho has a number of programmes geared towards addressing HIV/AIDS in the country. However, all these attempts exclude the learners in HEIs, yet the majority of learners are found within the most affected age group. It is also to be noted that Higher Education provides the bedrock for socio-economic and political development in Africa. Some studies have identified insufficient knowledge as being at the root of the increasing HIV infections among youth. However, other studies have shown that there is adequate knowledge among the young people, but still a challenge remains and that is to facilitate changes in behavioural patterns as a component to be linked to the knowledge. Studies conducted in other African countries have shown that there are anti-AIDS programmes and clubs for learners in HEIs where learners are involved in the fight against HIV/AIDS. No publication indicating the same for Lesotho’s HEIs could be found, except for the National University of Lesotho (NUL) that only launched its HIV/AIDS policy for learners in 2009. The researcher is of the opinion that HEIs in Lesotho are not doing enough to combat HIV/AIDS and hence intends to focus on HEIs in Lesotho. This study had two objectives namely:  To determine the knowledge of learners in a specific HEI in Lesotho regarding HIV/AIDS prevention and care.  To explore the needs of learners in a specific HEI in Lesotho regarding HIV/AIDS prevention and care. This mixed method study was conducted, comprising of both quantitative and qualitative designs. Quantitative phase used a questionnaire for determining the knowledge of learners. The questionnaire was adopted from a study that was performed to determine knowledge of South African educators in public schools with some modifications. The qualitative phase was used to explore the needs of the learners through the focus group discussions with the leaders of the learners. Sample was drawn from the entire population using stratified random sampling for the quantitative phase. The qualitative phase used the purposive sampling to obtain in-depth information concerning learners’ needs. Quantitative data was analysed through the use of statistical package for social sciences (SPSS) and qualitative data was analysed using the thematic analysis and open-coding. All ethical principles were adhered to especially the principle of respect for persons. The findings from the quantitative phase of the study showed that learners had adequate knowledge regarding HIV/AIDS prevention and care and the findings from the qualitative phase showed the various needs of the learners with regards to prevention and care of HIV/AIDS in a specific HEI in Lesotho. Recommendations have been proposed based on the findings from the two phases of the study. Limitations observed by the researcher have also been identified. In conclusion the objectives of the study were met and the research questions had been answered. / AFRIKAANSE OPSOMMING: MIV/Vigs word as ‘n internasionale probleem erken, siende dat daar ‘n verhoging in die toename van MIVgeïnfekteerde indiwidue tans is . Einde 2007 het MIV/Vigs het reeds 25 miljoen lewens ge-eis . In 2008 is 71% van al die nuwe MIV-infeksies in die Sub-Sahara streek gediagnoseer, wat aandui dat die streek die mees geaffekteerde streek tans is. UNAIDS (2008:43) het aangedui dat heteroseksuele omgang die hoofoorsaak van MIV-oordrag in die Sub-Sahara-streek is. Laasgenoemde het daartoe gelei dat die navorser van mening is dat voorkomende strategieë meestal op seksuele oordrag van die siekte moet fokus. MIV/Vigs affekteer meestal mense in die ouderdomsgroep 15-24, opmerklik is dit die ouderdomsgroep waarby meesste leerders in Hoëronderwysinstellings (HOI) is. Lesotho, ‘n land in die Sub-Sahara-streek, het tans die derde-hoogste MIV-voorkoms (23.2%) in die wêreld en in die streek. Lesotho het verskeie programme ontlont om MIV/Vigs te bekamp in ‘n poging om die huidige situasie te beredder . Nieteenstaande sluit al die programme leerders in HOI uit, alhoewel die leerders in die ouderdomsgroep van die mees-geaffekteerde groep val. Dit is ook duidelik dat Hoëronderwys die fondasie vir sosio-ekonomiese- en politieke ontwikkeling in Afrika verskaf. Sommige studies het onvoldoende kennis as die wortel van die verhoging van MIV-infeksies onder die jeug geïdentifiseer. Ander studies, daarenteen, wys dat kennis voldoende is onder jeug, alhoewel veranderinge in gedragspatrone om by die kennis aan te sluit ‘n uitdaging bly. Studies uit ander Afrikalande dui daarop dat daar anti-Vigs programme en klubs is waarby HO leerders betrokke is om teen die verspreiding van MIV/Vigs te veg. Geen publikasies in hierdie verband word in Lesotho aangetref nie, behalwe ‘n MIV/Vigs-beleid wat in 2009 deur “National University of Lesotho’ (NUL) gepubliseer is. Dus is die navorser van mening dat HOI nie genoeg doen om MIV/Vigs te beveg nie, daarom fokus sy op HOI in Lesotho. Hierdie studie het twee doelstellings ten doel gehad, naamlik om die leerders in ‘n sekere HOI in Lesotho se kennis aangaande MIV/Vigs voorkoming en sorg te bepaal en die behoeftes van die leerders aangaande MIV/Vigs voorkoming en sorg te verken. ‘n Studie met beide kwantitatiewe- en kwalitatiewe metodes is gebruik om die doelstellings te verwesenlik. In die kwantitatiewe fase is ‘n vraelys gebruik om leerders se kennis te bepaal. Die vraelys is verkry uit ‘n vorige studie wat in RSA gedoen is, maar aangepas om in die Lesotho-konteks te gebruik. Gedurende die kwalitatiewe fase is fokusgroep besprekings met die leiers van die leerders gehou om die behoeftes indiepte te verken. Die steekproef was uit die totale populasie getrek deur van gestratifiseerde streekproefneming gebruik te maak in die kwantitatiewe fase en ‘n doelgerigte steekproefneming is in die kwalitatiewe fase te gebruik. Die navorser het ‘n kwantitatiewe data-analise sagteware (SPSS)gebruik om kwantitatiewe data te ontleed en tematiese- oopkodering is gedurende die kwalitatiewe fase gebruik. Etiese kode is ten volle gerespekteer, veral die respek vir mense gedurende navorsing. Bevindinge van die kwantitatiewe fase het bewys dat leerders voldoende kennis aangaande die voorkoming en sorg van MIV/Vigs besit en die kwalitatiewe bevindinge het die behoeftes van leerders met betrekking tot die voorkoming en sorg van MIV/Vigs in ‘n spesifieke HOI in Lesotho geopenbaar. Die aanbevelings is gemaak, gebaseer op die bevindinge uit die twee fases. Beperkinge in die studie is uitgelig. Ter afsluiting is die doelstellings in die studie bereik en die navorsingsvrae beantwoord.

Thesis (M.Phil.)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: AIDS is the most important threat to world health. Recent years have seen a dramatic spread of HIVand AIDS in South Africa. Health education directed at modifying risk behaviour appears to be the only way in which the disease can be contained. Controlling AIDS is not only by controlling the virus, but also involves tackling social, economic and political issues and putting AIDS into the broader context of sexuality and gender roles. This requires a broader understanding of this aspect of HIV-AIDS ranging from population dynamics, through to research on individual behaviour and its socio-economic impact; so that we can dispel the myths and rumours that surround AIDS and answer searching questions that will be asked by the community. In South Africa, HIV-AIDS remains a stigmatized disease. There have been calls from courageous and influential people for those who are living with HIV-AIDS to be open about their status and to destigmatise the disease. Institutions too have been drawn into the controversy about whether to remain silent or speak out. Southern African Anglican bishops, as well as some politicians declared their intention to undergo testing for HIV status in order to sensitise the public to the seriousness of the epidemic. Were AIDS not regarded as intolerable, the entire issue of confidentiality would fall away. Calls to destigmatise the disease through openness cannot stand alone. Government must put effective treatment programmes in place. In the absence of treatment, AIDS may represent only frustration and hopelessness to those who test positive; and fear, danger and resultant animosity to those who are HIV negative. The text is in four chapters. Chapter 1 focuses on confidentiality as an important principle in the management of disease. In HIV -AIDS, confidentiality is a more sensitive issue as AIDS is particularly viewed as a social stigma, accompanied by discrimination and harassment. The chapter also addresses HIV infection, transmission, counseling and screemng. Chapter 2 deals with the principles of biomedical ethics namely, autonomy, to enable the patient to determine his/her course of treatment; informed consent, designed to protect the interests of patients from exploitation and harm, and encourage health professionals to act responsibly; beneficence and nonmaleficence, to protect the welfare of others; and justice, to ensure access to health care for all. It also highlights the aspects of and limitations to confidentiality. Chapter 3 discusses broadly the ethical dilemmas pertammg to professional-patient relationships, women and HIV-AIDS, religion, prisoners and employer-employee relationships. When the AIDS epidemic started, very few people suffered from the disease, and the disease was treated with great caution and confidentiality. Today, AIDS is a pandemic and emphasis should shift from the ethic of autonomy and confidentiality, to a social ethic, which emphasizes the responsibility of minimizing the risk of spread of infection. The chapter also examines the role of the Department of Health, the participation of health professional bodies and the legal aspects relating to confidentiality in HIV-AIDS. Chapter 4 attempts to construct an argument to destigmatise HIV-AIDS by arguing the responsibility of the government to make sufficient resources available for the treatment and control of the pandemic. Health professionals are challenged to engage their expertise and skills in the service of the sick with dignity and respect. The community is encouraged to support the drive towards controlling the spread of HIV infection and enable people living with AIDS to disclose their status without fear of harassment. / AFRIKAANSE OPSOMMING: Vigs is die gevaarlikste bedreiging van wéreldgesondheid. Die afgelope paar jaar het 'n dramatiese verspreiding van mv en VIGS in Suid-Afrika plaasgevind. Gesondheidsopvoeding wat gemik is op die verandering van risiko-gedrag is skynbaar die enigste metode wat die siekte kan beheer. Die kontrolering van VIGS is nie net die kontrolering van die virus nie, maar dit betref ook herbesinning oor sosiale, ekonomiese en politiese en geslagsrolle. Dit vereis 'n omvattender verstaan van hierdie aspek van HIV-VIGS, wat strek vanaf van bevolkingspatrone tot by die navorsing oor individuele gedrag en die sosio-ekonomiese impak van 19. So kan ons hopelik help om die mites rondom VIGS te besweer. In Suid-Afrika bly mV-VIGS 'n gestigmatiseerde siekte. Daar rus 'n veranbtwoordelikheid op invloedryke mense wat met mV-VIGS leef en wat as rolmodelle sou kon dien, om hul mv -status te openbaar en sodoeonde te help om die siekte te destigmatiseer. Instansies is ook by hierdie twispunt betrek om vas te stelof die mense moet praat of swyg. Suider-Afrikaanse Anglikaanse Biskoppe, asook somige politici het hulle intensies aangekondig om die mv -toets te ondergaan om sodoende die publiek te help opvoed oor die gevaar van hierdie epidemie. Oproepe om die siekte te destigmatiseer deur openbaarheid kan nie in isolasie funksioneer nie. Die staat moet effektiewe kuratiewe en voorkomingsprogramme hier rondom loods en kontinueer. In die afwesigheid van 'n geneesmiddel, sal VIGS slegs frustrasie, hopeloosheid, en vrees skep by diegene wat positief getoets is, sowel as vyandigheid onder diegene wat nie mv positief is nie. Die teks het vier hoofstukke. Hoofstuk 1 fokus op vertroulikheid as 'n belangrike beginsel in die bestuur van die siekte. In mV-VIGS is vertroulikheid 'n meer sensitiewe beginsel aangesien VIGS in die besonder as 'n sosiale skandvlek, aangevreet deur diskriminasie, gesien word. Die hoofstuk bespreek ook mv -infeksie, transmissie, raadgewing en toetsing. Hoofstuk 2 gaan oor die beginsels van die biomediese etiek, naamlik, outonomie, waaronder ingeligte toetstemming, ontwerp om die belange van die pasiente te beskerm teen eksploitasie en gevaar: om gesondheids professionele aan te moedig om hulle op 'n verantwoordelike manier te gedra. Ander beginsels is goedwilligheid en niekwaadwiligheid om die welsyn van ander te beskerm, asook geregtigheid, om toegang tot gesondheidshulp vir almal te verseker. Dit beklemtoon ook die aspekte verwant aan beperkinge tot vertroulikheid. Hoofstuk 3 bespreek breedweg die etiese dilemmas met betrekking tot die verhouding tussen pasiënye en professionele gesondheidswerkers, vrouens en mV-VIGS, godsdiens, gevangenes en werkgewer-werker verhoudings. Toe die VIGS-epidemie begin het, het min mense aan die siekte gely, en die siekte is met groot sorg en vertroulikheid behandel. Vandag is VIGS 'n pandemie en die klem moet geskuif word vanaf outonomie en vetrouilikheid na 'n sosiale etos wat verantwoordlikheid en die vermindering van die risiko van die verspreiding van die infeksie beklemtoon. Die hoofstuk kyk ook na die rolle van gesondheidsdepartmente, deelname van gesondheids professionele organisasies en die juridiese aspekte met betrekking tot vertroulikheid van HIV-VIGS. Hoofstuk 4 poog om 'n argument te ontwikkel wat daartoe sou kon bydra dat HIV-VIGS gedestigmatiseer sal word. Klem word gelê op die verabtwoordelikheid van die staat om soveel moontlike bronne beskikbaar te stel vir die behandeling van en beheer oor hierdie pandemie. Gesondheids professionele word uitgedaag om hulle deskundigheid en bekwaamheid in die diens van die siekes met waardigheid en respek te gebruik. Die gemeenskap word aangemoedig om die poging tot die beheer van die verspreiding van die HIV -infeksie te ondersteun en om die mense wat met VIGS leef in staat te stelom hul status sonder die dreigement van stigmatisering bekend te maak.

This study using a quantitative, descriptive design with a questionnaire investigated cultural, religious and social factors that might impact on ARV treatment in HIV/AIDS-infected women in Botswana. The study found that the majority never missed any doses, a few missed doses once or twice, and a small minority missed more than three times. The respondents’ perception of cultural influence on treatment of HIV/AIDS in women revealed that the majority (70%) believe culture has an influence on the treatment. Social factors also impacted on ARV adherence. A few of the respondents indicated that side effects and the number of pills prevented ARV medication adherence. The main reason for non-adherence, however, was forgetfulness. There had been an improvement in the majority of the respondents’ health status and quality of life. Maximizing adherence is essential. Providers and patients both have responsibilities in this regard. / Health Studies / M.A.(Health Studies)

M.Ed. ( Educational Psychology) / This research study shows that young HIV sufferers undergo disturbances involving the mind, body and spirit causing a variety of future adjustment difficulties, problems and coping abilities. This is attributed to fear, loss, grief, guilt, denial, anger, anxiety, depression, stress, physiological changes, pain and hypochondria. This study indicates that they are particularly fearful about being isolated and rejected. They are overwhelmed by thoughts of loss of everything, accompanied by profound feelings of grief. Guilt and self-reproach affect their health further, having an effect on them both physically and mentally. The uncertainty of their future having contracted HIV intensifies anger with themselves as well as others. This also brings about anxiety due to lack of information and appropriate support systems in Soweto...

AIM: This study aimed to explore the factors influencing antiretroviral therapy patients` data quality at Princess Marina Hospital Pharmacy in Botswana. METHODS: A phenomenological approach was adopted in this study. Specifically, Interpretative Phenomenological Analysis qualitative design was used to explore the factors influencing antiretroviral therapy patients` data quality at Princess Marina Hospital Pharmacy in Botswana. Data were collected using a semi-structured interview format on 18 conveniently selected pharmacy staff. Data were analysed using Smith’s (2005) Interpretative Phenomenological Analysis framework. RESULT: Five thematic categories emerged from data analysis: data capturing: an extra task, knowledge and experience of IPMS, training and education, mentoring and supervision, and data quality: impact on patients’ care. The findings of this study have implications for practice, training and research. CONCLUSION: Pharmacy staff had limited knowledge of IPMS and its utilisation in data capturing. Such limitations have implications in the context of the quality of data captured / Health Studies / M. A. (Health Studies)

A research report submitted to the Faculty of Humanities University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Arts (Migration and Displacement Studies), March 2017 / Background: Policy responses to communicable diseases and other noncommunicable ones in South (ern) Africa have not adequately engaged with mobility. While Southern African Development Community member states have all adopted clear policies and programmes to deal with communicable diseases for their population in South Africa and elsewhere, deliberately, these do not extend to non nationals. In South Africa, there is a perception that many health care workers are not aware of national health policies and legislation that affect their practice, which leads to poor outcomes. But, in reality, a number of polices and guidelines are incomplete or inapplicable to non nationals, making frontline discretion unavoidable. Objectives: This study mainly sought to understand the practices that frontline health care workers adopt to navigate a space of blurred policy and the “grey areas inbetween” (McConnel, 2010), in relation to migration and antiretroviral treatment, using bottom-up policy analysis, namely “street-level bureaucracy” (Lipsky, 2010) as an analytical tool. Methods: Qualitative methods were used including policy review, literature review, in-depth interviews with frontline health care workers and participant observation. Findings: Empirical research in Vhembe district and Johannesburg found that in spite of several institutional challenges, health care workers were providing health care services and antiretroviral treatment to various categories of non-nationals reliant on public health care, albeit sometimes with some difficulties. But, the difficulties they faced in providing antiretroviral treatment were policy and systems related, in that, those that had a hard time accessing treatment did so because they were not in possession of identity documents, required referral letters or spoke non-native languages in the absence of translation services. This thesis illustrates the various innovations frontline health care workers employed to address these challenges. It demonstrates that health care workers discretion plays a crucial role in health care delivery, and there is need to recognise the importance of informal elements such as human relationships, communication networks, leadership and motivation towards the policy function of the country’s health system. It concludes that the informal practices of frontline health care workers ought not only to be recognised but also strengthened where possible. / XL2018

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.