The limited success of HIV-testing facilities in South Africa means that many people are not accessing necessary antiretroviral treatment services. This study investigates the practical implications of HIV exceptionalism inherent in Voluntary Counselling and Testing (VCT). A semi-structured interview schedule was used to survey participants for their perspectives on barriers to HIV-testing uptake as well as the effects of exceptionalist practices at VCT clinics. Responses showed marked perceptions of gender differences in people's willingness to test and several important barriers including problems of access to services. Significantly, exceptionalism displayed in certain clinic procedures was thought to contribute to stigma, and attempts to normalise HIV practice in order to combat the effects of stigma were being informally implemented. Participants' views on routine opt-out testing were explored. The researcher recommended further investigation on how HIV testing and treatment policies can be normalised so as to reduce stigma and increase testing uptake. / Social Work / M.A. Sociology (Social Behaviour Studies in HIV/AIDS)

A needs assessment during 2000 guided the design of a buddy system in Botswana. Implementation of this care and support system for and by 39 HIV+ve female buddy-client pairs started in 2002. During April and November 2002, levels of disclosure, self-care, support and quality of life of buddy-client pairs and the controls (n = 38) were compared. Orem's self-care theory, Maslow's hierarchy of needs and Cohen and Syme's conceptualisation of social support formed the theoretical framework. By November 2002, clients' disclosure levels, self-care for TB, and antiretroviral therapy adherence had improved. Higher income, higher education and older age predicted higher levels of self-care for antiretroviral therapy. The social support survey reported satisfaction with types of support available in November 2002 (N = 112). Clients' scores for self-care for TB, antiretroviral therapy and social support improved more than those of controls over the study period. The personal resource questionnaire measured perceptions of support: buddies' scores increased more than those of clients. Women on antiretroviral therapy completed the adherence attitudes inventory in April and November 2002 and reported a downward trend in adherence. Findings of the quality of life (SF 36) instrument showed that during the six-month study period, physical and mental health component summary scores improved but remained low (N = 112). During 2003 Botswana's community-based buddy-support programme was adopted by four other countries in Southern Africa in an attempt to enhance the quality of life of HIV+ve women in these countries. / Health Studies / D. Litt. et Phil. (Health Studies)

The escalating number of people infected by HIV and AIDS poses a challenge to current resources both at the hospital and household level. Community/Home based care is a viable option in response to the scourge of HIV/AIDS to compliment secondary and tertiary care as well as providing support to affected families in coping with the stress of caring for their terminally ill family members. This study explored the effectiveness of the implementation of Community/Home based care services by focusing on three sites at Bushbuckridge i.e. Cunningmore, Maviljan and Hluvukani. Findings revealed that family members were satisfied to have community caregivers entering their homes to provide care and support to their AIDS ill family members. Significant barriers were highlighted by families and community caregivers that hinder effective implementation of the programme, for instance, cultural sensitivity. The study proffered recommendations on how to deal with these issues. / SOCIAL WORK / MA(SS) (SOCIAL WORK)

Twenty four eThekwini HIV/AIDS counsellors based in four different work settings and who received training from five different training providers, shared their HIV/AIDS counsellor training experiences. The qualitative, phenomenological study utilized a multi-methods approach. The purpose of HIV/AIDS counselling lacks uniformity. Participants reflected upon their distinction between training satisfaction and perceived competency to render HIV/AIDS counselling after training. Although they were satisfied and empowered by the useful information gained, many felt inadequate to counsel an HIV positive person on completion of training. Inadequate practical learning opportunities were evident. Participants identified the need for a more balanced theoretical and practical training program incorporating experiential and didactic training methods. Entrance criteria to HIV/AIDS counsellor training courses and eventual assessment procedures in the study were diverse. Participants suggested improvements for training methods and course content and proposed a tiered training model that will result in standardized and certified training modules. / Social Work / MA(SS) (Social Work)

The study analysed and compared data from patients' medical and pharmacy refill records to identify correlations between CD4 cell counts and adherence to antiretroviral drugs at Katutura Intermediate Hospital (KIH) in Windhoek, Namibia. The study investigated whether the pharmacy refill adherence measurement methodology could predict immunological recovery through increased CD4 cell counts. There was a positive but weak relationship between adherence and CD4 cell counts. Although the pharmacy refill records could predict immunological response it was not sensitive enough and should be used in combination with other adherence measurement tools. / Public Health / M.A. (Public Health)

Kenyan labour laws inadequately protect HIV positive worker. The Constitution of Kenya, 1963, does not prohibit stereotypical attitudes adverse to HIV positive workers and discrimination on the basis of health status. It does not provide for the right to employment, health and health care services, and fails to delimit privacy and dignity rights. Under the Industrial Property Act, 2001, the basis for Government exploitation of patent through compulsory licensing is whimsical and parallel importing is not envisaged. Employers unilaterally draft employment contracts notwithstanding their unequal power relations to employees. The HIV and AIDS Tribunal institutionalises discrimination against HIV positive workers on the basis of the ambiguous ‘inherent job requirements.’ Plausible international labour laws and practices have no place in Kenya unless they are domesticated. SUMMARY This thesis interrogates the Kenyan labour laws and policies to identify their inefficiencies and suggest recommendations for reform. It commences with an analysis of the topical issues associated with the HIV positive worker. It then examines the extent of prevalence and ramifications of HIV/AIDS in Kenya. Subsequently, it studies the efforts made at the international and domestic arena in protecting the HIV positive worker. A comparative analysis is made of the laws protecting the HIV positive worker in a number of countries, namely, South Africa, United States of America and Australia. The thesis draws conclusions and recommends measures on how best to protect the Kenyan HIV positive worker. The labour laws should be amended to prohibit discrimination on the basis of health status, provide for right to affordable medication and work, allow negotiation of employment contracts, list international laws that Kenya ratifies without reservation as a source of law and delimit the concept of ‘inherent requirements of a job.’ The public should be sensitised to embrace HIV positive workers. Once the new Constitution is enacted, it should list socio-economic rights as fundamental rights and reform the office of the ombudsman to deal with complaints against private employers. / (LL.D.)

A structured questionnaire was used to survey the perceptions of programme coordinators, fieldworkers and beneficiaries of the role of church-based programmes in addressing HIV and AIDS in the inner-city of Durban. One hundred and ninety two respondents were recruited from seventeen churches. Findings indicate that fear of HIV- and AIDS-related stigma and discrimination abound. The material and spiritual roles of church-based programmes in addressing the needs of people infected with HIV and affected by HIV and AIDS were stressed by the respondents. Whereas programme coordinators were well informed about HIV and AIDS, information that can dispel fears about stigma and correct myths about HIV-transmission should be tailored to reach ordinary men and women. It is recommended that further research be conducted on the preventive aspects of church-based programmes in the Durban inner-city. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

Uganda has experienced 1.6 million deaths to HIV/AIDS related illness. Introduction of free-ART in rural hospitals that bear the burden od AIDS reduces adults morbidity and mortality. The study design was a quantitative, retrospective and descriptive design through data mining of medical records. In the six years, hospital admissions decreased by 16.7% and the median age at death increased by seven years. Hospital admissions decreased from three to seven deaths per 100 admissions per month. Male and female mortality was 1:1.6 and females in the 15-34 age group had a 37% higher likeliness of dying in hospital compared to males. Deaths from sub-countries with an ART site reduced by 4% to 8.6%. The data revealed that despite ART coverage of 60%, mortality rates showed a rising trend. Free access to ART's over three years did not make any observable changes to overall mortality. Therefore, ART access contributed to a decline in overall hospital admissions, an increase in median age at time of death and a reduction in deaths from sub-counties with an ART site. There was no reduction in overall hospital mortality rate. / M.A. (Public Health) / Health Studies

Afrikaans text / Die studie ondersoek die leemte aan teoreties gefundeerde riglyne om pleegouers in die bekendmakingsproses van hulle kind se MIV-positiewe status te ondersteun Die studie geskied binne die teoretiese raamwerk van ʼn intervensienavorsingsmodel. In die empiriese navorsing is die vrese en probleme van pleegouers by die bekendmakingsproses ondersoek. Daar is bevind dat hierdie vrese en probleme in ag geneem moet word in die beoogde riglyne. Die kognitiewe ontwikkeling van die kind is deur middel van ʼn literatuurstudie ondersoek om vas te stel watter kennis, denke en inligting die kind op verskillende ouderdomme begryp. Daar is bevind dat kinders wat MIV-positief is, moontlike agterstande ondervind en dat die riglyne gevolglik gebaseer moet word op die toenemende ontwikkeling van die kind, met begrip vir individuele ontwikkelingsverskille. Voorts is bevind dat pleegouers se eie gereedheid ʼn belangrike rol speel. Alhoewel die pleegouer die bekendmakingsproses self moet aanvoer en hanteer is dit belangrik dat die pleegouers deur ʼn interdissiplinêre span ondersteun en begelei sal word. / This study investigates the absence of theoretical grounded guidelines to support foster parents when disclosing paediatric HIV. The study was done within the theoretical framework of an intervention research model. The empirical research investigated the fears and problems experienced by foster parents during the disclosure process. It was found that these fears and problems should be taken into account when compiling guidelines. The child‟s cognitive development was researched by way of a literary study in order to determine what knowledge, thoughts and information the child is able to grasp at different ages. It was found that children who are HIV positive could possibly lag behind and that the guidelines should therefore be based on the accumulative development of the child, with consideration given to individual developmental differences. Furthermore, it was established that foster parents‟ own readiness plays an important role. For this reason the foster parents should be supported and guided by an interdisciplinary team, but that they themselves should take care and execute the process of disclosure. / Social Work / M. Diac. (Spelterapie)

A qualitative study aimed at exploring the nature and extent of the perceived social support available to male prisoners living with HIV at Pretoria Central Prison was conducted. A literature investigation into the life and world of male prisoners, with a focus on the nature and extent of the perceived social support provided to prisoners living with HIV, is presented. Fifteen (15) prisoners were identified by means of non-probability purposive sampling. In-depth interviews were conducted to collect information on how male prisoners living with HIV at Pretoria Central Prison viewed the nature and extent of the social support available to them. The study shows that the research participants living with HIV tended to receive social support from practitioners and other prisoners trained as voluntary caregivers. The study recommends that prisoners living with HIV should have greater access to social support from their significant others. / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)