Effective linkage to HIV care and treatment for all people diagnosed with HIV is crucial if positive treatment outcomes are to be realised. The study used the client records for all those newly diagnosed with HIV through the two entry points for HIV testing between January 2016 and December 2016. The aim of the study was to determine the proportions between the linkages to HIV care and treatment as per entry point for the people diagnosed with HIV at a Norton Health Centre in Zimbabwe. More importantly, the study sought to make recommendations to improve linkage per entry point. This was achieved through determining the proportion of individuals diagnosed with HIV that had documented evidence of linkage to HIV care and treatment by entry point. The study also evaluated the association between the entry point of HIV diagnosis and the linkage to HIV care and treatment.. In total, 239 clients’ records were reviewed who were over the age of 16 years. Overall, 144 (60%) had documented evidence of being linked to HIV care while about 95 (40%) of the client records had no documented evidence of linkage to HIV care. 143(60%) had documented evidence of initiation on antiretroviral therapy (ART) while about 96 (40%) had no documented evidence of initiation on ART. A statistically significant association between entry point for HIV diagnosis and the linkage to HIV care and treatment was demonstrated. A statistically significant higher proportion of females was demonstrated to be linked to HIV care and treatment than for males. The Prevention of Mother to Child Transmission of HIV (PMTCT) entry point showed higher linkages than OPD and wards entry point. Therefore, there is need to make put measures in place that encourage all clients that are diagnosed with HIV through the various entry points at the health centre to be linked to HIV care and treatment. The study made recommendations based on the findings. It is also recommended that male partners be encouraged to accompany their female expectant partners when attending PMTCT sessions. Youth were found to be lower in terms of linkages and the youth user friendly centre is recommended so as to attract more youths to come for testing. / Health Studies / M.A. (Public Health)

Background. An inherent challenge in HIV prevention studies is making sure that trial participants understand the information. This study explored trial participants’ perceptions and comprehension of the informed consent process in a pre-exposure HIV prevention study. Method. Face-to-face in-depth interviews, using a study guide, were held with twenty interviewees purposively selected from ex-participants of an HIV prevention study. Audio-recorded data were transcribed, translated, coded using NVivo 8, and analysed according to themes. Results. The participants were all women between the ages of 18 and 40. Participants felt that key information had been given during the informed consent process. Most felt that the process of obtaining informed consent was rushed with some participants citing a need for more time to make a decision regarding participation. Some participants felt pressured to sign consent forms. Some found it difficult to ask questions and mixed feelings existed on male partner involvement in the decision-making process. Conclusions: Participants experienced the consent process as rushed and most only fully comprehended study concepts with time. Their concerns necessitate the reassessment of informed consent processes in a developing world setting. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

The thesis focuses on the survival mechanisms of the rural poor elderly in Zimbabwe. The situation of the rural elderly is looked at in the context of the ravaging HIV/AIDS pandemic. The focus is specifically directed on the increasing numbers of orphans who are generated following the rampant deaths of their parents (sexually active individuals). With Africa failing to effectively withstand the forcefulness of the pandemic, the community structures in Zimbabwe are being heavily shaken to the detriment of all social groups. It is within this continuum that the research is laid out to investigate the situation on the ground. In this case, a fieldwork exercise was carried out in the Hobodo ward of Mangwe district in Zimbabwe. An intensive and in-depth examination of the critical situation was pursued under the case study model. To make the study more focused, the elderly were placed under investigation with regards to their new role of providing familial care for the orphans. The manner in which they face such a towering task under strained resources and limited knowhow was explored. The well-being of the orphans was also investigated in close relation to the welfare efforts of the elderly guardians. The investigations were made in respect of the contribution of the local resources towards the innovativeness of the elderly guardians. The adaptivity of the elderly and the versatility of the orphans were examined within the confines of the social and the economic capitals of the Hobodo ward. It is within the natural, social and economic capital dimensions of the Hobodo rural locality that the applicability of the sustainable livelihoods framework in explaining the dire social situation of the elderly and the orphans was brought under spotlight. The study was pursued through the qualitative research paradigm. This was done to capture the social perceptions, beliefs and the innovative capabilities of the elderly in their natural environment; and under the fieldwork setting. Several data collection techniques were employed to unveil the subject under study. These included interviews, questionnaires, participant observations, focus group discussions. Sampling was used to produce the research framework. Participants in the research were largely identified through random sampling. In special circumstances, purposive sampling was used. Tape recording and note taking were largely used to capture the responses of the research participants.

Despite efforts by the government, non-governmental organizations (NGOs), faith-based organizations (FBOs) and churches, the HIV epidemic remains one of the major challenges in Zimbabwe. Its impact cuts across all sectors of life and society. The context of HIV in Zimbabwe reflects that the economic and political decisions and policies have contributed to the spread of HIV. The spread of HIV is also exacerbated by some socio-cultural practices in that context. Among these socio-cultural factors are marriage practices, stigma and discrimination. This study is an investigation of the response of the Evangelical Lutheran Church in Zimbabwe (ELCZ) to HIV and AIDS. This is done through analysis of the ELCZ HIV and AIDS policy document (ELCZHAP). The ELCZ HIV and AIDS policy document is analysed by using the “HIV competent framework” (Parry 2008:20) in an attempt to understand the strengths and weaknesses of the response to the HIV epidemic by the ELCZ. From this analysis the policy document shows that the ELCZ has some competence but it needs to be strengthened in order to address socio-cultural and political factors, as well as improve engagement with government policies. The study reveals that the ELCZ lacks a comprehensive theological discourse in responding to HIV. Through this investigation, recommendations are made in order to strengthen the ELCZ HIV and AIDS policy document and indicate areas needing further research. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.

Zimbabwe is one of the priority countries nominated by the World Health Organisation and the Joint United Nations Programme on HIV and AIDS to adopt and implement voluntary medical male circumcision (VMMC) because of its high rate of HIV prevalence and its low level of male circumcision. VMMC, which was introduced in Zimbabwe in 2009, is a new HIV prevention method which reportedly offers partial protection of about 60 percent for circumcised males with respect to contracting HIV through sexual relations. The other key prevention method, namely the use of condoms consistently and correctly, has a protection rate of up to 95 percent. As a result, because of only partial protection, medically-circumcised men are encouraged to use condoms to decrease the chances of HIV infection. Concerns though have been raised about the possibility of risk compensation by circumcised males by way of increases in unsafe or risky sexual practices subsequent to circumcision and arising from perceptions of reduced risk through VMMC. This compensation may take the form of condom use aversion including when involved with concurrent sexual partners. If risk compensation does take place, this would lead to increases in HIV transmissions affecting not only the circumcised men but their sexual partners as well. The supposed effectiveness of VMMC as a HIV prevention method has been subjected to significant criticism and, as yet, no significant study has been undertaken in Zimbabwe on the relationship between VMMC, condom use, concurrent sexual partners and risk compensation. Based on a study of twenty-five medically-circumcised males in Harare, the capital of Zimbabwe, this thesis seeks to understand and explain the relationship between voluntary medical male circumcision and risky sexual practices with particular reference to condom use amongst men engaged in concurrent sexual partnerships. While the thesis finds evidence of risky sexual practices subsequent to circumcision, risk compensation does not seem to be particularly prevalent.

This study describes the HIV/AIDS knowledge of Form 1 secondary school learners in Harare. Structured interviews were conducted with 75 learners from four schools representing a low density, a high density, a rural and a private school. Most learners had obtained their HIVAIDS knowledge from schools and a few did so from their parents. None of the learners had reportedly yet engaged in sexual activities and all had heard about HIV, but not all knew what HIV was, and even fewer could define AIDS. Generally the learners’ HIV/AIDS knowledge levels were high but some misconceptions persisted. Future programmes should emphasise that there is no cure for HIV/AIDS, and that condoms should be used at every sexual encounter. Radio, television and school programmes should emphasise that every person can become infected with HIV/AIDS, if preventive measures are disregarded. / Public Health / M.A. (Public Health)

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: This qualitatively oriented Practical Theological research journey, informed by the philosophical ideas of postmodern, contextual, participatory and feminist theologies, postmodern and social construction epistemologies was based on a participatory action research through the therapeutic lens of narrative inquiry. The thesis is about the spiritual problems and spiritual needs of people living with HIV and AIDS and how they can be addressed as part of a holistic approach to their care within the primary healthcare delivery system in Zimbabwe. The research curiosity was prompted by the HIV and AIDS policy in Zimbabwe that advocates for a holistic approach to the care of HIV and AIDS patients within the primary health care delivery system. The recognition that healthcare has to be holistic for the best outcome for patients creates an expectation that spiritual care will also be incorporated into clinical practice. However there is a puzzling blind spot and a strange silence about the spiritual problems and spiritual needs of people living with HIV and AIDS within the HIV and AIDS policy. This has had the effects of reducing intervention programmes to purely medical, psychological and sociological. This research sought to correct such an approach by highlighting the role of spiritual care in the healing process of people living with HIV and AIDS as part of the holistic approach to their care. The core information, on which this research is based, comes from the experiences of people living with HIV and AIDS who are receiving care within the primary health care delivery system in Zimbabwe. It sweeps away statistics and places those questing for spiritual healing at the core of the study. All the participants in the study affirmed that the why me questions as a summation of their indescribable and unimaginable spiritual pain felt in the spirit were directed to God. They confirmed that their spiritual problem was spiritual pain and their spiritual need therefore was spiritual healing from the spiritual pain of which God is believed to be the healer. The belief that God is the ultimate healer of the spiritual pain stood out from the midst of problem saturated narratives of spiritual pain and suffering as the unique outcome to reconstruct the alternative problem free stories of healing. The research opted for an approach that is informed by the experiences of people living with HIV and AIDS. In the light of the stories shared by the participants in this study, it became evident that there is an existing need within the Primary Health Care delivery system in Zimbabwe to provide spiritual care to people living with HIV and AIDS. The research aimed at co-creating a spiritual care approach in which those living with HIV and AIDS as well as those working with them can be empowered to re-author the stories of patients‟ lives around their self preferred images. The narrative approach was explored in this research as a possible therapeutic approach that could be used to journey pastorally with people living with HIV and AIDS in a non-controlling, non-blaming, non-directive and not knowing guiding manner that would permit the people living with HIV and AIDS to use their own spiritual resources in a way that can bring spiritual healing to their troubled spirits. The research also emphasizes the position of the people living with HIV and AIDS which they can inhabit and lay claim to the many possibilities of their own lives that lie beyond the expertise of the pastoral caregiver. The strong suggestion emerging from this study is that a spiritual care approach to healing must of necessity be integrated into the holistic approach to the care of people living with HIV and AIDS in Zimbabwe. The wish of participants that their spiritual well-being be considered in their health care adds momentum to this suggestion. Hence the research argues for the inclusion of a spiritual and pastoral approach to spiritual healing which links the patient‟s spirituality and pastoral care. The research does not claim to have the solutions or quick fix miracle to the complicated spiritual pain of people living with HIV and AIDS and neither claims to have the power to bring any neat conclusions to the spiritual healing of people living with HIV and AIDS. However, the research has the potential to stimulate a new story of spirituality as a vital resource in the healing process of people living with HIV and AIDS and ignoring it may defeat the purpose of a holistic approach to the care of people living with HIV. The re-authoring of alternative stories is an ongoing process but like in all journeys, there are landmarks that indicate achievements, places of transfer or starting new directions or turning around. Hence this research process may be regarded as a landmark that indicated a new direction in the participants‟ journey towards spiritual healing. / AFRIKAANSE OPSOMMING: Hierdie kwalitatief-georiënteerde Praktiese Teologie navorsingsreis, geïnformeer deur die filosofiese idees van postmoderne, kontekstuele, deelnemende en feministiese teologie, postmoderne en sosiale konstruksie epistemologie, is gebaseer op deelnemende aksie-navorsing deur die terapeutiese lens van narratiewe ondersoek. Die tesis handel oor die spirituele probleme en navorsingsbehoeftes van mense wat met MIV en vigs leef en hoe dit aangespreek kan word as deel van ʼn holistiese benadering tot hul sorg binne die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Die navorsing-belangstelling het ontwikkel na aanleiding van die MIV en vigs beleid in Zimbabwe wat ʼn holistiese benadering tot die sorg van MIV en vigs pasiënte in die primêre gesondheidsorg-diensleweringstelsel bepleit. Die erkenning dat gesondheidsorg holisties moet wees om die beste uitkoms vir pasiënte te bied, skep ʼn verwagting dat spirituele sorg ook by kliniese praktyk ingesluit sal word. Daar is egter in die HIV en vigs beleid ʼn raaiselagtige blinde kol, ʼn vreemde stilte oor die spirituele probleme en spirituele behoeftes van mense wat met MIV en vigs leef. Die gevolg is dat intervensie-programme gereduseer word tot slegs mediese, sielkundige en sosiologiese programme. Hierdie navorsing streef om dié benadering reg te stel deur die beklemtoning van die rol van spirituele sorg in die heling-proses van mense wat met MIV en vigs leef as deel van die holistiese benadering tot hul sorg. Die kerninligting waarop hierdie navorsing gegrond is, vloei voort uit die ervarings van mense wat leef met MIV en vigs en sorg ontvang binne die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Dit vee statistiek van die tafel af en plaas diegene wat soek na spirituele heling, in die hart van die ondersoek. Al die deelnemers aan die ondersoek het bevestig dat hul “Waarom ek?” vrae, as opsomming van hul onbeskryflike, ondenkbare geestelike pyn, aan God gerig is. Hulle het bevestig dat hul spirituele probleem spirituele pyn is, en dat hul spirituele behoefte dus spirituele genesing is van die spirituele pyn, die pyn waarvan geglo word dat God die geneser is. Die geloof dat God die opperste geneser is, het uitgestaan te midde van die probleem-deurdrenkte narratiewe van spirituele pyn en lyding as die unieke uitkoms om alternatiewe probleem-vrye verhale van heling te herkonstrueer. Die navorsing het ʼn benadering gekies wat geïnformeer is deur die ervarings van mense wat leef met MIV en vigs. In die lig van die verhale wat die deelnemers aan die studie gedeel het, het dit duidelik geword dat daar ʼn behoefte is dat spirituele sorg ook aan mense wat leef met MIV en vigs verskaf word in die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Die doel van die navorsing was om saam ʼn spirituele sorg benadering te skep waarin diegene wat met MIV en vigs leef, sowel as diegene wat met hulle werk, bemagtig kan word om die stories van pasiënte se lewens te herskryf in terme van pasiënte se verkose beelde. Die narratiewe benadering is in hierdie studie ondersoek as ʼn moontlike terapeutiese benadering wat gebruik kan word om pastoraal te reis met mense wat leef met MIV en vigs op ʼn manier wat nie kontroleer, beskuldig, voorskryf of weet nie, maar wat mense wat met MIV en vigs leef eerder begelei en toelaat om hul eie spirituele bronne te gebruik op ʼn manier wat spirituele genesing vir hul gekwelde siele kan bring. Die navorsing beklemtoon ook die posisie van mense wat leef met MIV en vigs waarin hulle spirituele moontlikhede, areas van hul lewens kan eien en bewoon, moontlikhede wat buite die bereik van pastorale versorgers lê. Uit hierdie studie vloei ʼn sterk suggestie dat ʼn spirituele benadering tot genesing noodwendig geïntegreer moet wees in die holistiese benadering tot die sorg van mense wat leef met MIV en vigs in Zimbabwe. Deelnemers se wens dat hul spirituele behoeftes ook in hul gesondheidsorg oorweeg word, gee aan dié suggestie verdere momentum. Derhalwe argumenteer hierdie navorsing ten gunste van die insluiting van ʼn spirituele en pastorale benadering tot spirituele genesing wat die pasiënt se spiritualiteit en pastorale sorg verbind. Die studie maak nie daarop aanspraak dat dit antwoorde of ʼn wonderbare kits-oplossing bied vir die gekompliseerde spirituele pyn van mens wat leef met MIV en vigs nie, of spirituele genesing netjies afsluit nie. Die navorsing het egter wel die potensiaal om ʼn nuwe verhaal te stimuleer van spiritualiteit as ʼn deurslaggewende bron in die genesingsproses van mense wat leef met MIV en vigs. Om spiritualiteit te ignoreer, mag dalk die doel verydel van ʼn holistiese benadering tot die sorg van mense wat met MIV en vigs leef. Die herskryf van alternatiewe verhale is ʼn voortdurende proses, maar soos alle reise, is daar landmerke wat prestasies aandui, en ook punte van verplasing, rigtingverandering of selfs ommekeer. Hierdie navorsing kan beskou word as ʼn landmerk van ʼn verandering van rigting in deelnemers se reis na spirituele genesing.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The catering industry by its constituent membership of hotels, restaurants, lodges, bars, night clubs, takeaways and every tourist activity is susceptible and vulnerable to HIV/AIDS. This study analysed the business response to HIV/AIDS by establishments in the catering industry in Zimbabwe. The case study focused on establishments in Harare using a questionnaire with both open-ended and closed questions for data collection. The results of the study acknowledged the impact of HIV/AIDS on human resources capital and the business. The study also highlighted the need to conduct an assessment of the status of HIV/AIDS in the industry and its impact on both people and business. The epidemic was also acknowledged as a threat to the industry (both workforce and the business)hence the need for business response. However, the study revealed that the current business response was very minimal, erratic and uncoordinated. The study also highlighted the discriminatory practices in the catering industry especially in the treatment of persons infected with HIV. The study revealed the urgent need to put in place effective response to mitigate the impact of HIV/AIDS in the catering industry. Recommendations have been made to address HIV/AIDS in the workplace. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om te bepaal tot watter mate die voedselverskaffingsindustrie in Zimbabwe as besigheid gereageer het teenoor MIV/Vigs en wat hulle besigheidsrespons was. Resultate van die studie dui aan dat hierdie besigheidsektor wel erkenning gee aan die negatiewe impak wat MIV/Vigs op menslike hulpbronne . MIV/Vigs word as ‘n bedreiging erken en die negatiewe impak daarvan op besighede word deeglik besef. Die studie dui egter ook aan dat die huidige respons van die voedselverskaffingsektor minimaal, ongereeld en ongekoordineerd is. Die studie wys ook daarop dat daar nog steeds baie hoogs-diskriminerende praktyke binne die industrie bestaan, veral ten opsigte van pasiënte wat tans op behandeling is vir MIV-verwante siektetoestande. Die studie wys op die noodsaaklikheid van ‘n doeltreffende besigheidsrepons binne die voedselverskaffingsindustrie en voorstelle word gemaak vir die beter bestuur van MIV/Vigs binne hierdie bedryfsektor.

Within the context of debates concerning the reception and interpretation of media texts by television audiences, this qualitative reception study explores how a sample of Bulawayo students negotiate meanings from Zimbabwe's first health communication soap opera, Studio 263. The study thus examines the reasons behind the popularity of this programme with this target audience. The findings of the study reveal that meaning making is a complex process that is dependent on a variety of factors which include, among others, the socio-cultural context of media consumption, gender, economic disposition and age. It particularly maintains that gender and lived realities influence the interpretation and negotiation of meanings in this particular study. / Adobe Acrobat Pro 11.0.0 Paper Capture Plug-in

Factors that Impact on Learning in Orphanhood in Zimbabwe The aim of the study was to provide scientific knowledge on the factors impacting on the learning profile of orphans as compared to those who are not orphaned, and to identify the relationships between these factors and learning outcomes. This is a quantitative study and the Evaluation-Process and Outcome design was used. Structured quantitative data collection methods, questionnaires, interviews, observation and document analysis were used in this study. Maslow’s humanistic motivation theory of learning is the theoretical framework. The population included form four students and teachers from the Harare Metropole Province in Zimbabwe. A stratified random sampling procedure was used to sample schools, and the simple random procedure was used to sample both students and teachers. The experimental design was used to allow comparisons among orphans and between orphans and non-orphans. Ethical principles including consent, confidentiality and privacy were adhered to. Measures to uphold the quality of the study were applied. In the study it was found that in the peri-urban area, students who had been orphaned for one year or less performed poorly compared to other orphans and to non-orphaned students in their average examination marks, (p<. 023). Lack of books was significantly different amongst the non-orphaned and orphans (p<. 003), mostly affecting those orphaned for one year or less. There was a significant difference in the performance of orphans whose mothers had died and those whose mothers were alive, according to their average coursework marks (p<. 001) and average examination marks (p<. 005). The performance of single orphans, double orphans and non- orphans did not differ significantly, but the post hoc analysis revealed that in most subjects double orphans performed worse than single orphans and non-orphaned students. In the HIV/AIDS/Reproductive health and life-skills teaching-learning sessions observed, the majority of teachers, 12, (66.7%) (n =18) did not agree that relevant assignments were being given and 16 (88.9%) (n =18) did not agree that reading references were available. The majority of students (55.2% n = 509) had inadequate information on HIV and AIDS prevention, and those orphaned for one year or less (62% n = 29) and those orphaned for two to three years (62.5% n = 48) had even less information on HIV and AIDS prevention than the other groups. There was a difference in what the students perceived as life skills and what the teachers reported as life skills. It is recommended that this study be replicated on a larger scale and that factors that impact on learning be studied in national school settings in order to determine orphans’ and non-orphans’ learning outcomes. / Health Studies / D. Litt. et Phil. (Health Studies)