The overall aim of this study was to understand the determinants of VCT uptake in the general population of Nigeria’s federal capital territory of Abuja. Uptake of VCT still remains low despite increased availability of VCT information and services in Abuja, Nigeria. A quantitative cross-sectional study was undertaken with 180 respondents from Abuja, using an adaptation of the Health Belief Model as conceptual framework, to elucidate the social demographics of respondents, their HIV/VCT knowledge, their perceptions of VCT facility design, societal support for VCT, and how HIV stigma shapes the phenomenon of VCT uptake in Abuja, Nigeria. The key findings were that a better understanding of HIV prevention, a perception of support from community and religious leaders, and access to HIV test services in government facilities are positive predictors of higher VCT uptake. Poor personal risk assessment and the cost of HIV testing were identified as the key barriers to VCT access. / Health Studies / M.P.H.

This study was conducted to determine retention rate and factors associated with loss to follow-up (LTFU) of adult pre-ART patients in St. Luke hospital, Ethiopia. Cross-sectional study with quantitative and qualitative data collection techniques was used. Review of patient records, focus group discussions and review of program guidelines was conducted to determine level of adherence among pre-ART patients. In addition, pre-ART service quality and perceived reasons for discontinuation was explored. The study revealed that only 38.2% of the 335 patients enrolled in the pre-ART care were retained after 12 months of follow-up in the program. More than half (55.6%), of the LTFU occurred during the first 6 months of follow-up. Fear of discrimination, high transportation cost and mistrust in the pre-ART service were perceived reasons for LTFU. Absences of clear pre-ART service package and implementation guideline were also identified as important factors that may be related to LTFU. The findings call for improved quality of care and a better pre-ART service packaging that will address the gaps identified in order to increase patient retention. / Health Studies / MA (Public Health)

The study explored the factors influencing the use of voluntary counselling and testing by university students. This was done by undertaking an exploratory and descriptive qualitative study. Focus group discussions and field notes were used to collect data from the participants. Outcomes from the study revealed various factors to the uptake of Voluntary Counselling and Testing (VCT) services by university students namely: the desire to know one‟s HIV status, illness, pregnancy, blood donation, to get a reward, the influence of significant others, the influence of media, awareness campaigns, compulsion, to get a job, curiosity, to be a positive role model and the positive attitude and professional conduct of the health care provider. The study also revealed various challenges to the uptake of VCT services by university students namely: the fear of being diagnosed HIV positive, HIV/AIDS-related stigma and discrimination, the low perception of risk to HIV infection, the lack of student friendly VCT services, the shortage of human and infrastructural resources, the inaccessibility of VCT services, the long waiting period for test results, negative perceptions about VCT, the problems with pre-test counselling and ignorance. Going by the participants‟ suggestions VCT services uptake by university students could be improved by increased resource allocation (incentives, human and infrastructural resources), increased awareness campaigns, and improved counselling and making VCT services more accessible / Information Science / MA (Public Health)

South Africa is one of the countries hardest hit with the Human Immunodeficiency Virus (HIV) and Acquired Immuno Deficiency Syndrome (AIDS) epidemic. In response to the epidemic, the South African government adopted the Comprehensive HIV & AIDS Care, Management and Treatment programme strategic plan (CCMT) in 2000 (1) and developed the Operational Plan for CCMT for antiretroviral therapy rollout in 2003 (2). In order to monitor the progress of the implementation of CCMT, the National Department of Health (NDOH) adopted the Monitoring and Evaluation (M & E) framework in 2004 (3). The aim of this study was to assess the HIV & AIDS programme in Grahamstown‘s public sector health care system by using the national M & E indicators of the HIV & AIDS programme. The national M & E framework was used as the data collection tool and available information was collected from various sources such as the District Health Office (DHO), Primary Health Care (PHC) office, accredited antiretroviral sites and the provincial pharmaceutical depot. Group interviews were conducted with key stakeholder health care professionals at the District Health Office, Primary Health Care office, Settlers Hospital and the provincial Department of Health personnel. A one-on-one interview was conducted with the Deputy Director of HIV & AIDS Directorate, monitoring and evaluation in the National Department of Health. Available indicators such as budget and expenditure including antiretroviral procurement; human resources; nutrition-related indicators; prevention care and treatment indicators were collected. A group interview was conducted to document current practices, or where there was a lack of documentation, for indicators such as traditional medicines and pharmacovigilance. Most of the national M & E indicators are not required to be collected or collated by the district because the reporting format designed by the provincial Department of Health is different. Facilities, districts and provinces in South Africa are at different levels of implementation of the antiretroviral programme and hence a common format of the M & E indicators is not used by all provinces. Uniform data collection is not achieved due to human resources‘ constraints and other challenges such as continued use of manual reporting systems by the clinics. Districts are expected to report according to the formats drawn up by the provincial Department of Health (DOH) and there is a lack of awareness regarding the national M & E document amongst the Grahamstown Health Care Professionals. There is a need for training on the use of the M & E national framework so that the HCPs at the primary and secondary levels of the health care system are proficient with the process of M & E, and can provide inputs as well as take ownership of the process. The establishment of an M & E unit in Grahamstown is essential so that data collection and submission of the HIV & AIDS programme in the public sector according to the National M & E framework is addressed. However, despite all constraints and challenges in the public sector health care system in Grahamstown, available human and financial resources are being used effectively to maintain the HIV & AIDS programme.

Volunteer caregivers provide essential services to people in the terminal stages of AIDS and their families. Volunteers are exposed to stress and burnout. This study investigated the relationships between stress, coping strategies, levels of burnout and resilience in this population. Volunteers from Societas ‘O Sosiale (SOS) Children Villages and community based organisation (CBO) partnerships, were selected using non-probability purposive convenience sampling. A total of 110 participants were given the Experience of Work and Life Circumstances Questionnaire (WLQ), Brief-Cope, Maslach’s Burnout Inventory (MBI), a Resilience scale and the Living Standard Measure to complete. Statistical analyses were performed on the data. This includes descriptive statistics, reliability analysis, factor analysis, correlations and multivariate analysis of variance. The study found that volunteer caregivers experience high stress levels and burnout related to stressors outside work, remuneration, personnel policies and high resilience. High burnout is associated with all forms of coping. Further it is shown that training in problem-solving skills, counselling, government and public lobbying for support, registration with relevant professional bodies, furnished offices, reasonable recruitment requirements and compensation are needed to help the care givers avert the effect of stressors and control stress by stopping it from turning to burnout. / Psychology / M.A. (Psychology with specialisation in Research Consultation)

Background: The South Africa’s reproductive health policy put more emphasis on dual methods in preventing unwanted pregnancies, sexually transmitted infections (STIs) and Human Immunodeficiency Virus (HIV) transmission. Regardless of such policies, the uptake of voluntary counselling and testing (VCT) services remains a personal choice. Aim: The purpose of the study was to determine the accessibility, acceptance and utilisation of VCT services by women on hormonal contraceptives. Methods: About 134 women obtaining hormonal contraceptives were interviewed in a cross-sectional study. Descriptive and logistic regression analysis was applied to analyse the study data. Results: Respondents displayed positive attitudes towards Human Immunodeficiency Virus (HIV) testing. Unavailability and poor access to in-house VCT services was found to be a barrier for use of these services. Conclusion: There’s a need for provider initiated counselling and testing (PICT) strengthening and integration of VCT services into family planning. / Health Studies / M (Public Health) / 362.104256

Text in English / The discovery that anti-retroviral therapy (ART) is important for human immunodeficiency syndrome (HIV) prevention has increased interest in factors that influence adherence to HIV treatment. Studies have shown that non-adherence to ART results in drug resistance, morbidity and person-to-person HIV transmission. For persons defaulting on or living risky sexual lives, becoming adherent is a life-saving behavioural change, both for themselves and for their sexual partners. HIV/AIDS programmes are trying different innovations to enhance behavioural outcomes of people living with HIV (PLHIV). This study sought to determine the value of support group participation and based on the findings, to develop an evidence-based model for revitalising caregiver social support competencies. The study was conducted in two phases. In the first phase, a cross-sectional descriptive design was used to compare PLHIV who participate in support group activities with those who do not, in terms of their behavioural outcomes. Multistage probability sampling was used to select study respondents. Data was collected using a selfadministered questionnaire from 1,676 respondents between February and May 2014. Data was analysed using STATA. Data analysis shows that 47% of respondents had once (ever) participated in support group activities while 53% had never. PLHIV who participated in support group activities differed from those who did not in terms of HIV-related stigma (p=<0.001), positive HIV status disclosure (p=0.005), ART adherence (p=0.021), and sexual risk behaviours (p=0.045). PLHIV who participated in support group activities were more likely to have less internal HIV-related stigma, disclose their positive HIV status, adhere to ART and live less risky sexual lives. The two study groups were not different in terms of perceived social support (p=0.28) and external stigma (p=0.250). More PLHIV obtained social support from health workers (66%) and family members (36%) than from PLHIV support groups (16%). The researcher concludes that participating in support group activities positively impacts on behavioural outcomes of PLHIV, but PLHIV support groups are not the only sources of social support. In the second phase, a model for revitalising PLHIV caregiver social support competencies was developed as a recommendation for assuring PLHIV access to holistic care and support. / Health Studies / D. Litt. et Phil. (Health Studies)

M.A. (Social Behaviour Studies in HIV/AIDS) / This study sought to investigate factors that influence adherence to treatment amongst rural people living with HIV and accessing antiretroviral therapy (ART) at Shongwe hospital in Mpumalanga. Both quantitative and qualitative methods were used. From patients’ case files, a sample of twenty-eight respondents was recruited for the completion of questionnaires. A focus group discussion with nine participants was held, followed by qualitative interviews with three key informants. Findings indicated that a complex web of factors unique to each patient’s social context plays a role in determining whether or not patients adhere to their regimens. Obstacles to adherence are poor social support, problems relating to disclosure, unemployment and economic hardship, traditional and religious beliefs, the quality and nature of adherence counselling and treatment side effects. / Sociology

Thesis (MPhil (Industrial Psychology))--University of Stellenbosch, 2006. / This research paper investigates the need for emotional and psychosocial support for people infected and affected by HIV and AIDS in the workplace. Most employees infected and affected by HIV and AIDS, as well as their families, often need assistance to cope with stigma, rejection, and discrimination, as well as having to adjust to the diagnosis, to confront the fear of losing independence, and to prepare themselves for the changes that might happen to their lives. Hence, through counseling and support, they can have more knowledge about HIV and AIDS and reduced fears and misconceptions about living with HIV and AIDS. Some research organizations, such as the Perinatal HIV Research Unit, do provide emotional and psychosocial support, and advice for people infected and affected by HIV and AIDS. An attitude survey was conducted with about 400 employees at the Unilever Company in Boksburg, Johannesburg, in September and October 2005 to determine whether emotional and psychosocial support could play a role in motivating people infected and affected by HIV and AIDS to live positively with the virus, in eliminating related stigma and fears. Employees from this organization were chosen as the population for this survey as a prevalence study and VCT was carried out with them in August and September 2005, so they knew and trusted the councilors who were giving results to them and they had established a relationship with them. I booked appointments for follow-up counseling sessions of 45 minutes after VCT (Voluntary Counseling and Testing) and then told them about the support group at their workplace. The findings indicate that there is indeed a need for emotional and psychosocial support for people infected and affected by HIV and AIDS in the workplace. Among other findings, respondents, especially those infected, reported that they had learned that being HIV positive is not the end of the world but the beginning as long as you look after yourself you can live a normal and productive life for many years, as long as you take extra care of yourself. Most of the affected respondents reported that they had never done an HIV test before due to their own fear of the prognosis. Having acquired more facts about HIV and AIDS, those that had not been tested stated that they now planned to do so. Both groups – those who tested negative and those who tested positive – reported that they also learned about the importance of disclosing your one’s status as a means of getting support.

Thesis (MPhil)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: It is very common to talk about or refer to people as “People Living with HIV/AIDS” but never “A Church with Aids”. Responding to HIV/AIDS has earned the JL Zwane Memorial Church this name or rather this label. Members of the congregation, many of them young, were dying and remaining silent, not doing anything, would have meant contributing to the disaster that had struck. Something drastic had to be done to respond to the pandemic or else the whole community would have perished. This was not easy as it meant risking losing those already in the church. To many people, HIV/AIDS was seen as a punishment from God to those who have sinned. For this reason many did not want to have anything to do with People Living with HIV/AIDS. The whole response is driven by the needs of the community i.e. those infected and those affected. This means listening to people tell their stories and then respond accordingly. Listening is the key in the response as the whole response revolves around people and their experiences. / AFRIKAANSE OPSOMMING: Die kerk, of geloofsgebaseerde organisasies , is dikwels die eerste om te weet dat iemand MIV positief is. Dit is ook die eerste persoon of organisasie wat deur die geïnfekteerde in vertroue geneem word. Die Kerk, as organisasie, kan dus 'n deurslaggewende rol vervul in die voorkoming, maar ook by die versorging van diegene wat MIV positief is of aan Vigsverwante siektes ly. Hierdie studie beskryf, in die vorm van 'n gevallestudie, die rol wat die Presbiteriaanse Kerk in Guguleto in die voorkoming van MIV/Vigs vervul. Die gevallestudie bespreek die probleem; die ontleding van die probleem en die uiteindelike program(me) wat daargestel is. Riglyne vir die betrokkenheid van Kerke (en geloofsgebasserde organisasies) word uitgespel en voorstelle vir verdere studie word gemaak.