The students are the future economic backbone of the country and it is essential that measures are taken to reduce the number of new HIV infections in this segment of the population. Free voluntary counselling and testing for HIV was introduced at the Nelson Mandela Metropolitan University as one of the prevention strategies to curb the spread of HIV. This service has grown steadily over the years but strategies need to be formulated and implemented to improve the existing service and thereby increase the utilisation of the testing service. This treatise takes the form of an investigative survey involving literature review and a survey of all the individuals who utilised the VCT service over a three month period. The author has attempted to portray the general views and best practices of experts in the field of VCT service delivery. The identified best practices were used as an assessment tool to determine to what extent the VCT service at the NMMU complies with national and international standards. The quantification of these insights must be viewed with caution since the survey sample was relatively low due to time constraints. It has been shown that the VCT service at the NMMU largely complies with national and international standards although several recommendations have been presented for consideration.

HIV/AIDS is a pandemic infecting and affecting millions of people worldwide. South Africa is also severely affected by this disease. Because hospitals cannot cope with patients admitted daily especially with the influx caused by HIV/AIDS patients, the government has introduced home-based care of people living with HIV/AIDS. Amongst those who practice home-based care are the volunteers. This study is aimed at exploring and describing the experiences of volunteers involved in home-based care of people living with HIV/AIDS in the Lusikisiki Magisterial district in the former Transkei area of the Province of the Eastern Cape. The researcher used a qualitative methodology with the aim of finding out what it is like to be a volunteer involved in home-based care in a rural area. The data was collected by means of semi-structured one-to-one interviews or guided interviews. A total sample of thirteen research participants was acquired through purposive as well as snowball sampling. The interviews were guided by a number of broad question themes. Data was analyzed using Tesch’s framework of data analysis as described in Creswell (1994). The researcher used Guba’s model as outlined in Krefting (1991) to ensure trustworthiness of the research findings. A literature control was undertaken to find out what other researchers and authors say about the issues raised by the study. There were five themes that came out of the data analysis process and these themes are: o The experiences of volunteers with home-based care. o Factors facilitating the work of volunteers. o Problems encountered by volunteers. o Possible solutions to problems encountered. o Views of volunteers regarding home-based care. These broad themes were further reduced into sub-themes and categories. Based on the discussion of themes, sub-themes, and categories, some research findings were presented. The discussion of the themes, sub-themes and categories was supported by verbatim quotations from the participants. On the basis of research findings, conclusions and recommendations were made.

Vulnerable populations comprise a growing number of people living with HIV/AIDS and are at increased risk for poorer health outcomes. The purpose of this research was to approximate the effect of the Ryan White CARE Act on the health status of people living with HIV/AIDS who were receiving medical care in the United States. The vulnerable populations model was utilized to identify appropriate variables for analysis as well as to provide a sequencing for the testing of models. Data analyzed in this study came from the 1996 Baseline Survey of the HIV Cost and Services Utilization Study (HCSUS), a cooperative study between RAND and the Agency for Health Care Policy and Research (now known as the Agency for Health Care Quality and Research). Three analyses sequences, using different dependent variables, to estimate health status were conducted. In the first analysis, health status was measured by CD-4 count and stage of illness. In the second analysis, only CD-4 counts were used for health status. In the final analysis, health status was estimated based on AIDS diagnosis. Each of the three analyses included the same independent variables: race, gender, education, sexual orientation, income, insurance status, region of the country, receipt of case management, perceived health, and level of antiviral therapy. The three analyses suggested similar results. Specifically, that African Americans and women had better health status as compared to whites and men, respectively. Additionally, insurance, case management, and antiviral therapy were associated with poorer health status. Factors such as education, income, and region of the country yielded inconsistent results between models. To better understand the effect of the Ryan White CARE Act on health outcomes for people living with HIV/AIDS, future research should consider inclusion of a variable that more directly measures the CARE Act, such as payer source for medical care.

Department of Public Health / MPH

Department of Advanced Nursing Science / MCur

Department of Advanced Nursing Science / PhD (Health Sciences)

MPM / Oliver Tambo Institute of Governance and Policy Studies

Mahole, E / MPM / Oliver Tambo Institute of Governance and Policy Studies

MPH / Department of Public Health

MPH / Department of Public Health