published_or_final_version / Social Work / Master / Master of Social Work

The purpose of this study was to explore HIV/AIDS client experiences with supportive services. The consumption of social services for individuals living with HIV/AIDS has assumed increasing importance. This is a crucial population that requires a multifaceted approach to treatment in order to remain active and productive for longer periods of time.

The Home and Community Based Care (HCBC) and Support programme has been established as a cost effective response for communities to tackle HIV and AIDS and many other chronic conditions and vulnerabilities which are faced by individuals, families and communities. In terms of the Framework for Home and Community Based Care and Support Programme (2012: 4) HCBCs create an enabling platform for “individuals, families and communities to have access to holistic and comprehensive services nearest to home, which encourages participations by people, responds to the needs of the people, encourages traditional community life and strengthens mutual support opportunity and social responsibility”. Victor Khanye Local Municipality, IDP (2010-2011: 116) states that VKLM is faced with: a high incidence of HIV and AIDS due to poverty, ignorance and a lack of proper entertainment facilities; shortage of clinics and professional staff members, which makes it difficult for patients to access treatment and maximum care and support; and an increase in the number of OVCs which results in a lack of parental care and guidance, poverty, illiteracy, lack of access to medical care, school drop-outs and ultimately an increase in criminal activity and the further spread of HIV and AIDS. The research will assess the effectiveness of Home Community Based Care programmes (HCBCs) on orphaned and vulnerable children with specific reference to the Victor Khanye sub-district in Nkangala District, Mpumalanga Province. The research was conducted in Delmas and its surrounding farming areas. Victor Khanye sub-District has nine wards, most of which are predominantly farming rural areas. The field research took place during June and August 2013 and represents observations recorded at the field interviews, the local AIDS committee and one-on-one interviews with beneficiaries The study is concluded with conclusions drawn from the field study and recommendations.

published_or_final_version / Social Work / Master / Master of Social Work

This study explores and describes the perceived needs of women living with HIV/AIDS in Saskatchewan. A purposive sample was used to recruit women to participate in three focus groups. A total of eleven women from urban and rural areas of Saskatchewan participated. Based on seroprevalence estimates this number may represent one third to one half of all expected cases of women with HIV/AIDS in Saskatchewan. Recursive analysis was used to validate the themes identified in the first two focus groups with participants in a third focus group. Content analysis of the data identified four themes from the women's experiences: 1) medical needs, 2) economic needs, 3) mental health needs, and 4) service needs. The results support previous studies which indicate that women with HIV have a number of unmet heeds. Women from rural areas were found to have more unmet needs and limited access to appropriate services and supports than urban women. Three types of coping strategies were found to be used by the women in getting their needs met: avoidance, maintenance, and mastery. Those who utilized a mastery coping strategy were more successful in having their needs met than those who did not. A number of individual, organizational, systemic, and policy interventions are identified to assist women in moving towards mastery coping strategies. Social workers can work at the clinical, family group, and policy levels to improve the situation for women living with HIV/AIDS in Saskatchewan.

AIDS has established itself over more than three decades as a major international pandemic3. While initial cases of the disease were documented in 1981 in the USA and Europe, cases in Africa became known at around the same time. It is however probable that the disease existed in Africa long before this time (Pratt, 1986:17). Due to the prominence of the AIDS epidemic and its related opportunistic diseases in South Africa and most acutely in KwaZulu-Natal (Smith, 2002 and South African Department of Health Report 2006) , the associated impact of the need for care of those living with and those affected by the virus has been brought to the fore. The accommodation of these persons occurs in a variety of building forms and types, and may vary depending on the stage within the individual’s health cycle related to the impact of the virus. With the advent of medication, termed anti-retroviral therapy, designed to retard the development of the virus, life expectancy has been extended, but with no confirmed cure and viral resistances, death is inevitable. While those living with the virus may continue to live productive lives for some time, the infirm largely seek care within medical facilities. Should access to formal health services be difficult due to remoteness or a lack of transport, such people are often cared for within the homes of surviving family members – often by children - or by their community. With the largest impact on the population being found within the 20 – 29 age bracket in the late 1990's (Smith, 1999: HIV Positive Results, June 1998), shifting to the 25 – 34 age bracket from 2003 onwards (South African Department of Health Report 2006), tertiary education institutions, through their clinics, have increasingly dealt with the management of student and staff health. Other building types affected by the AIDS epidemic4 include prisons and mortuaries, while care for those remaining behind after the death of family members to AIDS is usually within children’s homes or street shelters. The impact of AIDS on the built environment professions will permeate its way to all involved. Through selected case studies one will observe the impact of the epidemic on existing facilities and examine current methods employed to accommodate the problem. Architects, through the modification of existing structures or through the design of new facilities, are assisting in the struggle. New methods of dealing with the care of patients are being considered as well as alternative and innovative design approaches. This includes the need for flexibility of building layouts and universal design. Most proposals in the researched context require cost effective and workable solutions. Hope for the future lies with the management of the virus through medication, enabling the extension of life expectancies. Architects need to adapt to the incumbent problem while medical researchers develop a workable vaccine to confine HIV/ AIDS to the history books with the likes of Bubonic Plague, Smallpox and Typhus. It is through good architectural design and detailing that Architects can assist in the AIDS fight. This can be achieved firstly through research – gaining an understanding of the AIDS Brief – then designing for the specific needs for the infected and affected. These needs will include comfort, accessibility, anthropometrics, ease of maintenance, affordability, ventilation and illumination conducive to good health, and sustainability. Architects therefore have a major role to play within this epidemic. / Thesis (M.Arch.)-University of KwaZulu-Natal, Durban, 2008.

Thesis (MPhil)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: This study investigates the employee perceptions towards outsourcing of HIV/AIDS services in a retail working environment. Thirty participants were included using a self-administered questionnaire. The questionnaire assessed attitudinal disposition through questions aimed testing knowledge, preferences and environmental factors influencing perception towards alternative HTC service centres. Results show employees have positive perceptions towards the utilisation of external HTC and welfare services compared to those offered on-site. On-site employer initiated HTC services through mobile testing facilities are perceived as failing to offer privacy, anonymity and security of continued employment as testing outside the employer’s premises would provide. Outsourced services such as public hospitals or clinics are seen to offer better testing environment because of their natural health settings and non-association with the employer whose motives for providing testing services in the workplace are held in suspicion. Ninety four per cent of the employees expressed desire to have HTC services provided in the workplace. Potential utilisation level of such services dropped to 33% among these employees with 50% indicating a desire to use external health services providers. This disparity is explained by the negative environmental and social factors prevailing in the workplace which make access to HTC difficult. Recommendations for improving employee attitudes towards on-site HTC services include implementing educational programs to reduce peer stigma, scepticism to employer motives for initiating health intervention programs and demonstrating fair employment practices which do not associate HIV status with different treatment in the workplace. There is also a need for companies to plan around facilitating employee use of public health facilities even when they have on-site services to promote a perception of holistic care towards employees. / AFRIKAANSE OPSOMMING: Nie beskikbaar.

This study explores and describes the perceived needs of women living with HIV/AIDS in Saskatchewan. A purposive sample was used to recruit women to participate in three focus groups. A total of eleven women from urban and rural areas of Saskatchewan participated. Based on seroprevalence estimates this number may represent one third to one half of all expected cases of women with HIV/AIDS in Saskatchewan. Recursive analysis was used to validate the themes identified in the first two focus groups with participants in a third focus group. Content analysis of the data identified four themes from the women's experiences: 1) medical needs, 2) economic needs, 3) mental health needs, and 4) service needs. The results support previous studies which indicate that women with HIV have a number of unmet heeds. Women from rural areas were found to have more unmet needs and limited access to appropriate services and supports than urban women. Three types of coping strategies were found to be used by the women in getting their needs met: avoidance, maintenance, and mastery. Those who utilized a mastery coping strategy were more successful in having their needs met than those who did not. A number of individual, organizational, systemic, and policy interventions are identified to assist women in moving towards mastery coping strategies. Social workers can work at the clinical, family group, and policy levels to improve the situation for women living with HIV/AIDS in Saskatchewan. / Arts, Faculty of / Social Work, School of / Graduate

The complex problems of the twenty-first century cannot be effectively addressed with twentieth century top-down bureaucratic governance alone because of limited stakeholder participation in collective decision making and/or implementation. The somewhat limited stakeholder participation in the policy process, especially, that of target populations, can impact generating viable solutions to complex problems. Collaborative governance has emerged as a promising alternative to traditional management in addressing contemporary complex problems. Collaborative governance is thus a type of governance that promotes joint participation of state and non-state stakeholders in decision making and/or implementation by using agreed upon processes of engagement to collectively address problems. Such governance is especially beneficial for addressing the challenges posed by the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). This dissertation uses the collaborative governance concept to explicate the efforts of HIV Health Services Planning Councils in Broward County and Palm Beach County of South Florida with the purpose of accentuating how collaborative governance works in providing various categories of services to meet the needs of people with AIDS (PWAs), as part of the implementation of the Ryan White CARE Act. The study focuses on critical variables of collaborative governance such as facilitative leadership and institutional design, the collaborative process variables such as trust building, commitment to the process and shared understanding, and outputs such as allocation priorities of the Councils. This study employed mixed methods in collecting data from various relevant sources. / The combined findings from surveys, interviews, observations and document reviews were essential to knowledge and understanding of collaborative governance of the respective Councils. The results revealed more similarities than differences between the Councils in their efforts towards addressing the HIV/AIDS problem. The Councils are similar in all variables of collaborative governance with few exceptions relative to facilitative leadership and institutional design. The differences were relative to membership, number of committees, amount allocated for various service categories and number of clients served. Furthermore, the Councils were slightly different in reaching consensus on subjects of deliberation. On the average, Palm Beach County's Council make decisions by consensus relatively easily when compared with the Broward County's Council. Nonetheless, both Councils are consensus-oriented and strive to make decision by consensus as evidenced by unanimous votes or simple majority votes on various subjects of deliberation. In addition, representation and participation of target populations in collaborative governance have contributed to the empowerment of those target populations. The study contributes to the literature by developing a conceptual model for HIV/AIDS collaborative governance for producing outputs to help meet needs of target populations. Also, the study contributes to collaborative governance theorizing by drawing a nexus between variables of collaborative governance and by complementing the existing non-linear perspective of collaborative process for collective problem solving. Collaborative governance involving state and non-state stakeholders thereby enhances efforts of public managers by harnessing resources to effectively manage and/or address complex problems for the benefit of society. / by James K. Agbodzakey. / Vita. / Thesis (Ph.D.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

This ethnography was undertaken in an AIDS hospice with the objective of understanding the functioning of the Centre holistically, including the experiences of the patients and the role of the Centre in the fight against HIV/AIDS. Organisational anthropology in a clinical setting involved gaining entry and rapport with the staff and patients. The methodology included interviewing and observation. The personnel structure and leadership of the Centre were explored, revealing communication, power and management relations that shape the organisational culture. The staff’s attitude towards their jobs and their commitment to assisting those suffering from AIDS revealed the underpinnings of the organisation. The care that patients receive at the Centre was examined along with adoption of the children and the effects of stigmatisation surrounding HIV/AIDS and its impact on patients and their families. The meaning of illness for patients and their sick role as well as the impact of death from HIV/AIDS are exposed. / Anthropology and Archaeology / M.A. (Anthropology)