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Reproductive decision-making in the era of high levels of unwanted pregnancy and HIV/AIDS among young people : a case study of Nelson Mandela Drive Campus in the Eastern Cape.Kyabaishiki, Eunice. January 2008
Young people are faced with high levels of HIV/AIDS and unwanted pregnancy in South
Africa. In this context it is important to understand the reproductive decision-making
process with regard to these sexual risks. The study draws on in-depth interviews
conducted with 20 Black students aged 18 to 24 years at the Walter Sisulu University.
The study found that there was a high level of awareness of unwanted pregnancy and
HIV/AIDS. However, many young people engaged in risky sexual behaviours. Differing gender roles seemed to significantly promote risky sex and discouraged shared decision making.
The study suggests that men often dominated the decision-making process. In
addition, partner coercion was prevalent, and it negatively affected the health choices of
young people. Other factors that were barriers to adopting prevention strategies included
the negative attitudes of health providers and limited communication between parents and
children and also, between sexual partners. Young people were afraid to freely discuss
sexual issues and preferred actions to avoid antagonizing partners who might suspect
infidelity, lack of commitment and HIV infection. Some young people also expressed
concern that contraceptives were not safe. Young people emphasized the negative
repercussions of HIV/AIDS and unwanted pregnancy and the importance of creating
greater awareness of the risks and adopting prevention strategies. However, the study
findings point to the need for health promotion interventions to go beyond risk awareness
and incorporate the cultural, social and economic contextual factors in which the
behaviour takes place. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2008.
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Process evaluation of the Indlela HIV/AIDS and life skills programme in Amaoti, Durban.Erasmus, Miridtza' January 2009 (has links)
BACKGROUND: HIV/AIDS has seemingly conquered all medical means of prevention. An approach is therefore needed which focuses on the future of a generation, in equipping today‟s children with the necessary knowledge and skills, to prevent future HIV/AIDS infections and implications. In an attempt to combat HIV/AIDS, Life Orientation has been incorporated in the South African school curriculum as one of the learning areas. Children hereby are receiving knowledge on HIV/AIDS and life skills. Research however, has found that young people do not necessarily respond to, or internalise information received. Programmes which focus on interactive participation and experiential learning are needed for desired outcomes. Specific focus on self-esteem, self-efficacy, communication and a sense of future are also necessary, as these aspects play a crucial role in health behaviour or the lack thereof. iThemba Lethu has been endorsed by the KwaZulu-Natal Department of Education and focuses specifically on these issues. iThemba Lethu has granted Indlela permission to use their programme in schools in the Amaoti community, referred to as the Indlela Life Skills programme, to make a positive contribution to the youth of this vulnerable community. Because programme evaluation is an integral part of programme implementation and development, this study will focus on process evaluation of the Indlela programme. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.
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Experiences of HIV positive clients defaulting isoniazid preventive therapy (IPT) in King Williams Town area under the Buffalo City Municipality in the Eastern Cape ProvinceWilliams, Nelisa Colleen January 2015 (has links)
This qualitative study using a phenomenological design, aimed at exploring and describing and exploring the experiences of HIV positive clients defaulting Isoniazid Preventive Therapy services in the Bhisho Primary Health Care Services. The emphasis was on the factors leading clients to default. An in- depth unstructured face to face interviews were done on 14 participants from 4 clinics or facilities under Bhisho Primary Health Care Services. From the respondents’ responses it can be noted that work and family related issues, ignorance of patients, side effects, and negligence of nurses and denial of HIV status were identified as reasons for defaulting. Having knowledge about the treatment and health providers’ attitudes to patients also played a role in patients defaulting their treatment.Many suggestions were then put forward by the respondents to curb defaulting among patients. These included the use of text message reminders, not to discrimination HIV patients because of their status, to use consulting rooms for privacy and also nurses and caregivers to control their attitudes when dealing with patients.
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Factors associated with loss to follow-up HIV-uninfected tuberculosis patients in Ekurhuleni North sub-districtMoyo, Batanai January 2017 (has links)
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of MSc Epidemiology (Infectious Disease Epidemiology), Johannesburg, November 2017 / Tuberculosis (TB) is a leading cause of death worldwide, causing more deaths than HIV/AIDS.
A TB patient can have pulmonary or extrapulmonary TB or both. South Africa has a high
incidence rate of TB, recording 834 cases per 100 000 population in 2015, compared to 142
per 100 000 globally. Loss to follow-up (LTFU) rates during TB treatment in South Africa
have ranged from 7% to 30%.
The factors associated with LTFU can be divided into four groups: socioeconomic factors,
patient-related factors, treatment factors, and health system or programmatic factors.
Socioeconomic factors include a lack of support and a low socioeconomic status. Patient
related factors include substance abuse, beliefs and low TB knowledge, while treatment factors
include side effects and a history of LTFU. Among health system or programmatic factors that
contribute to LTFU are a poor relationship with the healthcare workers and large treatment
programmes.
Studies to determine the factors associated with LTFU in HIV-uninfected TB patients are few
as most studies have focused on HIV/TB co-infected patients. Co-infected patients make up
almost 60% of TB patients. The aim of this study was to determine the demographic and
clinical factors associated with LTFU in HIV-uninfected TB patients who registered for TB
treatment in Ekurhuleni North sub-district from 1st January 2011 to 30th June 2012. LTFU was
defined as a lack of a documented treatment outcome among TB patients who should have
completed TB treatment based on TB treatment start date.
The study was a retrospective cohort study involving the secondary analysis of routine TB
treatment data collected from 18 primary care clinics in Ekurhuleni North sub-district. The
participants were described at the beginning of TB treatment using clinical and demographic
data. The treatment duration and outcomes were also described. The burden of LTFU was
determined. Univariate and multivariate logistic regression and Cox proportional hazards
regression were used to determine the factors associated with LTFU. In addition, survival
analysis was conducted to determine if there was a difference in the time to LTFU among HIV
uninfected TB patients based on clinical and demographic factors. Sensitivity analysis of the
multivariate logistic regression and Cox proportional hazards regression was carried out to
compare the results obtained when follow-up was restricted to 8 months to those obtained for
12 months of follow-up. Sensitivity analysis was also conducted around the definition of
LTFU. The impact on the results of multivariate logistic regression after assuming that
participants who had a missing treatment outcome in the primary study were not lost to follow
up was determined.
Five hundred and fifteen participants were included in the analysis. The median age of the
participants was 33 years (IQR: 26-47). Fifty-eight percent of the participants were male.
Pulmonary TB was the most common form of TB among the participants. The rate of treatment
success was 77.67% and that of LTFU was 17.28%. Of those lost to follow-up, 60 had a missing
treatment outcome and 29 had default as an outcome in the primary study. The median length
of treatment was 6.39 months (IQR: 5.67-7.44), and the median time to LTFU was 3.67 months
(IQR: 1.54-6.33). Eighty-two percent of the participants had a documented change of treatment
phase. Clinics with a high patient burden had a similar proportion of poor outcomes (death,
LTFU and treatment failure) to clinics with low patient burdens. Significant differences in
change of treatment phase and length of treatment were observed between those lost to follow
up and those not lost to follow-up.
LTFU took place throughout TB treatment, with a steady increase in the probability of LTFU
over the first 6 months of follow-up. None of the factors investigated had a significant effect
on time to LTFU. Following logistic regression and Cox proportional hazards regression
analyses, none of the factors assessed were significantly associated with LTFU. Sensitivity
analysis showed that censoring the participants at 8 months did not change the results of the
logistic regression analysis. For Cox proportional hazards regression, female participants had
a 5% lower risk of LTFU compared to male participants in the 12-month analysis. In the 8
month analysis, female participants had a 5% higher risk of LTFU. When participants with a
missing treatment outcome were not considered lost to follow-up, sex was found to be
significantly associated with LTFU. Female participants had a 66% lower risk of LTFU
compared to male participants.
A limitation of the use of secondary data in this study was that the study question asked in this
study was different from the question that was asked in the primary study. As a result, the
variables collected in the primary study were different from the variables required in this study.
Information on socioeconomic status, residence type, comorbidities, treatment clinics and
health system factors was not available.
None of the factors investigated in this study were significantly associated with LTFU in HIV
uninfected TB patients in Ekurhuleni North sub-district. The factors influencing LTFU in
Ekurhuleni North may not have been investigated in this study. More studies need to be
conducted with a wide range of variables in Ekurhuleni North to determine the factors that
influence LTFU among HIV-uninfected TB patients. / XL2018
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Molecular-genetic investigation into host susceptibility and variability to HIV/AIDS in the South African populationPretorius, Gideon Stephan 12 1900 (has links)
Thesis (PhD)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: The risk of human immunodeficiency virus type-1 (HIV-1) infection and rate of progression
towards development of the acquired immunodeficiency syndrome (AIDS) is determined
by a combination of viral characteristics, immune function and host genetic variation.
Although mutations of the chemokine and chemokine co-receptor genes and allelic
variation of the major histocompatibility complex (MHC) have been studied extensively,
variation in these host genetic factors does not explain the differences in HIV/AIDS
susceptibility in all cases. This study represents the first analysis of new candidate genes
implicated in iron metabolism and immune function in relation to HIV-1 disease in the
African context. Both case-control association studies and genotype-phenotype
correlations were performed to determine the potential functional significance of genetic
variants that may be involved, either directly or indirectly, in susceptibility to HIV-1 disease
in the South African population.
Genotyping was performed to identify potentially important polymorphisms in the solute
carrier family 11 member 1 (SLC11A 1), haemochromatosis (HFE) and protein-tyrosine
phosphatase receptor-type C (PTPRC/CD45) genes in HIV-seropositive versus HIVseronegative
individuals. This was followed by HLA-B27 genotyping in HIV-1 infected
individuals with known disease status to determine the potential impact of combined
genotypes for different mutations identified in the same study cohort. Preferential
association with any of the mutations screened for in the CCR5, SLC 11A1, HFE or CD45
genes were not detected in HLA-B27 positive individuals identified. These findings were in
accordance with the independent protective role of HLA-B27 in relation to disease
progression in HIV-1 infected individuals.
Although differences in allelic distribution were not significant between the study groups,
an apparently African-specific mutation 32A~G, identified in an exonic splicing silencer
element (ESS-1) of the CD45 gene, appeared to predominate in HIV-1 infected subjects
with WHO Class I disease status and slow progression to AIDS. This mutation was
present in 35.7% (5/14) of HIV-seropositive individuals with WHO Class I disease status,
whilst absent in 22 HIV-seropositive patients with rapid disease progression. This finding
may be related to differences in proportions of both CD4+ and CD8+ subsets observed
following flow cytometry (FACs) analys.s in two HIV-seropositive individuals with mutation
32A~G, compared with an HIV-seropositive individual without this mutation. Analysis of the iron-related SLC11A1 and HFE genes did not reveal significant
associations with modified risk of HIV-1 infection or progression to AIDS in our
predominantly African study population. However, the effect of the virus on iron
metabolism was demonstrated for the first time at the DNA level. Haemoglobin levels were
significantly reduced in both HIV-seropositive (P=O.004) and HIV-seronegative (P=O.02)
Black Africans with mutation IVS3-48c~g in the HFE gene, compared with mutationnegative
individuals in both groups. Since this effect was more pronounced in HIV-infected
individuals compared with controls, presence of the HFE mutation seems to result in an
even stronger effect on haemoglobin levels, which may be related to the acute phase
response following virus infection. This effect possibly results from genetic variation in a
nearby gene involved in innate immunity, most likely in the HLA region on chromosome 6.
It therefore seems possible that genetic variation in any of the host molecules involved in
response to infection could contribute to clinical outcome.
The significance of the multitude of host genetic factors investigated in this study, or
previously implicated in susceptibility to HIV-1 infection and disease progression, revealed
a complex interrelationship between the host and HIV-1. In some instances the disease
process following HIV-1 infection depends on combined effects of different mutations
occurring in the same individual, while independent effects of specific genes in conjunction
with environmental influences may explain diverse clinical outcomes in others. / AFRIKAANSE OPSOMMING: Die risiko vir menslike immuniteitsgebrek virus tipe-1 (MIV-1) infeksie en die progressietempo
vir ontwikkeling van die verworwe immuniteits gebrek sindroom (VIGS) word
hoofsaaklik deur fn kombinasie van virale eienskappe, immuunfunksie en gasheer
genetiese variasie bepaal. Alhoewel mutasies van die chemokien en chemokien koreseptor
gene en alleliese variasie van die major weefsel-verenigbaarheidskompleks
(MWVK) reeds omvattend bestudeer is, verklaar variasie van hierdie gasheer genetiese
faktore nie noodwendig verskille in vatbaarheid vir MIVNIGS in alle gevalle nie. Hierdie
studie verteenwoordig die eerste analise van nuwe kandidaatgene, geïmpliseer in yster
metabolisme en immuunfunksie in die konteks van MIV-1 siekte in Swart
bevolkingsgroepe. Beide gevalle-kontrole assosiasie-studies en genotipe-fenotipe
korrelasies is uitgevoer om moontlik betekenisvolle verwantskappe met genetiese variante
te bepaal, wat moontlik direk of indirek betrokke mag wees in vatbaarheid vir MIV-1 siekte
in die Suid Afrikaanse populasie.
Genotipering van die solute draer familie 11 lid 1 (SLC11A1), hemochromatose (HFE) en
protein-tirosien fosfatase reseptor-tipe C (PTFRC/CD45) gene is uitgevoer in beide MIVseropositiewe
en MIV-seronegatiewe individue. Daaropvolgend is genotipering van die
menslike leukosien antigeen-B27 (MLA-B27) uitgevoer in MIV-1 geïnfekteerde individue
met bekende siekte-status, om die potensiële impak van gekombineerde genotipes te
bepaal vir verskillende mutasies wat in dieselfde studie populasie geïdentifiseer is.
Voorkeur-assosiasie is nie waargeneem vir enige van die mutasies waarvoor geanaliseer
is in die CCR5, SLC11A1, HFE of CD45 gene nie. Hierdie bevinding is in ooreenstemming
met die onafhanklike rol van MLA-B27 in verwantskap met siekte progressie in MIV-1
geïnfekteerde individue.
Alhoewel die alleelverspreiding van In Afrika-spesifieke mutasie 32A~GI wat in In
eksoniese splytingsdemper-element (ESS-1) van die CD45 geen geïdentifiseer is, nie
statisties betekenisvolle verskille getoon het tussen studiegroepe nie, is die mutasie
oorheersend waargeneem in MIV-1 geïnfekteerde individue met WGO Klas I siektestatus
en stadige progressie na VIGS. Hierdie mutasie was teenwoordig in 35.7% (5/14)
van HIV-seropositiewe individue met WGO Klas I siekte-status, terwyl dit afwesig was in
22 HIV-seropositiewe pasiënte met vinnige siekteprogressie. Hierdie bevinding mag moontlik verband hou met verskille in verhoudings van beide die
CD4+ en CD8+ substelle, soos waargeneem gedurende vloei sitometriese (VAS, FACs)
analise in twee HIV-seropositiewe individue met mutasie 32A---+G, in vergelyking met en
HIV-seropositiewe individu sonder hierdie mutasie.
Analise van die yster-verwante SLC11A 1 en HFE gene het nie betekenisvolle assosiasies
opgelewer met gemodifiseerde risiko vir MIV-1 siekte of progressie na VIGS in die
hoofsaaklik Swart studie-populasie nie. Die effek van die virus op ystermetabolisme is wel
vir die eerste keer op DNS vlak gedemonstreer. Hemoglobien vlakke was betekenisvol
verlaag in beide MIV-seropositiewe (P=O.004) en MIV-seronegatiewe (P=O.02) Swart
individue met die HFE geen IVS3-48C---+G mutasie, in vergelyking met mutasie-negatiewe
individue in beide groepe. Aangesien hierdie effek meer uitgesproke was in MIVgeïnfekteerde
individue as in kontroles, blyk dit dat die teenwoordigheid van die HFE
mutasie die hemoglobienvlakke tot engroter mate beïnvloed weens die akute fase respons
wat verband hou met die virusinfeksie. Hierdie effek kan moontlik toegeskryf word aan
genetiese variasie in ennaasliggende geen wat in aangebore immuniteit betrokke is, heel
moontlik in die MLA gebied van chromosoom 6. Dit wil dus voorkom asof genetiese
variasie in enige van die gasheer molekules betrokke by respons op infeksie kan bydra tot
die kliniese uitkoms.
Die belangrike rol van die veelvuldige gasheer genetiese faktore wat in hierdie studie
bestudeer is, of wat voorheen geïmpliseer is in vatbaarheid vir MIV-1 infeksie en siekte
progressie, het enkomplekse inter-verwantskap tussen gasheer en MIV-1 geopenbaar. In
sommige gevalle is die siekte-proses na MIV-1 infeksie afhanklik van gekombineerde
effekte van verskillende mutasies in dieselfde individu, terwylonafhanklike effekte van
spesifieke gene tesame met omgewings-invloede uiteenlopende kliniese uitkomste in
ander mag verklaar.
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A contextual assessment of a workplace HIV/AIDS peer education programme.Anderson, Roslyn. January 2009 (has links)
Set in the mining sector, the aim of this study was to explore the experiences, insights and reflections of a particular group of peer educator's with regard to their organisation’s peer education programme. Using the PRECEDE-PROCEED Model (Green & Kreuter, 1991) as an organising framework, this study explored the pre-disposing, enabling and reinforcing factors that had an impact on this HIV/AIDS peer education programme. The specific objectives to be assessed in this study were the peer educator’s perceived impact on attitude and behaviour change amongst employees; the perceived organisational barriers and supports that peer educators encountered in programme delivery as well as further training needs of the peer educators. Using an interpretivist paradigm, the study was concerned with describing and interpreting people’s feelings and experiences with qualitative depth. Interviewees comprised of a non-probability saturation sample of five current adult peer educators and one adult ex-peer educator, employed in the Eastern Region of the Organisation (KwaZulu-Natal). In addition the regional manager and the human resource manager were interviewed. Semi-structured tape recorded interviews were used to collect data from the peer educators, and the data was transcribed verbatim from the digital recording. Themes were induced and coded by looking for reoccurring peer educator views, following which the researcher was able to induce potential predisposing, enabling and reinforcing factors that the peer educators faced in programme delivery. Based on the findings of the study, appropriate recommendations are offered with a view to improving programme delivery and quality. Finally, the main constraints which limited the study findings are considered. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.
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Acquired immuno deficiency syndrome (AIDS) : an impact on marketing strategies in retail food companies in South AfricaVeerasamy, Ashika 27 August 2012 (has links)
M.B.A. / The purpose of this research project will be to test the impacts of HIV/AIDS and the manner in which it will influence changes in marketing strategies for Retail Food Companies in the future. The research questions posed are: What do Retail Food Companies perceive the impact of HIV/AIDS to be on their customer profile in the next 5 years? Do Retail Food Companies have marketing strategies in place to address the impact of HIV/AIDS on their primary target market? Do Retail Food Companies perceive HIV/AIDS to impact on their current product portfolio and their product portfolio in the next 5 years?
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Rumours of war : de-constructing media discourses of HIV/AIDS in South AfricaConnelly, Mark January 2002 (has links)
This paper explores discourses of HIV/AIDS evident in a South African daily newspaper from 1985 to 2000, and discusses the implications of these in terms of the way in which HIV/AIDS is constructed in society. In this paper I utilize a Foucauldian analysis of the relationship between power and knowledge. The discursive framework of the war against HIV/AIDS is used to show how different groups of subjects are positioned in relations of power. Within this the power of western science and medicine is influential and supports and informs other discourses of HIV/AIDS. I argue that the discursive framework constructing HIV/AIDS as a war does far more than provide a useful vehicle within which HIV/AIDS can be understood as it supports certain institutions and groups of people above others. The paper concludes by identifying the silenced voices of women and dissidents, and calling for greater reflection concerning the critical analysis of current issues surrounding HIV/AIDS.
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An investigation into prisoners' awareness about HIV/AIDS with reference to the Empangeni Qalakabusha PrisonMkhize, Nompumelelo. January 2003 (has links)
Submitted in fulfillment of the requirements for the Degree Master of Arts in Sociology at the University of Zululand, South Africa, 2003. / It gives me pleasure to present the first report on "Prisoner's awareness on HIV-AIDS with reference to Empangeni Qalakabusha prison. The compilation of this research emanates from the willingness to inform, educate, advice and guide the Government and Prison management on the issues relating to HIV-AIDS in South African prisons, since less has been compiled in relation to this issue.
The report reflects on the most important challenges facing our prison society, their causes and consequences. This is done to ascertain whether there is progress, activities or means done in relation to developing HIV-AIDS awareness in the prison institutions.
The contents of this report are organized and delivered in a series of four chapters, dealing with specific and different contents, under the umbrella of the main study topic. Each chapter simply begins with an introduction, which gives an overview of the material entertained in that particular section.
An inclusive response from all Empangeni Qalakabusha prison stakeholders' through questionnaires and interviews form bases of this qualitative study report findings. Recommendations are made inter alia some of the findings.
These recommendations are aimed at all South Africans facing this epidemic. The researcher also sincerely hopes that information on this report will be used to promote the culture of "Breaking the silence" around this silent killer of our nation. As South Africa faces the challenges of its renewal or renaissance, there is no greater potential barrier to the attainment of this vision than the spectra of the HIVAIDS epidemi
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The dissemination of knowledge between medical and non-medical staff in a hospital setting as a means of preventing AIDS infection of hospital workersAbrahamsohn, David Alan January 2016 (has links)
Knowing about .AIDS and the manner in which it can be contracted in the
workplace is essentlal for preventing infection. This thesis attempts to explore
whether non-medlcal hospital workers are placed at risk of Infection by virtue
of their ignorance of the virus and further seeks to investigate whether
"expert" knowledge possessed by professional health workers is disseminated
to less-skilled and less-knowledgeable workers. Processes around class and
status involved in social closure are investigated to account for the lack of
communication concerning AIDS amongst hospital workers. Two research
procedures were adopted in this study, namely the intensive interview and
participant observation.
Findings of the thesis indicate that though all hospital workers are at risk of AIDS infection, unskilled workers remain more vulnerable because they lack knowledge and awareness of the virus. Factors of class, status, educational opportunity and professional elitism striate the hospital workforce and result in exclusionary practices, including the non-dissemination of knowledge about AIDS in the hospital work setting
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