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Development of HIV Testing Belief Scale (HTBS) and application of Health Belief Model (HBM) to predict HIV testing intention and behaviour among university students in EthiopiaZelalem Mehari Alemayehu 11 1900 (has links)
Appendix B (leaves 217-218), Appendix M (leaves 239-247) and Appendix O (leaves 253-259) in English and Amharic / The purpose of this research was to develop HIV testing Health Belief Scale (HTBS)
that contains the constructs of Health Belief Model (HBM), and also to analyse HIV
testing intention and behaviour among university students.
The mixed method approach was used in phases. First, Literature review and in-depth interviews were
conducted to develop item pool for HTBS, which was followed by content validity assessment by
experts. In the second phase, a pilot survey was conducted on randomly selected 318 university
students to refine the HTBS using item analysis and Exploratory Factor Analysis (EFA). Lastly,
cross-sectional survey was conducted on representative sample of 612 students in order to further
refine the HTBS using Confirmatory Factor Analysis (CFA) and also analyse predictors of HIV testing
intention and behaviour. A total of 61 items was written for the HTBS and 23 of these were generated from the
in-depth interviews. Content validity assessment by three experts indicated that the average
content validity index (CVI) for the 61 items was 91.2% which was more than the recommended cut off
point of 90%. The HTBS, after experts review, contained 64 items.
EFA indicated that a five factor model which was roughly consistent with HBM was identified and 44
items were retained based on factor loading and reliability analysis. The Cronbach’s alpha for all
the six constructs of HBM and HIV testing intention in the HTBS were >0,70.
(susceptibility, benefit, self-efficacy and HIV testing intention) fitted the sample data based on
chi-square test. However, all the seven constructs demonstrated RMSEA value of less than 0.08 and
GFI value of >0.90 indicating acceptable fit. The final HTBS was reduced to 39 items based on
factor loading and reliability assessment. All the constructs demonstrated a Cronbach’s alpha value
>0.70 except for perceived susceptibility and cues to action.
Analysis of multiple linear regression indicated that class year, perceived benefit, perceived
self-efficacy and cues to action were significant predictors of HIV testing intention. However,
only marital status and cues to action were significant predictors of recent history of HIV testing
through analysis of binary logistic regression. / Health Studies / D.Litt. et Phil. (Health Studies)
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Strategies to strengthen referral and linkage system of HIV positive clients in Addis Ababa, EthiopiaFasika Dessalegne Dinku 11 1900 (has links)
Introduction: HIV referral and linkage system in many countries in general and in Ethiopia in particular was poorly characterised by low linkage rate. The purpose of this study was to analyses factors associated with poor referral and linkage system and develop strategies to improve the system.
Methods: A sequential mixed method approach using exploratory descriptive study design was employed. The study was conducted in Addis Ababa, Ethiopia and it was conducted in two phases. Phase I involved data collection and analysis as evidence for the development of strategies while phase II was the development of strategies. For phase I, data were collected in steps 1 and 2 using individual interviews and focus group discussions respectively. The study participants were programme owners and partners who were supporting facilities during the data collection period in step 1 and health care providers in step 2. A total of 4 individual interviews and 3 FGDs were conducted with purposively selected participants. Data were analysed using computer assisted software called OpenCode version 4.2.
Results: The findings revealed five themes namely, issues of referral and linkage practice, ensuring linkage through communication, issues of health care, issues of health care system and issues of partnerships and Health Bureau. Many gaps that affected the referral system were identified and in phase II, nine strategies were developed to strengthen the referral and linkage system.
Conclusion:The results of this study highlighted weaknesses in the referral and linkage system of the HIV positive clients from counselling and testing services to chronic care and proposed strategies to strengthen those weaknesses. Measures to operationalise those strategies are also proposed. The successful implementation of the proposed strategies depends on the support of the ministry of health and regional bureau in terms of resources and the readiness of the health care providers to adhere to the proposed measures. Intervention research is needed to test the effectiveness of the proposed strategies. / Health Studies / D. Litt. et Phil. (Health Studies)
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HIV exceptionalism and the South African HIV and AIDS epidemic: perspectives of health care workers in PietermaritzburgStill, Linda Joy 31 October 2008 (has links)
The limited success of HIV-testing facilities in South Africa means that many
people are not accessing necessary antiretroviral treatment services. This
study investigates the practical implications of HIV exceptionalism inherent in
Voluntary Counselling and Testing (VCT). A semi-structured interview
schedule was used to survey participants for their perspectives on barriers to
HIV-testing uptake as well as the effects of exceptionalist practices at VCT
clinics. Responses showed marked perceptions of gender differences in
people's willingness to test and several important barriers including problems
of access to services. Significantly, exceptionalism displayed in certain clinic
procedures was thought to contribute to stigma, and attempts to normalise
HIV practice in order to combat the effects of stigma were being informally
implemented. Participants' views on routine opt-out testing were explored.
The researcher recommended further investigation on how HIV testing and
treatment policies can be normalised so as to reduce stigma and increase
testing uptake. / Social Work / M.A. Sociology (Social Behaviour Studies in HIV/AIDS)
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HIV exceptionalism and the South African HIV and AIDS epidemic: perspectives of health care workers in PietermaritzburgStill, Linda Joy 31 October 2008 (has links)
The limited success of HIV-testing facilities in South Africa means that many
people are not accessing necessary antiretroviral treatment services. This
study investigates the practical implications of HIV exceptionalism inherent in
Voluntary Counselling and Testing (VCT). A semi-structured interview
schedule was used to survey participants for their perspectives on barriers to
HIV-testing uptake as well as the effects of exceptionalist practices at VCT
clinics. Responses showed marked perceptions of gender differences in
people's willingness to test and several important barriers including problems
of access to services. Significantly, exceptionalism displayed in certain clinic
procedures was thought to contribute to stigma, and attempts to normalise
HIV practice in order to combat the effects of stigma were being informally
implemented. Participants' views on routine opt-out testing were explored.
The researcher recommended further investigation on how HIV testing and
treatment policies can be normalised so as to reduce stigma and increase
testing uptake. / Social Work / M.A. Sociology (Social Behaviour Studies in HIV/AIDS)
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