Magister Public Health - MPH / Background:HIV is a worldwide pandemic with an estimated 2.5 million children under the age of 15 living with HIV in the world in 2009. Children account for approximately 14% of all HIV-related deaths around the world. Several studies have shown that the use of antiretroviral drugs greatly improve the lives of HIV-1 infected individuals, however, most of these studies report on outcomes of ART programmes in developed world and for adult patients. Very few settings have published outcomes of paediatric ART programmes.Objectives This research was aimed at describing the long term (at least one year) treatment outcome of HIV-1 infected children in the HIV/AIDS Prevention Group (HAPG) program in Bela-Bela in the Limpopo province of South Africa.Study design and methods: A quantitative approach involving a retrospective cohort design was used for the study. The study included all children under the age of 15 that were enrolled in the HATG treatment programme in Bela-Bela between February 2004 and December2009.Immunological, virological, clinical outcomes and loss to follow-up were determined for this cohort. Mortality and survival was also determined. Results: The median age of children in this study was 5 years (IQR: 2-7) with 14% (10/71) of them being less than 18 months. Median CD4 count at commencement of ART, viral load and weight were 358 cells/mm3 (IQR 203.5-, 125673 RNA copies/μL (IQR 58094-328424.5) and 14.5Kg (IQR: 11.0-18.35) respectively. CD4 counts and weight showed increase within the study period, and there was also a decline in viral load. Loss to follow-up was 7.04% while mortality was 19% with 21.43% of mortality cases being children who were ≤18months. Mortality occurred within the first year of ART initiation and occurred in cases that had advanced disease.Conclusion: This study shows that the ART program in Bela-Bela has a positive outcome on HIV positive children.The high mortality rate was due to children starting ART at an advanced disease stage. Despite the good outcome, it is recommended that a system be put into place that will aid in identifying children at an early stage of the disease and treatment initiated promptly.

Text in English with abstracts and keywords in English, Tswana and Sepedi / Providing support to employees living with HIV to adhere with treatment at home and at work is the key to prolong life and wellbeing of those who are infected and affected by HIV/AIDS pandemic. This study was qualitative explorative research. The study used qualitative method of collecting data which allowed the researcher to conduct interviews at the natural settings where it was convenient for participants to take interview calls. The purpose of this study was to explore how implementation of ART programmes support employees living with HIV (ELWHIV) to adhere with treatment at home and work so that gaps and areas of improvement are identified. The study took place at SWHAP companies that are based in Ekurhuleni, Gauteng. The study used purposive sampling to identify key informants who were directly involved in the implementation of the ART programmes. Data was largely analysed using content, thematic and triangulation analysis. Theory of social ecology and empowerment theory were applied as companies are seen using workplaces as safe space to provide counselling and psychosocial support to ELWHIV through Reality Wellness. Findings: The findings of the study revealed that ART programmes are in place in SWHAP companies and are also ongoing. The study also reveals that Reality Wellness provided counselling and psychosocial support to ELWHIV to adhere with treatment at home and at work. The study further reveals that ELWHIV fear to disclose their HIV status because of stigma and discrimination. Recommendations: More dialogue and further studies on ART programmes particularly on ART adherence at home and at work need to be done. Management should take ownership and get involved directly with ART programmes and enhance support to ELWHIV to adhere with treatment at home and at work. / Go tshegetsa badiri ba ba tshelang ka mogare wa HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong go botlhokwa go tshegetsa botshelo le itekanelo ya ba ba tshwaeditsweng le ba ba amilweng ke leroborobo la AIDS. Thutopatlisiso eno e ne e lebelela mabaka mme e tlhotlhomisa. Mokgwa wa go lebelela mabaka go kokoanya data o letlile mmatlisisi go dira dipotsolotso mo mafelong a tlwaelo a banni-le-seabe moo go neng go le bonolo mo go bone go araba megala ya dipotsolotso. Maikemisetso a thutopatlisiso eno, e ne e le go tlhotlhomisa ka moo go tsenngwa tirisong ga mananeo a ART go tshegetsang badiri ba ba tshelang ka HIV (ELWHIV) ka go na go obamela tiriso ya kalafi kwa gae le kwa tirong gore go kgone go supiwa diphatlha le dikarolo tse di ka tokafadiwang. Thutopatlisiso e dirilwe kwa ditlamong tsa SWHAP tse di kwa Ekurhuleni, Gauteng. Go diragaditswe mokgwa wa go tlhopha sampole go ya ka maikaelelo a thutopatlisiso go supa basedimosetsi ba botlhokwa ba ba neng ba na le seabe ka tlhamalalo mo go tsenngweng tirisong ga mananeo a ART. Go lokolotswe data go dirisiwa molokololo wa diteng, morero le tiriso ya melebo e e farologaneng go lokolola. Go dirisitswe tiori ya ikholoji ya loago le tiori ya maatlafatso ka ntlha ya fa ditlamo di bonwa di dirisa mafelo a tiro jaaka dibaka tse di bolokesegileng tsa go tlamela tshegetso ya maikutlo le tshegetso ya tlhaloganyoloago go badiri ba ba tshelang ka HIV ka itekanelo ya nnete. Diphitlhelelo: Diphitlhelelo tsa thutopatlisiso di bontsha gore mananeo a ART a gona mo ditlamong tsa SWHAP mme a tswelela pele. Itekanelo ya nnete e tlamela ka tshegetso ya maikutlo le ya tlhaloganyoloago go badiri ba ba tshelang ka HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong. Gape thutopatlisiso e bontsha gore badiri ba ba tshelang ka HIV ba tshaba go senola seemo sa bona sa HIV ka ntlha ya sekgobo le go tlhaolwa. Dikatlenegiso: Go tshwanetse ga nna le dipuisano le dithutopatlisiso tse dingwe tsa manaeo a ART, bogolo segolo kobamelo ya tiriso ya ART kwa gae le kwa tirong. Botsamaisi bo tshwanetse go nna beng ba, e bile bo nne le seabe ka tlhamalalo mo mananeong a ART le go tshegetsa badiri ba ba tshelang ka HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong. / Go fa bašomi bao ba phelago ka HIV gore ba obamele go nwa dihlare ka gae le mošomong ke selo se bohlokwa go dira gore ba phele lebaka le letelele le gore bao ba fetetšwego le go angwa ke leuba la AIDS ba phele gabotse. Dinyakišišo tše di bile tša boleng le tša go utolla. Mokgwa wa go kgoboketša tshedimošo wa boleng o kgontšhitše monyakišiši go dira dipoledišano ka seemong sa tlhago sa mokgathatema fao go bilego bonolo go yena go araba megala ya dipoledišano. Maikemišetšo a dinyakišišo tše e bile go utolla ka fao go tsenya tirišong ga mananeo a ART go thekgago bašomi bao ba phelago ka HIV (ELWHIV) go obamela go nwa dihlare ka gae le mošomong gore dikgoba le dibaka tša kaonafalo di tsebje. Dinyakišišo tše di dirilwe ka dikhamphaning tša SWHAP tšeo di lego ka Ekurhuleni, Gauteng. Go dira sampole ka maikemišetšo go phethagaditšwe ka nepo ya go tseba baseboši ba bohlokwa bao ba bego ba kgatha tema thwii ka mananeong a ART. Tshedimošo e sekasekilwe ka go šomiša tshekatsheko ya diteng, ya morero le ya seemokhutlotharo. Teori ya ekholotši ya leago le theori ya maatlafatšo di dirišitšwe ka ge dikhamphani di bonwa e le tšeo di šomišago mafelo a mošomong bjalo ka mafelo ao a bolokegilego a go fana ka keletšo le thekgo ya tša menagano go ELWHIV ka go diriša temogo ya seemo sa makgonthe. Dikutollo: Dikutollo tša dinyakišišo di utolla gore mananeo a ART a tsentšwe tirišong ka dikhamphaning tša SWHAP ebile a tšwela pele. Temogo ya seemo sa makgonthe e fana ka keletšo le thekgo ya menagano go ELWHIV ka nepo ya gore ba omabele go nwa dihlare ka gae le mošomong. Dinyakišišo di tšwela pele go utolla gore ELWHIV ba tšhoga go tsebagatša maemo a bona a HIV ka lebaka la kgobošo le kgethologanyo. Ditšhišinyo: Dingangišano tše dingwe le dinyakišišo go tšwela pele ka go mananeo a ART, kudukudu mabapi le go obamela go nwa dihlare tša ART ka gae le mošomong, di swanetše go dirwa. Ba taolo ba swanetše go tšea maikarabelo a mananeo a ART le go kgatha tema ka go ona thwii le go maatlafatša thekgo go ELWHIV ka nepo ya go obamela go nwa dihlare ka gae le mošomong. / Health Studies / M.A. (Social Behaviour Studies in HIV/AIDS)