Puberty rites are practised in many countries including South Africa. In South Africa the puberty rites have different names and different practices. This study focused on vukhomba among the Manchangana/Vatsonga. Vukhomba is conducted exclusively for girls who have reached menarche. The purpose of this study was to explore the possibility of utilising vukhomba for the improvement of the health status of women. The study design is a qualitative, exploratory, descriptive contextual research study conducted in the Northern region of the Northern Province among Vatsonga\Manchangana in four selected areas. The ethnographic strategy was used to gain access to the vukhomba to view and describe the rite from an emic perspective. The sample included all girls who were initiates during January 1998 and December 1999 in the four selected areas, as well as Vadzabi, varileri, initiated girls, initiated women and vukhomba elders who attended the initaitions. The techniques for data collection included participant observation, semi-structured interviews, focus group discussions, key informant interviews and feedback workshops. The findings indicate that vukhomba is conducted during the school holidays in order to cater for girls who are still attending school. The sexuality education in this rite is mainly about encouraging initiates to maintain their virginity for their future husbands. Vukhomba therefore teaches girls attending the initiation the facts of life. It was however, found that girls often attend the initiation for material gain and respect for elders. The content of sexuality education information given to girls during the rite is inadequate. Initiated women and girls wanted to gain more knowledge about their bodies, their health, menstruation, child bearing and pregnancy, contraceptives and pregnancy. After reviewing the findings of the research an intervention programme was developed and discussed with the initiated women and initiated girls. Vukhomba elders accepted the intervention programme, however, certain topics were not approved e.g. contraception. The intervention programme is expected to form part of the initiation programme in the future. Initiated community members will be trained to facilitate the activities of this programme. / Health Studies / D.Litt. et Phil.

HIV/AIDS is a global challenge and its impact is evident. This places a burden on hospitals and health professionals. To ease this burden there are home-based care programmes which, through home-based caregivers, provide patients living with HIV/AIDS with physical and palliative care. However, these HBCGs face various challenges such as poverty, discrimination and stigma when caring for PALHIV, and their own emotional strain, which becomes burdensome without sufficient support from the home-based care centre. The qualitative study undertaken investigates the challenges and coping mechanisms of the HBCGs. Thirteen research participants were drawn from a centre in Mamelodi. Data was gathered through interviews and observations, categorised into themes and analysed. Major findings revealed that social challenges faced by HBCGs include poverty, stigmatisation and discrimination. Emotions experienced by HBCGs include guilt, anger, hopelessness, but they have spiritual reliance through prayer as one of their coping mechanisms. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

The purpose of this study is to explore the EAP environment and provide a better understanding of the related roles of the Employee Assistant Practitioners/Professionals (EAPs) in respect of their treatment of various forms of illnesses in the workplace – particularly HIV and AIDS. The EAP role is not aligned to any individual profession, as it is designed to match employees’ holistic needs. It is in this context that the repertoire of EAP roles would include caring, psycho-social, therapeutic and technical skills. The EAP role is therefore endowed with the potential to meet a range of inter-departmental and multi-disciplinary needs – such as Nursing, Allied Health Professions, and Healthcare Sciences. A generic Assistant Practitioners Performance Management system (scorecard) had to be developed and agreed to with the City of Johannesburg’s (CoJ) Management in order to maintain consistency when developing APE programmes and roles. Notwithstanding the fact that the Employee Assistant Practitioners do also address the growing HIV/AIDS concerns in the workplace – including psycho-social problems of employees and their families – there is minimal acknowledgment of the EAPs’ roles, and little recognition of their welfare and well-being programmes. Drawing eclectically from various inter-related disciplinary terrains, the study centripetally explores the roles of EAPs as well as HIV/AIDS frameworks in the workplace. Quantitative and qualitative descriptive research methods were employed to assess challenges encountered by the City of Johannesburg (C.o.J) employees and their dependants. Questionnaires were used for the data collection of this study. The repertoire of participants in the study (n=55) comprised of doctors, social workers, nurses, HR officers, and other CoJ employees themselves. vi The questionnaire became the pivotal quantitative data analysis reference point ias it focused on numbers or quantities, and less on the qualitative analysis, which focused on differences in quality. The results of the study are based on numeric analysis and statistics to quantify the qualitative analysis. The prevalence of fewer participants was largely influenced by the depth of the data collection process, which did not allow for large numbers of research participants. The findings of the study revealed, amongst other factors, that there was an unsurpassed need to integrate different HIV/AIDS frameworks in order that the roles of EAPs becomes more effectively and efficiently defined and executed. The roles of EAPs were hitherto not well defined, resulting in duplication and confusion of service delivery to some employees utilising the EAP services. However, some of the EAP roles are highly appreciated and increasingly supported by managers and employees. Based on the findings of the study, recommendations were made for clarifying and extending the criticality of EAP roles and functions. / Health Studies / Ph. D. (Health Studies)

Using non-experimental descriptive exploratory survey, this study sought to find out factors associated with delayed entry into HIV medical care among HIV positive people who are aware of their status. A quantitative design was used and a structured questionnaire was used as the data collection instrument. Respondents were patients in a hospital’s Opportunistic Infection Department whose hospital records indicated that they were HIV positive during the time of the study. The study found out that as much as 71.6% (n =43) first entered HIV medical care more than 12 months after testing HIV positive while 40% (n = 24) did so as a result of illness. Low education levels, unemployment and being single are associated with delayed entry into HIV medical care. A percentage of the population uses and trusts non-biomedical approaches to dealing with HIV/AIDS. Being diagnosed HIV positive is therefore not necessarily a strong reason enough for one to immediately enter into medical care. Intensive health education needs to be done at work places, health facilities, schools, through print and electronic media, churches and other community settings to equip the population with knowledge of the advantages of early entry into HIV care. / Health Studies / M.A. (Public Health)

The purpose of this study was to develop a support programme for facilitating the integration of nutrition and food security with HIV prevention, treatment and care. The study was organised in three phases. Phase one was a quantitative cross-sectional survey that employed a structured interview with people living with HIV among selected two public hospitals and three health centres. The second phase employed focus group discussion with senior health experts to explore their perspective and experience in integrating nutrition and food security with HIV prevention, treatment, and care. The findings indicated that malnutrition and food insecurity were highly prevalent and significantly affected the treatment outcome and quality of life of PLWHA in the region. Socio-economic, clinical features and structural factors, such as educational status, place of residence, household income, source of drinking water, kind of toilet facility, inadequate dietary diversity, poor asset possession, opportunistic infections, duration on ART, CD4 cell count, and health system-related factors such as lack of viral and CD4 analysis laboratories and inconsistent antiretroviral medication supply were found as predictors of malnutrition and food insecurity. To cope up with the dire impact of malnutrition and food insecurity, short term, erosive and unsustainable food consumption coping strategies were employed. Based on the findings, the researcher developed a support programme for facilitating the integration of nutrition and food security with HIV prevention, treatment and care as phase three of the study. The developed programme is holistic and focuses on multi- and intersectoral collaboration to improve the treatment outcome, quality of life and overall wellbeing people living with HIV. / Health Studies / D. Litt. et Phil. (Health Studies)

Este estudo faz uma revisão sobre a relação das concentrações de vitamina D e doenças cardiovasculares (DVC) em indivíduos com vírus da imunodeficiência humana e/ou síndrome da imunodeficiência adquirida (HIV/AIDS) em tratamento com terapia antirretroviral (TARV). Um total de 1.288 artigos foram recuperados dos bancos de dados do PubMed, EMBASE, OVID, Cochrane Central, ERIC, SIBi, SciELO, LILACS e Grey literature. Nove deles preencheram os critérios de seleção e foram inclusos nesta revisão sistemática. Existe uma alta prevalência da deficiência de vitamina D em indivíduos HIV-positivo, independentemente da região climática que vivem. Tanto a infecção pelo HIV-1 como a TARV podem interferir no metabolismo da vitamina D. Essa vitamina mostrou uma tendência a decrescer do momento antes da TARV ao depois da iniciação da TARV, sua deficiência foi mais prevalente em pacientes que fazem utilização da TARV do que aqueles que nunca a utilizaram e suas concentrações no organismo mostraram significantes associações com medidores da elasticidade arterial, como Espessamento Média-Íntima (EMI) e Dilatação Mediada por Fluxo (DMF). Essas alterações nos vasos e sistema circulatório predispõem doenças cardiovasculares, tais como, aterosclerose, trombose, infarto do miocárdio e acidente vascular cerebral. Portanto, apesar de existirem controvérsias, indivíduos HIV-positivo podem estar mais propensos ao desenvolvimento de DCV, não apenas pelos efeitos colaterais comuns da TARV e da infecção pelo HIV-1, mas também por estarem mais predispostos a terem hipovitaminose D, e as alterações causadas por este quadro em seu organismo. / This study reviewed the relationship of vitamin D levels and cardiovascular disease (CVD) in individuals with human immunodeficiency virus and/or acquired immunodeficiency syndrome (HIV/AIDS) in treatment with antiretroviral therapy (ART). A total of 1,288 articles were retrieved from the PubMed, EMBASE, Ovid, Cochrane Central, ERIC, SIBi, SciELO, LILACS and Grey literature databases. Nine of them met the selection criteria and were included in this systematic review. There is a high vitamin D deficiency prevalence in HIV positive individuals, regardless of climate area where they live. Both, HIV-1 infection and ART can interfere with the metabolism of vitamin D. This vitamin has shown a tendency to decrease from the moment before ART to the one after the initiation of ART. Its deficiency was more prevalent in patients who use ART than those who are ART-naïve. Vitamin D concentrations showed significant associations with markers of arterial dysfunction, such as carotid artery intima-media thickness (cIMT) and flow-mediated dilatation (FMD). These changes in vessels and circulatory system predispose CVD, such as atherosclerosis, thrombosis, myocardial infarction and stroke. Therefore, although there are controversies, HIV positive individuals may be more prone to the development of CVD, not just for the common side effects of ART and HIV- 1 infection, but also because they are predisposed to have vitamin D deficiency, and all the metabolic changes caused by this situation in his organism. Key-

Neste estudo, busca-se compreender o existir da criança com aids no mundo da vida de uma Casa de Apoio, sob o olhar da Teoria de Enfermagem Humanística de Paterson e Zderad. Trata-se de uma pesquisa qualitativa com abordagem existencial-fenomenológico-humanística proposta por Paterson e Zderad, tendo como cenário uma Casa de Apoio a Crianças com HIV/aids, na cidade de Santa Maria, Rio Grande do Sul. A Casa abriga crianças portadoras ou não do vírus HIV/aids, as quais são privadas do núcleo da família biológica por seus pais serem portadores do HIV e não terem condições de cuidá-las. O estudo obteve aprovação do Comitê de Ética em Pesquisa do Centro Universitário Franciscano-UNIFRA. Os participantes da pesquisa foram três crianças com aids, que residem ou já residiram nessa Casa. Para a coleta das informações, utilizaram-se a entrevista fenomenológica e o desenho como recurso, que emergiram quatro unidades de significação: criança mostra que brincar é um modo de estar-melhor; criança se percebe no mundo com os outros; criança visualiza a família como parte do seu existir; criança preocupa-se com o estar-melhor e o vir-a-ser.A interpretação das informações foi fundamentada na Nursology de Paterson e Zderad. Assim, este estudo possibilitou compreenderem-se as necessidades expressas pela criança com aids que vive ou viveu em uma Casa de Apoio, na qual o cuidado de Enfermagem possibilita a criança ser-mais no mundo da vida. Espera-se que este estudo auxilie os cuidadores em saúde e, em especial, em Enfermagem a lançarem um outro olhar para essas crianças, com o intuito de perceberem que, nelas, há um ser humano com sentimentos singulares, que tem potencialidades para vir-a-ser, limitações de não-ser e que necessita do outro para realizar-se no mundo. Por fim, apresentam-se recomendações nas áreas da pesquisa, do ensino, da extensão e do cuidado em Enfermagem. / In this study, one searchs to understand existing of the child with AIDS in the worldlife of a House of Support, under the look of the Theory of Humanistic Nursing of Paterson and Zderad. One is about a qualitative research with existentialphenomenological- humanist boarding, having as scene a House of Support the Children with HIV/aids, in the city of Santa Maria, Rio Grande Do Sul. The House shelters carrying children or not of the HIV/aids virus, which finishes being private it nucleus of the biological family for its parents to be carrying of the HIV and not there are conditions to take care of them. The study it got approval of the Committee of Ethics in Research of the University Center Franciscano-UNIFRA. The partners of the research had been three children with AIDS and its familiar ones, that they inhabit or already they had inhabited in this House. For the collection of the information, they had used it phenomenological interview and the drawing as resource, that four units, of unification had emerged: child sample that to play is a way to be-good; child if perceives in the world with the others; child visualizes the family as part of its to exist; child is worried about being-good and come-the-to be. The interpretation of the information was based on the Humanistic Nursology of Paterson and Zderad. Thus, this study it made possible to understand the express necessities for the child with AIDS that lives or lived in a House of Support, in which the care of Nursing makes possible the child to be-more in the world of the life. One expects that this study it assists the cuidadores in health and, in special, in Nursing launching one another look for these children, with intention to perceive that, in them, it has a human being with singular only feelings e, that have potentialities come-the-to be, limitations of not-being and that needs the other to become fullfilled itself in the world. And so, we point to proposals in areas of search, teaching, extension and nursing taking care / En este estudio nosotros buscamos comprender el existir del niño portador de la sida en el mundo del vida de una Casa de Apoyo, bajo la mirada de la Teoría de Enfermage Humanística de Paterson y Zderad. El escenario en que se desarrolló fue el de una Casa de Apoyo para niños con AIV/Sida, en la ciudad de Santa Maria, Río Grande del Sur. La Casa abriga niños, portadoras o no del virus del HIV/Sida, los cuáles acaban por ser privados de la familia biológica una vez que sus padres son portadores del HIV e no tienen condiciones de cuida-los. Los participantes de la encuesta han sido tres niños con Sida y sus familiares, que residen o ya residieron en esa Casa. Para la coleta de las informaciones, fue utilizada la entrevista fenomenológica y la observación. La interpretación de los datos fue fundamentada en la Teoría Humanística de Paterson y Sderad. El estudio obtuvo aprobación del Comité de Ética en Pesquisa. Emergieron cuatro categorías: el niño muestra que brincar es un modo de estar-mejor; el niño que se percibe en el mundo con los otros, habla de sus amiguitos, de su familia, de la escuela y de la Casa de Apoyo como un lugar de cuidados; el niño muestra que la familia hace parte de su existir; las manifestaciones de la enfermedad causan en el niño la preocupación con el estarmejor y con el venir-a-ser. Este estudio posibilitó comprender las necesidades expresas por el niño con Sida que vive o vivió en una Casa de Apoyo, en la cual el cuidado de Enfermage hace el niño ser-más en el mundo de la vida. Sin embargo, se espera que ayude los cuidadores en salud y, en especial, en Enfermage, a tener un mirar diferenciado a eses niños, con el intuito de percibieren que existe un ser humano con sentimientos únicos y singulares, que tienen potencialidades de venir-aser, limitaciones de no-ser y que necesita del otro para realizar-se en el mundo. Como recomendaciones, quedan propuestas en las áreas de la pesquisa, de la enseñanza de la extensión y del cuidado en Enfermage.

Este estudo faz uma revisão sobre a relação das concentrações de vitamina D e doenças cardiovasculares (DVC) em indivíduos com vírus da imunodeficiência humana e/ou síndrome da imunodeficiência adquirida (HIV/AIDS) em tratamento com terapia antirretroviral (TARV). Um total de 1.288 artigos foram recuperados dos bancos de dados do PubMed, EMBASE, OVID, Cochrane Central, ERIC, SIBi, SciELO, LILACS e Grey literature. Nove deles preencheram os critérios de seleção e foram inclusos nesta revisão sistemática. Existe uma alta prevalência da deficiência de vitamina D em indivíduos HIV-positivo, independentemente da região climática que vivem. Tanto a infecção pelo HIV-1 como a TARV podem interferir no metabolismo da vitamina D. Essa vitamina mostrou uma tendência a decrescer do momento antes da TARV ao depois da iniciação da TARV, sua deficiência foi mais prevalente em pacientes que fazem utilização da TARV do que aqueles que nunca a utilizaram e suas concentrações no organismo mostraram significantes associações com medidores da elasticidade arterial, como Espessamento Média-Íntima (EMI) e Dilatação Mediada por Fluxo (DMF). Essas alterações nos vasos e sistema circulatório predispõem doenças cardiovasculares, tais como, aterosclerose, trombose, infarto do miocárdio e acidente vascular cerebral. Portanto, apesar de existirem controvérsias, indivíduos HIV-positivo podem estar mais propensos ao desenvolvimento de DCV, não apenas pelos efeitos colaterais comuns da TARV e da infecção pelo HIV-1, mas também por estarem mais predispostos a terem hipovitaminose D, e as alterações causadas por este quadro em seu organismo. / This study reviewed the relationship of vitamin D levels and cardiovascular disease (CVD) in individuals with human immunodeficiency virus and/or acquired immunodeficiency syndrome (HIV/AIDS) in treatment with antiretroviral therapy (ART). A total of 1,288 articles were retrieved from the PubMed, EMBASE, Ovid, Cochrane Central, ERIC, SIBi, SciELO, LILACS and Grey literature databases. Nine of them met the selection criteria and were included in this systematic review. There is a high vitamin D deficiency prevalence in HIV positive individuals, regardless of climate area where they live. Both, HIV-1 infection and ART can interfere with the metabolism of vitamin D. This vitamin has shown a tendency to decrease from the moment before ART to the one after the initiation of ART. Its deficiency was more prevalent in patients who use ART than those who are ART-naïve. Vitamin D concentrations showed significant associations with markers of arterial dysfunction, such as carotid artery intima-media thickness (cIMT) and flow-mediated dilatation (FMD). These changes in vessels and circulatory system predispose CVD, such as atherosclerosis, thrombosis, myocardial infarction and stroke. Therefore, although there are controversies, HIV positive individuals may be more prone to the development of CVD, not just for the common side effects of ART and HIV- 1 infection, but also because they are predisposed to have vitamin D deficiency, and all the metabolic changes caused by this situation in his organism. Key-

Magister Psychologiae - MPsych / This study utilised secondary data from a larger study that looked at individuals that are already infected by HIV which is entitled Implicative personal dilemmas and cognitive conflicts in health decision making in HIV positive adults and adults with AIDS. The primary aim of the larger study was to examine the cognitive construction of the individual and how they utilised their individual resources to construct who they are and how they perceived the difficulties and challenges that they face and the decisions they make regarding their health. HIV and AIDS is a debilitating disease and it affects millions worldwide. South Africa, presently, has the largest burden of this disease with those between the ages of 15 – 49 years of age being most affected. As previously mentioned the decisions that individuals make can impact on their health. Decisions to take necessary precautions such as protected sex during sexual intercourse can decrease the progression of the disease. Decisions made regarding abstinence of risky behaviour as well as being committed to taking medication could also positively impact health. People living with HIV and AIDS find it difficult to adjust to the challenges that this disease presents. Depression is often experienced due to the changes in self image and perception. Studies show that females are twice more likely to experience depression than men. There has however been no conclusive evidence showing the reason for this, however, the perception of stress based on gender could shed some light on this matter and how these perceptions can increase the likelihood of women being more vulnerable to depression. Due to the limitation of this study, it will only look at depression as it relates to HIV and AIDS. Psychological problems such as depression can hamper the adjustment process and the effect of depression is evident in that it can lower the CD 4 + cells. Not only are those living with HIV and AIDS affected by depression, but they also have a lifetime prevalence to depression. It is important to have an effective screening tool for depression so that the detection of this disease can be made and effective treatment can be implemented to enhance health. The sample consisted of 113 adult participants that have already been diagnosed with HIV and AIDS. The primary aim of this study was to compare the Beck’s Depression Inventory II (BDI II) and the Hospital Anxiety and Depression Scale –(the Depression component) (HADS-D) as a screening tool for depression. Exploratory Factor Analysis revealed a 5 factor structure which accounted for 60.14 % of the total variance. The HADS yielded one factor accounting for 14.33% of total variance. The BDI II has proven to be more a reliable measure of depression with 0.89 according to the Cronbach’s Alpha co efficient opposed to 0.375 as per the HADS-D. The secondary aim was to establish the sociodemographic and disease profiles of the participants under study. / South Africa

<p>This study utilised secondary data from a larger study that looked at individuals that are already infected by HIV which is entitled Implicative personal dilemmas and cognitive conflicts in health decision making in HIV positive adults and adults with AIDS. The primary aim of the larger study was to examine the cognitive construction of the individual and how they utilised their individual resources to construct who they are and how they perceived the difficulties and challenges that they face and the decisions they make regarding their health. HIV and AIDS is a debilitating disease and it affects millions worldwide. South Africa, presently, has the largest burden of this disease with those between the ages of 15 &ndash / 49 years of age being most affected. As previously&nbsp / mentioned the decisions that individuals make can impact on their health. Decisions to take necessary precautions such as protected sex during sexual intercourse can decrease the&nbsp / progression of the disease. Decisions made regarding abstinence of risky behaviour as well as being committed to taking medication could also positively impact health. People living with HIV and AIDS find it&nbsp / difficult to adjust to the challenges that this disease presents. Depression is often experienced due to the changes in self image and perception. Studies show that&nbsp / females are twice more likely to experience depression than men. There has however been no conclusive evidence showing the reason for this, however, the perception of stress based on&nbsp / gender could shed some light on this matter and how these perceptions can increase the likelihood of women being more vulnerable to depression. Due to the limitation of this study, it will&nbsp / only look at depression as it relates to HIV and AIDS. Psychological problems such as depression can hamper the adjustment process and the effect of depression is evident in that it can lower the CD 4 + cells. Not only are those&nbsp / living with HIV and AIDS affected by depression, but they also have a lifetime prevalence to depression. It is important to have an effective screening tool for depression so that the detection of this&nbsp / disease can be made and effective treatment can be implemented to enhance health. The sample consisted of 113 adult participants that have already been diagnosed with HIV and AIDS. The&nbsp / primary aim of this study was to compare the Beck&rsquo / s Depression Inventory II (BDI II) and the Hospital Anxiety and Depression Scale &ndash / (the Depression component) (HADS-D) as a screening tool&nbsp / &nbsp / for depression. Exploratory Factor Analysis revealed a 5 factor structure which accounted for 60.14 % of the total variance. The HADS yielded one factor accounting for 14.33% of total variance. The BDI II has proven to be more a reliable measure of depression with 0.89 according to the Cronbach&rsquo / s Alpha co efficient opposed to 0.375 as per the HADS-D. The secondary aim was to establish&nbsp / the sociodemographic and disease profiles of the participants under study. </p>