Magister Psychologiae - MPsych / The aim of the study was to establish what the perceptions and attitudes are of employees at different levels of the organisation with regard to HIV/AIDS testing. A further aim was to identify possible reasons for the poor employee response to voluntary HIV/AIDS testing. It was thus important for this research to gauge employee knowledge, attitude and behaviour toward HIV/AIDS in order for organisations to develop strategies for effective HIV/AIDS counselling and testing programmes.

Magister Artium (Social Work) - MA(SW) / The burden of HIV disease is concentrated in sub-Saharan Africa and South Africa (SA) is particularly affected. Whilst there have been many studies conducted on the biomedical and socio-psychological aspects of HIV and AIDS, insufficient attention has been paid to the quality of life of those infected with the virus. The primary purpose of this study was to determine the predictors of quality of life enjoyment and satisfaction (Q-LES) of individuals living with HIV and or AIDS and those on anti-retroviral treatment or being prepared for it. Further, the study determined the relationship between psychological distress and Q-LES of HIV positive individuals because psychological distress is reported to contribute substantially to the burden of the disease in sub-Saharan Africa, including SA. This quantitative study used a battery of questionnaires administered to 121 participants in an out-patient clinic setting. The main hypothesis tested in this study is: psychological distress is a strong predictor of Q-LES. The Hospital Anxiety and Depression Scale (HADS) was used to screen for psychological distress and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) to assess the various components of QoL. A purposive sampling strategy was used to recruit participants into the study. Data analysis included descriptive and inferential statistics using SPSS to test the hypothesis. Of the total sample (N=121), 74% were females. The study found that a large proportion (49.5%) of the sample within the age group 25-49 years old had significant presence of psychological distress. Those not on ART yet were significantly affected (66%). The relationship between Q-LES subscales and psychological distress was significant (p< 0.01). The results show that psychological distress was significantly prevalent among HIV positive individuals and it was the strongest predictor of Q-LES among the study participants. Modifying the current psychological intervention programmes, in the public health clinics, for individuals vi infected with the HI virus will assist in improving the current health outcomes and also help to achieve better Quality of Life outcomes.

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) is a worldwide pandemic that affects the lives of millions of people across all ages. Its devastating effects are far-reaching and affect all aspects of an individual’s daily life. HIV/AIDS is responsible for widespread clinical manifestations involving the head and neck. Disorders of the auditory and vestibular systems are often associated with HIV/AIDS, however the extent and nature of these vestibular manifestations is still largely unknown. The main aim of this research study was to investigate vestibular functioning and pathology in adults with HIV/AIDS. This was achieved through three main research steps: a systematic literature review of the body of peer-reviewed literature on HIV/AIDS related vestibular manifestations and pathology, a description and comparison of vestibular involvement in adults with and without HIV/AIDS and an investigation to determine if HIV/AIDS influence the vestibulocollic reflex (VCR) pathways. For the first study a systematic literature review related to vestibular findings in individuals with HIV infection and AIDS was conducted. A varied search strategy was used across several electronic databases to identify relevant peer-reviewed reports in English. Several databases (Medline, Scopus and PubMed) and search strategies were employed. Where abstracts were not available, the full paper was reviewed, and excluded if not directly relevant to the study’s aims. Articles were reviewed for any HIV/AIDS associated vestibular symptoms and pathologies reported. For the second and third study, a cross-sectional, quasi-experimental comparative research design was employed. A convenience sampling method was used to recruit subjects. The sample consisted of 53 adults (29 male, 24 female, aged 23-49 years, mean = 38.5, SD = 4.4) infected with HIV, compared to a control group of 38 HIV negative adults (18 male, 20 female, aged 20-49 years, mean = 36.9, SD = 8.2). A structured interview probed the subjective perception of vestibular complaints and symptoms. Medical records were reviewed for cluster of differentiation 4+ (CD4+) cell counts and the use of antiretroviral (ARV) medication. An otologic assessment and a comprehensive vestibular assessment (bedside assessments, vestibular evoked myogenic potentials, ocular motor and positional tests and bithermal caloric irrigation) were conducted on all subjects. The systematic literature review identified 442 records, reduced to 210 after excluding duplicates, reviews, editorials, notes, letters and short surveys. These were reviewed for relevance to the scope of the study. There were only 13 reports investigating vestibular functioning and pathology in individuals affected by HIV/AIDS. This condition can affect both the peripheral and central vestibular system, irrespective of age and viral disease stage. Post-mortem studies suggest direct involvement of the entire vestibular system, while opportunistic infections such as oto- and neurosyphilis and encephalitis cause secondary vestibular dysfunction resulting in vertigo, dizziness and imbalance. The second study showed an overall vestibular involvement in 79.2% of subjects with HIV in all categories of disease progression, compared to 18.4% in those without HIV. Vestibular involvement increased from 18.9% in the Centers for Disease Control and Prevention (CDC) category 1 to 30.2% in category 2. Vestibular involvement was 30.1% in category 3. There was vestibular involvement in 35.9% of symptomatic HIV positive subjects and 41.5% in asymptomatic HIV positive subjects. Individuals with HIV were 16.6 times more likely to develop vestibular involvement during their lifetime, than among individuals without this disease. Vestibular involvement may occur despite being asymptomatic. The third study showed that abnormal cervical vestibular evoked myogenic potentials and caloric results were significantly higher in the HIV positive group (p=.001), with an odds ratio of 10.2. Vestibulocollic reflex and vestibulo-ocular reflex involvement increased with progression of the disease. There were more abnormal test results in subjects using ARV therapies (66.7%) compared to those not using ARV therapies (63.6%), but this difference was not statistically significant. Vestibular involvement was significantly more common in subjects with HIV than among those without this disease. This disease and its associated risk profile include direct effects of the virus on the vestibular system as demonstrated by postmortem studies. Opportunistic infections may compromise the functioning of the sensory and neural structures of hearing and the vestibular system indirectly, causing vertigo, dizziness or disequilibrium. Ototoxicity may also be related to vestibular dysfunction, due to the ototoxic nature of certain ARV medications. HIV/AIDS influence not only the vestibulo-ocular reflex, but also the vestibulocollic reflex pathways. Primary health care providers could screen HIV positive patients to ascertain if there are symptoms of vestibular involvement. If there are any, then they may consider further vestibular assessments and subsequent vestibular rehabilitation therapy, to minimize functional limitations of quality of life. / Thesis (DPhil)--University of Pretoria, 2014. / lk2014 / Speech-Language Pathology and Audiology / DPhil / Unrestricted

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)

Philosophiae Doctor - PhD / The school environment presents a valuable opportunity for the identification, monitoring and support of children made vulnerable by HIV/AIDS and poverty. Many children are caring for parents suffering from AIDS-related illnesses and/or they are the main breadwinner of the household. As a result of HIV/AIDS and poverty therefore, children might be dropping out of school, or their ability to perform adequately at school might be significantly reduced. The aim of this study was to use a case study approach to explore and describe support provision in a South African formal school, examining, in particular, the relative significance of leadership, organisational development and gender-related matters in addressing the needs of children made vulnerable by HIV/AIDS and poverty. The availability and quality of this support is analysed within the context of the Western Cape Education Department (WCED) transforming itself from a system focused on controlling schools to a system focused on supporting schools. The reflexive qualitative research approach was decided upon m order to describe and understand how, and to what extent, the teachers and the principal of a poverty-stricken primary school might benefit from the WCED's systemic change processes when addressing issues related to HIV/AIDS and poverty. The methodological rationale for this qualitative research approach forms part of a search for meaning within the cultural context(s) of the school in an effort to understand issues related to HIV/AIDS in schools. The research's second aim was to establish principles for an approach to educational support, which would be applicable in similar situations elsewhere. In the case study, the focus is on the WCED supporting the principal and teachers at a poverty-stricken primary school in carrying out their roles as leaders, teachers and caregivers. In order for the principal and teachers to provide quality support to the learners, they themselves need to receive appropriate forms of support from the education system. For this research to be contextually grounded, questions around HIV/AIDS and the growing number of orphans and vulnerable children in many communities were considered. One of the central questions was: How are the challenges of daily life in the running of a school met where issues related to poverty and health are dominant? Gender-based sexual violence and sexual abuse of children, as well as other social problems affecting learners in the school investigated for this thesis were included in the addressing of the main questions The complexity of the issues involved when exploring the research questions became increasingly more apparent during the research journey of this thesis. I experienced fully the potential of the case study to provide a 'thick' description and contribute significantly to an in-depth understanding of a complex phenomenon from a local and holistic perspective. I was able to focus on how the macro-narratives of support policy connected to the micro-narratives of teachers in primary schools. Based on the findings of the research, I concluded that the problems of HIV/AIDS-affected children, families and communities do not only overlap considerably with the problems related to poverty - a widely held view among researchers - but that poverty-related problems may, indeed, conceal the very existence of HIV/AIDS. The investigation shows that the wide-spread poverty affecting the case school learners, seems to have 'blinded' teachers in terms of 'seeing' the learner in a context of HIV/AIDS. This phenomenon in the case school was observed in spite of the HIV/AIDS Programme Coordinator claiming that the district's teachers had learned to 'see' the learner in ways which they had not prior to the introduction of the WCED's HIV/AIDS Life Skills Programme I trust that the different stakeholders within the field of education and HIV/AIDS will benefit from the findings and recommendations flowing from this investigation. First and foremost, I believe that the lessons learnt from the fieldwork, could be of use to South African stakeholders generally, and, in particular, to the Western Cape Education Department and those working as school support staff at district level (the EMDCs). The findings of the study may provide valuable feedback to the current practices of the school support structures, including the voluntary HIV/AIDS support structure, and form a basis for informed further action by the relevant government departments and other stakeholders in education. In this way, the thesis could contribute to improved formal school support provision in the context of HIV/AIDS, and therefore, serve to enhance the quality of education for all children.

The purpose of the study was to determine the effect of antenatal health education on postnatal care (PNC) among Human Immunodeficiency Virus (HIV) positive women in Francistown city, Botswana. This study followed a quantitative research paradigm. Data was collected with the aid of a questionnaire from eligible women who consented in writing to participate in the study. Forty-five percent (45%) (n=45) HIV positive women came with babies for 6 weeks PNC and 55% (n=55) brought 8 weeks old babies either for weighing or for the two months immunisation from 28 April to 10 June 2014. The responses regarding the source of health education received were as follows: 40% lay counselors, 31% midwives, 15% doctors, 5% nurses without midwifery, 5% cadre unknown, 2% both lay counselors and midwives, 1% by a health education assistant and 1% was not health educated at all. Conclusion: The study revealed that HIV positive pregnant women received health education from different cadres of health and mostly by lay counselors. Literature indicates that lay counselors may give health information but at a very superficial level. / Health Studies / M.A. (Health Studies)

The purpose of the study was to determine the effect of antenatal health education on postnatal care (PNC) among Human Immunodeficiency Virus (HIV) positive women in Francistown city, Botswana. This study followed a quantitative research paradigm. Data was collected with the aid of a questionnaire from eligible women who consented in writing to participate in the study. Forty-five percent (45%) (n=45) HIV positive women came with babies for 6 weeks PNC and 55% (n=55) brought 8 weeks old babies either for weighing or for the two months immunisation from 28 April to 10 June 2014. The responses regarding the source of health education received were as follows: 40% lay counselors, 31% midwives, 15% doctors, 5% nurses without midwifery, 5% cadre unknown, 2% both lay counselors and midwives, 1% by a health education assistant and 1% was not health educated at all. Conclusion: The study revealed that HIV positive pregnant women received health education from different cadres of health and mostly by lay counselors. Literature indicates that lay counselors may give health information but at a very superficial level. / Health Studies / M. A. (Health Studies)

The lack of a contextualised, relevant communication strategy focusing specifically on HAST diseases in the Limpopo Province was the impetus for this research. The purpose of this study was, therefore, to explore the knowledge, perceptions and utilisation of health facilities for HAST in order to develop an acceptable and effective communication strategy for the Province to address the high rate of HAST diseases. The study followed a qualitative approach guided by the major tenets of the Health Belief Model, namely, to determine modifying factors, individual beliefs and cues for action. An in-depth literature review was followed by focus group interviews with the community members and personal interviews with District and Provincial Deputy Directors. Based on these findings, a communication strategy was drafted and piloted for three months in one of the districts in Limpopo. Further refinement of the communication strategy followed after member-checking and further interviews with directors HAST. The final strategy specifically focused on risk groups with each of the diseases in terms of their beliefs and perceptions. It further resulted in guidelines for health providers in terms of the content and implementation of effective communication strategies within the context of educational, cultural, social and economic factors relevant to Limpopo / Health Studies / D. Litt. et Phil. (Health Studies)

Made available in DSpace on 2014-07-29T15:29:11Z (GMT). No. of bitstreams: 1 Marianne de Oliveira Falco.pdf: 1327193 bytes, checksum: f2c63ea5da2350c16f08f39b5e787803 (MD5) Previous issue date: 2011-12-16 / Objective: To assess the available scientific knowledge on the effect of nutritional treatment abnormality metabolic in adult patients living with Aids in the use of HAART and adherence of nutritional/diet therapy. Methods: A systematic review of literature was conducted through a search protocol developed by the authors: articles were searched in Pubmed, Lilacs and Cochrane, between 1996 and 2010, of the type: controlled clinical trial, randomized or crossover; were adults, living with HIV/Aids under anti-retroviral therapy showing no opportunistic diseases. The intervention of interest was oral nutritional supplementation and/or lifestyle changes through specific nutritional therapy: dyslipidaemia, insulin resistance, lipodystrophy and systemic arterial hypertension. For qualitative classification of the articles we used the Jadad scale. The clinical trials, was controlled, randomized, open label, with a target population of adults with Aids in antiretroviral therapy and without opportunistic diseases. In the study on adherence was held randomized controlled trial and open. Among the 165 patients randomly assigned to two treatment groups for nutritional / dietary. The group treatment 1 (T1) and Treatment 2 (T2) received nutrition care, and the stage of nutritional diagnosis performed similarly in both groups and with service until completing treatment. With respect to conduct diet therapy groups (T1) and (T2)received nutritional counseling, group T2 also received individualized dietary plan. The groups had returns quaterly (T1) and monthly (T2). We considered dietary before and after the intervention and attendance at meetings as parameters of adherence to treatment. Results: In a systematic review 385 papers were found and seven met the inclusion criteria. The interventions applied in such studies were: diet plus physical exercises, diet plus supplement and only supplements. Dyslipidaemia was the common outcome to all studies. The studies assessing supplementation with omega 3 found significant reduction on triglycerides. Specific diet plus omega 3 supplementation showed an increase on HDL cholesterol. Supplementation with chromo nycotinate showed no effect on dyslipidaemia. Lifestyle modification,including diet and physical activity, drastically reduced the waist circumference, lipodystrophy and systolic arterial pressure. In the clinical trial among 165 patients in the study were 83 T1 and 82 T2. At the end of 7,3 months, 20% patients dropped out of the nutrition therapy. The T1 and T2 groups showed no significant difference in relation to socio demographic parameters. 15,63% of group T2 reached the goal considered optimal for adhesion while 42.65% of group T1 were 100% adherence to queries. The T1 and T2 groups showed a reduction to the risk of food consumption, increased consumption of protective foods, increased fractioning meals in T2 group. Conclusion: In the systematic review by lowering triglycerides with omega 3 supplementation was the greatest nutritional intervention with scientific evidence. Prescription diet seems to be the most appropriate intervention to increase HDL. Still can not make inferences about the nutritional treatment of total cholesterol, LDL and insulin resistance. In the study of adherence, there were no differences between groups T1and T2, in relation to adherence and in relation to the goals of food consumption. / Objetivo: Avaliar o conhecimento científico disponível sobre o efeito do tratamento nutricional nas alterações metabólicas em pacientes com Aids e a adesão destes ao serviço de Nutrição e ao tratamento nutricional/dietoterápico. Métodos: Para revisão sistemática, conduziu-se revisão sistemática de literatura por meio de protocolo de busca nas bases de dados: Pubmed, LIlacs e Cochrane, entre 1996 e 2010, do tipo ensaio clínico, controlado, randomizado, crossover, sendo a população alvo: adultos, vivendo com HIV/Aids, em uso de terapia anti-retroviral e sem doenças oportunistas. A intervenção de interesse foi suplementação nutricional via oral e/ou mudança de estilo de vida através de tratamento dietoterápico específico: dislipidemia, resistência insulínica, lipodistrofia e hipertensão arterial sistêmica. Para o estudo de adesão realizou-se ensaio clínico controlado, randomizado e aberto. Cento e sessenta e cinco adultos com Aids em uso de TARV, alocados aleatoriamente em dois grupos para tratamento nutricional/dietoterápico. Os grupos Tratamento1(T1) e Tratamento 2 (T2) receberam consulta de nutrição, sendo a etapa de diagnóstico nutricional realizada de mesma forma em ambos os grupos e com atendimento até completar o tratamento. Os grupos (T1) e (T2) receberam orientações nutricionais, o grupo T2 recebeu ainda plano alimentar individualizado. O grupo T1 tinha agendamento de retornos trimestrais e o T2 mensal. Consideraram-se repercussões dietéticas após a intervenção e assiduidade às reuniões como parâmetros de adesão ao tratamento. Resultados: Na revisão sistemática, após localizar 385 artigos, sete foram incluídos. As intervenções utilizadas nesses estudos foram: dieta, dieta mais exercício físico, dieta mais suplemento e somente suplementos. Dislipidemia foi desfecho avaliado em todos os estudos. Os estudos que avaliaram suplementação com ômega 3 encontraram redução significativa dos triglicérides. Dieta específica mais suplementação de ômega 3 mostrou aumento de HDL-colesterol. Suplementação com nicotinato de cromo não teve efeito sobre a dislipidemia. Modificação de estilo de vida reduziu, significativamente a circunferência da cintura, lipodistrofia e pressão arterial sistólica. No ensaio clínico dentre os 165 pacientes incluídos no estudo 83 receberam o T1 e 82 o T2. Ao final de 7,3 meses, 20% pacientes desistiram do tratamento nutricional. 15,63% dos pacientes do grupo T2 e 42,65% do grupo T2 atingiram a meta considerada ótima para adesão. Os grupos T1 e T2 apresentaram redução para o consumo de alimento de risco, aumento do consumo de alimentos de proteção, aumento e no fracionamento das refeições no grupo. Conclusão: Na revisão sistemática a redução de triglicérides pela suplementação com ômega 3 foi a intervenção nutricional com maiores evidências científicas. A prescrição de dieta parece ser a intervenção mais adequada para aumentar HDL. Ainda não é possível fazer inferências sobre o tratamento nutricional do colesterol total, LDL e resistência insulínica. No estudo de adesão, não houve diferenças entre os grupos T1 e T2, em relação à adesão às consultas analisada pela assiduidade e em relação às metas de consumo alimentar avaliada pelas modificações de hábitos alimentares.

AFRIKAANS: In hierdie studie is daar gelet op MIV en VIGS en die geslagsrolle van die Noord-Sotho/Tswana-sprekende vrou in die Limpopo Provinsie. Daar is spesifiek gefokus op watter MIV- en VIGS-verbandhoudende risiko’s voorkom rondom die geslagsrolle van die Noord-Sotho/Tswana-sprekende vrou in die Limpopo Provinsie. Sewe relevante geslagsrolle van die vrou is geïdentifiseer vir ondersoek, en het die vrou as individuelewese, seksuelewese, huweliksmaat, moeder, versorger, enkelouer en broodwinner ingesluit. Verbandhoudende aspekte van hierdie rolle is ook ondersoek en het mishandeling van die vrou, die vrou se opvoeding, geloof, kultuur, gesondheid, geslag en spesifieke beradingsbehoeftes ingesluit. Waar geslag ‘n sosiale- en kulturelestruktuur is en ook kultuur-spesifiek is, was dit van belang om die vrou se geslagsrolle en die verbandhoudende aspekte daarvan binne die vrou se relevante kulturelekonteks te ondersoek. Die navorsingsmetodologie vir hierdie studie is duidelik omskryf en uiteengesit, waarna verskeie literatuurhoofstukke volg. Die literatuurhoofstukke fokus op MIV en VIGS as medieseverskynsel en die beradingsaspekte wat daarmee verband hou. In die literatuurhoofstukke is daar ook gelet op die Afrika-kultuur en geslagsrolvorming, waarna die sewe geslagsrolle van die vrou en die verbandhoudende aspekte daarvan bespreek is. Die literatuurhoofstukke voorsien die nodige agtergrond wat aanduidend is van spesifieke MIV-risiko’s wat deur Afrika-vroue in hul geslagsrolle beleef word. Navorsingsbevindings vir hierdie kwalitatiewe studie is met behulp van tabelle voorgestel wat volledig bespreek is, ten einde te bepaal watter spesifieke MIV-risiko’s deur Noord-Sotho/Tswana-sprekende vroue in die Limpopo Provinsie beleef word. Navorsingsbevindings vir hierdie kwalitatiewe studie is met behulp van tabelle voorgestel wat volledig bespreek is, ten einde te bepaal watter spesifieke MIV-risiko’s deur Noord-Sotho/Tswana-sprekende vroue in die Limpopo Provinsie beleef word. Hierdie bevindings het getoon dat Noord-Sotho/Tswana-sprekende vroue in die Limpopo Provinsie veral kwesbaar is vir MIV waar hierdie vroue ‘n tekort aan mag het om te onderhandel vir veilige seksuele-omgang en kondoomgebruik. ‘n Raamwerk vir kultuursensitiewe MIV- en VIGS-berading is ontwikkel, en bestaan uit inligting bekom vanuit die empiriese ondersoek, praktykervaring asook die navorser se kennis van relevante literatuur. Die raamwerk vir kultuursensitiewe MIV- en VIGS-berading is op wyses aangebied wat as gepas beskou word vir die spesifieke probleme of behoeftes van die vrou, en bestaan uit afmerklyste, kolomme en gevallestudies. Die raamwerk is ook saamgestel sodat dit deur die maatskaplike werker, MIV-berader en ander lede van die multidissiplinêrespan benut kan word tydens hulpverlening aan MIV-positiewe Noord-Sotho/Tswana-sprekende vroue. Ten slotte is ‘n algemene samevatting, gevolgtrekkings en aanbevelings gemaak na aanleiding van relevante bevindings vanuit die studie. Die navorsingsvraag vir hierdie studie in geheel is beantwoord deurdat die empiriese ondersoek sowel as die raamwerk vir kultuursensitiewe MIV- en VIGS-berading, die MIV- en VIGS-verbandhoudende risiko’s rondom die geslagsrolle van die Noord-Sotho/Tswanasprekende MIV-positiewe vrou in die Limpopo Provinsie duidelik geïdentifiseer en logies gegroepeer het, en gevolgtrekkings en aanbevelings gebied het. Hierdie studie het getoon dat elk van die vrou se sewe geslagsrolle, asook die verbandhoudende aspekte daarvan, verband hou met spesifieke MIV-risiko’s wat op fisiologiesesosiale-, psigologiese-, ekonomiese- en kulturele vlak beleef word deur Noord-Sotho/Tswana-sprekende vroue in die Limpopo Provinsie. ENGLISH: This study considered HIV and AIDS and the gender roles of Northern Sotho/Tswana speaking women in the Limpopo Province. Specific focus was placed on HIV and AIDS related risks surrounding the gender roles of Northern Sotho/Tswana speaking women in the Limpopo Province. Seven relevant gender roles were identified for investigation; these include women as individual beings, sexual beings, wives, mothers, caregivers, single parents and breadwinners. Related aspects of these roles were also investigated and include the abuse of women, education, religion, culture, health, gender and specific counselling needs. It was of importance to examine gender roles and the related aspects in the woman’s relevant cultural context since gender is seen as a social and cultural construct and is also culture-specific. The research methodology for this study was clearly defined and outlined. The literature chapters focussed on HIV and AIDS as medical phenomenon and related counselling aspects. The literature chapters also considered the African culture and gender role development, the seven gender roles of women and aspects related to these. The literature chapters provided the necessary background which is indicative of the specific HIV risks which are experienced by African women in their gender roles. Research findings for this qualitative study were presented using tables which were fully discussed in the study in order to determine the specific HIV risks experienced by Northern Sotho/Tswana speaking women in the Limpopo province. These findings showed that Northern Sotho/Tswana speaking women in the Limpopo Province are particularly vulnerable to HIV as these women experience a lack of power to negotiate for safe sex and condom use. A framework for culturally sensitive HIV and AIDS counselling was developed and consists of information obtained from the empirical investigation, practical experience and the researcher’s knowledge of relevant literature. The framework for culturally sensitive HIV and AIDS counselling was presented in a manner which is suited to the specific problems and needs of these women and consists of tick-mark lists, columns and case studies. The framework was also compiled in such a manner that it may be utilised by the social worker, HIV counsellor and other members of the multidisciplinary team during the counselling of HIV positive Northern Sotho/Tswana speaking women. A general summary, conclusions and recommendations were finally made following the relevant findings of the study. The research question for this study was fully answered in that the empirical investigation as well as the framework for culturally sensitive HIV and AIDS counselling identified, logically grouped and made conclusions and recommendations about the HIV and AIDS related risks surrounding the gender roles of Northern Sotho/Tswana speaking women in the Limpopo Province. This study showed that each of the seven gender roles of women as well as the related aspects of these roles are associated with specific HIV risks which are experienced on a physiological, social, psychological, economical and cultural level by Northern Sotho/Tswana speaking women in the Limpopo Province. / Thesis (PhD)--University of Pretoria, 2011. / Social Work and Criminology / PhD / Unrestricted