In 2008, 1.8 million children under the age of 15 were living with HIV/AIDS in sub-Saharan Africa. The same report estimates that in 2008, there were 390 000 new infections in children below the age of 15 in Sub- Saharan Africa. Children appear to be the generation most affected by the HIV/AIDS epidemic. With the introduction of Highly Active Antiretroviral therapy (HAART) more perinatally infected children are living into adolescence and beyond. They will have to learn to live with a stigmatising, potentially fatal chronic illness. Health care workers can no longer rely solely on traditionally used outcome measures, such as viral loads and CD4+ percentages, to monitor effectiveness of interventions and treatments. Quality of Life (QoL) has been suggested as an additional essential outcome measure in clinical practice and research involving children living with a chronic illness. In this research the concept of Health Related Quality of Life (HRQoL) is evaluated in HIV-infected children using the PedsQL 4.0 Generic Core Scale (child self-reports, ages five-seven). The PedsQL 4.0 Generic Core Scales has been found to be a valid and reliable HRQoL measurement tool in children with chronic diseases, school-going children and children infected with HIV. Domains of Physical, Emotional, Social and School Functioning were evaluated. The children in the comparison group scored significantly higher (p<0.01) indicating a better quality of life. The HIV-infected children scored significantly lower in all four domains, with Physical Functioning being most affected (p<0.01). The children with HIV were found to be shorter (p<0.01) and lighter (p<0.01) than those in the comparison group. This could be a contributing factor to the physical difficulties experienced by the HIV-infected children. No relationship could be established between total scores of HRQoL and CD4+ percentages, viral load and duration of HAART treatment. Demographic data collected indicate that the HIV-infected children were more likely to have a primary caregiver with a lower level of education (p=0.01) and more likely to be receiving a Dependency Care Grant (p=0.05). The HRQoL results of this study are similar to those conducted in other parts of the world. The results stress the need for a multi-disciplinary approach when treating HIV-infected children. It has become essential to focus on the medical, physical and psychosocial functioning of the HIV-infected child thereby promoting participation in the family, school and the broader community.

Background: The inexorable spread of HIV infection across all continents is attributable to many factors, including male sexual behaviour. Such behaviour is often considered recalcitrant to change. Aim: The purpose of this study was to determine if sexual behaviour does or does not change after the diagnosis of HIV infection and to elucidate some of the psychosocial factors that may be operant in this context. Materials and Methods: The research consisted of a structured selfadministered questionnaire designed to measure ten psychosexual and sociosexual parameters in a group of HIV positive men. The questionnaire evaluated parameters at three different time points i.e. before HIV diagnosis, one year after HIV diagnosis and the present (2002). Participants were recruited from patients attending a private HIV treatment centre, in Pretoria, South Africa. Results: 53 participants completed the questionnaire. Descriptive statistics were used to elucidate trends. Statistically significant changes were seen in most studied domains, suggesting that beneficial change in sexual behaviour is possible after a diagnosis of HIV infection. These changes were seen, over time, in all the measured parameters, thus, change appears both possible and sustainable. This change was often detrimental to participants as it impacted negatively on some aspects of their personal and social functioning. Safer sex knowledge was weak in the studied group. Conclusion: The data indicate that change in behaviour is possible after a diagnosis of HIV infection and occurred in the studied population. Some changes were good for public health initiatives; many were detrimental to the psychosexual functioning of participants. Public health officials and other medical practitioners should include interventions aimed at reducing the negative psychosocial impact of HIV diagnosis at every patient encounter, as these changes do not resolve by themselves over time and are detrimental to the quality of life of patients.