Tuberculosis (TB) has become a serious South African health problem because it is the most common opportunistic disease that leads to death in people with HIV/AIDS. Due to the airborne nature of the disease it can easily be spread to anyone including healthy people. A lack of compliance to treatment by TB patients explains why prevalence rates of the disease are high and why there is an emergence of drug resistant strains such as XDR-TB and MDR-TB. Information on existing knowledge, attitudes and perceptions regarding TB can provide a crucial foundation for the development of educational programmes and interventions aimed at reducing the further spread of the disease. This study aimed at understanding the knowledge, attitudes and perceptions towards TB and relating these to the current prevalence of HIV/AIDS. A face-to-face interview survey was conducted among adult Grahamstown East residents (n=1020). The Health Belief Model (Rosenstock et al., 1994) and Bandura’s (1986) Social Cognitive Theory formed the theoretical framework of the data collection and analysis. The data generated from the field work was first descriptively analysed providing frequency tables. Thereafter cross tabulations were calculated for relevant items using independent variables, namely gender, level of education, and experience of dealing with TB. The results of the study show that, in general, knowledge concerning TB was sufficient to provide a foundation for the adoption of healthier behaviours in the female respondents. Few of the respondents reported feeling personally susceptible although the majority of the respondents acknowledged the severity of the disease. The cues to action lacked the influence to persuade people to adopt positive health related behaviours. The perceived benefits of adopting preventative behaviour were not very influential in the adoption of healthier behavioural changes in the respondents. Disease stigma regarding the dual association of TB and HIV/AIDS was the main barrier for the adoption of healthier behavioural attitudes. Perceived self-efficacy in preventative behaviours was generally low in the less educated respondents. Recommendations regarding areas for future research and change interventions are provided.

Introduction: Adherence to Highly Active Antiretroviral Therapy (HAART) is critical for optimal therapeutic outcomes. A possible factor in adherence is the impact of HAART on sexual functioning. Methods: A mixed methods approach was used. A cohort of 14 people living with HIV/AIDS (PLWHA) in Grahamstown was identified. Two semi-structured interviews and two structured questionnaires were administered. In-depth interviews were conducted with two HIV counsellors in so as to obtain a different perspective on the topics. The theoretical framework used three health behaviour models: the Health Belief Model, Leventhal‘s Common-Sense Model of self regulation and the Transtheoretical model. Results: The participants were between 27 and 49 years old and had been on HAART for between 9 months and 10 years. Six participants were support staff members from Rhodes University and eight from the Raphael Centre – a local NGO which assists PLWHA.In most of the participants HAART was associated with increased libido and improved sexual functioning (sexual activity and sexual enjoyment). The use of alcohol increased risky sexual behaviour. Issues of adherence were seemingly not directly affected by the effects of HAART on sexuality. PLWHA, especially women, face challenges related to their sexuality, some of which are not directly related to their illness and treatment. The fear of transmitting drug resistant HIV or getting re-infected, stigma, disclosure issues,difficulties negotiating for safe sex among women, HAART-related lipodystrophic changes that affect one‘s sense of self and unmet reproductive needs are some of the problems that were reported. The men‘s dislike for condoms was overt and blatant. Discussion: Being diagnosed with HIV and reaching a point where treatment is requiredare life-changing events. Making decisions about one‘s life (including adherence to HAART, alcohol use and knowingly partaking in risky sexual encounters) become all the more significant in the context of AIDS. Intentional non-adherence is informed by the individual‘s assessment of the costs and benefits of taking treatment. Cultural influences,gendered power relations and misconceptions strongly influence sexual behaviours. Conclusion: The general lack of attention among health care providers concerning issues related to PLWHA‘s sexuality and reproductive issues needs to be addressed. Insights fromthe theoretical models should be integrated with empirical findings in designing adherence interventions.

How should the impact of HIV and AIDS on rural livelihoods be factored into efforts to monitor and stabilise household food security? With both HIV and AIDS and food security at the top of the global development agenda, this is a question posed by many scholars, practitioners, donor agencies and government departments. However, while there is an excess of discourse outlining the theoretical bases for how HIV and AIDS can, and is, radically transforming household food acquisition; there is a lack of empirical evidence from the South African context that demonstrates if, and how, HIV and AIDS changes household-level strategies of food acquisition and intake. This thesis explores the association of household-level mortality, chronic illness and additional child-dependent fostering with household experience of food security and food acquisition strategies, in three rural villages in the Eastern Cape and KwaZulu-Natal Provinces of South Africa. Qualitative and quantitative methods of data-collection were applied to 307 households in the three sites. For twelve months, both HIV and AIDS-afflicted and non-afflicted households were repeatedly visited at 3-month intervals, in order to be assessed for levels of food security, dietary intake and method of food procurement (purchased, cultivated, wild or donated). Overall, HIV and AIDS-afflicted households showed a significantly higher experience of food insecurity, probably attributable to shortages in food quantity. Dietary composition and overall diversity, however, was not significantly different. Although households with chronic illness and recent mortality showed a heightened investment in cultivation sources, the success of these strategies were to a great extent mediated by household income, and the level of medical treatment received by those who were chronically ill. Chronic illness was also associated with more donations, but these required considerable investments in social capital networks. Finally, use of wild leafy vegetables was not associated with household HIV and AIDS status, despite the financial, nutritional and labour-saving properties of these foods. Overall, the study suggests that there was little evidence of long-term planning and strategy in household food security responses. There was no evidence for shifts to labour-saving crops or foods and, in some instances, child labour was being used to ameliorate prime-adult labour deficits. Moreover, given that the vast majority (89.2%) of food groups were sourced through purchase, it is questionable whether investing in diverse food acquisition strategies would be advisable. Unless supported by medical treatment and steady earned household income, policies to promote intensified household agricultural subsistence production in the wake of HIV and AIDS are unlikely to provide households with anything more than short-term safety-nets, rather than long-term, sustainable food security solutions.

The MA Social Behaviour Studies in HIV and AIDS as a postgraduate degree requires students to work and conduct research independently. The purpose of the study was to gauge the perceptions, attitudes and experiences of second year students and key personnel concerning student support. A mixed methods research design was used. It was found that students and staff regarded support in a positive light, although concerns about insufficient resources were expressed. Students expressed needs for specific academic and research support. Staff tended to romanticise the reasons for students enrolling for the degree. Possible conflicting expectations of the degree and the amount and type of support offered were found between the staff and the students and also among various staff members. / Social Work / M.A. (Social Behaviour Studies in HIV-AIDS)

This ethnographic study explored and described practices and beliefs that may have an impact on the management of HIV and AIDS among Tsonga people in Bushbuckridge. Data was collected through face to face in-depth individual interviews with 19 key informants who are highly knowledgeable about the Tsonga culture. The researcher used ethnographic content analysis to analyse data. Findings indicated that language, rituals, beliefs related to the origin of diseases, traditional healers, and tattoos are among Tsonga cultural practices and beliefs that have an impact on management of HIV and AIDS. Some of the practices increase the risk of HIV infection while some assist in the reduction of the risk of HIV infection. Based on the findings of the study and literature, the researcher managed to develop a contextual, cultural approach model for HIV and AIDS management for Tsonga people in Bushbuckridge. The model development was guided by Leininger theory of culture, care, diversity, and universality. To organise the model, the researcher used CIPO model to guide the elements of the cultural approach model. Though the model takes into consideration global and national context, the main focus was the local context in particular Bushbuckridge. The success of this model is dependent on the availability of knowledgeable healthcare practitioners, relevant resources and engaged community structure. The process of the model includes Cultural Care Preservation, Cultural care Accommodation, and Cultural care Re-patterning. The expected output of the model is modification of HIV risky cultural practices, improved health-seeking behaviour, reduction of new HIV infections and reduction of HIV and AIDS-related deaths. Based on the study outcomes, the researcher makes several recommendations in relation to implementation of the model, Nursing Practice and Education, and further research. The study has contributed to the body of knowledge in relation to cultural practices and management of HIV and AIDS. The model can be utilised to enhance nursing education and practice and further research. / Health Studies / Ph. D. (Health Studies)

The study was an exploration of how internal savings and lending (ISAL) influenced the way in which persons affected by HIV and AIDS earned and spent income. The researcher engaged with the life stories of participants belonging to HIV and AIDS support groups that practised ISAL in rural Bikita district in Zimbabwe. The negative changes brought about by HIV and AIDS were found to influence the way participants generated and spent their income. The initial illness of family members reduced the participation in productive activities of the ill and family members providing care. Compounding effects included reduced attention to and increasing abandonment of productive activities, reduction in the scale of production, the use of inappropriate inputs, forced disposal of assets, increased household debts, reliance on social networks, and dependence on begging and piecework for income. The low productivity from activities meant that households generated less produce and income. This triggered changes in the prioritisation of spending, with healthcare and associated transportation needs superseding all, followed by spending on food. Expenses that were not prioritised during the period of illness included the purchase of improved agricultural inputs, spending on education and clothing and, in some cases, food purchases. In the findings, ISAL is associated with restoring past and starting up new productive and income-generating activities. Regular access to loans allowed storytellers to invest in activities that improved the levels and frequency of income that they earned. Loans were used to directly cover daily family needs, reducing reliance on risky coping mechanisms. Lump sum payments and bulk grocery purchases helped storytellers to invest and manage their cashflow. Overall, households that practised ISAL improved and increased their incomes and ability to spend on healthcare and satisfy other daily needs to levels similar to and better than those experienced before they had to cope with the effects of HIV and AIDS. Recommendations from the study include enabling persons testing HIV positive to access social protection, adapted agriculture technologies and financial education tailored to those affected by HIV and AIDS. Areas for potential further research include a quantitative and qualitative analysis of income and expenditure changes for persons affected by HIV and AIDS and the effects on children of dropping out and being re-enrolled at school. / Sociology / M.A. (Sociology) (Social Behaviour Studies in HIV and AIDS)) / 1 online resource (ix, 153 pages)

Voluntary Counselling and Testing (VCT) is at the core of HIV and AIDS prevention, treatment and care programmes. Timely access to treatment and related services requires knowledge of one‟s HIV status. Adolescents are at the epicentre of the HIV and AIDS pandemic. This study investigated the factors that influence adolescents‟ decisions to actively seek VCT. Semi-structured, in-depth individual interviews were conducted with twelve adolescents aged 15 to 19 who were conveniently selected to participate in the study. The study found that adolescents have extensive knowledge regarding the benefits of VCT and acknowledge the need to test for HIV. However, fear of the consequences of testing positive for HIV such as stigmatisation by family and the community, inability to influence their partners to take an HIV test and the inability to make their own decisions and follow through on them still hinder their maximum uptake of VCT. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

This study was a situation analysis of the socio-economic conditions of orphans and vulnerable children in Dessie Town. Specifically the study assessed the educational attainment, economic status, social isolation, adjustment, discrimination and psycho-social status of OVCs, the characteristics of the care-givers of OVCs and the support systems for OVCs. Therefore, 270 OVCs, 130 guardians and 4 OVCs service-providing organisations were selected as respondents. A survey research design was used. The study found that OVCs and their households faced problems such as school dropout, low educational performance; economic and food insecurity, lack of adequate clothing; social isolation and emotional hardships due to separation of siblings; discrimination, and neglect. Children’s housing conditions, toilet facilities, and access to clean water and health facilities were poor. The majority of guardians were unemployed and unable to fulfil the needs of the OVCs in their care. It is recommended that support systems for OVCs be strengthened. / Sociology / M.A. (Sociology)

This study focussed on determining the knowledge and understanding of Angolan women pertaining to the causes and consequences of HIV/AIDS with the aim of developing an information leaflet about HIV/AIDS for disseminating information to the vulnerable community. A quantitative approach was applied using an exploratory and descriptive design, utilising a self-developed questionnaire to collect the data, from 100 females who accompanied sick children to a specific hospital in Luanda. The findings indicated that even though the respondents were aware of certain key issues in the transmission and consequences of the HIV infection, there were many areas in which a great measure of uncertainty existed such as the causes of the disease, prevention methods, risk factors and precautions to take when living with an HIV positive person. Recommendations were made in view of enhancing the distribution of information regarding the causes and consequences of HIV and AIDS by means of different structures. / HEALTH STUDIES / MA (HEALTH STUDIES)

AIDS-related bereavement counselling programmes / The aim of this study was to determine whether there is a need for specific bereavement counselling programmes for women affected by HIV/AIDS in Indonesia, where death is believed to be fated. Six AIDS-bereaved women were recruited. Data analysis was conducted based on the women's interview transcripts and journal entries. The women experienced at least three traumatic life events. The most challenging experience was learning that they have contracted a disease they knew to be mostly associated with prostitution. Given the short lapse of time between their husbands' deaths and learning about their seropositivity, biographical disruption appeared to have acted as an "analgesic", while concerns to protect their children seemed to have triggered biographical reinforcement. This phenomenon may have brought about a positive bereavement outcome. Specific counselling programmes for women affected by HIV/AIDS are needed, but emphasis should first be placed on improving their wellbeing and their perception of stigma. / Sociology / M.A. (Sociology (Social Behaviour Studies in HIV/AIDS))