Adherence to long-term medications has remained a problem among adolescents worldwide. Antiretroviral therapy adherence is a wide-reaching challenge among HIV positive adolescents. The aim of this study is to explore and describe poor ART adherence among HIV positive adolescents in Maseru: influential factors and the need of social work support. Qualitative approach was used, following an explorative, descriptive and contextual research design. The research was conducted at BCMCOE Lesotho. Data was collected by using semi-structured in-depth interviews and purposive sampling was applied to select a sample of adolescents who are HIV positive and who have poor adherence to ART. Data was analysed according to the framework provided by Tesch (in Creswell 2003). Guba’s model (in Krefting 1991) was employed for data verification. Conclusions were drawn and recommendations were made about factors influencing adherence of adolescents to ART and support needed from social workers. / Social Work / M.A.(S.S.)

The purpose of this study was to determine factors affecting non-adherence to Anti-retroviral therapy among AIDS patients. A cross sectional quantitative survey, was used. Structured interviews were conducted with 300 ART patients. Data were analysed using SPSS version 13 and presented in charts, graphs and frequency tables. Motivators of good adherence were identified as disclosure of HIV positive status to more than one person, frequent adherence counselling, self-efficacy to adhere to ART, positive interactions between patients and healthcare providers; and using an adherence partner. Barriers to adherence were forgetfulness, transportation costs to and from the clinic, time away from work and side effects. There was a strong positive correlation between adherence, CD4 counts and viral load. Adherence was closely tied to immunologic and virologic improvements. Respondents with poor adherence were likely to have unsuppressed viral loads (OR 12.98, 95%, CI 4.9-34). / Health Studies / Masters of Public Health

MCur / Department of Advanced Nursing Science / Survival of children with HIV/AIDS has increased considerably with the use of effective antiretroviral therapy. However, the benefits of this therapy are limited by the difficulty of adherence to the treatment. This study sought to explore the role of professional nurses on anti-retroviral therapy adherence among children in Lejweleputswa district: Free State, South Africa. An exploratory descriptive qualitative research design was used to identify and describe role of professional nurses toward anti-retroviral therapy adherence among children. Population for this study included seventeen (17) professional nurses working in four purposively sampled Primary Health Care clinics invited to participate in the study. Four focus group discussions were conducted in which each group had 6 participants. The transcribed data was analysed using the framework approach of data analysis. Professional nurses in Lejweleputswa district report poor knowledge of parents/caregivers of children, perceived poverty, stigma and discrimination, inappropriate care approaches, and parental dynamics as factors influencing poor ART adherence. Recommendations for enhancing children ART adherence levels in Lejweleputswa district included: mainstreaming adherence counselling in children ART and adopting a comprehensive family centered care approach were identified as measures for improving children ART adherence. Other measures included integration of ART services into Primary Health Care (PHC) services, parental empowerment, development of a programme to reduce stigma and discrimination in the community.

MA (Psychology) / Department of Psychology / Background: An estimated 70% of people in Sub-Saharan Africa out of 25 million are living with HIV. HIV is a debilitating disease, however, antiretroviral treatment helps promote effective viral suppression, reduces the risk of transmission and prevents death (WHO, 2013). To ensure positive treatment outcomes, high levels of Anti-Retroviral Therapy (ART) adherence, 95%, is necessary, however, research indicates that 23% of Africans are achieving less than 80% adherence, potentially impacting negatively on prognosis. Aim: The aim of this study was to determine adherence, explore perceptions and behaviour of patients on Antiretroviral Therapy attending Thohoyandou Health Centre, in Vhembe District, Limpopo, South Africa. Methodology: This was a mixed method which employed both quantitative and qualitative research approaches. In quantitative, triangulation was utilised through a questionnaire and patients’ file, simple random sampling was used to select 105 male and female patients aged 18-60 who are on ART at Thohoyandou Health Centre; data were collected and SPSSversion 25 was used to analyse the data through descriptive, cross tabulation and inferential statistics using Chi-square.Qualitative phase – phenomelogical research design was utilised, twenty participants were purposively sampled and individually interviewed, ATLAS. ti program was used to analyse the data collected. Results: 67% of respondents were females, 34% of the respondents’ age range was 50-60 years, 44.8% were single, 48.6% had tertiary education and 69.5% were unemployed. The self-report of ART adherence of 87.6% among patients was indicated, with 19.6% who reported defaulting ART, 14.3% admitted to missing medical appointments. The reasons for missing medical appointments were: forgetfulness, not a convenient time, patient feeling better, transportation challenges and being too sick to attend. The objective evaluation of patients’ CD4 count at baseline revealed that 40.9% of patients had a CD4 count of <200c/mm3, out of 40.9% respondents (15.2%) were those aged between 41-50 years, 31.4% of respondents did not know their CD4 count for various reasons (defaulted on treatment, missed appointments). CD4 count follow-up data after six months revealed that 33% of patients had a CD4 count <200c/mm3 and 39% accounted for unknown CD4 count. vi Three themes emerged from the data, namely: Knowledge of HIV were respondents presented a negaitive and positive perception of ths diagnosis; barriers to ART adherence where sub-themes included discrimination, strigma, rejection, inadequate knowledge about the diagnosis and treatment, side effects; coping strategies where acceptance, religion and social support serve as corner stones for patients. Association was examined and findings did not reveal any significant association between gender, marital status, education, occupation; however, age was significantly associated with non-adherence to ART with X2 = 3.69, df = 1, p = < .002. Recommendations: The study recommends intensification of health education campaign against stigma, discrimination, rejection and other barriers to enhance positive attitude towards HIV patients that wil consequently stimulate adherence and alleviate the burden associated with taking treatment unswervingly. Given the high percentage of infected older respondents, government must also focus its resources to educate illiterate and older people about HIV, adherence and management in order to achieve the golden standardrate of 95% adherence. Strategies to facilitate and normalise adherence among males is indicated. / NRF

MA (Psychology) / Department of Psychology / Background: Given that there is 57.7 million HIV-diagnosed people living in South Africa and the government has established the largest public antiretroviral programme in the whole world but only 53% are adhering. Adherence remains a challenge, due to presence of mental health issues among HIV diagnosed. Aim: The aim of this study was to investigate adherence to antiretroviral therapy and mental health of HIV-diagnosed patients in Vhembe District, Limpopo Province. Methods: This was a mixed method study using a combination of quantitative and qualitative research approaches. In the quantitative approach, triangulation was utilised in the form of a questionnaire and patients records. Simple random sampling was used to select 134, descriptive analysis using SPSS version 25. For the qualitative approach, a phenomenological research designs was considered and convenience sampling was used to select fifteen participants (15). Data was collected using semi-structured interview; responses were analysed using a computer-aided program called, ATLAS ti. Results: The self-report of adherence was 94.8 %, objectively 39.6% of CD4 count <200c/mm3 at baseline and 34.3% CD4 count after six months was found. 16.5% of females and 2% of males defaulted treatment and 14.9% of missed medical appointments 1-6 times. This study also revealed the mental health issues that HIV-diagnosed patients are struggling with after the diagnosis include the stages of grief, stress, depression, anxiety, mistrust, shame, stigma and discrimination. Recommendation: Effective strategies need to be enhanced and tailor made in effort to encourage patients to take ART diligently. The healthcare providers, community members and the government should be made aware of mental health issues. / NRF