Antiretroviral drugs were introduced into Uganda during the past decade and have revolutionised the treatment of AIDS. However, in as much as success was recorded, new challenges emerged. One such challenge was the continued use of condoms. This study investigated existing knowledge, attitudes and practices of condom use in a time of highly active antiretroviral therapy in a rural area. A quantitative, cross sectional design, with probability sampling form the general population was utilised. A self-designed questionnaire was used to collect data which was then analysed at the descriptive statistics level. The results indicated that: knowledge of HIV, its transmission, condoms and antiretroviral drugs were high among the respondents; condom acceptance and use were low; and respondents would not intentionally engage in unprotected sexual intercourse because of availability of ARVs. However it was acknowledged that some people taking ARVs have engaged in risky sexual behaviours that would expose others to infection. / Health Studies / M.A. (Public Health)

This non-experimental, retrospective, descriptive and correlational study investigated adherence to antiretroviral drugs among HIV positive patients at Mpilo Central Hospital in Bulawayo Zimbabwe. Data among 118 patients was extracted from clinic registers and patient facility held medical records to determine level of adherence to ART using pharmacy refills (a non-immunological adherence parameter) and compared to CD4 cell count ( an immunological adherence parameter). Adherence levels obtained in this study using pharmacy refills was low (62.7%) and a relatively high non-adherence level of 37.3%. The pharmacy refill adherence level obtained was comparable to CD4 cell count adherence level of 64.6% (as indicated by a 50% CD4 cell count gain). These findings would seem to indicate the need for more education on the importance of adherence and further the need for better adherence monitoring systems / Health Studies / M.A. (Public Health)

This study analysed data obtained from respondents and their medical records to determine the barriers and motivators for good adherence to ART. Respondents' records were also reviewed together with their pharmacy refill records to identify any correlation between .CD4 cell counts, viral load, VL and adherence to antiretroviral drugs at extension 15 ARV clinic in Gaborone, Botswana. The study investigated whether the combination of pharmacy refills and pill counts adherence measurement methodologies could predict immunological recovery and virologic response through increased CD4 cell counts and suppressed VL. . There was a positive relationship between adherence, CD4 cell counts and VL. Pharmacy refills and pill counts adherence measurement methodologies scored high on sensitivity, specificity, and positive predictive values but low on negative predictive values. / Health Studies / M.A. (Public Health)

Antiretroviral drugs were introduced into Uganda during the past decade and have revolutionised the treatment of AIDS. However, in as much as success was recorded, new challenges emerged. One such challenge was the continued use of condoms. This study investigated existing knowledge, attitudes and practices of condom use in a time of highly active antiretroviral therapy in a rural area. A quantitative, cross sectional design, with probability sampling form the general population was utilised. A self-designed questionnaire was used to collect data which was then analysed at the descriptive statistics level. The results indicated that: knowledge of HIV, its transmission, condoms and antiretroviral drugs were high among the respondents; condom acceptance and use were low; and respondents would not intentionally engage in unprotected sexual intercourse because of availability of ARVs. However it was acknowledged that some people taking ARVs have engaged in risky sexual behaviours that would expose others to infection. / Health Studies / M.A. (Public Health)

This non-experimental, retrospective, descriptive and correlational study investigated adherence to antiretroviral drugs among HIV positive patients at Mpilo Central Hospital in Bulawayo Zimbabwe. Data among 118 patients was extracted from clinic registers and patient facility held medical records to determine level of adherence to ART using pharmacy refills (a non-immunological adherence parameter) and compared to CD4 cell count ( an immunological adherence parameter). Adherence levels obtained in this study using pharmacy refills was low (62.7%) and a relatively high non-adherence level of 37.3%. The pharmacy refill adherence level obtained was comparable to CD4 cell count adherence level of 64.6% (as indicated by a 50% CD4 cell count gain). These findings would seem to indicate the need for more education on the importance of adherence and further the need for better adherence monitoring systems / Health Studies / M.A. (Public Health)

The background and problem statement focuses on antiretroviral therapy (ART) and the use of mobile technology to improve compliance within a primary health care (PHC) context in South Africa. South Africa is one of the countries, globally, with the highest HIV incidence and prevalence and ART enrolled patients visiting PHC facilities. Compliance to ART plays an integral part in effective HIV/AIDS management. HIV/AIDS management entails a complex process of patient education and pharmacological control to improve ART compliance in South Africa. Studies were done in South Africa on reminder messages as most studies focused on chronic conditions in general. A literature review explored what is known about ART and mobile technology to improve compliance. Literature confirmed that compliance through reminder messages were done worldwide and in Sub-Saharan countries. Previous research indicated that the compliance rate of the patients increased through reminder messages. Yet there is a gap in the literature regarding reminder messages combined with health education on ART compliance. The aim of the study was to determine the impact of reminder messages combined with health education on ART compliance among patients receiving ART at a PHC facility Methodology: The study followed a quantitative, experimental, intervention, randomised multi-group, pre- and post measurement design (Creswell, 2012:1, Welman et al., 2012:80). The research design is experimental because the researcher applied an intervention (reminder messages) to two experimental groups. Random sampling was applied and participants were grouped into three groups: Group A, (control group), Group B, (reminder messages only) and Group C (reminder messages combined with health education). A preand post-measurement design is followed as each participant’s pill count and return date were measured before and after the reminder messages with/without health education were given. The sample size was 202 eligible patients receiving Regime 1 and 2 ART’s (Lamuvidine, Tenofovir, Efavirenz, Nevirapine, Alluvia® and Zidovudine) at a PHC facility in the North West, South Africa (N=202). The sample size was determined with guidance of statistical services to ensure that results obtained from the study would be reliable and significant. Data collection was done in three phases. Phase one (1) consisted of collecting the biographical data and a pre-measurement of pill count and return dates for participants in Groups A, B and C. Phase two (2) consisted of sending bi-weekly messages (Group B) via WinSMS and with health education (Group C) for three (3) months. Phase three (3) consisted of post-measurement of participants’ pill count and return date for Groups A,B and C. Data collection stretched over six months (October 2013-March 2014), namely three months pre-measurement, then activation of intervention combined with another three months post-measurement. Descriptive and inferential statistical analysis was conducted through SPSS (SPSS Inc., 2013). Descriptive statistics indicated that more female patients visited the PHC facility for ART on a more regular basis. It was concluded that the experimental group proved a slight increase in compliance with regards to return date after the SMS intervention. No difference was noted in compliance to pill counts. It can also be concluded that pill counts is a complex monitoring procedure with room for error from the patients’ aspect. / MCur, North-West University, Potchefstroom Campus, 2015

The background and problem statement focuses on antiretroviral therapy (ART) and the use of mobile technology to improve compliance within a primary health care (PHC) context in South Africa. South Africa is one of the countries, globally, with the highest HIV incidence and prevalence and ART enrolled patients visiting PHC facilities. Compliance to ART plays an integral part in effective HIV/AIDS management. HIV/AIDS management entails a complex process of patient education and pharmacological control to improve ART compliance in South Africa. Studies were done in South Africa on reminder messages as most studies focused on chronic conditions in general. A literature review explored what is known about ART and mobile technology to improve compliance. Literature confirmed that compliance through reminder messages were done worldwide and in Sub-Saharan countries. Previous research indicated that the compliance rate of the patients increased through reminder messages. Yet there is a gap in the literature regarding reminder messages combined with health education on ART compliance. The aim of the study was to determine the impact of reminder messages combined with health education on ART compliance among patients receiving ART at a PHC facility Methodology: The study followed a quantitative, experimental, intervention, randomised multi-group, pre- and post measurement design (Creswell, 2012:1, Welman et al., 2012:80). The research design is experimental because the researcher applied an intervention (reminder messages) to two experimental groups. Random sampling was applied and participants were grouped into three groups: Group A, (control group), Group B, (reminder messages only) and Group C (reminder messages combined with health education). A preand post-measurement design is followed as each participant’s pill count and return date were measured before and after the reminder messages with/without health education were given. The sample size was 202 eligible patients receiving Regime 1 and 2 ART’s (Lamuvidine, Tenofovir, Efavirenz, Nevirapine, Alluvia® and Zidovudine) at a PHC facility in the North West, South Africa (N=202). The sample size was determined with guidance of statistical services to ensure that results obtained from the study would be reliable and significant. Data collection was done in three phases. Phase one (1) consisted of collecting the biographical data and a pre-measurement of pill count and return dates for participants in Groups A, B and C. Phase two (2) consisted of sending bi-weekly messages (Group B) via WinSMS and with health education (Group C) for three (3) months. Phase three (3) consisted of post-measurement of participants’ pill count and return date for Groups A,B and C. Data collection stretched over six months (October 2013-March 2014), namely three months pre-measurement, then activation of intervention combined with another three months post-measurement. Descriptive and inferential statistical analysis was conducted through SPSS (SPSS Inc., 2013). Descriptive statistics indicated that more female patients visited the PHC facility for ART on a more regular basis. It was concluded that the experimental group proved a slight increase in compliance with regards to return date after the SMS intervention. No difference was noted in compliance to pill counts. It can also be concluded that pill counts is a complex monitoring procedure with room for error from the patients’ aspect. / MCur, North-West University, Potchefstroom Campus, 2015

This study sought to explore and describe the perceptions and beliefs of physicians about adherence to antiretroviral treatment by patients in the South-East district of Botswana. The Health Belief Model (Naidoo & Willis 2003:222) was adapted to suit and be used in the study. A descriptive, exploratory qualitative design was used. Unstructured interviews and unstructured observation data collection methods were applied. Informed consent was obtained prior to data collection. For triangulation purposes, observations were done following interviews, and data analysis was done by two different people. The findings of the study revealed that the perceptions and beliefs of treating physicians contributed towards adherence. Physicians perceived adherence as an important aspect in the success of antiretroviral treatment. Giving patients correct information, personal motivation, patients' understanding of treatment, traditional and religious beliefs were among other factors perceived by physicians to be impacting on adherence. / Health Studies / M.A. (Public Health)

Health communication is a vital part of health care and treatment. For patients living with HIV, effective health communication is crucial. This study aimed at describing health communication from the perspective of HIV-positive patients by uncovering their experiences as they interacted with various medical staff members at Stanger Hospital. Guided by a review of various health communication models, data were collected via individual interviews and non-participant observation. The findings showed that interactive communication was favoured by all the respondents, especially communication that was patient-centred. Such communication encompassed education on how to live and cope with HIV. Obstacles to effective communication such as power differentials, lack of time and privacy at public health care clinics were identified. The study found that the different medical staff members at the clinic to various degrees addressed distinctive communication needs of HIV-positive patients. This study contributed to effectively understating the communication process as a whole. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

The purpose of this study is to explore and describe the challenges experienced by non-governmental organisations with regards to the roll-out of ART, with an aim to facilitate strategy development to overcome the challenges and enhance the success of ART rollout by the NGOs. A qualitative, exploratory and descriptive study was conducted. Data collection was done using in-depth semi-structured interviews. Three groups of respondents participated in the study; programme coordinators who directed and supervised ART programmes; doctors who were responsible for prescribing, monitoring and dealing with ART complications; and registered nurses who were responsible for monitoring, referring and providing nursing care to patients on ART. The findings revealed five broad areas of challenges namely; challenges related to sustainability, challenges related to adherence, challenges related to health systems, challenges related to stigma and challenges related to behavior. Of interest were the surge of whoonga and the infiltration of ART roll-out by crime and violence. / Health Studies / MA (Public Health)