Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: Chronic drug therapy has been fraught with many issues such as adherence, drug intolerance, long-term toxicity and resistance. In HIV/AIDS care, adherence is a major problem due to the fact that for success of the therapy, adherence must be in the region of ninety five percent. If this is not maintained the virus begins to mutate and resistant moieties appear, and this in turn leads to failure of the therapy. This high level of adherence is very difficult to maintain especially in patients who begin antiretroviral therapy (ART) for various reasons such as persuasion by health workers and family, and not due to their own conviction. They usually tend not to adhere to the therapy when symptoms resolve and they start feeling better. There are a number of factors that promote adherence and these are incorporated into HIV care for the programme to succeed. The research was intended to explore and describe factors causing patients to default ART on the Copper belt in Ndola at Ndola Central Hospital and to ultimately propose appropriate interventions to ensure improved return rates of patients on ART. Qualitative tools i.e. interviews and focus group discussions respectively were used, taking into account ethical considerations and data collected was then analyzed. Factors causing patients to default on ART were found to be poor social economic background, inadequate finance, unavailability of food, poor or little understanding of instructions, poor quality of counseling or low literacy levels, high pill burden, unpalatability of drugs and patient readiness to life time commitment to taking ARVS. / AFRIKAANSE OPSOMMING: Chroniese medisyneterapie is gepaard gaande met vele kwessies soos trou bly, weerstandsgebrek aan medisyne, langtermyn toksisiteit en weerstand. In MIV/Vigs sorg, is trou bly 'n groot probleem weens die feit dat vir sukses in terapie moet dit oor vyf-en-negentig persent wees. As dit nie gehandhaaf word nie sal die virus begin verander en weerstand weestandbiedende gedeeltes sal verskyn, en dit op sy beurt lei tot die mislukking van die terapie. Hierdie hoë vlak van trou bly is baie moeilik om te handhaaf veral in pasiente wie antiretrovirale terapie (ART) vir verskeie redes begin het soos oorreeding deur gesondheids werkers en familie, en nie deur hul eie oortuiging nie. Hulle neig gewoonlik om die terapie te laat vaar wanneer simptome verminder en hulle begin beter voel. Daar is verskeie faktore wat trou bly bevorder en wat ingelyf word in MIV sorg om die program te laat slaag. Die doel van hierdie navorsing was om die faktore te beskryf wat veroorsaak dat pasiente op die Copperbelt in Ndola by Ndola Sentrale Hospitaal hul ART verpligtinge nie nakom nie en om uiteindelik geskikte intervensies voor te stel om verbeterde terugkeer koerse van pasiente op ART te verseker. Kwalitatiewe insrumente, dit is, onderhoude en fokusgroupe is gebruik, met in agneming etiese kwessies, en data is daarna geanaliseer.

Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2010. / ENGLISH SUMMARY: The study sought to investigate adherence for people living with HIV who are on ART. Since high levels of adherence of more than 95% are required to achieve the durable suppression of the viral load, the researcher finds it very important to find out whether the people are doing what is expected of them. While the rollout of antiretroviral (ARV) therapy has brought much excitement and hope to both patients and practitioners in South Africa, it has also brought many new questions and challenges, including adherence. Adherence is therefore very crucial to the success of ART. The research sought to investigate adherence in resource-poor settings. The research was conducted on patients attending Ithembalabantu clinic in Umlazi, Durban, Kwazulu Natal, South Africa. Respondents were recruited as they come to the clinic to collect their medication. Triangulation of qualitative and quantitative research was used to collect data in the study. The quantitative data involved 90 questionnaires. The qualitative data involved 15 semi structured interviews. The results indicated that adherence to ART is very high and satisfactory among the sample population with 79% who never skipped or missed their medication and 64% who indicated that they followed their specific schedule all the time; and 88% of the respondents were aware of the dangers of sleeping without a condom more especially while on ART. The results showed that there is a very high level of condom usage among the sample population. The respondents from the in-depth interviews indicated that participants are not affected by the factors that lead to poor adherence. The only problem that needs urgent attention is the importance of the knowledge of viral load and CD4 count. The participants seemed to be confused by the two and most of them did not know why they are measured. / AFRIKAANSE OPSOMMING: Hierdie studie het gepoog om vlakke van getrouheid aan volgehoue deelneming te ondersoek onder MIV positiewe persone wie antiretrovirale terapie (ART) ontvang. Omdat hoë vlakke van getrouheid van meer as 95% nodig is om duursame suppressie van die virale lading to bereik, voel die navorser dat dit baie belangrek is om uit te vind of persone doen wat van hulle verwag word. Terwyl die uitrol van ART opgewondenheid en hoop vir beide pasiënte en praktisyne in Suid-Afrika gebring het, het dit ook baie nuwe vrae en uitdagings gebring, getrouheid ingesluit. Getrouheid is dus beslissend vir die sukses van ART. Die navorsing het gepoog om getrouheid in hulpbron-swak areas te ondersoek. Die navorsing is uitgevoer op pasiënte wat die Ithembalabantu kliniek in Umlazi, Durban, Kwazulu Natal, Suid-Afrika bywoon. Respondente is gewerf soos hulle na die kliniek toe gekom het om hul medikasie te kry. Triangulasie van kwalitatiewe en kwantitatiewe navorsing is gebruik om data in te samel. Die kwantitatiewe data is deur vraelyste ingesamel en die kwalitatiewe data is deur 15 semigestruktureerde onderhoude ingesamel. Die resultate het gewys dat getrouheid aan ART hoog en voldoende onder die steekproek populasie is met 79% wie nooit hul medikasie gemis het, 64% wie aangedui het dat hulle hul spesifieke skedule heeltyd volg, en 88% van die respondente is bewus van die gevaar van seks sonder 'n kondoom, veral vir persone op ART. Die uitslae wys dat daar 'n hoë valk van kondoom gebruik onder die steekproef populasie is. Die respondente in die onderhoud groep is nie deur die faktore wat tot swak getrouheid lei geaffekteer nie. Die enigste probleem wat dringende aandag benodig is die belangrikheid van kennis van virale vrag en CD4 telling. Dit het voorgekom asof die deelnemers deur die twee verwar word en meeste van hulle het nie geweet waarom hulle gemeet word nie.

Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The AIDS epidemic presently engulfing South Africa is mostly based on heterosexual transmission. This paper discusses the male role in African culture in the HIV and AIDS context. Issues facing African women, domestic violence in particular, remain a pervasive problem. Women have not yet reached a level of equality and are still being dominated by their male partners. Women’s subordination can be directly linked to the increasing number of women becoming infected with HIV/AIDS, especially within the African cultural context. Culture plays a vital role in determining the level of health of the individual, the family and the community. This is particularly relevant in the context of Africa, where the values of extended family and community significantly influence the behaviour of the individual. The behaviour of the individual in relation to family and community is one major cultural factor that has implications for sexual behaviour and HIV/AIDS prevention and control efforts. As the impact of HIV/AIDS in South Africa remains unabated, a culture-centred approach to prevention, care and support is increasingly desirable as a critical strategy. The focus of prevention of the heterosexual AIDS epidemic has been on women. The role of men in sexual decision-making has not been emphasized enough in AIDS prevention approaches. As a result, the heterosexual epidemic for women continues unabated because of the lack of attention to the behaviour of male sex partners. Discussion focuses on the cultural and contemporary sexual culture as shaping factors in the enactment of high-risk sexual behaviour. There are numerous social, political, cultural and economic factors affecting the HIV pandemic in the SA region. The main ones are: low status of women and male dominance in sexual and economic relations; sexual abuse (of particularly young girls); historic and current separation of families resulting from the migrant labour system which resulted in multiple sexual partners; high use of sex workers due to single-sex quarters at the workplace; cultural resistance to the use of condoms; high rates of other STD’s; and high levels of poverty and other inequalities such as health access and education. Stigma about HIV is also a barrier to reaching the most vulnerable, including those already infected. The paper draws the conclusion that discrimination against women, coupled with male dominance in all aspects of social structures; polygamous marriages were prescribed and supervised by maledominated social structures has increased the prevalence rate of HIV/AIDS in the African cultural context. / AFRIKAANSE OPSOMMING: Die HIV/Vigs pandemie wat tans Suid Afrika oorweldig is meestal die gevolg van heteroseksuele oordrag. Hierdie verhandeling bespreek die manlike rol in die Afrika kultuur in die konteks van MIV en Vigs. Aspekte wat die Afrika vroue in die gesig staar in terme van gesinsgeweld bly `n aanhoudende probleem. Vroue word steeds deur hul manlike maats gedomineer word en dus steeds nie `n vlak van gelykheid bereik het nie. Die onderdrukking van vroue kan direk gekoppel word aan die toenemende aantal vroue wat met MIV/Vigs geïnfekteer word – veral in die Afrika konteks. Kultuur speel ʼn kritieke rol in die bepaling van die gesondheidsvlak van die individu, gesin en gemeenskap. Dit is besonder relevant in die Afrika konteks, waar die waardes van `n uitgebreide gesin en gemeenskap ʼn enorme invloed het op die optrede van `n individu. Hierdie optrede in verhouding tot die gesin en gemeenskap is `n geweldige factor wat implikasies het op seksuele gedrag en op pogings tot voorkoming en beheer van MIV/Vigs. Terwyl die impak van MIV/Vigs in Suid Afrika ongesteurd voortstu, word `n kultuur gesentreerde benadering tot voorkoming, versorging en ondersteuning toenemend nodig as `n kritieke strategie. Die fokus op die voorkoming van die heteroseksuele Vigs pandemie was tot nou toe op vroue. Die rol van mans in seksuele besluitneming was tot dusvêr nie voldoende beklemtoon in Vigs voorkomende benaderings nie. Die gevolg is dat die heteroseksuele Vigs pandemie vir vroue ongesteurd voortduur weens die gebrek aan aandag op die gedrag van manlike seksmaats. Bespreking fokus op die kulturele en kontemporêre seksuele kultuur as vormende faktore in die uitvoer van hoë risiko seksuele gedrag. Daar is verskeie sosiale, politieke, kulturele en ekonomiese faktore wat die MIV/Vigs pandemie in die streek beïnvloed. Die belangrikstes is: lae status van vroue; manlike dominasie in seksuele en ekonomiese verhoudings; seksuele mishandeling – veral van jong meisies; historiese en huidige skeiding van gesinne voortspruitend uit die stelsel van trekarbeid – wat aanleiding gegee het tot `n verskeidenheid van seksuele maats; die hoë voorkoms van sekswerkers agv enkelgeslag woonkwartiere by die werksplek; kulturele weerstand teen die gebruik van kondome; hoë voorkoms van seksueel oordraagbare siektes; hoë vlakke van armoede en ander ongelykhede soos toegang tot gesondheidsdienste en onderwys. Die stigma van MIV/Vigs is ook `n hindernis in die bereiking van die mees kwesbare, insluitend die wat geïnfekteer is. Hierdie verhandeling maak die gevolgtrekking dat diskriminasie teen vroue, gekoppel met manlike dominasie in alle aspekte van sosiale strukture; poligamiese huwelike wat voorgeskryf word en onder toesig is van manlik gedomineerde sosiale strukture, die voorkoms van MIV/Vigs in die Afrika kulturele konteks verhoog het.

Thesis (MPhil (Industrial Psychology. Centre for HIV/AIDS Management))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: This study was conducted as an inquiry into the living conditions of children living with terminally ill parents due to HIV and AIDS. It examined possible support systems that such children can access from general communities in which they live. The study was also purposed to identify specific needs related to the fact of living with terminally ill parents due to HIV and AIDS. Both qualitative and quantitative research methods were employed in conducting the study. These included interviews, focus group discussions and questionnaires. Social workers, class teachers and parents were the main respondents in the study. The study revealed that children living with terminally ill parents suffer multidimensional effects that are social, economic and psychological. Children assume adult responsibilities at a very early stage including that of fending for the family. In an effort to meet family needs, older children resort to a host of activities in an attempt to earn money for self and family survival from temporary paid labor, sex work to rudimentary trade. In effect, children become prone to abuse, exploitation and are exposed to crime. / AFRIKAANSE OPSOMMING: Hierdie studie was gedoen om inligting te verkry oor die lewensstandard van kinders wat saam met hul ouers woon wat terminal siek is weens MIV/VIGS. Die beskikbare ondersteunings sisteme in hul gemeenskap was ondersoek. Die novorsingsstudie het ook daarop gefokus om die kinders wat as gevolg van MIV/VIGS saam met hul terminale siek ouers woon se spesifieke behoettes te identifiseer. Tydens die norsingsstudie was kwalitatiewe en kwantitatiewe navorsingsmetodes gevolg. Onderhoud focus groep besprekings en vraelyste was benut. Maatsplike werkers, onderwysers en terminal siek ouers was die hoof respondenete in die navorsingdstudie. Die navorsingsstudie het bewys dat kinders wat saam met hul terminale siek ouers woon, multidimensionele gevolge ervaar waat sosiaal-ekonomies en psigologies van aard is. Kinders neem ouers se verantwoordelikhede op „n vroeë ouderdom aan. Om vir die gesin te voorsien, gaan die ouer kinders tot die ekstreem en raak betrokke in seks werk en smous vir „n tydelike inkomste. Die gevolg is dat die kinders blootgestel word aan mishandeling, en moontlike misdaad. Die addisionele verantwoordlikhede dwing hulle om te oorleef deur gebruik te maak van misdaad, prostitusie en kinderarbeid. Al die kondisies dra by daartoe dat kinders blootgestel word.

Thesis (MPhil)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: The study was conducted at the Lungisa High School, at KwaDwesi in Port Elizabeth. The study aimed at describing attitudes of parents of adolescents of this school as possible reasons for the lack of sexuality education for their adolescents. The sample comprised 150 parents of adolescents (guardians) who participated in the survey. Probability sampling was used. This means that each member of the parent population had a specificable probability of being chosen. A questionnaire, two focus groups and interviews were used to solicit responses. Use of descriptive statistics helped in presenting and analysing the data. The survey revealed that parents‟ attitudes inhibit them from talking about sexuality issues to their adolescents. Parents also fear that if they talk about sexuality issues to their adolescents, they will be sexually active at a younger age. Responses of participants (married parents living together, single mothers, single fathers and guardians) indicated this concern. It can be concluded that education for parents of adolescents is imperative. They must be caused to join the fight against HIV and AIDS, but first they must shed these attitudes to reduce HIV infection and other sexually transmitted infections (STIs). Suggestions and recommendations of the syllabus for this kind of education are discussed under the “Conclusion and Recommendations” part of the research article. / AFRIKAANSE OPSOMMING: Hierdie studie was uitgevoer by Hoërskool Lungisa op KwaDwesi, Port Elizabeth. Die fokus van die studie poog om die houdings van ouers van adolessente as moontlike redes aan te voer vir die gebrek van seksualiteitsopvoeding vir hul adolessente kinders. 'n Steekproef van 150 ouers (sowel as voogde) het deelgeneem aan die opname. Die waarskynlikheid monsterneming metode was gebruik. Dit beteken dat elke lid van die ouer-populasie het 'n bepaalde waarskynlikheid om gekies te word. 'n Vraelys, twee fokusgroepe en onderhoude is gebruik om reaksie van die deelnemers uit te lok. Die gebruik van beskrywende statistiek het gehelp met die voorstelling en analisering van data. Die opname het getoon dat die houdings van ouers verhinder hulle om seksualiteitskwelpunte met hul adolessente kinders te bespreek. Ouers vrees dat die praatjies met betrekking tot seksualiteitskwelpunte met hul adolessente kinders sal lei tot vroeë seksuele betrokkenheid op 'n jonger ouderdom. Antwoorde van deelnemers (getroude ouers wat saamwoon, enkel ma's, enkel pa's en voogde) het hierdie besorgheid aangedui. Ter afsluiting kan beklemtoon word dat opvoeding van ouers uiters belangrik is. Ouers moet aangemoedig word om aan te sluit by die oorlog teen Vigs, maar hulle moet eers hul houdings aanpas sodat MIV-infeksie en ander seksuele oordraagbare infeksies verminder word. Voorstelle en aanbevelings van die sillabus van hierdie soort opvoeding word bespreek onder die “Slot en aanbevelings” gedeelte van hierdie artikel.

Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: This study examines the methods of condom distribution as a potential barrier to condom uptake among sexually active clients at the out-patient unit of Settlers hospital. This study was quantitative and it utilised a self-administered questionnaire. A total of 60 sexually active clients comprising of 30 women and 30 men all aged 18 years and above with a prior HIV/AIDS prevention knowledge at the out-patient unit of Settlers hospital formed part of the study. Data was analysed using descriptive analysis and chi square. The responses given by the participants provide an understanding of the perceptions about the methods of condom distribution as a potential barrier to condom uptake and use. Evidently the methods of condom distribution have an impact on the likelihood of condom uptake at the out-patient unit of Settlers hospital and a certain method of condom distribution (placement of condoms in private spaces) is also preferred to another ( condom display in the waiting area). Although the study sample (n=60) was too small to make a representative and definite conclusions, the findings seem to suggest the method of condom distribution is important in condom promotion for increased uptake. Despite the high level of HIV/AIDS prevention knowledge among the study participants there seems to be real barriers to condom uptake and use. However there is a need for policy-makers and stake-holders to ensure that effective condom distribution methods are encouraged and implemented. Finally it would be useful to invest further in research to not only identify more barriers to condom uptake at the hospital but also establish barriers to condom uptake and use in the society where our people live. This was beyond the scope of this study. / AFRIKAANSE OPSOMMING: Hierdie studie vors die verspreidingsmetodes na wat die beskikbaarheid van kondome vir seksueel-aktiewe pasiënte van die buitepasiënt-afdeling by die Setlaars-hospitaal op Grahamstad moontlik kan kortwiek. Die studie was kwantitatief van aard en is deur middel van 'n self-geadministreerde vraelys uitgevoer. Sestig (60) seksueel-aktiewe pasiënte – 30 vroue en 30 mans – van 18 jaar en ouer, by die buitepasiënt-afdeling van bovermelde hospitaal, wat almal voor hulle deelname aan die studie voorkomingskennis van MIV/Vigs opgedoen het, het deel aan die studie gehad. Data is geanaliseer deur gebruikmaking van beskrywende analise en “chi-square.” Die deelnemers se antwoorde bied begrip oor die persepsies rondom die verspreidingsmetodes as moontlike belemmering vir die beskikbaarheid en gebruik van kondome. Klaarblyklik het die metodes van kondoomverspreiding by die Settlers-hospitaal se buitepasiënt-afdeling 'n impak op die waarskynlike gebruik daarvan. 'n Spesifieke verspreidingsmetode – die plaas van kondome in privaatruimtes – word verkies bo 'n ander waar kondome in die wagarea van die hospital se buitepasiënt-afdeling beskikbaar gestel en as't ware uitgestal word. Hoewel die studiemonster (n=60) te klein was om verteenwoordigende en klinkklare gevolgtrekkings te formuleer, dui afleidings daarop dat die metode van kondoomverspreiding belangrik is vir die bevordering en bekendstelling van kondoomgebruik. Ondanks die hoë vlak voorkomingskennis oor MIV/Vigs onder deelnemers aan die studie, wil dit voorkom of daar besliste hindernisse bestaan wat betref kondoombeskikbaarheid en –gebruik. En daar is beslis 'n heersende behoefte dat beleidmakers en betrokkenes behoort te verseker dat doeltreffende kondoomverspreidingsmetodes bevorder en toegepas word. Ten slotte kan dit nuttig en raadsaam wees om verder in navorsing te belê, nie alleen om nog hindernisse rondom kondoomgebruik by die bovermelde hospital te identifiseer nie, maar ook maatreëls in plek te stel ter bevordering van kondoombeskikbaarheid en –gebruik in die gemeenskappe waar ons mense hulleself bevind. Laasvermelde was nie binne die raamwerk van hierdie studie nie.

Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: “Treatment failure, defaulter rate, patients lost to follow up”. These are the words usually spoken by health care workers at the CCMT clinics in the country. These are words that they try at all times to come with solutions to, without much success. Much as both the health care workers and patients know the importance of taking medication, often medication is not taken as required. Adherence is defined as the degree to which a patient follows a treatment regimen which has been designed in the context of a consultative partnership between the client and the health care worker. This obligation is comprehensive as it tends to examine all factors that can affect adherence. It includes characteristics such as the treatment regimen, the provider behaviour, social and environmental factors that may hinder adherence on the patient. There are several factors that lead to non-adherence to treatment. The factors may be classified as Biomedical, Psychological and Social factors. The major tool that can be used to address such issues is adequate training of all staff members working at the CCMT clinics. The researcher explored training needs and gaps at a CCMT site that will assist to combat problems of non-adherence to treatment. Health care works at an identified site where questioned on the level of training they have received and on what they need to improve their management of patients and adherence. It was realised that some categories of staff at the clinic do not receive training as expected and that others do not receive adequate training that will assist them in adherence counselling. Recommendations made by staff members were that training should be readily available to all staff members and that it should also be rolled out to other departments and sections within the hospital so there is continuum of care of HIV positive patients. Non adherence to antiretroviral treatment is a challenge faced by health care providers as well as patients themselves. It results in treatment failure, a decrease in the quality of life of the patient and an increase in morbidity and mobility. Non-adherence means any reason where the patient is not taking recommended doses, not sticking to the recommended time or not taking it in the recommended way. / AFRIKAANSE OPSOMMING: Navolging word gedefinieer as die mate waarop die pasiënt die behandeling wat voorgeskryf is in samewerking tussen die pasiënt en die gesondheidsorgwerker, nakom. Hierdie vepligting is omvattend omdat dit geneig is om alle faktore wat die nakoming kan beinvloed, ondersoek. Dit sluit eienskappe in soos die behandeling regimen, die verskaffersgedrag, sosiale en omgewingsfaktore wat ‘n struikelblok kan wees vir die nakoming van die pasiënt. Daar is verskeie faktore wat kan lei tot nie-nakoming van behandeling. Die faktore kan geklassifiseer word as bio-mediese, sielkundige en sosiale faktore. Die belangrike instrument wat gebruik word om sulke sake aan te spreek, is voldoende opleiding van alle personeellede wat by CCMT klinieke werk. Die navorser ondersoek opvoedkundige behoeftes en leemtes by ‘n CCMT perseel, wat sal help om probleme van nie-nakoming van behandeling sal bestry. Gesondheidsorgwerkers by ‘n geïdentifiseerde perseel, was ondervra oor die vlak van opleiding wat hulle ontvang het en wat hulle nodig het vir beter bestuur van pasiënte en nakoming van behandeling deur pasiënte. Daar is gevind dat sommige kategorieë van personeel by die klinkiek nie die opleiding ontvang het wat nodig is nie en dat ander personeellede nie voldoende opleiding ontvang het wat hulle sal help met nakoming van berading nie. Personeellede het aanbeveel dat opleiding geredelik beskikbaar gemaak moet word aan alle personneel en dat dit na ander departemente en afdelings binne die hospitaal uitgebrei moet word om die voortsetting van sorg vir MIV/VIGS-positiewe pasiënte te verseker. Nie-nakoming van antiretrovirale behandeling is ‘n uitdaging vir beide gesondheidsorgwerkers en pasiënte. Dit lei tot die mislukking van behandeling, ‘n afname in die kwaliteit van die pasiënt se lewe en ‘n verhoging in morbiditeit en mobiliteit.

Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Although VCT has been recognized for its importance in HIV prevention and control, there are several matters of concern surrounding it that potentially limit its uptake. Clients' selective behavior in tandem with service provider and operating environment factors determine uptake of VCT service. This study sought to contribute knowledge on the influence that specialized HIV/AIDS sites have on first time clients' initiative to seek VCT services in comparison with the general health care sites. The study also analyzed factors that determine clients' preference of VCT access point. The study was done within a student population of Nkumba University in Entebbe municipality, Uganda. A sample of students to fill the study questionnaire was selected using a simple random sampling method from a population frame established from a class identified haphazardly. Four focus group discussions were done: two of the groups participants were stratified as students' male and female groups and were selected using convenient sampling from the sampling frame. The other FGDs were done with two groups of nurse counselors – one from a general health care site while the other was from a specialized VCT site, selected purposively. Specialized VCT sites had a higher frequency of first student clients than general health care sites. Results however indicated that though the perception of service providers' attitude and availability of trained councilors affected their choice, there was no significant difference between specialized and general VCT sites in terms of first time clients' preference. Reasons for preference of site differed. Specialized sites were preferred because they are perceived to offer better quality service owing to their concentration on VCT services, but shunned by others for lack disguise. Conversely, respondents revealed that there is disguise at general health j sites which enhances confidentiality and anonymity thereby curbing clients fears of being identified making it easier for first time clients to go to these sites for VCT. / AFRIKAANSE OPSOMMING: Alhoewel vrywillige raadgewing en toetsing (VRT) erken is vir sy belangrikheid met betrekking tot MIV voorkoming en beheer, is daar verskeie kwessies daaraan verbonde wat die gebruik daarvan kan beperk. Kliënte se selektiewe gedrag saam met diensverskaffers en omgewingsfaktore bepaal die gebruik van VRT dienste. Hierdie studie het gepoog om kennis by te dra oor die invloed wat gespesialiseerde MIV/Vigs toetsingsterreine het op eerstelinge se inisiatief om VRT dienste te soek in vergelyking met algemene gesondheidssorgterreine. Die studie het ook faktore geanaliseer wat kliënte se voorkeur van VRT terreine bepaal. Die studie is binne 'n studente populasie van Nkumba Universiteit in Entebbe Munisipaliteit, Uganda, uitgevoer. 'n Steekproef van studente om die vraelyste in te vul is geselekteer deur die eenvoudige toevalmonster metode te gebruik van 'n populasie raam geskep van 'n klas was lukraak geidentifiseer is. Vier fokusgroepe het plaasgevind: twee waar deelnemers as manlike en vroulike studentegroepe gestratifiseerd was en geselekteer deur gerieflike steekproeneming van die steekproefraam. Die ander fokusgroepe was twee groepe van verpleegster beraders – een van 'n algemene gesondheidssorgterrein en die ander van 'n gespesialiseerde VRT terrein, doelbewus geselekteer. Gespesialiseerde VRT terreine het 'n hoër frekwensie van eersteling student-kliente as algemene gesondheidssorgterreine. Uitslae het aangedui dat hoewel die persepsie van diensverskaffers se houdings en beskikbaarheid van opgeleide beraders hul keuse geaffekteer het, dat daar geen betekenisvolle verskil was tussen gespesialiseerde en algemene VRT terreine in terme van eerstelinge se voorkeur. Redes vir voorkeur van terrein het verskil. Gepesialiseerde terreine is verkies weens die persepise dat hulle 'n beter kwaliteit diens lewer weens hul konsentrasie op VRT dienste, maar deur ander vermy was weens gebrek aan vermomming. Omgekeerd het respondente aan die lig gebring dat daar wel vemomming by algemene gesondheidssorg terreine is wat vertroulikheid en anonimiteit verhoog en kliënte se vrese verminder wat dit makliker maak vir eerstelinge om na hierdie terreine vir VRT te gaan.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: In the light of the roll-out of the national combined school-health program which will include the availability of condoms to learners, this study was undertaken to determine what the perceptions of learners and educators are regarding the provision of condoms to learners at Malibu High School in Eerste River, Cape Town as a prevention strategy. The learners’ knowledge levels on HIV and AIDS were also tested. Questionnaires were handed out to learners as well as Life Orientation educators. The findings of the study revealed that the learners’ knowledge levels on HIV and AIDS are reasonably high and that parents are more involved as originally perceived to be. Learners seem to think that the provision of condoms by schools is a good idea. The educators’ views differ. The educators feel that the knowledge levels are low and that there is no visible parental or community involvement regarding HIV and AIDS. They see this as separate to their function. Educators are unanimous in their response that the provision of condoms by schools is not a good idea at all. They feel that it would send out the wrong message to learners. From the study, it became apparent that the Education department still needs to do a lot to get schools on board for the roll-out of the school-health program. A lot needs to be done regarding the training of and support to the educators. A few recommendations are listed in order for the school to effectively address the HIV and AIDS issues at the school in order to reduce its impact. / AFRIKAANSE OPSOMMING: Die toekomstige uitrol van die nasionale gekombineerde skole-gesondheidsprogram sluit die verskaffing van kondome aan leerders in. Hierdie studie was dus hiervolgens onderneem om juis uit te vind wat die persepsies van leerders sowel as die opvoeders van Malibu Hoërskool in Eersterivier, Kaapstad is rakende die verskaffing van kondome aan leerders. Die leerders se kennisvlakke rakende MIV en VIGS was ook getoets. Vraelyste was uitgehandig aan beide die leerders en die Lewensoriëntering-opvoeders. Die bevindinge van die studie weerspiëel egter dat die kennisvlakke van leerders taamlik hoog is en dat ouers eitlik meer betrokke is as wat aanvanklik waargeneem was. Leerders is van mening dat die voorsiening van kondome aan hulle deur skole eintlik ‘n goeie idée is. Die opvoeders se menings verskil egter. Die opvoeders is van mening dat die leerders se kennisvlakke laag is en dat daar egter geen sigbare ouer- en gemeenskapsbetrokkenheid bestaan nie. Opvoeders sien hierdie as apart van hul opvoedingsfunksie. Opvoeders voel dat die verskaffing van kondome aan leerders by skole nie ‘n goeie idée is nie. Volgens hulle sal dit egter die verkeerde boodskap aan leerders deurgee. Volgens die bevindinge van die studie is dit dus baie duidelik dat die Onderwysdepartement nóg baie moet doen om skole aan boord te kry rakende die uitrol van die skole-gesondheidsprogram. Baie moet gedoen word rakende die opleiding van en ondersteuning aan opvoeders in hierdie verband. ‘n Paar aanbevelings word voorgelê om die skool in staat te stel om die MIV en VIGS-kwessies effektief aan te spreek om sodoende die impak daarvan by die skool te verminder.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Reproductive health of people living with HIV/AIDS is a significant public health issue because of its associated risks of HIV transmission to both, the baby and the sexual partner. Provision of effective contraceptive to HIV-positive women is a proven prevention strategy, and can help prevent unintended pregnancy and other sexually transmitted infections. Unmet need for contraception in developing world and rates of unintended pregnancies among women living with HIV remain highly prevalent. The objectives of this study were to identify the current knowledge of HIV-positive women on existing contraceptive methods, determine their current contraceptive practices, identify barriers to contraception use, and provide recommendations on how contraception uptake can be improved among these women in Kasane. A cross-sectional study using qualitative technique was used among twenty five (25) participants at Kasane Primary Hospital. In-depth interviews were conducted with the help of research assistants for data collection. Excel Microsoft Office Software was used for socio-demographics data entry and analysis, and qualitative data were analysed manually using descriptive statistics. Main reasons for low uptake of contraception were desire for children, partner refusal, side effects, and socio-cultural and religious factors. Contraception prevalence was 56 % and condom was the most used contraceptive method (36%). whereas the rate of unintended pregnancies was 60% . Knowledge of contraception was high (100%) but limited proportion of participants (12%) had an expended understanding of contraception as a HIV prevention strategy. Most women living with HIV prefer to space, limit or stop childbearing but do not use any contraceptive method and found themselves with unintended pregnancy. Despite the good knowledge about contraception among participants, the uptake remained low. About half (44%) of the women interviewed were not on any contraceptive method. The choice to use contraception interferes with many factors and the desire to fulfil the primary reproductive intention of men and women, including those living with HIV, mostly override this choice. There is need for a strategic integrated approach that conveys HIV prevention messages and discusses the importance of planning a pregnancy. Thus promoting dual protection among women living with HIV. / AFRIKAANSE OPSOMMING: Die voortplantingsgesondheid van mense wat met MIV/vigs leef, is ‘n belangrike openbaregesondheidskwessie, aangesien voortplantingsgesondheid verband hou met die gevaar van MIV-oordrag na babas sowel as seksmaats. Daar is al bewys dat ander seksueel oordraagbare siektes sowel as onbeplande swangerskappe voorkom word as doeltreffende voorbehoedmiddels verskaf word aan vroue wat MIV-positief is. Dit behoefte aan voorbehoeding in ontwikkelende lande bly egter baie dikwels agterweë, en ‘n groot persentasie vroue wat met MIV leef, raak onbepland swanger. Die doel met hierdie ondersoek is om vas te stel wat vroue wat MIV-positief is, tans oor bestaande voorbehoeding weet, watter voorbehoedingsmetodes hulle tans gebruik en watter struikelblokke daar vir die gebruik van voorbehoeding is, en om voorstelle te maak oor hoe ʼn groter persentasie van hierdie vroue in Kasane oortuig kan word om voorbehoedmiddels te gebruik. ‘n Deursnee-studie wat met behulp van kwalitatiewe tegnieke by die Kasane Primêre Hospitaal uitgevoer is, het vyf en twintig (25) deelnemers betrek. Met die hulp van navorsingsassistente is diepte-onderhoude gevoer om inligting in te samel. Microsoft Office se Excel-sagteware is gebruik om sosio-demografiese inligting in te voer en te ontleed, en kwalitatiewe inligting is met verwysing na beskrywende statistiek met die hand ontleed. Die vernaamste redes vir die trae gebruik van voorbehoeding was die begeerte na ‘n kind, die teenstand van seksmaats, die newe-effekte, en sosio-kulturele en godsdienstige oorwegings. Daar is bevind dat 56% van die deelnemers voorbehoeding gebruik, dat kondome die algemeenste voorbehoedmiddel is (36%) en dat 60% van alle swangerskappe ongewens was. Die deelnemers was almal oor voorbehoeding ingelig (100%), maar slegs ‘n klein persentasie (12%) het ook geweet dat voorbehoedmiddels ‘n voorkomingstrategie vir MIV-infeksie is. Die meeste vroue wat met MIV leef, verkies om swangerskappe te versprei, te beperk of te verhoed, maar gebruik geen voorbehoedmiddels nie en het dus onbepland swanger geraak. Hoewel die deelnemers goed ingelig was oor voorbehoeding, het min van hulle dit gebruik. Ongeveer die helfte (44%) van die vroue met wie onderhoude gevoer is, het geen voorbehoeding gebruik nie. Die keuse om ‘n voorbehoedmiddel te gebruik, word beïnvloed talle ander faktore, en mans en vroue se primêre begeerte om voort te plant – ook al leef hulle met MIV – weeg gewoonlik swaarder as hierdie keuse. Daar is ‘n behoefte aan ‘n strategiese, geïntegreerde benadering wat boodskappe oor MIV-voorkoming oordra en wat tuisbring hoe belangrik dit is om swangerskappe te beplan. Sodoende sal vroue wat met MIV leef, tweedoelige beskerming kry.