Acquired Immune Deficiency Syndrome (AIDS) has become the world's foremost health threat and is the number one killer in Zimbabwe. Acquired Immune Deficiency Syndrome impacts not only the individual who has AIDS, but on nuclear and extended families, and all aspects of society in Zimbabwe. Since studies have indicated that counseling could be an effective tool in preventing the spread of Human Immuno Deficiency Virus (HIV) and helping those who are already impacted by the virus, it would be important for counselors to be knowledgeable about HIV/AIDS and have positive attitudes towards people with HIV/AIDS. Therefore, the main purpose of this study was to investigate eight practicing Zimbabwean counselors' attitudes towards and knowledge of HIV/AIDS. Additionally, the study explored the emotions the counselors experienced while counseling HI V/AIDS clients, their beliefs about the origin of HI V/AIDS, and their perceptions about HI V/AIDS counseling in Zimbabwe. Eight practicing counselors in Zimbabwe participated in this study. A mixed method Model III with a sequential exploratory design was used amid phenomenological underpinnings. The counselors provided information through a mailed (electronic mail) questionnaire and telephone interviews. Follow-ups to the interviews were carried out through the electronic mail. Results indicated that the counselors in the study were generally knowledgeable about HIV/AIDS, had positive attitudes toward people with HIV/AIDS, and did not think that the origin of HIV/AIDS was important and that it was better to focus on the solutions to the problem. The counselors experienced a wide variety of feelings while counseling HIV/AIDS clients. The counselors reported more negative than positive feelings, but most of the feelings were not directed toward the client. The counselors revealed that HIV/AIDS counseling was complex and difficult. The counselors thought counselor training in Zimbabwe was too limited and that counselors in Zimbabwe in general lacked both support and supervision services. Despite the difficulties of, and the lack of support and supervision, the counselors found meaning in counseling HIV/AIDS clients. / Graduation date: 2004

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: This qualitatively oriented Practical Theological research journey, informed by the philosophical ideas of postmodern, contextual, participatory and feminist theologies, postmodern and social construction epistemologies was based on a participatory action research through the therapeutic lens of narrative inquiry. The thesis is about the spiritual problems and spiritual needs of people living with HIV and AIDS and how they can be addressed as part of a holistic approach to their care within the primary healthcare delivery system in Zimbabwe. The research curiosity was prompted by the HIV and AIDS policy in Zimbabwe that advocates for a holistic approach to the care of HIV and AIDS patients within the primary health care delivery system. The recognition that healthcare has to be holistic for the best outcome for patients creates an expectation that spiritual care will also be incorporated into clinical practice. However there is a puzzling blind spot and a strange silence about the spiritual problems and spiritual needs of people living with HIV and AIDS within the HIV and AIDS policy. This has had the effects of reducing intervention programmes to purely medical, psychological and sociological. This research sought to correct such an approach by highlighting the role of spiritual care in the healing process of people living with HIV and AIDS as part of the holistic approach to their care. The core information, on which this research is based, comes from the experiences of people living with HIV and AIDS who are receiving care within the primary health care delivery system in Zimbabwe. It sweeps away statistics and places those questing for spiritual healing at the core of the study. All the participants in the study affirmed that the why me questions as a summation of their indescribable and unimaginable spiritual pain felt in the spirit were directed to God. They confirmed that their spiritual problem was spiritual pain and their spiritual need therefore was spiritual healing from the spiritual pain of which God is believed to be the healer. The belief that God is the ultimate healer of the spiritual pain stood out from the midst of problem saturated narratives of spiritual pain and suffering as the unique outcome to reconstruct the alternative problem free stories of healing. The research opted for an approach that is informed by the experiences of people living with HIV and AIDS. In the light of the stories shared by the participants in this study, it became evident that there is an existing need within the Primary Health Care delivery system in Zimbabwe to provide spiritual care to people living with HIV and AIDS. The research aimed at co-creating a spiritual care approach in which those living with HIV and AIDS as well as those working with them can be empowered to re-author the stories of patients‟ lives around their self preferred images. The narrative approach was explored in this research as a possible therapeutic approach that could be used to journey pastorally with people living with HIV and AIDS in a non-controlling, non-blaming, non-directive and not knowing guiding manner that would permit the people living with HIV and AIDS to use their own spiritual resources in a way that can bring spiritual healing to their troubled spirits. The research also emphasizes the position of the people living with HIV and AIDS which they can inhabit and lay claim to the many possibilities of their own lives that lie beyond the expertise of the pastoral caregiver. The strong suggestion emerging from this study is that a spiritual care approach to healing must of necessity be integrated into the holistic approach to the care of people living with HIV and AIDS in Zimbabwe. The wish of participants that their spiritual well-being be considered in their health care adds momentum to this suggestion. Hence the research argues for the inclusion of a spiritual and pastoral approach to spiritual healing which links the patient‟s spirituality and pastoral care. The research does not claim to have the solutions or quick fix miracle to the complicated spiritual pain of people living with HIV and AIDS and neither claims to have the power to bring any neat conclusions to the spiritual healing of people living with HIV and AIDS. However, the research has the potential to stimulate a new story of spirituality as a vital resource in the healing process of people living with HIV and AIDS and ignoring it may defeat the purpose of a holistic approach to the care of people living with HIV. The re-authoring of alternative stories is an ongoing process but like in all journeys, there are landmarks that indicate achievements, places of transfer or starting new directions or turning around. Hence this research process may be regarded as a landmark that indicated a new direction in the participants‟ journey towards spiritual healing. / AFRIKAANSE OPSOMMING: Hierdie kwalitatief-georiënteerde Praktiese Teologie navorsingsreis, geïnformeer deur die filosofiese idees van postmoderne, kontekstuele, deelnemende en feministiese teologie, postmoderne en sosiale konstruksie epistemologie, is gebaseer op deelnemende aksie-navorsing deur die terapeutiese lens van narratiewe ondersoek. Die tesis handel oor die spirituele probleme en navorsingsbehoeftes van mense wat met MIV en vigs leef en hoe dit aangespreek kan word as deel van ʼn holistiese benadering tot hul sorg binne die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Die navorsing-belangstelling het ontwikkel na aanleiding van die MIV en vigs beleid in Zimbabwe wat ʼn holistiese benadering tot die sorg van MIV en vigs pasiënte in die primêre gesondheidsorg-diensleweringstelsel bepleit. Die erkenning dat gesondheidsorg holisties moet wees om die beste uitkoms vir pasiënte te bied, skep ʼn verwagting dat spirituele sorg ook by kliniese praktyk ingesluit sal word. Daar is egter in die HIV en vigs beleid ʼn raaiselagtige blinde kol, ʼn vreemde stilte oor die spirituele probleme en spirituele behoeftes van mense wat met MIV en vigs leef. Die gevolg is dat intervensie-programme gereduseer word tot slegs mediese, sielkundige en sosiologiese programme. Hierdie navorsing streef om dié benadering reg te stel deur die beklemtoning van die rol van spirituele sorg in die heling-proses van mense wat met MIV en vigs leef as deel van die holistiese benadering tot hul sorg. Die kerninligting waarop hierdie navorsing gegrond is, vloei voort uit die ervarings van mense wat leef met MIV en vigs en sorg ontvang binne die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Dit vee statistiek van die tafel af en plaas diegene wat soek na spirituele heling, in die hart van die ondersoek. Al die deelnemers aan die ondersoek het bevestig dat hul “Waarom ek?” vrae, as opsomming van hul onbeskryflike, ondenkbare geestelike pyn, aan God gerig is. Hulle het bevestig dat hul spirituele probleem spirituele pyn is, en dat hul spirituele behoefte dus spirituele genesing is van die spirituele pyn, die pyn waarvan geglo word dat God die geneser is. Die geloof dat God die opperste geneser is, het uitgestaan te midde van die probleem-deurdrenkte narratiewe van spirituele pyn en lyding as die unieke uitkoms om alternatiewe probleem-vrye verhale van heling te herkonstrueer. Die navorsing het ʼn benadering gekies wat geïnformeer is deur die ervarings van mense wat leef met MIV en vigs. In die lig van die verhale wat die deelnemers aan die studie gedeel het, het dit duidelik geword dat daar ʼn behoefte is dat spirituele sorg ook aan mense wat leef met MIV en vigs verskaf word in die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Die doel van die navorsing was om saam ʼn spirituele sorg benadering te skep waarin diegene wat met MIV en vigs leef, sowel as diegene wat met hulle werk, bemagtig kan word om die stories van pasiënte se lewens te herskryf in terme van pasiënte se verkose beelde. Die narratiewe benadering is in hierdie studie ondersoek as ʼn moontlike terapeutiese benadering wat gebruik kan word om pastoraal te reis met mense wat leef met MIV en vigs op ʼn manier wat nie kontroleer, beskuldig, voorskryf of weet nie, maar wat mense wat met MIV en vigs leef eerder begelei en toelaat om hul eie spirituele bronne te gebruik op ʼn manier wat spirituele genesing vir hul gekwelde siele kan bring. Die navorsing beklemtoon ook die posisie van mense wat leef met MIV en vigs waarin hulle spirituele moontlikhede, areas van hul lewens kan eien en bewoon, moontlikhede wat buite die bereik van pastorale versorgers lê. Uit hierdie studie vloei ʼn sterk suggestie dat ʼn spirituele benadering tot genesing noodwendig geïntegreer moet wees in die holistiese benadering tot die sorg van mense wat leef met MIV en vigs in Zimbabwe. Deelnemers se wens dat hul spirituele behoeftes ook in hul gesondheidsorg oorweeg word, gee aan dié suggestie verdere momentum. Derhalwe argumenteer hierdie navorsing ten gunste van die insluiting van ʼn spirituele en pastorale benadering tot spirituele genesing wat die pasiënt se spiritualiteit en pastorale sorg verbind. Die studie maak nie daarop aanspraak dat dit antwoorde of ʼn wonderbare kits-oplossing bied vir die gekompliseerde spirituele pyn van mens wat leef met MIV en vigs nie, of spirituele genesing netjies afsluit nie. Die navorsing het egter wel die potensiaal om ʼn nuwe verhaal te stimuleer van spiritualiteit as ʼn deurslaggewende bron in die genesingsproses van mense wat leef met MIV en vigs. Om spiritualiteit te ignoreer, mag dalk die doel verydel van ʼn holistiese benadering tot die sorg van mense wat met MIV en vigs leef. Die herskryf van alternatiewe verhale is ʼn voortdurende proses, maar soos alle reise, is daar landmerke wat prestasies aandui, en ook punte van verplasing, rigtingverandering of selfs ommekeer. Hierdie navorsing kan beskou word as ʼn landmerk van ʼn verandering van rigting in deelnemers se reis na spirituele genesing.

The purpose of this study was to explain the ways in which parents of children with hearing impairments access counseling services. In order to focus attention on these issues, a research question and objectives were formulated: In what ways did parents of children with hearing impairments in Zimbabwe access counseling services during the period 1999 to 2000? Five distinct but related major issues, in relation to parents of children with hearing impairments accessing counseling services in Zimbabwe during the period 1999 to 2000 emerged. This came from observation of practice, personal experiences, and discussions with parents. The objectives of the study were thus formulated as follows: · to find out who counseled parents of children with hearing impairments. · to investigate whether parents who received or did not receive counseling were aware of organizations that offered guidance and counseling. · to find out parents’ perceptions on whether or not counseling helped them to accept and cope with their children. · to establish the qualifications of the counselors who counseled parents of children with hearing impairments. · to explore recommendations by parents on ways in which counseling can be made more accessible in Zimbabwe. A pilot study was conducted in which two questionnaires that covered the research question and the five objectives were constructed and refined. Subsequently a survey was carried out on a sample of 300 parents of children with hearing impairments and 28 counseling service organizations. The questionnaires sought to find out: who counseled parents of children with hearing impairments, their views about the counseling they received, whether they were able to accept and cope with their children after counseling and their views on how counseling could be made more accessible. The questionnaire to service organizations sought to establish the qualifications of their counselors, the needs of parents of children with hearing impairments and their views on what they thought could be done to help parents access counseling services. Female and male parents were compared in terms of their sources of counseling, acceptance and coping with children of different genders and different age groups. Quantitative data on organizations and parents’ responses were analyzed using descriptive statistics. Qualitative analysis was used to analyze data from open-ended questions collected from parents of children with hearing impairments. Results from the study indicate that the majority of the parents received counseling from special schools, followed by individuals, then hospitals, churches, registered counseling organizations and friends. Slightly more than half of the parents were aware of registered organizations that offer counseling services. Most parents believed that counseling helped them and were able to cope with their children after counseling. The majority of the counselors who counseled parents of children with hearing impairments were not qualified. Most parents indicated that they faced difficulties in communication, financial constraints, societal attitude, lack of transport and lack of skills to teach children basic living skills. Parents suggested the use of parent support groups, workshops and advertisements as means of making counseling services more accessible. / Thesis (PhD (Learning Support, Guidance and Counceling))--University of Pretoria, 2004. / Educational Psychology / unrestricted

This study explored Childline Zimbabwe’s provision of psychosocial support to sexually abused children. This was done by reviewing counsellors’ practices regarding face-to-face counselling, counselling approaches, referrals, follow-ups, case recording and through measuring client satisfaction levels. A qualitative case study approach was adopted with mixed methods to collect data from counsellors and clients. Data analysis was informed by grounded theory and followed an inductive process of coding and categorising the data into relevant themes. The outcomes of this study showed that referral of clients represents a major strategy of addressing child sexual abuse cases. The engagement of clients in face-to-face counselling stages however remained limited due to difficult work environments and challenges related to individual counsellors’ capacities. This posed questions about Childline’s role as a counselling or referral organisation. This study contributes to counselling of sexually abused children with information over the counselling interventions necessary in addressing survivors of sexual abuse. / Psychology / M.A. (Psychology)

This study explored Childline Zimbabwe’s provision of psychosocial support to sexually abused children. This was done by reviewing counsellors’ practices regarding face-to-face counselling, counselling approaches, referrals, follow-ups, case recording and through measuring client satisfaction levels. A qualitative case study approach was adopted with mixed methods to collect data from counsellors and clients. Data analysis was informed by grounded theory and followed an inductive process of coding and categorising the data into relevant themes. The outcomes of this study showed that referral of clients represents a major strategy of addressing child sexual abuse cases. The engagement of clients in face-to-face counselling stages however remained limited due to difficult work environments and challenges related to individual counsellors’ capacities. This posed questions about Childline’s role as a counselling or referral organisation. This study contributes to counselling of sexually abused children with information over the counselling interventions necessary in addressing survivors of sexual abuse. / Psychology / M. A. (Psychology)

Voluntary Counselling and Testing (VCT) is vital in the management of HIV/AIDS as it is the first step in treatment, care and behavioural change. Entrenched economic and gender inequities drive an increasingly feminized HIV/AIDS pandemic. This study investigated factors influencing VCT attendance by women in the Glen View high density suburb in Harare. A survey methodology was followed using a semi-structured, self-administered questionnaire that was distributed to randomly selected women of reproductive ages in the area. The analysis showed that VCT usage is low and that factors such as fear of the consequences of testing positive for HIV, such as violence and rejection by male partners are to blame. Importantly, the findings suggest that if the vulnerability of women is not addressed, then increased VCT uptake and better reproductive health outcomes for women are also unlikely. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

The study investigated challenges in School Guidance and Counselling (SGC) services provisions for children with disabilities in Zimbabwean inclusive primary schools as a context for strategizing on overcoming them and proposing a model of School Guidance and Counselling services provisions for children with disabilities. The survey design, which was mainly quantitative in nature, was used. Self-administered questionnaires were used to collect data. Three hundred inclusive primary school administrators and three hundred school counsellors participated in the study. The Statistical Package for the Social Sciences, version 11.0 was used to analyze data. Frequency tables, ratios and Chi-square tests were computed. The study revealed that Zimbabwean inclusive primary school counsellors lacked training in School Guidance and Counselling and Special Needs Education. The school counsellors also lacked experience in teaching children with disabilities and the stakeholders had negative attitudes towards School Guidance and Counselling services provisions for children with disabilities. It was further revealed that inclusive primary schools lacked materials and supplies, time, finance, physical and curricular resources. The study revealed that there was no mandatory School Guidance and Counselling policy and legislation, clear mission statement, School Guidance and Counselling Framework, school counsellor certification requirements nor a School Guidance and Counselling national model. These facilities, together with Special Needs Education, experience in teaching children with disabilities and staff development, were found to positively impact on SGC services provisions for children with disabilities. School counsellors’ training in School Guidance and Counselling, advocacy on disabilities, stakeholders’ collaboration, passing mandatory School Guidance and Counselling policy and legislation, adequate budgetary and time allocation were seen as strategies to overcome challenges in SGC services provisions for children with disabilities in Zimbabwean inclusive primary schools. It was recommended that School Guidance and Counselling services provisions for children with disabilities in Zimbabwean inclusive primary schools would improve if there would be promulgation of mandatory School Guidance and Counselling policy and legislation, school counsellors’ training in School Guidance and Counselling, requisition of adequate resources and development of positive attitudes among stakeholders. Recommendations for further research were made. / Inclusive Education / D. Ed. (Inclusive Education)

This study was an attempt to investigate the influence of socio-cultural factors on HIV prevention strategies among HIV discordant couples in Harare, Zimbabwe. HIV sero-discordance is a scenario whereby one partner is HIV-positive and the other is HIV-negative. HIV sero-discordant couples are a unique and vulnerable population that encounters many peculiar challenges. When dealing with this population, researchers have to deal with contradictory ideas and perceptions presented by each partner making up the couples and also understand the relationship in the context of cultural values, norms and the dynamic of power and oppression. In addition to this, the concept of HIV sero-discordance and the frequency of its occurrence are poorly understood in most African communities. Despite the growing evidence of HIV discordance, HIV prevention strategies have largely focused on clinical aspects at the expense of socio-cultural issues that impact on HIV prevention strategies targeted at HIV sero- discordant couples. The study seeks to contribute to the conceptualization and design of intervention programs dealing with sero-discordance. The study is underpinned by the symbolic interactionism theory and was qualitative in design involving 13 HIV discordant couples in heterosexual relationships enrolled in the HIV Preventions Trials Network 052 Study (HPTN 052 Study) being undertaken by the University of Zimbabwe’s department of medicine. The study utilized 2 Focus Group Discussions (FGD) and 10 in-depth interviews (IDI) to collect data. The study’s findings indicate that discordant couples are in fact critical stakeholders in the uptake of all the available HIV prevention strategies. Failure to acknowledge this tenet is self-defeating as evidenced by the perception of viewing condom use within a marriage as humiliating for a woman. The study further noted that practitioners in the HIV prevention domain must guard against over-relying on the scientifically demonstrated efficacy of the strategies. The study recommends that HIV prevention strategies must be socially and culturally acceptable and embedded for them to be more efficacious. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)

This study was an attempt to investigate the influence of socio-cultural factors on HIV prevention strategies among HIV discordant couples in Harare, Zimbabwe. HIV sero-discordance is a scenario whereby one partner is HIV-positive and the other is HIV-negative. HIV sero-discordant couples are a unique and vulnerable population that encounters many peculiar challenges. When dealing with this population, researchers have to deal with contradictory ideas and perceptions presented by each partner making up the couples and also understand the relationship in the context of cultural values, norms and the dynamic of power and oppression. In addition to this, the concept of HIV sero-discordance and the frequency of its occurrence are poorly understood in most African communities. Despite the growing evidence of HIV discordance, HIV prevention strategies have largely focused on clinical aspects at the expense of socio-cultural issues that impact on HIV prevention strategies targeted at HIV sero- discordant couples. The study seeks to contribute to the conceptualization and design of intervention programs dealing with sero-discordance. The study is underpinned by the symbolic interactionism theory and was qualitative in design involving 13 HIV discordant couples in heterosexual relationships enrolled in the HIV Preventions Trials Network 052 Study (HPTN 052 Study) being undertaken by the University of Zimbabwe’s department of medicine. The study utilized 2 Focus Group Discussions (FGD) and 10 in-depth interviews (IDI) to collect data. The study’s findings indicate that discordant couples are in fact critical stakeholders in the uptake of all the available HIV prevention strategies. Failure to acknowledge this tenet is self-defeating as evidenced by the perception of viewing condom use within a marriage as humiliating for a woman. The study further noted that practitioners in the HIV prevention domain must guard against over-relying on the scientifically demonstrated efficacy of the strategies. The study recommends that HIV prevention strategies must be socially and culturally acceptable and embedded for them to be more efficacious. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)

Voluntary Counselling and Testing (VCT) is vital in the management of HIV/AIDS as it is the first step in treatment, care and behavioural change. Entrenched economic and gender inequities drive an increasingly feminized HIV/AIDS pandemic. This study investigated factors influencing VCT attendance by women in the Glen View high density suburb in Harare. A survey methodology was followed using a semi-structured, self-administered questionnaire that was distributed to randomly selected women of reproductive ages in the area. The analysis showed that VCT usage is low and that factors such as fear of the consequences of testing positive for HIV, such as violence and rejection by male partners are to blame. Importantly, the findings suggest that if the vulnerability of women is not addressed, then increased VCT uptake and better reproductive health outcomes for women are also unlikely. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)