A dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Arts (Clinical Psychology) in the Department of Psychology University of Zululand, 2008. / Since the surfacing of HIV and AIDS epidemic in South Africa, various programs were implemented in order to educate and prevent the spread of this devastating disease. The Department of Health in South Africa therefore implemented the Voluntary Counseling Testing (VCT) programs across the country in workplaces, tertiary institutions, clinics as well as in hospitals. However in spite of these attempts current studies indicate that the spread of HIV and AIDS is escalated particularly amongst the people between the ages of eighteen and thirty. With so many available VCT sites and centers that provide information about the disease and an opportunity to test for one's sero-status, one would expect not hear such an increase in new HIV/AIDS infections! In view of the above a qualitative study was therefore undertaken to find out from the twenty five students who took part in this study. The aim of the research study is to find from the students who utilize the VCT program services at the University of Zuluiand their experiences about the program, what they appreciate about it and what can be done in order to ensure an efficient service which is in line with the South African HIV/AIDS Strategic Plan 2000 - 2005.

A research report submitted to the School of Public Health, University of the Witwatersrand in partial fulfillment of the requirements for the degree of Master of Public Health. June 2018. / Introduction Southern Africa forms the epicentre of the HIV epidemic and young people commonly get diagnosed long after infection. Despite the evidence that HIV Counselling and Testing (HCT) can reduce risky sexual behaviors and prevent HIV, uptake of testing in young people remains limited and this is especially true in Southern Africa. In the last few years, effective interventions for HIV prevention have been implemented, including treatment as prevention and pre-exposure prophylaxis. In the context of very high prevalence of HIV among young people in Southern Africa, it is critical that countries attain higher levels of HCT. Demand creation is one of the means to increase uptake of HCT. This study investigated the relationship between exposure to a mass media campaign and uptake of HIV counselling and testing among young people in five countries of Southern Africa (Lesotho, Mozambique, South Africa, Swaziland and Zambia) for the period 2008 to 2012. A secondary data analysis from a multi-country study was undertaken. Methods: Secondary data on young people aged 15-24 years from a post-only cross-sectional observational multi-country study that was undertaken in 2012 to evaluate the One Love Campaign, a regional behavior change media campaign coordinated by Soul City Institute for Development Communication was undertaken. The exposure variable was exposure to One Love campaign (in the form of television film series; locally produced radio drama series, television public service announcements and a television series in South Africa. In other participating countries the programme also comprised talk shows broadcast by national- and community broadcasters; booklets, billboards used to trigger discussion during community dialogues and community outreach events) with the outcome of interest being HIV testing, with a number of covariates such as socio-demographic characteristics (e.g age, education level, nationality, sex, marital status, socio-economic status (defined as wealth quintile), whether respondent had children or not, and country of residence. Bivariate and multivariate analysis was conducted to establish the relationship between exposure to One Love campaign and HIV testing among the study population. Results: A total of eight-thousand-six-hundred and thirteen young people (n=8613) participated in the study. There was nearly equal distribution of respondents between those that had had an HIV test (52.0%) and those that had not (48.0%). Exposure to One Love through multiple media, was positively associated with HIV testing (aOR=2.34, 95% CI 1.94-2.81), and there was a dose response. Other factors associated with having an HIV test included being female (aOR= 1.95, 95% CI 1.75 - 2.18); having living child (aOR=4.23, 95% CI 3.57-5.01); being the aged 18-20 years (aOR=2.24, 95% CI 1.95 - 2.58) or group 20-24 years (aOR=4.14, 95% CI 3.57 - 4.81) and having secondary or tertiary education ( aOR= 2.67, 95% CI 1.92 - 3.68). Increased wealth until quintile 4 was negatively associated with having an HIV test, (aOR= 0.93, 95% CI 0.77 - 1.12). Conclusion: Overall the findings of this study show that exposure to more than one medium in the campaign has greater odds of testing. The results of this study provide important information on the relationship between exposure to a media campaign and HIV testing among young people. Social and behaviour change communication strategies that use multi-media are necessary to achieve improved HIV testing among young people. / LG2018

The health of University students is important as these individuals are central to the future economic sector. Since HIV/AIDS is a major public health threat in South Africa (SA), it is vital to develop health initiatives that aim to reduce the HIV prevalence rate among youth and to promote positive health behaviour. Voluntary Counselling and Testing (VCT) is one such initiative. The National Department of Health (NDoH) recently implemented the „First Things First‟ campaign that aims to promote VCT among youth. In line with the NDoH‟s initiative, this study explored the factors that shape attitudes towards VCT among first year students at the University of the Witwatersrand (WITS). This study was conducted using a combination of quantitative and qualitative research methods. The respondents included 195 first year students out of approximately 220 who participated in a survey and two key informants in the field of HIV/AIDS whom I interviewed. With regards to ethical considerations, the study protected the respondent‟s rights by maintaining anonymity of all survey participants and exercised care that the human rights of individuals and the reputation of WITS as an institution were safeguarded. Based on conceptual models of health behaviour, the study identified factors that shaped students responses to VCT. The results of this study indicate that youth at WITS go for VCT mainly to know their HIV status. This is being triggered by them knowing someone who has either; been for VCT, is living with HIV or passed away due to AIDS. In addition, the free availability and easy accessibility of VCT services on campus and the positive influence of peers through social mobilisation were regarded as key motivations for students accessing VCT. However, some students seem to not access VCT services due to personal fears of rejection, blame and discrimination if they were to be found HIV-positive. The gendered dynamics and nature of clinics together with the poor attitudes of some health service providers were also major barriers to VCT uptake among youth. The findings conclude that many students know that VCT is a necessary and beneficial process. It also found that there are multiple factors that work together in complex ways to shape the reasons why youth choose to „test‟ or not to „test‟ for HIV.

Magister Public Health - MPH / Background: HIV counselling and testing is important as a gateway to accessing prevention, treatment, care and support services. Studies have shown that couples who are married or are in a stable heterosexual relationship are at risk of transmitting HIV infection to each other if one partner is infected. The uptake of couples counselling and testing (CHCT) by males in Livingstone is very low despite the fact that they are the decision makers in most homes. Aim: The aim of the study was to assess the factors determining the uptake of CHCT amongst males in a long term heterosexual relationship who came to a health facility for HIV counselling and testing in Livingstone, Zambia and their perceived benefits of CHCT. Methodology: A case control study was conducted with cases being men age 21 years and above, who were married/cohabiting or were in a steady heterosexual relationship for six months and more and had jointly tested for HIV as a couple, and controls were men age 21 years and above, who were married/cohabiting or were in a steady relationship for six months and more and came to be tested for HIV alone without a partner. The structured questionnaires were administered to a total of 294 participants (147 controls, 147 cases) who were recruited from three public health facilities and one private facility in Livingstone between August and September 2013.Results: The only 2 factors independently associated with testing for HIV via CHCT was, talking about HIV as a couple‟ which positively affected CHCT and „had a previous HIV test as a couple‟ which negatively affected CHCT. Findings indicate that „talk about HIV as a couple‟ was a strong independent predictor of CHCT in the multivariate analysis; however it was uncertain whether it was a predictor of CHCT or a consequence of CHCT. It is probable that having already „had a previous HIV test as a couple‟ the participants would not see the need for testing via CHCT again. Other factors that were significantly associated with uptake of CHCT on bivariate analysis but were not significant on multivariate logistic regression analysis included those that are associated with a greater likelihood of CHCT: think CHCT is beneficial /useful, know partners HIV status, know positive things about CHCT and talk about sexual issues as a couple. Other factors negatively associated with uptake of CHCT were: ever tested for HIV before, informed partner about HIV status, think partner is at risk of contracting HIV, think self is at risk of contracting HIV, low self-risk-rating of HIV infection and marital status. Conclusion: The decision for a couple to go for CHCT is probably relatively complex, because most of the factors measured were linked to each other and it was difficult to separate them to identify if a factor on its own was able to influence the uptake of CHCT. However a couple that communicates with each other about HIV issues is likely to be motivated to go for CHCT.

Background: Countries in sub-Saharan Africa are scaling up access to Voluntary Counselling and Testing (VCT) services as a strategy for HIV prevention, treatment, care and support. The international and national push to achieve targets for anti-retroviral therapy scale up has emphasised VCT as an entry point to treatment, with follow-up mostly directed at those who test positive. Yet over 60% of those testing are HIV negative. Limited understanding of how HIV voluntary counselling and testing, and receipt of a negative result impact on sexual behaviour has resulted in underdeveloped support for those testing HIV negative. Aims: To gain the perspective of those who have tested HIV-negative on the following: (1) the decision making process that precedes attendance for voluntary counselling and testing; (2) how voluntary counselling and a negative test result influence sexual behavioural intentions and reported subsequent behaviour; and (3) support systems and networks that would enhance the respondent’s ability to remain HIV negative. Method: Qualitative longitudinal study utilising semi-structured interviews, six months apart, with people who have tested negative and three one-off focus group discussions with counsellors. Participants were purposively sampled from VCT centres in two mining towns in Zambia. Interviews were digitally recorded, transcribed verbatim and analysed thematically with the aid of the qualitative data analysis software, Nvivo7. Cross-sectional analysis of all data sets was conducted and paired transcripts were analysed longitudinally to assess change over time. Results: Forty-two HIV-negative people were interviewed, with thirty-one returning for the follow-up interview (74% return rate). VCT was perceived as ‚testing for HIV‛. Before attending VCT most participants had gone through a protracted period of angst, resulting in a resolution to reduce number of partners, use condoms or abstain from sex. Counselling affirmed life choices, rather than initiating them. Although perception of the risk of HIV increased, misconceptions about HIV transmission persisted post-counselling. The negative test result provided impetus and resolve to implement or maintain life change. Themes identified were: (1) recognising personal susceptibility to HIV infection; (2) emotional and cognitive engagement with the problem of testing; (3) a driving need to know status (regardless of test result); and (4) empowerment and being in control providing the ability to plan for the future. Analysis of post-test support needs revealed two further themes: (1) reinforcement of behaviour change through additional knowledge, supportive networks, and life-skills training; and (2) access to recreational activities. There was no reported post-test increase in unsafe sexual behaviour among those that returned for the follow-up interview. Focus group findings reinforced those from interviews. Conclusions: This study has shown that in this population of people who tested HIV-negative: 1. the majority made life changes before attending VCT and used VCT to know their status 2. counselling consolidated pre-test decisions about risk behaviour and testing provided motivation to adopt safer behaviour and to maintain previous low- or no-risk behaviour and 3. there is a felt need for post-testing recreational activities, further HIV/AIDS education and participation in HIV prevention activities. Recommendations include: (1) the promotion of community-based interactive one-to-one and group information, education and communication (IEC) (to aid understanding and progression to the point where testing appears to be of optimum benefit) ; (2) referral to post-test support options such as support groups and inclusion on a text messaging list should be made available; and (3) post-test intervention strategies, for example, provision of result-specific IEC materials and active involvement in prevention activities should be developed and evaluated.

<p><font face="Times New Roman" size="3"><font face="Times New Roman" size="3"> <p align="left">Despite wide acceptance of Voluntary Counselling and Testing (VCT) as a crucial entry point for the prevention, treatment, care and support of HIV-infected persons / the prevalence of testing in Ethiopia remains very low. A review of the literature identifies the set of factors that influence HIV testing of individuals to include socio-economic and demographic factors, knowledge of HIV/AIDS, risk perception, fear of stigma, social capital and the perceived benefit of VCT. By drawing assumptions based on the known literature, this mini-thesis explores the relationship between VCT usage and the above factors in order to explain the status of HIV testing in Moher and Aklil district, Gurage Zone, Ethiopia. The study hopes to address the dearth of material on VCT and contribute to it in a non-clinical and rural context.</p> </font></font></p>

An understanding of individual cognitions that influence both behavioural intentions and the enactment of actual behaviours is provided by the conceptual model of the Theory of Planned Behaviour (TPB). This study used the Theory of Planned Behaviour, with the added variable of perceived risk, to predict Kenyan students’ intention to use HIV voluntary counselling and testing (VCT) centres within the country. We conducted a survey questionnaire with 200 students, aged 13-15 years, within high schools in the Nairobi and Nakuru districts in May 2009. Chi-squared analysis showed no relationships between age, school, school level, knowledge of a VCT centre, or past sexual experience with intention to uptake HIV counselling and testing. Pearson product-moment analysis revealed a small positive correlation between attitude and subjective norm and a medium negative correlation between perceived behavioural control and perceived risk. One-way analysis of variance showed a relationship between perceived behavioural control and intention. Results of block entry logistic regression analysis indicate that perceived behavioural control and perceived risk were significant predictors of intention to use VCT services in the TPB model. The present study suggests that Kenyan teens’ perceived ease/difficulty in performing a specific behaviour is the most influential aspect in predicting their subsequent intention to carry through the behaviour. A theory-based intervention program should focus on reducing practical barriers related to the use of VCT services. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2009-12-04 10:06:25.104

<p><font face="Times New Roman" size="3"><font face="Times New Roman" size="3"> <p align="left">Despite wide acceptance of Voluntary Counselling and Testing (VCT) as a crucial entry point for the prevention, treatment, care and support of HIV-infected persons / the prevalence of testing in Ethiopia remains very low. A review of the literature identifies the set of factors that influence HIV testing of individuals to include socio-economic and demographic factors, knowledge of HIV/AIDS, risk perception, fear of stigma, social capital and the perceived benefit of VCT. By drawing assumptions based on the known literature, this mini-thesis explores the relationship between VCT usage and the above factors in order to explain the status of HIV testing in Moher and Aklil district, Gurage Zone, Ethiopia. The study hopes to address the dearth of material on VCT and contribute to it in a non-clinical and rural context.</p> </font></font></p>

Philosophiae Doctor - PhD / HIV counselling and testing (HCT) is an essential element in the response to the HIV epidemic. There are still major gaps in research about the best ways to provide HCT, especially to young people. School-based HCT is a model which has been suggested for providing HCT to young people in a youth friendly manner. This study was aimed at producing recommendations for providing a youth friendly school-based HCT service using the World Health Organisation (WHO) framework for youth friendly health services. It was conducted in six secondary schools in Cape Town, where a mobile HCT service is provided by a nongovernmental organisation (NGO). It was an exploratory descriptive study, using a mixed-methods approach. Twelve focus group discussions (FGDs) were held with learners to explore their needs with regards to school-based HCT. An evaluation (which consisted of observation of the HCT site, service provider interviews and direct observation of the HCT counselling process) was done to determine whether the mobile school-based HCT service was youth friendly. A learner survey was conducted with 529 learners to investigate the factors that influence the uptake of HCT and to explore learners’ behaviours and experiences under test conditions. In the FGDs, learners said that they wanted HCT to be provided in schools on condition that their fears and expressed needs were taken into account. They wanted their concerns regarding privacy and confidentiality addressed; they wanted to be provided with information regarding the benefits and procedure of HCT before testing took place; they wanted service providers to be competent to work with young people, and they wanted to be assured that those who tested positive were followed up and supported. On evaluation of the mobile school-based HCT service, it was evident that the service did not meet all the needs of the learners nor did it have all the characteristics of a youth friendly health service. The model of ‘mass testing’ used by the NGO did not fulfil learners’ expressed need for privacy with regards to HCT. Service providers were friendly and non-judgemental but had not been trained to work with young people (especially marginalised groups e.g. young men who have sex with men). The information needs of learners were not addressed, and learners were not involved in the provision of the HCT service. Learners who tested positive were not assisted in accessing care and support. The learner survey revealed a high uptake of HCT (71% of learners) at schools with learners who do not identify themselves as Black, with female learners and older learners being more likely to have had an HIV test. Factors that influenced uptake of HCT were complex, with learners reporting many different motivators and barriers to testing. Of concern was the low risk perception of leaners with regards to HIV infection and the fact that learners who tested HIV positive were not being linked up with treatment and care. Based on the findings of the study, recommendations were made for providing youth friendly school based HCT. A multisectoral approach, with learner and community involvement, was suggested in order to provide a service which is equitable, accessible, acceptable, appropriate and effective.

Voluntary counselling and testing (VCT) has become a vital process in combating the spread of HIV/AIDS. Yet little has been published on how students experience the process of VCT. This study sought to describe and understand the experiences of voluntary counselling and testing among four students at Tshwane University of Technology. This research project focussed on students’ experiences when reporting for voluntary counselling and testing. The results were used to make recommendations for strategies to increase the accessibility and uptake of VCT by students. Using a phenomenological approach, tape recorded interviews were conducted with the four students of Tshwane University of Technology (TUT). The data were then categorised into five themes relating to the experience of VCT: emotions, perceptions, actions, thoughts and desires. The results showed that the students were mostly dissatisfied with the VCT clinic’s procedures and the counsellor’s attitudes. Also evident from this study was that counsellors’ professionalism, peer support, and a service that offers both pre- and post-test counselling play a significant role in students’ use of VCT. The findings of this study suggest that the following could be used as strategies to motivate students to utilise VCT services of VCT: (1) increase access and acceptability of VCT for students; (2) ensure access to factual information in the form of counselling; (3) make counselling a priority. / Dissertation (MA)--University of Pretoria, 2008. / Psychology / unrestricted