Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: This study, which was conducted from 1 to 31 October 2012, was aimed at describing the main factors that influence adolescent adherence to antiretroviral treatment in three selected health facilities of Palapye Health District. During the one-month data collection period, 30 adolescents were interviewed using semi-structured interview tools. Different factors influencing adolescent adherence to antiretroviral treatment were highlighted and adherence to such treatment was measured using the method of calculating the percentage of returned pills. The mean adherence level for the entire sample was 76.96%, with common factors contributing to poor adherence among adolescents being found to be the poor processing of disclosure, stigma, the accessibility of health facilities, due distance and waiting time, the nature of social support, and feelings toward taking antiretroviral. Thus, by addressing adolescent adherence to antiretroviral treatment, adolescent-adherence counselling before and during treatment is to be shaped, insisting on the preparation of young patient caregivers for the process of disclosure; the reinforcement of positive messages during consultations; insistence on the importance of disclosing HIV status to others; the implementation of the antiretroviral dispensing outreach at health posts; and exerting effort to reduce the waiting time at health facilities prioritising young patients and adolescents. / AFRIKAANSE OPSOMMING: Hierdie studie, wat vanaf 1 tot 31 Oktober 2012 onderneem is, het ten doel gehad om die hooffaktore te beskryf wat adolessente se getrouheid met antiretrovirale behandeling in drie gekose gesondheidsfasiliteite in die Palapye-gesondheidsdistrik beïnvloed. Semigestruktureerde onderhoude is gedurende die maand lange datainsamelingstydperk met 30 adolessente gevoer. Die studie dui op verskillende faktore wat adolessente se getrouheid met antiretrovirale behandeling beïnvloed, welke getrouheid gemeet is aan die hand van die persentasie teruggestuurde pille. Die gemiddelde getrouheidsvlak vir die algehele steekproef was 76,96%. Algemene faktore wat oënskynlik tot swak behandelingsgetrouheid onder adolessente bydra, is die swak verwerking van MIV-statusonthulling, stigma, die toeganklikheid van gesondheidsfasiliteite, reisafstand en wagtyd, die aard van maatskaplike steun, en gevoelens oor die gebruik van antiretrovirale middels. Hierdie ondersoek na adolessente se getrouheid met antiretrovirale behandeling behoort adolessentberading oor behandelingsgetrouheid voor én gedurende behandeling te rig. Die klem moet in die besonder val op die voorbereiding van die versorgers van jong pasiënte om die onthullingsproses beter te hanteer; die versterking van positiewe boodskappe gedurende konsultasies; die belang van MIV-statusonthulling aan ander; die inwerkingstelling van uitreikaksies om voorskrifte vir antiretrovirale middels by sogenaamde ‘gesondheidstasies’ te resepteer, en daadwerklike pogings om die wagtyd by gesondheidsfasiliteite te verkort, met voorrang aan jong pasiënte en adolessente.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Health statistics on adolescents in Namibia indaicate high incidences of teenage unwanted pregnancies, unsafe abortions, baby dumping, maternal ill health, early marriages and STIs including HIV. These are indicators of underutilisation of adolescent friendly health services (AFHS) by adolescents as education on these problems are covered in it. Although Government has made some strides to esure implementation starts, there is a recognisable lack of its adoption by health workers. The aim of this study was to establish the reasons for the slow adoption of AFHS practices by health workers at Katutura Health Centre. A quantitative non-experimental cross-sectional descriprive research approach was used in this study. Evidence using both primary data collected in the field through self-administered semi-structured questionnaires (with both open and closed questions) and secondary data collected in the literature review was employed . A census of the entire population of health workers was prefered over sampling. A total of 56 health workers accepted to participate in the study and the questionnaire, 46 of which returned it within a stipulated three weeks data collection period. Descriptive statistics was utilised together with frequencies, mean and basic collection. Eighty two percent of the sample participated in the study of which 67% respondents were female and 33% were male. The majority of the respondents (78.3%) had tertiary education. The results indicated: AFHS were not known to the majority of health workers; there is slow adoption of AFHS; and the programme introduction could have been done better. Factors significantly associated with adoption of AFHS are knowledge of such services, sex, level of education, job position, work experience and effective implementation of the programme. A probability value of p<0.05 was adopted. The programme is well appreciated despite concerns of lack of training and proper implementation. Key recommendations were on staff recruitment, retention and training of health workers; creation of space for implementing AFHS and marketing the programme. The system is in place, what is left is to tighten some loose ends and programme is up and running. / AFRIKAANSE OPSOMMING: Gesondheid statistieke oor die jeug in Namibië verwys na hoë voorkoms van ongewenste tiener swangerskappe en onveilige aborsies, weg gooi van babas, swak moederlike gesondheid, vroeë huwelike en seksueel oordraagbare siektes, insluitend MIV. Dit is aanwysers van die onderbenutting van jeug vriendelike gesondheidsdienste (AFHS) deur die jeug, as die onderwys op hierdie probleme gedek word. Hoewel die regering 'n paar implementerings begin het, is daar 'n beduidende gebrek van aanneming deur gesondheidswerkers. Die doel van hierdie studie was om die redes vas te stel vir die stadige aanvaarding van AFHS praktyke deur gesondheidswerkers by Katutura Gesondheids Sentrum. 'n Kwantitatiewe, nie-eksperimentele navorsingsbenadering is gebruik in hierdie studie. Bewyse uit beide primêre data wat ingesamel is in die veld deur middel van self-geadministreerde semi-gestruktureerde vraelyste (met beide oop en geslote vrae) en sekondêre data wat ingesamel is in die literatuuroorsig was gebruik. 'n Sensus van die hele bevolking van gesondheidswerkers is verkies in plaas van steekproefneming. 'n Totaal van 56 gesondheidswerkers het aanvaar om deel te neem aan die studie en die vraelys, waarvan 46 teruggedien is binne die vasgestelde tydperk van drie weke se data-invorderingstermyn. Beskrywende statistiek is gebruik saam met frekwensies, gemiddelde en basiese versameling. Tagtig en twee persent van die steekproef het deelgeneem aan die studie, waarvan 67% respondente vroulik en 33% manlik was. Die meerderheid van die respondente (78,3%) het tersiêre opleiding. Die resultate het aangedui: AFHS is nie bekend aan die meeste van gesondheidswerkers nie, en daar is stadige aanneming van AFHS; en die program inleiding kon beter gedoen gewees het. Faktore wat beduidend verband hou met die aanneming van AFHS is kennis van sodanige dienste, geslag, vlak van onderwys, werk posisie, werkervaring en doeltreffende implementering van die program. 'n Waarskynlikheid waarde van p <0,05 is aangeneem. Die program is goed waardeer ten spyte van kommer aan 'n gebrek van opleiding en behoorlike implementering. Belangrikste aanbevelings was op die personeel werwing, behoud en die opleiding van gesondheidswerkers; skepping van ruimte vir die implementering van AFHS en bemarking van die program. Die stelsel is in plek, wat oorbly om gedoen te word, is om 'n paar los punte te versterk en die program is aan die gang.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Scaling up of male circumcision in Namibia is running at a low pace. People need to understand the role that male circumcision plays in the prevention of HIV acquisition. Therefore, it is important to increase knowledge among individuals in order to make them acquire positive attitudes and perceptions towards male circumcision as an HIV preventive strategy. Method: This research study investigated the perceptions of men and women towards male circumcision as an HIV prevention intervention in the Windhoek District. A total number of 250 respondents were conveniently selected for participation in the study, of which 50% were males and another 50% represented females. All respondents were 18 years and older. A quantitative method of sampling was employed with the use of anonymous questionnaires. Data were captured and analyzed using SPSS version 20. Results: Most respondents (76.8%) reflected good knowledge about male circumcision and positive attitude (93.6%) towards male circumcision and its benefits but there were still a proportion of respondents (23.2%) who are not knowledgeable about the benefits of MC, and 6.4% of the respondents have negative attitude towards MC, whilst a large proportion of 53.2% have negative perceptions towards MC and its benefits. The study also found that there is an association between knowledge and perceptions of 0.250 at p-value < 0.05, as well as an association between attitudes and perceptions 0.213, p-value <0.001. Conclusion: It was concluded that knowledge plays a major role on attitude and perception changing. The more knowledgeable an individual is, the more the chances of them of having positive attitudes towards MC, which could also influence positive perceptions towards MC. In order to strengthen male circumcision as an HIV prevention strategy, it is imperative to provide the population that reflected low knowledge and negative attitudes with information, education and counselling services. This may help to make them change their attitudes towards MC and acquire positive perceptions towards it. On barriers, the relevant authorities should come up with a strategy to eliminate barriers in order to facilitate acceptability among non-circumcised groups. / AFRIKAANSE OPSOMMING: Agtergrond: Die opskaling van manlike besnyding in Namibië word teen ‘n stadige pas uitgevoer. Mense moet die rol verstaan wat manlike besnyding in die voorkoming van MIV speel. Dit is daarom belangrik om hierdie kennis onder individue te vermeerder ten einde hulle te bemagtig om positiewe houdings en persepsies teenoor manlike besnyding as MIV-voorkoming strategie te bekom. Metode: Hierdie navorsingstudie het die persepsies van mans en vroue teenoor manlike besnyding as MIV-voorkoming ingryping in die Windhoek streek ondersoek. ‘n Aantal van 250 deelnemers is geselekteer vir deelname aan die studie, waarvan 50% manlik en 50% vroulik was. Alle deelnemers was 18 jaar en ouer. ‘n Kwantitatiewe metode en anonieme vraelyste is vir steekproefneming gebruik. Data is vasgelê en ontleed met behulp van SPSS weergawe 20. Resultate: Die meerderheid van die respondente (76.8%) het goeie kennis van manlike besnyding en ‘n positiewe houding (93.6%) teenoor manlike besnyding getoon, maar daar was ‘n deel van die respondente (23.2%) wat nie ingelig was oor die voordele van manlike besnyding nie, en 6.4% van die respondente het ‘n negatiewe houding teenoor manlike besnyding gehad, terwyl ‘n groot deel van 53.2% negatiewe persepsies van manlike besnyding en die voordele daarvan gehad het. Die studie het ook bevind dat daar ‘n verband is tussen kennis en persepsies van 0.250 teen p-waarde < 0.05, sowel as ‘n verband tussen houdings en persepsies 0.213, p-waarde <0.001. Gevolgtrekking: Daar is tot die gevolgtrekking gekom dat kennis ‘n belangrike rol speel in die verandering van houdings en persepsies. Hoe meer ingelig ‘n individu is, hoe beter is die kanse dat hulle ‘n positiewe houding teenoor manlike besnyding sal hê, wat ook positiewe persepsies van manlike besnyding kan beïnvloed. Ten einde manlike besnyding as MIV-voorkoming strategie te versterk is dit noodsaaklik om die bevolking wat min kennis en negatiewe houdings getoon het met inligting, opvoeding en berading te verskaf. Dit kan help om hul houding teenoor manlike besnyding te verander en om meer positiewe persepsies daarvan te ontwikkel. Met betrekking tot hindernisse moet die relevante owerhede vorendag kom met ‘n strategie om die struikelblokke uit te skakel ten einde aanvaarbaarheid van manlike besnyding onder groepe wat nie besny is nie, te fasiliteer.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Purpose of the study The purpose of the study was to find out the effectiveness of Life Orientation (LO) as a life skills programme in the school curriculum in meeting the needs and challenges of the youth. Learners from the ages of 16 to 24 in the Further Education Training (FET) sector that is, from grade 10 to 12 in the Hewu area Secondary School in Queenstown District were used as a case study. Research design A descriptive research design using a quantitative approach was used in the study. Data collection Data was collected from learners through questionnaires and from teachers through a focus group discussion. The learners and LO teachers from Ekuphumleni, Funda, Hewu, Nomphumelelo and Sovuke Sikhanye Secondary Schools were used as a study sample. Findings Almost all the learners, 90 %, found LO effective in meeting their needs and challenges. LO has helped them to resist peer pressure, saying no to negative and risky behaviour, and to cope with difficult situations like the loss of loved ones. The LO teachers as well found the programme helpful and relevant in meeting the needs and challenges of the youth. However, the LO teachers observed that although the programme was helpful and relevant, the expected attitudes and behaviour of learners contradict what the programme was offering. This disparity can be attributed to the social ills in the community, such as substance abuse, domestic violence, incest, unemployment, poverty and the negative influence of the media. Conclusion The finding of the study has shown that although the learners and LO teachers find the programme relevant and useful in addressing the needs and challenges of the learners, there are so many social ills within the community that destruct and derail the learners hence creating a disparity between what is said about the programme versus the behaviour and attitude that is displayed. This disparity calls for a discourse between teachers and parents, as well as with the community leaders, pastors and other stakeholders. / AFRIKAANSE OPSOMMING: Doel van die studie Die doel van die studie was om die doeltreffendheid van Lewensoriëntering as 'n lewensvaardigheidsprogram in die skoolkurrikulum vir die behoeftes en uitdagings van die jeug, te bepaal. Leerders van die ouderdomme van16 tot 24 in die Verdere Onderwys en Opleiding (VOO) sektor vanaf graad 10 tot 12 in die Hewu area Sekondêre Skool in Queenstown-distrik is gebruik as 'n gevalle studie. Navorsingsontwerp 'n Beskrywende navorsingsontwerp met behulp van ’n kwantitatiewe benadering is gebruik in die studie. Data-insameling Data van leerders is deur middel van vraelyste ingesamel en van onderwysers deur middel van 'n fokusgroepbespreking. Die leerders en die LO-onderwysers van Ekuphumleni, Funda, Hewu, Nomphumelelo en Sovuke Sikhanye hoër skole is gebruik as 'n steekproefbevolking. Resultate Byna al die leerders, 90 % vind LOeffektief om aan hulle behoeftes en uitdagings te voldoen. LOhet gehelp om hulle groepsdruk te weerstaan, nee te sê vir negatiewe en gewaagde gedrag, en om moeilike situasies soos die verlies van geliefdes te hanteer. Die LO-onderwysers vind ook die program nuttig en relevant deurdat dit voldoen aan die behoeftes en uitdagings van die jeug. Die LO-onderwysers het egter opgemerk dat alhoewel die program nuttig en relevant is, die verwagte houdings en gedrag van leerders in teenstelling hiermee is. Hierdie teenstrydigheid kan toegeskryf word aan die maatskaplike euwels in die gemeenskap, soos dwelmmisbruik, gesinsgeweld, bloedskande, werkloosheid, armoede en die negatiewe invloed van die media. Gevolgtrekking Die bevinding van die studie het getoon dat alhoewel die leerders en LO-onderwysers die program relevant en nuttig vind in die aanspreek van die behoeftes en uitdagings van die leerders, daar so baie sosiale euwels in die gemeenskap is wat die leerders vernietig en laat ontspoor, datdat daar 'n wanverhouding tussen wat gesê is oor die program versus die gedrag en houding wat vertoon word, bestaan. Vanweë hierdie teenstrydigheid word 'n beroep gedoen vir 'n diskoers tussen onderwysers en ouers, sowel as die gemeenskapleiers, pastore en ander belanghebbendes.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Since the beginning of the HIV epidemic in the early 1980s, men who have sex with men (MSM) have been disproportionately affected by the virus. Sex between men is the main route of transmission of HIV in some parts of the world. In some other places it is a secondary route of transmission. Worldwide, MSM are classified as most-at-risk populations because of their higher risk of HIV transmission. Although sex between men occurs in most societies, its existence, importance in HIV prevention are frequently denied. Often, these men are neglected in HIV prevention interventions. Sexual acts between men have often been condemned and sometimes criminalized. In some countries, penalties for those accused of sexual acts between men are among the severest available. Elsewhere, even where same-sex behaviour is not illegal, there is frequently unofficial persecution by the authorities or discrimination against or stigmatisation of those men known or thought to be having sexual relations with other men. For these reasons, in many parts of the world, sex between men is hidden or secretive. This makes an assessment of its extent, and of the various types of sexual acts that occur, even more difficult. As a result of being neglected, there has been generally lack of research and services directed towards MSM. In sub-Saharan Africa, for instance, it was only over 10 years ago, in 2001, when the first behavioural survey among MSM was conducted. However, few countries have conducted such studies and MSM’s specific health needs, especially for HIV prevention, are still not being met. In most countries, like Swaziland, the HIV prevalence is still generalized. Although Swaziland bears the burden the highest HIV prevalence in the world at 26% for the age group 15-49 (UNAIDS, 2010), interventions to MSM and other most-at-risk populations are limited. The study’s main aim was to identify the prevention needs of MSM in Swaziland. A total of 50 MSM were interviewed in order to find information. In addition, five key informants who were managers of HIV prevention programmes were also interviewed. It was established that there is a gap between the MSM’s needs and the interventions currently available. There were factors that put MSM at risk for HIV infection that were identified by the study. It was established that some of the HIV prevention did not meet the specific needs and expectations of MSM. Knowledge on some HIV risk behaviours and some prevention strategies targeting MSM was limited. / AFRIKAANSE OPSOMMING: Sedert die begin van die MIV-epidemie in die vroeë 1980's, het die mans wat seks het met mans (MSM) is buite verhouding beïnvloed deur die virus. Seks tussen mans is die belangrikste roete van die oordrag van MIV in sommige dele van die wêreld. In sommige ander plekke is dit is 'n sekondêre roete van oordrag. Wêreldwyd, MSM word geklassifiseer as die meeste-at-Risk bevolking as gevolg van hul hoër risiko van MIV-oordrag. Alhoewel seks tussen mans in die meeste samelewings voorkom, word dikwels sy bestaan, belang in MIV-voorkoming geweier. Dikwels word hierdie manne verwaarloos in MIV-voorkoming intervensies. Seksuele dade tussen mans dikwels veroordeel en soms gekriminaliseer. In sommige lande, strawwe vir diegene wat beskuldig word van seksuele dade tussen mans is onder die ergste beskikbaar. Elders, selfs waar van dieselfde geslag gedrag nie onwettig is nie, is daar dikwels nie-amptelike vervolging deur die owerhede of diskriminasie of stigmatisering van daardie manne wat bekend is of gedink word om seksuele verhoudings met ander mans. Vir hierdie redes, seks tussen mans, in baie dele van die wêreld is verborge of geheimsinnig. Dit maak 'n assessering van die omvang, en van die verskillende tipes van seksuele dade wat plaasvind, nog moeiliker. As 'n gevolg van verwaarloos, is daar gewoonlik gebrek aan navorsing en dienste gerig op MSM. In sub-Sahara Afrika, byvoorbeeld, dit was net meer as 10 jaar gelede, in 2001, toe die eerste gedrags-opname onder MSM is uitgevoer. Egter, het 'n paar lande uitgevoer sodanige studies en MSM se spesifieke gesondheid behoeftes, veral vir MIV-voorkoming, is nog steeds nie bereik word nie. In die meeste lande, soos Swaziland, die voorkoms van MIV is nog steeds algemene. Hoewel Swaziland dra die las om die hoogste voorkoms van MIV in die wêreld op 26% vir die ouderdomsgroep 15-49 (UNAIDS, 2010), intervensies MSM en ander die meeste-op-risiko bevolkings is beperk. Die studie se hoofdoel was om die voorkoming van MSM te identifiseer in Swaziland. 'N totaal van 50 MSM is ondervra ten einde inligting te vind. Daarbenewens is ook vyf sleutel informante wat bestuurders van die voorkoming van MIV-programme ondervra. Daar is vasgestel dat daar is 'n gaping tussen die MSM se behoeftes en die intervensies wat tans beskikbaar is. Daar is faktore wat sit MSM 'n risiko vir MIV-infeksie wat deur die studie geïdentifiseer is. Daar is vasgestel dat sommige van die MIV-voorkoming het nie voldoen aan die spesifieke behoeftes en verwagtinge van MSM. Kennis op 'n aantal MIV-risiko gedrag en 'n paar voorkoming strategieë fokus MSM is beperk.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The aim of the study was to establish the factors that influence young men to attend and access HIV education programme in order to improve young men’s focus on HIV education programme and to increase young men’s involvement with HIV prevention initiatives. The researcher used the qualitative research method to establish factors why young men were not attending HIV education programmes in Mogale City, Gauteng. It was found that young men are willing to attend HIV education programme that are innovative, interesting and will meet their sexual and reproductive health needs. Although they are willing to attend HIV education programmes, young men are scared of the reality of visiting clinics for testing, because clinics perpetuate stigma by separating HIV counselling and testing rooms and healthcare provider attitudes towards young men. They would also like to be part of the planning process to ensure that HIV education programmes are tailored to their needs. / AFRIKAANSE OPSOMMING: Die oogmerk van die studie was om die faktore te bepaal wat jongmans beïnvloed om MIV-opvoedingsprogramme by te woon en toegang daartoe te verkry, ten einde jongmans se fokus op MIV-opvoedingsprogramme te verbeter en jongmans se betrokkenheid by MIV-voorkomingsinisiatiewe te verhoog. Die navorser het die kwalitatiewe navorsingsmetode gebruik om die faktore te bepaal waarom jongmans nie MIV-opvoedingsprogramme in Mogale City, Gauteng, bywoon nie. Daar is gevind dat jongmans bereid was om MIV-opvoedingsprogramme by te woon wat innoverend en interessant is en aan hulle seksuele en reproduktiewe gesondheidsbehoeftes sal voldoen. Alhoewel hulle bereid was om MIVopvoedingsprogramme by te woon, is jongmans bang vir die werklikheid daarvan om klinieke vir toetsing te besoek, omdat klinieke stigma perpetueer deur MIVberadingskamers en toetskamers van mekaar te skei; en vanweë gesondheidsorgverskaffers se houding teenoor jongmans. Hulle wil ook graag deel wees van die beplanningsproses om te verseker dat MIV-opvoedingsprogramme volgens hulle behoeftes aangepas word.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: There have been new infections of HIV despite campaigns aimed at arresting the further spread of the epidemic particularly the new infections. This study sought to investigate whether HIV positive individuals disclose their status to their sexual partners. The study looked at both longtime partners and casual partners. The overall aim was to find the factors that contribute to non-disclosure or to disclosure to sexual partners by HIV positive individuals. The specific objectives were to identify prevailing levels of HIV sero-status disclosure among people living with HIV who were attending the ARV clinic; to identify people living with HIV’s attitude towards HIV status disclosure; to establish factors contributing to disclosure or non-disclosure among people living with HIV; to establish if there is a difference between disclosure rates between ‘long time’ sex partners and casual/’once-off’ sex partners and to provide guidelines to counsellors on how to educate HIV positive people on disclosure. The objectives were achieved by using a quantitative research design through the use of questionnaires targeting 50 HIV positive individuals attending the ARV clinic at Katutura Hospital in Windhoek Namibia. The questionnaire was self-administered and consisted of close-ended questions and one open-ended question which helped collect the quantitative data. The quantitative data was then analyzed using statistical tools (graphs, tables and charts). Results showed that HIV positive individuals are aware of the importance of disclosure. The results showed that majority of the participants did not disclose for fear of abandonment. Some did not disclose because they thought that their partner was also already infected. As for casual sex partners, some did not disclose because they wanted ‘to infect someone since they were also infected by someone’. Some said that they were drunk and hence did not disclose. Participants disclosed because they wanted moral support, they did not want to infect their partners and that they wanted their partners to get tested as well. One of the recommendations was that there is a need to encourage couple counselling in cases of married couples or ‘live-in’ couples to reduce the need for disclosure. It was also recommended that HIV/AIDS health workers need special training to enhance their skills on how to educate HIV positive individuals about disclosure. The link between risky sexual behavior and alcohol abuse was highlighted and it was recommended that there is a need to educate people, particular teenagers, the link between the two. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie was die bepaling van die mate waartoe persone wat MIV-positief is en klinieke bywoon hulle MIV-status bekendmaak. Die studie is by die Katutura hospitaal in Windhoek, Namibië gedoen en 50 MIV-positiewe pasiënte is as steekproef gebruik. ‘n Vraelys wat die pasiënte self ingevul het is in die studie gebruik en data is op ‘n beskrywende wyse ontleed. Resultate het aangetoon dat MIV-positiewe pasiënte wel bewus is van die belangrikheid om hulle MIV-status bekend te maak. Laasgenoemde pasiënte doen dit egter nie, hoofsaaklik uit vrees vir stigma, diskriminasie en verwerping. Sommige pasiënte maak ook nie hulle status bekend nie omdat hulle bloot aanvaar dat die persoon met wie hulle saambly ook MIV-positief is en die bekendmaking van status dus onbelangrik is. Een van die belangrikste aanbevelings wat in die studie gemaak word is dat getroude paartjies aangemoedig moet word om MIV-voorligting by te woon, hulle te laat toets en hulle status bekend te maak. Dit word ook verder aanbeveel dat MIV/Vigs-gesondheidswerkers spesiale opleiding moet kry in hoe om persone wat MIV-positief is te oorreed om hulle MIV-status bekend te maak. Die studie sluit af deur te wys op die belangrike verwantskap tussen seksuele risikogedrag en die misbruik van alkohol. Daar word sterk gepleit dat die gemeenskap, en veral tienderjariges, bewus gemaak moet word van hierdie gevaar.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: With the existence of many HIV and AIDS service providers especially at Local Authority Level which is government closer to the people, multi sector coordination of service provision becomes crucial. Therefore, this study undertook to assess the effectiveness of coordination of HIV and AIDS service provision in Salima District Council in Malawi. The researcher used the following methods to collect data: qualitative method, through a questionnaire where data was collected from the District AIDS Coordinating Committee (DACC) responsible for multi sector coordination at district level; and qualitative method, through focus Group Discussions that enabled collection of data from targeted sector heads from government, non- governmental organisations, Faith Based Organisations and Private Sector. The research found that Salima District Council has the necessary structural set-up to coordinate HIV and AIDS Response. In keeping with the three – one principle, Salima District Council has managed to develop one coordination body, one action framework and one M&E framework. The availability of the one action framework and one M&E framework (LAHARF) and that these are annually replicable, shows a level of coordination is available and it is working. Lack of adequate funding for HIV interventions and lack of involvement of DACC in planning process by most service providers are major challenges. It is thus recommended that Salima District Council should put in place a deliberate policy that makes it mandatory for all organizations working in the district to participate in planning and or share their plans with the district council. The Council should also ensure that strategic policy and guidelines documents are readily available to service providers for use when planning HIV and AIDS interventions. / AFRIKAANSE OPSOMMING: Wanneer daar baie diensverskaffers op Plaaslike bestuursvlak is word die koördinering van MIV/Vigsdienste baie belangrik. Die doel van hierdie studie was die bepaling van die doeltreffendheid van die koördinering van MIV/Vigsdienste in die Salima Distriksraad in Malawi. Data in ingewin deur gebruik te maak van kwantitatiew metodes en „n gestruktureerde vraelys is vir dataversameling gebruik. Ten einde nog eer data in te samel is fokusgroepe gebruik binne die Regeringsorganisasies, Nie-regeringsorganisasies, die privaatsektor en geloofsgeörienteerde organisasies. Die studie het bevind dat die nodige strukturele opset wel binne die Salima Distriksraad bestaan. Die Salima Distriksraad het ook daarin geslaag om „n enkele koördineringsliggaam te vestig en die studie het bevestig dat hierdie koördineringsliggaam inderdaar funksioneel is. Daar is egter nog steeds „n gebrek aan voldoende fondse en die nie-betrokkendheid van sekere van die diensverskaffers is steeds „n uitdaging. Voorstelle vir die verbetering van die betrokkendheid van al die diensverskaffers word in die studie aan die hand gedoen.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: HIV counseling and testing (HCT) is a cornerstone of both HIV prevention and care in South Africa, but only one in five South Africans who are aware of HCT services have been tested for HIV and hence the uptake is reportedly low. This study investigated factors that prevent the uptake of HCT programme in the workplace. Specific factors that were looked at include: fear of learning about one‟s HIV status, HIV-stigma and discrimination and knowledge of and attitudes towards HCT. The study employed descriptive survey design; anonymous questionnaires were randomly distributed irrespective of age, gender, marital status, race, educational level, work position and experience. Closed and open-ended easy- to- answer questions which were written in English were asked; and they required fewer instructions. Ethical issues were considered and university guidelines followed. The results of this study showed that a great proportion of participants (93.8%) tested for HIV as compared to (6.2%) who had never tested. Of these, 59.4 % tested because they wanted to know their HIV status and, 43.8% of participants preferred using the workplace HCT programme for convenience; while 50% used private facilities for privacy and confidentiality. The study further established that fear of knowing one‟s HIV status, workplace discrimination, knowledge of and attitudes towards HCT were not associated with workplace HCT programme uptake. The results did however show that both participants who had tested and those who had not tested (68.8%) demonstrated significantly greater AIDS-related stigma. Supportive and collaborative efforts are necessary to create and promote an enabling and conducive environment in order to dispel workplace HIV-related stigma. In addition, it is imperative to develop and implement workplace stigma mitigation strategy putting in place interventions that aim to reduce all forms of stigma, as well as emphasizing on the benefits of testing. / AFRIKAANSE OPSOMMING: MIV/Vigs-voorligting en toetsing is die hoeksteen vir beide die voorkoming en versorging van MIV-pasiënte in Suid-Afrika. Ongelukkig is net ongeveer een uit elke vyf mense bewus van hulle MIV-status. Die doel van hierdie studie is 'n poging om vas te stel waarom so min mense gebruik maak van gratis toetsingsdienste in die werksplek. 'n Beskrywende studie-ontwerp is in hierdie navorsing gebruik met anonieme vraelyste wat ewekansig versprei is onder 'n steekproef waarin geen onderskeid ten opsigte van ras, geslag. opvoedkundige vlak, posisie in die werk en ervaring gemaak is nie. Geslote en oop-einde vrae is gebruik en Engels is as kommunikasiemedium gebruik omdat al die proefpersone dit verstaan het. Resultate van die studie het aangetoon dat beduidend meer mense hulle wel laat toets het teenoor die wat hulle nie laat toets het nie. Die studie het verder bevind dat faktore soos die vrees om status te weet; diskriminasie in die werksplek, kennis van en houding teenoor MIV/Vigs nie geassosieer kan word met die lae opname van vrywillige toetsing in die werksplek nie. Die studie het wel bevind dat diegene wat hulle . laat toets het, beduidend meer stigma in die werksplek ondervind. Ondersteunende dienste is uiters nodig ten einde stigma suksesvol in die werksplek te bestuur. Daar word voorgestel dat daar 'n volledige opleidingsprogram ,in die werksplek van die organisasie wat in die studie gebruik is, ontwikkel moet word ten einde die invloed van stigma tot 'n minimum te beperk.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The South African prevalence is estimated at just over 17.1%, but efforts to reduce the number of HIV and AIDS deaths have dramatically changed. What is disturbing is that HIV prevalence rate in South African correctional facilities is higher than in general population. At 44%, HIV prevalence rate in South African correctional facilities are more than double of the just over 17.1% HIV prevalence rate in general population at the end of 2012 (UNAIDS, 2013). South African department of correctional services should regard these as a serious challenge given the increased number of sexual assaults and rape in correctional facilities as the Minister of correctional services Sbu Ndebele recently stated in Prison Brief. These could be worsening if the DCS does not come up with proactive strategies to reduce this prevalence in our Correctional facilities. These come back to the very same correctional officers who are not even aware of this state of HIV prevalence in their correctional facilities. This is because the findings of this study illustrate that majority of the correctional officers stationed in Johannesburg management area have limited knowledge about HIV and AIDS general information and they do not trust their management and their employee assistant staff when it comes to HIV and AIDS and this deny them necessary support and care from their employer. As the global HIV and AIDS epidemic enters its fourth decade, we are confronted by new challenges. In recent years, research related to HIV and AIDS has abounded as scholars continue to seek insight into the reciprocal influence of the pandemic on the one hand and various social systems on the other (Ebersohn, 2008). The purpose of this study was to explore the knowledge, attitudes and sexual practices of correctional officers relating to HIV in Johannesburg management area, Gauteng Region: South Africa. In this study the emerging findings are that Johannesburg management area are implementing their workplace HIV and AIDS programmes without a KAP study conducted to establish the baseline information about their employees, let alone conducting the KAP study on the regular basis to establish the effect of their workplace HIV and AIDS programmes. This was evident when majority of the respondents in this study had a limited knowledge about HIV in general and HIV prevalence in their country and their correctional facilities. Furthermore, there were also a poor monitoring and evaluation of such programmes. Another disturbing finding was that correctional officers in this management area did not have trust on their employee assistant staff and this was evident when 56% of the respondents responded that they would not use their internal EAP in HIV/AIDS related matters. This was the same when it comes to correctional officers attitudes towards management of this management area. This is evident when 71% of the respondents responded that if tested positive for HIV, they would not inform their immediate supervisors, managers, EAP and let alone their chaplain. This implies that there is a lack of trust between the management and their employees and between the employees and the employee assistant programme staff. However, correctional officers attitudes towards offenders living with HIV and AIDS is very good and encouraging and if correctional officers of this management area are given enough HIV information, they may pass it easily to all offenders as they interact with them on a daily basis. Given correctional officers‟ response on HIV testing and the use of EAP it is recommended that external service providers unknown to correctional officers should be used instead if management is unable to conduct a successful capacity building within the management area. Majority of the correctional officers according to this study had a limited knowledge about HIV treatment, cure and vaccine as they are unable to differentiate between the three and this is should be a serious concern for the department of correctional services. Although correctional officers sexual practices in this study findings indicated that correctional officers are well equipped when it comes to safe sexual practices, workplace HIV and AIDS programmes should include cultural beliefs, religion, tradition and myths to fight the spread of this epidemic. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om die kennisvlakke asook die houdings en seksuele praktyke van korrektiewe offisiere binne die Departement van Korrektiewe Dienste in die Gauteng Streek in Suid-Afrika te ondersoek. Indien die korrektiewe offisier nie die nodige kennis en vaardighede besit om die verspreiding van die MIV-virus te beperk nie, kan hulle nie 'n doeltreffende rol speel in die Suid-Afrikaanse tronke nie. 'n Vraelys is vir die inwin van data gebruik en 'n steekproef van korrektiewe offisiere is vir die studie gebruik. Die data is op 'n beskrywende vlak ontleed en gevolgtrekkings is gemaak. Die studie bevind dat 'n minderheid van korrektiewe offisiere oor 'n voldoende kennisvlak van MIV beskik. Daar is verder bevind dat daar nie voldoende opleidingsfasiliteite vir hierdie korrektiewe amptenare bestaan nie en dat die programme wat wel aangebied word, nie behoorlik gemonitor en ge-evalueer word nie. Daar is egter bevind dat korrektiewe amptenare wel 'n positiewe houding het teenoor oortreders wat wel MIV-positief is en dat hulle wel die beperkte kennis waaroor hulle beskik na die beste van hulle vermoë oordra aan die oortreders gesurende hulle daaglikse interaksie. Voorstelle word in die studie gemaak vir die ontwikkeling en aanbieding van doeltreffende opleidingsprogramme vir korrektiewe offisiere. Daar word ook voorgestel dat korrektiewe offisiere op 'n veel groter skaal bewus gemaak word van die komplekse interaksie tussen tradisie, vooroordele en mites wat rondom suksesvolle MIV/Vigs-bekamping bestaan.