The South African Constitution (South Africa, 1996) states that access to healthcare services is a basic human right. The Patients’ Rights Charter (HPCSA, 2008: 6) stipulates that the provision for “special needs in the case of persons living with HIV or AIDS” and palliative care be “affordable and effective”. The need for palliative care in South Africa today continues to increase. Khan and Sayed 2011[2]) found that five years after commencement of anti-retrovirals, twenty five percent of their patients had passed away. This study was performed in the Eastern Cape which is one of the poorest provinces with the second highest HIV prevalence rate. Since 2008, Sophumelela Centre Incorporated has offered palliative care for HIV and AIDS patients in Buffalo City. Some of these patients and their families were interviewed about their experiences in this care centre. The South African Constitution (South Africa, 1996) states that access to healthcare services is a basic human right. The Patients’ Rights Charter (HPCSA, 2008: 6) stipulates that the provision for “special needs in the case of persons living with HIV or AIDS” and palliative care be “affordable and effective”. The need for palliative care in South Africa today continues to increase. Khan and Sayed (2011[2]) found that five years after commencement of anti-retrovirals, twenty five percent of their patients had passed away. This study was performed in the Eastern Cape which is one of the poorest provinces with the second highest HIV prevalence rate. Since 2008, Sophumelela Centre Incorporated has offered palliative care for HIV and AIDS patients in Buffalo City. Some of these patients and their families were interviewed about their experiences in this care centre.

This study investigated the question: Have the Amathole District Municipality Schools and higher education institutions established and successfully run Health Advisory Committees (HACs) in accordance with stipulations of the National Policy on HIV/AIDS for Learners and Educators in Public Schools Act No.27 0f 1996 (DoE, 1996). The main focus of the study was to determine the existence and the performance of HIV/AIDS Health Advisory Committees in 16 senior secondary schools selected from the Amathole District Municipality in the Eastern Cape Province of South Africa. The two main research questions which the study seeks to interrogate are: Does any of the selected 16 secondary schools have HIV/AIDS Health Advisory Committees? And if HIV/AIDS Health Advisory Committees had been established in any of the schools, are they managed in accordance with the stipulated guidelines of the national education policy? The decision to investigate this phenomenon stemmed from the researcher’s observation that schools might have failed to establish and to effectively manage the HAC. This assumption was based upon the fact that in rural schools located among the less educated and illiterate rural masses, semi-educated and illiterate parent members of the school governing bodies are more likely to be poorly informed about HIV/AIDS and might not be aware of the importance setting up committees and running them efficiently. The study used a survey as its research design. Surveys typically rely on large scale data, e.g. from questionnaires ,test scores, attendance rates results of public examinations etc., all of which would be enable comparisons to be made over time or between groups. Data was collected by means of questionnaires which were analysed using SPSS. The findings produced evidence that backed the above assumption. The study revealed that Data and the findings indicated that some schools in the Amathole District do not have HAC. Instead of HACs, they have other health advisory structures. However, parents believed that there was the need for HIV/AIDS HACs in their school communities as they were considered capable of addressing health related challenges/ problems such as teenage pregnancy HIV/AIDS diseases, hygiene and healthy living style among the school stakeholders. The study concluded that the existence of the HIV/AIDS HAC is essential and necessary in all schools as it ensures a healthy living in the school communities as suggest by the findings of this study.

There are growing calls for the involvement of multiple agencies to address health inequities. Many international non-governmental organizations (INGOs) working in health and development mention equity principles in their vision statements, missions, or strategic directions, and many authors view equity, including focusing on vulnerable populations, as an important role for these INGOs. However, there is a lack of in-depth empirical research on what influences INGOs’ implementation of equity principles in their work. The present study helps to fill this gap by using a case study to examine INGOs’ implementation of equity principles in their HIV/AIDS initiatives. In this case study, I focused on HIV/AIDS initiatives in Kenya to illustrate the nature of the implementation gap between the intent of INGOs to ensure equity in their work and actual practice, and to examine the various influences that affected the implementation of INGOs’ equity principles. I used HIV/AIDS as the exemplar because of the global epidemic of HIV/AIDS and the resulting large monetary investments made by donors to Southern countries and INGOs to address the disease. I conducted an in-depth case study of an INGO operating in Kenya. The research questions were: “What is the nature of the implementation gap between the intent of an INGO to ensure equity in its HIV/AIDS work and actual practice? What characterizes multi-level influences that affect an INGO’s implementation of equity principles in its HIV/AIDS work? How do multi-level influences affect an INGO’s implementation of equity principles in its HIV/AIDS work?” The case study design employed multiple methods including document reviews, interviews with staff of the INGO in Kenya, as well as its Northern INGO counterparts in Canada and the U.S., interviews with partners and clients of the INGO in Kenya, and participant observation with staff of the INGO in Kenya. I found that many players (e.g. Southern country government and the Northern donors) from different levels (e.g. in-country as well as Northern donor countries) shape INGOs’ implementation of equity principles in their HIV/AIDS work. Influences from donors include donor agendas and the focus of donor funding, as well as donor country policies. Influences from the Southern country government include government priorities and legislation. These influence INGOs’ implementation of equity principles in their HIV/AIDS work, and in some cases can outright contradict equity principles. However, since INGOs are often reliant on donor funding and need Southern governments’ permissions to work in-country, INGOs work within a system that is characterized by asymmetrical interdependence. They have to find a middle ground for implementing equity principles in their HIVAIDS work. Hence, these influences help give rise to an implementation gap between what INGOs intend to accomplish in implementing equity principles in HIV/AIDS work and actual practice. Implications for policy and practice include the need to: increase awareness of the roles various players have in implementing equity and the need for ongoing collaboration to achieve equity aims; continue work in capacity building on equity for INGO staff and its partners; and develop and refine tools for measuring and monitoring the implementation of equity. The present research clearly shows the significant role that INGOs play in equity, and the importance of understanding the multiple players and levels that influence INGOs’ implementation of equity principles in HIV/AIDS. The research can help INGOs, Southern country governments, and donors to better understand the system within which INGOs work in implementing equity principles, as multiple organizations continue to try to address health inequities around the globe.

The purpose of the current study is to investigate the extent to which mindfulness (observing and describing), dispositional optimism and personal meaning are associated with self-efficacy for managing a chronic disease (SEMCD) among 57 people living with HIV in the DFW Metroplex. Several statistical analyses, including a hierarchical linear regression analysis, were conducted. Results indicate, after controlling for age and gender, the overall model accounted for a significant proportion of the variance (adjusted R2 = .39) in self-efficacy for managing chronic disease, F (6, 50) = 5.80, p < .01. Both subscales of mindfulness were significantly related to self-efficacy. However, observing was negatively, associated with SEMCD (β = -0.44, p < .05), and describing was positively associated with self-efficacy (β = 0.60, p < .01). As a result, incorporating these mindfulness skills into self-efficacy based self-management programs may greatly improve self-management, thus positively influencing psychological and physiological health outcomes that are essential to the health and wellbeing of people living with HIV/AIDS. Future research should investigate methods of manipulating observing and describing, and determine what proficiency in these skills is most beneficial to improve self-efficacy.

More Texans are living with HIV infection than ever before. in fact, there has been a 6% increase annually, since 2002. This trend is not a result of increased HIV/AIDS incidence, but rather improving life expectancy of those living with HIV. Due to significant advances in HIV/AIDS testing, prevention, and treatment, individuals with HIV are living longer than ever before. However, throughout the state, the life expectancy of a person infected with HIV/AIDS varies spatially. This study investigates and attempts to explain the spatial distribution of HIV/AIDS survival rates by examining neighborhood socioeconomic characteristics. the results suggest that, contrary to expectation, the lowest survival rates occur, not in extreme poverty areas, but rather in moderate SES areas. Too rich to qualify for free treatments, but not rich enough to afford purchasing such treatments, the middle income living with HIV infection are caught between the cracks. the results provide important input for targeting public health interventions to improve HIV/AIDS survival.

The study was conducted to describe the knowledge and beliefs of mothers regarding infant feeding practices in the context of HIV/AIDS. The mothers of infants aged 0 - 6 months attending at the Gilgal clinic in Manzini region, Swaziland were sampled for the study. This was a cross sectional descriptive survey in the quantitative paradigm. A qualitative research technique (focus groups) was used for support purposes. The aim of the study was to describe the knowledge and attitUdes of the mothers with regard to infant feeding practices in the context of HIV, to describe the relationships among these three concepts, and to describe the influence of social referents on mothers' beliefs. The research was carried out in the month of June 2006 in Swaziland. A stratified (age) and convenience (clinic attendance) sampling technique was used to select the sample from mothers and their babies attending at the Gilgal clinic. An adapted 24-h recall was used to assess infant feeding practices; questionnaires and focus group discussions were used to assess knowledge, beliefs and demographic information. Descriptive, inferential and multivariate statistics were used on the quantitative data and content analysis and ethnography on the qualitative data. The results indicated that as much as breastfeeding is still a norm (94.5%), exclusive breastfeeding (11 %) is rarely understood and practiced in this community. Focus group data revealed that the matter is complicated by the fact that some mothers fed ORT to their babies immediately after birth. Generally knowledge on HIV and infant feeding practices was high and beliefs on HIV and infant feeding were negative. Partners and nurses advice on infant feeding was most regarded by mothers. There was no significant relationship found between knowledge and attitudes. A significant relationship between knowledge and beliefs/attitudes was found in mothers who practiced predominant breastfeeding, complementary and replacement feeding. However, the relationships were weak and negative, proving the necessity to strengthen the relationship between knowledge and attitudes. There was no statistical relationship found between knowledge and attitude of mothers who practiced exclusive breastfeeding. In conclusion attitudes were dominant predictors of behavior compared to knowledge. This indicated that good knowledge does not warrant positive attitudes and appropriate behavior. Therefore it is vital to investigate the other factors that influence attitudes in efforts to improve infant feeding. The study was successful in identifying gaps that supported the recommendations for a PMTC program focusing on nutritional aspects. / Dissertation (MConsSci)--University of Pretoria, 2009. / Consumer Science / unrestricted

Magister Artium (Social Work) - MA(SW) / The HIV/AIDS pandemic with its tremendous impact has been a major cause of death and disruption of people’s lives. The youth of South Africa continues to be the most at risk and vulnerable by both being affected and infected by HIV/AIDS. There are non-conclusive research about the relationship between knowledge and behaviour of the youth in relation to HIV/AIDS. The goal of this research was to quantitatively explore the knowledge, attitudes and sexual practices of high school learners in the era of HIV/AIDS in a rural Free State town.The objectives of the study were to: • Explore the knowledge levels, attitudes and sexual practices of high school learners at a selected rural town;• Establish whether there is a difference in knowledge levels and sexual behaviour pattern of learners according to age at first sex; • Establish whether there is an association between knowledge levels and sexual behaviours; and • Explore problems experienced by participants when seeking information or help and what their suggestions are on prevention strategies.A total of 462 high school learners who were enrolled for grades 9, 10 and 11 in 2007 were selected to take part in the study. A self constructed questionnaire that also included open-ended questions for qualitative exploration was used to collect data. A total of 303 respondents responded.The SPSS programme was used for data analysis and open questions were analysed thematically. Measures were employed to ensure a form of face validity and reliability of the questionnaire. Results indicated poor knowledge levels of HIV/AIDS and positive attitudes towards people infected by HIV/AIDS. Teenagers’ sexual practices are rife but the majority of sexually active respondents have reported the use of condoms at first sex and last occasion of sex. Based on reported negative experiences at clinics, parental homes and schools regarding sexual health promotion and knowledge sharing, robust engagement of community leaders and elders working together with teenagers in programmes designed to enhance HIV/AIDS education is recommended.

Purpose of the study - Identify predictors of mortality and develop a related care plan for patients who are on antiretroviral therapy (ART) in Gondar, Ethiopia. Design - A quantitative, retrospective cohort study was conducted analysing medical records of HIV patients who presented to Gondar University Hospital (GUH), Gondar, and started ART between 1 January 2007 and 30 June 2010. Results - In defining the predictors of mortality, the findings in bivariate analysis revealed: female sex, CD4 cell count ≤ 50/μl, CD4 cell count 51-199/μl, a haemoglobin concentration ≤8g/dl, a history of oral candidiasis, tuberculosis and Cryptococcus meningitis were all statistically significant. A female sex, CD4 cell count ≤ 50/μl and CD4 cell count 51-199/μl maintain their significance level in the multivariate analysis. Conclusions - The study therefore recommends that clinicians and case managers be vigilant of these predictors of mortality while managing HIV patients who are on ART. Key Concepts- ART, AIDS, HIV, predictors of mortality / Health Studies / (M.A. (Public Health))

Magister Artium (Psychology) - MA(Psych) / Tuberculosis continues to affect a third of the world’s population annually. Globally, Africa constitutes more than 25% of tuberculosis-related deaths. The high incidence of HIV/AIDS in Africa is associated with the severe tuberculosis fatality figures. The aim of this study was to systematically review literature with methodological rigour on people’s beliefs and attitudes regarding tuberculosis causation and treatment in Africa. Ethical approval was obtained from the Biomedical Research Ethics Committee at the University of the Western Cape (Reference: BM19/5/1). A systematic search was conducted from the months of June 2019 to September 2019 and March 2020 to April 2020 as part of the initial data collection phase and the verification process, respectively. Index keywords were divided into two phases to identify literature on both the beliefs and attitudes (Phase 1: N = 5; Phase 2: N = 19, respectively) on the topic.

Pregnancy is period in a woman's life when she has many fears, uncertainties and expectations. To receive an HIV positive diagnosis during this period, has devastating effects on women. The burden of HIV and AIDS does not fall evenly or equally. The overwhelming majority of those currently living with HIV/AIDS are young women in developing countries. The impact of HIV on women's lives, including their roles as mothers, economic providers and caregivers within households, emphasises the importance of psychosocial counselling and other interventions. Most women only find out about their HIV status while pregnant. Being diagnosed with HIV infection during pregnancy has become one of the greatest complications of pregnancy in South Africa. WHO (2012:2) predicted that the prevalence of HIV infection among pregnant women is likely to remain high for at least the next two decades, because of the number of people receiving life-long antiretroviral therapy (ART) in South Africa. It is still increasing and was predicted to plateau at around 3 million in 2016. South Africa has implemented a Prevention of Mother-To-Child Treatment programme in which all women who are pregnant are tested for HIV at the ante-natal clinics. If they are diagnosed with HIV, they are immediately enrolled in the PMTCT programme. Despite the remarkably successful implementation of the PMTCT programme in South Africa, women diagnosed with HIV during pregnancy face many challenges. This research found that the HIV diagnosis has a complex mix of emotional, psychosocial, relationship, economic and even legal issues that arise directly from the HIV diagnosis. HIV diagnosis provides concrete evidence that being HIV positive and pregnant at the same time is not a good experience; one is often filled with mixed emotions and uncertainties. The findings also indicate sadness and fear among HIV positive pregnant women, sadness in response to their HIV-positive status and the possibility of not seeing their babies grow up. The reality of an HIV diagnosis in pregnancy remains the same globally and continues to affect women who are diagnosed with HIV during pregnancy. A multidisciplinary approach is the most effective way to address the medical, psychological, social, and practical challenges. The biopsychosocial approach was also found applicable in underpinning this study. The goal of the study was to explore and describe the experiences of pregnant women diagnosed with HIV while pregnant and how diagnosis influences their maternal needs. The guiding research question was: What are the experiences of women diagnosed with HIV during pregnancy? A qualitative research approach was followed with a phenomenological research design. The population for this study was women who were diagnosed with HIV during their pregnancy in a state health centre, in Gauteng. Non probability purposive sampling was utilized to select a sample of 10 women who were diagnosed with HIV during pregnancy, who attended antenatal sessions in the health centre were selected. Their informed consent was obtained. Semi-structured individual interviews were conducted with participants. Interviews were voice recorded with the permission of the participants, and were transcribed by the researcher. Data gathered were analysed by the researcher and themes and sub-themes were identified. The research findings were presented by providing a biographic profile of the research participants, followed by a thematic analysis of the themes and sub-themes from the transcriptions. Literature control and verbatim quotes from the interviews were used to support the findings. The themes included the following: Theme One - Knowledge of HIV/AIDS; Theme Two - HIV diagnosis; Theme Three - Experiences of living with HIV Status; Theme Four HIV Treatment; Theme Five - Knowledge of mother to-child transmission; Theme Six - Relationship and disclosure and recommendations. / Mini Dissertation (MSW)--University of Pretoria, 2016. / Social Work and Criminology / MSW / Unrestricted