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Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: This research study looked at the factors that affect HCT in provision of PMTCT services. It explored the socio cultural and personal factors that affect HCT. It also established the knowledge level about HIV/AIDS and PMTCT among pregnant women in Kabwe. The transmission of HIV from mother to child contributes largely to HIV prevalence among children. Efforts to reduce this mode of transmission include increasing number of women who know their HIV status and increasing the number of HIV positive women who when pregnant take instructions and act on them to protect their children from the possibility of infection (Bartlett et al. 2004). Individuals can only know their HIV status once they are tested for HIV. However, there are socio cultural and personal factors among other factors that affect the access of HCT. The aim of this study was to identify socio cultural and personal factors that affect HIV counseling and testing in provision of PMTCT services among pregnant women in Kabwe, in order to make recommendations for the development of an intervention program to help improve uptake of HIV counseling and testing for PMTCT services. Both quantitative and qualitative methodologies were used to conduct this study. Focus Group Discussions were conducted with groups of pregnant women that have never been tested for HIV before and Key Informant Interviews with health care workers (midwives or nurses) to ask them about factors affecting HCT in provision of PMTCT services among pregnant women were used. A retrospective statistical report review was also used to ascertain the accessibility rate for the HIV counseling and testing for PMTCT services. In this light, statistical report review was used to collect the number of pregnant women attending ANC and number of pregnant women receiving HIV testing. The findings of this study revealed that the pregnant women had excellent knowledge about HIV/AIDS and the update of HCT was as good as 91% among pregnant women. The research also revealed domestic violence, accusation of promiscuity by partner, abandonment by partner, and stigma & discrimination as socio factors that affect HCT in provision of PMTCT. Religion, fear disbelief of test results was revealed as personal factors affecting HCT in provision of PMTCT. The research revealed decision making, tradition medicines, and practices as cultural factors affecting HCT in provision of PMTCT. The conclusion was made that fear of abandonment by partner, fear of being accused of being promiscuous by partner, and fear of domestic violence were the main factors why some pregnant women did not accept to take an HIV test during their pregnancies. It is also concluded that most men make decisions for their families. Women in homes have no powers to make decisions, so if the husband refuses her to take a test, the wife just has to comply. It is also concluded that a person’s ability to access health related services is shaped by socio cultural and personal factors among others factors. These findings fit well with the Anderson behavioral model which describes the individual factors as having three elements that relate to the individual’s ability to access and utilize health care services. / AFRIKAANSE OPSOMMING: Hierdie navorsingstudie het gekyk na die faktore wat 'n invloed HCT in die voorsiening van VMTKO dienste. Dit ondersoek die sosio-kulturele en persoonlike faktore wat HCT. Dit het ook die kennis oor MIV / VIGS en VMNKO onder swanger vroue in Kabwe. Die oordrag van MIV van moeder na kind dra grootliks by tot die voorkoms van MIV onder kinders (Bartlett et al. 2004). Pogings om hierdie wyse van oordrag te verminder sluit in toenemende aantal vroue wat hul MIV-status ken en die verhoging van die aantal MIV-positiewe vroue wat toe swanger neem instruksies en reageer op hulle om hul kinders te beskerm teen die moontlikheid van infeksie. Individue kan slegs weet wat hul MIV-status wanneer hulle getoets word vir MIV. Egter, is daar sosiaal-kulturele en persoonlike faktore onder ander faktore wees wat die toegang van HCT. Die doel van hierdie studie was om sosiaal-kulturele en persoonlike faktore wat die MIV-berading en toetsing in die voorsiening van VMTKO dienste onder swanger vroue in Kabwe te identifiseer, ten einde aanbevelings te maak vir die ontwikkeling van 'n intervensie program te help opname van MIV-berading en toetsing vir VMNKO dienste te verbeter. Beide kwantitatiewe en kwalitatiewe metodes is gebruik om hierdie studie uit te voer. Fokusgroepbesprekings is gevoer met groepe van swanger vroue wat nog nooit vir MIV getoets is voor en onderhoude met sleutelinformante met gesondheidsorgwerkersVroedvroue of verpleegsters) is gebruik om hulle te vra oor die faktore wat HCT in voorsiening van PMTCT dienste onder swanger vroue. 'n Retrospektiewe statistiese verslag review is ook gebruik om die toeganklikheid koers vir die MIV-berading en om vas te stel toetsing vir VMNKO dienste. In hierdie lig, is statistiese verslag hersiening gebruik word om die aantal swanger vroue wat die ANC en die aantal swanger vroue MIV-toetsing in te samel. Die bevindinge van hierdie studie het aan die lig gebring dat die swanger vroue het uitstekende kennis oor MIV / VIGS en die update van HCT was so goed as 91% onder swanger vroue. Die navorsing het ook aan die lig gebring huishoudelike geweld, beskuldiging van losbandigheid deur vennoot, verlating deur vennoot, en stigma diskriminasie as sosio faktore wat 'n invloed HCT in die bepaling van die PMTCT. Godsdiens, vrees ongeloof van toetsresultate is geopenbaar as persoonlike faktore wat HCT in die voorsiening van PMTCT. Die navorsing het aan die lig gebring besluitneming, tradisie medisyne, en praktyke as kulturele faktore wat HCT in die voorsiening van PMTCT. Die gevolgtrekking is gemaak dat vrees vir verlating deur vennoot, vrees daarvan beskuldig dat hy van promisku deur vennoot, en die vrees van huishoudelike geweld was die belangrikste faktore waarom sommige swanger vroue nie aanvaar het nie 'n MIV-toets te neem tydens hul swangerskappe. Dit is ook die gevolgtrekking gekom dat die meeste mense besluite neem vir hul families. Vroue in huise het geen magte om besluite te neem, so as die man weier om vir haar 'n toets te neem, die vrou net om daaraan te voldoen. Dit is ook die gevolgtrekking gekom dat 'n persoon se vermoë om gesondheid verwante dienste om toegang te verkry tot gevorm word deur die sosiaal-kulturele en persoonlike faktore onder andere faktore. Hierdie bevindings pas goed met die Anderson gedrags-model wat die individuele faktore beskryf met drie elemente wat betrekking het op die individu se vermoë om toegang te verkry tot en gebruik van gesondheidsorgdienste.

This research critically analysed Muslim approaches to five women with HIV/AIDS in Cape Town focussing particularly on the approach of 'Positive Muslims' - an awareness-raising and support group for Muslims living with HIV/AIDS. The central question of this thesis dealt with the impact of the norms, values and practices of Cape Muslims on the approach of Positive Muslims to women living with HIV/AIDS. It is suggested that while norms and values articulated in religious texts inform the ideological approach of the organisation's AIDS prevention model. This is due to the pragmatic approach adopted by Postive Muslims which recognises that the articulated norms and values do not always conform to the practices of Cape Muslims.

<p>South Africa has the largest percentage of people living with HIV/AIDS in the world. However, the response against the further spread of HIV/AIDS in the country is being hindered by stigma and discrimination. In order to develop effective intervention programmes to control and reduce the further spread of the disease, it is first important to understand the nature of HIV/AIDS-related stigma and especially how people construct it. In the present study, the social construction of HIV/AIDS-related stigma among Muslims was investigated because high levels of stigma were found in this group. This was fuelled partly by the belief that HIV/AIDS was not a serious problem amongst Muslims. Two focus groups were conducted, one among Muslim women only and the second among Muslim men only. The main aim of the study was to examine the perceptions of HIV/AIDS-related stigma among Muslims. The transcripts were analyzed using thematic content analysis to determine the themes that emerged from the research material. The main findings of the study included that Muslims&rsquo / religious identity/positioning was the most salient discourse that informed how they understood, made meaning of, and responded to HIV/AIDS. They engaged in various forms of stigma such as &lsquo / othering&rsquo / , and mediating factors of stigma included religious positioning. Stigma also served as a social barrier to VCT and disclosure of HIV status. However, supportive attitudes and behaviours were also evident. The findings yielded useful insights into possible elements of intervention programmes, both to reduce HIV/AIDS-related stigma, and also to encourage behavioural change in order to control and reduce the spread of HIV/AIDS in this community.</p>

Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2009. / The study was about assessing the dropout rate of children who are heads of households at Mandela Village in Tshwane Municipality, Gauteng Province. Given the number of orphans who are escalating in each year as a result of HIV/AIDS pandemic especially in the Sub Saharan region, the author’s intention was to analyse what are the causes for these children to drop out from school, and what can be done to minimize the dropout rate of these children. All the participants were the children who are heads of households and residents of Mandela Village, East of Mamelodi Township, and Pretoria. Data was collected through in-depth interviews with thirty-one children who are heads of households, as well as with two educators in schools where these children are attending school or were attending school. This was followed by two focus groups with the same children. The intention of using the focus group was to investigate the issues raised during the interviews and to establish an understanding of how the children who are heads of households want to improve their own circumstances. The study findings observed that there were no strong linkages in assisting children who are heads of households between the Department of Social Development and Department of Education in the North Rand Region, Gauteng. Other findings were that the schools have no support programmes or teachers assigned to assist these children to cope with schoolwork. Due to multiplicity of responsibilities they are faced with, they are not copying with their studies.

Text in English / Breastfeeding is particularly important in resource-poor regions of the world, where limited access to clean water increases the risk of diarrhoeal disease if replacement feeding is used. However, human immunodeficiency virus type 1 (HIV-1) is transmitted through human milk. Purpose of the study The purpose of this study was to describe the determinants contributing to exclusive breastfeeding in HIV-infected mothers of infants aged 0 to 6 months who attend an NGO Health Centre in Elandsdoorn Village. Methods A quantitative research approach using a non-experimental cross-sectional study was undertaken to conduct this study. A self-reported study questionnaire was used to collect data from study participants. Purposive sampling was used to sample 75 mothers from 18 to 45 years of age who were HIV-positive. SPSS version 23 was used to analyse the data. Results The study results indicated that there are determinants contributing to exclusive breastfeeding and a need to establish a more comprehensive approach to educating pregnant women on reproductive health issues, and exclusive breastfeeding in particular. Factors contributing to low levels of exclusive breastfeeding included breast problems, societal influence, maternal health concerns, insufficient support, fear of stigmatisation, and babies’ health concerns. This caused mothers to discontinue exclusive breastfeeding. Conclusions The intention of this study was to reveal the determinants of exclusive breastfeeding affecting mothers who are HIV-infected and breastfeeding their infants. / Health Studies / M.P.H.

The aim of the study was to explore the accessibility of antiretroviral treatment amongst people living with HIV and AIDS at Public Health Care Facilities in Gert-Sibande Region in Mpumalanga. The study was conducted at a selected Public Health Care facility in Gert Sibande Region at Msukaligwa Municipality in Mpumalanga. The study focused primarily on people attending wellness programmes that are living with HIV and AIDS, receiving antiretroviral treatment in Public Health Care facilities. Research design of the study was exploratory which fundamentally used to explore a new topic or to learn more about issues where little is known. The research approach was purely qualitative methodology which allowed the researcher to explore deeply the perceptions of people living with HIV and AIDS and the capabilities in the provision of antiretroviral treatment at public health care facilities in Msukaligwa municipality of Gert-Sibande Region in Mpumalanga. Qualitative interview is the method that has been used to gather data from 23 participants who took part in the study. Questions of the interview were semi-structured in-depth one-on-one interviews and were used to explore understanding in relation to the accessibility of antiretroviral treatment amongst people living with HIV and AIDS at Public Health Care Facilities in Gert- Sibande Region in Mpumalanga. The findings of the study revealed that, there is good accessibility of antiretroviral treatment at public health care facilities in Msukaligwa Municipality of Gert-Sibande Region in Mpumalanga. There is also an existence of negative staff attitude towards patients and a probable poor service delivery at the referral local clinics. It can be concluded that there is a need to re-look into the current Hospital’s reception filing system and the turnaround time at certain areas of the Hospital and the capacitation of staff at the wellness centre. There is also a need to intensify the established programmes and the encouragement of people on treatment to take their antiretroviral treatment consistently. / Health Studies / M.A. (Social behaviour Studies in HIV & AIDS)

This study attempted to identify personal (patient-related) factors influencing anti-retroviral therapy (ART) adherence in Addis Ababa, Ethiopia. A quantitative, descriptive, cross-sectional and analytical design was used. Structured interviews were conducted with 355 ART patients. The findings revealed that stigma, discrimination, depression and alcohol use negatively affected patients’ ART adherence levels. However, patients’ knowledge levels had no influence on their ART adherence levels, contrary to other researchers’ reports. Addressing stigma and discrimination at community levels might enhance patients’ abilities to take their medications in the presence of others. Healthcare professionals should be enabled to diagnose and treat depression among ART patients during the early stages. Non-adherent ART patients should be counseled about possible alcohol abuse. / Health Studies / M.A. (Public Health with specialisation in Medical Informatics)

This study aimed at assessing factors related to male participation in PMTCT in three public hospitals in Addis Ababa, Ethiopia. A quantitative, descriptive correlational design was used to assess correlation between male participation and socio-demographics, knowledge and awareness in HIV/PMTCT, socio-cultural belief, programmatic factors and reported risk. Male partners (n=216) were interviewed and reviews of HIV counselling and testing (HCT) acceptance formats were made. The major findings were 54.5% (n=156) males reported receiving HCT during their visit to partner’s antenatal care. Some 71.5 % (n=677) of women were accompanied to labour wards by male partners; 86.5% (n=208) of males accepted intra-partum HCT; 55.1% (n=216) scored above the mean score (10) on a 15-point scale for male participation. Male participation in PMTCT was found to have a statistically significant but weak correlation with educational level (r=0.193), income (r=0.167), PMTCT knowledge and awareness (r=0.172), socio-cultural belief (r=-0.164) and reported risk (r=-0.23). / Health Studies / M.A. (Public Health)

Anti-Retroviral Therapy (ART) adherence is a crucial component of the patient management framework for people living with Human Immune Deficiency Virus (HIV). Trait emotional intelligence is “the constellation of behavioural-dispositions and self-perceived abilities to recognise, process, and utilise emotion-laden information”. The purpose of the study was to determine whether there was a correlation between ART adherence behaviour and behavioural-dispositions related to trait emotional intelligence among HIV/AIDS infected people receiving ART at the regional public hospitals in Addis Ababa. The study used observational, analytical, and cross-sectional research design. The participants were selected through a proportionally stratified systematic random sampling method. Data collection was through a structured self-report questionnaire format. The findings showed that 79.1% had optimal ART adherence behaviour; 84.4% had average trait emotional intelligence. The research finding showed a statistically significant positive correlation between ART adherence behaviour and behavioural-dispositions related to trait emotional intelligence at (r =0.417, n=392, P<0.001). / Health Studies / M. A. (Public Health)