Thesis (M.Sc.) -- University of Limpopo, 2016 / Purpose of the study The purpose of this study was to investigate the experiences of couples on disclosure of their HIV-positive status to each other. Research methodology Qualitative, Phenomenology, exploratory descriptive and contextual research was conducted to identify the experiences and to determine the strategies that address non-disclosure of couples on their HIV-positive status. The population comprised 12 participants (six (6) couples). Purposive sampling was used to select eight (8) participants (four (4) couples) who participated in the study. Semi-structured interviews were used to collect data until data saturation was reached. Study findings Data were analysed using Tesch’s open-coding method. Five themes emerged, namely, fear of being HIV-positive, disclosure of HIV-positive status is a difficult process, acceptance of HIV-positive status, relations between partners post knowledge of HIV-positive results and encouragement pertaining to disclosure of HIV-positive status. Strategies were developed to address the experiences identified. Recommendations were made for the Department of Health, clinic staff, future researchers, patients and community members. Conclusion Although couples disclosed their status to one another disclosure was found to be a difficult process. Acceptance of HIV status was also found to be one of the challenges that led to delayed disclosure of the status. Support system from both family and community is a very important factor which might increase HIV status acceptance and disclosure from couples. Keywords: Couples, experiences, disclosure, HIV-positive status.

PhD (Microbiology)

Thesis (Ph. D. (Psychology)) -- University of Limpopo, 2016. / Exploring the lived experiences of People Living with HIV/AIDS in relation to stigma and discrimination was the purpose of this qualitative research underpinned by Jungian Phenomenology. The study was qualitative in nature with a non-probability sample of fifteen participants aged from twenty tree to sixty four years. The setting was a rural and the research took place at a designated HIV/AIDS clinic in Limpopo. Semi-structured interviews, in the vernacular, were constructed so that the in-depth, lived experience of the participants relating to stigmatisation and discrimination could be ascertained. The participants’ responses were organised through the application of the Jungian metaphors and presented as themes which were presented in English. The archetypes of the Self, Shadow and Persona were highlighted as dominant metaphors with the Animus playing an important. These were followed by archetypes which represented more marginal roles in the participants’ personality development namely, the Anima, Hero, Caregiver, Innocent and Orphan. Everyone has the desire to develop a well-rounded socially acceptable and fulfilling personality, whose development process is accompanied by the generation and maturation of various archetypal traits. Once this is achieved, the process of personal individuation is completed and an individual is able to experience their true Self and live a fulfilling and authentic (honest) life. HIV infection and HIV related stigma generate archetypal traits which tend to impede the personality development of individuals. As a result they were not able to merge their personality development into an integrated unit and emerge as spiritual and deep-thinking beings.

Department of Public health / MPH

MPH / Department of Public Health / The main entry point for the HIV/AIDS prevention, care and treatment is through HIV Testing Services (HTS). Despite undeniable benefits and increased availability of HIV Testing Services, uptake remains low among students. The aim of this study was to investigate factors contributing to low HIV Testing Services (HTS) among Health Sciences students. Quantitative research method was used to conduct this study. Descriptive quantitative research design was employed. 306 respondents determined by the sample formula were selected through Probability, Systematic sampling technique. Structured questionnaires were used to collect data from respondents. Validity was ensured through content and face validity. Reliability in the form of test-retest reliability were ensured through pre-testing the instrument using 31 respondents from the target population. Data collected was analysed using SPSS version 24. Ethical considerations were ensured throughout the study. The findings of the study showed that out of 306 respondents, 44,1% (n=135) of respondents, comprising 30,7% (n=94) of females and 13,4% (n=41) of males had gone for HIV testing. Respondents had adequate knowledge about HIV Testing Services (HTS) and their attitude towards HIV Testing Services (HTS) was favourable. HIV/AIDS-related stigma, fear of potential HIV positive diagnosis, low perception of HIV infection risk and negative attitude of healthcare service providers were attributed to low uptake of HIV Testing Services (HTS) among respondents. There were recommendations for HIV Testing Services (HTS) workshops, education and awareness campaigns emphasizing the benefits and importance of HIV Testing Services (HTS). The use of various forms of media including campus radio and newsletters to promote the uptake of HIV Testing Services (HTS) among university students was also recommended. / NRF

MPH / Department of Public Health / See the attached abstract below

PhD (Health) / Department of Public Health / The Government of South Africa in response to a prevalent human immunodeficiency virus (HIV) has adopted an approach of integrating HIV/AIDS service into primary health care, as a key to achieving universal access to antiretroviral treatment (ART). Despite the government’s efforts of integrating HIV service into Primary Health Care (PHC), insufficient numbers of PHC staff and inadequate infrastructure is challenging when integrating HIV/AIDS service into PHC. This study explored the extent of HIV service integration into PHC and whether the clinic/health centre’s environment is enabling to integrate HIV service into PHC. Barriers to HIV/AIDS services integration as well as attitudes of PHC nurses were assessed. The overall purpose of this study was to develop guidelines to facilitate the integration of HIV/AIDS services into PHC in Vhembe district of Limpopo province, South Africa. An exploratory sequential mixed methods design was used. The qualitative data was collected and analysed before and results for qualitative approach used to build a subsequent quantitative phase. The current study revealed that HIV/AIDS services are integrated into every existing programme at the PHC clinic and health centres; these include: Immunisation programme, Family planning, PMTCT and ANC programmes, STIs, minor ailments and chronic illness and TB. The study further revealed that the environments at PHC clinics and health centres are not enabling the integration of HIV/AIDS services into PHC due to insufficient staff and inadequate infrastructure. Guidelines to facilitate the integration of HIV/AIDS services based on the findings was developed. The study recommendations comprise; increasing knowledge of HIV serostatus, accelerating HIV prevention, accelerating the scale-up of HIV treatment and care, creating of enabling environment for the integration of HIV/AIDS services into PHC, nursing education and training and nursing education and training.

MPH / Department of Public Health / See the attached abstract below

MA (Psychology) / Department of Psychology / Background: An estimated 70% of people in Sub-Saharan Africa out of 25 million are living with HIV. HIV is a debilitating disease, however, antiretroviral treatment helps promote effective viral suppression, reduces the risk of transmission and prevents death (WHO, 2013). To ensure positive treatment outcomes, high levels of Anti-Retroviral Therapy (ART) adherence, 95%, is necessary, however, research indicates that 23% of Africans are achieving less than 80% adherence, potentially impacting negatively on prognosis. Aim: The aim of this study was to determine adherence, explore perceptions and behaviour of patients on Antiretroviral Therapy attending Thohoyandou Health Centre, in Vhembe District, Limpopo, South Africa. Methodology: This was a mixed method which employed both quantitative and qualitative research approaches. In quantitative, triangulation was utilised through a questionnaire and patients’ file, simple random sampling was used to select 105 male and female patients aged 18-60 who are on ART at Thohoyandou Health Centre; data were collected and SPSSversion 25 was used to analyse the data through descriptive, cross tabulation and inferential statistics using Chi-square.Qualitative phase – phenomelogical research design was utilised, twenty participants were purposively sampled and individually interviewed, ATLAS. ti program was used to analyse the data collected. Results: 67% of respondents were females, 34% of the respondents’ age range was 50-60 years, 44.8% were single, 48.6% had tertiary education and 69.5% were unemployed. The self-report of ART adherence of 87.6% among patients was indicated, with 19.6% who reported defaulting ART, 14.3% admitted to missing medical appointments. The reasons for missing medical appointments were: forgetfulness, not a convenient time, patient feeling better, transportation challenges and being too sick to attend. The objective evaluation of patients’ CD4 count at baseline revealed that 40.9% of patients had a CD4 count of <200c/mm3, out of 40.9% respondents (15.2%) were those aged between 41-50 years, 31.4% of respondents did not know their CD4 count for various reasons (defaulted on treatment, missed appointments). CD4 count follow-up data after six months revealed that 33% of patients had a CD4 count <200c/mm3 and 39% accounted for unknown CD4 count. vi Three themes emerged from the data, namely: Knowledge of HIV were respondents presented a negaitive and positive perception of ths diagnosis; barriers to ART adherence where sub-themes included discrimination, strigma, rejection, inadequate knowledge about the diagnosis and treatment, side effects; coping strategies where acceptance, religion and social support serve as corner stones for patients. Association was examined and findings did not reveal any significant association between gender, marital status, education, occupation; however, age was significantly associated with non-adherence to ART with X2 = 3.69, df = 1, p = < .002. Recommendations: The study recommends intensification of health education campaign against stigma, discrimination, rejection and other barriers to enhance positive attitude towards HIV patients that wil consequently stimulate adherence and alleviate the burden associated with taking treatment unswervingly. Given the high percentage of infected older respondents, government must also focus its resources to educate illiterate and older people about HIV, adherence and management in order to achieve the golden standardrate of 95% adherence. Strategies to facilitate and normalise adherence among males is indicated. / NRF