Thesis (MA)--University of Stellenbosch, 2001. / ENGLISH ABSTRACT: This paper provides an overview and critical evaluation of current (1990-2001) research into Human Immune-deficiency Virus (HIV) and Acquired Immuno-deficiency Syndrome (AIDS), with particular reference to factors affecting quality of life (QOL) among those living with the disease. A brief look at the importance of optimal QOL when faced with a life crisis such as HIV/AIDS, leads to a discussion of factors influencing QOL in HIV/AIDS. These factors include coping styles, mental adjustment, social support, stigmatization, socio-economic and socia-cultural factors, gender, depression as well as disease progression. The overview is informed by prominent research trends and a critical look at the current understanding of factors impacting on the QOL of people living with HIV/AIDS. Recommendations are made on issues that need further clarification, while future research orientations are also suggested. In the absence of satisfactory treatment strategies or a cure for HIV/AIDS, as well as the evidence of a potentiall0 to 12 year life expectancy, there is a pressing need for a better understanding of factors that influence QOL. There is strong support for the notion that QOL directly impacts on disease progression and therefore also on the quality and quantity of survival time. It follows that a better understanding of the nature and determinants of QOL for HIV patients will yield valuable intervention guidelines within a biopsychosocial framework. / AFRIKAANSE OPSOMMING: Hierdie artikel bied 'n oorsig en kritiese evaluering van onlangse (1990-2001) navorsing in die veld van Menslike Immuniteitsgebrek Virus (MIV) en Verworwe Immuniteitsgebrek Sindroom (VIGS), met besondere verwysing na faktore wat bydra tot die lewenskwaliteit van geïnfekteerde indiwidue. Die belangrikheid van optimale lewenskwaliteit teen die agtergrond van 'n lewenskrisis soos 'n MIV-diagnose, word kortliks bepsreek. Daarop volg In bespreking van faktore wat In invloed het op lewenskwaliteit in HIV/AIDS. Hierdie faktore sluit in hanteringstyl, psigiese aanpasbaarheid, sosiale ondersteuning, stigmatisering, sosio-ekonomies en sosio-kulturele faktore, geslag, depressie asook siekteverloop. Die oorsig word gerugsteun deur prominente navorsingstendense asook 'n kritiese blik op huidige perspektiewe op faktore wat 'n impak het op die lewenskwaliteit van mense wat leef met MIVjVIGS. Aanbevelings word gemaak aangaande aspekte waaroor verdere helderheid verkry moet word, asook oor toekomstige navorsingsvraagstukke. Gegewe die afwesigheid van voldoende behandelingstrategieë of selfs 'n geneesmiddel vir MIV, tesame met die bewys van 'n 10 tot 12 jaar potensiële lewensverwagting, bestaan daar 'n dringende noodsaaklikheid vir grondiger insig in faktore wat lewenskwaliteit beïnvloed. Daar is sterk steun vir die uitgangspunt dat lewenskwaliteit 'n direkte impak het op siekteverloop en derhalwe ook op die duur en kwaliteit van oorlewingstyd. Verbeterde kennis oor die aard en determinante van lewenskwaliteit in MIV-pasiënte sal dus waardevolle inligting kan verskaf in terme van toepaslike riglyne vir intervensies binne 'n biopsigososiale raamwerk.

published_or_final_version / Social Work / Master / Master of Social Work

This research explored cultural perceptions of HIV&amp / AIDS with students at the University of the Western Cape and attempted to understand how these perceptions of the disease reinforce stigma and stigmatising attitudes towards people living with HIV/AIDS. This study investigated HIV/AIDS stigma as a social phenomenon and analysed the socio-cultural and historical roots of HIV/AIDS stigma.

Thesis presented in partial fulfilment for the degree of Master of Management (in the field of Public Sector Monitoring and Evaluation) to the Faculty of Commerce, Law, and Management, University of the Witwatersrand 2016 / The purpose of this research was to assess outcomes of the antiretroviral treatment intervention in Mankweng. The antiretroviral treatment intervention was conceived with the aim to reduce HIV transmission through viral load suppression. Literature has shown that viral load is used as a tool to measure the performance of the intervention and studies on viral load outcomes in rural settings of Limpopo are limited. For this reason, the research was focused on viral load suppression with the aim of (1) determining the proportion of adults with viral load suppression among people taking antiretroviral treatment for 12 months, and (2) identifying factors associated with failure to achieve viral load suppression among people on antiretroviral treatment for 12 months. Binomial logistic regression model was used to identify factors associated with failure to suppress viral load. This study used the theory of change to interpret its findings as well as theories of behavioural planning and self-regulation models to understand the logic that underpins the theory of change. The findings revealed that the majority (78%) of adults achieved viral load suppression, and a quarter of the individuals failed to suppress the viral load. There was no significant difference in baseline characteristics between people who achieved viral load suppression and those who did not. In addition, males, with a low CD4 and opportunistic illnesses when in the primary disease stages were more likely to fail to suppress the viral load. Moreover, people who were initiated on a 3-pill containing treatment and do not have social support were also likely to fail to achieve viral load suppression. Although the study showed a trend of likelihood towards failure to achieve viral load suppression, the estimates were not statistically significant. Theoretical arguments from this study suggest that failure to achieve viral load was attributed to poor adherence to treatment. This is supported by the logic that underpins the theory of change, in which the assumption of adherence was possibly violated. However, the results chain framework highlighted that the implementation of the intervention was effective as it led to good outcomes and an effective intervention. Drawing all this together, the study highlights the need for intensified adherence counseling during treatment in order to improve the performance of the intervention. Author: Ramatsobane Johanna Ledwaba, Thesis Title: Outcomes of the antiretroviral treatment intervention in Mankweng, Johannesburg, March 2016 / GR2018

As the economic hub of South Africa, Johannesburg attracts cross-border migrants in search of improved livelihoods; over half the population of some of its inner-city suburbs are made up of cross border migrants. Globally as well as locally, foreigners have been blamed for the spread of diseases such as HIV. As a result, they have suffered challenges in accessing public healthcare, particularly antiretroviral treatment (ART) for HIV. Studies have shown that despite these challenges - foreigners experienced better ART outcomes than nationals. There is a need to explore the ways in which cross border migrants use to access and to stay on treatment, given the wide-range of challenges that they face during their stay in Johannesburg. Semi-structured interviews with five nurses and ten cross-border migrants currently receiving ART, along with non-participant observations, were used to collect data from two public clinics in inner-city Johannesburg. Analysis suggests that the family network in the country of origin remains critical, as cross border migrants are not disclosing their status in the city in which they live, but do so to their families in their countries of origin. Data shows that when it comes to accessing and staying on treatment, cross-border migrants go to the clinic every month as do nationals; ask for more treatment from nurses when going home temporarily; eat healthily; but hide when taking medication, and negotiate confidentiality and trust within their families in countries of origin. Some are found to access treatment in their countries of origin while staying in Johannesburg. Despite the lack of social networks in the inner city, this data suggests that cross-border migrants are successful in accessing and continuing with ART. There is need for future research to look at social networks for internal migrants, so as to compare results.

Thesis (M.A. (Clinical Psychology)) --University of Limpopo, 2013 / Studies have indicated that help-seeking behaviour of people living with HIV is not predictable and linear and may entail the utilization of western medicine, traditional medicine and/or complementary medicine. The aim of this study was to explore pre- and post- HIV diagnosis help-seeking behaviour by patients receiving antiretroviral treatment at Witbank Hospital in Mpumalanga Province (South Africa).A qualitative, descriptive phenomenological approach was utilized in the study. Ten participants (male = 5; female = 5, and aged between 30 and 50 years)diagnosed with HIV and who came to the hospital to collect their treatment and for medical review were interviewed using semi-structured interviews. Interpretive analysis method was used to analyse the data. The results suggest the preference for western medicine pre-and post-HIV diagnosis. The results further suggest that help-seeking behaviour is a dynamic process embedded mainly in the conceptualization of the health problem, perception of its severity, the treatment given, and social support experienced.

Thesis (MPH.) --Univesity of Limpopo, 2014 / Background: The main goal of HAART is to achieve maximal viral suppression. However, with poor adherence to therapy the chances of achieving and maintaining successful viral suppression are decreased, leading to virological failure. And virological failure has been recognized by WHO as one of the early warning signs of drug resistance. This operational research sought to explore virological failure as a treatment outcome to evaluate program performance at a facility level. Methods: Purposive sampling as per inclusion and exclusion criteria was used to retrospectively review clinical records of the first 700 adult HIV positive patients (350 males and 350 females) who initiated antiretroviral treatment between April 2004 and December 2007 at this adult HIV clinic, were followed up for at least 3 years and treated according to the South African government’s National Department of Health 2004 HIV treatment guidelines for adults and adolescents. Major Results: 268 clinical records, 97 (27.71%) male and 171 (58.86%) female records were eligible for inclusion in the study. The proportion of females was higher (63.8%) than males (32.8%) with an average age of 38.95 years. 24 (8.9%) patients in the study sample experienced virological failure during the study period; 11 (11.3%) males and 13 (7.6%) females. Two-thirds (66.6%) of patients who failed to suppress at their first viral load measurement proceeded to develop virological failure. Overall, there was no association of statistical significance between age, sex, baseline CD4 cell count and baseline regimen, and virological failure at various intervals, p> 0.05. Conclusion: It was a challenge to keep patients in care but those that remained in care had good treatment outcomes with only 8.9% developing virological failure. Failure to suppress at first viral load preceded virological failure in the majority of patients.

Thesis (Ph. D.)--University of Montana, 2007. / Title from title screen. Description based on contents viewed Apr. 2, 2007. Includes bibliographical references (p. 87-92).

The current study aims to determine physical activity levels among people living with HIV treated with high active antiretroviral therapy in Kigali, Rwanda. A cross-sectional design using quantitative method was used. The participant’s levels of physical activity participation and their association with anthropometric profiles were measured, using a structured selfadministered questionnaire adapted from the Sub-Saharan Africa Activity Questionnaire. Based on a scientific calculation, 407 clients passing through the clinics were included in the study. A convenient sample of people attending the clinics approached to participate voluntarily in the study. The findings of the current study highlighted the lack of motivation, lack of time and fear of worsening the disease amongst the strong barriers to physical activity participation. The current study recommends education about the benefits of physical activity participation and encouragement of patient treated with high active antiretroviral therapy in Rwanda to be emphasized on to improve their lives.

The consequences of the African AIDS epidemic are growing--not just in size--but in complexity. These consequences are no longer just biological; increasingly, they are also social, cultural, economic, and psychological. In this dissertation, I consider one overlooked consequence of the epidemic by asking how HIV infection affects the desire to have children in a context where reproduction is so highly valued. Taking advantage of a unique situation in rural Malawi, where no one knew their HIV status prior to testing being introduced as part of an ongoing longitudinal survey, I use a quasiexperimental design and in‐depth interviews to examine the evidence for an intentional relationship between HIV/AIDS and fertility. Rural Malawians adjust their childbearing desires in response to information about their HIV status. The relationship--both in magnitude and in motivation--is highly gendered. HIV positive women fear that a pregnancy will worsen their disease. Despite this widely shared belief, there remains a lot of ambivalence: women who are positive, or who fear they are positive, want to live normal lives. For some, that means avoiding childbearing as a strategy to delay the symptoms of HIV. For others, it means having children as they would have had despite what they think it might mean for their health. Male fertility preferences are more volatile to information about HIV status. Men see childbearing as futile if they are HIV positive because they anticipate their own death and the death of their future offspring. However, men may be less likely to translate their preferences into action because--after learning they are infected--they are less motivated to stop having children than they are unmotivated to have children. This dissertation shows that rural Malawians adapt their childbearing preferences to information about their HIV status. There are strategies in these adaptations, as well as hope for a future where the conditions of childbearing in an AIDS epidemic might have changed. I conclude by discussing what the findings mean for fertility, fertility theory, and policy. / text