M.A. (Psychology) / The present study was undertaken in an attempt to understand and ascertain the nature and influence of psychological variables on the longevity of people who are infected withHN. The specific postulate of this study was that depression is the most important psychological variable that influences the longevity of people with my, either directly or indirectly. A number of variables were hypothesized to playa concomitant role with depression as factors that mediate longevity in people with my. These factors include learned helplessness, self-efficacy, sickness impact, sexual risk behaviors and substance use. The testing of these hypotheses involved an experimental group consisting ofHN positive, gay men who suffered from depression and a control group that consisted ofmv positive gay men who did not suffer from depression. None of the subjects had previously been diagnosed with depression. The subjects were subjected to testing of the mentioned psychological variables by means of the Hamilton-Depression Scale, the Attributional Style Questionnaire, the Coping Self-Efficacy Scale, the Biweekly Record of Sexual Behavior, the Substance Use Behavior Questionnaire and the Sickness Impact Profile. It was found that the experimental group differed significantly from the control group in terms of self-efficacy, sexual risk behavior, substance use and sickness impact. It has been speculated that the lack of significant difference between the experimental and control groups on learned helplessness could imply that equal amounts of learned helplessness was present in both groups.

M.A. / Die doel van hierdie studie is om riglyne vir n geïntegreerde seksualiteit program vir adolosente daar te stel wat aandag skenk aan dwelmmisbruik en verhoogde HIV risiko. Daar is nie hipoteses geformuleer nie. Navorsing vrae is gestel en n literatuurstudie is aan die hand van die vrae gedoen. Daar is gepoog om die profiel van die skool gaande adolosent wat dwelmmiddels misbruik vas te stel. Verder is daar gepoog om die frekwensie van dwelmmisbruik by adolosente vas te stel, sowel as hulle kennis oor die verwantskap tussen HIV/Vigs en dwelmmisbruik. Daar is na die aard en effektiwiteit van huidige seksualiteit programme in die onderwys gekyk om vas te stel of hulle doeltreffend is. n Kwantitatiewe data insamelings metode is gebruik. n Beskrywende en n ondersoekende navorsings ontwerp is gebruik in die studie. Twee honderd-en-vyftig vraelyste is by twee skole versprei. Adolosente van graad agt tot graad elf het die vraelyste ewekansig beantwoord. Die hulp van Statistiese Konsultasie Dienste, te RAU, is ingewin met die optrek van die vraelys sowel as die verwerking van die data. Die profiel van die respondente toon dat die meerderheid 15 jaar en ouer is. Die meeste van die respondente was meisies. Graad nege leerders was die meerderheid van respondente terwyl die ander drie grade eweredig versprei was. Die respondente het meestal by beide of minstens by een biologiese ouer gewoon. Afrikane was die meerderheid van respondente. Blankes was tweede meeste verteenwoordig en die res was verteenwoordig deur Asiërs en Kleurlinge. Leerders het hul skool prestasie as gemiddeld beleef. Belangstelling in skoolwerk was matig. Die misbruik van dwelmmiddels het n verhoogde misbruik oor die naweek getoon. Al die dwelmmiddels was in n mate gebruik, met dagga as die gewildste middel. Die respondente was ambivalent oor die invloed van verhoogde risiko vir HIV met alkohol misbruik. Die meerderheid het bevestig dat daar n verhoogde risiko vir HIV is met die misbruik van dwelmmiddels. Die meerderheid van die adolosente is nie seksueel aktief nie. Die respondente wat wel seksueel aktief is, erken dat hulle in meeste gevalle onder die invloed van dwelmmiddels was tydens hulle laaste seksuele omgang. Die skool is geïdentifiseer as die prominentste plek waar leerders oor dwelmmiddels leer. Die media en tweedens, die skool, is aangedui as die belangrikste plek van leer aangaande HIV. Die leerders verkies klasse waar beide geslagte teenwoordig is. Die medium van onderwys wat verkies word, is n dialoog vorm. Daar is twee groepe adolosente geïdentifiseer in die studie. Die minderheid van adolosente is in gevaar van HIV/Vigs. Die ontwikkeling van n omvattende geïntegreerde seksualiteit program moet gemik wees op die groep adolosente. Aanbevelings met betrekking tot die ontwikkeling van n geïntegreerde seksualiteit program word aan die hand gedoen. / Prof. L. Patel

M.Cur. (Nursing Education) / There is a high number of nursing students suffering from the HIV and AIDS pandemic, causing them to have low self-esteem, being stigmatized and being on the receiving end of negative attitudes from their nursing colleagues. The infected students perform poorly and decide to terminate their training. This has a significant impact on the nursing profession, which is already suffering from a tremendous shortage of nurses (Minaar, 2005: 31). The purpose of this study is to explore and describe the experiences of student nurses living with HIV and AIDS at a nursing college in Gauteng, and to describe the strategies to improve the support system for these student nurses. A qualitative, exploratory, descriptive, contextual phenomenological study was used in order to gain insight into the experience of student nurses living with HIV and AIDS. A purposive sampling method was used. The data collection method was collated through an individual semi-structured interview. Open-coding data analysis method using Tesch’s protocol (in Creswell 2009: 186) was used. Measures to ensure trustworthiness were used according to Lincoln and Guba’s Model (1985: 327). Ethical standards for nurse researchers were adhered to in accordance with the DENOSA position statement (1998). The experiences of nursing students living with HIV and AIDS at a nursing college in Gauteng included both positive and negative categories. The following sub-category emerged under the positive experiences of coping with HIV and AIDS: aspects related to internal motivation and positive self-talk. Emerging themes were: 1. living positively with HIV and AIDS, 2. spiritual fulfillment, 3. Hope: 3.1 hope to live for one’s child/children and 3.2 hope for a cure of HIV and AIDS; 4. concern for colleagues and patients living a risky lifestyle. The following sub-category emerged under the negative experiences: The negative emotion related to the disease process. Emerging themes were: 1 fear: 1.1 fear of disclosure, 1.2 fear of stigmatisation, 1.3 fear of re-infection; 2 stress: 2.1 stress experienced when nursing terminally ill HIV and AIDS patients, 2.2 stress caused by inability to meet academic requirements due to the physical impact of the disease (sickness, exhaustion and fatigue); 3 side effects of ARVs; 4 the lack of support: 4.1 lack of support from family members, 4.2 lack of support from tutors and colleagues. The supportive strategies were described. Recommendations for Nursing Education, Nursing Research and Nursing Practice were made.

People living with HIV/AIDS (PLH) struggle with depression. Recent research suggests that depression affects medical regimen adherence, disease progression, and risky sexual behaviors. The present study uses a stress and coping theory viewing HIV-related stigma and physical symptoms as stressors in PLH. Results suggest whereas symptoms and stigma consistently predict negative affect, positive affect, and overall depression, the role of optimism, pessimism, active coping, denial, and behavioral disengagement is not as clear. Pessimism and denial predict negative affect and depression. Optimism and behavioral disengagement predict depression and positive affect. Active coping only predicts positive affect. Focusing on positive and negative affect as distinct components that contribute to overall depression may help researchers develop interventions more effectively.

Thesis (MPH.) -- University of Limpopo, 2016 / Purpose of study: The purpose of this study was to determine the factors that contribute to HIV and AIDS stigma amongst nurses at the Polokwane-Mankweng Hospital Complex in Limpopo Province, South Africa. Objectives: The objectives of this study were to identify the sources of stigma at the health facility, to determine whether attitudes, beliefs, and knowledge contribute to HIV and AIDS stigma, and to develop intervention programmes to reduce HIVrelated stigma. Method: A descriptive cross sectional survey using self-administered questionnaire was used in this study to describe factors that contributed to HIV and AIDS stigma. Data collection: The researcher collected data by means of a structured questionnaire and analysed the results with the assistance of the Statistical Package for Social Sciences (SPSS) software program. Results: The study revealed that negative attitudes and a lack of knowledge contributed to AIDS-related stigma. The study recommended that any stigma reduction programme should be implemented at three levels; namely at the individual, environmental, and policy levels. Conclusion: Fear of infection and lack of knowledge about HIV and AIDS fuel negative attitudes towards people living with HIV and AIDS. Education and training are necessary to mitigate stigma.

The HIV/AIDS epidemic continues to grow and minorities have been affected at a disproportionate rate. Two factors that are hypothesized to be associated with HIV/AIDS stigma include ethnic identity and acculturation. The current study uses a diverse, gender-balanced sample (n= 201, aged 23-68) of African-Americans (54.2%), European Americans (31.8%), and Latinos/Hispanics (10%) to evaluate the relationship among the proposed variables. The study found that higher levels of ethnic identity and other group orientation were associated with lower levels of perceived HIV/AIDS stigma. A stepwise linear regression analysis (adjusted R2 = .13, F(11, 189) = 3.74, p < .001) revealed that as the level of inclusiveness of other ethnic groups (t = -4.263, p < .001) increases, the level of perceived HIV/AIDS stigma decreases. The results from this study suggest that the development of interventions that address stigma and inclusiveness of other ethnic groups may benefit people living with HIV/AIDS.

"The insurance industry was among the first to understand clearly the serious nature of the epidemic, as the HIV/AIDS epidemic disintegrates and destabilizes slowly the traditional extended African family system. The extended family, which traditionally constitutes a social safety net in African communities, is not able to cope with the sudden burden of HIV/AIDS orphans, since the age group 20-44 is the most hit by the epidemic. A study commissioned by the Henry Kaiser Family Foundation showed that, by the year 2005, HIV/AIDS is expected to make around one million children under the age of 15 orphans in South Africa. Besides, stigma and secrecy around the disease expose HIV/AIDS orphans to discrimination in their community and even in their extended family. As a result, a large number of HIV/AIDS orphans are abandoned and forced to seek help in the streets, begging for money, a situation that exposes them to abuse and criminality. Since 1988, most insurance companies in South Africa have had a policy of compulsory HIV testing which excludes HIV positive candidates from their scheme. The reason put forward is that they represent an 'unacceptable risk'. According to the National Association of People Living with HIV/AIDS (NAPWA), this is a widespread problem in South Africa. The impact of discrimination in getting life insurance is catastrophic on the lives of people living with HIV/AIDS and their families. As was noted by the Supreme Court of Canada in the case of Zurich Insurance Company v Ontario, there is a fundamental tension between human rights law and insurance practice. Insurance practices, particularly, impedes on equality and privacy rights of HIV positive persons. ... Therefore, at the root of the debate on HIV/AIDS and insurance is the question on how to strike a balance between the need to ensure that insurance companies extend their coverage without being financially endangered and the human and constitutional rights of HIV positive persons. ... The study is divided into five chapters. Chapter one is the introductory chapter. Chapter two examines the principles of insurance as well as the characteristics of HIV/AIDS. It aims at understanding the arguments in favour of HIV testing and exclusion of persons living with HIV/AIDS from life insurance schemes. Chapter three analyses the problem from the perspective of persons infected with HIV. It investigates the impact of the refusal to grant them life insurance because of their HIV status. This chapter shows how the insurance business infringes the rights of HIV positive persons ot non0discriminatory treatment. Chapter four looks at the position of foreign jurisdictions in the conflict of interests and analyses how they have dealt with the human rights implications of insurance companies policy towards the HIV/AIDS epidemic. Chapter five is the concluding chapter, which puts forward redommendations." -- Introduction. / Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2003. / Prepared under the supervision of Adv. Annelize Nienaber at the Centre for Human Rights, Faculty of Law, University of Pretoria / http://www.chr.up.ac.za/academic_pro/llm1/dissertations.html / Centre for Human Rights / LLM

PhD / Department of Microbiology

Thesis (MPH.) -- University of Limpopo, 2019 / Background: HIV and AIDS is the leading cause of death among adults in subSaharan Africa, and the burden of non- communicable diseases such as diabetes mellitus is high and growing as well. This has resulted in the increase of dual diagnosis of HIV and Diabetes Mellitus in recent years increasing disease burden and self-care challenges being experienced by these patients. This study explored patient challenges arising from this dual diagnosis, and investigated how well the Limpopo healthcare system is servicing these lived experiences, and disease burden challenges these patients have to bear. Methods: A qualitative study approach was used and a phenomenology study design employed in this study. Patients‟ lived experiences and their capability to cope with the co-morbidity of HIV and Diabetes Mellitus was investigated. Sixty four (64) HIV patients with Diabetes Mellitus were identified representing 48% of HIV patients in the HIV/AIDS program at the sites of the study (Mankweng hospital POP clinic, Nobody and Dikgale Clinics) in the Polokwane municipality area of the Limpopo province in South Africa. Fifteen (15) of these patients made the sample and were interviewed. In addition, the five (5) of the seventeen (17) health care providers participated in the interviews. Criterion purposive sampling was used whereby the subjects had to have HIV and AIDS and diabetes in order to be part of the study. The semi-structured interview was conducted. An interview schedule was created to ensure that the key research questions related to workload and capacity are adequately covered during the interviews. Results: The evidence collected suggested that HIV and Diabetes comorbidity patients had increased workload and capacity challenges for self-care. Among the challenges was despondency. Patients found it difficult to adjust to symptoms and demands of the dual diagnosis. Counseling and education was noted as easing anxiety and lowered despondency. Poor services at the clinics worsened their experience and disease burden. Shortage of staff, poor housing of clinics, poor facilities and equipment, lack of training and occasional shortage of drugs were the reasons put forward by the health 2 care professional for the poor services. Separate clinics for HIV and Diabetes Mellitus increased the patients time away from a productive life, increased expenses, and somewhat complicated their lives. Good compliance to treatment was observed. Most patients coped well with medication and had no side effects, the few that had side effects continued to take their medication incorporating additional instructions from the health workers who managed the side effects. Family and buddy support improved the capability to cope with the disease burden and their general attitude to life. Conclusion and recommendations: Primary health care must be strengthened to meet the challenges disease convergence is bringing through continued education of staff and improvement of facilities and equipment, and streamlining service delivery processes. Note of significance is that despite the health care professionals being poorly prepared and under staffed, the clinic facility being poorly housed and poorly equipped, the healthcare professionals are managing to meet their service mandate through commitment and hard work.

Complex patient are becoming more and more of a challenge to the health care system given the amount of care they require and the amount of documentation needed to keep track of their state of health and treatment. Record keeping using the EHR makes this easier but mounting amounts of patient data also means that clinicians are faced with information overload. Information overload has been shown to have deleterious effects on care, with increased safety concerns due to missed information. Patient record summarization has been a promising mitigator for information overload. Subsequently, a lot of research has been dedicated to record summarization since the introduction of EHRs. In this dissertation we examine whether unsupervised inference methods can derive patient problem-oriented summaries, that are robust to different patients. By grounding our experiments with HIV patients we leverage the data of a group of patients that are similar in that they share one common disease (HIV) but also exhibit complex histories of diverse comorbidities. Using a user-centered, iterative design process, we design an interactive, longitudinal patient record summarization tool, that leverages automated inferences about the patient's problems. We find that unsupervised, joint learning of problems using correlated topic models, adapted to handle the multiple data types (structured and unstructured) of the EHR, is successful in identifying the salient problems of complex patients. Utilizing interactive visualization that exposes inference results to users enables them to make sense of a patient's problems over time and to answer questions about a patient more accurately and faster than using the EHR alone.