The overall aim of this study was to understand the determinants of VCT uptake in the general population of Nigeria’s federal capital territory of Abuja. Uptake of VCT still remains low despite increased availability of VCT information and services in Abuja, Nigeria. A quantitative cross-sectional study was undertaken with 180 respondents from Abuja, using an adaptation of the Health Belief Model as conceptual framework, to elucidate the social demographics of respondents, their HIV/VCT knowledge, their perceptions of VCT facility design, societal support for VCT, and how HIV stigma shapes the phenomenon of VCT uptake in Abuja, Nigeria. The key findings were that a better understanding of HIV prevention, a perception of support from community and religious leaders, and access to HIV test services in government facilities are positive predictors of higher VCT uptake. Poor personal risk assessment and the cost of HIV testing were identified as the key barriers to VCT access. / Health Studies / M.P.H.

The purpose of this study was to understand employees’ perceptions of the benefits of and the challenges in utilising VCT services at the workplace. With Mittal Steel in Vanderbijlpark as a case study, the researcher investigated the types of VCT services offered, the reasons why employees used these services, the perceived benefits and challenges related to these services, and made suggestions for service improvements. Using a qualitative approach, the main data-collection strategies were non-participant observation and in-depth interviews with five purposefully recruited research participants. The study showed that knowledge of HIV and AIDS among employees was adequate but that this could not be attributed to company efforts only. The study also revealed that employees utilised VCT for personal reasons rather than based on company incentives. Stigmatisation and discrimination appeared to be on the decline. It is recommended that the company could do more to market and promote HIV and AIDS awareness at the workplace. / Sociology / M.A (Sociology - Social Behavioural Studies in HIV/AIDS)

Besides constituting major obstacle to effectively addressing HIV/AIDS, Stigma has remained among the least understood experiences of PLWHA. Limited knowledge and understanding of HIV/AIDS related S&D has very much contributed to poor implementation and in most cases failure of HIV intervention programmes at national, regional and international levels. Sociological analysis of Stigma in PLWHA lends verifiable insight into the nature, extent and comprehensiveness of HIV/AIDS related Stigma. With 129 participants from Gauteng regions of Ekurhuleni, Sedibeng and West Rand, the study confirms that Stigma and Discrimination (S&D) still thrives, quantifying its magnitude, implications and impacts in the lives of the HIV infected. Inter alia, the findings showcase the complex matrix analysis of emotion and behaviour associated with HIV/AIDS related S&D. Finally, the study offered a comprehensive recommendation on how to address HIV/AIDS related S&D at individual/family, institutional/community and government levels. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

Volunteer caregivers provide essential services to people in the terminal stages of AIDS and their families. Volunteers are exposed to stress and burnout. This study investigated the relationships between stress, coping strategies, levels of burnout and resilience in this population. Volunteers from Societas ‘O Sosiale (SOS) Children Villages and community based organisation (CBO) partnerships, were selected using non-probability purposive convenience sampling. A total of 110 participants were given the Experience of Work and Life Circumstances Questionnaire (WLQ), Brief-Cope, Maslach’s Burnout Inventory (MBI), a Resilience scale and the Living Standard Measure to complete. Statistical analyses were performed on the data. This includes descriptive statistics, reliability analysis, factor analysis, correlations and multivariate analysis of variance. The study found that volunteer caregivers experience high stress levels and burnout related to stressors outside work, remuneration, personnel policies and high resilience. High burnout is associated with all forms of coping. Further it is shown that training in problem-solving skills, counselling, government and public lobbying for support, registration with relevant professional bodies, furnished offices, reasonable recruitment requirements and compensation are needed to help the care givers avert the effect of stressors and control stress by stopping it from turning to burnout. / Psychology / M.A. (Psychology - Research Consultation)

The phenomenon of HIV discordance has been in existence for a long time along with HIV. However, very limited attention has been given to HIV discordance. This phenomenological study aimed at gaining a deeper understanding on the lived experiences of sero-discordant couples in Botswana. Reports show that discordance in Botswana is around 17%. The main objectives of this study were to identify HIV discordant couples living in Botswana and explore their knowledge and understanding of the situation, explore the psychological, social and sexual experiences of the HIV discordant couples and determine its impact in their lives, and examine the meaning they attach to such experiences and challenges they face as well as their coping strategies. A qualitative phenomenological approach using face to face in-depth interviews was used to explore and describe meanings and experience as lived by the HIV discordant couples. The study sample consisted of forty-six (N=46) (twenty-nine (n=29) females and seventeen (n=17) males) participants selected using purposive sampling from three cities in Botswana. The Inclusion criteria were that participants should be aged 21 years and above; with no known diagnosis of mental illness; having been in a discordant relationship for at least six months at the time of data collection; living in Botswana and willing to participate in the study. The findings were that there are three forms of discordance, which are: discordant unaware which are couples who went into the relation unaware of their HIV status. Discordant aware; those who got into the relationship already knowing each other’s HIV status and discordantly discordant which are those with differing HIV status and differing motives of going into the relationship. These are the couples that conceal their status from one another. The results revealed intense emotional/psychological, sexual and social stresses as experienced by couples. HIV discordant goes through three phases of initial shock, conflict and resolution. The researcher recommends the OPEN DESK MODEL to be integrated in the health facilities to encompass the concept of a family or couple and as a unit. / Health Studies / D. Litt. et Phil. (Health Studies)

Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is a global problem. Introduction of antiretroviral therapy (ART) came as a relief to people living with HIV and AIDS as it improved their quality of life. However, maintaining high adherence levels to antiretroviral treatment is still a challenge in some settings yet strict adherence to treatment instructions is critical for successful suppression of HIV. A qualitative, descriptive phenomenological research was conducted to explore factors that influence adherence to antiretroviral therapy at Beatrice Road Infectious Disease Hospital (BRIDH). Purposive homogenous sampling was done. Data was collected from twenty patients through in-depth interviews. Study findings identified five main themes that facilitate adherence and these entail knowledge on HIV and AIDS and ART, motivation to live, adherence support networks, good service delivery and factors related to medication / Health Studies / M.A. (Public Health)

South African palliative care volunteer caregivers play a crucial role in caring for people living with HIV and Aids, but frequently do not receive the support and respect that they deserve. The current study explored the psychosocial challenges and coping mechanisms of palliative care volunteer caregivers for people living with HIV and Aids. The researcher conducted in-depth interviews with 24 participants who also filled in questionnaires. The aim was to explore their experiences, their challenges, and coping mechanisms. Although these volunteer caregivers shared many positive experiences, they also faced multiple challenges in the workplace, their personal lives, financial challenges as well as psychological and emotional ones. Despite these challenges, the caregivers showed only moderate levels of stress on the stress scale. Recommendations for overcoming these challenges were provided to caregivers, organisations and the Department of Health / Psychology / M. Sc. (Psychology)

Adherence to antiretroviral therapy is crucial to ensure viral suppression. In the scientific community it is widely accepted that an adherence level of at least 90% is necessary to achieve viral suppression. This study uses pharmacy refill records to describe antiretroviral adherence in HIV-positive patients in Ugu District and to describe pharmacy refill records as reliable monitoring method of antiretroviral therapy. In total, 61 patients’ records were reviewed. Overall, 82% of participants (n=50) achieved an optimum adherence level of at least 90%. Although 38% (n=19) of these participants did not show any related viral suppression. A statistically significant relationship between adherence and viral suppression was not demonstrated. Therefore, pharmacy refill records cannot be recommended as an alternative method of monitoring response to antiretroviral therapy, but laboratory tests including CD4 cell count and or viral load must be combined to pharmacy refill method for monitoring of antiretroviral therapy in HIV-positive patients / Health Studies / M.A. (Public Health)

The purpose of this study was to determine and compare the outcomes of tuberculosis (TB) treatment among Human Immunodeficiency Virus (HIV) co-infected TB patients, and identify factors associated with these outcomes. A quantitative cross-sectional analytic design was used. Patient level secondary data was collected and analysed for the study. A total of 575 TB patients, including 360 non-HIV infected, 169 HIV co-infected and 46 without a documented HIV status, were enrolled. The overall treatment success rate was 91.5%, and HIV co-infected TB patients had a high rate (11.8%) of unfavourable outcomes. The cure rate was significantly lower (10.1% versus 24.2%) and the death rate higher in HIV co-infected patients (8.3% versus 2.5%). Age and TB classification were significantly associated with treatment outcome. No association was found with starting ART, Cotrimoxazole prophylactic treatment or enrolment in HIV care, but 22% of HIV co-infected TB patients were taking ART when they developed TB disease / Health Studies / M.A. (Public Health)

The purpose of the study was to evaluate the IMB skills model for its relevance to the Ethiopian context. According to the model, adherence-related information and motivation work through adherence-related behavioural skills to affect adherence to ART. Quantitative, analytical, observational, cross-sectional, institution-based study was conducted to evaluate the model by assessing those patients who have and do not have the right information, motivation, and behavioural skills whether they have or do not have good adherence to ART. Data was collected using structured questionnaires where a total of 400 randomly selected participants provided data on adherence-related information, motivation and behavioral skills as well as adherence behavior per se. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 20.0. Both descriptive and inferential statistics used in the study. Only 90.75 % of the total sample population reported ART adherence rate of more than or equal to 95% in this study. Free and restricted model tests, through bivariate and multivariate analyses, used to assess the propositions of the IMB model of ART adherence and provided support for the interrelations between the elements proposed by the model. The study has supported the applicability of the IMB model of adherence to the Ethiopian context highlighting its application in adherence-promotion intervention efforts. The findings revealed the need for on-going educational, informational and other interventions to address the knowledge, motivation and adherence behavioural skills of patients in order to improve the current levels of ART adherence behaviour. / Health Studies / D. Litt. et. Phil. (Health Studies)