Dissertation submitted in fulfilment of the requirements for the Degree in Masters of Technology: Nursing, Durban University of Technology, 2012. / In South Africa, HIV and AIDS workplace programmes have been implemented for more than two decades without any audited and certifiable standards. In 2007, the South African National Standard launched South African National Standard (SANS 16001) 16001 to assist, encourage and support companies to implement minimum standards for HAMS. Companies are now expected to use this standard to improve HIV and AIDS Management System. It therefore, becomes imperative for companies to establish workplace HAMS in line with the set standard. To determine to what extent the company‟s HAMS has been aligned to the SANS 16001, an evaluation of the current management system in relation to the new SANS 16001 system is needed. Aim of the study The aim of the study was to evaluate the implementation of the HIV and AIDS Management System in a Richards Bay Company. Methodology A single case study using a quantitative research design was used to evaluate HAMS in a Richards Bay Company. The sample consisted of all consenting participants who were selected from key position holders in accordance with the requirements of SANS 16001: 2007 and the general workers. These key position holders were comprised of senior managers, middle managers and those employees who play an important role in implementing HAMS. Two different sets of questionnaires were used to collect data. One questionnaire was used to collect data from the managers because they were key role players in HAMS. The second questionnaire was used to collect data from the general workforce. The data from the questionnaire was captured and subsequently analysed using the version 9 of SPSS. Results There was evidence that the company was committed to continuous improvement regarding HIV and AIDS management as indicated by both key position holders and the general workforce.

Submitted in fulfilment of the requirements of the full Degree of Master of Technology: Nursing, Durban University of Technology, 2011. / South Africa is currently at the epicentre of the AIDS epidemic with 5.6 million people living with HIV disease. The province of KwaZulu-Natal has the biggest burden with an antenatal HIV prevalence of 39.5% in 2010. It is estimated that 24.5% of South Africa‟s working age population is HIV positive. Most infected people living with HIV in Africa are between ages 15 and 50 years which is the peak working age. AIDS now causes more deaths and suffering among the 18-44 year age group than any other disease. Organisations clearly present as one of the most effective and significant settings in which to respond to the epidemic. The effective management of HIV and AIDS within organisations is critical in order to reduce the negative consequences of the epidemic on the economy. HIV and AIDS Management Systems (HAMS) within organisations have been implemented for approximately twenty years but they have been largely ineffective, mainly due to poor uptake of services. Therefore, there is a need for HAMS practice to be evaluated in relation to current best practice standards to ensure quality management, continual improvement and successful uptake of services. This qualitative study evaluated one organisation‟s HAMS in relation to SANS 16001 and described employees‟ experiences of HAMS in this setting. The theoretical framework underpinning this study is the Deming cycle which is a well known quality management system methodology. From the results of the study it was apparent that the organisation was aligned with most of SANS 16001 general requirements for HAMS. Employees experienced the intended benefits of prevention, treatment and support from the organisation‟s HAMS.

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: HIV infection, substance abuse, and psychiatric disorders are major public health issues in South Africa. Psychiatric disorders and substance-use disorders together have a negative impact on the health outcomes of people living with HIV and AIDS (PLWHA), such as poor adherence to anti-retrovirals (ARVs), HIV disease progression, lower CD4 counts, vulnerability to opportunistic infections, high viral loads, possible drug resistance, and an earlier onset of death. The overall aim of this study was to investigate the relationship between substance abuse practices and the health status and health behaviour of patients attending HIV clinics in the Cape Metropole. The study used a cross-sectional study design for collecting data on hazardous or harmful use of alcohol and problematic drug use, demographic information and health status among patients attending eight HIV clinics in the Cape Metropole. A sub-sample of patients were assessed on the following domains: depression, psychological distress, psychopathology, post-traumatic stress disorder (PTSD), risky sexual behaviour, adherence to ARVs, levels of resilience, levels of social support and patient’s work, family and social functioning. Of the 608, 10% of consecutively selected patients completed an additional psychiatric diagnostic interview (Mini International Neuropsychiatric Interview). The main findings to emerge from this study are: 1. Patients reporting hazardous or harmful use of alcohol and/or drug use are significantly more likely to be non-adherent to ARVs and have lower CD4 counts than their non-substance abusing counterparts 2. Hazardous or harmful use of alcohol has a direct influence on CD4 count resulting in lower CD4 counts and participants being less likely to be on ARVs. 3. Hazardous or harmful use of alcohol has a direct relationship in predicting tuberculosis (TB). 4. Hazardous or harmful users of alcohol and/or problematic drug users are more likely to report psychological distress (anxiety and depression), depression and low levels of family support than their non-using counterparts. 5. Participants who met the criteria for major depression are significantly more likely to be non-adherent to ARVs. 6. Gender, depression, psychological distress, and PTSD were found to be significant determinants of hazardous or harmful use of alcohol. 7. Psychological distress (anxiety and depression) is significant in directly predicting ARV non-adherence. 8. Male participants and those who stopped taking their ARVs were more likely to have lower CD4 counts than female participants and those who did not stop. 9. PTSD was found to predict psychological distress indicating that participants who experienced trauma were more likely to suffer from psychological distress (anxiety and depression) compared to those who did not experience any PTSD. Participants with lower levels of family support were more likely to suffer from psychological distress than those with high levels of family support. / AFRIKAANSE OPSOMMING: MIV infeksie, dwelmmisbruik en geestesversteurings is groot gesondheidskwessies in Suid-Afrika. Geestesversteurings en dwelmmisbruik het gesamentlik 'n negatiewe uitwerking op die gesondheid van mense wat met MIV en VIGS saamleef (PLWHA), soos byvoorbeeld nie-nakoming in die gebruik van antiretrovirale (ARV’s), MIVsiekteverloop, laer CD4-tellings, vatbaarheid vir opportunistiese infeksies, hoë virale ladings, moontlike weerstand teen medikasie en 'n verkorte leeftyd. Die oorkoepelende doel van hierdie studie was om die verhouding tussen dwelmmisbruik en die gesondheidstatus en -gedrag van pasiënte wat MIV klinieke in die Kaapse Metropool besoek, te bestudeer. Die studie het 'n deursnee-ontwerp gebruik om data in te samel oor die nadelige en gevaarlike gebruik van alkohol en problematiese dwelmgebruik, demografiese inligting, en die gesondheidstatus onder pasiënte wat agt MIV klinieke in die Kaapse Metropool besoek het. 'n Subgroep pasiënte geassesseer op die volgende gebiede: depressie, psigologiese angsversteuring, psigopatologie, posttraumatiese stresversteuring (PTSV), riskante seksuele gedrag, nakoming in die gebruik van ARV’s, weerstandigheidsvlakke , vlakke van sosiale ondersteuning, asook pasiënte se werk, familie en sosiale funksionering. Van die 608 deelnemers is 10% van die pasiënte opeenvolgend geselekteer om 'n addisionele diagnostiese psigiatriese onderhoud te ondergaan (Mini International Neuropsychiatric Interview). Die vernaamste bevindinge wat uit die studie gekom het, is: 1. Pasiënte wat nadelige en gevaarlike gebruik van alkohol en/of dwelms rapporteer is beduidend meer geneig om nie die gebruik van ARV’s na te kom nie, en het laer CD4-tellings as hulle eweknieë wat nie dwelms misbruik nie. 2. Die nadelige en gevaarlike gebruik van alkohol het 'n direkte invloed op CD4- tellings wat lei tot laer CD4-tellings en dat pasiënte minder geneig is om op ARV’s te wees. 3. Die nadelige en gevaarlike gebruik van alkohol hou direk verband met die voorspelbaarheid van tuberkulose (TB). 4. Nadelige en gevaarlike gebruikers van alkohol en/of problematiese dwelmgebruikers, is meer geneig om psigologiese angsversteurings (angs en depressie), depressie, en laer vlakke van familieondersteuning te rapporteer as hul niegebruiker-eweknieë. 5. Deelnemers wat aan die kriteria vir ernstige depressie voldoen, is aansienlik meer geneig tot nie-nakoming in die gebruik van ARV’s. 6. Daar is gevind dat geslag, depressie, psigologiese angs en PTSV beduidende bydraende faktore is tot die nadelige en gevaarlike gebruik van alkohol. 7. Psigologiese angsversteurings (angs en depressie) is beduidend om direk die nie-nakoming van ARV’s te voorspel. 8. Manlike deelnemers en diegene wat hul ARV’s gestaak het, was meer geneig om laer CD4-tellings te hê as vroulike deelnemers en diegene wat nie die gebruik van medikasie gestaak het nie. 9. Daar is gevind dat PTSV psigologiese angs voorspel het wat aandui dat deelnemers wat trauma ondervind het, meer geneig was om aan psigologiese angsversteurings (angs en depressie) te ly in vergelyking met diegene wat geen PTSV ervaar het nie. Deelnemers met laer vlakke van familieondersteuning was meer geneig om aan psigologiese angsversteurings te ly as diegene met hoë vlakke van familiebystand.

Using non-experimental descriptive exploratory survey, this study sought to find out factors associated with delayed entry into HIV medical care among HIV positive people who are aware of their status. A quantitative design was used and a structured questionnaire was used as the data collection instrument. Respondents were patients in a hospital’s Opportunistic Infection Department whose hospital records indicated that they were HIV positive during the time of the study. The study found out that as much as 71.6% (n =43) first entered HIV medical care more than 12 months after testing HIV positive while 40% (n = 24) did so as a result of illness. Low education levels, unemployment and being single are associated with delayed entry into HIV medical care. A percentage of the population uses and trusts non-biomedical approaches to dealing with HIV/AIDS. Being diagnosed HIV positive is therefore not necessarily a strong reason enough for one to immediately enter into medical care. Intensive health education needs to be done at work places, health facilities, schools, through print and electronic media, churches and other community settings to equip the population with knowledge of the advantages of early entry into HIV care. / Health Studies / M.A. (Public Health)

Background: Literature has shown that negative attitudes and unwillingness to care for HIV-infected patients are prevailing among healthcare workers. This study aimed to assess the attitudes and willingness of student nurses towards caring for HIV-infected patients in some public hospitals in Gert Sibande district, Mpumalanga. Method: A contextual exploratory quantitative descriptive survey was conducted among student nurses enrolled for a four-year nursing qualification in a nursing college at Mpumalanga province. Self-administered questionnaires were completed after obtaining an informed consent. Results: A total of 122 (70.9%) students participated in this survey. Findings showed that most participants had positive attitudes 66 (52.7%) and were willing 121 (99.1%) to care for HIV-infected patients. Significant associations were revealed between participants’ previous HIV testing (p=0.012), age group (p=0.009), and their willingness to provide care to HIV-infected patients. Conclusion: Results showed a generally positive attitude and willingness by participants to care for HIV-infected patients. / Health Studies / M.A. (Health Studies)

The study investigated the role of churches in HIV prevention among young adults in the Polokwane Municipality of the Limpopo Province. Qualitative research method was followed. Data was obtained and tape-recorded during the in-depth face-to-face interviews. Fourteen churches are affiliated with the Limpopo South African Council of Churches, seven of which run HIV/AIDS programmes and services. They were the target of this study, which investigated how churches could give more support to people infected with HIV. Results show that churches are determined to assist in the prevention of HIV. They have already contributed to supporting those with HIV and those affected by HIV and AIDS. The findings / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

This study explored factors associated with the reluctance of people living with HIV (PLWH) to disclose their (Human Immunodeficiency Virus (HIV) statuses to their sexual partners at Galeshewe Day Hospital in Kimberley in the Northern Cape. The study was an in-depth interview based qualitative research; and purposive sampling technique was utilised to select 13 PLWH aged between 18 and 45. Among males, factors contributing to the reluctance of disclosure to sexual partners are ignorance, fear of rejection, not knowing where to start when disclosing and secrecy. Despite the complexity of disclosure, all participants understood the importance of disclosing to sexual partners as this will prevent new infections. There is a need for HIV prevention strategies to focus on males particularly, to strengthen disclosure counselling services provided to PLWH and to advocate strongly for partner testing / Health Studies / M.A. (Public Health)

Background: IPT is an effective, safe and feasible disease prevention scheme that should be administered for all PLHIV living in areas with high latent TB prevalence. Objective: To assess the impact of isoniazid in the incidence of tuberculosis among HIV infected individuals in Addis Ababa. Methods: A case control study design was undertaken among 489 HIV and TB infected patients in Addis Ababa from January 2008 to December 2010. Results: Tuberculosis incidence rate among those who developed TB after completing 6-9 month isoniazid preventative therapy was17.14 PYO compared to 10.28 PYO among those who were not. Isonizide reduced the chance of developing tuberculosis among HIV infected patients (OR= 0.072; 95% CI 0.044, 0.12). Age (AOR= 0.14; 95% CI 0.03, 0.97) and sex (AOR= 1.86; 95% CI 1.02, 2.23) of the patient, CD4 count at HIV diagnosis (AOR= 0.21; 95% CI 0.13, 0.31), clinical stage of HIV illness (AOR= 1.22; 95% CI 1.09, 1.84) and past tuberculosis history (AOR = 1.97; 95% CI 1.24, 3.67) were major factors associated with tuberculosis incidence. Conclusions: INH prophylaxis was associated with lower incidence of tuberculosis among PLHIV. / Health Studies / M. Public Health

Digitized using a Konica Minolta 211 PCL scanner at 300 dpi. / Thesis (MA (Psychology))--University of Stellenbosch, 2006. / Please refer to full text for abstract.

Thesis (MA) -- University of Stellenbosch, 2004. / ENGLISH ABSTRACT: The relentless progression of HfV /AIDS epidemic has made it imperative that measures are put in place to minimise its impact on Small and Medium Enterprises (SME). mv is set to have a significant effect on every facet of the population, and SME is not immune. Business is likely to feel the impact ofmv/AIDS epidemic through reduced productivity, increased absenteeism, increased staff turnover, increased recruitment and training costs, increased cost of employee benefits and poor staff morale. One of the interventions is to implement a mv/AIDS policy and programme, yet a literature search showed that psychological studies of SME in implementing a mv/AIDS policy and programme are limited. The present study utilised the model of the theory of planned behaviour (Ajzen, 1985,1988, 1991), which is an extension of the theory of reasoned action (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980). Intention to implement a mv/AIDS policy and programme was predicted by the theory of planned behaviour constructs such as attitude, subjective norm and perceived behavioural control. The theory of planned behaviour was found to be useful in assessing behavioural intention of SME in implementing a mv/AIDS policy and programme. These findings indicate that implementing an intervention like a mv/AIDS policy and programme by SMES is a behavioural intention motivated by attitudes, subjective norms and perceived behavioural control. / AFRIKAANSE OPSOMMING: Die meedoënlose progressie van die HIVNIGS pandemie het dit gebiedend noodsaaklik gemaak om maatreëls daar te stelom die impak daarvan op klein en medium sakeondernemings te minimaliseer. HIVNIGS sal 'n beduidende uitwerking hê op alle vlakke van die bevolking. Klein en medium sakeondernemings is geen uitsondering nie. Die uitwerking van die HIVNIGS pandemie sal tot gevolg hê 'n afname in produktiwiteit; 'n toename in personeelafwesigheid, personeelomset, personeelwerwing en - opleidingskoste, personeelvoordele; en swak personeel moreel. Een manier om die probleem aan te spreek is om 'n HIVNIGS beleid en program te implimenteer. Ongelukkig toon literêre navorsing dat psigologiese studies van klein en medium sakeondernemings om 'n HIVNIGS beleid en program te implimenteer, beperk is. Dié navorsing steun op die teorie van planmatige gedrag (Ajzen, 1985; 1988; 1991), wat 'n verlenging is van die teorie van beredeneerde optrede (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980). Die oogmerk met die implimentering van 'n HIVNIGS beleid en program is bepaal deur die teorie van planmagtige gedrag soos waargeneem in geesteshouding, subjektiewe norme en waargenome beheerde gedrag. Daar is gevind dat die teorie van planmagtige gedrag nuttig is om die oogmerke en optrede van werknemers in klein en medium sakeondernemings te bepaal met die implimentering van 'n HIVNIGS beleid en program. Hierdie bevindings toon dat die implimentering en tussenkoms van 'n HIVNIGS beleid en program by klein en medium sakeondernemings'n gedragsoogmerk is wat gemotiveer word deur geesteshoudings, subjektiewe norme en waargenome beheerde gedrag.