The purpose of this study was to determine factors affecting non-adherence to Anti-retroviral therapy among AIDS patients. A cross sectional quantitative survey, was used. Structured interviews were conducted with 300 ART patients. Data were analysed using SPSS version 13 and presented in charts, graphs and frequency tables. Motivators of good adherence were identified as disclosure of HIV positive status to more than one person, frequent adherence counselling, self-efficacy to adhere to ART, positive interactions between patients and healthcare providers; and using an adherence partner. Barriers to adherence were forgetfulness, transportation costs to and from the clinic, time away from work and side effects. There was a strong positive correlation between adherence, CD4 counts and viral load. Adherence was closely tied to immunologic and virologic improvements. Respondents with poor adherence were likely to have unsuppressed viral loads (OR 12.98, 95%, CI 4.9-34). / Health Studies / Masters of Public Health

This study assessed healthcare providers’ knowledge, attitudes and practices towards IPT provision for people living with HIV (PLHIV) in Addis Ababa, the capital city of Ethiopia. A quantitative, descriptive, cross-sectional study design was used for the study and data was collected using a self-administered questionnaire from 104 clinicians working in ART clinics. The findings show that healthcare providers who participated in this study had a mean value of high knowledge, positive attitude and good practice towards IPT provision for PLHIV. Significant association was found between knowledge and attitude (P=0.000) but no significant associations were found between knowledge and practice, attitude and practice as well as between the type of facility (public/private) and level of practice. This implied that, the low level of IPT implementation in Addis Ababa doesn’t seem due to health care providers’ lack of knowledge and resistance to provide IPT for people living with HIV. As a result, the researcher recommends for further researches of other possible factors like; the reliability of IPT information/data management, drug supply and the leadership and governance of the health system that IPT program is a direct concern. / Health Studies / M. Public Health (with specialisation in Medical Informatics)

The purpose of this study was to determine how pain in PLHIV on community home based care programme was managed using the Roy adaptation model (RAM) as the theoretical framework. This study used a descriptive mixed method research design which allowed for the research topic to be investigated and described in terms of both narrative qualitative accounts and descriptive statistics. A sequential exploratory approach was adopted in which qualitative data collection was conducted in the initial phase followed by quantitative data collection. Ten qualitative interviews, guided by the components of the RAM were conducted in the initial phase and a structured interview schedule (questionnaire) partially based on the result of the qualitative phase and (which was also structured in accordance with the RAM) was administered to 120 respondents who met the inclusion criteria of being on CHBC. Convenience sampling was used to select study participants and respondents in both phases of the study. Peripheral neuropathy was the most common pain syndrome experienced by patients. More females suffered numbness/tingling sensation of toes, followed by chest pains than their male counterparts. Pain experienced was moderate to severe which was not treated effectively. The study findings could assist health care providers, policy makers and researchers to invest into improving pain management for PLHIV, strengthen education of patients and their primary caregivers on the causes of pain and modalities to employ for pain relief and implement palliative care guidelines for PLHIV. / Health Studies / D. Litt. et Phil. (Health Studies)

In English / This study investigates the resilience of caregivers at a Gauteng-based hospice with patients living with HIV/AIDS. The primary focus of this study was to describe the impact on caregivers working with terminally ill patients predominantly with HIV/AIDS. Six participants were selected for this study utilising purposive sampling. Their ages ranged between 30 and 70 years. For the purpose of data collection, face-to-face semi-structured interviews were undertaken. In analysing data, the themes and sub-themes were extracted and presented by employing thematic analysis. The findings of this study revealed that in times of adversity and setbacks most caregivers utilise various skills to bounce back, and they still showed contentment in serving community members. However, caregivers have also voiced the concern that the support offered at work was not sufficient in meeting their needs. Recommendations for further research, on the resilience of caregivers when working with terminally ill patients is highlighted. / Psychology / M. A. (Clinical Psychology)

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: This research study looked at the factors that affect HCT in provision of PMTCT services. It explored the socio cultural and personal factors that affect HCT. It also established the knowledge level about HIV/AIDS and PMTCT among pregnant women in Kabwe. The transmission of HIV from mother to child contributes largely to HIV prevalence among children. Efforts to reduce this mode of transmission include increasing number of women who know their HIV status and increasing the number of HIV positive women who when pregnant take instructions and act on them to protect their children from the possibility of infection (Bartlett et al. 2004). Individuals can only know their HIV status once they are tested for HIV. However, there are socio cultural and personal factors among other factors that affect the access of HCT. The aim of this study was to identify socio cultural and personal factors that affect HIV counseling and testing in provision of PMTCT services among pregnant women in Kabwe, in order to make recommendations for the development of an intervention program to help improve uptake of HIV counseling and testing for PMTCT services. Both quantitative and qualitative methodologies were used to conduct this study. Focus Group Discussions were conducted with groups of pregnant women that have never been tested for HIV before and Key Informant Interviews with health care workers (midwives or nurses) to ask them about factors affecting HCT in provision of PMTCT services among pregnant women were used. A retrospective statistical report review was also used to ascertain the accessibility rate for the HIV counseling and testing for PMTCT services. In this light, statistical report review was used to collect the number of pregnant women attending ANC and number of pregnant women receiving HIV testing. The findings of this study revealed that the pregnant women had excellent knowledge about HIV/AIDS and the update of HCT was as good as 91% among pregnant women. The research also revealed domestic violence, accusation of promiscuity by partner, abandonment by partner, and stigma & discrimination as socio factors that affect HCT in provision of PMTCT. Religion, fear disbelief of test results was revealed as personal factors affecting HCT in provision of PMTCT. The research revealed decision making, tradition medicines, and practices as cultural factors affecting HCT in provision of PMTCT. The conclusion was made that fear of abandonment by partner, fear of being accused of being promiscuous by partner, and fear of domestic violence were the main factors why some pregnant women did not accept to take an HIV test during their pregnancies. It is also concluded that most men make decisions for their families. Women in homes have no powers to make decisions, so if the husband refuses her to take a test, the wife just has to comply. It is also concluded that a person’s ability to access health related services is shaped by socio cultural and personal factors among others factors. These findings fit well with the Anderson behavioral model which describes the individual factors as having three elements that relate to the individual’s ability to access and utilize health care services. / AFRIKAANSE OPSOMMING: Hierdie navorsingstudie het gekyk na die faktore wat 'n invloed HCT in die voorsiening van VMTKO dienste. Dit ondersoek die sosio-kulturele en persoonlike faktore wat HCT. Dit het ook die kennis oor MIV / VIGS en VMNKO onder swanger vroue in Kabwe. Die oordrag van MIV van moeder na kind dra grootliks by tot die voorkoms van MIV onder kinders (Bartlett et al. 2004). Pogings om hierdie wyse van oordrag te verminder sluit in toenemende aantal vroue wat hul MIV-status ken en die verhoging van die aantal MIV-positiewe vroue wat toe swanger neem instruksies en reageer op hulle om hul kinders te beskerm teen die moontlikheid van infeksie. Individue kan slegs weet wat hul MIV-status wanneer hulle getoets word vir MIV. Egter, is daar sosiaal-kulturele en persoonlike faktore onder ander faktore wees wat die toegang van HCT. Die doel van hierdie studie was om sosiaal-kulturele en persoonlike faktore wat die MIV-berading en toetsing in die voorsiening van VMTKO dienste onder swanger vroue in Kabwe te identifiseer, ten einde aanbevelings te maak vir die ontwikkeling van 'n intervensie program te help opname van MIV-berading en toetsing vir VMNKO dienste te verbeter. Beide kwantitatiewe en kwalitatiewe metodes is gebruik om hierdie studie uit te voer. Fokusgroepbesprekings is gevoer met groepe van swanger vroue wat nog nooit vir MIV getoets is voor en onderhoude met sleutelinformante met gesondheidsorgwerkersVroedvroue of verpleegsters) is gebruik om hulle te vra oor die faktore wat HCT in voorsiening van PMTCT dienste onder swanger vroue. 'n Retrospektiewe statistiese verslag review is ook gebruik om die toeganklikheid koers vir die MIV-berading en om vas te stel toetsing vir VMNKO dienste. In hierdie lig, is statistiese verslag hersiening gebruik word om die aantal swanger vroue wat die ANC en die aantal swanger vroue MIV-toetsing in te samel. Die bevindinge van hierdie studie het aan die lig gebring dat die swanger vroue het uitstekende kennis oor MIV / VIGS en die update van HCT was so goed as 91% onder swanger vroue. Die navorsing het ook aan die lig gebring huishoudelike geweld, beskuldiging van losbandigheid deur vennoot, verlating deur vennoot, en stigma diskriminasie as sosio faktore wat 'n invloed HCT in die bepaling van die PMTCT. Godsdiens, vrees ongeloof van toetsresultate is geopenbaar as persoonlike faktore wat HCT in die voorsiening van PMTCT. Die navorsing het aan die lig gebring besluitneming, tradisie medisyne, en praktyke as kulturele faktore wat HCT in die voorsiening van PMTCT. Die gevolgtrekking is gemaak dat vrees vir verlating deur vennoot, vrees daarvan beskuldig dat hy van promisku deur vennoot, en die vrees van huishoudelike geweld was die belangrikste faktore waarom sommige swanger vroue nie aanvaar het nie 'n MIV-toets te neem tydens hul swangerskappe. Dit is ook die gevolgtrekking gekom dat die meeste mense besluite neem vir hul families. Vroue in huise het geen magte om besluite te neem, so as die man weier om vir haar 'n toets te neem, die vrou net om daaraan te voldoen. Dit is ook die gevolgtrekking gekom dat 'n persoon se vermoë om gesondheid verwante dienste om toegang te verkry tot gevorm word deur die sosiaal-kulturele en persoonlike faktore onder andere faktore. Hierdie bevindings pas goed met die Anderson gedrags-model wat die individuele faktore beskryf met drie elemente wat betrekking het op die individu se vermoë om toegang te verkry tot en gebruik van gesondheidsorgdienste.

The main aim of this study was to explore the extent of freedom or lack thereof in the relationships of HIV positive pregnant women and their partners. These women were attending antenatal care in two Soweto clinics, run by the Perinatal HIV Research Unit. A semi-structured interview schedule was developed and used as the data collection tool. A theoretical framework based on Amartya Sen's theory of Development as Freedom and Isabel Apawo Phiri's theological reflections on women's freedom, was used to analyze data collected from the participants of the study. The ideas of the two theorists complemented each other with regard to the sources of "unfreedom" for women from an economic point of view and from the cultural and religious points of view. Sen highlighted lack of basic freedoms and human rights as the core causes of lack of freedom, which is both a primary means and principal ends of development. Phiri advocated for the liberation of women from the oppressive cultural and religious practices brought about by patriarchy. Removal of all those key sources of unfreedom would provide an ideal situation in which women would be less vulnerable to HIV infection. The analysis of the participants' responses in this study suggested a lack of freedom in their relationships with the fathers of their unborn babies. This had an adverse effect in their ability to disclose their HIV positive status, negotiate safer sex and contraception. Economic dependency on the partners was found to be the major cornerstone that kept women in bondage in their relationships. The churches in Soweto did not seem to have any plausible impact in the lives of the participants and as a result all of them had very loose links with the church. This was another major gap in the initiatives to reduce HIV infection which challenges the churches in Soweto to strengthen their prophetic ministry in terms of women's freedom and their dignity both in the church and in society. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2007

Thesis (MPhil)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: It is very common to talk about or refer to people as “People Living with HIV/AIDS” but never “A Church with Aids”. Responding to HIV/AIDS has earned the JL Zwane Memorial Church this name or rather this label. Members of the congregation, many of them young, were dying and remaining silent, not doing anything, would have meant contributing to the disaster that had struck. Something drastic had to be done to respond to the pandemic or else the whole community would have perished. This was not easy as it meant risking losing those already in the church. To many people, HIV/AIDS was seen as a punishment from God to those who have sinned. For this reason many did not want to have anything to do with People Living with HIV/AIDS. The whole response is driven by the needs of the community i.e. those infected and those affected. This means listening to people tell their stories and then respond accordingly. Listening is the key in the response as the whole response revolves around people and their experiences. / AFRIKAANSE OPSOMMING: Die kerk, of geloofsgebaseerde organisasies , is dikwels die eerste om te weet dat iemand MIV positief is. Dit is ook die eerste persoon of organisasie wat deur die geïnfekteerde in vertroue geneem word. Die Kerk, as organisasie, kan dus 'n deurslaggewende rol vervul in die voorkoming, maar ook by die versorging van diegene wat MIV positief is of aan Vigsverwante siektes ly. Hierdie studie beskryf, in die vorm van 'n gevallestudie, die rol wat die Presbiteriaanse Kerk in Guguleto in die voorkoming van MIV/Vigs vervul. Die gevallestudie bespreek die probleem; die ontleding van die probleem en die uiteindelike program(me) wat daargestel is. Riglyne vir die betrokkenheid van Kerke (en geloofsgebasserde organisasies) word uitgespel en voorstelle vir verdere studie word gemaak.

Twenty four eThekwini HIV/AIDS counsellors based in four different work settings and who received training from five different training providers, shared their HIV/AIDS counsellor training experiences. The qualitative, phenomenological study utilized a multi-methods approach. The purpose of HIV/AIDS counselling lacks uniformity. Participants reflected upon their distinction between training satisfaction and perceived competency to render HIV/AIDS counselling after training. Although they were satisfied and empowered by the useful information gained, many felt inadequate to counsel an HIV positive person on completion of training. Inadequate practical learning opportunities were evident. Participants identified the need for a more balanced theoretical and practical training program incorporating experiential and didactic training methods. Entrance criteria to HIV/AIDS counsellor training courses and eventual assessment procedures in the study were diverse. Participants suggested improvements for training methods and course content and proposed a tiered training model that will result in standardized and certified training modules. / Social Work / MA(SS) (Social Work)

This thesis sought to develop an agent-based model that replicates the formation of social and sexual partnerships in real-world settings with an eventual aim of revealing the main drivers of the HIV pandemic in a closed mixed society. Agent-based modelling is a computational modelling approach that allows for the simulation of the actions and interactions of autonomous agents, with the eventual objective of disovering global effects on the system. This modelling technique is less dependent on generalisations and does not average out the behaviour of individuals. Sexual partnerships formed in the model goes through the process of dating, courting and has a chance of developing into marriage as well as the possibility of breaking up or undergo divorce. Sexual partnership formation is based on a likeability index calculated using aspiration, attractiveness and age. Over and above the the sexual relationships we include commercial sex work. Commercial sex work depends mainly on the availability of female sex workers and their clients. We superimpose the spread of HIV on the social and sexual network model. Results from the model reveal that saturation of HIV prevalence is driven by the social and sexual network structure, behaviour change as well as biologic factors. Excluding commercial sex work in the model resulted in a decrease in HIV prevalence and incidence. Dense social networks resulted in a dense sexual network which consequently increased HIV incidence. A change in the infection probability per coital act contributed significantly to a change in incidence and prevalence levels. Model results also show that enrolling all HIV positive agents on antiretroviral therapy (ART) as from 2016 simulation year will help in curbing HIV transmission if zero dropout rate from ART is assumed. Therefore, on concomitant action to avoid dropouts from ART is necessary if full benefits of introducing ART to all HIV positive individuals are to be realised. / Operations Management / D.Phil. (Operations Research)

As the Human Immunodeficiency Virus (HIV) prevalence rises, uninfected Basotho face an increased risk of exposure. This necessitates strengthening of strategies that prevent exposure, and where exposure has occurred, measures that prevent infection. One such measure is Human Immunodeficiency Virus (HIV) Post-Exposure Prophylaxis (PEP). Awareness and knowledge of HIV PEP is therefore of paramount importance. The purpose of this study was to assess knowledge, attitudes and utilisation of HIV PEP among adults in Roma, Lesotho. A quantitative cross-sectional study was conducted among 96 adult outpatients at St Joseph’s Hospital. Data were collected by means of structured questionnaire and analysed using SPSS version 23.0. Results were presented using charts and tables. Awareness of HIV PEP among the respondents was found to be very low and for most respondents’ knowledge of HIV PEP was either non-existent or very poor. Utilisation was also found to be very low. Attitudes towards HIV PEP were, however, found to be favourable. More studies should be conducted throughout the country to further explore Basotho’s knowledge, attitude and use of HIV PEP. / Health Studies / M.A. (Nursing Science)