Magister Scientiae Dentium - MSc(Dent) / Aim The aim of the study was to determine the oral health knowledge,management and referral patterns of patients with oral manifestations of HIV by Primary Health Care Nurses.Background Nurses working in Primary Health Care (PHC) facilities, and nursing educators, play a pivotal role in the early identification, referral and diagnosis of patients who present for treatment of health problems. They are in an ideal position to identify HIVinfected persons through a simple visual assessment of the mouth, in order to diagnose oral lesions that may be prognostic of HIV, and to then refer these persons for voluntary counselling and testing (VCT). Timely referral will lead to early medical intervention, with lower treatment costs and improved patient quality of life.Methods The study design comprised of a pre- and post-education test, training and provision of educational material, together with a quantitative and qualitative selfadministered questionnaire. The questionnaire gathered information on nurses demographics,experience, knowledge, training and treatment practices.The study design was a cross-sectional survey which was conducted during the period July to October 2010. The study population consisted of 121 nurses based at Primary Health Care and nursing education facilities within the uMgungundlovu Health District in KwaZulu-Natal. The chi-squared test was utilised to determine the statistical significance of the preeducation and post-education test results and Pearsons Correlation Coefficient was used to determine the significance of correlations between variables. A p-value of <0.05 was regarded as being statistically significant.Results A large number of the respondents did not receive substantial oral health education during both their pre-qualification and post-qualification education stages. Nurses had an inadequate knowledge of oral health assessment and of oral conditions, especially with regard to the common prognostic oral manifestations of HIV. The post-test results were statistically significant (p< .0001), indicating that the provision of education and training to the nurses had a significant impact on nurses knowledge of oral conditions. More than twothirds of the nurses (67,8%) reported that they do not examine the mouth as part of routine overall assessment of the patient, and only 13% referred patients for VCT.Conclusions There is a need to include oral health assessment and oral health promotion into both undergraduate and post-graduate nursing curricula. Further research is needed to identify the specific oral health training needs of all categories of nurses in order to overcome the barriers that prevent nurses from assessing the mouth. Oral health assessment and oral health promotion should become a key part of the curricula of nurses training. The use of oral health promotion workers at a primary health care level should also be considered.

This study describes the HIV/AIDS knowledge of Form 1 secondary school learners in Harare. Structured interviews were conducted with 75 learners from four schools representing a low density, a high density, a rural and a private school. Most learners had obtained their HIVAIDS knowledge from schools and a few did so from their parents. None of the learners had reportedly yet engaged in sexual activities and all had heard about HIV, but not all knew what HIV was, and even fewer could define AIDS. Generally the learners’ HIV/AIDS knowledge levels were high but some misconceptions persisted. Future programmes should emphasise that there is no cure for HIV/AIDS, and that condoms should be used at every sexual encounter. Radio, television and school programmes should emphasise that every person can become infected with HIV/AIDS, if preventive measures are disregarded. / Public Health / M.A. (Public Health)

<p>The main purpose of the study was to assess and explore the knowledge of HIV/AIDS among secondary learners in rural Bergville district of KwaZulu-Natal. A stratified random sample of 100&nbsp / learners was selected from two secondary schools in the area. Data was collected using a questionnaire and interviews were scheduled with the teachers from the selected schools. The&nbsp / questionnaire was administered to a sample of 54 learners from school A and 46 from school B. The mean age was 16, with age range from 13-20. The participants were enrolled for grade&nbsp / 8-12 in both schools. Both qualitative and quantitative data on learners‟ knowledge and perception about HIV/AIDS, condom use and sexual issues including their attitudes towards people living with HIV/AIDS were collected in the questionnaire. Chi-square test was used for statistics purpose to test if the HIV knowledge of learners were associated with gender, culture and&nbsp / religion. Qualitative interviews with 9 teachers from both schools were conducted. The main purpose of the interviews was to investigate the management of HIV/AIDS in public schools in rural&nbsp / areas. Furthermore, to assess the learner‟s attitude towards HIV/AIDS education provided in schools. The results showed that the learners in Bergville district were more knowledgeable of&nbsp / HIV/AIDS through HIV/AIDS education in schools that had limited effect on gender, culture and religion. Quantitative findings presented, indicated no significant differences between those&nbsp / learners attending church and cultural activities that offer&nbsp / HIV/AIDS awareness programmes and those who do not with regard to the knowledge of HIV/AIDS. However, culture stood out to be associated with one item on the knowledge of whether school children can get HIV/AIDS (p-value = 0.04). On average, the level of knowledge of HIV/AIDS between female and male learners was similar. The major findings on both quantitative and qualitative findings confirmed that learners‟ knowledge levels were very high for modes of transmission and prevention of HIV/AIDS. Despite this knowledge, poor&nbsp / behavioural change among learners is a major setback thus increasing high risk of contracting HIV. Adequate knowledge about issues of cure, HIV testing and treatment was of concern in the findings in this study. Furthermore, data from qualitative interviews with the teachers highlighted the lack of multisectoral response to HIV/AIDS in Bergville rural communities which thus&nbsp / compromise the effectiveness in management of HIV/AIDS in schools. In summary, the study revealed some of the challenges faced by teachers and learners in regard to HIV/AIDS education.</p>

<p>The main purpose of the study was to assess and explore the knowledge of HIV/AIDS among secondary learners in rural Bergville district of KwaZulu-Natal. A stratified random sample of 100&nbsp / learners was selected from two secondary schools in the area. Data was collected using a questionnaire and interviews were scheduled with the teachers from the selected schools. The&nbsp / questionnaire was administered to a sample of 54 learners from school A and 46 from school B. The mean age was 16, with age range from 13-20. The participants were enrolled for grade&nbsp / 8-12 in both schools. Both qualitative and quantitative data on learners‟ knowledge and perception about HIV/AIDS, condom use and sexual issues including their attitudes towards people living with HIV/AIDS were collected in the questionnaire. Chi-square test was used for statistics purpose to test if the HIV knowledge of learners were associated with gender, culture and&nbsp / religion. Qualitative interviews with 9 teachers from both schools were conducted. The main purpose of the interviews was to investigate the management of HIV/AIDS in public schools in rural&nbsp / areas. Furthermore, to assess the learner‟s attitude towards HIV/AIDS education provided in schools. The results showed that the learners in Bergville district were more knowledgeable of&nbsp / HIV/AIDS through HIV/AIDS education in schools that had limited effect on gender, culture and religion. Quantitative findings presented, indicated no significant differences between those&nbsp / learners attending church and cultural activities that offer&nbsp / HIV/AIDS awareness programmes and those who do not with regard to the knowledge of HIV/AIDS. However, culture stood out to be associated with one item on the knowledge of whether school children can get HIV/AIDS (p-value = 0.04). On average, the level of knowledge of HIV/AIDS between female and male learners was similar. The major findings on both quantitative and qualitative findings confirmed that learners‟ knowledge levels were very high for modes of transmission and prevention of HIV/AIDS. Despite this knowledge, poor&nbsp / behavioural change among learners is a major setback thus increasing high risk of contracting HIV. Adequate knowledge about issues of cure, HIV testing and treatment was of concern in the findings in this study. Furthermore, data from qualitative interviews with the teachers highlighted the lack of multisectoral response to HIV/AIDS in Bergville rural communities which thus&nbsp / compromise the effectiveness in management of HIV/AIDS in schools. In summary, the study revealed some of the challenges faced by teachers and learners in regard to HIV/AIDS education.</p>

This study describes the HIV/AIDS knowledge of Form 1 secondary school learners in Harare. Structured interviews were conducted with 75 learners from four schools representing a low density, a high density, a rural and a private school. Most learners had obtained their HIVAIDS knowledge from schools and a few did so from their parents. None of the learners had reportedly yet engaged in sexual activities and all had heard about HIV, but not all knew what HIV was, and even fewer could define AIDS. Generally the learners’ HIV/AIDS knowledge levels were high but some misconceptions persisted. Future programmes should emphasise that there is no cure for HIV/AIDS, and that condoms should be used at every sexual encounter. Radio, television and school programmes should emphasise that every person can become infected with HIV/AIDS, if preventive measures are disregarded. / Public Health / M.A. (Public Health)

Magister Administrationis - MAdmin / The main purpose of the study was to assess and explore the knowledge of HIV/AIDS among secondary learners in rural Bergville district of KwaZulu-Natal. A stratified random sample of 100 learners was selected from two secondary schools in the area. Data was collected using a questionnaire and interviews were scheduled with the teachers from the selected schools. The questionnaire was administered to a sample of 54 learners from school A and 46 from school B. The mean age was 16, with age range from 13-20. The participants were enrolled for grade 8-12 in both schools. Both qualitative and quantitative data on learners‟ knowledge and perception about HIV/AIDS, condom use and sexual issues including their attitudes towards people living with HIV/AIDS were collected in the questionnaire. Chi-square test was used for statistics purpose to test if the HIV knowledge of learners were associated with gender, culture and religion. Qualitative interviews with 9 teachers from both schools were conducted. The main purpose of the interviews was to investigate the management of HIV/AIDS in public schools in rural areas. Furthermore, to assess the learner‟s attitude towards HIV/AIDS education provided in schools. The results showed that the learners in Bergville district were more knowledgeable of HIV/AIDS through HIV/AIDS education in schools that had limited effect on gender, culture and religion. Quantitative findings presented, indicated no significant differences between those learners attending church and cultural activities that offer HIV/AIDS awareness programmes and those who do not with regard to the knowledge of HIV/AIDS. However, culture stood out to be associated with one item on the knowledge of whether school children can get HIV/AIDS (p-value = 0.04). On average, the level of knowledge of HIV/AIDS between female and male learners was similar. The major findings on both quantitative and qualitative findings confirmed that learners‟ knowledge levels were very high for modes of transmission and prevention of HIV/AIDS. Despite this knowledge, poor behavioural change among learners is a major setback thus increasing high risk of contracting HIV. Adequate knowledge about issues of cure, HIV testing and treatment was of concern in the findings in this study. Furthermore, data from qualitative interviews with the teachers highlighted the lack of multisectoral response to HIV/AIDS in Bergville rural communities which thus compromise the effectiveness in management of HIV/AIDS in schools. In summary, the study revealed some of the challenges faced by teachers and learners in regard to HIV/AIDS education. / South Africa

In this study the impact of the UNISA HIV/AIDS training programme on participants' learning and involvement in their respective communities was explored. The UNISA HIV/AIDS programme comprises Modules 1, 2 and 3. Module 1 focuses on orientation and background to HIV/AIDS Care and Counselling, Module 2 on HIV/AIDS counselling skills and Module 3 on train the trainer in HIV/AIDS education and counselling. This study focused only on Modules 1 and 2. Kirkpatrick's model of evaluating education and training programmes was used as a framework to evaluate the programme. Participants for the study consisted of 116 students who attended the UNISA HIV/AIDS Module 2 workshops between December 2005 and December 2006. The study was conducted in two phases, the first phase during the workshops, where participants were asked to indicate both quantitatively and qualitatively how they experienced Module 1 and Module 2 as well as what they learnt in the two modules. The participants' involvement in HIV/AIDS work prior and post Module 2 training as well as the aspects of the programme that are being applied within their work in the community was assessed during the second phase of the study, which took place during 2007. The results of the study indicate that the programme has successfully equipped participants with the necessary HIV/AIDS information and skills. The programme has further empowered participants to engage in HIV/AIDS education and counselling in their communities. Participants' attitudes towards the disease and towards those infected and affected by HIV/AIDS were challenged, resulting in less stigmatization and discrimination. The programme further challenged participants to start adopting health protective behaviours. The present study concludes that for HIV/AIDS programmes to be effective, they need to include, amongst other things, a well-researched basic HIV/AIDS factual information section, a component on attitudes and one on skills (particularly linked to behaviour change). These should be presented in an interactive way, engaging the participants in active learning. / Psychology / D. Litt. et Phil. (Psychology)

In this study the impact of the UNISA HIV/AIDS training programme on participants' learning and involvement in their respective communities was explored. The UNISA HIV/AIDS programme comprises Modules 1, 2 and 3. Module 1 focuses on orientation and background to HIV/AIDS Care and Counselling, Module 2 on HIV/AIDS counselling skills and Module 3 on train the trainer in HIV/AIDS education and counselling. This study focused only on Modules 1 and 2. Kirkpatrick's model of evaluating education and training programmes was used as a framework to evaluate the programme. Participants for the study consisted of 116 students who attended the UNISA HIV/AIDS Module 2 workshops between December 2005 and December 2006. The study was conducted in two phases, the first phase during the workshops, where participants were asked to indicate both quantitatively and qualitatively how they experienced Module 1 and Module 2 as well as what they learnt in the two modules. The participants' involvement in HIV/AIDS work prior and post Module 2 training as well as the aspects of the programme that are being applied within their work in the community was assessed during the second phase of the study, which took place during 2007. The results of the study indicate that the programme has successfully equipped participants with the necessary HIV/AIDS information and skills. The programme has further empowered participants to engage in HIV/AIDS education and counselling in their communities. Participants' attitudes towards the disease and towards those infected and affected by HIV/AIDS were challenged, resulting in less stigmatization and discrimination. The programme further challenged participants to start adopting health protective behaviours. The present study concludes that for HIV/AIDS programmes to be effective, they need to include, amongst other things, a well-researched basic HIV/AIDS factual information section, a component on attitudes and one on skills (particularly linked to behaviour change). These should be presented in an interactive way, engaging the participants in active learning. / Psychology / D. Litt. et Phil. (Psychology)

This study identified factors influencing the practice of HIV prevention behaviours amongst Tanzania youths. Structured interviews with in-school youths (n=222) and out-of school youths (n=150); and focus groups discussions with 25 youths were conducted to collect data. Although the level of HIV/AIDS awareness was 97.6% and 58.5% of the youths had positive attitudes towards HIV prevention, only 50.8% practised at least one mode of HIV prevention. Factors which promoted HIV prevention practices included positive attitudes towards specific preventive behaviours and the individual’s self-efficacy to enact such behaviours. The barriers against the practice of HIV prevention behaviours included the lack of comprehensive knowledge about HIV/AIDS and HIV prevention, socio-economic issues such as unemployment, influx of mobile populations, loss of cultural values, negative social norms, peer pressure, alcohol abuse and the lack of adequate HIV preventive services. / Health Studies / M.A. (Public Health)

En dépit de nombreuses interventions en santé reproductive en Afrique subsaharienne, la trilogie « IST/VIH/SIDA - grossesses précoces - avortements » persiste à des niveaux très élevés par rapport aux autres parties du monde. Cela indique que les nombreuses interventions en santé reproductive auprès des adolescents et des jeunes ont enregistré peu de succès en ce qui concerne le changement des comportements sexuels. Ces interventions se focalisent souvent sur l’individu, et négligent les environnements sociaux et culturels dans lesquels se forge le vécu de la sexualité chez les jeunes. Un de ces agents de socialisation est la famille, où les individus naissent, grandissent, et sont socialisés selon les valeurs et normes en vigueur. Fort de ce constat, l’objectif principal de la présente thèse est de resituer l’environnement familial au cœur des débats en santé reproductive chez les adolescents et les jeunes en Afrique subsaharienne. Trois questions spécifiques sont examinées dans cette thèse. Premièrement, elle aborde les associations entre les structures familiales et l’entrée en sexualité. Deuxièmement, elle analyse leurs influences sur les connaissances des modes de transmission et des moyens de prévention du VIH/SIDA. Troisièmement, elle cherche à déterminer les forces potentielles dans les familles dites « à risque » (ayant au plus un parent biologique) à partir de la théorie de résilience selon laquelle des facteurs familiaux et contextuels peuvent atténuer les comportements sexuels à risque chez les adolescents et jeunes. Cette thèse démontre substantiellement que vivre avec ses deux parents biologiques, la nature des relations entre parents/tuteurs et le jeune et un niveau élevé du contrôle parental sont significativement associés à de faibles risques des rapports sexuels prémaritaux. Par contre, les unions polygamiques, un statut socioéconomique élevé du ménage, et le fait d’être orphelin augmentent significativement le risque de rapports sexuels prémaritaux. L’étude démontre aussi que l’environnement familial et la communication sur la sexualité, aussi bien avec les parents/tuteurs qu’avec les pairs, jouent un rôle fondamental dans l’acquisition des connaissances correctes des modes de transmission et de prévention du VIH/SIDA. Néanmoins, le rôle des parents/tuteurs sur l’acquisition des connaissances sur le VIH/SIDA s’avère indirect puisqu’elle repose sur une hypothèse implicite. Seule une mesure directe des connaissances des parents sur les modes de transmission et les moyens de prévention peut mieux rendre compte de cette association. Les résultats obtenus à partir de la théorie de résilience indiquent, dans chaque type de familles, que la qualité des relations entre les parents/tuteurs et le jeune est significativement associée à une faible probabilité de comportement sexuel à risque, défini comme étant la cooccurrence de plusieurs partenaires sexuels au cours de 12 derniers mois et de non-utilisation du condom. Par contre, le contrôle parental est associé à une faible probabilité de comportement sexuel à risque seulement dans les familles à deux parents biologiques. Ce résultat suggère que l’influence du contrôle parental baisse une fois que les jeunes ont eu une expérience sexuelle. Les interventions en santé reproductive devraient promouvoir chez les parents/tuteurs les facteurs familiaux susceptibles de réduire les comportements sexuels à risque. / In spite of numerous reproductive health interventions in sub-Saharan Africa, the trilogy “STDs/HIV/AIDS - Unwanted pregnancies - Abortion” remains at the highest rates compared with other regions of the world. In fact, youth-oriented reproductive health programmes did not work adequately in sub-Saharan Africa, as regards changes in risky sexual behaviors. These interventions have often focused on individuals, and have neglected socio-cultural environments in which sexual behaviors are shaped. One of the most influential contexts is the family in which young people are born, grow up, learn and internalize norms and values about socially acceptable behaviors and sexual conduct. In order to fill this gap, this research aims to address the centrality of family structure in reproductive health debate in sub-Saharan Africa where little is known about its potential influences on sexual behaviors. Three issues are of interest in this thesis. Firstly, the study examines the interplay of family structure and premarital sexual intercourse. Secondly, it addresses the role of family structures in shaping accurate and inaccurate HIV/AIDS knowledge of transmission routes and preventive strategies. Thirdly, using the resilience theory, the study aims to determine the strengths within families “at-risk” that can prevent young people from engaging in risky sexual behaviors. The research substantiates that living in two-parent families, higher levels of parent/guardian monitoring, and good parent/guardian-youth relationships are associated with lower rates of premarital sexual intercourse. By contrast, polygamous families, parent/guardian-youth communication about sexuality, higher household socioeconomic status, change in family structure, and orphanhood were significantly associated with higher rates of premarital sexual intercourse. The study also finds that family structure as well as family/peer communication about sexuality is key explanatory variable on which HIV education and prevention efforts should be directed at. A more direct effect of family structure must be addressed in future research, using direct measures of parent/guardian’s HIV knowledge. Finally, using the resilience theory, this thesis finds that good parent/guardian-youth relationships are associated with lower rates of risky sexual behaviors, captured by the co-occurrence of multi-partnership and condom non-use in the last 12 months preceding the surveys, irrespective of the type of family. Parental monitoring showed a protective effect only in two-parent families. This finding suggests that when young people are sexually experienced, parental monitoring becomes less efficient than when they are not. HIV interventions must put emphasis on these factors that help to reduce risky sexual behaviors among young people even among those living in the so-called “at-risk” families.