Thesis (DTech (Mechanical Engineering))--Cape Peninsula University of Technology, 2012 / In this thesis, we investigate certain key aspects of mathematical modelling to explain the epidemiology of HIV/AIDS at the workplace and to assess the potential benefits of proposed control strategies. Deterministic models to investigate the effects of the transmission dynamics of HIV/AIDS on labour force productivity are formulated. The population is divided into mutually exclusive but exhaustive compartments and a system of differential equations is derived to describe the spread of the epidemic. The qualitative features of their equilibria are analyzed and conditions under which they are stable are provided. Sensitivity analysis of the reproductive number is carried out to determine the relative importance of model parameters to initial disease transmission. Results suggest that optimal control theory in conjunction with standard numerical procedures and cost effective analysis can be used to determine the best intervention strategies to curtail the burden HIV/AIDS is imposing on the human population, in particular to the global economy through infection of the most productive individuals. We utilise Pontryagin’s Maximum Principle to derive and then analyze numerically the conditions for optimal control of the disease with effective use of condoms, enlightenment/educational programs, treatment regime and screening of infectives. We study the potential impact on productivity of combinations of these conventional control measures against HIV. Our numerical results suggest that increased access to antiretroviral therapy (ART) could decrease not only the HIV prevalence but also increase productivity of the infected especially when coupled with prevention, enlightenment and screening efforts.

What are the school experiences of HIV-positive secondary school learners on ARV treatment? Although the provision of life-saving antiretroviral (ARV) treatment is central in the medical and policy response to the HIV pandemic, relatively little research (in the SADC region and in Namibia particularly) attends to people’s experiences and the social effects of taking ARV treatment. This study probed the experiences of high school learners on ARV treatment in Khomas Region, Namibia. As researcher I used a qualitative case study design based mainly on interviews with a purposive, select sample of eight learners at the school where I am a teacher-counsellor. Methods used also included: observations; focus group interviews with eight teachers at the site school; a questionnaire survey with Life Skills teachers from 25 schools in the Khomas Region; and document analysis. Using a theory of health-related stigma and discrimination as well as perspectives on resilience and agency as conceptual and analytical lenses, this study found that only a handful of these learners were living openly with HIV and AIDS. Being both HIV-positive and on ARV medication was a double bind for learners facing pervasive stigma and discrimination in and out of school. Discourses associated with HIV and AIDS, sex, and sexuality shaped people’s response to them and they feared being ‘caught out’. Here the study explores the complex reciprocal relationship between cause and effect in stigma, showing some consequences for these learners: isolation (both voluntary and imposed), mental anguish, depression and suicidal leanings; also (at school) absenteeism, grade repetition and dropout. Distinguishing stigma from discrimination in this study enabled insight into actual practices that constrain learner participation and inclusion in and out of school. Trust between learners on ARVs and teachers proved to be low. Teacher respondents not only felt unequipped to deal with the psychosocial needs of learners on ARVs but also indicated that confronting these needs animated their personal vulnerability (around HIV-related experiences in their own families). However, hopeful patterns also emerged. Some mediatory factors out of school shaped these learners’ experiences and identities positively, with implications for in-school experiences and participation. Some learner journeys reflected shifts from deep despair towards the emergence of voice, positive self-concepts and resilient dispositions. Here, also, this study enters a neglected area of research, showing how the complex interplay of learners’ own agency with social support brought these positive outcomes. Most learners had experienced rejection from immediate family, receiving support rather from community members who became ‘family’. The study thus also raises pressing questions on the nature of support structures (both in and out of school) in contexts shaped by HIV and AIDS, where stigma and discrimination are pervasive and where stable family structures, parental oversight and ‘normal’ progression through school cannot be assumed. It recommends that schools gain better insight into how learners’ circumstances shape their experiences, and develop internal policies, procedures and networks to reduce stigma and discrimination against HIV-positive learners on ARV treatment, as well as. ensuring material, medical, emotional, and psychological support for them.

MSc (Microbiology) / Department of Microbiology

PhD (Advanced Nursing Sicence) / Department of Advanced Nursing Science

No description available.

Health Studies / M.A. (Health Studies)

Health Studies / (M.P.H. (Health Studies))

A quantitative, descriptive, explorative survey was conducted to explore and describe nurses’ perceptions of disclosure to children of their HIV positive status in Addis Ababa. 100 nurses working in six conveniently sampled health centres participated by completing a self-administered questionnaire. The findings revealed that the majority of participants were of the opinion that children have the right to know their HIV status, participate in their own treatment, and that disclosure contributes towards improved adherence. Forty-one of the participants said that it is nurses’ role to support caregivers in the disclosure process. But 56.3% felt they lacked the training to disclose to children that they are infected with HIV. Accordingly, it is recommended that relevant and applied training is required to equip nurses with the knowledge and skills to disclose to children their status. The importance of nurses’ proactive role in disclosure to children of their HIV status needs to be emphasised. / Health Studies / M.A. (Public Health)

The aim of this study was to explore, describe and interpret the experiences of Immunodeficiency Human Virus (HIV) infected mothers regarding exclusive breastfeeding in the first six months of the infant’s life. This was a qualitative study with phenomenology as a design as the study was about lived experiences. The sample consisted of HIV infected mothers aged 18 years and above who opted for exclusive breastfeeding for the first six months of their infant’s lives. Purposive sampling was used. Data was collected through one to one semi structured interviews of fifteen mothers of babies aged six to twelve months. The study revealed that mothers had both positive and negative experiences which were influenced by among others; the level of support the mothers received, disclosure of HIV status and health education received at the health facility. The findings of the study revealed a low level of understanding of the Infant and Young Child Feeding Policy by health professionals / Health Studies / M.A. (Health Studies)

Stigma and discrimination (SAD) attached to Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has been recognised as a major obstacle to HIV prevention, treatment, care and support throughout the world. SAD is more devastating when it occurs in health care settings where it is least expected. Health care providers (HCPs) are supposed to provide physical, social and psychological support to people living with HIV (PLWHA) but HIV and AIDS-related SAD has been extensively documented among the HCPs. Different studies have pointed out that there are three major actionable causes of HIV-related SAD in health care settings. These are lack of awareness among HCPs, fear of casual contacts and associating the SAD to immoral behaviour. The main objective of the current study is to determine the magnitude of HIV and AIDS-related SAD and its associated factors in hospitals and then to propose appropriate SAD reduction-intervention strategy in the health care settings. The study employed pre-test-post-test design with non-equivalent control group. Two paradigms were used in this study including quantitative and qualitative approaches. The sampling method for the quantitative part of the study was probability sampling in which the respondents were randomly selected using stratified sampling technique. The study was able to determine the magnitude of HIV and AIDS-related SAD among the HCPs. Moreover, the study has identified the factors that are attributed to the prevalence of SAD in the hospitals. The major factors identified for causing the SAD in the hospitals were sex, age, work experience, low level of knowledge, negative attitudes and percieved risk of HIV infection of some HCPs toward the PLWHA. The intervention made on the respondents in the treatment group was able to reduce the overall prevalence of the SAD among the HCPs. The study suggests that to reduce the SAD, HIV and AIDS-related trainings before and after graduation is critical to improve the knowledge, attitudes and practices of the HCPs. Besides, ensuring the availability of the protective supplies in hospitals is crucial in reducing the fear of HIV infection among the HCPs while providing care for HIV positive patients. Effective implementation of the hospital policies, strategies, guidelines and protocols along with good institutional support is also vital in creating safe and user-friendly hospitals for PLWHA. / Health Studies