Text in English and siSwati / The purpose of this study was to develop support guidelines to assist with disclosure of HIV status to HIV infected children by their parents and caregivers in Swaziland. The study explored parents’ and caregivers’ experiences with disclosure, and described the pattern of disclosure for HIV status to infected children. A qualitative descriptive research was conducted. Data were collected through semi-structured with thirteen (13) parents and caregivers who were purposively selected to participate in the study. Data analysis was done using qualitative content analysis. Three themes emerged which were understanding the general concept of disclosure, the pattern followed by parents and caregivers on disclosure of HIV status to infected children and the experiences of parents and caregivers on HIV status disclosure to their children. Based on the findings, support guidelines were formulated to assist parents and caregivers with disclosure of HIV status to their infected children. The outcome of this study is the description of a clear pattern of when, how and what to be disclosed to HIV infected children; as described by the parents and caregivers of the HIV positive children. / Health Studies / M.A. (Nursing Science)

Most children born HIV positive live longer and have more healthy lives since the advent of Anti-Retroviral Therapy (ART), together with the accessibility of Anti-Retroviral Drugs (ARV) to persons living with HIV. However, some of those children find themselves in need of care due to abandonment, orphanhood and / or neglect. In South Africa such children may enter the formal Child and Youth Care System and be placed in centres such as Epworth Child and Youth Care Centre. Due to the complex nature of the consequences of such disclosure or non-disclosure of HIV positive children’s status to them, social service workers are posed with a dilemma. In the absence of clear guidelines and policy around such disclosure, the children concerned may be unaware of their HIV positive status, despite being on a medication regime. The aim of the study was to explore the perceptions of social service workers regarding disclosure of HIV status to children born HIV positive living at Epworth Child and Youth Care Centre in Lambton, Ekurhuleni, South Africa. The study was located within a qualitative research paradigm, and utilised a purposive stratified sample of 15 social service workers form various occupational groupings recruited from Epworth Child and Youth Care Centre. A semi-structured interview schedule was employed as the research tool, with in-depth one-on-one interviews being adopted as a method of data collection. Thematic content analysis was used to analyse the data collected during the interviews. The main findings of the study were that HIV status disclosure is viewed as a complex but essential process as it reinforces children’s ability to adhere to medication regimes and to dispel anxiety and suspicion within themselves and around their status; that non-disclosure may lead to poor or coerced adherence and strains the relationship between the children and the social service workers. Disclosure of children’s HIV positive status can be viewed as complex as it presents both positive and the negative. Recommendations relate to community educative and awareness programmes, policy and practice changes regarding disclosure and none disclosure of children’s HIV positive status, as well as future research.

Philosophiae Doctor - PhD / The study assessed the linkages between HIV infection and intimate partner violence (IPV) during pregnancy and after HIV status disclosure in a context where HIV testing has become almost mandatory through the provider-initiated counselling and testing approach and non-disclosure of HIV status to sexual partners has been criminalised in many countries including Zimbabwe. The study also explored women’s experiences of and health workers’ perceptions of IPV during pregnancy.

This study will look at the possible interpretations and implementation methods that a state may adopt in accordance with internationally recognised standards and best practices. This will be in light of the special context of Africa and specifically as regards the disposition of women in the HIV and AIDS pandemic. The author critically analyse article 14(1)(e)of the African Women’s Protocol and establish possible interpretations that best advance the public health goal of arresting the spread of HIV in Africa / Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2008. / A Dissertation submitted to the Faculty of Law University of Pretoria, in partial fulfilment of the requirements for the degree Masters of Law (LLM in Human Rights and Democratisation in Africa). Prepared under the supervision of Dr. Patrice E. Vahard of the Faculty of Law, Addis Ababa University / http://www.chr.up.ac.za/ / Centre for Human Rights / LLM

Master dissertation consists of theoretical and empirical parts. Theoretical part observes medical and psychological issues of HIV infection, development scheme of cognitive function in teenage, development points of cognitive functions of children and teenagers with positive HIV status. Empirical part observes comparative results of HIV positive and negative status teenager’s cognitive functions research. The research showed that HIV-positive teenagers' cognitive functions are developed worse, than healthy. / Магистерская диссертация содержит теоретическую и эмпирическую часть. В теоретической части представлен обзор медико-психологических особенностей ВИЧ-инфекции, закономерностей развития когнитивных функций в подростковом возрасте, особенностей развития когнитивных функций у ВИЧ-инфицированных детей и подростков. В эмпирической части описываются сравнительные результаты исследования когнитивных функций у подростков с положительным и отрицательным ВИЧ-статусом. Исследование показало, что у ВИЧ-инфицированных подростков когнитивные функции развиты хуже, чем у здоровых.

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)

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: Non-disclosure of HIV positive status to a partner threatens to reverse gains made in prevention of mother-to-child transmission (PMTCT) in resource limited settings. Determining the association between non-disclosure and infant HIV acquisition is important to justify focussing on disclosure as a strategy in PMTCT programmes. Objective: To determine the association between non-disclosure of HIV positive status to a partner and mother-to-child transmission (MTCT). Methods: Using a matched case-control design, we compared 34 HIV positive infants to 146 HIV negative infants and evaluated whether the mothers had disclosed their HIV status to their partner. Results: Non-disclosure was more frequent among cases (overall, 16.7%; cases, 52.8%; controls 7.6%), p<0.001 and significantly associated with MTCT (aOR 8.9 (3.0-26.3); p<0.0001), with male partner involvement partially mediating the effect of non-disclosure on MTCT. Conclusions: There is a need for PMTCT programs to focus on strategies to improve male partner involvement and partner disclosure without compromising the woman’s safety. / Health Studies / M. (Public Health)

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)

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)