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: This research provides some insight into some of the socio-cultural barriers hindering the implementation of MTCT programmes in Eastern Cape. In most parts of the world today, HIV infection is increasing faster among women more than men. The resulting infection of women is that many babies born to HIV mother become automatically infected. Mother-to-Child transmission (MTCT) of HIV is most significant source of HIV infection in children. Of the estimated 36 million people living with HIV/AIDS, 1.4 million are children (UNAIDS, 2002). The devastating effect of MTCT, prompted the South African government to initiate an urgent programme. In 2000, the SA government set up 18 pilot sites, including 2 sites in Eastern-Cape; the East London Complex, to curb children HIV infection. However, four years after the inception of the programme its success still depends largely on many factors, one of which is the socio-cultural barrier. This research therefore set out to explore some aspect of these socio-cultural barriers that is hindering the PMTCT programme in Eastern Cape. The research report consists of five chapters. Chapter 1. Deals with the introduction into the topic. Chapter 2. Summarises the literature on PMTCT associated with the research, as well as risk factors associated with PMTCT and possible interventions that were identified in various literature that attempts to reduce MTCT. Chapter 3. Focus on the research methodology. It explains the study design, the research aim and objectives, the study population and data analysis resulting from the research. Chapter 4. The results of the research findings is discussed in-dept in this chapter. An overarching theme of high level of societal stigma emerged as the key socio-cultural barrier. Chapter 5. This chapter discusses the identified socio-cultural barrier as well as possible recommendations as to how to address some of these barriers and also suggestion for further research. / AFRIKAANSE OPSOMMING: Hierdie navorsing bied ‘n mate van insig tot sommige van die sosiokulturele beperkinge wat die implementering van sogenaamde MTCT-programme in die Ooskaap kortwiek. In die meeste wêrelddele styg die voorkoms van die HIV-virus onder vroue tans vinniger as onder mans. Die resultaat daarvan is dat die babas van geïnfekteerde vroue outomaties ook geïnfekteer word. Moeder-tot-kind-oordrag MTKO (Mother-to-child transmission –MTCT) van MIV is die hoofsaaklike bron van infeksie in kinders. Van die geskatte 36 miljoen mense wat tans met MIV/VIGS lewe, is 1, 4 miljoen kinders (UNAIDS, 2002). Die vernietigende effek van MTKO het die Suidafrikaanse regering daartoe genoop om ‘n dringende program van stapel te stuur. Gedurende die jaar 2000, het die SA regering beslag gegee aan 18 loodsterreine, waarvan 2 in die Ooskaap-Oos-Londen-kompleks, om MIV-infeksies onder kinders te begin beperk. Vier jaar na die aanvang van die program, egter, is die sukses daarvan steeds afhanklik van ‘n veeltal faktore, een waarvan die sosio-kulturele grens is. Om hierdie rede was hierdie navorsing daarop ingestel om sommige aspekte van hierdie sosio-kulturele grense wat die VMTKO-programme (Voorkomig van MTKO) in die Ooskaap bemoeilik, van nader te ondersoek. Die navorsingsverslag bestaan uit vyf hoofstukke. Hoofstuk 1. Handel oor die inleiding tot die onderwerp. Hoofstuk 2. Som die bestaande literatuur oor VMTKO op sover dit op die navorsing van toepassing is; insluitende risikofaktore wat met VMTKO geassosieer word asook moontlike intervensies met die oog op pogings om MTKO te verlaag, soos geïdentifiseer in verskeie bronne in die literatuur. Hoofstuk 3. Fokus op die navorsings metodologie. Dit verduidelik die ontwerpbeginsels van die studie, die navorsingsdoelstellings en oogmerke, die teikengroep van die studie en die data-analise voortspruitend uit die navorsing. Hoofstuk 4. Die navorsingsresultate word hierin in diepte bespreek. ‘n Oorheersende tema van stigma binne gemeenskapsverband tree as sentrale sosiokulturele grens na vore. Hoofstuk 5. Die geïdentifiseerde sosiokulturele grense word bespreek en moontlike aanbevelings gemaak ten opsigte van hoe sulke grense aangespreek kan word, asook voorstelle vir verdere navorsing.

Text in English / Breastfeeding is particularly important in resource-poor regions of the world, where limited access to clean water increases the risk of diarrhoeal disease if replacement feeding is used. However, human immunodeficiency virus type 1 (HIV-1) is transmitted through human milk. Purpose of the study The purpose of this study was to describe the determinants contributing to exclusive breastfeeding in HIV-infected mothers of infants aged 0 to 6 months who attend an NGO Health Centre in Elandsdoorn Village. Methods A quantitative research approach using a non-experimental cross-sectional study was undertaken to conduct this study. A self-reported study questionnaire was used to collect data from study participants. Purposive sampling was used to sample 75 mothers from 18 to 45 years of age who were HIV-positive. SPSS version 23 was used to analyse the data. Results The study results indicated that there are determinants contributing to exclusive breastfeeding and a need to establish a more comprehensive approach to educating pregnant women on reproductive health issues, and exclusive breastfeeding in particular. Factors contributing to low levels of exclusive breastfeeding included breast problems, societal influence, maternal health concerns, insufficient support, fear of stigmatisation, and babies’ health concerns. This caused mothers to discontinue exclusive breastfeeding. Conclusions The intention of this study was to reveal the determinants of exclusive breastfeeding affecting mothers who are HIV-infected and breastfeeding their infants. / Health Studies / M.P.H.

Text in English / The purpose of the study was to explore and describe the perceptions of the HIV positive pregnant mothers regarding the PMTCT Option B+ programme in order to identify and describe gaps; and also help the Swaziland government address these gaps. The study was conducted in one of the public health units in the Manzini Region of Swaziland. The qualitative, exploratory and descriptive research design was used and data collection was done using individual interviews and field notes. Permission was also requested from the participants in order to record the interviews. Population of the study were all cases of HIV positive pregnant mothers enrolled on PMTCT Option B+ programme, and were aged between 18 and 40 years. Number of participants sampled was 20 and only 17 participants were interviewed. Themes of the study were: perceptions of being enrolled on the PMTCT Option B+ programme, understanding about PMTCT Option B+ programme and information needed with regard to PMTCT Option B+ programme, perceptions with the care received from the nurses and their assistance on PMTCT Option B+ programme, effectiveness of the PMTCT Option B+ programme and challenges of taking ARVs. The findings revealed that Option B+ programme was perceived as preventing HIV from mother-to-child. It boosts the mother’s immune system, prevents opportunistic infections and prolongs life. Knowledge and understanding of the programme was displayed by the participants even though challenges such as discrimination and no support by families and partners were mentioned. Improvement of the programme on how to prevent the spread of HIV to babies and strategies to assist participants on how to disclose were recommended. This was found to be having a huge effect on treatment adherence. / Health Studies / M.A. (Health Studies)

Young women working in SMEs are increasingly being affected by HIV and AIDS, and SMEs are expected to respond to HIV and AIDS through workplace policies and programmes. This requires commitment from SMEs to help young women who face various gendered vulnerabilities to HIV and AIDs. The study, whose purpose was to investigate young women workers’ experiences of the HIV and AIDS response of small and medium enterprises in a semi urban area in KwaZulu-Natal, used a qualitative approach and collected data from three SMEs in Pietermaritzburg during the period of the study. Findings of the study indicate that the majority of respondents from all three SMEs agree on experiencing limited or no HIV and AIDS policies and programmes in SMEs. With reference to incomplete or limited responses, two SMEs provide financial assistance for funerals. However, some aspects such as education and awareness, monitoring, management commitment, provision of medical aid, facilitation of peer education, appointment of an HIV officer and more were not evident. Thus recommendations were made on how SMEs should respond, and future research ideas were outlined. / Health Studies / M. A. (Social Behaviour Studies in HIV/AIDS)

This study investigated the factors influencing the utilisation of PMTCT of HIV services and proposed measures to promote service utilisation by HIV positive pregnant women in the FCT, Abuja, Nigeria. Effective interventions exist that can reduce the transmission of HIV infection to the baby. The study is a quantitative descriptive one, with 190 HIV positive pregnant women from 20 health Centres in three area councils in Abuja, who were interviewed using structured questionnaire to get their opinion. The findings revealed that the majority (90.4%) of the respondents were aware of PMTCT and how HIV can be transmitted from mother-to-child. The respondents (95.9%) were of the opinion that all pregnant women should be tested. Notably, PMTCT services will be hindered by the following: permission from spouse before being tested, couple counselling not done, group post test counselling, non-incorporation of family planning and low support group enrolment. Recommendations made include emphasis on couple counselling, confidentiality and friendly environment / Health Studies / M.A. (Public Health)

Postnatal care provides the opportunity for protecting the health of women and their babies by optimising human immunodeficiency virus (HIV) treatment and management. This study intended to explore the implementation of postnatal care to HIV positive women by explicating nurses’ views regarding their practices with the aim of improving the programme. The study was conducted at three clinics in Mangaung. An evaluative case study design was used to provide a detailed account on implementation of postnatal care to HIV positive clients. The purposive non-probability sampling was used. Semi-structured methods using focus group interviews were used to collect data. Data were reviewed through thematic analysis. The study found that nurses understood guidelines, used them to direct their practice and challenges were highlighted. It was concluded that the system limitations needed to be addressed, skills of health care providers improved and linkages with community based services strengthened to improve effectiveness of care. / Health Studies / M.PH.

The focus of this study was on the experiences of a small sample of local women who are HIVpositive and are living in poverty. The researcher was interested in exploring the psychological and social experiences of these women using Interpretive Phenomenological Analysis. This research aimed at giving these women a voice to express their first-hand, personal accounts of living with HIV in poverty. Data was analysed for meaningful units, which were interpreted inductively and hermeneutically, and categorised into super-ordinate themes. Six themes within the participants' experiences of living with HIV were determined, namely: (I) experiences of diagnosis, (2) disclosure experiences, (3) stigma, (4) ARV experiences, (5) experiences of social support and (6) poverty. This research found that after an HIV-positive diagnosis, most women experience a variety of emotional reactions. These reactions however seem to change overtime into positive acceptance of the HIV diagnosis. Most of the women in this study preferred to use partial disclosure than to fully disclose their HJV-positive status openly to families, friends and to their community. Reasons for not using full disclosure included fear of discrimination and stigma, which included a fear of being rejected or being blamed for their status and a fear of losing relationships. It was also evident from the findings that most of the women had experienced stigma directly and therefore partial disclosure was used as a coping mechanism to protect the self from further harm. It was also revealed that stigma not only has a negative impact on disclosure but also on social support and ARV experiences. Because ofHIV-related stigma, lack of social support was a struggle that almost all the women in this study had experienced. Lack of understandings about their medication also had a negative impact of the ARV experiences. Stigmas along with poverty are the major struggles that HIV -positive women have to deal with in their day to day living. The findings of this study reveal a need for further research in this experiential area as well as campaigns and education around issues such as stigma, medication, and emotional difficulties associated with HIV.

The purpose of this research study is to determine the factors influencing reproductive health choices of women living with HIV attending primary health care services. The need for this research study is evident in that most women attending health care services at primary health care clinics, and who are HIV positive report unintended pregnancy. The study sought to provide answers to factors influencing their reproductive choices. A quantitative, descriptive and cross-sectional research study was used in this study. The sample consisted of 83 females between the ages of 18 and 40. The findings of the research study provided the researcher with adequate evidence on the factors influencing reproductive health choices of women living with HIV attending primary health care services. The approach to reproductive health services was still acceptable but needs to be improved. Moreover, the identified factors therefore influenced one’s perceptions on reproductive health decisions among HIV-infected women. / Health Studies / M.A. (Public Health)

This study explores the subjective experiences of mothers living with HIV from Southeastern Ontario when accessing health and social services. Drawing on principles of feminist participatory action research, 5 MLWH were brought together in order to share their stories of accessing health and social services and to participate in the creation of a collage as part of the storytelling process. Intersectional feminist theory was chosen as a theoretical lens for this project to highlight the ways women’s multiple identities intersect and contribute to HIV-stigma. Emerging from the storytelling and arts based process were stories about the women’s interactions with the criminal justice system, Children’s Aid Societies, social welfare programs and women-specific supports. The key concerns that the women raised in connection to these interactions included having to re-tell their story, concerns about confidentiality and disclosure and experiencing a loss of control as a result of depending on a myriad of health and social services. In addition, the participants identified changes they would like to see within health/social services including more opportunities for peer support and an increase in services available to support the unique psychosocial challenges of MLWH. / Thesis / Master of Social Work (MSW)