The aim of the study was to investigate the management of HIV /AIDS programmes at the workplace in four selected organisations in Chris Hani District, Eastern Cape Province of South Africa. Four organisations were studied, two public organisations and two private organisations. With the use of triangulation method, two hundred employees were administered a semi- structured questionnaire while for (four) managers, semi structured in-depth interviews were conducted. The major findings of this study outline that all the four organisations studied have HIV/AIDS programmes and policies for their employees. However, there were no budget allocations for these programmes to be fully implemented for effectiveness. From the data, it can be concluded that HIV/AIDS has a negative impact on organisations‟ production like high training costs, high labour turnover and high absenteeism from work. This has been as a result of managers who did not put their total commitment towards HIV/AIDS management at their workplaces in the same way they have done to other core areas of businesses of their organisations. The study therefore recommends the management of these organisations to demonstrate a clear commitment to the HIV/AIDS management strategies by fully implementing the HIV/AIDS management programmes in their workplaces. It is very crucial for employees to see this commitment in a concrete form through non-discrimination and support for the people living with HIV/AIDS. Clear unambiguous commitment will go far in developing mutual trust between employers and employees and facilitate an atmosphere where people are willing to undergo VCT and to possibly disclose their status. Furthermore, managers are recommended to hire quality service providers to carry out intensive de-stigmatisation processes. This will create a supportive environment and adequately address the fears of employees about HIV/AIDS issues at the workplace. All these recommendations will go a long way in assisting organisations achieve their strategic business objectives and reduce the negative impact of HIV/AIDS at their workplaces.

Department of Public Health / MPH

MSc (Microbiology) / Department of Microbiology

Department of Advanced Nursing Science / PhD (Health Sciences)

MSc (Microbiology) / Department of Microbiology

Mahole, E / MPM / Oliver Tambo Institute of Governance and Policy Studies

MPH / Department of Public Health

MPH / Department of Public Health / Background: South Africa presently has a very high HIV burden. It has adopted the UNAIDS “90-90-90 targets” to curb its HIV burden. This target aims to attain sustained viral suppression in 90% of all persons receiving antiretroviral therapy. This is supported by several studies. Studies to observe if patients are achieving and sustaining viral suppression in Limpopo, South Africa, are few. Objective: To investigate the viral and immunologic responses of patients in Vhembe District to highly active antiretroviral therapy (HAART) between the 1st of January 2004 and 31st of July 2016. Methodology: This was a retrospective medical record review conducted in Vhembe District in rural Limpopo. It included the medical records of 1247 individuals from Thohoyandou Community Health Centre. Analysis was done using SPSS 24.0. To model the factors associated with virologic and immunologic responses, each independent variable was tested for association with the dependent variable (viral suppression and CD4 count increase of ≥ 50 cells/μL from baseline to 6 months). The independent variables included age, year of initiation, gender, marital status, baseline BMI, haemoglobin, clinical stage and estimated creatinine clearance. The Pearson Chi square (X2) was used for all categorical independent variables and the t-test, for all continuous independent variables, to test for association. The estimate used was a 95% confidence interval, and a p-value of < 0.05 was considered significant. Results: The study showed that 52.6% of individuals were in clinical stage I at baseline. Viral suppression (viral load < 50 copies/ml) at 6 months was 64% (n = 648), 72% (n =193) at 60 months and 94% (n = 16) at 132 months. Fifty-nine percent had consistent viral suppression for a period of at least 6 months. Consistent viral suppression (viral load < 50 copies/ml on at least one consecutive occasion without any intervening viral load > 50 copies/ml) for at least 54 months was only 14%, while 2.3% had a delay in switching from a failing regimen. The mean CD4 count at baseline was 227 cells/μL, and 538 cells/μL at 60 months. The mean CD4 cell count increase from baseline to 6 months was 190 cells/μL. The immuno-virologic discordance was 27%. Patients with higher baseline CD4 count and females were significantly (p = 0.001 and 0.031 respectively) more likely to achieve viral suppression at 6 months. Those below 45 years and females were v significantly (p = 0.011 and 0.043 respectively) more likely to achieve adequate CD4 count increase at 6 months. Conclusions: The proportion of individuals with viral suppression in the District increased from 6 months onwards, and is fairly adequate. However, sustainability of viral suppression, once attained, is low. Adequate immunologic response, however, seems high. Males and age group above 45 years appear to have poorer responses to HAART.

MPH / Department of Public Health / Background: The provision of antiretroviral treatment for people living with HIV/AIDS has encountered many challenges associated with poor adherence in South African and other countries in Africa as a whole including globally. Taking ARVs Properly has shown to reduce viral load to a level where the virus becomes undetectable and these results in an increase of CD4 count cells. These decreases chances of oppotunistic infections but it requires a proper adherence and compliance to treatment which seems to be difficult to most patients on ART. Purpose: The study investigated factors contributing to clients defaulting antiretroviral treatment. Methodology: A qualitative explorative cross-sectional study design was conducted at Matoks in Capricon District, in the months of May, June and July 2017. A purposive sampling method was used to select 19 respondents whom where willing to voluntrily participate in the study from a population of People Living With HIV/AIDS (PLWHV). An indepth face to face interview was used to collect data, guided by a central question and probing. It was then analyzed by the use of eight steps of Tesch. Results: The findings revealed that women were more defaulters than men. Shortages of antiretroviral treatment and most clients were unable to collect ART on time due to lack of transport to the clinic and the long distance from their perspective homes to the clinic. Socio economic conditions and indegenious health beliefs were some of factors identified. Recommendations: extensive health education and promotion should be intensified to reach all community members of Matoks and PLWHA in terms of HIV/AIDS care and consistent taking of treatment that clients who live far away from the clinic will be able to collect the ARV treatment nearer to their place of residents. / NRF

MPH / Department of Public Health / Human Immune Deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) place a significant burden on the caregivers for people living with HIV/AIDS (PLWHA). Caring for PLWHA is usually carried out by community members who are recruited from the same community as the PLWHA. These community members are trained to provide services as volunteer caregivers. The caregivers face various challenges in the process of giving care to PLWHA, often inadequately assisted by relatives, friends, neighbours, private individuals, grassroots traditional and political leaders. This results in caregivers being overwhelmed by their responsibilities, making their coping process even more difficult. The aim of this study was to explore the challenges experienced by community home-based caregivers (CHBCGs) caring for people living with HIV/AIDS at Tsianda Village, in Makhado Municipality, South Africa. This study adopted a qualitative explorative design. The population for this study were all CHBCGs caring for PLWHA. Non probability purposive sampling was used to select the community home-based caregivers working at Tsianda Community Home-based care organisation. In-depth interviews, using a semi-structured interview guide, was conducted by the researcher and a voice recorder were used to record data from participants. Data saturation was reached at the 11th participant. This is when the participants were no longer giving new information. The data collected from the study were analysed thematically. The following themes emerged from data analysis: Challenges for community home-based caregivers, perceived support for community home-based caregivers, coping strategies for community home-based caregivers. Measures to ensure trustworthiness and the code of ethics to protect the rights of the participants was applied and observed. The findings of the study revealed that community home-based caregivers experience various challenges which have a negative impact on their personal life, as well as their physical and psychological wellbeing. Community home-based care also uses different strategies to cope with these challenges. It was concluded that the community home-based caregivers are experiencing serious shortages of personal protective equipment, which makes them work with the fear of being infected with the diseases. It is recommended that the DOH should take it into consideration to provide the CHBCG’s organization with enough personal protective equipment for their safety and working without fear of being infected with deadly viruses. / NRF