The earlier optimism generated by the efficacy of antiretroviral drugs in human immuno-deficiency virus (HIV) patients has been dissipated in the face of the enormous chal-lenge of maintaining a nearly perfect adherence indefinitely. This study set to determine the influence of HIV adherence self-efficacy and beliefs about medicines on antiretrovi-ral therapy adherence, with the aim of developing a framework for enhancing antiretrovi-ral therapy (ART) adherence through focused intervention on modifiable factors from study variables that are strongly associated with ART adherence. A descriptive correlational design was used to assess the predictive relationships of HIV adherence Self-Efficacy, Beliefs about Medicines and ART adherence among 232 HIV-infected patients in a large public health facility in Pretoria. Participants' medication be-liefs were assessed using the Beliefs about Medicines Questionnaire, HIV adherence self-efficacy was assessed with HIV adherence self-efficacy scale (HIV-ASES) and ART adherence was assessed using the AIDS Clinical Trial Group questionnaire. Pearson correlation analysis was used to assess bivariate associations among the variables, and multiple regression analysis was used to examine the relationships among the inde-pendent variables and ART adherence. Mean adherence for the 232 participants was 95% (SD=13.2). Correlation analysis re-vealed positive bivariate associations between perceived general harm and overuse of medications, and ART adherence (p<0.05); between specific necessity and concerns about ARVs, and perceived general harm and overuse of medications (p<0.05); be-tween HIV adherence self efficacy and ART non-adherence (p<0.05). Multiple regres-sion analysis showed significance for perceived general harm and overuse of medica-tions on ART adherence (F(1;231)=11,583;p<0,001) with perceived general harmful ef-fects and overuse of medications explaining 4.8% of the variance. There was signifi-cance for HIV adherence self-efficacy on ART non-adherence (F(1;41)=4.440; p<0.041), with HIV-ASES explaining 9,8% of the variance. Based on the results, a framework for enhancing ART adherence was developed. Activities in the framework consist of baseline screening for adherence facilitators and barriers using the beliefs about medicine questionnaire and HIV ASES, this is followed by focused interventions on identified barriers of ART adherence / Health Studies / D.Litt. et Phil. (Health Studies)

The purpose of this study was to determine factors affecting non-adherence to Anti-retroviral therapy among AIDS patients. A cross sectional quantitative survey, was used. Structured interviews were conducted with 300 ART patients. Data were analysed using SPSS version 13 and presented in charts, graphs and frequency tables. Motivators of good adherence were identified as disclosure of HIV positive status to more than one person, frequent adherence counselling, self-efficacy to adhere to ART, positive interactions between patients and healthcare providers; and using an adherence partner. Barriers to adherence were forgetfulness, transportation costs to and from the clinic, time away from work and side effects. There was a strong positive correlation between adherence, CD4 counts and viral load. Adherence was closely tied to immunologic and virologic improvements. Respondents with poor adherence were likely to have unsuppressed viral loads (OR 12.98, 95%, CI 4.9-34). / Health Studies / Masters of Public Health

The purpose of this study was to investigate the Isoniazid preventive therapy (IPT) initiation amongst eligible HIV positive patients at health facilities in the Polokwane subdistrict to identify key features in the knowledge and practice of health professionals as well as available resources at the health facilities. A quantitative non-experimental, descriptive, cross-sectional design was used to describe the practice of IPT initiation in health facilities. Data were collected using a structured questionnaire with medical doctors, operational managers and registered nurses from the district’s 34 health care facilities. The census sample was 124. Data were captured and analysed using Statistical Package for the Social Sciences (SPSS) Version 24. The results showed that the health care professionals knew the policy and procedures for the implementation of IPT but lacked knowledge on patient screening. The findings further suggest that record keeping and data capturing was not implemented sufficiently. Resources at the facilities were found to be sufficient. / Health Studies / M. P. H.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Men might benefit from opportunities specific to their needs in improving access to HIV care. This is a group vulnerable to higher morbidity and mortality than their female counterparts, due not only to poor or delayed health seeking behaviour and the culture of blame for the transmission of HIV, but probably due to neglect, inadequate or poor support by the current policies, by a gender biased research agenda, by the international research community and global health funders. Objectives: The objectives of this current study were: - to explore the reasons for poor health seeking behaviour amongst African men seeking HIV care in KZN; - to establish the health care practitioners’ views about the reasons for the perceived poor health seeking behaviour amongst African men accessing HIV services in KZN; - to inform guidelines in improving access to HIV services by African men Methodology In-depth interviews were employed as the method of obtaining lived experiences, perspectives and opinions of men living with HIV and that of their health care practitioners. Results It was found that men still feared the diagnosis of being HIV positive, even with the advent of highly active anti-retroviral therapy (HAART) and the advances in managing this disease. Several reasons for this fear emerged with the common theme being the doom of impending death, social stigma and fear of abandonment as well as social marginalization. Conclusions We cannot expect to attract men to predominantly female orientated settings within health faculties. Special attempts need to be made to reach out to men in places they are comfortable being in. Messages should be clear and concise about the effectiveness of low cost, available treatment for HIV; and that early diagnosis improves health outcomes. Cultural sensitive interventions are needed that are suitable, in generating a clearer understanding of health management options and motives. / AFRIKAANSE OPSOMMING: Mans kan voordeel trek uit geleenthede wat spesifiek op hul behoeftes in die verbetering van toegang tot MIV-sorg. Dit is 'n groep kwesbaar vir hoër morbiditeit en mortaliteit as hul vroulike eweknieë, nie net die gevolg swak of vertraagde gesondheid gedrag en die kultuur van die blaam vir die oordrag van MIV, maar waarskynlik as gevolg van verwaarlosing, onvoldoende of swak ondersteuning deur die huidige beleid , deur 'n geslag bevooroordeeld navorsing agenda, deur die internasionale navorsing gemeenskap en globale gesondheid-befondsers. Doelstellings: Die doelwitte van die huidige studie was: - die gesondheidsorg-praktisyns se siening oor die redes vir die waargenome swak gesondheid gedrag onder-Afrikaanse mans toegang tot MIV-dienste in KZN tot stand te bring; - die redes vir swak gesondheid gedrag onder-Afrikaanse mans wat MIV-sorg in KZN te verken en - riglyne te stel in die verbetering van toegang tot MIV-dienste deur swart mans Metodes In-diepte onderhoude is gebruik as die metode van die verkryging van geleefde ervarings, perspektiewe en menings van mense wat met MIV en dié van hul gesondheidsorg praktisyns. Bevindings Daar is bevind dat mans nog bang was vir die diagnose van MIV-positief is, selfs met die koms van hoogs aktiewe antiretrovirale terapie (HAART) en die vooruitgang in die bestuur van hierdie siekte. Verskeie redes vir hierdie vrees na vore gekom met die gemeenskaplike tema synde die straf van die naderende dood, sosiale stigma en vrees vir verlating, sowel as sosiale negatief. Gevolgtrekkings Ons kan nie verwag om mense te lok om oorwegend vroulike georiënteerde instellings in gesondheid fakulteite. Spesiale pogings moet aangewend word om uit te reik na die mans in plekke waar hulle gemaklik is. Boodskappe moet duidelik en bondig oor die doeltreffendheid van lae koste, beskikbare behandeling vir MIV, en dat die vroeë diagnose verbeter gesondheid uitkomste. Kulturele sensitiewe intervensies word benodig wat geskik is, in die skep van 'n beter begrip van gesondheid opsies en motiewe.

No description available.

The purpose of this study was to evaluate the antiretroviral therapy program in primary health care settings in Lesotho. Mixed methods research using a convergent parallel mixed methods design was used to collect both quantitative and qualitative data which were analysed during the same phase of the research process. Two groups of participants participated in the study, the registered nurse group was composed of registered nurses/midwives/nurse clinicians involved in ART service provision and the second group was composed of adults aged 18 years and older who were HIV/AIDS positive. Quantitative data had a compliance rate of 92% and it were analysed using SPSS (23). Qualitative data were analysed using constant comparison analysis and seven themes, fourteen categories and twenty two sub-categories emerged from the data analysis. Findings of the study revealed that the majority of PHC facilities were staffed by registered nurse midwives and nurse clinicians who were qualified, confident, knowledgeable and competent in the execution of duties. Generally there were a large number of patients that sought ART services which were offered on a weekly basis although there was variation in the actual number of days the services were provided. The time patients spent seeking ART services varied across the facilities and ARVs and other drugs were usually available. Challenges in the delivery of ART services included unsatisfactory staffing resulting in the provision of inadequate services and work overload, lack of knowledge of some patients, use of incentives by some partners and too many partners being involved in ART, inadequate documentary evidence and stigma pertaining to the HIV status of individuals. Furthermore, ARVs were reported to make patients feel hungry hence resulting in lack of satisfaction in ART services, ART services were inadequate due to dysfunctional equipment and some patients had been lost due to inability to screen for cancer and there was incomplete monitoring and evaluation of the ART program. However, participants in this study generally showed their acknowledgement of the ART services as they generally improved their health status despite the many challenges that were being faced. / Health Studies / D.Litt.et Phil. (Health Studies)

As the Human Immunodeficiency Virus (HIV) prevalence rises, uninfected Basotho face an increased risk of exposure. This necessitates strengthening of strategies that prevent exposure, and where exposure has occurred, measures that prevent infection. One such measure is Human Immunodeficiency Virus (HIV) Post-Exposure Prophylaxis (PEP). Awareness and knowledge of HIV PEP is therefore of paramount importance. The purpose of this study was to assess knowledge, attitudes and utilisation of HIV PEP among adults in Roma, Lesotho. A quantitative cross-sectional study was conducted among 96 adult outpatients at St Joseph’s Hospital. Data were collected by means of structured questionnaire and analysed using SPSS version 23.0. Results were presented using charts and tables. Awareness of HIV PEP among the respondents was found to be very low and for most respondents’ knowledge of HIV PEP was either non-existent or very poor. Utilisation was also found to be very low. Attitudes towards HIV PEP were, however, found to be favourable. More studies should be conducted throughout the country to further explore Basotho’s knowledge, attitude and use of HIV PEP. / Health Studies / M.A. (Nursing Science)

The objectives of the study were (1) to quantify adherence rate among the study participants in the ART unit and (2) to identify factors that contribute to non-adherence. This cross sectional study was carried out at Nekemete referral clinic. Data was collected using a self-developed structured questionnaire where a total of 338 participants grouped into adherent and non-adherent based on a score derived from an adherence assessment were interviewed. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 17.0. By using multivariate analysis of variables identified as correlates of adherence, non-adherence was common among those; with age between 18-30 yrs, with no education, who were not married, who had no pipe water supply, those with no electricity in the house, who perceived had no access to assistance from providers, who perceived the health care providers (HCPs) did not keep information confidentially, who had a language barrier with providers, and who were treated with a psychiatric illness. The study concludes that adherence is multi-factorial and varies significantly by individual and care setting. Psychosocial factors were found to impact adherence and should be analysed in more detail by further studies. Three psychosocial factors were independently associated with poor adherence: the study found that patients perceiving poor access; those perceiving problems in information confidentiality (and possibly experiencing stigmatisation); and having psychiatric morbidity (and possibly with less social support) are more likely to be non-adherent. Furthermore, individuals without electricity and those without piped water supply, implying low income, are at risk for non-adherence / Health Studies / M.A. (Public Health)

The earlier optimism generated by the efficacy of antiretroviral drugs in human immuno-deficiency virus (HIV) patients has been dissipated in the face of the enormous chal-lenge of maintaining a nearly perfect adherence indefinitely. This study set to determine the influence of HIV adherence self-efficacy and beliefs about medicines on antiretrovi-ral therapy adherence, with the aim of developing a framework for enhancing antiretrovi-ral therapy (ART) adherence through focused intervention on modifiable factors from study variables that are strongly associated with ART adherence. A descriptive correlational design was used to assess the predictive relationships of HIV adherence Self-Efficacy, Beliefs about Medicines and ART adherence among 232 HIV-infected patients in a large public health facility in Pretoria. Participants' medication be-liefs were assessed using the Beliefs about Medicines Questionnaire, HIV adherence self-efficacy was assessed with HIV adherence self-efficacy scale (HIV-ASES) and ART adherence was assessed using the AIDS Clinical Trial Group questionnaire. Pearson correlation analysis was used to assess bivariate associations among the variables, and multiple regression analysis was used to examine the relationships among the inde-pendent variables and ART adherence. Mean adherence for the 232 participants was 95% (SD=13.2). Correlation analysis re-vealed positive bivariate associations between perceived general harm and overuse of medications, and ART adherence (p<0.05); between specific necessity and concerns about ARVs, and perceived general harm and overuse of medications (p<0.05); be-tween HIV adherence self efficacy and ART non-adherence (p<0.05). Multiple regres-sion analysis showed significance for perceived general harm and overuse of medica-tions on ART adherence (F(1;231)=11,583;p<0,001) with perceived general harmful ef-fects and overuse of medications explaining 4.8% of the variance. There was signifi-cance for HIV adherence self-efficacy on ART non-adherence (F(1;41)=4.440; p<0.041), with HIV-ASES explaining 9,8% of the variance. Based on the results, a framework for enhancing ART adherence was developed. Activities in the framework consist of baseline screening for adherence facilitators and barriers using the beliefs about medicine questionnaire and HIV ASES, this is followed by focused interventions on identified barriers of ART adherence / Health Studies / D.Litt. et Phil. (Health Studies)

This non-experimental, retrospective, descriptive and correlational study investigated adherence to antiretroviral drugs among HIV positive patients at Mpilo Central Hospital in Bulawayo Zimbabwe. Data among 118 patients was extracted from clinic registers and patient facility held medical records to determine level of adherence to ART using pharmacy refills (a non-immunological adherence parameter) and compared to CD4 cell count ( an immunological adherence parameter). Adherence levels obtained in this study using pharmacy refills was low (62.7%) and a relatively high non-adherence level of 37.3%. The pharmacy refill adherence level obtained was comparable to CD4 cell count adherence level of 64.6% (as indicated by a 50% CD4 cell count gain). These findings would seem to indicate the need for more education on the importance of adherence and further the need for better adherence monitoring systems / Health Studies / M.A. (Public Health)