The purpose of the study is to investigate and identify the factors that affect utilisation of prevention mother to child transmission of HIV services and propose measures to promote utilisation of services by HIV positive pregnant women in Onitsha, Anambra State, Nigeria. Mother-to-child transmission of HIV accounts for over 90% of infections in children under 15 years. Infected pregnant women can pass on the infection to their babies during pregnancy, delivery or through breastfeeding. There are effective interventions now reduce of the infection to the baby. However some infected women still do not avail themselves of these services due to several reasons. A quantitative descriptive study, using the Health Belief Model as the conceptual framework was used to conduct the research. A structured interview schedule was used to interview 102 pregnant women at two health facilities in Onitsha, Anambra state, Nigeria. The findings from the study reveal that majority of the respondents knew about HIV transmission but not about ways the infection can be transmitted from mother-to-child. The respondents recognise that HIV/AIDS is a very serious threat in Nigeria and the study site and were of the opinion that all pregnant women should know their HIV status. The attitude of health care workers and fears about disclosure of HIV status to others was a setback. Revealing their status to the spouse was feared.

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)

In its efforts to reduce maternal mortality and prevent Mother-to-Child Transmission of HIV, the government of Swaziland developed and implemented several programmes including a special antenatal care package for HIV-positive pregnant women in line with the WHO (2009) guidelines. Since the implementation of this latest special ANC package for HIV-positive women, little is known about how these services are experienced by the intended recipients. The purpose of this study was to explore and describe the actual experiences of HIV-positive women with the antenatal care services provided at a regional referral hospital in Swaziland, with the view of providing more insight into the quality of ANC services from the users' perspectives. A qualitative descriptive, exploratory design was used to address the above purpose. The researcher used purposive sampling to select the participants who met the inclusion criteria for the study. Semi-structured individual interviews were used and saturation was reached after 18 individual face-to-face interviews. Thematic content analysis was used to analyse the collected data. Forteen themes related to the participants experiences with the ANC services and seven related to measures for improvement emerged from data. In general HIV positive pregnant women expressed positive views towards ANC services they received at the target institution. The results give an indication on the quality of the focussed ANC package provided at the hospital and specific recommendations for improvement are outlined. / Health Studies / M. A. (Nursing Science)

This study aimed at exploring the influence of the home environment of women that were on the prevention of mother-to-child transmission (PMTCT) programme for HIV/AIDS. A qualitative descriptive study was conducted to explore the home environment for the psycho-social support that was available for women on the PMTCT programme and the influence this had on compliance to the programme. Data collection was done using a semi-structured interview guide, with a sample size of 14 participants (n=14). The data was then coded and grouped into categories and major themes. The findings revealed that the common barriers that prevented full disclosure of an HIV positive status included stigma and discrimination, fear of social isolation and financial dependence. A major constraint that affected the women’s full utilisation of the PMTCT preventative strategies and their adherence to treatment was the poor acceptance of people living with HIV in the family and community / Health Studies / M.A. (Health Studies)

The purpose of the study is to investigate and identify the factors that affect utilisation of prevention mother to child transmission of HIV services and propose measures to promote utilisation of services by HIV positive pregnant women in Onitsha, Anambra State, Nigeria. Mother-to-child transmission of HIV accounts for over 90% of infections in children under 15 years. Infected pregnant women can pass on the infection to their babies during pregnancy, delivery or through breastfeeding. There are effective interventions now reduce of the infection to the baby. However some infected women still do not avail themselves of these services due to several reasons. A quantitative descriptive study, using the Health Belief Model as the conceptual framework was used to conduct the research. A structured interview schedule was used to interview 102 pregnant women at two health facilities in Onitsha, Anambra state, Nigeria. The findings from the study reveal that majority of the respondents knew about HIV transmission but not about ways the infection can be transmitted from mother-to-child. The respondents recognise that HIV/AIDS is a very serious threat in Nigeria and the study site and were of the opinion that all pregnant women should know their HIV status. The attitude of health care workers and fears about disclosure of HIV status to others was a setback. Revealing their status to the spouse was feared.

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.

This thesis sought to develop an agent-based model that replicates the formation of social and sexual partnerships in real-world settings with an eventual aim of revealing the main drivers of the HIV pandemic in a closed mixed society. Agent-based modelling is a computational modelling approach that allows for the simulation of the actions and interactions of autonomous agents, with the eventual objective of disovering global effects on the system. This modelling technique is less dependent on generalisations and does not average out the behaviour of individuals. Sexual partnerships formed in the model goes through the process of dating, courting and has a chance of developing into marriage as well as the possibility of breaking up or undergo divorce. Sexual partnership formation is based on a likeability index calculated using aspiration, attractiveness and age. Over and above the the sexual relationships we include commercial sex work. Commercial sex work depends mainly on the availability of female sex workers and their clients. We superimpose the spread of HIV on the social and sexual network model. Results from the model reveal that saturation of HIV prevalence is driven by the social and sexual network structure, behaviour change as well as biologic factors. Excluding commercial sex work in the model resulted in a decrease in HIV prevalence and incidence. Dense social networks resulted in a dense sexual network which consequently increased HIV incidence. A change in the infection probability per coital act contributed significantly to a change in incidence and prevalence levels. Model results also show that enrolling all HIV positive agents on antiretroviral therapy (ART) as from 2016 simulation year will help in curbing HIV transmission if zero dropout rate from ART is assumed. Therefore, on concomitant action to avoid dropouts from ART is necessary if full benefits of introducing ART to all HIV positive individuals are to be realised. / Operations Management / D.Phil. (Operations Research)

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)

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)

The study aimed at assessing the factors influencing the low involvement of men in prevention of mother-to-child transmission (PMTCT) of HIV programmes in the Mambwe district, Zambia. The factors studied were grouped as knowledge and awareness, socio-cultural, programmatic and demographic characteristics. A quantitative, exploratory study was used and 127 men were interviewed. The major findings were: Knowledge of PMTCT was the strongest factor which was positively associated with the level of men's involvement in PMTCT. Socio-cultural and programmatic factors were found to negatively influence men's involvement (although weakly); and among the demographic characteristics, age and level of education were positively associated with an increase in the level of involvement, while the duration of the relationship with the female partner was negatively associated with the level of men involvement. / Health Studies / M.A. (Public Health)