Thesis (Ph. D.)--University of Washington, 2007. / Vita. Includes bibliographical references (leaves 93-109).

Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2009. / Includes bibliographical references. Also available online.

The purpose of this research study was to explore successes and challenges of Vhutshilo 2 HIV Prevention Programme in reducing HIV Infections amongst Adolescent Girls and Young Women [AGYW] in Alexandra. Qualitative, narrative research design was conducted to explore the experiences of the adolescent girls and young women in the Vhutshilo 2 programme. In order to obtain the data for this research the researcher used focus group interviews. Since the current study did not seek to generalize findings, a purposive sampling approach was seen as appropriate to use for this study. Two groups of respondents participated in the study. The first group of 7 participants were from Ratang Bana Organisation from Alexandra and the second group of 12 participants was from Friends for Life from the Mayibuye site. The data of this research project was analyzed using thematic analysis. Findings revealed that Vhutshilo was successful in achieving its desired results of helping adolescents to adopt healthy sexual behavior, developing positive values and behavior through exploring options, promoting assertiveness, understanding different influences on their lives and coming to their own views and decisions, rather than being told what to do. Recommendations made included taking the Vhutshilo 2 to other places like rural areas as the adolescent girls in the rural areas are at high risk of getting infected by HIV mostly due to cultural practices that expose them to such risks together with ignorance and limited access to health facilities. / Health Studies / M.P.H.

The medical model has been criticised for its failure to attend to individuals' experience of illness and the meaning they attribute to illness. HIV / AIDS has challenged its adequacy and brought the question of meaning in illness into sharp focus. This study aimed to understand what it means to live with HIV by exploring the fantasies, images and metaphors that make up the depth of such an experience. Phenomenology was deemed the appropriate approach, as it assigns epistemological significance to metaphor and ontological primacy to the lifeworld. An interview guide was fashioned from existing phenomenological literature and in-depth interviews were conducted with eight HIV -infected individuals. Five protocols were selected to constitute the study. In addition, an audio tape recording of one individual's metaphorical dialogue with HIV was obtained and transcribed. The three protocols with the richest content of imagery and metaphor were subjected to phenomenological explication. The remaining two protocols were used to support and clarify emergent meaning. A phenomenological explication of the data revealed a number of salient metaphors and themes. Upon being diagnosed with HIV, individuals were confronted with a socially and institutionally prescribed understanding of the disease; HIV as synonymous with AIDS and immediate death, HIV as sexual deviance, and HIV as myth. These metaphors influenced their conceptualisation and handling of HIV. Individual embodied metaphors included: embodying a heart of stone to live with HIV and perceiving HIV as a punishment from God, a demon from the Devil, a death sentence and a torture. Affectively, the experience of HIV was constituted as fear of physical disfigurement and exposure, anxiety, vulnerability, anger, betrayal, injustice and isolation. In a process of resolution and transformation, individuals imbibed positive metaphors with which to continue living with HIV. In order to cope with HIV, individuals seemed to negotiate a metaphorical space in which to dwell with their virus. This entailed establishing some form of dialogue with HIV or a Higher Power. This study revealed that metaphorical thinking about HIV /AIDS has a powerful impact on individuals' embodiment of their world. Metaphor is also an effective means Clf conveying and eliciting meaning in the experience of illness. Based upon these findings, it was suggested that metaphor be a prime focus for future research endeavours.

Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2009. / At the request of the South African Department of Health's Western Cape Provincial Tuberculosis Control Directorate, the Cape Peninsula University of Technology, a Higher Education Institution, developed and implemented a Tuberculosis and Human Immunodeficiency Virus community outreach train the trainer project to train community members about Tuberculosis and Human Immunodeficiency Virus. This study aimed to provide a historical overview of the Cape Peninsula University of Technology Tuberculosis and Human Immunodeficiency Virus project and describe the experiences of the trainers involved. A descriptive case study design, using a qualitative approach was applied during this study. The historical overview of the project showed the need for a broad base of networking, securing funding and a project facilitator from the outset of such a project. This study found that trainers had experienced self-development in terms of knowledge, skills and self confidence and that the training had far reaching effects by spreading Tuberculosis and Human Immunodeficiency Virus information in diverse community settings, despite notable challenges experienced in the community settings. Community outreach training projects from a recognized training institution have a positive impact at community level. However, political commitment and development of the course content into a registered learnership are required for sustainability.

nÃo hà / Objetivou-se com esta pesquisa construir uma escala de avaliaÃÃo da capacidade para cuidar de crianÃas expostas ao HIV (EACCC-HIV); elaborar itens e dimensÃes e avaliar as propriedades psicomÃtricas em termos de validade e confiabilidade do instrumento. A validade de conteÃdo da EACCC-HIV foi verificada pela concordÃncia entre os juÃzes (opiniÃo de cinco especialistas) e a anÃlise semÃntica por um professor de portuguÃs e tÃcnica de brainstorming. Na validade do construto comparou-se os grupos contrastados. Para a confiabilidade da escala utilizaram-se o alfa de cronbach e o teste-reteste. A pesquisa foi do tipo metodolÃgica com abordagem quantitativa, realizada em duas unidades de referÃncia no atendimento de crianÃas expostas ao HIV em Fortaleza-CE. A amostra aplicada no piloto foi constituÃda de 26 cuidadores de crianÃas expostas ao HIV. Quanto ao desenvolvimento metodolÃgico, ocorreu de fevereiro a outubro de 2008, e neste foram utilizados como instrumentos a escala inicial com 55 itens, a escala para o piloto com 70 itens e os formulÃrios para avaliaÃÃo com os juÃzes. Conforme os resultados revelaram, nos 55 itens iniciais uma concordÃncia de 98,5% (p=0,470) entre os juÃzes. No entanto, 32 itens foram mantidos, um excluÃdo e 16 incluÃdos, ficando o total de 70 itens para aplicaÃÃo no piloto. ApÃs a anÃlise semÃntica, 14 itens foram reformulados. Com 70 itens, o instrumento piloto foi aplicado na amostra de 26 cuidadores de crianÃas expostas ao HIV. A maioria dos cuidadores tinha entre 20 e 29 anos; convivia com o parceiro, a metade tinha o ensino fundamental completo e incompleto, grande parte estava desempregada e recebia menos de um salÃrio mÃnimo. Nos grupos contrastados, identificou-se nÃo ter havido associaÃÃo estatisticamente significante entre a variÃvel renda e 49 itens da escala. Existiu, porÃm, associaÃÃo significante ou valor limÃtrofe em sete itens (p<0,05). Neste caso sugere-se a variÃvel renda na aplicaÃÃo desta escala em outras pesquisas. A confiabilidade pelo alfa de cronbach apresentou valor total de 0,954 e p=0,0001. Portanto, houve consistÃncia interna dos itens, mas para o teste-reteste nÃo foi possÃvel realizar testes estatÃsticos. Na segunda fase com os juÃzes, o alfa de cronbach total para claridade, relaÃÃo dimensÃo-item e relevÃncia obteve-se o valor de 0,800 e p=0,0001, demonstrando concordÃncia entre eles. Contudo, na anÃlise para a claridade do item nÃo se observou equivalÃncia (&#945;=0,110 e p=0,262) e alguns itens do instrumento foram reformulados ou excluÃdos. Elaborou-se no final a EACCC-HIV com 52 itens e cinco dimensÃes. ApÃs a realizaÃÃo do estudo, obteve-se um instrumento confiÃvel capaz de avaliar a capacidade para cuidar de crianÃas expostas ao HIV. Este poderà ser usado amplamente na clÃnica e na pesquisa, e assim, contribuirà para a realizaÃÃo de estudos futuros com esta temÃtica. Sugere-se, ainda, a aplicaÃÃo da EACCC-HIV em amostras maiores e com testes de associaÃÃo com as variÃveis maternas e infantis, a fim de verificar a confiabilidade e a validade do instrumento com novos pesquisadores e chegar a uma escala estÃvel e replicÃvel / It was objectified with this research to construct a scale of evaluation of the capacity to take care of children displayed to HIV (EACCC-HIV); to elaborate item and dimensions and to evaluate the psychometric properties in validity terms and trustworthiness of the instrument. The validity of content of the EACCC-HIV was verified by the agreement enters the judges (opinion of five specialists) and the semantics analysis by Portuguese teacher and technique of Brainstorming. In the validity of construct were compared the contrasted groups. For the trustworthiness of the scale the Alpha of Cronbach and the test-retest had been used. The research was of the methodological type with quantitative boarding, carried through in two units of reference in the attendance of children displayed to the HIV in Fortaleza-CE. The sample applied in the pilot was constituted of 26 caregivers of children displayed to the HIV. How much to the methodological development, occurred of February to October of 2008, and in this had been used as instruments the initial scale with 55 item, the scale for the pilot with 70 item and the forms for evaluation with the judges. As the results had disclosed, in the 55 initial item an agreement of 98,5% (p=0,470) between the judges. However, 32 item had been kept, one excluded and 16 enclosed ones, being the total of 70 item for application in the pilot. After the semantics analysis, 14 item had been reformulated. With 70 item, the pilot instrument was applied in the sample of 26 caregivers of children displayed to the HIV. The majority of the caregivers had between 20 and 29 years; it coexisted the partner, the half had complete basic education and incomplete, great part was dismissed and received less from one minimum wage. In the contrasted groups, it was identified that not to have had statistical significant association between the changeable income and 49 item of the scale. It existed, however, significant association or bordering value in seven item (p<0,05). In this in case that it is suggested changeable income in the application of this scale in other research. The trustworthiness for the Alpha of Cronbach presented total value of 0,954 and p=0,0001. Therefore, it had internal consistency of the item, but for the test-retest it was not possible to carry through statistical tests. In the second phase with the judges, the total Alpha of Cronbach for clarity, relation dimension-item and relevance got the value of 0,800 and p=0.0001, demonstrating agreement between them. However, in the analysis for the clarity of the item equivalence was not observed (&#945;=0,110 and p=0,262) and some item of the instrument had been reformulated or excluded. It was elaborated in the end the EACCC-HIV with 52 item and five dimensions. After the accomplishment of the study, got a trustworthy instrument capable to evaluate the capacity to take care of children displayed to the HIV. This could widely be used in the clinic and in the research, and, thus, it will contribute for the accomplishment of future studies with this thematic one. It is suggested, still, the application of the EACCC-HIV in bigger samples and with tests of association with the infantile and maternal variable and, in order to verify the trustworthiness and the validity of the instrument with new researchers and to arrive at a steady and reapplicable scale

M.Tech. / The most susceptible and vulnerable segment of society to HIV/AIDS infection is the population sector aged between twenty and forty years old. This threatens to impact negatively on South Africa’s economic, social and human development (Whiteside and Sunter, 2001). The aim of this descriptive pilot study is to elicit a homoeopathic symptom picture of HIV positive Black females living in Gauteng, and also to compare this symptom picture to existing HIV proving pictures. Ten HIV positive Black females living in Gauteng were interviewed from a homoeopathic perspective. The participants were aged between twenty-two and forty years, and were in the asymptomatic carrier phase or the AIDS related complex (ARC) phase of HIV infection. None of the participants were receiving antiretroviral treatment. The researcher utilized a set questionnaire to conduct the interviews with. Each interview was compared to one another to determine the common themes and trends emerging from the case histories. These common features were utilized to produce a unique homoeopathic symptom picture of HIV infection in Black females. This symptom picture was compared to the existing HIV proving pictures of Stallick’s and Norland’s AIDS nosodes and Chappell’s PC1. The symptom picture was repertorised using the Cara Pro computerized repertory programme to determine possible constitutional and genus epidemicus treatment options for HIV infection as well as to evaluate the miasmatic presentation of HIV. This study indicates that the HIV proving pictures of the AIDS nosodes and PC1 closely match the unique homoeopathic symptom picture derived from this study. Possible genus epidemicus treatment options include Iodium and PC1. A wide variety of constitutional prescription options materialized from this research. This study also supports the idea that HIV/AIDS is a miasm in its own right, and is represented by aspects of the psoric, sycotic, syphilitic, tuburculinic and cancer miasms. This work is dedicated to the memory of Bongi, a fun-loving, sincere and courageous woman, and to all the HIV/AIDS sufferers in South Africa. / Dr. J. Roohani Dr. K.S Peck Dr. T.A Blake

M.Tech. / The worldwide dissemination of Human Immunodeficiency Virus (HIV) over the past four decades has entered our consciousness as one of the most catastrophic examples of the emergence, transmission and propagation of a virus (Department of Health, 2000; Stebbing et al., 2004). Globally, an estimated 40.3 million people are living with the virus. In 2005 alone, the World Health Organisation estimated that there were close to five million new HIV infections worldwide (UNAIDS/WHO, 2005). Southern Africa is experiencing an HIV/AIDS epidemic of shattering dimensions and, unfortunately, shows little evidence of possible future declines in HIV prevalence. It remains by far the worst-affected region, with 25.8 million people infected at the end of 2005. Of these infected, only one in ten Africans were receiving anti-retroviral treatment (ART) in mid-2005 (Dorrington et al., 2001; UNAIDS/WHO, 2005). Since South Africa carries the biggest global burden of HIV, it is difficult to provide and sustain treatment for all individuals infected with HIV (Department of Health, 2004b). Previous research on the efficacy of homoeopathic treatment in HIV has been done by Brewitt et al (1999) and Da Silva et al (2005) with beneficial results. The aim of this study was to determine the effect of homoeopathic growth factors (HoGF’s) on CD4 cell count, measurements such as weight and body mass index (BMI), symptoms associated with HIV/AIDS, and quality of life of participants living with HIV. The research was conducted on a sample of twenty five participants (n=25) drawn from a population of persons from eighteen to sixty years of age. Twenty two participants (n=22) completed the research. Participants were recruited from the Inkanyezi ARV Clinic, situated in an informal settlement in Orange Farm, south of Johannesburg, South Africa. The recruited participants were requested to read and sign the Participant Information and Consent form (Appendix A) providing them with the necessary information regarding the research. The duration of the clinical trial was thirteen weeks. Analysis of CD4 cell count, measurements of weight and body mass index (BMI) and symptoms associated with HIV/AIDS were conducted at day 1, week 5, week 9 and week 13. A quality of life questionnaire was conducted and analysed at day 1 and week 13. The HoGF medication was administered to each participant, who received sufficient medication until the next follow up consultation. This allowed the researcher to monitor patient compliance. One tablet was given three times a day, for a thirteen-week period. The participants were instructed to suck or chew the pleasant tasting, white tablet. The statistical models such as the repeated measures ANOVA analysis test, the non-parametric Wilcoxon test and the McNemar test were used to statistically analyse the data. The resultant analyses of the data have provided the following conclusions. HoGF treatment did not improve overall immune function of the participants, as there was a decrease in the average CD4 cell count of the HIV infected adults over the 13 week period. HoGF was effective in increasing immune functionality of the major symptomatic group but did not show improved immune functionality in the asymptomatic or minor symptomatic groups. There was, however, an overall decrease in the occurrence of the common symptoms of HIV seen in the entire sample group and HoGF intervention stabilised weight and BMI over the trial period. HoGF treatment also demonstrated an improvement in the quality of life of the participants. There were no reported signs of adverse side effects while on HoGF treatment. The results of this study are expected to initiate further research in the area of homoeopathy and HIV/AIDS. It is recommended that future studies include a control group with placebo for inter-group comparisons. This HoGF treatment can therefore be seen as a possible complementary treatment option for treating the common symptoms associated with HIV/AIDS in the absence of ART, and maintaining wellness in HIV patients. / Dr. R. Razlog Dr. M. Da Silva

M.Cur. / The Sub-Sahara region is riddled with HIV/AIDS to such an extent it has became a pandemic. The challenge to control or to minimize further infections has been left to the community nurses. The community nurses' primary aim is to promote and prevent the spread of infection, especially HIV I AIDS, amongst vulnerable groups (Clemen-Stone, 2002-134 ). The under-utilisation of the voluntary HIV -testing facility by hostel dwellers is a cause of concern among nurses in this Southern Metropolitan Health Care Centre. Clinic statistics for the year 2002 indicate that only sixty-six hostel dwellers used the voluntary HIV -testing. This number is low compared to the approximate population of twelve thousand hostel dwellers of the three hostels. The purpose of the research is to describe strategies to promote voluntary HIV -testing in the Southern Metropolitan Health Care Centre by community nurses. To realise the purpose of the research, the following research objectives are stated: To explore and describe factors that influence hostel dwellers not to utilise voluntary HIV -testing by community nurses in the Southern Metropolitan Health Care Centre. To explore and describe the community nurses' response to the factors that influence hostel dwellers not to utilise voluntary HIV -testing in the Southern Metropolitan Health Care Centre. To describe strategies for community nurses to promote the utilisation of the voluntary HIV -testing. The research design for this study is qualitative, descriptive and contextual in nature, (Mouton, 1996:102-103, 10, 133). The research in phase one was conducted in two steps. Step one focused on the exploration and description of the factors that influence hostel dwellers not to utilise the voluntary HIV -testing in health care centers. Step two dealt with the responses of community nurses as to how to address these factors in the health care centre.

D.Phil. / This study addresses communication, organising and ethics in this time of HIV/AIDS. Special attention is given to the HIV/AIDS communication strategies of selected organisations. As a prolegomenon, the study offers a critique of current approaches which are in denial of the individual. An existential normative position is adopted for this. But the task of the prolegomenon is not complete until an alternative approach with corrective possibilities is offered. Existential concerns are prioritised to assert that communication is, above all, a mode of existence. What is advocated is not abdication of the objective in favour of the subjective. Rather what is proposed is that the human being is biographically determined. Being is meeting. A critical appreciation is shown of the structuration tradition for theorising communication and organisation from among the rational structure and the organising process traditions of organisational communication. The structuration tradition regards organisation as a manifestation of communication, or as different expressions of the same phenomenon. The tradition posits neither determinism and its twin, objectivity, nor transcendence of reality and its twin, subjectivity. This is particularly important in terms of the existential considerations of this research. The communicative interaction of individuals through which an organisation emerges, produces and reproduces (un)ethical communication and organisation. Because strategic production and reproduction of organisation is expressive of the possibility for denial of the individual, organising raises the question of ethics. A universal embodiment of ethical practices that regards ethics as subjectively experienced is sought. Study of selected South African business organisations’ HIV/AIDS communication strategies enables further insight into this enquiry. A manifesto on communication, organising and ethics in the time of HIV/AIDS is offered as a step towards elaborating a corrective approach that begins with the individual. / Prof. G. De Wet Prof. G.J. Rossouw