Student Number:9402474A Master of Education (Educational Psychology) School of Human and Community Development Faculty Humanities / The aim of the study was to determine the beliefs and practices regarding HIV/Aids awareness and prevention among service providers working in the field of intellectual disability. In order to investigate this aim, a cross-sectional survey research design was employed which incorporated a purposive sampel that consisted of 28 participants representing 21 organizations catering for adults with intellectual disability in Gauteng. These participants were interviewed using a structured interview schedule and the data were analysed using both descriptive statistics and content analysis. The results indicated that the majority of participants perceived that their organization had a role to play in raising awareness and preventing the spread of HIV/Aids and considered adults with intellectual disability to be a risk for contracting HIV.

Background: Adherence to antiretroviral (ARV) medications in excess of 90-95% is necessary for optimal response to suppress HIV replication and to maintain and/or restore immune function. A number of interventions have been shown to improve ARV adherence, but no research has been conducted which evaluates proactive monitoring of pharmacy refill adherence and subsequent intervention when inadequate adherence is identified. Purpose: The purpose of this project was to compare treatment response, pharmacy refill adherence and self-reported medication adherence between two groups of patients: those participating in an AIDS Drug Assistance Program (ADAP) and those participating in a Medicaid-funded medication access program. The ADAP served as a structured adherence intervention (SAI) based on procedural and administrative processes required by the state-managed program Additionally, covariates that can impact adherence were studied including utilization of adherence services and interventions and factors related to HIV disease, antiretroviral agents and sociodemographic factors. Method: This retrospective comparative study examined secondary data to assess 424 patients who received clinical and pharmacy services at one treatment site in 2005. Analysis: Logistic regression was performed to test the effects of the SAI on treatment response (CD4 and HIV RNA response), self-reported adherence, and pharmacy refill adherence while controlling for the covariates. Results: Patients participating in the SAI demonstrated higher levels of both self-reported and pharmacy refill adherence compared to patients receiving usual care. Although patients participating in the SAI program demonstrated better virologic (HIV RNA) responses to HAART compared to patients receiving usual care, immunologic (CD4 lymphocyte) responses to HAART were not significantly different compared to subjects in the usual care program. Conclusion/Discussion: This study provides information on the effects of a structured programmatic intervention on medication adherence and response to treatment and will be used to inform policy decision making at the local and State level.

Traditionally, in Nigeria women play a subservient role in relation to men. While a man can practice polygamy by marrying many wives, women cannot marry more than one husband at a time. Although researchers have documented the effects of polygamy on the spread of HIV/AIDS, little is known about the experiences of polygamy by Nigerian women who stopped practicing polygamy by immigrating to the United States without their husbands. It is important to know the experiences of these women as they pertain specifically to the spread of HIV/AIDS so as to develop a preventive intervention for HIV/AIDS among Nigerian women in polygamy. The purpose of this phenomenological study was to explore the perspectives on HIV/AIDS held by 10 Nigerian women who practiced polygamy in Nigeria before immigrating to the United States. Recruitment was done through purposive sampling at a faith-based organization. Guided by the health belief model, interview transcripts from the 10 women were analyzed to reveal recurrent themes that expressed the women's lived experiences in polygamy with their perspectives on HIV/AIDS. Findings revealed that these women had a basic knowledge of the risk of contracting HIV/AIDS by engaging in polygamy but needed to comply with the terms of sexual encounters as dictated by their husbands; therefore, they were at risk for HIV/AIDS. The results of this study can be used to increase awareness among Nigerian women in polygamy and Nigerian health policy makers regarding the transmission of HIV/AIDS and the preventive measures available for HIV/AIDS. Understanding the experiences of women in polygamy may lead to greater understanding of the impact of polygamy on HIV/AIDS and may help to decrease the prevalence of this disease.

Thesis (M.Sc. (Agricultural Economics)) --University of Limpopo, 2005 / This study is based on a survey of 396 farming households from Mabele; Khubu and Nwahajeni communities. The results show that in general, HIV/AIDS status appears to have a significant negative impact on the number of household members working full time on the farm. An indication that households affected by HIV/AIDS are likely to suffer loss of farm labour due to sick household members who cannot work on the farm. Generally, information on HIV/AIDS appears to have a significant positive impact on the number of household members working full time on the farm. An indication that households that are well-informed about HIV/AIDS are likely to have higher number of households members working full time on the farm. The study shows that HIV/AIDS is negatively correlated with household farm income. An indication that the higher the number of household members infected with HIV/AIDS, household farm income is likely to decrease. This may be due to shortage of household farm labour. Farm labour shortage results in the reduction of farming operations and loss of total household farm income. The study shows that the number of household members working full time on the farm is negatively correlated with difficulty to pay for health care; difficulty to pay for agricultural inputs; and difficulty to save money. An indication that as the number of household members working full time on the farm is reduced, it is likely that households will find it difficult to pay for health care, agricultural inputs and saving money. / National Research Foundation (NRF)

Thesis (M Med.(Family Medicine))--University of Limpopo, 2010. / OBJECTIVE: In 2007 36% of the pregnant women tested positive for HIV at Embhuleni Hospital and its satellite clinics. However, only one quarter of those returned to the wellness clinic for their CD4 results so as to begin with Anti-Retrovirus Therapy (ART) if they qualified. The rest would not return to the wellness clinic, and would only present late with opportunistic infections or a subsequent pregnancy. The study aimed at exploring the reasons why women who had been tested for HIV by means of VCT failed to return for their CD4 results, to understand those reasons, to determine what information was given to them before they were tested, to assess the availability of personal support systems (family, friends, etc), and finally to assess the women’s understanding of HIV/AIDS, for which they were tested. METHODS: A descriptive qualitative study was conducted using the free attitude interview technique for data collection. The Ante-natal care (ANC) clinic register of the Embhuleni Hospital was used to trace patients who had consented for voluntary counselling and testing (VCT), but who had since not returned for their results after 30 days of testing. Those patients were visited at their places of residence by the research team (interviewing nurse and the researcher) to request them to participate in the study. The exploratory question was: “May you tell us why you did not come back for your HIV test results?” “Sicela usichazele kutsi yinindzaba ungasetanga kutewuhlola imiphumela yakho yengati? (SiSwati Version). The interviews were audio recorded and field notes taken. The interviewer sought clarification for unclear issues raised, and gave reflective summaries at the conclusion of each idea under discussion. The interviews continued until there was information saturation. In this study, was reached at respondent number nine. The audio-tapes were transcribed verbatim, followed by translation into English. The emerging themes formed the basis for the write-up. RESULTS: The following themes emerged:  Communication between health care workers and patients Poor quality of communication (patients not told to come back)  Knowledge on HIV/AIDS and PMTCT Patients had poor knowledge of HIV/AIDS and PMTCT  Fear of stigma for HIV/AIDS The community associated coming back for the results with being HIV positive  Poor patient support Poor family support system for the patient Limited patient financial resources  Experience at the health facilities Lack of patient privacy Attitude of the health care workers not acceptable to patients CONCLUSION: The factors that resulted in non-return of the pregnant women to the facility for their results were that the women were not made aware that they were to return for their results; poor quality of communication by the hospital staff; unpleasant experiences by patients at the facility; patients feared community stigmatisation; there was lack of patient support, and the patients had poor knowledge of HIV/AIDS and PMTCT

Thesis (PhD)--University of Limpopo, 2010. / The role of indigenous healers and spiritual faith healers in managing various conditions of ill-health has been studied and debated. The aim of this study was to determine how indigenous healers and spiritual faith healers understand and define HIV/AIDS stigma and to explore the role that indigenous healers and faith healers play in reducing or reinforcing HIV/AIDS stigma in their communities. In this study, a qualitative approach and in particular, the grounded theory methodology was used. Grounded theory is described as a research method in which theory is developed from data, rather than the other way round. The application of this methodology included personal interviews with thirty-nine practising indigenous healers and spiritual faith healers in the Limpopo Province, while additional information was gleaned from the literature review. The researcher focused on the participants‟ conceptualisation of HIV stigma, from the context of the African world view in order to gain insight into their roles as healers. The findings indicate that indigenous healers‟ cultural beliefs prevented them from having a deeper understanding of HIV stigma when compared to the faith healers. Indigenous healers were generally found to have a positive attitude towards People Living with HIV/AIDS (PLWA), while spiritual faith healers showed a less positive attitude towards PLWA. The study further found that „HIV secrecy clause‟ contained in the South African National Policy on HIV/AIDS for Learners and Educators (August 1999) prevents traditional and spiritual faith healers, the affected and infected, the family and society at large from disclosing the HIV status of those infected. It is suggested that the tendency not to disclose has the potential to encourage stigmatization and discrimination whilst at the same time hindering efforts to find solutions to the problem. The study is concluded by suggesting that HIV testing must be compulsory for every person who consults in a hospital. Such a policy move could contribute positively in terms of health promotion. / Medical Research Council

Illness. A secret. Feeling alone? Have you ever kept a secret? A life-changing secret that keeps you secluded, isolated, and contained in a bubble, lonely and empty? The daily struggle of coping with your own secret, yet feeling like everyone you come in contact with already knows, takes its toll in the lives of those who carry the burden of a chronic disease. While dealing with judgmental thoughts, and the scrutinizing gaze from others, do we think that the stigma of a medical diagnosis affects our ability to love someone? More specifically, how about being capable of allowing someone to love you knowing that you are HIV positive? In We Were Here, the choreographic research speaks directly to the topic of secrecy and isolation through song, dance, poetry, and videography of people living with life-threatening diseases in today’s society. This piece will take the audience on a short journey through the lives of seven individuals who seek to find peace and understanding in revealing their conditions to their family, friends and loved ones. In seven different journeys, through the highs and lows of coping with a chronic disease, the silver lining of WE WERE HERE, provides a friendly reminder that everyone needs somebody, sometimes.

HIV/AIDS is a global pandemic with critical demographic, economic, and social implications. The pandemic is widespread in poor regions of the world, including Southeast Asia where its long-term effects are potentially catastrophic. Despite the major impacts of the epidemic being already felt at the household level in many countries, a lack of recognition of the socioeconomic determinants of HIV infection and the economic and social impacts of HIV/AIDS and their relationship with poverty persists. This is due in part to the lack of systematic studies at the household, community, sectoral, and macro levels. The thesis describes a 'vicious circle' between HIV/AIDS, poverty and high-risk behaviour at the individual level. In the poverty-HIV/AIDS cycle, HIV-infected individuals are especially vulnerable to poverty, the poor are more likely to engage in high-risk behaviour such as commercial sex work, and high-risk behaviour in turn makes people susceptible to HIV infection. The thesis examines whether rural Northeast Thailand exhibits characteristics that support the existence of such a cycle. Four key relationships are considered and tested: (i) the relationship between previous HIV infection and current wealth or poverty; (ii) the relationship betweem wealth or poverty and HIV/AIDS knowledge; (iii) the relationship between previous wealth or poverty and current HIV infection; and (iv) the relationship between previous migration and current HIV infection. All four relationships are shown to hold using survey data from Khon Kaen province in Northeast Thailand. Poverty is shown to increase susceptibility to HIV infection, and HIV/AIDS is shown to reduce wealth and hence increase poverty. Under the circumstances, the hypothesis that rural Northeast Thailand exhibits characteristics that would suggest the existence of a poverty-HIV/AIDS cycle cannot be rejected. This thesis also provides several key contributions to the literature on HIV/AIDS and poverty. First, it provides quantitative and qualitative empirical analysis of the impacts of HIV/AIDS on households in a moderately affected region of Thailand. Second, it provides empirical analysis both on whether wealth and poverty affect the risk of HIV infection, and whether HIV infection affects wealth and poverty. The results from this thesis also provide significant empirical evidence of the importance of rural-urban migration in the spread of HIV in Asia. Finally, the thesis investigates the potential effects on the poverty-HIV/AIDS cycle of an ongoing socio-economic intervention, namely breaking the poverty-HIV/AIDS cycle via intensive rural development.

My research involves a critical analysis of the sexual cultures of young heterosexual Australian men. This research is driven by the need to understand and prevent the heterosexual sexual transmission of HIV/AIDS. I focus on young heterosexual men’s understandings and experiences of condom use and non-use, given that condoms are a key means of preventing the sexual transmission of HIV. ¶ I conducted in-depth interviews with seventeen men, using these to explore sexual practices and the meanings and sociosexual relations through which these are organised. This ‘close-focus’ qualitative approach is oriented to assessing the interplay between men’s personal experience and the social relations of sexuality and gender. I draw on empirical feminist investigations of women’s relation to HIV/AIDS, the critical scholarship on men and masculinities and masculine sexualities, and sociological scholarship on sexualities. ¶ My research finds that young heterosexual men emphasise five themes in accounting for their non-use of condoms. First, men stress the risk of pregnancy rather than the risks of HIV or other sexually transmitted infections, and they respond to the former risk by relying on their partners’ use of the Pill. Second, men perceive that wearing condoms decreases their penile sensation and that condoms are difficult to use. Third, men find that the “heat of the moment” of sexual episodes, their spontaneous and passionate ambience, makes it hard to incorporate condoms and, indeed, condoms destroy this “moment”. Fourth, men privilege “trust” as fundamental to their sexual involvements, and they quickly define involvements as “relationships” and therefore as trusting and monogamous, such that they abandon condoms. Fifth, men believe that they are very unlikely to contract HIV because they see their social circles, institutions, the heterosexual community or heterosexual sex per se as safe and free of HIV/AIDS, so there is no need to wear condoms. ¶ I compare these findings with the argument in the AIDS literature that heterosexual men’s use of condoms is limited by several understandings associated with masculine sexuality and masculinity. I argue that these understandings do not appear to be widespread as the literature claims, some work in contradictory ways and are compatible with safe sex, and other sets of meanings are more influential in heterosexual men’s unsafe sex. Men do not represent wearing condoms as feminising or homosexualising, nor as masculine. I conclude by exploring how heterosexual men could be encouraged to use condoms through appeals to notions associated with masculinity and masculine sexuality.

<p> </p><p>HIV (humant immunbristvirus) är en sjukdom som bryter ned kroppens immunförsvar och utan bromsmedicin är risken stor att drabbas av den sekundära fasen, AIDS. Sjukdomen, som globalt innefattar cirka 33 miljoner virusbärare, har inget botemedel, vilket leder till att många människor avlider av sjukdomen. Eftersom det finns så många HIV-smittade människor, är sannolikheten stor att sjukvårdspersonalen möter dessa patienter inom de olika delarna av sjukvården. Förståelsen för hur dessa patienter upplever en vårdrelation med sjukvårdspersonal är viktig för att kunna ge dessa patienter en god vård.</p><p><strong>Syftet med studien är att beskriva HIV/AIDS-positiva patienters upplevelser av vårdrelationen med sjukvårdspersonal. I detta examensarbete inom vårdvetenskap gjordes en systematisk litteraturstudie efter Evans (2002) modell, där vetenskapliga artiklar av kvalitativ design analyseras vilket är en <strong>metod för att finna ny kunskap som besvarar syftet. <strong>Resultatet kan delas in i tre olika teman; upplevelser av trygghet, upplevelser av att inte bli bekräftad och upplevelser av att känna avvisning och skam. Det förekommer att HIV-positiva patienter antingen blir vägrade vård eller att de själva väljer att inte söka vård på grund av sjukdomen och att sjukvårdspersonal undviker fysisk kontakt. Alla HIV-positiva patienter är inte missnöjda med vården, vilket redovisas i studien. <strong>Diskussionen utgår från Katie Erikssons (1987; 1990; 1994; 1995) teori om vårdlidande och tar upp olika orsaker till varför vårdlidande uppstår med fynden i resultatet som utgångspunkt. Författarna föreslår att ökad kunskap ska införas på alla vårdnivåer för att ge en ökad medvetenhet, vilket ger patienterna trygghet. </strong></strong></strong></strong></p>