Voluntary Counselling and Testing (VCT) is vital in the management of HIV/AIDS as it is the first step in treatment, care and behavioural change. Entrenched economic and gender inequities drive an increasingly feminized HIV/AIDS pandemic. This study investigated factors influencing VCT attendance by women in the Glen View high density suburb in Harare. A survey methodology was followed using a semi-structured, self-administered questionnaire that was distributed to randomly selected women of reproductive ages in the area. The analysis showed that VCT usage is low and that factors such as fear of the consequences of testing positive for HIV, such as violence and rejection by male partners are to blame. Importantly, the findings suggest that if the vulnerability of women is not addressed, then increased VCT uptake and better reproductive health outcomes for women are also unlikely. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

The purpose of this study was to evaluate care rendered to HIV positive women and their infants during the first six weeks of postpartum. Quantitative, descriptive, cross sectional and analytic study was conducted to investigate postnatal care services provided to HIV positive mothers. Data collection was done using structured questionnaires. 372 respondents participated in the study. Descriptive data analysis was used; Epi info version 3.5.2 software was used. The study highlighted that the quality of PNC was compromised, in all levels including the critical immediate postnatal care, 3-14 days and 6 weeks postnatal care services. All health facilities that were involved in the study had the basic resources to render quality postnatal care. Negative attitudes of staff and long waiting time (16.7%), were the most deterrents to postnatal care. / Health Studies / M.A. (Health Studies)

This study was an attempt to investigate the influence of socio-cultural factors on HIV prevention strategies among HIV discordant couples in Harare, Zimbabwe. HIV sero-discordance is a scenario whereby one partner is HIV-positive and the other is HIV-negative. HIV sero-discordant couples are a unique and vulnerable population that encounters many peculiar challenges. When dealing with this population, researchers have to deal with contradictory ideas and perceptions presented by each partner making up the couples and also understand the relationship in the context of cultural values, norms and the dynamic of power and oppression. In addition to this, the concept of HIV sero-discordance and the frequency of its occurrence are poorly understood in most African communities. Despite the growing evidence of HIV discordance, HIV prevention strategies have largely focused on clinical aspects at the expense of socio-cultural issues that impact on HIV prevention strategies targeted at HIV sero- discordant couples. The study seeks to contribute to the conceptualization and design of intervention programs dealing with sero-discordance. The study is underpinned by the symbolic interactionism theory and was qualitative in design involving 13 HIV discordant couples in heterosexual relationships enrolled in the HIV Preventions Trials Network 052 Study (HPTN 052 Study) being undertaken by the University of Zimbabwe’s department of medicine. The study utilized 2 Focus Group Discussions (FGD) and 10 in-depth interviews (IDI) to collect data. The study’s findings indicate that discordant couples are in fact critical stakeholders in the uptake of all the available HIV prevention strategies. Failure to acknowledge this tenet is self-defeating as evidenced by the perception of viewing condom use within a marriage as humiliating for a woman. The study further noted that practitioners in the HIV prevention domain must guard against over-relying on the scientifically demonstrated efficacy of the strategies. The study recommends that HIV prevention strategies must be socially and culturally acceptable and embedded for them to be more efficacious. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)

Adherence to antiretroviral therapy is crucial to ensure viral suppression. In the scientific community it is widely accepted that an adherence level of at least 90% is necessary to achieve viral suppression. This study uses pharmacy refill records to describe antiretroviral adherence in HIV-positive patients in Ugu District and to describe pharmacy refill records as reliable monitoring method of antiretroviral therapy. In total, 61 patients’ records were reviewed. Overall, 82% of participants (n=50) achieved an optimum adherence level of at least 90%. Although 38% (n=19) of these participants did not show any related viral suppression. A statistically significant relationship between adherence and viral suppression was not demonstrated. Therefore, pharmacy refill records cannot be recommended as an alternative method of monitoring response to antiretroviral therapy, but laboratory tests including CD4 cell count and or viral load must be combined to pharmacy refill method for monitoring of antiretroviral therapy in HIV-positive patients / Health Studies / M.A. (Public Health)

Vertical transmission of HIV is still a growing concern in South Africa. Breastfed infants are still at risk as HIV is present in breast milk, leaving HIV-positive mothers unsure of the best feeding option for their infants. However, there are various infant feeding techniques that HIV-positive mothers can use to supplement breastfeeding and flash-heat is one of them. Flash-heat is heat treating expressed breast milk to deactivate HIV for infant feeding. This study explored the possibility of HIV-positive mothers to practice flash-heating method for their infants exclusively for four months as a strategy to prevent vertical transmission of HIV. A descriptive, explorative and contextual design using a mixed method was used to obtain data from mothers in a post natal ward at Tembisa hospital. The mixed method used was useful in identifying the number of HIV-positive mothers who would adopt the flash-heat technique, the characteristics of mothers whom the technique could be promoted to, the factors that influence/affect the choice of infant feeding for these mothers, as well as their feelings associated with the feeding technique. Most (74%) mothers had a positive response to the flash-heat technique compared to 10% who were uncertain. They believed that heat treating their breast milk would result in their infants being HIV-free. In addition they believed that this method was cheaper than formula feeding and expressed positive feelings about touching their breast milk while expressing with no adverse feelings of expressing into a glass jar. Furthermore, findings of this study indicated that HIV-positive mothers in a public health facility would adopt flash-heat as an alternative infant feeding method. Thus practical guidelines to promote this feeding method were proposed. The proposed draft guidelines which promote the use of the flash-heat infant feeding method for HIV-positive mothers in public sector facilities will be communicated to relevant authorities such as the National Department of Health. These guidelines support the new policy shift to exclusive breastfeeding as a child survival strategy in South Africa. / Health Studies / D.Litt. et Phil. (Health Studies)

The study explored the factors influencing the use of voluntary counselling and testing by university students. This was done by undertaking an exploratory and descriptive qualitative study. Focus group discussions and field notes were used to collect data from the participants. Outcomes from the study revealed various factors to the uptake of Voluntary Counselling and Testing (VCT) services by university students namely: the desire to know one‟s HIV status, illness, pregnancy, blood donation, to get a reward, the influence of significant others, the influence of media, awareness campaigns, compulsion, to get a job, curiosity, to be a positive role model and the positive attitude and professional conduct of the health care provider. The study also revealed various challenges to the uptake of VCT services by university students namely: the fear of being diagnosed HIV positive, HIV/AIDS-related stigma and discrimination, the low perception of risk to HIV infection, the lack of student friendly VCT services, the shortage of human and infrastructural resources, the inaccessibility of VCT services, the long waiting period for test results, negative perceptions about VCT, the problems with pre-test counselling and ignorance. Going by the participants‟ suggestions VCT services uptake by university students could be improved by increased resource allocation (incentives, human and infrastructural resources), increased awareness campaigns, and improved counselling and making VCT services more accessible / Information Science / MA (Public Health)

Thesis (MPhil)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: In Namibia the HIV prevalence rate in adults (15 to 45 years of age) is estimated at 18.1%. The first HIV infection in Namibia was reported in 1986 and the epidemic constitutes the biggest developmental challenge for Namibia. Approximately 39 new infections occur every day and approximately 28% of deaths in the country are AIDS-related. The majority of Namibia’s workforce is in the age group of 15 years to 45 years and it can be anticipated that HIV and AIDS will have a major disruptive effect on the country’s workforce as well as its economy over the next two decades. According to the Namibian government, voluntary counselling and testing (VCT) for HIV is one of the most effective methods to prevent the spread of the epidemic. With this in mind, this study aims to evaluate the outcome of voluntary counselling and testing at one workplace in Windhoek, Namibia, to see whether VCT provides education as well as whether VCT is a vehicle to promote awareness, good attitudes, intentions and behaviour change. The main purpose of this outcome evaluation is to determine to what extent voluntary counselling and testing at the workplace has led to HIV-related changes in knowledge, attitudes, behaviour and practises. Although the majority of respondents indicated that their knowledge of HIV had increased after their participation in the VCT programme, upon closer analysis it was evident that participants who had a secondary or higher level of education had more knowledge, or had had more of a knowledge increase, than participants with a primary or lower level of education. From the research findings, it appeared that the voluntary counselling and testing had helped participants to identify their individual risks, as their self-reported risk perceptions with regard to becoming infected with HIV and/or a sexually transmitted disease increased after their participation in the VCT. There was also evidence that participants implemented risk reduction plans after the voluntary counselling and testing, as the percentage of participants who had casual sex partners decreased while the percentage of participants who had not had casual sex partners in the previous six months increased. It can be concluded that the general attitude amongst employees towards HIV-positive people is relatively non-discriminatory. However, it seems that the VCT was not as successful in transferring information and education on HIV amongst employees with lower education levels than amongst their peers with higher levels of education, and employees with primary or lower education levels appear not to have benefited much from the intervention in terms of an increase in knowledge. It is recommended that voluntary counselling and testing be provided to the employees at the company on a regular basis, not only because employees have requested it, but also to monitor whether the voluntary counselling and testing for HIV at the company has had the desired effects on the employees, especially with regard to effecting an increase in knowledge, a reduction of stigma and discriminatory attitudes, and the desired behaviour change amongst participants. / AFRIKAANSE OPSOMMING: In Namibië word die MIV voorkomssyfer onder volwassenes (ouderdom 15 tot 45 jaar) op 18,1% geskat. Die eerste MIV-geval in Namibië is in 1986 aangemeld en vertoonwoordig die land se grootste ontwikkelingsuitdaging met ongeveer 39 nuwe infeksies daagliks en ongeveer 28% van sterftes in die land wat VIGS-verwant is. Die meerderheid van Namibië se werksmag val in die ouderdomsgroep 15 tot 45 jaar en daar kan verwag word dat MIV en VIGS oor die volgende twee dekades grootskaalse ontwrigting op die land se werksmag sowel as sy ekonomie gaan veroorsaak. Volgens die Namibiese regering is vrywillige berading en toetsing (VBT) een van die mees doeltreffende metodes om die verspreiding van die epidemie te verhoed. Gedagtig hieraan het hierdie navorsingsprojek dit ten doel om die uitkomste van vrywillige berading en toetsing by een werksplek in Windhoek, Namibië, te evalueer ten einde te bepaal of VBT opvoedkundig is en of dit bewuswording, gesonde houdings, voornemens en gedragsverandering bevorder. Die hoofdoelwit van hierdie uitkomsevaluering is om die mate waartoe vrywillige berading en toetsing tot verandering in kennis, houding, gedrag en praktyke gelei het, te bepaal. Alhoewel die meerderheid respondente aangedui het dat hulle kennis na VBT verbeter het, het dit by nadere ondersoek geblyk dat deelnemers wat sekondêre of hoëronderwys gehad het, oor meer kennis beskik het of hul kennis meer uitgebrei het as respondente wat slegs 'n primêre of laer vlak van onderwys gehad het. Uit die navorsingsbevindings blyk dit dat daar onder deelnemers aan vrywillige berading en toetsing 'n toename in die self-aangemelde risiko-persepsie van besmetting met HIV en/of geslagsoordraagbare siektes na hul deelname aan VBT was. Daar was ook bewyse dat deelnemers na die vrywillige berading en toetsing risikoverminderingsplanne geïmplementeer het, omdat daar 'n afname was in die persentasie deelnemers wat informele seksmaats gehad het, sowel as 'n toename in deelnemers wat geen informele seksmaats in die vorige ses maande gehad het nie. Daar kan tot die slotsom gekom word dat werknemers se houding teenoor MIV-positiewe mense oor die algemeen betreklik nie-diskriminerend is. Dit blyk egter asof VBT ten opsigte van die oordrag van inligting en opvoeding oor MIV aan werknemers met laer vlakke van onderwys nie so geslaagd was nie omdat werknemers met primêre of 'n laer vlak van opleiding nie veel by die ingrypaksie gebaat het in terme van ‘n toename in kennis nie. Daar word aanbeveel dat vrywillige berading en toetsing op 'n gereelde grondslag aan werknemers by die maatskappy aangebied moet word, nie bloot omdat werknemers daarvoor gevra het nie, maar ook om te bepaal of vrywillige berading en toetsing vir MIV by die maatskappy die gewenste uitwerking op die werknemers gehad het, veral met betrekking tot die uitbou van kennis, 'n afname in stigmatisering en diskriminerende houdings, en 'n toename in die gewenste gedragsverandering onder deelnemers. / jfl2011 / Imported from http://etd.sun.ac.za

Thesis (M Social Work)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The South African government has laws and policies that forbid discrimination against individuals. These policies protect people from being discriminated against in the workplace due to sickness, race and many other factors. Discrimination against people living with HIV/AIDS has caused many people who suffer from this disease not to come forward with their illness because they fear being discriminated against and stigmatised; some even lose their jobs because they are infected with HIV. People infected with HIV are discriminated against not only in the workplace but also in their communities and families. This implies that people living with HIV/AIDS need support from all levels of society in order to live positive lives, which may lead infected people to live longer. This study explored HIV/AIDS as terminal illness and the stressors experienced by people infected with the virus. This was done by examining the support available to people living with HIV/AIDS, as well as identifying the support needed by these people. By adopting an ecological approach to the study, the need for support could be investigated on multiple levels. A combination of a quantitative and qualitative research design was used in the study. Data were gathered by means of a semi-structured interview schedule that was administered during individual interviews with service providers. This allowed for data that were both measurable as well as rich in description to be collected. The questions in the semi-structured questionnaire were based on the information retrieved from the literature review. The findings from the empirical investigation revealed that people living with HIV/AIDS receive limited support from their families, the South African government and society at large. The findings further indicated that informal sources of support such as family, friends and partners are relatively supportive of people living with HIV/AIDS. However, the relationships between people living with HIV/AIDS and their families and partners are often strained, especially when a person first discovers his or her status as HIV positive. Furthermore, people living with HIV/AIDS are stigmatised on multiple levels because of their status. There is stigmatisation from family, friends, in the workplace and in the community. The most important recommendations resulting from the study are that services such as counselling are needed for people living with HIV/AIDS together with their families. This is of particular significance to the South African government, especially the health sector, which needs to improve the health care system. In addition, recommendations emphasise the importance of promoting education and awareness, which could have great value for people living with HIV/AIDS, their families and communities. Knowledge about HIV/AIDS would empower people at all levels to support those who live with the disease and would also be of great value in helping those living with the disease to contribute something of value towards their health condition. / AFRIKAANSE OPSOMMING: Die Suid-Afrikaanse regering beskik oor wette en beleide wat diskriminasie teen individue verbied. Hierdie wette en beleide beskerm mense teen diskriminasie in die werkplek, diskriminasie op grond van siekte, gestremdheid, ras en vele ander redes. Diskriminasie teen mense wat met MIV/vigs leef, laat baie van hulle hul MIV/vigs-status geheim hou omdat hulle diskriminasie en stigmatisasie vrees. Sommige verloor selfs hulle werk wanneer dit rugbaar word dat hulle aan MIV/vigs ly. Diegene met MIV/vigs ervaar egter nie net in die werkplek diskriminasie nie, maar ook in hul gemeenskappe en families. Dít impliseer dat mense met MIV/vigs op alle vlakke ondersteuning nodig het om ’n positiewe lewe te lei en daarmee hul lewensverwagting so ver moontlik te verleng. Hierdie studie het die stresfaktore van terminale MIV/vigs-lyers ondersoek. Daar is voorts ondersoek ingestel na die ondersteuning wat mense met MIV/vigs ontvang, sowel as die ondersteuning wat hulle nodig het. MIV/vigs-lyers se ondersteuningsbehoeftes op etlike vlakke is deur middel van ’n ekologiese navorsingsbenadering bepaal. ’n Kombinasie van ’n kwantitatiewe en kwalitatiewe navorsingsmetodologie is vir die studie gebruik. Data is met behulp van ’n semigestruktureerde vraelys ingesamel, wat gedurende individuele onderhoude met diensverskaffers afgeneem is. Sodoende kon meetbare sowel as hoogs beskrywende data ingesamel word. Die vrae in die semigestruktureerde vraelys was gegrond op die inligting uit die literatuuroorsig. Die bevindinge van die empiriese ondersoek toon dat mense wat met MIV/vigs leef beperkte ondersteuning van hul familie, die Suid-Afrikaanse regering en die groter samelewing ontvang. Die bevindinge dui voorts daarop dat informele ondersteuningsbronne, soos familie, vriende en lewensmaats, betreklik ondersteunend is teenoor diegene met MIV/vigs. Tog is die verhouding tussen MIV/vigs-lyers en hul families en lewensmaats ook dikwels onder druk, veral net nadat die persoon ontdek dat hy/sy MIV-positief is. Daarbenewens word mense met MIV/vigs op verskeie vlakke gestigmatiseer – deur hul familie, vriende, in die werkplek en die gemeenskap. Die belangrikste aanbeveling uit die studie handel oor die behoefte aan dienste soos berading vir mense wat met die virus leef, sowel as vir hul familie. Die aanbeveling behoort veral van belang te wees vir die Suid-Afrikaanse regering, en in die besonder die gesondheidsektor, wat hierdie behoefte in gedagte moet hou om die gesondheidsorgstelsel te verbeter. Ander aanbevelings beklemtoon die belang van meer opvoeding en bewusmaking, aangesien dit uiters waardevol kan wees vir mense met MIV/vigs, hul familie en gemeenskappe. Kennis oor MIV/vigs sal mense op alle vlakke bemagtig om diegene met die virus te ondersteun, terwyl dit MIV/vigs-lyers self ook sal help om hul eie gesondheidstoestand beter te bestuur.

Thesis (MBA)--University of Stellenbosch, 2010. / Since the first case was discovered in Africa in the late 80s, the HIV/AIDS epidemic has gradually increased at alarming proportions worldwide especially in sub-Saharan Africa which prompted the United Nations' World Health Organisation to declare it a global pandemic. This research undertakes to highlight the current composition of care given for HIV and Aids, and the strengths and weaknesses of such programmes. The aim of this is to establish a better home based care programme in Swakopmund, Namibia, for improving the quality of care as well as living conditions for the infected and affected. For this initiative to be of the highest quality there is need to pay special attention to various regional and national HIV/AIDS programmes and policies. As the HIV/AIDS epidemic continues to spread, organisations and communities are now considering engaging more programmatic approaches as sub-Saharan countries are looking for scaled-up responses and national strategies for home based care. Policy-makers and senior administrators must be involved in developing and monitoring home based care programmes, and the people who manage and run the programmes must share information and feedback with senior administrators. In this sense, policy and action are interrelated as each partner learns from and guides the other. The researcher saw the need to involve community members and home based care-givers in a participatory process to research this topic and engage them in a process on how to improve the programmes that already exist. 52 Pages.

<p>This thesis examined to what extent the current legislation protects the HIV positive employee against unfair discrimination and dismissal. The study gave short medical background to HIV/AIDS and introduced HIV discrimination by giving the historical background to HIV related discrimination. From this, the extent of stigmatization against this group was introduced.</p>