In this study both qualitative and quantitative methods were used to find out to what extent the Lobatse Town Council employees used Voluntary Counseling and Testing (VCT) HIV and AIDS services, the reasons for using or not using the services, the preferred service providers reasons for choosing a service provider. Lastly recommendations were made on how the uptake HIV and AIDS VCT services could increased amongst the employees. A sample of 200 respondents was selected from the employees of the Lobatse Town Council, and it was established that 65.5 percent of the respondents had used VCT. Females had a higher testing participation rates than males, white collar respondents had a higher testing participation than the blue collar respondents. There was a higher rate amongst the married than the single respondents and the older ages of 30 and above than the young ages of 29 years and under. In the study it was also established that the majority of the respondents considered voluntary counselling and testing for HIV and AIDS as being important. However there were some groups that were more positive than others regarding the importance of testing. More females than males were positive regarding the importance of testing, and also amongst the employment categories the white collar respondents were more positive than the blue collar respondents regarding the importance of HIV and AIDS testing. Furthermore it was established that the most important reason for testing amongst the employees that did test for HIV and AIDS was that they felt that they needed to undergo testing before they tested. The respondents that did not test for HIV and AIDS indicated that the most important reason for not testing was that they were scared the results could not be kept confidential. The research also showed that the most preferred service provider was Tebelopele. Tebelopele was the most used and preferred service provider amongst both gender and age groups, all marital groups and the blue collar group in the employment categories. However, for the white collar group the most preferred service provider was the private practitioners. The most common reason for choosing a service provider was confidentiality and privacy. Lastly, the research makes recommendations on what needs to be done to increase the uptake of VCT HIV and AIDS testing amongst the Lobatse Town Council employees. One of the recommendations is that there was a need to educate the employees of the Lobatse Town Council and that the education should be specific for each group. For example from the group discussion the participants felt that the reason to why males did not want to utilise HIV and AIDS VCT was because they lacked knowledge on the importance of testing. Also the respondents indicated that there was a need to remove stigma and discrimination through removing confidentiality attached to HIV and AIDS. It was also, recommended that the Lobatse Town Council formulate and implements a workplace policy on HIV and AIDS

The overall aim of this study was to understand the determinants of VCT uptake in the general population of Nigeria’s federal capital territory of Abuja. Uptake of VCT still remains low despite increased availability of VCT information and services in Abuja, Nigeria. A quantitative cross-sectional study was undertaken with 180 respondents from Abuja, using an adaptation of the Health Belief Model as conceptual framework, to elucidate the social demographics of respondents, their HIV/VCT knowledge, their perceptions of VCT facility design, societal support for VCT, and how HIV stigma shapes the phenomenon of VCT uptake in Abuja, Nigeria. The key findings were that a better understanding of HIV prevention, a perception of support from community and religious leaders, and access to HIV test services in government facilities are positive predictors of higher VCT uptake. Poor personal risk assessment and the cost of HIV testing were identified as the key barriers to VCT access. / Health Studies / M.P.H.

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)

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)

Digitized using a Konica Minolta 211 PCL scanner at 300 dpi. / Thesis (MA (Psychology))--University of Stellenbosch, 2006. / Please refer to full text for abstract.

Thesis (M Social Work (Social Work))--Stellenbosch University, 2008. / South Africa is experiencing a serious HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome) epidemic, with millions of its people living with the disease and dying from related diseases. As there is no cure as yet, counselling as a form of intervention is one of the most powerful ways to address the psychosocial aspects of HIV/AIDS. The motivation for this study was the lack of research concerning skills needed by counsellors in counselling HIV/AIDS patients who are on antiretroviral treatment (ART) or are about to commence antiretroviral treatment. To add to the knowledge that is lacking, the study was approached by means of both quantitative and qualitative research methods. The purpose of the research was explorative and descriptive. The discussion on the literature that was studied provides an overview of the implications of HIV/AIDS for the individual and the family, and of the psychosocial implications, in addition to describing antiretroviral treatment and the nature of HIV and adherence counselling processes and skills. A sample of 16 adherence counsellors who were between the ages of 27 and 57 years was interviewed. These adherence counsellors were employed by Sothemba Aids Action, placed at the different ART sites, trained at the Aids, Training, Information and Counselling Centre (ATTIC) and have gained one or more years’ experience in HIV/AIDS counselling. A semi-structured questionnaire was used as research instrument. It contained both open- and closed-ended questions. All the interviews took place at the clinics where the counsellors were employed or worked. The results of the study showed that an equal number of respondents from two different ethnic groups were interviewed; all the participants had received high school education; and a few obtained tertiary level qualifications. They all received training in basic counselling skills and adherence counselling skills. A few indicated additional training in Voluntary Counselling and Testing (VCT), as well as Prevention of Mother-to-child Transmission Counselling (PMTC). A minority of counsellors indicated making use of a translator and that their experience was that the message was always misinterpreted. All the adherence counsellors indicated a need for further training involving social problems and counselling of children at different ages and stages of development. It was also found that the adherence counsellors lack skills in counselling intervention processes and in intervention. All the adherence counsellors raised concerns regarding their working conditions and salaries. In light of the above it is recommended that patients be counselled in their preferred language, that all counsellors receive the same training in counselling and in the additional areas where they experience a shortcoming. Data on HIV/AIDS and adherence counselling, including the views of counsellors and patients are limited. It is recommended that more research be done on HIV/AIDS and adherence counselling, including the different disciplines that are involved and the views of patients about services rendered to them by those in the different disciplines, and counsellors.

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)

The overall aim of this study was to understand the determinants of VCT uptake in the general population of Nigeria’s federal capital territory of Abuja. Uptake of VCT still remains low despite increased availability of VCT information and services in Abuja, Nigeria. A quantitative cross-sectional study was undertaken with 180 respondents from Abuja, using an adaptation of the Health Belief Model as conceptual framework, to elucidate the social demographics of respondents, their HIV/VCT knowledge, their perceptions of VCT facility design, societal support for VCT, and how HIV stigma shapes the phenomenon of VCT uptake in Abuja, Nigeria. The key findings were that a better understanding of HIV prevention, a perception of support from community and religious leaders, and access to HIV test services in government facilities are positive predictors of higher VCT uptake. Poor personal risk assessment and the cost of HIV testing were identified as the key barriers to VCT access. / Health Studies / M.P.H.

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)

Cognisant of the fact that counselling has become an essential aspect of dealing with HIV/AIDS in South Africa, the researcher aimed to explore the stressors experienced by HIV/AIDS counsellors. It was envisioned that the results obtained would both help to improve the counselling services provided at Settlers Hospital, and assist other organisations to do so. The research focused on how the participants dealt with the dual roles of non-directive listening and the more prescriptive advice-giving, the stressors they experienced and the support structures they had, or needed, to assist them in being more effective HIV/AIDS counsellors. The sample consisted of four HIV/AIDS counsellors working at Settlers Hospital, Grahamstown. The co-ordinator of HIV/AIDS at the hospital was interviewed for collateral information. A qualitative, multiple case study was undertaken. In-depth, semi-structured interviews were used to collect the data which were recorded and transcribed and then constructed into coherently organised personal narratives of each participant’s experiences. A composite description of all the results was arrived at through the use of a reading guide which reduced the data into a thematic content analysis. The analysed data served to present an understanding of the counsellors’ experiences and to enable recommendations to be made which could assist them in pursuing their work more effectively. The findings of this study indicate that HIV/AIDS counselling is an emotionally stressful occupation. Contributory factors include the twofold role of promoting prevention and serving as empathic listeners. Other stressors derive from issues of confidentiality and stigma concerning HIV/AIDS, counsellors’ identification with clients’ experiences and the demographics of HIV/AIDS in South Africa. Situational stressors which arise from working as both nurses and counsellors in a public health institution were also identified. Recommendations are made to alleviate the counsellors’ stress in the form of facilitated emotional support groups, professional supervision, managerial support to improve the working environment, and ongoing in-service training.