The purpose of this study was to explore and identify factors that either facilitate or inhibit individuals volunteering for HIV-testing. The target group was comprised of Xhosa first-language construction workers in a company with an HIV/AIDS workplace policy and programme. This programme provides basic education and awareness about HIV/AIDS. This education includes information about where to access voluntary counselling and testing (VCT) services. Interpretive qualitative research was undertaken in order to explore the beliefs, perceptions and intentions of the target group in regard to the utilisation VCT services. Data was collected using an unstructured interview guide. The data was analysed using Tesch’s approach to content analysis. Concerns about validity and reliability were engaged throughout the research process and supported further by using researcher reflexivity and an independent researcher. The independent researcher analysed data separately and only after discussion and consensus being found between the two researchers were final categories and codes agreed upon and data analysis considered complete. Findings revealed that an HIV/AIDS workplace programme has a positive impact on the health-seeking behaviour of workers in the construction company used in this research. Respondents knew how HIV/AIDS is transmitted, how to prevent transmission and where to find HIV-testing treatment and support. In this case HIV-testing services can easily be accessed further facilitating respondents volunteering for HIV-testing. It was also found that family, friends and churches support HIV-testing behaviour by providing education, guidance and support to respondents encouraging behaviour change. On the other hand, respondents held that community members who had not benefited from an HIV/AIDS workplace programme such as theirs are exposed daily to the devastating effects of HIV leading to AIDS deaths and live in fear of the disease. Debilitating illness and eventual death is equated with an HIV-positive diagnosis which causes community members to believe it is better not to volunteer for HIV-testing than to ascertain one’s HIV-status. The HIV/AIDS workplace policy and xv programme on the other hand is seen to have provided respondents with HIV/AIDS knowledge enabling them to overcome their fear of an HIV-positive diagnosis and to volunteer for regular HIV-testing.

The students are the future economic backbone of the country and it is essential that measures are taken to reduce the number of new HIV infections in this segment of the population. Free voluntary counselling and testing for HIV was introduced at the Nelson Mandela Metropolitan University as one of the prevention strategies to curb the spread of HIV. This service has grown steadily over the years but strategies need to be formulated and implemented to improve the existing service and thereby increase the utilisation of the testing service. This treatise takes the form of an investigative survey involving literature review and a survey of all the individuals who utilised the VCT service over a three month period. The author has attempted to portray the general views and best practices of experts in the field of VCT service delivery. The identified best practices were used as an assessment tool to determine to what extent the VCT service at the NMMU complies with national and international standards. The quantification of these insights must be viewed with caution since the survey sample was relatively low due to time constraints. It has been shown that the VCT service at the NMMU largely complies with national and international standards although several recommendations have been presented for consideration.

Twenty four eThekwini HIV/AIDS counsellors based in four different work settings and who received training from five different training providers, shared their HIV/AIDS counsellor training experiences. The qualitative, phenomenological study utilized a multi-methods approach. The purpose of HIV/AIDS counselling lacks uniformity. Participants reflected upon their distinction between training satisfaction and perceived competency to render HIV/AIDS counselling after training. Although they were satisfied and empowered by the useful information gained, many felt inadequate to counsel an HIV positive person on completion of training. Inadequate practical learning opportunities were evident. Participants identified the need for a more balanced theoretical and practical training program incorporating experiential and didactic training methods. Entrance criteria to HIV/AIDS counsellor training courses and eventual assessment procedures in the study were diverse. Participants suggested improvements for training methods and course content and proposed a tiered training model that will result in standardized and certified training modules. / Social Work / MA(SS) (Social Work)

This qualitative exploratory and descriptive study explored and described the experiences of HIV sero-discordant couples post diagnosis at the Perinatal HIV Research Unit in Soweto, Gauteng Province. Data was collected using in-depth interviews with each individual from seven HIV sero-discordant couples. Following thematic analysis, four themes emerged: immediate response to HIV sero-discordant results; challenges in relation to disclosure of HIV sero-status; limited information on HIV sero-discordant; and the impact of HIV sero-discordant on the couples. All these were mainly linked to poor counselling and inadequate support to HIV sero-discordant couples. The findings of this study have both clinical and policy development implications. Recommendations have been put forward for development of contextual relevant HIV Sero-discordant Couple Counselling and support guidelines focusing of enhancing knowledge and skills of health care professionals responsible for counselling and supporting HIV sero-discordant couples. / Health Studies / MA (Public Health)

This qualitative exploratory and descriptive study explored and described the experiences of HIV sero-discordant couples post diagnosis at the Perinatal HIV Research Unit in Soweto, Gauteng Province. Data was collected using in-depth interviews with each individual from seven HIV sero-discordant couples. Following thematic analysis, four themes emerged: immediate response to HIV sero-discordant results; challenges in relation to disclosure of HIV sero-status; limited information on HIV sero-discordant; and the impact of HIV sero-discordant on the couples. All these were mainly linked to poor counselling and inadequate support to HIV sero-discordant couples. The findings of this study have both clinical and policy development implications. Recommendations have been put forward for development of contextual relevant HIV Sero-discordant Couple Counselling and support guidelines focusing of enhancing knowledge and skills of health care professionals responsible for counselling and supporting HIV sero-discordant couples. / Health Studies / M. A. (Public Health)

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: This research study looked at the factors that affect HCT in provision of PMTCT services. It explored the socio cultural and personal factors that affect HCT. It also established the knowledge level about HIV/AIDS and PMTCT among pregnant women in Kabwe. The transmission of HIV from mother to child contributes largely to HIV prevalence among children. Efforts to reduce this mode of transmission include increasing number of women who know their HIV status and increasing the number of HIV positive women who when pregnant take instructions and act on them to protect their children from the possibility of infection (Bartlett et al. 2004). Individuals can only know their HIV status once they are tested for HIV. However, there are socio cultural and personal factors among other factors that affect the access of HCT. The aim of this study was to identify socio cultural and personal factors that affect HIV counseling and testing in provision of PMTCT services among pregnant women in Kabwe, in order to make recommendations for the development of an intervention program to help improve uptake of HIV counseling and testing for PMTCT services. Both quantitative and qualitative methodologies were used to conduct this study. Focus Group Discussions were conducted with groups of pregnant women that have never been tested for HIV before and Key Informant Interviews with health care workers (midwives or nurses) to ask them about factors affecting HCT in provision of PMTCT services among pregnant women were used. A retrospective statistical report review was also used to ascertain the accessibility rate for the HIV counseling and testing for PMTCT services. In this light, statistical report review was used to collect the number of pregnant women attending ANC and number of pregnant women receiving HIV testing. The findings of this study revealed that the pregnant women had excellent knowledge about HIV/AIDS and the update of HCT was as good as 91% among pregnant women. The research also revealed domestic violence, accusation of promiscuity by partner, abandonment by partner, and stigma & discrimination as socio factors that affect HCT in provision of PMTCT. Religion, fear disbelief of test results was revealed as personal factors affecting HCT in provision of PMTCT. The research revealed decision making, tradition medicines, and practices as cultural factors affecting HCT in provision of PMTCT. The conclusion was made that fear of abandonment by partner, fear of being accused of being promiscuous by partner, and fear of domestic violence were the main factors why some pregnant women did not accept to take an HIV test during their pregnancies. It is also concluded that most men make decisions for their families. Women in homes have no powers to make decisions, so if the husband refuses her to take a test, the wife just has to comply. It is also concluded that a person’s ability to access health related services is shaped by socio cultural and personal factors among others factors. These findings fit well with the Anderson behavioral model which describes the individual factors as having three elements that relate to the individual’s ability to access and utilize health care services. / AFRIKAANSE OPSOMMING: Hierdie navorsingstudie het gekyk na die faktore wat 'n invloed HCT in die voorsiening van VMTKO dienste. Dit ondersoek die sosio-kulturele en persoonlike faktore wat HCT. Dit het ook die kennis oor MIV / VIGS en VMNKO onder swanger vroue in Kabwe. Die oordrag van MIV van moeder na kind dra grootliks by tot die voorkoms van MIV onder kinders (Bartlett et al. 2004). Pogings om hierdie wyse van oordrag te verminder sluit in toenemende aantal vroue wat hul MIV-status ken en die verhoging van die aantal MIV-positiewe vroue wat toe swanger neem instruksies en reageer op hulle om hul kinders te beskerm teen die moontlikheid van infeksie. Individue kan slegs weet wat hul MIV-status wanneer hulle getoets word vir MIV. Egter, is daar sosiaal-kulturele en persoonlike faktore onder ander faktore wees wat die toegang van HCT. Die doel van hierdie studie was om sosiaal-kulturele en persoonlike faktore wat die MIV-berading en toetsing in die voorsiening van VMTKO dienste onder swanger vroue in Kabwe te identifiseer, ten einde aanbevelings te maak vir die ontwikkeling van 'n intervensie program te help opname van MIV-berading en toetsing vir VMNKO dienste te verbeter. Beide kwantitatiewe en kwalitatiewe metodes is gebruik om hierdie studie uit te voer. Fokusgroepbesprekings is gevoer met groepe van swanger vroue wat nog nooit vir MIV getoets is voor en onderhoude met sleutelinformante met gesondheidsorgwerkersVroedvroue of verpleegsters) is gebruik om hulle te vra oor die faktore wat HCT in voorsiening van PMTCT dienste onder swanger vroue. 'n Retrospektiewe statistiese verslag review is ook gebruik om die toeganklikheid koers vir die MIV-berading en om vas te stel toetsing vir VMNKO dienste. In hierdie lig, is statistiese verslag hersiening gebruik word om die aantal swanger vroue wat die ANC en die aantal swanger vroue MIV-toetsing in te samel. Die bevindinge van hierdie studie het aan die lig gebring dat die swanger vroue het uitstekende kennis oor MIV / VIGS en die update van HCT was so goed as 91% onder swanger vroue. Die navorsing het ook aan die lig gebring huishoudelike geweld, beskuldiging van losbandigheid deur vennoot, verlating deur vennoot, en stigma diskriminasie as sosio faktore wat 'n invloed HCT in die bepaling van die PMTCT. Godsdiens, vrees ongeloof van toetsresultate is geopenbaar as persoonlike faktore wat HCT in die voorsiening van PMTCT. Die navorsing het aan die lig gebring besluitneming, tradisie medisyne, en praktyke as kulturele faktore wat HCT in die voorsiening van PMTCT. Die gevolgtrekking is gemaak dat vrees vir verlating deur vennoot, vrees daarvan beskuldig dat hy van promisku deur vennoot, en die vrees van huishoudelike geweld was die belangrikste faktore waarom sommige swanger vroue nie aanvaar het nie 'n MIV-toets te neem tydens hul swangerskappe. Dit is ook die gevolgtrekking gekom dat die meeste mense besluite neem vir hul families. Vroue in huise het geen magte om besluite te neem, so as die man weier om vir haar 'n toets te neem, die vrou net om daaraan te voldoen. Dit is ook die gevolgtrekking gekom dat 'n persoon se vermoë om gesondheid verwante dienste om toegang te verkry tot gevorm word deur die sosiaal-kulturele en persoonlike faktore onder andere faktore. Hierdie bevindings pas goed met die Anderson gedrags-model wat die individuele faktore beskryf met drie elemente wat betrekking het op die individu se vermoë om toegang te verkry tot en gebruik van gesondheidsorgdienste.

Twenty four eThekwini HIV/AIDS counsellors based in four different work settings and who received training from five different training providers, shared their HIV/AIDS counsellor training experiences. The qualitative, phenomenological study utilized a multi-methods approach. The purpose of HIV/AIDS counselling lacks uniformity. Participants reflected upon their distinction between training satisfaction and perceived competency to render HIV/AIDS counselling after training. Although they were satisfied and empowered by the useful information gained, many felt inadequate to counsel an HIV positive person on completion of training. Inadequate practical learning opportunities were evident. Participants identified the need for a more balanced theoretical and practical training program incorporating experiential and didactic training methods. Entrance criteria to HIV/AIDS counsellor training courses and eventual assessment procedures in the study were diverse. Participants suggested improvements for training methods and course content and proposed a tiered training model that will result in standardized and certified training modules. / Social Work / MA(SS) (Social Work)

This study investigated the exposure of employees in the South African Police Service (SAPS) to the HIV/AIDS workplace programme, levels of knowledge of HIV/AIDS, perceptions of stigma and discrimination and of participation by stakeholders in programme implementation. The researcher subscribes to the view that stigma and discrimination are major obstacles to the successful implementation of the HIV/AIDS workplace programme as this notion has been substantiated by numerous studies. Self-administered questionnaire was used as means of data collection. Findings suggest that the employees of SAPS based at the National Head Office have high levels of knowledge on HIV/AIDS. However, the majority of the respondents indicated that they would not feel comfortable to disclose their HIV positive status, fearing the consequences thereof. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

Appendix B (leaves 217-218), Appendix M (leaves 239-247) and Appendix O (leaves 253-259) in English and Amharic / The purpose of this research was to develop HIV testing Health Belief Scale (HTBS) that contains the constructs of Health Belief Model (HBM), and also to analyse HIV testing intention and behaviour among university students. The mixed method approach was used in phases. First, Literature review and in-depth interviews were conducted to develop item pool for HTBS, which was followed by content validity assessment by experts. In the second phase, a pilot survey was conducted on randomly selected 318 university students to refine the HTBS using item analysis and Exploratory Factor Analysis (EFA). Lastly, cross-sectional survey was conducted on representative sample of 612 students in order to further refine the HTBS using Confirmatory Factor Analysis (CFA) and also analyse predictors of HIV testing intention and behaviour. A total of 61 items was written for the HTBS and 23 of these were generated from the in-depth interviews. Content validity assessment by three experts indicated that the average content validity index (CVI) for the 61 items was 91.2% which was more than the recommended cut off point of 90%. The HTBS, after experts review, contained 64 items. EFA indicated that a five factor model which was roughly consistent with HBM was identified and 44 items were retained based on factor loading and reliability analysis. The Cronbach’s alpha for all the six constructs of HBM and HIV testing intention in the HTBS were >0,70. (susceptibility, benefit, self-efficacy and HIV testing intention) fitted the sample data based on chi-square test. However, all the seven constructs demonstrated RMSEA value of less than 0.08 and GFI value of >0.90 indicating acceptable fit. The final HTBS was reduced to 39 items based on factor loading and reliability assessment. All the constructs demonstrated a Cronbach’s alpha value >0.70 except for perceived susceptibility and cues to action. Analysis of multiple linear regression indicated that class year, perceived benefit, perceived self-efficacy and cues to action were significant predictors of HIV testing intention. However, only marital status and cues to action were significant predictors of recent history of HIV testing through analysis of binary logistic regression. / Health Studies / D.Litt. et Phil. (Health Studies)

This study investigated the exposure of employees in the South African Police Service (SAPS) to the HIV/AIDS workplace programme, levels of knowledge of HIV/AIDS, perceptions of stigma and discrimination and of participation by stakeholders in programme implementation. The researcher subscribes to the view that stigma and discrimination are major obstacles to the successful implementation of the HIV/AIDS workplace programme as this notion has been substantiated by numerous studies. Self-administered questionnaire was used as means of data collection. Findings suggest that the employees of SAPS based at the National Head Office have high levels of knowledge on HIV/AIDS. However, the majority of the respondents indicated that they would not feel comfortable to disclose their HIV positive status, fearing the consequences thereof. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)