This study explores women’s access to land under the customary tenure system. It examines how the changes in land tenure, access and rights to land as a consequence of HIV/AIDS are affecting agricultural productivity, food security and poverty, with a specific focus on women who have lost their husbands to HIV/AIDS in Zvimba. Zvimba is a village community located in Zvimba District in the Mashonaland West Province of Zimbabwe. The study also discusses policy responses designed to cushion the impact of HIV/AIDS on local communities especially women living with HIV/AIDS. The study highlights the vulnerability of widows to land rights violations, mainly inflicted by relatives but sometimes by the wider community. The main form of abuse encountered included the use of abusive language, threats of evictions and at times, beatings. The legal route for seeking redress was rarely used. Fear of witchcraft, low educational levels and fear of causing conflict between children and their paternal relatives also led widows to abandon the fight for their rights. The study further reveals that widows are heavily exposed to dispossession of their land rights. HIV/AIDS has increased the vulnerability of widows and other women to threats and dispossession of their land and other property rights. Dispossession of arable fields was observed in the four wards. The dispossessions and threats to livelihoods were directly related to the HIV positive status of the widows. The findings from this study illustrate the predominant role that male members of the household or family have over land. Thus, culture and traditional practices still affect women in other cases, disadvantaging them in favour of men, as in inheritance of land and property in the household.

MPH / Department of Public Health / Background: Human Immunodeficiency virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) is one of the major public health problems that has negatively impacted mostly orphans leaving in child-headed families in the world. A child- headed family is defined as a family, living under the same roof, which is headed by a person under the age of 18 years. Many of these children have become heads of households and they are obliged to look after themselves and siblings. As a result, some children drop out from school while looking for jobs to sustain the family. Purpose: The purpose of the study is to explore and describe the experiences of children in HIV/AIDS-affected child-headed families in Zimbabwe. Methodology: The researcher employed qualitative approach with explorative, descriptive, contextual and phenomenological designs. Nonprobability purposive sampling was used to select the participant. Children aged between 12-18 years were selected as they were able to narrate their life experiences. In-depth face to face individual interviews were used to collect data pertaining to experiences of children in HIV/AIDS child-headed families. Data was transcribed verbatim, and then translated from Shona to English. The data was then analysed following Tesch’s eight steps model. Findings: The findings of the study revealed that children in HIV/AIDS-affected child-headed families were lacking basic commodities such as food, clothing, shelter and clean water. The findings also revealed that children living in HIV/AIDS-affected child-headed families were being abused physically, sexually, emotionally and verbally. The findings of the study also revealed that children living in HIV/AIDS-affected child-headed families received support from the government, non-governmental organisations, community and relatives. / NRF

This study articulates the lived experiences regarding drug adherence by adolescents in Zimbabwe. The study was conducted in Bulawayo, the second largest city in Zimbabwe to aid understanding the experiences the adolescents go through as they try to live as normal a life as possible despite them having the most stigmatised condition in the country in particular and the world at large. A phenomenological inquiry was undertaken using Wertz’s (1983, 2005, 2011) empirical psychological reflection approach for data analysis, after utilizing purposive, convenience and criterion sampling techniques to select thirteen (13) adolescents who were on ART and were in good health and also willing to take part in the study. Data were generated using in-depth qualitative interviews and the interviews continued until data redundancy was reached. The interview proceedings were digitally audio-recorded in addition to taking field notes and these were transcribed verbatim. Data analysis occurred at idiographic and nomothetic levels according to the principles of Wertz’s empirical psychological reflection. Thematic analysis of the research data revealed six (6) themes namely:  Treatment fatigue.  Delay in getting to know own HIV status.  Stigma  Disability (visual impairment).  Lack of support.  Religious beliefs (church). Wholeness emerged as the single most encompassing and accommodating concept that united the various themes and categories. It further grounded adolescents’ experiences regarding drug adherence and coping with challenges associated with HIV. The findings add substantial knowledge about how adolescents experience drug adherence. Important recommendations are made and guidelines that may be used to increase adolescents’ resilience to challenges of being HIV infected are suggested. / Health Studies / D. Litt. et Phil. (Nursing)

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)

Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is a global problem. Introduction of antiretroviral therapy (ART) came as a relief to people living with HIV and AIDS as it improved their quality of life. However, maintaining high adherence levels to antiretroviral treatment is still a challenge in some settings yet strict adherence to treatment instructions is critical for successful suppression of HIV. A qualitative, descriptive phenomenological research was conducted to explore factors that influence adherence to antiretroviral therapy at Beatrice Road Infectious Disease Hospital (BRIDH). Purposive homogenous sampling was done. Data was collected from twenty patients through in-depth interviews. Study findings identified five main themes that facilitate adherence and these entail knowledge on HIV and AIDS and ART, motivation to live, adherence support networks, good service delivery and factors related to medication / Health Studies / M.A. (Public Health)

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)

Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is a global problem. Introduction of antiretroviral therapy (ART) came as a relief to people living with HIV and AIDS as it improved their quality of life. However, maintaining high adherence levels to antiretroviral treatment is still a challenge in some settings yet strict adherence to treatment instructions is critical for successful suppression of HIV. A qualitative, descriptive phenomenological research was conducted to explore factors that influence adherence to antiretroviral therapy at Beatrice Road Infectious Disease Hospital (BRIDH). Purposive homogenous sampling was done. Data was collected from twenty patients through in-depth interviews. Study findings identified five main themes that facilitate adherence and these entail knowledge on HIV and AIDS and ART, motivation to live, adherence support networks, good service delivery and factors related to medication / Health Studies / M.A. (Public Health)

This non-experimental, retrospective, descriptive and correlational study investigated adherence to antiretroviral drugs among HIV positive patients at Mpilo Central Hospital in Bulawayo Zimbabwe. Data among 118 patients was extracted from clinic registers and patient facility held medical records to determine level of adherence to ART using pharmacy refills (a non-immunological adherence parameter) and compared to CD4 cell count ( an immunological adherence parameter). Adherence levels obtained in this study using pharmacy refills was low (62.7%) and a relatively high non-adherence level of 37.3%. The pharmacy refill adherence level obtained was comparable to CD4 cell count adherence level of 64.6% (as indicated by a 50% CD4 cell count gain). These findings would seem to indicate the need for more education on the importance of adherence and further the need for better adherence monitoring systems / Health Studies / M.A. (Public Health)

This non-experimental, retrospective, descriptive and correlational study investigated adherence to antiretroviral drugs among HIV positive patients at Mpilo Central Hospital in Bulawayo Zimbabwe. Data among 118 patients was extracted from clinic registers and patient facility held medical records to determine level of adherence to ART using pharmacy refills (a non-immunological adherence parameter) and compared to CD4 cell count ( an immunological adherence parameter). Adherence levels obtained in this study using pharmacy refills was low (62.7%) and a relatively high non-adherence level of 37.3%. The pharmacy refill adherence level obtained was comparable to CD4 cell count adherence level of 64.6% (as indicated by a 50% CD4 cell count gain). These findings would seem to indicate the need for more education on the importance of adherence and further the need for better adherence monitoring systems / Health Studies / M.A. (Public Health)