Thesis (MPhil)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: It is very common to talk about or refer to people as “People Living with HIV/AIDS” but never “A Church with Aids”. Responding to HIV/AIDS has earned the JL Zwane Memorial Church this name or rather this label. Members of the congregation, many of them young, were dying and remaining silent, not doing anything, would have meant contributing to the disaster that had struck. Something drastic had to be done to respond to the pandemic or else the whole community would have perished. This was not easy as it meant risking losing those already in the church. To many people, HIV/AIDS was seen as a punishment from God to those who have sinned. For this reason many did not want to have anything to do with People Living with HIV/AIDS. The whole response is driven by the needs of the community i.e. those infected and those affected. This means listening to people tell their stories and then respond accordingly. Listening is the key in the response as the whole response revolves around people and their experiences. / AFRIKAANSE OPSOMMING: Die kerk, of geloofsgebaseerde organisasies , is dikwels die eerste om te weet dat iemand MIV positief is. Dit is ook die eerste persoon of organisasie wat deur die geïnfekteerde in vertroue geneem word. Die Kerk, as organisasie, kan dus 'n deurslaggewende rol vervul in die voorkoming, maar ook by die versorging van diegene wat MIV positief is of aan Vigsverwante siektes ly. Hierdie studie beskryf, in die vorm van 'n gevallestudie, die rol wat die Presbiteriaanse Kerk in Guguleto in die voorkoming van MIV/Vigs vervul. Die gevallestudie bespreek die probleem; die ontleding van die probleem en die uiteindelike program(me) wat daargestel is. Riglyne vir die betrokkenheid van Kerke (en geloofsgebasserde organisasies) word uitgespel en voorstelle vir verdere studie word gemaak.

A qualitative study aimed at exploring the nature and extent of the perceived social support available to male prisoners living with HIV at Pretoria Central Prison was conducted. A literature investigation into the life and world of male prisoners, with a focus on the nature and extent of the perceived social support provided to prisoners living with HIV, is presented. Fifteen (15) prisoners were identified by means of non-probability purposive sampling. In-depth interviews were conducted to collect information on how male prisoners living with HIV at Pretoria Central Prison viewed the nature and extent of the social support available to them. The study shows that the research participants living with HIV tended to receive social support from practitioners and other prisoners trained as voluntary caregivers. The study recommends that prisoners living with HIV should have greater access to social support from their significant others. / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

The purpose of the study was to evaluate the management of the HIV and AIDS workplace policy at Statistics South Africa (Stats SA). This entailed an assessment of the levels of awareness amongst employees, and an assessment of employees’ knowledge of the policy and its implementation. Data were collected through a structured questionnaire administered to randomly selected employees. It was found that the respondents’ level of awareness of the HIV and AIDS workplace policy at Stats SA was satisfactory. Although some differences were observed, overall it seems that Stats SA was successful in promoting general awareness of its policy and its contents. However, as far as the respondents’ attitudes and opinions relating to the implementation of the policy at Stats SA are concerned, several issues still need to be addressed. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

This study was done to assess the quality of life (QOL) of people living with HIV and AIDS (PLWHA) in Swaziland who are on antiretroviral therapy (ART). No study has been done on QOL of PLWHA in Swaziland who are on ART since it started to be administered in Swaziland in 2001. A qualitative, exploratory, descriptive, and contextual design was used to assess QOL of PLWHA in Swaziland who are on ART. Twenty-four PLWHA were purposely selected to participate in the study. Methods of data collection used were semi-structured individual in-depth interviews, focus group discussions, and observations. The data (tape-recorded interviews and discussions, and field notes) were transcribed verbatim for data analysis. Data analysed was done using Tesch’s framework of data analysis as described in Creswell (2002:256-283). The research findings are reflected, with the six domains of QOL identified through a literature review and validated by nurses’ expertise. These domains are the physiological, psychological, spiritual, socio-economic, cognitive, and environmental domains.The study revealed that PLWHA in Swaziland are faced with many challenges concerning ART, namely: inability to meet their nutrition needs, non-adherence to ART, experience of disfiguring side effects of ARVs, inconsistent condom use, experience of stigma and discrimination, depression, difficulty in accepting and coping with ARVs, lowered self-esteem, a negative influence of some religions on ART, a lack of financial support, poor support systems, poor understanding of ARVs, negative thoughts about HIV and AIDS and ART, an unsatisfactory health care delivery system, a negative influence of culture on ART, and violation of the rights of PLWHA. These challenges negatively influence the QOL of PLWHA and hence the study concluded that PLWHA in Swaziland who are on ART have a poor QOL. Conclusions drawn from the data analysis reveal that PLWHA in Swaziland are powerless to deal with the above challenges and improve their QOL. The researcher, therefore, developed guidelines to empower PLWHA to deal with these challenges and adhere to ART, thus improving their QOL. Recommendations were made with regard to nursing practice, nursing education, and further nursing research. / Health Studies / D. Litt. et Phil. (Health Studies)

Stigma and discrimination (SAD) attached to Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has been recognised as a major obstacle to HIV prevention, treatment, care and support throughout the world. SAD is more devastating when it occurs in health care settings where it is least expected. Health care providers (HCPs) are supposed to provide physical, social and psychological support to people living with HIV (PLWHA) but HIV and AIDS-related SAD has been extensively documented among the HCPs. Different studies have pointed out that there are three major actionable causes of HIV-related SAD in health care settings. These are lack of awareness among HCPs, fear of casual contacts and associating the SAD to immoral behaviour. The main objective of the current study is to determine the magnitude of HIV and AIDS-related SAD and its associated factors in hospitals and then to propose appropriate SAD reduction-intervention strategy in the health care settings. The study employed pre-test-post-test design with non-equivalent control group. Two paradigms were used in this study including quantitative and qualitative approaches. The sampling method for the quantitative part of the study was probability sampling in which the respondents were randomly selected using stratified sampling technique. The study was able to determine the magnitude of HIV and AIDS-related SAD among the HCPs. Moreover, the study has identified the factors that are attributed to the prevalence of SAD in the hospitals. The major factors identified for causing the SAD in the hospitals were sex, age, work experience, low level of knowledge, negative attitudes and percieved risk of HIV infection of some HCPs toward the PLWHA. The intervention made on the respondents in the treatment group was able to reduce the overall prevalence of the SAD among the HCPs. The study suggests that to reduce the SAD, HIV and AIDS-related trainings before and after graduation is critical to improve the knowledge, attitudes and practices of the HCPs. Besides, ensuring the availability of the protective supplies in hospitals is crucial in reducing the fear of HIV infection among the HCPs while providing care for HIV positive patients. Effective implementation of the hospital policies, strategies, guidelines and protocols along with good institutional support is also vital in creating safe and user-friendly hospitals for PLWHA. / Health Studies

Text in English / The discovery that anti-retroviral therapy (ART) is important for human immunodeficiency syndrome (HIV) prevention has increased interest in factors that influence adherence to HIV treatment. Studies have shown that non-adherence to ART results in drug resistance, morbidity and person-to-person HIV transmission. For persons defaulting on or living risky sexual lives, becoming adherent is a life-saving behavioural change, both for themselves and for their sexual partners. HIV/AIDS programmes are trying different innovations to enhance behavioural outcomes of people living with HIV (PLHIV). This study sought to determine the value of support group participation and based on the findings, to develop an evidence-based model for revitalising caregiver social support competencies. The study was conducted in two phases. In the first phase, a cross-sectional descriptive design was used to compare PLHIV who participate in support group activities with those who do not, in terms of their behavioural outcomes. Multistage probability sampling was used to select study respondents. Data was collected using a selfadministered questionnaire from 1,676 respondents between February and May 2014. Data was analysed using STATA. Data analysis shows that 47% of respondents had once (ever) participated in support group activities while 53% had never. PLHIV who participated in support group activities differed from those who did not in terms of HIV-related stigma (p=<0.001), positive HIV status disclosure (p=0.005), ART adherence (p=0.021), and sexual risk behaviours (p=0.045). PLHIV who participated in support group activities were more likely to have less internal HIV-related stigma, disclose their positive HIV status, adhere to ART and live less risky sexual lives. The two study groups were not different in terms of perceived social support (p=0.28) and external stigma (p=0.250). More PLHIV obtained social support from health workers (66%) and family members (36%) than from PLHIV support groups (16%). The researcher concludes that participating in support group activities positively impacts on behavioural outcomes of PLHIV, but PLHIV support groups are not the only sources of social support. In the second phase, a model for revitalising PLHIV caregiver social support competencies was developed as a recommendation for assuring PLHIV access to holistic care and support. / Health Studies / D. Litt. et Phil. (Health Studies)

The study was about the process evaluation of the development of the YOUNG WORKERS CAMPAIGN (YWC) Programme to document and analyses the involvement and participation of stakeholders in the development process. The purpose of the study was on the assessment of stakeholder participation and involvement in the development of the YWC to maximise the effectiveness, acceptability and sustainability of the intended programme. Informant interviews, focus group interviews and document analysis were the primary means of collecting data for this research study. The main findings are as follows: Few of the stakeholders were involved in the conceptualisation phase of the YWC Programme and their roles in the development process were not clearly described. Stakeholder analysis was not done and their involvement in decision-making was limited. In order to address the problem of participation, YWC stakeholders should pass through a process of stakeholder analysis, that is, they should be assessed in terms of contribution and value-adding to the development process. / Sociology / M.A. (Social Behaviour Studies HIV/AIDS)

A quantitative approach was used to investigate the stigmatization of HIV positive clients in the Leribe District of Lesotho. The study population included 5200 HIV positive patients who enrolled for ARV in government clinics. A randomly selected sample of 520 clients responded through a questionnaire and interviews. The statistical package (STATA version 9) was used to analyze data. The objectives of the study were to explore the type and level of stigmatization of HIV-positive clients and to describe ways in which health workers in the PHC can reduce the stigmatization of HIV-positive clients at the clinics. The findings revealed that types of stigmatization included separation, isolation, labeling and discrimination. Ways to reduce the stigma within a community based primary health care facility included educating people living with HIV on how to protect themselves from multiple infection, providing effective counselling to clients and families maintaining confidentiality, and using change strategies to change attitudes of health care providers. The integration of HIV-related activities is a strong recommendation and the importance of the consistent availability of ARV treatment was emphasized. / Public Health / M.A. (Public Health)

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)

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)