In English / This study investigates the resilience of caregivers at a Gauteng-based hospice with patients living with HIV/AIDS. The primary focus of this study was to describe the impact on caregivers working with terminally ill patients predominantly with HIV/AIDS. Six participants were selected for this study utilising purposive sampling. Their ages ranged between 30 and 70 years. For the purpose of data collection, face-to-face semi-structured interviews were undertaken. In analysing data, the themes and sub-themes were extracted and presented by employing thematic analysis. The findings of this study revealed that in times of adversity and setbacks most caregivers utilise various skills to bounce back, and they still showed contentment in serving community members. However, caregivers have also voiced the concern that the support offered at work was not sufficient in meeting their needs. Recommendations for further research, on the resilience of caregivers when working with terminally ill patients is highlighted. / Psychology / M.A. (Clinical Psychology)

In English / This study investigates the resilience of caregivers at a Gauteng-based hospice with patients living with HIV/AIDS. The primary focus of this study was to describe the impact on caregivers working with terminally ill patients predominantly with HIV/AIDS. Six participants were selected for this study utilising purposive sampling. Their ages ranged between 30 and 70 years. For the purpose of data collection, face-to-face semi-structured interviews were undertaken. In analysing data, the themes and sub-themes were extracted and presented by employing thematic analysis. The findings of this study revealed that in times of adversity and setbacks most caregivers utilise various skills to bounce back, and they still showed contentment in serving community members. However, caregivers have also voiced the concern that the support offered at work was not sufficient in meeting their needs. Recommendations for further research, on the resilience of caregivers when working with terminally ill patients is highlighted. / Psychology / M. A. (Clinical Psychology)

No description available.

This thesis sought to develop an agent-based model that replicates the formation of social and sexual partnerships in real-world settings with an eventual aim of revealing the main drivers of the HIV pandemic in a closed mixed society. Agent-based modelling is a computational modelling approach that allows for the simulation of the actions and interactions of autonomous agents, with the eventual objective of disovering global effects on the system. This modelling technique is less dependent on generalisations and does not average out the behaviour of individuals. Sexual partnerships formed in the model goes through the process of dating, courting and has a chance of developing into marriage as well as the possibility of breaking up or undergo divorce. Sexual partnership formation is based on a likeability index calculated using aspiration, attractiveness and age. Over and above the the sexual relationships we include commercial sex work. Commercial sex work depends mainly on the availability of female sex workers and their clients. We superimpose the spread of HIV on the social and sexual network model. Results from the model reveal that saturation of HIV prevalence is driven by the social and sexual network structure, behaviour change as well as biologic factors. Excluding commercial sex work in the model resulted in a decrease in HIV prevalence and incidence. Dense social networks resulted in a dense sexual network which consequently increased HIV incidence. A change in the infection probability per coital act contributed significantly to a change in incidence and prevalence levels. Model results also show that enrolling all HIV positive agents on antiretroviral therapy (ART) as from 2016 simulation year will help in curbing HIV transmission if zero dropout rate from ART is assumed. Therefore, on concomitant action to avoid dropouts from ART is necessary if full benefits of introducing ART to all HIV positive individuals are to be realised. / Operations Management / D.Phil. (Operations Research)

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 this study was to explore the lived experiences of older caregivers of adult AIDS ill children in Umlazi Township in the province of Kwa- Zulu Natal. A qualitative research design which was exploratory was executed with a sample of purposively selected participants who are the members of the organization that provides support to the older caregivers. Data saturation occurred after focus group and in depth individual interview with ten participants. The findings revealed that older caregivers experience lot of challenges which ranges from emotional, physical, financial, psychological, social and time constraints when caring for their adult AIDS ill children .The study further revealed that older caregivers developed a wide range of coping strategies to face their challenging caregiving task and most of the older caregivers utilized positive coping strategies. Recommendations that are described focus on the inclusion and consultation of older caregivers in all decisions and programmes about them. / Appendix C (Interview guide) in English as well as in Zulu / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

South Africa's HIV prevalence rate is estimated to be 5.7 million and at the end of2007 a total of 45845 HIV/AIDS adult patients were taking antiretroviral therapy (ART). The global incidence of HIV/AIDS has been slowly decreasing over the years but is still widespread. This disease is still more prevalent in sub-Saharan Africa than in other parts of the world, with more than 60% people living with HIV/AIDS. Highly active antiretroviral therapy (HAART), the treatment of choice, slows the progression of the human immunovirus but demands a high adherence rate in excess of 95%. Patients who are poorly informed about antiretrovirals (ARVs) and misunderstand medicine-taking instructions or experience unexpected side effects may interrupt therapy, predisposing them to the development of resistance. Such patients need information but, given the poor literacy skills prevalent in South Africa, written information is often not fully comprehended and is often written at too high a reading level. The objectives of this research project were to design, modify and evaluate HIV / AIDS patient education materials for low-literate isiXhosa speaking adults residing in Grahamstown and to examine their impact on the understanding of various aspects of the disease and its treatment. Pictograms illustrating common side effects of ARVs (e.g. stavudine, efavirenz, lamivudine), as well as various sources 'for purchasing nonprescription medicines, storage and medicine-taking instructions were designed and evaluated both qualitatively, using group discussions, and quantitatively through individual interviews where interpretation of the pictograms was assessed. These pictograms were incorporated in a patient information leaflet (PIL) which had been specifically designed for people with limited reading skills and was a simple document containing the minimum of essential text. A previously developed PIL was modified in collaboration with the target population and two versions were produced, one incorporating pictograms illustrating side effects, the other with none. Pictograms were used in both to illustrate other medicine-taking instructions. The PILs were tested objectively to assess the readability, format, content, and general design. They were translated into isiXhosa prior to being qualitatively and quantitatively evaluated in a low-literate isiXhosa speaking population. Understanding of the PILs was assessed by asking a series of questions about the PIL content. Participant opinion of the readability and appearance of the PIL was recorded. The relationship between PIL understanding and selected demographic variables was investigated. Findings from this study illustrated that well designed pictograms assist in the location of information in written leaflets and they may enhance understanding of the information. It was further demonstrated that education influences total understanding of PIL content thus emphasizing the need for tailor-written information in accordance with the education level of the target population. A desire to receive PILs incorporating pictograms was expressed by the majority of participants. Collaboration with the intended target population is essential to design culturally acceptable, easily interpreted pictograms and to produce user-friendly, easy-to-read, comprehensible patient education materials. The rigorous, iterative design, modification and testing process described in this study is one that should be adopted in producing all health-related education materials.

The purpose of this study was to develop a laboratory based Comprehensive Care, Management and Treatment of HIV and AIDS (CCMT) programme status reporting system using a methodological research study design. Quantitative data was collected using a request form and qualitative data was collected using structured questionnaires. For the study 1190 eligible CD4 samples were received, of which 1004 (84%) had a valid CCMT programme status. Overall 32% of the CD4 samples had a pre-ART status (n=383) and 52% had an ART status (n=621). The remaining 16% of CD4 samples (n=186) did not have a valid CCMT programme status. A pre-ART register was generated and assessed using a structured questionnaire. Based on the study findings a recommendation has been made to adopt the two-tick design for all NHLS request forms where programmatic data is collected. Additionally the CCMT programme status reporting system is recommended for rollout to other health districts / Health Studies / M.A. (Public Health with specialisation in Medical Informatics)

The purpose of the study was to describe the determinants and practice of HIV self-testing among health care workers (HCWs) in Nyeri provincial hospital, Kenya. A descriptive cross-sectional study was conducted to determine the rate of HIV self-testing, explore the factors influencing the practice and describe access to HIV psychosocial support, care and treatment. The study was guided by the concepts of the protection motivation theory. Data was collected from 348 HCWs and analysed by means of logistic regression. Results showed that 65.8% of the HCWs had practiced HIV self-testing among themselves. Age, self efficacy and response efficacy were found to be significant predictors of HIV self-testing. Willingness to access HIV psychosocial support (71.3%) and care and treatment (73.9%) was high. Self-testing is highly practiced by HCWs. / HIV self-testing among health care workers at Nyeri Provincial Hospital in Kenya / HIV self-testing among health care workers / Public Health / M.A. (Public Health)

Thesis (MPhil)--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: This reflexive study of responses to the HIV/AIDS pandemic was set in Stellenbosch, a town in the Cape Winelands that, with its diverse but disjointed population, in many ways is a microcosm of South African society. My question was what happens when the experience of HIV/AIDS, with its personal impacts and global connections, reaches a particular locality in South Africa. I worked on the assumption that the reach of the disease in this specific locality reflects the disconnectedness of people through historical, political, social and economic processes, and that responses to the disease attempt to repair ruptures through integrating people into caring systems of support. By tracking and interrogating responses at public health and service organisation levels as a participant observer, I noted recurrent references to the importance of engaging patients in the treatment process. My observations revealed a transformation in the dyadic relationship between doctor and patient, as well as an embracing reach of networked service organisations, both initiatives striving to render more effective services. In the process relationships developed between patients and service providers at health and social levels, and between providers themselves. Much of the impetus for these local developments was derived from global inputs as local players draw down packaged practices and funds from the global assemblage that Nguyen refers to as the “AIDS industry” (2005a). Thus, I suggest that HIV/AIDS becomes a catalyst for local innovation within globally standardised structures, such innovation being driven principally by building social relationships. / AFRIKAANSE OPSOMMING: Hierdie reflektiewe studie aangaande die response tot die MIV/VIGS pandemie is in Stellenbosch, ‘n dorp in die Kaapse Wynlande, gedoen. Stellenbosch se diverse, maar tog onsamehangende, populasie is in verskeie maniere ‘n mikrokosmos van die Suid- Afrikaanse samelewing. My vraag het gevra wat gebeur as die ondervinding van MIV/VIGS, wat persoonlike impakte en globale konneksies insluit, ‘n spesifieke lokaliteit in Suid-Afrika bereik. Ek het gewerk volgens die aanname dat die omvang van die siekte in dié spesifieke lokaliteit die uitskakeling van mense deur historiese, politieke, sosiale en ekonomiese prosesse reflekteer, en dat response tot die siekte poog om ontwrigtings te herstel deur die integrasie van mense in versorgende ondersteunings sisteme. Deur response, op publieke gesondheid en dienslewerings organisasie vlak, as deelnemende waarnemer op te volg en te ondersoek, het ek herhaaldelike verwysings gekry na die noodsaaklikheid om pasiente te betrek in die behandelings proses. My observasies het ’n transformasie in die wederkerige verhouding tussen dokters en pasiente ontbloot, sowel as ’n omvattende omvang van netwerke van dienslewerings organisasies. Beide inisiatiewe streef daarna om meer effektiewe dienste te lewer. In die proses ontwikkel verhoudings tussen pasiente en diensverskaffers op gesondheids and sosiale vlakke, asook tussen diensverskaffers. ’n Groot gedeelte van die dryfkrag agter hierdie plaaslike ontwikkelings spruit uit globale insette namate plaaslike spelers verpakte praktyke en fondse ontvang/trek van die globale groep, wat Nguyen na verwys as die ’VIGS industrie’ (2005a). Daarvoor, stel ek voor dat HIV/VIGS ’n katalisator vir plaaslike innovasie binne globaal gestandardiseerde strukture word, en dat inovasies van die aard hoofsaaklik deur die bou van sosiale verhoudings gedryf word.