A group of five HIV-positive gay men were compared with a group of five HIV-negative gay men. All participants were currently engaged in therapy. Participants completed the Session Evaluation Questionnaire (SEQ) and the Session Impacts Scale (SIS) in order to determine what these different groups of individuals felt was helpful or hindering in therapy. Results indicated that both groups of participants found therapy to be powerful, valuable, and helpful in that they: (a) learned something new about themselves or others, (b) changed their ways of thinking, (c) acquired insight into issues, (d) were more clear about their feelings, (e) were able to define their problems, and (f) were feeling understood, supported, and close to their counsellor. In comparison to the HIV-negative group, the HIV-positive group experienced many hindering aspects to counselling. Seropositive participants felt: (a) less understood, supported, and close to their counsellor, (b) more confused, or distracted in counselling, (c) more bothered by unpleasant thoughts in counselling, (d) more impatient or doubting of the value of therapy, and (e) felt more angry, more afraid, and less confident during and as a result of therapy. Implications for counselling are discussed.

No description available.

This research project examined the changing expectations and knowledge of Managers in the Department of Health who attended the Sexual Health Counselling Project offered by Rhodes University, East London, South Africa. These managers came from contexts in which the hierarchical medical model is firmly entrenched. The Sexual Health Counselling Project, drawing on theoretical principles from Narrative and other theories,presented a challenge to the standard management practices used by the managers. It also challenged how they dealt with clients. This research explored changes in expectations and knowledge prior to and during a two- week training course that the managers attended. A personal awareness and shift in knowledge occurred for many managers who examined their current practices. Some managers, who were firmly entrenched in the hierarchical model,found it difficult to change their ways of working.

This purpose of this study was to investigate and examine the attitudes of therapists who treat HIV-positive (HIV+) clients. Specifically, therapists' perceptions of their own preparedness in dealing with specific issues and emotions of HIV+ clients were examined. Also, therapists' evaluation of their own efficacy of specific therapeutic approaches with HIV+ clients was examined. These therapists' perceptions and evaluations of all their clients in general were compared to their HIV+ clients. Comparisons were also made within the two groups.

The study sought to identify factors motivating young people aged 14-25 years to use voluntary counseling and testing (VCT) for HIV in Malawi by interviewing 145 young people. The study identified barriers affecting and strategies promoting young people's access to VCT. The research results indicate that young people go for VCT mainly to know their HIV status. The availability of VCT services, and the provision of VCT services by peers motivate young people to access VCT. Some young people do not access VCT services due to fears of being found HIV+ve and because of the poor attitudes of the health service providers. Providing more information about VCT, involving young people as VCT providers, using youth friendly health service providers, providing VCT in a separate room for young people and through mobile services will increase young people's access to VCT services in Malawi. / Health Studies / M.A. (Public Health)

Thesis (MA)--University of Stellenbosch, 2002. / ENGLISH ABSTRACT: The human immune deficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) have already reached a magnitude in Southern Africa which can hardly be addressed by the existing structures. HIV counselling is considered to be an important preventative and supportive strategy in the battle against HIV. In recent years therefore, urgent attempts have been made to provide HIV/AIDS counselling services throughout South Africa. The researcher had a firsthand experience of such an attempt as manager of HIV counselling services for a NGO working in a peri-urban community. She realised that although the ideal outcome and aims of HIV counselling have been widely documented, very little research has been done on the implementation of these principles in health systems with limited resources. It was thought that a meaningful contribution could be made to the development of HIV counselling services in a specific South African community by critically exploring current HIV counselling services in such a community. This exploration entailed the following: • reviewing the literature on HIV counselling; • clarifying the goal of HIV counselling; • clarifying behaviour change as an outcome of HIV counselling; • exploring the influence of the Stellenbosch context on the content and outcome of HIV counselling; and; • exploring to what extent the goals of HIV counselling (as prescribed by international and national literature) are pursued in the Stellenbosch context. The ecological model and an action research method were used to direct this study. The researcher used her position and experience as manager of the HIV counselling services within a non-governmental organisation to access sources of information. Direct and participatory observations were utilised to gather information regarding the implementation of HIV counselling services in the community. The model of Raeburn and Seymour (1979) and specifically the overview phase have been used as a framework to organise the data and to describe the HIV counselling system in the specific community. The researcher concluded that the theoretical principles that were identified as prerequisites for effective HIV counselling services were often irreconcilable with the management skills, context, infrastructure and aims of the primary health services within the district. It was highlighted that a systemic understanding of the impact of the environment should be considered when future models and outcomes are formulated and implemented. Finally, alternative suggestions for the management, the formulation of outcomes and the utilisation of personnel in HIV counselling in this specific community were discussed. / AFRIKAANSE OPSOMMING: Die Menslike Immuniteitsgebreksvirus (MIV) en Verworwe Immuniteitsgebreksindroom (Vigs) in Suider-Afrika het reeds 'n omvang bereik wat beswaarlik deur die bestaande strukture aangespreek kan word. MIV-berading word beskou as 'n belangrike voorkomende en ondersteunende strategie in die stryd teen MIV. In die laaste paar jaar is dringende pogings dus aangewend om MIV-beradingsdienste in die hele Suid Afrika beskikbaar te stel. Die navorser het eerstehandse ervaring gehad van hierdie inisiatief as bestuurder van MIV -beradingsdienste vir 'n nie-regeringsorganisasie wat werksaam is in 'n semilandelike gemeenskap. Alhoewel die ideale uitkoms en doel van MIV -berading wyd gedokumenteer is, het sy besef dat baie min navorsing gedoen is oor die implementering van hierdie beginsels in gesondheidsisteme met beperkte bronne. Daar is geredeneer dat 'n betekenisvolle bydrae gemaak kan word tot die ontwikkeling van MIV -beradingsdienste binne 'n spesifike Suid-Afrikaanse gemeenskap deur die huidige MIV -beradingsdienste in so 'n gemeenskap krities te verken. Hierdie verkenning het die volgende behels : • literatuur oor MIV -berading te bestudeer; • MIV-berading se doelwitte te verhelder; • gedragsverandering as uitkoms van MIV -berading te verhelder; • te eksploreer hoe die Stellenbosch konteks die inhoud en uitkoms van MIV -berading beïnvloed; en • te eksploreer tot watter mate die doelwitte van MIV -berading ( soos voorgeskryf deur internasionale en nasionale literatuur) in die Stellenbosch konteks nagestreefword. Die ekologiese model en 'n aksienavorsingsmetode is gebruik om die ondersoek te rig. Die navorser het haar posisie en ervaring as bestuurder van MIV -beradingsdienste binne 'n nie-regeringsorganisasie gebruik om toegang te verkry tot inligting. Direkte en deelnemende waarneming is gebruik om inligting in te samel rakende die implementering van MIV -beradingsdienste in die gemeenskap. Die model van Raeburn en Seymour ( 1979) en spesifiek die oorsigfase is gebruik as 'n raamwerk om data te organiseer en die MIV -beradingsisteem in die spesifieke gemeenskap te beskryf. Die navorser het tot die gevolgtrekking gekom dat die teoretiese beginsels wat geïdentifiseer is as essensiële voorvereistes vir effektiewe MIV -beradingsdienste in soveelopsigte onversoenbaar is met die bestuursvaardighede, konteks, infrastruktuur en doelwitte wat binne die spesifieke primêre gesondheidsdienste geld. Dit is beklemtoon dat In sistemiese verstaan van die invloed van die omgewing en die inagneming van die sisteem belangrik is wanneer toekomstige doelwitte geformuleer en modelle geïmplementeer word. Alternatiewe voorstelle vir die bestuur van beradingsdienste, die formulering van uitkomsdoelwitte en die benutting van personeel in hierdie dienste is ten slotte bespreek.

Acquired Immune Deficiency Syndrome (AIDS) has become the world's foremost health threat and is the number one killer in Zimbabwe. Acquired Immune Deficiency Syndrome impacts not only the individual who has AIDS, but on nuclear and extended families, and all aspects of society in Zimbabwe. Since studies have indicated that counseling could be an effective tool in preventing the spread of Human Immuno Deficiency Virus (HIV) and helping those who are already impacted by the virus, it would be important for counselors to be knowledgeable about HIV/AIDS and have positive attitudes towards people with HIV/AIDS. Therefore, the main purpose of this study was to investigate eight practicing Zimbabwean counselors' attitudes towards and knowledge of HIV/AIDS. Additionally, the study explored the emotions the counselors experienced while counseling HI V/AIDS clients, their beliefs about the origin of HI V/AIDS, and their perceptions about HI V/AIDS counseling in Zimbabwe. Eight practicing counselors in Zimbabwe participated in this study. A mixed method Model III with a sequential exploratory design was used amid phenomenological underpinnings. The counselors provided information through a mailed (electronic mail) questionnaire and telephone interviews. Follow-ups to the interviews were carried out through the electronic mail. Results indicated that the counselors in the study were generally knowledgeable about HIV/AIDS, had positive attitudes toward people with HIV/AIDS, and did not think that the origin of HIV/AIDS was important and that it was better to focus on the solutions to the problem. The counselors experienced a wide variety of feelings while counseling HIV/AIDS clients. The counselors reported more negative than positive feelings, but most of the feelings were not directed toward the client. The counselors revealed that HIV/AIDS counseling was complex and difficult. The counselors thought counselor training in Zimbabwe was too limited and that counselors in Zimbabwe in general lacked both support and supervision services. Despite the difficulties of, and the lack of support and supervision, the counselors found meaning in counseling HIV/AIDS clients. / Graduation date: 2004

The study sought to identify factors motivating young people aged 14-25 years to use voluntary counseling and testing (VCT) for HIV in Malawi by interviewing 145 young people. The study identified barriers affecting and strategies promoting young people's access to VCT. The research results indicate that young people go for VCT mainly to know their HIV status. The availability of VCT services, and the provision of VCT services by peers motivate young people to access VCT. Some young people do not access VCT services due to fears of being found HIV+ve and because of the poor attitudes of the health service providers. Providing more information about VCT, involving young people as VCT providers, using youth friendly health service providers, providing VCT in a separate room for young people and through mobile services will increase young people's access to VCT services in Malawi. / Health Studies / M.A. (Public Health)

Rape survivors often have two traumatic events to deal with. In addition to the actual rape experience, survivors commonly need to deal with hearing the results of human immunodeficiency virus (HIV) testing (which is standard practice after rape in South Africa). The relationship between these two traumatic events in terms of the survivors specific traumatic stress symptoms have not been well explored in the literature. The primary aim of this study was therefore an exploration of the relationship between receiving an HIV test result and the traumatic stress symptoms of rape survivors. In order to contextualise the main aim, an exploration of the relationship between demographic variables, knowledge of HIV status and early traumatic stress symptoms was also completed. The initial sample consisted of 97 South African rape survivors, however, only 45 participants returned for the second part of the study. This quantitative study utilised an exploratory descriptive design using the Harvard Trauma Questionnaire-Revised (HTQ-R) to measure the traumatic stress symptoms of rape survivors. The results of the first part of the study indicated that there was no significant difference between participants’ demographic factors in relation to their knowledge of HIV status or their overall traumatic stress symptom severity. Significant differences on individual traumatic stress symptoms indicated a relationship between not knowing one’s HIV status and dissociation after a rape incident, as well as a relationship between rape survivors who knew their HIV status is positive and emotional dysregulation. The results of the second part (and main analysis) of the study indicated that most participants presented with less severe overall traumatic stress severity after receiving their HIV test results (irrespective of their status before and after hearing their results). However, participants whose HIV status was unknown and who received a positive test result reported more severe overall traumatic stress compared to those whose HIV status was unknown and received a negative test result. Some inter-group differences on individual symptoms were HIV TEST RESULT TRAUMATIC STRESS RAPE SURVIVORS noted that highlight the possibility that dissociative and an intrusion/hyperarousal subtypes may be at work to explain some of the differences seen.

People living with HIV and AIDS (PLHIV) suffer from a number of stress-related psychological disorders. The aim of this study was to develop an integrative intervention, which combined Cognitive Behaviour Therapy (CBT), Body-Mind Therapy and Multicultural perspectives to assist health care workers in identifying and treating stressrelated psychological disorders among people living with HIV and AIDS. The study employed an intervention research design using both qualitative and quantitative methods. The quantitative data was collected from PLHIV attending HIV Counselling and Testing (HCT) and Anti-retroviral therapy clinics in the Buffalo City Municipality (BCM) of the Eastern Cape Province. The qualitative data was collected from the health care workers of the selected study sites. Purposive sampling was used to select the study sample. Instruments used included a biographical questionnaire, the Beck Depression Inventory-II (BDI-II), Medical Outcome Study- HIV (MOS-HIV) and focus group interviews to gather data for the development of an intervention model that would address reported stress-related psychological disorders. Findings showed that people living with HIV and AIDS endure stress in their lives on daily basis rather than episodes of severe or clinical depression. Many of the PLHIV are dealing with a number of psychosocial problems that compromise their quality of life and health status. In conclusion, the study illustratively interpreted and discussed the results in relation to the objectives of the study. The study recommends that PLHIV should be exposed to stress management programmes, and health care workers (HCWs) should be offered training in basic counselling skills, stress management and/or debriefing.