As part of the Serithi project a longitudinal study of HIV positive women diagnosed during pregnancy, support groups for HIV-positive women were established in Mamelodi and Atteridgeville (Tshwane). Eighty-eight women participated in these groups during 2005, with the groups being facilitated by Masters Psychology students. This study explores therapeutic processes in these support groups. Yalom’s therapeutic factors were used as the underlying theory. These are factors that Yalom advances as therapeutic processes in understanding group psychotherapy. The process notes of the Masters Student facilitators, together with the interviews that were conducted with the women after the support group experience, were analysed to identify therapeutic processes that manifested themselves in the support group experience. Qualitative methods were used to collect data and thematic analysis was utilised to analyse the data. The research results revealed that support groups are therapeutic, in the sense that ten of the twelve therapeutic factors advanced by Yalom proved to have been made manifest, or demonstrated, within these groups. These are: altruism, group cohesion, interpersonal learning input, interpersonal learning output, guidance, identification, family re-enactment, instillation of hope and existential factors. The women reported having felt a sense of relief from being part of a group of people who experienced similar issues. They also reported that they learnt from each other. This gave them hope and an understanding that, even though there may be people going through the same problems as they are, they still need to face life alone. The women reported feeling a sense of self-worth from helping others, which contributed to rebuilding their self-esteem. These results indicate that support groups can be therapeutic for the people involved. They can be used to guide support group facilitators with regards to what to look for when facilitating groups. They can also assist policy makers in developing guidelines for the facilitation of support groups in order for the participants to obtain maximum benefit from their support group experience. / Dissertation (MA)--University of Pretoria, 2009. / Psychology / unrestricted

Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009. / Full text also available online. Scroll down for electronic link.

South Africa has an estimated population of approximately 47. 9 million of which almost (51%) are female; according to the 2007 mid-year report of Statistics South Africa (Stats-SA, 2007). The availability of Antiretroviral (ARVs) that delay HIV progression and improve quality of life of HIV infected individuals and the roll-out of prevention of mother to child transmission (PMTCT) have brought renewed hope among many couples and individuals in South Africa. The four pillars of the Prevention of Mother to Child Transmission (PMTCT) programme include prevention of HIV infection among young women, prevention of un-intended pregnancies among HIV infected women, prevention of HIV infection to the child and provision of care and support services. HIV-positive young women live by socially and medically constructed values that expect them to avoid becoming pregnant, but at the same time they are expected to marry and bear children. A more in-depth understanding of the reproductive decision making experiences of women below the age of 35 is needed because they are at reproductive age and most at risk of HIV infection in South Africa. The impact of a positive HIV diagnosis may be best understood when viewed within a social constructivist framework. A few studies in South Africa (Cooper et al, 2005; Harries et al, 2007; Myer, Morroni, and Rebe, 2007; Orner et al, 2007; Stevens, 2008) have been conducted on fertility desires of HIV positive individuals and couples although not specifically exploring young women who are mostly vulnerable to HIV infection. Recognizing the gap in the desired public health care objectives, such as preventing mother to child transmission of HIV and the lived experiences of young women living with HIV, this qualitative exploratory research was conducted in two South African Townships. The purpose was to explore the reproductive aspirations and intentions of the women below the age of 35, in the light of the higher HIV prevalence in this population, compared to other groups. The research explored two theories of human behaviour; the theory of planned behaviour and Erick Erikson’s human developmental theory. Eleven semi-structured in-depth interviews and two focus group discussions were conducted through support groups at clinics in Soweto and Attridgeville. Ethical approval was obtained from the University of KwaZulu-Natal and all participants signed consent to participate in the research. Findings showed that women younger than 30 who did not have a child, desired and intended to have biological children. Health concerns such as CD4 count, concerns about HIV progression, early death and orphan-hood, previous loss of a child due to HIV and financial concerns were often cited. Tied to this were health workers’ attitudes towards pregnancy among women who knew their HIV status. Women said that a child brought joy, strength and courage to the mother and was seen as an image, when the mother dies, due to HIV. Almost all the women were in support groups that openly discouraged pregnancy among HIV positive women, especially those who already have a child or children. This research indicates that in practice, counselling and information around reproductive health and choices, is often offered in a quest to dissuade HIV-infected women from considering pregnancy. Health services, families and partners, as well as past experiences of motherhood, all play a role in decision making (Cooper et al, 2005). Sometimes policy guidelines alone are not enough to ensure that reproductive rights of women living with HIV are respected at the different levels. This research points out the population of women who have specific needs and who should not be treated as a homogenous group with all women. This recognition should go beyond policy recommendations into implementation and monitoring. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Women living with HIV have a variety of reproductive health and psychosocial needs. The purpose of this critical ethnographic study was to examine how HIV, empowerment and reproduction are experienced by a volunteer sample of HIVpositive women attending public health care facilities in Gauteng. Feminist and critical approaches were used to guide the methodology of the research and the interpretation of the findings. Data were collected through in-depth interviews and observation. An overview of literature pertaining to the social construction of HIV-AIDS, women’s empowerment and reproductive decision-making is presented. A discourse of “healthy lifestyle” as technologies of the self is considered. Women’s empowerment as an ideal is described and structural barriers to its achievement are discussed. Stigma and discrimination as products of hegemony are discussed as important issues in the disempowerment of women living with HIV. HIV-AIDS as illness experience is reviewed with reference to the social context and to the individual context. Reproductive decision-making models and theories are critically analysed for their applicability to women living with HIV. The need for a conceptual shift in the notion of empowerment in order to understand constrained decision-making for women living with HIV is propagated. The stories of women living with HIV and dependent on public health care services are presented. Through the principles of a critical ethnography the lived experiences of these women are described by means of emerging themes. A historiography of family planning and HIV-AIDS services throws the narrations of the research participants into broader historic relief. Findings revealed that biomedical hegemonic power contoured and marked the lived experiences of women following an HIV-positive diagnosis. Taken-for-granted views of passivity and of own responsibilities regarding reproductive health are challenged. The women in the study were dependent upon public health care personnel for treatment, testing, dietary advice/supplementation and recommendations for a social xii disability grant. ARV-treatment was regarded as a low point in the illness career. All of the participants reported that the overriding problems in their lives were having too few material resources and not having the means to change this. This made them vulnerable to compounded health problems and decreased their ability to voice their own opinions about treatment. They did not regard themselves as having been at risk for contracting HIV and some harboured resentment towards men who were seen as being absolved from testing and responsibilities towards female partners, born and unborn children. Women who were not tested as part of antenatal sentinel groups tended to suffer symptoms of ill health for some time prior to being tested for HIV. Social support systems were either absent or consisted of trusted family members and friends. In many cases, women became the silent care-givers for those affected and infected by HIV. Anticipated stigma permeated the participants’ narrations of living with HIV and disclosure of their statuses was difficult. The use of male condoms, stressed during counselling sessions, was narrated as a difficult burden for women to bear. Although the research participants expressed low fertility preferences, HIV-AIDS was seen as disrupting the link between heterosexual conjugal relations and the taken-for-grantedness of procreation. HIV-AIDS also disrupted norms in infant feeding practices and bottle-feeding was regarded as a sign of possible HIV-infection and hidden. The research participants were not empowered with knowledge about how to deal with side-effects, condom failures and the reluctance of male partners to be tested for HIV. They enacted, resisted and lived with HIV in different ways, incorporating some of the biomedically prescribed posturing as women living positively and blending it with stigma-negating performances and gender-prescribed ways of dressing, walking and acting. Participation in a support group validated their experiences and promoted positive self-perception. The formation of a collective voice in the support group was hampered by irregular attendance, the interference of community leaders and horizontal violence. Power relations, yielded by biomedical hegemony, androcentric sociocultural practices, material deprivation, fear, discrimination and stigma potentially undermined the women’s abilities to become empowered. Expansion of choices in various spheres or fields and collective action xiii are proposed as dimensions to be added to an empowerment-of-women approach to the problems of reproductive health in the age of HIV-AIDS. The contribution of the study as an emancipatory project is evaluated and implications for policy and practice are suggested. On a methodological level, this study is a demonstration of the contribution to be made by a micro-level, critical analysis to the body of knowledge about female reproductive health in the era of HIV-AIDS in South Africa. On a theoretical level, this study contributes to a wider conceptualisation of women’s empowerment by recognising the interplay between micro-level elements of situated experience, knowledge and preferences and the macro-level elements of sociocultural, biomedical and material influences on health and reproductive behavior.

Thesis (MA)--University of Stellenbosch, 2001. / ENGLISH ABSTRACT: In a qualitative study, a convenience sampling technique was used to ensure a study population of eleven HIV-infected low-income women. These participants were all direct referrals from municipal clinics and the provincial hospital. The criteria for participation were HIV sero-positivity and being a mother of a child or children. Semi-structured open-ended individual interviews were conducted, transcribed and then analysed, using grounded theory. Additional data were gained by using a standardised psychological measure, the Revised UCLA Loneliness Scale (RULS). The two main types of loneliness that these women experienced were loneliness of emotional isolation and loneliness of social isolation. These terms can be defined as the absence of a close emotional attachment and lack of support and understanding of intimate others (emotional isolation) and the absence of an accessible and engaging social network and lack of social support and acceptance (social isolation). The most significant causes of loneliness for these women were stigmatisation; fear and/or shame of rejection and victimisation; fear of losing custody or care of their children; fear of losing financial and emotional support; and using secrecy and non-disclosure as main coping strategy for their emotional and physical safety. Experiences of emotional isolation were also provoked or enhanced by the lack of involvement and support from their partners and the partners' denial of the illness and its consequences. Experiences of social isolation were also caused or increased by the general lack of HIV/AIDS information, education and support services. Significantly, it was found that for most of the women the psychological effect of loneliness was primarily a depressed mood as well as using negative coping mechanisms, such as alcohol abuse and further withdrawal from important others. The psychosocial needs of these women were also significantly similar. Broad guidelines are offered for health workers in assisting/supporting HIV-infected low-income mothers in general, based on the core needs of the women in this study; to be listened to and heard, understanding and acceptance, and social support. / AFRIKAANSE OPSOMMING: In 'n kwalitatiewe studie is 'n gerieflikheidsteekproeftegniek gebruik om 'n studiepopulasie van elf MIV-geïnfekteerde lae-inkomste-vroue te verseker. Hierdie deelnemers was almal direkte verwysings van munisipale klinieke en die provinsiale hospitaal. Die kriteria vir deelname was MIV-sero-positiwiteit en moeder wees van 'n kind of kinders. Semigestruktureerde oop individuele onderhoude is gevoer, getranskribeer en toe ontleed deur gegronde teorie te gebruik. Bykomende data is verkry met behulp van 'n gestandaardiseerde psigometriese instrument, die "Revised UCLA Loneliness Scale (RULS)". Die twee hooftipes eensaamheid wat hierdie vroue ervaar het was eensaamheid van emosionele isolasie en eensaamheid van sosiale isolasie. Hierdie terme kan omskryf word as die afwesigheid van 'n nou emosionele band en gebrek aan ondersteuning en begrip van intieme ander (emosionele isolasie) en die afwesigheid van 'n toeganklike en inskakelende sosiale netwerk en gebrek aan sosiale ondersteuning en aanvaarding (sosiale isolasie). Die beduidendste oorsake van eensaamheid vir hierdie vroue was stigmatisasie; vrees en/of skaamte vir verwerping en viktimisasie; vrees vir verlies van voogdyskap of sorg van hul kinders; vrees vir die verlies van finansiële en emosionele ondersteuning; en die gebruik van geheimhouding en nie-openbaarmaking as belangrikste hanteringstrategie vir hul emosionele en fisieke veiligheid. Ervarings van emosionele isolasie is ook uitgelok of versterk deur die gebrek aan betrokkenheid en ondersteuning van hul lewensmaats en die lewensmaats se ontkenning van die siekte en sy gevolge. Ervarings van sosiale isolasie is ook veroorsaak of verhoog deur die algemene gebrek aan inligting, opvoeding en ondersteuningsdienste ten opsigte van MIVNIGS. 'n Betekenisvolle bevinding was dat vir die meeste van die vroue die psigologiese effek van eensaamheid primêr 'n depressiewe gemoedstemming was sowel as die gebruik van negatiewe hanteringstrategieë soos alkoholmisbruik en verdere onttrekking van belangrike ander. Die psigososiale behoeftes van hierdie vroue was ook beduidend eenders. Breë riglyne word voorgestel vir gesondheidswerkers wat betref die bystaan/ondersteuning van MIV-geïnfekteerde lae-inkomste-moeders in die algemeen, gebaseer op die kernbehoeftes van die vroue in hierdie studie; om na geluister en gehoor te word, begrip en aanvaarding, en sosiale ondersteuning.

Thesis (M.A.(Psychology))--University of Pretoria, 2009. / Includes bibliographical references.

Thesis (PhD(Social Work))--University of Pretoria, 2009. / Includes bibliographical references.

Though an industrialized nation characterized by increasing secularization and liberalization, the Republic of Ireland has a long history of religious and morally-driven politics. Much of Ireland's economic success of the last ten years has been noted as a significant motivator for social change. However, a shift in the Irish moral sphere has been underway for at least thirty years. Despite a flourishing self confidence in National identity, already marginalized women---including drug-users, asylum-seekers from sub-Saharan Africa, and those in economically deprived communities of Greater Dublin---have felt increased social polarization. The cultural and epidemiological boundaries created between the 'healthy' Irish self and the 'dangerous' others have contributed to a unique climate regarding HIV/AIDS and cultural constructions of 'risk'. This anthropological analysis utilizes both political-economic and social constructionist frameworks so that both structural and discursive contributions to the spread of HIV/AIDS are examined. Particularly important are the ways competing discourses shape both practices and conceptions of HIV and the 'other'.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2008. / Title from title screen (site viewed Aug. 14, 2008). PDF text: 208 p. : ill. (some col.) ; 3 Mb. UMI publication number: AAT 3297662. Includes bibliographical references. Also available in microfilm and microfiche formats.

Thesis (Ph.D.)--Drexel University, 2008. / Includes abstract and vita. Also includes "Healthy eating" slides. Includes bibliographical references (leaves 72-80).