The African continent has been hit the hardest by the HIV/AIDS epidemic which has seen more women becoming infected than men (Hunter, 2003; UNAIDS, 2004). This has been attributed to the permissible nature of the African culture which is lenient on male promiscuity (Foreman, 1999; Colvin 2000; Leclerc-Madlala 2001; Dube 2003). African women are not only vulnerable to infection but are also vulnerable to negative disclosure experiences when they disclose their status to sexual partners. This double impact of culture has not been addressed by past researches (UNAIDS 2004). The present research thus attempts to fill that gap. It explores the interplay between culture and HIV transmission as well as the interplay between culture and disclosure experiences. The study’s setting is Magunje Township, a rural village in Mashonaland Central province in Zimbabwe. Taking into consideration the limitations of the present analysis, data gathered indicates that African women are vulnerable to both HIV infection and negative disclosure experiences. Their vulnerability also hampers prevention and treatment efforts as it makes them decide to keep their status a secret from sexual partners for fear of losing the financial income tied to sexual partners. The present researcher concludes with some suggestions for policy makers and programme implementers, highlighting the importance of focusing on HIV/AIDS status disclosure as a prevention and treatment method in the absence of a cure for HIV.

Health Studies / M.A. (Health Studies)

Health Studies / M.A. (Health Studies)

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The study sought to answer the question, what are the reasons for low utilization of long acting contraceptives among HIV positive women attending the Harare Post-test support services clinic. The study was conducted at Harare Post-test support services clinic from September to December 2012. Data was collected using respondent administered questionnaires. A sample of 30 respondents was used for the study. After data collection, data was grouped, analysed and presented in the form of tables, figures, charts and descriptive statistics. The major findings from the study were that the majority of the women who attend the Harare Post-test support services clinic are within the age groups 35-49yaers. Most of the women are not using and modern contraceptive method. Condoms are used by 17% of the respondents and the long acting contraceptives, Jadelle and IUCD and used by a very low number of women attending the clinic. Fear of side effects is one of the reasons why the women are not suing long acting contraception. Most of the women know that the Jadelle and IUCD are long acting methods of contraception which prevents unintended pregnancy for up to five years for Jadelle and up to ten years for the IUCD. The long acting contraceptives are not available at the post test-support services clinic since the set-up of the clinic is not ideal for the provision of these services, women who need the methods are refereed outside the clinic were the cost to access the services is not affordable for most of the respondents. The conclusion drawn from the study is that women living with HIV have limited knowledge and access the long acting contraceptives at Harare Post-test support services clinic hence are not utilizing the methods. The researcher recommends that all women attending the clinic should be educated on the benefits of using dual protection to protect against unintended pregnancy as well as HIV transmission. A proper referral system should be established so that women referred to other service providers do not pay extra fees to access family planning services at the referral centres. Any IEC material should address the myths and fears related to use of long acting contraception by HIV positive women. The young age group below 35years should also be encouraged to access family planning services through the Post-test support services clinic. / AFRIKAANSE OPSOMMING: Die doel van die studie was om te bepaal wat die redes is vir die lae gebruik van langwerkende voorbehoeding onder MIV positiewe vroue wat die Harare Post-test ondersteuningsdienste kliniek besoek. Data is deur middel van vraelyste onder 30 deelnemers ingesamel. Die resultate het getoon dat die meerderheid van vroue wat die kliniek besoek het tussen die ouderdomme van 35 en 49 was. Meeste van hulle gebruik nie moderne voorbehoeding nie, slegs 17% het aangedui dat hul kondome gebruik. Die langwerkende voorbehoeding Jadelle en IUCD word deur min die van vroue gebruik. ‘n Vrees vir die nadelige uitwerking daarvan is een van die redes waarom hul nie die voorbehoeding gebruik nie. Meeste van die vroue is bewus dat Jadelle en IUCd langwerkede metodes is wat swangerskap voorkom en dat Jadell tot 5 jaar werk en IUCD tot 10 jaar effektief kan wees. Die langwerkende metodes is egter nie by die kliniek beskikbaar nie en vroue wat die metodes verkies word na ander diensverskaffers verwys waar wat vir meeste van die vroue nie bekostigbaar is nie. Daar kan dus van die studie afgelei word dat MIV positiewe vroue beperkte kennis en toegang rakende die langwerkende voorbehoeding het en daarom nie die metodes ten volle benut nie. Die navorser beveel aan dat alle vroue wie die klinkiek besoek ingelig moet word oor die voordele van die tweeledige vorm van beskerming, nie net teen swangerskap nie maar ook teen MIV-infeksie. ‘n Verwysingstelsel moet in plek gestel word sodat die vroue wat na ander diensverskaffers verwys word nie nodig het om ekstra daarvoor te betaal nie. Daar word verder ook voorgestel dat die klinkiek meer inligtig rakende die langwerkende voorbehoeding beskikbaar stel en ook gesinsbeplanningsdienste aanbied.

The study into the socio-economic challenges of HIV and AIDS on widowed women in rural communities of Zimbabwe was carried out in the village of Mukadziwashe. The main aim of the study was to find out the socio-economic challenges that are faced by HIV and AIDS widows. Of particular concern has been role played change agent since the dawn of the HIV and AIDS pandemic and its devastating socio-economic impact on families, especially widows. The findings of this study are based on a sample of limited number (12) widows based in the village of Mukadziwashe in Gutu Central District, as well interviews of key informants who happen to be representatives of change agents in the main. In-depth interviews were the tool used to collect information from the research participants identified above. The findings of the study revealed that widows still suffer from the serious social and economic challenges posed by HIV and AIDS such as cultural oppressions and prevention of women from inheriting their late husbands’ wealth The continued denial of women of their constitutionally enshrined rights is difficult to understand, because many studies have been conducted on this subject. It is reasonable to expect noticeable progress in promoting the rights of women, especially widows. What is apparent in this sad story is the mute role of change agents, be they government, non-governmental or community based, in affirming widows’ rights. Based on these observations, the study strongly recommends the design, implementation and constant monitoring of intervention programmes aimed at women empowerment in general. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)

The study into the socio-economic challenges of HIV and AIDS on widowed women in rural communities of Zimbabwe was carried out in the village of Mukadziwashe. The main aim of the study was to find out the socio-economic challenges that are faced by HIV and AIDS widows. Of particular concern has been role played change agent since the dawn of the HIV and AIDS pandemic and its devastating socio-economic impact on families, especially widows. The findings of this study are based on a sample of limited number (12) widows based in the village of Mukadziwashe in Gutu Central District, as well interviews of key informants who happen to be representatives of change agents in the main. In-depth interviews were the tool used to collect information from the research participants identified above. The findings of the study revealed that widows still suffer from the serious social and economic challenges posed by HIV and AIDS such as cultural oppressions and prevention of women from inheriting their late husbands’ wealth The continued denial of women of their constitutionally enshrined rights is difficult to understand, because many studies have been conducted on this subject. It is reasonable to expect noticeable progress in promoting the rights of women, especially widows. What is apparent in this sad story is the mute role of change agents, be they government, non-governmental or community based, in affirming widows’ rights. Based on these observations, the study strongly recommends the design, implementation and constant monitoring of intervention programmes aimed at women empowerment in general. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)

Voluntary Counselling and Testing (VCT) is vital in the management of HIV/AIDS as it is the first step in treatment, care and behavioural change. Entrenched economic and gender inequities drive an increasingly feminized HIV/AIDS pandemic. This study investigated factors influencing VCT attendance by women in the Glen View high density suburb in Harare. A survey methodology was followed using a semi-structured, self-administered questionnaire that was distributed to randomly selected women of reproductive ages in the area. The analysis showed that VCT usage is low and that factors such as fear of the consequences of testing positive for HIV, such as violence and rejection by male partners are to blame. Importantly, the findings suggest that if the vulnerability of women is not addressed, then increased VCT uptake and better reproductive health outcomes for women are also unlikely. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

Voluntary Counselling and Testing (VCT) is vital in the management of HIV/AIDS as it is the first step in treatment, care and behavioural change. Entrenched economic and gender inequities drive an increasingly feminized HIV/AIDS pandemic. This study investigated factors influencing VCT attendance by women in the Glen View high density suburb in Harare. A survey methodology was followed using a semi-structured, self-administered questionnaire that was distributed to randomly selected women of reproductive ages in the area. The analysis showed that VCT usage is low and that factors such as fear of the consequences of testing positive for HIV, such as violence and rejection by male partners are to blame. Importantly, the findings suggest that if the vulnerability of women is not addressed, then increased VCT uptake and better reproductive health outcomes for women are also unlikely. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

Text in English / This qualitative descriptive phenomenological study explored the experiences of HIV positive women utilising PMTCT services at a central hospital in Zimbabwe. Data was collected using in-depth interviews of fifteen participants. The interviews were audio recorded and transcribed verbatim. Using the Interpretive Phenomenological Analysis framework for data analysis, two super-ordinate themes emerged, namely resources for provision of PMTCT services and approaches and nature of PMTCT care. The study revealed challenges experienced by HIV positive women emanating from material, financial and human resource related constraints in the PMTCT setting. The resource challenges negatively affected access and utilisation of PMTCT services. A practice model, whose purpose is to enhance the quality and utilisation of PMTCT services, was developed and described. The model was evaluated using Chin and Krammer (2011) criteria plus a modified form of the Delphi technique. These findings have implications for effective PMTCT service provision. The key lessons learnt for programmatic improvement were that in order to provide quality and accessible PMTCT services the health care system will need to be well resourced. There is need to strengthen the health care system in line with HIV related programmatic changes. / Health Studies / D. L.itt. et Phil. (Health Studies)