The aim of the study was to determine the factors that influence adherence to ART among adolescents who contracted HIV through vertical transmission. Qualitative research using descriptive phenomenology was conducted at Botswana-Baylor Children’s Clinical Centre of Excellence. Data was collected using in-depth individual semi-structured interviews. Eight (8) adolescents between 14 and 19 years who had been on ART for minimum of 4 years were interviewed. Thematic analysis of data was done and five (5) themes emerged from the participants' description of the experience of taking ART over a long period of time. The themes that emerged indicated the factors that influence adherence to ART, and they included knowledge and positive beliefs about ART, need for support, ART difficult treatment regimen, having a regular doctor and psychosocial emotional needs. The findings suggested that the adolescents who contracted HIV through vertical transmission require support while continuing on a simplified long-term ART regimen after an assessment of their psychological well beings and periodic checks. / Health Studies / M.A. (Public Health)

This research explores the lived experience of being a vertically or prenatally-infected HIV-positive adolescent. It looks specifically at how the participants experience intimacy, sex and sexuality. HIV/AIDS remains a global pandemic and vertically-infected adolescents are a growing new demographic. However, there is a poverty of research, and therefore interventions and support, for this demographic. This qualitative research conducted six individual, in-depth, semi-structured, psychoanalytic research interviews with three participants. The interviews were structured around projective drawings that the participants did in the course of each interview. The interviews were transcribed and analysed using psychodynamic object relations theory and organised through interpretative phenomenological analysis. Every effort was made to ensure that the research was conducted ethically and validly. The analysis found that the participants' experience of intimacy has resulted in a self that is constantly under threat. This in turn has negatively impacted on the participants' experience of sex and sexuality. The implication of this research is that more in-depth research needs to be done into this demographic so that better interventions and support may be offered.

This qualitative exploratory study explored adolescents’ perceptions of the HIV youth friendly centre at a hospital in Lesotho in order to improve adolescent-friendly health care services in Lesotho. Data was obtained through interviewing nine purposively selected adolescents aged 18–19 years who accessed health care services at the centre, and was analysed using an adapted version of Colaizzi’s seven-step thematic analysis. Six themes emerged from this study: attributes experienced during adolescents’ visits to health care facilities, adolescents’ perceptions of the health care facility, waiting times, facts related to HIV pre-test counselling, description of services available for adolescents’ health, and challenges faced by adolescents in relation to their HIV positive status. The adolescents explained the factors that encouraged them to be tested, and to commit to HIV management and treatment. The findings showed that it is important to reserve a dedicated space for adolescents, to provide comprehensive health services at one site, to ensure adolescents’ privacy and confidentiality, to indicate patient flow clearly, to indicate the service offering clearly, to offer flexible operating hours and days, to involve youth in the service provision, to keep queues short, and to establish peer support groups. / Health Studies / M.A. (Public Health)

This qualitative study explored the lived experiences of adolescents living with vertically acquired HIV receiving treatment, care and support services at Dora Nginza Wellness clinic, in Port Elizabeth, South Africa. Six adolescents living with vertically acquired HIV (four females and two males) between the ages of 16-17 years participated in in-depth semi-structured open-ended individual interviews. Tesch’s (1990) method of data analysis for qualitative research was used to analyse the interviews. Adolescents that participated in the study spoke widely about the outlook on their illness and their lives both in the past and present. They depicted fear, anxiety, pain and sadness in their lived experiences. They were anxious about their own death and had experienced illness and death of parents, siblings and close relatives due to HIV and AIDS. They described painful and traumatic life events related to their illness which included knowing their own HIV status and severe health problems and hospitalisations. They all learnt about their HIV status in early adolescence and choose not to disclose their status to people outside the family due to fear of rejection, stigma and discrimination. Taking ARVs was challenging to the participants due to side effects and strict medication schedules. Their school attendance and performance was affected by their illness. Family was an important resource of support. The participants had good experiences of HIV treatment at the Wellness clinic. The findings suggest that adolescents living with vertically acquired HIV faced a number of challenges in dealing with their disease and its treatment. They need intensive care and support services that enhance their positive self, facilitate self-disclosure and decrease and discourage stigma and discrimination at school and within their communities. / Health Studies / M.A. (Social Behavioural Studies in HIV/AIDS)

This qualitative study explored the lived experiences of adolescents living with vertically acquired HIV receiving treatment, care and support services at Dora Nginza Wellness clinic, in Port Elizabeth, South Africa. Six adolescents living with vertically acquired HIV (four females and two males) between the ages of 16-17 years participated in in-depth semi-structured open-ended individual interviews. Tesch’s (1990) method of data analysis for qualitative research was used to analyse the interviews. Adolescents that participated in the study spoke widely about the outlook on their illness and their lives both in the past and present. They depicted fear, anxiety, pain and sadness in their lived experiences. They were anxious about their own death and had experienced illness and death of parents, siblings and close relatives due to HIV and AIDS. They described painful and traumatic life events related to their illness which included knowing their own HIV status and severe health problems and hospitalisations. They all learnt about their HIV status in early adolescence and choose not to disclose their status to people outside the family due to fear of rejection, stigma and discrimination. Taking ARVs was challenging to the participants due to side effects and strict medication schedules. Their school attendance and performance was affected by their illness. Family was an important resource of support. The participants had good experiences of HIV treatment at the Wellness clinic. The findings suggest that adolescents living with vertically acquired HIV faced a number of challenges in dealing with their disease and its treatment. They need intensive care and support services that enhance their positive self, facilitate self-disclosure and decrease and discourage stigma and discrimination at school and within their communities. / Health Studies / M.A. (Social Behavioural Studies in HIV/AIDS)

Voluntary HIV counselling and testing (VHCT) is one of the key strategies in the prevention of HIV in Ethiopia. However, utilization of the VHCT services among adolescents has been reported as low by previous studies. The purpose of this study was to investigate adolescents’ knowledge and attitudes towards VHCT services among adolescents attending high school in Addis Ababa, the capital city of Ethiopia. A cross-sectional school-based design using quantitative methods was employed to attain the objectives of the study. Data collection was done using self-administered structured questionnaires among 378 adolescent high school students. Data was analysed using the Statistical Package for Social Sciences (SPSS). The findings revealed that 75.7% of students are aware of the voluntary HIV counselling and testing services; 62.2% use the services and suggested that VHCT services should be located in schools and youth clubs for better access by adolescents. Thirty-two percent of respondents rated themselves at risk of HIV infection and 35.2% were not willing to disclose their HIV positive status to anybody. The findings of the study clearly indicate a need for a more accessible voluntary HIV counselling and testing services for adolescents. / Health Studies / M.A. (Public Health)

The study examined the sexual and reproductive health needs of adolescents infected with HIV and AIDS. This was a qualitative study that involved semi-structured interviews and observation. The sampling method used was purposive and it entailed 10 adolescents (4 boys and 6 girls) who are living with HIV at Chiedza Child Care Centre in Zimbabwe. This study revealed that adolescents’ sexual and reproductive health needs are the desire to have sex, desire to have children, the need for prevention of unwanted pregnancy and care and treatment support. However, their knowledge of HIV and AIDS was inadequate. Adolescents also revealed their lack of proper information regarding their health care and treatment needs. However, adolescents illustrated an adequate knowledge of the services available for them for their health, treatment and care needs. The study recommended that there is need to strengthen the provision of information and services on adolescents’ sexual and reproductive health issues. The study also recommended that counsellors should improve their counselling skills so that they can empower adolescents living with HIV to be able to negotiate condom usage, matters of dating and handling relationships. / Sociology / M. A. (Social Behaviour Studies in HIV and AIDS)

Voluntary HIV counselling and testing (VHCT) is one of the key strategies in the prevention of HIV in Ethiopia. However, utilization of the VHCT services among adolescents has been reported as low by previous studies. The purpose of this study was to investigate adolescents’ knowledge and attitudes towards VHCT services among adolescents attending high school in Addis Ababa, the capital city of Ethiopia. A cross-sectional school-based design using quantitative methods was employed to attain the objectives of the study. Data collection was done using self-administered structured questionnaires among 378 adolescent high school students. Data was analysed using the Statistical Package for Social Sciences (SPSS). The findings revealed that 75.7% of students are aware of the voluntary HIV counselling and testing services; 62.2% use the services and suggested that VHCT services should be located in schools and youth clubs for better access by adolescents. Thirty-two percent of respondents rated themselves at risk of HIV infection and 35.2% were not willing to disclose their HIV positive status to anybody. The findings of the study clearly indicate a need for a more accessible voluntary HIV counselling and testing services for adolescents. / Health Studies / M.A. (Public Health)

Adolescence is a significant period of change in physical and psychosocial development of human beings. Being HIV positive and growing up on a dynamically multifaceted HAART treatment, adds to the complexity of adolescence. This study was aimed at exploring the nature of experiences of adolescents who are on long-term Highly Active Antiretroviral Therapy (HAART) in Tembisa, Gauteng province. The study is based on a qualitative research method using in-depth semi-structured open-ended interviews and a focus group for data collection. The sample consisted of seven individual adolescent participants, three parents, guardians and caregivers, as well as 11 health care professionals. The thematic data analysis and the phenomelogical analysis methods were used to analyse data qualitative data while descriptive statistics were used to analyse quantitative biographical data. The study findings cover the negative and positive experiences and the perceived role of HAART treatment over a long period of time. The predominant themes identified from adolescent participants were disclosure of HIV positive status and the stigma surrounding a positive status, early childhood experience of parental death, challenges of taking HAART treatment, factors influencing adherence and non-adherence to HAART treatment, and lastly, the impact of religion on HAART treatment adherence. The findings suggest that adolescents who are on HAART treatment over an extended period of time experience drug fatigue. Drug fatigue has far-reaching implications for the health of an adolescent, as it has a higher likelihood that poor adherence or even complete refusal to take HAART treatment will occur. Poor adherence or refusal to take HAART treatment will most likely lead to cross infection and further spread of HIV and AIDS. A recommendation was made to include the establishment of a youth and adolescent-friendly centre by the hospital – one that is designated for the provision of tailored adolescent services and sensitive to adolescent developmental stages so as to minimise the likelihood of infected adolescents falling through the health care cracks. The introduction of a hospital-based school, an education unit run by dedicated and qualified facilitators focusing on aiding hospitalised learners with catch-up scholarly programmes, was a further recommendation. It was further recommended that reproductive health care needs of adolescents who grow up on HAART treatment be given attention in further research. / Psychology / Ph.D. (Psychology)