Cervical cancer remains the main source of mortality among women around the world. It is a burden in developing countries and generally recognized through the complications of the advanced stages. The aim of this study was to investigate the utilisation of cervical cancer screening services among women living with HIV in Hawassa in order to develop a strategy to enhance cervical cancer screening service utilisation among this population in Ethiopia. A quantitative approach with a cross-sectional study design was used in this study. The data were collected using a standard structured questionnaire from 309 women living with HIV attending health care facilities in Hawassa city Administration. Statistical Package for Social Sciences version 25 software was used to analyse data. The results are presented based on the Health belief Model’s construct. The result revealed a low utilisation of cervical cancer screening services. Knowledge and perception of cervical cancer and cervical cancer screening service were also low. The main reason for being not screened was feeling healthy, lack of awareness, and embarrassment. Knowledge of cervical cancer was affected by factors such as knowing someone with cervical cancer, educational status, and monthly income. The finding indicated that utilisation of screenings could be determined by composite knowledge, perceived susceptibility to cervical cancer, duration on Highly Active Anti-Retroviral Treatment and willingness to be screened. The findings of this study, findings from the literature review and relevant legislation guided the researcher to develop a strategy to enhance cervical cancer screening service utilisation among women living with HIV Ethiopia. Relevant recommendations were put forward to promote utilisation of strategy and also for future research. The utilisation of the developed strategy may improve the uptake of screening for cervical cancer, improve early diagnosis and treatment of cervical malignant growth, and decrease mortality among women living with HIV in Hawassa city organization. / Health Studies / Ph. D. (Public Health)

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Appendix B (leaves 217-218), Appendix M (leaves 239-247) and Appendix O (leaves 253-259) in English and Amharic / The purpose of this research was to develop HIV testing Health Belief Scale (HTBS) that contains the constructs of Health Belief Model (HBM), and also to analyse HIV testing intention and behaviour among university students. The mixed method approach was used in phases. First, Literature review and in-depth interviews were conducted to develop item pool for HTBS, which was followed by content validity assessment by experts. In the second phase, a pilot survey was conducted on randomly selected 318 university students to refine the HTBS using item analysis and Exploratory Factor Analysis (EFA). Lastly, cross-sectional survey was conducted on representative sample of 612 students in order to further refine the HTBS using Confirmatory Factor Analysis (CFA) and also analyse predictors of HIV testing intention and behaviour. A total of 61 items was written for the HTBS and 23 of these were generated from the in-depth interviews. Content validity assessment by three experts indicated that the average content validity index (CVI) for the 61 items was 91.2% which was more than the recommended cut off point of 90%. The HTBS, after experts review, contained 64 items. EFA indicated that a five factor model which was roughly consistent with HBM was identified and 44 items were retained based on factor loading and reliability analysis. The Cronbach’s alpha for all the six constructs of HBM and HIV testing intention in the HTBS were >0,70. (susceptibility, benefit, self-efficacy and HIV testing intention) fitted the sample data based on chi-square test. However, all the seven constructs demonstrated RMSEA value of less than 0.08 and GFI value of >0.90 indicating acceptable fit. The final HTBS was reduced to 39 items based on factor loading and reliability assessment. All the constructs demonstrated a Cronbach’s alpha value >0.70 except for perceived susceptibility and cues to action. Analysis of multiple linear regression indicated that class year, perceived benefit, perceived self-efficacy and cues to action were significant predictors of HIV testing intention. However, only marital status and cues to action were significant predictors of recent history of HIV testing through analysis of binary logistic regression. / Health Studies / D.Litt. et Phil. (Health Studies)

Appendix B (leaves 217-218), Appendix M (leaves 239-247) and Appendix O (leaves 253-259) in English and Amharic / The purpose of this research was to develop HIV testing Health Belief Scale (HTBS) that contains the constructs of Health Belief Model (HBM), and also to analyse HIV testing intention and behaviour among university students. The mixed method approach was used in phases. First, Literature review and in-depth interviews were conducted to develop item pool for HTBS, which was followed by content validity assessment by experts. In the second phase, a pilot survey was conducted on randomly selected 318 university students to refine the HTBS using item analysis and Exploratory Factor Analysis (EFA). Lastly, cross-sectional survey was conducted on representative sample of 612 students in order to further refine the HTBS using Confirmatory Factor Analysis (CFA) and also analyse predictors of HIV testing intention and behaviour. A total of 61 items was written for the HTBS and 23 of these were generated from the in-depth interviews. Content validity assessment by three experts indicated that the average content validity index (CVI) for the 61 items was 91.2% which was more than the recommended cut off point of 90%. The HTBS, after experts review, contained 64 items. EFA indicated that a five factor model which was roughly consistent with HBM was identified and 44 items were retained based on factor loading and reliability analysis. The Cronbach’s alpha for all the six constructs of HBM and HIV testing intention in the HTBS were >0,70. (susceptibility, benefit, self-efficacy and HIV testing intention) fitted the sample data based on chi-square test. However, all the seven constructs demonstrated RMSEA value of less than 0.08 and GFI value of >0.90 indicating acceptable fit. The final HTBS was reduced to 39 items based on factor loading and reliability assessment. All the constructs demonstrated a Cronbach’s alpha value >0.70 except for perceived susceptibility and cues to action. Analysis of multiple linear regression indicated that class year, perceived benefit, perceived self-efficacy and cues to action were significant predictors of HIV testing intention. However, only marital status and cues to action were significant predictors of recent history of HIV testing through analysis of binary logistic regression. / Health Studies / D.Litt. et Phil. (Health Studies)

This study’s purpose was to explore the knowledge, attitudes and perceptions regarding HIV/AIDS and condom use, and sexual behaviours among senior secondary school learners in Kumba, Cameroon using the Health Belief Model (HBM) as the theoretical framework. The ultimate goal was to determine how at risk learners were of contracting HIV/AIDS. A quantitative, non-experimental descriptive, explorative and correlational research design was adapted; using self-designed questionnaires for data collection. Respondents were sampled through proportionally stratified simple random sampling resulting in 480 (240 male and 240 female) grade 10 to grade 12 learners from two participating high schools. Descriptive and inferential statistics were calculated using the SPSS version 12 software program. Most learners were knowledgeable about HIV transmission; the prevention of HIV/AIDS; and sexual risk behaviours pertaining to HIV transmission. Learners also manifested positive attitudes towards PLWHA. Most learners did not perceive themselves to be at high risk of contracting HIV/AIDS. Up to 52,3% who were sexually active, only 30,0% used condoms consistently. The respondents knew about condoms, but had poor attitudes towards condom use. Most respondents received information on HIV/AIDS, condoms and sexuality from magazines/newspapers and teachers. The findings could assist policy makers, programme planners and educators in developing and implementing programmes to improve the health of adolescents. The perceived barriers to condom use and modifying factors should be addressed into consideration in designing any policy geared towards controlling risk exposure to HIV/AIDS among youths in Kumba, Cameroon.

Text in English / The Department of Education nationwide introduced HIV and AIDS care and support for learning and teaching programmes as intervention strategies for supporting vulnerable learners. Despite these interventions, teenagers continue to fall pregnant and this increases their vulnerability to HIV infection. HIV and STIs are rife among teenagers owing to ignorance and peer pressure, among other factors. The aim of this exploratory qualitative study was to explore factors that influence condom use among high school teenagers aged between 16 and 18 in Dutywa District. Focus group discussions and in-depth face-to-face interviews with 12 high school teenagers from one high school (High School X) were used to collect data. Thematic analysis was used to analyse data. The findings of this study revealed that high school teenagers are not using condoms to any significant degree. In their opinion, condoms limit sexual pleasure; they indicate a lack of trust and unfaithfulness between partners and are associated with sexually transmitted diseases. The findings of this study are significant for the policy implementation of schools. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)

This study investigated the challenges faced by implementers of VCT campaigns for higher education distance learning students. Qualitative and explorative approaches, using a case study, were employed as the research methodology. It has been concluded that the administrative planning procedures of VCT campaigns were not properly followed, which resulted in the following difficulties: defining the roles and responsibilities of stakeholders, using limited resources, and the inability to reach all the students, in order to get them to actively participate in the campaigns. Lack of coordination of HIV and AIDS activities and the absence of monitoring and evaluation also impacted negatively on the success of VCT campaigns. This study recommends that VCT campaigns have a proper task team constituting of experts in VCT campaign operations, in order to strategically plan and coordinate all the campaigns' activities. The implementers should also monitor and evaluate these activities on a regular basis. / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)