Philosophiae Doctor - PhD / The school environment presents a valuable opportunity for the identification, monitoring and support of children made vulnerable by HIV/AIDS and poverty. Many children are caring for parents suffering from AIDS related illnesses and/or they are the main breadwimnner of the household. As a reult of HIV/AIDS and poverty therefore, children might be dropping out of school, or their ability to performadequately at school might be significantly reduced. The main aim of this study was to use a case study approach to explore and describe support provision in a South African formal school, examining in particular, the relative significance of leadership, organisational development and gender-related matters in addressing the needs of children made vulnerableby HIV/AIDS and poverty.The availability and quality of this support is analysed within the context of the Western Cape Education Department (WECD) transforming itself from a system focussed on controlling schools to a system focused on supporting schools. / South Africa

Masters of Public Health - see Magister Public Health / With a prevalence of 14.3% among the 15-49 years age group, HIV/AIDS still constitutes a significant challenge in Zambia. In order to respond to the impact of HIV/AIDS within the workplace, government ministries have developed HIV-focused workplace policies and programmes that provide HIV/AIDS services. However, despite their availability, the number of employees accessing the services, especially those targetting HIV positive workers remains low. The fear (either perceived or real) of disclosing an HIV positive status is one likely reason for the low uptake of services. HIV-positive status disclosure is an important public health goal as it can create opportunities for an individual to access information and social and medical support, and this will affect career and workload related decisions. This exploratory, qualitative study aims to identify and describe the HIV-disclosure experiences of 12 openly HIV-positive Zambian public sector workers living in Lusaka and working in four Zambian Ministries. Both male and female public sector workers were interviewed. The participants’ experiences of disclosing their HIV positive status in the workplace were explored in depth in this study. With the aim of providing those responsible for overseeing and managing the Zambian public sector HIV workplace initiatives with some practical recommendations regarding the disclosure support needed by HIV-positive public sector workers. The study found that whilst participants had an initial fear of disclosing their HIVpositive status in the workplace, their HIV disclosure actually proved to be very beneficial. Not only did it allow their health-related needs (such as accessing medication and visiting a doctor) to be met, but their disclosure also encouraged others to also disclose their status. The recommendations are are aimed at creating a supportive working environment for people living with HIV within the Zambian public service, and offering suggestions to their managers on how best to support the process of disclosure amongst their staff.

Philosophiae Doctor - PhD / There are number of Non-Governmental Organisations (NGOs) in South Africa that use sport as a tool to respond to HIV/AIDS mainly among young people, however, little is reported about the outcomes and impact of these programmes. The aim of this study is to contribute to a generic monitoring and evaluation framework by improving the options for the use of outcome indicators of sport-based HIV/AIDS awareness programmes of selected NGOs in South Africa. The research followed a qualitative multiple case study design using multiple data collection instruments. The overall findings revealed that the sport-based HIV/AIDS awareness programmes of five selected NGOs examined in this study focus on similar HIV prevention messages within the key priorities highlighted in the current National Strategic Plan for HIV/AIDS, STIs and TB of South Africa. The HIV prevention messages of selected NGOs are also in line with the commitments and targets of the 2011 UN Political Declaration on HIV/AIDS. The sport-based HIV/AIDS programmes target youth with messages that raise awareness of HIV/AIDS, HIV risk behaviours and HIV stigma. Furthermore messages that promote uptake of health services such as HIV Counselling and Testing (HCT) and Voluntary Medical Male Circumcision (VMMC). However, evaluating outcomes and impact of such programmes remains a challenge. Descriptive information and outputs are more recorded rather than information about the actual outcomes which occurred as a result of sport-based HIV/AIDS awareness programmes. The use of multiple data collection instruments in conjunction with approaches of the ten-step model to a result-based monitoring and evaluation systems enables this study to propose a total of fifty one generic outcome indicators. These generic outcome indicators focus on measuring change in the knowledge of HIV/AIDS and change in attitude and intention towards HIV risk behaviours. In addition, this study further proposed a total of eight generic outcome indicators to measurepredictors of HIV risk behaviour. The selected NGOs can adapt the proposed generic outcomes and indicators based on the settings of their programmes. It can be concluded that the proposed generic outcome indicators are able to assist the NGOs to improve monitoring and evaluation of their sport-based HIV/AIDS awareness programmes. A collaborative approach by all stakeholders is required, from international organisations, funders, governments, NGOs and communities to strengthening monitoring and evaluation of sport-based HIV/AIDS awareness programmes including other development programmes.

Master of Public Health - MPH / The Family Life and HIV/AIDS Education (FLHE) curriculum was introduced into Junior Secondary Schools (JSS) in Nigeria to provide young people with life skills and knowledge essential for protecting themselves from HIV/AIDS. However, coverage of schools with the FLHE curriculum implementation is low. The purpose of this study was to determine the factors that affect the implementation of the FLHE curriculum in JSS in Abuja, Nigeria. This study was a quantitative descriptive cross-sectional survey. The study populations were teachers from public JSS implementing the FLHE curriculum in Abuja, among whom 300 teachers selected using systematic random sampling constituted the sample size. A close-ended anonymous questionnaire was administered to the research respondents as a self-administered questionnaire in English Language in their schools. A total of 300 questionnaires were administered of which 251 completed questionnaires were returned and analysed. Data analysis was undertaken using SPSS version 17 and included frequency distribution, mean score and standard deviation (univariate analysis), and cross tabulations of dependent variable (teaching of FLHE curriculum) and independent variables (awareness of HIV/AIDS policy and government directive; level of knowledge of the FLHE curriculum; level of comfort to teach FLHE curriculum; religious belief and affiliation; and cultural values of respondents). Chi-square tests and p-values were calculated to determine relationship between variables. Throughout this study, the autonomy of the respondents and dignity were respected; and their participation was voluntary. There was full disclosure of the purpose of the study. The respondents were assured of the confidentiality and anonymity of the information collected; and their written consent were secured prior to participation in the study. The majority (72%) of teachers in this study were aware of the National HIV/AIDS Policy and the government directive to mainstream topics in the FLHE curriculum into existing subjects (78%). Just above one-third (36%) of the teachers had ever seen a copy of the HIV/AIDS policy and knew all the content of the policy. The study revealed that only 5% of the teachers in schools implementing the FLHE curriculum had sufficient level of knowledge of the FLHE curriculum. Majority of the teachers (71%) knew the content of only one (HIV infection) out of the five themes in the curriculum, and 4 out of 5 of the teachers were comfortable in teaching the curriculum to students. The lack of sufficient level of knowledge of the FLHE curriculum and the content of the HIV/AIDS policy and government directive among majority of the teachers were major factors that affected the implementation of the curriculum. Awareness of the government directive (P= 0.000) as opposed to the HIV/AIDS policy (P= 0.772) among the teachers was found to be an important factor to harmonize implementation modalities of the curriculum. The study also noted that personal perception (P = 0.000), cultural values (P = 0.000) and religious belief (P = 0.000) of the teachers as opposed to their religious affiliation (P= 0.218) were important factors in the teaching of FLHE curriculum to students. This study has established that several factors among teachers that included awareness of the government directive to mainstream topics in the FLHE curriculum into subjects, knowledge of the content of the FLHE curriculum and personal perception to the teaching of the curriculum, as well as religious belief and cultural values affected the implementation of FLHE curriculum in JSS in Abuja, Nigeria.

The internal auditing profession has undergone considerable changes during the past few years. A new definition has been formulated in 1999 for the profession and the Professional Practices Framework, including the Standards, has had to be adapted to incorporate this new definition. An internal auditor, in addition to being a control specialist, must now also assist management in a consulting capacity with risk management and corporate governance. According to the new Standards, an internal auditor should assist his or her organisation in maintaining effective controls by evaluating its effectiveness and efficiency and by continuously promoting improvement. The basis for the control system is a control environment that provides an atmosphere in which people conduct their activities and this has a direct influence on the way activities are structured, objectives are established and risk is addressed. HIV/AIDS is a disease that threatens the world as a whole, global economies, individual countries, governments and also the business world, especially individual organisations. It is therefore vital that the consequences of this potential risk on an organisation are studied. Various studies done on this subject have indicated that managements are aware of the possible risk of HIV/AIDS to their organisations, but no study has at yet investigated the role that internal auditors can play or the effect of HIV/AIDS on the control environment. This study firstly investigated whether HIV/AIDS has an effect on the control environment of an organisation. Secondly, the knowledge of internal auditors regarding the potential risk of HIV/AIDS to the organisation and the role they should play in assisting management with this risk, including its effect on the control environment, was investigated. The research findings showed that HIV/AIDS does have an effect on certain elements of the control environment, namely the competence of the workforce, organisational structure and the human resources policies and practices. The study also concluded that internal auditing should treat the risk of HIV/AIDS like all other risks threatening the organisation. Thus they should assist management in managing the risk and giving assurance to all stakeholders that the risk is being adequately managed. It was also concluded that although internal auditors are aware of the risk of HIV/AIDS to their organisations, especially the control environment, only a few internal auditing departments were performing their responsibilities in full. The level of commitment to managing this risk varied from total ignorance of HIV/AIDS in a business environment, to internal auditors performing audits on certain aspects in the management of this risk. HIV/AIDS is not a normal business risk. Factors such as additional legislation, the disease being non-notifiable, the stigma associated with the illness, the fact that no cure is available, and many more make this a difficult risk to understand and to manage, thus complicating the responsibilities of internal auditors. Professional guidance is needed for the internal auditor on how to handle this risk. / Dissertation (MCom(Internal auditing))--University of Pretoria, 2005. / Auditing / unrestricted

Desde a sua descoberta, no início da década de 80, o HIV/aids, constituiu-se como uma doença que ultrapassa os limites da dimensão biomédica, apresentando diversos desafios à sociedade. No Brasil, estima-se que aproximadamente 734 mil pessoas vivem com HIV/aids. Foram desenvolvidas diferentes classes de drogas antirretrovirais para seu tratamento; as quais são eficazes para o controle parcial da replicação viral. Sem a descoberta da cura, é imprescindível que as pessoas vivendo com HIV/aids sigam as recomendações da equipe de saúde, aderindo ao tratamento proposto; aumentando sua qualidade de vida, bem como contribuindo para a diminuição da transmissão do vírus. Durante o tratamento, algumas dificuldades podem surgir, determinando momentos de maior ou menor adesão ao mesmo e os profissionais de saúde, dentre eles, os farmacêuticos, devem estar atentos a estes momentos. Este estudo transversal teve como objetivo analisar a retirada do TARV nos últimos 24 meses e investigar os possíveis fatores que levam a retirada desta medicação de forma irregular na Unidade Especial de Tratamento de Doenças Infecciosas (UETDI) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo. Participaram 250 pessoas que vivem com HIV/aids que retiram a medicação na Farmácia do local do estudo. Os participantes foram separados em dois grupos: Grupo em Atraso e Grupo Controle segundo seus históricos de dispensação da TARV nos vinte e quatro meses anteriores a realização das entrevistas. Predominaram participantes do sexo masculino (57,6%), com mais de 40 anos (76%), brancos (51,6%), com baixa escolaridade (48,4%), sem parceiro fixo (52,4%), residentes em Ribeirão Preto (63,6%). Todas as variáveis foram relacionadas em um estudo univariado e aquelas com um valor de \"p\" igual ou menor que 0,2 foram selecionadas para análise multivariada. As associações entre variáveis selecionadas e a retirada irregular comparada com a retirada regular, foi estimada pela estimativa com intervalo de confiança de 95%. As variáveis que mostraram associação com a retirada da TARV em atraso foram: fazer uso de outro medicamento além da TARV, apresentar resultado de exame de carga viral como detectável, ter, no início do período analisado, contagem de linfócitos T CD4 menor que 200 células /mm3 e ter baixa adesão como resultado do Teste de Morisky- Green / Since its discovery in the early 80s, HIV / AIDS was established as a disease that pushes the boundaries of biomedical dimension, presenting many challenges to the society. In Brazil, there are almost 734,000 people carrying HIV / AIDS. Different classes of antiretroviral drugs were developed for their treatment, which are effective in partial control of viral replication. Yet incurable disease it is essential that people living with HIV / AIDS follow the recommendations of the health care agents, adhering to the proposed treatment, increasing their quality of life, and contributing to the reduction of transmission of the virus. During treatment, some difficulties may arise, determining moments of greater or lesser adherence, and pharmacists among other health professionals, should be aware of these moments. This cross-sectional study aimed to analyze the withdrawal of ART in the last 24 months, and investigate the possible factors that lead the medication withdrawal erratically on Special Treatment of Infectious Diseases Unit (UETDI) of the Clinics Hospital - School of Medicine of Ribeirao Preto, University of São Paulo. Two hundred and fifty people living with HIV / AIDS got medication in the study site pharmacy. Participants were divided into two groups: Group Control and Group Delay, according to their historical dispensing of ART in twenty-four months prior to the interviews; predominant male participants (57.6%) with more than 40 years (76%), white (51.6%), with low education (48.4%), with no steady partner (52.4%), residents in Ribeirão Preto (63.6%). All variables related in a univariate analysis, and those with a value of \"p\" equal to or smaller than 0.2 were selected for multivariate analysis. The associations between selected variables, and the irregular removal compared to regular withdrawal were estimated with 95% confidence interval. The variables that were associated with the withdrawal of ART arrears, and making use of another drug in addition to HAART, presented results of viral load test as detectable, having the beginning of period analyzed, CD4 lymphocyte count less than 200 cells / mm3, and have low compliance as a result of Morisky- Green test.

O conhecimento sobre a epidemia de AIDS e a organização dos serviços de saúde de atendimento aos pacientes HIV/AIDS no estado é indispensável para a realização de atividades de planejamento de ações que possam oferecer uma melhor assistência a esses pacientes. O estudo realizou um diagnóstico da assistência odontológica ao usuário HIV/AIDS prestado através das Equipes do Serviço Ambulatorial Especializado - SAE, tendo como foco a percepção do usuário e a do Cirurgião Dentista (CD) na qualidade dessa assistência.Trata-se de um estudo qualitativo que no primeiro momento descreve o fluxo de atendimento do SAE; o serviço de referência e contra referência e, no segundo momento aplicação de dois questionários, um voltado para o usuário e outro para o CD; o questionário destinado ao usuário foi aplicado pelos coordenadores dos SAES. Os dados foram agrupados em categorias que se relacionam entre si, buscando avaliar: opiniões, atitudes, preferências e comportamento do usuário e CD em relação ao serviço prestado e o oferecido,e a descrição de citações diretas do usuário e CD sobre suas vivências. Participaram da pesquisa 174 usuários pertencentes aos SAES de Porto Velho, Vilhena, Cacoal e Ji-Paraná, todos pacientes HIV/AIDS em registro ativo, ambos os sexos, adultos, e 13 CD. A maioria dos usuários mostrou satisfação com o atendimento realizado pelos CD de seus municípios, percebe-se a falta de conhecimento dos CD no atendimento a pacientes HIV/AIDS. O preconceito, o medo e a discriminação são fatores comuns entre pacientes e CD. Através das informações obtidas podemos destacar os seguintes pontos: É primordial a participação integral do CD nas equipes do SAE; Estabelecer novas estratégias de Capacitação para os CD; A Pactuação de medicamento no âmbito do SUS deve incluir lista de medicamento utilizados pelos CD no atendimento a pacientes HIV/AIDS; Ampliar o conhecimento da infecção HIV, incluindo atualização para os pacientes sobre saúde bucal e biossegurança. / The knowledge about the AIDS epidemy and the organization of health services for HIV/AIDS patients in the state is essencial to carry out planning activities of actions that might offer a better assistance for those patients.The study carried out a diagnosis of odontological assistance to HIV/AIDS user provided by the teams of Specialized Outpatient Service, focusing the users and dentists perception of the quality of such assistance.This is a qualitative study that in the first moment describes the flow of the attendance at the Specialized Outpatient Service; the reference and counter reference service and, in a second moment, the aplication of two questionaries, one to the users and other to the dentists; the questinaries to users were applied by the coordinators of the Specialized Outpatient Service. Data were gathered into categories that mix to each other, in order to evaluate: opinions, attitudes, preferences and behavior of users and dentists in relation to the service provided and offered and the quotations of users and dentistis about their experiences;174 users of Specialized Outpatient Services from Porto Velho, Vilhena, Cacoal and Ji-Paraná took part into this research, all them were HIV/AIDS patients in active registration, of both sexes, adults, and 13 dentists. Most of the users demonstrated satisfaction about the attendance carried out by dentists in their municipalities. We could notice the lack of knowledge by the dentists about the attendance to HIV/AIDS patients. Prejudice, fear and discrimination are common factors between patients and dentists.From the informations collected we are able to point out the following aspects as essencial: The paticipation of dentists in teams of Specialized Outpatient Services; Defining new strategies for training the dentists; The agreement about medicines into the Unique Health System must include the list of medicines used by dentists on the attendance of HIV/AIDS; Extending the knowledge about the HIV infection, including getting up to date for patients about oral heath and biosafety.

Background:The number of persons living with hiv and aids are still high with the highest prevalence, one in twenty five adults found in Africa. Whilst there is no cure yet, there are antiretroviral drugs that substantially improve the life expectancy of people living with hiv and aids. However persons living with hiv and aids often face unfair stigma and discrimination and it is therefore important for the nurses to treat and address their issues with respect aswell diginity. Aim: The purpose was to describe the experiences of nurses who give care to patients living with hiv and aids. Method: The study is a literature review with ten original articles, analyzed with thematic analysis searched from Pubmed and Cinahl. Data was analyzed based on thematic analysis with a qualitative approach. Results: The results revealed that the experiences of nurse ́s working with personsliving with hiv and aids were twofold. The results are presented as the themes; Challenges in daily care, and emotionally stressful work situation, with four categories, limited experience and knowledge, lack of time for patient meetings, emotional experiences and factors that affect stress. Conclusion: Knowledge and education were needed to diminish the stigma tailored around persons living with hiv and aids, in order to be able to provide the best care. When there was lack of knowledge, people’s care opportunities suffered, this created stress and exhaustion among nurses. / Bakgrund: Antalet personer som lever med hiv och aids är fortfarande högt. Högst prevalens i Afrika, där en av tjugofem vuxna personer bär på viruset. Även om det inte finns något botemedel ännu, finns det antiretrovirala läkemedel som avsevärt förbättrar livslängden för personer som lever med hiv och aids. Personer med hiv och aids drabbas ofta av stigmatisering och diskriminering, och det är därför viktigt för sjuksköterskorna att möta och behandla dessa personerrespektfullt. Syfte: Syftet var att beskriva upplevelser hos sjuksköterskornasom vårdar personersom lever med hiv och aids. Metod: Studien är en litteraturöversikt med tio originalartiklar, analyserade med tematisk analys som sökts från Pubmed och Cinahl. Data analyserades baserat på tematisk analys med en kvalitativ metod. Resultat: Resultatet avslöjade sjuksköterskornas erfarenheter av att vårda personer som lever med hiv och aids där två teman kom till; Utmaningar i den dagliga vården, och emotionellt påfrestande arbetssituation, med fyra kategorier, begränsade erfarenheter och kunskaper, bristande tidför patientmöten, känslomässiga upplevelser och faktorer som påverkar stress. Slutsats: Kunskap och utbildning behövdes för att minska stigmatisering kring personer som lever med hiv och aids, för att den bästa vården skullekunna ges. Då det brast i kunskap blev patienternas vårdtillfälle lidande, detta skapade stress och utmattning hos sjuksköterskorna.

Includes bibliographical references (leaves 81-85). / HIV and AIDS are still affecting many people in Brazil, South Africa and across the world, even though much has been done to mitigate against its further spread. Often Brazil and South Africa are compared to each other because of their economic position in the world and also because of their similar political histories. This research compares the Brazilian and the South African HIV and AIDS National Strategic prevention policies and it also aims to find out why the HIV and AIDS prevalence rates took significantly different patterns in the respective countries. The study includes a policy comparison and qualitative in-depth interviews with 14 organisation directors whose main focus is HIV prevention in Brazil and South Africa. The mains findings revealed that one of the main reasons for the different prevalence rate in both countries was because the civil society in Brazil played a major role in pressurizing the government to respond to the pandemic, while in South African the civil society did not play a major role. The Brazilian government thus started responding to HIV at least 9 years before the South African government did. Also, the Brazilian National HIV and AIDS prevention policy has an action plan for each goal, while the South African Policy does not have action plans for their goals. The Brazilian policy is also decentralized to municipal level, while the South African policy is decentralized only to Provincial level. Another finding was that in Brazil the NGO sector was directly involved in formulating the policy while in South Africa the NGO sector was not. In Brazil the respondents had a good knowledge and understanding of the policy, while in South Africa the respondents did not have a good knowledge of the policy. In Brazil NGOs have formed partnerships between themselves in order to deliver better services and to make their voices stronger when pressurising the government. Respondents in Brazil also knew what other organisations were doing. In South Africa organisations did not know what other organisations were doing and the NGOs did not have strong partnerships between themselves.

akgrund: Sjuksköterskans huvudansvar är att tillgodose god och säker omvårdnad till sinapatienter. Detta innebär ett fysiskt patientnära arbete. Att arbeta patientnära innebär attsjuksköterskor och sjuksköterskestudenter kan exponeras för HIV. Oavsett var sjuksköterskanarbetar kan hen komma i kontakt med personer med HIV. Kunskapsluckor om HIV hossjuksköterskor och sjuksköterskestudenter bidrar till stigmatiserande attityd och uteblivenomvårdnad till patienter med HIV. Syfte: Faktorer som påverkar sjuksköterskor ellersjuksköterskestudenter vid omvårdnad av patienter med HIV/AIDS. Metod:Litteraturöversikten inkluderar tretton artiklar med både kvalitativ och kvantitativ design.Resultat: Faktorer som påverkar sjuksköterskan och sjuksköterskestudentersomvårdnadsarbete till patienter med HIV är rädsla, stigmatiserande attityd och okunskap.Rädslor för att utföra omvårdnad till patienter med HIV grundar sig i okunskap och fördomar.Detta resulterar i att patienter med HIV ej erhåller personcentrerad omvårdnad. Rädslorna somsjuksköterskor och sjuksköterskestudenter beskriver bidrar till att de aktivt väljer att ej utförapatientnära omvårdnadsarbete till patienter med HIV. Sjuksköterskor ochsjuksköterskestudenter generellt visar en nedvärderande och negativ attityd mot patienter medHIV. Slutsats: Resultatet tyder på att sjuksköterskor och sjuksköterskestudenter känner storrädsla för att utföra omvårdnad med patienter som har HIV vilket föranleds av okunskap ochstigmatisering. Genom att aktivt arbeta med att öka kunskapen samt stötta de sjuksköterskorsom dagligen kommer i kontakt med patienter som bär på HIV skulle sjuksköterskor kännastörre trygghet i sitt arbete och även känna större vilja att utföra patientnära arbete till patientersom har HIV. / Background: The nurse's main responsibility is to provide good and safe care for her patients.This means that the nurse has to work close to the patient. To work close to the patient meansthat the nurse and nursing students can be exposed to HIV. No matter where the nurse works,she can come into contact with people with HIV. Lack of knowledge about HIV among nursesand nursing students contributes to stigmatizing attitudes and lack of care for patients with HIV.Purpose: Factors affecting nurses or nursing students in the care of HIV / AIDS patients.Method: A literature review including thirteen articles of both quantitative and qualitativedesign. Results: Factors that affect the nurse and nursing students' nursing work to patients withHIV are fear, stigmatizing attitudes and ignorance. Fears of performing nursing care for patientswith HIV are based on ignorance and prejudice. As a result, patients with HIV do not receiveperson-centered care. The fears that nurses and nursing students describe contribute to themactively choosing not to perform patient-centred nursing work for patients with HIV. Nursesand nursing students often have a negative attitude towards patients with HIV. Conclusion: Theresults indicate that nurses and nursing students feel great fear of performing nursing care withpatients who have HIV, which is caused by ignorance and stigma. Through active work toincrease knowledge and support the nurses who come into daily contact with patients who carry HIV, nurses would feel greater security in their work but also feel greater willingness to performwork close to patients with HIV.