Submitted in partial completion for the degree of PHD in Community Psychology in the University of Zululand, 2006. / HIV/AIDS is the current century's challenge that stares humanity in the eye. The socio-political, economic, spiritual and philosophical dimensions of our society have to face up to this challenge. This brings one to the conclusion that HIV/AIDS is a national disaster and should be dealt with as such. In other words, interventions geared towards combating this epidemic should address all the spheres mentioned above. The main purpose of this study then was to investigate the role of indigenous healers in combating HIV and AIDS. The rationale for looking at the role of indigenous healers was to ensure that their role is highlighted for a joint effort that is necessary for the advocacy, awareness, education, care and medical intervention which is necessary to combat the HIV/AIDS crisis. This challenge goes as far as involving non-medical professionals and stakeholders in the fight against HIV/AIDS. Focus group interviews and individual interviews were conducted with indigenous healers in the Gauteng and North West provinces. The results were analysed thematically. The results are presented in relation to the questions which were posed. The results reflected that traditional healers have demonstrated that they can make a very important contribution to the treatment of HIV/AIDS. However, they feel that they are not receiving a fair opportunity to demonstrate their knowledge and expertise in treating HIV and AIDS. They also lack support from the public, from government policy, and from the modem medical fraternity. There have been efforts by the Minister of Health to incorporate traditional healing and traditional medicine as part of a holistic approach to the treatment and containment of HIV. This strengthens holistic health care ensuring the advocacy, awareness, education, care and medical intervention which is necessary to combat the HIV/AIDS crisis. Traditional healers need support and recognition from the public, the government and the modem medical fraternity. It was also evident from the results that the indigenous healers were very willing to co-operate with biomedical practitioners as shown in the statement below. Traditional healers reported that they did not routinely test their patients for HIV as they had no means of doing that. They were legally required to send their patients for testing through modem medical procedures. Most healers also said that they preferred their patients to be checked using modem medicine, and thereafter they would treat them accordingly. This is because they currently relied only on their ancestors to show them when the patient was positive. What is important to note is that these healers said that the disease was not presented to their bones as HIV/AIDS, but that they were only shown the known symptoms of HIV and then were able to deduce that the person was HIV positive.

O presente estudo tem como objetivo apreender e analisar as representações sociais do tratamento do HIV/AIDS para enfermeiros atuantes em um hospital de referência, localizado do município do Rio de Janeiro. Trata-se de um estudo descritivo com abordagem qualitativa, que utilizou como referencial teórico-metodológico a teoria das representações sociais. Os sujeitos do estudo foram 20 enfermeiros que atuam em um hospital público universitário da cidade do Rio de Janeiro. A coleta de dados deu-se por meio de entrevista semi-estruturada. Para análise dos depoimentos obtidos através das entrevistas utilizou-se a técnica de análise de conteúdo temática, proposta por Bardin (1977). Após a análise, emergiram nove categorias: O tratamento medicamentoso e os determinantes de sua adesão; O tratamento clínico e físico; Ações psico-espirituais enquanto parte do tratamento; A abordagem terapêutica social na busca da qualidade de vida; Ações educativas preventivas e terapêuticas; A dinâmica familiar envolvida no tratamento; O cuidado psicossocial no diagnóstico e suas repercussões; O relacionamento interpessoal como parte do tratamento; Sentimentos do profissional que cuida. A representação social do tratamento prestado ao portador do HIV/AIDS, identificada no presente estudo, foi construída a partir das novas necessidades apresentadas por estes pacientes, diante do caráter de cronicidade do HIV/AIDS. Observa-se que as representações sociais apreendidas apontam para uma concepção de tratamento dentro de uma perspectiva holística, e não apenas focada na doença e no corpo, apontando para o tratamento enquanto atendimento das necessidades humanas essenciais e não apenas garantia de sobrevivência. / The purpose of the present study is to apprehend and analyze the social representations of HIV/AIDS to nurses who work in a hospital of reference located in Rio de Janeiro. This is a qualitative descriptive study which used as theoretical-methodological reference the social representations theory. The study subjects were 20 nurses who work in a public university hospital in Rio de Janeiro City. The data collection was obtained by means of semi-structured interview. To analyze the statements obtained through the interviews the Technique of Analysis of Thematic Content proposed by Bardin (1977) was chosen. Nine categories emerged after analysing: The drug treatment and the determinants of its adherence; The clinic and physical treatment; Psycho-spiritual actions while treating; The social therapeutic approach in the pursuit of the quality of life; Preventive and therapeutic educative actions; The family dynamics involved in the treatment; The psychosocial care in diagnostic and its repercussions; The interpersonal relationship as part of the treatment; The professionals feelings who cares. The social representation of the treatment given to HIV-positive patients identified in this study was built from the new necessities presented by these patients before the character of HIV cronicity. It is observed that the social representations apprehended point to a treatment conception within a holistic perspective, and not only focused on the disease and body, indicating the treatment while attending the essential human necessities and not only assuring the survival.

O presente estudo tem como objetivo apreender e analisar as representações sociais do tratamento do HIV/AIDS para enfermeiros atuantes em um hospital de referência, localizado do município do Rio de Janeiro. Trata-se de um estudo descritivo com abordagem qualitativa, que utilizou como referencial teórico-metodológico a teoria das representações sociais. Os sujeitos do estudo foram 20 enfermeiros que atuam em um hospital público universitário da cidade do Rio de Janeiro. A coleta de dados deu-se por meio de entrevista semi-estruturada. Para análise dos depoimentos obtidos através das entrevistas utilizou-se a técnica de análise de conteúdo temática, proposta por Bardin (1977). Após a análise, emergiram nove categorias: O tratamento medicamentoso e os determinantes de sua adesão; O tratamento clínico e físico; Ações psico-espirituais enquanto parte do tratamento; A abordagem terapêutica social na busca da qualidade de vida; Ações educativas preventivas e terapêuticas; A dinâmica familiar envolvida no tratamento; O cuidado psicossocial no diagnóstico e suas repercussões; O relacionamento interpessoal como parte do tratamento; Sentimentos do profissional que cuida. A representação social do tratamento prestado ao portador do HIV/AIDS, identificada no presente estudo, foi construída a partir das novas necessidades apresentadas por estes pacientes, diante do caráter de cronicidade do HIV/AIDS. Observa-se que as representações sociais apreendidas apontam para uma concepção de tratamento dentro de uma perspectiva holística, e não apenas focada na doença e no corpo, apontando para o tratamento enquanto atendimento das necessidades humanas essenciais e não apenas garantia de sobrevivência. / The purpose of the present study is to apprehend and analyze the social representations of HIV/AIDS to nurses who work in a hospital of reference located in Rio de Janeiro. This is a qualitative descriptive study which used as theoretical-methodological reference the social representations theory. The study subjects were 20 nurses who work in a public university hospital in Rio de Janeiro City. The data collection was obtained by means of semi-structured interview. To analyze the statements obtained through the interviews the Technique of Analysis of Thematic Content proposed by Bardin (1977) was chosen. Nine categories emerged after analysing: The drug treatment and the determinants of its adherence; The clinic and physical treatment; Psycho-spiritual actions while treating; The social therapeutic approach in the pursuit of the quality of life; Preventive and therapeutic educative actions; The family dynamics involved in the treatment; The psychosocial care in diagnostic and its repercussions; The interpersonal relationship as part of the treatment; The professionals feelings who cares. The social representation of the treatment given to HIV-positive patients identified in this study was built from the new necessities presented by these patients before the character of HIV cronicity. It is observed that the social representations apprehended point to a treatment conception within a holistic perspective, and not only focused on the disease and body, indicating the treatment while attending the essential human necessities and not only assuring the survival.

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.

Dissertation submitted in partial fulfillment of the requirements for the Degree Master of Arts in Counselling Psychology at the University of Zululand, South Africa, 2003. / The study investigated student behaviour and knowledge related to HIV/AiDS on the University of Zuluiand campus. Because of the social and economic conditions that exist in the country today such research is seen as both urgent and pertinent it is hoped that the study will add to the knowledge base generated by other studies conducted at tertiary institutions throughout South Africa. The study had certain assumptions, which have been supported by the results of the survey, it was postulated that women students wouid be more conservative in sexual behaviour than mate students and that femaies would be more accepting and empathetic towards People living with HiV/AIDS (PLWHA). The study also predicted that there wouid be a segment of the student population who would reveal a dissonance between attitudes, knowledge and behaviours and also that a proportion of students of both sexes would reveal significant gaps in their knowledge about how HIV/AIDS is transmitted. These predictions are underpinned by the results and discussion thereof, which places them within the context of early 21st century South African society.

Thesis (MPH.) --University of Limpopo, 2018 / Background: The prevalence of HIV in South Africa has increased largely due to the combined effect of new infections, and a successfully expanded antiretroviral treatment programme, which has increased survival among people living with HIV. As the up-scaling of patients on ART has been increased, the aim of the current study was to investigate the variations of the clinical outcomes between patients initiated with CD4 < 350 and of those above 350 after the implementation of the new eligibility criteria for ARV therapy. Methods The current study used quantitative approach to retrospectively review a total of 488 records of adult patient who were registered in health facilities which were purposefully sampled from Sekhukhune District of Limpopo Province. SPSS version 23.0 was used to analyse data. Results Approximately 60% of the patients initiated on ART were having CD4 count <350 and male patients were more at 74% as compared to females at 54.7%. Patients who started ART with a baseline CD4 >350 had a high rate of lost to follow up within 3 months after start of ART at 15% than those with a baseline CD4 <350 at 10.2. More patients were lost to follow-up shortly after starting treatment at 3 months at an average of 13.8% in both CD4 counts. Majority of patients retained in care were those who started ART treatment with a baseline CD4<350 at 87.4%. Viral load completion rate at 12 months was higher than that of 6 months, at 86.8 and 80.5 respectively. Patients with a baseline CD4 >350 suppressed more than those who started ART with a baseline CD4 <350 at both 6 and 12 months at >90% suppression rate. Lastly, most of the patients died within 3 months of ART treatment and had a baseline CD4 < 350 than at 2.4% those with a baseline CD4 >350 at 0.6%. Conclusions The implementation of the new eligibility criteria of ART initiation improves the clinical outcome of patients on ART. There are still patients that are missed to be monitored viral load bloods which play a key role in determining the clinical outcomes of patients. Clinicians and nurses should adhere to the recommended time frames for monitoring of ART patients to improve clinical outcomes. Keywords: HIV/AIDS, antiretroviral therapy, clinical outcome, ART initiation; Eligibility Criteria;

Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: Chronic drug therapy has been fraught with many issues such as adherence, drug intolerance, long-term toxicity and resistance. In HIV/AIDS care, adherence is a major problem due to the fact that for success of the therapy, adherence must be in the region of ninety five percent. If this is not maintained the virus begins to mutate and resistant moieties appear, and this in turn leads to failure of the therapy. This high level of adherence is very difficult to maintain especially in patients who begin antiretroviral therapy (ART) for various reasons such as persuasion by health workers and family, and not due to their own conviction. They usually tend not to adhere to the therapy when symptoms resolve and they start feeling better. There are a number of factors that promote adherence and these are incorporated into HIV care for the programme to succeed. The research was intended to explore and describe factors causing patients to default ART on the Copper belt in Ndola at Ndola Central Hospital and to ultimately propose appropriate interventions to ensure improved return rates of patients on ART. Qualitative tools i.e. interviews and focus group discussions respectively were used, taking into account ethical considerations and data collected was then analyzed. Factors causing patients to default on ART were found to be poor social economic background, inadequate finance, unavailability of food, poor or little understanding of instructions, poor quality of counseling or low literacy levels, high pill burden, unpalatability of drugs and patient readiness to life time commitment to taking ARVS. / AFRIKAANSE OPSOMMING: Chroniese medisyneterapie is gepaard gaande met vele kwessies soos trou bly, weerstandsgebrek aan medisyne, langtermyn toksisiteit en weerstand. In MIV/Vigs sorg, is trou bly 'n groot probleem weens die feit dat vir sukses in terapie moet dit oor vyf-en-negentig persent wees. As dit nie gehandhaaf word nie sal die virus begin verander en weerstand weestandbiedende gedeeltes sal verskyn, en dit op sy beurt lei tot die mislukking van die terapie. Hierdie hoë vlak van trou bly is baie moeilik om te handhaaf veral in pasiente wie antiretrovirale terapie (ART) vir verskeie redes begin het soos oorreeding deur gesondheids werkers en familie, en nie deur hul eie oortuiging nie. Hulle neig gewoonlik om die terapie te laat vaar wanneer simptome verminder en hulle begin beter voel. Daar is verskeie faktore wat trou bly bevorder en wat ingelyf word in MIV sorg om die program te laat slaag. Die doel van hierdie navorsing was om die faktore te beskryf wat veroorsaak dat pasiente op die Copperbelt in Ndola by Ndola Sentrale Hospitaal hul ART verpligtinge nie nakom nie en om uiteindelik geskikte intervensies voor te stel om verbeterde terugkeer koerse van pasiente op ART te verseker. Kwalitatiewe insrumente, dit is, onderhoude en fokusgroupe is gebruik, met in agneming etiese kwessies, en data is daarna geanaliseer.

Made available in DSpace on 2014-12-17T14:19:52Z (GMT). No. of bitstreams: 1 AnaLS.pdf: 754560 bytes, checksum: 4352ce162cb36ae915a586c0706ec693 (MD5) Previous issue date: 2009-11-30 / We study the health care focused on care in an intercessor and dialogical relationship with the User, which involves the construction of therapeutic projects essential to the quality of the treatment of the user in health services, and it is necessary individual and collective actions. It is intended to acknowledge and analyze the perception of social subjects, users and professionals on the treatment given to a user of a Specialized Outpatient Service (Servi?o Ambulatorial Especializado SAE) in STD/HIV/AIDS state reference in Natal, RN. The study is structured in a transdisciplinary vision of science and knowledge, theoretical and methodological principles that give meaning to the expression of the institutional features of care and health care reconnecting them to the social context. As a research strategy we seek the expressions of 56 subjects of social research, which agreed to participate in the sample, from a symbolic map of the attention, coupled with the techniques of observation and semi-structured interview. For the analysis of the results, five categories of analysis were established: the meaning of the service, care perception, process of communication and interaction, treatment perception and organization and evaluation of the service. It is argued that the attention and care are developed in a technical health care assistance to the disease, focusing on attention based on treatment, on diagnostic and drug therapy of antiretroviral drugs, reflecting the traditional biomedical paradigm of attention to the disease. This is also the mode of organization of practical actions in daily SAE: the therapy proves to be fragmented in several specialties, vertical and feeds the same model, generating tension and overload for professionals; showing impersonal care focused on structured and informative technology, unrelated to an interactive dialogic. From the speech of the subjects, the SAE is understood as the place of confrontation with the disease, but also enables greater elaboration of the illness by meeting their peers. Living with HIV and AIDS is living with concern, apprehension and fear, but mainly with the stigma, prejudice and exclusion, which require that the disease is kept in secret. There is a movement of forces and power, expressed in the knowledge-power of those who dominate the technical and administrative capabilities, devices that concentrate the maintenance of the medicalization of care, rapid consultations and with little attention, making it difficult to interact with and listen to, combined with structural failures, organizational and inadequate management of the service. We conclude that there are dimensions that are not considered in the internal dynamics of the care service multiple forms, characterized by care conflicting models, marked by individual interventions related to the disease. The subject is not considered together with his speech as technical discourse is imposed and care production based on material technology is observed / Estuda-se a aten??o ? sa?de centrada no cuidar, em uma rela??o intercessora e dial?gica com o usu?rio, que envolve a constru??o de projetos terap?uticos essenciais para a qualidade do tratamento do usu?rio nos servi?os de sa?de, sendo fundamentais a??es individuais e coletivas. Tem-se como objetivo conhecer e analisar a percep??o dos sujeitos sociais, usu?rios e profissionais, sobre o tratamento dispensado ao usu?rio de um Servi?o Ambulatorial Especializado em DST/HIV/Aids, refer?ncia estadual em Natal, RN. Articulam-se, em uma vis?o transdisciplinar da ci?ncia e do conhecimento, referenciais te?rico-metodol?gicos que possam dar sentido ? express?o das caracter?sticas institucionais da aten??o e do cuidado em sa?de, religando-as ao contexto social. Como estrat?gia de pesquisa, buscam-se as express?es dos 56 sujeitos sociais da investiga??o, que aceitaram participar da amostra, a partir de uma cartografia simb?lica da aten??o, associada a t?cnicas de observa??o e entrevista semi-estruturada. Para an?lise dos resultados, estabeleceram-se cinco categorias de an?lise: significado do servi?o, percep??o do atendimento; processo de comunica??o e intera??o; percep??o do tratamento e organiza??o e avalia??o do servi?o. Discute-se que a aten??o e o cuidado desenvolvem-se em uma assist?ncia tecno-assistencial ? doen?a, centrados em uma aten??o focada no tratamento, na solicita??o de exames e na terap?utica medicamentosa dos anti-retrovirais, reflexo do paradigma tradicional biom?dico de aten??o ? doen?a. Este tamb?m ? o modo de organiza??o das a??es pr?ticas no cotidiano do SAE: a conduta terap?utica mostra-se fragmentada nas diversas especialidades, verticalizada e retro-alimentada no mesmo modelo, gerando tens?o e sobrecarga aos profissionais; evidenciam-se atendimentos impessoais focados em tecnologias estruturadas e informativas, desvinculadas da dial?gica interativa. A partir dos discursos dos sujeitos, o SAE ? interpretado como o lugar do confronto com a doen?a, mas tamb?m possibilita maiores elabora??es do adoecer pelo encontro com os iguais. Conviver com o HIV e Aids ? conviver com receios, apreens?o e medo, mas principalmente com o estigma, o preconceito e a exclus?o, o que requer o sigilo da doen?a. H? circula??o de for?as e de poder, expressos no saber-poder t?cnico-profissional e administrativo, dispositivos que concentram a manuten??o da medicaliza??o do atendimento, consultas r?pidas e com pouca aten??o, o que dificulta a intera??o e a escuta, aliados a falhas estruturais, organizacionais e a um gerenciamento inadequado do servi?o. Conclui-se que h? dimens?es n?o consideradas na din?mica interna das m?ltiplas formas do cuidar, caracterizado pelo modelo conflitante da aten??o, marcado por interven??es individuais relacionadas ? doen?a. Desconsidera-se o sujeito de seu discurso, imputando-lhe discursos tecnicistas, e observa-se a produ??o do cuidado baseada na tecnologia material

Magister Public Health - MPH / Aim: This study aimed to evaluate the effectiveness of the Mobile HIV/AIDS Treatment Teams in initiating and treating patients with HAART at fixed primary health care clinics Amajuba District.

The study analysed and compared data from patients' medical and pharmacy refill records to identify correlations between CD4 cell counts and adherence to antiretroviral drugs at Katutura Intermediate Hospital (KIH) in Windhoek, Namibia. The study investigated whether the pharmacy refill adherence measurement methodology could predict immunological recovery through increased CD4 cell counts. There was a positive but weak relationship between adherence and CD4 cell counts. Although the pharmacy refill records could predict immunological response it was not sensitive enough and should be used in combination with other adherence measurement tools. / Public Health / M.A. (Public Health)