A research report submitted to the Faculty of Human and Community Development, University of Witwatersrand in partial fulfilment of the requirements for the degree of Masters of Arts in the field of Social Development, January 2018 / Human Immunodeficiency Virus (HIV), which leads to Acquired Immune Deficiency Syndrome (AIDS), is one of the world’s greatest health threats and leads to death of millions of people. In 2016, an estimated one million people died of AIDS related causes globally. An estimated 36,7 million people in the world are living with HIV and AIDS. HIV counselling is regarded an integral part of prevention and coping strategies and an effective tool in preventing the spread of HIV and AIDS. HIV and AIDS have negative psycho-social effects to individuals and families. This study investigated counsellor’s knowledge of HIV and AIDS, attitudes towards PLWHA and counselling practices at Non-Governmental Organization (NGOs) operating within Emfuleni Local Municipality. Incorrect knowledge of HIV and AIDS, negative attitudes towards PLWHA and poor practices can negatively affect efforts to curb the pandemic. A non -experimental study was conducted with a sample of 101 HIV counsellors. Data was gathered by a self - administered questionnaire soliciting counsellors responses pertaining to knowledge of HIV and AIDS, attitudes towards PLWA and counselling practices. Data was analysed quantitatively utilising the Statistical Package for Social Scientists (SPSS). A statistical analysis was done to test the significance of relationship between knowledge of HIV and AIDS, attitudes towards PLWA and practices utilizing the demographics of the study group. The majority of respondents 86(84,8%) had good knowledge of HIV and AIDS. There were no significant relationships (P>0,05) between age, race, marital status, qualifications, years of experiences and respondents’ level of knowledge. Attitudes towards PLWHA (87,16%) were positive and were not statistically significantly correlated with HIV and AIDS knowledge and counselling practices. There were significant relationships between qualifications and counselling practices (F = 4,335, P= 0,003). / XL2019

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M.A. / The researcher has undertaken a social constructionist research project that aims to explore the narratives of therapists who work with HIV-positive clients in the South African context. The researcher hoped to generate information regarding the: difficulties or challenges that are peculiar to this type of therapy and the impact of this therapy on the professional and personal lives of the therapist. The initial part of the dissertation covers an investigation of the literature regarding HIV/AIDS and HIV-related therapy. This literature reveals that mental health workers and psychologists experience considerable stress and 'burn-out' related to the many difficult issues provoked by HIV-positive clients. The theoretical foundations of postmodernism and social constructionist research are also described. In line with the researcher's epistemology, the methodology was qualitative in nature and made use of unstructured interviews. The narratives of the participants were then subjected to a qualitative or thematic analysis. The results of the study are presented in terms of the significant themes in the participants' accounts. It is evident in the narratives of the research participants that there are peculiar difficulties in therapy with HIV-positive clients. Also evident are the significant effects that this work has on the therapists' professional and personal beliefs, attitudes, philosophies and behaviour. Finally the results are discussed and a critical evaluation of the study is offered. The objective of the research is not to generalise the findings to all Clinical Psychologists who work with HIV-positive clients. A recommendation based on the findings is that therapists considering working with HIV-positive clients familiarise themselves with the issues that this therapy raises.

Submitted in fulfillment of requirements for the Degree of Masters in Technology: Nursing, Durban University of Technology. 2013 / This study investigated the factors that impact on the utilisation of voluntary HIV counselling and testing (VCT) service at a wellness centre in a higher education institution. Purpose: The purpose of the study was to identify factors that impact on the utilisation of VCT service in a higher education institution. Methodology: A quantitative descriptive survey research design was used to describe the phenomenon and to establish relationships between variables. Participants were selected randomly in order to obtain a broad representative sample in three strata. A formal structured close-ended questionnaire was used to collect data. The questionnaire was designed to focus on variables such as demographic data, environmental factors, enabling factors, predisposing and behavioural factors. Findings: No significant relationship was identified between knowledge of HIV, AIDS and VCT and high school attended in rural, township and urban areas. There was no significant relationship between environmental factors and utilisation of VCT. There was no association between predisposing factors such as risk of VCT and perceived benefits of VCT utilisation. There was no relationship between knowledge and consistency of condom use and utilisation of VCT. The majority of respondents stated that the VCT service was not user friendly and the attitude of the staff toward students was poor. There was no significant relationship between accessibility of VCT service and utilisation of VCT. There was a lack of utilisation of campus VCT services and the majority of respondents utilised other services. Conclusion: The study showed that respondents who knew about availability of VCT were likely to have used the facility. Respondents who showed positive / Durban University of Technology

Thesis (MA)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: Counselling has been recognised as an important component ofHIV and AIDS care, and an essential part ofHIV testing. Counsellors are involved in a dynamic interrelationship with their clients as well as with the organisations in which they work. From a psychoanalytic framework, unconscious anxieties can playa role in the work of the counsellor. Transference and countertransference are processes, which are involved in the counselling situation. While these processes can be a source for understanding the client, they may also become problematic for the counsellor when they overwhelm the counsellor. This study explores the experiences of HIVIAIDS counsellors attached to Lifeline, Khayelitsha in Cape Town. Twenty-nine counsellors were interviewed using individual interviews and focus group discussions. Results explore the counselling training and activity; the difficulties of counselling; what helps the counsellor to cope; and the general impact that counselling has had on the counsellors' lives. The findings reveal the difficult and often distressing aspect of counselling persons with HIVand AIDS. A number of issues facing the client, as well as cultural and workplace issues may cause difficulties for the counsellor. In addition, the nature of the disease, and the issues it creates for the patient, can arouse a number of anxieties in the counsellor related to their own past. The results reveal some possible limitations to an individual client-centred approach. The study concludes that psychodynamic issues should form part of the counsellor's training, and be explored during regular counsellor supervision. / AFRIKAANSE OPSOMMING: Berading is erken as 'n belangrike komponent in HIV en VIGS sorg, en 'n essensiele deel van HIV toetsing. Beraders is betrokke in 'n dinamiese verhouding met hul kliënte so wel as die organisasies vir wie hulle werk. Vanaf 'n psigoanalitiese raamwerk kan angs in die onderbewussyn, 'n rol speel in die werk van beraders. Oordrag en teenoordrag is prosesse wat betrokke is by die beradingsituasie. Alhoewel die proses 'n bron is wat tot beter verstandhouding met die kliënt kan lei, mag dit ook die berader oorweldig. Hierdie studie verken die ervaringe van beraders verbonde aan LifeLine, Khayelitsha in Kaapstad. Nege-entwintig beraders is individueelonderhoude mee gevoer en het aan fokus groepe deelgeneem. Resultate ondersoek die berading opleiding en aktiwiteite; die problematiese aspek van berading; wat die berader help om klaar te kom; en die algemene impak wat berading het op die lewe van 'n berader. Die resultate onthul die moeilike en dikwelse stresvolle aspek van berading met HIV en VIGS pasiënte. 'n Aantal aspekte wat die pasiënte mee toe doen kry so wel as kulturele en werksplek faktore kan sake vir die berader beïnvloed. Verder kan die aard van die siekte en die probleme wat die siekte vir die pasiënt veroorsaak lei tot angs vir die berader ten opsigte van sy ofhaar eie verlede. Die resultate onthul verskeie tekortkominge tot 'n individueeie kliëntgesentreerde berading. Die studie beslus dat psigodinamiese probleme dalk deel moet vorm in die berader se opleiding, asook verder ondersoek moet word in gewone berader toesighouding.

Thesis (M. A. (Clinical Psychology)) --University of the North, 2002 / Refer to the document

M.A. (Counselling Psychology) / This study is an examination of the context of the gay male individual with HIV illness. A psychosocial model is used to investigate the effects of HIV disease on the individual, his partner and the relationship. The model includes a discussion of variables which are related to adjustment to the disease." These include the special characteristics of HIV disease such as the stigma and the progressive nature of the disease. Furthermore the personality characteristics of the individual and the characteristics of his situation are examined. These factors together contribute to making HIV positive diagnosis a crisis for the individual in his context. A case study approach was used to research the subjective experiences of an HIV infected gay man and his partner. In depth interviews were conducted in order to obtain qualitative data on the individuals within the context of their relationship. The data obtained from the interviews supports the literature in many respects. Of special importance is the impact of an HIV positive diagnosis on intimacy in the relationship. Also important are the changes which occur in the sexual relationship as a result of fear of transmission of the HIV virus. Other important changes include adapting to the uncertainty of living with HIV disease and coping with the emotional reactions, which follow HIV diagnosis. The study highlights the importance of emotional support within the primary relationship as well as the role of friends and family in adjusting to HIV disease. The study also demonstrates the importance of effective communication in dealing with the various stresses associated with HIV disease. Lastly therapeutic interventions have been suggested for counselling the gay infected person and his partner in order to help them to cope with the crisis of HIV disease.

The pandemic of HIV/AIDS has challenged several aspects of contemporary social life. HIV/AIDS counselling has developed as a social response to provide support for those infected with the disease. Due to the nature and complexity of the disease, HIV/AIDS counsellors encounter a diversity and intensity of emotions when counselling. A support system that includes effective management and supervision may assist in resolving emotions and reactions that HIV/AIDS counsellors may experience as a result of working with HIV/AIDS clients. This study examines the difficulties that both managers and the HIV/AIDS counsellors at a rural district hospital in the Eastern Cape and its surrounding clinics are faced with, in providing the HIV/AIDS counsellors with the support they need. Engestrom's (1987) model of activity theory was used as a conceptual framework guiding both the analysis and interpretation of the data. This model facilitates the identification of tensions and contradictions thereby opening a space for change and transformation within an activity system. Multiple sources of data collection were used that included focus groups with managers and HIV/AIDS counsellors, interviews with senior hospital staff and an official from the Department of Health, Eastern Cape, and a tour of the rural district hospital. The findings suggest that HIV/AIDS counsellors do not feel supported by their managers. Managers in turn are of the opinion that they do not offer the support the HIV/AIDS counsellors' need. The lack of support is attributed to geographic distances between hospitals and the clinics they serve, lack of available transport and the multiplicity of roles of both managers and the HIV/AIDS counsellors. The pandemic of HIV/AIDS has challenged several aspects of contemporary social life. HIV/AIDS counselling has developed as a social response to provide support for those infected with the disease. Due to the nature and complexity of the disease, HIV/AIDS counsellors encounter a diversity and intensity of emotions when counselling. A support system that includes effective management and supervision may assist in resolving emotions and reactions that HIV/AIDS counsellors may experience as a result of working with HIV/AIDS clients. This study examines the difficulties that both managers and the HIV/AIDS counsellors at a rural district hospital in the Eastern Cape and its surrounding clinics are faced with, in providing the HIV/AIDS counsellors with the support they need. Engestrom's (1987) model of activity theory was used as a conceptual framework guiding both the analysis and interpretation of the data. This model facilitates the identification of tensions and contradictions thereby opening a space for change and transformation within an activity system. Multiple sources of data collection were used that included focus groups with managers and HIV/AIDS counsellors, interviews with senior hospital staff and an official from the Department of Health, Eastern Cape, and a tour of the rural district hospital. The findings suggest that HIV/AIDS counsellors do not feel supported by their managers. Managers in turn are of the opinion that they do not offer the support the HIV/AIDS counsellors' need. The lack of support is attributed to geographic distances between hospitals and the clinics they serve, lack of available transport and the multiplicity of roles of both managers and the HIV/AIDS counsellors. Recommendations include the introduction of self-supervision , peer groupsupervision for HIV/AIDS counsellors.

The purpose of this study was to present and understand the experiences of HIV-positive lay counsellors working in Voluntary Counselling and Testing (VCT) settings. Specifically exploring and understanding the utilisation of personal experiences within counselling encounters, the practice of peer counselling within VCT, and the challenges experienced by HIV-positive lay counsellors within VCT settings. This study, employing a qualitative interpretative phenomenological methodology required a small sample of practicing HIV-positive lay counsellors, who were selected and interviewed on their experiences utilising semi-structured interviewing. Data was analysed for meaning units, which were interpreted inductively and hermeneutically, and categorised into super-ordinate themes. Three superordinate themes within the participants’ experiences of providing VCT services were determined, namely: ‘diagnosis and disclosure experiences’, ‘peer counselling’, and ‘challenges’. This research found that the experiences of providing peer counselling depended upon identification with their client’s negative appraisal of their diagnosis experiences. Whether through empathic connections generated through the shared experience of discovering a seropositive status, or through countertransferential reactions induced through their client’s yearning for care and support. This required the counsellor to selfdisclose within counselling encounters in order to provide personal experiences of living with HIV/AIDS. Successful implementation of peer counselling provided recently diagnosed individuals with knowledge surrounding HIV/AIDS, coping skills to manage the daily physiological and psychological challenges, facilitation and adherence to treatment, social assistance, ongoing relationships, inspiring hope, and the creation of positive appraisals. However the informal utilisation of task-shifting within lay healthcare cadres, and the lack of governmental recognition for the emotional labour provided within VCT indicated that HIVpositive lay counsellors require ongoing training, support and remuneration to limit potential occupational stress, resignation, and burnout.

Currently South Africa has the highest number of persons living with HIV-AIDS (PLWAs) in the world. Focus-group discussions conducted by Moon (2005:3) in the Eastern Cape indicated that people may not want to get tested for HIV or to access antiretroviral therapy (ART) for fear of disclosure of their HIV-positive status and of stigmatization. These findings prompted the researcher to conduct a study in this field. The objectives of this study are to explore and describe the experiences of PLWAs with regard to the comprehensive ART management received from registered nurses at selected public primary healthcare clinics in Nelson Mandela Bay; and to develop guidelines for registered nurses that could facilitate them in rendering appropriate comprehensive ART management. The research study is based on a qualitative, explorative, descriptive, phenomenological and contextual research design. The research population comprised of HIV-positive patients who received treatment at the selected public primary healthcare clinics. Criterion-based, purposive sampling was used to select participants for the interviews. Ten in-depth unstructured interviews were conducted. Data was then transcribed and coded. One central theme identified the fact that PLWAs experienced both positive and negative experiences at the clinics. The main findings of this research included evidence of various forms of stigma experienced by the PLWAs; distrust of the lay health counselors; but also that PLWAs were generally well-treated and satisfied with the service they had received. Broad guidelines for registered nurses was formulated that could facilitate them in rendering appropriate comprehensive ART management. The study concludes with recommendations made with regards to the areas of nursing practice, education and research. Throughout the study the researcher abided by the ethical considerations. The aspects of trustworthiness implemented in this study, included dependability, credibility, transferability and confirmability (Holloway & Wheeler, 2002:354).