Background: Non-disclosure of HIV positive status to a partner threatens to reverse gains made in prevention of mother-to-child transmission (PMTCT) in resource limited settings. Determining the association between non-disclosure and infant HIV acquisition is important to justify focussing on disclosure as a strategy in PMTCT programmes. Objective: To determine the association between non-disclosure of HIV positive status to a partner and mother-to-child transmission (MTCT). Methods: Using a matched case-control design, we compared 34 HIV positive infants to 146 HIV negative infants and evaluated whether the mothers had disclosed their HIV status to their partner. Results: Non-disclosure was more frequent among cases (overall, 16.7%; cases, 52.8%; controls 7.6%), p<0.001 and significantly associated with MTCT (aOR 8.9 (3.0-26.3); p<0.0001), with male partner involvement partially mediating the effect of non-disclosure on MTCT. Conclusions: There is a need for PMTCT programs to focus on strategies to improve male partner involvement and partner disclosure without compromising the woman’s safety. / Health Studies / M. (Public Health)

MSc (Microbiology) / Department of Microbiology

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)

AIDS-related bereavement counselling programmes / The aim of this study was to determine whether there is a need for specific bereavement counselling programmes for women affected by HIV/AIDS in Indonesia, where death is believed to be fated. Six AIDS-bereaved women were recruited. Data analysis was conducted based on the women's interview transcripts and journal entries. The women experienced at least three traumatic life events. The most challenging experience was learning that they have contracted a disease they knew to be mostly associated with prostitution. Given the short lapse of time between their husbands' deaths and learning about their seropositivity, biographical disruption appeared to have acted as an "analgesic", while concerns to protect their children seemed to have triggered biographical reinforcement. This phenomenon may have brought about a positive bereavement outcome. Specific counselling programmes for women affected by HIV/AIDS are needed, but emphasis should first be placed on improving their wellbeing and their perception of stigma. / Sociology / M.A. (Sociology (Social Behaviour Studies in HIV/AIDS))

Three years into the human territory, the fight against HIV/AIDS still prevails. According to Fuller (2008), it is estimated that by 2025, 80 million Africans will have been killed by this pandemic, while 90 million are estimated to be infected by HIV. Close to 3 thousand women are infected with HIV daily. In the beginning of 2008, some 22,5 million sub-Saharan Africans were living with HIV (Fuller 2008). In South Africa, 5 million people are estimated to be infected with HIV, 250 thousand die each year due to AIDS-related deaths, while a thousand people die daily and 17 hundred get infected daily. South African women are the hardest hit population group, compared to their male counterparts (Fuller 2008; Zuberi 2004). In South Africa this epidemic crawled under the shadow of denial, fear, ignorance, stigma and discrimination, which disrupted efforts to prevent further spread and care for the infected and the affected individuals and groups. South African women are subjected to gender inequality, sexual violence and rape, and in the presence of HIV/AIDS their plight became exacerbated. They became subjected to blame and rejection because people do not want to associate themselves with this group, who possess the deadly infectious disease which is associated with commercial sex workers, intravenous drug users and homosexuals. The aim of this research was to investigate the plight of anticipated and enacted stigma among the South African women who receive treatment as outpatients in the Chris Hani Baragwanath Hospital. The study was conducted among six women who are living with HIV/AIDS over a period of four weeks, with a qualitative research design adopted as research method. In-depth interviews were used as the primary tool for data collection. This study was conducted in order for the researcher to obtain insight into the subject of HIV- and AIDS-related stigma and to highlight the experiences of participants for policy and programme designing and development purposes.

AIDS-related bereavement counselling programmes / The aim of this study was to determine whether there is a need for specific bereavement counselling programmes for women affected by HIV/AIDS in Indonesia, where death is believed to be fated. Six AIDS-bereaved women were recruited. Data analysis was conducted based on the women's interview transcripts and journal entries. The women experienced at least three traumatic life events. The most challenging experience was learning that they have contracted a disease they knew to be mostly associated with prostitution. Given the short lapse of time between their husbands' deaths and learning about their seropositivity, biographical disruption appeared to have acted as an "analgesic", while concerns to protect their children seemed to have triggered biographical reinforcement. This phenomenon may have brought about a positive bereavement outcome. Specific counselling programmes for women affected by HIV/AIDS are needed, but emphasis should first be placed on improving their wellbeing and their perception of stigma. / Sociology / M.A. (Sociology (Social Behaviour Studies in HIV/AIDS))

Three years into the human territory, the fight against HIV/AIDS still prevails. According to Fuller (2008), it is estimated that by 2025, 80 million Africans will have been killed by this pandemic, while 90 million are estimated to be infected by HIV. Close to 3 thousand women are infected with HIV daily. In the beginning of 2008, some 22,5 million sub-Saharan Africans were living with HIV (Fuller 2008). In South Africa, 5 million people are estimated to be infected with HIV, 250 thousand die each year due to AIDS-related deaths, while a thousand people die daily and 17 hundred get infected daily. South African women are the hardest hit population group, compared to their male counterparts (Fuller 2008; Zuberi 2004). In South Africa this epidemic crawled under the shadow of denial, fear, ignorance, stigma and discrimination, which disrupted efforts to prevent further spread and care for the infected and the affected individuals and groups. South African women are subjected to gender inequality, sexual violence and rape, and in the presence of HIV/AIDS their plight became exacerbated. They became subjected to blame and rejection because people do not want to associate themselves with this group, who possess the deadly infectious disease which is associated with commercial sex workers, intravenous drug users and homosexuals. The aim of this research was to investigate the plight of anticipated and enacted stigma among the South African women who receive treatment as outpatients in the Chris Hani Baragwanath Hospital. The study was conducted among six women who are living with HIV/AIDS over a period of four weeks, with a qualitative research design adopted as research method. In-depth interviews were used as the primary tool for data collection. This study was conducted in order for the researcher to obtain insight into the subject of HIV- and AIDS-related stigma and to highlight the experiences of participants for policy and programme designing and development purposes.

Text in English / The study was conducted to determine the knowledge and to describe attitudes of HIV positive women on exclusive breastfeeding in Mopani District (the Greater Letaba Sub-District, Limpopo), South Africa. A quantitative, exploratory and descriptive design was adopted in this study to describe the knowledge and attitudes of HIV positive women on exclusive breastfeeding. The researcher used a self-developed structured questionnaire to collect data. Descriptive and inferential statistics were used to describe data. The SPSS software version 21.0 was used to analyse data and this were displayed in tables and figures. A total of 123 participants were included in the study. The study concluded that HIV positive women have good knowledge and positive attitude on exclusive breastfeeding. / Health Studies / M.P.H.

A needs assessment during 2000 guided the design of a buddy system in Botswana. Implementation of this care and support system for and by 39 HIV+ve female buddy-client pairs started in 2002. During April and November 2002, levels of disclosure, self-care, support and quality of life of buddy-client pairs and the controls (n = 38) were compared. Orem's self-care theory, Maslow's hierarchy of needs and Cohen and Syme's conceptualisation of social support formed the theoretical framework. By November 2002, clients' disclosure levels, self-care for TB, and antiretroviral therapy adherence had improved. Higher income, higher education and older age predicted higher levels of self-care for antiretroviral therapy. The social support survey reported satisfaction with types of support available in November 2002 (N = 112). Clients' scores for self-care for TB, antiretroviral therapy and social support improved more than those of controls over the study period. The personal resource questionnaire measured perceptions of support: buddies' scores increased more than those of clients. Women on antiretroviral therapy completed the adherence attitudes inventory in April and November 2002 and reported a downward trend in adherence. Findings of the quality of life (SF 36) instrument showed that during the six-month study period, physical and mental health component summary scores improved but remained low (N = 112). During 2003 Botswana's community-based buddy-support programme was adopted by four other countries in Southern Africa in an attempt to enhance the quality of life of HIV+ve women in these countries. / Health Studies / D. Litt. et Phil. (Health Studies)

A needs assessment during 2000 guided the design of a buddy system in Botswana. Implementation of this care and support system for and by 39 HIV+ve female buddy-client pairs started in 2002. During April and November 2002, levels of disclosure, self-care, support and quality of life of buddy-client pairs and the controls (n = 38) were compared. Orem's self-care theory, Maslow's hierarchy of needs and Cohen and Syme's conceptualisation of social support formed the theoretical framework. By November 2002, clients' disclosure levels, self-care for TB, and antiretroviral therapy adherence had improved. Higher income, higher education and older age predicted higher levels of self-care for antiretroviral therapy. The social support survey reported satisfaction with types of support available in November 2002 (N = 112). Clients' scores for self-care for TB, antiretroviral therapy and social support improved more than those of controls over the study period. The personal resource questionnaire measured perceptions of support: buddies' scores increased more than those of clients. Women on antiretroviral therapy completed the adherence attitudes inventory in April and November 2002 and reported a downward trend in adherence. Findings of the quality of life (SF 36) instrument showed that during the six-month study period, physical and mental health component summary scores improved but remained low (N = 112). During 2003 Botswana's community-based buddy-support programme was adopted by four other countries in Southern Africa in an attempt to enhance the quality of life of HIV+ve women in these countries. / Health Studies / D. Litt. et Phil. (Health Studies)