Magister Administrationis - MAdmin / The main purpose of the study was to assess and explore the knowledge of HIV/AIDS among secondary learners in rural Bergville district of KwaZulu-Natal. A stratified random sample of 100 learners was selected from two secondary schools in the area. Data was collected using a questionnaire and interviews were scheduled with the teachers from the selected schools. The questionnaire was administered to a sample of 54 learners from school A and 46 from school B. The mean age was 16, with age range from 13-20. The participants were enrolled for grade 8-12 in both schools. Both qualitative and quantitative data on learners‟ knowledge and perception about HIV/AIDS, condom use and sexual issues including their attitudes towards people living with HIV/AIDS were collected in the questionnaire. Chi-square test was used for statistics purpose to test if the HIV knowledge of learners were associated with gender, culture and religion. Qualitative interviews with 9 teachers from both schools were conducted. The main purpose of the interviews was to investigate the management of HIV/AIDS in public schools in rural areas. Furthermore, to assess the learner‟s attitude towards HIV/AIDS education provided in schools. The results showed that the learners in Bergville district were more knowledgeable of HIV/AIDS through HIV/AIDS education in schools that had limited effect on gender, culture and religion. Quantitative findings presented, indicated no significant differences between those learners attending church and cultural activities that offer HIV/AIDS awareness programmes and those who do not with regard to the knowledge of HIV/AIDS. However, culture stood out to be associated with one item on the knowledge of whether school children can get HIV/AIDS (p-value = 0.04). On average, the level of knowledge of HIV/AIDS between female and male learners was similar. The major findings on both quantitative and qualitative findings confirmed that learners‟ knowledge levels were very high for modes of transmission and prevention of HIV/AIDS. Despite this knowledge, poor behavioural change among learners is a major setback thus increasing high risk of contracting HIV. Adequate knowledge about issues of cure, HIV testing and treatment was of concern in the findings in this study. Furthermore, data from qualitative interviews with the teachers highlighted the lack of multisectoral response to HIV/AIDS in Bergville rural communities which thus compromise the effectiveness in management of HIV/AIDS in schools. In summary, the study revealed some of the challenges faced by teachers and learners in regard to HIV/AIDS education. / South Africa

Magister Public Health - MPH / BACKGROUND: Namibia has generalised Human Immunodeficiency Virus (HIV) and tuberculosis (TB) epidemics. In response to the TB/HIV co-epidemics in Namibia, the Ministry of Health and Social Services approved a policy of TB/HIV collaborative activities at national level and the integration of TB/HIV services at the point of service delivery. The present study explored barriers and facilitators of integration of TB and HIV service delivery in Tsandi District Hospital, which lies in rural northern Namibia. It focused on understanding the perspectives of healthcare workers and service users on integration of TB and HIV services at the health facility. AIMS & OBJECTIVES: The study aimed to describe the barriers, facilitators, and opportunities of integrated TB/HIV service delivery in Tsandi District Hospital. The specific objectives were: to describe the staffing and support systems in place for the integration of TB/HIV care; to describe the perceptions and experiences of integrated TB/HIV care by the health care workers, management and co-infected clients; and to describe the factors that facilitate or hinder the integration of TB/HIV services in the district from the point of view of district hospital managers, health care workers and co-infected clients. METHODS: The study used a descriptive qualitative study design with semistructured key-informant interviews conducted with five healthcare managers and senior clinicians and focus group discussions with 14 healthcare workers and five TB/HIV co-infected patients, supplemented by non-participant observation in Tsandi district hospital over two weeks between May – June 2011. Sessions were audiorecorded, transcribed, and thematically analysed. RESULTS: Several factors influenced whether and to what degree Tsandi district hospital was able to achieve integration of TB and HIV services. These are: (1) model of care and nature of referral links; (2) the availability and use of human resources and workspace; (3) the system of rotating staff among departments in the hospital; (4) the supply and mode of providing medicines to patients; (5) information systems, recording and reporting arrangements; (6) and the amount of follow-up and supervision of the integrated services. The main suggested barrier factors are: (1) poor communication and weak referrals links between services; (2) inadequate infrastructure to encourage and deliver TB and HIV care; (3) staff shortages and high workload; (4) lack of training and skills among healthcare workers; (5) financial constraints and other socioeconomic challenges; and (6) fragmented recording and reporting systems with limited data use to improve service delivery. The four main facilitating factors are: (1) positive staff attitudes towards TB/HIV integration; (2) common pool of staff managing different programmes; (3) joint planning and review of TB and HIV activities at the ARV Committee; and (4) informal task sharing to alleviate healthcare worker shortages. CONCLUSIONS: This study recommends that the district build on the current facilitators of integration, while the inhibitors should be worked on in order to improve the delivery of TB/HIV services in the district. Simple and practical recommendations have been made to address the some of the barriers at district level. It is hoped that these will inform future planning and review of the current model of care by the District nagement Team.

Magister Psychologiae - MPsych / Alcohol remains the most commonly abused substance in South Africa and several studies have shown associations between alcohol use and risky sexual behaviours, which pose a risk of HIV infection. Research indicates that the age group of 15-24 years is a high risk group for HIV infection. This study aimed at examining the perceptions of alcohol as a risk factor to HIV infection amoungst a sample of university students.Specifically, this study tested the hypotheses that most students perceive that those who consume alcohol were more likely to engage in unprotected sex, sex with multiple partners, casual sex and transactional sex. The Information Motivation Behavioural(IMB) skills model provided the theoretical framework for the study. Using a quantitative research design, a survey questionnaire was used to collect the data. The sample consisted of 240 first year psychology students (192 females, 48 males). Data analyses indicated support for the hypotheses that alcohol consumption was perceived as high risk for unprotected sex, casual sex and sex with multiple partners. However, the data showed no support for the hypothesis of alcohol increasing the risk of transactional sex. The data also indicated that non-drinkers were more likely to perceive alcohol as a risk factor than drinkers. The recognition by students of alcohol as a risk factor for HIV infection provides an opportunity for raising awareness about safer sex practices at institutions of higher learning in South Africa.

Magister Public Health - MPH / Antiretroviral therapy (ART) improves the quality of lives of people living with HIV/AIDS by suppressing HIV replication and improving the patient’s immunity. An improved immunity will help prevent patients from contracting opportunistic infections. Adherence to ART is vital to obtain good clinical outcome for patients. Defaulting ART leads to increase in viral load, decreased host immunity, development of HIV drug resistant strains, exposure to opportunistic infections and ultimately death. HIV positive patients who are on ART face many challenges in adhering to their medications, these challenges act as barriers to their adherence to treatment. This study explores the barriers that adult patients in a hospital in Eastern Cape of South Africa face while on treatment. These barriers include individual factors, socio-economic factors, health service factors, medical regimen factors.

Philosophiae Doctor - PhD / All research involving human subjects should be conducted in accordance to the general ethical principles of autonomy or respect for persons, beneficence and justice. Competent adults can exercise their autonomy and can choose to take on risk for the sake of others, therefore are able to protect their own interests while in the pediatric research the ‗best interests of the child‘ takes precedence over autonomy. In other words giving informed consent in the pediatric context, is not ‗who decides‟ but „what is the best decision for the child‟. Due to lack of consensus gold standard to guide researchers and assess the quality of parental informed consent in Botswana, the practical and ethical challenges posed in obtaining parental informed consent for child enrolment in pediatric HIV clinical trials were examined. The study aimed to determine the readability of the consent forms used in pediatric HIV clinical trials; assess communication methods, practices and perceptions of the trial staff regarding the informed consent process; assess the extent to which parents recall and understand the information disclosed to them and their satisfaction with the informed consent process as well as to identify and describe the reasons for parental approval to child enrolment into HIV clinical trial studies.

Magister Curationis - MCur / Background: Health care workers who sustain needle stick injuries are at risk of contracting blood-borne pathogens, e.g. Human Immunodeficiency Virus,Hepatitis B virus or Hepatitis C virus. Needle stick injuries are viewed as occupational hazards that can lead to health care workers developing acute or chronic diseases, which may lead to disability or death. Due to these healthrelated risks, health care workers are encouraged to adhere to universal precautions and standard operating procedures. In South Africa, the Occupational Health and Safety Act promulgated in 1993 required institutions draw up protocols in line with the regulations of the Act. However, if the health care workers do not comply with the protocols they may not be compensated for contracting a disease, e.g. Human Immunodeficiency Virus infection, following needle stick injuries. Aim: The aim of the study was to explore the health care workers’ perceptions of the needle stick injury protocol at a level 2 hospital in Cape Town. Research design: A qualitative approach was used to make sense of health care workers’ compliance to the protocols when sustaining a needle stick injury. An exploratory descriptive, contextual design was used to carry out an in-depth investigation of the phenomenon. Sample: The study was done at Mowbray Maternity Hospital, a level 2 obstetric hospital in Cape Town. The researcher made use of convenience, purposive sampling. Semi-structured interviews were used to collect the research data. Data collection: During the data collection phase, ethical considerations towards participants were ensured to include, among others, anonymity, autonomy and confidentiality of information. Data analysis: It included the following steps: reading and rereading,coding, displaying, reducing and interpreting the data. Findings: Some health care workers do not view sustaining a needle stick injury as risky enough to report the injury or even go for follow-up testing. This risky behaviour can have detrimental effects on their health. There is also a lack of knowledge about the institutional needle stick injury protocol. Recommendations: It is recommended to have educational and training sessions for all health care workers and new employees to familiarise them with the needle stick injury protocol and policies of the institution; to provide adequate management support 7 following work related injuries and to make health care workers aware of the consequences of non-compliance to institutional protocol.

HIV/Aids has become a household term in South Africa. Most people are aware of the existence of the disease and how it is transmitted. Several people have used this information as the impetus for behaviour change but there are many individuals who have not heeded this call and have not made any significant changes to their lifestyles. This is reflected in South Africa’s high infection rate. It would seem as if, for various reasons, people know how to protect themselves but have not used this knowledge to guard against possible infection. The purpose of this study is to explore the reasons why people have not changed their behaviour and to identify possible techniques that can be used to amend this situation. This will take the form of an intensive three-day prevention workshop where participants will be asked to think critically about their own behaviour. The aim of the programme will be to discuss, demystify and debate ideas. How will this programme be designed? The researcher will make use of focus groups consisting of Technikon students who will offer their thoughts and opinions. Once these focus groups have been conducted the researcher will undertake an intensive analysis of the data and identify certain key issues. A literature review will then follow. Therefore, the foundation of this programme will be based on the ideas of the participants, the researcher’s ideas and some points from formal behaviour change theories. The goal of this study is to add to the already growing body of HIV/Aids prevention literature and to design a programme that is useful and relevant. / Dissertation (MA (Counselling Psychology))--University of Pretoria, 2006. / Psychology / unrestricted

The incidence of HIV and AIDS is rising rapidly and has become a serious concern in South Africa. In order to address the HIV and AIDS problem, Community Based Care was introduced to render an effective service to the HIV and AIDS patient. The volunteers receive training to equip them to render a holistic service to the HIV and AIDS patient. The researcher’s concern is that despite the training programme offered, there are still problems regarding the service delivery by the volunteers. Volunteers focus on the physical needs of the HIV and AIDS patient only and do not attend to their psychosocial needs, despite the fact that they are trained to take care of the needs of the HIV and AIDS patient from a holistic approach. Due to this problem, the researcher decided to explore the experiences of the volunteers regarding the implementation of the training programme on HIV and AIDS Community Based Care in order to find answers as to why they do not attend to the psychosocial needs of the HIV and AIDS patient, although they were holistically trained. The research question was formulated as follows: What is the experience of volunteers in the Potchefstroom Municipality regarding the implementation of the training programme on HIV and AIDS Community Based Care? The researcher used a quantitative approach to explore the research question. Twenty (20) volunteers from the two Community Based Care programmes, namely Baptist Children’s Centre and Bambanani Youth Project, were randomly selected for inclusion in the study. The data collection method used was a group questionnaire. Three themes were explored, namely, the content of the training programme, presentation of the training programme and empowerment of the volunteers to render an effective service to the HIV and AIDS patient. The findings showed that volunteers experienced limitations regarding the content and the presentation of the training programme, and much so in the area of attending to the psychosocial needs of the HIV and AIDS patient. They recommended changes to the training programme, based on their experiences in practice. / Dissertation (MSW)--University of Pretoria, 2008. / Social Work and Criminology / unrestricted

The development of a safe and effective HIV vaccine remains challenging due to its high antigenic variability. Poxviruses are large, stable, and have a track record of use as human vaccine candidates. Recombinant fowlpox virus 9 (rFP9), a highly attenuated host range-restricted poxvirus strain, has been safely administered to humans with no ill effects, and is known to be immunogenic. This thesis describes the construction of complex rFP9 encoding various sequences of SIVmac239. The SIVmac239/macaque model is widely used for HIV vaccine development. The ultimate aim of this work was to combine the advantages of FP9 with those of live attenuated SIV to produce a safe yet hopefully effective model HIV vaccine candidate. Transfer plasmids for five different insertion sites within the FP9 genome were designed and constructed. Homologous recombination (HR) of adjacent FP9 sequences was employed to facilitate the integration of SIVmac239 sequences into the FP9 genome. Positive rFP9 were identified by blue colouration in presence of X-gal using a transient colour selection (TCS) technique, and the final markerless pure recombinants were confirmed by PCR. Expression of the target SIV proteins in the presence of T7 polymerase has been demonstrated by immunocytochemical (ICC) staining and Western blotting (WB) assays. Expression was also quantified by enzyme-linked immunosorbent assay (ELISA) in various cell lines at multiple time points. Five different unique rFP9 have been constructed through this project. All SIVmac239 open reading frames (ORFs) save nef have been integrated into the FP9 genome, and protein expression demonstrated where possible. Moreover, a single rFP9 vector expressing the defective SIVmac239 genome driven by T7 RNA polymerase has been successfully constructed and validated using a green fluorescent protein marker.rFP9 showed appropriate transgene expression in both avian and mammalian cells, although at different levels. The expression efficiency of rFP9 was finally compared to another attenuated poxvirus vector, modified vaccinia Ankara (MVA). Comparing the protein expression levels between rFP9 and rMVA was quite difficult because different poxvirus promoters (early/late in rFP9; intermediate in rMVA) were used to direct the transcription of the T7 RNA gene. Given this limitation, although generally higher levels of expression were seen with rFP9, this cannot be attributed to the FP9 with any certainty.

No description available.