Thesis (MPhil (Industrial Psychology))--Stellenbosch University, 2008. / The purpose of this research was to determine the efficacy of an innovation in HIV prevention programming in Ukraine, which leverages the culture of Ukrainian society by appreciating its values and incorporating them into the strategy. Analysis of the results indicates that positive changes in two of the questions of the Behavioural Models were significant among the participants of the Experimental Group. This was not seen in the Control Group. The number of respondents from the Experimental Group who spoke to their partner about HIV/AIDS in the past month increased during the month after the training. The number of people who were tested for HIV during the month after training also increased. Based on the results of this research, it can be concluded that participation of employees’ sexual partners in HIV prevention programs can influence Behaviour Models and lead to desired changes in this area changes in Behaviour Models, which are very important and as we can see depends much on participation of both sexual partners in training.

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal.

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Using non-experimental descriptive exploratory survey, this study sought to find out factors associated with delayed entry into HIV medical care among HIV positive people who are aware of their status. A quantitative design was used and a structured questionnaire was used as the data collection instrument. Respondents were patients in a hospital’s Opportunistic Infection Department whose hospital records indicated that they were HIV positive during the time of the study. The study found out that as much as 71.6% (n =43) first entered HIV medical care more than 12 months after testing HIV positive while 40% (n = 24) did so as a result of illness. Low education levels, unemployment and being single are associated with delayed entry into HIV medical care. A percentage of the population uses and trusts non-biomedical approaches to dealing with HIV/AIDS. Being diagnosed HIV positive is therefore not necessarily a strong reason enough for one to immediately enter into medical care. Intensive health education needs to be done at work places, health facilities, schools, through print and electronic media, churches and other community settings to equip the population with knowledge of the advantages of early entry into HIV care. / Health Studies / M.A. (Public Health)

Contexte : Les migrants d'Afrique subsaharienne (ASS) sont particulièrement touchés par l'épidémie de VIH/SIDA en France. Malgré une baisse du nombre de nouveaux diagnostics observés dans la dernière décennie en France, en 2016, les hétérosexuels originaires d'ASS comptent pour trois quarts de nouveaux diagnostics VIH versus un quart seulement pour les migrants hétérosexuels nés dans d'autres pays. Bien que la plupart de personnes concernées soient contaminées dans leurs pays d'origine où la situation épidémiologique de l'infection par le VIH reste préoccupante, des données virologiques et d'enquêtes transversales suggèrent qu'une partie des contaminations a lieu après la migration en France. Ces contaminations post migration peuvent être attribuées à des comportements sexuels à risque dans les réseaux sexuels intra-africains où la prévalence du VIH est élevée. Objectifs : il s'agit ici d'étudier à la fois, les déterminants de la divulgation du statut VIH, les facteurs prédictifs du rebond virologique à l'occasion d'un séjour transitoire en ASS et les facteurs associés aux comportements sexuels à risque. Méthodes : nous avons utilisé les données de l'enquête ANRS-VIHVO réalisée entre 2007- 2009 auprès des migrants d'ASS vivant en France avec une infection par le VIH contrôlée par le traitement antirétroviral, et ayant planifié un séjour transitoire dans leurs pays d'origine pour une durée de 15 jours à 6 mois. Résultats : nous avons trouvé un taux global important de divulgation du statut VIH, 86 % (IC à 95% : 82- 90%). La fréquence de la divulgation du statut VIH au partenaire, composante principale de la stratégie de réduction de risque de transmission du VIH dans les couples est relativement faible, 79% (IC à 95% : 73– 85%) globalement dont 88 % (IC 95% : 82- 94%) en France vs 53% (IC à 95% : 38- 69%)dans le pays d'origine où certaines personnes ont des partenaires sexuels réguliers. Au décours du voyage en ASS, 11,4% (IC à 95% : 7,3- 15,5%)de personnes ont développé un rebond virologique, principalement à cause de la perte d'adhérence à leur traitement antirétroviral pendant le voyage. L'utilisation non systématique du préservatif au cours du dernier mois avec le partenaire est observée chez plus d'un tiers de personnes, soit 38,4%(IC à 95% : 30,0- 46,7%) avec le partenaire régulier et 34,5%(IC à 95% : 21,8- 56,7%) avec le partenaire occasionnel. Plusieurs prédicteurs de la divulgation du statut VIH, de la survenue de rebond virologique au décours du voyage en ASS et de l'utilisation non systématique du préservatif au cours du dernier mois, ont ainsi été identifiés. Conclusion : Une charge virale indétectable tout au long du suivi permet de prévenir la transmission sexuelle du VIH au partenaire. Cette réduction de risque passe à la fois par la divulgation de la séropositivité au partenaire, l'usage du préservatif en cas de charge virale détectable ou de partenaires multiples, et l'adhérence soutenue au traitement antirétroviral / Background: Migrants from sub-Saharan Africa (SSA) are particularly affected by the HIV/ AIDS epidemic in France. Despite a fall in the number of new diagnoses observed in the last decade in France, in 2016 migrants from SSA accounted for 39% of the 6,003 people who discovered their HIV positive status in France. Although the majority of these people are infected in their country of origin because of the epidemiological situation, virological data and cross-sectional surveys suggest that some of the infections occur after migration to France. These post-migration infections can be attributed to risky sexual behavior in intra-African sexual networks where HIV prevalence is high. Objectives: to study at once the determinants of HIV status disclosure, predictive factors of virological rebound during a transitional stay in the country of origin and factors associated with risky sexual behavior. Methods: we used the ANRS-VIHVO survey data set up between 2007- 2009. This cohort studied migrants from SSA living in France with HIV infection managed with antiretroviral therapy, and who had planned a transitional stay in their countries of origin for a period of 15 days to 6 months. Results: Our work highlighted a significant overall rate of HIV status disclosure, 86 % [CI 95%: 82- 90%]. Disclosure to the partner, an important component of the risk reduction strategy of HIV transmission in couples, is relatively low, 79% (95% CI: 73-85%) overall, whose 88% (95% CI: 82-94%) in France vs 53% (95% CI: 38-69%) in the country of origin where some people have regular sex partners. After the trip in ASS, 11.4% (95% CI: 7.3- 15.5%) of people developed a virological rebound mainly due to lack of adherence to treatment during the trip. Non-systematic use of condoms is observed in more than a third of the study subjects, ie, 38.4 % (95% CI: 30.0- 46.7%) with the regular partner and 34.5% (95% CI: 21.8-56.7%) with casual partners. Several predictors of HIV status disclosure, the unsystematic use of condoms and the occurrence of virological rebound after the trip to SSA, were identified in our work. Conclusion: undetectable viral load throughout the follow-up prevents the sexual transmission of HIV to the partner. This risk reduction goes through by the disclosing the HIV status to the partner, condom use in case of detectable viral load or multiple partners, and sustained adherence to antiretroviral therapy

Using non-experimental descriptive exploratory survey, this study sought to find out factors associated with delayed entry into HIV medical care among HIV positive people who are aware of their status. A quantitative design was used and a structured questionnaire was used as the data collection instrument. Respondents were patients in a hospital’s Opportunistic Infection Department whose hospital records indicated that they were HIV positive during the time of the study. The study found out that as much as 71.6% (n =43) first entered HIV medical care more than 12 months after testing HIV positive while 40% (n = 24) did so as a result of illness. Low education levels, unemployment and being single are associated with delayed entry into HIV medical care. A percentage of the population uses and trusts non-biomedical approaches to dealing with HIV/AIDS. Being diagnosed HIV positive is therefore not necessarily a strong reason enough for one to immediately enter into medical care. Intensive health education needs to be done at work places, health facilities, schools, through print and electronic media, churches and other community settings to equip the population with knowledge of the advantages of early entry into HIV care. / Health Studies / M.A. (Public Health)