This study was undertaken in the Kingsway informal settlement, which is situated in Ekhurhuleni on the East Rand. This is a poor community as many residents are unemployed and unable to obtain adequate healthcare especially for HIV/AIDS. The perceived high rate of HIV infection, as well as, the apparent high death rate due to AIDS was my major concern. Intervention and help were my main intention. I was motivated to embark on this study to be empowered and informed about treatment processes of HIV/AIDS. The study was intended to use living theory action research to investigate the need for establishing a Voluntary Counselling and Testing (VCT) centre. For action in the real environment a research team was formed from volunteers. The relevant influential persons in the community were consulted and the required permission obtained to embark on the study. This was also to ensure that there was co-operation from community leaders. Proper documents, giving permission, were obtained after formal requests were made. Ethical guidelines were followed in this research. I started by stating my values before the research. During the process I showed how my values were transformed by various activities that were intended to educate me. These changes were indications of my development. At the end of the study I indicated how my initial values were improved or transformed, and what new values I gained. / Dissertation (MA)--University of Pretoria, 2010. / Psychology / unrestricted

Magister Artium (Psychology) - MA(Psych) / Student counselling services, typically located within a holistic developmental approach, aim to render comprehensive student services to service users in relation to their psychological, social, educational and spiritual well-being. However, a number of cognitive and affective barriers reportedly reduce the likelihood of young people at universities seeking professional psychological help for personal-emotional problems. Accordingly, the aim of this study, which is located within the Theory of Reasoned Action, was to explore students' attitudes towards utilising student counselling services, as well as their interpretations of the influence of age, gender and education on their attitudes and self-rated knowledge regarding seeking psychological help. The study thereby attempts to provide an understanding of the factors that influence help-seeking behaviours in university students. The research sample consisted of twenty nine students from the Cape Peninsula University of Technology. The data was collected through focus group discussions, which were conducted using an open-ended and participant centred approach to the discussion. The qualitative approach of the study was informed by the theory of social phenomenology. Data gathered from the focus group discussions was thematically analysed. The results suggest that attitudes have a potentially important influence on intentions to seek out psychological counselling. Findings show that students feel shame and guilt when they are struggling psychologically and as a result avoid seeking psychological intervention for fear of being negatively stigmatised. The study revealed that education around mental health disorders and the management thereof was crucial in order for them to be demystified and de-stigmatised, and to facilitate openness in the sharing of these problems, and society's understanding and acceptance of people experiencing psychological disorders. Results also indicate that there is a shift taking place in these attitudes, and suggest ways in which this change can be further facilitated, such as the utilisation of peer helpers who could playa key role in facilitating and reinforcing help seeking behaviour. The outcomes of the study may further contribute to informing universities' goal to provide accessible, quality and effective development and support services to its students.

Student Number : 0312394F - MPH research report - School of Public Health - Faculty of Health Sciences / Introduction: Human Immunodeficiency Virus (HIV) was first isolated from human blood in 1983 at the Pasteur Institute, Paris. Currently there is no cure for HIV and control efforts emphasize prevention. One of the components of the Global Strategy put forward to preventing HIV transmission is HIV Voluntary Counselling and Testing (VCT) (Ginwalla, Grant & Day:2002). Taxi drivers are part of the Ugandan population at special risk of acquiring this virus. It was therefore necessary to carry out a study in this group of people to assess how much they knew about HIV/VCT services. Study Objectives To establish the level of knowledge amongst the taxi drivers about the availability and accessibility of HIV VCT services in Kampala. To identify factors that influence the taxi drivers in Kampala, Uganda to access the VCT services. Methods and materials A cross-sectional descriptive study design was used to carry out the study amongst 400 taxi drivers who consented to participate and operated within and around the city of Kampala during 2004. A structured questionnaire to record variables that included, age, sex, marital status, level of education, level of knowledge of VCT, factors that enhance VCT uptake, factors that inhibit VCT uptake, history of having ever had VCT, and knowledge of spouse or sexual partner’s HIV serostatus, was used. Data was entered into EPI-INFO 6 computer program and descriptive and analytic investigation using proportion or percentages to compare the level of knowledge generated was used. Findings/Results A total of 399 taxi drivers with 52.8% of them aged between 26 – 35 years participated in the study. 68.8% lived within 6 km of the city centre. All were married and 78.8% had one spouse. 0.75% were lady drivers. 55% of the participants had attained secondary school level of education. 69% of the taxi drivers knew that HIV/AIDS was the commonest health problem in the country and 57.4% of the participants mentioned HIV testing as the only way one would ascertain their serostatus. 94.2% had heard about HIV/VCT mainly from the media and as much as 98.7% of the taxi drivers knew a place where such services could be got. 82.2% confirmed that these places were accessible and 85.9% said that the services were not expensive. However, 57.3% of the participants preferred getting these services where they were known in order to get genuine results and subsequent support. The 26% who opposed this idea sighted confidentiality as the main obstacle. Despite the knowledge level about HIV/VCT amongst the participants, 68.3% of the communal taxi drivers were willing to go for the service and only 16.1% had actually taken the test. Out of the 399 participants 59.6% felt that they could share their serostatus with their spouses. Conclusion The taxi drivers are knowledgeable about HIV/VCT services and these findings lie within the overall range of knowledge of the population in urban Uganda. The HIV/VCT services are accessible and affordable to the taxi drivers but the fear to receive the unexpected results and the consequences of having positive results hinder the taxi drivers from seeking the VCT services. The majority of taxi drivers preferred to go to HIV/VCT service points where they were known. This factor could have contributed to the small number of taxi drivers that had taken the test. Probably few suitable service points to go to had been identified by these taxi drivers. Recommendations The government and other organizations that provide care in the field of HIV should organize sensitization seminars for taxi drivers to address issues aimed at allaying their anxiety or fear to receive positive results. Also, there is a need to intensify counselling services for the taxi drivers by establishing counselling centres close to the two taxi parks in the City. HIV/VCT service centres should be integrated with other health services so that people who seek either of the services can gain from both. This will encourage more taxi drivers to come to these centres.

Many researchers have alluded to the inequity in distribution of HIV preventive services in South Africa (SA). Other researchers have demonstrated that socio-demographic factors are main determinants of distribution of preventive services like voluntary counseling and testing (VCT) in SA. VCT is a primary HIV prevention tool through which infected persons enter the treatment, care, and support programs; identifying the impact of socio-demographic determinants (SDDs) on VCT uptake in SA could help direct VCT services to areas and individuals that need them most. The research question in this study examined what and how SDDs impact the uptake of VCT in SA using the integrated theory of health behavior change (ITHBC) as its theoretical framework. A quantitative study with a cross-sectional design using secondary data from a population-based survey by the John Hopkins Education and Health SA (2012) was conducted. In a multivariate logistic regression analysis, SDDs like province, settlement, employment, races, and age were statistically significant while marital status, education, and SES (socio-economic status) did not have statistically significant impact on VCT uptake. This study demonstrated that Black, unemployed men of low to medium SES between the ages of 15-49 years living in peri-urban and urban-informal areas of all provinces but especially Eastern Cape, Northern Cape, and North West provinces of SA had the lowest VCT uptake. This study advocates policies and programs to improve VCT distribution and accessibility in places and individuals with lowest uptake. Improved uptake will help reduce new HIV infection, HIV-associated morbidity, and mortality; as well as ensure equity, equality, and social justice in the distribution of HIV preventive services in SA.

<p>Background: About 22.4 million people were living with HIV/AIDS in 2008 out of which women constitute approximately 57%. Namibia is one of the highly affected countries with a national HIV prevalence of 17.8% among women attending antenatal clinics. Antiretroviral medications have become available in Namibia since 2002 and presently all district hospitals and some health centres provide ARVs to those in need. Namibia is rated as one of the few countries in sub-Sahara Africa with a high coverage of ART, with 80% of those in need of ART receiving the treatment. An increasing trend has been observed whereby HIV+ women on ARV are becoming pregnant. Little is known about the attitude, knowledge and behavior of these women towards family planning and use of contraceptives and what barriers they may be facing in accessing these services.Aim: To determine the factors affecting the utilization of family planning services by HIV+ pregnant women receiving PMTCT services. Methodology: The study was a cross sectional study using both quantitative and qualitative methods to assess the critical elements of knowledge, attitude and perceptions of the study participants towards family planning services. The study also assessed the health system and other factors that impact on the use of contraceptives by HIV+ women. It was conducted in northern Namibia at Oshakati Health centre among randomly selected pregnant HIV+ women attending for PMTCT services.Results: Among the 113 respondents, who participated in the study, 97.3% knew at least one method of family planning but only 53.6% actually used any method of contraception prior to current pregnancy. Among the 46.4% who did not use any contraception, the reasons often cited for non-use were because they wanted a baby (52%), spouse objection (10%), being afraid of the effects (14%) and other reasons such as belief, culture and distance to travel to the health facility. 88% of the respondents indicated a willingness to use contraceptives after current pregnancy and expressed general satisfaction with services at the health centre while asking for more information on family planning services.Conclusion: HIV+ women have high awareness on some contraceptives but use of contraceptives is not as high as many of them have a desire to have children for self esteem and leave a legacy for the future. Knowledge of the risks of pregnancy on HIV+ woman may be limited and there is a need to improve educational intervention in this regard as well as integrate family planning services into all HIV/AIDS services.</p>

<p>HIV counselling and testing (HCT) is an essential element in the response to the HIV epidemic. There are still major gaps in research about the best ways to provide HCT, especially to young people. School-based HCT is a model which has been suggested for providing HCT to young people in a youth friendly manner. This study was aimed at producing recommendations for providing a youth friendly school-based HCT service using the World Health Organisation (WHO) framework for youth friendly health services. It was conducted in six secondary schools in Cape Town, where a mobile HCT service is provided by a nongovernmental organisation (NGO). It was an exploratory descriptive study, using a mixed-methods approach. Twelve focus group discussions (FGDs) were held with learners to explore their needs with regards to school-based HCT. An evaluation (which consisted of observation of the HCT site, service provider interviews and direct observation of the HCT counselling process) was done to determine whether the mobile school-based HCT service was youth friendly. A learner survey was conducted with 529 learners to investigate the factors that influence the uptake of HCT and to explore learners&rsquo / behaviours and experiences under test conditions. In the FGDs, learners said that they wanted HCT to be provided in schools on condition that their fears and expressed needs were taken into account. They wanted their concerns regarding privacy and<br /> confidentiality addressed / they wanted to be provided with information regarding the benefits and procedure of HCT before testing took place / they wanted service providers to be competent to work with young people, and they wanted to be assured that those who tested positive were followed up and supported. On evaluation of the mobile school-based HCT service, it was evident that the service did not meet all the needs of the learners nor did it have all the characteristics of a youth friendly health service. The model of &lsquo / mass testing&rsquo / used by the NGO did not fulfil learners&rsquo / expressed need for privacy with regards to HCT. Service providers were friendly and non-judgemental but had not been trained to work with young people (especially marginalised groups e.g. young men who have sex with men). The information needs of learners were not addressed, and learners were not involved in the provision of the HCT service. Learners who tested positive were not assisted in accessing care and support. The learner survey revealed a high uptake of HCT (71% of learners) at schools with learners who do not identify themselves as Black, with female learners and older learners being more likely to have had an HIV test. Factors that influenced uptake of HCT were complex, with learners reporting many different motivators and barriers to testing. Of concern was the low risk perception of leaners with regards to HIV infection and the fact that learners who tested HIV positive were not being linked up with treatment and care. Based on the findings of the study, recommendations were made for providing youth friendly schoolbased HCT. A multisectoral approach, with learner and community involvement, was suggested in order to provide a service which is equitable, accessible, acceptable, appropriate and effective.</p>

<p>Background: About 22.4 million people were living with HIV/AIDS in 2008 out of which women constitute approximately 57%. Namibia is one of the highly affected countries with a national HIV prevalence of 17.8% among women attending antenatal clinics. Antiretroviral medications have become available in Namibia since 2002 and presently all district hospitals and some health centres provide ARVs to those in need. Namibia is rated as one of the few countries in sub-Sahara Africa with a high coverage of ART, with 80% of those in need of ART receiving the treatment. An increasing trend has been observed whereby HIV+ women on ARV are becoming pregnant. Little is known about the attitude, knowledge and behavior of these women towards family planning and use of contraceptives and what barriers they may be facing in accessing these services.Aim: To determine the factors affecting the utilization of family planning services by HIV+ pregnant women receiving PMTCT services. Methodology: The study was a cross sectional study using both quantitative and qualitative methods to assess the critical elements of knowledge, attitude and perceptions of the study participants towards family planning services. The study also assessed the health system and other factors that impact on the use of contraceptives by HIV+ women. It was conducted in northern Namibia at Oshakati Health centre among randomly selected pregnant HIV+ women attending for PMTCT services.Results: Among the 113 respondents, who participated in the study, 97.3% knew at least one method of family planning but only 53.6% actually used any method of contraception prior to current pregnancy. Among the 46.4% who did not use any contraception, the reasons often cited for non-use were because they wanted a baby (52%), spouse objection (10%), being afraid of the effects (14%) and other reasons such as belief, culture and distance to travel to the health facility. 88% of the respondents indicated a willingness to use contraceptives after current pregnancy and expressed general satisfaction with services at the health centre while asking for more information on family planning services.Conclusion: HIV+ women have high awareness on some contraceptives but use of contraceptives is not as high as many of them have a desire to have children for self esteem and leave a legacy for the future. Knowledge of the risks of pregnancy on HIV+ woman may be limited and there is a need to improve educational intervention in this regard as well as integrate family planning services into all HIV/AIDS services.</p>

<p>HIV counselling and testing (HCT) is an essential element in the response to the HIV epidemic. There are still major gaps in research about the best ways to provide HCT, especially to young people. School-based HCT is a model which has been suggested for providing HCT to young people in a youth friendly manner. This study was aimed at producing recommendations for providing a youth friendly school-based HCT service using the World Health Organisation (WHO) framework for youth friendly health services. It was conducted in six secondary schools in Cape Town, where a mobile HCT service is provided by a nongovernmental organisation (NGO). It was an exploratory descriptive study, using a mixed-methods approach. Twelve focus group discussions (FGDs) were held with learners to explore their needs with regards to school-based HCT. An evaluation (which consisted of observation of the HCT site, service provider interviews and direct observation of the HCT counselling process) was done to determine whether the mobile school-based HCT service was youth friendly. A learner survey was conducted with 529 learners to investigate the factors that influence the uptake of HCT and to explore learners&rsquo / behaviours and experiences under test conditions. In the FGDs, learners said that they wanted HCT to be provided in schools on condition that their fears and expressed needs were taken into account. They wanted their concerns regarding privacy and<br /> confidentiality addressed / they wanted to be provided with information regarding the benefits and procedure of HCT before testing took place / they wanted service providers to be competent to work with young people, and they wanted to be assured that those who tested positive were followed up and supported. On evaluation of the mobile school-based HCT service, it was evident that the service did not meet all the needs of the learners nor did it have all the characteristics of a youth friendly health service. The model of &lsquo / mass testing&rsquo / used by the NGO did not fulfil learners&rsquo / expressed need for privacy with regards to HCT. Service providers were friendly and non-judgemental but had not been trained to work with young people (especially marginalised groups e.g. young men who have sex with men). The information needs of learners were not addressed, and learners were not involved in the provision of the HCT service. Learners who tested positive were not assisted in accessing care and support. The learner survey revealed a high uptake of HCT (71% of learners) at schools with learners who do not identify themselves as Black, with female learners and older learners being more likely to have had an HIV test. Factors that influenced uptake of HCT were complex, with learners reporting many different motivators and barriers to testing. Of concern was the low risk perception of leaners with regards to HIV infection and the fact that learners who tested HIV positive were not being linked up with treatment and care. Based on the findings of the study, recommendations were made for providing youth friendly schoolbased HCT. A multisectoral approach, with learner and community involvement, was suggested in order to provide a service which is equitable, accessible, acceptable, appropriate and effective.</p>

Magister Scientiae Dentium - MSc(Dent) / Aim The aim of the study was to determine the oral health knowledge,management and referral patterns of patients with oral manifestations of HIV by Primary Health Care Nurses.Background Nurses working in Primary Health Care (PHC) facilities, and nursing educators, play a pivotal role in the early identification, referral and diagnosis of patients who present for treatment of health problems. They are in an ideal position to identify HIVinfected persons through a simple visual assessment of the mouth, in order to diagnose oral lesions that may be prognostic of HIV, and to then refer these persons for voluntary counselling and testing (VCT). Timely referral will lead to early medical intervention, with lower treatment costs and improved patient quality of life.Methods The study design comprised of a pre- and post-education test, training and provision of educational material, together with a quantitative and qualitative selfadministered questionnaire. The questionnaire gathered information on nurses demographics,experience, knowledge, training and treatment practices.The study design was a cross-sectional survey which was conducted during the period July to October 2010. The study population consisted of 121 nurses based at Primary Health Care and nursing education facilities within the uMgungundlovu Health District in KwaZulu-Natal. The chi-squared test was utilised to determine the statistical significance of the preeducation and post-education test results and Pearsons Correlation Coefficient was used to determine the significance of correlations between variables. A p-value of <0.05 was regarded as being statistically significant.Results A large number of the respondents did not receive substantial oral health education during both their pre-qualification and post-qualification education stages. Nurses had an inadequate knowledge of oral health assessment and of oral conditions, especially with regard to the common prognostic oral manifestations of HIV. The post-test results were statistically significant (p< .0001), indicating that the provision of education and training to the nurses had a significant impact on nurses knowledge of oral conditions. More than twothirds of the nurses (67,8%) reported that they do not examine the mouth as part of routine overall assessment of the patient, and only 13% referred patients for VCT.Conclusions There is a need to include oral health assessment and oral health promotion into both undergraduate and post-graduate nursing curricula. Further research is needed to identify the specific oral health training needs of all categories of nurses in order to overcome the barriers that prevent nurses from assessing the mouth. Oral health assessment and oral health promotion should become a key part of the curricula of nurses training. The use of oral health promotion workers at a primary health care level should also be considered.

M.A. (Public Management and Governance) / The study deals with the effectiveness of the HIV/AIDS policy in City Power Johannesburg (CPJ). HIV/AIDS is a worldwide pandemic. Sub-Saharan Africa is the worst affected and very little is being done to suppress its destructive nature. All administrative spheres need to implement workplace policies, procedures and programs to curb and eventually eliminate any new infections and the spread of the pandemic. Whilst workplace policies are a statement of intent and are formulated to guide decision making, they are only effective when formulated, implemented, monitored and evaluated, and reviewed strategically. The methodological approach adopted in this study is qualitative by nature and interpretative. For this dissertation to achieve its purpose, the main study objectives were to determine the objectives of the current HIV/AIDS policy in CPJ, to determine how these objectives have been achieved and what measures could be taken if these objectives are not achieved? The dissertation proposed that in order to curb the pandemic in CPJ, the HIV/AIDS policy will only attain policy effectiveness if various interventions are implemented and adhered to.