A dissertation submitted to the Faculty of Education in fulfilment requirement for the Degree of Master of Education in the Department of Educational Psychology and Special Education at the University of Zululand, South Africa, 2005. / The aim of the study was to conduct a formative investigation into the effectiveness of "Wildfire" as a preventative intervention for HIV/AIDS. "Wildfire" is an experiential activity-based psycho-educational workshop/game that guides participants through the process of 'exposure' to HIV/AIDS, voluntary counseling and testing (VCT). It stimulates discussions and active reflections while imparting knowledge and information that goes beyond preventative awareness campaigns. The target population was Grade 9 learners. A representative sample of rural and township school contexts in the East London area of the Eastern Cape constituted the sites for intervention. The schools selected constituted a convenience sample and learner participation was voluntary, depending on parental permission. A total of 104 learners participated, 95 in the "Wildfire" intervention and 9 in the control group. The methodology applied included a pre- and post-test questionnaire, behavioural observations and verbal responses during the intervention, as well as focus-group notes arising from the debriefing after "Wildfire". The findings indicated that "Wildfire" was an effective and powerful psycho-educational tool for mediating an in-depth understanding of issues around HIV/AIDS and personal vulnerability for adolescents. The triangulation of methods provided evidence that the intended learnings of "Wildfire" were internalized to both group and individual levels. Furthermore, these points of planned learning were sustained over time. "Wildfire" provided psycho-social, emotional and cognitive 'maps' for individuals about how quickly HIV/AIDS can be spread, how to manage 'exposure* and how to treat those infected with the virus. The study was situated within practices of primary health care and prevention of HIV/AIDS. Its relevance to answering research needs and corroborating current research findings has been discussed. The utility of the study for practical purposes, was that it informed the current and future practices of an NGO and provided information for the Education Department which could enrich the effectiveness of its current HIV/AIDS education in a cost-effective way.

Master of Public Health - MPH / For more than two decades now, the acquired immune deficiency syndrome (AIDS) and its etiological agent, the human immunodeficiency virus (HIV), has been a growing challenge that affects all segments of the global population. Voluntary HIV counseling and testing (VCT) is one of the many prevention and control strategies adopted globally and by the Government of the Republic of Zambia. VCT is the process by which an individual undergoes counseling to enable him/her to make an informed choice about being tested for the human immunodeficiency virus (HIV). This decision must be entirely the choice of the individual and he or she must be assured that the process will be confidential. VCT is a key component of both HIV prevention and care programs. Although VCT is increasingly available in Zambia through public health facilities, VCT only or stand-alone sites and mobile counseling and testing services, there is still great reluctance among many people to be tested. Aim: This study explored factors affecting the utilization of VCT services in Mwense District, Zambia. Methodology: An explorative, qualitative study was conducted. Data was collected through focus group discussions with community members, and key informant interviews with lay counselors and health care workers. Thematic analysis of transcribed data was done to elucidate knowledge and awareness of HIV/AIDS and VCT services, factors facilitating uptake and barriers to utilization of VCT services and suggestions for improving VCT uptake. Results: The study found that HIV/AIDS was recognized as a major problem in the communities and that participants were aware of the availability and benefits of HIV counseling and testing services. The main reasons for seeking an HIV test included facilitating sexual behavior change to avoid infection, re-infection or infecting others with HIV. Facilitators to uptake of VCT services include accessing information on HIV/AIDS and other care and support services such as prevention of mother to child interventions, peer and social support systems, home-based care and early treatment with antiretroviral therapy if one is HIV positive. Community members indicated that VCT was an entry point to reaching out to the family and community for on-going counseling, which would lead to reduction in HIV/AIDS stigma and discrimination. Several barriers to VCT were identified by the participants. At individual level, barriers included: the fear of the ramifications of a positive test; fear of HIV/AIDS stigma and discrimination; doubt about the existence of HIV and AIDS; and fear of loss of control of life circumstances and destiny. Health facility level barriers included concerns about confidentiality of HIV-test results, familiarity with service providers, lack of promotional activities of the VCT services, shortage of testing logistics and commodities, and human resource shortages both in terms of numbers and confidence to promote VCT services. Community levels barriers included cultural beliefs and customs, gender imbalances, religious beliefs and stigma. Conclusions: There is urgent need for community sensitization about VCT and its benefits in HIV/AIDS control.

This study aimed at exploring the perceptions of teachers regarding HIV/AIDS in the Thohoyandou area. A survey design was employed to find out how teachers perceive HIV/AIDS. A group-administered questionnaire was used as a method of data collection. One Hundred and Fifty teachers were selected by using stratified random sampling technique. From each stratum the systematic random sampling method was used to select the sample. The respondents were selected from the population of teachers in the Thohoyandou, Thulamela area, in the Limpopo Province. HIV/AIDS in the workplace, with special emphasis on theoretical background, perceptions regarding HIV/AIDS and HIV/AIDS prevention strategies has been provided. Theoretical background covered what HIV/AIDS is, factors promoting the AIDS epidemic, HIV/AIDS in the workplace and psychosocial impact of HIV/AIDS on employees. Perceptions regarding HIV/AIDS covered voluntary counseling and testing and issues around working with someone who is HIV positive. HIV/AIDS prevention strategies focused on prevention and wellness programme, abstinence from sex, being faithful to one sexual partner, condom usage, managing STI and HIV/AIDS in the workplace. The research findings were presented graphically and discussed. It was found that teachers perceive HIV/AIDS as a reality and they also know the ways to prevent it, although most of them do not utilize those methods. Generally, teachers in Thohoyandou area are still at risk of contracting HIV/AIDS. The conclusion and recommendations derived from the study are provided lastly. / Dissertation (MSoc.Sci (EAP))--University of Pretoria, 2007. / Social Work and Criminology / unrestricted

Malgré une baisse importante de nouvelles infections, l’Afrique subsaharienne et la région des Caraïbes demeurent fortement touchées par l’épidémie du VIH/sida. La diaspora vivant ailleurs en Occident n’est pas épargnée : les communautés originaires de ces pays étant surreprésentées dans la cohorte des personnes vivant avec le VIH. De plus, ces individus rencontrent des difficultés spécifiques en matière d’accès au conseil et dépistage du VIH. Compte tenu l’importance de l’accessibilité à ce service dans la lutte contre le VIH, il devient crucial de mieux en cerner les enjeux. Fort de ces différents constats, le projet « Moi je fais le test » dont l’objectif était d’augmenter l’accès au conseil et dépistage du VIH a été déployé à Montréal en 2010. Notant le peu d’interventions recensées faisant la promotion du dépistage du VIH dans les communautés originaires de pays à forte prévalence pour le VIH, l’objectif de la présente évaluation est double : documenter le projet et évaluer l’implantation de ce dernier. L’évaluation réalisée sous la forme d’une étude de cas sera articulée autour de deux pôles : la théorie de changement sous-tendant le projet ainsi que le processus d’implantation. Les perspectives rapportées par les partenaires du projet de même que les éléments liés à l’implantation démontrent la complexité de mener des actions conjointes, même de tailles modestes. Dans la mesure où les approches combinées de prévention du VIH sont encouragées, l’évaluation du présent projet illustre de façon éloquente les défis du déploiement de projet similaires à l’échelle nationale et internationale. / Despite a significant reduction in new infections, sub-Saharan Africa and the Caribbean remain strongly affected by the HIV/aids pandemic. Caribbean and African diaspora communities living elsewhere in the West are also strongly impacted. There is an overrepresentation of individuals originating from these countries in the cohorts of people living with HIV. Moreover, individuals in these communities face specific challenges when trying to access voluntary counseling and testing services for HIV. These services are essential in trying to fight the HIV pandemic, thus, getting a better understanding of the issues at stake is crucial. Based on these observations, the “Moi je fais le test” project whose main objective was to increase HIV counseling and testing, was conducted in Montreal in 2010. Few interventions specifically addressing the needs of these communities in accessing voluntary counseling and testing for HIV have been reported, as such, the current evaluation has a double mandate: documenting the project and evaluating its implementation. The evaluation is conducted as a case study and is structured around two axes: the theory of change underlying the project and the implementation process. Key elements in the implementation process as well as the perspectives of the partners demonstrate how complex it is to conduct a project collaboratively, even modest in size. Insofar as combination HIV prevention strategies have been promoted, the evaluation demonstrates the many challenges that could be encountered in developing similar projects in national and international settings.

The main question addressed in this dissertation is: Are the legislation and policies of Ethiopia, Botswana and Uganda providing for various modalities of HIV testing consistent with human rights as enshrined under the African Human Rights system? Critically investigating the African human rights HIV testing instruments as well as the relevant domestic legislation and policies of the three countries. / Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2007. / A Dissertation submitted to the Faculty of Law University of Pretoria, in partial fulfilment of the requirements for the degree Masters of Law (LLM in Human Rights and Democratisation in Africa). Prepared under the supervision of Professor Julia Sloth-Nielsen of the Faculty of Law, University of the Western Cape, Cape Town, South Africa. / http://www.chr.up.ac.za/ / Centre for Human Rights / LLM

The HIV/AIDS epidemic is described as a crisis by the Global Report (UNAIDS 2004:13). Swaziland¡¦s King Mswati III also declared the HIV/AIDS epidemic as a disaster when the HIV/AIDS prevalence rate increased from 3.9% in 1992 to 42.6% in 2004 (MOHSW 2004:3). In responding to the increasing numbers, the Government of Swaziland established various programmes; one of them being the Voluntary Counselling and Testing (VCT) services to meet societal needs. The MOHSW designed guidelines to be utilized when training nurses to be pre and post HIV test counselors (TASC 2003:2). The period of training ranges between 1 to 2 weeks, after which they are deployed to the VCT centres where nurses provide counseling and testing, treatment of opportunistic infections and distributing antiretroviral drugs. Much research has been done in Swaziland on HIV/AIDS however; there is insufficient knowledge on the impact of HIV/AIDS on nurses working at the VCT services. The objectives of the study were to: ,,« Explore and describe the experiences of nurses working in the VCT services. ,,« Explore and describe the experiences of clients receiving VCT services. ,,« Design and develop an empowerment programme for nurses working in the VCT services in Swaziland. ,,« Formulate and describe guidelines for the implementation of the programme. In this qualitative study, the exploratory descriptive and contextual methodology was utilized to look into lived experiences of nurses and clients. This was done within the adaptation of the intervention Design and Development genre proposed by Rothman and Thomas (1994). Data was collected through purposive sampling and analysed according to Tesch¡¦s methods (Tesch 1990:890) The study revealed one major theme; constant experience of stress that was related to psychological and physical factors (categories). Nurses identified the complexity of HIV/AIDS, shortage of staff, lack of social support, lack of a supportive working environment, and a need for staff development under psychological factors. Clients identified stigma and discrimination. Constant exhaustion and development of medical conditions were identified as physical factors that led to constant experience of stress. Conclusions drawn from the data analysis revealed that nurses were stressed and felt disempowered at working in the VCT services. An empowerment programme was designed and developed to enable these nurses to deal with issues and VCT services for rendering quality care and enjoy the work they do. Guidelines were formulated to implement the empowerment programme. The study concluded with the identification of limitations and recommendations for future endeavours. / Health Studies / D.Litt. et Phil.

Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Although VCT has been recognized for its importance in HIV prevention and control, there are several matters of concern surrounding it that potentially limit its uptake. Clients' selective behavior in tandem with service provider and operating environment factors determine uptake of VCT service. This study sought to contribute knowledge on the influence that specialized HIV/AIDS sites have on first time clients' initiative to seek VCT services in comparison with the general health care sites. The study also analyzed factors that determine clients' preference of VCT access point. The study was done within a student population of Nkumba University in Entebbe municipality, Uganda. A sample of students to fill the study questionnaire was selected using a simple random sampling method from a population frame established from a class identified haphazardly. Four focus group discussions were done: two of the groups participants were stratified as students' male and female groups and were selected using convenient sampling from the sampling frame. The other FGDs were done with two groups of nurse counselors – one from a general health care site while the other was from a specialized VCT site, selected purposively. Specialized VCT sites had a higher frequency of first student clients than general health care sites. Results however indicated that though the perception of service providers' attitude and availability of trained councilors affected their choice, there was no significant difference between specialized and general VCT sites in terms of first time clients' preference. Reasons for preference of site differed. Specialized sites were preferred because they are perceived to offer better quality service owing to their concentration on VCT services, but shunned by others for lack disguise. Conversely, respondents revealed that there is disguise at general health j sites which enhances confidentiality and anonymity thereby curbing clients fears of being identified making it easier for first time clients to go to these sites for VCT. / AFRIKAANSE OPSOMMING: Alhoewel vrywillige raadgewing en toetsing (VRT) erken is vir sy belangrikheid met betrekking tot MIV voorkoming en beheer, is daar verskeie kwessies daaraan verbonde wat die gebruik daarvan kan beperk. Kliënte se selektiewe gedrag saam met diensverskaffers en omgewingsfaktore bepaal die gebruik van VRT dienste. Hierdie studie het gepoog om kennis by te dra oor die invloed wat gespesialiseerde MIV/Vigs toetsingsterreine het op eerstelinge se inisiatief om VRT dienste te soek in vergelyking met algemene gesondheidssorgterreine. Die studie het ook faktore geanaliseer wat kliënte se voorkeur van VRT terreine bepaal. Die studie is binne 'n studente populasie van Nkumba Universiteit in Entebbe Munisipaliteit, Uganda, uitgevoer. 'n Steekproef van studente om die vraelyste in te vul is geselekteer deur die eenvoudige toevalmonster metode te gebruik van 'n populasie raam geskep van 'n klas was lukraak geidentifiseer is. Vier fokusgroepe het plaasgevind: twee waar deelnemers as manlike en vroulike studentegroepe gestratifiseerd was en geselekteer deur gerieflike steekproeneming van die steekproefraam. Die ander fokusgroepe was twee groepe van verpleegster beraders – een van 'n algemene gesondheidssorgterrein en die ander van 'n gespesialiseerde VRT terrein, doelbewus geselekteer. Gespesialiseerde VRT terreine het 'n hoër frekwensie van eersteling student-kliente as algemene gesondheidssorgterreine. Uitslae het aangedui dat hoewel die persepsie van diensverskaffers se houdings en beskikbaarheid van opgeleide beraders hul keuse geaffekteer het, dat daar geen betekenisvolle verskil was tussen gespesialiseerde en algemene VRT terreine in terme van eerstelinge se voorkeur. Redes vir voorkeur van terrein het verskil. Gepesialiseerde terreine is verkies weens die persepise dat hulle 'n beter kwaliteit diens lewer weens hul konsentrasie op VRT dienste, maar deur ander vermy was weens gebrek aan vermomming. Omgekeerd het respondente aan die lig gebring dat daar wel vemomming by algemene gesondheidssorg terreine is wat vertroulikheid en anonimiteit verhoog en kliënte se vrese verminder wat dit makliker maak vir eerstelinge om na hierdie terreine vir VRT te gaan.

The HIV/AIDS epidemic is described as a crisis by the Global Report (UNAIDS 2004:13). Swaziland¡¦s King Mswati III also declared the HIV/AIDS epidemic as a disaster when the HIV/AIDS prevalence rate increased from 3.9% in 1992 to 42.6% in 2004 (MOHSW 2004:3). In responding to the increasing numbers, the Government of Swaziland established various programmes; one of them being the Voluntary Counselling and Testing (VCT) services to meet societal needs. The MOHSW designed guidelines to be utilized when training nurses to be pre and post HIV test counselors (TASC 2003:2). The period of training ranges between 1 to 2 weeks, after which they are deployed to the VCT centres where nurses provide counseling and testing, treatment of opportunistic infections and distributing antiretroviral drugs. Much research has been done in Swaziland on HIV/AIDS however; there is insufficient knowledge on the impact of HIV/AIDS on nurses working at the VCT services. The objectives of the study were to: ,,« Explore and describe the experiences of nurses working in the VCT services. ,,« Explore and describe the experiences of clients receiving VCT services. ,,« Design and develop an empowerment programme for nurses working in the VCT services in Swaziland. ,,« Formulate and describe guidelines for the implementation of the programme. In this qualitative study, the exploratory descriptive and contextual methodology was utilized to look into lived experiences of nurses and clients. This was done within the adaptation of the intervention Design and Development genre proposed by Rothman and Thomas (1994). Data was collected through purposive sampling and analysed according to Tesch¡¦s methods (Tesch 1990:890) The study revealed one major theme; constant experience of stress that was related to psychological and physical factors (categories). Nurses identified the complexity of HIV/AIDS, shortage of staff, lack of social support, lack of a supportive working environment, and a need for staff development under psychological factors. Clients identified stigma and discrimination. Constant exhaustion and development of medical conditions were identified as physical factors that led to constant experience of stress. Conclusions drawn from the data analysis revealed that nurses were stressed and felt disempowered at working in the VCT services. An empowerment programme was designed and developed to enable these nurses to deal with issues and VCT services for rendering quality care and enjoy the work they do. Guidelines were formulated to implement the empowerment programme. The study concluded with the identification of limitations and recommendations for future endeavours. / Health Studies / D.Litt. et Phil.

This study was done to assess the quality of life (QOL) of people living with HIV and AIDS (PLWHA) in Swaziland who are on antiretroviral therapy (ART). No study has been done on QOL of PLWHA in Swaziland who are on ART since it started to be administered in Swaziland in 2001. A qualitative, exploratory, descriptive, and contextual design was used to assess QOL of PLWHA in Swaziland who are on ART. Twenty-four PLWHA were purposely selected to participate in the study. Methods of data collection used were semi-structured individual in-depth interviews, focus group discussions, and observations. The data (tape-recorded interviews and discussions, and field notes) were transcribed verbatim for data analysis. Data analysed was done using Tesch’s framework of data analysis as described in Creswell (2002:256-283). The research findings are reflected, with the six domains of QOL identified through a literature review and validated by nurses’ expertise. These domains are the physiological, psychological, spiritual, socio-economic, cognitive, and environmental domains.The study revealed that PLWHA in Swaziland are faced with many challenges concerning ART, namely: inability to meet their nutrition needs, non-adherence to ART, experience of disfiguring side effects of ARVs, inconsistent condom use, experience of stigma and discrimination, depression, difficulty in accepting and coping with ARVs, lowered self-esteem, a negative influence of some religions on ART, a lack of financial support, poor support systems, poor understanding of ARVs, negative thoughts about HIV and AIDS and ART, an unsatisfactory health care delivery system, a negative influence of culture on ART, and violation of the rights of PLWHA. These challenges negatively influence the QOL of PLWHA and hence the study concluded that PLWHA in Swaziland who are on ART have a poor QOL. Conclusions drawn from the data analysis reveal that PLWHA in Swaziland are powerless to deal with the above challenges and improve their QOL. The researcher, therefore, developed guidelines to empower PLWHA to deal with these challenges and adhere to ART, thus improving their QOL. Recommendations were made with regard to nursing practice, nursing education, and further nursing research. / Health Studies / D. Litt. et Phil. (Health Studies)

This study was done to assess the quality of life (QOL) of people living with HIV and AIDS (PLWHA) in Swaziland who are on antiretroviral therapy (ART). No study has been done on QOL of PLWHA in Swaziland who are on ART since it started to be administered in Swaziland in 2001. A qualitative, exploratory, descriptive, and contextual design was used to assess QOL of PLWHA in Swaziland who are on ART. Twenty-four PLWHA were purposely selected to participate in the study. Methods of data collection used were semi-structured individual in-depth interviews, focus group discussions, and observations. The data (tape-recorded interviews and discussions, and field notes) were transcribed verbatim for data analysis. Data analysed was done using Tesch’s framework of data analysis as described in Creswell (2002:256-283). The research findings are reflected, with the six domains of QOL identified through a literature review and validated by nurses’ expertise. These domains are the physiological, psychological, spiritual, socio-economic, cognitive, and environmental domains.The study revealed that PLWHA in Swaziland are faced with many challenges concerning ART, namely: inability to meet their nutrition needs, non-adherence to ART, experience of disfiguring side effects of ARVs, inconsistent condom use, experience of stigma and discrimination, depression, difficulty in accepting and coping with ARVs, lowered self-esteem, a negative influence of some religions on ART, a lack of financial support, poor support systems, poor understanding of ARVs, negative thoughts about HIV and AIDS and ART, an unsatisfactory health care delivery system, a negative influence of culture on ART, and violation of the rights of PLWHA. These challenges negatively influence the QOL of PLWHA and hence the study concluded that PLWHA in Swaziland who are on ART have a poor QOL. Conclusions drawn from the data analysis reveal that PLWHA in Swaziland are powerless to deal with the above challenges and improve their QOL. The researcher, therefore, developed guidelines to empower PLWHA to deal with these challenges and adhere to ART, thus improving their QOL. Recommendations were made with regard to nursing practice, nursing education, and further nursing research. / Health Studies / D. Litt. et Phil. (Health Studies)