Submitted in fulfillment of the requirement for the Masters Degree of Technology (Public Relations Management), Durban University of Technology, Durban, South Africa, 2015. / The growing number of HIV/AIDS infections amongst the youth is a cause for concern, particularly with prevention messages being communicated through various media platforms. This signals gaps between the senders and receivers of these messages. Therefore, people are either not learning the message about the dangers of HIV, or are unable or unwilling to act on it. Mthatha is in the centre of the old Transkei region of the Eastern Cape. It falls under the King Sabata Dalindyebo Local Municipality and the OR Tambo District Municipality. Teenage pregnancy is a major challenge in this area, which indicates that most teenagers do not use protection during sexual intercourse. This suggests that the HIV infection rate may be too high. With there being no cure for this disease, communication has been identified as an ideal method of helping to curb the spread of this disease. The purpose of the study was to assess communication tools used to educate high school learners about HIV/AIDS in the Mthatha area. Data was collected through questionnaires administered to 341 high school learners. Three out of the eight high schools from the Mthatha Central Business District (CBD) in the Eastern Cape were identified for the study. The selection of these high schools was based on the demographics of the learners, which are age, gender and background. The findings have revealed that there are numerous methods used to educate learners about the HIV/AIDS pandemic. Learners identified mostly with three sources as the accurate tools of communication in HIV/AIDS education; Health education/curriculum, Entertainment-education and Peer Education.

Thesis (MPhil (Industrial Psychology. African Centre for HIV/AIDS Management))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: HIV/AIDS is a world wide pandemic and has caused threat in many organizations. Organizations are trying to put in place programmes to fight the spread of HIV/AIDS as it affects the productivity and profits due to increased absenteeism and turnover. The Joint United Nations programme on HIV/AIDS [UNAIDS] estimated that there are 40 million people living with HIV/AIDS world wide, 25 million has died and 15 millions are orphans due to HIV/AIDS. The Department of Agriculture [Limpopo] has recruited Peer Educators to assist in providing education, awareness and prevention programmes on HIV/AIDS to employees and stakeholders. However, it is essential to assess the knowledge, attitudes and perception of this Peer Educators in order to develop intervention measures to improve the effectiveness of the programme. The Department of Public Service Administration guideline on managing HIV/AIDS in the workplace (2002) requires departments to conduct KAP (knowledge, attitudes and perception) in order to have baseline data for responsive, relevant intervention strategies in the workplace. “HIV/AIDS workplace programmes can only be successful if the employees needs regarding knowledge, attitudes and practices have been thoroughly researched” (Family Health International, 2000). The aim of the study was to identify the knowledge, attitudes and practices of Peer Educators in the Limpopo Department of Agriculture. This will also assist to measure the impact of training provided to them. All Peer Educators were be given an opportunity to participate in the study. Self-administered questionnaire was be used to collect data and confidentiality was emphasized. Data was analysed using the SSP programme and Microsoft excel. The findings revealed an average knowledge of Peer Educators on HIV/AIDS, positive attitudes and safe sexual practice by using condoms. There is need for in service training for Peer Educators. The results also indicated the strong need of support from supervisors and management in the implementation of Peer Educators programme. The findings of the study will also assist the Limpopo Department of Agriculture to redesign the Peer Education Programme in order to minimize the risks and reduce the infection rate on HIV. Peer Educators are considered as key informants, it is significant to understand their level of knowledge, and what is their perception of risk to HIV/AIDS. / ARFIKAANSE OPSOMMING: Die doel van die studie was die bepaling van die kennisvlakke, houdings en persepsies van eweknie-opleiers in die Limpopo provinsie. Die resultate van die studie dui op sterk behoeftes aan verdere opleidng aan veral toesighouers en bestuurders van die Departement van Landbou van Limpopo provinsie. Voorstelle word aan die hand gedoen oor die wyse waarop hierdie opleidingsprogramme saamgestel behoort te word en riglyne word gegee vir die implementering daarvan.

Thesis (MA) -- University of Stellenbosch, 2004. / ENGLISH ABSTRACT: The relentless progression of HfV /AIDS epidemic has made it imperative that measures are put in place to minimise its impact on Small and Medium Enterprises (SME). mv is set to have a significant effect on every facet of the population, and SME is not immune. Business is likely to feel the impact ofmv/AIDS epidemic through reduced productivity, increased absenteeism, increased staff turnover, increased recruitment and training costs, increased cost of employee benefits and poor staff morale. One of the interventions is to implement a mv/AIDS policy and programme, yet a literature search showed that psychological studies of SME in implementing a mv/AIDS policy and programme are limited. The present study utilised the model of the theory of planned behaviour (Ajzen, 1985,1988, 1991), which is an extension of the theory of reasoned action (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980). Intention to implement a mv/AIDS policy and programme was predicted by the theory of planned behaviour constructs such as attitude, subjective norm and perceived behavioural control. The theory of planned behaviour was found to be useful in assessing behavioural intention of SME in implementing a mv/AIDS policy and programme. These findings indicate that implementing an intervention like a mv/AIDS policy and programme by SMES is a behavioural intention motivated by attitudes, subjective norms and perceived behavioural control. / AFRIKAANSE OPSOMMING: Die meedoënlose progressie van die HIVNIGS pandemie het dit gebiedend noodsaaklik gemaak om maatreëls daar te stelom die impak daarvan op klein en medium sakeondernemings te minimaliseer. HIVNIGS sal 'n beduidende uitwerking hê op alle vlakke van die bevolking. Klein en medium sakeondernemings is geen uitsondering nie. Die uitwerking van die HIVNIGS pandemie sal tot gevolg hê 'n afname in produktiwiteit; 'n toename in personeelafwesigheid, personeelomset, personeelwerwing en - opleidingskoste, personeelvoordele; en swak personeel moreel. Een manier om die probleem aan te spreek is om 'n HIVNIGS beleid en program te implimenteer. Ongelukkig toon literêre navorsing dat psigologiese studies van klein en medium sakeondernemings om 'n HIVNIGS beleid en program te implimenteer, beperk is. Dié navorsing steun op die teorie van planmatige gedrag (Ajzen, 1985; 1988; 1991), wat 'n verlenging is van die teorie van beredeneerde optrede (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980). Die oogmerk met die implimentering van 'n HIVNIGS beleid en program is bepaal deur die teorie van planmagtige gedrag soos waargeneem in geesteshouding, subjektiewe norme en waargenome beheerde gedrag. Daar is gevind dat die teorie van planmagtige gedrag nuttig is om die oogmerke en optrede van werknemers in klein en medium sakeondernemings te bepaal met die implimentering van 'n HIVNIGS beleid en program. Hierdie bevindings toon dat die implimentering en tussenkoms van 'n HIVNIGS beleid en program by klein en medium sakeondernemings'n gedragsoogmerk is wat gemotiveer word deur geesteshoudings, subjektiewe norme en waargenome beheerde gedrag.

Thesis (PhD)--Stellenbosch University, 2015 / ENGLISH ABSTRACT : In 2010, young people aged 15–24 years accounted for 42% of new HIV infections globally. In 2009, about five million (10%) of the total South African population was estimated to be aged 15–19 years. Current South African national sero-prevalence data estimate the prevalence of HIV to be 5.6% and 0.7% among adolescent girls and boys aged 15–19 years, respectively. HIV infections are mainly transmitted via sexual transmission. Adolescent sexuality is multi-faceted and influenced at multiple levels. In preparing to enroll adolescents in future biomedical HIV prevention trials, particularly prophylactic HIV vaccine trials, it is critical to provide counseling services appropriate to their needs. At the time of writing, there was no developed psychosocial intervention in South Africa for use among adolescent vaccine trial participants. Thus, the aim of the present study is to adapt and pilot-test a psychosocial intervention, namely, the Centers for Disease Control and Prevention (CDC) risk reduction counseling intervention of Project Respect, an intervention tasked at being developmentally and contextually appropriate among potential adolescent participants in HIV biomedical trials in the future. To achieve this overall aim, I qualitatively explored adolescent sexuality and risk factors for HIV among a diverse sample of participants aged 16–18 from Soweto. Thereafter, I developed a composite HIV risk scale in order to measure the variance in HIV risk among the sample of adolescents studied. The study followed a two-phased, mixed method research design and was informed by ecological systems theory and integrative model of behavioral prediction. The aim of Phase 1, split into phases 1a and b, was to conduct focus group discussions (FGDs) and to undertake a cross-sectional survey, respectively, to determine psychological (for example, self-esteem and depression), behavioral (specifically, sexual behavior) and social (specifically, social support, parent-adolescent communication) contexts that placed adolescents at risk for HIV infection. Phase 1a was qualitative, with data collected via nine FGDs: three involved parents of adolescents, four involved adolescents aged 16–18 years and two counselors. Nine key themes related to adolescent sexuality and risks for HIV acquisition were identified, namely: (1) dating during adolescence; (2) adolescent girls dating older men; (3) condom use amongst adolescents; (4) teenage pregnancies; (5) views about homosexuality; (6) parent-adolescent communication about sexual health; (7) the role of the media; (8) discipline and perceived government influence; and (9) group sex events. Phase 1b was quantitative and the data were collected via a cross-sectional survey to investigate the variance of risk for HIV. For Phase 1b, the sample consisted of 506 adolescents with a mean age of 17 years (interquartile range [IQR]: 16–18). More than half the participants were female (59%, n = 298). I used a three-step hierarchical multiple regression model to investigate the variance in risk for HIV. In step 3, the only significant predictors were “ever threatened to have sex” and “ever forced to have sex”, the combination of which explained 14% (R2 = 0.14; F (12, 236) = 3.14, p = 0.00). Depression and parentadolescent communication were added to steps 2 and 3, respectively, with both variables insignificant in these models. In Phase 2, I adapted and pilot tested the CDC risk reduction counseling intervention. The intervention was intended to be developmentally and contextually appropriate among adolescents from Soweto aged 16–18 years, viewed as potential participants in future HIV biomedical trials. Participants in Phase 2 were aged 16–18 years; the sample was mainly female (52%, n = 11) and most (91%, n = 19) were secondary school learners in grades 8 to 12. Participants provided feedback about their experiences of the adapted counseling intervention through in-depth interviews. I identified three main themes in this regard, namely: benefits of HIV testing services, reasons for seeking counseling and HIV testing services, and participants’ evaluation of the study visits and counseling sessions. The adapted CDC risk reduction counseling intervention was found to be acceptable with favorable outcomes for those adolescents who participated in the piloting phase. This study adds to the literature on risks for HIV among adolescents in Soweto, South Africa, by considering multiple levels of influence. Reaching a more complete understanding of ecological factors contributing to sexual risk behaviors among adolescents in the pilot-study enabled the development of a tailored counseling intervention. The findings showed the adapted CDC risk reduction counseling intervention to be feasible and acceptable among adolescents likely to be participants and eligible to participate in future HIV biomedical prevention trials. Thus, this study provides a much needed risk reduction counseling intervention that can be used among adolescents, an age group likely to participate in future HIV vaccine prevention research. / AFRIKAANSE OPSOMMING : In 2010 het jongmense tussen die ouderdomme van 15 en 24 jaar 42% van nuwe MIV-infeksies wêreldwyd uitgemaak. In 2009 was omtrent 5 miljoen mense (10%) van die Suid-Afrikaanse bevolking tussen 15 en 19 jaar oud. Volgens data oor die huidige Suid-Afrikaanse nasionale sero-voorkoms, word die voorkoms van MIV onderskeidelik op 5.6% en 0.7% onder tienermeisies en -seuns tussen die ouderdomme van 15 tot 19 jaar beraam. MIV-infeksies word hoofsaaklik deur seks oorgedra. Adolessente seksualiteit het baie fasette en word op verskeie vlakke beïnvloed. Ter voorbereiding van die werwing van adolessente vir toekomstige biomediese proewe, veral proewe oor profilaktiese MIVentstowwe, is dit van kritiese belang dat beradingsdienste verskaf word wat geskik is vir hul behoeftes. Op die tydstip wat hierdie tesis geskryf is, het daar nog geen psigososiale intervensie in Suid-Afrika bestaan vir gebruik onder adolessente deelnemers aan entstofproewe nie. Daarom is die doel van hierdie studie om ʼn psigososiale intervensie ‒ die Centers for Disease Control and Prevention (CDC) se Projek Respek, ʼn beradingsintervensie vir die vermindering van risiko ‒ aan te pas en met ʼn loodsprojek te toets. Hierdie intervensie is geskik vir die ontwikkelings- en kontekstuele vlak van adolessente deelnemers aan toekomstige MIV- biomediese proewe. Ten einde hierdie oorkoepelende doelwit te bereik, het ek adolessente seksualiteit en die risikofaktore vir MIV onder ʼn diverse steekproef deelnemers tussen die ouderdomme van 16 en 18 jaar van Soweto kwalitatief ondersoek. Daarna het ek ʼn saamgestelde MIV-risikoskaal ontwikkel om die variansie van MIV-risiko onder die groep adolessente te meet. Die studie se navorsingsontwerp het uit twee fases en gemengde metodes bestaan, en is gebaseer op ekologiesestelsel-teorie en die integrerende gedragsvoorspellingsmodel. Die doel van fase 1, wat in fases 1a en 1b verdeel is, was om onderskeidelik fokusgroepbesprekings te hou en om ʼn deursnitopname te doen om die sielkundige kontekste (byvoorbeeld elemente van selfbeeld en depressie), gedragskontekste (spesifiek seksuele gedrag) en sosiale kontekste (spesifiek sosiale ondersteuning en ouer-adolessent-kommunikasie) te bepaal waarin adolessente die risiko loop om MIV-infeksie op te doen. Fase 1a was kwalitatief en data is deur middel van nege fokusgroepbesprekings ingesamel: drie met die ouers van adolessente, vier met adolessente tussen 16 en 18 jaar oud en twee met beraders. Nege sleuteltemas is geïdentifiseer wat verband hou met adolessente seksualiteit en risiko’s om MIV op te doen: (1) verhoudings tydens adolessensie, (2) tienermeisies wat verhoudings met ouer mans het, (3) die gebruik van kondome onder adolessente, (4) tienerswangerskappe, (5) sienings oor homoseksualiteit, (6) ouer-adolessent-kommunikasie oor seksuele gesondheid, (7) die rol van die media, (8) dissipline en die ervaarde regeringsinvloed en (9) groepseksgeleenthede. Fase 1b was kwantitatief en data is deur middel van ’n deursnitopname ingesamel om die variansie van risiko vir MIV te ondersoek. Vir Fase 1b het die steekproef bestaan uit 506 adolessente met ’n gemiddelde ouderdom van 17 jaar (interkwartielwydte [IKW]: 16–18). Meer as die helfte van die deelnemers was vroulik (59%, n = 298). Ek het ’n hiërargiese meervoudige regressiemodel met drie stappe gebruik om die variansie van risiko vir MIV te ondersoek. Die enigste beduidende voorspellers in stap 3 was “ooit gedreig om seks te hê” en “ooit geforseer om seks te hê”. Die kombinasie hiervan het 14% (R2 = 0.14; F (12, 236) = 3.14, p = 0.00) verklaar. Depressie en oueradolessent- kommunikasie is onderskeidelik in stappe 2 en 3 bygevoeg, en albei veranderlikes was onbeduidend in hierdie modelle. In Fase 2 het ek die CDC se intervensie vir die verlaging van risiko aangepas en met ’n loodsprojek getoets. Die intervensie was bedoel om geskik te wees vir die ontwikkelings- en kontekstuele vlakke van 16- tot 18-jarige adolessente van Soweto wat beskou is as potensiële deelnemers aan toekomstige MIV- biomediese proewe. Deelnemers in Fase 2 was 16 tot 18 jaar oud, die steekproef was hoofsaaklik vroulik (52%, n = 11) en die meeste van die deelnemers (91%, n = 19) was in grade 8 tot 12 op hoërskool. Deelnemers het tydens indringende onderhoude terugvoering oor hulle ervarings van die aangepaste beradingsintervensie verskaf. Ek het drie hooftemas in hierdie verband geïdentifiseer, wat die volgende insluit: voordele van MIV-toetsingsdienste, redes waarom berading en MIV-toetsingsdienste verlang word, en die deelnemers se evaluering van die studiebesoeke en beradingsessies. Daar is bevind dat die aangepaste beradingsintervensie van die CDC aanvaarbaar was en gunstige uitkomste gelewer het vir die adolessente wat aan die loodsfase deelgeneem het. Hierdie studie dra by tot die literatuur oor MIV-risiko’s vir adolessente in Soweto, Suid-Afrika, deur meervoudige invloedsvlakke te oorweeg. Die feit dat ’n meer volledige begrip tydens die loodsondersoek verkry is van die interaksie van die ekologiese faktore wat tot seksuele risikogedrag onder adolessente bydra, het die ontwikkeling van ʼn doelgemaakte intervensie deur berading moontlik gemaak. Die bevindings het getoon dat die aangepaste beradingsintervensie van die CDC lewensvatbaar en aanvaarbaar is vir gebruik onder adolessente wat waarskynlik geskikte deelnemers aan toekomstige biomediese proewe oor MIV-voorkoming kan wees. Hierdie studie verskaf dus ʼn noodsaaklike beradingsintervensie om die MIV-risiko onder adolessente ‒ ʼn ouderdomsgroep wat waarskynlik aan toekomstige biomediese navorsing oor MIV-voorkoming sal deelneem ‒ te verminder.

Thesis (MA)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: This study investigates how the new technology of treatment, i.e. antiretroviral therapy (ART), is incorporated into public health care institutions. The success of this technology ideally relies on the notion of the ‘responsibilised’ patient as one who, simply put, consistently maintains the level of ARV-adherence necessary to suppress the viral load and to avoid drug resistance. The stringent management and continual monitoring of treatment adherence necessary to achieve these outcomes lie beyond the direct control of the health care institution. Given that the institution sees its patients irregularly, a patient’s divergence from treatment guidelines is established only after the fact. The institution takes on a supporting role while it is the patient who, on a day-to-day, dose-by-dose basis manages and monitors themselves, making ART a seemingly individual endeavour and responsibility. This shift in responsibility is compatible with the ‘new contract’ between provider and client, necessitated by ART. Even so, the institution attempts to manipulate the day-to-day behaviours of the patient to conform to those required in order to achieve treatment outcomes. This thesis examines how these different aspects of ART play out within two clinics in the Cape Winelands, and more specifically, the institutional intricacies of managing a disease which requires treatment that is not directly observed. / AFRIKAANSE OPSOMMING: Die studie ondersoek hoe die nuwe tegnologie van behandeling, antiretrovirale behandeling (ARB), in publieke gesondheidsorgklinieke geïntegreer word. Die sukses van hierdie tegnologie hang af van die nosie van die ‘verantwoordelike’ pasiënt wat, eenvoudig gestel, die nodige vlak ARV-gebruik handhaaf om die virale lading te onderdruk en weerstand te voorkom. Die streng kontrole oor die toewyding tot behandeling wat nodig is om hierdie uitkomstes te bereik, lê buite die direkte beheer van die gesondheidsorgkliniek. Aangesien die kliniek sy pasiënte slegs periodiek sien, word ʼn pasiënt se afwyking van behandelingsriglyne eers later gemeet. In hierdie opsig neem die kliniek 'n ondersteunende rol in, terwyl dit die pasiënte is wat op 'n daaglikse, dosis-tot-dosis basis hulself moet handhaaf en monitor. Dit maak ARB 'n oënskynlike individuele onderneming en verantwoordelikheid. Hierdie skuif in verantwoordelikheid is in lyn met die nuwe kontrak tussen die gesondheidsorgdiens en die kliënt, wat deur ARB genoodsaak word. In ieder geval probeer die institusie om die daaglikse gedrag van die pasiënt te manipuleer om te pas by die riglyne wat deur die uitkomstes genoodsaak word. Hierdie tesis ondersoek hoe hierdie verskillende aspekte van ARB binne twee klinieke in die Kaapse Wynland uitspeel, en meer spesifiek, die institusionele bestuur van 'n siekte waarvoor behandeling nie direk geobserveer kan word nie.

Thesis (MPhil)--Stellenbosch University, 2005. / On t.p.: HIV/AIDS Management. / ENGLISH ABSTRACT: This article describes the approach taken by a company to successfully implement prevalence testing for HIV at one of its manufacturing sites in KwaZulu-Natal. Ninety point four percent of the employees on site on the day of testing subjected themselves to voluntary anonymous testing. No rewards or incentives whatsoever were offered or given to the participants. The problem faced by the company was that there was increasing mortality amongst its employees, particularly those in the lower job grades, mainly machine operators and other lesser skilled positions. The cost of insured benefits provided by the company’s provident fund for death and disability were increasing and less money could be allocated to funding for retirement. In the absence of any empirical data the company had no idea how they would be affected by the HIV/AIDS pandemic, other than attempting to use provincial averages. The level of knowledge of HIV and AIDS in the company was judged as relatively poor. Many of the staff, more so the senior staff, had little or no exposure to the disease and what effect it had on those suffering from it or those supporting sufferers. Little had been achieved to manage HIV and AIDS until a workshop was organised by the company for representatives from all branches to attend. Various information topics about HIV were covered at the workshop, which concluded with the site representatives having to work out and table an action plan, and make a personal pledge of what they were going to do to help in the fight against HIV and AIDS. The workshop was attended by all board members, senior management, shop stewards and shop floor representatives. One of the key features of the presentations was by a senior official of the union, who then assisted throughout the rest of the workshop. Site plans were then later followed up when a central committee visited the sites and presentations on progress were made.At the workshop mention was made of the need to conduct prevalence testing and also the establishment of a HIV/AIDS committee. The site committee made the decision that prevalence testing should take place and consulted the workforce themselves and also through shop stewards. Once it was felt that sufficient support would be forthcoming a date for testing was set. The company had in the meantime contracted with a service provider to do testing where needed. A briefing session attended by the HIV/AIDS committee, shop stewards, the management team and two executive directors was arranged. A doctor employed by the service provider addressed the group and answered their concerns and demonstrated the saliva test on himself. On the day of testing senior management and the senior shop steward walked the factory floor encouraging employees to participate. This intervention has laid the foundation for a successful management campaign against HIV and AIDS in the workplace. / In hierdie artikel word die benadering wat n maatskappy gebruik om die voorkomsyfer van MIV by een van sy vervaardigingsterreine in KwaZulu-Natal to toets, beskryf. Op die dag waarop toetsing plaasgevind het, het 90,4% van die werknemers op die terrain hulleself vrywilliglik laat toets. Tydens hierdie anonieme toetsing is geen belonging of voordele van enige aard aan die deelnemers gebied nie. Die problem wat die maatskappy gehad het, was dat daar n toenemde sterftesyfer onder werknemers in die laer posvlakte soos masjienoperateurs en werknemers in posiese wat minder vaardighede vereis. Daar was stygende koste (in terme van dood en ongeskiktheid) van versekerde voordele waarvoor die maatskappy se voorsieningsfonds voorsiening maak, wat tot gevolg gehad het dat daar minder geld beskikbaar was vir pensionfondse. Omdat daar n tekort van empiriese data was, het die maatskappy geen idée gehad van die effek wat die MIV/VIGS-pandemie op hom sou uitoefen nie, behalwe deur die gebruik van provinsiale gemiddeldes. Die kennis van MIV/VIGS binne die maatskappy is as swak bestempel. ’n Groot hoeleevheid van die personeel, veral die in senior poste, het min of geen blootstelling gehad van die virus en die effek wat dit op VIGS-lyers en die ondersteuners van VIGS-lyers het nie. Min is gedoen on MIV/VIGS te bestuur, totdat n werkswinlek deur die maatskappy georganiseer is vir verteenwoordiges van al, die takke. ’n Verskeidenheid onderwerpe in verband met MIV/VIGS is deur die werkswinkel gedek. Een daarvan was dat die terreinverteenwoordiges n aksieplan moes opstel en n persoonlike eed moes afle dat hulle sou help in die stryd teen MIV/VIGS. Die werkswinkel is deur al die raadslede, senior bestuurslede, werkswinkelassistente en –verteenwoordiges bygewoon. Die hoofsaak van die voorleggings is deur n senior uniebeampte gelei, waarna hy vir die verloop van die program geassisteer het. Terreinplanne is opgestel en dit is later opgevolg deur n sentralle komitee wat die terreine besoek het en voorleggings gelewer het in verband met die vordering wat gemaak is. Tydens die werkswinkel is melding gemaak van die noodsaaklikheid van die toetsing van die voorkomsyfers van MIV en die instelling van n MIV/VIGS komitee. Die terreinkomitee het besluit dat die voorkomstoetsing moes plaasvind nadat die werkersmag en werkswinkelsttistente gekonsulteer is. Nadat besluit is dat die nodige ondersteuning uit hierdie toetsing sou voortspruit, is ’n datum vir die toetsing voorgestel. Vir die interementydperk het die maatskappy ’n diensverskaffer gekontrak om die toetsing, waar nodig, waar te neem. ’n Inligtingsessie is gereel wat deur die MIV/VIGS-komitee, werkswinkelassistente, die bestuurspan en twee uitvoerende direkteure bygewoon is. ’n Dokter, wat deur die diensverskaffer in diens geneem is, het die groep te word gestaan en antwoorde verskaf op hulle vraagstukke. Hy het ook die speekselftoets op himself gedemonstreer. Op die dag wat die toetsing plaasgevind het, het die seniorbestuur en werkswinkel-assistant deur die fabriek geloop en werknemers anngemoedig on aan die toetsing deel te neem. Hierdie intervensie het gelei tot die stigting van n suksesvolle bestuursveldtog teen MIV/VIGS in die werksplek.

Thesis (MPhil)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: Thus far, no youth intervention strategy has responded to the root causes of the HIV/AIDS crisis amongst young people through an approach that encompasses both a prevention and a future leadership strategy in one development model. This article tells the story of the development and pilot process of an adolescent peer education model, for which the author of this paper was the leader. The model is being proposed as a youth development strategy to positively impact community social norms by using young opinion leaders as the catalyst for change. The model was developed through an NGO, OIL Reach Out Adolescent Training (OIL), that specifically set out to pioneer, implement and evaluate best practice adolescent peer education in one cross-cultural community as a model for other communities in Africa. OIL set out basing its belief in the efficacy of peer education on behavioural theories, which support it as a strategy for behaviour change. At the heart of their peer education pilot was the belief that the message giver is the strongest message; people don’t change with information, they change when others around them change. Together with peer education theories, OIL applied a “futures-oriented” education approach in their curriculum development. OIL set out with a definition of peer education as being “the process whereby skilled facilitators assist a group of suitable young people to: educate their peers in a structured manner; informally role-model healthy behaviour; recognise youth in need of additional help and refer them for assistance; and advocate for resources and services for themselves and their peers”. (Deutsch, C. & Swartz. S 2003), OIL strategically selected a community at the tip of the Western Cape to pilot, made up of 4 diverse school communities and representing a microcosm of periurban South Africa as a whole. OIL was selected by the Western Cape Education Department as part of the provincial pilot programme. The core programme framework was designed together with community stakeholders and adolescent community representatives. Selection of Adolescent Peer Educators was through a combination of self-nomination and referrals from peers. The aim of this process was to yield a diverse group of teens from all the different sub-cultures who were leaders, chosen on their shared experience with learners and making up 10-15% of the class. Training content included a diverse values based curriculum that was designed to provide skills and information needed to tackle root issues facing young people and providing a sense of vision and purpose. Personal transformation of the peer educator was realized to be the critical factor in effective peer education.Over three years, a structured and long-term programme was put in place with programme standards and clear manageable outputs for peer educators. Once the pilot was drawing to completion in 2004, the author of this paper as representative of OIL at the time, together with representatives of the seven other implementing organisations involved in the pilot, were brought together to compile their learnings and document a proposed common model for implementation from 2005 into other communities. OIL’s model and uncompromising standards of peer education were recognized for future programmes to learn from and model. Challenges for future implementers include accessing financial sustainability, community buy and combatting HIV related attitudes / AFRIKAANSE OPSOMMING: Weinig beskikbare voorkomingsprogramme is tans op die jeug en toekomstige leiers gerig. In ander lande in Suider-Arika word voorkomingsprogramme sterk op die jeug gevestig ten einde die visie van 'n Vigsvrye generasie in die toekoms te probeer verwesentlik. Hierdie studie is as 'n gevallestudie opgeskryf met sterk klem op 'n volwasse opvoedkundige model en jeugontwikkeling en 'n positiewe fokus op jong opinieleiers, as teikengroep. Die uitkomste van die program is sterk op voorkoming gerig. Die model is ontwikkel deur 'n nie-winsgewende organisasie (NGO), OIL (Reach Out Adolescent Training). Die studie beskryf die ontstaan, metodiek en implementering van OIL en beskryf sekere van die suksesse wat reeds daarmee bereik is. Die teoretiese basis van die OIL program word beskryf. Ook word die belangrikheid van deeglike voorafopleiding en die transformasie wat deur OIL bereik kan word, deeglik op skrif gestel. Die verdere verloop van die opleidingsprogram word uitgespel en voorstelle vir verdere navorsings- en ontwikkelingswerk word aan die hand gedoen.

First eleven leaves not numbered / The purpose of this study was to identify, explore and describe the potential contributing factors of the upsurge of HIV among children aged three to eighteen months in the Mangaung Metropolitan area of the Free State Province in South Africa. The study was conducted at five primary healthcare facilities and one hospital in the Mangaung metropolitan municipality of the Free State Province with sixty randomly selected mothers of children testing HIV-positive for the first time between the ages of three and eighteen months. The convergent mixed-methods research design was opted for, according to which both qualitative and quantitative data were collected at the same health facilities selected by means of cluster sampling. The review of medical records, unstructured interviews, and structured questionnaires were used for qualitative and quantitative data collection, while random cluster sampling was used for participant selection. Thematic data analysis was applied for the interpretation of recurrent patterns of qualitative and quantitative data. The study results revealed that mothers were well-informed about the prevention of mother-to-child-transmission. The main factors that contributed to more children testing HIV positive after the routine tests were conducted at ten weeks included non-adherence factors to PMTCT prescripts mainly by mothers, such as: babies were not brought to the clinics for testing and immunisations at ten weeks, and that mothers acquired HIV infection during the breastfeeding period. Some other potential contributing factors were late antenatal booking which lead to the delay in initiation of antiretroviral treatment, nonadherence to antiretroviral therapy during pregnancy, and mixed feeding. The themes that emerged from the qualitative data were psychological factors, emotional factors, socioeconomic factors, missed opportunities, risky behaviour, as well as women disempowerment; while some mothers were left with unanswered questions. The results of the qualitative part complemented the quantitative findings as they uncovered the factors that led to the deviation from the PMTCT prescripts by the mothers. The study’s recommendations include PMTCT psychological assessment and counselling; partner and community involvement; women empowerment; and that couple testing at antenatal and postnatal clinics should be a national policy subjected to protracted monitoring and evaluation processes. / Health Studies / D. Litt. et Phil. (Health Studies)

In South Africa, HIV/AIDS takes the lead, and this is a serious health concern. Being a country that is mostly affected by this epidemic, various stakeholders such as international organizations, Non-governmental organizations, private organizations and government organizations have come up with a collaborative effort to manage the epidemic. Through various interventions, it has been noted that monitoring and evaluation of HIV/AIDS remains underdeveloped. The purpose of this study was to investigate the monitoring and evaluation process implemented on HIV/AIDS programmes by the Non- Governmental Organizations (NGOs) in a specific municipality in KwaZulu-Natal province. A quantitative, explorative and descriptive design was used. A self-developed questionnaire was used as data collection instrument. Data was collected from November 2017 to March 2018. Seventeen (17) NGOs and a total of 83 respondents who met the inclusion criteria participated to the study. The results revealed that the NGOs in this specific municipality had some inconsistency in implementing and delivering M&E process on the HIV/AIDS programme. The results of the study indicated that the challenges and issues identified by the respondents affected the way they monitored and evaluated the projects they implemented. It was recommended that through training of staff to acquire skills for designing monitoring and evaluation plan for all projects and development of comprehensive M&E plan document that detailed the programme’s objectives, developed the interventions to achieve these objectives, the NGOs in this specific municipality will be able to improve their current monitoring and evaluation process implementing on HIV/AIDS management programme. The need for communication between programme planners and various funders on how to put in place a structured M&E plan for all the projects to be implemented in future and adequate resources to implement M&E processes and functions were highly recommended. / Health Studies / M. P. H.

This Dissertation is submitted in partial fulfilment of the Master of Arts in Demography and Population Studies at the University of the Witwatersrand, 2017 / Background: In South Africa, poor choice of contraception method or contraceptive failure has been noted as one of the key contributors to high rates of unwanted pregnancy and HIV/AIDS. Contraceptive use is highly correlated with pregnancy and fertility intention. While research knows the role of contraceptive use in delaying conception and/or childbearing, what remains unknown is an understanding of whether the methods of contraception used by young women match their fertility intentions. The objective of this study is to determine the relationship between fertility intention and method of contraception among young women (20-24 years old) South Africa. Methods: This study provides a secondary data analysis on cross-sectional data from the 19992002 Transition to Adulthood in the Context of HIV/AIDS survey. Given that the survey involved two waves of data collection in 1999 and 2002, the two respective datasets are pooled together to achieve a representative sample of 8 370 adolescents aged 14 – 24. However, because the population of interest is young women, further sample restrictions are performed and a weighted sample of 1,020 sexually active young women aged 20-24 years old is attained. A multinomial regression is adopted for this study because the outcome variable-method of contraceptioncomprises of three categories: (1) modern method (2) traditional (3) no method. As such, in establishing the relationship between fertility intention and method of contraception, three levels of analysis are carried out. Firstly, is a univariate analysis of the variables in the study, followed by a bivariate analysis using Chi2 to examine the association between predictor variables and method of contraception. Finally, a multivariate analysis producing the adjusted and unadjusted associations is conducted to examine whether a statistical relationship exists between fertility intention and method of contraception. Results: Of the 1,020 sexually active young women 20-24 years old years old in the sample, 77.8% do not use any method of contraception while 13.9% make use of modern methods and only 8.1% use traditional methods of contraception. There was no significant association found between fertility intention and method of contraception. Among young women that intend to have three or more children in their lifetime compared to those that intend to have 1-2 children, the relative risk of using a modern method of contraception compared to not using any method of contraception is expected to decrease by a factor of 0.620 (95% CI=0.351,1.095; P>0.05). However, positive associations were found between relationship status and method of contraception as well as between place of residence and method of contraception. Among young women that have steady partners compared to those that are single/not in a relationship, the relative risk of using a traditional method of contraception compared to not using any method is expected to decrease by a factor of 0.274 (95% CI=0.122, 0.617; P<0.05). Furthermore, among young women living in rural areas compared to those in urban areas the relative risk of using a modern method of contraception compared to not using any method is expected to decrease by a factor of 0.499 (95% CI=0.300, 0.831; P<0.05). Conclusion: This study has demonstrated that fertility intention cannot be used as the sole predictor of the choice of contraception used by young women. Rather, there are prevailing and contextual demographic and socio-economic factors that intervene this relationship and influence women’s adoption of any method of contraception. Notably, the limited access to healthcare centres; ambivalent feelings about pregnancy as well as misconceptions and perceived side effects of contraception influence the poor use of modern methods of contraception. To address the high rate of unwanted pregnancy among youth in South Africa, it is advisable that policies and programmes assist young women to become decisive about their fertility intentions and provide them with the necessary support and resources to access contraceptive methods that will assist them in achieving their fertility goals. / XL2018