The human immunodeficiency virus / acquired immune deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. There is a concurrent and distinct increase in the prevalence of HIV/AIDS and HIV-related diseases in the paediatric population in South Africa, particularly those using public sector health services, with a corresponding increase in morbidity and mortality rates (Abdool Karim & Abdool Karim, 2010:363), which impacts greatly on paediatric healthcare services. Adding to this, the provision of paediatric antiretroviral care has numerous stumbling blocks, not least of which is lack of decentralisation of facilities to provide treatment. There is the additional shortage of staff, which includes staff that are comfortable dealing with children, lack of training programmes on the provision of antiretroviral therapy to children, and minimal on-site mentorship of staff regarding HIV/AIDS disease in children. This lack of capacity in the healthcare system means that not all of those who require treatment will be able to access it, and this is particularly pertinent to paediatric patients (Meyers et al., 2007:198). Therefore the purpose of this research was to develop a nursing model that would assist healthcare professionals, in particular professional nurses, to optimise the comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy at PHC clinics. To achieve the purpose of this study, a theory-generating design based on a qualitative, explorative, descriptive and contextual approach was implemented by the researcher to gain an understanding of how the healthcare professionals and parents/caregivers of HIV-positive children experienced the comprehensive treatment, care and support provided at primary healthcare clinics. The information obtained was used to develop a chronic care coordination model for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy. The study design comprised the following four steps: Step One of the research design focused on the identification, classification and definition of the major concepts of the study. This involved describing and selecting the research population and the sampling process prior to conducting the field work which comprised in-depth interviews with two groups of participants, namely healthcare professionals and parents/caregivers who accompany their HIV-positive children to PHC clinics in order to receive antiretroviral therapy. Step Two of the research design focused on the development of relationship statements in order to bring clarity and direction to the understanding of the phenomenon of interest. Step Three of the design concentrated on the development and description of the chronic care coordination model for optimising comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy in order to ensure a well-managed child on ART. A visual representation of the structure of the model for chronic care coordination was given and described as well as a detailed description of the process of the model. Step Four was the last step of the research design and its focus was the development of guidelines for the operationalisation of the model for chronic care coordination for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at PHC clinics. Guidelines and operational implications for each of the five sequential steps of the model were developed. The evaluation criteria of Chinn & Kramer (2008:237‒248) were used to evaluate the model. It is therefore concluded that the researcher succeeded in achieving the purpose for this study because a chronic care coordination model that is understandable, clear, simple, applicable and significant to nursing practice has been developed for use by healthcare professionals, particularly professional nurses, in order to optimise the comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at primary healthcare clinics.

Thesis (M.Sc.) -- University of Limpopo, 2016 / Purpose of the study The purpose of this study was to investigate the experiences of couples on disclosure of their HIV-positive status to each other. Research methodology Qualitative, Phenomenology, exploratory descriptive and contextual research was conducted to identify the experiences and to determine the strategies that address non-disclosure of couples on their HIV-positive status. The population comprised 12 participants (six (6) couples). Purposive sampling was used to select eight (8) participants (four (4) couples) who participated in the study. Semi-structured interviews were used to collect data until data saturation was reached. Study findings Data were analysed using Tesch’s open-coding method. Five themes emerged, namely, fear of being HIV-positive, disclosure of HIV-positive status is a difficult process, acceptance of HIV-positive status, relations between partners post knowledge of HIV-positive results and encouragement pertaining to disclosure of HIV-positive status. Strategies were developed to address the experiences identified. Recommendations were made for the Department of Health, clinic staff, future researchers, patients and community members. Conclusion Although couples disclosed their status to one another disclosure was found to be a difficult process. Acceptance of HIV status was also found to be one of the challenges that led to delayed disclosure of the status. Support system from both family and community is a very important factor which might increase HIV status acceptance and disclosure from couples. Keywords: Couples, experiences, disclosure, HIV-positive status.

Thesis (M. A. (Clinical Psychology)) --University of the North, 2002 / Refer to the document

The purpose of this study was to present and understand the experiences of HIV-positive lay counsellors working in Voluntary Counselling and Testing (VCT) settings. Specifically exploring and understanding the utilisation of personal experiences within counselling encounters, the practice of peer counselling within VCT, and the challenges experienced by HIV-positive lay counsellors within VCT settings. This study, employing a qualitative interpretative phenomenological methodology required a small sample of practicing HIV-positive lay counsellors, who were selected and interviewed on their experiences utilising semi-structured interviewing. Data was analysed for meaning units, which were interpreted inductively and hermeneutically, and categorised into super-ordinate themes. Three superordinate themes within the participants’ experiences of providing VCT services were determined, namely: ‘diagnosis and disclosure experiences’, ‘peer counselling’, and ‘challenges’. This research found that the experiences of providing peer counselling depended upon identification with their client’s negative appraisal of their diagnosis experiences. Whether through empathic connections generated through the shared experience of discovering a seropositive status, or through countertransferential reactions induced through their client’s yearning for care and support. This required the counsellor to selfdisclose within counselling encounters in order to provide personal experiences of living with HIV/AIDS. Successful implementation of peer counselling provided recently diagnosed individuals with knowledge surrounding HIV/AIDS, coping skills to manage the daily physiological and psychological challenges, facilitation and adherence to treatment, social assistance, ongoing relationships, inspiring hope, and the creation of positive appraisals. However the informal utilisation of task-shifting within lay healthcare cadres, and the lack of governmental recognition for the emotional labour provided within VCT indicated that HIVpositive lay counsellors require ongoing training, support and remuneration to limit potential occupational stress, resignation, and burnout.

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Disclosure of Human Immune Deficiency Virus (HIV) is still a challenge to people living with the disease because of the discrimination, stigma and judgemental attitudes. Women prefer to keep their illness to themselves and make it a secret. The revealing of HIV status relies on an individual who is living with the illness. The concept of non-disclosure is a vital issue that threatens immediate families in which there are people, especially women battling the non-disclosure of their HIV status. Objectives: The objectives of the study were to explore and describe the experiences of concealing HIV positive status to the immediate family by women living with Human Immunodeficiency Virus at the selected villages in Limpopo Province. Methods: The qualitative and descriptive phenomenological method was followed. Due to saturation, ten women participated after being selected through purposive sampling from the database with the consideration of the inclusion and exclusion criteria. Data was collected through semi-structured interviews in Sepedi. The data was transcribed, translated and analysed through Interpretative Phenomenological Analysis. Results: WLW-HIV continue to manage to live with a secret about their HIV status due to the unpleasant feelings they hold about the illness continue, still pointing fingers and sceptical about disclosing, particularly to their children. They further tell lies about their illness and hide their medications away from the members of their family. The reasons about concealing their status include among others fear of prejudice, lack of trust, fear of abandonment and rejection, fear of blame and humiliation, denial, misconceptions that people still hold about HIV and the view of it as a predicament. Others conceal because of the lack of support and the target of the disclosure. xii Conclusion: The outcomes of the study have uncovered that there is still less awareness by members of the society about HIV/AIDS, which puts pressure on the WLW-HIV to effectively deal with an HIV positive status and disclose to their family members. These factors contribute to concealment and compromise the level of support that WLW-HIV would get from their family members, further impacting negatively on adherence. Keywords: Concealment, HIV/AIDS, Phenomenological study, Stigma and Immediate family.

Thesis (MPH.) -- University of Limpopo, 2021 / Introduction: HIV/AIDS remains a disease of public health importance and mother-to-child transmission (MTCT) is one of the major problems. Sub-Saharan Africa is the most severely affected region, accounting for more than 90 percent of paediatric HIV infections. Most of these infections occurred during pregnancy, delivery or breastfeeding making the prevention of mother-to-child transmission (PMTCT) a public health priority. Over the last few years, efforts have been made in Sub-Saharan countries to improve PMTCT and the success of prevention of mother‐to‐child transmission of HIV (PMTCT) is dependent upon high retention of mother‐infant pairs within the PMTCT cascade. Assessing the risk factors for MTCT will help to decrease child morbidity and mortality and strengthen PMTCT programs as there is dearth of evidence regarding factors determining MTCT HIV infection to infants born to HIV positive mothers. The purpose of this study was to investigate the determinants for the human Immunodeficiency Virus positivity rates in the Greater Letaba Municipality. The study objectives were to describe the demographic characteristics of mothers and babies who tested polymerase chain reaction test (PCR)-positive in the Greater Letaba Municipality during the two-year period from 2015 to 2016, in order to determine maternal and neonatal factors associated with high positive PCR; and to determine health system-related factors associated with a high positive PCR result. Methodology The current study followed a quantitative approach in which convenient and purposive sampling was used, focusing on records of infants born from HIV-positive women in all clinics at Greater Letaba Municipality were reviewed. All records of infants who were tested for HIV and the PCR results were positive from birth up to 12 months of age were retrospectively reviewed and for the health care workers, all nurses working as managers of a clinic were interviewed. The Statistical Package for the Social Sciences (SPSS) version 23 computer software and Stata 15 was used. for comparison of categorical variables was done using a Chi-Squared test, whereas continuous variables were compared using a t-test and P-value of <0.05 was considered significant. To determine maternal and neonatal factors associated with high positive PCR, Factor analysis was used with rotated factor loadings done using the Varimax method. Results: A total of 107 records were retrieved and audited. Fisher’s exact test was used to determine the relationship between selected variables, where p<0.05 was set as level of significance. The findings reveal that the number of infants exposed to HIV during pregnancy has steadily increased. The current study further indicates that health system factors such as unskilled or untrained NIM-ART nurses in the facilities is a contributory factor to infant’s positivity rate in Greater Letaba hospital. Equal proportions of both male and female babies were found to be PCR positive at 6 weeks. The study further revealed that the highest proportion of the mothers who gave birth to PCR positive babies for the reporting period were married mothers, in the age group 25-29 years (46.1%). The second largest proportion of mothers who gave birth to PCR positive babies were single mothers in the age group 25-29 years (38.4%). The results show that high PCR positivity can be attributed to about 5 main Factors namely: maternal antenatal history (22% contribution to total variance), maternal HIV care history (18% contribution to total variance), measures of adherence to treatment (17% contribution to total variance), maternal exposure to HIV (14% contribution to total variance) and lastly the ART regimen (12% contribution to total variance). Conclusion: The study findings revealed that there is still vertical transmission of HIV to infants and the prevalence of HIV among infants born from seropositive mothers despite the availability of the latest Prevention of Mother to Child Transmission (PMTCT) Guidelines in all health care facilities. Even though transmission is reduced to the meaningful number (< 5%), there are still appropriate measures that should be taken to reduce the transmission of HIV from mothers to infants. The delayed diagnosis, adherence to ART by mothers, infant ARV prophylaxis at birth and feeding practices contributed the vertical transmission of HIV to infants. Strengthening of the PMTCT of HIV programme, increasing antenatal HIV screening and linking it to care and treatment of HIV positive mothers to obtain zero infant HIV prevalence in the region. Infant prophylaxis and maternal PMTCT interventions should be provided to all exposed infants and mothers based on the guidelines by the health institutions. Nurse-initiated management of antiretroviral treatment (NIM-ART) training of professional nurses is being offered by the Department of Health in South Africa, but it does not yield positive results as far as the PMTCT is concerned. This may be due to shortage of staff, especially trained professional nurses (PN), as well as the workload. Key concepts: Infant and Human immune deficiency virus

This qualitative study explored the use of Reiki in improving the quality of life of people living with HIV (PLWH). A purposive sample of seven participants consented to the study. Reiki attunement, self healing and data collection were done over a six-month period. An idiographic approach was used. The participants were interviewed, then underwent Reiki attunement, performed self healing for 21-30 days and were interviewed again. Responses suggest that Reiki therapy had positive outcomes. Illnessspecific symptom relief, increased levels of energy, improved sleeping patterns, decreased anxiety and depression, spiritual awakening and a better ability to handle stressful situations were reported. Reiki therapy enabled the participants to reappraise living with HIV, deal with anger, depression and self-blame. These positive changes led to some of them seeking employment, leaving destructive personal relationships and reconnecting with family members. The researcher strongly recommends further research in this area. / Sociology / (M.A. (Social Behavioural Studies HIV/AIDS))

Thesis (MSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Global estimates show that sub-Saharan Africa has the largest portion of HIV cases with South Africa having more people living with HIV than any other country in the world. Moreover, studies have shown a high incidence of intimate partner violence (IPV) among people living with HIV. IPV has been shown to be associated with mental health problems. Considerable empirical studies have demonstrated that HIV is a highly stigmatized disease. In addition, HIV-related stigma has also been shown to be a risk factor for mental health problems among persons living with HIV. However, no empirical studies have examined the combined effect of IPV and HIV-related stigma on mental health. This thesis builds on the existing body of research by examining to what extent the linear combination of IPV (timing and frequency) and HIV related stigma explained variation in symptoms of common mental health disorders in both men and women living with HIV. In addition, theoretical and empirical studies have suggested that social support may serve as a protective factor in the relationship between IPV, HIV-related stigma, and mental health. Yet, despite the increasing attention, no known studies have focused on the mediating or moderating role of social support in the relationship between IPV or HIV-related stigma, and mental health. This thesis examined the extent to which social support played a mediating or moderating role in these relationships. The study used a cross-sectional research design to study a convenience sample of 210 people living with HIV in three peri-urban areas in the Western Cape, South Africa. Participants completed a battery of self-report questionnaires that assessed IPV (timing and frequency), HIV-related stigma, social support, and symptoms of common mental health. The results from the hierarchical multiple regression analysis demonstrated that the linear combination of psychological aggression frequency and HIV related stigma explained a significant portion of the variance in symptoms of depression. Likewise, both physical assault timing and psychological aggression timing combined with HIV-related stigma explained a significant portion of variance in symptoms of depression. Psychological aggression timing combined with HIV-related stigma significantly explained variance in symptoms of posttraumatic stress disorder (PTSD). The results from the product-term regression analyses indicated that social support played a mediating role in the relationship between HIV-related stigma and symptoms of PTSD, but not depression. Social support did not moderate the relationship between HIV-related stigma and symptoms of common mental health disorders. In conclusion, the combination of IPV (physical assault and psychological aggression) and HIV-related stigma explained a significant portion of the variance in symptoms of common mental health disorders. Future research is needed for a better understanding of these relationships. A longitudinal experimental design is recommended in order to explore the direction of these relationships and to examine the context in which the IPV, HIV-related stigma, and social support is experienced. / AFRIKAANSE OPSOMMING: Wêreldwye beramings toon dat sub-Sahara Afrika die grootste gedeelte van HIV gevalle te wêreld het, terwyl Suid-Afrika meer mense het wat met MIV leef as enige ander land in die wêreld. Verder het studies getoon dat daar 'n hoë voorkoms van intiemepaargeweld (IPV) is onder mense wat met MIV leef. Daar is al getoon dat IPV verband hou met geestelike probleme. Aansienlike empiriese studies het getoon dat MIV 'n hoogs gestigmatiseer siekte is. Daarbenewens, is daar getoon dat MIV-verwante stigma 'n risiko faktor is vir geestelike probleme onder persone wat leef met MIV. Daar is egter geen empiriese studies wat die gekombineerde effek van IPV en MIV-verwante stigma op geestesgesondheid ondersoek nie. Hierdie tesis bou voort op die bestaande navorsing deur te ondersoek tot watter mate die lineêre kombinasie van IPV (tydsberekening en frekwensie) en MIV-verwante stigma variasie in die simptome van algemene geestesgesondheid afwykings verduidelik in beide mans en vroue wat met MIV leef. Daarbenewens, het teoretiese en empiriese studies voorgestel dat sosiale ondersteuning kan dien as 'n beskermende faktor in die verhouding tussen IPV, MIV-verwante stigma, en geestesgesondheid. Tog, ten spyte van die toenemende aandag, het daar al geen studies gefokus op die bemiddelende of modererende rol van sosiale ondersteuning in die verhouding tussen IPV of MIV-verwante stigma, en geestesgesondheid. Hierdie tesis ondersoek die mate waarin sosiale ondersteuning 'n bemiddelende of modererende rol speel in hierdie verhoudings. Die studie het 'n deursnee-navorsing ontwerp gebruik om 'n gerieflikheidsteekproef van 210 mense wat met MIV leef in drie peri-stedelike gebiede in die Wes-Kaap, Suid-Afrika te bestudeer. Deelnemers het 'n battery van self-verslag vraelyste voltooi wat IPV (tydsberekening en frekwensie), MIV-verwante stigma, sosiale ondersteuning, en simptome van algemene geestesgesondheid geassesseer het. Die resultate van die hiërargiese meervoudige regressie-analise het getoon dat die lineêre kombinasie van sielkundige aggressie frekwensie en MIV-verwante stigma 'n beduidende deel van die variansie in simptome van depressie verduidelik. Net so, het beide fisiese aanranding tydsberekening en sielkundige aggressie tydsberekening gekombineer met MIV-verwante stigma 'n beduidende deel van die variansie in simptome van depressie verduidelik. Sielkundige aggressie tydsberekening gekombineer met MIV-verwante stigma het „n beduidende variansie in simptome van post-traumatiese stresversteuring (PTSV) verduidelik. Die resultate van die produk-term regressie-analises het aangedui dat sosiale ondersteuning 'n bemiddelende rol speel in die verhouding tussen MIV-verwante stigma en simptome van PTSV, maar nie depressie nie. Sosiale ondersteuning het nie die verhouding tussen MIV-verwante stigma en simptome van algemene geestesgesondheid versteurings modereer nie. Ten slotte, die kombinasie van IPV (fisiese aanranding en sielkundige aggressie) en MIV-verwante stigma het 'n beduidende deel van die variansie in simptome van algemene geestesgesondheid versteurings verduidelik. Toekomstige navorsing is nodig vir 'n beter begrip van hierdie verhoudings. 'n Longitudinale eksperimentele ontwerp word aanbeveel om die rigting van hierdie verhoudings te verken en die konteks waarin die IPV, MIV-verwante stigma en sosiale ondersteuning ervaar is te ondersoek.

Thesis (MA)--University of Stellenbosch, 2001. / ENGLISH ABSTRACT: In a qualitative study, a convenience sampling technique was used to ensure a study population of eleven HIV-infected low-income women. These participants were all direct referrals from municipal clinics and the provincial hospital. The criteria for participation were HIV sero-positivity and being a mother of a child or children. Semi-structured open-ended individual interviews were conducted, transcribed and then analysed, using grounded theory. Additional data were gained by using a standardised psychological measure, the Revised UCLA Loneliness Scale (RULS). The two main types of loneliness that these women experienced were loneliness of emotional isolation and loneliness of social isolation. These terms can be defined as the absence of a close emotional attachment and lack of support and understanding of intimate others (emotional isolation) and the absence of an accessible and engaging social network and lack of social support and acceptance (social isolation). The most significant causes of loneliness for these women were stigmatisation; fear and/or shame of rejection and victimisation; fear of losing custody or care of their children; fear of losing financial and emotional support; and using secrecy and non-disclosure as main coping strategy for their emotional and physical safety. Experiences of emotional isolation were also provoked or enhanced by the lack of involvement and support from their partners and the partners' denial of the illness and its consequences. Experiences of social isolation were also caused or increased by the general lack of HIV/AIDS information, education and support services. Significantly, it was found that for most of the women the psychological effect of loneliness was primarily a depressed mood as well as using negative coping mechanisms, such as alcohol abuse and further withdrawal from important others. The psychosocial needs of these women were also significantly similar. Broad guidelines are offered for health workers in assisting/supporting HIV-infected low-income mothers in general, based on the core needs of the women in this study; to be listened to and heard, understanding and acceptance, and social support. / AFRIKAANSE OPSOMMING: In 'n kwalitatiewe studie is 'n gerieflikheidsteekproeftegniek gebruik om 'n studiepopulasie van elf MIV-geïnfekteerde lae-inkomste-vroue te verseker. Hierdie deelnemers was almal direkte verwysings van munisipale klinieke en die provinsiale hospitaal. Die kriteria vir deelname was MIV-sero-positiwiteit en moeder wees van 'n kind of kinders. Semigestruktureerde oop individuele onderhoude is gevoer, getranskribeer en toe ontleed deur gegronde teorie te gebruik. Bykomende data is verkry met behulp van 'n gestandaardiseerde psigometriese instrument, die "Revised UCLA Loneliness Scale (RULS)". Die twee hooftipes eensaamheid wat hierdie vroue ervaar het was eensaamheid van emosionele isolasie en eensaamheid van sosiale isolasie. Hierdie terme kan omskryf word as die afwesigheid van 'n nou emosionele band en gebrek aan ondersteuning en begrip van intieme ander (emosionele isolasie) en die afwesigheid van 'n toeganklike en inskakelende sosiale netwerk en gebrek aan sosiale ondersteuning en aanvaarding (sosiale isolasie). Die beduidendste oorsake van eensaamheid vir hierdie vroue was stigmatisasie; vrees en/of skaamte vir verwerping en viktimisasie; vrees vir verlies van voogdyskap of sorg van hul kinders; vrees vir die verlies van finansiële en emosionele ondersteuning; en die gebruik van geheimhouding en nie-openbaarmaking as belangrikste hanteringstrategie vir hul emosionele en fisieke veiligheid. Ervarings van emosionele isolasie is ook uitgelok of versterk deur die gebrek aan betrokkenheid en ondersteuning van hul lewensmaats en die lewensmaats se ontkenning van die siekte en sy gevolge. Ervarings van sosiale isolasie is ook veroorsaak of verhoog deur die algemene gebrek aan inligting, opvoeding en ondersteuningsdienste ten opsigte van MIVNIGS. 'n Betekenisvolle bevinding was dat vir die meeste van die vroue die psigologiese effek van eensaamheid primêr 'n depressiewe gemoedstemming was sowel as die gebruik van negatiewe hanteringstrategieë soos alkoholmisbruik en verdere onttrekking van belangrike ander. Die psigososiale behoeftes van hierdie vroue was ook beduidend eenders. Breë riglyne word voorgestel vir gesondheidswerkers wat betref die bystaan/ondersteuning van MIV-geïnfekteerde lae-inkomste-moeders in die algemeen, gebaseer op die kernbehoeftes van die vroue in hierdie studie; om na geluister en gehoor te word, begrip en aanvaarding, en sosiale ondersteuning.

Abstract Throughout history, many diseases have carried considerable stigma, including leprosy tuberculosis, cancer, mental illness and many STDs. Now HIV/AIDS is the topmost in the list of diseases that leads to devastating patient stigmatization. Despite international efforts to tackle HIV/AIDS, stigma and discrimination remain among the most poorly understood aspects of the epidemic. In the face of numerous intervention strategies, HIV/AIDS continues to spread and to pose a threat to the socio-economic transformation of South Africa. The broad objective of this study was to investigate how the stigmatisation of HIV-Positive women is made manifest and look at how successful the National Association of people living with HIV/AIDS (NAPWA) in South Africa has been in achieving their objectives and goals of changing the perceptions people have about HIV/AIDS and creating awareness about the debilitating effect stigmatisation has in the society, especially when it viciously targets HIV-positive women. A case study approach was used to examine the experiences of HIV/AIDS infected/affected women and NAPWA administrators. Methods used in the collection of data were self-administered questionnaires, participant observation and archival evidence in the form of documents. Through these methods, the study investigated ways in which the stigmatisation of HIV-positive women was made manifest, the role of NAPWA in fighting HIV/AIDS stigmatisation, how successful NAPWA has been in the fight against the stigmatisation of people infected and affected by HIV/AIDS in South Africa, challenges faced by NAPWA in the fight against HIV stigmatisation and discrimination, weaknesses of NAPWA and what impact all these have in the spread of HIV/AIDS. The research results show that HIV-positive women suffer stigmatisation and that; organisations of people living with HIV/AIDS (e.g. NAPWA-SA) play a major role in eradicating the stigma attached to HIV/AIDS. It also suggests that APWAs in effect help to reduce the spread of the disease and prolong the life span of those infected by it. All this not withstanding, the study also discovered that APWAs like NAPWA-SA need the support of government and stakeholders in South Africa to fully implement their strategies and programmes geared towards reducing stigma and the spread of HIV/AIDS.