<p>This was a descriptive qualitative study. Eight people living with HIV, four of which had disclosed their status, were individually interviewed. Two focus group discussions (each comprising 6 participants) were also conducted with health workers. The study was based at an urban TB hospital which is currently providing a range of HIV-related services including HIV Voluntary Counselling and Testing, case management and treatment.</p>

Orientador: Paulo Câmara Marques Pereira / Resumo: A lipodistrofia associada ao HIV (LAHIV) é caracterizada pela redistribuição de gordura corporal, sendo uma das consequências da introdução da terapia antirretroviral (TARV) e relacionada ao aumento do risco para o desenvolvimento de doenças cardiovasculares. Seu diagnóstico é subjetivo e classificado em três tipos, de acordo com a região corporal em que há perda e/ou acúmulo de gordura, a saber, lipoatrofia, lipohipertrofia e lipodistrofia mista, acompanhada ou não de alterações metabólicas. O objetivo do presente trabalho foi verificar a associação dos diferentes subtipos de LAHIV em pessoas vivendo com HIV/aids com os componentes da síndrome metabólica e composição corporal. Foram avaliados dados clínicos, imunológicos, metabólicos, antropométricos e composição corporal de 40 pessoas vivendo com HIV/aids em acompanhamento ambulatorial e uso regular de TARV, de ambos os sexos, com diagnóstico clínico de LAHIV. Os principais achados do estudo foram maiores alterações de perfil lipídico entre as mulheres. Não houve diferença estatística entre os subtipos para o perfil metabólico. As principais alterações foram identificadas no grupo lipohipertrofia, que tiveram maiores valores de porcentual de gordura corporal total, área de gordura visceral (AGV), índice de massa corpórea (IMC) e circunferências abdominal e do pescoço em relação aos outros dois grupos. A massa magra foi superior apenas em relação ao grupo lipodistrofia mista e a massa de gordura em relação ao grupo lipoatrof... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre

Magister Scientiae (Physiotherapy) - MSc(Physio) / Peripheral neuropathy (PN) is a common neurological complication occurring in the asymptomatic and symptomatic stages of human immune deficiency virus (HIV) infection. The pain and other symptoms caused by PN can impair functional ability and limit physical activity that could affect quality of life (QoL). Additionally, studies done on quality of life of people living with HIV/AIDS have shown that, HIV-related neurological syndromes, including PN, significantly reduce QoL. The aim of this study was to determine the prevalence of peripheral neuropathy amongst and the quality of life of adults living with HIV/AIDS attending the out-patient clinic at Rutongo Hospital in Rulindo District in Rwanda. / South Africa

Magister Public Health - MPH / This was a descriptive qualitative study. Eight people living with HIV, four of which had disclosed their status, were individually interviewed. Two focus group discussions (each comprising 6 participants) were also conducted with health workers. The study was based at an urban TB hospital which is currently providing a range of HIV-related services including HIV Voluntary Counseling and Testing, case management and treatment. / South Africa

Magister Public Health - MPH / HIV support groups have been widely adopted as part of care and support interventions in Zambia, yet there is very little research on the effectiveness of these groups in meeting the needs of the PLWHIV from the perspective of those who join them. This case study looks at a selected support group for People Living with HIV and AIDS (PLWHIV) facilitated by the Flying Angels, a faith based non-governmental organization established in 2007 by the Living Assemblies of God Church, in Ng‟ombe Township, Lusaka. The Support Group brings together around eighty young and old, married and single, men and women living with HIV and AIDS, to share experiences and find ways of coping with their situation. The qualitative case study sought to obtain a rich understanding of the experiences of members with a view to understanding the support they needed, the aspects of the support group that are relevant and effective to their situation, and which are not. In-depth interviews and focus group discussions methods were used to collect data. Discussion and interviews were audio-taped. Audio-recordings were translated during transcription, data organized, coded and thematically analysed.

Magister Artium - MA / Due to tremendous stigma attached to HIV/AIDS, revelation of HIV positive sero-status of an individual has become a significant risk in communities of South Africa (Kalichman el al., 2003;Deacon et al., 2004; Kalichman et al., 2005, Simbayi et al., 2007). Several researchers have argued that HIV/AIDS stigma poses severe problems which include that it delays HIV testing;stops people living with HIV and AIDS (PLWHA) from seeking care; inhibits incorporation of prevention behaviours; increases violence against HIV-positive people; and extends beyond PLWHA to families, providers and volunteers. HIV/AIDS stigma is widespread, and it is widely accepted that it does not only reflect but also is exacerbated by co-existing stigmas related to poverty, race, gender, substance use, and sexual behaviour (Parker et al., 2002; Parker & Aggleton, 2003; Holloway, Seaton, Taylor, 2004).This study aimed to understand whether HIV/AIDS as a social construct and those living with HIV/AIDS are understood and responded to differently by males and females and those previously classified by the apartheid divisive policy as African and Coloured participants in the context of their daily encounters. Hence, the study investigated whether there is a relationship between race, gender and HIV/AIDS stigma among participants and whether this relationship is mediated by age, educational level, and participants’ household situation. In addition, the study explored whether gendered stigmatization is subscribed to by participants, while it further sought to assess the extent to which participants were exposed to HIV and AIDS; and whether there were gender and racial differences with respect to participants’ perceptions about PLWHA.Finally, the study scrutinized participants’ perceived levels where they believe interventions to eliminate stigma could be prioritized. This study utilized a survey questionnaire drawn up on the basis of qualitative findings in earlier studies on stigma and HIV/AIDS in both ‘African’ and ‘coloured’ communities. Two hundred participants were recruited through a convenience sampling method in the Mitchell’s Plain area of Cape Town, South Africa. The sample was stratified by ‘race’ and gender with the majority between the age of 35 and 49 years; 50.3 % of the respondents in the sample were males, while 49.7 % were females. The majority of the respondents were Africans of Xhosa speaking descent(49.2 %) and coloureds (48.2 %) with a small proportion of whites (2.5 %). All standard ethical procedures for research with human participants were adhered to and the project was registered with the UWC Research & Ethics Committee. All participants responded on the basis of informed consent and consent forms were signed to confirm ethical assurances. Confidentiality of the data was observed and the data was kept in a locked up and secure place for a period of five years after the study. Completed survey questionnaires were coded, and analyzed quantitatively using the Statistical Package for Social Sciences version 17.0 (SPSS) and SAS.Inferential statistics showed highly significant gender differences in participants’ personal stigmatization. More so, personal stigma attitudes were more likely to be found among older males and with means to support their households. Descriptive results showed these older males were less likely to know someone with HIV. The study acknowledged that HIV and AIDS as well as PLWHA are socially constructed and intersected with existing social inequalities on difference and hence, recommends that interventions to address HIV/AIDS stigma need to take cognizance of the contexts in which it occurs. It seems important to address de-stigmatization efforts at coloured families since descriptive results reflect some denial that HIV is a challenge and/or that PLWHA are stigmatized in families and community at large. Gendered constructions of stigma, while impacting on both men and women (since both appear to be stigmatized differently), are clearly still salient and it is recommended that efforts be continually made to raise the way in which gender, class, racialised and other differences of power are being played in community responses to HIV and those living with HIV/AIDS.

Magister Public Health - MPH / According to the Demographic and Health Survey in Zambia the national HIV prevalence among population aged 15-49 years was 14%. In 2002 the Government of Zambia introduced Antiretroviral Therapy (ART) in two of the largest hospitals in Zambia: Lusaka and Ndola hospitals. As many people begin accessing ART in rural areas in Zambia, one of the major challenges is ensuring that those receiving ART adhere to treatment to avoid the emergence of drug resistance and treatment failure. The research therefore set to identify the potential barriers and facilitators to antiretroviral treatment adherence among people living with HIV and AIDS in the rural district of Chongwe,Zambia.A descriptive qualitative study was conducted over a period of three weeks from 11th December to 29th December 2008. The perceptions, opinions and experiences of PLHIV on ART and those of the health workers and treatment supporters were explored through in-depth interviews and focus group discussions. In-depth interviews were conducted with nine persons living with HIV (PLHIV): 5 females and 4 males. Two focus group discussions were conducted with members of 2 different PLHIV support groups from Refunsa and Chimusanya villages served by the ART clinic of St Luke Mission Hospital and another with a group of ART treatment supporters. In addition, interviews were held with five key informants, who were health workers from the ART clinic in St Luke Mission Hospital in Mpanshaya.Reported barriers to adherence among PLHIV in rural areas included experiencing side effects to ART drugs, stopping medication due to improvement in wellbeing, a lack of understanding of the importance of adherence, and forgetting to take their medication due to alcohol consumption. Other barriers included stigma and discrimination, inadequate food to support ART uptake and non disclosure of one’s status for fear of being rejected especially for women who feared rejection in relationships. Another key barrier to adherence was the religious belief held by some PLHIV that one would get healed after being prayed for and therefore discontinued treatment.Key facilitators to adherence identified in the study included getting into a regular routine of taking antiretroviral drugs (ARVs), knowledge of and belief in the efficacy of ART, disclosure of HIV status, access to social support and nutritional support. Other facilitators identified were use of treatment supporters who provided support to PLHIV by providing them with on-going adherence counseling, and making referrals to the ART facility for further support, mobile ART clinics that have brought ART services closer to the rural communities and the adaptation of strategies such as clocks and use of alarms by PLHIV to remind them to take their medication. Although better health resulting from taking ARVs was citied as a barrier to adherence it also acted as a facilitator to adherence as better health motivated PLHIV to continue taking their medication.In conclusion, based on the findings from the study a series of recommendations were made to inform the current ART adherence information and counseling strategies used by the ART facility at St Luke Mission Hospital in Mpanshaya - and other ART programmes being implemented in similar rural health facilities in Zambia. The recommendations included the need for the ART facility to address alcohol abuse among PLHIV taking ART, addressing perceptions on ARVs in the community, reviewing of the counseling programme, caring for treatment supporters, strengthening food security and livelihood opportunities for PLHIV and their families and increasing collaboration between the ART facility and the churches.

Thesis (PhD. (Nursing Science)) --University of Limpopo, 2019 / The ability of professional nurses to support and motivate people living with HIV and AIDS to disclose to sexual partner continue to be a challenge based on the social, economic, psychological and ethical circumstances that surround the process to do so. A qualitative research study using semi-structured interviews with a schedule guide whereby probing questions were used to elicit more data. Two focus groups with 6 professional nurses were also conducted to explore and describe professional nurse’s knowledge and practices as they support People Living With HIV and AIDS (PLWHA) to disclose their positive status to sexual partners. The interviews were carried out in five (5) district hospitals of Limpopo Province, South Africa. Dickoff, James, and Wiedenbach (1968) practice theory guided the study. Study findings revealed that professional nurses do understand the concept but however it is difficult for them to translate and link learning and understanding in the clinical area. Social, economic, psychological and ethical dilemmas pose a challenge for professional nurses to support individuals to disclose to sexual partners. Professional nurses refer individuals with challenges to psychologists and social workers, but however, they do not receive referral back on the outcome. The absence of support groups and link with community-based groups to support PLHWA reduce efforts to improve knowledge on benefits of disclosure to communities led by PLHWA including reduction of stigma and discrimination associated with the diagnosis. The study therefore, recommends a training programme that links the South African Nursing Council statutes, including that of World Health Organization and Department of Health with teaching and learning methods that clarify and simulate real clinical situation to enhance the translation of this policy in the real-life situation. The training programme further suggests a link with community base structures led by PLWHA to enhance disclosure of HIV positive status to a sexual partner, reduction of stigma and discrimination associated with the diagnosis and reduce the incidence of HIV among people living with HIV. Key words: People living with HIV infection, Professional nurses, disclosure of HIV to sexual partners

The delivery of psychosocial support (PSS) services to children living with HIV and AIDS (CLHA) by PSS service providers, such as community-based organisations (CBOs) in resource-poor settings, ensures the availability of consistent and sustainable support to children living with HIV and AIDS. These children face various psychological and social challenges associated with living with HIV and AIDS, such as drug adherence to HIV medication, stigmatisation and distress, among others. This qualitative study explored the critical factors that influence the delivery of community-based PSS services to CLHA younger than 15 years of age in a resource-poor setting by a community-based organisation. Multiple data-collection tools were adopted. The findings revealed the critical factors that contributed to the delivery of community-based PSS services to CLHA, and also ways in which these important services could be improved. / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

The delivery of psychosocial support (PSS) services to children living with HIV and AIDS (CLHA) by PSS service providers, such as community-based organisations (CBOs) in resource-poor settings, ensures the availability of consistent and sustainable support to children living with HIV and AIDS. These children face various psychological and social challenges associated with living with HIV and AIDS, such as drug adherence to HIV medication, stigmatisation and distress, among others. This qualitative study explored the critical factors that influence the delivery of community-based PSS services to CLHA younger than 15 years of age in a resource-poor setting by a community-based organisation. Multiple data-collection tools were adopted. The findings revealed the critical factors that contributed to the delivery of community-based PSS services to CLHA, and also ways in which these important services could be improved. / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)