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 assessed healthcare providers’ knowledge, attitudes and practices towards IPT provision for people living with HIV (PLHIV) in Addis Ababa, the capital city of Ethiopia. A quantitative, descriptive, cross-sectional study design was used for the study and data was collected using a self-administered questionnaire from 104 clinicians working in ART clinics. The findings show that healthcare providers who participated in this study had a mean value of high knowledge, positive attitude and good practice towards IPT provision for PLHIV. Significant association was found between knowledge and attitude (P=0.000) but no significant associations were found between knowledge and practice, attitude and practice as well as between the type of facility (public/private) and level of practice. This implied that, the low level of IPT implementation in Addis Ababa doesn’t seem due to health care providers’ lack of knowledge and resistance to provide IPT for people living with HIV. As a result, the researcher recommends for further researches of other possible factors like; the reliability of IPT information/data management, drug supply and the leadership and governance of the health system that IPT program is a direct concern. / Health Studies / M. Public Health (with specialisation in Medical Informatics)

The purpose of this study was to determine how pain in PLHIV on community home based care programme was managed using the Roy adaptation model (RAM) as the theoretical framework. This study used a descriptive mixed method research design which allowed for the research topic to be investigated and described in terms of both narrative qualitative accounts and descriptive statistics. A sequential exploratory approach was adopted in which qualitative data collection was conducted in the initial phase followed by quantitative data collection. Ten qualitative interviews, guided by the components of the RAM were conducted in the initial phase and a structured interview schedule (questionnaire) partially based on the result of the qualitative phase and (which was also structured in accordance with the RAM) was administered to 120 respondents who met the inclusion criteria of being on CHBC. Convenience sampling was used to select study participants and respondents in both phases of the study. Peripheral neuropathy was the most common pain syndrome experienced by patients. More females suffered numbness/tingling sensation of toes, followed by chest pains than their male counterparts. Pain experienced was moderate to severe which was not treated effectively. The study findings could assist health care providers, policy makers and researchers to invest into improving pain management for PLHIV, strengthen education of patients and their primary caregivers on the causes of pain and modalities to employ for pain relief and implement palliative care guidelines for PLHIV. / Health Studies / D. Litt. et Phil. (Health Studies)

Text in English / The South African government provides people living with HIV Temporary Disability Grants to assist them with money when they cannot work due to being disabled by HIV. The toll of the disease has contributed to the inability to be employed among black South Africans. The aim of this exploratory qualitative study was to investigate the challenges experienced by people living with HIV when their Temporary Disability Grants are terminated in the semi-urban area of Gauteng. The temporary disability grant is terminated after six months of receiving it. In-depth interviews were conducted with people who live with HIV who are members of Ekupholeni Mental Health and Trauma Centre support group. Thematic analysis was used to analyse data. The findings of the study revealed that the termination of Temporary Disability Grant affects the running of the households of people living with HIV, causes poor management of the disease, non-adherence to treatment which leads to viral rebound, poor nutrition as a result of poor finances. The findings of this study are significant for the policy review on how long a person should receive the disability grant and the criteria used to apply for a disability grant, and to encourage the people living with HIV to start their own gardening programmes for food supply. Moreover, to encourage the introduction of a Chronic Disease Grant (CDG) for people who live with HIV. / OKUFINYEZIWE Uhulumeni waseNingizimu Afrika uhlinzeka abantu abaphila ne-HIV Izibonelelo Zesikhashana Zabaphila Nokukhubazeka, ama-Temporary Disability Grants, ukubasiza ngemali ngesikhathi bengakwazi ukuthi bayosebenza ngesizathu sokukhubazeka ngenxa ye-HIV. Ubunzima balesi sifo sebubenomthelela wokuthi kube nokungaqasheki kwabantu abamnyama baseNingizimu Afrika. Injongo yalolu cwaningo oluchaza kabanzi kwakuwukuphenya ngezinselelo ezibhekana nabantu abaphila ne-HIV uma Izibonelelo Zesikhashana Zabaphila Nokukhubazeka zinqanyulwa endaweni yasemalokishini aseGauteng. Isibonelelo sesikhashana sabaphila nokukhubazeka sinqanyulwa emva kokutholakala kwaso izinyanga eziyisithupha. Ukuxoxisana okunzulu kwenziwa nabantu abaphila ne-HIV abangamalungu esikhungo Sezempilo Yangokomqondo, Ekupholeni nabayiqembu lokusekelana Lesikhungo Sokuphazamiseka Emqondweni. Ukuhlaziywa kwale ndikimba kwenziwa ukucwaninga imininingwane eyayiqoqiwe. Okwatholwa yisifundo kwaveza ukuthi ukunqanyulwa Kwesibonelelo Sesikhashana Sabaphila Nokukhubazeka kuthikameza ukuqhubeka ngendlela efanele kwamakhaya abantu abaphila ne-HIV, kubangele ukungalawuleki kahle kwesifo, ukungabambeleli ekuphuzweni kwemithi okubangela ukuthi igciwane lihlasele kabusha, ukungadli ngokufanele ngenxa yokuswela imali. Okutholakala kulolu cwaningo kusemqoka ekubuyekezweni kwenqubomgomo yokuthi kumele umuntu anikezwe isibonelelo sokuphila nokukhubazeka isikhathi esingakanani kanye nemigomo esetshenziswayo ukufaka isicelo semali yesibonelelo sokuphila nokukhubazeka, kanye nokukhuthaza abantu abaphila ne-HIV ukuthi baqale izinhlelo zabo zezingadi ukuze bathole ukudla. Ngaphezu kwalokho, ukukhuthaza ukuqala ukusebenzisa Isibonelelo Sezifo Ezingelapheki, i-Chronic Disease Grant (i-CDG) sabantu abaphila ne-HIV. / KGUTSUFATSO Mmuso wa Afrika Borwa o fana ka Dithuso tsa Nakwana ho batho tshwerweng ke HIV le ba Koafetseng ho ba thusa ka tjhelete nakong eo ba sa sebetseng ka lebaka la ho tshwarwa ke HIV le ho koafala. Sekgahla sa kokwana se bakile bothata ba ho hloka mesebetsi ka hara batho ba batsho ka hara Afrika Borwa. Maikemisetso a dipatlisiso tsena ke ho hlahloba diphephetso tseo batho ba phelang ka HIV ba kopanang le tsona nakong eo Dithuso tsa Nakwana tsa ho Kowafala di felang dibakeng tsa seka-ditoropo Gauteng. Dithuso tsa Nakwana tsa ho kowafala di fihla pheletsong ka moea dikgwedi tse tsheletseng ka mora ho di fumantshwa. Di-inthavu tse tebileng di ile tsa tshwarwa le batho ba phelang ka HIV bao e leng ditho tsa sehlopha se tshehetsang sa Ekupholeni Mental Health and Trauma Centre. Manollo ya mookotaba o ile wa sebediswa bakeng sa ho sekaseka lesedi. Tse fumanweng ka hara dipatlisiso tsena di hlahisa hore ho fela ha Dithuso tsa Nakwana tsa Ditjhelete di ama tsamaisong ya malapa a batho ba phelang ka HIV, di baka taolo e fokolang ya bohloko, ho se ikamahanye le phekolo ho etsang hore bohloko bo kgutle hape, phepo e sa lokang e bakwang ke tjhelete e nyane. Tse fumanwanwang ka hara dipatlisiso tsena ke tsa bohlokwa bakeng sa hore maano a shejwe hape mabapi le hore e k aba nako e kae moo mokudi a lokelang ho fumantshwa thuso, mmoho le tsela e sebediswang ho etsa kopo ya dithuso tsa bokowa, le ho kgothalletsa batho ba phelang ka HIV hore ba iqalle manane a temo bakeng sa phepelo ya dijo. Ho feta moo, ho kgothaletsa ho hlahiswa ha Dithuso tsa Mahloko a sa foleng (Chronic Desease Grant) bakeng sa batho ba phelang ka HIV. MANTSWE A SEHLOOHO Bokowa, dithuso tsa bokowa, baamohedi ba dithuso tsa bokowa, batho ba phelang ka HIV le AIDS, ho fela ha dithuso tsa bokowa le phekolo ka dipidisi tsa anthiritrovaerale. / Sociology / M.A. (Sociology (Social Behaviour Studies in HIV and AIDS))

This quantitative study sought to identify and describe factors influencing HIV disclosure and sexual practices among 340 PLWHA on ART at Mbabane National Referral VCT/ART Centre, Swaziland. Data were collected using a structured questionnaire. A high general HIV disclosure rate (94.1%; f=320; N=340) was observed of which 57.5% (f=184; n=320) was to sexual partners. X2 procedures indicate an association with gender, residential region, religion, and period of being on ART. The majority (70.2%; f=179; n=255) of the respondents used condoms all the time to avoid infecting their sexual partners (99.2%; f=243; n=245) and to avoid contracting STIs (99.2%; f=243; n=245). X2 procedures indicate an association with gender, residential region, marital status, number of sexual partners, knowledge of the HIV status of sexual partners and period of being on ART. The single leading reason for not using the condom was sexual partners’ refusal to use condoms (85.7%; f=54; n=63). / Health Studies / M.A.(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)

Stigma and discrimination (SAD) attached to Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has been recognised as a major obstacle to HIV prevention, treatment, care and support throughout the world. SAD is more devastating when it occurs in health care settings where it is least expected. Health care providers (HCPs) are supposed to provide physical, social and psychological support to people living with HIV (PLWHA) but HIV and AIDS-related SAD has been extensively documented among the HCPs. Different studies have pointed out that there are three major actionable causes of HIV-related SAD in health care settings. These are lack of awareness among HCPs, fear of casual contacts and associating the SAD to immoral behaviour. The main objective of the current study is to determine the magnitude of HIV and AIDS-related SAD and its associated factors in hospitals and then to propose appropriate SAD reduction-intervention strategy in the health care settings. The study employed pre-test-post-test design with non-equivalent control group. Two paradigms were used in this study including quantitative and qualitative approaches. The sampling method for the quantitative part of the study was probability sampling in which the respondents were randomly selected using stratified sampling technique. The study was able to determine the magnitude of HIV and AIDS-related SAD among the HCPs. Moreover, the study has identified the factors that are attributed to the prevalence of SAD in the hospitals. The major factors identified for causing the SAD in the hospitals were sex, age, work experience, low level of knowledge, negative attitudes and percieved risk of HIV infection of some HCPs toward the PLWHA. The intervention made on the respondents in the treatment group was able to reduce the overall prevalence of the SAD among the HCPs. The study suggests that to reduce the SAD, HIV and AIDS-related trainings before and after graduation is critical to improve the knowledge, attitudes and practices of the HCPs. Besides, ensuring the availability of the protective supplies in hospitals is crucial in reducing the fear of HIV infection among the HCPs while providing care for HIV positive patients. Effective implementation of the hospital policies, strategies, guidelines and protocols along with good institutional support is also vital in creating safe and user-friendly hospitals for PLWHA. / Health Studies

Stigma and discrimination (SAD) attached to Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has been recognised as a major obstacle to HIV prevention, treatment, care and support throughout the world. SAD is more devastating when it occurs in health care settings where it is least expected. Health care providers (HCPs) are supposed to provide physical, social and psychological support to people living with HIV (PLWHA) but HIV and AIDS-related SAD has been extensively documented among the HCPs. Different studies have pointed out that there are three major actionable causes of HIV-related SAD in health care settings. These are lack of awareness among HCPs, fear of casual contacts and associating the SAD to immoral behaviour. The main objective of the current study is to determine the magnitude of HIV and AIDS-related SAD and its associated factors in hospitals and then to propose appropriate SAD reduction-intervention strategy in the health care settings. The study employed pre-test-post-test design with non-equivalent control group. Two paradigms were used in this study including quantitative and qualitative approaches. The sampling method for the quantitative part of the study was probability sampling in which the respondents were randomly selected using stratified sampling technique. The study was able to determine the magnitude of HIV and AIDS-related SAD among the HCPs. Moreover, the study has identified the factors that are attributed to the prevalence of SAD in the hospitals. The major factors identified for causing the SAD in the hospitals were sex, age, work experience, low level of knowledge, negative attitudes and percieved risk of HIV infection of some HCPs toward the PLWHA. The intervention made on the respondents in the treatment group was able to reduce the overall prevalence of the SAD among the HCPs. The study suggests that to reduce the SAD, HIV and AIDS-related trainings before and after graduation is critical to improve the knowledge, attitudes and practices of the HCPs. Besides, ensuring the availability of the protective supplies in hospitals is crucial in reducing the fear of HIV infection among the HCPs while providing care for HIV positive patients. Effective implementation of the hospital policies, strategies, guidelines and protocols along with good institutional support is also vital in creating safe and user-friendly hospitals for PLWHA / Health Studies / D.Litt. et Phil. (Health Studies)

This study assessed healthcare providers’ knowledge, attitudes and practices towards IPT provision for people living with HIV (PLHIV) in Addis Ababa, the capital city of Ethiopia. A quantitative, descriptive, cross-sectional study design was used for the study and data was collected using a self-administered questionnaire from 104 clinicians working in ART clinics. The findings show that healthcare providers who participated in this study had a mean value of high knowledge, positive attitude and good practice towards IPT provision for PLHIV. Significant association was found between knowledge and attitude (P=0.000) but no significant associations were found between knowledge and practice, attitude and practice as well as between the type of facility (public/private) and level of practice. This implied that, the low level of IPT implementation in Addis Ababa doesn’t seem due to health care providers’ lack of knowledge and resistance to provide IPT for people living with HIV. As a result, the researcher recommends for further researches of other possible factors like; the reliability of IPT information/data management, drug supply and the leadership and governance of the health system that IPT program is a direct concern. / Health Studies / M.A. (Public Health (with specialisation in Medical Informatics))

The researcher investigated the knowledge, attitudes and experiences of people living with the Human Immunodeficiency Virus (HIV) towards antiretroviral treatment (ART) and who are accessing antiretroviral treatment at a public health clinic in Limpopo, South Africa. A qualitative method was used. The research findings revealed five themes: experiences, social support, knowledge, attitudes, unemployment and economic themes of the study. Factors reported influencing optimum adherence were the inability of the patients to take medication at work, laziness of the patients to collect medication, unemployment, economic hardship, poverty and lack of knowledge of employers regarding HIV/AIDS. / Health Studies / M.A. (Social Behaviour Studies in HIV and AIDS)