A dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Arts (Clinical Psychology) in the Department of Psychology University of Zululand, 2008. / Since the surfacing of HIV and AIDS epidemic in South Africa, various programs were implemented in order to educate and prevent the spread of this devastating disease. The Department of Health in South Africa therefore implemented the Voluntary Counseling Testing (VCT) programs across the country in workplaces, tertiary institutions, clinics as well as in hospitals. However in spite of these attempts current studies indicate that the spread of HIV and AIDS is escalated particularly amongst the people between the ages of eighteen and thirty. With so many available VCT sites and centers that provide information about the disease and an opportunity to test for one's sero-status, one would expect not hear such an increase in new HIV/AIDS infections! In view of the above a qualitative study was therefore undertaken to find out from the twenty five students who took part in this study. The aim of the research study is to find from the students who utilize the VCT program services at the University of Zuluiand their experiences about the program, what they appreciate about it and what can be done in order to ensure an efficient service which is in line with the South African HIV/AIDS Strategic Plan 2000 - 2005.

The health of University students is important as these individuals are central to the future economic sector. Since HIV/AIDS is a major public health threat in South Africa (SA), it is vital to develop health initiatives that aim to reduce the HIV prevalence rate among youth and to promote positive health behaviour. Voluntary Counselling and Testing (VCT) is one such initiative. The National Department of Health (NDoH) recently implemented the „First Things First‟ campaign that aims to promote VCT among youth. In line with the NDoH‟s initiative, this study explored the factors that shape attitudes towards VCT among first year students at the University of the Witwatersrand (WITS). This study was conducted using a combination of quantitative and qualitative research methods. The respondents included 195 first year students out of approximately 220 who participated in a survey and two key informants in the field of HIV/AIDS whom I interviewed. With regards to ethical considerations, the study protected the respondent‟s rights by maintaining anonymity of all survey participants and exercised care that the human rights of individuals and the reputation of WITS as an institution were safeguarded. Based on conceptual models of health behaviour, the study identified factors that shaped students responses to VCT. The results of this study indicate that youth at WITS go for VCT mainly to know their HIV status. This is being triggered by them knowing someone who has either; been for VCT, is living with HIV or passed away due to AIDS. In addition, the free availability and easy accessibility of VCT services on campus and the positive influence of peers through social mobilisation were regarded as key motivations for students accessing VCT. However, some students seem to not access VCT services due to personal fears of rejection, blame and discrimination if they were to be found HIV-positive. The gendered dynamics and nature of clinics together with the poor attitudes of some health service providers were also major barriers to VCT uptake among youth. The findings conclude that many students know that VCT is a necessary and beneficial process. It also found that there are multiple factors that work together in complex ways to shape the reasons why youth choose to „test‟ or not to „test‟ for HIV.

Background: Voluntary HIV counselling and testing (VCT) is considered one of the key strategies in the prevention and control of HIV/AIDS in South Africa. However its role in modifying risky sexual behaviour among patients tested as HIV-negative (primary prevention) is controversial. Objective: This study was intended to demonstrate the likelihood of VCT reducing risky sexual practices among patients testing sero-negative for HIV infection. Methods: This is a quantitative cross-sectional survey that took place over a period of 3½ months in a district hospital in rural South Africa. A self-administered questionnaire was completed by 54 patients who had VCT and tested sero-negative for HIV infection during the previous 12 months (Study Group). The same questionnaire was filled in by 61 patients who had never received VCT before (Control Group). Both groups consisted of women and men aged 18 years or older. Socio-demographic information, sexual behaviour, willingness to disclose the HIV sero-status with the sexual partner, and readiness to have VCT were asked in the survey. To compare differences between two independent proportions the Pearson Chi-square test was used. Significant results were regarded as a p-value of less than 0, 05, which was taken as an indication of association between VCT and the variable being measured. Results: The median age of our sample was 29 years (Interquartile Range 24-40), with most of the respondents (38 %) between the ages of 26 and 35 years. More than 90 % of patients in both groups reported being sexually active. Sexual intercourse with more than one partner was significantly lower in the Study group (p=0,003). Those who had never received VCT before had a higher (although not significant) incidence of episodes of unprotected sexual intercourse and symptoms of sexually transmitted infections (STIs) (81, 9 % and 42, 6 % respectively) when compared to the study group (77, 7 % and 35, 1 %). Most of the participants in both groups did not consider the disclosing of their sero-status an issue of concern for their sexual partner(s). Readiness to receive VCT was significantly higher in the study group (p=0, 02). Conclusions: In this study, people who tested sero-negative for HIV through VCT showed a significant decrease in the number of sexual partners as compared to the control group who did not undergo VCT. The VCT group had less unprotected sexual intercourse and less symptoms of STIs than the control group.

Background: Countries in sub-Saharan Africa are scaling up access to Voluntary Counselling and Testing (VCT) services as a strategy for HIV prevention, treatment, care and support. The international and national push to achieve targets for anti-retroviral therapy scale up has emphasised VCT as an entry point to treatment, with follow-up mostly directed at those who test positive. Yet over 60% of those testing are HIV negative. Limited understanding of how HIV voluntary counselling and testing, and receipt of a negative result impact on sexual behaviour has resulted in underdeveloped support for those testing HIV negative. Aims: To gain the perspective of those who have tested HIV-negative on the following: (1) the decision making process that precedes attendance for voluntary counselling and testing; (2) how voluntary counselling and a negative test result influence sexual behavioural intentions and reported subsequent behaviour; and (3) support systems and networks that would enhance the respondent’s ability to remain HIV negative. Method: Qualitative longitudinal study utilising semi-structured interviews, six months apart, with people who have tested negative and three one-off focus group discussions with counsellors. Participants were purposively sampled from VCT centres in two mining towns in Zambia. Interviews were digitally recorded, transcribed verbatim and analysed thematically with the aid of the qualitative data analysis software, Nvivo7. Cross-sectional analysis of all data sets was conducted and paired transcripts were analysed longitudinally to assess change over time. Results: Forty-two HIV-negative people were interviewed, with thirty-one returning for the follow-up interview (74% return rate). VCT was perceived as ‚testing for HIV‛. Before attending VCT most participants had gone through a protracted period of angst, resulting in a resolution to reduce number of partners, use condoms or abstain from sex. Counselling affirmed life choices, rather than initiating them. Although perception of the risk of HIV increased, misconceptions about HIV transmission persisted post-counselling. The negative test result provided impetus and resolve to implement or maintain life change. Themes identified were: (1) recognising personal susceptibility to HIV infection; (2) emotional and cognitive engagement with the problem of testing; (3) a driving need to know status (regardless of test result); and (4) empowerment and being in control providing the ability to plan for the future. Analysis of post-test support needs revealed two further themes: (1) reinforcement of behaviour change through additional knowledge, supportive networks, and life-skills training; and (2) access to recreational activities. There was no reported post-test increase in unsafe sexual behaviour among those that returned for the follow-up interview. Focus group findings reinforced those from interviews. Conclusions: This study has shown that in this population of people who tested HIV-negative: 1. the majority made life changes before attending VCT and used VCT to know their status 2. counselling consolidated pre-test decisions about risk behaviour and testing provided motivation to adopt safer behaviour and to maintain previous low- or no-risk behaviour and 3. there is a felt need for post-testing recreational activities, further HIV/AIDS education and participation in HIV prevention activities. Recommendations include: (1) the promotion of community-based interactive one-to-one and group information, education and communication (IEC) (to aid understanding and progression to the point where testing appears to be of optimum benefit) ; (2) referral to post-test support options such as support groups and inclusion on a text messaging list should be made available; and (3) post-test intervention strategies, for example, provision of result-specific IEC materials and active involvement in prevention activities should be developed and evaluated.

Thesis (M Med.(Family Medicine))--University of Limpopo, 2010. / OBJECTIVE: In 2007 36% of the pregnant women tested positive for HIV at Embhuleni Hospital and its satellite clinics. However, only one quarter of those returned to the wellness clinic for their CD4 results so as to begin with Anti-Retrovirus Therapy (ART) if they qualified. The rest would not return to the wellness clinic, and would only present late with opportunistic infections or a subsequent pregnancy. The study aimed at exploring the reasons why women who had been tested for HIV by means of VCT failed to return for their CD4 results, to understand those reasons, to determine what information was given to them before they were tested, to assess the availability of personal support systems (family, friends, etc), and finally to assess the women’s understanding of HIV/AIDS, for which they were tested. METHODS: A descriptive qualitative study was conducted using the free attitude interview technique for data collection. The Ante-natal care (ANC) clinic register of the Embhuleni Hospital was used to trace patients who had consented for voluntary counselling and testing (VCT), but who had since not returned for their results after 30 days of testing. Those patients were visited at their places of residence by the research team (interviewing nurse and the researcher) to request them to participate in the study. The exploratory question was: “May you tell us why you did not come back for your HIV test results?” “Sicela usichazele kutsi yinindzaba ungasetanga kutewuhlola imiphumela yakho yengati? (SiSwati Version). The interviews were audio recorded and field notes taken. The interviewer sought clarification for unclear issues raised, and gave reflective summaries at the conclusion of each idea under discussion. The interviews continued until there was information saturation. In this study, was reached at respondent number nine. The audio-tapes were transcribed verbatim, followed by translation into English. The emerging themes formed the basis for the write-up. RESULTS: The following themes emerged:  Communication between health care workers and patients Poor quality of communication (patients not told to come back)  Knowledge on HIV/AIDS and PMTCT Patients had poor knowledge of HIV/AIDS and PMTCT  Fear of stigma for HIV/AIDS The community associated coming back for the results with being HIV positive  Poor patient support Poor family support system for the patient Limited patient financial resources  Experience at the health facilities Lack of patient privacy Attitude of the health care workers not acceptable to patients CONCLUSION: The factors that resulted in non-return of the pregnant women to the facility for their results were that the women were not made aware that they were to return for their results; poor quality of communication by the hospital staff; unpleasant experiences by patients at the facility; patients feared community stigmatisation; there was lack of patient support, and the patients had poor knowledge of HIV/AIDS and PMTCT

<p><font face="Times New Roman" size="3"><font face="Times New Roman" size="3"> <p align="left">Despite wide acceptance of Voluntary Counselling and Testing (VCT) as a crucial entry point for the prevention, treatment, care and support of HIV-infected persons / the prevalence of testing in Ethiopia remains very low. A review of the literature identifies the set of factors that influence HIV testing of individuals to include socio-economic and demographic factors, knowledge of HIV/AIDS, risk perception, fear of stigma, social capital and the perceived benefit of VCT. By drawing assumptions based on the known literature, this mini-thesis explores the relationship between VCT usage and the above factors in order to explain the status of HIV testing in Moher and Aklil district, Gurage Zone, Ethiopia. The study hopes to address the dearth of material on VCT and contribute to it in a non-clinical and rural context.</p> </font></font></p>

An understanding of individual cognitions that influence both behavioural intentions and the enactment of actual behaviours is provided by the conceptual model of the Theory of Planned Behaviour (TPB). This study used the Theory of Planned Behaviour, with the added variable of perceived risk, to predict Kenyan students’ intention to use HIV voluntary counselling and testing (VCT) centres within the country. We conducted a survey questionnaire with 200 students, aged 13-15 years, within high schools in the Nairobi and Nakuru districts in May 2009. Chi-squared analysis showed no relationships between age, school, school level, knowledge of a VCT centre, or past sexual experience with intention to uptake HIV counselling and testing. Pearson product-moment analysis revealed a small positive correlation between attitude and subjective norm and a medium negative correlation between perceived behavioural control and perceived risk. One-way analysis of variance showed a relationship between perceived behavioural control and intention. Results of block entry logistic regression analysis indicate that perceived behavioural control and perceived risk were significant predictors of intention to use VCT services in the TPB model. The present study suggests that Kenyan teens’ perceived ease/difficulty in performing a specific behaviour is the most influential aspect in predicting their subsequent intention to carry through the behaviour. A theory-based intervention program should focus on reducing practical barriers related to the use of VCT services. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2009-12-04 10:06:25.104

<p><font face="Times New Roman" size="3"><font face="Times New Roman" size="3"> <p align="left">Despite wide acceptance of Voluntary Counselling and Testing (VCT) as a crucial entry point for the prevention, treatment, care and support of HIV-infected persons / the prevalence of testing in Ethiopia remains very low. A review of the literature identifies the set of factors that influence HIV testing of individuals to include socio-economic and demographic factors, knowledge of HIV/AIDS, risk perception, fear of stigma, social capital and the perceived benefit of VCT. By drawing assumptions based on the known literature, this mini-thesis explores the relationship between VCT usage and the above factors in order to explain the status of HIV testing in Moher and Aklil district, Gurage Zone, Ethiopia. The study hopes to address the dearth of material on VCT and contribute to it in a non-clinical and rural context.</p> </font></font></p>

Dyadic data analysis methods are underutilized in child and youth care, where much of the practice relies on relationships with individuals and groups. In this exploratory study, a dyadic data analysis approach was used to study the interdependence amongst client-counsellor dyads in a voluntary counselling setting. Ten counsellors and thirty-six clients from a Canadian voluntary counselling agency participated in this study. Counselling sessions ranged from two to 20 sessions. Clients completed a session rating scale, a measure of the therapeutic alliance. In addition, clients and counsellors completed an outcome rating scale and personal change questions. A one-with-many design was used to explore the similarity between client-counsellor dyads, the degree of consensus, assimilation, and uniqueness as well as the level of reciprocity for perceived client well-being. Multi-level modeling was used to partition the variance on the outcome rating scale to account for sources of non-independence in client-counsellor dyads, and the indirect relationships between multiple clients working with the same counsellor. Implications of the study and recommendations for future research are discussed. / Graduate

Voluntary counselling and testing (VCT) has become a vital process in combating the spread of HIV/AIDS. Yet little has been published on how students experience the process of VCT. This study sought to describe and understand the experiences of voluntary counselling and testing among four students at Tshwane University of Technology. This research project focussed on students’ experiences when reporting for voluntary counselling and testing. The results were used to make recommendations for strategies to increase the accessibility and uptake of VCT by students. Using a phenomenological approach, tape recorded interviews were conducted with the four students of Tshwane University of Technology (TUT). The data were then categorised into five themes relating to the experience of VCT: emotions, perceptions, actions, thoughts and desires. The results showed that the students were mostly dissatisfied with the VCT clinic’s procedures and the counsellor’s attitudes. Also evident from this study was that counsellors’ professionalism, peer support, and a service that offers both pre- and post-test counselling play a significant role in students’ use of VCT. The findings of this study suggest that the following could be used as strategies to motivate students to utilise VCT services of VCT: (1) increase access and acceptability of VCT for students; (2) ensure access to factual information in the form of counselling; (3) make counselling a priority. / Dissertation (MA)--University of Pretoria, 2008. / Psychology / unrestricted