<p>HIV counselling and testing (HCT) is an essential element in the response to the HIV epidemic. There are still major gaps in research about the best ways to provide HCT, especially to young people. School-based HCT is a model which has been suggested for providing HCT to young people in a youth friendly manner. This study was aimed at producing recommendations for providing a youth friendly school-based HCT service using the World Health Organisation (WHO) framework for youth friendly health services. It was conducted in six secondary schools in Cape Town, where a mobile HCT service is provided by a nongovernmental organisation (NGO). It was an exploratory descriptive study, using a mixed-methods approach. Twelve focus group discussions (FGDs) were held with learners to explore their needs with regards to school-based HCT. An evaluation (which consisted of observation of the HCT site, service provider interviews and direct observation of the HCT counselling process) was done to determine whether the mobile school-based HCT service was youth friendly. A learner survey was conducted with 529 learners to investigate the factors that influence the uptake of HCT and to explore learners&rsquo / behaviours and experiences under test conditions. In the FGDs, learners said that they wanted HCT to be provided in schools on condition that their fears and expressed needs were taken into account. They wanted their concerns regarding privacy and<br /> confidentiality addressed / they wanted to be provided with information regarding the benefits and procedure of HCT before testing took place / they wanted service providers to be competent to work with young people, and they wanted to be assured that those who tested positive were followed up and supported. On evaluation of the mobile school-based HCT service, it was evident that the service did not meet all the needs of the learners nor did it have all the characteristics of a youth friendly health service. The model of &lsquo / mass testing&rsquo / used by the NGO did not fulfil learners&rsquo / expressed need for privacy with regards to HCT. Service providers were friendly and non-judgemental but had not been trained to work with young people (especially marginalised groups e.g. young men who have sex with men). The information needs of learners were not addressed, and learners were not involved in the provision of the HCT service. Learners who tested positive were not assisted in accessing care and support. The learner survey revealed a high uptake of HCT (71% of learners) at schools with learners who do not identify themselves as Black, with female learners and older learners being more likely to have had an HIV test. Factors that influenced uptake of HCT were complex, with learners reporting many different motivators and barriers to testing. Of concern was the low risk perception of leaners with regards to HIV infection and the fact that learners who tested HIV positive were not being linked up with treatment and care. Based on the findings of the study, recommendations were made for providing youth friendly schoolbased HCT. A multisectoral approach, with learner and community involvement, was suggested in order to provide a service which is equitable, accessible, acceptable, appropriate and effective.</p>

Magister Scientiae Dentium - MSc(Dent) / Aim The aim of the study was to determine the oral health knowledge,management and referral patterns of patients with oral manifestations of HIV by Primary Health Care Nurses.Background Nurses working in Primary Health Care (PHC) facilities, and nursing educators, play a pivotal role in the early identification, referral and diagnosis of patients who present for treatment of health problems. They are in an ideal position to identify HIVinfected persons through a simple visual assessment of the mouth, in order to diagnose oral lesions that may be prognostic of HIV, and to then refer these persons for voluntary counselling and testing (VCT). Timely referral will lead to early medical intervention, with lower treatment costs and improved patient quality of life.Methods The study design comprised of a pre- and post-education test, training and provision of educational material, together with a quantitative and qualitative selfadministered questionnaire. The questionnaire gathered information on nurses demographics,experience, knowledge, training and treatment practices.The study design was a cross-sectional survey which was conducted during the period July to October 2010. The study population consisted of 121 nurses based at Primary Health Care and nursing education facilities within the uMgungundlovu Health District in KwaZulu-Natal. The chi-squared test was utilised to determine the statistical significance of the preeducation and post-education test results and Pearsons Correlation Coefficient was used to determine the significance of correlations between variables. A p-value of <0.05 was regarded as being statistically significant.Results A large number of the respondents did not receive substantial oral health education during both their pre-qualification and post-qualification education stages. Nurses had an inadequate knowledge of oral health assessment and of oral conditions, especially with regard to the common prognostic oral manifestations of HIV. The post-test results were statistically significant (p< .0001), indicating that the provision of education and training to the nurses had a significant impact on nurses knowledge of oral conditions. More than twothirds of the nurses (67,8%) reported that they do not examine the mouth as part of routine overall assessment of the patient, and only 13% referred patients for VCT.Conclusions There is a need to include oral health assessment and oral health promotion into both undergraduate and post-graduate nursing curricula. Further research is needed to identify the specific oral health training needs of all categories of nurses in order to overcome the barriers that prevent nurses from assessing the mouth. Oral health assessment and oral health promotion should become a key part of the curricula of nurses training. The use of oral health promotion workers at a primary health care level should also be considered.

The study sought to explore and describe the breastfeeding practices of Human Immunodeficiency Virus (HIV) positive postnatal clients’ non-commitment to exclusive breastfeeding in George Mukhari Hospital, South Africa. A non-experimental quantitative design was used. Inferences drawn from the study were that HIV positive clients that opted for exclusive breastfeeding did not commit for fear of transmission of HIV to the baby and exclusive breastfeeding was stopped before the recommended 6 months. Most of the respondents’ partners did not come for counselling. There was lack of emotional support by staff after testing. Health education and emotional support of HIV positive clients has to be intensified. / Health Studies / M. A. (Health Studies)

The study sought to explore and describe the breastfeeding practices of Human Immunodeficiency Virus (HIV) positive postnatal clients’ non-commitment to exclusive breastfeeding in George Mukhari Hospital, South Africa. A non-experimental quantitative design was used. Inferences drawn from the study were that HIV positive clients that opted for exclusive breastfeeding did not commit for fear of transmission of HIV to the baby and exclusive breastfeeding was stopped before the recommended 6 months. Most of the respondents’ partners did not come for counselling. There was lack of emotional support by staff after testing. Health education and emotional support of HIV positive clients has to be intensified. / Health Studies / M. A. (Health Studies)

M.A. (Public Management and Governance) / The study deals with the effectiveness of the HIV/AIDS policy in City Power Johannesburg (CPJ). HIV/AIDS is a worldwide pandemic. Sub-Saharan Africa is the worst affected and very little is being done to suppress its destructive nature. All administrative spheres need to implement workplace policies, procedures and programs to curb and eventually eliminate any new infections and the spread of the pandemic. Whilst workplace policies are a statement of intent and are formulated to guide decision making, they are only effective when formulated, implemented, monitored and evaluated, and reviewed strategically. The methodological approach adopted in this study is qualitative by nature and interpretative. For this dissertation to achieve its purpose, the main study objectives were to determine the objectives of the current HIV/AIDS policy in CPJ, to determine how these objectives have been achieved and what measures could be taken if these objectives are not achieved? The dissertation proposed that in order to curb the pandemic in CPJ, the HIV/AIDS policy will only attain policy effectiveness if various interventions are implemented and adhered to.

<p><font face="Times New Roman" size="3"><font face="Times New Roman" size="3"> <p align="left">The aim of the study is to explore the barriers associated with low VCT uptake by the TB patients attending primary health care clinics within the Buffalo City municipality. <font face="Times New Roman" size="3"><font face="Times New Roman" size="3">The study population was drawn from TB patients attending the primary health care facilities in Buffalo city municipality in the Eastern Cape Province. Eight participants were purposively selected to include those who had accepted VCT as well as those who did not.</font></font></p> </font></font></p>

<p>This study assessed the knowledge, attitudes and practices about MC as an HIV prevention intervention among adult males presenting for HIV Voluntary Counselling and Testing (VCT) services at Onandjokwe District Hospital in northern Namibia. A high level of knowledge of MC, particularly its potential to reduce the risk of HIV infection, STIs and enhance penile hygiene exists among VCT attendees in Onandjokwe District Hospital. MC will most likely to be accepted in this study area, especially when it is implemented to reduce the risk of HIV infection. The study recommends a comprehensive education and information program targeting males and their partners and a training for traditional and medical circumcisers to ensure a high quality of MC services.</p>

Counselling services as provided by non-professional counsellors have been in place for a number of decades. Counselling traumatised people demands a significant amount of emotional investment from the counsellor. A neglected area as far as non-professional counsellors in South Africa is concerned, is the well-being of the counsellors. Burnout as well as its antithesis, work engagement, are two possible transactional outcomes impacting on the well-being of these counsellors. The measurement of burnout and work engagement requires valid and reliable measuring instruments. The dearth of research studies in the area of burnout and work engagement, together with the unique contribution of non-professional counsellors in organisational settings, has led to the primary focus of this study being the exploration of the experience of this group of counsellors doing trauma counselling in financial institutions in South Africa. A lack of norms for the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), and the Utrecht Work Engagement Scale (UWES) for non-professional counsellors doing trauma counselling makes the identification of burnout and work engagement within this specialist environment difficult. Consequently, investigating the reliability and validity of the MBI-HSS and the UWES would result in the standardisation of these specific measuring instruments, therefore contributing to the identification of burnout and work engagement with non-professional trauma counsellors. Some of the factors that could play a role in the prevalence of burnout and work engagement are secondary traumatic stress, the demands of counselling, lack of resources, personal consequences, social support and sense of coherence. The objectives of this research were to standardise the MBI-HSS and UWES for non-professional counsellors as well as to develop and test a causal model of burnout and work engagement for this specialist group. The research method involved four separate articles, each consisting of a brief literature overview and an empirical study. A cross-sectional design, whereby a sample is drawn from a population at a particular point in time, was used. The data for this study was collected from 168 non-professional counsellors, employed by three of the major banks in South Africa. The MBI-HSS, UWES, Orientation to Life Questionnaire (OLQ) as well as a Self-Report Questionnaire (SRQ) and a biographical questionnaire were administered. Descriptive statistics, analysis of variance, correlations, canonical analysis, and structural equation modelling were used. Structural equation modelling confirmed a three-factor model of burnout (emotional exhaustion, depersonalisation and personal accomplishment). In contrast with research findings confirming the three-factor model of the UWES (vigour, dedication and absorption), a one-factor model for the UWES was confirmed for non-professional counsellors. The internal consistency of the scales for the MBI-HSS and UWES was found to be satisfactory and in line with reported findings in the literature. Structural equation analysis showed that the lack of resources and job demands predicted the core of burnout, namely emotional exhaustion and depersonalisation. The conflicts and pressures that are already associated with the everyday work of non-professional counsellors are likely to be magnified by the counselling role. Non-professional counsellors continually face conflicts created by the fact that they are accountable to large organisations, but professionally, ethically and morally devoted to their clients (the victims of trauma who are being counselled by them). They must balance the competing, and sometimes opposing demands of several parties such as trauma victims, employees, families and communities. To add to these circumstances it is important to remember that counselling is not the main job objective of the non-professional counsellors. Counselling is seen as an "add-on" to their job description and is in most instances not part of their performance measurement/assessment. Work engagement was related to low burnout scores, while personal accomplishment was associated with work engagement. High sense of coherence had a mediating effect on burnout and a positive effect on work engagement. This study seems to emphasise that job demands have a more negative effect on engagement when sense of coherence is low than when sense of coherence is high. Conversely, it is assumed that sense of coherence provides functions such as increased perception of coping capacity or minimised stress appraised, which decreases the effects of stress on an individual. Recommendations for the organisations and future research were made. / Thesis (Ph.D. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2004.

The prevalence of HIV infection in pregnant women is still on the rise despite existing preventive programmes aimed at reducing HIV-transmission. Voluntary counselling and testing during pregnancy is the key entry point in the prevention of mother-to-child transmission (Department of Health, 2000:16; Birdsall et al. 2004:3). Women are often diagnosed as being HIV-positive for the first time when they attend antenatal clinics and consent to HIV testing (UNAIDS, 1997). The objective of this study was to determine the pregnant women's experiences of voluntary counselling and testing (VCT) and to explore and describe the impeding and facilitating factors that played a role in their choice whether or not to consent to HIV testing after having received pre-test counselling. By understanding the impeding and facilitating factors that play a role in the pregnant woman's choice to undergo HIV testing, recommendations could be made to possibly improve the uptake of HIV testing among pregnant women. The population studied in this research consisted of pregnant women making use of antenatal clinics in the Potchefstroom sub-district. Purposive sampling was used to select participants with the assistance of mediators who were working in the local clinics and the hospital. The sample size was determined by data saturation, which was reached after 10 interviews. A qualitative design was used and data was collected by means of semi-structured interviews. Data analysis was carried out simultaneously with data collection. In consensus discussions, the researcher and the co-coder reached consensus on the main and sub-themes. The main themes are the facilitating and impeding factors that play a role in the pregnant women's choice to undergo HIV testing. Based on findings, it was concluded that facilitating and impeding factors that play a role in the pregnant woman's choice to HIV testing do indeed exist. Impeding factors identified were: fear of a positive status; fear of stigmatization and discrimination; fear of lack of support; lack of opportunity to consider their choice to undergo HIV testing; lack of trust that confidentiality will indeed be honoured; fear of knowing possible positive HIV-status that can lead to feelings of depression and mental anguish; differences between counsellors' and pregnant women's characteristics. Facilitating factors consist of the desire to be aware of own HIV status; desire to protect the baby; sufficient information and the importance of trust and confidentiality. Recommendations were subsequently made to make HIV counselling and testing services to pregnant women more user-friendly in order to facilitate the pregnant woman in her choice concerning HIV-testing. Heeding these recommendations will possibly lead to more pregnant women's HIV status being known by the time they go into labour. Recommendations were made that pregnant women be counselled for HIV testing during their first antenatal visit and the HIV-testing being offered to them during the second visit. Research findings reveal that most pregnant women need time to consider their choice to undergo HIV testing and to prepare themselves for the test. Most pregnant women felt that they would possibly consent to HIV testing during their second antenatal visit. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2008.

<p><font face="Times New Roman" size="3"><font face="Times New Roman" size="3"> <p align="left">The aim of the study is to explore the barriers associated with low VCT uptake by the TB patients attending primary health care clinics within the Buffalo City municipality. <font face="Times New Roman" size="3"><font face="Times New Roman" size="3">The study population was drawn from TB patients attending the primary health care facilities in Buffalo city municipality in the Eastern Cape Province. Eight participants were purposively selected to include those who had accepted VCT as well as those who did not.</font></font></p> </font></font></p>