Dissertations / Theses on the topic 'HIV infections – Botswana – Case studies'

All organizations are concerned with survival and effectiveness, but for third sector and public organizations these issues are acute; they hinge on the organization’s ability to establish and sustain its legitimacy. Legitimacy has been defined as a manifestation of value congruence between an organization’s activities and the social system within which it functions (Dowling and Pfeffer, 1975). This study oxamines the multi-dimensionality of organizational legitirnicy in a comparative case study of nonprofit service organizitions (NSO’s) which provide HIV education and support services for women. Processes of seeking organizational legitirnacy are identified and organizational relationships analyzed within the environmental networks of clientele and the interorganizational network. The study also seeks to identity tte focus and progression of legitimating efforts over tho course of the organization’s existence. Tw. Community based organizations are included; one in the United States and one in the Spanish-speaking Caribbean. The organizations studied are directed to women in a variety of circumstances: sex workers, drug users, and women who self-identify as being at risk. The majority of clients were Hispanic, although a few were Caucasian and African-American. The study is intended to generate theory as to how organizations address legitimacy in a multidimensional environment, and how this challenge has been confronted in the case of NSO’s serving women at risk for HIV. The study identifies strategies for preserving the organization’s internally defined objectives and processes and its active relationship with the client community.
Ph. D.

Maternal HIV-infection is considered to be a threat to the psychosocial development of AIDS-affected children. In South Africa, AIDS-affected children may be particularly vulnerable due to the unprecedented effects of the HIV/AIDS epidemic on the breakdown of family and community resources in already disadvantaged communities. The aim of this study was to explore the contextualised experiences of two children living with mothers who have HIV by conducting two case studies. Mother-child dyads were recruited from local HIV/AIDS centres and informed consent was obtained. The mothers were in the minor symptomatic phase of HIV-infection and the children were uninfected and aged between 10 and 12 years. Through semi-structured interviewing, the mothers provided background and contextual information about the children. Play techniques were used in the child interviews to encourage the introduction and exploration of issues salient to the children. Play facilitated engagement around sensitive and potentially anxiety-provoking material. A key issue for the children was their concerns about the anticipated deaths of their mothers. The children held misconceptions about the transmission of HIV/ AIDS. They feared HIV/AIDS and expected that others would have negative perceptions of them. Family processes such as secrecy and avoidance around HIV/AIDS-related issues were understood to perpetuate the children's fears and false beliefs in a broader community context that stigmatised HIV/AIDS. It was argued that the mothers' shame over HIV-infection and their need to protect their relationship with their children compromised their ability to communicate openly with their children and to offer them meaningful emotional support. Limited parental involvement was identified as the key contextual process that engendered vulnerability in the children, as they were isolated within and beyond the family. Recommendations to address the processes that engendered vulnerability in the children are discussed.

Thesis (Mnutr)--University of Stellenbosch, 2003.
ENGLISH ABSTRACT: Problem Definition: In the context of HIV/AIDS malnutrition is almost universal among children, and of the adverse effects of Protein Energy Malnutrition, the most frequent seems to be the occurrence of opportunistic infections with micro-organisms such as oral Candida. Objective: The aim of this study was to determine the nutritional status of children with oral complications in relation to HIV/AIDS as well as the effects of the oral lesions on nutritional status. Subjects/setting: The subjects of study were 24 children co-infected with TB and HIV who were admitted consecutively to the paediatric ward of Brooklyn Chest Hospital in Cape Town, South Africa. The nutritional status of the children was assessed over a maximum period of six months by nutrient intake, anthropometric status, and by biochemical parameters and clinical and oral examination on admission and at discharge from hospital. Results: Children with HIVand TB infection presenting with or without oral lesions were similarly malnourished throughout the period of hospitalization. There was no improvement in the nutritional status as indicated by height and weight measurements. Throughout the time of hospitalization, 7% of the children had a combination of stunting, underweight and wasting. Average nutrient intake was not found to be higher than the Recommended Dietary Allowance (RDA) in any of the children. At the time of admission to hospital and at discharge, carbohydrate intake provided most of the daily energy (36% and 42%, the difference not being statistically significant). There was a significant increase in the intake of energy (p=O.04) and a decrease in total fat intake (p=O.03) at discharge. Although not significant, mean protein intake at admission was higher than at time of discharge. Selected sub-optimal biochemical values were prevalent among the children studied, with 45% and 41% showing low serum albumin values «2.9g/dL) at the time of admission and at discharge respectively. Both on admission and at discharge, 38% of the children had Haemoglobin levels below normal values. Serum ferritin levels below normal values were present in almost all the children and the trend was similar for the prevalence of low zinc values. Sub-normal plasma retinol was present in 79% of the children at time of admission, while only 21% had deficient values at time of discharge (p=O.03). On admission, 29% of the children had vitamin evalues below the normal range whereas at time of discharge 17% of the children had values below normal (p=O.04). A total of 29% children presented with oral complications on admission. These included oral herpes, oral thrush, reflux, bleeding gums and stomatitis/angular cheilosis. Two children were asymptomatically colonized with Candida of the oral cavity. Mean total protein intake was higher (p=O.057) among the children who were not diagnosed with oral complications. Conclusions: This study confirmed that malnutrition is not only a common and serious problem associated with HIVand AIDS, but also that nutritional problems cannot be dealt with in isolation where Opportunistic Infections are present. The severity of malnutrition depends on various factors including oral complications. Additionally, appropriate management and treatment of tuberculosis did not appear to affect the nutritional status significantly. Recommendations: On the basis of these findings, and because of the increased risk of growth failure and developmental delays, children should be referred for full nutritional evaluation as soon as possible after diagnosis of HIV -infection. In addition, there is a need for intervention programmes to identify the immediate underlying causes of malnutrition and the ways in which such causes interact, in order to ensure that such interventions increase the resistance of HIV infected infants and children to the disease.
AFRIKAANSE OPSOMMING: Probleemdefiniëring: Binne die konteks van MIVNIGS is wanvoeding bykans universeelonder kinders en van die nadelige effekte van proteïen energie wanvoeding is die voorkoms van opportunistiese infeksies (Ol) met mikro-organismes soos orale candida die algemeenste. Doelwit: Die doel van dié studie was om die voedingstatus van kinders met orale komplikasies in verhouding tot MIVNIGS en die effek van orale letsels op voedingstatus, te bepaal. Proefpersone/omgewing: 'n Groep van 24 kinders, met beide tuberkulose en MIVNIGSinfeksie, wat agtereenvolgend in die kindersaal van Brooklyn Bors-Hospitaal in Kaapstad, Suid- Afrika opgeneem is, is bestudeer. Vir 'n periode van ses maande is die kinders se voedingstatus geassesseer deur middel van voedingstofinname, antropometriese status en biochemiese parameters met opname in en ontslag uit die hospitaal. Kliniese en orale ondersoeke was op elke kind uitgevoer met opname sowel as ontslag. Resultate: Kindres met HIV en tuberkulose, met of sonder orale letsels, het soortgelyke wanvoeding tydens hospitalisering ervaar het. Volgens antropometriese metings was daar geen verbetering in die voedingstatus nie. 'n Kombinasie van belemmerde groei, ondergewig en uittering het in 7% van die kinders tydens hospitalisering voorgekom. Nie een van die gemiddeldes van die voedingstowwe was hoër as die Aanbevole daaglikse toelatings (ADT) in enige van die kinders wat bestudeer is nie. Met opname sowel as ontslag, was koolhidraatinname die grootste energieverskaffer met onderskeidelik 36% en 42% (alhoewel die verskil nie statisties beduidend was nie). Daar was 'n beduidende toename in energie-inname (p=O.04) en 'n afname in totale vetinname (p=O.03) met ontslag. Alhoewel nie beduidend nie, was die gemiddelde proteïeninname hoër met ontslag. Die voorkoms van geselekteerde sub-optimale biochemiese waardes met toelating en ontslag wys dat onderskeidelik 45% en 41% van die kinders lae serum albumienwaardes «2.9g/dL) getoon het. Subnormale plasma retinol het in 79% van die kinders met toelating voorgekom, terwyl slegs 21% gebrekkige waardes (p=O.03) met ontslag getoon het. Tydens opname, sowel as met ontslag, was 38% van die kinders se hemoglobienvlakke laer as die normale. Serum ferritienvlakke was amper by al die kinders laer as die normale vlakke te bespeur, met sinkvlakke wat op soortgelyke lae vlakke voorkom. Met toelating was 29% van die kinders se Vitamien C-waardes laer as normaal en met ontslag was sowat 17% se waardes steeds laer as die normaal (p=O.04). Met toelating het 29% van die kinders orale komplikasies getoon. Ingeslote hierby was orale herpes, orale sproei, refluks, bloeiende tandvleise en stomatis/ angulêre cheilose. Slegs twee kinders was asimptomaties met orale Candida van die mondholte gediagnoseer. Die gemiddelde proteïeninname was hoër (p=O.057) onder die kindres wat nie orale komplikasies getoon het nie. Gevolgtrekking: Hierdie studie bevestig dat wanvoeding me net 'n algemene en ernstige probleem is wat met MIV en VIGS geassosieer word nie, maar ook in die teenwoordigheid van opportunistiese infeksies, die voedingsprobleem nie in isolasie gehanteer kan word nie. Die graad van wanvoeding hang af van ander faktore, insluitende orale komplikasies. Voldoende behandeling van TB het ook nie 'n beduidende effek op voedingstatus gehad nie. Aanbevelings: Op hierdie bevindings gebaseer, en as gevolg van die verhoogde risiko VIr belemmerde groei en vertraagde ontwikkeling wat al die liggaamstelsels van MIV -positiewe kinders affekteer, moet kinders so gou as moontlik nadat die MIV-infeksie gediagnoseer is, vir volle voedingsevaluasies verwys word. Daarmee gepaardgaande is daar 'n behoefte aan programme wat die onmiddellike onderliggende oorsake van wanvoeding identifiseer, asook om interaksie van hierdie oorsake met HIV vas te stel, ten einde intervensies wat weerstand van HIVkinders en-babas verbeter, positieftoe te pas.

Zimbabwe is one of the priority countries nominated by the World Health Organisation and the Joint United Nations Programme on HIV and AIDS to adopt and implement voluntary medical male circumcision (VMMC) because of its high rate of HIV prevalence and its low level of male circumcision. VMMC, which was introduced in Zimbabwe in 2009, is a new HIV prevention method which reportedly offers partial protection of about 60 percent for circumcised males with respect to contracting HIV through sexual relations. The other key prevention method, namely the use of condoms consistently and correctly, has a protection rate of up to 95 percent. As a result, because of only partial protection, medically-circumcised men are encouraged to use condoms to decrease the chances of HIV infection. Concerns though have been raised about the possibility of risk compensation by circumcised males by way of increases in unsafe or risky sexual practices subsequent to circumcision and arising from perceptions of reduced risk through VMMC. This compensation may take the form of condom use aversion including when involved with concurrent sexual partners. If risk compensation does take place, this would lead to increases in HIV transmissions affecting not only the circumcised men but their sexual partners as well. The supposed effectiveness of VMMC as a HIV prevention method has been subjected to significant criticism and, as yet, no significant study has been undertaken in Zimbabwe on the relationship between VMMC, condom use, concurrent sexual partners and risk compensation. Based on a study of twenty-five medically-circumcised males in Harare, the capital of Zimbabwe, this thesis seeks to understand and explain the relationship between voluntary medical male circumcision and risky sexual practices with particular reference to condom use amongst men engaged in concurrent sexual partnerships. While the thesis finds evidence of risky sexual practices subsequent to circumcision, risk compensation does not seem to be particularly prevalent.

RESUMO: O maraviroc (MVC) é o único anti-retroviral antagonista do co-receptor CCR5 licenciado e interage com as ansas transmembranares de CCR5, induzindo uma alteração da sua conformação e impedindo a interacção com gp120. O MVC é activo apenas contra estirpes R5 de HIV-1, sendo utilizado em terapia de recurso. Neste trabalho, foi estudada a diversidade genética da região C2V3C3 do gene env de estirpes de HIV-1 de oxicodependentes por via endovenosa da Grande Lisboa, pesquisando-se também a presença de polimorfismos genéticos naturais. Foram utilizadas 52 amostras de plasma e para 35 destas foi amplificado por RT-nested PCR um produto de 565 pb. A análise filogenética revelou a seguinte distribuição de genótipos: 23 B (incluindo, provavelmente, 2 CRF14_BG), 8 A, 3 G e 1 F1. Após tradução, e por comparação com a sequência consenso B, verificou-se uma elevada frequência de polimorfismos genéticos, sendo encontradas algumas “assinaturas de aminoácidos” relativas aos subtipos não-B. Realizou-se ainda uma pesquisa de locais de N-glicosilação e a previsão da utilização de co-receptores (abordagem genotípica), com recurso às regras 11/25 e da carga líquida da ansa V3 e aos programas PSSM e geno2pheno[coreceptor]. Observou-se uma conservação genérica do número de locais de N-glicosilação e foram identificadas 5 sequências com tropismo X4 ou duplo. Por fim, com base na literatura, realizou-se uma pesquisa de polimorfismos genéticos associados a resistência ao MVC presentes na ansa V3. Foi observado um número elevado destas mutações. A presença dos padrões 11S+26V e 20F+25D+26V, num total de 3 sequências, é relevante, visto estes estarem inequivocamente associados à resistência in vivo ao MVC. Apesar de não estar ainda definido um perfil de resistência para o MVC, a presença das mutações encontradas, em indivíduos sem contacto prévio com o fármaco, trará implicações relevantes na sua gestão clínica, considerando a introdução do MVC na terapia de recurso.---------- ABSTRACT: Maraviroc (MVC) is the only CCR5 inhibitor licensed today. This drug interacts with the transmembrane helices of CCR5 co-receptor, inducing a conformation change of its extracellular loops and preventing the interaction with gp120. MVC is only active against R5 strains of HIV-1 and is currently used in salvage therapy. The genetic diversity of the env C2V3C3 region of HIV-1 strains from injecting drug users in the Greater Lisbon was studied, along with the presence of natural genetic polymorphisms. 52 plasma samples were used and the amplification by RT-nested PCR of a 565 bp-product was possible in 35 of them. The phylogenetic analysis revealed 23 sequences classified as subtype B (probably including 2 CRF14_BG), 8 A, 3 G and 1 F1. After translation, the presence of natural genetic polymorphisms was studied by comparison to a subtype B consensus. A high frequency of genetic polymorphisms was observed and significant “amino acid signatures” were found in association with non-B subtypes. A full characterization of the N-glycosylation sites was also performed and a coreceptor prediction (genotypic approach) was accomplished using the 11/25 and the V3 net charge rules and the programs PSSM and geno2pheno[coreceptor]. The number of N-glycosylation sites was generically preserved. Five sequences were defined as X4 or dual-tropic. Based on published data, a search for genetic polymorphisms, present in V3loop, associated to MVC resistance was finally undertaken. Several of such mutations were observed, being particularly interesting the presence of the patterns 11S+26V and 20F+25D+26V, in a total of 3 sequences, since these patterns have unequivocally been associated with MVC resistance in vivo. Although a resistance profile for MVC is not yet defined, the presence of these mutations in MVC-naïve populations may have significant impact in their clinical management in the future, especially considering the introduction of this drug in salvage therapy.

The study was aimed at investigating the effectiveness of social support mechanisms provided to HIV and AIDS orphans in Tembisa, Gauteng Province. An interview guide was designed and it guided the in-depth interviews with HIV and AIDS affected and infected orphans. In addition, a focus group was run with the social workers and the children‟s caregivers. Empirical findings gathered were based on the qualitative information from the participants. The findings indicated that social support systems were effective although there were various challenges facing their smooth running. Firstly social support provided to orphans is mainly provided by caregivers, social workers, schools and the government. Secondly for some, the support is not entirely enough to help them cope with life. The minority of the orphans indicated that they were not even aware that they were orphaned. The study therefore recommends that social workers and caregivers be trained on how to be effective social support systems for HIV and AIDS orphans. Furthermore psycho-social support groups need to be more informational and inclusive of HIV and AIDS orphans.

Thesis (MPhil)--Stellenbosch University, 2005.
ENGLISH ABSTRACT: This work provides a comprehensive overview of the South African HIV/AIDS epidemic. It examines the historical and social background of the HIV/AIDS situation and looks at the importance of the media and science communication in combating the effects of the epidemic on society. This research explores the different forms of health communication and the varied benefits of each. Overall, it highlights positive media efforts that have helped redirect the HIV/AIDS epidemic within the social and political context of the HIV epidemic in South Africa. The second half of this work covers the challenges experienced in gaining publicsector antiretroviral treatment and the roles the media have played in informing and mobilizing society for these efforts. Through a community clinic ethnographic case study this work explores the current state of treatment clinics, social challenges experienced in the Usapho Lwethu Clinic of Gugulethu and the future of the HIV/AIDS epidemic in South Africa.
AFRIKAANSE OPSOMMING: Hierdie werk verskaf ‘n omvattende oorsig van die Suid-Afrikaanse HIV/VIGS epidemie. Dit ondersoek die historiese en sosiale agtergrond van die HIV/VIGS toestand en belig die belangrikheid van media en wetenskaplike kommunikasie in die bestryding van die effek van hierdie epidemie op die samelewing. Hierdie navorsing verken die verskillende vorms van gesondheidskommunikasie en die onderskeie voordele van elk. In sy geheel beklemtoon dit die positiewe pogings van die media wat gehelp het met die herkanalisering van die HIV/VIGS epidemie binne die sosiale en politieke konteks in Suid-Afrika. Die tweede helfte van die werk gee 'n oorsig van die rol wat die media speel in die beskikbaarstelling van inligting en die mobilisasie van die publiek en die stryd rondom die verkryging van antiretrovirale behandeling vir die algemene publiek. ‘n Etnies-grafiese gevallestudie van ‘n plaaslike gemeenskapskliniek word gebruik om die huidige toestand in behandelingsklinieke toe te lig asook die sosiale uitdagings in die Usapho Lwethu Kliniek in Gugulethu en die toekoms rondom die HIV/VIGS epidemie in Suid-Afrika.

OBJECTIVES: The integrin α4β7 is the gut-homing receptor for lymphocytes. It also is an important co-receptor for human immunodeficiency virus (HIV) via glycoprotein (gp)120 binding. Depletion of gut cluster of differentiation (CD)4 T cells is linked to chronic inflammation in patients with HIV; however, measuring CD4 cells in the gut is invasive and not routine. As such, establishing a peripheral marker for CD4 depletion of the gut is needed. We hypothesized that α4β7 CD4 T cells are depleted in the peripheral blood of treatment-naïve patients with HIV compared with healthy controls. METHODS: The study groups were treatment-naïve patients with HIV and uninfected controls. Subjects were included if they were 18 years or older with no history of opportunistic infections, active tuberculosis, or cancer. We collected peripheral blood and examined on whole blood using flow cytometry for the following cell surface markers: CD4, CD45RO, chemokine receptor type 5, C-X-C chemokine receptor type 4 (CXCR4), and the integrin β7. We collected demographic information, including age, sex, and ethnicity, as well as viral load (VL) and CD4 count. Two-samplettests and Fisher exact tests were used to compare the differences between the two groups. Spearman correlation coefficients were calculated between CD4 count and log10-VL and percentage of CD4+/CD45RO+/β7+and log10-VL in patients. RESULTS: Twenty-two subjects were enrolled in the study (12 patients with HIV and 10 controls). There were no differences in age or sex between the two groups. There were more Hispanics and fewer Asians in the group comprising patients with HIV compared with the control group (7 vs 2 and 0 vs 4,P= 0.05, respectively). Patients infected with HIV had significantly lower frequencies of CD4+/CD45RO+/β7+cells (median 12%, range 5-18 compared with uninfected controls: median 20%, range 11-26,P= 0.0007). There was a statistically significant difference in the percentage of CD4+/CD45RO+/C-X-C chemokine receptor type 4+cells between patients (72%, range 60%-91%) compared with controls (79%, range 72%-94%,P= 0.04). The percentage of CD4+/CD45RO+/chemokine receptor type 5+did not differ between the group of patients with HIV and the control groups (22%, range 11%-57% vs 27%, range 14%-31%;P= 0.8, respectively). There was no correlation between percentage of CD4+/CD45RO+/β+cells and log10-VL as measured by the Spearman correlation coefficient (r= 0.05,P= 0.88) in patients infected with HIV. CONCLUSIONS: Memory CD4 β7+cells are reduced significantly in the peripheral blood of untreated patients infected with HIV, which could be used as a noninvasive indicator of intestinal CD4 T cell loss and recovery. Further studies are needed to examine whether depletion of these CD4+/CD45RO+/β7+cells in the peripheral blood parallels depletion in the gut of treatment-naïve patients with HIV and whether levels return to control levels after treatment.

The phenomenon of HIV discordance has been in existence for a long time along with HIV. However, very limited attention has been given to HIV discordance. This phenomenological study aimed at gaining a deeper understanding on the lived experiences of sero-discordant couples in Botswana. Reports show that discordance in Botswana is around 17%. The main objectives of this study were to identify HIV discordant couples living in Botswana and explore their knowledge and understanding of the situation, explore the psychological, social and sexual experiences of the HIV discordant couples and determine its impact in their lives, and examine the meaning they attach to such experiences and challenges they face as well as their coping strategies. A qualitative phenomenological approach using face to face in-depth interviews was used to explore and describe meanings and experience as lived by the HIV discordant couples. The study sample consisted of forty-six (N=46) (twenty-nine (n=29) females and seventeen (n=17) males) participants selected using purposive sampling from three cities in Botswana. The Inclusion criteria were that participants should be aged 21 years and above; with no known diagnosis of mental illness; having been in a discordant relationship for at least six months at the time of data collection; living in Botswana and willing to participate in the study. The findings were that there are three forms of discordance, which are: discordant unaware which are couples who went into the relation unaware of their HIV status. Discordant aware; those who got into the relationship already knowing each other’s HIV status and discordantly discordant which are those with differing HIV status and differing motives of going into the relationship. These are the couples that conceal their status from one another. The results revealed intense emotional/psychological, sexual and social stresses as experienced by couples. HIV discordant goes through three phases of initial shock, conflict and resolution. The researcher recommends the OPEN DESK MODEL to be integrated in the health facilities to encompass the concept of a family or couple and as a unit.
Health Studies
D. Litt. et Phil. (Health Studies)

Background: Non-disclosure of HIV positive status to a partner threatens to reverse gains made in prevention of mother-to-child transmission (PMTCT) in resource limited settings. Determining the association between non-disclosure and infant HIV acquisition is important to justify focussing on disclosure as a strategy in PMTCT programmes. Objective: To determine the association between non-disclosure of HIV positive status to a partner and mother-to-child transmission (MTCT). Methods: Using a matched case-control design, we compared 34 HIV positive infants to 146 HIV negative infants and evaluated whether the mothers had disclosed their HIV status to their partner. Results: Non-disclosure was more frequent among cases (overall, 16.7%; cases, 52.8%; controls 7.6%), p<0.001 and significantly associated with MTCT (aOR 8.9 (3.0-26.3); p<0.0001), with male partner involvement partially mediating the effect of non-disclosure on MTCT. Conclusions: There is a need for PMTCT programs to focus on strategies to improve male partner involvement and partner disclosure without compromising the woman’s safety.
Health Studies
M. (Public Health)

M.A. (Psychology)
The present study was undertaken in an attempt to understand and ascertain the nature and influence of psychological variables on the longevity of people who are infected withHN. The specific postulate of this study was that depression is the most important psychological variable that influences the longevity of people with my, either directly or indirectly. A number of variables were hypothesized to playa concomitant role with depression as factors that mediate longevity in people with my. These factors include learned helplessness, self-efficacy, sickness impact, sexual risk behaviors and substance use. The testing of these hypotheses involved an experimental group consisting ofHN positive, gay men who suffered from depression and a control group that consisted ofmv positive gay men who did not suffer from depression. None of the subjects had previously been diagnosed with depression. The subjects were subjected to testing of the mentioned psychological variables by means of the Hamilton-Depression Scale, the Attributional Style Questionnaire, the Coping Self-Efficacy Scale, the Biweekly Record of Sexual Behavior, the Substance Use Behavior Questionnaire and the Sickness Impact Profile. It was found that the experimental group differed significantly from the control group in terms of self-efficacy, sexual risk behavior, substance use and sickness impact. It has been speculated that the lack of significant difference between the experimental and control groups on learned helplessness could imply that equal amounts of learned helplessness was present in both groups.

The thrust of this dissertation is concerned with investigating beneficiary communities‟ participation in HIV/AIDS communication through community radio stations. The aim is to understand the presence and access of targeted community voices in the dialogue against HIV/AIDS. The research focused on a single case study of a community radio station that is based in Platfontein, Kimberley in the Republic of South Africa. X-K FM is a community radio station under the auspices of the South African Broadcasting Corporation (SABC) and its primary target audiences are !Xun and Khwe communities of Platfontein. It is the only formal communication channel that targets these San community members in their respective mother tongues. The study approaches communication at a nuance level in that it evaluates participation possibilities between communicators and the communicated. In its third decade, the Human Immunodeficiency Virus is one of many challenges facing sub-Saharan Africa and the Republic of South Africa is no exception. This dissertation attempts to understand participation and access of civil voices in the strategies of prevention, care, support and treatment of HIV/AIDS. On a broader level, the dissertation seeks to understand the possibilities of bottom-up approaches in communicating about HIV/AIDS. In analysing the beneficiary community participation at X-K FM, the research was underpinned by the theory of Jurgen Habermas: The Structural Transformation of the Public Sphere – An Inquiry into a Category of Bourgeois Society. The data was gathered using semi-structured interviews, as well as simple and partial participant observation. The study concludes that the radio station has provided some avenues to facilitate the process of beneficiary community participation in HIV/AIDS communication content.
Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Durban, 2012.

The research objectives were to describe the age and gender of adult HIV positive clients on ART who received IPT; the incidence of tuberculosis among clients that received IPT and the defaulter rate among those that were commenced on IPT. Quantitative non-experimental descriptive retrospective cohort study was undertaken to ascertain the incidence of tuberculosis among adult HIV positive clients who received IPT. 104 clinic records of HIV positive adult clients accessing care at Isithebe Clinic, iLembe-South Africa who were commenced on IPT between 01 July 2010 and 30 November 2011 were analysed. The study found that 66 of 104 (63.5%) study respondents completed the course of IPT and the majority of those that defaulted were due to poor quality of care. Gender was statistically found to have played a role on whether a patient completes IPT. None of the study respondents that completed IPT was diagnosed with TB disease.
Health Studies
M.A. (Public Health)

Human Immunodeficiency Virus is the leading cause of death among women of reproductive age worldwide. It is also a major contributor to infant mortality. The effective application of prevention of mother-to-child transmission strategies effectively reduces the risk of mother-to-child transmission. The intent of this study was to determine the availability and accessibility of the PMTCT programme in one district of the North West Province of South Africa. A qualitative, explorative, descriptive and contextual design was utilised to gain better understanding of the experiences of both the HIV positive pregnant women and the Health Care Workers regarding the availability and access to the PMTCT programme. The study population consisted of HIV positive pregnant women between 18 and 49 years of age and Health Care Workers aged between 21 to 60 years of age. The non-probability purposive sampling technique was utilised to identify potential research participants. Data were collected by means of individual semi-structured interviews with HIV positive pregnant women and focus group discussions with the Health Care Workers. Adherence to Tesch’s eight descriptive methods was utilised as the primary form of data analysis, organisation and interpretation. The findings of the study revealed that availability and accessibility of PMTCT services are still problematic. Distance, waiting periods, and long queues were among the few mentioned as problematic. There were also few positives such as communication, counseling and health education. Strategies for facilitation of the availability and accessibility of the PMTCT programme were developed based on the findings. Themes emerged from the HIV positive pregnant women’s data included: acceptance of one’s sero positive status, maternal concerns, stressors about HIV status, as well as lack and shortage of resources and support by health care professionals and family; while emerging themes from the Health Care Workers included: fear of disclosure by HIV positive pregnant women, child feeding, formal trainings and workshops on PMTCT programme, as well as lack and shortage of resources and loss to follow-up activities
Health Studies
D. Litt. et Phil. (Health Studies)

This study explored preparatory students’ perceptions of the risk of contracting the Human Immuno-deficiency Virus (HIV) and sexually transmitted infections (STIs) in Ethopia. It utilised a non-experimental exploratory survey methodology. A range of findings was revealed. Most respondents (67.14%) were knowledgeable about HIV/AIDS and more than half of the respondents knew about STIs. A significant number of respondents (67.1%) were able to describe HIV transmission prevention methods. Twenty one percent of respondents were sexually active and 17.0% of these reported to have used condoms. Twenty nine percent and 4.25% of the respondents had selfperceived risk of contracting HIV infection and STIs respectively. In spite of increased awareness of HIV/AIDS, school youths still engage in high-risk sexual activities and believe that they are unlikely to contract the disease. The study findings have implications for practice, and recommendations are offered for further research
Health Studies
M.A. (Public Health)

HIV/Aids is a worldwide pandemic and as South Africans we are at the epicentre of this global health crisis. The harrowing statistics are useful as a means to quantify a horrific situation; however, what these facts do not do is provide connection amidst the uncertainty surrounding the disease. This research aims to bridge the disconnection and break the silence that weaves a net around the illness and those infected by it. This is done by deconstructing one man’s story of his journey with HIV; by looking at his personal epistemology; and by contextualising his story within his family and within the society in which he lives, South Africa. Finally, it is my reflections and interpretations that form the bridge between a construct of HIV/Aids and a life lived with the disease.
Psychology
M. A. (Clinical Psychology)

The researcher explored problems that hamper the implementation of the HIV/AIDS Policy at a specific public high school in KwaZulu-Natal. The research was designed as a qualitative single case study. Various data collection methods were implemented: a one-on-one interview was conducted with the principal, while the SMT and Life Orientation team took part in focus groups and the school governing body members completed a questionnaire. The researcher succeeded in answering the research question: Which problems hamper the implementation of the HIV/AIDS Policy at the participant high school in KwaZulu-Natal? She identified the principal and school governing body’s limited knowledge of their obligations with regard to the implementation of the HIV/AIDS Policy, different beliefs and myths related to specific ethnic groups towards HIV/AIDS, non-disclosure as a result of negative stigma and discrimination, the lack of cooperation from parents, cultural and religious beliefs as the main problems hindering the implementation of the HIV/AIDS Policy at this school.
Educational Leadership and Management
M. Ed. (Education Management)

This study investigated the attitudes of church leaders towards their perceived leadership roles in HIV prevention, using a sample of 85 clergy and lay leaders. Working from the premise that churches concentrate on care and support instead of HIV prevention, data were collected from Lutheran church leaders in Zimbabwe, using a questionnaire based on the constructs of the theory of reasoned action. The findings of this study suggest that the church is a potential source for HIV prevention. However, the capability to lead in HIV prevention was limited by barriers due to self-efficacy and cultural constraints, differences between communicator and audience, experiences and perceptions of the communicator and to some extent, institutional constraints. Programmers should focus on removing the barriers faced by the church leaders to improve their ability to lead in HIV prevention and strengthen prevention efforts.
Sociology
M.A. (Social Behaviour Studies in HIV/AIDS)

Factors that Impact on Learning in Orphanhood in Zimbabwe The aim of the study was to provide scientific knowledge on the factors impacting on the learning profile of orphans as compared to those who are not orphaned, and to identify the relationships between these factors and learning outcomes. This is a quantitative study and the Evaluation-Process and Outcome design was used. Structured quantitative data collection methods, questionnaires, interviews, observation and document analysis were used in this study. Maslow’s humanistic motivation theory of learning is the theoretical framework. The population included form four students and teachers from the Harare Metropole Province in Zimbabwe. A stratified random sampling procedure was used to sample schools, and the simple random procedure was used to sample both students and teachers. The experimental design was used to allow comparisons among orphans and between orphans and non-orphans. Ethical principles including consent, confidentiality and privacy were adhered to. Measures to uphold the quality of the study were applied. In the study it was found that in the peri-urban area, students who had been orphaned for one year or less performed poorly compared to other orphans and to non-orphaned students in their average examination marks, (p<. 023). Lack of books was significantly different amongst the non-orphaned and orphans (p<. 003), mostly affecting those orphaned for one year or less. There was a significant difference in the performance of orphans whose mothers had died and those whose mothers were alive, according to their average coursework marks (p<. 001) and average examination marks (p<. 005). The performance of single orphans, double orphans and non- orphans did not differ significantly, but the post hoc analysis revealed that in most subjects double orphans performed worse than single orphans and non-orphaned students. In the HIV/AIDS/Reproductive health and life-skills teaching-learning sessions observed, the majority of teachers, 12, (66.7%) (n =18) did not agree that relevant assignments were being given and 16 (88.9%) (n =18) did not agree that reading references were available. The majority of students (55.2% n = 509) had inadequate information on HIV and AIDS prevention, and those orphaned for one year or less (62% n = 29) and those orphaned for two to three years (62.5% n = 48) had even less information on HIV and AIDS prevention than the other groups. There was a difference in what the students perceived as life skills and what the teachers reported as life skills. It is recommended that this study be replicated on a larger scale and that factors that impact on learning be studied in national school settings in order to determine orphans’ and non-orphans’ learning outcomes.
Health Studies
D. Litt. et Phil. (Health Studies)

The MA Social Behaviour Studies in HIV and AIDS as a postgraduate degree requires students to work and conduct research independently. The purpose of the study was to gauge the perceptions, attitudes and experiences of second year students and key personnel concerning student support. A mixed methods research design was used. It was found that students and staff regarded support in a positive light, although concerns about insufficient resources were expressed. Students expressed needs for specific academic and research support. Staff tended to romanticise the reasons for students enrolling for the degree. Possible conflicting expectations of the degree and the amount and type of support offered were found between the staff and the students and also among various staff members.
Social Work
M.A. (Social Behaviour Studies in HIV-AIDS)

The MA Social Behaviour Studies in HIV and AIDS as a postgraduate degree requires students to work and conduct research independently. The purpose of the study was to gauge the perceptions, attitudes and experiences of second year students and key personnel concerning student support. A mixed methods research design was used. It was found that students and staff regarded support in a positive light, although concerns about insufficient resources were expressed. Students expressed needs for specific academic and research support. Staff tended to romanticise the reasons for students enrolling for the degree. Possible conflicting expectations of the degree and the amount and type of support offered were found between the staff and the students and also among various staff members.
Social Work
M.A. (Social Behaviour Studies in HIV-AIDS)

In English
The purpose of this study was to establish factors affecting the participation of men working in the informal sector economy of South Africa in HIV counselling and testing (HCT) or voluntary counselling and testing (VCT). This includes the exploration of reasons for acceptance and non-acceptance of HIV testing, knowledge and perceptions about HIV testing and behaviours and attitudes towards HIV testing. Data was collected through a structured questionnaire and a sample of fifty (50) men was purposively selected. It was found that the reasons for acceptance of HIV testing are satisfactory and reasons for non-acceptance are still a concern, and that several issues such as education about HIV testing and HIV in general still need to be addressed. Most of the respondents had undergone testing for HIV, but there is still a stigma attached to HIV testing.
Sociology
M. A. (Social Behaviour Studies in HIV/AIDS)

Socio-cultural factors oppress and construct women as men’s objects of desire and pleasure, thus increasing women’s vulnerability to HIV infection and, subsequently, maintaining the HIV and AIDS epidemic and prevalence in South Africa’s rural areas. South Africa’s rural women and their sexuality has not received adequate attention to date. This qualitative study sought to explore rural women’s perceptions on their sexuality and HIV prevention within the socio-cultural context of Schoemansdal (South Africa). A sample of ten participants, who are women from the Swazi ethnic group between the ages of twenty and fifty, were purposefully drawn to participate in this study. Data were collected by means of tape–recorded, face-to-face interviews and focus group discussions. Results of the study reveal that women’s social and cultural contexts have an influence on their perceptions of sexuality and HIV prevention, and that this poses a hindrance to women’s HIV-prevention behaviours such as condom use. The study’s findings reveal that in examining HIV infection and prevention, women’s diverse contexts and experiences cannot continue to be overlooked. This is because they may provide relevant understanding of the epidemic that is plaguing South Africa’s rural women.
An explorative study of rural women's perceptions of sexuality and HIV prevention in their local socio-cultural context : a case study of rural Schoemansdal, Mpumalanga
Social Work
M.A. (Social Behaviour Studies in HIV/AIDS)

Given the lack of effective vaccine or medicine, changing an individual's risk behaviours has been crucial in preventing the spread of HIV. Consistent and correct condom use has been considered as the most effective form of HIV prevention among female sex workers. Despite coordinated national level interventions over the last decade, a consistent decline in condom use among female sex workers has been evidenced in the Ethiopian context, particularly with non-paying partners. Thus far, no study has been produced that has illustrated major determinants of consistent condom use among female sex workers which would help in developing effective intervention strategies for the prevention of HIV spread in the country. In other countries, the Information, Motivation and Behaviour (IMB) model has been used to identify individual level determents of condom use. However, the researcher postulated that behaviour emanating from the personality structure of individuals could be the fundamental individual level determents of adherence to condom use and chose to investigate this using the Enneagram theory of personality, which was acknowledged for its heuristic value in explaining and enhancing self-development of at-risk individuals. This cross-sectional study was conducted in Addis Ababa. With the Without Finite Population Correction of the Sample Size Estimation Formula, the sample size of 350 was set and participants were recruited using Respondent-Driven Sampling (RDS). Using trained female sex workers, the Essential Enneagram Test (EET) and an Information-Motivation-Behaviour (IMB) questionnaire were administered to collect data. General Linear Modeling (GLM) Multivariate analysis was carried out to assess the correlation between personality style and consistent condom use among participants in the last seven days before the interview. The finding of this study revealed that personality type, measured by the Essential Enneagram Test (EET), is able to predict adherence to condom use among female sex workers and provided a new dimension for policy makers and practitioners in behavioural intervention programmes, such as Information-Education-Communication, peer-to-peer approaches, as well as health and rehabilitation services by using the Enneagram principles and universal growth process.
Psychology
D. Litt. et Phil. (Psychology)