Dissertations / Theses on the topic 'HIV-positive women – South Africa – Psychological aspects'

The focus of this study was on the experiences of a small sample of local women who are HIVpositive and are living in poverty. The researcher was interested in exploring the psychological and social experiences of these women using Interpretive Phenomenological Analysis. This research aimed at giving these women a voice to express their first-hand, personal accounts of living with HIV in poverty. Data was analysed for meaningful units, which were interpreted inductively and hermeneutically, and categorised into super-ordinate themes. Six themes within the participants' experiences of living with HIV were determined, namely: (I) experiences of diagnosis, (2) disclosure experiences, (3) stigma, (4) ARV experiences, (5) experiences of social support and (6) poverty. This research found that after an HIV-positive diagnosis, most women experience a variety of emotional reactions. These reactions however seem to change overtime into positive acceptance of the HIV diagnosis. Most of the women in this study preferred to use partial disclosure than to fully disclose their HJV-positive status openly to families, friends and to their community. Reasons for not using full disclosure included fear of discrimination and stigma, which included a fear of being rejected or being blamed for their status and a fear of losing relationships. It was also evident from the findings that most of the women had experienced stigma directly and therefore partial disclosure was used as a coping mechanism to protect the self from further harm. It was also revealed that stigma not only has a negative impact on disclosure but also on social support and ARV experiences. Because ofHIV-related stigma, lack of social support was a struggle that almost all the women in this study had experienced. Lack of understandings about their medication also had a negative impact of the ARV experiences. Stigmas along with poverty are the major struggles that HIV -positive women have to deal with in their day to day living. The findings of this study reveal a need for further research in this experiential area as well as campaigns and education around issues such as stigma, medication, and emotional difficulties associated with HIV.

Thesis (PhD)--University of Stellenbosch, 2011.
ENGLISH ABSTRACT: Pregnancy is a vulnerable time in settings such as sub-Saharan Africa, and is associated with exposure to a multitude of physiological, social and psychological risks. High HIV prevalence, and the fact that many women will test for HIV for the first time during their pregnancy, has raised concern about women‘s psychological health during pregnancy. Depression during the antenatal period is of public health concern as it has been shown to be associated with poorer foetal and delivery outcomes, risky behaviours, and poorer uptake of antenatal care. Antenatal depression is a predictor of postnatal depression, and postnatal depression has been associated with poor maternal sensitivity and attachment in mothers which is known to result in increased behavioural and developmental difficulties in children. The aim of this research was to provide a clear, in depth and culturally sensitive understanding of the manifestation of depression in pregnant women in a rural area with high HIV prevalence in South Africa. The research method included a diagnostic assessment of depression in 109 women in their third trimester of pregnancy, and an in-depth qualitative examination of the contextual framework within which HIV testing and depression are experienced with a sub-sample of 56 women. The quantitative results demonstrated that the prevalence of antenatal depression was high (46.7%), with close to half of the women being diagnosed with depression. Presentations of depression most frequently included disturbances in mood, loss of interest and suicide ideation. Symptoms which overlap with common side effects of pregnancy such as loss of energy and weight change did not result in an overestimation of depression. Likewise, very little evidence of the somatisation of depression, or particular cultural barriers to the diagnosis of depression based on DSM-IV criteria was found. Rates of suicide ideation were high and equally common among HIV positive as HIV negative women. Factors significantly associated with depression included living within a family homestead, access to a regular source of income and practical support from a partner. Both income and partner support had a negative association with depression. Living away from a family or parental home had a positive association with depression. The results showed that the Edinburgh Postnatal Depression Scale (EPDS) was effective in identifying depression and that a shorter three item version was as effective as longer versions. A positive score for depressed mood on the EPDS was significantly associated with HIV, suggesting that the EPDS is a good screening tool for elevated psychological risks among HIV positive women post HIV testing. Qualitative results showed that having an unsupportive partner and the occurrence of relationship or familial conflict played an important role in the development of emotional distress during pregnancy and resulted in a high number of unwanted pregnancies. Partner and familial conflict was intertwined with cultural practices which govern the acceptability of childbearing among unmarried women and the social recognition of partnerships and paternal responsibilities. Testing for HIV was considered a stressful life event for all women regardless of their HIV status and was a particularly negative life event for women who tested HIV positive or for women who had concerns over partner infidelity. Disclosure among HIV positive women frequently lead to increased partnership conflict. Qualitative findings suggested that depression and emotional distress after HIV testing did interfere with women‘s ability to engage with prevention messages. Women who were coping well with learning their HIV positive status had high levels of family disclosure and subsequent family support in common. The implication of this research is that it is important that public health programmes screen for depression among childbearing women. These data suggests that a shorter three item version of the EPDS along with screening for partner and family support or conflict would effectively detect most women at high risk for depression. Likewise, public health interventions for women with depression which are implemented in primary health care facilities and in isolation of the partnership and familial context within which depression occurs are not likely to be effective. Further research is needed to establish the precise prevalence of antenatal and postnatal depression in women at high risk for HIV; to validate the effectiveness of a shorter screening tool in resource limited settings; and to establish risk and protective factors, and trimester specific risks which could inform the design of cost effective interventions in poorly resourced settings.
AFRIKAANSE OPSOMMING: Swangerskap in Afrika, suid van die Sahara, is ʼn kwesbare tydperk met blootstelling aan ʼn menigte fisiologiese, sosiale en sielkundige risiko‘s. Die hoë voorkoms van HIV en die feit dat baie vrouens gedurende swangerskap vir die eerste keer vir HIV wil toets, het ‗n besorgdheid oor vrouens se sielkundige gesondheid gedurende swangerskap laat ontstaan. Depressie gedurende die voorgeboortelike periode is van belang vir publieke gesondheid, want daar is bewyse wat dui op ‗n verband tussen depressie en swakker fetale en geboorte resultate, riskante gedrag en verminderde gebruik van voorgeboortelike sorg . Voorgeboortelike depressie is ʼn indikasie van moontlike nageboortelike depressie en nageboortelike depressie word geassosieer met swak moederlike sensitiwiteit en die gebrekkige vorming van ‗n band tussen moeder en kind; wat reeds bewys is om te lei tot verhoogde gedrags- en ontwikkelingsprobleme in kinders. Die doel van hierdie navorsing was om ʼn duidelike, indiepte en kulturele-sensitiewe begrip van die manifestasie van depressie in swanger vroue in ʼn landelike omgewing met hoë HIV voorkoms in Suid Afrika te verkry. Die navorsingsmetode sluit in ʼn simptomatiese beraming van depressie by 109 vroue in hul derde trimester van swangerskap en ʼn indiepte kwalitatiewe ondersoek na die kontekstuele raamwerk waarbinne HIV toetse en depressie ondervind word met ʼn sub-steekproef van 56 vrouens. Die bevinding was dat die voorkoms van voorgeboortelike depressie hoog was, 46.7 %, met feitlik die helfte van die vrouens wat met depressie gediagnoseer is. In die meeste gevalle het die voorkoms van depressie gepaard gegaan met ʼn verandering in gemoedstoestand, ʼn verlies aan belangstelling en selfmoordgedagtes. Simptome wat ooreenstem met algemene newe-effekte van swangerskap, soos verlies aan energie en verandering in gewig, het nie bygedra tot ʼn oorberekening van depressie nie. Soortgelyk is baie min bewyse gevind dat somatosasie van depressie, of spesifieke kulturele grense, tot die diagnose van depressie gebaseer op DSM-IVkriteria bydra. Die oorweging van selfmoord was hoog en algemeen tussen beide HIV-positiewe en HIV-negatiewe vouens. Faktore wat aansienlik met depressie geassosieer word, sluit in om in ʼn familiegroep te bly, toegang tot ʼn vaste bron van inkomste en die praktiese ondersteuning van ʼn lewensmaat. Beide inkomste en die ondersteuning van ʼn lewensmaat het ʼn negatiewe verbintenis met depressive. Om nie by familie of in ʼn ouerhuis te bly nie het ʼn positiewe assosiasie met depressive. Alhoewel HIV-status verband hou met depressie, was dit nie uitermate die geval nie, alhoewel daar ʼn gebrek aan statistiese kragdoeltreffendheid was om die effek van HIV vas te stel, gegee die beperkte grootte van die steekproef. Die resultate het getoon dat die EPDS graderingsinstrument effektief was om depressie te identifiseer en dat ʼn korter driepunt weergawe daarvan net so effektief was soos die langer weergawe. ʼn Positiewe telling vir ʼn depressiewe gemoedstoestand op die EPDS het ʼn betekenisvolle assosiasie met HIV en dui daarop dat die EPDS ʼn goeie graderingsinstrument is vir verhoogde sielkundige risiko by HIV-positiewe vrouens, selfs al is HIV-positiewe vrouens in dié steekproef statistieksgewys nie meer geneig tot depressie as HIV-negatiewe vrouens nie. Kwalitatiewe resultate toon dat ʼn lewensmaat wat nie ondersteunend is nie en die voorkoms van verhoudings- of familiekonflik ʼn belangrike rol speel in die ontwikkeling van emosionele angs gedurende swangerskap en dit het gelei tot ʼn groot aantal ongewenste swangerskappe. Konflik met ʼn lewensmaat en met familie was verweefd met kulturele gebruike wat die aanvaarbaarheid van geboortes onder ongetroude vrouens beheer en die sosiale erkenning van verhoudings en die vader se verantwoordelikhede. ʼn HIV-toets is as ʼn stresvolle lewensgebeurtenis beskou deur alle vroue, ongeag van hulle HIV-status en was ʼn besondere negatiewe lewensgebeurtenis vir vroue wat HIV-positief getoets het of vir vroue wat bekommerd was oor hulle lewensmaats se getrouheid. Onthulling van die HIV-status van positiewe vrouens het gereeld tot verhoogde konflik in verhoudings gelei. Kwalitatiewe bevindings dui daarop dat depressie en emosionele angs na ʼn HIV-toets inmeng met ʼn vrou se vermoë om ag te slaan op voorkomingsboodskappe. Vroue wat die kennis van hulle HIV-positiewe status goed hanteer het, het hoë vlakke van bekendmaking van hulle status en die ondersteuning van hulle familie in gemeen. Die implikasie van die navorsing is dat dit belangrik is vir publieke gesondheidsorgprogramme om te toets vir depressie onder swanger vroue. Die resultate dui daarop dat ʼn korter driepunt weergawe van die EPDS, saam met ʼn ondersoek na die ondersteuning van of konflik met ʼn lewensmaat en familie, effektief kan wees om vroue met ʼn hoë risiko vir depressie te identifiseer. Soortgelyk, publieke gesondheidsingryping in primêre gesondheidsorg fasiliteite vir vroue met depressie wat in isolasie van die lewensmaat en familie konteks, waar depressie voorkom geadministreer word, is onwaarskynlik om te slaag. Bevindings onderskryf die belangrikheid van ondersteuning vir die familie om effektief te kan reageer en herstel van stresvolle faktore soos onbeplande swangerskappe en HIV-diagnose, in ʼn konteks wat swaar deur HIV geaffekteer word, aangesien dit ʼn voorkomende effek op depressie kan hê. Verdere navorsing is nodig om die presiese voorkoms van voorgeboortelike en nageboortelike depressie in vrouens met ʼn hoë blootstelling aan HIV vas te stel; om die sukses van ʼn korter graderingsinstrument in arm omgewings te staaf; en om die risiko en beskermende faktore vas te stel en trimester spesifieke risiko‘s wat die ontwerp van ʼn koste-effektiewe ingryping in gebiede met ontoereikende hulpbronne kan beïnvloed.

The effects of the spread of HIV/AIDS place a great burden on women and children, who will probably suffer most in terms of social and economic deprivation. Since HIV/AIDS is linked to social taboos such as sexuality, drug use and death, there are enormous levels of ignorance, denial, fear and intolerance in most communities. These prejudices lead to the stigmatisation and discrimination of people who are living with HIV/AIDS. Moreover the illness, as it is sexually transmitted, has been conflated with sexual excess, lack of morals, and those already stigmatised such as sex workers with associated discourses of blame, shame and guilt. Generally, responses to HIV and those living with HIV have served to reflect, legitimise and reproduce broader social inequalities on the basis of sexual orientation, gender, race and class. Stigma is the reason why many people who are living with HIV/AIDS, choose not to disclose their status and seek apposite assistance. This study explored the stigma experienced by a group of women who are living with HIV/AIDS and to develop a deeper understanding of whether these experiences are complicated by social responses.

Women living with HIV have a variety of reproductive health and psychosocial needs. The purpose of this critical ethnographic study was to examine how HIV, empowerment and reproduction are experienced by a volunteer sample of HIVpositive women attending public health care facilities in Gauteng. Feminist and critical approaches were used to guide the methodology of the research and the interpretation of the findings. Data were collected through in-depth interviews and observation. An overview of literature pertaining to the social construction of HIV-AIDS, women’s empowerment and reproductive decision-making is presented. A discourse of “healthy lifestyle” as technologies of the self is considered. Women’s empowerment as an ideal is described and structural barriers to its achievement are discussed. Stigma and discrimination as products of hegemony are discussed as important issues in the disempowerment of women living with HIV. HIV-AIDS as illness experience is reviewed with reference to the social context and to the individual context. Reproductive decision-making models and theories are critically analysed for their applicability to women living with HIV. The need for a conceptual shift in the notion of empowerment in order to understand constrained decision-making for women living with HIV is propagated. The stories of women living with HIV and dependent on public health care services are presented. Through the principles of a critical ethnography the lived experiences of these women are described by means of emerging themes. A historiography of family planning and HIV-AIDS services throws the narrations of the research participants into broader historic relief. Findings revealed that biomedical hegemonic power contoured and marked the lived experiences of women following an HIV-positive diagnosis. Taken-for-granted views of passivity and of own responsibilities regarding reproductive health are challenged. The women in the study were dependent upon public health care personnel for treatment, testing, dietary advice/supplementation and recommendations for a social xii disability grant. ARV-treatment was regarded as a low point in the illness career. All of the participants reported that the overriding problems in their lives were having too few material resources and not having the means to change this. This made them vulnerable to compounded health problems and decreased their ability to voice their own opinions about treatment. They did not regard themselves as having been at risk for contracting HIV and some harboured resentment towards men who were seen as being absolved from testing and responsibilities towards female partners, born and unborn children. Women who were not tested as part of antenatal sentinel groups tended to suffer symptoms of ill health for some time prior to being tested for HIV. Social support systems were either absent or consisted of trusted family members and friends. In many cases, women became the silent care-givers for those affected and infected by HIV. Anticipated stigma permeated the participants’ narrations of living with HIV and disclosure of their statuses was difficult. The use of male condoms, stressed during counselling sessions, was narrated as a difficult burden for women to bear. Although the research participants expressed low fertility preferences, HIV-AIDS was seen as disrupting the link between heterosexual conjugal relations and the taken-for-grantedness of procreation. HIV-AIDS also disrupted norms in infant feeding practices and bottle-feeding was regarded as a sign of possible HIV-infection and hidden. The research participants were not empowered with knowledge about how to deal with side-effects, condom failures and the reluctance of male partners to be tested for HIV. They enacted, resisted and lived with HIV in different ways, incorporating some of the biomedically prescribed posturing as women living positively and blending it with stigma-negating performances and gender-prescribed ways of dressing, walking and acting. Participation in a support group validated their experiences and promoted positive self-perception. The formation of a collective voice in the support group was hampered by irregular attendance, the interference of community leaders and horizontal violence. Power relations, yielded by biomedical hegemony, androcentric sociocultural practices, material deprivation, fear, discrimination and stigma potentially undermined the women’s abilities to become empowered. Expansion of choices in various spheres or fields and collective action xiii are proposed as dimensions to be added to an empowerment-of-women approach to the problems of reproductive health in the age of HIV-AIDS. The contribution of the study as an emancipatory project is evaluated and implications for policy and practice are suggested. On a methodological level, this study is a demonstration of the contribution to be made by a micro-level, critical analysis to the body of knowledge about female reproductive health in the era of HIV-AIDS in South Africa. On a theoretical level, this study contributes to a wider conceptualisation of women’s empowerment by recognising the interplay between micro-level elements of situated experience, knowledge and preferences and the macro-level elements of sociocultural, biomedical and material influences on health and reproductive behavior.

The focus of this study is on the experiences of a small sample of local women who have been recently diagnosed with HIV. The aim of the research was to give these women an opportunity to express their first-hand, personal accounts of living with HIV. Five isiXhosa-speaking women were recruited and interviewed. These accounts were collected and analysed within in the methodological framework of Interpretative Phenomenological Analysis, a qualitative approach that is becoming increasingly popular in the broad fields of health and clinical psychology. Data was analysed for meaningful units, which were interpreted inductively and hermeneutically, and categorised into super-ordinate themes. Five themes within the participants’ experiences of living with HIV were identified: (1) experiences of diagnosis, (2) experiences of stigma, (3) social support, (4) coping strategies, and (5) HIV as one of many assaults to self. Implicated in these experiences are the ways in which these women have appraised themselves and their situation after an HIV-positive diagnosis, appraisals that are shaped by HIV-related stigma. A variety of negative emotional reactions are common following the diagnosis, often compounded by the direct experiences of HIV-related stigma. Women in the study adopted different kinds of coping strategies based on the resources and social support available to them. Also significant is that for these women who had typically endured a variety of traumatic life events, a positive diagnosis was simply one of many life challenges

Thesis (MSc)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Global estimates show that sub-Saharan Africa has the largest portion of HIV cases with South Africa having more people living with HIV than any other country in the world. Moreover, studies have shown a high incidence of intimate partner violence (IPV) among people living with HIV. IPV has been shown to be associated with mental health problems. Considerable empirical studies have demonstrated that HIV is a highly stigmatized disease. In addition, HIV-related stigma has also been shown to be a risk factor for mental health problems among persons living with HIV. However, no empirical studies have examined the combined effect of IPV and HIV-related stigma on mental health. This thesis builds on the existing body of research by examining to what extent the linear combination of IPV (timing and frequency) and HIV related stigma explained variation in symptoms of common mental health disorders in both men and women living with HIV. In addition, theoretical and empirical studies have suggested that social support may serve as a protective factor in the relationship between IPV, HIV-related stigma, and mental health. Yet, despite the increasing attention, no known studies have focused on the mediating or moderating role of social support in the relationship between IPV or HIV-related stigma, and mental health. This thesis examined the extent to which social support played a mediating or moderating role in these relationships. The study used a cross-sectional research design to study a convenience sample of 210 people living with HIV in three peri-urban areas in the Western Cape, South Africa. Participants completed a battery of self-report questionnaires that assessed IPV (timing and frequency), HIV-related stigma, social support, and symptoms of common mental health. The results from the hierarchical multiple regression analysis demonstrated that the linear combination of psychological aggression frequency and HIV related stigma explained a significant portion of the variance in symptoms of depression. Likewise, both physical assault timing and psychological aggression timing combined with HIV-related stigma explained a significant portion of variance in symptoms of depression. Psychological aggression timing combined with HIV-related stigma significantly explained variance in symptoms of posttraumatic stress disorder (PTSD). The results from the product-term regression analyses indicated that social support played a mediating role in the relationship between HIV-related stigma and symptoms of PTSD, but not depression. Social support did not moderate the relationship between HIV-related stigma and symptoms of common mental health disorders. In conclusion, the combination of IPV (physical assault and psychological aggression) and HIV-related stigma explained a significant portion of the variance in symptoms of common mental health disorders. Future research is needed for a better understanding of these relationships. A longitudinal experimental design is recommended in order to explore the direction of these relationships and to examine the context in which the IPV, HIV-related stigma, and social support is experienced.
AFRIKAANSE OPSOMMING: Wêreldwye beramings toon dat sub-Sahara Afrika die grootste gedeelte van HIV gevalle te wêreld het, terwyl Suid-Afrika meer mense het wat met MIV leef as enige ander land in die wêreld. Verder het studies getoon dat daar 'n hoë voorkoms van intiemepaargeweld (IPV) is onder mense wat met MIV leef. Daar is al getoon dat IPV verband hou met geestelike probleme. Aansienlike empiriese studies het getoon dat MIV 'n hoogs gestigmatiseer siekte is. Daarbenewens, is daar getoon dat MIV-verwante stigma 'n risiko faktor is vir geestelike probleme onder persone wat leef met MIV. Daar is egter geen empiriese studies wat die gekombineerde effek van IPV en MIV-verwante stigma op geestesgesondheid ondersoek nie. Hierdie tesis bou voort op die bestaande navorsing deur te ondersoek tot watter mate die lineêre kombinasie van IPV (tydsberekening en frekwensie) en MIV-verwante stigma variasie in die simptome van algemene geestesgesondheid afwykings verduidelik in beide mans en vroue wat met MIV leef. Daarbenewens, het teoretiese en empiriese studies voorgestel dat sosiale ondersteuning kan dien as 'n beskermende faktor in die verhouding tussen IPV, MIV-verwante stigma, en geestesgesondheid. Tog, ten spyte van die toenemende aandag, het daar al geen studies gefokus op die bemiddelende of modererende rol van sosiale ondersteuning in die verhouding tussen IPV of MIV-verwante stigma, en geestesgesondheid. Hierdie tesis ondersoek die mate waarin sosiale ondersteuning 'n bemiddelende of modererende rol speel in hierdie verhoudings. Die studie het 'n deursnee-navorsing ontwerp gebruik om 'n gerieflikheidsteekproef van 210 mense wat met MIV leef in drie peri-stedelike gebiede in die Wes-Kaap, Suid-Afrika te bestudeer. Deelnemers het 'n battery van self-verslag vraelyste voltooi wat IPV (tydsberekening en frekwensie), MIV-verwante stigma, sosiale ondersteuning, en simptome van algemene geestesgesondheid geassesseer het. Die resultate van die hiërargiese meervoudige regressie-analise het getoon dat die lineêre kombinasie van sielkundige aggressie frekwensie en MIV-verwante stigma 'n beduidende deel van die variansie in simptome van depressie verduidelik. Net so, het beide fisiese aanranding tydsberekening en sielkundige aggressie tydsberekening gekombineer met MIV-verwante stigma 'n beduidende deel van die variansie in simptome van depressie verduidelik. Sielkundige aggressie tydsberekening gekombineer met MIV-verwante stigma het „n beduidende variansie in simptome van post-traumatiese stresversteuring (PTSV) verduidelik. Die resultate van die produk-term regressie-analises het aangedui dat sosiale ondersteuning 'n bemiddelende rol speel in die verhouding tussen MIV-verwante stigma en simptome van PTSV, maar nie depressie nie. Sosiale ondersteuning het nie die verhouding tussen MIV-verwante stigma en simptome van algemene geestesgesondheid versteurings modereer nie. Ten slotte, die kombinasie van IPV (fisiese aanranding en sielkundige aggressie) en MIV-verwante stigma het 'n beduidende deel van die variansie in simptome van algemene geestesgesondheid versteurings verduidelik. Toekomstige navorsing is nodig vir 'n beter begrip van hierdie verhoudings. 'n Longitudinale eksperimentele ontwerp word aanbeveel om die rigting van hierdie verhoudings te verken en die konteks waarin die IPV, MIV-verwante stigma en sosiale ondersteuning ervaar is te ondersoek.

There appears to be a growing body of literature focusing on PTSD and HIV-related PTSD (the diagnosis of HIV being the significant traumatic event) amongst HIV-positive samples, but only a few African studies that attempt to estimate the prevalence of PTSD amongst HIV-positive people, and even fewer that attempt to estimate the prevalence of HIV-related PTSD. The systemic review presented in this study is currently fully inclusive and is the most up-to-date available. Estimates of the prevalence of PTSD and HIV-related PTSD in South Africa range from 0.7 to 54.1% and, 4.2 to 40% respectively. The current cross-sectional study made use of a mixed-method approach to investigate traumatic life events, PTSD and HIV-related PTSD within a primary health-care centre in KwaZulu-Natal. The quantitative sample consisted of 159 adults (18-50 years) who were compliant on ARV medication. Using the CIDI-PTSD module, the adapted CIDI-PTSD module for HIV, and IES-R, findings indicated that 62% had reported some kind of traumatic event in their lifetime, with 29.6% of participants meeting the criteria for lifetime PTSD, and 40.9% meeting the criteria for lifetime HIV-related PTSD. Altogether, 57.9% of individuals met the criteria for some form of PTSD (either regular PTSD or HIV-related PTSD), and 12.6% met the criteria for both PTSD and HIV-related PTSD. Of the different categories of traumatic events, interpersonal violence has the highest rate of PTSD, followed by a diagnosis of and living with HIV, and then disaster. Furthermore, the IES-R was compared for its usefulness as a screening measure for PTSD against both the CIDI, but results suggest that it is an inferior screening measure to the PDS. The qualitative study consisted of six participants who were examined using IPA methodology informed by the Ehlers and Clark (2000) Model of trauma. Their experiences revealed experiences of stigma, a number of negative appraisals, negative emotions and coping behaviours. Some of the latter might serve as compensatory mechanisms to avoid negative judgements. Hypervigilance seems to be a feature of ARV-compliance that might confer added vulnerability to PTSD and other anxiety disorders.

This research critically analysed Muslim approaches to five women with HIV/AIDS in Cape Town focussing particularly on the approach of 'Positive Muslims' - an awareness-raising and support group for Muslims living with HIV/AIDS. The central question of this thesis dealt with the impact of the norms, values and practices of Cape Muslims on the approach of Positive Muslims to women living with HIV/AIDS. It is suggested that while norms and values articulated in religious texts inform the ideological approach of the organisation's AIDS prevention model. This is due to the pragmatic approach adopted by Postive Muslims which recognises that the articulated norms and values do not always conform to the practices of Cape Muslims.

One of the greatest challenges facing sub-Saharan Africa, which incorporates South Africa, is the AIDS pandemic. The devastation wrought by this disease is unsurpassed in recent times. The health and social development structures, already overburdened, are totally overwhelmed by the needs of povertystricken households and communities affected by AIDS. Caregivers attempting to support those affected and infected are also facing unique challenges and demands, particularly relating to dealing with the large numbers of deaths due to this disease. Experiences for these caregivers are likely to be varied, ranging on a continuum from positive to negative, for instance, the recovery of patients versus the death of patients. The objectives of this study are to explore and describe the lived experiences of caregivers working with AIDS patients, particularly patients who die from this disease whilst resident in a formal institution. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is grounded in a phenomenological approach to inquiry. Caregivers working fulltime in a formal institution caring for patients who are dying from AIDS were interviewed in an in-depth, unstructured manner in order to gather spontaneous, rich descriptions of their experiences. Through this study the researcher wants their voices to be heard, the potential richness of their reflections acknowledged and the generated data to be applied to the benefit of the field of HIV/AIDS – both for staff and patients. Thirteen in-depth, unstructured interviews provided saturated data, which was then transcribed and coded to yield the central and sub-themes that were identified in this study. One central theme identified the fact that in their daily duties (at their place of work), caregivers experience various challenges as a result of having to deal with the death and dying of their patients suffering from AIDS. These caregivers face the death of their patients daily, from a disease that causes untold suffering to the patient, family members and to the caregivers themselves, who wish they could prevent the anguish, the pain and the inability of the medical profession to do more than they are at present towards curing this disease. ii By describing the lived experiences of these caregivers by means of the research interviews, the researcher gained a clear picture of the AIDS environment. The information shared by the participants formed the foundation of the broad guidelines that were formulated. These are intended to provide support for the caregivers centering around the equipping of mentors of the caregivers, to enable them to support the caregivers in their daily task of caring for patients dying from AIDS. These caregivers, thus supported, will then be in a position to provide optimal care for these dying patients. These broad guidelines are intended to provide support by focusing firstly on the physical environment in which these caregivers work; secondly in providing education for the caregivers to enable them to fulfill their duties, and thirdly to provide adequate counselling to ensure that they do not succumb to caregiver fatigue/burnout, a constant threat in this type of environment. The study concludes with recommendations regarding the areas of nursing practice, education and research.

South Africa has the largest percentage of people living with HIV/AIDS in the world. However, the response against the further spread of HIV/AIDS in the country is being hindered by stigma and discrimination. In order to develop effective intervention programmes to control and reduce the further spread of the disease, it is first important to understand the nature of HIV/AIDS-related stigma and especially how people construct it. In the present study, the social construction of HIV/AIDS-related stigma among Muslims was investigated because high levels of stigma were found in this group. This was fuelled partly by the belief that HIV/AIDS was not a serious problem amongst Muslims. Two focus groups were conducted, one among Muslim women only and the second among Muslim men only. The main aim of the study was to examine the perceptions of HIV/AIDS-related stigma among Muslims. The transcripts were analyzed using thematic content analysis to determine the themes that emerged from the research material. The main findings of the study included that Muslims&rsquo
religious identity/positioning was the most salient discourse that informed how they understood, made meaning of, and responded to HIV/AIDS. They engaged in various forms of stigma such as &lsquo
othering&rsquo
, and mediating factors of stigma included religious positioning. Stigma also served as a social barrier to VCT and disclosure of HIV status. However, supportive attitudes and behaviours were also evident. The findings yielded useful insights into possible elements of intervention programmes, both to reduce HIV/AIDS-related stigma, and also to encourage behavioural change in order to control and reduce the spread of HIV/AIDS in this community.

Thesis (MPhil (Public Management and Planning))--University of Stellenbosch, 2010.
ENGLISH ABSTRACT: The research was conducted to explore the experiences of people living with Acquired Immunodeficiency Syndrome (AIDS) (PLWAs), especially women, as well as the factors influencing their non-participation in development projects aimed at improving their socio-economic status. The study was conducted amongst PLWAs who are members of the Tembisa Main Clinic and Winnie Mandela Clinic support groups in Tembisa, South Africa. The researcher was motivated to conduct the research because in her work as a social worker she is confronted daily with PWLAs who are from disadvantaged backgrounds and are struggling to make ends meet. Initiatives have been undertaken to try and encourage self–reliance and improve the health status of these women by developing food gardens to provide them with fresh vegetables and possible income sources from these gardens. The reluctance of members of two support groups of PLWAs to stay involved in these projects encouraged the researcher to explore these issues. The researcher consulted various sources to obtain literature on the factors influencing non-participation in development projects. In addition she undertook a qualitative study, wherein twenty participants participated. The data from this study was then interpreted and compared to the literature. The findings of this study highlighted several factors such as discrimination, local beliefs, stigma and lack of support, which influence the non- participation of PWLAs in sustainable development projects. The findings of this research also indicate that developments projects often fail to thrive because of topdown decisions about the projects, the fact that there is no start-up funding available for the projects and participants who become demotivated to participate. The research therefore concludes with recommendations in order to address these problems.
AFRIKAANSE OPSOMMING: Die navorsing is onderneem om die ondervinding van mense, veral vroue, wat met Verworwe Immuniteitsgebrek Sindroom (VIGS) lewe, te ondersoek, asook die faktore wat hulle daarvan weerhou om deel te neem aan ontwikkelingsprojekte wat daarop gemik is om hul sosio-ekonomiese status te verbeter. Die studie is onderneem onder pasiënte wat lede was van ondersteuningsgroepe by Tembisa Hoofkliniek en Winnie Mandela Kliniek in Tembisa, Suid-Afrika. Die navorser is gemotiveerd om die studie te onderneem omdat sy daagliks in haar werk as sosiale werker gekonfronteer is deur mense wat met VIGS lewe, wat uit minder bevoorregte agtergronde kom en wat sukkel om te oorleef. Inisiatiewe is onderneem om hierdie vroue se selfstandigheid te bevorder en om hul gesondheidstatus te verbeter deur groente tuine te ontwikkel om hulle van vars groente te verskaf, asook moontlike inkomstebronne uit hierdie tuine. Die onwilligheid van die lede van twee ondersteuningsgroepe om in hierdie projekte betrokke te bly, het die navorser aangemoedig om hierdie aangeleentheid verder te ondersoek. Die navorser het verskeie bronne geraadpleeg om literatuur te verkry oor die faktore wat die nie-deelname in ontwikkelingsprojekte beïnvloed. Sy het ook kwalitatiewe studie onderneem waaraan twintig respondente deelgeneem het. Die data van hierdie navorsing is daarna geïnterpreteer en met die literatuur vergelyk. Die bevindinge van hierdie navorsing het verskeie faktore uitgelig wat die niedeelname beïnvloed van mense wat met VIGS lewe, soos diskriminasie, plaaslike gelowe, stigma en gebrek aan ondersteuning. Die navorsing het ook bevind dat ontwikkelingsprojekte dikwels nie floreer nie as gevolg van die ‘topdown’ besluitneming oor die projekte en omdat daar nie genoegsame vooraf befondsing beskikbaar is vir die projekte nie en die deelnemers dus demotiveer om verder deel te neem. Die navorsing sluit dus af met voorstelle om hierdie probleme aan te spreek.

The media, through development communication and edutainment, plays a critical role in the transformation of societies. In line with this, this thesis discusses the extent to which commercially driven prosocial soap operas can provide a platform for public health messaging, in the context of the HIV/AIDS epidemic in South Africa, for antiretroviral treatment (ART) and for encouraging ART adherence to foster national development. Furthermore, this thesis examined the potential of celebrities as HIV/AIDS ambassadors and the potential of both fictional characters and ‘real-life’ celebrities to disseminate these health messages. Although the HIV/AIDS epidemic in South Africa is stabilising, this is not the time to relax the communication around the disease, particularly regarding adherence to ARVs, considering that South Africa has the largest ARV rollout in the world. The qualitative methodological approach taken for this thesis is a three-step approach examining the intended message, the text and the appropriated message by viewers. Firstly, a thematic content analysis of an episode of Isidingo, that illustrated Nandipha as HIV-positive and the side-effects that came with her ART adherence, and the 3Talk interview with Lesego Motsepe, where she announced that she was weaning herself off ART, was done in order to understand the intended health messaging in the soap opera and the health message disseminated by an HIV-positive actress with regards to ART. Thereafter interview responses by the production team as well as by HIV-positive viewers, using ARVs, were thematised. In addition media texts which provided commentary on the use of a celebrity as a HIV-positive role model were examined. In doing this, this thesis has offered up the meanings of how HIV-positive women taking ARVs and living in Makana experience and understand the media, particularly health messaging relating to ARVs. The findings of this study suggest that commercial soap operas are the perfect platform to address HIV/AIDS and that prosocial health messaging regarding ARV adherence is still necessary in this country. Soap operas have the potential to have an educational angle. Although, HIV-positive individuals serve as better role models as they are authentic; given human nature, fictional characters, such as Nandipha Matabane in Isidingo, may be more sustainable role models as their message can be scientifically-based and well-researched. Realistic characters serve as role models whose behaviour is to be emulated. Soap operas appeal to a wide audience and so storylines can be tailor-made according to the times and the needs in terms of health issues and messaging. Thus, soap operas are not a single platform but rather one which can be exploited to maximum advantage for public health messaging.

Please read the abstract (Summary) in the section 00front of this document. Please note: The Errata list is included as last page of each chapter
Dissertation (MA (Clinical Psychology))--University of Pretoria, 2007.
Psychology
unrestricted

M.Cur.
Statistics prove that the monster called HIV/AIDS invades our country. More women are said to be HIV positive in comparison to men. The midwives are the frontline health workers who have to care for these pregnant HIV positive women and therefore are at occupational risk of HIV infection because of their caring role. The experience of midwives regarding the delivery of the babies of HIV positive women was not well addressed before as limited studies have been undertaken about the experiences of midwives, therefore inspiring the researcher to undertake this study. The purpose of this study was to: • Explore and describe how midwives experienced the delivery of the babies of HIV positive women. • Describe the guidelines for health professionals to support midwives in order for them to render good midwifery care. The paradigmatic perspective of this study was guided by the Theory for Health Promotion in Nursing (Rand Afrikaans University, Department of Nursing Science, 1992:2-15), which reflects the focus on the whole person.

The research is about African women living with HIV and women grieving the death of loved ones as a result of AIDS. We discuss the women's preferred care for the ill person and for the family as well as for the bereaved family. We consider together the effects of HIV/AIDS in the community: the stigma attached to the disease and the fears of people that they may contract HIV. The women and I acknowledge the closely woven relationships between faith and culture in a predominantly Xhosa community. Participatory action research is used and contextual feminist theology within a postmodern social construction approach to narrative pastoral therapy.
Philosophy, Practical and Systematic Theology
M.Th. (Practical Theology)

Three years into the human territory, the fight against HIV/AIDS still prevails. According to Fuller (2008), it is estimated that by 2025, 80 million Africans will have been killed by this pandemic, while 90 million are estimated to be infected by HIV. Close to 3 thousand women are infected with HIV daily. In the beginning of 2008, some 22,5 million sub-Saharan Africans were living with HIV (Fuller 2008). In South Africa, 5 million people are estimated to be infected with HIV, 250 thousand die each year due to AIDS-related deaths, while a thousand people die daily and 17 hundred get infected daily. South African women are the hardest hit population group, compared to their male counterparts (Fuller 2008; Zuberi 2004). In South Africa this epidemic crawled under the shadow of denial, fear, ignorance, stigma and discrimination, which disrupted efforts to prevent further spread and care for the infected and the affected individuals and groups. South African women are subjected to gender inequality, sexual violence and rape, and in the presence of HIV/AIDS their plight became exacerbated. They became subjected to blame and rejection because people do not want to associate themselves with this group, who possess the deadly infectious disease which is associated with commercial sex workers, intravenous drug users and homosexuals. The aim of this research was to investigate the plight of anticipated and enacted stigma among the South African women who receive treatment as outpatients in the Chris Hani Baragwanath Hospital. The study was conducted among six women who are living with HIV/AIDS over a period of four weeks, with a qualitative research design adopted as research method. In-depth interviews were used as the primary tool for data collection. This study was conducted in order for the researcher to obtain insight into the subject of HIV- and AIDS-related stigma and to highlight the experiences of participants for policy and programme designing and development purposes.

Text in English
Previous studies have reported a high prevalence of HIV and AIDS among adolescent girls. It is estimated that there are 5,24 million people living with HIV/AIDS (PLWHA). These estimates would mean that about 2.36 million people living with HIV/AIDS would be young women and girls aged 15-24 years. The latest household survey conducted by the Human Science Research Council (HSRC) revealed that the prevalence of HIV is three to seven fold in girls and young women aged 15-24 than boys and young men (HSRC 2014) This resurgence in HIV incidence is occurring at a time when it is believed the epidemic has reached a plateau following aggressive behavioural, biomedical and structural interventions by the Department of Health, Non-Governmental Organizations (NGO) and civil society in general. A probability sampling method, involving a random selection of elements was used to select 130 young women and girls aged 18-24 presenting at Dr George Mukhari Academic Hospital by simple random sampling. Data were collected by self-administering questionnaires. High unemployment and greater age-disparity in the relationships were found to have a direct correlation with HIV incidence in the population under study. This study also shows that inconsistent condom use, low rate of medical male circumcision of male partners, coupled with lower HIV counselling and testing than the national average, was associated with new HIV infections, in spite of high level of condom availability, knowledge of HIV issues and an exposure to an array of behavioural change communication interventions.
Health Studies
M.A. (Public Health)

Text in English
Even though the prevalence of HIV has declined, South Africa continues to have a large number of people who are infected with HIV. Most communities still have to deal with the effects of HIV and AIDS on orphans and vulnerable children. One way of mitigating the effects of HIV and AIDS is strengthening families and communities to provide stable care to orphans. However, most families do not have the capacity to provide sufficient care to orphans hence the need for external support from the community and civil society organisations, in this instance provided through the loveLife goGogetter programme. The findings proved that the goGogetters relied on the support they received through the relationships and networks established in the community to enable them to provide effective service to orphans. The study demonstrated the importance of community networks in providing for the basic needs of orphans.
Social Work
M.A. (Social Behaviour Studies in HIV/AIDS)

The phenomenon of stigmatisation in the transmission of HIV/AIDS was highlighted in this study, and considered from a social constructionist perspective. The lived experiences of 20 participants were explored in the context of a stigma reduction programme. Perceived meanings attached to stigma, and its influence on participant behaviour was revealed through narratives. The influence of the programme on participant meaning making and perceptions was also revealed, and found that the meaning of stigma remained unchanged, and therefore stigma was not reduced. Not discounting the therapeutic platform of the programme in enabling co-construction of new perspectives which enabled coping mechanisms for participants in dealing with their circumstances. It is recommended that studies such as this be used to assist future stigma reduction programmes to identify their roles in meaning making regarding stigma, with the premise in mind that if meaning shifts, experiences will shift.
Psychology
M.A (Psychology)

This study investigated the subjective well-being of female strippers. The effect that certain variables namely, self-esteem, general health, self-efficacy, perceived social support and sense of coherence had on subjective well-being and the independent components of subjective well-being, namely life satisfaction and positive and negative affect, were investigated. The sample consisted of 75 female strippers and was a consequence of a combination of purposive and convenience non-probability sampling. These women were employed at Teazers - a chain of strip clubs in Gauteng, South Africa. Information was gathered through self-reported questionnaires with quantifiable scales. The results of the regression models showed that life satisfaction depends on perceived social support, but positive and negative affect depends on self-esteem and general health. If life satisfaction and positive and negative affect is combined into a measurement of subjective well-being, 6.7% of the total variance in subjective well-being is uniquely explained by self-esteem.
Psychology
M. Sc. (Psychology)

A Thesis submitted in fulfillment of the requirements for the degree of Doctor of Philosophy in Community Psychology in the Department of Psychology at the University of Zululand, 2007.
The major aim of the study was to determine whether broad-based initiatives, such as community based stigma reduction intervention programmes (later) based on the findings of the study, could have an impact on the uptake of HIV-testing and disclosure rate. The total sample comprised of 15 females and 15 males that were chosen from one of the support groups based at one of the selected Hospitals in KwaZulu-Natal Province. With the assistance of the hospital officials, the researcher was able to use the purposive sampling technique in selecting the respondents. From the themes, it became evident that people living with HIV and AIDS are faced with an important dilemma regarding whether or not they should reveal the HIV-positive status to significant others, in-depth interviews with the focus groups produced the following themes as accounts of emotional observations: isolation, social stigma, anger, revenge and depression. In the light of the findings of the study, a need arose for the establishment of an intervention programme aimed at addressing the common barriers associated with HIV disclosure. Community Psychology in particular, played a major role in shaping this study because of its action focus on groups.
National Research Fund (NRF)

The introduction of Antiretroviral (ARV) treatment has allowed for many children living with human immunodeficiency virus (HIV) to survive to adolescence. However for this to be a reality adherence to treatment is important. Many studies suggest that during adolescence adherence can be very challenging. However not much research has been done within the South African context to understand what HIV positive adolescents are experiencing, particularly in relation to ARV adherence. The aim of this research study was to explore the experiences of adolescents on antiretroviral therapy (ART) in order to understand what helps them to adhere to their medication and the challenges that they may have with adherence. This was achieved by carrying out 5 semi-structured in-depth interviews with HIV positive adolescents on ARVS at a shelter for HIV positive women and children in Johannesburg. A thematic content analysis was used to analyse the transcribed interviews. The results indicated several factors that both assist with adherence and those that challenge adherence. The participants reflected on the importance of full disclosure which increases their understanding of the importance of adherence, having people they trust whom they can confide in and who also support them to take and adhere to the ARVs, and having a positive experience at the hospital when they go for their regular checkups. Certain defence mechanisms adopted by the adolescents to help them cope with living with HIV and having to take medication every single day of their lives were also identified. The fact that acceptance is a process was also suggested by the research findings. The challenges the adolescents face were those of stigma and a fear of being rejected, bad experiences associated with taking medication, such as the negative side effects and the disruption of their leisure time, and negative experiences from going to the hospital. This study yielded some rich information that may aid in understanding what adolescents are experiencing and facing which may inform future research studies on this topic and policies which may assist with an increase in adherence.

M.A. (Psychology)
The Acquired Immunodeficiency Syndrome (AIDS) has become one of the major challenges that the health care system has had to face and will continue to present a significant health challenge well into the 21st century. Up to the present time no effective treatment method has been found as the retroviral agents typically only cause a temporary inhibition of the progression of the Human Immunodeficiency Virus (HlV) and not a permanent cessation of the activity ofthe virus. Psychosocial approaches to the management of HlV have been moderately successful, but more successful then the retroviral agents during the HIV but non Clinical stage. Considering the proportions of the HlV disease, there are few studies in South-Africa, that describe the therapeutic effects of a stress management package consisting of aerobic exercise, group-based cognitive behavioural therapy and relaxation training on mood state changes of asymptomatic and early symptomatic HIV sufferers. Psychological measures, like depression and anxiety have been found to be associated with lowered immune responsivity, thus enhancing the underlying immunodeficiency found in HlV/AIDS sufferers. Past research has also illustrated the benefits that may be derived from aerobic exercise on the physiological mechanisms of the body. The intention of this research, was therefore to further reinforce the positive effects of aerobic exercise by using a biopsychosocial approach in the treatment of HIV, leading to an overall improvement in the immunological status, depression and distress levels of HlV patients, as well as their ability to cope with the disease. The study took place within the context of a wider project, forming a component of the AIDS research conducted by Prof. E.Wolff (Rand Afrikaans University). The study assessed the relevance of this intervention for the South African Setting.

The main aim of this study was to explore the extent of freedom or lack thereof in the relationships of HIV positive pregnant women and their partners. These women were attending antenatal care in two Soweto clinics, run by the Perinatal HIV Research Unit. A semi-structured interview schedule was developed and used as the data collection tool. A theoretical framework based on Amartya Sen's theory of Development as Freedom and Isabel Apawo Phiri's theological reflections on women's freedom, was used to analyze data collected from the participants of the study. The ideas of the two theorists complemented each other with regard to the sources of "unfreedom" for women from an economic point of view and from the cultural and religious points of view. Sen highlighted lack of basic freedoms and human rights as the core causes of lack of freedom, which is both a primary means and principal ends of development. Phiri advocated for the liberation of women from the oppressive cultural and religious practices brought about by patriarchy. Removal of all those key sources of unfreedom would provide an ideal situation in which women would be less vulnerable to HIV infection. The analysis of the participants' responses in this study suggested a lack of freedom in their relationships with the fathers of their unborn babies. This had an adverse effect in their ability to disclose their HIV positive status, negotiate safer sex and contraception. Economic dependency on the partners was found to be the major cornerstone that kept women in bondage in their relationships. The churches in Soweto did not seem to have any plausible impact in the lives of the participants and as a result all of them had very loose links with the church. This was another major gap in the initiatives to reduce HIV infection which challenges the churches in Soweto to strengthen their prophetic ministry in terms of women's freedom and their dignity both in the church and in society.
Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2007

M.Cur.
The purpose of this study is to identify the midwives experience in doing the delivery or a HIV-positive patient. Because the incidence of AIDS is increasing in the heterosexual population and thus the women in their reproductive years, it is important for the midwife to know how feelings for the HIV-positive patient. It is the midwife who has to give counselling and support to tho HlV-positive patients and in doing so, she herself must get counselling end support. Unstructured in-depth interviewB wore held with r Ivo midwives on one occasion. Each midwife should have done at least one delivery of a HIV-positive patient. The experiences of the midwives was then combined and a literature control was done to consult other authors' findings on the heath workers experience of HIV positive patients. Recommendations were made at the end of the study concerning applications to practice, education, further research and the counselling of the midwife.

This study explores the subjective experiences of persons who have been informed of a positive HIV antibody test and, from their point of view, explains the meaning and impact that HIV discovery has on their quality of life. In this qualitative narrative study, a racially specific, low-income sample of 10 HIV-infected men and women shared their stories of living with the virus during in-depth interviews. Findings of a multi-staged narrative analysis suggest that for people like those in this study, stigma associated with mv infection results in the concealment of the diagnosis by the individual for fear of being labeled as deviant from the rest ofthe community. Secondly, the tragic manner in which these respondents narrated HIV discovery signifies the negative impact the disease has on their quality of life. Lastly, there is evidence for the effectiveness ofthe primary health-care services on the HIV positive patients. Implications for these findings are elaborated.
Thesis (M.Soc.Sc.)-University of Natal, Pietermaritzburg, 2000.

Disclosure of a Human Immunodeficiency Virus (HIV) positive status is vital for prevention and promotion of the couple‟s health. The study aimed to investigate the perceived barriers of pregnant women diagnosed as HIV positive towards disclosure of their HIV status to their partners in the Capricorn District, Limpopo Province. Recommendations were formulated to enhance the self-efficacy. A quantitative, explorative, descriptive cross-sectional design and the Health Belief Model theory was used. Non-probability, convenience sampling utilised and 170 respondents aged 18-40 years participated in the study. A questionnaire was used to collect data and the SSPS version 24.0 was utilised to analyse data. Overall, 87.64% respondents received disclosure education and 80% disclosed their status to their partners. Reasons for non-disclosure included fear of rejection, violent behaviour, blame and stigmatisation by partners. Health care workers should provide pregnant women with information on preventive strategies to enhance disclosure of HIV status.
Health Studies
M.A. (Nursing Science)

This research focused on the experiences of HIV disclosure to significant others amongst people living with HIV. The aim of the research was to explore how people living with HIV experience disclosure of their HIV positive status to their significant others. The social constructionist perspective was utilized to gain a deeper understanding of the experience of HIV positive status disclosure to significant others. The study’s sample comprised of five participants who were recruited using purposive sampling strategy. Data was collected with using face to face semi structured interviews. Themes were extracted and analysed using thematic content analysis. An analysis was made as to whom participants choose to disclose to, the reaction of the people they disclosed to, as well as their reasons for disclosing. Results were reported as the participants’ experiences and noted as is or unadulterated.
Psychology
M.A. (Psychology)

Text in English
The study was conducted to determine the knowledge and to describe attitudes of HIV positive women on exclusive breastfeeding in Mopani District (the Greater Letaba Sub-District, Limpopo), South Africa. A quantitative, exploratory and descriptive design was adopted in this study to describe the knowledge and attitudes of HIV positive women on exclusive breastfeeding. The researcher used a self-developed structured questionnaire to collect data. Descriptive and inferential statistics were used to describe data. The SPSS software version 21.0 was used to analyse data and this were displayed in tables and figures. A total of 123 participants were included in the study. The study concluded that HIV positive women have good knowledge and positive attitude on exclusive breastfeeding.
Health Studies
M.P.H.

Vertical transmission of HIV is still a growing concern in South Africa. Breastfed infants are still at risk as HIV is present in breast milk, leaving HIV-positive mothers unsure of the best feeding option for their infants. However, there are various infant feeding techniques that HIV-positive mothers can use to supplement breastfeeding and flash-heat is one of them. Flash-heat is heat treating expressed breast milk to deactivate HIV for infant feeding. This study explored the possibility of HIV-positive mothers to practice flash-heating method for their infants exclusively for four months as a strategy to prevent vertical transmission of HIV. A descriptive, explorative and contextual design using a mixed method was used to obtain data from mothers in a post natal ward at Tembisa hospital. The mixed method used was useful in identifying the number of HIV-positive mothers who would adopt the flash-heat technique, the characteristics of mothers whom the technique could be promoted to, the factors that influence/affect the choice of infant feeding for these mothers, as well as their feelings associated with the feeding technique. Most (74%) mothers had a positive response to the flash-heat technique compared to 10% who were uncertain. They believed that heat treating their breast milk would result in their infants being HIV-free. In addition they believed that this method was cheaper than formula feeding and expressed positive feelings about touching their breast milk while expressing with no adverse feelings of expressing into a glass jar. Furthermore, findings of this study indicated that HIV-positive mothers in a public health facility would adopt flash-heat as an alternative infant feeding method. Thus practical guidelines to promote this feeding method were proposed. The proposed draft guidelines which promote the use of the flash-heat infant feeding method for HIV-positive mothers in public sector facilities will be communicated to relevant authorities such as the National Department of Health. These guidelines support the new policy shift to exclusive breastfeeding as a child survival strategy in South Africa.
Health Studies
D.Litt. et Phil. (Health Studies)

This dissertation examines the participation of the church and Christians in the lives of women who are infected and affected by HIV/Aids in South Africa. To this end two Christian facilities; Sparrow Village and St Francis Care Centre, were examined in order to gain insight into the ethical issues of knowledge of patients and caregivers, the prevention measures being taught and the care facilities available to women in the plight in which they find themselves. A partial survey was conducted into the current policies and contributions by the church in an attempt to assess new ways to combat the disease. Medical information was examined as to what the virus is and how it is transmitted and reasons why women are particularly vulnerable to the virus. The dissertation seeks to understand practical ministerial ways in which the church should participate in women’s lives while being sensitive to the cultural, social and political and economic elements involved.
Systematic Theology & Theological Ethics
M.Th. (Theological Ethics)

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 aim of this study was to explore, describe and interpret the experiences of Immunodeficiency Human Virus (HIV) infected mothers regarding exclusive breastfeeding in the first six months of the infant’s life. This was a qualitative study with phenomenology as a design as the study was about lived experiences. The sample consisted of HIV infected mothers aged 18 years and above who opted for exclusive breastfeeding for the first six months of their infant’s lives. Purposive sampling was used. Data was collected through one to one semi structured interviews of fifteen mothers of babies aged six to twelve months. The study revealed that mothers had both positive and negative experiences which were influenced by among others; the level of support the mothers received, disclosure of HIV status and health education received at the health facility. The findings of the study revealed a low level of understanding of the Infant and Young Child Feeding Policy by health professionals
Health Studies
M.A. (Health Studies)

The purpose of the study was to evaluate the management of the HIV and AIDS workplace policy at Statistics South Africa (Stats SA). This entailed an assessment of the levels of awareness amongst employees, and an assessment of employees’ knowledge of the policy and its implementation. Data were collected through a structured questionnaire administered to randomly selected employees. It was found that the respondents’ level of awareness of the HIV and AIDS workplace policy at Stats SA was satisfactory. Although some differences were observed, overall it seems that Stats SA was successful in promoting general awareness of its policy and its contents. However, as far as the respondents’ attitudes and opinions relating to the implementation of the policy at Stats SA are concerned, several issues still need to be addressed.
Sociology
M.A. (Social Behaviour Studies in HIV/AIDS)

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)

Text in English with abstracts and keywords in English, Tswana and Sepedi
Providing support to employees living with HIV to adhere with treatment at home and at work is the key to prolong life and wellbeing of those who are infected and affected by HIV/AIDS pandemic. This study was qualitative explorative research. The study used qualitative method of collecting data which allowed the researcher to conduct interviews at the natural settings where it was convenient for participants to take interview calls. The purpose of this study was to explore how implementation of ART programmes support employees living with HIV (ELWHIV) to adhere with treatment at home and work so that gaps and areas of improvement are identified. The study took place at SWHAP companies that are based in Ekurhuleni, Gauteng. The study used purposive sampling to identify key informants who were directly involved in the implementation of the ART programmes. Data was largely analysed using content, thematic and triangulation analysis. Theory of social ecology and empowerment theory were applied as companies are seen using workplaces as safe space to provide counselling and psychosocial support to ELWHIV through Reality Wellness. Findings: The findings of the study revealed that ART programmes are in place in SWHAP companies and are also ongoing. The study also reveals that Reality Wellness provided counselling and psychosocial support to ELWHIV to adhere with treatment at home and at work. The study further reveals that ELWHIV fear to disclose their HIV status because of stigma and discrimination. Recommendations: More dialogue and further studies on ART programmes particularly on ART adherence at home and at work need to be done. Management should take ownership and get involved directly with ART programmes and enhance support to ELWHIV to adhere with treatment at home and at work.
Go tshegetsa badiri ba ba tshelang ka mogare wa HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong go botlhokwa go tshegetsa botshelo le itekanelo ya ba ba tshwaeditsweng le ba ba amilweng ke leroborobo la AIDS. Thutopatlisiso eno e ne e lebelela mabaka mme e tlhotlhomisa. Mokgwa wa go lebelela mabaka go kokoanya data o letlile mmatlisisi go dira dipotsolotso mo mafelong a tlwaelo a banni-le-seabe moo go neng go le bonolo mo go bone go araba megala ya dipotsolotso. Maikemisetso a thutopatlisiso eno, e ne e le go tlhotlhomisa ka moo go tsenngwa tirisong ga mananeo a ART go tshegetsang badiri ba ba tshelang ka HIV (ELWHIV) ka go na go obamela tiriso ya kalafi kwa gae le kwa tirong gore go kgone go supiwa diphatlha le dikarolo tse di ka tokafadiwang. Thutopatlisiso e dirilwe kwa ditlamong tsa SWHAP tse di kwa Ekurhuleni, Gauteng. Go diragaditswe mokgwa wa go tlhopha sampole go ya ka maikaelelo a thutopatlisiso go supa basedimosetsi ba botlhokwa ba ba neng ba na le seabe ka tlhamalalo mo go tsenngweng tirisong ga mananeo a ART. Go lokolotswe data go dirisiwa molokololo wa diteng, morero le tiriso ya melebo e e farologaneng go lokolola. Go dirisitswe tiori ya ikholoji ya loago le tiori ya maatlafatso ka ntlha ya fa ditlamo di bonwa di dirisa mafelo a tiro jaaka dibaka tse di bolokesegileng tsa go tlamela tshegetso ya maikutlo le tshegetso ya tlhaloganyoloago go badiri ba ba tshelang ka HIV ka itekanelo ya nnete. Diphitlhelelo: Diphitlhelelo tsa thutopatlisiso di bontsha gore mananeo a ART a gona mo ditlamong tsa SWHAP mme a tswelela pele. Itekanelo ya nnete e tlamela ka tshegetso ya maikutlo le ya tlhaloganyoloago go badiri ba ba tshelang ka HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong. Gape thutopatlisiso e bontsha gore badiri ba ba tshelang ka HIV ba tshaba go senola seemo sa bona sa HIV ka ntlha ya sekgobo le go tlhaolwa. Dikatlenegiso: Go tshwanetse ga nna le dipuisano le dithutopatlisiso tse dingwe tsa manaeo a ART, bogolo segolo kobamelo ya tiriso ya ART kwa gae le kwa tirong. Botsamaisi bo tshwanetse go nna beng ba, e bile bo nne le seabe ka tlhamalalo mo mananeong a ART le go tshegetsa badiri ba ba tshelang ka HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong.
Go fa bašomi bao ba phelago ka HIV gore ba obamele go nwa dihlare ka gae le mošomong ke selo se bohlokwa go dira gore ba phele lebaka le letelele le gore bao ba fetetšwego le go angwa ke leuba la AIDS ba phele gabotse. Dinyakišišo tše di bile tša boleng le tša go utolla. Mokgwa wa go kgoboketša tshedimošo wa boleng o kgontšhitše monyakišiši go dira dipoledišano ka seemong sa tlhago sa mokgathatema fao go bilego bonolo go yena go araba megala ya dipoledišano. Maikemišetšo a dinyakišišo tše e bile go utolla ka fao go tsenya tirišong ga mananeo a ART go thekgago bašomi bao ba phelago ka HIV (ELWHIV) go obamela go nwa dihlare ka gae le mošomong gore dikgoba le dibaka tša kaonafalo di tsebje. Dinyakišišo tše di dirilwe ka dikhamphaning tša SWHAP tšeo di lego ka Ekurhuleni, Gauteng. Go dira sampole ka maikemišetšo go phethagaditšwe ka nepo ya go tseba baseboši ba bohlokwa bao ba bego ba kgatha tema thwii ka mananeong a ART. Tshedimošo e sekasekilwe ka go šomiša tshekatsheko ya diteng, ya morero le ya seemokhutlotharo. Teori ya ekholotši ya leago le theori ya maatlafatšo di dirišitšwe ka ge dikhamphani di bonwa e le tšeo di šomišago mafelo a mošomong bjalo ka mafelo ao a bolokegilego a go fana ka keletšo le thekgo ya tša menagano go ELWHIV ka go diriša temogo ya seemo sa makgonthe. Dikutollo: Dikutollo tša dinyakišišo di utolla gore mananeo a ART a tsentšwe tirišong ka dikhamphaning tša SWHAP ebile a tšwela pele. Temogo ya seemo sa makgonthe e fana ka keletšo le thekgo ya menagano go ELWHIV ka nepo ya gore ba omabele go nwa dihlare ka gae le mošomong. Dinyakišišo di tšwela pele go utolla gore ELWHIV ba tšhoga go tsebagatša maemo a bona a HIV ka lebaka la kgobošo le kgethologanyo. Ditšhišinyo: Dingangišano tše dingwe le dinyakišišo go tšwela pele ka go mananeo a ART, kudukudu mabapi le go obamela go nwa dihlare tša ART ka gae le mošomong, di swanetše go dirwa. Ba taolo ba swanetše go tšea maikarabelo a mananeo a ART le go kgatha tema ka go ona thwii le go maatlafatša thekgo go ELWHIV ka nepo ya go obamela go nwa dihlare ka gae le mošomong.
Health Studies
M.A. (Social Behaviour Studies in HIV/AIDS)

A qualitative study was undertaken in Pietermaritzburg to unveil the experiences and challenges of WLWHIV as perceived by social workers as well as to explore and describe the experiences of social workers in rendering services to these women. Explorative, descriptive and contextual research designs were employed for the research process. Purposive and snowball sampling techniques were utilised to recruit participants who met the set criteria. Face-to-face semi-structured interviews were conducted with thirteen participants. Data obtained were transcribed and analysed applying Tesch‘s eight steps (Creswell, 2009). Data verification was guided by Guba‘s model (Krefting, 1991). The findings revealed the existence of strained relationships between WLWHIV and their partners and ineffective delivery of social work services to WLWHIV. Based on the findings, it is recommended that specialised training for social workers on issues related to death and dying and services for children of WLWHIV be incorporated in the guidelines for social work practice
Social Work
M.A. (social Work)

M.A. (Psychology)
The Acquired Immunodeficiency Syndrome not only threatens the world with hitherto unknown rates of mortality and economic ruin, but has also saddled the health sciences with an unprecedented challenge in curing and managing this disease. Herein, the health sciences have not found a cure, and the management of the disease is made extremely difficult because of the unpredictable nature of the interrelationships in biopsychosocial factors inherent in the disease. In order to attempt a description of the complex interrelationships between biopsychosocial factors in this disease, a group of twenty patients in a treatment programme comprising of an exercise and cognitive-behavioural intervention, were subjected to immunologic and psychological assessment before and subsequent to the intervention. The data obtained indicated that none of the interrelationships between psychological and immunological variables predicted by psychoneuroimmunological science existed prior to the intervention. It would appear that the interrelationships between these variables were in total disarray - defeating the object of systematic logical description of biopsychosocial factors in this condition. The post- intervention data suggested a pattern of interrelationships totally within the confines of predicted neuropsychoimmunologic patterns of a biopsychosocial interaction in a disease of immunologic origin. This pattern of predictability would then render possible a treatment programme of a multidisciplinary nature which would bear predictable fruit. It also underscores the necessity of psychological interventions as an adjunct in the treatment of AIDS.

Text in English with abstracts and keywords in English, Tswana and Sepedi
Providing support to employees living with HIV to adhere with treatment at home and at work is the key to prolong life and wellbeing of those who are infected and affected by HIV/AIDS pandemic. This study was qualitative explorative research. The study used qualitative method of collecting data which allowed the researcher to conduct interviews at the natural settings where it was convenient for participants to take interview calls. The purpose of this study was to explore how implementation of ART programmes support employees living with HIV (ELWHIV) to adhere with treatment at home and work so that gaps and areas of improvement are identified. The study took place at SWHAP companies that are based in Ekurhuleni, Gauteng. The study used purposive sampling to identify key informants who were directly involved in the implementation of the ART programmes. Data was largely analysed using content, thematic and triangulation analysis. Theory of social ecology and empowerment theory were applied as companies are seen using workplaces as safe space to provide counselling and psychosocial support to ELWHIV through Reality Wellness. Findings: The findings of the study revealed that ART programmes are in place in SWHAP companies and are also ongoing. The study also reveals that Reality Wellness provided counselling and psychosocial support to ELWHIV to adhere with treatment at home and at work. The study further reveals that ELWHIV fear to disclose their HIV status because of stigma and discrimination. Recommendations: More dialogue and further studies on ART programmes particularly on ART adherence at home and at work need to be done. Management should take ownership and get involved directly with ART programmes and enhance support to ELWHIV to adhere with treatment at home and at work.
Go tshegetsa badiri ba ba tshelang ka mogare wa HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong go botlhokwa go tshegetsa botshelo le itekanelo ya ba ba tshwaeditsweng le ba ba amilweng ke leroborobo la AIDS. Thutopatlisiso eno e ne e lebelela mabaka mme e tlhotlhomisa. Mokgwa wa go lebelela mabaka go kokoanya data o letlile mmatlisisi go dira dipotsolotso mo mafelong a tlwaelo a banni-le-seabe moo go neng go le bonolo mo go bone go araba megala ya dipotsolotso. Maikemisetso a thutopatlisiso eno, e ne e le go tlhotlhomisa ka moo go tsenngwa tirisong ga mananeo a ART go tshegetsang badiri ba ba tshelang ka HIV (ELWHIV) ka go na go obamela tiriso ya kalafi kwa gae le kwa tirong gore go kgone go supiwa diphatlha le dikarolo tse di ka tokafadiwang. Thutopatlisiso e dirilwe kwa ditlamong tsa SWHAP tse di kwa Ekurhuleni, Gauteng. Go diragaditswe mokgwa wa go tlhopha sampole go ya ka maikaelelo a thutopatlisiso go supa basedimosetsi ba botlhokwa ba ba neng ba na le seabe ka tlhamalalo mo go tsenngweng tirisong ga mananeo a ART. Go lokolotswe data go dirisiwa molokololo wa diteng, morero le tiriso ya melebo e e farologaneng go lokolola. Go dirisitswe tiori ya ikholoji ya loago le tiori ya maatlafatso ka ntlha ya fa ditlamo di bonwa di dirisa mafelo a tiro jaaka dibaka tse di bolokesegileng tsa go tlamela tshegetso ya maikutlo le tshegetso ya tlhaloganyoloago go badiri ba ba tshelang ka HIV ka itekanelo ya nnete. Diphitlhelelo: Diphitlhelelo tsa thutopatlisiso di bontsha gore mananeo a ART a gona mo ditlamong tsa SWHAP mme a tswelela pele. Itekanelo ya nnete e tlamela ka tshegetso ya maikutlo le ya tlhaloganyoloago go badiri ba ba tshelang ka HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong. Gape thutopatlisiso e bontsha gore badiri ba ba tshelang ka HIV ba tshaba go senola seemo sa bona sa HIV ka ntlha ya sekgobo le go tlhaolwa. Dikatlenegiso: Go tshwanetse ga nna le dipuisano le dithutopatlisiso tse dingwe tsa manaeo a ART, bogolo segolo kobamelo ya tiriso ya ART kwa gae le kwa tirong. Botsamaisi bo tshwanetse go nna beng ba, e bile bo nne le seabe ka tlhamalalo mo mananeong a ART le go tshegetsa badiri ba ba tshelang ka HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong.
Go fa bašomi bao ba phelago ka HIV gore ba obamele go nwa dihlare ka gae le mošomong ke selo se bohlokwa go dira gore ba phele lebaka le letelele le gore bao ba fetetšwego le go angwa ke leuba la AIDS ba phele gabotse. Dinyakišišo tše di bile tša boleng le tša go utolla. Mokgwa wa go kgoboketša tshedimošo wa boleng o kgontšhitše monyakišiši go dira dipoledišano ka seemong sa tlhago sa mokgathatema fao go bilego bonolo go yena go araba megala ya dipoledišano. Maikemišetšo a dinyakišišo tše e bile go utolla ka fao go tsenya tirišong ga mananeo a ART go thekgago bašomi bao ba phelago ka HIV (ELWHIV) go obamela go nwa dihlare ka gae le mošomong gore dikgoba le dibaka tša kaonafalo di tsebje. Dinyakišišo tše di dirilwe ka dikhamphaning tša SWHAP tšeo di lego ka Ekurhuleni, Gauteng. Go dira sampole ka maikemišetšo go phethagaditšwe ka nepo ya go tseba baseboši ba bohlokwa bao ba bego ba kgatha tema thwii ka mananeong a ART. Tshedimošo e sekasekilwe ka go šomiša tshekatsheko ya diteng, ya morero le ya seemokhutlotharo. Teori ya ekholotši ya leago le theori ya maatlafatšo di dirišitšwe ka ge dikhamphani di bonwa e le tšeo di šomišago mafelo a mošomong bjalo ka mafelo ao a bolokegilego a go fana ka keletšo le thekgo ya tša menagano go ELWHIV ka go diriša temogo ya seemo sa makgonthe. Dikutollo: Dikutollo tša dinyakišišo di utolla gore mananeo a ART a tsentšwe tirišong ka dikhamphaning tša SWHAP ebile a tšwela pele. Temogo ya seemo sa makgonthe e fana ka keletšo le thekgo ya menagano go ELWHIV ka nepo ya gore ba omabele go nwa dihlare ka gae le mošomong. Dinyakišišo di tšwela pele go utolla gore ELWHIV ba tšhoga go tsebagatša maemo a bona a HIV ka lebaka la kgobošo le kgethologanyo. Ditšhišinyo: Dingangišano tše dingwe le dinyakišišo go tšwela pele ka go mananeo a ART, kudukudu mabapi le go obamela go nwa dihlare tša ART ka gae le mošomong, di swanetše go dirwa. Ba taolo ba swanetše go tšea maikarabelo a mananeo a ART le go kgatha tema ka go ona thwii le go maatlafatša thekgo go ELWHIV ka nepo ya go obamela go nwa dihlare ka gae le mošomong.
Health Studies
M.A. (Social Behaviour Studies in HIV/AIDS)

This qualitative study aimed to explore and describe the experiences of women living with HIV and Aids in Centurion, Gauteng Province. The study was conducted at Lyttleton clinic and 12 women living with HIV and Aids were selected for the study using a non-probability, purposive sampling technique. In-depth, individual semi-structured interviews were used during data collection. A thematic content approach in data analysis yielded the following main themes: experience of being diagnosed HIV positive, disclosure of an HIV positive status, physical signs and symptoms of HIV and Aids, stigma/ emotional stress well experiences in services rendered. The study highlighted the need for a well-established health system, assisting women living with HIV and Aids on how to cope and to raise awareness on HIV and Aids.
Health Studies
M. A. (Public Health)

Young women working in SMEs are increasingly being affected by HIV and AIDS, and SMEs are expected to respond to HIV and AIDS through workplace policies and programmes. This requires commitment from SMEs to help young women who face various gendered vulnerabilities to HIV and AIDs. The study, whose purpose was to investigate young women workers’ experiences of the HIV and AIDS response of small and medium enterprises in a semi urban area in KwaZulu-Natal, used a qualitative approach and collected data from three SMEs in Pietermaritzburg during the period of the study. Findings of the study indicate that the majority of respondents from all three SMEs agree on experiencing limited or no HIV and AIDS policies and programmes in SMEs. With reference to incomplete or limited responses, two SMEs provide financial assistance for funerals. However, some aspects such as education and awareness, monitoring, management commitment, provision of medical aid, facilitation of peer education, appointment of an HIV officer and more were not evident. Thus recommendations were made on how SMEs should respond, and future research ideas were outlined.
Health Studies
M. A. (Social Behaviour Studies in HIV/AIDS)

South African palliative care volunteer caregivers play a crucial role in caring for people living with HIV and Aids, but frequently do not receive the support and respect that they deserve. The current study explored the psychosocial challenges and coping mechanisms of palliative care volunteer caregivers for people living with HIV and Aids. The researcher conducted in-depth interviews with 24 participants who also filled in questionnaires. The aim was to explore their experiences, their challenges, and coping mechanisms. Although these volunteer caregivers shared many positive experiences, they also faced multiple challenges in the workplace, their personal lives, financial challenges as well as psychological and emotional ones. Despite these challenges, the caregivers showed only moderate levels of stress on the stress scale. Recommendations for overcoming these challenges were provided to caregivers, organisations and the Department of Health
Psychology
M. Sc. (Psychology)

Women face a greater risk of HIV infection worldwide than men. This study explored socio-economic, cultural and environmental factors influencing young women’s vulnerability to HIV. A quantitative explorative study was conducted among young women in Sunnyside, Pretoria. A sample of 158 young women in the age group 18 to 24 years from all language groups was randomly selected to participate in this study. The findings showed that poverty, peer pressure and multiple sexual partners were the main factors that influenced young women in Sunnyside’s vulnerability to HIV. Behavioural change and social change were recommended as long-term processes, which need to be taken into consideration. Findings from the Sexual Relationship Power Scales show that young women between 18 and 21 years experience physical abuse, emotional abuse, sexual abuse and forced sex in their relationships. The study concluded with specific recommendations for the successful implementation of policy makers and planners to protect women.
Health Studies
M.A. (Social Behaviour Studies in HIV/AIDS)

This study investigated the exposure of employees in the South African Police Service (SAPS) to the HIV/AIDS workplace programme, levels of knowledge of HIV/AIDS, perceptions of stigma and discrimination and of participation by stakeholders in programme implementation. The researcher subscribes to the view that stigma and discrimination are major obstacles to the successful implementation of the HIV/AIDS workplace programme as this notion has been substantiated by numerous studies. Self-administered questionnaire was used as means of data collection. Findings suggest that the employees of SAPS based at the National Head Office have high levels of knowledge on HIV/AIDS. However, the majority of the respondents indicated that they would not feel comfortable to disclose their HIV positive status, fearing the consequences thereof.
Sociology
M.A. (Social Behaviour Studies in HIV/AIDS)

Adolescence is a significant period of change in physical and psychosocial development of human beings. Being HIV positive and growing up on a dynamically multifaceted HAART treatment, adds to the complexity of adolescence. This study was aimed at exploring the nature of experiences of adolescents who are on long-term Highly Active Antiretroviral Therapy (HAART) in Tembisa, Gauteng province. The study is based on a qualitative research method using in-depth semi-structured open-ended interviews and a focus group for data collection. The sample consisted of seven individual adolescent participants, three parents, guardians and caregivers, as well as 11 health care professionals. The thematic data analysis and the phenomelogical analysis methods were used to analyse data qualitative data while descriptive statistics were used to analyse quantitative biographical data. The study findings cover the negative and positive experiences and the perceived role of HAART treatment over a long period of time. The predominant themes identified from adolescent participants were disclosure of HIV positive status and the stigma surrounding a positive status, early childhood experience of parental death, challenges of taking HAART treatment, factors influencing adherence and non-adherence to HAART treatment, and lastly, the impact of religion on HAART treatment adherence. The findings suggest that adolescents who are on HAART treatment over an extended period of time experience drug fatigue. Drug fatigue has far-reaching implications for the health of an adolescent, as it has a higher likelihood that poor adherence or even complete refusal to take HAART treatment will occur. Poor adherence or refusal to take HAART treatment will most likely lead to cross infection and further spread of HIV and AIDS. A recommendation was made to include the establishment of a youth and adolescent-friendly centre by the hospital – one that is designated for the provision of tailored adolescent services and sensitive to adolescent developmental stages so as to minimise the likelihood of infected adolescents falling through the health care cracks. The introduction of a hospital-based school, an education unit run by dedicated and qualified facilitators focusing on aiding hospitalised learners with catch-up scholarly programmes, was a further recommendation. It was further recommended that reproductive health care needs of adolescents who grow up on HAART treatment be given attention in further research.
Psychology
Ph.D. (Psychology)

This study focuses on the psycho-social challenges faced by HIV/AIDS lay counsellors at a Voluntary Counselling and Testing (VCT) site in Tshwane, South Africa. A qualitative approach was employed by using semi-structured interviews with open-ended questions to obtain information from four lay counsellors, who provide pre- and post-test counselling at a VCT site. The results indicate that the management of clients’ emotions and needs pose enormous challenges to HIV/AIDS lay counsellors who do not receive any formal psycho-social support at VCT sites. The research participants in this study resort to their own coping mechanisms to deal with the challenges – with varying degrees of success. The recommendation is made that a formal support programme should be put in place at VCT sites, which will allow HIV/AIDS lay counsellors to respond to the many demands placed on them. Such a programme can help prevent burnout and a high turnover in lay counsellors.
Social Work
M. A. (Social Behaviour Studies in HIV/AIDS)

Text in English
Breastfeeding is particularly important in resource-poor regions of the world, where limited access to clean water increases the risk of diarrhoeal disease if replacement feeding is used. However, human immunodeficiency virus type 1 (HIV-1) is transmitted through human milk. Purpose of the study The purpose of this study was to describe the determinants contributing to exclusive breastfeeding in HIV-infected mothers of infants aged 0 to 6 months who attend an NGO Health Centre in Elandsdoorn Village. Methods A quantitative research approach using a non-experimental cross-sectional study was undertaken to conduct this study. A self-reported study questionnaire was used to collect data from study participants. Purposive sampling was used to sample 75 mothers from 18 to 45 years of age who were HIV-positive. SPSS version 23 was used to analyse the data. Results The study results indicated that there are determinants contributing to exclusive breastfeeding and a need to establish a more comprehensive approach to educating pregnant women on reproductive health issues, and exclusive breastfeeding in particular. Factors contributing to low levels of exclusive breastfeeding included breast problems, societal influence, maternal health concerns, insufficient support, fear of stigmatisation, and babies’ health concerns. This caused mothers to discontinue exclusive breastfeeding. Conclusions The intention of this study was to reveal the determinants of exclusive breastfeeding affecting mothers who are HIV-infected and breastfeeding their infants.
Health Studies
M.P.H.