Letteratura scientifica selezionata sul tema "HIV-positive persons – South Africa – Eastern Cape"

South Africa has one of the highest cases of HIV/AIDS infection in Africa, and Transkei, a former black homeland, now a part of the Eastern Cape Province, is one locality with a large number of HIV/AIDS sufferers. The unemployment level is very high and crime, including child rape, is very common. This report presents the case of a victim of rape, a nine-year old female child who was brought to the Umtata General Hospital, a victim of the mistaken belief that sex with a virgin will cure an HIV-infected person or AIDS sufferer of his illness. The alleged rapist was an HIV-positive uncle of the child. The myth of the `HIV/AIDS virgin cure' is prevalent in the community. The history, physical examination and laboratory investigations of this case are given. A conclusion is drawn and preventive methods are suggested.

Account is given of the distribution and habitats of the three Lymnaea species currently on recordin the National Freshwater Snail Collection (NFSC) of South Africa. A total number of 616, 353and 202 loci (1/16th square degrees) was respectively recorded for Lymnaea natalensis, L. columellaand L. truncatula. The number of loci in which the collection sites of each species was located, wasdistributed in intervals of mean annual air temperature and rainfall, as well as intervals of meanaltitude. A temperature index was calculated for all mollusc species in the database and the resultsused to rank them in order of their association with low to high climatic temperatures. Chi-squareand effect size values were calculated to determine the significance in differences between frequencies of occurrence of each species in, on, or at the different options for each of the variables investigated and also to determine the significance of the differences between the three species. None of the three Lymnaea species were well represented in the arid regions of the Northern ,Western and Eastern Cape Province, and only L. truncatula was reported from Lesotho. Lymnaeanatalensis is the most widespread of the three species, while the distribution of L. truncatula displaysa sporadic and limited pattern. The alien invader species L. columella was first reported from SouthAfrica in the early 1940’s but was so successful in its invasion of water-bodies in South Africa thatit is currently considered the third most widespread freshwater snail in the country. Lymnaea truncatula was the only one of the three species not recovered from all 14 water-body types represented in the database. The largest number of samples of L. truncatula by far, was yielded by marshes while the largest number of samples of the other two species was collected in rivers, streams and dams. The highest percentage occurrence of all three species was in habitats in which the water conditions were described as permanent, standing, fresh and clear. Although the highest percentage of samples of all three species was reported from loci that fell within the interval ranging from 16-20°C, a significant number of samples of L. truncatula came from loci falling with in the 11-15°C interval. In view of the fact that Lymnaea species are well known as intermediate hosts for liver fluke in South Africa and elsewhere in the world, the widespread occurrence of these snails could have considerable health and economic consequences. Lymnaea natalenis is the most important and probably the only intermediate host of Fasciola gigantica, the most common liver fluke in Africa but F. gigantica has been reliably reported only from Lesotho where its traditional intermediate host, L. truncatula is widespread. However, the epidemiology of fasciolosis in South Africa has been complicated by the invasion of many water-bodies by L. columella because this species has proved to be a successful host for F. hepatica where it had been introduced elsewhere in the world. To our knowledge its role in South Africa in this respect has not yet been evaluated. Due to the fact that no statistics are available in print, the results of positive serological tests on cattle herds all over South Africa were used to compile a map depicting the possible occurrence of Fasciola species in livestock in this country. Although human infections with Fasciola in Africa was considered as very rare in 1975 the situation has changed. It is considered an underrated and underreported disease in humans in Ethiopia and in Egypt an increase in cases of fasciolosis and prevalence’s as high as 12.8% in humans have also recently been reported. To our knowledge the only cases of human fasciolosis reported in literature for South Africa were from northern KwaZulu-Natal where F. hepatica infections were found in 22 out of 7 569 school children examined in 1981. Efforts to obtain recent statisticson human infections from various persons and authorities were totally unsuccessful. In view of statistics available for elsewhere in the world, it would be unwise to assume that no problems exist in this regard in South Africa. The number of people suffering from fasciolosis was already estimated at 2.4 million in 61 countries in 1995 and another 180 million at risk of becoming infected, with the highest prevalence’s reported from Bolivia, China, Ecuador, Egypt, France, Iran, Peru and Portugal. The results of recent serological assays for the detection of fasciolosis in cattle herds in selected areas in South Africa indicated positive cases from localities that closely correspond to the geographical distribution of the three Lymnaea species in this country. According to reports in the literature, the high prevalence of fasciolosis in livestock in the highlands of Ethiopia couldhave serious health implications for people in the area because they have to use the same water resources. In many rural areas in South Africa local populations also have no other options than to share natural water resources with their livestock. In most instances these water bodies harbour at least one of the Lymnaea species which can maintain the life cycle of fasciola. Under such conditions residents could daily be exposed to the risk of becoming infected. It is a matter of concern that epidemiological research with regard to human fasciolosis is such aneglected subject in South Africa. In our opinion epidemiological surveys should be conducted to determine the prevalence of human fasciolosis in specific areas which could be selected on the basis of using the geographical distribution of the three Linnaean species as guidelines. Efforts should also be made to conduct surveys to update the geographical distribution of the snail intermediate hosts and awareness programmes should be launched in rural areas at risk.

<p><strong>List of abstracts and authors:</strong></p><p><strong>1. Antipsychotics in anxiety disorders</strong></p><p>Christer Allgulander</p><p><strong>2. Anxiety in somatic disorders</strong></p><p>Christer Allgulander</p><p><strong>3. Community rehabilitation of the schizophrenic patient</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera</p><p><strong>4. Dual diagnosis: A theory-driven multidisciplinary approach for integrative care</strong></p><p>David Blackbeard</p><p><strong>5. The emotional language of the gut - when 'psyche' meets 'soma'</strong></p><p>Helen Clark</p><p><strong>6. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>7. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>8. Developing and adopting mental health policies and plans in Africa: Lessons from South Africa, Uganda and Zambia</strong></p><p>Sara Cooper, Sharon Kleintjes, Cynthia Isaacs, Fred Kigozi, Sheila Ndyanabangi, Augustus Kapungwe, John Mayeya, Michelle Funk, Natalie Drew, Crick Lund</p><p><strong>9. The importance of relapse prevention in schizophrenia</strong></p><p>Robin Emsley</p><p><strong>10. Mental Health care act: Fact or fiction?</strong></p><p>Helmut Erlacher, M Nagdee</p><p><strong>11. Does a dedicated 72-hour observation facility in a district hospital reduce the need for involuntary admissions to a psychiatric hospital?</strong></p><p>Lennart Eriksson</p><p><strong>12. The incidence and risk factors for dementia in the Ibadan study of ageing</strong></p><p>Oye Gureje, Lola Kola, Adesola Ogunniyi, Taiwo Abiona</p><p><strong>13. Is depression a disease of inflammation?</strong></p><p><strong></strong>Angelos Halaris</p><p><strong>14. Paediatric bipolar disorder: More heat than light?</strong></p><p>Sue Hawkridge</p><p><strong>15. EBM: Anova Conundrum</strong></p><p>Elizabeth L (Hoepie) Howell</p><p><strong>16. Tracking the legal status of a cohort of inpatients on discharge from a 72-hour assessment unit</strong></p><p>Bernard Janse van Rensburg</p><p><strong>17. Dual diagnosis units in psychiatric facilities: Opportunities and challenges</strong></p><p>Yasmien Jeenah</p><p><strong>18. Alcohol-induced psychotic disorder: A comparative study on the clinical characteristics of patients with alcohol dependence and schizophrenia</strong></p><p>Gerhard Jordaan, D G Nel, R Hewlett, R Emsley</p><p><strong>19. Anxiety disorders: the first evidence for a role in preventive psychiatry</strong></p><p>Andre F Joubert</p><p><strong>20. The end of risk assessment and the beginning of start</strong></p><p>Sean Kaliski</p><p><strong>21. Psychiatric disorders abd psychosocial correlates of high HIV risk sexual behaviour in war-effected Eatern Uganda</strong></p><p>E Kinyada, H A Weiss, M Mungherera, P Onyango Mangen, E Ngabirano, R Kajungu, J Kagugube, W Muhwezi, J Muron, V Patel</p><p><strong>22. One year of Forensic Psychiatric assessment in the Northern Cape: A comparison with an established assessment service in the Eastern Cape</strong></p><p>N K Kirimi, C Visser</p><p><strong>23. Mental Health service user priorities for service delivery in South Africa</strong></p><p>Sharon Kleintjes, Crick Lund, Leslie Swartz, Alan Flisher and MHaPP Research Programme Consortium</p><p><strong>24. The nature and extent of over-the-counter and prescription drug abuse in cape town</strong></p><p>Liezl Kramer</p><p><strong>25. Physical health issues in long-term psychiatric inpatients: An audit of nursing statistics and clinical files at Weskoppies Hospital</strong></p><p>Christa Kruger</p><p><strong>26. Suicide risk in Schizophrenia - 20 Years later, a cohort study</strong></p><p>Gian Lippi, Ean Smit, Joyce Jordaan, Louw Roos</p><p><strong>27.Developing mental health information systems in South Africa: Lessons from pilot projects in Northern Cape and KwaZulu-Natal</strong></p><p>Crick Lund, S Skeen, N Mapena, C Isaacs, T Mirozev and the Mental Health and Poverty Research Programme Consortium Institution</p><p><strong>28. Mental health aspects of South African emigration</strong></p><p>Maria Marchetti-Mercer</p><p><strong>29. What services SADAG can offer your patients</strong></p><p>Elizabeth Matare</p><p><strong>30. Culture and language in psychiatry</strong></p><p>Dan Mkize</p><p><strong>31. Latest psychotic episode</strong></p><p>Povl Munk-Jorgensen</p><p><strong>32. The Forensic profile of female offenders</strong></p><p>Mo Nagdee, Helmut Fletcher</p><p><strong>33. The intra-personal emotional impact of practising psychiatry</strong></p><p>Margaret Nair</p><p><strong>34. Highly sensitive persons (HSPs) and implications for treatment</strong></p><p>Margaret Nair</p><p><strong>35. Task shifting in mental health - The Kenyan experience</strong></p><p>David M Ndetei</p><p><strong>36. Bridging the gap between traditional healers and mental health in todya's modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>37. Integrating to achieve modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>38. Non-medical prescribing: Outcomes from a pharmacist-led post-traumatic stress disorder clinic</strong></p><p>A Parkinson</p><p><strong>39. Is there a causal relationship between alcohol and HIV? Implications for policy, practice and future research</strong></p><p>Charles Parry</p><p><strong>40. Global mental health - A new global health discipline comes of age</strong></p><p>Vikram Patel</p><p><strong>41. Integrating mental health into primary health care: Lessons from pilot District demonstration sites in Uganda and South Africa</strong></p><p>Inge Petersen, Arvin Bhana, K Baillie and MhaPP Research Programme Consortium</p><p><strong>42. Personality disorders -The orphan child in axis I - Axis II Dichotomy</strong></p><p><strong></strong>Willie Pienaar</p><p><strong>43. Case Studies in Psychiatric Ethics</strong></p><p>Willie Pienaar</p><p><strong>44. Coronary artery disease and depression: Insights into pathogenesis and clinical implications</strong></p><p>Janus Pretorius</p><p><strong>45. Impact of the Mental Health Care Act No. 17 of 2002 on designated hospitals in KwaZulu-Natal: Triumphs and trials</strong></p><p>Suvira Ramlall, Jennifer Chipps</p><p><strong>46. Biological basis of addication</strong></p><p>Solomon Rataemane</p><p><strong>47. Genetics of Schizophrenia</strong></p><p>Louw Roos</p><p><strong>48. Management of delirium - Recent advances</strong></p><p>Shaquir Salduker</p><p><strong>49. Social neuroscience: Brain research on social issues</strong></p><p>Manfred Spitzer</p><p><strong>50. Experiments on the unconscious</strong></p><p>Manfred Spitzer</p><p><strong>51. The Psychology and neuroscience of music</strong></p><p>Manfred Spitzer</p><p><strong>52. Mental disorders in DSM-V</strong></p><p>Dan Stein</p><p><strong>53. Personality, trauma exposure, PTSD and depression in a cohort of SA Metro policemen: A longitudinal study</strong></p><p>Ugashvaree Subramaney</p><p><strong>54. Eating disorders: An African perspective</strong></p><p>Christopher Szabo</p><p><strong>55. An evaluation of the WHO African Regional strategy for mental health 2001-2010</strong></p><p>Thandi van Heyningen, M Majavu, C Lund</p><p><strong>56. A unitary model for the motor origin of bipolar mood disorders and schizophrenia</strong></p><p>Jacques J M van Hoof</p><p><strong>57. The origin of mentalisation and the treatment of personality disorders</strong></p><p>Jacques J M Hoof</p><p><strong>58. How to account practically for 'The Cause' in psychiatric diagnostic classification</strong></p><p>C W (Werdie) van Staden</p><p><strong>POSTER PRESENTATIONS</strong></p><p><strong>59. Problem drinking and physical and sexual abuse at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>60. Prevalence of alcohol drinking problems and other substances at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>61. Lessons learnt from a modified assertive community-based treatment programme in a developing country</strong></p><p>Ulla Botha, Liezl Koen, John Joska, Linda Hering, Piet Ooosthuizen</p><p><strong>62. Perceptions of psychologists regarding the use of religion and spirituality in therapy</strong></p><p>Ottilia Brown, Diane Elkonin</p><p><strong>63. Resilience in families where a member is living with schizophreni</strong></p><p>Ottilia Brown, Jason Haddad, Greg Howcroft</p><p><strong>64. Fusion and grandiosity - The mastersonian approach to the narcissistic disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>65. Not being allowed to exist - The mastersonian approach to the Schizoid disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>66. Risky drug-injecting behaviours in Cape Town and the need for a needle exchange programme</strong></p><p>Volker Hitzeroth</p><p><strong>67. Neuroleptic malignant syndrome in adolescents in the Western Cape: A case series</strong></p><p>Terri Henderson</p><p><strong>68. Experience and view of local academic psychiatrists on the role of spirituality in South African specialist psychiatry, compared with a qualitative analysis of the medical literature</strong></p><p>Bernard Janse van Rensburg</p><p><strong>69. The role of defined spirituality in local specialist psychiatric practice and training: A model and operational guidelines for South African clinical care scenarios</strong></p><p>Bernard Janse van Rensburg</p><p><strong>70. Handedness in schizophrenia and schizoaffective disorder in an Afrikaner founder population</strong></p><p>Marinda Joubert, J L Roos, J Jordaan</p><p><strong>71. A role for structural equation modelling in subtyping schizophrenia in an African population</strong></p><p>Liezl Koen, Dana Niehaus, Esme Jordaan, Robin Emsley</p><p><strong>72. Caregivers of disabled elderly persons in Nigeria</strong></p><p>Lola Kola, Oye Gureje, Adesola Ogunniyi, Dapo Olley</p><p><strong>73. HIV Seropositivity in recently admitted and long-term psychiatric inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>74. Syphilis seropisitivity in recently admitted longterm psychiatry inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>75. 'The Great Suppression'</strong></p><p>Sarah Lamont, Joel Shapiro, Thandi Groves, Lindsey Bowes</p><p><strong>76. Not being allowed to grow up - The Mastersonian approach to the borderline personality</strong></p><p>Daleen Macklin, W Griffiths</p><p><strong>77. Exploring the internal confirguration of the cycloid personality: A Rorschach comprehensive system study</strong></p><p>Daleen Macklin, Loray Daws, M Aronstam</p><p><strong>78. A survey to determine the level of HIV related knowledge among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p><strong></strong> T G Magagula, M M Mamabolo, C Kruger, L Fletcher</p><p><strong>79. A survey of risk behaviour for contracting HIV among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p>M M Mamabolo, T G Magagula, C Kruger, L Fletcher</p><p><strong>80. A retrospective review of state sector outpatients (Tara Hospital) prescribed Olanzapine: Adherence to metabolic and cardiovascular screening and monitoring guidelines</strong></p><p>Carina Marsay, C P Szabo</p><p><strong>81. Reported rapes at a hospital rape centre: Demographic and clinical profiles</strong></p><p>Lindi Martin, Kees Lammers, Donavan Andrews, Soraya Seedat</p><p><strong>82. Exit examination in Final-Year medical students: Measurement validity of oral examinations in psychiatry</strong></p><p>Mpogisheng Mashile, D J H Niehaus, L Koen, E Jordaan</p><p><strong>83. Trends of suicide in the Transkei region of South Africa</strong></p><p>Banwari Meel</p><p><strong>84. Functional neuro-imaging in survivors of torture</strong></p><p>Thriya Ramasar, U Subramaney, M D T H W Vangu, N S Perumal</p><p><strong>85. Newly diagnosed HIV+ in South Africa: Do men and women enroll in care?</strong></p><p>Dinesh Singh, S Hoffman, E A Kelvin, K Blanchard, N Lince, J E Mantell, G Ramjee, T M Exner</p><p><strong>86. Diagnostic utitlity of the International HIC Dementia scale for Asymptomatic HIV-Associated neurocognitive impairment and HIV-Associated neurocognitive disorder in South Africa</strong></p><p>Dinesh Singh, K Goodkin, D J Hardy, E Lopez, G Morales</p><p><strong>87. The Psychological sequelae of first trimester termination of pregnancy (TOP): The impact of resilience</strong></p><p>Ugashvaree Subramaney</p><p><strong>88. Drugs and other therapies under investigation for PTSD: An international database</strong></p><p>Sharain Suliman, Soraya Seedat</p><p><strong>89. Frequency and correlates of HIV Testing in patients with severe mental illness</strong></p><p>Hendrik Temmingh, Leanne Parasram, John Joska, Tania Timmermans, Pete Milligan, Helen van der Plas, Henk Temmingh</p><p><strong>90. A proposed mental health service and personnel organogram for the Elizabeth Donkin psychiatric Hospital</strong></p><p>Stephan van Wyk, Zukiswa Zingela</p><p><strong>91. A brief report on the current state of mental health care services in the Eastern Cape</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri, Heloise Uys, Mo Nagdee, Maricela Morales, Helmut Erlacher, Orlando Alonso</p><p><strong>92. An integrated mental health care service model for the Nelson Mandela Bay Metro</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri</p><p><strong>93. Traditional and alternative healers: Prevalence of use in psychiatric patients</strong></p><p>Zukiswa Zingela, S van Wyk, W Esterhuysen, E Carr, L Gaauche</p>

The aim of this study was to examine the relationships among changes in self-reported HIV and sexually transmitted infection (STI) and exposure to the loveLife youth HIV prevention programmes. A cross-sectional population-based household survey was conducted using a multistage stratified cluster sampling approach. The total sample included 3123 participants, aged 18–24, 54.6% men and 45.4% women, from four provinces (Eastern Cape, Gauteng, KwaZulu-Natal and Mpumalanga). Results indicate a self-reported STI past-year prevalence of 2.6%, experienced genital sores or ulcers in the past year prevalence of 3.9% and an HIV self-reported prevalence of 7.4%. In multivariable analyses it was found that knowing a person living with HIV and a person who has died from AIDS, lower education, having had two or more sexual partners in the past year, not having talked with a partner about condom use, difficulty of getting condoms and not having been male circumcised were associated with having been diagnosed with an STI in the past 12 months and/or HIV. Face-to-face and multimedia youth HIV prevention programmes had limited effect.

South Africa accounts for the worst global tuberculosis epidemics fuelled by the spread of HIV infection. The tuberculosis (TB) incidence increased from 300 per 100,000 people in the early 1990s to more than 950 per 100,000 in 2012.1 In addition, the country remains one of the countries with the highest TB burden globally, with the World Health Organisation (WHO) statistics giving an estimated incidence of 454,000 cases of active TB in 2015.2 This means that about 0.8% of South Africa’s population of 54 million develop active TB disease annually. Of the 454 000 TB cases in South Africa in 2015, WHO estimated that about 57% (258,000) were HIV positive. It also estimated that of 157,505 whose status was known, and who were known to be HIV positive, some 85% (133,116) were on antiretroviral therapy.3 From the same 2015 report, Eastern Cape, KwaZulu-Natal and Western Cape provinces had the highest incidence rates of 692, 685 and 681 per 100,000 respectively. The most notable decline was in KwaZulu-Natal where the incidence decreased from 1,185 to 685 per 100,000 over the last five years.1

Bacterial vaginosis (BV) is extremely common among the African population and is associated with the transmission and acquisition of human immunodeficiency virus (HIV) infection. The objective of this study was to determine the prevalence and characteristics of BV among HIV-infected and -uninfected women in rural Eastern Cape province of South Africa. A descriptive cross-sectional study was conducted between September 2017 and March 2018 on women aged 18 years and above (n = 100), attending Nelson Mandela Academic Hospital and Ngangelizwe Community Health Centre with signs and symptoms suggestive of vaginal infection. High vaginal swabs were collected, and BV was diagnosed using Nugent’s score. The prevalence rate of BV was 70% irrespective of HIV status. Of the 61 HIV-infected patients, 49 (80.3%) and 12 (19.7%) were BV positive and BV negative, respectively; whilst of the 39 HIV-uninfected women, 21 (53.8%) and 18 (46.2%) were BV positive and BV negative, respectively (OR = 3.5; CI: 1.4–8.5; p = 0.005 ). Women aged above 35 years were highly likely to develop BV ( p = 0.049 ). The presence of Mobiluncus species (>25 per high microscopic field) was significantly associated with BV among HIV-infected patients ( p = 0.030 ). A recent history of antibiotic use (≤3 months) was significantly associated with BV among HIV-negative patients ( p = 0.044 ). This study shows that BV is more prevalent among HIV-positive women than their HIV-negative counterparts, and its occurrence is higher among those aged above 35 years. The predominance of Mobiluncus species in the vagina microbiota of HIV-infected women might play a significant role in the development of BV. These findings suggest that the treatment of BV could restore normal flora and reduce susceptibility to and transmission of HIV.

South African women have a high rate of cervical cancer cases, but there are limited data on human papillomavirus (HPV) genotypes in cervical intraepithelial neoplasia (CIN) in the Eastern Cape province, South Africa. A total of 193 cervical specimens with confirmed CIN from women aged 18 years or older, recruited from a referral hospital, were tested for HPV infection. The cervical specimens, smeared onto FTA cards, were screened for 36 HPV types using an HPV direct flow kit. HPV prevalence was 93.5% (43/46) in CIN2 and 96.6% (142/147) in CIN3. HIV-positive women had a significantly higher HPV prevalence than HIV-negative women (98.0% vs. 89.1%, p = 0.012). The prevalence of multiple types was significantly higher in HIV-positive than HIV-negative women (p = 0.034). The frequently detected genotypes were HPV35 (23.9%), HPV58 (23.9%), HPV45 (19.6%), and HPV16 (17.3%) in CIN2 cases, while in CIN3, HPV35 (22.5%), HPV16 (21.8%), HPV33 (15.6%), and HPV58 (14.3%) were the most common identified HPV types, independent of HIV status. The prevalence of HPV types targeted by the nonavalent HPV vaccine was 60.9% and 68.7% among women with CIN2 and CIN3, respectively, indicating that vaccination would have an impact both in HIV-negative and HIV-positive South African women, although it will not provide full protection in preventing HPV infection and cervical cancer lesions.

This study examines the lifestyle decisions of people who are diagnosed with HIV/AIDS in King Williams Town, Eastern Cape. The study was motivated by the ever growing number of people who are now living with HIV/AIDS. Therefore the researcher intended to examine their decisions regarding sexual choices, reproductive health, diet, physical fitness and their coping strategies. The study found that there is very low uptake of Voluntary Counseling and Testing (VCT). Most people only get tested if they are compelled by other factors, like illness and pregnancy. It also found that HIV positive people continue to engage in risky sexual behaviour regardless of their positive status. In addition it also found that HIV positive status does not affect sexual activity and social support from family and friends is a very important factor that is helping the respondents to cope with HIV diagnosis.

South Africa has the highest number of people living with HIV/AIDS in the world. The estimated 5,7 million South Africans that are living with HIV need comprehensive and holistic care. Psychosocial support is a vital aspect of care for HIV positive people. Support groups have been identified as a basic form of psychosocial support. The aim of this study was to evaluate the role of support groups in the lives of HIV positive people in East London, Eastern Cape. A qualitative study design was implemented using focus group interviews to explore the role of HIV support groups. The research questions were designed to elicit responses pertaining to the needs, expectations and experiences of HIV positive support group attendees. Activities conducted in support groups as well as the attitude of support group members towards recruiting other HIV positive people to join the group were also explored. Findings revealed that the benefits of attending a support group included emotional and psychological support, sense of belonging to a “family”, assistance with disclosure issues, gaining information about HIV and treatment as well as material benefits such as food parcels and job opportunities. The greatest need of support group attendees was assistance in obtaining a Social Support or Disability Grant. A few negative experiences were reported which included: unfulfilled promises by people outside of the group, unfair allocation of grants and food parcels, as well as negative group dynamics at times. Support group members agreed that even though there were few negative experiences, the benefits clearly outweighed the negative experiences. Most participants agreed that they would recommend the support group to other HIV positive people so that they could also enjoy the stated benefits. In summary, the study concluded that support groups are very helpful in the lives of HIV positive people.

The aim of the study was to investigate the management of HIV /AIDS programmes at the workplace in four selected organisations in Chris Hani District, Eastern Cape Province of South Africa. Four organisations were studied, two public organisations and two private organisations. With the use of triangulation method, two hundred employees were administered a semi- structured questionnaire while for (four) managers, semi structured in-depth interviews were conducted. The major findings of this study outline that all the four organisations studied have HIV/AIDS programmes and policies for their employees. However, there were no budget allocations for these programmes to be fully implemented for effectiveness. From the data, it can be concluded that HIV/AIDS has a negative impact on organisations‟ production like high training costs, high labour turnover and high absenteeism from work. This has been as a result of managers who did not put their total commitment towards HIV/AIDS management at their workplaces in the same way they have done to other core areas of businesses of their organisations. The study therefore recommends the management of these organisations to demonstrate a clear commitment to the HIV/AIDS management strategies by fully implementing the HIV/AIDS management programmes in their workplaces. It is very crucial for employees to see this commitment in a concrete form through non-discrimination and support for the people living with HIV/AIDS. Clear unambiguous commitment will go far in developing mutual trust between employers and employees and facilitate an atmosphere where people are willing to undergo VCT and to possibly disclose their status. Furthermore, managers are recommended to hire quality service providers to carry out intensive de-stigmatisation processes. This will create a supportive environment and adequately address the fears of employees about HIV/AIDS issues at the workplace. All these recommendations will go a long way in assisting organisations achieve their strategic business objectives and reduce the negative impact of HIV/AIDS at their workplaces.

The pandemic of HIV/AIDS has challenged several aspects of contemporary social life. HIV/AIDS counselling has developed as a social response to provide support for those infected with the disease. Due to the nature and complexity of the disease, HIV/AIDS counsellors encounter a diversity and intensity of emotions when counselling. A support system that includes effective management and supervision may assist in resolving emotions and reactions that HIV/AIDS counsellors may experience as a result of working with HIV/AIDS clients. This study examines the difficulties that both managers and the HIV/AIDS counsellors at a rural district hospital in the Eastern Cape and its surrounding clinics are faced with, in providing the HIV/AIDS counsellors with the support they need. Engestrom's (1987) model of activity theory was used as a conceptual framework guiding both the analysis and interpretation of the data. This model facilitates the identification of tensions and contradictions thereby opening a space for change and transformation within an activity system. Multiple sources of data collection were used that included focus groups with managers and HIV/AIDS counsellors, interviews with senior hospital staff and an official from the Department of Health, Eastern Cape, and a tour of the rural district hospital. The findings suggest that HIV/AIDS counsellors do not feel supported by their managers. Managers in turn are of the opinion that they do not offer the support the HIV/AIDS counsellors' need. The lack of support is attributed to geographic distances between hospitals and the clinics they serve, lack of available transport and the multiplicity of roles of both managers and the HIV/AIDS counsellors. The pandemic of HIV/AIDS has challenged several aspects of contemporary social life. HIV/AIDS counselling has developed as a social response to provide support for those infected with the disease. Due to the nature and complexity of the disease, HIV/AIDS counsellors encounter a diversity and intensity of emotions when counselling. A support system that includes effective management and supervision may assist in resolving emotions and reactions that HIV/AIDS counsellors may experience as a result of working with HIV/AIDS clients. This study examines the difficulties that both managers and the HIV/AIDS counsellors at a rural district hospital in the Eastern Cape and its surrounding clinics are faced with, in providing the HIV/AIDS counsellors with the support they need. Engestrom's (1987) model of activity theory was used as a conceptual framework guiding both the analysis and interpretation of the data. This model facilitates the identification of tensions and contradictions thereby opening a space for change and transformation within an activity system. Multiple sources of data collection were used that included focus groups with managers and HIV/AIDS counsellors, interviews with senior hospital staff and an official from the Department of Health, Eastern Cape, and a tour of the rural district hospital. The findings suggest that HIV/AIDS counsellors do not feel supported by their managers. Managers in turn are of the opinion that they do not offer the support the HIV/AIDS counsellors' need. The lack of support is attributed to geographic distances between hospitals and the clinics they serve, lack of available transport and the multiplicity of roles of both managers and the HIV/AIDS counsellors. Recommendations include the introduction of self-supervision , peer groupsupervision for HIV/AIDS counsellors.

The potential of community-based organisations (CBOs) to provide lasting solutions in the field of Human Immune Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has long been recognised. As interest in the role of CBOs has increased, so have attempts to build their capacity and increase their stability and sustainability. Capacity-building initiatives which aim to strengthen CBOs as if they were identical to formal, more established organisations have often proved ineffective, and even at times destructive, because they have ignored the very differences that make CBOs potentially the most effective agents of development change at community level. This study is a qualitative exploration of a new mentoring-based approach to CBO capacity-building, which is currently being used extensively with CBOs in the Eastern Cape of South Africa. The research is inductive, beginning with an exploratory, descriptive and contextual study of the personal experiences and perceptions of CBO leadership team members from four sample CBOs which have graduated from the Barnabas Trust mentoring programme. Data was collected using a combination of face-to-face unstructured interviews and focus group discussion, with the objective of exploring the subjects’ experiences and their perceptions of the impact of the Barnabas Trust mentoring programme on the sustainability of their organisations. The insights and findings arising from the research process are then applied as the basis for a series of recommendations for the adaptation of the Barnabas trust mentoring approach and materials. The findings of this study appear to show that the mentoring-based approach has been an effective strategy for capacity-building towards sustainability for the CBOs in the sample, bringing positive change at the individual, organisational and community levels.

The primary aim of this study was to determine the effect of an 11-week combined progressive resistance exercise and aerobic exercise programme on the health and well-being of a group of participants sampled from an HIV positive rural population. The study was exploratory and quasi-experimental in nature and utilised quantitative research methods. A total number of 37 participants that met the inclusion criteria were included in the study. The participants were assigned to an experimental group (EG) (n=19) based on their willingness to participate in the exercise intervention and the remainder were assigned to the control group (CG) (n=17). The experimental group participated in an 11-week intervention programme which entailed exercising twice a week for the duration of 60 minutes. The intervention entailed a low cost exercise programme which consisted of aerobic exercises (walking, jogging and stepping) and progressive resistance exercises (own body weight, core exercises and light free weight training). The following variables were measured pre-, mid- and post- intervention, namely: health related fitness components, quality of life, physical activity levels and relevant blood variables. An analysis of data was conducted utilising descriptive and inferential statistics. The outcome of the analyses indicated that the EG did not reveal significantly better post-intervention results than the CG in respect of any of the variables assessed. The CG remained sedentary during the intervention period and revealed either an increase in, or maintenance of the initial scores. The slight variation could have been attributed to the decrease in sample size at mid – and post – testing. At the post-intervention testing phase the majority of the participants available for testing were those who were working and healthy. However, it can be concluded that the overall aims and objectives of the study were achieved despite the attrition of participants during the study and that the subsequent outcome of the study was not expected.

People living with HIV and AIDS (PLHIV) suffer from a number of stress-related psychological disorders. The aim of this study was to develop an integrative intervention, which combined Cognitive Behaviour Therapy (CBT), Body-Mind Therapy and Multicultural perspectives to assist health care workers in identifying and treating stressrelated psychological disorders among people living with HIV and AIDS. The study employed an intervention research design using both qualitative and quantitative methods. The quantitative data was collected from PLHIV attending HIV Counselling and Testing (HCT) and Anti-retroviral therapy clinics in the Buffalo City Municipality (BCM) of the Eastern Cape Province. The qualitative data was collected from the health care workers of the selected study sites. Purposive sampling was used to select the study sample. Instruments used included a biographical questionnaire, the Beck Depression Inventory-II (BDI-II), Medical Outcome Study- HIV (MOS-HIV) and focus group interviews to gather data for the development of an intervention model that would address reported stress-related psychological disorders. Findings showed that people living with HIV and AIDS endure stress in their lives on daily basis rather than episodes of severe or clinical depression. Many of the PLHIV are dealing with a number of psychosocial problems that compromise their quality of life and health status. In conclusion, the study illustratively interpreted and discussed the results in relation to the objectives of the study. The study recommends that PLHIV should be exposed to stress management programmes, and health care workers (HCWs) should be offered training in basic counselling skills, stress management and/or debriefing.

Cognisant of the fact that counselling has become an essential aspect of dealing with HIV/AIDS in South Africa, the researcher aimed to explore the stressors experienced by HIV/AIDS counsellors. It was envisioned that the results obtained would both help to improve the counselling services provided at Settlers Hospital, and assist other organisations to do so. The research focused on how the participants dealt with the dual roles of non-directive listening and the more prescriptive advice-giving, the stressors they experienced and the support structures they had, or needed, to assist them in being more effective HIV/AIDS counsellors. The sample consisted of four HIV/AIDS counsellors working at Settlers Hospital, Grahamstown. The co-ordinator of HIV/AIDS at the hospital was interviewed for collateral information. A qualitative, multiple case study was undertaken. In-depth, semi-structured interviews were used to collect the data which were recorded and transcribed and then constructed into coherently organised personal narratives of each participant’s experiences. A composite description of all the results was arrived at through the use of a reading guide which reduced the data into a thematic content analysis. The analysed data served to present an understanding of the counsellors’ experiences and to enable recommendations to be made which could assist them in pursuing their work more effectively. The findings of this study indicate that HIV/AIDS counselling is an emotionally stressful occupation. Contributory factors include the twofold role of promoting prevention and serving as empathic listeners. Other stressors derive from issues of confidentiality and stigma concerning HIV/AIDS, counsellors’ identification with clients’ experiences and the demographics of HIV/AIDS in South Africa. Situational stressors which arise from working as both nurses and counsellors in a public health institution were also identified. Recommendations are made to alleviate the counsellors’ stress in the form of facilitated emotional support groups, professional supervision, managerial support to improve the working environment, and ongoing in-service training.