Browsing by Author "Kamupira, Mercy G S"

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    Dyad-related factors in HIV prevention
    (2010) Kamupira, Mercy G S; Myer, Landon
    [Objectives] Currently, HIV prevention strategies focus on promoting the modification of those individual behaviours that lead to an increase in susceptibility to and transmission of HIV infection. The focus on individuals in HIV voluntary counselling and testing frequently overlooks the fact that communication and collaboration between the sexual partners is required to effect any behavioural change within an intimate partnership. Developing HIV prevention strategies targeting couples is therefore noted to be increasingly relevant for improving HIV/STI risk reduction uptake. Couple HIV counselling and testing (CHCT) is a strategy that aims to bridge this gap by providing a safe environment for partners to be tested and counselled together. In this way, the burden of disclosing one's HIV status to one's partner is eliminated, and the difficulties experienced by the tested individual in negotiating risk reduction uptake are significantly reduced. There is a paucity of data regarding couples' experiences in and perceptions of CHCT within the South African setting. This study explores couples' experiences before, during and after CHCT; determines the socio-behavioural risk factors for HIV status in couples; explores the impact of couple HIV status on fertility desires, and lastly examines the reliability of inter-partner reports on sexual and other behaviours. [Methods] This was a cross-sectional study with baseline and follow-up components; in addition to a qualitative study component. Structured interviewer-administered questionnaires were applied to each member of the couple separately at baseline prior to CHCT (n=600 couples), immediately post CHCT, and at least 1 month post the CHCT process (n= 258 couples). In addition, in-depth qualitative interviews were done with each member of 27 couples at least one month post CHCT. [Results] Overall, the HIV prevalence in the study sample was 30% (24% in male and 35% in the female participants). Of the 600 couples tested for HIV, 354 (59%) were HIV concordant negative, 136 (23%) were HIV serodiscordant and 110 (18%) were HIV concordant positive. Of the HIV serodiscordant, 101(74%) were couples in which the female was the HIV positive partner and 35 (26%) had HIV positive males. Contextual factors such as community perceptions and levels of HIV-related stigma significantly influenced the couples' decision to test for HIV. Couples reported improved risk reduction uptake and improved communication as well as general improvements in other aspects of their lives at follow-up post the CHCT process. Factors such as community and family expectations as well as financial stability seemed to play a more influential role as determinants of fertility desire, compared to the couple HIV status. Comparison of couples' responses to some questions regarding sexual and other behaviours revealed that there was low inter-partner agreement particularly with respect to questions regarding communication behaviours. Key findings indicate that CHCT was acceptable to the couples who attended this process, and yet, making the decision to test was difficult for most couples. Partners devised various strategies to initiate the discussion on the need to test for HIV. However, after CHCT attendance, the process was highly rated, regardless of gender or resultant HIV status. [Conclusion] In order to increase the usefulness and effectiveness of CHCT, the process must be able to address pertinent uncertainties and concerns that couples might have with regard to HIV risk-reduction uptake and fertility desires.
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    Recognition of malaria, treatment seeking behaviour and perception of the causes and effects of malaria among women attending antenatal clinic in Mudzi district in Zimbabwe
    (2004) Kamupira, Mercy G S; Ehrlich, Rodney
    Malaria is an important public health problem with a high morbidity and mortality in more than 90 malaria endemic countries in the world. The burden of malaria is quite high especially among pregnant women and children under five years of age. There has been little focus on the factors that influence women's responses to malaria control strategies, It is important to establish whether the control measures, health education and the treatment options are available to and utilised by women. They are the caretakers of young children who are particularly vulnerable to severe malaria, and in need of prompt response to the illness, while women themselves are at great risk of severe anaemia and other complications during pregnancy. The purpose of the study is to better understand the role of women in the control and management of malaria at the household level, particularly with respect to women's awareness of transmission, prophylaxis, symptoms, complications, treatment and control of the disease and to provide recommendations to make malaria control programs more gender sensitive and therefore more effective.