Browsing by Subject "HIV/AIDS and Society"
Now showing 1 - 20 of 21
Results Per Page
Sort Options
- ItemOpen AccessAnalyzing how notions of masculinity influence the vulnerability of men to HIV(2008) Mumbengegwi, Elizabeth; Jubber, KenIncludes abstract. Includes bibliographical references (leaves 77-84).
- ItemOpen AccessConsidering alternatives to the predomination model of volentary councelling and testing practiced in South Africa(2009) Brown, Sean; Head, JudithTesting is widely acknowledged to be a useful and necessary secondary tool of Human Immunodeficiency Virus (HIV) prevention. It is the method by which to identify people who are living with the virus, so that their behaviour may be modified and medical condition treated in order to prevent further infection. Unfortunately, many persons in South Africa (SA) remain undiagnosed and therefore unaware of their HIV-positive status. This thesis explores why it is necessary to test for HIV in SA, where the incidence of the virus remains the highest in the world. Voluntary Counselling and Testing (VCT) or the âopt-inâ approach has been adopted as the norm or âsine qua nonâ. The efficacy of this method will be interrogated and shortcomings identified. The most notable is that few people in SA undergo an HIV test in order to learn their status. When they do, it is often late in the progression of opportunistic infections, requiring hospitalisation that increases pressure on an already over-stretched healthcare system. Reasons for the poor uptake of VCT are explained, including pervasive stigma and deficiencies in leadership of SAâs HIV and AIDS response. The expansion of testing is a proposed response to the challenge of persons remaining undiagnosed, and includes the acceleration of âopt-outâ or routine HIV testing (RHT) among SAâs high prevalence population. This model offers an HIV test routinely to persons attending government healthcare settings with an illness or for a routine check-up. Although the provider initiates the test, consent is necessary in order to proceed and there is an option to decline. While the key focus of this thesis is routine HIV testing, other approaches are explored in brief, including mandatory testing, mobile clinics and wellness screening. The thesis argues that if SA is to achieve the HIV and AIDS and STI National Strategic Plan (NSP) target of increasing the number of adults who have ever had a test to 70 percent by 2011, new approaches to testing, and especially opt-out, will need to be explored and more widely adopted. Key words: HIV/AIDS; Voluntary Counselling and Testing (VCT); Routine HIV Testing (RHT); Routinely Recommended Testing (RRT); Opt-out Testing; Provider-Initiated Testing and Counselling (PITC).
- ItemOpen AccessAn exploratory analysis of HIV/AIDS epidemic risk-factors among Aboriginal people in Canada and African South Africans(2010) Mayoh, MelanieWhen addressing the global HIV/AIDS pandemic, it is necessary to identify risk factors which are shared by populations, as well as those which may place populations uniquely at risk. Although Canada is a developed country, its Aboriginal population shares socio-economic characteristics with the world's developing populations. This thesis explores the shared risk factors among the Aboriginal population in Canada, where the HIV/AIDS epidemic is increasing despite relatively low national prevalence rates, and South Africa's African population, where the HIV/AIDS epidemic is particularly acute. The present analysis compares the profile of the African South African HIV/AIDS epidemic with risk factors that also occur among Aboriginal people. The results of this analysis show that the Aboriginal population has an epidemic risk profile that is similar to that of African South Africans. This points to the potential for a rapid increase of HIV/AIDS among Aboriginal people, as has been the case in the African South African population over the past two decades.
- ItemOpen AccessAn exploratory study into the factors that constrain or enable voluntary HIV testing among young adults in Cape Town, South Africa(2008) Lane, HannahDespite exceptionally high HIV prevalence rates, South Africa experiences prohibitively low levels of HIV testing. Considered to be a key element in the prevention of HIV transmission and a necessary gateway for providing care and treatment for those who are infected, widespread ignorance of HIV status has become a mounting concern in countries with high prevalence rates. Strategies for increasing testing rates have most commonly focused on testing and treatment services, such as the availability and accessibility of clinics offering voluntary counselling and testing (VCT), the number of trained nurses and health practitioners able to administer HIV tests, the possibility of instituting routine HIV testing to increase coverage, and the provision of highly active antiretroviral treatment (HAART) in the event of a positive diagnosis. These efforts seek to either increase access to testing through infrastructural improvements or encourage testing by highlighting its function as a gateway to accessing medical services to manage HIV infection and future transmission. In a departure from these strategies, this thesis considers the physical, social, and psychological ramifications of living with HIV - and not simply issues of access, treatment, and prevention - in order to understand HIV testing practices. Qualitative in-depth interviews were conducted with 15 young adults (6 mole and 9 female) living in Cape Town, South Africa. Semi-structured in-depth interviews collected information about: 1) knowledge and sources of knowledge about HIV/AIDS, as well as how this knowledge changes over time; 2) beliefs and attitudes towards HIV and HIV testing, including corresponding health-seeking behaviours; 3) personal stories about HIV testing, including reasons for and reactions to testing; and 4) possible strategies to encourage HIV testing in the future. Study participants identified three broad threats that were perceived to be experienced by HIV positive people and explained how the HIV test served to either mitigate or expose an individual to these threats. Physical threats posed by HIV, such as opportunistic infections or death, encouraged HIV testing as it was only through testing that these potential threats could be mitigated. Conversely, an HIV test exposed an individual to social and psychological threats. The social threats of living with HIV included exclusion, rejection by family and friends, and social shame. Psychological threats included mental destruction, depression, and stress, among others. Where social and psychological threats were perceived to be strong, testing was actively avoided. The findings of this study are that the decision to voluntarily test for HIV can be explained through a balance of the physical, social, and psychological threats that may be managed or catalysed through an HIV test. When study participants perceived physical threats to outweigh perceived social and psychological threats of living with HIV, they were biased towards testing. When they viewed social and psychological threats to outweigh physical threats, they were biased against testing. This focus on the perceived threats of living with HIV highlights the need to have a comprehensive approach to AIDS and HIV, rather than merely focusing on the clinical diagnosis and treatment of symptoms; enhanced infrastructural resources and the opportunity for mitigation of the physical threats alone do not encourage HIV testing.
- ItemOpen AccessFacilitating policy formulation and policy implementation : a case study of policy on the prevention of mother to child HIV transmission in South Africa(2006) Peterson, Jennifer; Butler, AnthonyThis case study explores the evolution of South African policy on prevention of mother to child HIV transmission (PMTCT). It employs the advocacy coalition framework developed by Paul Sabatier to analyse the factors that have hindered and facilitated the alteration and subsequent implementation of PMTCT policy. It provides a clear illustration of the impact that actors outside of the government can have on policy change and policy implementation.
- ItemOpen AccessFactors shaping pre-service teacher identities in a South African HIV/AIDS context: An examination of experience, knowledge and perceptions(2009) Arseneau, Robyn; Baxen, JeanThe HIV epidemic in South Africa is among the worst in the world with an estimated 5.7 million people living with HIV in 2007 (UNAIDS, 2008). South Africa's national education system has responded to the epidemic by introducing Life Skills HIV education across primary and secondary-level schools to promote HIV prevention, care and support among school learners. In particular, the Western Cape Education Department (WCED) has recommended that all teachers integrate HIV education across the curriculum. The Norms and Standards for Educators (NSE) policy document states that each pre-service teacher (PST) must meet 'community, citizenship and pastoral' practitioner roles; these roles entail student counselling, awareness and knowledge of issues impacting the community and corresponding support services, and promotion of HIV awareness in the school curriculum. HIV/AIDS education literature indicates that PST responses to teacher roles and responsibilities vary, and are often greatly influenced by the experiences PSTs bring with them into the teacher-training programme. This dissertation aimed to explore factors that shape PST identities in response to their HIV/AIDS teaching roles and responsibilities as outlined by the NSE policy document and the WCED. Research was conducted with a cohort of PSTs who attended the Post Graduate Certificate teachertraining programme at the University of Cape Town in 2007. A combination of qualitative and quantitative methods was used with a sample group of 81 PSTs. In total, 50 PSTs were surveyed and 19 PSTs were involved in 3 focus group discussions and 15 in-depth interviews. Findings from this study indicate that PSTs bring an array of their own experience, knowledge and perceptions to the teacher-training programme which ultimately shape and contribute to the teacher identity they create in responding to HIV/AIDS teaching roles and responsibilities. Based on evidence from the study, this thesis argues that the PST's experience, knowledge and perceptions of HIV I AIDS should be considered when developing teacher-training programmes in order to promote a comprehensive and effective response to HIV through the education sector in South Africa.
- ItemOpen AccessGrowing up on HAART : the experiences and needs of HIV positive adolescents in care and treatment in the Western Cape province of South Africa(2008) Li, Rachel; Nattrass, NicoliHIV positive adolescents are becoming a progressively more sizeable and prominent sub-group in the South African HIV/AIDS epidemic. As HAART becomes increasingly available, vertically infected children can be expected to survive into adolescence and adulthood. Additionally, sexual transmission of HIV remains a problem, and incidence and prevalence rates among South African youth are high. Experience from the developed world indicates that providing effective care and treatment for youth can be a challenging task. In light of the antiretroviral rollout in South Africa, this exploratory study aimed to identify the experiences and needs of adolescents growing up in care or on treatment for HIV in the Western Cape. To this end, a review of the existing literature on the psychosocial aspects of HIV infection in adolescents was undertaken. Relevant articles were identified, summarized and entered into a database, and particular attention was given to research conducted in the context of sub-Saharan Africa. Additionally, focus groups interviews were conducted with 26 young people attending an adolescent infectious diseases clinic at a tertiary hospital in the Western Cape. Focus groups proceeded according to a pre-set discussion guide and investigated participants' current life experinces, views on the future and self-perceived needs. All interviews were recorded, translated into English, and transcribed, and data were coded and analyzed using NVivo qualitative data analysis software. The study revealed that the psychosocial issues associated with HIV infection in adolescents coalesce around five central themes: knowledge and understanding about personal serostatus, mental health, network of support, treatment management, and healthy behaviour. These issues present challenges to HIV positive adolescents in the present, and affect their outlook on the future. Findings reveal that despite the fact that young seropositive South Africans live in a country where social contexts, available resources and healthcare systems differ markedly from those in developed countries, they share similar concerns and face many of the same challenges as other HIV positive young people around the world. Future studies should investigate each of the five identified themes in greater depth by determining the contextual correlates of individual views, experiences and needs.
- ItemOpen AccessHerstory : Maidei Chivi, an HIV positive Zimbabwean woman(2006) Mphisa, Abigael; Head, JudithThe thesis is based on the story of a 36 year old HIV positive middle class black Zimbabwean woman, Maidei Chivi (pseudonym). Maidei is well educated, financially secure and wields enormous power both within her family and at her workplace. She therefore, unlike many women, does not fall into the typical HIV victim category, characterised by poverty, coerced sex and desperation. Maidei's story demonstrates that economic security does not necessarily result in women taking decision making roles during sex.
- ItemOpen AccessAn HIV/AIDS intervention programme in the workplace: a case study of a medium-sized construction company in the Western Cape.(2006) Griffiths, Roger; Head, JudithGovernment and other NGOs want private sector companies to assist in countering the effects of HIV/AIDS by introducing interventions which follow generic outlined developed by the State and other institutions. The programmes are mainly aimed at the Human Rights of those who are HIV+, and do not have a commercial element. The assumption is that these programmes provide a cost benefit which outweighs the costs of a programme.
- ItemOpen AccessHope in view of HIV/AIDS in South Africa : public discourse, faith and the future(2005) Olivier, Jill; Cochrane, JamesDo discourses of "hope" have real and practical consequences when it come to crucial issues such as policy, prevention, stigma, risk perception or funding? The following exploratory and treansdisciplinary study seeks to pull together a wide variety of the theoretical and analytical stances in order to examine the social construction of hope in the context of HIV/AIDS in South Africa. the theoretical framework is built from a base of cultural theory, discourse analysis and theology, and binds these together into a transdisciplinary argument.
- ItemOpen AccessPerformance based funding from the Global Fund to fight AIDS, Tuberculosis and Malaria : a case study of Grant SAF-304-GO4-H in the Western Cape, South Africa(2006) Naimak, Trude HolmIncludes bibliographical references.
- ItemOpen AccessPoor, black and female : an analysis of South African print media framing of people living with HIV/AIDS(2005) Grant, Deirdre; Chuma, WallaceMedia coverage of HIV/AIDS issues influences how the public views the epidemic and people living with HIV/AIDS (PWAs). This dissertation investigates how two key lwge circulation English ianguage newspapers in South Africa frame PWAs. The research examines both the content of selected print media, Sunday Times and Daily Sun, and the context in which journalists work. In relation to the latter, the study adopts a critical political economy perspective of the media which argues that political and economic constraints on media organizations in tension with human agency by journalists and editors impacts on the content of newspapers and other mass media. This thesis examines HIV/AIDS coverage from the beginning of January until the end of April 2005 through the use of content analysis. Most previous research in relation to HIV/AIDS reporting in the print media has concentrated on the poiiticization of coverage during key moments in South Africa’s HIV/AIDS history. This period was deliberately chosen to be both contemporaneous and in order to examine the routine representations of PWAs during 'ordinary times', when HIV/AIDS was not high on the political agenda. Qualitative research in the form of semi-structured in-depth interviews was also conducted with five reporters and editors in order to explore in greater detail issues relating to HIV/AIDS reporting. This research found that the print media in South Africa frames the HIV/AIDS epidemic in a gendered and racialised way. From print media reports examined, the picture painted of PWAs is usually black, female and poor. Official sources continue to dominate coverage, but PWAs are gaining a voice in news reports. The language used in these reports is becoming more positive and empowering, but is still regularly stigmatizing.
- ItemOpen AccessA public health conflict : traditional medicinal practise and the bio-medical health norms and values at a time of HIV and AIDS in Swaziland(2010) Dlamini, Gcinekile G; Head, JudithMedical pluralism and the co-existence of a variety of different medical systems within a chosen context are common features in southern Africa as in the rest of the developing world. How do the different systems or practices interact? How does the dual systems of healing impact on the HIV and AIDS national mitigation programmes. The study assumes that the existence of different kinds of medical practices in the same community over a long period of time is an indication of the reality of medical pluralism in Swaziland. It questions its conflicting impact on the public health messages for managing the epidemic. The existence of different healers e.g. faith healers, medical doctors and traditional healers and herbalists is a significant aspect of health seeking behaviours among the larger population in Swaziland (only 22% of Swaziland is urbanized). The people‟s attitude towards and reception of the states public health policies and public health messages are heavily interpreted along and in view of the highly respected traditional medical health care systems. This phenomena also covers the people‟s spiritual and emotional health care systems and points of references and health seeking behaviours. The study also reflects upon the bias by a number of postcolonial writing towards traditional healing driven by colonialists‟ impressions and local rulers left in charge thereafter. The study also refers to the bias of a number of African leaders and governments who readily give support to bio-medical doctors and are not equally supportive to the structures that support traditional healing and yet a bigger size of the population is mostly reliant upon traditional medical care. In southern Africa self-medication is documented as an integral part of the health care system. This research project reflects extensively on the attitude of traditional and developing communities towards ARVs, ART and biomedical interventions at a time of HIV and AIDS in southern Africa. The study concludes that there are no cultural barriers for the traditional healers to collaborate with the bio-medicine practitioners; however there seems to be a lot of „public health‟ constraints for the medical doctor to working collaboratively with the traditional healer. Is this a one sided conflict, tension, bias?
- ItemOpen AccessThe Public Sector HIV/AIDS Treatment Roll-out Campaign in the Western Cape: A case study highlighting success factors and challenges(2006) Fuleihan, Nadia CUntil recently, the national implementation of a public sector Antiretroviral Therapy (ART) programme in South Africa seemed financially impossible. Drastically reduced prices for Antiretrovirals (ARVs) combined with substantial donor funding and the long-awaited adoption of a national treatment plan, have, however, shifted the debate. Now the question is not so much should universal ART be provided by government but, rather, is it possible to implement in severely resource-constrained environments and, if so, what are the best ways to deliver these services.
- ItemOpen AccessResponding to multi-dimensional forms of poverty in the context of HIV/AIDS: experiences of mothers in Khayelitsha(2008) Kane, Dianna; Head, JudithSouth Africa is a highly unequal society, comprised of a small, wealthy elite class and a large population living in deep, chronic poverty plagued with unemployment. Those suffering from the greatest poverty are unemployed women caring for children. In the context of a distinct underclass that has been historically marginalized from the labour market and a welfare system does not provide assistance for the unemployed, these women are left to cope with their own poverty. Additionally, the HIV/AIDS epidemic exacerbates existing vulnerabilities and compromises the capabilities of these women and children. Guided by a livelihood framework and based on a multi-dimensional definition of poverty, the study explored how women navigate within their difficult environment to respond to the poverty of their children.
- ItemOpen AccessSituating the HIV/AIDS epidemic in a historical context : a case study of orphans in Nguludi Mission Community, Malawi(2003) Croke, Rhian G; Head, JudithThis thesis is based on a series of interviews with key informants and a census of orphan households in Nguludi Mission Community, Southern Malawi, in 2000. The thesis argues that although HIV/AIDS is a relatively recent phenomenon, any contemporary understanding of the epidemic must be informed by an understanding of the past. The impact of the HIV/AIDS epidemic and the "orphan problem" at the local level, is, therefore, situated within the broader socio-economic context of the history of the region.
- ItemOpen AccessTeaching the Life Skills curriculum : experiences of managing the blurred terrain of the public and private : an exploratory case study of women who teach 7th grade Life Skills on the Cape Flats of Cape Town, South Africa(2007) McCulla, Amy; Baxen, JeanWord processed copy. Includes bibliographical references (leaves 117-123).
- ItemOpen AccessThe clinic as a gendered space: an exploratory study examining men's access to and uptake of voluntary counselling and testing services (VCT) in the context of a male-friendly health facility(2008) Faull, Maria; Colvin, Christopher[pg 78 missing] Men in South Africa test for HIV at lower rates than do women. Investigating ways to increase men's uptake of Voluntary Counselling and Testing (VCT) services is therefore of critical importance to public health. The Site C Men's Clinic in Khayelitsha, where this study took place, is an attempt at increasing men's use of VCT. Men's views about a male-friendly space and its influence on VCT uptake had not yet been investigated in South Africa. The Men's Clinic in Khayelitsha allowed me the opportunity to interview men attending the clinic to explore their perceptions and experiences of VCT within this environment. The central aim was to explore whether men perceive the facility to be enabling in their decision to use VCT now or in the future. Furthermore, the intention of this study was to explore whether male clients perceive male health workers any differently to women staff with specific attention to confidentiality. This is closely linked to the uptake of VCT, as trust in health-workers is central to the process. The study also sought to evaluate how this male-friendly environment may contribute to normalising testing in men, which is another encouraging factor In VCT uptake. Finally, although this is a critical issue for men's health, the study aimed to investigate whether VCT services targeted at men, may benefit women's health too. The interviews were qualitative, semi-structured interviews. Being an exploratory study dealing with men's perceptions of the clinic and its services, the qualitative approach was valid. This interview approach allowed for variety in answers, but also revealed commonality, as themes emerged in response to questions. The project involved 33 qualitative interviews with men attending the clinic In Khayelitsha (including 15 men who tested at the clinic and 18 non-testers). The client interviews took place between 5 - 27th October 2007. Getting men to test for HIV is an urgent task for public health in South Africa. This study explored whether men experienced the clinic to be male-friendly and whether this influenced their attitude to testing. Most men expressed an increase in comfort and personal safety at the facility, which are valued attributes of a VCT facility. Many clients expressed greater trust in male staff, and surprisingly, trust in male patients, which contributed to their comfort at the facility. There was evidence in the interview data to suggest that male clients would contribute to normalising VCT through talking to peers about the clinic and its services. This is also likely to contribute to the greater VCT uptake in men. Testing clients seemed open to talking to their partners, having tested at the clinic. Some clients wanted to return to the facility with their partner to test. This indicates a potentially positive influence on the health of the couple. Although the clinic quantitative data indicates a slow and disappointing start for the clinic, based on the perceptions expressed by these clients, the facility is filling an important health service for men. It is likely to encourage more men to access VCT, because men feel confident in the service and staff. This is arguably in the interests of men and women's health.
- ItemOpen Access'They say you are not a man' : hegemonic masculinity and peer pressure amongst male adolescents in KwaZulu-Natal : implications for the HIV epidemic(2009) Thomson, HayleyThis study explores the links between masculinity and the spread of HIV/AIDS by examining adolescents’ conceptions of manhood and the ways in which hegemonic masculinity manifests itself through peer pressure. The study employed qualitative methods, including in-depth interviews and focus group discussions. Interviews were conducted with fifteen adolescent males between the ages of twelve to sixteen, who live in areas with high levels of HIV prevalence outside Pietermaritzburg in KwaZulu-Natal.
- ItemOpen AccessUsing the Child Support Grant to advance the socio-economic rights of children affected by HIV/AIDS in South Africa : a critical reflection(2005) Fleming, Samantha; Head, JudithIncludes bibliographical references (leaves 95-102).