10 results
Search Results
2. Determinants of livelihood in the era of widespread access to ART.
- Author
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Hanass-Hancock, Jill, Misselhorn, Alison, Carpenter, Bradley, and Myezwa, Hellen
- Subjects
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ANTI-HIV agents , *AGE distribution , *DRUGS , *HEALTH services accessibility , *HEALTH status indicators , *HIV infections , *PSYCHOLOGY of HIV-positive persons , *MARITAL status , *PATIENT compliance , *PEOPLE with disabilities , *QUESTIONNAIRES , *SEX distribution , *STATISTICS , *SOCIOECONOMIC factors , *WELL-being , *CROSS-sectional method , *FOOD security , *DESCRIPTIVE statistics - Abstract
We have only just begun to understand the long-term impact of living with chronic HIV on health and livelihood after a decade of widespread access to treatment in southern Africa. This paper explores health and well-being, disability, and livelihood dynamics among people living with HIV (PLHIV) in a public healthcare setting in South Africa. We undertook a cross-sectional survey among a cohort of 1042 people on ART and explored associations between socio-demographic characteristics, treatment adherence, measures of disability (functional and activity limitations), livelihood resources (capitals) and outcomes, including food security, and exposure to livelihood shocks. A range of dynamic relationships relevant for decision-makers is evident. Age, gender, and marital status all had significant associations with levels of livelihood capitals and outcomes. Those who had been on ART for longer periods of time also had significantly higher aggregate livelihood capital. This was particularly driven by social and financial capital. Livelihoods are built within specific social and health contexts. Of particular importance is that the resources drawn on to build a livelihood differ significantly between men and women, and that different forms of disability also have gender-specific pathways in influencing livelihood and livelihood outcomes. Our results support the need for a gender-sensitive approach to supporting the well-being and livelihoods of PLHIV. Of equal importance is an approach that considers more comprehensively the new experiences of comorbidities and disabilities that may occur with a long life on ART. [ABSTRACT FROM PUBLISHER]
- Published
- 2017
- Full Text
- View/download PDF
3. A psychoeducational approach for prevention of burnout among teachers dealing with HIV/AIDS in South Africa.
- Author
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Johnson, Sharon Mary and Naidoo, Anthony Vernon
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PSYCHOLOGICAL burnout prevention , *EMOTIONS , *FOCUS groups , *INTERVIEWING , *JOB stress , *LAUGHTER , *PROFESSIONS , *QUESTIONNAIRES , *SELF-efficacy , *PSYCHOLOGY of teachers , *ADULT education workshops , *EMOTIONAL intelligence , *QUALITATIVE research , *SOCIAL support , *THEMATIC analysis , *MINDFULNESS , *DESCRIPTIVE statistics , *PSYCHOEDUCATION ,HIV infections & psychology - Abstract
Teaching is one of the most stressful occupations, with high stress and burnout levels of teachers necessitating intervention. This is especially relevant for South African teachers tasked with additional responsibilities of dealing with HIV/AIDS issues, as well as attending to normal curricula duties. A burnout prevention intervention, based on Paulo Freire’s adult educational approach, using transpersonal psychology techniques, was introduced to HIV/AIDS coordinator teachers (n = 27) at high-risk schools in the Western Cape, South Africa, who attended six three-hour weekly workshops. This paper presents the bottom-up thematic analyses of the group, as well as individual global analysis (n = 10) of the qualitative data, derived from focus group interviews and workshop evaluations after the intervention, providing insights into the experiences of workshop participants and their teaching contexts. The mind map of one participant is illustrated. The findings of the study confirmed that transpersonal practices (TP) presented in psychoeducation workshops were helpful in mediating stress and burnout in the work and personal contexts of teachers dealing with HIV/AIDS. TP offer practical applications of right brain emotional and social intelligence practices that could be incorporated into care and wellness school programmes for teachers vulnerable to stressors related to HIV/AIDS. [ABSTRACT FROM PUBLISHER]
- Published
- 2017
- Full Text
- View/download PDF
4. Shortcomings of adherence counselling provided to caregivers of children receiving antiretroviral therapy in rural South Africa.
- Author
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Coetzee, Bronwyne, Kagee, Ashraf, and Bland, Ruth
- Subjects
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CAREGIVER education , *BEHAVIOR , *COUNSELING , *DRUGS , *DRUG administration , *HIV infections , *HIV-positive persons , *MATHEMATICAL models , *MEDICAL quality control , *MEDICAL cooperation , *MOTIVATION (Psychology) , *SCIENTIFIC observation , *PATIENT compliance , *PEDIATRICS , *QUALITY assurance , *RESEARCH , *RESEARCH funding , *QUALITATIVE research , *THEORY , *JUDGMENT sampling , *VIRAL load , *ANTIRETROVIRAL agents , *DATA analysis software , *DESCRIPTIVE statistics , *CD4 lymphocyte count , *FIELD notes (Science) , *CHILDREN - Abstract
In order to achieve optimal benefits of antiretroviral therapy (ART), caregivers of children receiving ART are required to attend routine clinic visits monthly and administer medication to the child as prescribed. Yet, the level of adherence to these behaviours varies considerably in many settings. As a way to achieve optimal adherence in rural KwaZulu-Natal, caregivers are required to attend routine counselling sessions at HIV treatment clinics that are centred on imparting information, motivation, and behavioural skills related to medication administration. According to the information-motivation-behavioural skills model, information related to adherence, motivation, and behavioural skills are necessary and fundamental determinants of adherence to ART. The purpose of the study was to observe and document the content of adherence counselling sessions that caregivers attending rural clinics in KwaZulu Natal receive. We observed 25 adherence counselling sessions, which lasted on average 8.1 minutes. Counselling typically consisted of counsellors recording patient attendance, reporting CD4 count and viral load results to caregivers, emphasising dose times, and asking caregivers to name their medications and dosage amounts. Patients were seldom asked to demonstrate how they measure the medication. They were also not probed for problems regarding treatment, even when an unsuppressed VL was reported to a caregiver. This paper calls attention to the sub-optimal level of counselling provided to patients on ART and the urgent need to standardise and improve the training, support, and debriefing provided to counsellors. [ABSTRACT FROM PUBLISHER]
- Published
- 2016
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5. ISIBINDI, creating circles of care for orphans and vulnerable children in South Africa: post-programme outcomes.
- Author
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Visser, Maretha, Zungu, Nompumelelo, and Ndala-Magoro, Nkateko
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HIV prevention , *CHI-squared test , *FOCUS groups , *ORPHANAGES , *ORPHANS , *QUESTIONNAIRES , *RESEARCH funding , *RISK-taking behavior , *RURAL conditions , *SELF-perception , *T-test (Statistics) , *WELL-being , *COMMUNITY-based social services , *THEMATIC analysis , *EVALUATION of human services programs , *DATA analysis software , *DESCRIPTIVE statistics - Abstract
This paper presents the evaluation of post-programme outcomes of the ISIBINDI model, a community-based intervention to promote physical and psychosocial well-being of orphans and vulnerable children (OVC) in South Africa. A mixed methods quasi-experimental design was used to investigate the differences between former ISIBINDI participants (18 years and older) and a control group of similar background. ISIBINDI ex-participants at 12 sites (n= 427) and a control group of non-participants (n= 177) completed a questionnaire which explored level of education and employment, psychosocial well-being and HIV risk behaviour. Focus group discussions were conducted with various stakeholders. Ex-participants reported higher self-esteem and problem-solving abilities, family support and lower HIV risk behaviour than the control group. High levels of unemployment especially in rural areas resulted in unemployment of out-of-school OVC which creates new forms of vulnerability. The benefits of the programme may be compromised by the lack of community resources. An effective exit strategy is needed to contribute to financial independence of OVC after exiting the programme. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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6. Kganya Motsha Adolescent Centre: a model for adolescent friendly HIV management and reproductive health for adolescents in Soweto, South Africa.
- Author
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Nkala, Busisiwe, Khunwane, Mamakiri, Dietrich, Janan, Otwombe, Kennedy, Sekoane, Itumeleng, Sonqishe, Bulelwa, and Gray, Glenda
- Subjects
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COUNSELING , *THERAPEUTICS , *HIV infections , *HOSPITALS , *ANTIVIRAL agents , *CHI-squared test , *CONFIDENCE intervals , *PROBABILITY theory , *SEX distribution , *STATISTICS , *DATA analysis , *CROSS-sectional method , *RETROSPECTIVE studies , *DATA analysis software , *DESCRIPTIVE statistics , *ADOLESCENCE - Abstract
This paper reports on Kganya Motsha Adolescent Centre, an adolescent program specifically established to provide voluntary counseling and testing as well as management of HIV-positive young people in Soweto, South Africa. A retrospective cross-sectional analysis, using clinic records of young people accessing services from 2008 to 2012, was conducted. Of the 11,522 who tested, 7689 (67%) were females. The total number of HIV infections was 410, with an HIV prevalence of 3.6% (95% CI 3.2–3.9%). More females (332, 4% vs. 72, 2%;p< 0.0001) were HIV-infected than males. Of those testing HIV positive, 109 (26.5%) had a median CD4 cell count of 491 (IQR 345–686) cells/mm3. Only 12/410 individuals (2.9%) were eligible for antiretroviral treatment and 10 (2.4%) of those successfully received treatment. The program observed that young people testing HIV positive would not return for follow up blood specimens or confirmatory results. Future programs should consider innovative ways of retaining adolescents in care to reduce potential HIV transmissions that could lead to deteriorating health. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
7. “We have to try and have this child before it is too late”: missed opportunities in client–provider communication on reproductive intentions of people living with HIV.
- Author
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Mindry, D.L., Crankshaw, T.L., Maharaj, P., Munthree, C., Letsoalo, T., Milford, C., Greener, R.M., Rambally, L., Carpenter, S., and Smit, J.A.
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HUMAN reproduction , *DECISION making , *FOCUS groups , *INTERVIEWING , *RESEARCH methodology , *PATIENT-professional relations , *MOTIVATION (Psychology) , *PATIENTS , *RESEARCH funding , *SURVEYS , *PSYCHOLOGY of AIDS patients , *QUALITATIVE research , *DESCRIPTIVE statistics , *PSYCHOLOGY - Abstract
Men and women living with HIV with access to ARVs are living longer, healthier lives that can and often do include bearing children. Children occupy a key space in men and women's personal and social lives and often play a fundamental role in maintaining these relationships, irrespective of illness concerns. Couples living with HIV need to balance prevention needs and ill-health while trying to maintain healthy relationships. Health-care providers serving the reproductive needs of HIV-affected couples need to consider the social and relational factors shaping reproductive decisions associated with periconception risk behaviors. This paper based on qualitative research at three hospital sites in eThekwini District, South Africa, investigates the childbearing intentions and needs of people living with HIV (PLHIV), and the attitudes and experiences of health-care providers serving the reproductive needs of PLHIV, and client and provider views and knowledge of safer conception. This research revealed that personal, social, and relationship dynamics shape the reproductive decisions of PLHIV, and “unplanned” pregnancies are not always unintended. Additionally, conception desires are not driven by the number of living children; rather clients are motivated by whether or not they have had any children with their current partner/spouse. Providers should consider the relationship status of clients in discussions about childbearing desires and intentions. Although many providers recognize the complex social realities shaping their clients' reproductive decisions, they have outdated information on serving their reproductive needs. Appropriate training to enable providers to better understand the relationship and social realities surrounding their clients' childbearing intentions is required and should be used as a platform for couples to work together with providers toward safer conception. The adoption of a more participatory approach should be employed to equalize client–provider power dynamics and to ensure clients are more involved in decision-making about reproduction and conception. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
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8. Positive parenting for positive parents: HIV/AIDS, poverty, caregiver depression, child behavior, and parenting in South Africa.
- Author
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Lachman, Jamie M., Cluver, Lucie D., Boyes, Mark E., Kuo, Caroline, and Casale, Marisa
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CHILD welfare , *CHILD behavior , *CHILDREN of people with mental illness , *CONFIDENCE intervals , *MENTAL depression , *MULTIVARIATE analysis , *PARENTING , *POVERTY , *PROBABILITY theory , *REGRESSION analysis , *RESEARCH funding , *SURVEYS , *EFFECT sizes (Statistics) , *CROSS-sectional method , *DESCRIPTIVE statistics ,HIV infections & psychology - Abstract
Families affected by HIV/AIDS in the developing world experience higher risks of psychosocial problems than nonaffected families. Positive parenting behavior may buffer against the negative impact of child AIDS-orphanhood and caregiver AIDS-sickness on child well-being. Although there is substantial literature regarding the predictors of parenting behavior in Western populations, there is insufficient evidence on HIV/AIDS as a risk factor for poor parenting in low- and middle-income countries. This paper examines the relationship between HIV/AIDS and positive parenting by comparing HIV/AIDS-affected and nonaffected caregiver-child dyads (n=2477) from a cross-sectional survey in KwaZulu-Natal, South Africa (27.7% AIDS-ill caregivers; 7.4% child AIDS-orphanhood). Multiple mediation analyses tested an ecological model with poverty, caregiver depression, perceived social support, and child behavior problems as potential mediators of the association of HIV/AIDS with positive parenting. Results indicate that familial HIV/AIDS's association to reduced positive parenting was consistent with mediation by poverty, caregiver depression, and child behavior problems. Parenting interventions that situate positive parenting within a wider ecological framework by improving child behavior problems and caregiver depression may buffer against risks for poor child mental and physical health outcomes in families affected by HIV/AIDS and poverty. [ABSTRACT FROM PUBLISHER]
- Published
- 2014
- Full Text
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9. Factor structure of the Beck Depression Inventory-II among South Africans receiving antiretroviral therapy.
- Author
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Kagee, Ashraf, Nel, Adriaan, and Saal, Wylene
- Subjects
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DIAGNOSIS of mental depression , *ANTIVIRAL agents , *FACTOR analysis , *RESEARCH methodology , *SURVEYS , *RESEARCH methodology evaluation , *DESCRIPTIVE statistics ,HIV infections & psychology ,RESEARCH evaluation - Abstract
Considerable evidence suggests that mood disturbance is common among patients living with HIV and may be an important barrier to anti-retroviral therapy (ART) adherence. Thus the assessment of depressed mood is an important and necessary aspect of the experience of persons living with HIV as it may impact the health status of individuals directly and indirectly. We sought to determine the factor structure of the Beck Depression Inventory (BDI) among a sample of 185 South Africans living with HIV and receiving ART. The mean BDI score was 16.5 (SD 12.15) with a range from 0–50 (out of a possible 63), indicating on average moderate levels of depression. Cronbach's alpha for the total scale was 0.90. Although the four factors had eigenvalues that were technically above 1.0, only three factors could logically be extracted, the combination of which accounted for 47.29% of the variance. These three factors were Cognitive, Affective and Somatic. The results indicate that the BDI-II is a reliable measure of symptoms of depression among persons living with HIV. The factor structure among South Africans receiving ART is similar to that of other samples, although surprisingly, the item assessing appetite disturbance did not load on any factor. The results of the study suggest that the BDI-II is a useful measure among South Africans living with HIV. In the context of the need to rapidly identify depressed mood among persons receiving ART in public health clinics, the BDI may be a useful instrument. We end the paper with certain cautions associated with routine screening. [ABSTRACT FROM PUBLISHER]
- Published
- 2014
- Full Text
- View/download PDF
10. Weighing up the burden of care on caregivers of orphan children: The Amajuba District Child Health and Wellbeing Project, South Africa.
- Author
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Govender, Kaymarlin, Penning, Susan, George, Gavin, and Quinlan, Tim
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CHI-squared test , *CHILD welfare , *CLUSTER analysis (Statistics) , *HEALTH status indicators , *INTERGENERATIONAL relations , *LONGITUDINAL method , *ORPHANAGES , *ORPHANS , *PROBABILITY theory , *RESEARCH funding , *STATISTICAL sampling , *T-test (Statistics) , *SOCIOECONOMIC factors , *BURDEN of care , *CROSS-sectional method , *DESCRIPTIVE statistics - Abstract
This paper assesses the burden on orphan caregivers relative to non-orphan caregivers in the context of high HIV/AIDS mortality in South Africa. It presents findings from the third round of a study conducted in the Amajuba District of KwaZulu-Natal between 2003 and 2007. Significant differences were found between orphan and non-orphan caregivers; the former being more likely to care for more children, have poorer health, higher levels of chronic illness, less adult help and they appeared to have more daily responsibilities. Orphan caregivers were also more likely to indicate that children in their care needed help for mental or behavioural problems but overall results showed that only 3.4% of all households had contact with child welfare agencies. The findings question assumptions about the capacity and capability of the extended family to absorb shocks to individuals and families. [ABSTRACT FROM AUTHOR]
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- 2012
- Full Text
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