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In-clinic follow-up to assess completion of medical abortion is no longer a requirement according to World Health Organization guidance, provided adequate counselling is given. However, timely recognition of ongoing pregnancy, complications or incomplete abortion, which require treatment, is important. As part of a larger trial, this study aimed to establish whether women having a medical abortion could self-assess whether their abortion was complete using an automated, interactive questionnaire on their mobile phones. All 469 participants received standard abortion care and all returnees filled in a self-assessment on paper at clinic follow-up 2–3 weeks later. The 234 women allocated to receive the phone messages were also asked to do a mobile phone assessment at home ten days post-misoprostol. Completion of the mobile assessment was tracked by computer and all completed assessments, paper and mobile, were compared to providers’ assessments at clinic follow-up. Of the 226 women able to access the mobile phone assessment, 176 (78%) completed it; 161 of them (93%) reported it was easy to do so. Neither mobile nor paper self-assessments predicted all cases needing additional treatment at follow-up. Prediction of complete procedures was good; 71% of mobile assessments and 91% of paper assessments were accurate. We conclude that an interactive questionnaire assessing completion of medical abortion on mobile phones is feasible in the South African setting; however, it should be done later than day 10 and combined with an appropriate pregnancy test to accurately detect incomplete procedures. [ABSTRACT FROM AUTHOR]

Access to clean and functional toilet is quintessential in meeting children's physiological and psychosocial needs in a learning environment. However, little is known on experiences of children's access to quality toilets while in preschool institutions within urban settings of sub-Saharan Africa countries. This paper draws from a study that explored experiences of vulnerable children in early childhood development education (ECDE) institutions in underserved and informal urban settings of Kenya and South Africa. 11 urban ECDE centres were purposively selected and 17 teachers were recruited as key informants. Data was collected using an adapted infrastructural checklist, observation and conversational interviews. Findings indicated that a majority of toilets in ECDE centres were inadequate, inappropriate, poorly maintained, or had structural weaknesses which affected children's experiences of access and use of the facilities. Scheduled toilet visits as a control measure and toilet avoidance potentially exposed them to psychosocial and health risks. Insights into children's toilet facilities, managing their access in institutions located within informal and low resourced areas, and investment policies that target preschool children' sanitary facilities are given. Suggestions are made for interventions for children's positive toilet experiences in poor urban areas. [ABSTRACT FROM AUTHOR]

In this paper, we share some personal reflections of straddling different research roles in a doctoral study entitled Queering Sex Work and Mobility in South Africa. We highlight the importance of using a Feminist Participatory Action Research (FPAR) methodology when conducting studies with migrant and mobile sex workers as it offers participants an opportunity to express their lived realities and embodied knowledge(s) beyond linguistic barriers. Through our reflections, we demonstrate that marginalised communities can become co-creators in knowledge production processes, not just the givers of stories (aka 'poverty porn') but integral members of the research team who actively contribute towards the conceptualisation, data collection, analysis, publishing and distribution of scholarship. [ABSTRACT FROM AUTHOR]

Background: Sex workers in South Africa face various forms of structural and interpersonal violence, including police violence, exclusion from health services, and stigmatization and marginalization within their communities. In an attempt to counteract the harmful health effects of criminalization and exclusion, risk-reduction workshops are a key component of HIV prevention programs globally. This paper offers a critical investigation of Creative Space workshops – a South African model of risk-reduction workshops for sex workers – taking place in Soweto, Johannesburg. Drawing on Paulo Freire's work, the paper explores the potential of these workshops to contribute to the empowerment, health and well-being of sex workers. Objectives: The aim of this paper is to investigate the social and psychological effects of peer-led risk-reduction workshops for sex workers in Soweto, South Africa, with a particular focus on the ways in which they might contribute to community empowerment. Methods: This paper is based on in-depth interviews and focus group discussions with 32 sex workers conducted as part of a 20-month ethnographic study (December 2015 to July 2017). Data was analyzed combining inductive thematic analysis with a theoretical frame based on Freire's theory of community empowerment. Results: Peer-led risk-reduction workshops can serve as a 'safe space' for sex workers and distribute empowering forms of knowledge, particularly regarding health issues and rights. However, divisions between different groups of sex workers and between sex workers and non-sex workers counteract the potential benefits of the workshops. Conclusions: Peer-led sex worker programs are likely to be more empowering when they are committed to raising critical consciousness and creating solidarity, and embedded in community action, focusing on common issues such as institutionalized racism, livelihood insecurity, and lack of access to safe and secure housing. Such actions would have positive outcomes on health and well-being. [ABSTRACT FROM AUTHOR]

In this paper, we examine a prominent interpretation of HIV risk in a rural South African setting experiencing a severe HIV epidemic well into older ages: the discourse of caregiving HIV transmission. By caregiving transmission, we refer to HIV infection resulting from caring for family members who are living with HIV and may be sick with AIDS-related illnesses. We draw on individual life history and community focus group interviews with men and women aged 40–80+, as well as interviews with health workers providing HIV counselling and testing services at local health facilities in their communities. We illustrate the social and strategic role caregiving HIV transmission discourses play in re-signifying HIV as a sexless infection for older women, thereby promoting HIV testing as well as blameless acceptance of an HIV diagnosis. We further highlight the role of rural health workers who serve as medical epistemic bricoleurs, vernacularising global HIV counselling and prevention messages by blending ideas of gender, generation, and local lived experiences and practices so that they resonate with community norms, values and understandings. Our study highlights the gendered and generational complexities and challenges experienced by rural South Africans aging in a community over-burdened by an HIV epidemic and AIDS-related mortality. [ABSTRACT FROM AUTHOR]

In this paper, we draw from elements of a study that sought to examine how teenage South African girls, both white and black African, articulate their relationship with online sexually explicit materials (SEM). The study contributes to the literature by resisting the dominant discursive practices underlined by the construction of sexuality as an exclusive realm of danger for teenage girls. Challenging this static version of femininity, we focus on the ways in which teenage girls, aged between 13 and 18 years old in two elite private schools, use online SEM to expand their sexual knowledge and engage in pleasurable forms of sexuality. By drawing on individual interviews, focus group discussions and open-ended visual elicitation research methods, we show how girls embrace online SEM in ways that expand the definition of femininity beyond fearing sexuality whilst demonstrating the entanglement with gender inequalities. Girls' relationship with online SEM, whilst tenuous, disrupts normative assumptions around femininity. However, an ambiguous relationship with online SEM is evident as their challenges to dominant femininity are mediated by concerns about respect and innocence, as well as by persistent evidence of male power within online SEM. Implications for school-based sexuality education concludes the paper. [ABSTRACT FROM AUTHOR]

Globally, women with disabilities experience heightened and unique forms of violence compared to men with disabilities and women without disabilities. Yet formalised guidelines for their inclusion in gender-based violence (GBV) research is lacking. This paper draws on ethical guidelines for researching violence against women, and studies on the ethicality of including people with disabilities in research, to advocate for women with disabilities' inclusion and safety in GBV research. Reflecting on lessons from a qualitative study on violence against women living with disabilities in South Africa, the paper considers what could be of value for GBV researchers and ethics review committees in low-middle income countries (LMICs). It aims to stimulate debate around the integration of reasonable accommodation, accessibility, and equal participation of women with disabilities in planning and conducting ethical GBV research. The paper recommends that considerations are practically applied and tested in other LMICs, and thereafter critiqued in consultation with a range of stakeholders and women with disabilities, to enhance best practice and form a basis for developing guidelines for undertaking ethical and inclusive GBV research in LMICs. [ABSTRACT FROM AUTHOR]

The use of drugs amongst adolescents and youth has become a global phenomenon and South Africa is no exception. This paper aims to explore the familial contexts and childhood experiences leading up to the drug-taking pathways of young drug users. A qualitative approach was utilized to gather demographic from a purposive sample of 41 young (14–19 years) drug users, at five drug treatment centres in the Western Cape of South Africa. Additionally, participants could agree to participate in an in-depth interview or to provide a written life history account. A thematic data analysis was applied, and the results uncovered a range of family-related risk factors such as family structure (single motherhood and absent fatherhood), and other negative family functioning and practices such as troubled parent-child relationships, poor family communication/interactions, parental/family substance abuse, and conflict-ridden, stressful and often violent and abusive family situations. The findings suggest that prevention initiatives should focus on strengthening family functioning by reducing high conflict, stress, violent and abusive family situations, as well as aim to enhance the caregiver-child relationship. Prevention strategies should encourage live-in and non-live-in fathers to be actively involved in the lives of their children and should aim to reduce parental/caregiver substance abuse. [ABSTRACT FROM AUTHOR]

This paper takes the form of an account of the emergence of the field of psychoanalytically informed parent-infant/child psychotherapy in South Africa. It traces the origins and the development of the South African field by locating local practice within the international field. The influential links between international approaches and local practice and services are described. The historical account is based on a review of published parent-infant/child literature, including South African authored texts. Interviews with key local stakeholders and practitioners supplement the literature review. This paper endeavours to locate parent-infant/child psychotherapy more clearly on the map of mental health work in South Africa, and in so doing to promote the work as both a relevant and valuable intervention. [ABSTRACT FROM PUBLISHER]

This paper explores students', preservice teachers' and inservice teachers' perceptions of the contributions and challenges of using participatory visual methodologies (PVM) to enhance HIV education in rural schools. Drawing on findings from three research projects conducted in KwaZulu Natal, South Africa, four positive contributions are identified: 1) novelty, fun and engagement; 2) amplifying youth voices; 3) the facilitation of teachers' reflexive learning; and 4) the production of local resources in under-resourced schools. Challenges include: 1) limited technology access; 2) teacher discomfort; and 3) resistance to PVM integration. Teachers and young people, especially in under resourced rural settings, can benefit from integrating such methodologies into their responses to HIV and AIDS. However, sustainable integration must rely on choosing the most appropriate participatory visual methodologies given the technological resources available in school. The paper concludes with recommendations to optimise participatory visual methodologies integration into rural school-based HIV responses. [ABSTRACT FROM AUTHOR]

Non-state actors, including humanitarian agencies, play a prominent role in providing health care in low- and middle-income countries. Between 2007 and 2009, Musina, a South African municipality bordering Zimbabwe, became the site of several interventions by non-state organisations as an unprecedented number of Zimbabweans crossed the border, putting strain on already burdened local systems. After the initial need for humanitarian relief dissipated, organisations started to implement projects that were more developmental in nature. For example, Médecins sans Frontières developed a mobile clinic programme to improve health care access for migrant farm workers, a programme that was subsequently integrated into the Department of Health. Since the handover of the programme, it has faced multiple challenges. Using qualitative methodology and a case study approach, this paper traces the development of the programme, exploring the changing relationship between MSF and the state during this time. This research raises questions about the implications of short-term 'innovative' interventions targeting the access that migrants have to care, within a context in which policy and programmatic responses to health are not migration aware. Furthermore, it highlights the ways in which the energies and resources of local DoH employees were redirected by MSF's involvement in the area. [ABSTRACT FROM AUTHOR]

The social work profession has become critical in assisting victims of violent crime at social service agencies in South Africa. Social workers have been spearheading efforts to help trauma victims at the expense of their mental health. For Black South African social workers, the mental burden of working with victim collides with historical trauma to create new ways of experiencing mental health challenges. The study aimed to explore the experiences of social workers working with victims of violent crime at select social service agencies in Johannesburg. The study was qualitative in nature and a case study design was used. Data was collected using in-depth interviews. The researchers used purposive sampling and data was analyzed using thematic analysis. Results from the study showed that Black South African social workers working in the field of violent crime face challenges such as prolonged sadness, emotional exhaustion and vicarious trauma. All these psychological problems are amplified by the fact that social workers in South Africa work under strenuous conditions. This increases the impact of psychological problems on social workers. Therefore, this paper argues that when the psychological effects of working with victims of violent crime, intersect with historical trauma, it produces unique ways of experiencing trauma for Black South African social workers. This study has strong implications for research about the health and wellbeing of social work practitioners working with trauma victims. The study exposes the need to prioritize the wellbeing of social workers especially those working in contexts with a traumatic past. [ABSTRACT FROM AUTHOR]

Mothering in the context of a South African high-risk community has undue complexities. Apart from the compounding risks for families and the reality of many "poverty traps," when mothers' personal and parenting competencies within this context are compromised, then the entire family suffers. There is a need for the development and evaluation of a wellness program for mothers living in high-risk communities in the South African context. Moreover, scholars argue for a contextual understanding of structural conditions and, particularly, for the inclusion of a participatory and social justice approach to such program development. The aim of the program described in this paper was to strengthen the personal and parenting abilities of mothers living in a South African high-risk low-income community. We describe our modus operandi in combining research-generated academic information with contextual data obtained via participatory processes to inform the content and focus of the program. Additionally, thematic analysis of data obtained via a focus group discussion with social worker participants was used to identify prerequisite skills and competencies for this program to enhance mothers' well-being as well as appropriate parenting skills. We describe the content of the wellness program comprising concept mapping of four modules called Mattering; Mothering; Managing; and, Mentoring located within the theoretical framework of Community Psychology. Guidelines from various parenting programs were incorporated as best practices toward effective implementation. [ABSTRACT FROM AUTHOR]

Framed using queer theory and intersectionality theory, this paper unpacks the various ways in which Black South African male teachers who engage in same-sex relations negotiate and manage their identities in a context deeply riddled by the history of apartheid. Eight male teachers were interviewed using a life history methodology. Consistent with many international studies on the work experiences same-sex identifying teachers, the paper argues that the interviewed male teachers draw on a passing act in order to manage their identities in school contexts characterised by a culture of heteronormativity. This adopted passing act mainly draws upon the enactment of hyperprofessionalism, a localised form which safeguards same-sex 'desiring' teachers against possible homophobia. While this form of passing grants teachers significant respect and power, leading at times to the disruption of homophobia, not all teachers enjoy this power. Some teachers are forced out of their schools by threatened managers. The paper calls for more interventionist work at both basic education and higher education levels in South Africa in order to make schools more inclusive and welcoming for all students and teachers. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore Congolese refugees and asylum seekers' survival strategies in South Africa, the focus of this paper will be on the role of the social worker. The paper is part of the study that was conducted on Congolese refugees and asylum seekers in South Africa post-war or conflicts. The study employed a qualitative research method and a descriptive case study of 10 female Congolese refugees living in Yeoville, Johannesburg South Africa. The participants have lived in South African for less than five years and there were 30–40 years of age. Data were collected by means of one-on-one in-depth interviews in the form of semi-structured interviews. Purposive sampling and snowball sampling techniques were used in the selection of participants. Thematic content analysis was used in analyzing the data collected. The paper provides recommendations on what role can social workers play can in mental wellbeing interventions. This study also contributes to a better understanding of mental wellbeing issues of Congolese refugees and asylum seekers. Ethical approval for this research study was obtained from the Department of Social Work Human Research Ethics Committee (Non-medical) of the University of Witwatersrand. [ABSTRACT FROM AUTHOR]

Background: It is becoming increasingly important for researchers to critically reflect on approaches that can have a positive impact on the health outcomes of indigenous people. Such issues are of great importance and perhaps of special relevance to researchers in the Global South, and to the African context in which we work. Objective:To share some lessons learned from our fieldwork to contribute to current knowledge and conversations on decolonising research process. Methods: We used an African lens to critically reflect upon some issues raised from individual interviews and focus group discussions with our participants which we deem to be important for consideration in a decolonising research process. Results: The major issues that we raise are about important structures such as power, trust, cultural competence, respectful and legitimate research practice and recognition of individual and communities' health assets in a decolonising research process. Conclusions: Our paper argues for alternative approaches which are culturally appropriate for health research and for improved health outcomes of marginalised groups. In addition, we argue that participatory and transformative research methods which recognises individual and communities' assets are needed. We hope that the lessons that we share in this paper can contribute towards a respectful and good research practice among the marginalised population groups in our context. [ABSTRACT FROM AUTHOR]

The aim of this qualitative study was to explore how individuals living with multiple sclerosis experience their disorder in the South African working environment. In this paper we present the experiences of office-based workers living with multiple sclerosis, their challenges, and coping mechanisms. We purposively recruited seven participants who have been diagnosed with multiple sclerosis in the last five years. Participants were interviewed telephonically. Interviews were guided by a semi-structured interview schedule which was supplemented with additional probes. Interviews were analysed thematically using a qualitative software programme. We identified two superordinate themes: bringing multiple sclerosis into the workplace and adapting to multiple sclerosis in the workplace. The findings demonstrated the diverse manner in which participants chose to disclose their multiple sclerosis and manage co-workers' perceptions of multiple sclerosis. Participants employed practical strategies, such as making using of mobility aids, taking notes, conserving energy, and adapting responsibilities. Participants also negotiated accommodations, such as changing working hours, to overcome their unique challenges. Participants emphasised the importance of keeping a general positive attitude but showed reluctance to prepare for their future decline. Our findings indicate that participants manage the disclosure of their diagnosis of multiple sclerosis in order to maintain a favourable relationship with the workplace. Further, despite various physical and psychological limitations, participants were mostly able to adapt to their work environment. Although further research is required, employers and clinicians should consider focusing on the current needs of individuals living with multiple sclerosis to mitigate work-related challenges, rather than planning for future decline. For individuals living with multiple sclerosis and in employment in South Africa, disclosure, management of perceptions and providing accommodations are key aspects in the experience of multiple sclerosis in the workplace. Finding ways to help those in employment disclose their MS diagnosis to employers and co-workers, is an important avenue and next step for intervention research in this field. Early adjustment and adaptation to MS in the workplace is challenging and further negotiation with line-managers regarding accommodations is often required. Employers and clinicians should focus on accommodating the needs of those diagnosed with multiple sclerosis as they arise, rather than focusing solely on the accommodations needed in the future. [ABSTRACT FROM AUTHOR]

This paper offers a uniquely South African (SA) perspective on a blended learning course at a contact institution. In bringing together authentic learning (AL), social justice pedagogies and technology informed by student experiences, this paper hopes to contribute to the discourse around social justice in higher education (both nationally and internationally) and the inherent tension associated with critical (transformative) pedagogies. The attention is focussed on the experiences of a class of diverse 1 year Social Work students at a Higher Education Institution (HEI), particularly exploring the tensions inherent in the Health and Wellbeing Course. We sought to establish links between theory, practice, social thought and social change and understand the tensions and oppressive ideas and practices that abound in the activity system. The findings suggest that students experienced transformed learning, which in turn, transformed their views on their choice of social work as a career. Our argument is that in social work, the most suitable pedagogy in learning design is a type of critical pedagogy that lays bare the power relations and hegemony and requires robust critical articulation and dialogue that impacts on both the educator and the student. [ABSTRACT FROM AUTHOR]

Community home-based care (CHBC) is a critical component of non-formal care in communities in Africa that have a high prevalence of HIV and tuberculosis (TB). Community carers consisting primarily of volunteers are critical role players in African healthcare systems and particularly in South Africa’s strategy to fight HIV and AIDS. This paper explores the structural barriers volunteer caregivers need to overcome to provide quality CHBC. The researchers used two focus group discussions with key informants (each with four participants), and semi-structured interviews with six key informants to collect data relating to the meaning of quality CHBC. The data were coded using Tesch’s data analysis technique. A major theme that emerged from the results was “Addressing structural challenges to improve the quality of CHBC”. Subthemes underpinning this theme were: 1) lack of standardised training of volunteer caregivers; 2) the need for a scope of practice, parameters and legal boundaries; 3) lack of monitoring and evaluation (M&E) of CHBC; and 4) the importance of mentoring and supervision in CHBC. CHBC policy should address the need for standardised training programmes for caregivers, so that they are equipped with multiple skills. Furthermore CHBC policy must emphasise mentoring as well as M&E to encourage quality care. Finally, the policy should provide a clear scope of practice for caregivers to regulate their competencies and boundaries. [ABSTRACT FROM AUTHOR]

HIV/AIDS is a major driver of livelihood insecurity. The AIDS epidemic, through the death or disability of economically productive adults, destabilises and erodes the social networks which sustain the livelihoods of vulnerable households. This paper draws upon research with home-based care workers and family members of 14 households directly affected by HIV/AIDS in the rural district of Nkomazi, South Africa. Through a social capital framework this study reveals the fragile linkages between households and broader kin networks demonstrating the (in)ability of the households to adapt and manage the economic and social impact of the epidemic. The chronic financial burden of the epidemic on poor households compounded by HIV/AIDS-related stigma undermines kinship ties resulting in the extended family becoming more conditional, temporary and at times destructive. The extended family cannot be romanticised as a ‘safety net’ and instead needs to be problematised for its complexities, limitations and constraints while ensuring sufficient external support is provided to sustain the care and support provided by the family and local community. [ABSTRACT FROM PUBLISHER]

Informal settlements remain a public health problem as they lack basic infrastructure. Furthermore, it is challenging to enforce public health regulations and protocols to prevent the spread of infection during a pandemic. This paper was set out to explore the impact of lockdown during COVID-19 among people living in informal settlements. An exploratory qualitative design was utilised. Purposive sampling was used to select research participants. In-depth one-to-one interviews were held involving 30 research participants through a WhatsApp online telephone platform. A thematic approach underpinned by the four stages of data analysis in interpretive phenomenological analysis was utilised to analyse the data. The study found that during the the research participants were affected by lack of space to practice social distancing, over-burdened infrastructure, lack of savings, loss of income and shortage of food, hunger and diseases, anxiety and depression and poor access to education. There is a need to prioritise the needs of informal settlers and endeavour to establish permanent homes. Health promotion and communication initiatives and pandemic awareness programmes are needed to mitigate the impact of lockdown during a pandemic in informal settlements. [ABSTRACT FROM AUTHOR]

Globally, South Africa has one of the highest rates of gender based violence (GBV). While little is known about the levels of GBV against women with disabilities in the country, less is known about the accessibility or inclusivity of post-violence support and services. The paper draws on data from interviews and focus group discussions with thirty women with disabilities and nineteen disability and GBV service providers in Cape Town, South Africa. Thematic analysis revealed that women with disabilities experience unique disability-related barriers to GBV care and support. Disability-related stigma, accessibility barriers, inadequate training, limited resources and lack of funding contributed to poor GBV service provision for women with disabilities. Awareness and training, accessible information, reasonable accommodations, increased funding, and disability relevant referrals need to be integrated into existing GBV services to ensure sustainable and accessible pathways to inclusive violence prevention, support and responses in the country. [ABSTRACT FROM AUTHOR]

The Open Science (OS) movement promises nothing less than a revolution in the availability of scientific knowledge around the globe. By removing barriers to online data and encouraging publication in Open Access formats and Open Data archives, OS seeks to expand the role, reach and value of research. The promises of OS imply a set of expectations about what different publics hope to gain from research, how accountability and participation can be enhanced, and what makes science public in the first place. This paper presents empirical material from fieldwork undertaken in (bio)chemistry laboratories in Kenya and South Africa to examine the extent to which these ideals can be realized in a sub-Saharan context. To analyse the challenges African researchers face in making use of freely available data, we draw from Amartya Sen’s Capabilities Approach. His theorisations of ‘conversion factors’ helps to understand how seemingly minor economic and social contingencies can hamper the production and (re-)use of online data. In contrast to initiatives that seek to make more data available, we suggest the need to facilitate a more egalitarian engagement with online data resources. [ABSTRACT FROM PUBLISHER]

Young people, particularly adolescent girls and young women, represent a growing proportion of those living with HIV. Edutainment programmes have been widely used throughout the world to "educate" and "entertain" audiences and tackle serious social issues in bold and engaging ways. This paper examines the extent to which an edutainment programme, MTV-Shuga, was reported to influence young people's engagement with sexual and reproductive health (SRH) information in rural KwaZulu-Natal, South Africa. In 2019 we conducted eight community-based screenings of MTV-Shuga episodes followed by 25 individual in-depth interviews and 13 focus group discussions with young people aged between 15 and 30. Interviews were audio recorded and transcribed verbatim. Data analysis was thematic and complemented by constant comparison and deviant case analysis techniques. In this rural and poor setting with a high burden of HIV, young people exhibited high levels of awareness of SRH and HIV but had constrained access to services, and limited ability to engage with parents or guardians on SRH matters. MTV Shuga provided an entertaining guide of ways to navigate the risks that they faced in a way that resonated with them. The findings highlight the importance of enabling young people in rural areas to watch MTV Shuga with peers in a safe space in which discussion of the content is facilitated. There is also value in encouraging parents to watch MTV Shuga as a means of enabling discussions between children and adults in their lives about SRH matters. [ABSTRACT FROM AUTHOR]

It is timely to have this kind of study in South Africa as the country has an increasing number of people living with HIV and AIDS. While an extensive literature has documented factors associated with HIV and AIDS, psychosocial variables associated with the health of persons living with HIV (PLH) have only begun to receive attention recently. The objective of this paper was to explore the views of a group of people living with HIV and AIDS regarding HIV and AIDS and Self-Forgiveness. Theoretical base: To examine the role of self-forgiveness in people living with HIV and AIDS, George Engel's Biopsychosocial Model was adopted. Methods: Individual In-depth Interviews were conducted with 10 purposefully-selected participants in Ekurhuleni. Outcomes: Results showed that self-forgiveness has a huge role in the lives of people living with HIV and AIDS. For instance, it has been found that self-forgiveness leads to acceptance of HIV status, promote infected people to seek medical care, and eventually gain the confidence to disclose to friends and families. Work implications: In conclusion, self-forgiveness has micro, messo and macro implications as it promotes good health of people living with HIV and AIDS; enhance HIV status self-disclosure and adherence to HIV treatment. [ABSTRACT FROM AUTHOR]

The care offered to children living with HIV (CLHIV) experiencing HIV-related disability is often challenged by caregiver illness, poverty and poor support structures in and around communities. Since caregiver needs directly influences the care offered to CLHIV this paper aimed to explore the experiences of the caregivers of CLHIV in order to inform an appropriate rehabilitation model in South Africa. A qualitative enquiry using in-depth interviews with 14 caregivers (one male and thirteen females) of CLHIV experiencing disability in a peri-urban setting was conducted. Data were analysed using thematic analysis. Four themes emerged from the interviews: understanding of HIV-related disability and rehabilitation, challengers to care and well-being, enablers to care; and perceived needs of caregivers. The study revealed that caregiver burden is influenced by the availability of resources and social support services. Financial constraints, poor access to rehabilitation and reduced support networks challenged the care offered to CLHIV. The perceived needs of the caregivers in this study included appeals for improved social security, housing, accessible rehabilitation and education. Changes in government policy guiding social support, employment, education and rehabilitation interventions are needed to improve the availability of resources, education, health and well-being of CLHIV and their caregiver's in South Africa. [ABSTRACT FROM AUTHOR]

South Africa has increasing numbers of persons living with HIV on antiretroviral treatment (ART). There is evidence for a relationship between food, food security and HIV. Despite increasing rates of people older than 50 living with HIV coinciding with greater levels of co-morbidity, the existing research is largely limited to those aged 15–49 years. In this paper, we therefore explore how older people living with HIV (OPLWH) in two urban communities within South Africa negotiate and ensure they have sufficient access to food and how food insecurity may affect their retention in care and ART adherence. This study used exploratory qualitative semi-structured in-depth interviews with 23 OPLWH to collect data in isiXhosa. Data were analysed using thematic content analysis. Factors at the community, household and individual levels influence (a) access to sufficient and quality food, and (b) beliefs about ART and food based on (mis)understandings of messaging from health care providers. The results demonstrate the need to explore further and clarify the nutritional guidelines that OPLWH receive from providers to ensure this does not result in reduced adherence or retention in care. They also demonstrate the role that social welfare and family or kin obligations plays in ensuring the food security of OPLWH. [ABSTRACT FROM AUTHOR]

Purpose: Healthiness is constructed, in Western culture, as a moral ideal or supervalue. This paper will interrogate the assumption that health and the pursuit of healthiness is always and unquestionably positive, by exploring how discourses of health and freedom interact to reinforce the current inequalities and detract from social transformation. Method: Twenty young South African adults were interviewed about their understandings and experiences of health. These discussions were analysed using Foucauldian discourse analysis. Results: Participants constructed healthiness as facilitating the experience of freedom, while at the same time being dependent on a personal orientation towards freedom (as opposed to merely submitting to dominant health authorities). Freedom discourses also played a role in connecting health to neoliberal discourses idealizing economic productivity and hard work. Participants were able to construct a self that is active, productive, valuable, hopeful, and self-assured when talking about health using discourses of freedom. However, these discourses also functioned to moralise and idealise healthiness, which contributed to blaming poor health on its sufferers. Conclusion: Health/freedom discourses can further reinforce the neoliberal value of individual responsibility by constructing self-improvement and self-work as the solution to ill-health, thereby contributing to victim-blaming and weakening support for public health interventions. [ABSTRACT FROM AUTHOR]

The HIV response is hampered by many obstacles to progression along the HIV care cascade, with men, in particular, experiencing different forms of disruption. One group of men, whose stories remain untold, are those who have succumbed to HIV-related illness. In this paper, we explore how next-of-kin account for the death of a male relative. We conducted 26 qualitative after-death interviews with family members of male PLHIV who had recently died from HIV in health and demographic surveillance sites in Malawi, Tanzania, Kenya, Uganda, Zimbabwe and South Africa. The next-of-kin expressed frustration about the defiance of their male relative to disclose his HIV status and ask for support, and attributed this to shame, fear and a lack of self-acceptance of HIV diagnosis. Next-of-kin painted a picture of their male relative as rebellious. Some claimed that their deceased relative deliberately ignored instructions received by the health worker. Others described their male relatives as unable to maintain caring relationships that would avail day-to-day treatment partners, and give purpose to their lives. Through these accounts, next-of-kin vocalised the perceived rebellious behaviour of these men, and in the process of doing so neutralised their responsibility for the premature death of their relative. [ABSTRACT FROM AUTHOR]

This article reports on a study conducted to explore the barriers towards accessible quality higher education for students with disabilities (SwDs) in a South African Open Distance and e-Learning (ODeL) institution. The ultimate purpose of this study is to understand and shed light on the challenges that need to be addressed to improve the Unisa practices in a manner that would ensure accessible quality higher education for SwDs. As such, this study which is of a qualitative nature employed a single case study research design wherein nine interviews with lecturers from seven teaching colleges at Unisa are conducted. The findings reveal that, based on the perceptions of lecturers, quality higher education for SwDs at Unisa is hampered by lack of awareness and clear procedures to identify SwDs, inaccessible learning material for SwDs and lack of capacity by lecturers to support SwDs. While it is expected that this study may not culminate in recommendations for practice as a result of limitations posed by its design, it is anticipated that its logical ending points will serve to influence future practice. Nevertheless, it is recommended for future research in South African ODeL to focus on identifying best practices that can be adapted to enhance quality higher education for SwDs in relation to the above-mentioned challenges. [ABSTRACT FROM AUTHOR]

Various health promotion strategies have been implemented in South Africa aiming to encourage young people to talk about issues of sexuality and HIV with their parents/caregivers. Although parent/caregiver sexual communication may be an effective method of influencing sexual behaviour and curbing the incidence of HIV, very little is known about how young people with disabilities in South Africa communicate about these traditionally difficult subjects with their parents/caregivers. Based on findings from a participatory study conducted amongst 15–20-year-old Zulu-speaking youth with physical and visual disabilities, this paper explores how they perceive youth–parent/caregiver communication about sexuality and HIV. Using Foucauldian discourse analysis, the paper outlines how disabled youth–parent/caregiver sexual communication is governed by cultural customs, sexual secrecy and constructs of innocence. It also argues that the experiences and perceptions of young people with disabilities are critical to the development of future interventions to assist parents/caregivers develop communication strategies that help disabled young people make sense of sexual behaviour. [ABSTRACT FROM PUBLISHER]

Within the growing body of literature on sexuality education in South Africa, researchers have highlighted how teachers may face, or themselves be, barriers to the implementation of rights-based comprehensive sexuality education. Important issues with regard to educators are: firstly, the social and discursive space within which educators are located; and secondly, the complex emotional and psychic investments that educators take up within particular discourses and practices. This paper explores, through a psychosocial reading of an interview extract with a particular educator based in the Eastern Cape of South Africa, how discursive and psychic concerns are sutured within the complex subjectivity of the educator as the medium for sexual education in schools. Specifically, it highlights the numerous ways in which feminine sexuality and desire may be avoided, denied and silenced. Even when feminine desire is specifically evoked as in this case, it is done so in a way that ensures social and cultural respectability, thereby reproducing shame narratives that form and maintain traditional gender discourses. Our analysis demonstrates how engaging with educators as subjects with their own sexual history and psychic dynamics, and as individuals with raced, gendered and classed identities, is a potentially transformative perspective for effective sexuality education. [ABSTRACT FROM AUTHOR]

Unconditional cash transfers have risen in prominence for their potential to improve the health of the world’s most marginalised and bring them into a relationship with the state. Typically, challenges to accessing grants are described in terms of technical issues such as access to documents and distance to offices. This paper explores the challenges of 30 young, poor, black South African women in accessing the Child Support Grant (CSG), an unconditional cash transfer provided by the South African government. Data suggest that while there were ‘technical’ issues, young women were systematically excluded from accessing the CSG in two ways. First, women were symbolically marginalised by state officials, who humiliated them, forcing women to sit quietly and acquiesce to state power to access the CSG. Second, there were large distances for women to travel to access state services, despite these being geared to serve the poor. Rather than promoting the active citizenship of the poorest in South Africa, accessing the CSG reinforced marginalisation. Transforming this will not be achieved through technical solutions, rather the barriers to access need to be recognised as political. [ABSTRACT FROM AUTHOR]

The effects of HIV and AIDS have devastated families and communities in South Africa. The scourge has also left many children orphaned in the country. Given the vulnerability of orphaned children, social workers are in the forefront of ensuring that these children are cared for and protected from any harm. Hence, the purpose of this paper was to explore the role of a social worker in issues related to children orphaned by AIDS in their middle childhood. This study was situated within a qualitative research paradigm utilizing purposive, non-probability sampling of 10 participants recruited from Potchefstroom in the Northwest Province of South Africa. A semi-structured interview schedule was employed as a research tool, and in-depth one-on-one interviews were adopted as the method of data collection. A thematic content analysis was used to analyze the data collected during the interviews. The main findings point towards the need to educate children about HIV and AIDS and to empower their caregivers. The primary conclusion drawn from this study is that social workers play various key roles which contribute towards the well-being of orphaned children. Recommendations are posed in relation to social work service providers, government interventions, and future research. [ABSTRACT FROM AUTHOR]

This study aims to offer evidence-based feedback about the emotional challenges of cancer in South Africa. The action research photovoice methodology was used to capture accounts of cancer-related challenges via 316 face-to-face interviews with cancer patients and family members (n = 286), and oncology support and medical staff (n = 30). The photovoice contributions constituted qualitative data that were analysed according to inductive thematic analysis whereby nine themes of cancer challenges were identified and photovoice images were descriptively summarised from a phenomenological perspective. The emotional challenges theme was the most commonly reported of these themes, and is the focus of this paper. The findings of this study highlighted widespread emotional distress, anxiety, loss, poverty, physical challenges, traumatic impact of a cancer diagnosis, cancer stigma and low patient empowerment in the medical setting. Four main causes of patient emotional isolation in advanced stages of cancer are also identified, and this extends current understanding and offers new direction for clinical management. Recommendations from these findings include the need for the development and inclusion of psychosocial oncology services, best-practice standards of care, distress screening, patient empowerment and the prioritising of training and support for oncology staff in the South African health-care setting. [ABSTRACT FROM AUTHOR]

Background: At a political and academic level, South Africa propagates a rights-based approach to disability. The aim of this paper is to explore how disability is conceptualized by persons with disabilities living in a rural area of South Africa. Methods: In keeping with explorative studies, the study utilized a qualitative design in the form of eight case studies. Case study participants were sampled purposively and data were collected through semi-structured interviews. Data were analyzed according to the principles of interpretative phenomenological analysis. Results: Five themes evolved from the findings. These were no identification with disability, individual approach to disability, the role of personal factors, the role of Christianity as well as attitudes, and support of significant others. Conclusion: Findings showed that there is a need to bridge the divide between rhetoric and reality for these participants whose stories might resonate with those of many other South Africans. Implications for rehabilitation: South Africa is seen as a country that has an inclusive approach to disability and approach disability from a human rights angle. The article shows that some South Africans are excluded from the dialog on disability, human rights, access, and health care. Their health and community integration outcomes are left to crippling beliefs about disability, chance and personal attributes. The academic and political rhetoric does not describe the situation of study participants, and by assuming all South Africans are included, it further marginalizes them. [ABSTRACT FROM AUTHOR]

Community health workers deployed around South Africa’s primary health care clinics, supply indispensable support for the world’s largest HIV/AIDS treatment programme. Interviews with these workers illuminated the contribution they make to anti-retroviral treatment (ART) of HIV/AIDS patients and the motivations that sustain their engagement. Their testimony highlights points of stress in the programme and supplies insights into the quality of its implementation. Finally, the paper addresses issues about the sustainability of a programme that depends on a group of workers who are not yet fully incorporated into the public sector. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

South Africa, like other sub-Saharan African countries, is in the midst of the AIDS epidemic. Older women, here defined as aged 60 years and older, while at lower risk of infection than those aged 20–50, are amongst those deeply ‘affected’ by the epidemic. In rural areas, older women, who have always played central roles in social reproduction in South African households and families, bear the brunt of care giving for the sick and dying. For this reason, it is important to explore how these women understand the epidemic. In South Africa, the prominence of traditional healers and medicine alongside biomedicine has led to multiple ways of perceiving, explaining and treating illness. This paper explores the various discourses older women in rural South Africa employ to make sense of the HIV/ AIDS epidemic in their daily lives. The aim is to better understand how these women construct the epidemic and how this knowledge can be used to benefit education and treatment endeavours in similar contexts. This paper draws on interview data collected as part of the Gogo Project conducted in the Medical Research Council (MRC)/Wits Rural Public Health and Health Transitions Research Unit. Sixty women between the ages of 60 and 75 years living in the rural Agincourt sub-district participated in three in-depth, semi-structured interviews. The respondents in this study relied on a variety of discourses to make sense of the HIV/AIDS epidemic. They displayed a high level of knowledge based on biomedical education, however, they expressed ideas, often simultaneously, that seemed to contradict this education. Their ability to employ seemingly contradictory discourses represents the need to place the epidemic within familiar ‘explanatory models’ that are based on these women's life experiences and local knowledge. [ABSTRACT FROM PUBLISHER]

Background: The importance of tackling economic, social and health-related inequities is increasingly accepted as a core concern for the post-Millennium Development Goal framework. However, there is a global dearth of high-quality, policy-relevant and actionable data on inequities within populations, which means that development solutions seldom focus on the people who need them most. INTREC (INDEPTH Training and Research Centres of Excellence) was established with this concern in mind. It aims to provide training for researchers from the INDEPTH network on associations between health inequities, the social determinants of health (SDH), and health outcomes, and on presenting their findings in a usable form to policy makers. Objective: As part of a baseline situation analysis for INTREC, this paper assesses the current status of SDH training in three of the African INTREC countries - Ghana, Tanzania, and South Africa - as well as the gaps, barriers, and opportunities for training. Methods: SDH-related courses from the three countries were identified through personal knowledge of the researchers, supplemented by snowballing and online searches. Interviews were also conducted with, among others, academics engaged in SDH and public health training in order to provide context and complementary material. Information regarding access to the Internet, as a possible INTREC teaching medium, was gathered in each country through online searches. Results: SDH-relevant training is available, but 1) the number of places available for students is limited; 2) the training tends to be public-health-oriented rather than inclusive of the broader, multi-sectoral issues associated with SDH; and 3) insufficient funding places limitations on both students and on the training institutions themselves, thereby affecting participation and quality. We also identified rapidly expanding Internet connectivity in all three countries, which opens up opportunities for e-learning on SDH, though the current quality of the Internet services remains mixed. Conclusions: SDH training is currently in short supply, and there is a clear role for INTREC to contribute to the training of a critical mass of African researchers on the topic. This work will be accomplished most effectively by building on pre-existing networks, institutions, and methods. [ABSTRACT FROM AUTHOR]

Growing interest in bilingual education in sub-Saharan Africa has highlighted an urgent need for reading material in African languages. In this paper, we focus on authors, one of several groups of stakeholders with responsibility for meeting this demand. We address three main issues: the nature and extent of African language publishing for children; the challenges for authors; and the available support. Our analysis is based on interviews and focus group discussions with publishers, authors, translators, educationalists, and representatives of book promotion organisations from nine African countries and documentary data on children's books in African languages in South Africa. Although there is evidence of a growing interest in producing books in local languages, the number of titles is constrained by funding. The challenges for authors include the need to understand the ingredients for successful children's books and for the sensitivity necessary to negotiate the linguistic challenges associated with a newly emergent genre in African languages. Support, in the form of competitions and workshops, relies on external funding and expertise and offers only temporary solutions. We finish with suggestions for more sustainable ways forward. [ABSTRACT FROM AUTHOR]

This paper focuses on the reciprocal capacity building that occurred through collaborative research between occupational therapy departments from six higher education institutions in South Africa, community-based organizations and a disabled people's organization on disabled youth and their livelihoods. The authors aimed to identify principles for collaboration and capacity building from the pilot phase and first phase of the main study. Occupational therapy departments place students in communities for service learning experience, but little collaboration with disabled people's organizations and communities in research processes occurs that could enrich such partnerships and inform relevant curriculum development. Secondary data from different sources including a transcript of a focus-group interview with the researchers in the pilot phase, workshop reports, and transcripts of free-writing exercises done by researchers were analysed thematically, both inductively and deductively. Two themes are explored: first, reciprocal building of organizational capacity and, second, generating collaborative relationships. The principles that were identified are integral to the strengths and challenges faced when multiple organizations work together over a wide geographical area on a complex research topic that also builds capacity reciprocally. [ABSTRACT FROM AUTHOR]

This article is a review of the PhD thesis undertaken by Joanna Vearey that explores local government responses to the urban health challenges of migration, informal settlements, and HIV in Johannesburg, South Africa. Urbanisation in South Africa is a result of natural urban growth and (to a lesser extent) in-migration from within the country and across borders. This has led to the development of informal settlements within and on the periphery of urban areas. The highest HIV prevalence nationally is found within urban informal settlements. South African local government has a 'developmental mandate' that calls for government to work with citizens to develop sustainable interventions to address their social, economic, and material needs. Through a mixed-methods approach, four studies were undertaken within inner-city Johannesburg and a peripheral urban informal settlement. Two cross-sectional surveys -- one at a household level and one with migrant antiretroviral clients -- were supplemented with semi-structured interviews with multiple stakeholders involved with urban health and HIV in Johannesburg, and participatory photography and film projects undertaken with urban migrant communities. The findings show that local government requires support in developing and implementing appropriate intersectoral responses to address urban health. Existing urban health frameworks do not deal adequately with the complex health and development challenges identified; it is essential that urban public health practitioners and other development professionals in South Africa engage with the complexities of the urban environment. A revised, participatory approach to urban health -- 'concept mapping' -- is suggested which requires a recommitment to intersectoral action, 'healthy urban governance' and public health advocacy. [ABSTRACT FROM AUTHOR]

Background: South Africa has experienced a tremendous rise in methamphetamine use since the year 2000. Sex trading is a global phenomenon that has been observed in active drug users and has been associated with risks for HIV infection and violence. Objectives: This paper describes and examines the correlates of sex trading among active methamphetamine users in Cape Town, South Africa. Methods: Through peer referral, 360 (201 male; 159 female) active methamphetamine users were recruited in a peri-urban township. Demographics, sex trading, drug use, trauma, and mental health were assessed by a structured clinical interview and computer survey. Logistic regression models were used to examine predictors of sex trading for men and women. Results: In the past 3 months, 40% of men and 33% of women endorsed trading sex for methamphetamine or money. Among these, they reported trading with same sex partners (33%), high rates of inconsistent condom use (73%), and incidences of physical (23%) and sexual (27%) assault when sex trading. Increased drug use severity was correlated with sex trading. Women with experiences of violence and trauma were also more likely to trade sex. Conclusions/importance: The results stress a need for linkage to drug treatment, as addiction may be fueling sex trading. Targeted interventions geared towards safe sex practices may reduce risky sexual behaviors. Women need interventions that are attuned to their specific vulnerabilities. More research is needed to explore the experiences of men who have sex with men given their particularly high rates of sex trading behavior. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Sexuality education, as a component within the Life Orientation (LO) programme in South African schools, is intended to provide young people with knowledge and skills to make informed choices about their sexuality, their own health and that of others. Key to the programme are outcomes relating to power, power relations and gender. In this paper, we apply a critical gender lens to explore the ways in which the teaching of sexuality education engages with larger goals of gender justice. The paper draws from a number of ethnographic studies conducted at 12 South African schools. We focus here on the data collected from focus group discussions with learners, and semi-structured interviews with individual learners, principals and Life Orientation (LO) teachers. The paper highlights the complexities of having gender justice as a central goal of LO sexuality education. Teaching sexuality education is reported to contradict dominant community values and norms. Although some principals and school authorities support gender equity and problematize hegemonic masculinities, learners experience sexuality education as upholding normative gender roles and male power, rather than challenging it. Teachers rely heavily on cautionary messages that put more responsibility for reproductive health on female learners, and use didactic, authoritative pedagogical techniques, which do not acknowledge young people’s experience nor facilitate their sexual agency. These complexities need to be foregrounded and worked with systematically if the goal of gender justice within LO is to be realised. [ABSTRACT FROM AUTHOR]

Background: The incidence and prevalence of COVID-19 continues to escalate globally, with the consequence to quality of life, the economies of nations and various sectors of society. While there is substantial research on the impact and experiences of the COVID-19 pandemic, little remains known about the perceptions and lived experiences of families living with people diagnosed with COVID-19, particularly within the South African context. Purpose: To explore the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. Methods: A descriptive phenomenological design was used. Data were collected from 15 participants who were family members of people diagnosed with COVID-19 in South Africa. Purposive snowball sampling was used to identify and recruit participants, and data were collected at community level in KwaZulu-Natal, Western Cape and Gauteng, South Africa. Individual in-depth interviews were used to collect the data, and an audio tape was used to record all interviews. Data were transcribed verbatim and analysed using a phenomenological data analysis processes. Ethical approval to conduct the study was obtained from the University of KwaZulu-Natal Research Ethics Committee--reference number: BREC00003228/ 2021. Results: Four super-ordinate themes emerged in relation to the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. The superordinate themes were: (1) sources of information about COVID-19, (2) pandemic perceptions and experiences, (3) impact of diagnosis and related burden and (4) aftermath of living with a family member diagnosed with COVID-19. Discussion and conclusion: Family members' perceptions and lived experiences of COVID-19 are largely influenced by media, moreover, the impact of diagnosis has consequences for the physical, mental and emotional well-being of family members. Diagnosis disrupts family dynamics by depleting financial resources due to the caregiver burden experienced. The findings thus imply that provision of psychosocial support is imperative for families living with persons diagnosed with COVID-19. [ABSTRACT FROM AUTHOR]

Combination HIV prevention is being widely promoted by funders. This strategy aims to offer HIV prevention choices that can be selected and combined to decrease HIV risk in ways that fit with each individual’s situation. Treatment as prevention and pre-exposure prophylaxis are two new evidence-based strategies to decrease HIV incidence, both of which require high HIV testing rates to be effective, and the Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a goal of 90% of HIV-positive individuals knowing their status by 2030. However, HIV testing rates in many countries remain suboptimal. Just as no single HIV prevention method is ideal for all people in all situations, no single HIV testing modality is likely to be acceptable to everyone. By offering HIV testing choices, we may be able to increase testing rates. However, many low-resourced countries have been slow to take up new HIV testing options such as the self-administered at-home oral HIV test that is currently available in the United States. In this paper, we present findings from 20 in-depth interviews, conducted in 2010, documenting opinions about self-administered at-home oral HIV testing, a testing modality still largely unavailable in Africa. Participants were clients of three primary healthcare clinics in South Africa. Self-testing was seen as enabling confidentiality/privacy, saving time, and facilitating testing together with partners. However, concerns were raised about psychological distress when testing at home without a counsellor. Some suggested this concern could be minimised by having experienced clinic-based HIV testing and counselling before getting self-testing kits for home use. Thus, self-administered HIV testing could be an option added to the current testing modalities to address some important barriers to testing. [ABSTRACT FROM PUBLISHER]

The purpose of this paper is to bring to the attention of the AIDS research community the existence of an oral history project known as the Memories of AIDS Project. The project focused on HIV/AIDS support group members, non-governmental organisation (NGO) workers and home-based carers in the Umgungundlovu (Pietermaritzburg) District Municipality, South Africa. The project was carried out by the Sinomlando Centre for Oral History and Memory Work, a research and community development centre of the University of KwaZulu-Natal, over a period of three years (2011–2013). Sixty-five individual oral history interviews of 1 to 4 hours duration and 11 focus group sessions were recorded, transcribed and translated from isiZulu into English when necessary. The life stories of community workers and support group members documented in the interviews show, on the part of the informants, a remarkable degree of agency and assertiveness in matters of sexuality, gender relations and religious beliefs. They found innovative ways of navigating through the conflicting claims of biomedicine, Christianity and African traditional religion. As much as the epidemic caused grief and suffering, it opened the door to new knowledge and new opportunities. [ABSTRACT FROM AUTHOR]