Search

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]

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]

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]

Central to governance, comparison and evaluation—and evolving at the intersection of economic ideas, interests and institutions—official statistics are far from neutral artifacts in both the global north and south. This article investigates the case of South Africa. Building on primary sources and interviews, I distinguish between three periods in the history of the country's official economic statistics. This history—and the nation's statistical self-presentation—have been shaped by the legacy of apartheid, the construction of the new democratic state, the influence of international standards setters, and heated political struggles in a nation divided along racial and class lines. Although the South African case is unique in many ways, it offers valuable insights into the evolution of official statistics outside of the global north more broadly. [ABSTRACT FROM AUTHOR]

There is limited consensus on how to define informal employment in South Africa, but in the South African and international literature the three most common ways of capturing informal employment are the enterprise, employment relationship and worker characteristics approaches. This paper reviews the methods used by Statistics South Africa to measure informal employment before and after the introduction of the Quarterly Labour Force Survey, and other recently proposed methods. It then investigates the congruence, if any, between five measures of informality used in 2009. It finds that 94.7% of the self-employed are informal according to at least one definition, but only 62.6% according to all five combined. In addition, these two proportions are only 67.7% and 6.9% respectively in the case of informal employees. Econometric analysis is conducted to further investigate the differences between these measures. [ABSTRACT FROM PUBLISHER]

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]

Background: Worldwide, there is an increased reliance on casual staff in the health sector. Recent policy attention in South Africa has focused on the interrelated challenges of agency nursing and moonlighting in the health sector. Objective: This paper examines the potential health system consequences of agency nursing and moonlighting among South African nurses. Methods: During 2010, a cluster random sample of 80 hospitals was selected in four South African provinces. On the survey day, all nurses providing clinical care completed a self-administered questionnaire after giving informed consent. The questionnaire obtained information on socio-demographics, involvement in agency nursing and moonlighting, and self-reported indicators of potential health system consequences of agency nursing and moonlighting. A weighted analysis was done using STATA® 13. Results: In the survey, 40.7% of nurses reported moonlighting or working for an agency in the preceding year. Of all participants, 51.5% reported feeling too tired to work, 11.5% paid less attention to nursing work on duty, and 10.9% took sick leave when not actually sick in the preceding year. Among the moonlighters, 11.9% had taken vacation leave to do agency work or moonlighting, and 9.8% reported conflicting schedules between their primary and secondary jobs. In the bivariate analysis, moonlighting nurses were significantly more likely than non-moonlighters to take sick leave when not sick (p=0.011) and to pay less attention to nursing work on duty (p=0.035). However, in a multiple logistic regression analysis, the differences between moonlighters and non-moonlighters did not remain statistically significant after adjusting for other sociodemographic variables. Conclusion: Although moonlighting did not emerge as a statistically significant predictor, the reported health system consequences are serious. A combination of strong nursing leadership, effective management, and consultation with and buy-in from front-line nurses is needed to counteract the potential negative health system consequences of agency nursing and moonlighting. [ABSTRACT FROM AUTHOR]

Objective: A study was undertaken to explore the differences in nutrition knowledge, attitudes, beliefs and practices and their correlations among adults in both urban and rural communities in the Free State province of South Africa. Design: This study forms part of the cross-sectional Assuring Health for All in the Free-State (AHA-FS) study. Setting: The AHA-FS study is conducted in urban and rural parts of the Free State province of South Africa. The rural and urban stages of the study were conducted in 2007 and 2009, respectively. Subjects: The sample included 846 adult household members, aged between 25 and 65 years, from both rural and urban areas of the Free State province. Outcome measures: Nutrition knowledge, attitudes, beliefs and practices were measured. Results: The sample included predominantly females (78.2%). Rural adults had significantly better nutrition knowledge (p < 0.001), positive attitudes (p < 0.001) and positive beliefs (p < 0.001) and their nutrition knowledge and attitudes (r = 0.27, p < 0.001), nutrition knowledge and beliefs (r = 0.16, p < 0.001), and nutrition attitudes and beliefs (r = 0.38, p < 0.001) were significantly correlated with each other. However, nutrition knowledge, attitudes and beliefs were not correlated with nutrition practices among our sample in either the urban or rural setting. Conclusion and implication: The results of the current study confirm that relevant and culturally acceptable nutrition education interventions for translating nutrition-related knowledge, attitudes and beliefs into practices are required. [ABSTRACT FROM AUTHOR]

Algebra is a key course in the secondary mathematics curriculum. As a prerequisite for post-secondary mathematics, science and engineering courses, it is considered a gateway course. Since mathematical knowledge for teaching involves more than content knowledge algebra, teachers must be able to do more than successfully complete algebraic problems. They should understand algebra deeply and flexibly so that they are able to mediate students’ ideas, make choices about representations of content and modify curriculum materials. Yet, little is known about how certain groups view algebra and its teaching. In order to determine the beliefs held by a group of South African mathematics teachers with historically disadvantaged backgrounds teaching in schools that were previously segregated through Apartheid, this paper reports on what the group felt are the most important features of algebra. [ABSTRACT FROM PUBLISHER]

This paper examines the correlates of inconsistent condom use with most recent sexual partner among sexually experienced youth (N= 2 138) in South Africa. A cross-sectional population based survey with youth aged 18 to 24 years was conducted in 4 provinces (Eastern Cape, Gauteng, KwaZulu-Natal and Mpumalanga). More women than men (57.7% vs. 25.8%) reported inconsistent condom use with their most recent partner. Multivariate analysis indicated that for males, not having talked with a partner about condoms in the past 12 months, having 2 or more sexual partners in the past 12 months, having ever had a transactional sex partner and alcohol use before sex in the past 3 months were associated with inconsistent condom use with their most recent sexual partner. In females multivariate analysis showed that lack of self-efficacy, not having talked with a partner about condoms in the past 12 months, having ever had or been subjected to forced sex and hazardous or harmful alcohol use were found to be associated with inconsistent condom use with their most recent sexual partner in multivariate analysis. [ABSTRACT FROM PUBLISHER]

This paper compares data from two household surveys to assess the effect of questionnaire design on estimated use of health services and analyses this across geographic areas and different groups. Deficiencies in the design of Statistics South Africa's General Household Survey led to a substantial underestimation of utilisation (capturing less than a third of visits). The South Africa Consortium for Benefit Incidence Analysis survey, which was more comprehensive, indicated that three out of four outpatient visits are to public sector facilities. Medical scheme membership is the most important predictor of using a private provider, particularly for inpatient care. Socioeconomic status and rural versus urban residence also influence overall utilisation rates and use of public versus private providers. It is critical to improve the design of routine household surveys to monitor utilisation patterns during the implementation of the proposed health system reform. [ABSTRACT FROM PUBLISHER]

South Africa faces the challenge of supporting the well-being of adults caring for growing numbers of AIDS-orphaned children. These adults play a critical role in responses to the epidemic, but little information exists in regard to their mental health needs. This paper reports on findings from n=1599 adults, recruited through representative household sampling, who serve as primary carers for children in Umlazi Township, an HIV-endemic community. Overall, 22% of participants were carers of AIDS-orphaned children, 11% were carers of other-orphaned children and 67% were carers of non-orphaned children. Prevalence of depression was 30.3%. Orphan carers, regardless of whether they cared for AIDS-orphaned or other-orphaned children, were significantly more likely than carers of non-orphaned children to meet the clinical threshold for depression (35.2% vs. 27.9%, p < 0.01). In multivariate logistic regressions, food insecurity and being a female carer were identified as additional risk factors for greater depression. In contrast, households with access to running water and households dependent on salaries as the main source of income were identified as protective factors for disparities in depression. Mental health interventions are urgently needed to address an increased risk for depression among all orphan carers, not just those caring for AIDS-orphaned children. [ABSTRACT FROM AUTHOR]

Increasingly complex societies necessitate the collection of more information, or more sophisticated ways of estimation. This places upward pressure on the cost of collecting such information, as family structures are more complex, mobility more frequent, and willingness to provide information declines. As a result, rising census costs have become an issue in many countries. South Africa's 2001 Census was arguably the most expensive in the country's history. However, assessing the cost of a census requires a closer scrutiny of the cost of census-taking as well as the procedures that were followed and the benefits that might arise. This paper uses information provided by Statistics South Africa to analyse the cost of Census 2001 and explore lessons that may be derived for future census activities. [ABSTRACT FROM AUTHOR]

Social work in South Africa is currently engaged in a transformational process to adapt its developmental approach based on the pursuit of social justice. Research has indicated that the values, attitudes, and behaviours of newly qualified social workers is a major determining factor in their pursuit of social justice. Consequently, the study reported here aimed to investigate the above-mentioned as pertaining to the achievement of social justice within client systems. The study, which was of a quantitative, cross-sectional nature, collected responses to a standardised psychometric scale from 108 newly qualified social workers, measuring their values, attitudes, and behaviours regarding social justice. The results reveal that South African-based social workers feel impeded in the work for social justice by inadequate training, skill set, and other obstacles, despite being committed to social justice. [ABSTRACT FROM AUTHOR]

The South African national cause of death validation (NCODV 2017/18) project collected a national sample of verbal autopsies (VA) with cause of death (COD) assignment by physician-coded VA (PCVA) and computer-coded VA (CCVA). The performance of three CCVA algorithms (InterVA-5, InSilicoVA and Tariff 2.0) in assigning a COD was compared with PCVA (reference standard). Seven performance metrics assessed individual and population level agreement of COD assignment by age, sex and place of death subgroups. Positive predictive value (PPV), sensitivity, overall agreement, kappa, and chance corrected concordance (CCC) assessed individual level agreement. Cause-specific mortality fraction (CSMF) accuracy and Spearman's rank correlation assessed population level agreement. A total of 5386 VA records were analysed. PCVA and CCVAs all identified HIV/AIDS as the leading COD. CCVA PPV and sensitivity, based on confidence intervals, were comparable except for HIV/AIDS, TB, maternal, diabetes mellitus, other cancers, and some injuries. CCVAs performed well for identifying perinatal deaths, road traffic accidents, suicide and homicide but poorly for pneumonia, other infectious diseases and renal failure. Overall agreement between CCVAs and PCVA for the top single cause (48.2–51.6) indicated comparable weak agreement between methods. Overall agreement, for the top three causes showed moderate agreement for InterVA (70.9) and InSilicoVA (73.8). Agreement based on kappa (−0.05–0.49)and CCC (0.06–0.43) was weak to none for all algorithms and groups. CCVAs had moderate to strong agreement for CSMF accuracy, with InterVA-5 highest for neonates (0.90), Tariff 2.0 highest for adults (0.89) and males (0.84), and InSilicoVA highest for females (0.88), elders (0.83) and out-of-facility deaths (0.85). Rank correlation indicated moderate agreement for adults (0.75–0.79). Whilst CCVAs identified HIV/AIDS as the leading COD, consistent with PCVA, there is scope for improving the algorithms for use in South Africa. [ABSTRACT FROM AUTHOR]

Partner engagement in antenatal care can improve care for pregnant people living with HIV. However, concerns about engaging unsupportive non-pregnant partners warrant further study to avoid engaging partners who pressure their pregnant partner to refuse testing or treatment and/or perpetuate intimate partner violence. We adapted established relationship functioning and partner behaviour questionnaires among pregnant people living with HIV initiating antenatal care in rural South Africa. We identified 13 previously validated psychometric scales with 255 items that assess relationship functioning and partner behaviour, but, to our knowledge, had not been used in Southern Africa. After item translation and cognitive interviewing with 30 pregnant people, we recruited an additional 208 pregnant people living with HIV receiving antenatal care. We conducted an exploratory factor analysis with maximum-likelihood extraction and oblique promax rotation with the 58 items and 10 scales that remained after translation and cognitive interviewing. We used parallel analysis, scree plots, and the Kaiser criterion to guide factor retention and assessed internal factor consistency via Cronbach's alpha. Of the 208 participants recruited, 197 (95%) answered each question and were included in the analysis. Exploratory factor analysis revealed 7 factors that assessed partner social support, sexual relationship power, emotional intimacy, threatened or enacted violence, sexual intimacy, violence in relationships, and partner engagement in pregnancy care via 37 items. Factor absolute Spearman correlations ranged from 0.012 to 0.518 and Cronbach's alpha ranged from 0.84 to 0.92. This preliminary analysis will guide further scale development. Future developments will also include relevant clinical outcomes to assess the predictive validity of the resulting measures. These steps will further refine these questions into a succinct screening tool to assess relationship functioning and partner behaviour. This screening tool may eventually guide the selection of partner-based interventions during pregnancy to improve outcomes for pregnant people and their partners. [ABSTRACT FROM AUTHOR]

Central for governance, official statistics are far from natural artefacts. The purpose, meaning and interpretation of statistical conventions evolve across time and space, in relation to social and political aspects. If criticism of indicators is growing since several years, less is understood on the process of quantification himself, especially in non-Western countries. Understanding quantification processes in different contexts is even more important as statistics are widely used in the development field. With a different complexity compared to Northern societies, African countries appear as privileged fields for this understanding and its connection with state-building. By using the analytical framework of the conventions school, I reread the case of official statistics in South Africa. Based on process-tracing, I show the history of the quantification process through its relations with the state, from a racial state during the apartheid to a developmental state nowadays. [ABSTRACT FROM AUTHOR]

Despite HIV testing having improved globally, men remain disproportionately less likely to test for HIV. While violence against women (VAW) and HIV risk have a strong association among women, few studies explore men around VAW perpetration, risky-sexual behaviour, and HIV testing. Males aged 18–42 years were recruited from a peri-urban settlement near Johannesburg, South Africa. Data were from an endline of a trial. We used logistic regression to assess odds of non-HIV testing using STATA 13. At endline, 1508 men participated in the study. Of these nearly one-third (31.6%, n = 475) had not tested for HIV in the past year. HIV non-testing was significantly lower among men who were single, older, did not complete high school and were less food secure. VAW perpetration retained a significant association with HIV non-testing after controlling for socio-demographics (AOR = 0.73, 95%CI = 0.58–0.93). In multivariate models, HIV non-testing was also associated with inconsistent condom use (AOR = 0.64, 95%CI = 0.48–0.85), problem drinking (AOR = 0.72, 95%CI = 0.55–0.94) and reporting of all four risky sexual behaviours (AOR = 0.70, 95%CI = 0.49–1.01). Data suggests that one-third of men who never test for HIV in this setting may represent a high-risk group. Future campaigns could consider behaviour change around non-violence, relationship quality, and gender norms alongside HIV testing. [ABSTRACT FROM AUTHOR]

Treatment among pYLHIV focuses on their physical health. However, they also experience depression and anxiety, compounded by developmental challenges and the stress of managing a chronic illness. However, limited services are available to help pYLHIV manage the emotional stressors of living with a stigmatized condition. Data are from 37 caregiver-child dyads in the VUKA EKHAYA study, in Durban, South Africa. Outcomes were self-esteem and stigma. Predictors included symptoms of depression and anxiety, and HIV treatment and transmission knowledge. Outcomes and predictors were standardized (mean: 0, standard deviation: 1). Pearson correlation, bivariate and multivariate associations between predictors and outcomes were examined. Self-esteem was negatively correlated with symptoms of anxiety (r=-0.5675; p<0.001) and depression (r=-0.6836; p<0.001), suggesting higher self-concept was correlated with fewer symptoms. In multivariate analyses, increased depressive and anxiety symptoms were associated with lower self-esteem, B=0.68 and 0.57, respectively. Higher depressive and anxiety symptoms connected to more internalized stigma B=0.38 and 0.34, respectively. Conversely, HIV knowledge was not related to self-esteem or stigma. HIV treatment and transmission knowledge are not enough to reduce stigma and improve the self-esteem of pYLHIV. Integrated mental and physical health care is needed to help pYLHIV manage psychological stressors that can mitigate their emotional wellbeing. [ABSTRACT FROM AUTHOR]

Although evidence indicates that task-shared psychological interventions can reduce mental health treatment gaps in resource-constrained settings, systemic barriers have limited their widespread implementation. Evidence on how to sustain and scale such approaches is scant. This study responds to this gap by examining the experiences of South African health managers involved in the implementation of a task-shared counselling service for Project MIND. To qualitatively describe managers' experiences of implementing the MIND programme and their insights into potential strategies for supporting sustained implementation. Two focus group discussions (FGDs) and eight in-depth interviews (IDIs) were conducted with managers of urban and rural primary care facilities in the Western Cape province. All managers were female and 30–50 years old. FGDs and IDIs used an identical semi-structured topic guide to explore the experiences of the MIND programme and perceived barriers to sustained implementation. Normalisation process theory (NPT) guided the thematic analysis. Four themes emerged that mapped onto the NPT constructs. First, managers noted that their relational work with staff to promote support for the intervention and reduce resistance was key to facilitating implementation. Second, managers emphasised the need for staff reorientation and upskilling to foster openness to mental health practice and for adequate time for quality counselling. Third, managers underscored the importance of strengthening linkages between the health and social service sectors to facilitate delivery of comprehensive mental health services. Finally, managers recommended ongoing monitoring of the service and communication about its impacts as strategies for supporting integration into routine practice. Findings contribute to the emerging literature on strategies to support implementation of task-shared interventions in low- and middle-income countries. The findings highlight the leadership role of managers in identifying and actioning these strategies. Investing in managers' capacity to support implementation of psychological interventions is critical for scale-up of these mental health innovations. [ABSTRACT FROM AUTHOR]

The attraction of Twenty20 cricket for spectators has sparked huge commercial interest in the marketing of the concept. The International Cricket Council has sanctioned world tournaments, the inaugural tournament in South Africa and the recent 2009 event, while the 2008 and 2009 Indian Premier League tournaments have generated profitable returns for both players and franchise owners. This paper describes methods for quantifying a cricket player's performance based on his ability to score runs and take wickets. These performance measures are then used to determine the optimal team using an integer programme. An illustration of the method is provided using data from the inaugural Twenty20 World Cup held in South Africa in 2007. [ABSTRACT FROM AUTHOR]

This article reports a one-year study examining the effect of a smartphone meditation app (M-App) in alleviating burnout and promoting resilience among chaplains working in hospices of older adults in Asian and African cities (N1 = 96; N2 = 85). Results indicated that chaplains who used the M-App exhibited lesser emotional exhaustion and depersonalization as burnout markers and higher personal achievement and resilience as compared to leisure app (L-App) users. The M-App was effective (Cohen's d range = 3.08–5.07, p =.001) for the intervention cohort. Male chaplains, highly qualified, attached to assisted living hospices, who used the M-App once-twice a day, perused both videos and learning sessions and self-practiced regularly, reported lower emotional exhaustion and depersonalization and higher personal achievement and resilience post-test. M-App usage behavior mediated the relationship between demographic and hospice related moderators and outcomes. [ABSTRACT FROM AUTHOR]

Inadequate toilet facilities may increase women's risk of experiencing non-partner sexual violence. We sought to assess the association between young (18–24 year-olds) women's access to toilets and past year non-partner rape experience, in deprived communities in South Africa. Data came from cross-sectional, population-based survey from poor communities from four health districts in two provinces, namely, City of Johannesburg, and Ekurhuleni in Gauteng, and eThekwini and uMgungundlovu, in KwaZulu-Natal. Descriptive, unadjusted and adjusted associations, were estimated in STATA/IC16, accounting for study design. In total, 10,635 young women provided data on toilet access. Past year non-partner rape prevalence was 5.7%. In adjusted analyses, those reporting a shared toilet were more likely to report past year experience of non-partner rape (adjusted odds ratio: 1.45, 95% confidence intervals [1.17, 1.80]), compared to those with their own toilet indoors. Improving access to private, secure toilets is an important component for the prevention of non-partner sexual violence. [ABSTRACT FROM AUTHOR]

In South Africa, 'decolonisation' has re-emerged as a theme for identity, economic and cultural contestations among the youth. In this, the celebratory rhetoric of rainbow nationalism of post-apartheid utopia is confronted head-on. From a theoretical discourse of the problematics of 'the postcolonial' this inquiry engages a critical question: if decolonisation is to undo colonial (and apartheid) economic, political and cultural legacies, to what extent has this been achieved for the South African youth? The struggle for political decolonisation (freedom) was such a long and painful journey that the wounded still bear the scars. But political freedom is an imagined trophy that newly independent states parade as decolonisation; cultural and economic colonisations are more indelible to unsettle. Drawing from public data, social statistical information, media narratives and academic literature, I argue that the post-apartheid youth, although 'born-free', remain victims of coloniality and the difficult process of decolonisation. [ABSTRACT FROM AUTHOR]

Statistical relationships between surface ozone (O3) concentration, precursor species and meteorological conditions in continental South Africa were examined from data obtained from measurement stations in north-eastern South Africa. Three multivariate statistical methods were applied in the investigation, i.e. multiple linear regression (MLR), principal component analysis (PCA) and –regression (PCR), and generalised additive model (GAM) analysis. The daily maximum 8-h moving average O3 concentrations were considered in these statistical models (dependent variable). MLR models indicated that meteorology and precursor species concentrations are able to explain ~50% of the variability in daily maximum O3 levels. MLR analysis revealed that atmospheric carbon monoxide (CO), temperature and relative humidity were the strongest factors affecting the daily O3 variability. In summer, daily O3 variances were mostly associated with relative humidity, while winter O3 levels were mostly linked to temperature and CO. PCA indicated that CO, temperature and relative humidity were not strongly collinear. GAM also identified CO, temperature and relative humidity as the strongest factors affecting the daily variation of O3. Partial residual plots found that temperature, radiation and nitrogen oxides most likely have a non-linear relationship with O3,while the relationship with relative humidity and CO is probably linear. An inter-comparison between O3 levels modelled with the three statistical models compared to measured O3 concentrations showed that the GAM model offered a slight improvement over the MLR model. These findings emphasise the critical role of regional-scale O3 precursors coupled with meteorological conditions in daily variances of O3 levels in continental South Africa. [ABSTRACT FROM AUTHOR]

Among men in South Africa, the prevalence of tobacco smoking is as high as 33%. Although smoking is responsible for most lung cancer in South Africa, occupational and environmental exposures contribute greatly to risk. We conducted a tobacco and lung cancer screening needs assessment and administered surveys to adults who smoked >100 cigarettes in their lifetime in Johannesburg (urban) and Kimberley (rural). We compared tobacco use, risk exposure, attitudes toward and knowledge of, and receptivity to cessation and screening, by site. Of 324 smokers, nearly 85% of current smokers had a <30 pack-year history of smoking; 58.7% had tried to stop smoking ≥1 time, and 78.9% wanted to quit. Kimberley smokers more often reported being advised by a healthcare provider to stop smoking (56.5% vs. 37.3%, p=0.001) than smokers in Johannesburg but smokers in Johannesburg were more willing to stop smoking if advised by their doctor (72.9% vs. 41.7%, p<0.001). Findings indicate that tobacco smokers in two geographic areas of South Africa are motivated to stop smoking but receive no healthcare support to do so. Developing high risk criteria for lung cancer screening and creating tobacco cessation infrastructure may reduce tobacco use and decrease lung cancer mortality in South Africa. [ABSTRACT FROM AUTHOR]

Alcohol and drug misuse (ADM) pose a significant disease burden globally. Yet, there remains a gap in understanding risk factors associated with women's ADM, particularly those in marginalised settings. We investigated risk factors associated with ADM amongst young women in urban informal settlements in South Africa. Bivariate and multivariable logistic regression analyses were conducted on a sample of 680 young women assessing associations between sociodemographic factors, mental health, relationship factors and past year ADM. Alcohol misuse was assessed using the 10 item Alcohol Use Disorders Identification Test (AUDIT) scale, with scores ≥8 defining misuse, a single item assessed past year illegal drug use. Alcohol and drug misuse were reported by 23.1% and 31.8% of the women respectively. In multivariable regression, alcohol misuse was associated with experiencing past year non-partner sexual violence, transactional sex with a main partner, past year drug use, and past week depressive symptoms, while drug misuse was associated with alcohol misuse, transactional sex with a casual partner, past year experience of physical and/or sexual IPV and having a functional limitation (disability). Results indicate ADM in informal settlements are shaped by violence and poor mental health. Interventions geared towards strengthening women's economic position and mental healthcare are recommended. [ABSTRACT FROM AUTHOR]

Background: Participation comprises attendance and involvement in everyday situations. Picture My Participation (PmP) is an instrument intended to measure participation in children with disabilities, particularly in low and middle income countries. Aim: To investigate content validity and usefulness of PmP for measuring participation in children with intellectual disability (ID) in South Africa and Sweden. Methods: A picture supported interview with 149 children, 6–18 years, with and without ID. Twenty everyday activities were provided. The three most important activities were selected by the child. Attendance was rated on all activities. Involvement was rated on the most important. Results: All activities were selected as important by at least one child with ID in both countries. There were similarities in perceived importance between the children with and without ID from South Africa. The children from South Africa with ID were the only subgroup that used all scale points for rating attendance and involvement. Conclusion: The 20 selected activities of PmP were especially relevant for children with ID in South Africa. The usefulness of the scales was higher for the children with ID in both countries. PmP is promising for assessing participation across different settings but psychometrical properties and clinical utility need further exploration. [ABSTRACT FROM AUTHOR]

Objective: The toxicity associated with the use of kanamycin includes irreversible hearing loss. There are limited data describing the relationship between hearing loss and kanamycin pharmacokinetics (PK). We explored the association of kanamycin PK with hearing loss in patients on MDR-TB treatment. Design: We prospectively recruited patients on kanamycin-based MDR-TB treatment in Cape Town. Hearing thresholds from 0.25 to 16 kHz were tested at baseline and at 4, 8 and 12 weeks. We determined kanamycin concentrations at steady-state in serial plasma samples over 10 h, and explored factors associated with hearing loss. Study sample: One hundred and two participants including 58 (56.9%) men had analysable audiometric data; median age was 34.9 years, 65 (63.7%) were HIV-positive, and 24 (23.5%) had been treated for MDR-TB previously. Results: Eighty-four participants (82.4%) developed hearing loss. We found a 3% (95% CI: 1–6%, p = 0.028) increased risk of cochleotoxicity for each 10 µg h/L increase in 0–10 h AUC. Conclusion: We describe a high incidence of hearing loss in MDR-TB patients treated with kanamycin, with higher AUC0–10 significantly associated with hearing loss. [ABSTRACT FROM AUTHOR]

Depressive symptoms occur frequently among people living with HIV, especially women. These symptoms are associated with human, social, financial, and physical/natural capabilities and life stressors that differ between women and men. However, the link between depressive symptoms and functional limitations/disability is seldom discussed in the context of HIV, especially for gender-specific relationships. A cross-sectional survey of 1042 people living with HIV and using long-term antiretroviral therapy (ART) in South Africa was conducted from June to August 2014 to investigate the associations of disability, human, social, physical/natural, and financial capabilities, health, and adherence to ART, including possible gender-specific factors. Socio-demographic information, capabilities, health indicators, functional limitations/disability, and depressive symptoms (CES-D 10) were measured. We applied descriptive and bivariate statistics and multiple regression. Overall, 26% of people presented with depressive symptoms. Greater functional limitations and health symptoms and lower food security were strongly associated with depressive symptoms, while associations with financial capital and body mass index were gender-specific. The results call for the improvement of comprehensive care, including gender-sensitive mental health interventions. The results further indicate that functional limitations/disability needs to be considered, along with linking rehabilitation and livelihood programs with comprehensive HIV-care, in particular for those who experience depressive symptoms. [ABSTRACT FROM AUTHOR]

We investigated the impact of an eclectic framework for combining theoretical conceptual practice models on occupational therapists' theoretical reasoning using concurrent mixed methods with repeated measures and grounded theory designs. Study participants (n = 9) attended two workshops to review select occupational therapy theoretical conceptual practice models and learn how to use the eclectic framework. We assessed skills in eclectic combination of theoretical conceptual practice models using the Theory Application Assessment Instrument. The skills improved significantly [χ2(2, 9) = 7.09, p =.02], a finding that was corroborated by the qualitative findings indicating that the eclectic framework may potentially help improve theoretical reasoning among occupational therapists. [ABSTRACT FROM AUTHOR]

Background: Stability of measures in quantitative social science research is crucial to understand. There is very little evidence on the stability of violence against women and girls measures in the global South. Objective: To assess the test-retest stability of violence against women and girls measures, amongst young (18–30) people in South Africa. Methods: Data were collected from 124 women and 112 men at zero weeks (time 1) and two weeks (time 2), who resided in urban informal settlements in South Africa. Prevalence of each construct was assessed using chi-square contingency tables. Stability of self-report over time was assessed using Cohen's Kappa. Bivariate logistic regression assessed factors associated with changing responses between time 1 and time 2. Results: At group level prevalence of all measures showed no significant differences. Stability of self-report: kappas for past year physical IPV were both k0.20, for ever physical IPV (women k0.58; men k0.50). Sexual IPV in past 12m (women k0.44; men k0.18), and for ever sexual IPV (women k0.56; men k0.46). Kappas for men's perpetration of non-partner sexual violence was k0.29 for past 12m and k0.38 ever. In bivariate regression, completion of secondary education was associated with a reduced odds of changing responses over the time-period for sexual IPV ever women (OR0.16, 0.02–1.04), sexual IPV past 12 months men (OR 0.09, 0.01–0.56), past 12 month non-partner sexual violence men (OR0.19, 0.02–1.41) and lifetime non-partner sexual violence (OR0.23, 0.04–1.19). Being male, compared to being female, was associated with an increased likelihood of changing responses for past 12 month sexual IPV (OR2.10, 1.08–4.09). Conclusions: Prevalence estimates of violence against women measures are stable at group level, but stability of self-reported measures remains a concern. Individual statistical analyses must be treated with caution. Future studies are required to develop further understandings of stability of measures over time. [ABSTRACT FROM AUTHOR]

Objectives: A cross-sectional study was undertaken at Lancers Road Clinic, Durban, South Africa to determine body composition, haemoglobin, serum albumin and serum high sensitivity C-reactive protein (hs-CRP) levels in asymptomatic ART-naive HIV positive adults. Methods: All eligible adults attending the clinic were sampled. Body composition was assessed using deuterium dilution. Descriptive statistics, Wilcoxon rank-sum test, chi-square test, Fisher’s exact test and Spearman’s rank correlation coefficient were used for data analysis. Results: A total of 84 participants (CD4 count: 542.5 ± 145 cell/mm3) enrolled. The mean body mass index (BMI) was 29.5 (± 6.4) kg/m2 and the mean fat mass percentage was 44.9 (± 18.7). The prevalence of overweight (26.2%, 22/84) and obesity (46.4%, 39/84) was high. Mean haemoglobin (Hb) levels were 12.0 ± 1.6 g/dl. Mild, moderate and severe anaemia was present in 21.4% (18/84), 20.2% (17/84) and 1.2% (1/84) of patients, respectively. Mean albumin levels (36.2 ± 3.8 g/l) were on the borderline low range of normal with mildly depleted albumin levels being present in a third (32.1%, 27/84) of patients. The mean hs-CRP levels (5.5 ± 7.2 mg/l) were high. Conclusion: In this cohort of patients, wasting was not associated with HIV as the prevalence of overweight/obesity was high and followed the population trend in SA. This seemingly well, asymptomatic population of people living with HIV was at an increased risk of morbidity, progression and death due to the compounding factors of overweight/obesity, hypoalbuminemia, raised hs-CRP levels and anaemia. [ABSTRACT FROM AUTHOR]

Speech-language therapists (SLTs) have direct contact with a wide variety of individuals who require augmentative and alternative communication (AAC) and they are therefore considered to have a primary role in the assessment, selection, and implementation of AAC symbols, techniques, aids, and strategies. Limited information is available with regard to SLTs’ practices in the field of AAC, and there is a particular paucity of information about developing country contexts such as South Africa. The aim of this study was to determine how South African SLTs perceive their current AAC practices. Specifically, the study aimed to investigate SLTs’ assessment and intervention practices, their choice and use of graphic symbols, and display layouts for aided AAC systems. An online survey was developed, using the Qualtrics Research Suite™ online survey software. The survey included open-ended questions (analyzed using thematic analysis) and closed questions (analyzed using descriptive statistics). The responses indicated that SLTs in South Africa currently use a limited variety of assessment and intervention approaches. The data suggest that current practices are informed by previous experience with various technologies and AAC systems and that the primary caseloads of SLTs do not appear to inform specific approaches to assessment and AAC implementation. [ABSTRACT FROM PUBLISHER]

The majority of current health literacy measures emanate from high-income countries. In South Africa, there is no appropriate measure available for use by the diverse public sector population, many of whom have some literacy limitations. The objective was to develop a bank of questions for this population informed by a broader definition of health literacy, which acknowledges both traditional cognitive skills and explores the influence of the collective social environment on health literacy. Thirty questions for the Item Bank were developed to ensure cultural, contextual and educational appropriateness, and were continuously subjected to critical review by an expert consultant panel. Patients (n = 120) were recruited from a local primary care clinic and individually interviewed with the assistance of an interpreter to collect data on the Item Bank, Multidimensional Screener of Functional Health Literacy (MSFHL) and sociodemographics. The mean Item Bank score was 55% ± 11.3%. A high 82.5% was categorized as having either inadequate or marginal health literacy. Skills-based questions, particularly numeracy questions, were poorly answered. A significant education effect was established with 8/30 questions. The Procedural knowledge domain had the lowest score, but was not significantly different to the Access and Factual domain scores. The questions afforded preliminary insight into health literacy in a previously unstudied population and clearly demonstrated the need to include questions that did not rely solely on cognitive skills. Study findings provided an ideal base for further question refinement to generate a health literacy measure suitable for this population. [ABSTRACT FROM PUBLISHER]

Introduction: The burden of HIV is increasing among adults aged over 50, who generally experience increased risk of cormorbid illnesses and poorer financial protection. We compared patterns of health utilisation and expenditure among HIV-positive and HIV-negative adults over 50.Methods: Data were drawn from the Study on global AGEing and adult health in South Africa with analysis focusing on individual and household-level data of 147 HIV-positive and 2725 HIV-negative respondents.Results: HIV-positive respondents reported lower utilisation of private health-care facilities (11.8%) than HIV-negative respondents (25.0%) (p = .03) and generally had more negative attitudes towards health system responsiveness than HIV-negative counterparts. Less than 10% of HIV-positive and HIV-negative respondents experienced catastrophic health expenditure (CHE). Women (OR 1.8;p < .001) and respondents from rural settings (OR 2.9;p < .01) had higher odds of CHE than men or respondents in urban settings. Over half the respondents in both groups indicated that they had received free health care.Conclusions: These findings suggest that although HIV-positive and HIV-negative older adults in South Africa are protected to some extent from CHE, inequalities still exist in access to and quality of care available at health-care services – which can inform South Africa’s development of a national health insurance scheme. [ABSTRACT FROM AUTHOR]

Background:Mental health problems of adolescents are underserved in low and middle-income countries where they account for a significant proportion of disease burden. Perinatally infected HIV-positive adolescents have a high prevalence of mental health disorders; however, little is known about those retained in care in South Africa. Methods:HIV-positive adolescents aged 13–19 years (n= 343) accessing five paediatric antiretroviral clinics in Johannesburg were assessed using standardized measures for depression, anxiety, post-traumatic stress disorder (PTSD), and suicidality. Descriptive and bivariate analyses were conducted on all variables using Statistica v13. Results:Twenty-seven percent were symptomatic for depression, anxiety, or PTSD; 24% reported suicidality. Peer violence was significantly correlated to all mental health problems, as was hunger, being inappropriately touched, being hit, and being female. Those reporting sickness in the past year were more symptomatic. High exposure to violence was evident. Additionally, not feeling safe at home or in the community increased risk for all mental health disorders. Knowing one’s HIV status was protective as was having dreams for the future. Conclusion: HIV-positive adolescents accessing care demonstrated high levels of mental health problems that are largely unrecognized and could potentially be addressed within health systems. Mental health difficulties are driven by social challenges that require attention. [ABSTRACT FROM PUBLISHER]

Although hazardous/harmful alcohol use impacts response to HIV treatment, there have been few attempts to deliver alcohol-reduction interventions within South African HIV treatment services. As a first step towards implementing alcohol-focused interventions in these settings, we explored patients’ views of the acceptability of a brief motivational interviewing and problem-solving intervention. In-depth interviews were conducted with 11 patients recruited from three HIV treatment sites in Tshwane, South Africa, who had completed the intervention. Participants noted that the intervention was acceptable and appropriate. As a result of the intervention, participants reported less use of alcohol as a coping mechanism. They described greater use of problem-focused and emotional coping strategies for dealing with mutable and immutable problems, respectively. Their only recommendation for improving the intervention was the addition of booster sessions. Findings suggest that this intervention is acceptable to patients receiving HIV treatment and is perceived to be helpful for reducing their use of alcohol. [ABSTRACT FROM AUTHOR]

Globally intimate partner violence (IPV) is a public health problem that can be perpetrated by both males and females, although males are more likely to inflict severe IPV-related injuries on their female partners. In low- and middle-income countries like South Africa, few studies have conducted research to determine whether IPV perpetration by men may be a risk factor for engaging in other risk behaviours. The aim of this study is to determine whether IPV perpetration by men is a risk factor for engaging in other risk behaviours with a particular focus on risky sexual behaviours and alcohol misuse. The data for this study were drawn from a multilevel intervention study, which addressed the nexus of alcohol abuse and HIV prevention among men in South Africa. Men were screened and recruited from informal drinking places within 12 communities situated in one of the oldest, predominantly Xhosa-speaking African townships in Cape Town. Univariate and multivariate logistic regression models were used to analyse the associations between IVP and potential explanatory variables. Of the 975 men included in the survey, 39.9% reported to have been involved in Intimate Partner Violence. IPV perpetration was significantly more likely among men who reported having a child [OR 1.51 (1.07-2.14) p = .019], having a casual sexual partner [OR 1.51 (1.11-2.05) p = .008], and those with possible alcohol dependence [OR 3.46 (1.17-10.20) p = .024]. IPV was significantly less likely among men with matric educational qualification than those with no education [OR 0.30 (95% CI: 0.09-1.02) p = .053] and among those who reported using a condom at last sex [OR 0.69 (0.50-0.97) p = .034]. We therefore recommend that interventions aimed at reducing IPV need to address risky sexual and drinking behaviours amongst men simultaneously, while also focusing on intimate relationship power dynamics and gendered norms amongst couples. [ABSTRACT FROM AUTHOR]

The current study sought to explore the association between primary caregiver depressive symptoms and the psychological functioning in children vertically infected with human immunodeficiency virus (HIV) living in Eastern Cape, South Africa. A cross-sectional data were collected using the Beck Depression Inventory and Strength and Difficulties Questionnaire in a sample of 152 caregiver/child dyads. The results revealed that poorer psychological functioning in children was significantly associated with depressive symptoms in caregivers. This relationship existed whether or not the child was raised by a biological or non-biological caregiver as well as for both genders. Younger children's psychological functioning was more negatively influenced than that of older children raised by a caregiver with depressive symptoms. In the context of a large treatment gap for common mental disorders in South Africa, there is a need for interventions to address maternal mental health in families infected and affected by the HIV/AIDS pandemic as a mental health promotion strategy given that HIV-infected children are a particularly vulnerable population for poor mental and behavioural health outcomes. [ABSTRACT FROM PUBLISHER]

Extensive research over the past 30 years has revealed that individual and social determinants impact HIV risk. Even so, prevention efforts focus primarily on individual behaviour change, with little recognition of the dynamic interplay of individual and social environment factors that further exacerbate risk engagement. Drawing on long-term research with young adults in Lesotho, I examine how social environment factors contribute to HIV risk. During preliminary ethnographic analysis, I developed novel scales to measure social control, adoption of modernity, and HIV knowledge. In survey research, I examined the effects of individual characteristics (i.e., socioeconomic status, HIV knowledge, adoption of modernity) and social environment (i.e., social control) on HIV risk behaviours. In addition, I measured the impact of altered environments by taking advantage of an existing situation whereby young adults attending a national college are assigned to either a main campus in a metropolitan setting or a satellite campus in a remote setting, irrespective of the environment in which they were socialised as youth. This arbitrary assignment process generates four distinct groups of young adults with altered or constant environments. Regression models show that lower levels of perceived social control and greater adoption of modernity are associated with HIV risk, controlling for other factors. The impact of social control and modernity varies with environment dynamics. [ABSTRACT FROM PUBLISHER]

Poor motor performance and reduced physical fitness are characteristic of children with Developmental Coordination Disorder (DCD). These features have also been identified more frequently among children living in low socio-economic circumstances. Aims: To evaluate the outcomes of a nine-week health promotion program (HPP) on the motor performance and fitness levels of children (6-10 years) with and without DCD attending a low-income primary school. Methods: The HPP was designed and implemented by undergraduate physiotherapy students using guidelines from the World Health Organization School Health Initiative and their physiotherapy curriculum. Children with DCD ( n = 22) and a control group without DCD ( n = 19) participated in the evaluation. Motor skill, functional strength, aerobic capacity, and anaerobic power were measured at baseline and after nine weeks. Results: Both groups of children improved on all measures at the conclusion of the HPP. Children with DCD showed greater improvement than the control group in motor performance and the control group showed greater improvement on one of the anaerobic fitness outcomes. Conclusions: A school-based HPP that focuses on increasing opportunities for physical activity may be effective in improving motor performance in children with DCD and can increase fitness levels in general. [ABSTRACT FROM AUTHOR]

Although there is a high prevalence of anxiety and depression amongst people receiving antiretroviral treatment (ART), many patients are not screened, diagnosed or referred for mental health problems. This study aims to determine whether public sector health care workers in South Africa observe, screen, diagnose and refer ART patients that show symptoms of common mental disorders. It also aims to ascertain the extent of mental health training received by public sector health care workers working in ART. The study was cross-sectional in design. Self-administered questionnaires were completed by 40 nurses and structured interviews were conducted with 23 lay workers across the five districts in the Free State between July 2009 and October 2009. STATA version 12 was used to perform statistical data analysis. The health care workers reported observing a high frequency of symptoms of common mental disorders among public sector ART patients. While 70% of nurses screened and diagnosed, only 40% of lay workers screened and diagnosed patients on ART for a mental disorder. Health care workers who had received training in mental health were more likely to screen or diagnose a mental disorder, but only 14% of the workers had received such training. We recommend that health care workers should receive task-specific training to screen and/or diagnose patients on ART for common mental disorders using the guidelines of the South African HIV Clinicians Society. A positive diagnosis should be referred to a health care practitioner for appropriate evidence-based treatment in the form of medication or psychotherapy. [ABSTRACT FROM PUBLISHER]

Depression and other health problems are common co-morbidities among persons living with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS). The aim of this study was to investigate depression, health status, and substance use in relation to HIV-infected and uninfected individuals in South Africa. Using a cross-sectional case-control design, we compared depression, physical health, mental health, problem alcohol use, and tobacco use in a sample of HIV-infected (N= 143) and HIV-uninfected (N= 199) respondents who had known their HIV status for two months. We found that depression was higher, and physical health and mental health were lower in HIV-positive than HIV-negative individuals. Poor physical health also moderated the effect of HIV infection on depression; HIV-positive individuals were significantly more depressed than HIV-negative controls, but only when general physical health was also poor. We did not find an association between alcohol or tobacco use and HIV status. These results suggest the importance of incorporating the management of psychological health in the treatment of HIV. [ABSTRACT FROM AUTHOR]

This research sought to examine South African teachers’ attitudes toward the inclusion of learners with different abilities in their hypothetical mainstream classrooms. Participants were 93 South African teachers who responded to the Teachers’ Attitudes and Expectations Scale, a measure developed for this study, regarding four vignettes depicting learners with different types of impairments. Overall, teachers reported that inclusion would benefit learners’ social development (mean scores from 2.57 to 3.35) more than their intellectual development (mean scores from 2.14 to 2.83). It also was found that teachers overwhelmingly were more confident about including learners with Down syndrome into their hypothetical mainstream classes when compared with the inclusion of learners with other disabilities,F(3, 90) = 9.59,p < 0.01. The results suggest that providing teachers with sufficient resources within the classroom and training that includes hands-on experience with children with disabilities could positively influence their attitudes toward the inclusion of learners with disabilities in their classrooms. [ABSTRACT FROM AUTHOR]

While research now highlights that men who have sex with men (MSM) in places such as South Africa are at particular risk of HIV infection, left relatively unexplored are potential relationships between one of the most pressing social issues affecting peri-urban MSM – namely homophobic stigma – and sexual risk-taking behaviour. Drawing on research from theUkwazanabaseline study of 316 township MSM in Cape Town we examine how homophobic stigma relates to psychosocial factors such as depression and self-efficacy and the risk activity of unprotected anal intercourse (UAI). By deploying cross-sectional association models, we examine a series of relationships between these variables and offer evidence to suggest that HIV prevention programmes aimed at sexual minority groups should be mindful of potentially complex relationships between social stigmas such as homophobia and sexual risk-taking behaviour. [ABSTRACT FROM AUTHOR]

Psychosocial health care for persons living with HIV/AIDS (PLWHA) is inadequate. Support groups for PLWHA could offer arenas where psychosocial issues are addressed, yet more knowledge is needed about those who join and those who do not join such groups. In this study, conducted in Limpopo province, South Africa, 49 PLWHA were asked about their motivations for joining a support group, while 22 PLWHA were asked about their reasons for not joining a support group. The most prevalent motivations for joining were to get information (59%) and social support (53%). The main reasons for not having joined were lack of knowledge (32%) and understanding (19%) about the support group and time constraints (19%). Physical symptoms and mental health were measured using the Stages of HIV Related Physical Symptoms & 20-item Symptom Checklist for HIV Infection and the General Health Questionnaire-28 (GHQ-28). Physical symptoms ranged from 0 to 17 with an average of 6. Mental distress was high, with 55% of members and 46% of non-members scoring above threshold levels. Support group members tended to be female, younger, to have tested due to pregnancy or out of concern, and to have grants as their sources of income. Non-members had tested due to illness, reported considerably more pain and were more likely to have no income. PLWHA experienced high mental, physical and social distress which must be addressed. Attention to gender differences is called for. While all members joined the support group to gain information and learn to cope, women were more likely to join to get support and deal with stress, while men joined to stay active and educate others. Support groups could be important links in the chain of comprehensive HIV health service delivery, given that they manage to recruit and meet the needs of PLWHA. [ABSTRACT FROM PUBLISHER]

Parent and peer relationships are important social resources for adolescents. South African research on adolescents' relationships, however, underemphasises these relationships as potential positive resources. Studies also tend to use samples from urban populations, while rural and semi-rural adolescent populations are neglected. This study focused on White and Coloured adolescents living in one South African semi-rural community and their ratings of positive and negative relationship qualities in relationships with parents and peers. Using the Network of Relationships Inventory (NRI), we found that mothers, best friends and romantic partners were relatively equal sources of social support. Mothers' high ratings for support, conflict and punishment may point to mothers bearing the primary responsibility for child care. Fathers' low support ratings raise concern as father involvement is important for adolescents' well-being. White participants overall rated their relationship higher for support and lower for negative qualities than the Coloured participants. [ABSTRACT FROM PUBLISHER]

Formative work to inform interventions aimed at addressing drug and sexual risk behaviours among men who have sex with men (MSM) in South Africa highlighted the need to target drug-using MSM with prevention interventions addressing both sexual and drug-related HIV risk. From 2007, in collaboration with two local NGOs, intervention activities were rolled out to vulnerable drug-using MSM. Over the first two years, 3475 drug-using MSM were reached through community outreach that promotes HIV/AIDS prevention and addresses drug risk behaviours and 745 among them were tested for HIV and received their results and 239 of them were referred from HCT to other services. Additionally, 66 individuals were trained to promote HIV/AIDS prevention services and 15 were trained in HCT. Twelve new targeted condom and lubrication services and 7 new HCT outlets were established. MSM reported a variety of high-risk activities including not using condoms for anal sex, having sex while under the influence of alcohol or drugs and sharing needles (among injection drug users). However, MSM were willing to develop risk reduction strategies. Year one and two of the intervention has demonstrated the willingness of the NGOs to broaden their service delivery, improved integration of drug treatment, HIV intervention and other services, and has shown positive results across a number of risk behaviours among MSM. [ABSTRACT FROM AUTHOR]

Background Human rights provide fundamental conditions for people to maintain dignity and self-determination and protect a nation's most vulnerable citizens. In South Africa, children with intellectual disability who experience socioeconomic disadvantage may be particularly vulnerable due to their cognitive impairments and inability to garner needed resources. Method The perceptions of children with intellectual disability regarding their access to basic amenities in their home environments were examined to determine whether their positive human rights were met. Risk factors were examined in relation to these perceptions. Results The results suggested that participants generally reported high degrees of access to basic resources. Logistic regressions suggested socioeconomic risk factors (e.g., income, education, household size, relationship status) were negatively related to children's reports of access to food and their own beds and positively related to having someone available to explain confusing concepts to them. Conclusions The positive human rights of children living in high-risk environments should be monitored to ensure all South Africans have their rights met. [ABSTRACT FROM AUTHOR]