Hiv/Aids communication and youth behaviour in South Africa: a study of female high school students in the Eastern Cape Province
- Authors: Mpofu, Nkosinothando
- Date: 2012
- Subjects: HIV infections -- Social aspects -- South Africa , AIDS (Disease) -- Social aspects -- South Africa , Communication in public health -- South Africa
- Language: English
- Type: Thesis , Doctoral , PhD (Com)
- Identifier: vital:11368 , http://hdl.handle.net/10353/d1015374 , HIV infections -- Social aspects -- South Africa , AIDS (Disease) -- Social aspects -- South Africa , Communication in public health -- South Africa
- Description: Human Immuno-Deficiency Virus and Acquired Immune-Deficiency Syndrome communication remains one of the most significant tools in the fight against HIV/AIDS given the absence of the cure to fight the growth and spread of the global pandemic. Through the use of information, HIV/AIDS communication seeks to empower recipients or societies with skills that will help reduce their risk of infection. South Africa has seen a high visibility of HIV/AIDS communication programmes or campaigns aimed at empowering different audiences, whilst paying particular emphasis on the most vulnerable. Young people, in particular young women, have a higher prevalence of HIV/AIDS in South Africa. This has prompted the development of many youth focused communication campaigns which have sought to address factors that increase young people`s vulnerability to HIV infection. However, despite the high visibility of HIV/AIDS communication campaigns targeting young people, high risk behaviours are still being seen among young women. Important to note are the high teenage pregnancy rates, growing abuse of substances and even the premature engagement of sexual activities among female youths. This, therefore, raises questions on the effect of HIV/AIDS communication programmes in encouraging protective behaviour against risky behavioural practices amongst young women. Using both quantitative and qualitative research approaches to this study, an investigation was conducted into whether current HIV/AIDS communication campaigns have been limited (in terms of effectiveness) when it comes to communicating with young women on issues relating to HIV/AIDS. Awareness of HIV/AIDS and HIV/AIDS communication programmes, relevance of HIV/AIDS communication programmes, the factors that influence the use and understanding of HIV/AIDS messages and the impact of HIV/AIDS communication on attitude and behaviour change amongst female youths is measured. A total of 350 questionnaire copies were self-administered to 350 participants, with a 100 percent response rate. From the 350 participants, seventy five took part in focus group discussions. Data obtained was analysed using SPSS (for descriptive statistics), and the grounded theory. The results of the study indicate that all participants were aware of HIV/AIDS with at least 60% of the participants aware of at least three HIV/AIDS communication campaigns. When measuring the relevance of HIV/AIDS communication campaigns, participants (58%) indicate that issues discussed in most HIV/AIDS communication campaigns increased the relevance of HIV/AIDS messages to young women although such relevance was, for some respondents, affected by limited access to communication campaigns. Results also show that levels of knowledge and understanding of factors that expose young women to HIV infections differed amongst participants in as much as the factors that hinder the use of advice contained in HIV/AIDS messages also differed. Sixty-nine percent of the participants have knowledge and a better understanding of factors that expose young females to HIV infections. Twenty-five percent of the participants identified peer pressure, whilst 23% identified limited access to HIV/AIDS communication campaigns and another 18% identified a disregard of HIV/AIDS messages as significant factors that limit the ability of individuals to implement advice contained in HIV/AIDS messages. The results also indicate that although HIV/AIDS communication campaigns seem to have played a role in empowering some participants, there is still a significant minority whom communication has not effectively communicated with. Based on these findings, the study suggests, amongst other things, the need to intensify current HIV/AIDS communication campaigns through the provision of consistent messages on appropriate condom use, the identification of easily accessible communication channels and the development of thought provoking and attention grabbing campaigns as well as the need to continue to directly involve young women in the processes of their own development.
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- Date Issued: 2012
Illustrated medicines information for HIV/AIDS patients: influence on adherence,self-efficacy and health outcomes
- Authors: Barford, Kirsty-Lee
- Date: 2012
- Subjects: AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa , AIDS (Disease) -- Patients -- South Africa , HIV-positive persons -- South Africa , AIDS (Disease) -- Study and teaching -- South Africa , Antiretroviral agents -- South Africa , Communication in medicine -- South Africa , Communication in public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3863 , http://hdl.handle.net/10962/d1015678
- Description: South Africa has an estimated 920 000 patients on antiretrovirals (ARVs), the largest number of patients in any country. ARV therapy demands adherence levels in excess of 95% to avoid development of drug resistance, but adherence to ARV therapy is estimated to be only between 50% and 70%. Poor medication adherence is acknowledged as a major public health problem, reducing the effectiveness of therapy and promoting resistance to ARVs. More than two thirds of the South African population have marginal reading skills and this significantly influences a patient’s ability to read and understand health-related information. Patient education materials tailored for the South African population could be a useful aid in facilitating communication with patients and perhaps impact positively on their medicine-taking behaviour. This behaviour is influenced by patient knowledge, beliefs, attitudes and expectations and includes self-management, self-efficacy and adherence. Self-efficacy, which refers to patient confidence in the ability to self-manage medicine taking, is a key factor influencing adherence. This study aimed to develop illustrated patient information leaflets (PILs) and medicine labels for all first-line ARV regimens used in the public health sector in South Africa and, using a randomised control study design, to investigate the impact of these illustrated information materials on knowledge, medication-taking behaviours and health outcomes in HIV/AIDS patients taking ARVs. To achieve this aim, the objectives were to assess HIV/AIDS and ARV-related knowledge, as well as self-efficacy and adherence to ARV therapy; to assess the influence of demographic variables on knowledge, adherence and self-efficacy; to assess the influence of the information materials on knowledge, self-efficacy and adherence and to assess the association of knowledge with health outcomes. Medicine labels and PILs, both English and isiXhosa, were developed for ARV regimens 1a, 1b, 1c and 1d. The 8-item Morisky Medication Adherence Scale (MMAS-8) and HIV Treatment Adherence Self Efficacy Scale (HIV-ASES) instruments for measuring respectively adherence and self-efficacy, were modified to optimize clarity, simplicity and cultural acceptability and were translated into isiXhosa using a multi-stage translation-back translation. The questions and the rating scales, for both the MMAS and HIV-ASES, underwent preliminary qualitative evaluation in focus group discussions. Patients were recruited from local Grahamstown clinics. A pilot study to evaluate applicability of the instruments was conducted in 16 isiXhosa AIDS patients on ARVs and the results from this study informed further modifications to the instruments. One hundred and seventeen patients were recruited for the randomised control trial and were randomly allocated to either control group (who received standard care) or experimental group (who received standard care as well as pictogram medicine labels and the illustrated PIL). Interviews were conducted at baseline and at one, three and six months. Data were analysed statistically using the t-test, chi-squared test and ANOVA (Analysis of Variance) at a 5% level of significance. Correlations were determined using Pearson and Spearman rho correlations. Approval was obtained from Rhodes University Ethical Standards Committee, Settlers Hospital Ethics Committee and the Eastern Cape Department of Health. The results of this research showed that illustrated PILs and medicine labels enhanced understanding of HIV/AIDS and ARV information, resulting in a mean overall knowledge score in the experimental group of 96%, which was significantly higher than the 75% measured in the control group. Variable knowledge scores were measured in three areas: baseline knowledge of general HIV/AIDS-related information was good at 87%, whereas knowledge scores relating to ARV-related information (60%) and side-effects (52%) were lower. These scores improved significantly in the experimental group over the 4 interviews during the 6 month trial duration, whereas in the control group, they fluctuated only slightly around the original baseline score. There was no significant influence of gender on knowledge score, whereas health literacy, education level and age tested (at one and three months) had a significant influence on knowledge. Self-efficacy and adherence results were high, indicating that the patients have confidence in their ability to adhere to the ARV therapy and to practice optimal self-care. Age, gender and education, in most cases, significantly influenced self-efficacy, but were found to have no effect on adherence. The CD4 count improved over the trial duration which may have been influenced by a number of factors, including better knowledge of ARVs and improved adherence. No significant parametric correlation was found between knowledge score and change in CD4 count, however, Spearman's rho showed significance (rs=0.498; p=0.022). Both patients and healthcare providers were highly enthusiastic about the illustrated labels and PILs, and indicated their desire for such materials to be routinely available to public sector HIV/AIDS patients. The isiXhosa version of the PIL was preferred by all the patients. These simple, easy-to-read leaflets and illustrated medication labels were shown to increase understanding and knowledge of ARVs and HIV/AIDS in low-literate patients, and their availability in the first-language of the patients was central to making them a highly useful information source.
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- Date Issued: 2012