Annotated Bibliography: Voluntary Counselling and Testing

Annotated Bibliography:
Voluntary Counselling and Testing
Literature in Africa (all years until end 2001).
V. Solomon, H. Van Rooyen, R. Griesel, D. Gray, J. Stein
and V. Nott
HIV/AIDS Counselling Research and Evaluation Group
School of Psychology
University of Natal, Pietermaritzburg
Prepared for the Health Systems Trust, as part of Grant
number 286/01: An Audit of Voluntary Counselling
and Testing Services in South Africa.

185.
Ref ID: 345
Aid for persons with AIDS (1883). Australian Journal of Sex, Marriage and Family, 6, 183-
Abstract: We hesitate to add to the media splurge on the Acquired Immunity Deficiency
Syndrome, but we do so for two reasons. First, many of our readers will probably find themselves
counselling persons with AIDS at least occasionally and may feel the need for some clarification
about it. Second, it seems to us that the emotional and social needs of the person with AIDS are
all too often overlooked. What follows therefore is a brief statement of the main facts at present
known about AIDS, and some comments on its psychosocial aspects.
Notes: 1 copy
Ref ID: 16
HIV counselling: Its nature and purpose (1980). In - (- ed., pp. 27-35). -: -.
Keywords: education/guidelines/health/health education/information/prevention/primary
prevention/risk behaviour/secondary prevention/transmission
Abstract: HIV/AIDS counselling is aimed at providing psychosocial support and preventing HIV
infection. Psychosocial support is necessary because a diagnosis of HIV infection confronts
people with a host of emotional and/or practical problems. Counselling is of vital importance in
overcoming resistance to making the changes in behaviour that are necessary if risk is to be
avoided and transmission prevented. Counselling in the context of prevention can make the form
of primary prevention, intended for people at risk but not known to be infected. Primary
prevention focuses on risk behaviour, while the main emphasis in secondary prevention is on
preventing transmission. Counselling implies education but, unlike health education, is directed
towards the specific needs arising from HIV infection. It also involves communication: however, it
differs form casual conversation in that the information exchanged and obtained is specific,
focused, and serves a purpose.
Notes: 1 copy
2

Ref ID: 121
AIDS Counselling (1989). South African family practice, 6, 63.
Keywords: model
Abstract: This paper gives a model of counselling suggested for AIDS victims and HIV carriers
and patients
Notes: 1 copy
Ref ID: 8
AIDS fact sheet No. 208: AIDS counselling in the workplace (1991). IMP journal, -, 1-6.
Keywords: business/employee/employer/guidelines/workplace
Abstract: This fact sheet highlights the importance of counselling employees who have AIDS or
who are infected with the AIDS virus(HIV). It also provides guidelines for human resources
personnel responsible for counselling. To effectively manage AIDS in the workplace, there is a
need to be proactively equipped with skills and knowledge about the disease.
Notes: 2 copies
Chronicle, -, 11.
Ref ID: 282
Better to counsel about HIV and AIDS before patient is tested for virus. (1992). Medical
Keywords: HIV testing
Abstract: The most important time for educating patients about HIV and AIDS is while counselling
them before they are tested for the virus because it is much harder for them to receive
information after the results are in, Dr Ronald H Goldschmidt said at the annual review in family
medicine sponsored by the university of California, San Francisco, School of Medicine.
HIV testing has its up and down sides, and physicians can make an enormous difference by
counselling patients both before and after the test, said Dr Goldschmidt, professor of clinical
family and community medicine at the university. The positive aspects of HIV aspects are that
they can identify people who are infected so they will not infect others; early diagnosis allows
advanced intervention and prophylactic treatment. Physicians should be giving essentially the
3

same education, however, to all patients, infected or not, he said. The diagnosis challenge for
primary care physicians is to make an early diagnosis of HIV infection so that available strategies
can be used, such as antiretroviral therapy, pneumocystis prophylaxis, and early identification of
opportunistic infections.
Notes: 1 copy
Women as caregivers: An interview with clinic sister, Mandisa Dlamini (1993). AIDS
Bulletin, no. 2, 4-5.
Ref ID: 5
Keywords: health worker/Nurse/primary health care/women
Reprint: Not in File
Abstract: This article gives the interview of a clinic sister caregiver working with HIV/AIDS people.
Notes: 1 copy
HIV Infection in South Africa: The implications of the VIII International Congress on AIDS
and STDs for Psycho-social care and counselling in respect of HIV infection within the South
Africa context- an AIDS patient. (1993). Medical Sex Journal of South Africa, 4, 10-12.
Ref ID: 83
Keywords: conference/counsellor/counsellors/Developing countries/drug-
users/medical/policy/political/sex workers/social
Abstract: This congress provided a safe environment for the diversity of the pandemic to be
experienced by 11 700 delegates. Delegates were struck by the high number of persons
presenting papers that identified themselves as HIV infected. These included scientists,
clinicians and prevention workers and in many respect the role of seropositive persons in meeting
the challenge of AIDS, is both pivotal and the significant difference between the international
response to this disease compared to others. The participation of a growing number of sero-
positive persons at all levels of intervention helps to focus the response and sustains its sense of
urgency. Although this voluntary admission of infection by speakers was powerful, the congress
organisers had also seen to it that marginalised and/or oppressed populations of the world, who
4

are bearing the brunt of the pandemic, were strongly represented. Women, persons form
impoverished and developing countries, sex workers, homosexuals and injecting drug users were
all strong represented.
Notes: 1 copy
Conference Highlights: 2nd International Conference on the Biopsychosocial aspects of
HIV/AIDS, Brighton, July 1994 (1994). AIDS Bulletin, 3, 28-29.
Ref ID: 4
Keywords: biospychosocial/community/computer
counselling/conference/counsellor/counsellors/Nurse/training
Reprint: Not in File
Abstract: AIDS research/newsflashes gives different abstracts of conference papers presented by
a number of different authors at the 2nd International Conference on the Biopsychosocial aspects
of HIV/AIDS, Brighton, July 1994. Papers were presented on confidential sharing (the link from
individual to community counselling); evaluating counselling training, and using PWAs ( People
with AIDS) and nurses as AIDS counsellors.
Notes: 1 copy
Ref ID: 122
AIDS counselling (1994). South African Family Practice Manual, 8, 8.07-8.08.
Keywords: guidelines/model
Abstract: Counselling is a key component in AIDS control and prevention. It is the ongoing
dialogue and relationship between client and counsellor that has as an objective the prevention of
HIV transmission and the provision of psych-social support for those affected directly and
indirectly by HIV.
Notes: 1 copy
Ref ID: 179
Pre-HIV test counselling too much? (1994). CME, 12, 294.
Keywords: pre-test
5

Abstract: An editorial from an AIDS counselling unit in the UK is sure to raise the ire of many. It
argues that it is time to consider the place and purpose of pre-test counselling, given the
increasing numbers of tests and knowledge about HIV in the patient community. It observes that
pre-HIV test counselling should form part of the discussion about other tests and procedures that
doctors carry out in their daily practice and discuss with their patients. The editorial does point
out, however, that special provision must still be made for specialist counsellors to help with HIV-
positive patients.
Notes: 1 copy
Ref ID: 7712
(1994). Wits Aids research a world first. Diverse publikasies.
Keywords: AZT/research
Abstract: Research conducted by members of the Commerce faculty of Wits University on the
use of the drug AZT in people with Aids is a World first and is to be published in the University of
London's journal of Applied Economics.
Professor Duncan Reekie, outgoing dean of the Commerce faculty together with colleagues
Stephen Meyer and Mark Lasser, found that despite the high cost of AZT, it was a very
worthwhile therapy for Aids patients. It not only prolonged their lives, but also enhanced their
quality of life and enabled them to work productively for significant periods of time after
developing Aids. Although the study was started in 1986, the researchers only began evaluating
the results in 1992.
A complicating factor in the research was the time frames in which they had to work because the
AIDS patients who took part in the study died at different times.
Notes: 1 copy
Increasing the effectiveness of HIV counselling (1994). American Journal of Public
Health, 84, 1179-1180.
Ref ID: 416
Keywords: client/clients/clinic/efficacy/impact/sexually transmitted disease/Virus
6

Abstract: Otten et al raise serious concerns about the impact of human immunodeficiency virus
(HIV) counselling and testing among sexually transmitted disease clients. Lack of behavioral
change subsequent to HIV counselling and testing (or increased risk behavior among
seronegatives warrants reassessment of HIV counselling and testing procedures. The apparent
ineffectiveness of counselling, however, may be peculiar to this clinic's stated procedures.
Notes: 1 copy
Ref ID: 445
HIV and the Mind (1994). South African Family Practice Manual, 8, 8.47.
Keywords: emotional reactions
Abstract: The article just gives a summary of the emotional reactions of people with HIV and
AIDS. Those reactions are: shock, anger, guilt, anxiety, depression, obsessive disorders, and
psychiatric manifestations.
Notes: 1 copy
Do HIV testing and counselling increase risk behavior? (1995). American Journal of
Public Health, 85, 1297-1298.
Ref ID: 418
Keywords: HIV prevention/HIV testing/HIV transmission/impact/prevention/transmission/Virus
Abstract: Recent publications have stressed the needs to investigate further the impact of human
immunodeficiency virus (HIV) testing and counselling programs on HIV transmission. In
particular, W. Otten et al. raised the concern that counselling may increase high-risk behaviors in
some patients. In theory, disinhibition effect due to counselling ( but more likely due to learning
test results) is clearly conceivable and, if real, would have considerable implications for the
design and the implementation of future HIV prevention programs. However, we believe that
Otten's findings do not provide strong evidence of such a harmful effect of counselling.
Notes: 1 copy
Youth and HIV/AIDS (1996). In J.a.T.D.J.M.Mann (Ed.), AIDS in the World II: global
dimensions, social roots, and responses: the global AIDS policy coalition (pp. 236-250). New
7

York, Oxford: Oxford University Press.
Ref ID: 384
Keywords: adolescents/teenagers/Young people/youth
Abstract: Societies around the world have great difficulty promoting and protecting the health of
young people (which we will consider here as 13 - 24 years old) against HIV infection as well as
other hazards. Yet the HIV/AIDS pandemic will have a growing impact on their health and their
lives.
It is appropriate to focus on young people as they fall between children and adults, two well-
established demographic and social categories. Children are generally considered to be in need
of protection against HIV, to which they may be exposed through their relation to and the actions
of others: through HIV-infected mothers, unsterile medical injections, contaminated blood
products, or sexual abuse by adults. In contrast, adults are assumed to be capable of protecting
themselves; they are seen as independent and autonomous, as making informed choices and
using appropriate health and social services. Within this framework, the concept of childhood
virtually denies personal choice or preference, while personal responsibility for actions and
outcomes is the defining principle of adulthood.
Notes: 1 copy
Ref ID: 437
AIDS home test on trial (1996). AIDS Bulletin, 5, 25.
Keywords: counsellor/counsellors/pre-test
Abstract: The US food and Drug Administration recently approved the first-ever AIDS home test
kit. The product, known as Confide was developed by Direct Access Diagnostics, a Johnson and
Johnson Company in conjunction with Chiron Corporation. The product will initially only be
available in Texas and Florida. The kits contain pre-test counselling booklets about HIV/AIDS.
The person takes a finger stick blood sample and places it on a designated area on a test card
that is precoded with a unique identification number. The card is then mailed to a laboratory for
testing. A week later the results can be obtained by calling a toll-free number. If the result is
positive, certified counsellors are connected to the caller directly. Negative results are provided
8

y an automated message which includes an explanation of the window period in which a positive
person may test negative. Negative callers are also given an opportunity to speak to a counsellor
if they wish to.
Notes: 1 copy
Ref ID: 440
HIV/AIDS and life insurance (1996). AIDS Bulletin, 5, 27.
Keywords: benefits/HIV testing/impact/insurance/policies/policy
Abstract: According to the latest Mercantile and General Reinsurance Report there was a 24%
increase in AIDS-related claims in the first 6 months of 1996 compared with the previous 6-month
period. According to the report, there were 2077 AIDS - related reported claims totaling R 83
million with a further R 187 000 being paid out monthly in permanent disability insurance up to the
end of June. However, the actual number of AIDS-related claims could, in fact, be double this
amount as AIDS is not notifiable and many deaths are reported as resulting from associated
conditions. The rise in AIDS-related deaths is having an increasing impact on the structure of life
assurance for both individuals and group insurance schemes. Changes which premium holders
can expect include measures such as increased premiums, reduced benefits as opposed to lump
sums. Some of the changes which insurance companies have introduced to prevent soaring
premiums have included: AIDS exclusion clauses, compulsory HIV testing, reducing guarantee
periods for premiums, insisting that all policies include an investment portion so that there is a
build up in the cash value of the policy, reducing the guarantee period for premiums and
increasing reserves held by life companies to cover future AIDS-related death pay-outs.
Notes: 1 copy
Ref ID: 442
AIDS deaths in KwaZulu/Natal (1996). AIDS Bulletin, 5, 27.
Keywords: KwaZulu-Natal
Abstract: A report by the Select Committee on Liaison with Provinces estimates that 167 000
AIDS deaths will occur by the year 2001 in KwaZulu/Natal. The prevalence of HIV in adults is
9

currently at about 16% and will rise to about 20% by the year 2000. Annual HIV-positive births
were estimates to be 27 000 this year increasing to 39 000 by 2001 and the number of AIDS
orphans was projected to reach 200 000 by the year 2000.
Notes: 1 copy
Ref ID: 8297
(1997). New combination has lower price. The star.
Keywords: Africa/drugs/South Africa
Abstract: Two groups to drugs are used to fight HIV, and both interrupt the replication of the HIV
virus. Reverse transcriptase inhibitors (RTI) inhibit the reverse transcriptase enzyme, which
helps the viral RNA to replicate. Protease inhibitors (RTI) inhibit the reverse transcriptase
enzyme, which helps the viral RNA to replicate Protease inhibitors (PI) inhibit the protease
enzyme required for viral maturation. The oldest combination is of two types of RTIs, but this is
less effective in the long run. The most widely used new combination is of one PI and two RTIs,
which costs around R3 175 a month. This became possible when PIs were registered in South
Africa at the end of 1996. The combination is the most researched, most effective and most
expensive treatment. But there is a chance of drug resistance developing due to poor
compliance as a result of four to six pill-taking sessions a day. A new PI is now available which
has made combination therapy easier as it has only to be taken twice daily. It has also made
possible a new and as yet unregistered combination treatment, that of two protease inhibitors
together. This costs R1 815 per month, and has been found to reduce the viral load to
undetectable levels in 90% of patients treated.
Notes: 1 copy
Ref ID: 7563
(1997). Mothers' HIV screening gives hope to newborn babies. The Daily News..
Keywords: babies/Baragwanath/infection/intervention/medical/research/transmission
Abstract: Doctors hop to formulate by mid-1998 a package of medical interventions to reduce the
numbers of newborn babies who contract HIV from their mothers. But, for the interventions to
10

educe the number of newborn babies who contract HIV from their mothers. But, for the
interventions to make any real impact, more mother need to voluntarily opt for HIV screening to
determine their status. Mothers-to-child transmission account for an estimated 20% of new HIV
infections, says Dr James McIntyre of the HIV/Aids peri-Natal Research Unit at the Chris Hani
Baragwanath Hospital.
Notes: 1 copy
Ref ID: 423
Psychology and counselling impressions from the conference. (1997). CME, 15, 498-500.
Keywords: Africa/behaviour
change/communication/community/conference/couples/health/infection/intervention/Kenya/resear
ch
Abstract: Several research papers documented the value of counselling as an integral part of
care for people living with HIV/AIDS, not only in developed countries but also as part of a model
of care and support for people living with HIV/AIDS in resource-poor communities in Africa. A
study from India also documents the valuable role of supportive psychotherapy in helping couples
to deal with accepting the reality of infection, issues of guilt and blame, anxiety and depression.
Art therapy and recreational therapy services were also reported to significantly enhance mental
health status and to decrease noncompliance among disenfranchised AIDS patients by fostering
community development and providing opportunities for self-expression and productivity. Other
presentations from as far as afield as Thailand and Kenya noted the value of group counselling in
providing support and in initiating and sustaining behaviour change. A meta-analytic study found
that interventions using techniques like relaxation, cognitive restructuring and inner
communication were more successful and in reducing anxiety and depression than other
techniques.
Notes: 1 copy
Ref ID: 426
Counselling needs identified by people living with HIV (1997). Positive outlook, 4, 21.
11

Keywords: client/confidentiality/counsellor/counsellors/KwaZulu-Natal/training
Abstract: A workshop, aimed at counsellors and HIV positive people, was recently run at
Amatikulu on the KwaZulu-Natal north coast to explore various issues about being HIV positive
and about counselling HIV positive people. The group of PWAs and counsellors established that
support groups for HIV positive people would assist with their needs, that counsellors are needed
to help with setting up support groups and also facilitating some of their activities, and that
guidelines on the setting up of these groups should be widely distributed to all role players. Some
interesting issues were raised by counsellors and PWAs during the workshop. Training issues
including: a need for greater duration of the training period, greater emphasis on confidentiality,
helping counsellors understand their own limitations, and encouraging the counsellor to allow the
client to make their own decisions at their own pace.
Notes: 1 copy
Ref ID: 451
Keywords: Virus
HIV to test or not to test: is it a question? (1997). Director's report, 2, 2.
Abstract: In the old days, those dark old days when social gatherings were for fun, conversation
and partying, dinner parties, clubbing and even dates were focused on the pursuit of pleasure
and fun. Since the profile of HIV and AIDS increased to the level of everyday conversation, my
social life has died. I have become a 24 h, "on call" mobile, AIDS resource centre. Few events
pass by without me being drawn quietly into a corner or trapped in a public toilet to listen to
friends and colleagues agonising about whether they should be tested for HIV or not.
So what do you say to someone when they ask if they should be tested for he HIV virus?
Possibly, but there are also convincing arguments for choosing against being tested.
Notes: 1 copy
Ref ID: 113
Lay counsellor project (1998). Red Hot News, 3, 3-4.
Keywords: counsellor/counsellors/lay counselling/resources/social/support
12

Abstract: With the rate of HIV infections on the increase, demands for HIV/ AIDS counselling are
putting pressures on the current counselling services at two levels. Firstly, in terms of the need to
expand services in relation to the increasing number of people who are daily discovering their HIV
positive status. Secondly, to discover new counselling techniques and approaches that enable
creative management of the trauma and other social impact associated with sero-positive status
discovery, amidst limited resources. Counselling has a critical role to play in support of strategies
such as prevention of HIV infection, care and support of people affected by or infected with HIV.
Its importance as a strategic intervention to curb the spread of AIDS was recognised as early as
the 1990s when a national response to AIDS was being hammered out, and it is currently fully
entrenched in the NACOSA plan. The need to expand counselling services and to increase its
accessibility were also highlighted in the NACOSA plan.
Notes: 1 copy
Ref ID: 7511
(1998). Helping others living with HIV. The Natal Witness.
Keywords: community/disease/health/Department of Health/Nurse/response/Virus/WHO
Abstract: When Jabu Molefe was diagnosed HIV positive in 1993, she received no counselling
before her blood was taken. Neither the doctor nor nurses at the hospital asked for the
permission. The doctor merely said that Molefe, who had been to the hospital several times
because of painful tonsils, should have her blood tested. "After the results came positive I cried
and cried, right throughout the night", Molefe remembers. She says one of the problems at the
time was that HIV/AIDS was still very much taboo. However, one of Molefe's surprises was that
when she told her mother that she had been diagnosed with the dreaded disease, her mother
was very reassuring. "She told me that I was not dead yet and there was still a lot of things that I
could do in life". Her boyfriend did not believe her, and they separated. But in 1995, he was
diagnosed as having the virus too. However, her mother's prophetic words have proved true.
Molefe has been employed by the provincial Health department in its project called"faces"
"The main aim of the project is to show the face of a person living with HIV/Aids, because we
have found that people are more inclined to believe what they can see," Molefe said. In fact, the
13

position response can be seen in the fact that Mole has given talks to areas including Kimball,
Emendable, Escort, Poleax, Awardable and Blacksmith. She also helped form a support group
for people living with the Aids called Syphilis HIV/Aids outreach Programme. "I think God has
allowed me to live for so long so that I can help other fight against HIV/Aids", she said. Mole said
communities need to know that people living with HIV/Aids are people like everybody else, who
need to be cared for and loved.
Notes: 1 copy
Ref ID: 7609
(1998). A place where miracles can still happen. Eastern Provincial Herald.
Abstract: Rev. Underwood talks about the seriousness of AIDS disease. " We are going the road
of Uganda and Zaire. Do we want to be totally devastated or are we going to acknowledge that
we have a problem?" Said Rev. Underwood. The Haven, in which opened four years ago, is one
of the many struggling organisations at the forefront of a desperate battle in which the cards are
stacked heavily against them. We must face the fact that we are living in the era of HIV/AIDS.
We' ve got to build structures. Companies are going to have to work it into their policies because
their workforces and management are going to be weakened and dying. We' ve got to deal with
how we can prolong life expectancy.
In the Haven, nurses find it very hard. They're dealing with people who are hurting. It's not easy.
"The principles which make the programme at the Haven the success it is, are misleading simple
in theory, yet incredibility complex in practice - the right diet hygiene, and psychologogical and
spiritual support. Patients are trained in a unique regimen of "wellness management", a
programme which has now also been adopted by countries and organisations in South America.
Most patients are incredibly ill, some on the brink of death when they arrive at the Haven.
Astonishingly many have left to resume their lives. In the past two months, eight people have
died and 20 have returned home. But those who have left, now have the skills to keep
themselves relatively healthy and prevent, to some degree, the opportunistic infections taking
advantage of their weakened immune systems. The Rev Underwood maintains that even in the
14

dark shadow of Aids, miracles still happen.
Notes: 1 copy
Ref ID: 5802
(1998). Prejudice against Aids victims. The Daily News.
Keywords: community/employer/family
Abstract: Community workers have an uphill battle to help Aids sufferers.
Illness and now hunger and violent death - threaten to overwhelm the cash strapped Hillcrest
Aids Centre, near Durban. The centre provides for people with Aids from Field's Hill to
Camperdown. Centre director Neil Oosthuizen said there were 28 000 people terminally ill in the
area. The population was estimated at 80 000. In any given family in the area, at least one in
five had the HIV virus, he said. "Apart from counselling people with Aids and their families, we
are getting an evergrowing number of them who are also facing starvation. "We are forced to
arrange food parcel. Even that is not without its problems. Our helpers know that they are
caught handing over food parcels to people with Aids, they could be attacked and perhaps killed
by a hostile community". The head of the centre's feeding scheme, Moira Cooke, said she and
her co-worker had to meet people with Aids secretly to give them food. " We dare not do it
openly. There is great prejudice in the region against people who have Aids. Employers will not
keep them, schools will not admit their children, their homes are often burned down and they are
either killed or chased into the wilds" She said what was perceived to be a "simple act of
kindness" could result in gruesome death.
Notes: 1 copy
Ref ID: 6563
(1998). A refuge for those who have been abandoned. Sowetan.
Keywords: care/disease/Virus/WHO
Abstract: In a country where colour is no longer tolerated as a basic for differentiation, a new
denominator has taken its place- Aids. People infected with HIV find themselves increasingly
marginalised due to the public's ignorance about the disease, despite the fact that the virus was
15

first diagnosed as long ago as the early 1980s. "People who are infected and affected by HIV
live in isolated world without any hope, a world ruled by fear of being rejected once they disclose
they are living with HIV-Aids or are related to someone who is HIV positive, " said Pam Kisten,
managing director of Open Door, a drop-in HIV-Aids care centre. Situated amid the hustle and
bustle of Durban's city centre, where thousands of people go about their lives seemingly
unaffected and untouched by the trials and tribulations of their fellow city dwellers. Open Door on
330 to 332 West Street offers a refuge for people infected or affected by HIV-Aids. The centre
has been operating from Colonial Building since 1996 when Old Mutual responded to Open
Door's request for assistance and provided accommodation for the centre, free of charge, in one
of its properties.
Notes: 1 copy
Ref ID: 3164
(1998). Why drug "cocktails" fight virus effectively. The Cape Times.
Keywords: Africa/AZT/drugs/South Africa
Abstract: The arena of antiretroviral therapy (what the clinicians call the drugs that fight HIV
infection) is a confusing one. Anti-Aids drugs come with names that easily fill a mouth and most
of them are known be acronyms, which can be confusing in itself. New drugs are being
developed all the time and ongoing research adds to the knowledge about existing treatments.
Nothing is certain-except that people who take these drugs properly live longer and are healthier
than people who don't.
The drugs don't cure HIV infection, but have turned it from a fatal disease into a long-term
manageable one, with about 60% of people who take them responding so well that the virus
remains in their bodies. These people remain HIV-positive and are able to pass HIV to others.
Years of research has shown that all these drug work best when used together.-hence the
"cocktails" or combination therapies. If they are used alone the virus quickly learns to resist the
drug (through normal processes of mutation).
The drugs are all aimed at stopping the virus from reproducing, but are divided into three
classes according to how they do this.
16

.The first class to be developed were nucleoside analogues- or nucleoside analogue reverse
transcriptase inhibitors (NRTIS). The most famous of these is AZT, the first HIV treatment
discovered, which was launched in the US in 1987. Other well-known ones available in South
Africa are 3TC, ddl and d4t. These drugs mimic part of the virus' genetic material and work to
interfere with the virus' creating new copies of itself. The prices of AZT and ddl have dropped
dramatically in the last few months, to about R450 and R250 per person per month, respectively,
as drug companies fight to capture the market. The others range from R350 to R1 000.
.The newest class of drugs work at the same stage as NRTIS, but in a different way. They are
known as non-nucleoside reverse transcriptase inhibitors(NNRTIs). These drugs bind directly to
enzymes in the virus, upsetting the reproductive cycle. The only one of this class approved for
use in South Africa is nevirapine, which was registered two weeks ago. It cost about R1 200 for a
month's supply.
.The last class is the protease inhibitors, which work at the final stage of the virus' reproductive
cycle. The drug interferes with the newly made HIV proteins being cut into the small pieces
needed to build more viruses. Examples available here include saquinavir, ritonavir and indinavir.
These are the most expensive drugs to make and it is unlikely that their prices will drop
significantly. They cost about R2 000 a month.
.Another drug, which doesn't fit into these classes, is hydroxyrea. It was developed as a
treatment for cancer, but has been found to boost the effects of other anti-Aids drugs and reduce
the supply of DNA-building blocks that HIV need to reproduce. It is the cheapest of the drugs,
available for about R60 a month, and has shown promising results when used with ddf.
Clinicians typically select two drugs the first class and one from the third-although people
sometimes take four or five different drugs, and when resources are limited two drugs from the
first class are used alone. Other combinations are also being attempted. A big factor, of course,
is cost, with triple- combinator therapy costing up to R4 000 a month, depending on which drugs
are selected. Not all drugs work for all people, so clinicians often have to alter the combinations
used. Many of these drugs have unpleasant side-effects, such as rashes, nausea, vomiting and
fatigue. Patients have to take a large number of tablets, every day often stop the therapy or don't
17

follow the prescribed doses reliability. This can lead to drug-resistant HIV infection.
Notes: 1 copy
Ref ID: 2716
(1998). Prevention, not cure: Aids focus for Africa. The Citizen.
Keywords: Africa/prevention/Sub-Saharan Africa/traditional healer/UNAIDS
Abstract: Traditional healers claim a mysterious paste rubbed all over the body will provide
protection from the disease, while young men believe sleeping with a fat woman is safe because
Aids victims waste away before dying. But the epidemic marches on. On 31 million people
worldwide living with the human- immuno deficiency virus (HIV) that precedes Aids, 21 million are
in sub-Saharan Africa, the latest figures from UNAids. Africa is clearly the most affected area in
the world. Over 10% of all adults are HIV positive compared to one percent global average.
Africa could not afford to wait for scientists to find a cure or vaccine and must concentrate on
prevention. We have to face that in the next decade we will not have a vaccine deliverable to
people on a large scale. Prevention is the most important thing to focus on.
Notes: 1 copy
Ref ID: 2675
(1998). Joint initiative could reduce the costs of AIDS treatment. Business day.
Abstract: The long-term costs of treating Aids sufferers in SA, as well as the number of deaths
from the disease, could be drastically reduced through an initiative by the business sector,
medical aid societies and major pharmaceutical manufacturers.
Notes: 1 copy
Ref ID: 2154
Keywords: clinic
(1998). "Miracle" that two patients say saved them from death's door. Saturday Star.
Abstract: Can claims made by Shawn Stewart and his controversial clinic team be substantiated?
The Sunday Star retested two of Stewart's HIV-infected patients, whom he claimed had
18

significantly better" virus counts since undergoing oxytherapy.
Notes: 1 copy
(1998).
Voluntary counselling and testing: a prevention method for HIV/STDs: discussion paper.
Ref Type: Unpublished Work
Ref ID: 517
Keywords:
Africa/care/client/clients/communication/community/counsellor/counsellors/education/family/HIV
testing/impact/infection/information/knowledge/media/prevention/sub-Saharan/Sub-Saharan
Africa/transmission/Uganda/voluntary counselling and testing
Abstract: Non-medical prevention of HIV/STD infections is basically approached in three years:
* information campaigns that provide basic facts about HIV/STD transmission and prevention; the
focus is on increasing knowledge
* education and communication programmes designed to help people develop and maintain
healthy behaviours and change practices that entail transmission risks; here the focus is on
attitudes, motivation and commitment
* counselling on risk factors and possibilities for risk reduction, in which the focus is on supporting
action.
Though there is some overlap in these approaches, they usually address people with different
degrees of personal contact. Information campaigns tend to target large groups of people in an
impersonal manner, commonly using the mass media or disseminating printed materials.
Education and communication programmes often involve smaller groups of people in some type
of personal contact with programme implementers and educators.
Many counselling programmes involve one-on-one contacts between individual clients and
counsellors. However, some experimentation has been done with group counselling (especially
prior to HIV testing), while the concept of "community counselling" has become widespread in
19

sub-Saharan Africa. The latter involves community mobilization and/or follow - up to individual
counselling whereby significant persons in the client's social network (fami ly and community
members) are motivated to provide active support with the aim of enabling the client, family and
community to deal with the impact of AIDS. Community counselling includes aspects of
participatory education programmes. For example, a programme in Gaba, Uganda, developed
educational drama and music groups including both HIV-positive and -negative members, home
visiting and care, and referrals for individual counselling and testing; these activities contributed to
the cessation of discrimination against infected persons.
Notes: 1 copy
Ref ID: 6890
(1999). Opleiding om vigsslagffers raad te gee. Die Burger.
Abstract: Bellville - Die joan Cousin sending vir MIV/vigs-slagoffers hou van 23 tot 25 November
'n opleidingsessie vir kerkleiers, maatskaplike werkers en polisielede wat daagliks in aanraking is
met verkragtingslagoffers en diegene wat die vigsvirus het. Die doel van die sessie, wat by die
Mediese Navorsingsraad in Parow gehou sal word, is om die deelnemers in berading op te lei.
Die sending se kantoor is in Eersterivier gelee, en dit sal sy eerste sessie in die Wes-Kaap wees
waar vigsslagoffers se behoeftes bespreek sal word. Me. Qiaro Ali van die Beheersentrum vir
Siektes in Atlanta, Amerika, is een van die aanbieders. Openingsaand
Burgmeesters van die Stad Tygerberg, Kaapstad, KMR, Stellenbosch, Paarl, Wellington en
Oostenberg is genooi om op die openingsaand - 23 November - aan die sessie by die kantoor
van die wes-Kaapse premier, mnr. Gerald Morkel, deel te neem. Morkel is die hoofspreker by
die geleentheid. Volgens David van Neel, die woordvoerder van die sending, is die wes-kaap
een van die provinsies met die hoogste voorkmssyfer van MIV/vigs. "Ons, as 'n gemeenskap,
moet ons self help deur meer mense bewus te maak van die gevare van die vigsvirus," het van
Neel gese. Belangstellendes wat besonderhede oor die opleidingsessies verlang of meer
inligting die sending wil he kan Van Neel by 904-7397.
Notes: 1 copy
20

Ref ID: 6848
(1999). Vigsman glo in hoop. Beeld.
Abstract: NIck(36) is elf jaar gelede positief getoets vir die HI-virus. Nieteenstaande die feit dat
sy immuunstelsel byna geheel en al afgebreek is, is sy verhaal die van hoop. Thalyta Swanepoel
het met hom gesels.
Notes: 1 copy
Ref ID: 6489
(1999). Three thorny issues: living with AIDS. The Daily News.
Abstract: It is easy for us to get lost in the doom and gloom of what is presented about the
HIV/AIDS epidemic. Sadly, it is even easier for us to still believe that it will not happen to us. The
virus, minuscule in size, is powerful and demanding in the lessons that it has to offer, deceptive in
its live and formation, and silent and invisible in its line of infection. Within the drawining of the
New millenium, it is useful and appropriate to reflect on what has happened since this little virus
was first discovered in the early 1980. One should also look into the crystal ball and attempt to
identify some of the challenges that lie ahead of us in our continued struggle against HIV/AIDS.
Notes: 1 copy
Independent.
Ref ID: 7339
(1999). Hardest part of counsellor's job is being friendly, but not friends. The Sunday
Keywords: counsellor
Abstract: Six years ago, Gloria Sidyiyo thought Aids was "an American idea for destroying sex".
Today she is part of a network of HIV/Aids counsellors who provide support and caring to
hundreds of people living with Aids in Soweto. Sidyiyo witnesses the reality of HIV/Aids every
day in her work of hope Worldwide, an international NGO which opened its Soweto office in 1993.
She listens to men and women speak of the fear and pain of rejection,the anxieties of joblessness
and hunger, and the worries over children who are either HIV positive or will one day be
orphaned because of Aids. "The stressful par of this job is to see them die after you get to know
21

them. We're supposed to be friendly, but not friends. But as human beings you develop
relationships.
Notes: 1 copy
(1999).
National HIV/AIDS Counsellor Accreditation and Minimum: Standards Policy Committee.
Ref Type: Unpublished Work
Ref ID: 505
Keywords: community/counsellor/counsellors/health/HIV/AIDS counselling/impact/lay
counselling/policies/policy/supervision/training
Abstract: The minimum Standards National Workshop in March 1998 was convened by the
HIV/AIDS Directorate of the National Department of Health to address the issue of counselling in
HIV/AIDS. This initiative recognises that counselling is a pivot component of the national
HIV/AIDS strategy. In many respects HIV/AIDS counselling could be considered the crux of the
national strategy as it is a multi-pronged service which directly impacts individuals, groups and
communities. In respect of service-delivery, a large group of HIV/AIDS lay counsellors are seen
as indispensable to the service delivery of the counselling component of the national strategy.
Consequently, it was acknowledged at the Minimum Standards National Workshop that there is
an urgent need for a consensus generated policy, process and structure which will facilitate the
provision of quality lay counselling, training and supervision. Significantly, the accreditation
structure is envisaged as the implementation structure for the minimum standards policy.
Notes: 1 copy
Ref ID: 218
An overview of the AIDS Conference (2000). AIDS Analysis Africa, 11, 4-5.
Keywords: barriers/conference/Developing countries/NGO/response
Abstract: The XIII International AIDS conference, which was held in Durban in July 2000, was the
largest such conference ever to be held in a developing country. The theme break the silence
recognised the need to break down persistent prejudices and barriers and to allow for the
22

development of creative, collective responses to the epidemic.
The Conference programme included daily plenaries, 794 oral sessions, 16 community symposia,
64 skills-building workshops, 6 debates a two-day Community Indaba Forum, a cultural
programme, 4300 poster presentations, 66 commercial and 107 NGO exhibits, plus a number of
late breakers. From the stunning opening ceremony to the closing address by Nelson Mandela,
the organisers deserve to be warmly congratulated for creating a truly historic event.
Notes: 1 copy
Ref ID: 938
(2000). NG Kerk help stryd teen vigs. Rapport.
Abstract: Die NG Kerk gaan help om die gevolge van die vigsepidemie in Suid-Afrika aan te pak.
Sowat R 500 000 is reeds daarvoor bewillig. Luidens 'n berig wat Vrydag, op internasionale
vigsdag, in die NG Kerk se koerant, Die Kerkbode, verskyn het, het veral die kerk se algemene
jeugkommisie die afgelope tyd al meer betrokke geraak by die stryd teen vigs. Volgens dr Louis
Dressel, NG leraar in diens van die algemente sinode vir jeug, gaan R 100 000 per jaar vir die
volgende drie jaar aan die Hugenote Kollege in Wellington beskikbaar gestel word om 'n
vigssentrum daar op te rig. Die bekende leraar en vigslyer ds Christo Greyling, wat gereeld
landwyd voorlightingpraatjies ooor vigs lewer, is reeds genader om by die sentrum betrokke te
raak. Ander kerkgroepe sal ook genader word. Volgens prof. Attie van Wijk, rektor van die
Hugenote -kollege, kan die sentrum voorsien in behoeftes aan opleiding, ondersteuning,
berading, versorging en programme. Die kollegeraad het reeds in beginsel goedgekeur dat die
ondersoek na die vestiging van die sentrum kan voortgaan.
Notes: 1 copy
Ref ID: 8221
(2000). Who do you turn to if you test positive. The star.
Keywords: family/HIV testing/medical/policies/WHO
Abstract: Amid the wrangling over HIV/AIDS policy the people left to suffer most have been the
patients, says Dr Lizette de Lange, the general manager of medical affairs at Medicross Family
23

Medical an Dental Centres. If one has an HIV test, one is scared, she says. "Is there someone
who cares enough to help you deal with your fear and te body blow you get if you find out you're
positive?"
De Lange says a family doctor who is trained to deal with the issues is best suited to assist. She
says that Medicross has gone out of its way to ensure family practitioners are equipped to handle
HIV-positive patients. "In five years time we estimate that at some of our practices one in three
patients will be HIV -positive. With that kind of scenario in mind, all GPs simply have to get up to
speed on HIV treatment and counselling. "We feel that it's better for a patient to go through the
process of testing and coping with the result with someone he or she knows and trusts already,
rather than a stranger." Another potential source of help are medical laid schemes. "Patients are
afraid of making their condition known to the medical aid schemes, but the schemes expect HIV-
positive patients to surface at a rate of one to two percent of their patient base. They have drawn
up specific HIV disease management packages, which help to take some of the emotional and
financial burden of patients. But to benefit from the plan, the person has to register as an HIV-
positive patient," says De Lange.
Notes: 1 copy
Ref ID: 7882
(2000). AIDS for AIDS offers widespread benefits. The star.
Keywords: benefits/confidentiality/infection/medical
Abstract: AIDS for Aids (AFA) is a comprehensive disease management programme providing
members and dependants living with HIV/AIDS access to the following benefits:
. Confidentiality ;
. Regular consultations and tests;
. Counselling, including lifestyle and treatment compliance advice via the AFA Nurse-line;
.Vaccinations
. Medicines, including antiretrovirals ( anti-HIV medication); and
.Hospitalisation
Early detection of HIV infection means that preventive and other forms of treatment can begin
24

immediately. This lengthens and improves quality of life and decreases the chances of
unpleasant and costly infections. Schemes can contain costs by allowing their members access
to preventive medical care, so reducing the chances of unpleasant and expensive treatment,
which occurs if the condition is left unmanaged . The programme, available to all 50 schemes
administered by Med-scheme emphasises that HIV and AIDS affects everyone, and the
importance of getting tested. If your test shows you are HIV-positive, join AIDS for AIDS by
calling them, in confidence, on 0860 100 646, and asking for an application form.
Notes: 1 copy
Ref ID: 6501
(2000). Rolmodel. Die Burger.
Abstract: As meer mense die moed van Faghmeda Miller gehad het, sou die prentjie van
MIV/vigs in Suid-Afrika minder donker gewees het. Sou die stigma en veroordeling al minder fel
gewees het, die vrees vir openbaarmaking kleiner en gevolgik ook die risiko om die siekte op te
doen. Die rede waarom sy self met die MI- virus besmet is, is juis dat sy nie geweet het dat die
Malawier met wie sy teen die wense van haar gemeenskap getrou het, MIV-positive was nie.
Faghmeda, 'n jong vrou van Belhar wat ses jaar gelede die verskriklike nuus verneem het, in pas
in 'n landwye kompetisie van 'n vrouetydskrif as die vrou met Moed aangewys. Haar moed nie net
daar dat sy haar aanvanklike wanhoop en vrese oorkom, haar geheim openbaar gemaak en
groot projekte aangepak het om ander MIV/vigsleers te help en te inspireer nie. Dit le ook en
veral in die feit dat sy as 'n streng gelowige Moslem vrou gevaar geloop het dat haar
gemeenskap haar oor haar siekte sou verwerp. Sy het egter met die steum van haar familie die
uitdaging aanvaar. 'n suksesvolle ondersteunings groep vir Moslems met vigs begin en 'n Derde
droom om Mekka te besoek- word in Januarie bewaarheid wanneer sy en haar ma daarheen
vertrek. Deur haar moed het sy gehelp om die stigma rondom die siekte te laar verklein en dit vir
ander lyers makliker gemaak om haar voorbeeld te volg, ook hul siektetoestand openbaar te
maak en tot die stryd teen die siekte toe te tree. Dye hydrae wat mense soos sy en hulle tot die
stryd kan waarsku en met begrip en deernis met ander lyers kan praaf. Maar om hierin 'n
voorbeeld te stel, moet van Faghmeda enorme dapperheid geverg het. 'n Moedige rolmodel - dit
25

is sy inderdaad.
Notes: 1 copy
Ref ID: 6537
(2000). AIDS victims' trust launched. Eastern Province Herald.
Abstract: East London - Health activists opposed to the Government's refusal to provide drug
treatment for people with HIV/AIDS have set up a trust to fund clinics to give counselling, testing
and anti - retroviral drug therapics to HIV-positive pregnant women, PAC health secretary Costa
Gazi announced yesterday. Some criticism on Mbeki view that HIV does not cause AIDS have
been mentioned.
Notes: 1 copy
Ref ID: 5441
Keywords: myth
(2000). Engaging the AIDS enemy. City press.
Abstract: Doctors are now challenged to think laterally. We also need to develop ourselves
further and learn all there is to know about the disease. Several black doctors have set up
institutions to help combat the spread of AIDS. Doctors have to start with the basic explanations
of differentiating between HIV and AIDS, as this is still confusing may of our people. It is also the
doctor's duty to clear myths about the disease. The most important aspect is to arm your patient
with factual, accurate and current knowledge. Doctors HIV and AIDS say doctors need to have a
more normal relationship with patients. Counselling needs to be a life-long process.
Notes: 1 copy
Ref ID: 2934
(2000). Die hartseer van vigs. Die Volksblad.
Abstract: Die hartseer van MIV/vigs is dat verdeeldheid op vele enige poging om die groeiende
krisis hok te slaan. Skaars was die woored van politici koud dat die Mbeki- vigspaneel se beraad
die na week 'n "mors van tyd" (en geld was en weinig meer insig gebring het as om bloot die
tweespalt tussen "vigsafvalliges" en ortodokse wetenskaplikes te beklemtoon, of die vigsdebat
26

vandeesweek in die parlement le die groeiende spanning en wantroue tuseen die regering en die
internasionale farmaseutiese bedryf nogmaals bloot. Die hoof van die Farmaseutiese
Vervaardigersvereniging (F VV), mev. Mirryena Deeb, het die regering voor die bors gegryp oor
sy versuim om die epidemie behoorlik te pak. Hoe kan 'n regering wat R 30 miljard aan
verdedigingsaankope bestee, se hy het nie geld vir vigsbehandeling nie, het st gevra. Pres.
Mbeki is gestriem oor sy "gebrek aan prioriteirte". "Ongegronde verskonings," soos die beweerde
buitengewone giftigheid van teen-retrovirale middels, word gebruik om nie meer geld te bestee
aan die behandeling van vigs nie. Sy had reg dat 'n land " waar tot 50% van staatsmedisyne
gesteel word", sal sukkel met geld vir medisyne en dus ook om die epidemie in bedwang te bring.
Dis harde woorde wat hopelik ter harte geneem sal word. Die debat oor of die MI-virus vigs
veroorsaak of nie, is irrelevant. 'n Antwoord moet gevind word oor hoe die krisis nou gehanteer
moet word en watter behandeling nou die doeltreffendste is. En dit kan slegs deur samewerking
geskied.
Notes: 1 copy
Ref ID: 3041
(2000). Health care cost projections. Business day.
Keywords: clinic/employment/health/medical/population/primary health care
Abstract: Public and private sectors: One of the most immediately evident economic
consequences of the HIV/AIDS epidemic is the increasing need for resources for caring for AIDS-
sick persons. Although these are not routinely measured, they can be estimated using
demographic projection models and currently observed HIV-associated health care costs. South
African health care is characterised by two distinct funding and provision environments. Private
health care is funded mainly via employment - related medical schemes, covering around 20% of
the population. The balance of the population make use of publicly funded hospital and primary
care clinic system funded out of general tax revenue. Although public hospitals are required to
charge means tested user fees, services are essentially free of charge. A model has been used
to project likely health care expenditure increases due to AIDS in both public and private sectors.
This approach assumes that levels of care offered early on in the epidemic (1992 to 1996) will be
27

maintained despite increasing levels of illness. The model thus gives an estimate of likely costs
should all needs continue to be met at mid-1990s levels. Both public and private sectors will be
seriously affected by the HIV/AIDS epidemic, with seroprevalence levels in the total population
reaching 13% and 9% respectively by 2010 under a best scenario projection. The effects the
situation in the public sector can easily be confirmed by using antenatal seroprevalence data,
there is little confirmatory
Notes: 1 copy
(2000). Tonic for diseases in leaves: Cancer Bush may improve appetite and mood of
AIDS and TB sufferers. The star.
Ref ID: 2521
Keywords: benefits/infection
Abstract: Southern African plant could help AIDS and TB sufferers by improving appetite, possibly
suppressing secondary infections, and elevating mood, and in so doing dramatically improve the
quality of their lives. Tablets made of milled leaves of a carefully selected variety of Sutherlandia
or Cancer Bush is not being touted as a "cure" for AIDS, TB, or cancers by the multi-disciplinary
team of scientists researching and developing it. Rather, it is a profound tonic with multiple
mechanism of action. The cancer Bush has been used by indigenous healers and rural folk of
Khoikhoi descent for hundreds, and possibly even thousands, of years as a remedy for diverse
ailments, in including cancers, TB, peptic ulcers, diabetes and all infectious diseases. Some of
the important benefits of the plant have been documented for the time in a book called People's
Plants (Briza), written by Rand Afrikaans University Botany professor Ben-Erik van Wyk, and
Cape Town-based doctor, Nigel Gericke.
Notes: 1 copy
Ref ID: 2384
(2000). Time to drop politically correct jargon about disease. Eastern Province Herald.
Abstract: Pastor A A Kern of the Potter's House Christian Church in Port Elizabeth writes that it is
time to stop promoting condoms as a solution to the AIDS problem rather than as an excuse for
28

immoral behaviour.
Notes: 1 copy
Ref ID: 2385
(2000). AIDS: End the secrecy. Eastern Province Herald.
Keywords: ethics/male/medical
Abstract: Both the medical profession and the public must take up to the realities surrounding
HIV/AIDS before the problem can be tackled. Linda Jones is to be congratulated on having the
courage to publicly make the statements and ask the questions she did in her Herald article"
AIDS: Where should the treatment end?" It is time that we, both in the medical profession and
the public, face up to and start to address the realities involved. She has set a number of
questions that we as doctors ask ourselves daily and she touches on a number of very practical
points with regard to the treatment of patients with HIV/AIDS. The ethics and views surrounding
the pandemic of HIV has, as she very rightly stated, are being strongly influenced by the manner
in which it surfaced and the sensitivity of the male gay group to the attitude of some of their
disease been discovered in a heterosexual group, it would not have developed the notoriety that
it has.
Notes: 1 copy
Ref ID: 1659
(2000). AIDS: Where should treatment end? Eastern Province Herald.
Abstract: The Eastern Cape government is groaning under the huge health and welfare burden
we carry. A significant part of this burden now comprises HIV positive patients with AIDS-related
infections such as tuberculosis. No extra beds have been created for this extra burden, and the
stated government policy for them is home management. Yet nobody has had the courage to
commit to hospital play anything short of active management to the last gasp. And finally Linda
Jones, a general surgeon at Livingstone Hospital asks "how far should the state go in the
treatment of AIDS without actually spreading the disease?
Notes: 1 copy
29

Likely impacts of HIV/AIDS on the Departments of Education, Health, and Public
Services and Administration: Summary Results of Studies Commissioned by Government from
Abt Associated (South Africa). (2000).
Ref Type: Unpublished Work
Ref ID: 552
Keywords: National policy
Abstract: This paper gives a highlight on three studies of likely sectorial impacts of HIV/AIDS
commissioned by Departments of Education, Health and DPSA. It gives also the reports
delivered in last few months, and a short summary of selected key results of the studies to
accompany Cabinet memorandum.
Notes: 1 copy
Re: Project plan: Voluntary HIV Counselling and Testing (VCT): Free State. (2000).
Ref Type: Unpublished Work
Ref ID: 555
Keywords: Voluntary HIV counselling and Testing/VCT
Abstract: This document contains a proposed project plan for voluntary HIV counselling and
Testing (VCT) in Free State
Notes: 1 copy
HIV/AIDS: recent policy decisions. (2000).
Ref Type: Unpublished Work
Ref ID: 553
Keywords: policy/policies/intervention/prevention/mother-to-child
transmission/transmission/MTCT
Abstract: In the 2000/01 financial year the HIV/AIDS and STD Programme focused on planning
for major programmatic interventions over the next 3 years. The primary policy drive was focused
on:
*The integrated Plan for Children Infected and Affected by HIV/AIDS; and
30

* Prevention of Mother-to-Child Transmission of HIV (MTCT).
Notes: 1 copy
Ref ID: 579
Criteria VCT for site selection (in press).
Keywords: HIV prevalence/population/VCT
Abstract: The decision on the number of VCT sites should be based:
* On the population of that district
* HIV prevalence rate
* Linkages with welfare services
* Linkages with the Regional / district laboratory service.
* Capacity in term of infrastructure
* For better access to VCT services the VCT sites should be spread proportionally in terms of the
geographic location
* The selection of sites in rural, urban, peri-urban should be proportional.
Notes: 1 copy
Ref ID: 582
Accreditation of HIV/AIDS counsellors, trainers and mentors (2000).
Keywords: counsellor/counsellors/health/HIV/AIDS counselling/lay
counselling/policies/policy/supervision/training/WHO
Abstract: The department initiated A process of developing minimum standards. A need of
accrediting those counsellors who meet these standards was identified. Therefore the
accreditation of HIV/AIDS counsellors formed part of these minimum standards. In October 1999
the minimum standards were finalised and the Department adopted them in February 2000.
The minimum Standards National Workshop in March 1998 was convened by the HIV/AIDS
Directorate of the National Department of Health to address the issue of counselling in HIV/AIDS.
This initiative recognises that counselling is a pivotal component of the national HIV/AIDS
strategy. In many respects HIV/AIDS counselling could be considered the crux of the national
31

strategy, as it is a multi-pronged service with directly, a large group of HIV/AIDS lay counsellors
are seen as indispensable to the service delivery of the counselling component of the national
strategy. Consequently, it was acknowledged at the-Minimum Standards National Workshop that
there is an urgent need for a consensus generated policy on minimum standards for HIV/AIDS
counselling and an accreditation policy, process and structure which will facilitate the provision of
quality lay counselling, training and supervision. Significantly, the accreditation structure is
envisaged as the implementation structure for the minimum standards policy.
Notes: 1 copy
Ref ID: 424
Counselling and HIV/AIDS (2001). Africa Journal of nursing and midwifery, 3, 7.1-7.7.
Keywords: caregiver/communication/counsellor/counsellors/health/HIV/AIDS
counselling/information/Nurse/transmission
Abstract: Numerous studies suggest that good counselling assists people to make informed
decisions, cope better with their health condition, lead more positive lives, and prevents further
transmission of HIV. HIV/AIDS counselling is sometimes provided by trained counsellors, though
nurses and caregivers are often in ideal position to provide effective counselling, advice, and
support. However, when nurses and caregivers are busy, emotional caring and support are often
overlooked, despite evidence that providing emotional support does not take only longer than not
providing such care. Frequently, nurses and others indicate that they do not know how to provide
more subtle counselling and emotional support and therefore avoid this aspect of care. The
following pages provide useful information about effective communication in the context of
providing care to HIV/AIDS patients.
Notes: 1 copy
Ref ID: 444
Continuum of care (2001). Africa Journal of nursing and midwifery, 3, 3-1-3-8.
Keywords: community/education/family/government/prevention/social support
Abstract: Comprehensive care involves a network of resources and services which provide
32

holistic, comprehensive, wide ranging support for people living with HIV/AIDS (PLHA) and their
families. A continuum of care includes care between hospital and home over the course of the
illness. There are many issues that need to be addressed before continuous can be provided.
There need to be adequate resources ( financial, supplies, services, staff, volunteers, government
and community support), and connections between them. Care must incorporate clinical
management, direct patient care, education, prevention counselling, palliative care and social
support.
Notes: 1 copy
Ref ID: 530
(2001). The good news. Natal Witness.
Keywords: health/HIV/AIDS counselling/infection
Abstract: The rate of HIV infection in the North West province had dropped by 0,2% from 23,1%
to 22,9%. MEC for Health Molefi Sefularo says his department has embarked on several
programmes in an attempt to stem the HIV/AIDS tide. The department has increased its
voluntary HIV/AIDS counselling and testing sites from 11 to 55 and plans to open more in the
near future.
Notes: 1 copy
An assessment of Voluntary Counselling and Testing (VCT) sites in South Africa. (2001).
Ref Type: Organisational research report
Ref ID: 548
Keywords:
acceptability/Africa/care/client/clients/community/counsellor/counsellors/government/health/HIV
testing/rapid testing/South Africa/transmission/VCT/voluntary counselling and testing
Abstract: VCT is an entry points for the continuum of care:
> Counselling, care and support
> HIV testing
>Prevention and care
33

Medical care
>Prevention of parent to child transmission
>Emotional and spiritual care
>Social and community support
Aim: To assess all the government VCT sites to inform the Department of Health regarding the
VCT implementation process and progress made.
Objectives:
Clients to:
>Assess accessibility and acceptability and develop strategies used to enhance these.
>Understand client's motivation for VCT service update or decline
> Assess if VCT is indeed voluntary and confidential in the sites
VCT Service Delivery and Organisations to:
>Measure the number of HIV tests conducted at me VCT sites and compare these against the
target
>Identify factors necessary for efficient and effective VCT services
>Assess the quality and types of counselling being provided in all sites
>Assess the adherence to quality assurance measures for rapid testing in the sites.
Staff and Key informants to:
> To measure the number of trained counsellors and assess staff work load and skills gained
> Assess the views and measures ensuring effective delivery of VCT service
>Assess the views for up-scaling and roll-out of VCT services.
Notes: 1 copy
VCT Quarterly report: September - November 2001. (2001).
Ref Type: Unpublished Work
34

Ref ID: 578
Keywords: information/VCT
Abstract: Eight out of the nine Provinces submitted their quarterly reports. The information in
some of the reports is inaccurate and there are discrepancies. Although a standard reporting
format was distributed to Provinces, important information is left out in some of the reports, as
some of the Provinces used their own formats which does not yield the expected information.
Notes: 1 copy
(2001).
VCT Progress report: for the evaluation of the national integrated plan - November 2001.
Ref Type: Unpublished Work
Ref ID: 580
Keywords: evaluation/medical/Nurse/VCT
Abstract: VCT sites: list has been compiled and will be updated regularly to accommodate
expansion of VCT sties. VCT sites have successfully expanded. Out of 495 VCT sites identified,
359 are operational. Most of the sites are medical sites.
Challenges:
Out of the sites that are operational less than 1% are non-medical sites. The problems faced by
Provinces are that it is difficult to get a nurse on loan to perform HIV rapid test for the non-medical
sites.
Although the majority of the VCT sites are operational, the uptake in these sites is very low. This
raises a very serious concern. One of the reasons sited for the low uptake is lack of marketing of
the VCT services offered by the site as well as a limited VCT promotional material.
Notes: 1 copy
Programme - VCT stakeholders meeting. (9-14-2001).
Ref Type: Unpublished Work
Ref ID: 8799
Keywords: VCT/VCT
35

stakeholders/strategy/prevention/medical/counsellors/counsellor/health/confidentiality/information
Abstract: The purpose of the meeting was to review progress made on the strategy for prevention
that was adopted in February 2000. Issue to be discussed were establishing VCT in non medical
sites, Stipends for HIV/AIDS counsellors
The use of non-medical health workers to administer the rapid test. Defining boundaries of
confidentiality, data collection and information safe keeping and accessibility to VCT services
Two day consultative workshop to develop a national care policy framework for HIV
treatment, care and support. (2-13-2001).
Ref Type: Unpublished Work
Ref ID: 8800
Keywords: care/policy/policies/treatment/intervention/National policy
Abstract: The objective of this workshop is to develop a detailed policy framework for HIV
treatment, care and support that will establish specific policy recommendations to the South
African National AIDS council and ultimately guide the National Department in delivering its
HIV/AIDS programmes and interventions within a clearly defined National Policy.
Echo.
Ref ID: 8802
(2001, July 4). How does voluntary counselling and testing help you? Natal Witness -
Keywords: voluntary counselling and testing
Ref ID: 4892
Keywords:
(2002). Anglo Gold faces AIDS, TB pressures. Star.
Africa/clinic/drugs/employee/family/health/medical/prevention/research/response/South
Africa/tuberculosis
Abstract: AngloGold is developing the needs of a motivation, skilled and experienced workforce
geared to the needs of a globally competitive company. Colin Eisenstein, medical consultant to
AngloGold, says part of this broad strategic goal includes providing healthcare to the company's
36

employees at no cost to the majority of workers. Eisenstein sats the major challenge facing the
group's South African operations is the spread of HIV/AIDS, and the resultant resurgence of
tuberculosis (TB). The company has developed a comprehensive response to HIV/AIDS which
includes preventative management, and managing the disease in those who are HIV positive,
along with sensitivity in dealing with affected families and communities. Eisenstein says the
company is looking at the issue from a practical and business point of view. " HIV is no different
from other epidemics and one should apply the same principles when dealing with this one." He
says AngloGold's approach is to apply different strategies when dealing with HIV positive people
and those who do not have the virus. "This entails reducing the spread of HIV by making sure
that those who are not infected stay HIV negative. AngloGold has been heavily involved in AIDS
education for its employees since the 1980s. "But education is seen only as a long-term solution,
" says Eisenstein. In response to the short-term limitations of educations, AngloGold has
developed a wellness programme which comprises voluntary counselling, testing and prevention
clinics, offering HIV-positive employees affordable and effective therapies to extend their
productive life and well- being. Eisenstein says the group's focus has been to keep diseases
such as TB at bay, which where the leading killer in South Africa. He says there should be an
increased effort in treating opportunistic diseases in order to improve the quality of employees'
lives and to prolong the productive life of the employee. The use of anti-retroviral drugs from only
a part of a total management approach. "Increasing the life span of HIV positive people has to be
done in a rational, affordable and sustainable way, " he says.
Furthermore, it is important to ensure that the financial and logistical resources are intact and
robust to facilitate the monitoring and administration of anti-retroviral drugs." Through Aurum
Health, the largest privately-funded research organisation in the world, AngloGold is also
involved in HIV vaccine research. "This is, of course the ultimate solution, but an HIV vaccine is
still a long way out of our reach. He says the group's prevalence survey shows that the HIV
seroprevalence rate was slowing and stood at about 25 percent in 1998.
Notes: 1 copy
37

Ref ID: 375
- (2002). Sociology of Health and illness, -, -.
Keywords: Africa/caregiver/client/clinic/clinic staff/community/Community caregivers/Home
care/South Africa/symptom
Abstract: The aim of this study was to describe the practice of community caregivers in a home-
based AIDS care project at seven sites in South Africa.
The community caregivers felt positive about the contribution they made, but found it difficult to
cope with the poverty and complexity of problems they were faced with. They visited each client
an average of five times per month, and their care usually involved counselling and informing,
symptom control, psychosocial support and welfare assistance. The caregivers worked in close
collaboration with the South African Hospice Association and clinic staff, and each site developed
a work pattern suitable to its resources
Notes: 1 copy
Work Plan and Budget: 2002 / 2003: Programme Area; Voluntary Counselling and
Testing (VCT). (2002).
Ref Type: Unpublished Work
Ref ID: 535
Keywords: voluntary counselling and testing/VCT
Abstract: The paper is just a plan and Budget for 2002 / 2003
Notes: 1 copy
Ref ID: 544
Counselling programme (in press).
Keywords: community/counsellor/counsellors/government/HIV/AIDS
counselling/impact/prevention/VCT
Abstract: HIV/AIDS counselling should be considered the crux of the national strategy, as it is a
multi-pronged service, which directly impacts individuals, groups and communities. In respect of
service delivery a large group of HIV/AIDS lay counsellors are seen as indispensable to the
38

service delivery of the counselling component of the National Strategic plan. Consequently
Government acknowledges the importance of the counselling service as a means of prevention.
VCT has a vital role to play within a comprehensive range of measure for HIV/AIDS prevention
and support, and should be encouraged.
Notes: 1 copy
VCT Progress report. (2002).
Ref Type: Unpublished Work
Ref ID: 545
Keywords: KwaZulu-Natal/VCT
Abstract: This paper gives the progress report on different provinces such Free State, Western
Cape, Northern Province, Eastern Cape, KwaZulu-Natal, Northern Cape Province, North West
Province, Gauteng, Mpumalanga,
Notes: 1 copy
National VCT Monitoring and Evaluation plan. (2002).
Ref Type: Unpublished Work
Ref ID: 570
Keywords: behaviour change/evaluation/information/knowledge/on-site/performance/VCT
Abstract: Monitoring and Evaluation aims at describing the data, tools and analysis of the key
information obtained on progress and effectiveness of the VCT services. This should be done
timeously and be able to disseminate the required information about the performance of the
programme. This document will describe tools currently used as well as the procedures for data
capturing.
The VCT programme is monitored at different level, i.e. National, Provincial, district and on sites.
The purpose of Monitoring and Evaluation is :
* To help the programme focus on key areas of implementation.
* To assist in tracking changes over time.
* To be able to compare progress with other countries.
39

* To be able to measure how the programme is progressing .
* To help in measuring long-term outcome indicators i.e. behaviour change, attitude, knowledge
etc.
Notes: 1 copy
Establishment of VCT sites to strengthen the current sites. (2002).
Ref Type: Organisational research report
Ref ID: 574
Keywords: counsellor/counsellors/intervention/supervision/VCT
Abstract: In scaling up to VCT sites there are challenges that are related to the implementation.
Provinces have identified 495 VT sites that are earmarked for expansion, out of these, 359 are
operational.
The pace that Provinces are required to adopt in making services available in increase the
pressure for the Provinces to identify more and more sites. This drive towards quantity is a threat
to the provision of quality services as more effort is put to open more sites rather than to ensure
the quality of counselling service provision.
The national department is the key partner in the initiative of increasing access to VT. Its role is
to provide strategic leadership, guidance and support to provinces. In so far as the
implementation is concerned a maximum support has been give to the Provinces and we are
continued to do so.
In dealing with the issue of the provision of quality of VT services in the operational sites, it is
proposed that model sites be established. These sites will be used as demonstration sites. This
will provide Provinces with an opportunity of learning about the best practices. It is envisaged
that the learning process will be about the following:
* The provision of and maintenance of quality counselling services.
*A best approach to the supervision and support of HIV/AIDS counselors.
*The use of a well-developed system of data collection
*The Conducting local marketing interventions for promoting local VT services
* The use of monitoring tools to obtain the necessary data.
40

Percentage of Provincial Hospitals and Clinics where Voluntary HIV Testing and
Counselling is available and accessible. (2002).
Ref Type: Unpublished Work
Ref ID: 575
Keywords: clinic/counsellor/HIV testing/information/WHO
Abstract: Information is not currently available regarding the numbers ( and percentages) of
provincial hospitals and clinics were voluntary HIV testing and counselling is available and
accessible. The following estimated scenario however prevails.
With regard to the hospitals, the following estimation exists - about 80-90% of provincial hospitals
have at least on practising HIV counsellor, although they might have about 70% of trained
counselling.
Clinics-Urban based clinics have about 60% of trained counselors. Most clinics in outskirts areas
(+/- 80%) do not even have HIV/AIDS counselors. There is a big gap between the numbers of
people trained as HIV/AIDS counselors and that of those who are actually doing counselling. The
drop out rate of trained HIV/AIDS counselors is very high. It is estimated to be about +/- 95%.
Notes: 1 copy
Voluntary counselling and testing programme - operational plan 2002 - 2003. (2002).
Ref Type: Unpublished Work
Ref ID: 577
Keywords: community/education/health/population/voluntary counselling and testing/youth
Abstract: To provide HIV counselling and testing to 12.5% of the adult population ages 15-49
years within three years targeting the youth and rural communities through improving linkages
between health, welfare and education sectors at district level.
Notes: 1 copy
Executive summary of the VCT stakeholders meeting and recommendations. (2002).
Ref Type: Unpublished Work
Ref ID: 583
41

Keywords: care/client/clients/clinic/counsellor/counsellors/medical/Nurse/on-
site/supervision/VCT/VCT stakeholders
Abstract: Issues raised around the VCT strategy:
* It is broad, does not address specifics that arise in the VCT sites
* Using existing staff to do HIV counselling is an add on job and has implications for sustaining
counselling services.
* In non-medical sites the issue of non-health care workers not being allowed to perform the test
and yet it is difficult to get a nurse on loan for a non-medical site.
* What is a non-medical site? The Department needs to give clear guidance on site selection
especially non-medical sites.
* There is a discrepancy between the targets of the VCT strategy and the capacity of Provinces to
deliver.
* There is an urgent need to provide support and mentorship / supervision to counsellors in-order
to prevent burn out and increase skills thereby increase quality of service provision.
HIV counselling issues and challenges raised:
* Different type of incentive for lay counsellors
* The marketing strategy to promote and encourage people to come to testing is needed.
* Need for more relevant VCT material
* Getting around the legality of a lay counsellor performing the HIV rapid test
* A need for more statistical gathering in the VCT sites
* How many clients can each counsellor see a day? Need guidance in this area.
* Is there a national body for counsellors?
* How voluntary is the VCT in the medical sites? Are people accessing the sites because they
are already in the clinics? How much self-referral is there?
Notes: 1 copy
Voluntary counselling and testing (VCT) business plan: 2002-2005. (2002).
Ref Type: Unpublished Work
42

Ref ID: 595
Keywords: business plan/care/infection/intervention/knowledge/population/prevention/risk
behaviour/social support/VCT/voluntary counselling and testing/WHO
Abstract: Voluntary counselling and testing is a cornerstone for early access to prevention as well
to care and support services. High public awareness of HIV, increasing numbers of person sick
and dying with AIDS, and knowledge of personal risk behaviours results in as increased desire to
learn one's serostatus. The need for VCT is increasingly compelling as HIV infection rates
continue to rise and countries recognise the need for their population to know their serostatus as
an important intervention and intervention tool. Those people who learn they are seronegative
can be empowered to remain disease-free. For those HIV infected would have an opportunity to
seek early intervention and as well as receive the required social support services. VCT plays an
essential role at many levels.
Notes: 1 copy
KwaZulu-Natal Voluntary Counselling and Testing: sites for phase 1. (2002).
Ref Type: Unpublished Work
Ref ID: 596
Keywords: community/HIV testing/KwaZulu-Natal/response/VCT/voluntary counselling and
testing
Abstract: The Province decided to start the VCT program in phases, with a view of getting the
community response and then go full scale. A one day VCT workshop which aims at exploring
the implications of voluntary HIV testing and counselling and sharing experiences with
organisations / programmes that had already started the programme has been planned for the
29. 06.00. It is hoped that the province will learn a lot from this discussion before it embarks on a
full scale programme. Participants will be predominantly from the proposed sites for phase 1.
KwaZulu-Natal is committed to budget for the subsequent years following the withdrawal of
National funding.
Notes: 1 copy
43

Ref ID: 597
Keywords: VCT
Development of VCT rollout plan (in press).
Abstract: The paper contains a development of VCT rollout plan.
Notes: 1 copy
Ref ID: 598
Development of VCT guidelines. A Workshop report (2002).
Keywords: VCT/guidelines
Abstract: This paper contains just the minute of the workshop report.
Notes: 1 copy
Provincial HIV/AIDS meeting. (2002).
Ref Type: Unpublished Work
Ref ID: 599
Abstract: This paper contains various minutes of provincial HIV/AIDS meeting.
Notes: 1 copy
VCT Assessment meeting. (2002).
Ref Type: Unpublished Work
Ref ID: 600
Keywords: VCT
Abstract: This paper contains a minute of a VCT assessment meeting
Notes: 1 copy
Ensuring a public health impact of programs to reduce HIV transmission from mothers to
infants: the place of voluntary counselling and testing. (2002). American Journal of Public Health,
92, 347-351.
Ref ID: 8822
Keywords: health/impact/HIV transmission/transmission/voluntary counselling and
44

testing/government/HIV testing/care/pilot
projects/Africa/drugs/women/barriers/barrier/community/education/men/intervention/treatment/HI
V-status
Abstract: Since 1999, many African governments have launched programs to offer short-course
antiretroviral drug regimens to reduce mother-to child transmission of HIV. HIV testing in prenatal
care is the gateway to these antiretroviral regimens. Pilot projects in Africa show an uptake of
antiretroviral drugs in 8% to 50% of pregnant women presumed to be HIV infected; often, a
minority of eligible women in care received these regimens. Use of lay counselors and rapid
onsite HIV testing may alleviate health service barriers. Community education to promote
voluntary counseling and testing, which involves men, is the long-term solution. In the short term,
possibilities to enhance delivery of an effective intervention include group pretest counseling,
universal offer of testing with women having the right to "opt out," universal treatment (mass
treatment for those whose HIV status is not determined by voluntary counseling and testing),
universal testing with women having the right to "opt out" of learning their test results, and mass
treatment for all without testing.
VCT a new challenge for the DHS. (2003).
Ref Type: Unpublished Work
Ref ID: 8793
Keywords: VCT
Abstract: An effective response to HIV/AIDS would be to try and reduce the number of new
infections, expand access to care and treatment for people with HIV/Aids and to soften the impact
of the epidemic on social and economic development.VCT is considered as one of the most
essential, cost-effectve interventions that offers multiple advantages and gains in the prevention,
treatment, care and support terrain Greater use of voluntary counselling and HIV testing is an
important key to encouraging changes in risky behaviour and effective prevention. Like many
other policies, the concept of VCT has not yet been well interpreted by many stakeholders and a
modified version is cascaded downwards throughout the system as most top-down HIV
45

interventions. The aim of VCT is not persuading people to be tested. VCT stands for voluntary,
which means a decision taken by the person themself.
In a nutshell - In 'n neutedop. (2003).
Ref Type: Unpublished Work
Ref ID: 8794
Keywords: guidelines/counsellors/counsellor
Abstract: Counselling JOurnal insert offering guidelines for HIV/AIDS counsellors
A time to VCT. (2003).
Ref Type: Unpublished Work
Ref ID: 8796
Keywords: VCT/guidelines/sex/behaviour change
Abstract: This paper contains guidelines and reasons of VCT promotion.The process of
counselling and testing is a higly cost-effective way of reducing unsafe sex and consequently the
spread of HIV. Factors which make for a successful VCT service are good quality counselling.
Some studies have shown that where counselling is of a poor quality, the process of VCT may be
counterproductive in terms of behaviour change.Guidelines are given in the form of a model
Abdool Karim, Q. A., Abdool Karim, S. S., & Nkomokazi, J. (1991). Sexual behaviour and
knowledge of AIDS among urban black mothers: Implications for AIDS intervention programmes.
South African Medical Journal, 80, 340-343.
Ref ID: 64
Keywords: condom/condoms/knowledge/mother/mothers/prevention/sexual
behaviour/urban/Young people/youth
Abstract: Questionnaires were administered to 122 urban black mothers of teenagers in order
to:I) understand aspects of their sexual behaviour and knowledge of the acquired
immunodeficiency syndrome(AIDS); and ii) assess their communication with their teenage
children with regard to AIDS and sexual behaviour. The subjects comprised a 12,5% random
sample of all houses in Lamontville, a black township south of Durban. The level of AIDS
46

knowledge among mothers was high, while their sexual behaviour, characterised by a high
pregnancy rate and high proportion who have had children by more than one consort, placed
them at high risk of acquiring human immunodeficiency virus (HIV) infection. No mother had
experienced sexual intercourse during which her partner used a condom. Communication with
their teenage children was poor; none of the mothers had spoken with them about AIDS and
89,3% had not discussed contraceptive methods with their teenage children. We found that
urban black mothers were at high risk of acquiring HIV and, despite their knowledge of the modes
of transmission and prevention of HIV infection, they had not begun using condoms as a risk-
reducing measure, nor had they communicated the risk of unprotected sex to their teenage
children. We recommend that AIDS intervention strategies should not concentrate only on
passing on knowledge but also on providing women with the communication skills to negotiate
the use of condoms with their partners and to convey the risk of HIV infection to their teenage
children.
Notes: 1 copy
Abdool Karim, Q. A., Abdool Karim, S. S., & Preston-whyte, E. (1992). Teenagers
seeking condoms at family planning services. South African Medical Journal, 82, 360-362.
Ref ID: 164
Keywords: clinic/condom/condom use/evaluation/family planning/prevention/teenagers/Young
people/youth
Abstract: This study assessed the ability and preparedness of staff at family planning clinics in
Durban to assist in AIDS prevention by promoting condom use among teenagers. Staff at 12
randomly selected clinics were interviewed to assess their attitudes towards teenagers seeking
condoms, the information imparted on AIDS and condom use, constraints faced in delivering
services, and their perceived their role in controlling the spread of AIDS. Despite their awareness
of AIDS, those interviewed perceived their role to be that of promoting contraception. Condoms
were perceived as a poor choice of contraceptive and their use was discouraged. The
pamphlets dispensed along with condoms were thought to provide adequate information about
condom used. Information on AIDS was given only if the clinic attended initiated discussion on
47

the subject. Most of the clinic staff were keen to discuss other issues during their consultation,
but felt constrained by the large number of people they had to attend to and the lack of adequate
facilities. If family planning services are to play a role in controlling the spread of AIDS, the first
step must be to make this function part of the overall policy. For there to be effective counseling
on AIDS prevention, in-service training of current staff is required, as well as more staff and
improvement in facilities to ensure greater privacy.
Notes: 1 copy
Ref ID: 70
Abdool Karim, Q. A. (1993). Article review. AIDS Bulletin, 2, 22-23.
Keywords: barrier/barriers/gender/risk/sexual behaviour/women/Young people/youth
Abstract: This paper provides a review of the United Nations Development Programme document
on "Young women: Silence, susceptibility and HIV infection. Age and Gender as independent
variables in the acquisition of HIV infection" and its pertinence to the South African context.
Notes: 1 copy
Abdool Karim, Q. A., Abdool Karim, S. S., Hoosen, M. C., & Susser, M. (1998). Informed
consent for HIV Testing in a South African Hospital: Is it Truly Informed and Truly Voluntary?
American Journal of Public Health, 88, 637-640.
Ref ID: 69
Keywords: ethics/health systems/Informed consent/VCT/voluntary counselling and testing
Abstract: The objective of this study was to assess informed consent to human immunodeficiency
virus-(HIV) testing in a perinatal HIV transmission study in a major referral hospital serving a
largely Black population in South Africa. Methods: First-time antenatal clinic attenders who were
randomly selected from those enrolled in the perinatal HIV study( n = 56) answered
questionnaires before and after counselling. Results: knowledge of HIV transmission and
prevention, high at the outset, was little improved after counselling. The acceptance rate for HIV
testing was high. Despite assurances that participation was voluntary, 88% of the women said
they felt compelled to participate in the study. The conclusions were drawn that informed consent
48

in this setting was truly informed but not truly voluntary.
Notes: 1 copy
Abdool Karim, S. S. (1993). Traditional healers and AIDS prevention. South African
Medical Journal, 83, 423-425.
Ref ID: 163
Keywords: community/education/knowledge/model/prevention/programmes/traditional
healer/transmission
Abstract: A qualitative case study of the views and experiences of an isangoma was undertaken
to explore potential preventive health roles that traditional healers could play with regard to the
AIDS epidemic. The isangoma's knowledge of the transmission mechanisms, risk groups and
prevention strategies for AIDS was accurate. Her questionable beliefs included a Nazi
conspiracy as the source of AIDS, a string ritual to prevent promiscuity and a conviction that she
could treat AIDS. Notwithstanding the latter beliefs, her generally factual knowledge of AIDS
indicated that she could be an important source of AIDS indicated that she could be an important
source of AIDS information in the community; she was, in fact, already providing some AIDS
counseling. Considering their large clientele, established preventive health ethic, extensive
distribution in rural areas and potential ability to influence the contextual factors that affect risk-
reducing behaviors( e.g. condom use), it is recommended that traditional healers be incorporated
into AIDS prevention programmes where they can play a role in community-based AIDS
education and condom promotion.
Notes: 1 copy
Abdullah, M. F., Young, T., Bitalo, L., Coetzee, N., & Myers, J. E. (2001). Public Health
lessons from a pilot programme to reduce mother-to-child transmission of HIV-1 in Khayelitsha.
South African Medical Journal, 91, 579-583.
Ref ID: 178
Keywords: ARV/clinic/MTCT/prevention/primary health care/public health/South Africa/treatment
Abstract: Objective: Short-course antiretroviral therapy(ART) has been shown to be effective in
49

educing mother-to-child transmission(MTCT) of HIV-1. This article details the public health
lessons learnt from a district-based pilot programme where a short-course zidovudine(ZDV)
regimen has been used in a typical South African peri-urban setting.
Methods: The pilot programme was initiated at two midwife obstetric units in January 1999. Lay
counsellors conducted pre- and post-test counselling and nurses took blood for HIV enzyme-
linked immunosorbent assay( ELISA) testing. Short-course ZDV was administered antenatally
(from 36 weeks' gestation) and during labour. Mother-infant pairs were followed up at eight child
health clinics where free formula feed was dispensed weekly. Infants received co-trimoxazole
prophylaxis and were ELISA tested for HIV at 9 and 18 months. After 17 months protocol
changes aimed at eliminating weaknesses included initiation to ZDV at 34 weeks, self-
administration of the first dose of ZDV with the onset of labour, and rapid HIV testing for both
mothers and infants.
Results: Voluntary counselling and testing was shown to be highly acceptable, with individual
counselling more effective than group counselling. Based on less than optimal availability of
records, ZDV utilisations was encouraging with up to 59% of subjects initiating treatment, 3
weeks' median duration of ZDV use, and up to 88% receiving at least one intrapartum dose
reached 41%.
Conclusion: Short-course antenatal and intrapartum ART to prevent MTCT of HIV1 was shown to
be feasible.
Notes: 1 copy
Ref ID: 9
Abels, C. (1993). Approaching AIDS with care. Christian living today, 52, 10-12.
Keywords: christian/church/condom/intervention/prevention/religion
Abstract: Scripture Union sympathises with other agents in the field, believing they are sincere
and genuinely concerned about the spread of AIDS and often sacrificially involved in AIDS
prevention. Scripture Union is concerned however that these models do not really address the
problem. Morals matter most when it comes to the prevention of AIDS .
Notes: 1 copy
50

Abouya, L., Coulibaly, I. M., Wiktor, S., Coulibaly, D., N'kragbo, M., N' gbo, A. et al.
(1998). The Cote d'Ivoire national HIV counselling and testing program for tuberculosis patients:
Implementation and analysis of epidemiology data. AIDS, 12, 505-512.
Ref ID: 14
Keywords: epidemiology/tuberculosis/VCT/voluntary counselling and testing
Abstract: This paper describes the implementation of a free, voluntary and confidential HIV
counselling and testing program for patients with newly diagnosed tuberculosis at the eight large
outpatient tuberculosis centres in Cote d' Ivoire, and do present epidemiologic on participating
patients.
Notes: 1 copy
Adamachak, J. D., Mbizvo, T. M., & Tawanda, M. (1990). Male knowledge, attitudes and
practices towards AIDS in Zimbabwe. AIDS, 4, 245-250.
Ref ID: 10
Keywords: attitudes/barrier/culture/knowledge/male/Zimbabwe
Abstract: This paper presents findings from a survey on knowledge of and attitudes and practices
towards AIDS among currently married Zimbabwean men conducted between April and June
1988. Findings indicated that knowledge was reasonably high: 89.7% reported having heard of
AIDS. The young and middle -aged groups, the most educate, and the urban men were the most
knowledgeable in identifying routes of transmission. However, 22% did not know that there could
be asymptomatic carriers of the virus capable of transmitting the virus and infecting others.
Furthermore, 38% did not know that all those infected with AIDS eventually die as a result, and
only 55%knew that there is no cure for AIDS. Behavioral change in order to avoid contracting
AIDS seems relatively low given this sample's history of sexually transmitted diseases and
extramarital sexual relations during the year prior to the survey. Although condom use was the
lowest percentage of the behavioral change categories, a high percentage reported ever using a
condom.
Notes: 1 copy
51

Adendorff, C. & Wood, G. (1995). Evaluation of ATICC's Basic HIV/AIDS counselling
course. Positive outlook, 2, 6-7.
Ref ID: 287
Keywords: counsellor/training/counsellors/disease/evaluation/HIV/AIDS
counselling/knowledge/research/supervision/WHO
Abstract: Research indicates that accelerated lay counsellor programmes can be effective, at
least in the short term. Ongoing support, training, supervision and evaluation of lay counsellors
are necessary to foster the maintenance of skills, to assist some form of "quality control". With
regards to counsellor training, training content should cover the relevant counselling skills, theory
and the development of personal insight. Methods found to be effective include didactic and
experiential techniques. These should be presented in a structured and systematic format, suited
to the trainees' needs. Ongoing support and supervision is also necessary.
With regards to selection of trainees, there are several personality characteristics and non-
technical abilities which have been consistently linked with counsellor efficacy and inefficacy. For
example, it would seem advisable to avoid candidates who are inflexible, excessively anxious or
aggressive, or both and to select trainees who demonstrate warmth, sensitivity and a genuine
desire to help others. Successful screening instruments have included questionnaires, role-play
evaluations and the Carkhuff scales. As it is evident that assessment must invariably and involve
elements of intuition and personal judgment, selection should be conducted by more than one
person, and by experienced and skilled counsellors and trainers. Given the current uncertainty
regarding the prediction of effective counsellors, it may be advisable to base selection of trainees
on multiple dimensions, such as previous experience, opportunity to utilise the training after the
course and motivation (i.e. interest must be primarily in the training rather than personal
development).
Cross-cultural issues are important, and counsellors need to become aware of their own biases,
accept and respect difference and common humanity, and avoid stereotyping. Training must be
provided in an environment that truly espouses the spirit of cultural diversity. For example,
literacy levels, cultural differences and traditional beliefs of trainees need to be taken into
52

account. Counselling and counsellor training needs to be freely available, culturally sensitive and
appropriate, and regularly monitored and evaluated. HIV/AIDS counselling is made unique by its
association with death and dying and sexuality, cross-cultural issues, the uncertainty surrounding
the disease, and the fear and discrimination which usually go with these issues. Counsellor
training therefore needs to explore attitudes and knowledge / insight into self and others, in
addition to theory and basic counselling skills.
Notes: 1 copy
Bulletin, 3, 17.
Ref ID: 459
Aegis Network (1994). Task force to study implications of AZT in pregnancy. AIDS
Keywords: AZT/health/HIV transmission/medical/policies/policy/pregnancy/transmission/women
Abstract: The Unites States Public Health service has established a task force to explore the
medical and policy implications of the recently announced findings of a National Institute of Health
clinical trial that tested the effectiveness of AZT in preventing transmission of HIV from pregnant
women to their infants. Preliminary findings from randomised, blind clinical trials showed a 67,5%
effectiveness rate in blocking HIV transmission to a newborn infants through the use of AZT, with
no apparent adverse effects on the mothers. The task force will aim to develop a rational
approach in translating the results of these clinical trials into policy and practices. The nine
member task force will also make use of outside experts.
Notes: 1 copy
Ref ID: 2401
African Eye News Service (2001). Verkragtingsberaders in hospitale uitgesit. Beeld.
Keywords: intervention/rape
Abstract: Nelspruit - Vrywilligers wat help met berading vir verkragtingslag offers is vrydag uit alle
provinsiale hospitale in Mpumalanga gesit, vermoedelik omdat hulle gratis teen vigsmiddels
verskaf het. Die onverwagte stap kom nadat dissiplinere klagte vroeer vandees maand ingedien
is teen dokters en verpleegpersoneel, nadat hulle geprobeer het om herading en gratis middels
53

soos AZT en 3TC vir slag offers te kry. Die vrywilligers, vat onder die vaandel werk van die
Greater Nelspruit Rape Intervention Project ( Grip), het al herhaaldelik swaarde gekruis met me.
Sibongile Manana, LUR vir gesondheid, wat daarop staan dat teen vigsmiddels deet is van 'n
komplot om pres. Thabo Mbeki en die ANC te ondermyn. Manana se persoonlike assistent,
Lucky Molobela, het tydens 'n ont moeting Vrydag met Grip gese dat die nie-regeringsorganisasie
30 dae tyd het om sy kamers in provinsiale hospitale te ontruim. Hul plek ingeneem word deur
provinsiale amptenare. Die 90 amptenare, wat nog nie voertuie of 'n begroting het nie, sal nie
toegelaat word om teenivigs middels te verskaf of mense te adviseer oor waar om dit te kry nie.
Opgeleide vrywilligers van GRIP verskaf tans berading aan verkrag tingslagoffers, skoon klere,
regsadvies en gratis antiretrovirale middels aan die honderde vroue en kinders wat na seksuele
aanvalle na hospitale verwys word elke maand. 'n Regsadviseur van Grip, mnr Richard Spoor,
het die naweek die optrede teen die organisasie as onwettig betsempel en die department van
gesondheid beskuldig dat hy slagoffors in die landelike gebiede ontneem van lewensbelangrike
behandeling net om " ' n polieke punt te bewys". Hy se GRIP sal nie toegee aan die
uitsettingsbevel nie aangesien dit onwettig is
Notes: 1 copy
Aggleton, P. (1989). Evaluating Health Education about AIDS. In P.Aggleton, G. Hart, &
P. Davies (Eds.), AIDS: social representations, social practices (pp. 220-235). New York,
Philadelphia, London: The Falmer Press.
Ref ID: 394
Keywords: health education/infection/treatment
Abstract: As there is no cure for AIDS, nor is there a vaccine to protect against infection.
Available treatments tend to be limited in their effectiveness and some have debilitating side
effects requiring blood transfusions and sometimes the discontinuation of therapy. Whilst a
significant number of new advances in treatment are being made, it may be many years before
their overall effectiveness can be evaluated. In this situation, health education has been
identified as the most effective means by which to limit the further spread of infection, and there
have now been a number of local and national initiatives to achieve this goal. In Britain, much of
54

the early work was carried out by voluntary organizations providing counselling and support for
the first voluntary organizations providing counselling and support for the first people to be
affected by AIDS.
Notes: 1 copy
Akpede, G. O., Lawal, R. S., & Momoh, O. (20032). Perception of voluntary screening for
paediatric HIV and response to post-test counselling by Nigerian parents. AIDS care, 14, 683-
697.
Ref ID: 8828
Keywords: couples/family/guidelines/health/knowledge/Nigeria/parents/policies/policy/post-
test/response/transmission/treatment/vertical transmission
Abstract: Nigeria may be taken to represent countries with an evolving HIV/AIDS epidemic. With
particular reference to pediatric HIV, the voluntary testing of young children and their parents may
provide an important entry point for the institution of control measures. However, there is a
paucity of knowledge about how individuals perceive voluntary testing. This knowledge is
important to the development of guidelines for counselling. To reduce this gap, 258 parents of
hospitalised children (>1month to 15 years of age) were interviewed using a structural
questionnaire. In addition, to complement the data, four examples of seropositive mother's
responses during post-test counselling are presented and analysed. In the survey 223 (86%)
parents were HIV/AIDS aware but only 88 (39%) of these parents could describe one or more
route(s) of transmission and none described vertical transmission. among the respondents, 153
(62%) of 248 would consent to the screening of self, and 195 (85%) of 230 to the screening of a
hospitalised child if based on his/her clinical condition. Perceptions of good health and lack of
exposure and despair owing to lack of a specific treatment, were the common reasons for
refusing consent. These represent some of the issues which would need to be addressed to
increase the acceptance of voluntary testing. The fear of a break up of families with sero-positive
mothers but seronegative fathers was a major concern expressed during post-test counselling.
HIV discordance among couples may be frequent and should be considered in the formulation of
policies on counselling and voluntary testing.
55

11).
Ref ID: 13
Albertyn, C. (1992). HIV testing and counselling in Natal: Utopia meets reality. In (pp. 1-
Keywords: guidelines/KwaZulu-Natal/legislation/South Africa/VCT/voluntary counselling and
testing
Abstract: This paper was presented by C. Albertyn at the MASA CME Congress in
Pietermaritzburg, South Africa in August 1992. This paper sets a context by examining the
consequences of perceiving HIV/AIDS as a disease /syndrome or as an illness. The possible
motivations for, and utility of testing for HIV antibodies is examined from both an international and
local perspective. Having established the purposes and recognised processes involved in
testing, a set of "criteria" are proposed. The criteria, responding the utopia are world apart,
especially in considering the interests of the testees and society. It is argued that, in some
instances, the testing process is not only contrary to the interests of the testee, but is also
antithetical to the interests of society and counter to efforts aimed at limiting the spread of the
virus.
Notes: 1 copy
Allen, D. (2000). The HIV/AIDS/STD Strategic Plan for South Africa, 2000-2005.
Ref Type: Unpublished Work
Ref ID: 512
Keywords: Africa/evaluation/failure/government/health/impact/information/population/safe
sex/sex/South Africa
Abstract: The HIV/AIDS/STD Strategic Plan for South Africa, 2000-2005 provides a vision for
addressing the most important issues facing South Africa today. The plan provides background
information on the HIV/AIDS epidemic in South Africa, lists guiding principles for addressing this
epidemic; discusses the role of sectors and how the plan will be implemented, monitored and
evaluated; and presents 15 goals and 37 objectives in four priority areas. This plan provided an
impressive framework for how South Africa can effectively address HIV/AIDS. Without
addressing several essential issues surrounding the plan however, actions necessary to reduce
56

the effect of HIV/AIDS may not occur. Issues that require urgent attention include the following:
Evaluation of previous plans
There are other impressive documents that describe how the HIV/AIDS epidemic in South Africa
should be addressed. These include: A National AIDS Plan for South Africa, 1994-1995; South
Africa STD/HIV/AIDS review, 1997; Year 2000 Health Goals and Objectives for South Africa;
White paper for the transformation of the National Health System, 1997; and, Health Sector
Strategic Framework, 1999-2004. The reasons for the successes and failures in attaining the
goals and objectives listed in these other equally impressive documents should be addressed.
Lack of Measurable Objectives
The listed objectives in the plan are very general and are difficult to monitor or evaluation. For
each objective there is a need to develop measurable targets. For example the
objective"promote improved health-seeking behaviour and adoption of safe sex practices"
requires more specific and measurable objectives that define the types of health seeking
behaviours to improve, by what degree, and in what population or age group.
Need to Prioritize and Expand Successful Programs Nationally
There are 37 objectives within 15 priority areas. There is a need to define the most urgent
priorities that will have greatest impact and expand success programs nationally. This can
contribute to the appropriate allocation of resources and to focus national efforts.
Excessive focus on Health
The Department of Health is listed is a bad agency for 34 of the 37 listed objectives. If HIV/AIDS
is to become a social and development rather than a health issue, the active role of other sectors
is needed.
Confusing Array of National and Provincial Structures which address HIV/AIDS
There are numerous National and Provincial structures that address HIV/AIDS. These include
the South African National AIDS Council (SANAC) and the Presidential Panel on AIDS. The role
57

of SANAC and the leadership, organisation, and management of the societal fight against
HIV/AIDS should be clarified.
The South African Government should be congratulated on developing the HIV/AIDS/STD
Strategic Plan for South Africa, 2000-2005. The plan should be seen as a stimulus for new
actions to improve the ability to address the most important threat to the reconstruction and
development of South Africa.
Notes: 1 copy
Allen, M. D. (2000). Business Plan for VCT Western Cape 2000-2001: draft.
Ref Type: Unpublished Work
Ref ID: 572
Keywords: Africa/business plan/care/community/counsellor/counsellors/HIV-status/HIV
testing/information/knowledge/Nurse/primary health care/sex/sex workers/South Africa/truck
drivers/VCT/voluntary counselling and testing/youth
Abstract: The Western Cape is short of 1000 nurses and therefore at primary care level it will be
impossible to use the existing staff to deal with the increased demand for Voluntary Counselling
and Testing (VCT). It will take away from the already stretched human and other resources.
Counsellors should mainly be trained in and concentrate on HIV counselling, but should have a
clear understanding regarding the links wit TB and STD's. The Western Cape has the highest
incidence of TB in South Africa. Therefore TB and STD carry a large load in their own right.
Specialist expertise is required to deal with the interaction with AIDS. Close co-operation
between the programmes will be more advantageous.
Purpose:
> To increase access to HIV counselling and testing particularly for high risk groups.
> To strengthen existing structures with additional counsellors, so that flow of information to and
from the provincial department is improved.
> To ensure more accurate HIV testing
>To ensure that finances are managed properly
58

To support the members of the community which is at risk in determining their own HIV status,
especially the youth, sexually active adults and high risk professions such as sex workers and
truck drivers.
> To use this information to improve awareness, increase knowledge and promote people taking
responsibility for their actions.
Notes: 1 copy
Allen, S., Tice, J., Van de Perre, P., Serufilira, A., Hudes, E., Nsengumuremyi, F. et al.
(1992). Effect of serotesting with counselling on condom use and seroconversion among HIV
discordant couples in Africa. BMJ, 304, 1605-1609.
Ref ID: 342
Keywords: Africa/condom/condoms/couples/HIV
testing/infection/intervention/men/Rwanda/transmission/women
Abstract: Objectives: To determine whether HIV testing and counselling increased condom use
and decreased heterosexual transmission of HIV in discordant couples.
Design: Prospective study
Setting: Kigali, the capital of Rwanda.
Subjects: Cohabiting couples with discordant HIV serology results.
Main outcome measures: Condom use in the couple and HIV seroconversion in the negative.
Results: 60 HIV discordant couples were identified, of whom 53 were followed for an average of
2.2 years. The proportion of discordant couples using condoms increased from 4% to 57% after
one year of follow up. During follow up two of the 23 HIV negative men and six of the 30 HIV
negative women seroconverted (seroconversion rates of 4 and 9 per 100 person years). The rate
among women was less than half that estimated for similar women in discordant couples whose
partners had not been serotested. Condom use was less common among those who
seroconverted ( 100% v 5%, p=0.01 in men; 67% v 25%, p=0.14 in women.
Conclusions = Roughly on in seven cohabiting couples in Kigali discordant HIV serological
results. Confidential HIV serotesting with counselling caused a large increase in condom use and
was associated with a lower rate of new HIV infections. HIV testing is a promising intervention for
59

preventing the spread of HIV in African cities.
Notes: 1 copy
Allen, S., Serufilira, A., Bogaerts, J., Van de Perre, P., Nsengumuremyi, F., Lindan, C. et
al. (1992). Confidential HIV testing and condom promotion in Africa. The Journal of the American
Medical Association, -, 3338-3343.
Ref ID: 351
Keywords: clinic/cohort/condom/condom promotion/condom use/condoms/HIV
testing/impact/intervention/male/research/Rwanda/seroconversion/sexual
partner/Virus/WHO/women
Abstract: Objective: We evaluated the impact of human immunodeficiency virus (HIV) testing and
counselling on self-reported condom and spermicide use and on corresponding HIV
seroconversion and gonorrhea rates in urban Rwandan women.
Design: Prospective cohort study with 2 years of follow-up, comparison of outcome variables
before and after an intervention, and condom use measured in a control group that did not
receive the intervention.
Setting: Outpatient research clinic in Kigali, the capital of Rwanda.
Participants: One thousand four hundred fifty-eight childbearing women, 32% of whom were
infected with HIV, were enrolled in a prospective study in 1988, and followed at 3- to 6-month
intervals for 2 years. Follow-up was available for 95 % of subjects at year 1 and 92 at year 2.
Intervention:An acquired immunodeficiency syndrome (AIDS) educational videotape, HIV testing
and counselling, and free condoms and permicide were provided to all participants and interested
sexual partners.
Main outcome Measures: Self-report of compliance with condom-spermicide use and observed
incidence of HIV and gonorrhea.
Results: Only 7% of the women reported ever trying condoms before the intervention, but 22%
reported condom use with good compliance 1 year later. Women who were HIV-positive were
more likely to adopt condom use than HIV-negative women(36% vs 16%; p

predictors of condom use, both in HIV-positive and in HIV-negative more likely to adopt condom
use, both HIV-positive and in HIV-negative women, included HIV testing and counselling of the
male partner, having a nonmonogamous relationship, and believing condoms were not
dangerous. Human immunodeficiency virus seroconversion rates decreased significantly (from
4.1 to 1.8 per 100 person-years; p

provided at the study clinic, but 40% of HIV positive women desired more children. Research is
needed to identify the practical and psychosocial obstacles to effective long-term contraception
among HIV positive women. HIV counselling programmes must specifically address the issue of
childbearing.
Notes: 1 copy
Allen, S., Karita, E., N'gandu, N., & Tichacek, A. (2002). The evolution of Voluntary
Testing and Counselling as an HIV Prevention Strategy. In Voluntary Testing and Counselling (-
ed., pp. 90-107).
Ref ID: 266
Keywords: antibody/HIV testing/infection/physician/prevention/research/VCT
Abstract: HIV testing is done in different circumstances for a variety of reasons. Blood
transfusion centers perform HIV testing to ensure an uninfected blood supply, physicians use the
test results to aid in patient management and to research the manifestations of HIV infection,
surveillance programs test for HIV to determine the magnitude of the epidemic in a given risk
group or geographic area, and voluntary testing centers provide HIV antibody test results to
people who want to know their serostatus. Depending on the reasons for testing, the priorities
established by the given programs, and the available resources, HIV test results may or may not
be linked to patient identifiers, and if linked, may or may not be communicated to the individual
concerned. Several years of experience with giving HIV antibody test results has led to the
recommendations that, if and when a HIV test result is given, it should be voluntary, accompanied
by a thorough explanation, emotional support, and practical recommendations. This process is
referred is to here as "voluntary HIV testing and counselling" (VCT).
Notes: 1 copy
Allwood, C. W., Friedland, I. R., Karstaedt, A. S., & McIntyre, J. A. (1992). AIDS - the
Baragwanath experience. South African Medical Journal, 82, 98-100.
Ref ID: 11
Keywords: evaluation/Nurse/patient care/quality of care/South Africa/training
62

Abstract: This article describes the setting up of counselling for HIV- positive patients in response
to the need at Baragwanath Hospital. Nurse counsellors were trained and supervised. The work,
extending over 2 and half years, raised a numberof issues for patient care and also for wider
community education. Brief reference is made to pertinent ethical and cultural issues.
Notes: 1 copy
Altenroxel, L. (2000). Child holding AIDS at bay, but lack of funds looming: Family needs
R5 000 a month for the drugs that keep her alive. The star.
Ref ID: 2653
Keywords: drugs/family/medical
Abstract: The miraculous recovery of a 10-year-old girl who has survived against huge odds could
be brought to a grounding halt-all because of money. This bubbly little girl with an infectious
laugh and shiny, blonde hair is at the centre of a medical aid dispute which is threatening her
access to the medicine that is keeping her alive.
Notes: 1 copy
Ref ID: 2459
Altenroxel, L. (2000). Can we afford to treat the terminally ill? The star.
Keywords: AZT/health
Abstract: Budget constraints are forcing doctors to ask questions about spending the State's
limited resources on terminally-ill Aids patients. Aids activists speak of people who have been
turned away from hospitals, and controversial Dr Costa Gazi, who has threatened to take health
minister Dr Manto Tshabalala- Msimang to court over her decision to deny pregnant mothers AZT
medication, says he knows of "at least one hospital which has started having to ration its care
and its admission of children. " The pressure is on" he said
Notes: 1 copy
Alwano-Edyegu, M. G. (1999). Knowledge is power: Voluntary HIV counselling and
testing in Uganda: a case study. Geneva, UNAIDS.
Ref Type: Unpublished Work
63

Ref ID: 506
Keywords: case study/community/HIV
testing/infection/information/intervention/knowledge/response/Uganda/Voluntary HIV counselling
and Testing
Abstract: The AIDS information Centre (AIC) was established in February 1990 to provide
anonymous, voluntary and confidential HIV testing and counselling services to the people of
Uganda. The Centre operates with the understanding that knowledge for one's HIV infection
status in an important intervention in controlling HIV infection.
High Public awareness of HIV and the increasing numbers of persons sick and dying with AIDS
resulted in many Ugandans wanting to know their sero-status. Because there were no voluntary
testing and counselling sites, people began donating blood in order to learn whether they were
infected with HIV, and a few private laboratories began offering HIV testing. The private labs not
provide any counselling at all. The establishment of AIC was a response to the growing
community need for knowledge of sero-status.
Notes: 1 copy
Ref ID: 3389
Ancer, J. (1999). In the frontline of the fight against a resilient enemy. Sunday World.
Keywords: Young people/youth
Abstract: young people are giving up some of their free time to counsel those living with HIV/AIDS
and help prevent the spread of the disease.
Notes: 1 copy
Antelman, G., Kaaya, M. C. S., Mbwambo, J., Msamanga, G. I., & Fawzi, W. W. (2001).
Predictors of HIV-1 Serostatus Disclosure: a prospective - study among HIV-infected pregnant-
women in Dar-Es-Salam, Tanzania. AIDS, 15, 1865-1874.
Ref ID: 363
Keywords: men/prevention/disclosure/Tanzania/transmission/Uganda/women
Abstract: Objectives: To examine the socio-demographic and behavioral factors predictive of
64

women's disclosure of an HIV positive test result in Dar es Salaam, Tanzania
Design: From April 1995 to May 2000, 1078 HIV-positive pregnant women participated in an
ongoing randomized trial on micronutrients and HIV-1 vertical transmission and progression.
Disclosure to a partner or to a female relative was assessed 2 months after post-test counselling
and at 6 month follow-up visits. Socio-demographic, health, behavioral, and psychological factors
were measured at baseline and during follow-up
Methods: Predictors of time to disclosure of HIV serostatus were determined using cox
proportional hazards regression models.
Results: Prevalence of disclosure to a partner ranged from 22% within 22% months to 40% after
nearly 4 years. Women were less likely to disclose to their partners if they were cohabiting, had
low wage employment, had previously disclosed to a female relative, or reported ever-use of a
modern contraceptives method. Women reporting fewer than six lifetime sexual partners or
knowing someone with HIV/AIDS were more likely to disclose to their partners. Disclose to a
female relative was predicted by knowing more than two individuals with HIV/AIDS, full economic
dependency on their partner, high levels of social support, and prior attendance at a support
group meeting.
Conclusions: A substantial proportion of HIV-infected pregnant women never disclosed their
results to a partner or a close female relative. Lack of disclosure may have limited their ability to
engage in preventive behaviors or to obtain the necessary emotional support for coping with their
serostatus or illness
Notes: 1 copy
indepedent.
Ref ID: 4030
Keywords:
Arenstein, J. (2001). Mpumalanga to evict rape counsellors from hospitals. Sunday
AZT/counsellor/counsellors/drugs/government/health/intervention/medicine/rape/women
Abstract: Mpumalanga fast-tracked its campaign this week to halt the provision of free anti-AIDS
drugs to rural rape survivors by instructing state attorneys to evict volunteer rape counsellors
65

from government hospitals by the end of the month. The volunteer counsellors currently provide
rape survivors with free trauma counselling, clean clothes, toys for child victims, toiletries and
transport 24 hours a day, seven days a week.
Rape survivors, 70 percent of whom are children in Mpumalanga, used to get free anti-retroviral
drugs such as AZT and 3 TC before health MEC Sibongile Manana banned the practice earlier
this year.
All the medicine and counselling are provided free of charge by the volunteer Greater Nelspruit
Rape Intervention Project(Grip) women's group. Counsellors claim they have also ben banned
from even advising rape survivors where to find anti AIDS medicines or how to use them.
Notes: 1 copy
Ref ID: 2913
Arenstein, J. (2001). Rape counsellors told to go. City press.
Keywords: drugs/health/intervention/rape/women
Abstract: The Mpumalanga government evicted volunteer rape counsellors from all provincial
hospitals on Friday in apparent retaliation for their providing free Anti-AIDS drugs to rape
survivors. The volunteers, operating under the aegis of the Greater Nelspruit Rape Intervention
Project (GRIP), have repeatedly clashed with Mpumalanga Health MEC Sibongile Manana after
she insisted anti-AIDS drugs were part of a plot to undermine President Thabo Mbeki and the
African National Congress government. Manana's personal assistant, Lucky Molobela, told Grip
during a heated meeting on Friday the non-government organisation had 30 days to close its care
rooms at provincial hospitals so government officials could take over any counselling. The 90
officials, who do not yet have vehicles or an operational budget, will not be allowed to distribute
anti-AIDS drugs or advise rape victims where to find the drugs. Grip's trained volunteers
currently use the care rooms for rape counselling, and to provide clean clothing legal advice and
free anti- retroviral drugs to the hundreds of women and children who are referred to hospitals
after sexual assaults every month. Grip's attorney Richard Spoor yesterday branded the eviction
unlawful and accused the department of deliberately depriving rural rape victims of life-saving
treatment to prove a "petty political point". "Manana is embarrassed that an organisition like Grip
66

supplied AZT free of charge to rape victims when she has decided to ban state doctors from
doing so, " said Spoor. "Grip will not heed the eviction order. "If Manana wants Grip to move,
she will have to get a court order, " he added.
Notes: 1 Copy
Arthur, G., Mutemi, R., Odhiambo, J., Kariuki, S., Ngatia, G., Forsythe, S. et al. (2000).
Voluntary counselling and testing (VCT): improved access for the poor through integrating same
day services into public primary health care clinics. In (pp. 3).
Ref ID: 221
Keywords: barriers/clinic/confidentiality/health/men/pre-test/prevention/voluntary counselling and
testing/care/VCT/counsellors/counsellor/rapid testing/barrier/clients/client/population/primary
health care
Abstract: Background: The poor mainly access formal health care via public health centre
services but VCT is not available in this setting. This study assessed the feasibility of integrating
VCT into public health centres to improve equity of access. Methods: Counselling and same-
day testing services using trained counsellors and a nurse-led dual rapid testing algorithm were
(FGDs) were used to determine uptake, user characteristics and attitudes and barriers to testing.
All were retested using ELISA at a central laboratory to assess the reliability of the field testing
algorithm.
Results: After 13 months 885 people had been pre-test counselled (1.4 per clinic per day), of
which 801(91%)( seroprevalence 18%; men age 29y ( SD 10); 52% female) were tested and 683(
85%) received results (548(68%) the same day). Preliminary central laboratory data suggested
the algorithm had a sensitivity of 96.9% and a specificity of 98.8%, with 2.5% indeterminate.
Most clients self referred, motivated usually by learning their status, suggesting a large
component were worried well from the general population. In FGDs, fear about lack of
confidentiality was a key service- related barrier to uptake of testing.
Conclusion: Same day testing can be successful implemented at local public primary health care
facilities and attracts the worried well, not just internal referral from curative services.
Confidentiality is a major public concern. If such barriers can be overcome, this approach could
67

apidly achieve sustainable national coverage and could facilitate equitable access to a
fundamental component of HIV care and prevention.
Notes: 1 copy
Arthur, G., Gilks, C., Forsythe, S., Mutemi, R., & Doyle, V. Implementing voluntary
counselling and testing (VCT): lessons learned from Kenya. (in press).
Ref ID: 353
Keywords: Kenya/policy/prevention/VCT/voluntary counselling and testing
Abstract: HIV/AIDS is now an unavoidable fact for most African countries, and millions of
individuals are currently living with HIV. However successful prevention activities become, many
more Africans will acquire HIV infection over the next few years. Most African countries are
reforming their health systems but can only afford a few dollars per person per year on health. It
remains to be seen if any restructured health system will be better able to deal with HIV. With so
much attention now given to improving health service performance and reducing costs, there is a
danger of neglecting the care and prevention demands generated by HIV infection. One hope is
that reforms might deliver enlightened district planning that recognises the impact of HIV on the
demand for health services and sets out a coping strategy for tackling these increased demands.
The challenge is clear: how to deliver comprehensive care across the continuum and provide
effective, appropriate care and support for all people living with HIV/AIDS with limited resources.
In this policy briefing, experiences and results drawn from two districts in Kenya are used to
provide a district-based solution for implementing voluntary and testing services for HIV.
Notes: 1 copy
Ashery, R. S. (1992). Issues in AIDS Training for Substance Abuse Workers. Journal of
Substance Abuse Treatment, 9, 15-19.
Ref ID: 344
Keywords: community/counsellors/evaluation/information/training/treatment
Abstract: Workers in drug treatment programs need specialized training concerning acquired
immune deficiency syndrome (AIDS) to meet the demands of their expanding roles. Initially, the
68

treatment community failed to anticipate training needs fully, but now, comprehensive and
systematic AIDS training programs must be developed. This article discusses the five steps in
developing and implementing such programs: a) assessment and information gathering, b)
curriculum development, c) training of instruction, d) training delivery, and e) evaluation
Notes: 1 copy
[-], 11.
ATIC. (1992). Western Cape Resource Directory for HIV and AIDS now available. ATIC.
Ref Type: Organisational research report
Ref ID: 318
Keywords: Africa/ATICC/bereavement
counselling/condom/condoms/education/government/health/HIV testing/Home
care/policies/research/sex/South Africa/training
Abstract: A new edition of the resource directory for HIV and AIDS has just been published by
ATICC, Western Cape AIDS Training, information and Counselling Centre. It is two years since
the previous edition was produced and it is notable how much more provision there is for dealing
with the pandemic - though much remains to be done. The directory aimed mainly at the Western
Cape, is in four sections. The first deals with AWARENESS: this section lists organisations that
run courses or arrange talks. Details of theatre group education and campaigns in nightclubs and
bars dispensing condoms and safer sex information are also provided.
Included in this section are materials such as pamphlets, manuals, journals and lists of libraries
and resource centres that house good collections of relevant information and organisations that
hire or sell videos.
The second deals with CARE. Lists of HIV testing centres(all offer pre- and post -test counselling
are recorded as well as organisations offering more broad ranging counselling.
This section also covers in-patient care at hospitals, hospices and home-care provision.
Alternative health care organisations and personnel are listed. The section concludes with lists of
organisations also offering bereavement counselling and/or spiritual support.
Section 3 deals with issues related to awareness and care - co-coordinating bodies, policy
69

development, government pensions and grants, fund-raising, research and legal advice. There is
also information about condom supply and biohazard waste removal.
In Section 4 key organisations operating in other parts of South Africa are listed.
The Resource Directory provides the following information about the more than 120 organisations
listed:
*Name
*Street and postal address
*Telephone and fax number
*Contact person
*Opening times and charges
*Referral procedures
*Description of services provided
Notes: 1 copy
ATICC (1991). Management and treatment of HIV disease. South Africa Medical Journal
(Supplement), 34.
Ref ID: 3
Keywords: guidelines/post-test/pre-test
Reprint: Not in File
Abstract: This article offers a set of guidelines for pre-test and post- HIV test counselling
Notes: 1 copy
Ref ID: 1
ATICC (1994). INFO-AIDS. CME, 12, 511-513.
Keywords: guidelines/post-test/counselling/positive/negative/negative status/client
Reprint: Not in File
Abstract: The journal gives HIV/AIDS post-test counselling guidelines. Discussion of issues
relevant to both positive and negative status client counselling.
Notes: 2 copies
70

Ref ID: 2
ATICC (1994). INFO-AIDS. CME, 12, 224-226.
Keywords: guidelines/Informed consent/pre-test
Reprint: In File
Abstract: Info-AIDS offers practical guidelines for AIDS pre-test conselling. The pre-test
session(s) can raise a patient's anxiety level as he/she explores personal risk for HIV infection.
Acknowledgement and discussion of this stress critical to the counselling process. The following
is a 13 -step guide to assist you in sharing and gathering information which will help patients
consider and understand the value of HIV testing. These steps should be completed before a
patient signs the required informed consent form and the test is ordered, although not necessarily
in this order.
Notes: 2 copies
Awudabo-Asare, K. & Anarfi, J. K. (1999). Routes to HIV transmission and interventions:
an analytical framework (Rep. No. -). Canberra: Health Transition centre, National Centre for
Epidemiology and population Health, Australian National University.
Ref ID: 12
Keywords: economy/intervention/political/transmission
Abstract: This paper proposes a proximate determinants model as a framework for analysing
routes to HIV infection and intervention. The model attempts to bring together the remote and the
proximate factors responsible for risk-taking behaviour and subsequent infection. With HIV
infection resulting from background and proximate factor, intervention strategies that are being
designated should consider the multi-layered nature of the epidemic. The model will offer the
opportunity for HIV/AIDS intervention programs to tackle both the causes and the manifestations.
Notes: 1 copy
Ayiga, N., Ntozi, J. P. M., Ahimbisibwe, F. E., Odwee, J., & Okurut, F. N. (1999). Deaths,
HIV testing and sexual behaviour change and its determinants in northern Uganda. In Resistance
to Behavioural Change to Reduce HIV/AIDS infection, (pp. 65-81). Kampala: Makerere
71

University.
Ref ID: 15
Keywords: attitudes/barriers/culture/sexual behaviour/Uganda
Abstract: AIDS is a major global health and socio-economic problem. The socio-economic effects
of HIV and AIDS are greater in poor societies such as Uganda because the disease draws a lot of
resources for health care, and it affects the most productive population groups. Its prevention is
difficult since it is largely spread through heterosexual intercourse. The most effective preventive
measure is therefore sexual behaviour change.
This chapter uses data from a survey in northern Uganda to examine changes in attitudes
towards death, HIV testing and sexual behaviour as a result of AIDS. It was found that attitudes
towards deaths have changed and this was because deaths were common. Attitudes towards
HIV testing were also positive for most respondents who would like to know their HIV status and
plan for the future just in case they are HIV-positive. Some changes in sexual behaviour were
reported. However, resistance to sexual behaviour change was observed in some population
subgroups.
Notes: 1 copy
(pp. 1).
Ref ID: 242
Ayles, H., Mwale, A., & Chikwampu, D. (2000). Household counselling for HIV and TB. In
Keywords: clinic/confidentiality/health/HIV testing/pre-test
Abstract: Aim: To provide counselling for HIV and TB at a household level
Methods: All patients diagnosed with smear positive TB from 2 urban health centres are
approached by a nurse/ counsellor and asked for permission to visit them in their home to discuss
TB and HIV. The household is visited on several occasions and discussions initiated firstly about
TB and then HIV. Specific HIV pre-test counselling is offered to all adult members of the
household either on as an individual, a couple or as a group depending on client wishes. HIV
testing is offered either at the counselling centre or in the household. Any household contact of
the TB patient found to be HIV positive is offered isoniazid preventive therapy (IPT).
72

Symptomatic questionnaires and clinic screening is offered to detect cases of TB in the
household.
Results: The study is still ongoing. 105 households have so far been visited with 602 members
(292 Adults). 190 household members have been counselled and 30 TB cases and 27
household members tested for HIV. Of HIV - positive household contacts only 1 has accepted
IPT. 4 cases of smear - positive TB have been diagnosed amongst contacts.
Discussion: HIV and TB in Lusaka are inextricably linked, and inevitably affect the entire
household on a social and economic level. Individual responsibility for the disease with individual
confidentiality about an HIV diagnosis may not be appropriated in this setting. We discuss the
results of our household" shared confidentiality" approach. We also discuss whether active case
finding of TB or for IPT is worthwhile.
Notes: 1 copy
Bachmann, M., Mtwazi, L., & Barron, P. (1996). Quality of Care in Family Planning clinics
in a South African Peri-urban Settlement. CHASA Journal of Comprehensive Health, 7, 35-40.
Ref ID: 297
Keywords: peri-urban settlement/quality of care/South Africa
Abstract: Quality of care in all four family planning clinics serving the large peri-urban informal
settlement of Khayelitsha, South Africa was evaluated using operations research methods: 396
consultations were observed and 367 clients were interviewed. Injectable progesterone was
used by 97% of clients, although oral methods and condoms were discussed with over 45% of
first-time attenders. Family planning, AIDS and HIV were discussed infrequently. Information
provided varied by clinic, age employment status and previous attendance. Most clients
expressed approval of their method, and satisfaction with clinic staff. Rapid teenage clinic growth
revealed previously unmet demand. This report demonstrates, in a new setting, potential and
limitations of quantitive evaluation methods for service development.
Notes: 1copy
73

Bachmann, M., Mtwazi, L., & Barron, P. (1996). Quality of care in family planning clinics
in a South African peri-urban settlement. Family planning, 7, 34-40.
Ref ID: 376
Keywords: Africa/client/clients/clinic/clinic
staff/condom/condoms/employment/evaluation/family/family planning/information/peri-urban
settlement/quality of care/research/South Africa
Abstract: Quality of care in all four family planning clinics serving the large peri-urban informal
settlement of Khayelitsha, South Africa was evaluated using operations research methods: 396
consultations were observed and 367 clients were interviewed. Injectable progesterone was
used by 97% of clients, although oral methods and condoms were discussed with over 45% of
first-time attenders. Family planning, AIDS and HIV were discussed infrequently information
provided varied by clinic, age employment status and previous attendance. Most clients
expressed approval of their method, and satisfaction with clinic staff. Rapid teenage clinic growth
revealed previously unmet demand. This report demonstrates, in a new setting, potential and
limitations of qualitative evaluation methods for service development.
Notes: 1 copy
Baez, C. & Mwite, E. (2001). HIV/Aids training at district level: "The software issues". 1.
Ref Type: Unpublished Work
Ref ID: 8779
Keywords:
communication/community/counsellor/counsellors/evaluation/health/knowledge/mentoring/training
Reprint: Not in File
Abstract: Objective of this study was to identify gaps and success of HIV/Aids training for health
workers and lay counsellors at district level and unpack the salient issues underlying the whole
process of training. Method - questionnaire and in-depth interviews with counseling trainers and
trainees of the study revealed several shortfalls as far as training is concerned. Training gap
exists between theoretical and practical training local knowledge is not utilised effectively. Poor
communication between different administrative levels. Lack of previous training or inadequate
74

previous training which is serious if it involves health workers. Training does not take into account
the cultural values and beliefs of the community. Emphasis is sometimes placed on content rather
than process.Issue about quality versus quantity of training were found. The quality of training
should empower the individual to use the training for the benefit of the community. Lack of
mentoring and followup systems which are important in ensuring outcomes. Evaluation of the
outcomes has not been satisfactory.
Baez, C. (2001). Identifying the most important processes and components of a
successful HIV/AIDS counselling system at district level.
Ref Type: Unpublished Work
Ref ID: 8783
Keywords: care/clinic/community/counsellor/health/health worker/HIV/AIDS counselling/Home
based care/infection/knowledge/mentoring/NGO/supervision/training/transmission/VCT
Abstract: Health managers are encouraging the implementation of HIV/Aids packages which
include VCT, including pre-and post counselling, management of secondary infections at clinic
and hospital level, home based care, mother to child transmission programmes etc. Counselling
being the essential component need therefore, exists for HIV/Aids counselling training. 1999, an
NGO Project was introduced to provide training of health care workers and interested community
members in HIV/Aids basics and counselling. The training programme show some gaps and
weaknesses of previous HIV/AIDS training - which were based on knowledge of HIV/AIDS which
is not the case. A second phase of the project was the introduction of a locally adapted
supervision and mentoring system. Introduction of onsite mentors, supervisors and the
establishment of local peer support counsellor groups, which will be monitored and evaluated by
different stakeholders. Third phase will include the training of local trainers to guarantee that local
capacity is built, in terns of counselling and managerial aspects.
Baez, C. (10-30-2001). Support systems and mentorship for counsellors after training in
basic HIV counselling.
Ref Type: Unpublished Work
75

Ref ID: 8790
Keywords: counsellors/counsellor/training/HIV transmission/transmission/care/strategy/voluntary
counselling and testing/Home based care/mentoring/supervision/qualitative research
Abstract: Various studies have proved that good HIV counselling has assisted people to make
informed decisions such as whether to have an HIV test; helped many other people living with
HIV or AIDS to cope better with their condition and lead more positive lives; and helped prevent
HIV transmission. HIV counselling services are an essential component of many preventive and
care strategies like voluntary counselling and testing , mother-to child-transmission and home
based care. HIV/AIDS counsellors themselves need help and support. This is the reason why a
locally adapted support system is vital.International experience has shown that effective HIV
counselling requires an integrated approach between training and followup support and
mentoring. Different models have been developed with alternating training and supervision over
an extended period of time.This study describes the existing support systems for HIV counsellors
in the Lejweleputwa district in the Free State and to determine their characteristics and
appropriateness. A survey was done on HIV trainers and counsellors, followed by a qualitative
study amongst counsellors, supervisors and mentors regarding the support and followup after
training in HIV counselling over the past 12 months, using face to face interviews, groups
discussions and observation methods. A workshop is planned to inform all stakeholders at
district level of the findings and get input from them on the recommendations, focusing on local
resources and needs.
Day..
Ref ID: 3630
Ballenger, J. (1998). Project launched to reduce transmission of Aids to babies. Business
Keywords: AZT/babies/intervention/mother-to-child transmission/MTCT/transmission
Abstract: Three provinces are set to launch an anti-Aids initiatives in the next few months that will
signify SA's most direct intervention in the epidemic to date, health authorities say. Rose Smart,
head of the national health department's HIV, AIDS and sexually transmitted diseases
directorate, said the project would aim to reduce the mother-to-child transmission of HIV through
76

the use of the patented, anti-retroviral drug AZT.
Notes: 1 copy
Balmer, D. H. (1991). Towards a unified theory for HIV/AIDS counselling. International
Journal for the Advancement of Counselling, 14, 129-139.
Ref ID: 18
Keywords: model/theory
Abstract: The paper explores the introduction of an unified theory for HIV/AIDS counselling. To
date the provision of HIV/AIDS counselling has been largely based upon the behavioural theory
of counselling. This theory has been adopted by WHO/GPA and its main aims have been the
prevention of HIV infection and the psychosocial support for those already infected. It is argued
that future counselling interventions should be redirected from a disease-centred approach to a
person centred approach. This redirection can be facilitated by the adoption of the self concept
as the central measure for evaluating change. It is argued that various ideas should be selected
from the behavioural, psychoanalytical and humanistic theories of counselling. These ideas
should be amalgamated into a unified theory which provides the theoretical foundation upon
which a comprehensive counselling intervention can be based.
Notes: 3 copies
Balmer, D. H. (1992). The aims of HIV/AIDS counselling revisited. Counselling
psychology Quarterly, 5, 203-212.
Ref ID: 267
Keywords: HIV/AIDS counselling
Abstract: This paper investigates the present WHO/GPA counselling aims which are based on a
disease-centred approach. It argues that as the parameters of the pandemic have changed the
present counselling aims are no longer as relevant. These aims need to be revised in the light of
recent developments and should be based upon a person-centered approach. The new
counselling aims concentrate upon improving an individual's self concept and self esteem and
recommend that people with AIDS continue to participate in society to make a valid contribution
77

and maximize their individual satisfaction.
Notes: 1 copy
Balmer, D. H. (1993). The evaluation of a unified theory for HIV/AIDS counselling.
International Journal for the Advancement of Counselling, 16, 269-280.
Ref ID: 19
Keywords: evaluation/group counselling/model/theory
Abstract: This paper evaluates a unified theory for HIV/AIDS counselling. The evaluation was
based upon the hypothesis that if the theory was valid it would generate therapeutic outcomes.
The theory was operationalised and evaluated in the context of group counselling. The group
counselling sessions were recorded through the process of triangulation. The therapeutic
outcomes were stated and confirmed with the group members through the process of respondent
validation. In conclusion the hypothesis was accepted and the unified theory does offer an
appropriate foundation upon which HIV/AIDS counselling can be based.
Notes: 1 copy
Balmer, D. H. (1994). The efficacy of a scientific and ethnographic research design for
evaluating AIDS group counselling. Counselling psychology Quarterly, 7, 429-440.
Ref ID: 20
Keywords: efficacy/ethnography/evaluation/group counselling/research
Abstract: This paper reports a study of group counselling for people who are HIV+ based upon a
scientific and ethnographic research methodology. The group counselling was underpinned by a
unified theory, appropriate for counselling in the HIV/AIDS context. Counselling sessions lasted
for six months and were evaluated by quantitative and qualitative analysis. The quantitative
analysis used standardized psychological measurement on pre- and post-test design. The
qualitative analysis was based upon triangulation and respondent validation using video
recordings of the counselling sessions, viewed by a research team and then corroborated by the
members of the counselled group. The two methods of analysis confirmed that group counselling
is a therapeutic intervention for this group. The methods of analysis confirmed that group
78

counselling is a therapeutic intervention for this group of people.
Notes: 1 copy
Balmer, D. H., Seeley, J., & Bachengana, C. (1996). The role of counselling in community
support for HIV/AIDS in Uganda. Counselling psychology Quarterly, 9, 177-190.
Ref ID: 21
Keywords: community/intervention/model/post-test/pre-test/support/Uganda
Abstract: HIV/AIDS counselling in medical related programmes focuses upon pre- and post-test
counselling. The MRC programme in rural Uganda, a high prevalence area, began with pre-and
post- test counselling, but as it was community based programme this was not found to be
adequate. As the programme developed, the counselling service became a way of strengthening
the community to withstand the effects of HIV/AIDS. The paper describes the de-centralization of
the counselling programme from medical centre to community centres. To monitor and evaluate
the programme a set of quantitative and qualitative indicators were developed, these are
introduced and discussed.
Notes: 2 copies
Balmer, D. H., Grinstead, O., Kihuho, F., Gregorich, S. E., Sweat, M. D., Kamenga, M. C.
et al. (2000). Characteristics of individuals and couples seeking HIV-1 prevention services in
Nairobi, Kenya: The voluntary HIV-1 counselling and Testing Efficacy study. AIDS and Behavior,
4, 15-23.
Ref ID: 183
Keywords: client/client profile/couples/prevention/VCT/voluntary counselling and testing
Abstract: This paper describes the recruitment and baseline characteristics of men, women, and
couples who enrolled in the Voluntary Counselling and Testing Efficacy Study at the study site in
Nairobi, Kenya. The purpose of this study was to test the effectiveness of Voluntary HIV
Counselling and Testing(HIV VCT) to reduce sexual risk behavior. Between June 1995 and
March 1996, 500 individual men, 500 individual women, 515 couple members were recruited for a
total sample of 1,515 participants. Participants were young( average age 29 years) and of low
79

income. High levels of risk behavior and self-reported STD symptoms and high rate of HIV
seropositivity among those tested at baseline (15% of men and 27% of women indicate that an
at-risk sample was recruited. Women and participants reporting symptoms of a sexually
transmitted infected were significantly more likely to be infected with HIV. Findings suggest that
HIV VCT services combined with STD diagnosis and treatment and economic development
services could motivate more at-risk individuals and couples to receive counselling and testing.
Notes: 1 copy
Ref ID: 456
Banda, M. A. (1994). Evaluating home-based care. AIDS Bulletin, 3, 17.
Keywords: community/education/evaluation/family/health/health education/Home based
care/Zambia
Abstract: Acceptance of home-based by patients is generally high ( ranging between 65% and
95%) and home-based care has the potential to lessen the load at hospitals and reduce the cost
of care. These were some of the conclusions of an evaluation of seven home-based care
projects in Zambia in 1992 which included the well-known Chikankata programme. It was found
that services offered to patients and communities also included counselling, health education,
food supplementation, spiritual and material assistance. Home-based care appeared to be
cheaper than hospital admissions for HIV/AIDS related conditions but it was not possible to
determine indirect costs ( such as the burden on the family).
Notes: 1 copy
Banerjee, K. (1993). AIDS - Glimpses of African Experience. Journal of Indian Medical
Association, 91, 317-318.
Ref ID: 268
Keywords: Africa/Zimbabwe
Abstract: The article gives a historical review of AIDS in Africa, state of Aids epidemic in Africa,
and it gives the national Aids control programme with some observations done in Zimbabwe.
Notes: 1 copy
80

Ref ID: 8506
Bantam, H. (2001). Hospice scheme to aid township AIDS victims. Herald.
Keywords: Africa/care/clinic/community/family/government/health/Home care/Home based
care/poverty/Southern Africa/training/WHO/women
Abstract: Motherwell and Walmer Township AIDS sufferers will soon benefit from a project
initiated by the Hospice Association of Southern Africa (Hasa) to help them. The integrated
community Home-based care (ICHC) pilot project has found home-based care is a proven
method of helping people who are dying from HIV/AIDS. St Francis Hospice in Cotswold
Extension is one of seven hospices around the country which started projects 18 months ago.
Running from March 1999 to August this year, the Government funded project involved the
training of two careworkers, backed by various health care professionals and the hospice on foot
service to patients in the New Brighton area dying of AIDS, said Alison Shelton of St Francis
Hospice. She said the care process began when the hospital or clinic referred the patient to
hospice. She said the care process began when the hospital or clinic referred the patient to
hospice. "A visit by the home care sister decides whether careworkers are needed. Counselling
the patient and family, and helping them come to terms with the diagnosis is also part of the care.
In addition, an important educational aspect of their work is to hold workshops. "Through this
project, the prejudice against some patients is lessened ," she said. "Because many recipients of
the service live in poverty and their medication cannot be taken on an empty stomach, a group of
Greek women , philoptochos, has provided soup to patients". Any assistance for the project will
be welcome.
Notes: 1 copy
Ref ID: 8149
Barker, W. (1998). "I am so tired, so tired". Saturday Argus.
Keywords: Zimbabwe
Abstract: The article gives the story of a zimbabwean lady who caught up Aids. She tells her own
experience.
Notes: 1 copy
81

Barnes, L. (1998). AIDS test not a priority when survival is key: HIV-positive black gays
face double stigma due to "in-African" lifestyle. Cape Argus.
Ref ID: 762
Keywords: community/counsellor/HIV-status
Abstract: If you don't have a job or a solid roof over your head at night and don't know where you
are going to get your next meal, what difference will having an Aids test make to you? Knowing
whether or not one has been infected with the Human Immuno-deficiency Virus (HIV) is not
always a priority in certain communities exist and energy is spent on survival and meeting basic
needs. This is the finding of counsellors working for Triangle Project in Gugulethu, the area
which at 12% has the highest percentage of people infected with the virus. Added to this is the
stigma attached to people known to be HIV-positive, who face rejection, threat of harm and may
even be hounded out of their homes and communities by fearful or ignorant neighbours. The
considerable resistance to testing that community workers encounter is hardly surprising. " Some
people prefer not to know their HIV status as they fear rejection and blame." There is a high level
of denial and fear. Many of our clients are unemployed and are supporting themselves, so HIV
becomes a secondary concern. Other things become more important, like getting work and
something to eat.
Notes: 1 copy
Barron, P., Strachan, K., & Ijsselmuiden, C. B. (1988). The year in review.
Ref Type: Unpublished Work
Ref ID: 519
Keywords: health/media
Abstract: Health was again never far from the headlines during 1996/97. This chapter highlights
many of those moments that grabbed the public's attention. It also points out some of the
achievements, problems and changes of the health sector that were not so attention grabbing in
the eyes of the media, but which were at least as important in the long term transformation of the
health sector.
Notes: 1 copy
82

Basson, P. M. (1992). 'N verpleegkundige begeleidingsprogram vir persone wat
infektering met die mensllike immuniteitsgebrekvirus vermoed. Dissertation, Universiteit van die
Oranje-Vrystaat.
Ref ID: 205
Keywords: Nurse/Nursing
Notes: 1 copy
Beardsell, S. (1994). Should wider HIV testing be encouraged on the grounds of HIV
prevention? AIDS care, 6, 5-19.
Ref ID: 270
Keywords: behaviour change/HIV testing/prevention/research/safe sex/sex
Abstract: The issue of the role of HIV testing in HIV prevention is an important one. Some
commentators have argued that HIV testing should be encouraged more widely on the grounds
that it can stimulate behaviour change to safe sex and drug use. Testing has been advanced as
an important means to control the epidemic. There is, however, insufficient evidence to support
this contention at this time. The hypothesis of a link between HIV testing and behaviour change
is based on the assumption of a linear relationship. It is argued that this assumption is based on
two others, that the "stimulus" of testing and counselling is uniform, and that information will be
perceived and used by all recipients in an identical way. It is argued that there is currently
insufficient research evidence to encourage more widespread testing on prevention grounds.
Issues which should be considered in future research designs are discussed.
Notes: 1 copy
Beardsell, S. & Coyle, A. (1996). A review of research on the nature and quality of HIV
testing services: a proposal for process-based studies. Social Science and Medicine, 42, 733-
743.
Ref ID: 413
Keywords: HIV testing/process research
Abstract: Considerable research has been conducted on various issues associated with HIV
83

testing. However, rather than conceptualizing HIV testing as a dynamic process which consists
of interrelated elements, this body of work has focused on discrete aspects of the HIV testing
process. As an example of such research, studies which have examined HIV testing in terms of
various behavioural and psychological outcomes are critically reviewed. Their limitations are
attributed to their failure account for all the elements involved in the HIV testing process that -
singly and in dynamic combination - could have produced the measured outcomes. It is
contended that if research on HIV testing is to be of use in the development and improvement of
HIV testing services, it should be able to identify and describe in detail the factors that might lead
to various outcomes of testing. This requires an in-depth examination of all aspects of the HIV
testing process and their interrelationships from the perspectives of those undergoing testing and
those providing testing services. The principal process element in HIV testing are described;
existing research on these topics is critically reviewed; and recommendations are made for future
research. The process elements of HIV testing are identified as making a decision to be tested;
accessing testing services; test counselling; and waiting for the test result. Of these, most
consideration is accorded to the HIV test counselling process. It is contended that research is
needed which examines both clients' and counsellors' expectations, experiences of and
satisfaction with HIV test counselling. Specific issues that could usefully be addressed by future
research include the process of obtaining clients' informed consent for testing; the ways in which
test results are conveyed to clients; the strategies used in HIV counselling to help clients avoid or
reduce risk behaviours in the future; partner notification; and professional groups are best placed
to conduct HIV test counselling. Finally, the question of which research methods might be
suitable for process-based studies is considered. It is concluded that qualitative methods could
be particularly appropriately as they are well-placed to chart in detail the varied aspects of the
HIV testing process and their interrelationships.
Notes: 1 copy
Ref ID: 7792
Beaver, T. (1999). Comfort in the abyss of despair. Saturday Star.
Keywords: clinic/counsellor/health/medical/suicide
84

Abstract: The author writes about a family doctor in the Southern suburbs of Johannesburg who
had to give three high school children their HIV results - all had tested positive. Within a week,
one of them, a matric pupil, shot and killed himself, unwilling to live with this premature death
sentence. The doctor who read about the suicide in a newspaper, phoned a friend in a panic and
said:" I don't know what I did wrong. I feel so responsible". This scenario can be avoided if
medical professionals and counsellors who deal daily with HIV results are able to manage the
outcome of an HIV test effectively. Although doctors are usually informed about the prognosis
and treatment of an HIV- positive patient, some are not at all prepared for the emotional fallout of
an infected person. The Esselen Street Health Clinic in Hillbrow offers a two-week course to
people willing to learn the complicated process of counselling and HIV-positive person, although it
may seem that the infected person is the person most likely to need counselling, it isn't that
simple.
Notes: 1 copy
Ref ID: 4696
Beaver, T. (1999). Keeping hope alive in the face of death. Sunday World.
Keywords: care/counsellor/disease/information/quality of life/sex/Virus/WHO
Abstract: South Africans are finally beginning to realise the deadliness of HIV/Aids and are
beginning to take more care. Just because a person tests negative does not mean that they
should go on as usual. Having an HIV test means taking responsibility for your status-positive or
negative. We speak to about having safer sex, offer them free condoms."
If they are positive, we let them know that HIV is a disease that can be lived with. Although there
is no cure, your quality of life can be as good or as bad as your attitude." Tshabalala says that as
a trainee counsellor he felt awful telling anyone that they had tested positive for the HIV virus.
"You feel as if you are responsible for telling them they have a serious disease. They come into
your office happy and smiling and sometimes they leave devastated and you really feel for them.
Tshabalala says people are aware of Aids, but many are not educated on issues that could
prolong their lives or save the lives of others. He says:" We cannot give people who have tested
positive a false hope, but we can arm them with information that could prolong their lives for
85

years.
Notes: 1 copy
Ref ID: 3425
Bechoo, I. (2001). Hospital's new resource centre proves popular. Daily News.
Keywords: clinic/HIV testing/medical/NGO/women
Abstract: Addington Hospital's new advice desk and HIV /AIDS resource centre have become a
beacon of hope for people with HIV and victims of abuse who are flocking to the hospital for
support and testing. Visitors to the Sinothando( we have love) Centre, which comprises the
advice desk and HIV/AIDS resource centre, have increased rapidly over the last few months.
The advice desk was initiated by nursing tutor Miss Claire Mooideen, who joined forces with other
hospital staff like sister Daphne Pretorius, who is charge of the staff clinic, to make the idea a
reality. The steering committee approached non-governmental organisation. The Advice Desk
for Abused Women for guidance in setting up the desk and the NGO also provided man it.
However; by June more than 30 hospitals staff, who have volunteered to be trained as
counsellors, will man the desk in their spare time. A helpline has also been set up at the hospital.
Mooiden said women did not want to talk about abuse when they went to hospitals. "They come
in only for medical treatment, but it is left to healthcare workers to find out what happened. We
must not look only at their physical injuries and overlook the abuse". Deputy managing director at
Independent Newspapers KwaZulu-Natal, Mrs Fathima Ussuph, a member of the board of
directors on the Advice Desk of Abused Women, said the help desk was a critical one stop shop
for people with problems of abuse. "There is such a lot of abuse going on and women have to
stand together and stamp it out. We have to talk with a united voice to get rid of social abuses".
She said it was our responsibility to support those who were making a difference. "We can make
a difference by being observant, aware and by encouraging others to speak out against abuse.
We can educate women and people in general about their rights." The HIV/AIDS resource centre
at Sinothando has also proved to be very much in demand. Run by Sister Cynthia Luthuli, an
HIV counsellor who also trains counsellors, the centre attracted seven people in January, but this
number rose to 33 in February. Acting medical superintendent Dr Valerie Geyer said the initiative
86

came about after staff raised concerns about the increases in HIV and abuse. Luthuli said 53
HIV/AIDS counsellors would be trained to deal with patients. Her centre offers counselling and
HIV testing for as little as R12. She said she was pleased to see young people coming in to the
centre to be tested voluntarily. Geyer said legal advice was also offered to patients and the
public at the hospital twice a month on Fridays at the resource centre. The staff have been
raising funds through cake sales to furnish the centre and are making an appeal to the corporate
sector for funding.
Notes: 1 copy
Behrendt, C., Kendig, N., & Dambita, C. (1994). Voluntary testing for HIV in a prison
population with high HIV prevalence. American Journal of Epidemiol, 139, 918-926.
Ref ID: 434
Keywords: HIV prevalence/HIV testing/infection/men/population/strategy/Virus/women
Abstract: This study evaluated voluntary testing for human immunodeficiency virus (HIV) in a
prison population with a high HIV seroprevalence. Data on demographic variables and
participation in Voluntary testing were linked to a blinded HIV serosurvey of consecutive Maryland
prison entrants (April - July 1991). Among 2,842 entrants, HIV seroprevalence was 8.5% (men,
7.9 %; women, 15.3 %). Voluntary testing was accepted by 47% of the entrants, and it identified
34% of the HIV - seropositive inmates detected by the serosurvey. Refusers of testing were
more likely to test HIV-seropositive than were acceptors. Refusers and acceptors of testing had
similar risk factors for HIV infection, chiefly current syphillis infection and prior injected drug use.
Among 100 entrants asked why they refused testing, primary reasons given included low risk of
HIV, fear of testing HIV seropositive, and lack of interest. Voluntary testing appears only
moderately successful in identifying HIV - seropositive inmates in a high-seroprevalence prison
population. However, the alternative, mandatory HIV testing of prisoners, can be construed as
discriminatory and unethical when similar screening is not imposed on the population at large.
Data presented here suggest strategies to improve acceptance of voluntary testing, especially by
high risk inmates.
Notes: 1 copy
87

AIDS.
Bennett, J. (2000). A district guide to prevention of HIV infection and care of patients with
Ref Type: Unpublished Work
Ref ID: 550
Keywords: care/HIV prevalence/Home care/infection/male/population/prevention/WHO/Young
people
Abstract: The population pyramids in the different regions of the Eastern Cape province are not
all the same as have very different proportions of male and female, children, adults and elders.
With the sexually active and most at risk population stretching from 14 to 65 it might include 56%
of the total population. This group as a whole now has an HIV prevalence rate estimated at 20%
meaning that the prevalence rate calculated for the whole population is about 11%. With a
duration from infection to AIDS and death of approximately 10 years this implies an incidence of +
-1-3% and probably about + -1-3% developing AIDS each year.
The 89% not infected need increased preventive measures to remain HIV negative. Most of
these are children and young people and some are older people, in stable unions.
The 11% HIV infected people in the whole population can be divided into two groups.
- the 10% infective not yet very ill who must be encouraged to be identified, to keep well, and not
to transmit the infection.
-The 1-3% who are developing AIDS and will need home care and terminal care.
These three categories of non-infected, infected and transmitting, and terminal hardly transmitting
will be described in greater detail. To assist in visualizing this situation of HIV and AIDS in the
population a draft diagram of a population pyramid is annexed.
Notes: 1 copy
Bennett, L. (1998). Psychological and socio-medical aspects of HIV/AIDS: a reflection on
publications in AIDS care(1989-1995). AIDS care, 10, 115-121.
Ref ID: 412
Keywords: community/condom/condom use/impact/policies/policy/research/sexual behaviour
Abstract: It is necessary to consider the content and methods of AIDS social research
88

publications for these represent research advances as well as current issues of concern for
practitioners, communities and researchers alike. This article critically examines some of the
research that has been conducted to date into social aspects of HIV and AIDS. It quantifies the
content and major methodological style of publications in the journal AIDS care from 1989 to
1995. The most commonly published topic area in AIDS care, during this period was cultural and
demographic issues (15.9%), followed by issues pertinent to the psychological impact of HIV
(13.6%), sexual behaviour and condom use (11.3%) and policy and services (9.5%). Research
and measurement issues were the least examined content area in AIDS Care 1989 -1995 (
2.6%). This article discusses possible variables that influence the style and topics that are
published in AIDS Care and makes suggestions for authors to consider before embarking on
future research projects or publications.
Notes: 1 copy
Ref ID: 2582
Benter, L. (2001). No govt AIDS commitment. Citizen.
Keywords: Africa/conference/drugs/medical/government
Abstract: The pharmaceutical Manufacturers Association (PMA) accused the government of not
regarding the treatment of HIV/AIDS as serious.
"We battle to see commitment from the South African Government to treat HIV in a responsible
and safe way," said Mirryena Deeb, chief executive officer of the PMA. "Pharmaceutical
companies have repeatedly said they would offer world-best prices for HIV/AIDS medication if a
government was serious and committed to treating HIV/AIDS." Speaking at a media conference
at the PMA offices in Midrand, Deeb said since the AIDS conference in Durban there have been
appeals for commitment from the South African Government to medication for HIV/AIDS. She
said the pharmaceutical industry could take responsibility industry could take responsibility only
for some things." First it was the pricing and then the toxicity of drugs followed by the questions
on whether HIV causes AIDS. She said an infrastructure was needed so that drugs could be
distributed to patients and monitored as being used correctly. "South Africa already has access
to world-best prices on various drugs, not only AIDS medication. Also, many companies have
89

made offers of free or cheap drugs to the government." The PMA and the government have been
involved in a court case since February 1998 regarding the Medicines and Related Substances
Control and Amendment Act No 90 of 1997 - specifically Section 15C. This section allows for the
abrogation of all patent rights for any pharmaceutical, upon ministerial discretion, said Deep.
Since the institution of legal action against the government, Act 90 of 1997 has been amended
with the introduction of the South African Medicines and Medical Devices Regulatory Authority
Act( Sammdra). According to Deeb while section 15C ultimately remained intact, the amended
law effectively rendered Act 90 of 1997 and Samdra unworkable. Deep said on realising that the
premature promulgation of Samdra brought about the collapse of the entire medicine regulatory
system in SA, the government joined the PMA in a court application to set the promulgation
aside. During this time the PMA had been affordable extensions to enable it to file final papers on
Act 90 of 1997.
Notes: 1 copy
Ref ID: 3764
Beresford, B. (2001). Govt sticks to current AIDS policy. Weekly mail and guardian.
Keywords: drugs/HIV testing/policies/prevention/research/transmission
Abstract: The government is set to move ahead with its current policies on the HIV/AIDS
epidemic, despite the failure of the presidential AIDS advisory panel to agree on many issues,
including whether HIV causes AIDS. The interim report of the advisory panel is a "synthesis of
deliberations" on HIV/AIDS among some of the famous - and controversial experts on the subject
in the world. The panel failed to reach consensus on many issues, including a causal link
between HIV and AIDS, the treatment and prevention of the diseases and the need and ability to
test for HIV. Saying that stimulating debate rather than reaching agreement was the purpose of
the panel, the government nonetheless will continue to follow the orthodox view that the HIV virus
causes AIDS. However, it will drive forward further research, including into the efficacy of local
testing for HIV in conjunction with research centres in the Unites States. Similarly, the
government will continue with HIV testing and surveillance, as well as the provision of anti-
90

etroviral drugs as part of a study into curbing the transmission of HIV from mother to child.
Notes: 1 copy
Ref ID: 4115
Beresford, G. (2001). Half of nothing and still fighting. Weekly mail and guardian.
Abstract: Nkosi Johnson is among the children to have survived longest with HIV, but this
determined 11 -years- old is now helpless.
They come to praise him. And to mourn him, although the skeletal 11-years-old child lying
unmoving in his bed is still doing the thing that brought him worldwide fame - living
For 11 years Nkosi Johnson has fought the good fight against HIV. He watched his mother and
many of his friends die of the disease, yet that did not drain the bright, vigorous boy of life. But
now the virus has attacked his brain, causing AIDS-related dementia. Although there is still
hope, the politicians, media and friends flooding his house make it clear they are attending
deathwatch.
Notes: 1 copy
Berger, R. A., Porter, L., Mekisini, G., & Courtright, P. (1994). Traditional healers in AIDS
control. AIDS, 8, 1511-1512.
Ref ID: 27
Keywords: acceptability/health worker/health workers/knowledge/prevention/support/traditional
healer/traditional healers/training
Abstract: This paper states that traditional healers are common and culturally accepted health-
care providers throughout Africa. Because of their community acceptance, their role as
"guardians of traditional codes of morality and values", and their freedom to discuss sensitive
matters, healers represent an important community resource in AIDS prevention and control
efforts. The evaluation of whether participatory education of healers would bring about changes
in knowledge and practice surrounding recognition and treatment of sexually transmitted diseases
(STD) and AIDS.
Notes: 1 copy
91

Biehl, L., Coutinho, D., & Outeiro, A. L. (2001). Culture Medicine and Psychiatry. Culture
Medicine and Psychiatry, 25, 87-129.
Ref ID: 366
Keywords: culture/medicine/psychiatry
Abstract: Contemporary techno scientific and medical developments are restructuring social
interactions and the very processes by which individual subjectivity is formed. This essay
elaborates on the experiential and ethical impact of such transformations from the perspective of
people who, in ordinary and unexpected ways, act science and technology out. We carried out
ethnographic research in an HIV/AIDS Testing and counselling Center (CTA) in northeastern
Brazil, combining participant observation with epidemiological analyses and clinical survey. We
found a high demand for free testing by low-risk clients, largely working and middle class,
experiencing anxiety and complaining of AIDS-like symptoms. Most of the clients were sero-
negative and many returned for a second and third testing. We understand this to be a new
techno-cultural phenomenon and call it imaginary AIDS. Throughout this essay, we describe
CTA's routine practices, place these practices in historical, political, economic and cross-cultural
perspective, and analyze the subjective data we collected from the clients of our pilot study. We
explore how clinical epidemiological expertise and HIV testing technology are integrated into new
forms of bio-politics aimed at specific marketable and disease-free populations, and on the
effective absorption of bio-technical truth and the engendering of technoneurosis in this testing
center.
Notes: 1 copy
Ref ID: 193
Bisseker, C. & Lundin, J. (2001). Anglo's leap of Faith. Financial Mail, 161, 38-46.
Keywords: ARV/business/employee/employer/mining industry/prevention/treatment/workplace
Abstract: We need to prove the hypothesis that the cost of treating AIDS effectively will be less
than the cost of doing nothing. This is our point of departure. At the moment, it's leap of faith, but
we can get the evidence to prove the hypothesis.
Anglo's new AIDS strategy:
92

.Support community-based HIV/AIDS prevention initiatives.
.Carry out anonymous, voluntary HIV prevalence surveys at all Anglo operations
.Encourage large-scale voluntary counselling and testing for HIV
. Improve care for all HIV-infected employees and their families.
.Seek to offer cost-effective antiretroviral therapy to all workers with AIDS.
. Prevent mother-to-child transmission
. Carry out a mass campaign to treat and prevent sexually transmitted diseases
. Participate in AIDS vaccine trials.
Pushing for growth: Cabinet briefings key points:
. Review immigration laws to attract high-end skills by the end of the year.
.Targeted assistance for growth sectors like tourism and IT
. State-led black economic empowerment, for example more affirmative procurement; to help to
access finance
. Dispose of 669 000 ha of State land.
. Reduce poverty by half in 13 targeted rural and urban areas over 10 years.
. Lift moratorium on crime statistics at end of June Business and employment opportunities
. R 6bn infrastructure budget, channeled through private sector, for roads, schools, clinics
. 3 000 apprenticeships in tourism sector.
. Assistance for 4 000 new black - owned tourism enterprises
. Sea port concessions
. Incentives for investments in 13 rural and urban development "nodes".
Notes: 1 copy
Peninsula.
Ref ID: 380
Blecher, M. S. (1992). Awareness of AIDS among STD clinic attenders in the Cape
Keywords: health education
Abstract: This descriptive study aimed to determine the knowledge attitudes and practices about
AIDS among Sexually Transmitted Disease (STD) clinic attenders in the Cape Peninsula. A
93

questionnaire containing open and closed questions in the appropriate language (English,
Afrikaans or Xhosa) was administered by trained clinic staff to 306 patients in 9 or the 29 STD
clinics in the region. The study was requested by the local authorities to initiate and improve
AIDS education programmes within the STD clinics. 306 patients were interviewed in 9 clinics.
The median age of attenders was 25 years. The median period of residence in the peninsula was
7 years. Knowledge of AIDS is reasonably good when tested by true/false questions bears little
relationship to practice. There is inadequate awareness of the asymptomatic carrier state, the
incurability of AIDS and ways to prevent AIDS. Sexual practice is high risk. Condom use is
extremely low especially in the Africa areas where only 9,6% used a condom in the past year.
Prostitution is perceived to be a common occurrence in attenders' communities. There is a low
perception of risk to self. The most important beliefs militating against condom use are that they
are unacceptable to partners and peer group. More information about AIDS was requested by
90% of patients and a strong preference was expressed for programmes to the conducted in the
patient's home anguage. l
This study supports the urgent need for an AIDS education and counselling programmes for
patients with STD's in the region. Recommendations include the need to address the emotions,
attitudes and beliefs that affect behaviour as well as to convey knowledge. Condom acceptability
poses a major problem that will need to be addressed. Patients with STDs represent an
extremely important core group for HIV transmission to others in the community and need specific
attention and resources.
Notes: 1 copy
Ref ID: 2492
Bloch, J. (2000). Creativity project helps people living with AIDS. Saturday Star.
Keywords: Africa/America/community/family/infection/South Africa/women
Abstract: How do South Africa's millions of HIV positive people come to terms with theirdisease,
and live the fullest lives possible? The Living Together Project is a project of Global Alliance for
Africa initiated and coordinated by fieldworker Betsi Pendry. It uses a simple but powerful tool to
help people accept and even embrace their circumstances-their own human creativity. "
94

Creativity is so important", says Pendry, an American who came to live and work in South Africa
in 1998, after doing HIV/AIDS-related work for about 10 years in North and South America. " As
human beings, we often identify intelligence as our greatest strength, and forget our capacity to
create and recreate, either in the making of art, or in the social environment". Pendry says that
women are not only particularly vulnerable to infection, but are often the ones who care for sick
family members. She hopes to address the gap between those who are infected and the
communities they live in.
Notes: 1 copy
Ref ID: 226
Boncoungou, J. (2000). Couple and HIV/AIDS: break the silence. In (pp. 7).
Keywords: couples/prevention/impact/WHO/information
Abstract: Objectives: To assess how often HIV/AIDS talks are involved into household
conversations in the one hand, and equally to assess of what interest HIV-screening is to
couples.
Methods: In order to assess the impact of counselling about HIV -screening among seropositive
couples, a questionnaire was made available to all consultants of Bobo- Dioulasso city who
agegroup ranges 18-45, having an active sexual live and living together as couples.
Results: A total number of 128 consultants were addressed for the study. Among them, 78 i.e.
(61%) were reported to often talk about HIV/AIDS affection in their couple conversations or with
partners. Yet 39% kept silence about their affection for various reasons. However 91 i.e. (71%)
of them agree to be screened after counselling. Among them only 55 were found couple
seropositives. Out of the affection by informing their partners.
Conclusion: HIV/AIDS affection often comes into private conversations of many couples (61%).
Although a considerable number of consultants show sessions, a great number (76%) remain
silence about their affection only to reveal it too much late. So far strong efforts remain to be
made through permanent sensitization and information and adequate care-taking of the already
affected, if we are to achieve good results in prevention and fighting against HIV/AIDS
95

dissemination inside our hearts.
Notes: 1 copy
Bonnin, D. (1990). 1st International Regional Meeting of Women and Health in Africa.
Agenda: A journal about women and gender., 6, 31-39.
Ref ID: 22
Keywords: Africa/conference/health/Uganda/women
Abstract: The paper gives the account of the International first regional meeting of women and
health in Africa. From the 23-28 October 1989 over 200 delegates from 12 African countries met
in Mukono, Uganda to attend the first African Regional Meeting of women and Health organised
by the Uganda Chapter of the Women's Global Network on Reproductive Rights. The main aim
of this historic event was: to bring women from all African countries to a single platform to
discuss the issues related to their health, to share experience and problems that affect them as
African women, to strengthen and consolidate networking on women's health issues in Africa and
to decide on priorities and activities at country and regional level. the main themes for the
meeting were reproductive rights, community health, environmental health hazards, population
policy and aids. Recommendations and resolutions from the conference are provided.
Notes: 1 copy
Bor, R., Miller, R., & Perry, L. (1988). AIDS Counselling: Clinical Application and
Development of services. British Journal of Guidance and Counselling, 16, 11-19.
Ref ID: 214
Keywords: HIV/AIDS counselling/medical/psychosocial/service/service delivery/stress
Abstract: The reasons for the provision of AIDS counselling services, and the ways in which they
have developed, are described. The role of the counsellor both in medicine, and in the field of
AIDS/HIV infection, is outlined. The psychosocial difficulties accompanying this illness are
reviewed. stress is placed on the need to consider not only the client, but also their sexual
partners, family, friends, colleagues and even other members of the health-care team. Further
investigations need to be carried out to clarify where AIDS counselling services fit with other
96

medical and paramedical services.
Notes: 1 copy
Bor, R. & Miller, R. (1988). Addressing "dreaded issues": a description of a unique
counselling intervention with patients with AIDS/HIV. Counselling psychology Quarterly, 1, 397-
406.
Ref ID: 410
Keywords: counsellor/intervention
Abstract: The authors describe an approach to counselling patients with AIDS/HIV in which the
patients main anxieties can be addressed. A definition of 'AIDS counselling and 'Dreaded issues'
is offered. The choice of method is derived from experience with over 1,000 patients. A
therapeutic strategy is used in which hypothetical and future-orientated questions asked by the
counsellor can help to sidestep denial and resistance with patients. Clinical case examples are
described in order to illustrate the approach. Some of the advantages as well as the limitations of
the approach, patients and staff, are considered.
Notes: 1 copy
Ref ID: 567
Bor, R. (1989). AIDS Counselling. AIDS care, 1, 184-185.
Keywords: conference/medical/research/treatment
Abstract: Those awaiting news of a significant breakthrough in the fight against AIDS are least
likely to find them in research into the psychosocial aspects of HIV/AIDS and AIDS counselling.
In this respect, the 1989 Montreal AIDS conference was predictable. Nonetheless, there is
evidence of considerable activity in counselling (theory, research and practice) and it seems
certain that as long as there is no cure and treatment of only limited efficacy, that this interest in
counselling will be sustained and supported by the medical profession as well as others.
Notes: 1 copy
Bor, R., Miller, R., Scher, I., & Salt, H. (1991). The practice of counselling HIV/AIDS
Clients. British Journal of Guidance and Counselling, 19, 129-138.
97

Ref ID: 215
Keywords: HIV/AIDS counselling/model/psychological issues/psychology/review
Abstract: AIDS/HIV has been described as one of the most pressing medical and social problems
of this century. A review of the psychological and counselling literature relating to it indicates that
the predominant psychological problems as being inevitable in the course of illness. A systems
approach is considered to have a good 'fit' with HIV -related problems because of issues relating
to unpredictability, relationships, interaction, complexity and secrecy which arise in the course of
the illness and its management. Some of the counselling tasks of an AIDS counsellor are set out.
Consideration of these can help the system (client, family, health care team, counsellor) both to
define problems and to find solutions to them without resorting) both to define problems and to
find solutions to them without resorting to prior assumptions about either.
Notes: 1 copy
Bor, R., Miller, R., Salt, H., & Scher, I. (1991). The relevance of a Family Counselling
Approach in HIV/AIDS: Discussion paper. Patient Education and Counselling, 17, 235-242.
Ref ID: 343
Keywords: family counselling/system approach
Abstract: Most AIDS counsellors have tended to focus on the individual plight of patients. This
engenders symptom ( depression, anxiety, suicide attempts and so on), relief. No illness occurs
in a vacuum. Treatment and care takes place in a particular setting with designated staff at a
certain point in the evolution of a socio-medical context. While AIDS may be seen in the context
of both general chronic illness, and a specific illness in view of its unique social connotations, it is
also a symptom. AIDS is a symptom because it brings into focus relationship issues. A symptom
may also be defined as a metaphor for an ecology of relationships. These may engender some
of the following: problems associated with uncertainty, unpredictability, continuity, change,
transition, stability and complexity. There is a fit or coherence between a family counselling or
systemic conceptual framework and the management of HIV/AIDS - related problems. The
relevance of this is discussed.
98

Bor, R., Miller, R., & Johnson, M. (1991). A testing time for doctors: counselling patients
before an HIV test. BMJ, 303, 905-907.
Ref ID: 378
Keywords: health/HIV testing/Informed consent/prevention
Abstract: There have been considerable advances in the diagnosis, assessment, treatment, and
prevention of HIV infection since AIDS was first described in 1981. Because of these advances
HIV testing will inevitably become more widespread and more routine part of clinical investigation
and diagnosis. Up to now, however, doctors have often been deterred from testing patients for
HIV. This may be due in part to the apparent mystique that surrounds pre-HIV test counselling.
Deciding whether to test for HIV has always been difficult because social, psychological, and
ethical consequences have tended to be as pressing as the medical implications. These have
deterred patients from coming forward for testing and some doctors from suggesting a test to
patients. In addition, informed consent to testing has been recommended in pretest guidelines
from the World Health Organisation and the BMA, which may intimidate doctors as there is no
consensus about what constitutes informed consent. HIV and AIDS counselling is not
psychotherapy and there is no right or wrong way to counsel in medical settings. Ultimately, the
decision to test lies at the confluence of the doctor's clinical judgment and the patient's personal
views and psychological circumstances. The overall aim of counselling before an HIV antibody
test is to "provide individuals who are considering being tested with information on the technical
aspects of screening and the possible personal, medical, social, psychological and legal
implications of being diagnosed either HIV positive or negative". Counselling also provides an
opportunity to educate people about the risks of transmission and discuss behaviours that may
reduce these risks.
Notes: 1 copy
Bor, R., Miller, R., & Salt, H. (1991). Uptake of HIV testing following counselling. Sexual
and marital therapy, 6, 25-28.
Ref ID: 565
Keywords: clinic/HIV testing/impact/information/physician/pre-test
99

Abstract: To date there is little information on the impact of pre-test counselling on patients
decisions about consenting for HIV testing. One-hundred patients, 58% referred by a physician
and 42% self-referred, were counselled about the test. Almost all reported some previous risk of
HIV. Ninety-three subsequently underwent testing. Of the remaining seven, five were unsuitable
for testing and two did not attend the phlebotomy clinic. The approach to and method of HIV test
counselling may be one of the factors involved in he high uptake of testing, although there are
methodological difficulties in proving this.
Bor, R. & Elford, J. (1992). Evaluation of an intense HIV/AIDS counselling course in
Zimbabwe. Health and Education Research: Theory and Practice, 7, 431-436.
Ref ID: 269
Keywords: evaluation/HIV/AIDS counselling/training/Zimbabwe
Abstract: The anticipated increase in the number of people with HIV infection and AIDS in
Zimbabwe, together with those who have associated worries, will place extra demands upon
clinical and counselling services in the coming decade. To meet these demands, a wide range
of health care staff will have to acquire specialist counselling skills. For this reason, an intensive
2 day HIV/AIDS counselling training course was run at the family counselling unit, Harare, in
February 1989. The structure, content and evaluation of the course are present here. Overall,
the course was positively evaluated by the 38 trainees. However, a number of trainees were
critical about some of the teaching methods and the degree of emphasis given to some of the
objectives. Our experiences may help others in establishing HIV/AIDS counselling courses
elsewhere.
Notes: 1 copy
Bor, R., Miller, R., & Goldman, E. (1993). Counselling the "worried well"in HIV disease.
International Journal for the Advancement of Counselling, 16, 47-55.
Ref ID: 339
Keywords: counsellor/infection
Abstract: HIV infection may have a psychological impact not only on those who live with the
100

disease, but also on people who may worry that they have been infected. Counselling people
who are worried about infection, but who are HIV negative is an important, yet challenging,
dimension of HIV care. If forces counsellors to address how they deal with resistant patients and
those who, in some cases, present serious psychological disturbances. This paper discusses the
presentation and management of the "worried well" in HIV disease.
Notes: 1 copy
Bor, R., Miller, R., Goldman, E., & Scher, I. (1993). Counselling in action: The meaning
of bad news in HIV disease: counselling about dreaded issues revisited. Counselling psychology
Quarterly, 6, 69-80.
Ref ID: 340
Keywords: disease/health/infection/medical
Abstract: HIV disease is a slow, progressive immunological disorder. As there is neither a cure
nor a vaccine, morbidity and mortality arising from HIV infection will continue to challenge health
care providers, including those who counsel these patients. Psychological preparation for "bad
news" and support for those whose health is deteriorating is an important task in HIV counselling.
This paper describes what may be considered bad news for people living with HIV, how to
prepare them for unwelcome changes in their medical condition and how to give bad news,
should the need arise.
Notes: 1 copy
Bor, R., Miller, R., Godlman, E., & Scher, I. (1993). Systemic theory in counselling people
with HIV disease. International Journal for the advancement of counselling 1, 16, 37-46.
Ref ID: 341
Keywords: infection/Informed consent
Abstract: Since HIV disease became a pressing medical and social problem over a decade ago,
there have been significant advances in the care and treatment of those who have been infected
with the virus. Psychological counselling is a cornerstone of some programmes designed to
provide support and care. The emphasis has been on preventing the spread of HIV infection,
101

obtaining informed consent for an HIV test and psychological support in counselling. This paper
addresses the provision of psychological support for people with HIV disease in the context of a
systemic theoretical framework.
Notes: 1 copy
Bor, R. (1995). HIV counselling in the 1990 and beyond. British Journal of Guidance and
Counselling, 23, 3-7.
Ref ID: 411
Abstract: It is 15 years since AIDS was first described in the medical literature. Reports of
immune system disorders among gay men in large cities in the USA in 1981 signalled the start of
what has now become a pandemic affecting millions of people. The psychological impact of HIV
infection has been well-document and it is widely reported that psychological treatment is mostly
provided for the treatment of adjustment reactions. Counselling for HIV prevention and HIV
antibody testing has also been at the forefront of psychological support services. More recently,
there has been a determined effort among counsellors to develop a range of psychotherapeutic
approaches to help people to cope with and adjust to living with terminal illness. Most research
published in the 1980s on the psychological impact of HIV addressed the infected individual. This
symposium introduces a growing interest in the field for counselling those who are affected by
HIV, including families, health-care workers and communities. This trend is becoming the focus
of many counselling programmes worldwide and is likely to continue throughout the 1990s and
beyond.
Notes: 1 copy
Boswell, D. K., Kasonde, F., & Mwape, L. K. (2000). Counselling supervision: Promoting
best practice in counselling in Zambia. In (pp. 22).
Ref ID: 241
Keywords: Africa/burnout/ethics/NGO/Southern
Africa/training/Zambia/government/WHO/supervision/counsellors/counsellor/case
study/workplace/community/clients/client
102

Abstract: Issues: The practice of counselling remains largely unregulated in Zambia. Numerous
individuals have undergone counselling skills training provided by both government and NGOs.
This has resulted in a mass of individuals who refer to themselves as "counsellors" and who
practice "counselling" with no or limited supervision. When supervision does occur, it often does
not relate to best practice in counselling, nor does it address ethics, burnout or professional
development issues.
Description: In November 1999, Kara counselling and training Trust piloted the first course in
counselling Supervision to be held in Southern Africa. The course aims to improve the standards
of counselling in Zambia by developing a pool of individuals with basic competencies in
supervising fellow counsellors. The course was of ten day duration and included practical
components such as a role play, case studies, critiquing verbatim, homework tasks, videotaping
of individual sessions, and modelling the supervision process. Participants were drawn from
government and non-government sectors.
Conclusion: There is further need to promote the role of supervision as an integral component
of counselling practice across all sectors. Individuals who demonstrate competencies in
counselling as well as capacity to supervise others should be recruited and trained in counselling
supervision skills. Issues relating to ethics, professional development and burnout can be
appropriately addressed with the context of supervision. The introduction of counselling
supervision within workplaces and communities plays a crucial role in ensuring optimal outcomes
for our clients.
Notes: 1 copy
Botha, A. (1991). Die bepaling van standaarde vir gesondheidsvoorligting aan
tuberkulosepasiente.
The determination of standards for health counselling to tuberculosis patients. Submitted for
Degree of Masters in Social Science (Nursing) University of the Orange Free State ( UOFS)
(Medial Sciences :Nursing).
Ref ID: 198
Keywords: guidelines/health/model/standards/tuberculosis
103

Abstract: Tuberculosis is a chronic, sometimes acute, infectious disease which is characterised
by the formation of lesions in any tissue of organ, but mainly in the lungs. Although there are
effective, simple and standardised treatments of this disease, the health services world wide
could not eradicate this disease. The emergence of the Acquired Immunize Deficiency Syndrome
(AIDS) brought about an increase in the incident and prevalence of tuberculosis. The
development of resistant tuberculosisbacilli increases this threat even more. Health education
can play a major role in the prevention, early identification and successful treatment of
tuberculosis if programmes of high quality can be implemented. The formation of standards for a
health education programme are essential to ensure a high quality programme. Standards for the
structure requirements as well as the requirements for the development and evaluation processes
for a health education programme for the control of tuberculosis have been formulated by the
researcher and sent for a group of 14 experts in the RSA for validation. An evaluation instrument
for a health education has been compiled from the validated standards with a valid grading of
between 3 and 4. It is recommended that this instruments be used to evaluate the quality of the
health education programmes for the control of tuberculosis in order to identify and correct
deficiencies in the programmes.
Notes: 1 copy
Boult, B. (1992). Psychology of living with HIV infection:suicidal thoughts, behaviour
examined. Medical Chronicle, May, 66-68.
Ref ID: 92
Keywords: positive status/psychology/suicide
Abstract: The mental health professions were well represented in the early years of research and
service delivery in the AIDS area. The primary aim of these activities was directed towards
promoting behaviour change in the general population. This paper looks at the psychology of
living with HIV infection: how to overcome suicidal thoughts by pre-test counselling.
Notes: 1 copy
104

Boyer, C. B. (1997). Sexually transmitted disease (STD) and HIV risk in heterosexual
adults attending a public STD clinic: evaluation of a randomized controlled behavioral risk-
reduction intervention trial. AIDS, 11, 359-367.
Ref ID: 704
Keywords: clinic/education/evaluation/HIV prevention/intervention/sexually transmitted disease
Abstract: Objective:
To evaluate the efficacy of a cognitive/behavioral skills-building intervention to prevent sexually
transmitted diseases (STD) in high-risk heterosexual adults.
Design:
A randomized controlled trial with assessments at baseline, and at 3 and 5 months.
Setting:
San Francisco STD clinic
Patients:
A total of 399 patients were randomly assigned to a four-session, individual, multi-component,
cognitive/behavior intervention (n=199), or a brief standardized counselling session offered to all
patients (n=200).
Intervention:
Based on the AIDS risk-reduction Model, the aims of the intervention were to increase prevention
knowledge, reduce high - risk psychosocial factors, and build decision-making and
communication skills to modify sexual behaviors.
Main outcome measures:
The primary outcome of interest was STD. The secondary outcome was number of risk sexual
activities.
105

Results:
There were no differences between the intervention (13%) and control (11%) groups in their
acquisition of STD. Among men, condom use increased more at 3 months in the intervention
group than the control group (56.8 versus 42.3%; p< 0.05). In addition, the mean number of
sexual partners without condom use was lower in the intervention group than in the control group
at 5 months (0.6 versus 0.9; p< 0.01).
Conclusions:
The results suggest that a cognitive/behavioral, skills-building intervention consisting of individual,
multiple sessions and follow-up assessments can be implemented and evaluated with high-risk
heterosexually active adults attending public STD clinics. Our intervention did not have a
significant impact on STD, although it hard some impact on behavior in men, but not in women.
Notes: 1 copy
Bradshaw, D. (2000). Health for All - Monitoring Equity.
Ref Type: Unpublished Work
Ref ID: 518
Keywords: care/conference/health/primary health care
Abstract: The importance of equity in health is increasingly being recognised. Wilkinson, among
others, has argued that socio-economic inequalities are associated with poor health, probably
through the stresses generated by social breakdown that accompany inequalities and social
segregation. Equity was one of the principles of the "Health for all" strategy developed at Alma
Ata in 1978. The Alma Ata conference provided a vision of achieving the best attainable levels of
health for everybody through the implementation of comprehensive primary health care.
Equitable distribution of resources was included as one the global indicators 2 to monitor
progress towards "Health for All" by the year 2000.
Notes: 1 copy
106

Bradshaw, D., Masiteng, K., & Nannan, N. (2003). South African Health Review 2000.
Ntuli A., Crisp, N., Clarke, E., and Barron, P.
Ref Type: Unpublished Work
Ref ID: 8809
Keywords: disease/women/transmission/behaviour change/infection/health
Abstract: Infectious diseases
The SADHS showed that women were reasonably knowledgeable about the transmission of HIV
but this has not been translated into behaviour changes that will reduce the risk of HIV infections.
The prevalence os STD a co-factor in the spread of HIV, was high.
Notes: Chapter 4
Brimmer, W., Gillespie, I., & Schomer, H. (1996). Profile of attendees for voluntary HIV
testing-Western Province ATICC. South African Medical Journal, 86, 182.
Ref ID: 290
Keywords: ATICC/training/Western Province
Abstract: The Western Province AIDS Training, Information and Counselling Centre, known as
ATICC, has been operative July 26, 1989. According to Van der Velded and Taylor (1993) the
provision of a counselling service was, from the outset, regarded as an essential part of
preventative education, in accordance with the recommendations of the World Health
Organisation and successful AIDS service organisations.
By 1992 the number of persons presenting for blood tests for HIV Virus had reached 573 for the
calender year, of whom 533 were actually tested.
This paper describes various characteristics of these persons, based on counselling records, in
order to provide a demographic and behavioural profile of those presenting for HIV testing during
1992.
Overall, males presented at ATICC in greater numbers than females during 1992 (56% as
opposed to 44%) while females tended to present at a somewhat younger age(74% of females
under the age of 30% compared to 56% of males under that age ). Males generally reported
more sexual partners than females in both the preceding five and ten years and reported condom
107

usage tended to increase with increasing numbers of sexual partners. Accordingly those
reporting fewer sexual partners appear less likely to use condoms and therefore could be at
higher risk of contracting the HIV virus.
Males tended to exhibit greater condom usage consciousness than females. Reported condom
usage was lower amongst both sexes in those aged 40 and over and highest in the 20-29 age
group (66% using condoms" sometimes" or "always"). The most condom usage conscious age
group age group was the 20-29 year old group. There would therefore appear to be a greater
need to extend safer sex education to the older age groups.
It is recommended that a similar technical report be prepared in respect of 1993 to establish
whether or not the pattern shown in the present report has been maintained.
Notes: 1 copy
Broomberg, J. & Schopper, D. (1996). Global spending on HIV/AIDS prevention care,
and research. In M.J.a.T.J.M.Mann (Ed.), AIDS in the World II: global dimensions, social roots,
and responses: The global AIDS policy coalition (pp. 414-427). Oxford University Press.
Ref ID: 386
Keywords: global spending
Abstract: Estimating how much is spent on HIV/AIDS prevention and care in any country and at
the global poses an enormous challenge. Studies of public spending on AIDS often focus on the
cost of medical care and rarely consider prevention spending except for central government
expenditures. In the absence of clear information on funding of prevention and care, some
researchers suggest that spending on prevention and care represents only small fraction of
overall health expenditures; others claim that this spending adds a tremendous burden onto
already strained national budgets; and still others propose that a significant impact on the
pandemic could be achieved with global investment of a relatively modest amount of resources.
Notes: 1 copy
Ref ID: 309
Brouard, P. (1992). HIV and AIDS - a counsellor's perspective. The Leech, 61, 32-31.
108

Keywords: counsellor/health/sex
Abstract: In the absence of a cure or a therapeutic vaccine, this is a job which stretches to the
limit one's ability to deal with endless misery and helplessness. Yes, there are times when one is
able to help people to live more productive and interesting lives and there is a sense of
satisfaction in helping someone survive a crisis. But in the end it boils down to what one of my
clients said to me once - "Have you heard about wild animals when their leg is caught in a trap,
they bite the leg off to escape. Being HIV positive makes you want to do the same.
This work challenges all of us who deal with in any way to confront our prejudices around sex and
sexuality, our understandings of social forces, our ultimate powerlessness in the face of the
inevitability of death. But most of all we are challenges to confront our own discomfort with
human pain and our unwillingness to delve in the much and gore of emotions. We are so
tempted to "make nice", to cure, to treat that we dismiss, patronise and ultimately diminish the
people we help.
If I was to give any advice to a health worker when working either with someone contemplating
the HIV test or someone who is HIV-positive it would be: to treat your patient as someone who is
capable of making decisions( even if it takes time and thought for the decision to be made), give
your patient as much information as possible to make informed choices, consider the patient's
social context and most of all, be prepared to acknowledge the fears and feelings associated with
an HIV diagnosis. Your patient, once identified as being infected with HIV, is living with a sense
of loss and uncertainty. He or she is often forced to contemplate a shortened future and there are
many though decisions to be made.
Notes: 1 copy
Brouard, P. (1993). Deliberate infection with HIV: Myth or reality? AIDS Bulletin, 7, 11-20,
(Interview is only on pge 11, and continues on page 20).
Ref ID: 30
Keywords: deliberate infection/myth/psychology
Abstract: This article takes another look at deliberate infection of HIV negative individuals by HIV
positive individuals. Proper HIV counselling - both pre and post-test - is regarded as a means of
109

helping people own and accept the results of the test in a supportive environment and therefore
as a way of avoiding any possible antisocial or destructive behaviour from those who test
positive.
Notes: 1 copy
Brouard, P. (1997). Pitfalls in counselling - A response to Graham Greer. Positive
outlook, 4, 16-17.
Ref ID: 29
Keywords: quality of care/training
Abstract: Pierre Brouard, a psychologist involved in setting standards for HIV counselling in
Gauteng, responds to Graham Greer's ar ticle, "A family's journey through dying" in the last edition
of positive outlook.
Notes: 1 copy
Ref ID: 170
Brouard, P. (1998). The realities of counsellor training. AIDS Bulletin, 7, 15.
Keywords: counsellor/counsellors/training
Abstract: Earlier issues of the AIDS Bulletin and many other publications have featured articles on
the "do's and don'ts" of counseling and we continually hear that the standards of HIV/AIDS
counseling could be improved. However, counselors are only as good as the training they
receive, and often this vital aspect is not given the attention and respect it deserves. I have been
involved in training counselors in Gauteng, Kwa Zulu/Natal and the Northern Cape and would like
to share some of my experiences of the realities of and constraints to effective counselor training.
Notes: 1 copy
Brown, L., Macintyre, K., Rutenberg, N., & Hassig, S. (2001). Voluntary HIV counselling
and testing in sub-saharan Africa: an overview. Tulane School of Public Health and Tropical
Medicine and The Population Council Horizons Project. [-], 1-39.
Ref Type: Unpublished Work
Ref ID: 352
110

Keywords: Africa/condom/HIV-status/mother-to-child transmission/MTCT/prevention/sub-
Saharan/Sub-Saharan Africa/transmission/VCT/voluntary counselling and testing/Voluntary HIV
counselling and Testing
Abstract: Estimates of HIV in sub-Saharan Africa are becoming increasingly familiar, as the
prevalence of HIV in several southern African countries exceeds 20 percent. However, most of
those infected do not know it. Voluntary counselling and testing (VCT) is a programmatic strategy
for individuals to learn of their HIV status, while at the same time providing then with a link to both
prevention and care and support services. While many national HIV/AIDS programs include
VCT, services are not widespread and in many countries are limited to a few urban areas. The
efficacy of VCT has debated since the beginning of the epidemic, particularly in resource poor
setting and in the context of widespread stigma, although a recent multi-country randomized trial
of VCT has provided strong evidence that VCT services promote sexual behavior change in sub-
Saharan Africa. Despite the mixed evidence base on the efficacy of VCT the current emphasis
has largely shifted towards how to scale-up VCT services in resource poor settings. However
there are many obstacles to the widespread provision of VCT, including cost and a wide range of
operational issues necessary to improve the accessibility and quality of services. In a region of
scarce resources, VCT must compete with other prevention strategies such as media campaigns,
condom distribution, and STD control programs. Nevertheless, the imminent availability of
antiretrovirals to prevent mother-to-child transmission (MTCT) and to treat those who are infected
in sub-Saharan Africa may substantially increase the demand for VCT in the near future. People
must know their status prior to receiving care. Therefore it is crucial for us to understand and
ultimately overcome the operational issues related to delivering VCT services.
Notes: 1 copy
Brugha, R. (1994). HIV counselling and care programmes at the district level in Ghana.
AIDS care, 6, 129-137.
Ref ID: 23
Keywords: community/Ghana/health systems/patient care/primary health care/support/training
Abstract: The district hospital is the focus for the presentation of HIV-related disease in rural sub-
111

Saharan Africa. Patients require not only medical care, but often economic support and
counselling for themselves and their families. Psychosocial support should be provided at the
hospital and in the home, the latter often being the preferred option. A team approach to HIV
disease care and counselling, with careful selection and support of staff, and appropriate training
in counselling skills is essential. A primary health care approach at the district level, mobilizing
community participation and intersectoral support is necessary. community Health Outreach
Departments, as integral parts of the district hospital, are recommended and could pilot low-cost
HIV hospital and home-care programmes.
Ref ID: 5827
Brummer, W. (2000). Anglikaanse biskoppe laat hulle vir MIV toets. Die Burger.
Abstract: Kaapstad - Alle Anglikaanse biskoppe in Suider-Afrika sal hulle so gou moontlik vir die
MI-virus laat toets om onder meer hul solidariteit met MIV-lyers te betoon.
Die biskoppe sal ander geestelikes en leiers in hul gemeentes aanmoedig om hul voorbeeld te
volg. Die besluit is verlede week by die algemente sinode van biskoppe in Bloemfontein geneem,
te midde van kommer in kerkgeledere dat die Anglikaanse kerk nie aan die spits van die stryd
teen die MI-virus is nie. Die kerk wou ook sy solidariteit betoon met mense wat met die MI-virus
besmet is. Volgens die aartsbiskop van Kaapstad, eerw. Njongonkulu Ndungane, is die besluit
positief, omdat dit 'n eerste stap is in die verbreking van die stilte om die MI -virus, " Dit is hoog tyd
dat mense ophou om still te bly daaroor dat hulle positief is, " het Ndungane gese. Die ekonoom
mnr. Clem sunter het gese deur die besluit van die biskoppe sal ander hopelik aangemoedig
word om hulle ook te laat toets.
Notes: 1 copy
Ref ID: 7213
Brummer, W. (2001). Kliniek bied troos vir MIV-positiewe ma's en kinders. Burger.
Abstract: Kaapstad.- In die Groote Schuurhospitaal immuniteitsgebrek-kliniek vir MIV-positiewe
kinders en hul ma's is genesing en selfs langdurige beterskap buite die kwessie.
Die kliniek is egter 'n veilige hawe waar ma's soveel van moederskap kan smaak as wat vir hulle
112

moontlik is, en waar 'n dokter wat oor die jare vir hulle 'n vriend geword het, hulle en hul kinders
tot die einde kan vertroos.
Die kliniek is 1998 deur die pediater dr. Paul Roux met"slegs 'n ketel, koppies en 'n paar sakkies
tee" op die been gebring nadat hy besef het positiewe kinders en hul ma's het 'n behoefte
daaraan om deurentyd deur dieselfde dokter behandel te word.
Omdat daar reeds so 'n stigma aan vigs kleef, vertel Roux, wil pasiente nie elke keer dat hulle
dokter toe gaan, met iemand anders te doen kry nie.
Wanner enige kind met MIV/ vigs die eerste keer by Groote Schuur toegerlaat word, word 'n
suster na die ma gestuur om haar van die gratis kliniek te vertel.
Hierna kan die ma een keer per maand na die kliniek kom. Die kinders word dan ondersoek deur
dr. Roux en dr. Hillary-Ann van Wyk, 'n private dokter van Gatesville wat self haar dienste
aangebied het. Die ma's kry melk, pap, vitamiene en profilaktiese medisyne vir hulle en hul
knders en hulle het toegang tot die dienste van 'n maatskaplike werker en 'n arbeidsterapeut.
Om in hul eie gemeenskap na die ma's en kinders om te sien en gereelde steungroep by
eenkomste te hou, maak die kliniek gebruik van twee gemeenskapswerkers van die Rooi Kruis-
vereniging.
Volgens Roux word die belangrikste versorging egter deur die ma's self gedoen. "Die ma's vorm
hul eie steunnetwerk. Wanneer 'n ma haar kind moet afstaan, is daar altyd 'n ander ma op wie se
skouer sy kan huil. Die ma wat haar ondersteun, word terselfdertyd deur die ervaring voorberei
op haar kind en haar eie dood, "se Roux.
Wanner die kinders hul oe die laaste keer toemaak is dit in Groote Schuur se kindersaal met
dokters en verpleegsters wat hulle reeds hul hele lewe lank ken aan hul sy. Volgens Roux is dit-
veral vir die jong dokters - geweldig moeilik om na sterwende kinders om te sien. "'n Paar jaar
terug het dokters maar min daar- mee te doen gekry. Nou verloor ons soms drie kinders per
week-almal aan vigs ,"se hy. Sowat die helfte van die beddens in die kindersaal word aan
kinders met vigs afgestaan. Die kinders word op 'n al hoe jonger ouderdom opgeneen en gaan al
hoe vroeer dood. Dat die dokters die kinders en hul ma's so goed ken, maak dit vir hulle ook
makliker, reken Roux. Want daar is 'n gevoel dat hulle dot die bitter einde alles gedoen het wat
113

hulle kan...
"'n Mens kry twee soorte dokters, " se hy. "Die een soort loop die gevaar om te dink hulle is
almagtig en hulle kan mense genees. Die ander soort is bloot outydse sieketroosters. En dit is
nou wat jy nodig het vir vigspasiente. Dokters wat besef jy kan nie die siekte genees nie - jy kan
eintlik net troos." Om meet oor die kliniek te lees, besoek www.kidzpositive.org
Notes: 1 copy
Ref ID: 336
Burbidge, M. (2000). Women who cares for prostitutes speaks out. Saturday Star.
Keywords: prostitutes/prostitution/women
Abstract: The article outlines the concern of a woman who cares about the well-being of the
prostitutes. Her major concern is to make them the best prostitutes they can be, and that they
are HIV negative and remain that way.
Notes: 1 copy
Burgess, J. D. & Jacob, C. (1996). Home care for patients with HIV infection and AIDS:
Practical implications. CME, 14, 811-816.
Ref ID: 28
Keywords: guidelines/Home care/patient care/support
Abstract: South Africa will soon be dealing with the full effects of the AIDS epidemic. One of the
major problems will be the strain placed upon the health services and the resultant inability of the
established health facilities to admit and treat all the infected patients. It will fall upon the home
carer to look after them. Any health professional who has even a single HIV- positive patient
must prepared to become involved in a home care programme. This article considers some of
the practical issues pertaining to home care, and highlights some of the problems experienced by
a non-government agency, viz. the South African Red Cross Society, which developed a pilot
home-based care programme in Cape Town.
Notes: 1 copy
114

215-220.
Ref ID: 409
Burnard, P. (1992). AIDS counselling and nurse education. Nurse education today, 12,
Keywords: counsellor/counsellors/information/Nurse
Abstract: The number of people with AIDS and HIV related disorders is increasing. Nurses are
going to be called, increasingly, to act as AIDS counsellors. This paper explores some of the
issues involved in counselling people with AIDS and some of the related literature. It suggests
that any course for helping nurses to develop such skills will involve at least the following
elements: information, values clarification and basic counselling skills.
Notes: 1 copy
Burnett, A., Baggaley, R., McMillan, M. N., Sulwe, J., Hang'omba, B., & Bennett, J.
(1999). In Practice: Caring for people with HIV in Zambia: are traditional healers and formal
health workers willing to work together? AIDS care, 11, 481-491.
Ref ID: 24
Keywords: culture/health worker/health workers/knowledge/patient care/prevention/traditional
healer/traditional healers/training/transmission/treatment/Zambia
Abstract: This study of traditional healers and formal health workers determined their knowledge
and practices in the field of HIV/AIDS and examined their training needs and attitudes to
collaboration, in preparation for planning joint training workshops. Several misconception
concerning symptoms and transmission of HIV disease were found in both groups, particularly
among traditional healers. Twenty healers (51%) and four formal health workers (15%) claimed a
cure existed for AIDS. The majority of traditional healers interviewed expressed difficulties
discussing a diagnosis of HIV directly with patients, mainly due to fear of the patient becoming
depressed and suicidal. Most interviewees wanted more training- the majority of traditional
healers in recognizing symptoms of HIV/AIDS and their treatment, and the majority of formal
health workers in HIV counselling. Most were interested in supplying condoms. Almost all
healers and half of the formal health workers were keen to collaborate in training and patient
care. The study indicated that there is willingness amongst Zambian traditional healers and
115

formal health workers to collaborate in training and patient care in the field of HIV/AIDS. As well
as covering symptoms, transmission and prevention of HIV/AIDS, training should aim to increase
ability to openly discuss HIV with patients, which may traditional healers and some formal health
workers find difficult. Involving traditional healers in supplying condoms may improve
acceptability and availability, particularly in rural areas.
Notes: 1 copy
144-145.
Ref ID: 702
Burns-cox, C. (2001). Voluntary counselling and testing for HIV-1. The LANCET, 357,
Keywords: Africa/benefits/condom/condom use/information/intervention/men/VCT/voluntary
counselling and testing
Abstract: Michael Sweat and Colleagues make an important contribution to the understanding of
the role of voluntary counselling and testing (VCT) in Africa.
We believe that many people will use variables from this study to estimate costs and
effectiveness in other regions when relevant local parameters are not available. Many of Sweat's
efficacy parameters are attributed to the accompanying paper by the Voluntary HIV-1 Counselling
and Testing efficacy Study Group but we cannot find them there. We would like to know how the
investigators derived their estimates because some costs and benefits seem high compared with
those from previous studies.
Sweat and colleagues suggest that condom use per act after VCT increased to 83-88%. We can
find no information on pre-act condom use in the accompanying paper, but at 12 months, 196
men reported intercourse with a main partner and 125 (64%) reported unprotected intercourse ( a
decrease from 79% at baseline). Another study found much less condom use per year after
testing and counselling intervention.
Notes: 1 copy
Ref ID: 284
Bury, J. K. (1989). Counselling HIV-positive women. Medicine Digest, 14, 116-122.
116

Keywords: women/transmission/babies/sexual partner/condom
Abstract: According to an Edinburgh obstetrician, recent evidence seems to suggest that
pregnancy might not be dangerous for women who are infected with HIV, as long as they remain
well. The risk of transmission to the baby may also not be as great as previously thought.
A woman who HIV-positive may infect her sexual partner during normal intercourse. She should
avoid intercourse if possible, but if not she may need to use contraception that both prevents
pregnancy and acts as a barrier to HIV transmission. A woman who remains well may continue
with her usual method of contraception and ideally should use a condom and spermicide as well.
Once the immune system is compromised, a depot source of progestogen may be the safest. If
she has an IUD, however, she should be advised to have it removed.
Notes:
1 copy
Bulletin, 3, 7-9.
Ref ID: 31
Busse, P. (1994). Counselling as part of the NACOSA implementation plan. AIDS
Keywords: evaluation/guidelines/policy
Abstract: This paper gives the highlights of the National AIDS Convention of South
Africa(NACOSA) counselling strategy. And five priorities were highlighted in the strategy,
namely all people must receive pre- and post-test counselling; the development of an extensive
network of trained conselling in both health care setting and in the community; that all counselling
must be accessible and culturally sensitive; that confidentiality and support are recognized and
that counselling be into other services. The NACOSA counselling strategy also gives a very
comprehensive overview of why HIV/AIDS counselling is so important. It details why it should
be offered as a special service and not be submed into care and prevention. It examines what is
understood by counselling, who should receive counselling and who can and should offer
counselling. It gives details about how counsellors and trainers should be selected and trained,
as well as the requirements for supervision, support and evaluation. It looks at the importance of
confidentiality, the need for the registration of counsellors, and the location of counselling
117

services. the strategy makes it possible for people who wish to start counselling services to
follow basic priorities, and to see what the basic requirements for such a service would be.
Notes: 1 copy
Busse, P. (1994). The relationship between the National HIV/AIDS and STD Directorate
and the PWA sector/community. AIDS, -, 13-17.
Ref ID: 293
Keywords: family/government/health/Department of Health/NACOSA/NGO/policies/response
Abstract: The history of the Department of Health (DOH) and the state in its response living with
HIV and AIDS(PWAs) falls into two distinct periods -pre- and post- April `1994.
Prior to April 1994, there was virtually no official response to people with HIV or AIDS. Most of
the work in this regard was done by non-government organisations (NGOs) and although the
DOH had an AIDS Unit no programmes or services directly affecting PWAs and their partners or
families were initiated.
The DOH was a major player in the NACOSA initiative to develop a National AIDS plan (NAP).
The NAP established as a fundamental principle the involvement of PWAs in all sectors of HIV
and AIDS and at all levels of decision making.
This fundamental guiding principle underpins the entire National AIDS Programme. The
government, on taking office in April 1994, accepted and endorsed the NAP as the official DOH
AIDS policy, and established the national HIV/AIDS and STD Directorate.
Notes: 1 copy
Buwalda, P., Kruijthoff, D. J., De Bruyn, M., & Hogewoning, A. (1994). Evaluation of a
home-care/counselling AIDS programme in Kgatleng District, Botswana. AIDS care, 6, 153-160.
Ref ID: 25
Keywords: Botswana/confidentiality/evaluation/health systems/Home care/Nurse/patient care
Abstract: In 1988 a programme for care and follow-up of HIV-positive persons and AIDS patients
was implemented by the existing health facilities (district health team and hospital team) of
Kgaleng District, Botswana. A survey study in 1991 tried to indicate the effectiveness and
118

ottlenecks of the program. All advisory nurses(AN) were interviewed via two questionnaires:
one pertaining to case management of clients and one on their perceptions of their work.
Seventy-tow of 109 HIV-infected persons accepted and received counselling. Response of the
72 varied: 26 with a good, 34 with a moderate and 12 with a bad response. Prevention, contact
tracing and home visiting were studied, as well as ANs' experiences and opinions of the
programme. Some behavioural change by clients was indicated by the results though its extent
remains questionable. Program problems included client migration and refusal of counselling,
and discontinuation of HIV-testing facilities. Once a relationship was established, confidentiality,
questions and fear of stigmatization posed major problems. One -to-one support ANs could help
them cope better with these problems as well as discuss their won worries.
Notes: 3 copies
Ref ID: 6001
Caelers, D. I. (2001). Two health doses of hope in war on HIV. Cape Argus.
Keywords: Africa/antibody/health/Nurse/South Africa/transmission
Abstract: The twins are loudly demanding their lunch, just a couple of hungry babies obvious that
their HIV -negative status has provided hope for thousands of AIDS orphans anticipated in South
Africa. After being given AZT for eight weeks after their birth, the girls, whose mother is HIV-
positive, have been given the all-clear. The staff at Beautiful Gate home for children with HIV and
AIDS in crossroad is celebrating. Nine-week-old twins Amy Victoria and Michelle Faith are a ray
of hope among the 31children, the rest of whom will die of AIDS and the majority before they
reach their sixth birthdays. Amy and Michelle were referred for care to Beautiful Gate after
testing negative for HIV at Tygerberg Hospital. Born prematurely, they have been fed three-
hourly by dedicated staff, whose care has ensured they have blossomed, increasing from less
than two kilograms they each weighed when they arrived to 3.8 kg and 3.5kg respectively.
The question of saving the lives of babies likely to become AIDS orphans can become the
president of the country, an orphan can become the head of a company. At the very least of an
orphan can make a positive contribution to the future of South Africa, and with so many people
here destined to die from AIDS, we need to save as many of these babies as we can" she says.
119

Although Mark Cotton, head of peadiatric infectious diseases at Tygerberg Hospital, says HIV-
positive mothers have a 70% chance of not passing on the virus to their unborn children, he
believes it is worth improving the odds by providing anti-retrovirals temporarily as a preventative
measure. "If we give them the medicine we add on another 20% chance of the virus not being
passed on," she says.
So while there is a good chance that even without the AZT treatment following their birth, the
twins might not have contracted the virus, their negative status means another two lives will not
be lost to the pandemic. The twins ' diagnosis came faster than it does for most mothers and
children involved in the Western Cape's campaign to prevent mother -to-child HIV transmission,
which involves treating mothers and babies with AZT or Nevarapine. This is because of a faster
test that looks for the virus in the baby, rather than for antibodies, which is the cheaper more
common test.
Babies born of HIV-positive mothers will mostly test positive initially when the antibody test, is
used because they carry their mothers' antibodies. So you only know their status for sure whey
they are tested again nine moths later, " Cotton says.
"We used a test that in the private sector costs about R 200, but it can give us a 95% accurate
diagnosis early on". The twins were tested at six weeks, and again at eight weeks just to make
absolutely certain. Their sick mother can rest easy that her babies are healthy and will be well
cared for.
Judy Moses, Beautiful Gate's nurse, says the mother is in Tygerberg Hospital and sees the twins
when they go for their check-ups there.
"She's very happy her babies are going so well and longs to have them back with her, but for now
she is ill and that is not possible.
" We will have to wait and see how she does and whether it becomes possible for them to be
reunited" Moses said.
Notes: 1 copy
Cain, R. (1997). Environmental change and organizational evolution: reconsidering the
niche of community-based AIDS organizations. AIDS care, 9, 331-344.
120

Ref ID: 408
Keywords: Community based organisation/environmental change
Abstract: This paper examines the changing role of AIDS service organizations (ASOs) in the
provision of community-based HIV services. The paper draws on a study of the development of
ASOs that is based on in-depth interviews with about 250 individuals involved in the provision of
HIV-related community-based services in 12 cities in Canada. Findings indicate how the
broadening and increasingly complex needs confronting ASO workers are leading them to
become more focused in their efforts. The paper also shows how ASOs are having to reassess
their ties to other service organizations and, often, to redefine their mandate in the light of the
changing needs associated with HIV. The paper explores some of the problems associated with
these changes, and suggests how changing service needs require a renewed commitment on the
part of ASOs to work at the level of advocacy and political change.
Notes: 1 copy
Ref ID: 5649
Cameron, E. (1999). Facing a grim reality. Sowetan.
Keywords: Africa/America/infection/South Africa
Abstract: One of the South Africa's biggest challenges lies in getting effective treatment to
millions of citizens living in the shadow of HIV-Aids. The biggest challenge facing us as persons
openly living with HIV-Aids, as persons privileged with visibility and mobility, is to use our voices
and our power to broaden access to treatment beyond the minority that enjoys it at present.
Already activists in North America have made increased provision of anti- retroviral medication
to people living with Aids in resource poor countries a priority. Their demonstration have given an
electric urgency to this issue. They are succeeding in making the issue one of significance to
United States domestic politics, which may be an essential precursor to broader progress. Four
million South Africans living with HIV have no access to treatment. The Treatment Action
Campaign(TAC) has offered a focus for their activism, a channel for their energy and an outlet for
well-justified anger about the awesome spread of HIV infection in our country. The attention
121

should be drawn to the plight of millions of fellow Africans who have no access to treatment.
Notes: 1 copy
Ref ID: 2093
Cameron, J. and Hogan, H. (1998). Winnie and the Aids cure clinic. Saturday Stard.
Keywords: clinic/health
Abstract: Winnie Madikizela-Mandela had personally witnessed highly controversial "miracle
treatments" carried out on volunteer HIV infected patients at a secret and unregistered
Johannesburg clinic - and given the procedures her tacit stamp of approval. And she disclosed
this week that the Health Minister, Dr Nkosazana Zuma, has been informed and would also visit
the establishment, where procedures banned in the United States and most European countries
are carried out. The clinic has been covertly operating for several months using human
volunteers as guinea-pigs and claims a high success rate in the treatment of Aids and other
deadly diseases.
Notes: 1copy
Ref ID: 2152
Cameron, J. and Hogan, H. (1998). Oxytherapy - the new panacea? Saturday Star.
Keywords: clinic/Johannesburg/medical
Abstract: Not only is "research" into oxytherapy being conducted on the sly in South Africa, but a
private Johannesburg clinic is seeking approval to use controversial oxytherapy treatment-
banned in the US-on Aids patients. A doctor at the Selbypat Medical Centre, owned by RMH
Hospital Ltd, has applied to the Medicines Control Council (MCC) for permission to use a
machine which effectively oxygenrates blood. She believes it could be an effective treatment for
Aids. Hospital managing directory Jimmy Carroll confirmed this week that one of this doctors,
Lavinia clausen, had applied to use a polyatomic apheresis machine on Aids patients at the
private hospital. Carroll said: " I' m not really prepared to comment at the moment. I can't deny
that we want to conduct oxytherapy. We are expecting approval from the MCC shortly. It is
122

highly illegal to use this machine at the moment.
Notes: 1 copy
Campbell, C. & MacPhail, C. (2001). Peer education, gender and the development of
critical consciousness: participatory HIV prevention by South African youth. Social Science and
Medicine .
Ref Type: Unpublished Work
Ref ID: 8781
Keywords: case study/education/gender/HIV prevention/impact/prevention/strategy/youth
Abstract: Despite the growing popularity of participatory peer education as an HIV prevention
strategy worldwide, our understanding of the process underlying its impact on sexual norms is still
in their ungracefulness a framework for conceptualizing the process underlying successful peer
education. This study draws on the interrelated concepts of social identity, empowerment and
concepts of social capital. Uses Freire's account of critical consciousness. Critical longitudinal
case study of a schoolbased peer education programme in a South African township school.
Includes a number of the programme features and the broader context within which it was
implemented, which are likely to undermine the development of the critical thinking and
empowerment which is argued are key preconditions for programme success.
Notes: uncorrected proof - article in press
Campbell, I. D. & Rader, A. D. (1995). HIV counseling in developing countries: The link
from individual to community counselling for support and change. British Journal of Guidance and
Counselling, 23, 33-43.
Ref ID: 39
Keywords: community/Developing countries/family/model/prevention/support/Zambia/Zimbabwe
Abstract: Counseling in developing countries can extend from individual to family and community,
can be implemented as a means of facilitating changes or support, and in the community context
can be used to measure as well as sustain behavior change. Contrasts between developed and
developing countries include the capacity of communities in developing countries to acknowledge
123

loss and find hope. Community involvement in counseling, and capacity for confidential sharing,
are building blocks for strategic participatory response to AIDS and HIV, that can link inclusive
care to prevention by community-determined change in attitudes, behaviors and environment.
The premise that there can be a positive link from the individual to the community through
confidential sharing and that it can give rise to prevention through counseling the community is
illustrated by reference to programme examples from Brazil, Sri Lanka, North-Eastern India,
Zambia and Zimbabwe. Community hope exists through recognition of loss, inclusion of suffering
people, and capacity and action for change. One transferable tool for community development is
community counseling in relation to HIV and AIDS. A visible and expected outcomes is increased
community capacity to care and hope.
Notes: 2 copies
Campbell, L. & Hausler, H. (2000). A base line assessment of HIV counselling, testing
and TB services in preparation for introduction of TB preventive therapy to HIV positive people. In
(pp. -30-30-).
Ref ID: 250
Keywords: Developing countries/HIV testing/men/women
Abstract: Background: Meta-analysis of clinical trials indicate that preventive therapy with reduce
the incidence of TB in HIV positive people. Impact of introduction of preventive therapy in a
developing country is less clear. Baseline assessment of HIV and TB services was carried out in
order to assess the feasibility of providing TB preventive therapy.
Methods: Analysis of existing records. Development of questionnaires. Anonymous testing of
blood for HIV. Counselling and HIV testing to TB patients.
Results: Prevalence of HIV was 33%-28% regionally. Incidence - 9% per annum. 10880 people
were tested for HIV. 52% tested positive. More women than men were tested. 58% were
women of which 37% were positive and 21% negative. 54% of men and 72% of women testing
positive were under the age of 30. The majority of HIV testing is for clinical reasons. Only 1.8 %
were self referred. A small number of those counselled and tested returned for results-35%. The
average time taken for a result to be available was ten days. The number of admission for TB
124

has increased from 313 in 1992 to 1200 in 1999. Of TB patients tested 66% were were positive.
The profile of TB patients reflects more non pulmonary or sputum negative pulmonary of the
pulmonary cases 10.5% were sputum negative.
Conclusion: Most HIV testing is now for clinical indications with little set referral. More women
than men test positive and appear to test positive at a younger age. Only 35% of those tested for
HIV return within a three month period for results. The profile of patients with TB reflects more
non pulmonary and rapid HIV tests on the above will be studied with the introduction of preventive
therapy.
Notes: 1 copy
Campbell, L. (2001). UGU South HIV/AIDS/STD/ TB Pilot site.
Ref Type: Unpublished Work
Ref ID: 511
Keywords: Africa/client/clients/counsellor/counsellors/health/HIV
testing/infection/intervention/KwaZulu-Natal/Nurse/rapid HIV testing/rapid tests/research/South
Africa/training/UNAIDS/VCT/WHO/women
Abstract: A large international project-"the PROtest initiative" was commenced in 1999. The aim
was to increase access to HIV counselling and testing, and to offer preventive therapy for HIV
positive people. The project was supported by the World Health Organization and UNAIDS. As
part of this international project four sites were selected by the National Department of Health of
South Africa. UGU south health district was select as a pilot site in KwaZulu-Natal. All pilot sites
offered rapid HIV testing and preventive therapy for TB and other opportunistic infections in HIV
positive people. UGU South was unique in providing lay counsellors.
Purpose of the pilot sites:
The purpose of the pilot sites was to assess the feasibility of lay counsellors, rapid HIV tests and
preventive therapy.
Process
A full time pilot coordinator and ten lay counsellors were employed. The lay counsellors collected
data on counselling and testing for HIV. Nurses carried out rapid HIV tests. Isoniazid was offered
125

to all HIV positive people after strict clinical screening to exclude active TB. Co-trimoxazole was
offered to HIV positive clients who were sick. Training Programmes in HIV/AIDS and TB were
supported by the pilot.
Findings
All the interventions were acceptable. The numbers of people accessing VCT increased
dramatically. This increase was due more to the presence of full time lay counsellors than to the
presence of rapid HIV tests. The numbers of clients self-referring who tested HIV negative
increased. Women and people aged 20-30 yeas appeared to have greatest access to VCT. A
minority of HIV positive people were started on preventive therapy and there were problems with
adherence.
Recommendations
It is recommended that current lay counsellors continue their duties and that more are trained
because nurses are too busy to offer an adequate VCT service. The rapid tests should be
available at all health facilities. Further research should be carried out into preventive therapy
before it is offered on a wide scale.
Notes: 1 copy
Carballo, M. & Miller, D. (1989). HIV counselling: problems and opportunities in defining
the new agenda for the 1990s. AIDS care, 1, 117-123.
Ref ID: 37
Keywords: barrier/education/model/policy/prevention/support/theory
Abstract: The principle of providing counselling on a regular and systematic basis to people with
HIV and AIDS has been taken by health planners and AIDS committees in a wield range of
countries the world over. HIV counselling is increasingly being proposed as a key component of
programmes, for example, which within national AIDS control and prevention plans, both
complementing and supporting information, education and communication strategies, and as a
sine qua non of clinical management. Even in countries that have not traditionally recognised the
need for counselling in other preventive or chronic disease management programmes, it is now
generally held that AIDS control and prevention cannot and should be carried out in the absence
126

of counselling.
Notes: 1 copy
Carpenter, C. C., Mayer, K. H., & Stein, M. D. (1991). HIV-infected women under
continuing medical care do not progress more rapidly to AIDS than men. Medicine, 70, 307-325.
Ref ID: 430
Keywords: America/HIV testing/infection/information/male/medical/men/sexual
partner/transmission/treatment/United States/women
Abstract: A major review of HIV infection in North American women reflecting clinical experience
with 200 cases provides valuable information confronting some of the earlier views published on
HIV-infected women.
While the socio-economic backgrounds of the 200 HIV positive women of whom 53% were White,
Black (28%) Hispanic (16%) may be better than other inner-city American studies and access to
medical care and treatment in this study easier (patients were evaluated at 3-6 month intervals for
12 to 60 months), this study provides interesting data, particularly with regard to heterosexually
acquired infection in women in industrialised countries.
The major findings include:
1. rapid shift of dominant mode of transmission form intravenous drug sharing to the heterosexual
route;
2. gender-specific differences in clinical presentation but no gender-specific differences in the
progression of HIV infection;
3. increased frequency of cervical dysplasia in women infected via intravenous needle sharing.
This study was able to pinpoint the probable mode of transmission in each of the 200 women in
this study: 63% was due to IV drug use; 35.5% to heterosexual transmission ; 1% to transfusion;
and 0.5% to needle stick injury.
The heterosexual mode of transmission increased dramatically from 23% between 1986 and
1988 to 48% between 1989 and 1990. During the last three quarters of 1990, 25 of 42 newly
127

ecognised cases were transmitted via the heterosexual route. Overall, 29% of Whites, 38% of
Blacks and 67% of Hispanics were infected heterosexual.
Of considerable concern is the observation that 70% of the women infected by the heterosexual
route are currently in stable monogamous heterosexual relationships and the numbers of their
sexual partners is not the dominant factor in their risk profile.
The authors conclude that "their study strongly supports the concept that the number of sexual
partners may not be the major factor in male- to - female transmission of HIV in North America
and supports the hypothesis that for a seronegative woman in the United States, risk of having
multiple sexual partners is less than the risk of a monogamous relationship with one of the
increasingly large reservoir of HIV infected heterosexual men.
In a section dealing with gynaecological issues, the authors stress the high incidence of high-
grade squamous intracellular lession in cervico-vaginal specimens from HIV-infected women,
supporting the recommendation that women on routine examination found with these lesions
should be considered for HIV testing. Furthermore, women with IVDU - acquired HIV infection
should undergo cervico-vaginal cytological studies every 6 months.
Notes: 1 copy
Cartoux, M., Msellati, P., Meda, N., Welffens-Ekra, C., Mandelbrot, L., Leroy, V. et al.
(1998). Attitude of pregnant women towards HIV testing in Abidjan, Cote d' Ivoire and Bobo-
Dioulasso, Burkina Faso. AIDS, 12, 2337-2344.
Ref ID: 42
Keywords: attitudes/Burkina Faso/Developing countries/pregnancy/pregnant/prevention/primary
prevention/transmission/VCT/vertical transmission/voluntary counselling and testing/West
Africa/women
Abstract: Since the beginning of the epidemic, more than 16 million adults have been infected by
HIV in Africa. More than half of them are women, and as one million of African children are
128

estimated to have been infected as a result of mother -to- child transmission of HIV. Cote d'Ivoire
and Burkina Faso are among the most affected countries in West Africa. In Abidjan, the
economic capital city of Cote d'Ivoire ( 3 million inhabitants), and in Bobo- Dioulasso, the second
city of Burkina Faso ( 400 000 inhabitants), the 1995 prevalence of HIV infection among pregnant
women was 14.2 and7.5%, respectively. Several interventions offer the potential to reduce
vertical HIV transmission in developing countries. Some of theses interventions, such as
antenatal administration of antiretroviral drugs, imply organization of HIV counselling and testing
among pregnant women. Observational studies conducted in East Africa have suggested that
HIV-infected pregnant women are less likely to return to obtain test results than uninfected
women. This may have an impact on perinatal interventions strategies that require antenatal HIV
screening.
Notes: 1 copy
Cartoux, M., Meda, N., Van de Perre, P., Newell, M. L., de Vincentzi, I., Dabis, F. et al.
(1998). Acceptability of voluntary HIV testing by pregnant women in developing countries: An
international survey. AIDS, 12, 2489-2493.
Ref ID: 40
Keywords: acceptability/VCT/Developing
countries/pregnancy/pregnant/research/transmission/vertical transmission/women/voluntary
counselling and testing
Abstract: Since the beginning of HIV/AIDS epidemic, 3 millions children have been infected,
usually as a result of mother-to-child transmission ( MCT) in developing countries. Several
interventions offer the potential to reduce MCT. A short course regimen of zidovudine (ZDV) has
been recently proven effective in reducing perinatal HIV transmission in Thailand and offers a real
hope for the developing world. Such interventions imply availability of HIV voluntary counselling
and testing(VCT) services. Low acceptability of VCT in pregnant women may limit uptake and
therefore the potential public health benefits of these interventions. In the context of clinical trials
assessing different types of interventions of reduce MCT, the acceptability of VCT was evaluated
129

in several cities of developing countries through a postal survey carried out in 1997.
Notes: 2 copies
Chaava, T. (1990). In practice: Approaches to HIV counselling in a Zambian rural
community. AIDS care, 2, 81-87.
Ref ID: 36
Keywords: community/culture/family/model/patient care/prevention/women/Zambia
Abstract: The counselling experience at Chikankata hospital for the first year of the AIDS care
and prevention programme is described. People in the counselling team are selected according
to specific criteria. Counselling is conducted in integrated AIDS management context, at the
individual family and community levels. Counselling emphases differ according to the clinical
expression of the disease. Some cultural issues require specific counselling approaches, such
as ritual cleansing, and dealing with seropositive women of childbearing age. Counselling is
integral to comprehensive AIDS management which is inclusive of the disciplines of clinical care,
education, counselling, pastoral care and administration.
Notes: 1 copy
Chama, S. (2000). HIV voluntary counselling and testing (VCT): Promoting partnership
between government and non governmental organisation (NGO). In (pp. 32).
Ref ID: 252
Keywords: health/NGO/prevention/training/voluntary counselling and testing/VCT
Abstract: Issues: VCT has become an integral part of HIV prevention and care programmes.
Governmental bodies and NGOs have taken up different initiatives aimed at making VCT
available to their constituents. However, the service has not been accessible to many community
localities. Joint programmes between NGOs and governmental bodies ensure increased
availability and accessibility to VCT as well as standardisation of approach. Integrating VCT into
other existing health programmes is likely to improve its acceptance and demystification in
respective communities.
Description: Kara counselling and Training Trust (KCTT) has been offering VCT at three centres
130

in the Zambian capital city of Lusaka since 1992. Although the centres were strategically situated
in residential areas and within town they had not been accessible to many other Lusaka
communities. The Lusaka Urban District Health Management Team (LUDHMT) runs government
health centres placed in most major residential compounds. In 1999, KCTT and LUDHMT
embarked on a joint programme aimed at introducing VCT in respective health centres. Two VCT
centres have since been opened at the two health centres. The two parties combined resources
and this collaborative effort has yielded significant positive results in terms of acceptance and
utilisation of VCT by the community.
Conclusion: Taking VCT closer to the people improves its accessibility and utilisation. It's
introduction in health centres paves way for easy integration into other health services and
provides for continuum of care. Collaborative efforts significantly reduce costs as already existing
resources from both parties are utilised. Goodwill and full participation of government bodies are
essential for the success of any HIV/AIDS prevention and care strategy.
Notes: 1 copy
Chamane, N. J. (1993). Professional nurses knowledge and understanding of AIDS/ HIV
infection. MA Dissertation, University of Natal Durban ( Department of Nursing).
Ref ID: 208
Keywords: attitude/knowledge/Nurse/Nursing
Abstract: No abstract available
Notes: 1 copy
Charles, K. (2000). The traditional healer and the HIV/AIDS.
Ref Type: Unpublished Work
Ref ID: 8784
Keywords: traditional healer/Africa/traditional healers/knowledge/training/disease/positive
Abstract: 90 % of people in Africa that know to be HIV positive resort to traditional healers to find
solutions to theses conditions.What is the logic used by the traditional leaders? How do they
require their knowledge. Diverse types of knowledge is found amongst traditional healers.
131

1.Exclusive, Innate knowledge, spiritual type knowledge acquired from a protective lineage.2.
Hereditary knowledge - a gift conferred on them by God .3. acquired knowledge, acqusition of
knowledge after a period of training 3. Knowledge obtained through initiatory disease - can only
cure somebody of a particular disease if he himself had experienced that disease
Ref ID: 6419
Check, E. (2000). Can the body control HIV infection without drugs? Newsweek.
Keywords: drugs/infection/strategy/symptom/Virus
Abstract: The patient had stayed home from work one day three years ago because he thought
he had the flu. But as he read a front-page article in a Boston newspaper, he got worried. The
article described a flulike syndrom that people develop shortly after contracting HIV. It's often the
only symptom an infected person shows until years later, when the immune system falters and
the first signs of AIDS appear. So the patient decided to get tested for the virus. The results
confirmed his worst fear - he tested positive- but there was one small consolation. Researchers
at Massachusetts General Hospital were investigating a new strategy against HIV. They wanted
to know whether treating people intensively during the early phase of infection might ultimately
enable them to suppress the virus on their own.
Notes: 1 copy
Chibwesha, C., Luo, C., Chomba, E., McGarvey, S., & Cu-Uvin, S. (2000). Acceptability
of HIV counselling and testing - Lusaka, Zambia. In (pp. 40).
Ref ID: 260
Keywords: acceptability/clinic/health/transmission/women/Zambia
Abstract: Background: Mother-to- transmission of HIV-1 can be reduced by antiretroviral
prophylaxis. To achieve such reductions it is important to know the HIV status of pregnant
women. In Zambia, the prevalence of HIV-1 among pregnant women was reported to be 24% in
1998. We examined attitudes towards HIV counselling and testing of pregnant women at the
public, low-cost antenatal clinic at the University Teaching Hospital (UTH), Lusaka, Zambia.
Methods: A total of 2566 women attended the antenatal clinic at UTH during June and July
132

1998. Questionnaires were administered to a convenience sample of 172 pregnant women over
the course of 17 days in June and July. 162 surveys were completed and the data were analyzed
according to the socio-demographic, obstetric, and HIV knowledge-related characteristics of the
survey respondents.
Results: The mean age of participants was 27 years, 67% had > 8 years of schooling, 88% were
married, and 58% had at least 1 prior pregnancy. 85% reported that they had heard of HIV/AIDS
before participating in our study. 93% knew that HIV can be transmitted through sexual contact.
71% knew that a mother can transmit HIV to her infant. Only 22% had discussed HIV/AIDS with
a healthcare provider during pregnancy. 88% stated that it is important for health workers to
discuss HIV as part of routine prenatal care. 65% (106/162) of women would agree to prenatal
HIV counselling and testing if such a service were offered free of charge. Among those at > 28
weeks, 28 -36 weeks, and > 36 weeks of gestation at interview, 71%, 62%, and 64%,
respectively, would agree to HIV counselling and testing (p = 0.031). Other characteristics
examined were not significant associated with acceptance of HIV counselling and testing.
Conclusion: The majority of women would agree to free HIV counselling and testing during
pregnancy. There is a paucity of HIV/AIDS discussion during routine prenatal care in Zambia.
Notes: 1 copy
Chippindale, S. & French, L. (2001). ABC of AIDS:HIV counselling and the psychosocial
management of patients with HIV or AIDS. BMJ:British Medical Journal, 322, 1533-1535.
Ref ID: 8821
Keywords: health/care/psychological issues/prevention/HIV transmission/transmission/post-
test/response/HIV/AIDS counselling
Abstract: Counselling in HIV and Aids has become a core element in a holistic model of health
care, in which psychological issues are recognised as integral to patient management. HIV and
AIDS counselling has 2 general aims: (1) the prevention of HIV transmission and (2) the support
of those affected directly and indirectly by HIV. This article discusses when HIV counselling is
necessary in the context of the HIV test and post-test, psychological responses to an HIV positive
133

esult, psychological issues in HIV/AIDS counselling, and counselling patients and partners
together.
Christie, G. & Hickson, J. (1990). The nursing care of AIDS patients: Caring, not curing.
Nursing RSA Verpleging, 5, 26-28.
Ref ID: 35
Keywords: Nurse/patient care/quality of care/support/training
Abstract: Briefly saying, examination of the complex issues surrounding AIDS brings the disease
into clearer focus for the individual health care professional. One of the benefit is that AIDS is
causing the nursing profession to re-examine its role in health care. Absence of a cure is not
tantamount to having nothing more to offer. In fact, care rather than cure, becomes imperative.
The highest quality care possible for all patients irrespective of their background, color, religion,
sexual orientation, diagnosis and prognosis, is a priority. Hopefully everyone in health care and
society at large will learn valuable lessons from the AIDS experience. In this context, the role of
health care professionals should be that of student learning from the patient.
Notes: 1 copy
Ref ID: 296
Christie, G. (1992). Overview of AIDS counselling. Medical Sex Journal, 3, 102-108.
Abstract: Counselling for education and support is essential for people with HIV and AIDS. The
stages at which counselling is urgently required include: having the HIV antibody test; coping
with a positive test result and being diagnosed with AIDS. Severe emotional reactions to
knowledge of infection include: shock, anger, guilt, anxiety, depression, obsessional thinking and
behaviours. People in the terminal stage of AIDS may experience denial, depression, anger,
bargaining or acceptance. The need to identify and resolve the psychological effects of AIDS is a
priority in providing optimal care to patients.
Notes: 1 copy
Coates, T. & The Voluntary Counselling and Testing Efficacy Study Group (1998). The
efficacy of counselling and testing in reducing HIV risk in developing countries: A three-country
134

andomized controlled trial. In (pp. 82).
Ref ID: 33
Keywords: behaviour change/conference/couples/Developing
countries/efficacy/Kenya/randomised control trial/research/Tanzania/Trinidad/VCT/voluntary
counselling and testing
Abstract: This conference paper discusses the impact of voluntary HIV/AIDS counselling and
testing on behavior change among individuals and couples seeking such services in Nairobi
(Kenya); Dar-Es Salaam (Tanzania) and Port-of -Spain (Trinidad).
Notes: 1 copy
Coates, T. & The Voluntary Counselling and Testing Efficacy Study Group (2000).
Efficacy of voluntary HIV-1 counselling and testing in individuals and couples in Kenya, Tanzania,
and Trinidad: A randomised trial. Lancet, 356, 103-112.
Ref ID: 34
Keywords: behaviour change/couples/efficacy/Kenya/men/prevention/randomised control
trial/research/Tanzania/Trinidad/VCT/voluntary counselling and testing/women
Abstract: The aim of this paper is to determine the efficacy of HIV- 1 voluntary counselling and
testing (VCT) in reducing unprotected intercourse among individuals and sex-partner couples in
Nairobi( Kenya), Dar-es-Salam (Tanzania) and Port of Spain( Trinidad). Methods: Individual or
couple participants were randomly assigned HIV VCT or basic health information. At first follow-
up (mean 7.3 months after baseline) health-information participants were offered VCT and all
VCT participants were offered retesting. Sexually transmitted infections were diagnosed and
treated at first follow-up. The second follow-up (mean 13.9 months after baseline) involved only
behavioural assessment, and all participants were again offered VCT. Findings:3120 individuals
and 586 couples were enrolled. The proportion of individuals reporting unprotected intercourse
with non-primary partners declined significantly more for those receiving VCT than those
receiving health information( men, 35% reduction with VCT vs 13% reduction with health
information; women, 39% reduction with VCT vs 17% reduction with health information), and
these results were maintained at the second follow-up. Individual HIV-1-infected men were more
135

likely than uninfected men to reduce unprotected intercourse with primary and non-primary
partners, whereas HIV-1 infected women were more likely than uninfected women to reduce
unprotected intercourse with primary partners. Couples assigned health information, but no
differences were found in unprotected intercourse with non-enrollment partners. Couples in
which one or both members were diagnosed with HIV-1 were more likely to reduce unprotected
intercourse with each other than couples in which both members were uninfected. These
changes were replicated by those in the health-information group diagnosed with HIV-1 at first
follow-up.
Interpretation: These data support the efficacy of HIV-1 VCT in promoting behaviour change.
Notes: 3 copies
Coleman, L. M. & Ford, N. J. (1996). An extensive literature review of the evaluation of
HIV prevention programmes. Health Education Research: Theory and Practice, 11, 327-338.
Ref ID: 38
Keywords: evaluation/intervention/literature review/prevention/research
Abstract: This paper draws out and distills three key themes that have emerged from a
substantial bibliographical review of a range of HIV intervention programmes, implemented
through the world between years 1987 and 1995. Specifically, the paper assesses (1) to what
extent intervention programmes have been tailored to meet the requirements and needs of
specific target groups; (2) to what extent intervention programmes are supported by social and
psychological theory of attitudinal and behavioural change, and also to what extent the results
and findings from the interventions have amended existing theory; and, finally, (3) the range of
methodologies employed in evaluating intervention programmes and also to what extent
behavioural measures have been used in examining a programme's effectiveness. In light of
these themes, the paper presents and discusses the principal factors thought to contribute
towards the effectiveness of HIV intervention programmes.
Notes: 1 copy
136

Colvin, M., Abdool Karim, S. S., Connolly, C., & Hoosen, A. (1996). The prevalence of
HIV and other selected STDs in a rural South African community. The status and trends of the
global HIV/AIDS pandemic symposium final report -[-], 19. Vancouver.
Ref Type: Abstract
Ref ID: 285
Keywords: HIV-status/migrant/transmission/community/health/infection
Abstract: Objective: to determine the prevalence of HIV and other STDs and associated factors in
a rural South African community. Methods: The sample comprised all adults living under the
care of a randomly chosen community health worker in the vicinity of Hlabisa Hospital, i.e. about
120 homesteads. Consenting subjects provided information on household demographics,
migration patterns, sexual practices and symptoms of STDs. In addition, blood and urine
samples were collected for HIV and syphillis serology and LCR (ligase chain reaction) tests for
chlamydial and gonococcal infections.
Results: From a potential 469 subjects, 33.0% were temporarily or permanently away from home
(migrants) and 17.1% refused to participate. The prevalence of HIV among the 239 studies
subjects was 11%, syphillis 10%, chlamydia 8% and gonorrhoea 4%. There was no association
between positive HIV status and positive tests for others STDs. Only one subject reported
symptoms. All cases of HIV occurred among persons who spent 10 or less nights per month with
their regular partners (p

of HIV testing
strategy, the rapid test vs the ELISA, confirmatory tests, indications for use of HIV rapid tests,
universal precautions and other requirements and other rapid HIV tests. Illustrates with tables.
Coovadia, H. M. (2000). Access to voluntary counselling and testing for HIV in developing
countries. Ann N Y acad Sci, -, 57-63.
Ref ID: 274
Keywords: Africa/HIV testing/intervention/prevention/South Africa/VCT/voluntary counselling and
testing
Abstract: The counselling that precedes and follows testing of subjects for HIV has become, quite
unexpectedly, of focal point for assessment of the ethical propriety, availability, and
appropriateness of health services during the AIDS epidemic. It can be anticipated that in the
worst affected regions, voluntary confidential Counseling and Testing (VCCT) will be an integral
component of "....access to comprehensive, essential, quality health care" which is WHO's goal of
"Health for All" in the next century. The role, purpose, location and methods of VCCT, which
were reviewed at the previous global strategies conference in 1997, are summarized. Currently
understood objectives of VCCT include acceptance of the test, provision of care for HIV infected
individuals (particularly pregnant women), prevention of HIV transmission, and social support.
For example" ...access to care counselling and support"for HIV/AIDS and STDs is one of the top
10 national priorities in South Africa. However, closer examination in the country reveals
personnel and skill shortages, inability of half the primary health care (PHC) clinics to provide
antenatal services, and HIV testing being offered in only 56%. Condom availability is generally
good, but termination of pregnancy is undertaken in a bare 27% of hospitals. In other regions of
Africa, VCCT is also deficient in many respects: medical services are often unavailable, support is
absent, availability is restricted and there are few trained counsellors. Consequently, workloads
are heavy. Requirements for effective counselling will be listed. The global determinants of
inequities in accessing VCCT, such as the GNP and the crushing debt burden borne by poor
countries are discussed. A third of women worldwide receive no antenatal care, and just 60% of
the roughly 133 million annual births throughout the world are attended by trained health
138

personnel. Even when VCCT services are available, they are often not acceptable. The
overwhelming majority of African women appear to accept HIV testing, but only a proportion (59-
61% in recent intervention trials) return for the results. Obstacles to be overcome for provision of
VCCT services are identified. Evidence for a positive impact of VCCT services includes
facilitated decision-making, acceptance and coping with HIV, improved family and community
acceptance, increased condom use, and reduced gonorrhea rates and HIV transmission.
Notes: 1 copy
Ref ID: 6975
Corbett, P. (2001). Council fails HIV victim. Leader.
Keywords: Cape Town/clinic/HIV/AIDS counselling
Abstract: Sir- This week the unicity council passed a resolution about HIV/AIDS counselling
courses for counsellors, introduced by the IFP. It was supported by the DA as having some merit
but fell short of the actual life-saving projects included as top priority items in our selection
manifesto. Some three months ago the DA brought a notice of motion to the Council calling for
an urgent investigation into providing treatment for HIV positive mothers in Council clinics. At the
last minute the ANC supported the notion, despite a lengthy debate during which are they derided
the proposition. Clearly, judging by the subsequent lack of urgency, the approval of the ANC and
IFP was simply to push it back to a committee, so as to avoid negative press publicity. But their
real credentials are now clear. This year's budget fails to provide the funds needed to save the
lives of many babies born to HIV positive mothers. It is now a month into the new financial year
and in Durban hundreds of HIV positive mothers have already given birth to babies, of whom
some 300 -400 will die because this council did not act timeously. In DA run Cape Town a high
proportion of such babies will not die, because the DA has delivered a real service by providing a
full service of counselling, Nevarapine, and six months supply of free milk formula. On whose
consciences will these infant deaths lie?
Notes: 1 copy
139

Couper, D. I. & Vumase, S. B. (1996). HIV in northern KwaZulu-Natal. South African
Medical Journal, 86, 179.
Ref ID: 291
Keywords: antenatal clinic/clinic/health/HIV prevalence/KwaZulu-Natal/women
Abstract: Results of the fifth national HIV survey among women attending antenatal clinics
(November / December 1994) confirm that KwaZulu-Natal is at the forefront of the epidemic, with
an HIV prevalence estimate of 14.35% (Directory of Epidemiology, Dept of Health Pretoria). An
anonymous survey over 1 week in January 1995 of antenatal patients attending the Manguzi
Hospital clinic or admitted to await delivery, showed a significantly higher positive rate. Of the
80% women tested, 19 were HIV-positive, 1.67 times higher than the provincial average.
Notes: 1 copy
Courydoniger, P. A., Levenkron, J. C., Mcgrath, J. C., Knox, K. L., & Urban, M. A. (2000).
From theory to practice: use of stage of change to develop an STD/HIV Behavioral Intervention -
phase 2- stage -Based behavioral-counselling strategies for sexual risk reduction. Cognitive and
behavioral practice, 7, 395--.
Ref ID: 365
Keywords: client/education/substance use/primary prevention/prevention/intervention/sexually
transmitted disease/disease/barriers/barrier/WHO/strategy/health/training/treatment
Abstract: In the first 15 years of the HIV epidemic, client education alone has not resulted in
sustained sexual and substance use behavior change needed for primary prevention. More
recently, interventions grounded in social and behavioral science have demonstrated efficacy in
the primary prevention of HIV and other sexually transmitted diseases (STDs). Many barriers
exist, however, in the implementation of research-proven behavioral interventions in real-world
settings. This paper describes an adaptation of the stage of change/ transtheoretical Model
(SOC/TTM) to develop a stage-based method of counselling that is currently being used to
promote sexual and substance use behavior change for reducing the risk of acquiring STDs and
HM. This behavioral counselling intervention, named Rochester STD/HIV behavior counselling
(RosSHBec), was developed for front-line providers who deliver STD/HIV prevention
140

interventions to at-risk individuals in both clinical and community-based settings. A systematic
method for assessing SOC, previously described in Coury-adapted from the processes of change
described in the TTM. The present paper traces our efforts to develop these counselling
strategies specific to behaviors and illustrates their use in 12 common clinical cases (STD/HIV-
prevention counselling sessions). The RoSHBeC behavioral counselling intervention can also be
used to influence other health- related behaviors at individual and group levels. The steps of
RoSHBeC provide a structured psychological intervention that is grounded in social and
behavioral science (SOC/TTM) and is practical enough to be delivered by a wide variety of
providers with limited formal training in counselling and behavioral treatment methods.
Notes: 1 copy
Ref ID: 464
Crewe, M. (1994). Reflections on NACOSA. AIDS Bulletin, 3, 1-11.
Keywords: education/government/health/NACOSA/policies/policy/prevention
Abstract: In many ways the development of the National AIDS policy through NACOSA has been
a unique process. In most other countries the National AIDS plan was developed by the
government department responsible for AIDS education and care. Often an outside agency such
as the World Health Organizations' Global Programme on AIDS (WHO/GPA) would then send
advisors to the country to develop the policy. The WHO/GPA programmes are of a standard
format and seldom recognise the specific development of HIV/AIDS in a particular region or
country. NACOSA was a crucial process because the government had failed both to develop a
National AIDS programme, and to take the AIDS epidemic seriously enough to ensure that
effective education and prevention programmes were developed and supported
Notes: 1 copy
Ref ID: 292
Crewe, M. (1999). New AIDS Unit opened. AIDS Bulletin, -, 19.
Keywords: education/response
Abstract: A sustained societal theoretical critique of our society and its response to the epidemic
141

will be developed. This will challenge and explain why we have been unable adequately to
address HIV and AIDS in South Africa and lead to new levels of social explanation and
understanding.
These new debates and explanations will be taken forward into the students to have a
theoretically informed understanding of the epidemic and the ways in which it will impact on their
future and their careers. They will understand how they may act to mitigate these effects and
promote economic growth and social understanding. At a further level this expended
understanding will be used to inform, critique and evaluate the extensive community outreach
work undertaken by the university. HIV and AIDS will have a major role in all aspects of
university life.
Extensive interdisciplinary research will be fostered. Staff and students will claim to expand our
understanding of HIV/AIDS in relation to economic, social and cultural development, to education
and social work, through law, commerce, agriculture, theology, arts, and new forms of social and
technological understanding. Such research will complement the work done in the sciences,
medical and dental faculties and in public health. Staff and students will have access to an
extensive programme of education, information, counselling and support services on all the
campuses and through university-driven and supported projects. These initiatives will be peer
driven and offered through the professional staff of the university. A climate of tolerance
understanding, compassion and dignity will be generated, in which people with HIV/AIDS will be
able to voluntarily disclose their status and receive the support and respect all people deserve.
Notes: 1 copy
Cullinan, K. (2000). Looking towards the future on World AIDS Day: government looks at
economics of treatment. The Cape Times.
Ref ID: 8309
Keywords: government
Abstract: Following President Thabo Mbeki's earlier hardline stance against drug treatment for
HIV/AIDS, the government is seriously considering a range of drug options as the epidemic eats
142

into the population.
Notes: 1 copy
Independent.
Ref ID: 5901
Cullinan, K. (2000). AIDS memory boxes become treasure chests. The Sunday
Keywords: Africa/community/family/memory boxes/South Africa/women
Abstract: There is a painful experience when children come to know about their parents' status
from outside instead of hearing from their parents directly. In the Ugandan National Community
of women living with HIV/AIDS (Nacwola) they meet to make books and boxes for their children.
These books and boxes are treasure chests of family information, based on a series of "prompts"
such as family trees, description family values and traditions, and records of incidents like the first
time the child walked or spoke. Photographs, drawings and favourite items may also be put into
the boxes. These family records are especially vital for children who lose their parents when they
are very young, providing insight into the parents they never knew. These books empower
parents to communicate with their children and help children to understand where they come
from, and to establish a sense of identity. In south Africa the idea of making memory boxes is still
new. But a group of HIV-positive people in Soweto and KwaZulu Natal organized by AIDS
counseling, care and training (Soweto) and Philippe Denis of the University of Natal (KwaZulu-
Natal) have started to make memory boxes for the past few moths.
Notes: 1 copy
Curran, L., McHugh, M., & Nooney, K. (1989). HIV counselling in prisons. Counselling
psychology Quarterly, 2, 33-51.
Ref ID: 377
Keywords: policy/population/post-test/prisons/transmission
Abstract: HIV presents particular problems in penal establishments: the nature of the populations;
conditions in prisons; media attention and misinformation; the possibility of transmission within
and beyond the prison population; the extra issues that apply to female prisoners. These are
143

discussed in the context of prison policy regarding HIV and the broad strategic approach which is
being adopted to manage the problem of HIV within penal institutions. Counselling has a key role
in the overall strategy. Pre- and post-test counselling with prisoners is described and the
particular problems presented by inmates are discussed and illustrated by reference to case
histories. Developments in counselling provision for inmates are outlined.
Notes: 1 copy
d'Gruz-Grote, D. (1996). Integrate HIV prevention and promotion of sexual health into
development programmes. Lancet, 348, 1071-1074.
Ref ID: 299
Keywords: HIV prevention/health education/Developing
countries/strategy/women/youth/migrant/population/health/education/information/Young
people/prevention/sex/adolescents/infection/community/Nigeria/men/organisation/social support
Abstract: In this thought-provoking review published in the Lancet of HIV-prevention in developing
countries. D d'Cruz - Grote from Berlin stresses the need for contextualised preventive strategies
for women, youth single-gender migrant groups, and other marginalised segments of the
population living under economic and social deprivation. Her strategy to reduce the vulnerability
of these groups such as the planned parenthood Association.
Provision of sexual health education
All individuals should have access to correct, objective and complete information not only on
HIV/AIDS but also on sexual and reproductive health. Young people are achieving physical
maturity earlier, continuing their education longer, and marrying later. Consequently, targeting
abstinence as the primary goal of HIV prevention in schools with no mention of sex. Recent
studies show that comprehensive sexual health education, when implemented before
adolescents become sexually active, is effective in encouraging young people to delay sexual
activity and to practice safer sex when they are sexually active.
Women's groups repeatedly emphasise the need for women to be informed about their
reproductive system if they are to protect themselves from sexually transmitted infection.
Participatory community- organising approaches and collective action by women, as used in the
144

Calabar Project in Nigeria, have proved effective not only in encouraging women to voice their
anxieties, problems, and needs but also for developing strategies and messages that are
appropriate and acceptable. Focus on women alone is not sufficient. Community-organising
approaches also offer potential for addressing sexual health concerns of men such as long-
distances lorry drivers, members of armed forces, and men involved in the sex industry.
Likewise, youth organisations and clubs, which already exist in some communities, have proved
useful in providing social support for young girls and in providing space for both girls and boys.
Notes: 1 copy
Dabis, F., Newell, M. L., Fransen, L., Saba, J., Lepage, P., Leroy, V. et al. (2000).
Prevention of mother-to- child transmission of HIV in developing countries: Recommendations for
practice. Health Policy and Planning, 15, 34-42.
Ref ID: 41
Keywords: Developing
countries/government/guidelines/MTCT/policy/pregnancy/pregnant/primary
prevention/transmission/VCT/vertical transmission/voluntary counselling and testing/women
Abstract: The magnitude of the pandemic of human immunodeficiency virus type1 (HIV) infection
in developing countries is such that multiple approaches are required to slow its spread and
alleviate the burden on the health sector and society in general. Primary prevention of
heterosexual transmission of HIV remains a key component of HIV/AIDS programmes, and
should be led by governments and donor agencies.
Notes: 1 copy
Danila, R. N., MacDonald, K. L., & Rhame, F. S. (1991). Look-back investigation of
patients of an HIV-infected physician - no HIV-positive patients found. N Engl J Med, 325, 1406-
1411.
Ref ID: 433
Keywords: HIV transmission/infection/physician/Virus
Abstract: The well- publicised case of an HIV-infected dentist in Florida who transmitted the
145

human immunodeficiency virus to five patients has provoked concern about HIV-transmission
from an infected health care worker to his/her patients.
This study examine the case of an HIV-infected physician who had severe dermittis caused by
Mycobacterium marinum on his hands and foreams. All of his patients (336) who had undergone
procedures placing them at any risk of HIV infection, were traced and tested for HIV infection
after counsellor.
Of the 336 patients, 325 (97%) had negative tests for HIV antibody, 3 (1`%) refused testing, 1( <
1%) died of a cause unrelated to HIV infection before notification, the HIV- antibody status of
7(2%) remained unknown. The direct and indirect public health costs of this investigation were
approximately $ 130, 000.
The look-back investigation provoked extreme anxiety among the patients and was conducted at
considerable cost. (30 % of the entire Minnesota budget for HIV-surveillance).
The authors recommend that look - back investigations should only be undertaken in three
situations.
Notes: 1 copy
Daviaud, E., Engelbrecht, B., Molefakgotla, P., Crisp, C., Collins, D., & Barron, P. (2000).
South African Health Review 2000. Ntuli A., Crisp, N., Clarke, E., and Barron, P.
Ref Type: Unpublished Work
Ref ID: 8810
Keywords: health
Abstract: District health expenditure reviews can be used as part of a district manger's tool kit.
DHER's provide a picture of how resources are allocated and used and assist district
management teams in becoming better planners and spenders. the most salient features are the
under-resourcing of PHC and poor staff utilisation and deployment in the district health system.
Notes: Chapter 6
Day, H. J., Charalambous, S., Grant, A. D., & Churchyard, G. J. (2000). Integrated HIV
prevention and care: Experience from the South African mining industry. AIDS Bulletin, -, 4-9.
146

Ref ID: 298
Keywords: HIV prevention/mining industry
Abstract: The South African mining industry has been hard hit by the HIV epidemic. Faced with
high prevalence of HIV infection among its work-force, it is responding with initiatives aimed at
mitigating its impact on the mining communities. The health service of one mining company is
developing a programme that seeks to offer an integrated service encompassing all aspects of
HIV prevention and care, not only to its employees, but also their families and others at risk in the
local community. This venture is grounded in the firm belief that a profitable business can be
sustained, despite a quarter of the workforce being HIV infected, if strategic and timely
investment is made in measures to promote and protect the health of its workforce. Although the
cost of such an approach is a major consideration, the cost of failing to address the HIV crisis is
likely to be even greater.
Notes: 1 copy
De Cock, K. M., Mbori-Ngacha, D., & Marum, E. (2002). Shadow on the continent: public
health and HIV/AIDS in Africa in the 21st century. Lancet, 360.
Ref ID: 8818
Keywords: Africa/care/disease/global response/health/HIV testing/human rights/partner
notification/policies/policy/prevention/response/treatment
Abstract: Abstract:Approaches to the prevention and control of the HIV/AIDS epidemic in Africa
have been heavily based on early experiences and policies from industrialised countries, where
the disease affects specific risk groups. HIV/AIDS has been dealt with differently from other
sexually transmitted or lethal infectious diseases, despite being Africa's leading cause of death. In
this review, we discuss the evolution of the global response to the epidemic, and the importance
of redefining HIV/AIDS in Africa as a public health and infectious disease emergency. We discuss
reconsideration of policies and practice around HIV testing and partner notification, and
emphasise the need for an increased focus on treatment. Human-rights based approaches to
HIV/AIDS prevention might have reduced the role of public health and social justice, which offer a
147

more applied and practical framework for HIV/AIDS prevention and care in Africa's devastating
epidemic.[ABSTRACT FROM AUTHOR]
Ref ID: 6574
De Lange, L. (1999). "Staat kan verkragtes nie vigsmiddels weier". Beeld.
Abstract: Die AIDS Law Project en die Gender Research Project berei 'n toetssaak voor om in die
konstitusionele hof aan te voer dat die staat behandeling teen HIV/vigs aan verkragtingslagoffers
beskikbaar moet stel. Die organisasies wil onder meer aanvoer dat niemand ingevolge die
Grondwet mediese noodbehandeling geweier mag word nie, het adv. Shireen Mills gister in 'n
debat van die Kommissie vir Geslagsgelykheid oor verkragting en vigsmedisyne gese. Volgens
Mills maak Suid-Afrika se hoe verkragtingsyfer en die erns van die vigsepidemie sulke
behandeling noodsaaklik. " Ons beset die staat het beperkte hulpbronne, maar hulle kan nie die
behandeling weier nie". Volgens haar is die koste om te verhinder dat 'n slagoffer die virus
opdoen minder as om so iemand te behandel as hy of sy die virus opdoen. Vigsbelangegroepe
voer lank reeds aan dat die farmaseutiese bedryf in die pad staan van goedkoper medisyne in die
stryd teen HIV/vigs. Mev. Mirryena Deeb, uitvoerende hoofamptenaar van die Farmaseutiese
Versaardigersvereniging, hetegter in die debat beklemtoon dat die regering nog nie werklik weet
wat sulke medisyne sal kos nie. "Die tenderstelset is nog nooit vir vigsmiddels gebruik nie," het
sy gese. "Die regering gebruik dit al dertig jaar om die pryse vir medisyne te bepaal en daar is
geen rede om te dink dat die stelsel nie ook bekostigbare vigs medisyne sal meebring nie." "
Daar bestaan geen kliniese toets of wetenskaplike data wat bewys dat medisyne om te verhinder
dat iemand die virus opdoen doeltreffend is in die geval van verkragting nie, "het dr. Charmaine
Gittleson, vigsspesialis, gese. Die aanname dat dit die oordrag van die virus sal verhinder, is
gegrond op toetse wat gedoen is op die slagoffers van naaldprikvoorvalle en van ma-tot-kind-
oordrag van die virus. Volgens Gittleson beveel die sentrum vir siekterbeheer in Amerika aan dat
'n mens moet oorweeg om die medisyne aan verkragtingslagoffers te gee as tussen 10% en 30%
van 'n land se bevolking HI -positief is. In Suid-Afrika is die syfer na raming sowat 12.5%.
Notes: 1 copy
148

Ref ID: 2169
De Lange, L. (2000). Loop lig vir sogenaamde vigskuur van Nigeriese arts. Beeld.
Abstract: Medinfo het 'n dringende waarskuwing aan Suid-Afrikaners gerig om hulle nie te laat
bluf deur bewerings dat sommige dokters in Nigerie 'n kuur vir HIV/Vigs gekry het nie. Dr Andrew
Jamieson van Medinfo het ook sy kommer uitgespreek dat sulke betweerde kure ook hul pad na
Suid-Afrika kan vind. "'n Aantal Nigeriese dokters het oor die afgelope weke bekend gemaak dat
hulle 'n kuur vir HIV/vigs gekry het, " het Jamieson gese. Onder hull dr Jacob Abdullahi van
Nigerie se Federale Skool vir Mediese Laboratorium Tegnologie. Adullahi beweer hy het oor die
afgelope twee jaar sowat seshonderd pasiente met HIV/vigs gesond gemaak met 'n plantekstrak
wat as die Winnie-kuur bekend staan. Dr. Jeremiah Abalaka, wat in immunologye gespesialiseer
het aan die Universiteit van Nigerie, per dag met middels wat hy voorberei van die bloed van
ander HIV/vigs-pasiente. Nog dokters maak hulle glo aan soorgelyke praktyke skuldig. " Die
gebeure wys dat daar geen beheer is oor sulke praktyke in Nigerie nie, "het Jamieson gese.
"Mense moet dus baie versigtig wees voordat hulle mediese hulp in die land gaan soek".
Notes: 1 copy
Ref ID: 2184
De Lange, L. (2000). Siekefondse "moet vigs pak". Beeld.
Abstract: Siekefondse wat die HIV/vigs - epidemie probeer ignoreer en wat nie vir hul lede
middels teen vigsverwante siektes beskikbaar stel nie, dal nie die volgende vyf jaar oorleef nie.
"Die bedryf moet ophou om risiko te ignoreer en dit begin bestuur," het mnr. Anton Roux, hoof
van Med-schem, op 'n vigskonferendse, waaronder Bonitas, Finmed en Midmed, is reeds deel
van Medscheme se Aid for AIDS - program. Bykans 5 000 siekefondslede het al by die program
geregistreer om vir die voordele in aanmerking te kom. Die program betaal onder meer vir
Kombinasieterapie om die HI-virus te onderdruk en gereelde toetse, berading en mediese
ondersoeke. "Gee vir die pasiente die teen vigs medikasie om hulle uit die hospitaal te hou, " het
dr. Leon Regensburg, hoof van Aid for AIDS, gese. Volgens hom is dit algemeen bekend dat die
mediese koste baie laer is as die HI-virus deur medikasie onderdruk word. "Dit kos geld om met
die virus te werk, maar die koste kan deur be planning en bestuur gehanteer word," het
149

Regensburg gese. Mnr. Patrick Matshidze, 'n epidemoloog, het beklemtoon dat die epidemie al
hoe erger afmetings gaan aanneem. "Verlede jaar het 11% van Suid-Afrika se werksmag reeds
HIV/AIDS gehad". Volgens hom sal dit na verwagting in 2005 tot sowat 19% toeneem. "Die
meeste siekefondse probeer steeds die risiko vermy," het Roux gese. "Maar dit kos die
siekefondse baie meer omdat die HIV/vigs - pasiente vir al die vigs verwante siektes behandel
word.
Notes: 1 copy
Ref ID: 3620
De Lange, L. (2000). 'Siekefondse kan miljoene spaar met vigsbehandeling". Beeld.
Keywords: South Africa/Africa
Abstract: Mense met HIV/vigs wat behandel word, kan tot twintig jaar langer leef. Boonop spaar
hul werkgewers en siekefondse so miljoene rande aan hospitaalkoste en onproduktiwiteit. Net
Sowat 'n derde van Suid-Afrika se minstens 150 siekefondse het egter tans 'n HIV-vigsprogram,
het mnr Andre van Bassen, besturende direkteur van LifeSense Disease Management, gister
gese. Terwyl baie siekefondse die koste van HIV/vigs vrees, betaal hulle reeds vir die
behandeling van vigs verwante siektes in baie gevalle onwetend. Die hospitaalkioste kan fondse
sonder 'n HIV/ vigs - program uiteindelik lamle."Dokters wil mense met HIV/vigs nie wegwys as
hulle nie siekefonds voordele het nie. Hulle pleeg selfs bedrog deur voorskriffe vir ander
medisyne deur te stuur om te verseker dat pasiente die behandeling kry," het Van Bassen gese.
"'n Maatskappy kan hom nie blind staar teen watdit
sal kos om werknemers met HIV/vigs te
behandel nie, Hy moet daardie koste opweeg teen die koste as hy hulle nie behandel nie,"het
mnr. Clem Sunter, medeskrywer van die boek AIDS, The Challenge for South Africa, gese. Hy
meen verder medisyne in Suid-Afrika sal baie goedkoper wees as die regering BTW en
invoerbelasting daarop afskaf. "Talle groot maatskappye onder handel ook reeds met
farmaseutiese vervaardigers oor goedkoper HIV/Vigs - medesyne. "Dit kan die koste per pasient
per jaar van tussen R35 000 en R50 000 na so laag as R15 000 afdwing." LifeSense bied aan
siekefonde 'n siektebestuursprogram waarvolgens sowat 2 000 mense met HIV/vigs reeds
behandel word. Dit kos sowat R1 100 per maand per pasient. Volgens Van Bassen is daar uit
150

die groep die afgelope 2 jaar net 18 mense dood en 32 hospitaalgevalle aangemeld. Daarsonder
sou tot 100 van die pasiente na raming gesterf en meer as 400 hospitaalgevalle voorgekom het.
Notes: 1 copy
De Rosa, C. J. & Marks, G. (1998). Preventive counselling of HIV-Positive Men and Self-
Disclosure of Serostatus to Sex Partners: New opportunities for Prevention. Health Psychology,
17, 224-231.
Ref ID: 346
Keywords: disclosure/sexual behaviour/men/sex/WHO/clinic/sexual practice/intervention/sexual
partner
Abstract: This study examined whether preventive counselling of HIV-positive men (N=25) was
associated with self-disclosure of serostatus to sex partners. Men who reported being counseled
at posttest and at their current HIV clinic to disclose their serostatus to partners were more likely
to have done so than men counselled only at posttest, only at the HIV clinic, or not counseled at
either site. Disclosure increased with the number of times counselled at the HIV clinic. These
patterns held for HIV-negative partners, but not for HIV-positive or HIV-unknown partners.
Disclosure to HIV-negative partners was associated with safer sexual practices. The findings
suggest that counselling interventions for HIV-positive men, when delivered by multiple sources,
many provide an effective means of increasing disclosure to sexual partners.
Notes: 1 copy
1604.
Ref ID: 566
Decosas, J. (2002). Reducing HIV-1 in Kenya and Tanzania. The LANCET, 356, 1602-
Keywords: Africa/cohort/cost-effectiveness/infection/intervention/Kenya/prevention/Southern
Africa/Tanzania/VCT
Abstract: This is a correspondence: - The pressing need to identify cost-effective interventions
for HIV-1 prevention in less-developed countries makes the paper by Michael Sweat and
colleagues on the cost-effectiveness of voluntary counselling and testing(VCT) of great
151

importance. However, we believe that there are some faults in their analysis. The costing of the
intervention seems to have been carefully undertaken, but we have been carefully undertaken,
but we have reservations about the effectiveness calculations. The investigators predict that in a
hypothetical cohort of 10 000 individuals, the VCT intervention in Kenya would prevent 1104 HIV-
1 infections in 1 year. The 20% HIV-1 prevalence in the cohort roughly equals that of many urban
centres in eastern and Southern Africa, such as Nairobi. With an average duration of infection
before death of 7-10 years, an annual incidence of 2-3% is required to maintain a stable 20%
prevalence - 200 - 300 incident infections per 10 000 individuals annually.
Notes: 1copy
Denolf, D., Shamavu, J., & Tahiri, J. (2000). Feasibility of implementing interventions for
the prevention of perinatal HIV transmission in low income countries. In (pp. 39).
Ref ID: 259
Keywords: acceptability/Developing countries/drugs/health/HIV
testing/intervention/medical/prevention/transmission/women/MTCT/therapy/sub-
Saharan/knowledge/population/WHO/care/male/social support/strategy/political
Abstract: Background: How to implement successfully proven interventions for the prevention of
mother-to child transmission (MTCT) in developing countries still remains a huge challenge. We
assess the presence of minimum requirements for introducing antiretroviral (ARV) therapy for
MTCT in two sub-Saharan cities: Kinshasa( Democratic Republic of Congo), Pointe Noir (
Republic of Congo)
Methods: Data collection is based on interviews with key public role players in the public health
sector, on analysis of documentary sources and on questionnaire survey of pregnant women to
assess their knowledge and acceptability for ARV drugs for MTCT.
Results:
-Insufficient percentage of the urban population who access and utilise antenatal, intrapartum and
post partum care with trained health workers
-Insufficient affordable and reliable HIV testing and counselling centers
-little knowledge of the pregnant women of the efficacy of ARC drugs for MTCT
152

-low acceptance rate of pregnant women to be tested for HIV ( fear of results, fear of reaction of
male partner)
-high acceptance rate of pregnant women to pay for the ARV drugs only if the HIV test has not to
be done
-limited number of services which offer continuing medical and social support for HIV infected
women
-expensive ARV drugs available mainly on the black market(no legislation on ARV)
-low availability of affordable and adequate supply of breast milk substitutes associated with
proper counselling about infant feeding
Conclusion: The minimum requirements to ensure a successful introduction of MTCT strategies
in low income countries need to be extensively reinforced before large scale implementation is
possible. A country specific approach is needed to implement sustainable and cost-effective
interventions adapted to the social -economic and political context of country.
Notes: 1 copy
Department of Health and Population Development (1993). The healthcare worker's role
in counselling HIV-infected people and persons with AIDS (PWAS). Health & Hygiene, 4, 10-11.
Ref ID: 57
Keywords: counsellor/guidelines/health worker/health workers/Nurse
Abstract: The shortage of trained counsellors, limited financial resources and the increase of HIV
infected people as well as PWAs ( patients with AIDS) make it necessary for health care workers
to be able to do AIDS education and basic counselling. In many instances the nurse will be the
first person that will be confronted with the person's HIV infection and his/her fears and concerns
about AIDS. The nurse will therefore be obliged to inform the client about AIDS and about the
meaning of the various HIV tests. The nurse will also have to assist the HIV-infected person to
come to terms with his/her infection, state of health and provide guidelines for future planning.
The nurse has an important role to play in facilitating communication and understanding between
the doctor and the client by providing opportunities to address sensitive issues and discussions of
153

medical procedures.
Notes: 1 copy
Department of Health. (1994). A National AIDS Plan for South Africa 1994 - 1995.
Ref Type: Unpublished Work
Ref ID: 522
Keywords: Africa/political/South Africa
Abstract: As South Africa establishes a new order, the HIV/AIDS epidemic poses a real threat to
future social, political and economic development. There has been a growing recognition that
efforts to control and curb the further spread of the epidemic could not wait for the new political
dispensation, but needed to take place alongside the process of political transition. Previous anti-
AIDS initiatives had been marked by a lack of credibility and by distrust of the state campaigns,
by a tentative and hesitant approach by other groups and a lack of unity in AIDS programmes in
other sectors.
Department of Health. (1994). National HIV/AIDS Strategy.
Ref Type: Unpublished Work
Ref ID: 528
Keywords: Africa/information/intervention/media/policies/policy/research/response/South Africa
Abstract: To be effective a National HIV/AIDS Strategy needs to be underpinned by an extensive,
coordinated and optimally resourced research programme.
The HIV/AIDS epidemic in South Africa has to date largely been characterised by misinformation,
misunderstanding and often inappropriate responses, particularly from the media.
In order both to understand and rectify the mistakes of the past as well as to plan effectively for
the future, extensive research programmes and projects will need to be undertaken. This will
ensure need to be undertaken. This will ensure that future directives will regard to policy and
interventions can be based on reliable and current information.
Notes: 1 copy
154

Department of Health. (1998). HIV/AIDS counselling. Gauteng, KwaZulu-Natal, and Free
State, Department of health.
Ref Type: Unpublished Work
Ref ID: 477
Keywords: disease/HIV/AIDS counselling/Virus
Abstract: AIDS is a disease that affects millions of South Africans. It is caused by a virus called
HIV that slowly weakens a person's ability to fight off other diseases. People who are HIV
positive have many feelings including negative feelings such as fear, helplessness and anger.
Notes: 1 copy
Department of Health HIV and STD Directorate. (1998). Caring for people with HIV/AIDS.
Pretoria, Department of Health and STD Directorate.
Ref Type: Unpublished Work
Ref ID: 479
Keywords: barrier/barriers
Abstract: There may be situations where you need to clean up body fluids or blood from someone
infected with HIV. It is important to use rubber or plastic gloves or other barriers such as plastic
bags or thick cloth to prevent direct contact. Make sure that you have these easily available at all
times.
Notes: 1 copy
Department of Health and Social Services. (1998). Criteria for assessing quality of care
for people with HIV at primary health care level. -. -, Department of health and social services.
Ref Type: Unpublished Work
Ref ID: 497
Keywords: quality of care/care/primary health care/health
Abstract: The pamphlet gives criteria for assessing quality of care for people with HIV at primary
health care level.
Notes: 1 copy
155

Department of Health. (1998). HIV/AIDS and sexually transmitted Diseases.
Ref Type: Unpublished Work
Ref ID: 521
Keywords: Africa/antenatal clinic/barrier/care/clinic/health/impact/infection/intervention/KwaZulu-
Natal/NACOSA/NGO/population/sexually transmitted disease/South
Africa/transmission/treatment/Virus/women/Young people
Abstract: The HIV epidemic is well established in South Africa. Approximately 1,8 million people
are already infected, and more than 700 new infections occur every day.
Statistics from the national annual antenatal clinic surveys indicate that the epidemic has
increased tenfold in the last five years. At present, the doubling rate of infection is estimated to
be between 13 and 15 months. The results of the annual survey conducted in October -
November 1995 show that 10,4 % of women attending antenatal clinics of the public health
services were infected. The prevalence of HIV in each province was found to be as follows:
KwaZulu-Natal 18,2%; Mpumalanga 16,2%; Gauteng 12%, Free State 11,)%; North-West 8,3%;
Eastern Cape 6,0%; Northern Cape 5,3%; Northern Province 4,9 %; and Western Cape 1,7%. It
is evident that the virus is spreading more rapidly among young people aged between 15 and 30
years, women and mobile persons.
It is clear that HIV/AIDS is one of the key health issues affecting our population, and that the
State's commitment to developing a comprehensive and coordinated national AIDS programme is
essential. In terms of this commitment a National AIDS control Programme is essential. In terms
of this commitment a National AIDS control Programme was formed. It is based on the National
AIDS plan for South Africa, which was developed through a consultative process by the National
AIDS convention of South Africa (NACOSA). The plan identified various mechanisms for the
control of HIV including behavioural. Strategies; early detection and treatment of classical
sexually transmitted diseases (STI)s; maintenance of safe blood supplies; and popularisation and
extensive distribution of barrier methods. These have been adopted and are being implemented
in terms of the National AIDS control Programme.
Overall, the Programme aims to reduce the transmission of STI's and HIV infection, and provide
156

appropriate care, treatment and support for those infected. The Programme endeavours to
coordinate the efforts of all role-players to ensure the optimal use of resources.
It is recognised that HIV/AIDS cannot be prevented without addressing the socioeconomic factors
which underlie its spread. The cause and impact of AIDS extends beyond the health sector,
requiring the commitment of and intervention by a sectors - the state, private sector, non-
government organisations (NGOs) and community-based organisations (CBOs).
Notes: 1 copy
by HIV/AIDS.
Department of Health. (1999). National integrated plan for children infected and affected
Ref Type: Unpublished Work
Ref ID: 499
Keywords: education/health/men/response/women/youth
Abstract: On 24 November 1999 Cabinet approved the setting aside of funds over a period of
three years for an effective integrated response to the HIV/AIDS epidemic. At a meeting held on
14 December 1999, the Directors-General of the Departments of Health, Welfare, Education and
Finance met. Their consensus on the focus of the plan can be summarized as follows:
.Children and youth should be the integrating principle and the focus of the integrated response.
The position of women in society and the relationship between men and women would also be an
important component.
. An integrated approach and not fragmented departmental initiatives will be followed
Department of Health. (1999). Health sector strategic framework 2000 - 2004:
Accelerating quality health service delivery.
Ref Type: Unpublished Work
Ref ID: 520
Keywords: barrier/barriers/care/community/government/health/medical/doctor/primary health
care/quality of care
Abstract: Prior to 1994 the South African health system was built on apartheid ideology and
157

characterised by racial and geographic disparities, fragmentation and duplication and hospi-
centricism with lip service paid to the primary health care approach. There were 14 Departments
of Health each having their own objectives. Access to health care for rural communities and
those classified as "black" was difficult. Besides the lack of facilities, the financial burden of
finding and financing transport to health facilities and payment for health services acted as
barriers to access to care. Many rural hospitals had very limited access to medical doctors and
medicines were not always available at public health facilities and expensive.
Over the past few years, our country has been through an exciting process of transformation.
During this time we have benefited from the lessons of others and believe that we have also
contributed to humanity's common foundation of wisdom.
We have firmly placed before our country a perspective of health that recognise good health as
both a pre-requisite for social and economic development as well as an simply as expenditure. It
is also a perspective that sees good health as a product of many determinants - many of which lie
outside the formal health sector. For our country to succeed and our citizens to be healthy -
government and all associated institutions cannot and should not function in isolation. Our
inability to form strong partnerships has been one of our key weaknesses as a government over
the past 5 years, a weakness that must be urgently corrected.
The key message that constitutes the essence of what we have to do in coming years is the need
to:
. consolidate achievements in improving access to care and advancing equity;
.deal decisively with the HIV/AIDS epidemic and its ramification which threatens to undo our
developmental gains; and
.stabilise the hospital sector, including the need to promote greater efficiency and consider
additional sources of funding for this sector; and adopt a multidimensional approach to ensure
steady improvement in quality of care.
158

This strategic framework outlines the Department's strategic plans for the next five years.
Notes: 1 copy
Department of Health. (1999). Minimum standards for counselling and training.
Ref Type: Unpublished Work
Ref ID: 529
Keywords: client/clients/counsellor/research/training
Abstract: Research has shown that counselling courses that accept all interested people training
run the risk of providing an inferior service to clients (Carkuff, 1969). It was seen then, that pre -
selection contributes somewhat to the provision of good counselling services.
The original qualities and skills proposed at Mount Amanzi are still full useful ones to include. In
particular counsellor self confidence, warmth, well being, general competence, enthusiasm and
genuine desire to help others, self-insight and attitudes towards HIV/AIDS are considered useful
qualities to look out for (Drydon and Thorne, 1991, Egan, 1982 and Carkuff, 1969).
Notes: 1 copy
Department of Health. (1999). The VCT Strategy - What it is and how it fits in with the
Government's total AIDS Strategy.
Ref Type: Unpublished Work
Ref ID: 569
Keywords: care/community/government/research/response/VCT/voluntary counselling and testing
Abstract: In November 1999, Cabinet approved funds for the implementation of an integrated
response to the HIV/AIDS epidemic. This integrated plan is only one component of the
Government's HIV/AIDS strategy. The integrated plan has six components:
1. The introduction of life skills programmes in schools
2. The development of strategies for the care of orphans, and home - based models of care for
people
3. The strengthening of efforts to make voluntary counselling and testing facilities available.
4. Research
159

5. Limited support for Government Departments with links to business
6. The development of a public campaign to link the other components by mobilising communities
through community - based HIV/AIDS awareness programmes.
Notes: 1 copy
Department of Health. (2000). Management of occupational exposure to HIV. HIV/AIDS
policy guideline .
Ref Type: Unpublished Work
Ref ID: 480
Keywords: drugs/guidelines/HIV-status/HIV
transmission/infection/prevention/transmission/treatment/Virus
Abstract: This document provides guidelines for the management of occupational exposure to
blood and body fluids that may contain the human immunodeficiency virus (HIV), and
recommendations for HIV post-exposure prophylaxis (PEP). These guidelines also assess
available data on the risk of acquiring HIV infection from occupational exposure, the efficacy of
antiviral drugs, recommendations for the management of occupational exposure to blood or body
fluids and issues relating to compensation for occupationally acquired HIV infection.
Recommendations for PEP are related to the risk of infection from selected exposures and the
HIV status of the exposure source. For high-risk exposures a four-week course of Zidovudine
and Lamivudine are recommended. The addition of Indinivir is recommended for selected very
high - risk exposures. The focus of these guidelines is occupational exposure to blood and blood
products. Saliva, tears, sweat, urine and breastmilk are not associated with the risk of HIV
transmission in an occupational setting.
Advances in the prevention and treatment of HIV and AIDS are progressing at a rapid rate and
recommended clinical practice may change over time.
Notes: 1 copy
guideline .
Department of Health. (2000). Tuberculosis (TB) and HIV/AIDS. HIV/AIDS policy
160

Ref Type: Unpublished Work
Ref ID: 481
Keywords: care/guidelines/health/Nurse/primary health care/symptom/tuberculosis
Abstract: These guidelines are for the use of doctors and nurses who provide clinical care to
tuberculosis (TB) patients and to patients living with HIV/AIDS. It should be feasible to implement
the recommendations, at all levels of the health system including primary care level. Practical
advice is offered on how to deliver care to patients with the symptoms of TB and HIV/AIDS and
when to refer patients for more specialised care.
Notes: 1 copy
Department of Health. (2000). Prevention and treatment of opportunistic and HIV related
diseases in adults. HIV/AIDS policy document .
Ref Type: Unpublished Work
Ref ID: 483
Keywords: care/disease/drugs/guidelines/health/infection/medical/people living with
AIDS/prevention/treatment
Abstract: This document provides recommendations for the medical management of people living
with HIV infection and AIDS. Whenever possible, the recommendations in this guide use
medications that are listed as essential drugs (for primary and hospital care) by the Essential
Drugs Programme within the Department of Health. It is recognised that there may be
differences in opinion with regard to aspect of these guidelines. The Department of Health will
revise these guidelines regularly. Suggested revisions are welcome.
Notes: 1 copy
Department of Health. (2000). Managing HIV in children. HIV/AIDS policy guideline .
Ref Type: Unpublished Work
Ref ID: 484
Keywords: Africa/care/disease/guidelines/health/infection/medical/prevention/South
Africa/treatment
161

Abstract: These guidelines present recommendations for the treatment of HIV positive Children
and Children with AIDS. Clinical science and the treatment of HIV positive persons and persons
living with AIDS is developing rapidly. These recommendations are not intended to provide the
state of the art medical care, but a practical approach for managing HIV/AIDS related diseases
within health services in South Africa. Primary and secondary prevention of HIV infection should
be emphasized at all opportunities.
Notes: 1 copy
Department of Health. (2000). HIV/AIDS and STD: strategic plan for South Africa.
HIV/AIDS and STD .
Ref Type: Unpublished Work
Ref ID: 485
Keywords: Africa/government/health/response/South Africa
Abstract: This document is a broad national strategic plan designed to guide the country's
response to the epidemic. It is not a plan for the health sector specifically, but a statement of
intent for the whole country, both within and outside for the whole country. It is recognised that
no single sector, ministry, department or organisation is by itself responsible for addressing the
HIV epidemic. It is envisaged that all government departments, organisations and stakeholders
will use this document as a basis to develop their own strategic and operational plans so that all
our initiatives as a country can be harmonised to maximise efficiency and effectiveness.
Notes: 1 copy
Department of Health HIV and STD Directorate. (2000). Rapid HIV testing. HIV/AIDS
policy guideline .
Ref Type: Unpublished Work
Ref ID: 508
Keywords: antibody/confidentiality/health/HIV-status/HIV testing/infection/Informed consent/post-
test/rapid HIV testing/rapid testing/rapid tests/WHO
Abstract: This document provides recommendations on the issue of rapid HIV tests. Rapid HIV
162

testing can provide a result within 10 to 30 minutes compared to 1 to 2 weeks for the enzyme
immunoassay.(EIA). The accuracy of rapid tests is comparable to the standard EIA tests. Rapid
HIV testing must be conducted according to the same ethical standards as for any other HIV test
including pre- and post-test counselling, informed consent, privacy and confidentiality. Rapid
tests to detect antibodies to HIV can enable health providers to supply definitive negative and
positive results to patients at the time of testing. Most people receiving rapid HIV test results can
receive counselling and learn their HIV status in a single visit. Therefore rapid testing can
increase the number of people undergoing HIV testing who know their results. Rapid testing may
also assist in facilitating the diagnosis of HIV infection, improving HIV testing capabilities in
facilities without access to laboratories, and facilitating post exposure prophylaxis in health
workers following occupational exposure to blood and body fluids. Rapid tests have important
implications for HIV counselling procedures.
Notes: 1 copy
Department of Health. (2000). Department of Health, HIV/AIDS Directorate: HIV/AIDS
counselling evaluation follow-up implementation proposal and budget. Department of health.
Ref Type: Unpublished Work
Ref ID: 510
Keywords: Africa/care/evaluation/health/HIV/AIDS counselling/policies/policy/pre-
test/research/South Africa/training
Abstract: Following completion and submission of the recent national HIV/AIDS counselling
evaluation research agreement was reached between the Director of the HIV/AIDS directorate
and the School of Psychology(SoP) that the SoP would submit a budget for implementation of
some of the recommendations emergent from the study.
The general conclusions from the study are re-produced here as a introductory comment to the
implementation proposal.
. Whereas enormous resources have been allocated from time to time to build the counselling
service, HIV/AIDS counselling in South Africa remains underdeveloped, constrained by issues of
competence, policy obstacles, lack of coordination, and lack of resources.
163

.Counselling is also caught in a paradox of attempting to render a psycho-social service in the
bio-medical context of health care settings with preferred outcomes for such counselling
sessions. To achieve any of its goals beyond the mandatory pre-test counselling session, a
concerted and coordinated policy, training and implementation process must be undertaken.
Notes: 1 copy
Department of Health. (2000). To refund the accreditation of HIV/AIDS counsellors,
trainers, mentors and training institutions.
Ref Type: Unpublished Work
Ref ID: 581
Keywords: counsellor/counsellors/training
Abstract: The letter is about to fund the accreditation of HIV/AIDS counsellors, trainers, mentors
and training institutions to the amount not exceeding R 704 148.
Notes: 1 copy
Department of Health. (2002). Approval of Provincial VCT conditional grant Business
Plans - 2002 / 2003.
Ref Type: Unpublished Work
Ref ID: 534
Keywords: health/VCT
Abstract: This is a letter for approval of Provincial VCT conditional grant Business Plans -
2002/2003.
Its purpose is to request the Director-General of Health to approve the attached VCT conditional
grant Business Plans from 9 Provinces.
Notes: 1 copy
Department of Health HIV and STD Directorate. (2002). Voluntary Counselling and
Testing: Business Plan 2002 / 2003 (Amended Final Draft).
Ref Type: Unpublished Work
Ref ID: 539
164

Keywords: business/client/clients/counselling and testing/medical/population/VCT/voluntary
counselling and testing
Abstract: In Mpumalanga Province, 49 sites had been identified to provide HIV voluntary
counselling and testing services. Only 21 of these sites are operational; mostly because the
other sites do not have the required testing kits.
In nine of the seventeen sub-districts in the province, meetings were held to discuss about the
VCT progress and needs for each sub-district. A need to identify more VCT sites was expressed
so that the majority of the targeted population throughout the province can have access to VCT
services. The necessary VCT sites for each sub-district were identified. These access to VCT
services. The necessary to cover most of the Province's scattered settlement areas and also to
make it easy for the clients to be provided with follow-up/on-going counselling services in sites
that are close to their domicile areas.
The identified VCT sites range from 6 to 23 per sub-district to a total of 88 sites (for an average of
about ten sites per sub-district). This total includes the VCT sites that are already operational.
Only one of the 88 sites is a non-medical site. The idea is to have VCT sites in mostly medical
settings and then later on roll them out to non-medical settings.
In terms of the eight sub-districts that have not yet been met, the assumption is that they will also
identify an average of about ten sites per sub-district; to a total of 80. The overall total of the
identified VCT sites in all the sub-districts in the Province would be about 168.
There is a need to urgently assess all the identified sites in terms of the VCT sites selection
criteria so as to launch sites to offer VCT services.
Notes: 1 copy
/ 2003.
Department of Health and Welfare. (2002). Business Plan for Voluntary Counselling 2002
Ref Type: Unpublished Work
Ref ID: 542
Keywords: business plan/care/client/clients/clinic/health/HIV-status/HIV
prevalence/information/media/population/prevention/primary health care/VCT/youth
165

Abstract: # The Northern province with a population of 5,6 million has a prevalence rate of 13.2%
as depicted in 2000 HIV prevalence survey.
# The province has 42 hospitals, 240 clinics and 4 youth information centres and 3 Y - centres in
the six districts.
# The intention is to incorporate VCT services into all provincial districts over a 3 - year period.
# The Province regards counselling as a medium for prevention. Counselling provides the clients
with the opportunity to make informed decisions, in terms of behavioural changes. It also offers
care and support to the infected and affected. Counselling is both educational and informative; it
also helps people to know their HIV status and means to prevent reinfection and spread of the
epidemic.
# It has been established that the most effective way to do this is to introduce the service at
primary Health Care level.
# The Agincourt of the Eastern District has been the site of a joint National - provincial HIV/TB
pilot programme. The lessons learned here are to be used in informing the strategy for roll-out in
the Northern Province as a whole.
Notes: 1 copy
2003.
Department of Health. (2002). Voluntary Counselling and Testing: Business plan 2002 /
Ref Type: Unpublished Work
Ref ID: 543
Keywords: antenatal clinic/business plan/clinic/counselling and
testing/counsellor/counsellors/family/family planning/health/infection/Nurse/VCT/voluntary
counselling and testing
Abstract: The prevalence of HIV infection among antenatal clinics for 2000 was 11.2, this
prevalence has increased from 8.6 in 1997, 9.9 in 1998 to 10.05 in 1999.
Voluntary Counselling and Testing services are currently in cooperated into the District health
system. With the shortage of nurses, it is difficult for existing staff to effectively deal with the
increased demand for Voluntary Counselling and Testing. Therefore counsellors should continue
166

to be trained on HIV.
The current VCT initiative encourage all individuals to become aware of their status, particularly
those with STDs or TB, attending family planning and antenatal clinics as well as high risk
groups.
Notes: 1 copy
Department of Health. (2002). HIV/AIDS Strategic Plan, 2000 - 2005.
Ref Type: Unpublished Work
Ref ID: 546
Keywords: Africa/economy/grief/health/impact/sub-Saharan/Sub-Saharan Africa/UNAIDS/WHO
Abstract: During the last two decades, the HIV pandemic has entered our consciousness as an
incomprehensible calamity. HIV/AIDS has already taken a terrible human toll, laying claim to
millions of lives, inflicting pain and grief, causing fear and uncertainty and threatening economic
devastation.
According to recent estimates by the Joint United Programme on HIV/AIDS (UNAIDS) and the
World Health Organisation (WHO), the number of people living with HIV will be 33.4 million by the
end of 1998, a 100% increase compared to one year ago. In Sub-Saharan Africa, more than a
quarter of young adults are infected with HIV.
Assuming that no cure is found, it is estimated that more than 40 million people will be living with
HIV by 2000. The impact of the epidemic on the economy is already being felt in some countries.
Life expectancy has been significantly reduced as many people in the 15-49 year age group are
now dying of AIDS.
Notes: 1 copy
Testing.
Department of Health and Welfare. (2002). Business Plan for Voluntary Counselling and
Ref Type: Unpublished Work
Ref ID: 547
Keywords: behaviour change/business plan/care/client/clients/clinic/community/health/HIV-
167

status/HIV prevalence/HIV testing/media/population/prevention/primary health care/rapid HIV
testing/VCT/voluntary counselling and testing/youth
Abstract: The Northern Province with a population of 5,5 million has a prevalence of 11,4 % as
depicted in 1999 HIV prevalence survey. Voluntary counselling and testing is neither readily
available nor accessible to the communities. The province regards counselling as medium of
prevention. Counselling provides the clients with the opportunity to make informed decisions, in
terms of behaviour change. It also offices care and support to the infected and affected.
Counselling is both educational and informative, it also helps people to know their HIV status and
how to prevent reinfection and spread of the epidemic.
Objectives: The Northern Province is embarking on a strategy to increase access to VCT.
To provide continuum of counselling service, testing and ongoing care and support in the
Province, targeting the 15 - 49 year groups.
VCT Plan: The province has 42 hospitals and +- 500 clinic and 45 youth centres in its 7 regions.
The intention is to incorporate VCT services into all provincial regions over a 3 year period.
It is felt that the most effective way to do this is to introduce the service at the Primary Health
Care level
The introduction of rapid HIV testing is an accurate and affordable means of making same day
results available to clients.
Notes: 1 copy
Department of Health. (2002). Updated list of finalized policy documents (Annex A) and
draft policy documents still in the process of being finalized (Annex B).
Ref Type: Unpublished Work
Ref ID: 554
Keywords: policies/policy/policy documents
Abstract: This document contains an updated list of finalized policy documents (Annex A) and
draft policy documents still in the process of being finalized (Annex B).
Notes: 1 copy
168

Department of Health. (2002). Conditional grant allocation for 2000-2001- request for
approval of the seven voluntary counselling and testing business plans.
Ref Type: Unpublished Work
Ref ID: 571
Keywords: voluntary counselling and testing/business plan
Abstract: This letter is to request the Director - General: Health to approve the attached seven -
(7) Voluntary Counselling and Testing business plans for the financial year 2000/2001.
Notes: 1 copy
Devlin, J. (1999). Communicating Beyond AIDS Awareness - a Manual for South Africa.
AIDS Analysis Africa, 10, 2.
Ref ID: 450
Keywords: Africa/case study/communication/evaluation/health/knowledge/media/research/South
Africa/strategy
Abstract: This attractively presented publication is a valuable addition to the burgeoning library of
work on effective long-term solutions to the epidemic. It is about communication, specifically
related to HIV/AIDS in South Africa, and is one of a number of initiatives concerning enhanced
communication commissioned by Department of Health in 1997 under the "Beyond Awareness"
campaign.
The manual, although pleasingly styled, is clearly intended mainly as a work of reference, and its
six chapters are minutely indexed. There is a key point summary at the end of each chapter.
The wide margins feature many illustrations and highlights of the narrative, and 25 case studies
and examples are sprinkled throughout the next.
The manual presents an overview of communications issues, but inside the constraints of its size
and intended scope it delivers rather more. The incisive and concise text could serve very well as
a primer for anyone wishing to acquire knowledge of the various forms of media and
communication available, quite divorced from HIV/AIDS. The volume concentrates on the
epidemic and its relationship to society mainly in Chapter One, which also defines the terms and
strategies to follow. Chapter two reviews the various channels of mass communication in a
169

succinct and understandable way. Chapter three similarly examines what the authors call " small
media". Interestingly, a case study in this chapter reviews another publication in the beyond
Awareness campaign: a catalogue listing all known South African HIV/AIDS print, audio and
videos material, in a laudable attempt to reduce duplication and cost.
Chapter four examines the difference between conventional media, one-on-one communication
and participatory strategies. Chapter five brings HIV/AIDS into the communications picture, and
the last chapter is devoted to research and evaluation, stressing the necessity for setting defined
objectives and indicators of progress towards them, and thus evolving the best strategy for
success. A page of bibliography completes the work. The authors have produced an excellent
publication, of considerable use to a wider readership than envisaged, and a valuable reference
work for HIV/AIDS planners and strategies
Notes: 1 copy
Dickson-Tetteh, K. & Ladha, S. (2000). South African Health Review. Ntuli A., Crisp, N.,
Clarke, E., and Barron, P.
Ref Type: Unpublished Work
Ref ID: 8812
Abstract: Between 1197and 1998 alone HIV infection rates amongst young people almost
doubled. Policies and programmes have been developed to address the problems and
challenges facing the youth in South Africa. The rapid spread of the HIV epidemic especially
amongst adolescents has also meant that programmes have had to focus their attentions on
interventions that aim to raise awareness and influence positive behaviour change amongst
adolescents. Policies strategies should address, education and awareness of HIV transmission
and safer sex practices, strategies to ensure access to condoms, access to HIV testing and
counselling services.
Notes: Chapter 20
Ref ID: 6275
Dickson, P. (1998). "Virgin cure" myth is debunked. City press.
170

Keywords: Africa/male/myth/rape/South Africa
Abstract: Police and AIDS-relief workers in Port Elizabeth's sprawling townships, still reeling from
last weekend's shack rape of two little girls, face a new horror. The Eastern Cape's health MEC
Dr Trudy Thomas is very worried about her province's skyrocketing Aids figures. " There exists
an awful myth that Aids can be cured when a carrier has sexual intercourse with a young virgin.
We see this in a very serious light," when said. Port Elizabeth's police spokesman Capt Johan
Buys said it seemed belief in the myth was widespread among Xhosa - speaking males.
Municipal Aids adviser Aliman Mazosiwe said while the myth existed, there was no proof that it
encouraged child rape. Thomas said there were many factors that played a role in the increase
in abuse of South Africa's children. She said the myth of the "virgin cure" was not restricted to
Xhosa-speaking males, but was widespread in many countries. She added that her department's
Aids information campaign had already made considerable progress in debuking the myth. The
girls, aged four and five, who Mbeki settlement are still being treated in the city's Dora Nginza
hospital.
Notes: 1 copy
Doyle, P. R. (1991). How AIDS could affect the economically active and reduce the
educated and skilled in the workplace. In.
Ref ID: 6D
Keywords: business/economy/workplace/conference/insurance/South Africa/Africa
Abstract: This conference paper was read by Mr P.R. Doyle at the annual conference on the
Insurance Institute of South Africa. The article makes a number of conclusions about the effects
of HIV/AIDS on the pool of economically active, educated and skilled individuals in the workforce
drawn from the actuarial/demographic model developed at Metropolitan Life.
Natal Witness.
Ref ID: 8803
Dr Mkhize, Z. (2002). Govt challenge to ruling 'not about a reluctance to supply drug'.
Keywords: government/women/prevention
171

Abstract: The government is committed to supplying the cheap anti-retroviral drug to pregnant
women but it may find itself acting against the law if it is not able to structure its programme to the
letter.For the best results one-to one counselling is ideal. The article looks at the importance of
counselling as an effective method of promoting prevention through assisting the mother to
understand the implications of HIV.
Du Preez, M. & Bosch, A. B. (1992). Doctor I want An AIDS Test: Some guidelines for the
psychological management of persons requesting HIV antibody testing. Update, 6, 158-159.
Ref ID: 44
Keywords: guidelines/psychology/VCT/voluntary counselling and testing
Abstract: The global AIDS pandemic has created new challenges for Health services. In South
Africa, general practitioners( GP) were among the first health workers confronted with the
disease. General practice has always embodied the dual roles of curative and preventative
medicine. Since we lack a 'cure' at this stage, the real challenges for the GP must lie with
management and prevention.
Notes: 1 copy
du Toit, J. D. (1996). AIDS prevention in Kwa-Zulu Natal. AIDS Analysis Africa (Southern
Africa Edition), 6, 8-9.
Ref ID: 43
Keywords: attitudes/condom/condoms/knowledge/KwaZulu-Natal/prevention
Abstract: Of all the regions in South Africa, Kwa Zulu-Natal seems to have the highest HIV
infection rate. Prevention efforts are hampered by the remoteness of certain areas where
modern communication methods or transport do not reach the population. Illiteracy contributes to
the problem. The study has been done in the Ingwavuma area, in the north-eastern part of Kwa
Zulu-Natal. The study was about measuring the impact of the intervention, measuring the
knowledge of HIV/AIDS, the attitude towards HIV/AIDS and condoms use and sexual practice.
Notes: 1 copy
172

Eastern Cape Department of Health. (2002). Voluntary Counselling and Testing Province
of the Eastern Cape.
Ref Type: Unpublished Work
Ref ID: 558
Keywords: voluntary counselling and testing
Abstract: The paper contains the budget for voluntary counselling and testing for 2000/2001
Notes: 1 copy
Engelbrecht, B. (2000). Towards developing cultural competency in HIV/AIDS
counselling. In (pp. 1).
Ref ID: 246
Keywords: Africa/family/guidelines/HIV/AIDS counselling/infection/intervention/prevention/South
Africa/training
Abstract: The steadily rising incidence of HIV/AIDS in the developing world and in South Africa in
particular, has the capacity to decimate large number of people, to destroy the social fabric of
communities and their ability to sustain themselves. The consequences of HIV/AIDS can be seen
at micro level in terms of its impact on individuals and their families and also at a macro level in
terms of socio economic consequences . It is therefore crucial that AIDS programmes become
effective in curbing further spread and minimising the impact of this epidemic. HIV/AIDS
counselling is an important aspect of HIV/AIDS intervention programmes and can be utilised as
an effective tool at the level of both prevention and care. Whilst it is a global problem, the
experience of individuals affected by HIV/AIDS varies between communities. Attitudes, belief
systems, norms, practices and power relations may contribute to increased vulnerability to HIV
infection and may also be incorporated as a strength in assisting families and communities cope
with HIV/AIDS.
To increase the effectiveness of counselling programmes it is important that counsellors become
equipped with the knowledge, sensitivity and skills to work effectively in a multicultural context.
This requires an acknowledgement that all contexts are multicultural and that all interactions
between people therefore are cross cultural. Cultural competency training makes possible the
173

shift from the intention to be culturally sensitive to providing the skills to do so.
Service provider in the field of HIV/AIDS counselling have a responsibility to ensure that
counsellors have the skills to work more effectively in the diverse contexts with which they are
confronted.
The presentation will explore the issue of cultural competency in the context of HIV/AIDS
counselling and will identify some guidelines that could be utilised in practice.
Notes: 1 copy
Ref ID: 448
Evian, C. (2000). The importance of counselling for AIDS. People dynamics, 18, 14.
Keywords: babies/confidentiality/counsellor/disease/family/health/health worker/infection
Abstract: HIV infection and AIDS can lead to ill health and often emotional, psychological and
social problems. These problems can also cause severe difficulties with relationships. HIV/AIDS
usually affects people between the age of 15 and 50, as well as new born babies and young
children. AIDS is very much a disease of families. The infected people, their partners and
members of their family or close friends often need support during this difficult time. We usually
solve our problems through a process of learning and experience. Sometimes we may seek help
from a family member, a friend or a respected colleague. There are times, however, when even
these people cannot help because the problem is too big, too new, too much of a secret or too
strange. When this happens, counselling can be very helpful. Confidentiality is a major issue
with HIV/AIDS. People are often too scared or ashamed to speak to their family or friends about
their condition or about their feeling and concerns. Health care workers can provide counselling
to such people, without becoming involved in their personal lives. The counsellor can offer help
which is fair, objective and balanced.
Notes: 1 copy
Fawcett, C. (2001). HIV counselling and the social-medical interface: Contested terrain.
In (pp. 1-12). Paper presented at the AIDS in Context Conference, University of The
Witwatersrand, April 2001: Centre for AIDS Development, Research and Evaluation (CADRE).
174

Ref ID: 47
Keywords: community/counsellor/counsellors/medical/model/patient care/political/politics/primary
health care/social/training
Abstract: In attempting to address the needs of HIV positive individuals at a community level, an
increasing number of health care practitioners are being trained as HIV counsellors. It is
recognised that HIV counselling addresses the social, emotional and behavioural needs of these
HIV positive individuals, while the conventional training of health care practitioners is based on
addressing their bio-medical needs. This paper proposes a method for understanding the
opposing facets of HIV counselling within a primary health care context and seeks ways in which
to integrate the seemingly opposing roles of counsellor and health care practitioner. Activity
theory, developed from the socio-cultural-historical school of Psychology, provides a framework
for understanding the interaction of different elements constitutive of activity systems within their
contexts by employing contextually embedded activity as the unit of analysis. The activity of 'HIV
counselling' is viewed within a multidimensional model of activity outlined by transformation
processes occurring at levels of: society ( changes in community needs, practices and norms);
local organisation ( changing health care practices within the hospital); and individual interaction(
shifting roles in client-counsellor relationships). Transformation processes occurring at each of
these levels derive from social, cultural, political and historical contexts. By viewing HIV
counselling as an outcome of the interactions between these three levels of activity, the
challenges facing health care practitioners doing HIV counselling, and their achievements, are
contextually understood. The analysis provides a conceptual framework for understanding the
transformation processes involved in developing health care services.
Notes: 1 copy
Ref ID: 335
Fawcett, C. (2001). Counselling. AIDS Bulletin, 10, 22-25.
Keywords: infection/response
Abstract: There is widespread recognition that being diagnosed with, or suspecting personal HIV
infection or AIDS, brings with it profound emotional, social and behavioural consequences. The
175

concept of HIV counselling has developed worldwide as a response to these consequences.
There is no single overarching definition of HIV counselling. Instead, it has become a field
characterised by multiple approaches, methods and contexts.
Notes: 1 copy
Ref ID: 2045
Ferreira, J. (1999). Medici "oningelig, bang" vir MIV / vigs. Die Burger.
Abstract: Kaapstad - Dokters se onkunde oor MIV en vigs is 'n groot struikelblok in die stryd teen
die virus, het sprekers gister hier by die bekendstelling van die program Aid for Aids gese.
"Die algemene praktisyn se rol in die bestryding van MIV/vigs word totaal onderskat. Ongelukkig
is praktisyns oningelig oor die siekte. Hulle verstaan baie dinge nie en is gevolglik bang
daarvoor," het dr. Lalubi Walters van die farmaseutiese bestuursmaatskappy PBM gese.
Walters het gese hy verneem 85% van pasiente in 'n private hospitaal in Mpumalanga het vigs,
maar verskeie ander siektes soos longontsteking, diaree, tuberculose en brein vliesontsteking
word amptelik deur hul dokters aangegee.
Te veel bangmaakpraatjies.
Volgens hom doen hopeloos te veel bangmaakpraatjies die ronde oor wat 'n verskriklike ramp
weens MIV/vigs voorle.
"Ons het 'n paradigmaskuif nodig. Mense moet hulle aanmeld vir behandeling, want daar is
goeie behandeling beskikbaar." Ons het 'n paradigmaskuif nodig. Mense moet hulle aanmeld vir
behandeling, want daar is goeie behandeling beskikbaar." Dr. Andrew Clark, 'n algemente
praktisyn van Kaapstad en kundige op die gebied van MIV/ vigs, het gese die meeste dokters
weet nie eens waar om te begin as 'n pasient met MIV of vigs hulle spreek nie. "Ek hoor nog te
veel van enkelvoudige terapie, of pasiente wat na openbare hospitale gestuur word wat nie
spesialiseenhede vir MIV / vigs het nie, het Clark gese. Hy het ook 'n hou na die media ingekry. "
Die media moet 'n groot deel van die skuld vir al hierdie verkeerde persepsies kry.
Onkundiges word aangehaal
"Ek sien soms uiters onverantwoordelike verslaggewig waarin onkundiges oor 'n onderwerp
aangehaal word." As voorbeeld het hy na 'n onlangse opskrif "AZT" - drug from hell" verwys.
176

MIV/vigs kan baie doeltreffender as hepatitis B en C. gekompliseerde suikersiekte, sekere
kankersoorte en veelvuldige sklerose behandel word, het Clark gese. Nagenoeg 15 siekefondse
het hulle reeds by die program Aid for Aids aangesluit. Daarvolgens word pasiente met MIV/vigs
aangemoedig om dit aan te meld, in ruil waarvoor hulle omvattende dekking, vertroulikheid en
persoonlike ondersteuning kry.
Notes: 1 copy
Floyd, L. & Molekwa. (2000). The partnership against AIDS in Action: annual report of the
Gauteng AIDS programme 1999/2000.
Ref Type: Unpublished Work
Ref ID: 487
Keywords: KwaZulu-Natal
Abstract: The Gauteng Province had developed and implemented a strategic, effective inter-
sectoral AIDS Programme to intervene in the HIV/AIDS epidemic. As a result, local inter-sectoral
programmes are now being developed in the Province, providing early, important signs of how
the national partnership against Aids can operate at the local. These are the features that will
make the programme work. AIDS is a widespread reality. It is noticeable by the number of AIDS
deaths and growing openness around living with HIV, particularly in provinces such as Gauteng
and kwaZulu-Natal.
Notes: 1 copy
Ref ID: 3217
Forbes, A. (1998). Artificial barriers halt progress on Aids cures. The star.
Keywords: Africa/barrier/barriers/health/medical/regulations/research/South
Africa/treatment/UNAIDS/WHO
Abstract: The article on the Aids pandemic (UNAids and WHO report, the Star June 26), yet again
highlights the terrible hypocrisy of UNAids and World Health Organization as well as national
medical control structures supporting concern in regard to this scourge. These bodies
conveniently forget that right in South Africa, two potent cures for HIV and Aids have hit the
177

headlines within the last two years, namely virodene and Oxytherapy. Both of these treatments
initially met with successes only to be immediately closed down by the South African Medical
Control Council because they are cheap and did not conform to the prescribed academic red tape
allowing them to further their research, dispense and/or practice
It is obvious to any who have followed today's workings of medical health control bodies
worldwide, especially where HIV/Aids are concerned, that he called -for regulations were not
followed here by those involved with these potential cures (or their only-too- willing-to try
patients), because they knew perfectly well that every possible barrier would be placed in their
way by the hypocrisy of such august bodies as the MCC and their parent bodies internationally:
UNAids, the World Health Organisation and pharmaceutical companies.
Notes: 1 copy
Ref ID: 8100
Keywords: AZT
Ford D. (2000). HIV: Know your enemy. Mail and Guardian.
Abstract: The treatment of HIV requires knowledge of the disease and how specific drugs work.
HIV treatment is a minefield. The disease is almost always fatal, but the drugs have many side
effect, not the least of which are not medical bills. Complicating matters, treatment started too
early may lead to resistance, patient non-compliance, and limited treatment options later.
Notes: 1 copy
Fouche, C. B. & de Vos, A. S. (1995). Hulpverlening aan persone met HIV-infeksie.
Social work, 31, 293-304.
Ref ID: 300
Keywords: information/training/client/knowledge/WHO/research
Abstract: People in the helping professions are currently experiencing mounting pressure to
disseminate information regarding HIV- and AIDS and to render professional help in this field.
Generic training in values and skills enables practitioners in various disciplines to do this
effectively for different client groups. Unfortunately they do not always dispose of the relevant
178

knowledge. This often leads to helpers feeling uncomfortable or even unable to render effective
help. They turn to educationers who find themselves in more or less the same predicament.
This article is an attempt to address this void experienced by practitioners and educationers alike.
Based on research done in this regard, a summary is given of the most important themes to be
focussed on in the different phases of HIV-infection.
Notes: 1 copy
Fountain, D. E. & Masieta, M. (1996). Telling a person: You have AIDS. South African
family practice, 17, 56-60.
Ref ID: 48
Keywords: family/guidelines/positive status
Abstract: This paper describes the experience of a counselling team with 400+ HIV positive
persons. They have developed a specific process of eight steps by which they prepare the
patient and reveal the diagnosis to him in such a way that it is constructive and reinforcing. This
process is explained here step by step. Their findings, after having applied this process to about
400 HIV positive persons, are given. There are no suicidal reactions. No serious reactions of
revengeful behaviour. Often patients showed gratitude for having been told the truth and
expressed acceptance of the diagnosis and courage to do what was necessary. And often
considerable ( occasionally remarkable!) improvement in the clinical condition of the person.
Fountain, D. E. & Masiesta, M. (1996). When do we talk to a sick person about AIDS.
South African family practice, 17, 230-234.
Ref ID: 49
Keywords: efficacy/ethics/family/Informed consent/medical/model/transmission/Zaire
Abstract: Do we discuss the possibility of HIV infection immediately with a sick person? Or do we
test him first and discuss it only when the result is positive and he has had adequate counselling?
This paper from Vanga Hospital in rural Zaire declares that the informed consent approach adds
further stress to a person already ill. Also, if the person refused testing, this diminishes the effect
of counselling about the behaviour necessary to reduce possible transmission of the virus. In the
179

Vanga approach, a patient is tested and referred to the counselling team. If the test result is
positive, counselling continues until the person seems psychologically able to receive the
diagnosis with hope. No serious reactions have occurred after revealing the diagnosis of HIV
infection to more than 700 persons. Careful preparation by counselling and a support approach
have positive psychological effects, and often physiological benefits.
Notes: 1 copy
Fransman, D., Van der Velde, P., & Hussey, G. (1996). Home-based care for patients
with HIV infection and AIDS: a conceptual framework. CME, 14, 801-809.
Ref ID: 428
Keywords: Africa/Home based care/Nursing/South Africa
Abstract: The AIDS epidemic is currently into its second phase in South Africa with increasing
numbers of persons in need of medical and psychosocial care and support as a result of HIV
infection. It is estimated that between 1.2 and 1.8 million of people in South Africa are already
infected with HIV, and about 12000 to 15000 people have AIDS. The fifth national antenatal
survey on HIV infection indicated an increase in the prevalence rate from 0.76% in 1990 to 7.5%
in 1994. Since in adults it takes between 5 and 10 years for the disease to progress from the
onset of HIV infection to the development of AIDS, models predict that between 250 000 and 300
000 individuals will begin to develop symptoms in the nest 5 years. Such numbers of infected
patients could have catastrophic effects on our health care services within the next 5 to 10 years.
This is also a time of transition and high expectations for a more equitable social system,
especially for previously disadvantaged and marginalised groups.
Added to its inherited problems, the health sector has been plunged into further crisis by budget
cuts in certain action by nursing staff. In 1993, a study by the Medical Research Council (MRC)
investigated the ability of health services in the Cape Peninsula to respond to the HIV epidemic.
This revealed that those services, although they are relatively well resourced compared with other
urban centres in the country, would be unable to cope with the demand for care of persons living
with AIDS (PWAs). Alternative strategies for care should, therefore, be developed. One such
strategy is home-based care, as part of a continuum of care, from diagnosis to death. this article
180

provides a conceptual framework for the development of such a strategy.
Notes: 1 copy
Free State Department of Health Business plan for Voluntary Counselling and testing:
Free State Province. (in press).
Ref ID: 538
Keywords: Africa/employer/infection/information/KwaZulu-Natal/male/migrant/mining
industry/population/South Africa/Southern Africa/voluntary counselling and testing
Abstract: The 2000 statistics shows that Free State has the fourth highest prevalence rate of
HIV/AIDS infection with 27.9% following the KwaZulu Natal, which lead with 32,5%. The province
is located in the centre of South Africa. As a result national roads namely N1, N3, N5, N6 and N8
cross it, which are, used by various users including trucks. Moreover the province has strong
agricultural and mining industries contributing respectively with about 14% and 15% of the total
mining and agricultural GDP in South Africa. It also has one of the largest petro-chemical plants
in the country, SASOL that is located in Sasolburg. This makes Free State the largest employer
of the migrant mine labor in its mining and industrial sectors. These factors, and especially the
Goldfields area and Sasolburg increase vulnerability to HIV/AIDS infection and the spread of
AIDS.
In its profile of the Free State, the Development Bank of Southern Africa reported that the social
structure of the province has early as 1994 a negative effect in its potential population growth.
The report further stated that the population in the province is relatively old and predominantly
male.
Different situation and factors in South Africa and particularly in the Free State led to the
development of a formal information dissemination programme such as the Voluntary Counselling
and Testing programme. Some of the factors indicating the context of South Africa are :
* The social Context.
* HIV/AIDS in the Free State.
Notes: 1 copy
181

Funk, B. (1994). Counselling the dying patient - some issues in terminal counselling.
AIDS Bulletin, 3, 18-19.
Ref ID: 46
Keywords: family/guidelines/patient care/positive status
Abstract: The World Health Organisation states that "Palliative care is the active, total care of
patients at a time when their disease is no longer responsive to curative treatment and when
control of pain, or other symptoms, and of psychological, social and spiritual problem is
paramount. The overall goal of palliative care is the highest possible quality of life for the patient
and family. Palliative care affirms life and regards dying as a normal process. Palliative care
emphasises relief from pain and other distressing symptoms, integrates the physical,
psychological and spiritual aspects of patient care, offers a support system to help the patient live
as actively as possible until death and a support system to help the family cope during the
patient's illness and in bereavement.
Notes: 1 copy
Furlonge, C., Gregorich, S. E., Kalibala, S., Grinstead, O., Coates, T., & O'Reilly, K. R.
(2000). HIV- Related Risk Factors in a population - Based probability Sample of North and
Central Trinidad: The Voluntary HIV- 1 Counselling and Testing Efficacy Study. AIDS and
Behaviour, 4, 49-62.
Ref ID: 50
Keywords: alcohol/condom/drugs/gender/knowledge/risk/sexual behaviour/transmission/Trinidad
Abstract: A population-based probability sample of North and Central Trinidad collected
information on 860 respondents' demographic characteristics, as well as the prevalence of sexual
risk behaviors and precursors to sexual risk taking in the 2 months preceding interview.
Precursors of sexual risk behavior included HIV transmission knowledge, condom possession,
and alcohol and drug use prior to sexual intercourse. A 91% response rate was achieved.
Overall, approximately 51% of respondents reports unprotected sexual intercourse with a primary
sex partner (i.e. spouse or "steady" partner, and 4% reported unprotected sexual intercourse
with a nonprimary partner( i.e, causal or commercial partner) during the 2 months prior to
182

interview. Substantial variability on these risk behaviors was noted across demographic strata.
Alcohol and drug use prior to intercourse was associated with reports of unprotected intercourse
with primary and nonprimary partners. The demographic indicators of marital status and
respondent gender had indirect( i.e., mediated) effects, through one or more of the risk
precursors, on sexual risk behaviors. Implications for the design and targeting of HIV- related
interventions and services are discussed.
Notes: 3 copies
Fylkesnes, K., Haworth, A., Rosensvard, C., & Kwapa, P. M. (1999). HIV counselling and
testing: Overemphasizing high acceptance rates a threat to confidentiality and the right not to
know. AIDS, 13, 2469-2474.
Ref ID: 185
Keywords: acceptability/confidentiality/prevention/VCT/voluntary counselling and testing/Zambia
Abstract: Objective: To examine factors affecting the readiness for HIV-related voluntary
confidential counselling and testing (VCT).
Methods: In a population-based HIV survey in selected urban and rural areas in Zambia, adults
aged>15 years inclusive were selected by stratified random cluster sampling. The participants
were asked to provide a saliva sample for anonymous HIV testing(n= 4812, consent rate 93.5%)
and, as a part of an interview, were asked about previous HIV testing experience and if they
wished to be counselled and tested for HIV. Those indicating interest (initially willing) were
provided with an invitation letter to see a counsellor. In rural areas, VCT was provided by
personnel brought in from outside the local community, whereas in urban areas it was provided
by locally recruited staff.
Results : The overall HIV test rate was 6.5%, but rates appeared to be considerably biased
towards higher education groups. The proportion initially willing was 37% while 3.6% actually
came for counselling and were tested (9.3% of those initially willing), of which 47% returned for
the result. Actual use was four to five times higher in rural compared with urban areas. Self-
perceived risk and high-risk behaviour were positively associated with initial willingness but not
with actual use.
183

Conclusion: The readiness for VCT in the general population was found to be very low.
Provision factors such as concern about confidentiality and length of time waiting for the test
result contributed to the low utilization rate. Results of this study contrast sharply with reported
VCT acceptance rates of 70-90% among women attending antenatal care in Zambian and in
other African populations, suggesting an urgent need to evaluate testing policy and practice of
antenatal VCT in particular.
Notes: 1 copy
Galloway, M. (1996). AIDS: The plague of the 20th Century or a challenge for modern
medicine. Arcimedes, 38, 22-26.
Ref ID: 212
Keywords: attitude/health/infection/medicine/response/South Africa
Abstract: Mention the world AIDS and you will get a variety of responses from disinterest and fear
to total lack of knowledge. What is abundantly clear, however, is that most people do not think it
will affect them and therefore they do nothing about it. Unfortunately AIDS is our problem, it's
everyone's problem and, whether we like it or not, it will profoundly affect our lives in one way or
another.
Despite the fact that AIDS has been known about since the early 1980s ( and it is believed that
the first cases go back further than that), it is only beginning to feature in everyday life with
movies like Philadelphia, Peter's Friends and And the Band Played on as well as episodes in
series like LA Law. However, people still seem to think it is something which affects other people
only and this will probably continue until each of us knows someone who infected - that time is
not too far away!
The latest figures released by the Department of Health indicate that there are approximately one
million HIV positive people in this country, with an estimated 800 new infections every day, and
that 250 000 South Africans will be sick and dying from AIDS within the next four years.
With all the other problems which South Africa faces it may not seem that AIDS should be a
major priority. However, estimated that by the year 2005 (10 years from now) a quarter of the
184

sexually active population of this country will be HIV positive.
Notes: 1 copy
Gapiya, J. (2000). How pre-and post-test counselling being made by PWAs can improve
support programmes. In (pp. 41).
Ref ID: 261
Keywords: confidentiality/NGO/physician/post-test/pre-and post-test counselling
Abstract: Issues: The National NGO for Support to PWAs in Burundi (A.N.S.S. Burundi) has
chosen to have PWAs testing counsellors. At first, our NGO had set up sensitisation
programmes in which PWAs were calling for early testing. Some of our members had been living
with HIV for more than ten years. They set an example that you can live as a PWA for many
years if you've known about HIV status early enough to take it into account in your daily life and
make the right steps. This was then a way to introduce counselling on how to live as a PWA.
Description: The next step for our NGO was to rule testings themselves, thanks to people
trusting in our ability to respect confidentiality. A PWA knows what he/she talks about when it
comes to testing: he/she knows taking into account the implication of ones result largely depends
on how one finds out about it. When a result is positive, the counsellor can find the right distance
between being professional and being personal and, being concerned himself, can find the right
words. The PWA to counsellor relationship is different from that to a physician, and allows for
more confidence in the counsellors experience.
Conclusion: Support and care teams exist in most hospitals in Burundi. They work in very close
relationship with testing teams. Nevertheless, no other care and support team in the country
deals with as many persons as A.N.S.S.
Notes: 1 copy
Gauteng Provincial Government. (2002). Gauteng Provincial Government: business plan
for voluntary counselling and testing programme 2002/2003.
Ref Type: Unpublished Work
Ref ID: 537
185

Keywords: care/government/HIV-status/medical/prevention/VCT/voluntary counselling and
testing/youth
Abstract: VCT has been introduced and implemented as both a preventative and care strategy.
Voluntary counselling and testing enhances the chances for early access to medical care and
support services, and to preventive measures. The strategy is in its second year of
implementation, targeting youth from the age of 15 to adults of up to 49 years.
As foundation or an entry point to care and prevention, voluntary counselling and testing
promotes and encourages testing so that people may know their HIV status and therefore be able
to plan accordingly and access relevant services earlier.
Notes: 1 copy
Geralds, F. (1983). Counselling in HIV Infection and AIDS. Patient Education and
Counselling, 19, 94-95.
Ref ID: 348
Keywords: infection
Abstract: Counseling in HIV infection and AIDS can be viewed as a new field and discipline. The
purpose of this new field and discipline is twofold; (1) preventing the spread of infection and (2)
promoting and maintaining the physical and mental well-being of the victims and their
relationships. Because outcome of the disease, HIV infection and AIDS can result in a variety of
psychological consequences. For example, patients and their environment have to deal with
feelings of anxiety and depression, with emotions of anger and guilt and often with a gradual
deterioration of their physical attractiveness and, in consequence of it, a loss of self esteem,
patients can be worried about their sexual relationships.
Notes: 1 copy
Gibney, L., Wade, S., Madzime, S., & Mbizvo, M. (1999). HIV testing practices of
Zimbabwean physicians and their perspectives on the future use of rapid on-site tests. AIDS care,
11, 603-673.
Ref ID: 54
186

Keywords: barriers/rapid testing/rapid tests/training/Zimbabwe
Abstract: To improve HIV testing procedure, rapid on-site HIV tests have been introduced in
Zimbabwe. At present, little is known about physicians' perspectives on the potential use of rapid
tests in their clinics or about their current laboratory-based testing practices. In a sample of 63
general practitioners in Harare, this study found physicians were generally testing individuals, not
couples, and an important reason for suggesting a patient be tested was medical symptoms;
frequent reasons for patients requesting the test were insurance purposes, being about to get
married or having suspicions about a partner. A primary deterrent to physicians testing patients,
even when patients requested it, was fear of traumatizing them. Fifty-six per cent of the
physicians believed rapid tests would increase the number of HIV tests they performed;
significant associations were found between this relief and whether physicians ever chose not to
test patients they suspected were HIV - positive( a positive association) and whether they chose
not to test specifically out of fear what patients would commit suicide( a negative association).
Prior to any expansion of testing with rapid tests, training in counselling and confidentiality
measures is essential, given that over half the medical personnel providing counselling to these
physicians' patients had received no training in pre- and post-test HIV counselling.
Notes: 1 copy
Gibney, L. (1999). HIV prevention in Developing countries: tenets of Behavioral and
Biomedical Approaches: Tenets of Behavioral and Biomedical Approaches. In L.Gibney (Ed.),
Preventing developing countries Biomedical and behavioural approaches. (- ed., pp. 1-7-71-85).
New York press.
Ref ID: 337
Keywords: biomedical/Developing countries/HIV prevention/population/prevention
Abstract: The reach of the HIV pandemic has been felt in all nations, whether they are presently
experiencing a high prevalence or low prevalence of HIV. In low-prevalence nations, the priority
has become the prevention of an epidemic, particularly in those nations considered to be at risk
because of sexual and injection drug use behaviors in the population and, in some cases,
biomedical risks such as inadequate screening for HIV in the blood supply system. In high-
187

prevalence nations, the priority is curtailing the spread of the disease and coping with the
morbidity, mortality, and lost productivity it currently entails.
Notes: 1 copy
Gibney, L. (1999). Intervention Research for future HIV prevention: design and
implementation considerations. In L.Gibney (Ed.), Preventing HIV in developing countries:
Biomedical and Behavioral Approaches (pp. 363-379). New York.
Ref ID: 417
Keywords: benefits/Developing countries/disease/HIV prevention/impact/intervention
research/prevention/research/sexually transmitted disease
Abstract: Concomitant with the spread of the HIV pandemic has been the desire to learn more
about how to prevent proliferation of the disease in a variety of contexts. This had led to the
implementation of increasing numbers of "intervention research projects. These projects are
typically conducted in order to (1) assess the impact of a behavioral change intervention on the
reduction on the reduction of risk behaviors, and in some cases on incidence of HIV or sexually
transmitted disease (STD), and (2) learn how to effectively implement such an intervention. An
additional purpose can be to (3) demonstrate to policy makers and funding agencies that an
intervention can be effectively implemented, with positive benefits to the target group, and is
therefore worthy of being sustained, expanded on a larger scale, or replicated elsewhere with
support from funding agencies. To serve the purposes it is important that an appropriate
intervention be implemented, the research plan for evaluating the impact well-designed, and the
results diffused effectively to relevant audience.
Notes: 1 copy
Gibson, D., Wermuth, L., Lovelife-drache, J., Ham, J., & Sorensen, J. L. (1989). Brief
Counselling to reduce AIDS risk in intravenous drug users and their sexual partners: preliminary
results. Counselling psychology Quarterly, 2, 15-19.
Ref ID: 564
Keywords: communication/condom/condoms/guidelines/infection/intervention/risk
188

ehaviour/sex/sexual partner/WHO
Abstract: Intravenous drug users (N=88) and their sexual partners (N=45) were randomly
assigned to either counselling intervention or an information-brochure only condition (aimed at
reducing behavioural risk for HIV infection). At 10 day follow-up, intravenous drug users exposed
to brief counselling were more knowledgeable about risk behaviour, and reported higher levels of
self-efficacy and communication skill, and more frequent use of condoms and sterilisation of
needles. At 90 day follow-up, intravenous drug users were more accepting of guidelines to
reduce sex-related risk and reported greater self-efficacy in relation to drug. Sexual partners who
received brief counselling showed a small reduction in unprotected sex (at 90-day follow-up),
while those receiving brochures were slightly less likely to use condom. Methodological problems
of the study are discussed.
Notes: 1 copy
Gibson, D. R., McCusker, J., & Chesney, M. (1998). Effectiveness of psychosocial
interventions in preventing HIV risk behaviour in injecting drug users. AIDS, 12, 919-929.
Ref ID: 51
Keywords: drug-users/drugs/efficacy/intervention/psychology/risk/social
Abstract: The purpose of this paper is to provide a comprehensive review of published controlled
evaluations of preventive interventions for drug users. We focus here on psychosocial
interventions. Previous reviews have assessed the effectiveness of treatment programs for drug
use in preventing HIV infection, and many others, have surveyed evidence of the effectiveness of
the needle exchange programmes in slowing the transmission of HIV. The interventions
described here differ from drug treatment and needle exchange in that they attempted to alter
behaviour by changing the attitudes and beliefs that support high risk practices. It is important to
note that although the interventions reviewed here may create "motivation" to change behaviour,
drug use treatment and/or access to sterile injection equipment are often the necessary means
through motivated injecting drug users( IDU) can change their behaviour.
Notes: 1 copy
189

Gillies, P. (1996). The Contribution of Social and Behavioral Science to HIV/AIDS
Prevention. In J.a.T.D.Mann (Ed.), AIDS in the World II: global dimensions, social roots and
responses: the global aids policy coalition (pp. 131-158). Oxford: Oxford University Press.
Ref ID: 381
Abstract: The contribution of social scientific research to HIV/AIDS prevention and care has been
questioned repeatedly. Reasons for frustration and dissatisfaction have included reliance on
quantitative survey research, lack of exploration into the social context of behavior, limited
discussion of national and local policies, limited evaluation, inadequate consideration of diverse
processes for preventing HIV infection, and poor elaboration of concepts of sexuality.
It is therefore important to assess the content, quality, and direction of this research and to
consider the critique of social science's contribution to HIV/AIDS prevention and control. To do
so, this section reviews, in a systematic yet selective manner, HIV-related social and behavioral
research published from 1991 to 1993. The first part identifies and discusses the conceptual
frameworks that have been used in social science research on HIV/AIDS. The second part
examines methodological approaches thus far applied to the study of sexual behavior in the
context of HIV/AIDS. The final part considers the role of social science in evaluating outcomes of
HIV prevention efforts.
Notes: 1 copy
Ginwalla, S. K., Grant, A. D., Day, J. H., Dlova, T. W., Macintyre, S., Baggaley, R. et al.
(2002). Use of UNAIDS tools to evaluate HIV voluntary counselling and testing services for
mineworkers in South Africa. AIDS care, 14, 707-726.
Ref ID: 8827
Keywords: UNAIDS/voluntary counselling and testing/counselling and testing/South
Africa/Africa/VCT/care/evaluation/client/counsellor/barriers/barrier/Nurse/counsellors/community/t
raining/HIV testing/clients/confidentiality
Abstract: HIV voluntary counselling and testing (VCT) is now an integral part of many HIV care
and control programmes. However, very little work has been done to assess the quality of VCT
services. An evaluation of VCT services for mineworkers in Welkom, South Africa was conducted
190

to assess client and counsellor satisfaction, the quality of the services and to identify barriers to
uptake of VCT. A cross-sectional survey was carried out using tools developed by UNSAIDS,
consisting of semi-structured interviews and observation of counselling sessions. Twenty-two
nurse counsellors and six community volunteers were interviewed. Twenty four counselling
sessions were observed and 24 client exit interviews were conducted. Although nine of the 22
nurse counsellors had only in-service rather than formal training for HIV counselling whereas all
community volunteers had been formally trained, nurse counsellors identified fear of a positive
result as a major barrier to HIV testing. Clients also raised concerns about confidentiality.
UNAIDS evaluation tools were a feasible and an acceptable method of assessing VCT in this
operational setting. The study identified areas where training needs to be strengthen and
suggested ways of improving the services, and changes to the service have now been
implemented inline with these recommendations
Glenn, M. (1998). Preparation of Rehabilitation counselors to serve people living with
HIV/AIDS. Rehabilitation counselling bulletin, 41, 191-201.
Ref ID: 466
Keywords: counsellor/knowledge/rehabilitation/sex/training
Abstract: The researchers investigated the relationship among rehabitation counsellor's years of
experience in rehabilitation, age, sex, previous training, and experience with HIV/AIDS and three
criterion variables, namely their perceptions, knowledge, and self-reported level of skill levels.
Results indicated statistically significant correlations between predictor and criterion variables.
Professional implications and recommendations for specialized training are also discussed.
Notes: 1 copy
Ref ID: 4943
Govender, P. (2001). AIDS orphan numbers to soar. Pretoria News.
Keywords: church/family/health/Home based care/training
Abstract: More than 350 Mamelody children have been orphaned by AIDS in less than three
years and health workers expect the numbers to escalate. These figures, compiled by the Tateni
191

home-based care centre in Mamelodi, are based on parental deaths between 1998 and now.
"We actually expect the situation to get worse as the number of people dying from AIDS
increases," said Tateni social worker Veronica Khosa. "While most of the children are looked
after by their grandparents, others are left to fend for themselves", and Mrs Khosa, adding she
knew of a 17 -year-old who was the head of a family.
But except for sympathy and counselling for the children, there is little cash-strapped Tateni can
do. "Children who contract HIV from their mothers are often sent to homes like Cotlands because
they cannot get the best care from the families. "Those living with grandparents have to survive
on a state pension, which isn't even enough for their grandparents. An added problem for the
elderly minders is providing for the children's schooling and daily requirements. Mrs Khosa said
situation would not improve unless the community became involved in helping the children "in
whatever way they can". Acknowledging that Mamelodi was not a wealthy area, she said
financial support, was as well as adult guidance, were needed for the orphans. Mrs Khosa said it
was difficult to determine the magnitude of the pandemic in Mamelodi as her statistics were
based on cases which had relied on home-based care. "Those who can afford it go to hospitals.
Others die without disclosing their illness". She said the number of children being orphaned by
the disease was on the increase as their parents may have contracted the disease a couple of
years ago and were too ashamed to disclose it. Unlike in the past where people died without
disclosing their HIV status, victims now want to educate others to prevent the pandemic from
reaching uncontrollable proportions, Mrs Khosa said. She spoke to the Pretoria News at a candle
- lighting ceremony at the Charity and Faith Mission Church in Mamelodi to highlight the plight of
people suffering from AIDS. The event was organised by the AIDS Training Information and
Counselling Centre( ATICC) as part of a worldwide candle-lighting ceremony for AIDS sufferers.
Aticc's acting manager in Mamelodi, Catherine Tonga, said the organisation was a local
government initiative aimed at educating the community of the spread of HIV/AIDS, changing the
community's perceptions of the stigmas attached to the disease and providing counselling
facilities to victims. Home-based care for terminally ill patients is out-sourced to the Tabeni and
Thembelisha centres. Both centres care for the ill patients without disclosing their HIV status.
192

They teach their families how to care for the patient. Tateni mainly focuses on Mamelodi, while
Thembelisha works with people in the informal settlements around the township. The most
difficult problem faced by sufferers was "breaking the silence"and disclosing to their families and
friends that they were HIV positive, Mrs Tonga said.
"They don't want to confess, because they are afraid they are going to be chased out to home
and ostracised by the community." She said Aticc advised sufferers to disclose their status when
they were mentally and emotionally fit enough to do so. Aticc has also embarked on community
outreach programmes stressing that people with AIDS need to be treated with respect, dignity
and love. Pastors at the ceremony prayed for sufferers and for a "possible cure".
Notes: 1 copy
Ref ID: 3661
Govender, S. (1999). Ayurvedic treatment to slow down effects of Aids. Leader.
Keywords: Africa/conference/Developing countries/NACOSA/response/South Africa
Abstract: Yet another claim of ground breaking treatment to one of the world's deadliest
scourges- HIV virus has surfaced. According to the Indian Sunday Magazine, three Mumbai
researchers are claiming to have developed an ayurvetic drug to treat the dreaded disease, which
will help boost the HIV infected patient's immune system and maintain it at normal levels. The
report says this newly discovered ayurvedic drug restores the immune response of HIV response
patients so that they can be protected against fatal diseases and thereby improve their quality of
life as well as life expectancy. It is understood that a one-year pilot study was conducted to
evaluate the herbal drug, the findings of which were presented at the 12th World Aids Conference
in Switzerland.
Advantages
The medicine, states the conference report, is inexpensive, free from side effects and is a
promising immynopotentiator and therefore useful in developing countries. It is believed a
number of HIV positive patients, who have been treated with the ayurvedic drug- Reimun- have
shown encouraging improvements in their condition. But the researchers warn in the report that
Reimun should not be confused as a cure for Aids, instead it merely counteracts the virus so that
193

it does not create havoc with its victim's immune system, giving the person a new lease on life.
The drug will soon be launched world-wide. Much in the same vein, in an advertisement
published in the Indian daily-The Hindustan Times- a company claims that a young woman and
her daughter who both tested HIV positive in 1992, have now turned HIV negative, after being
treated with immuno QR, the drug which also apparently contains ayurvedic herbs and is
believed to after the virus. A local ayurvedic practitioner Dr Thiru Govender, also stressed that
Immuno QR merely helped to strengthen the immune system but was not a cure for the virus.
Immuno QR, it is understood, is used to build up the immune system and increase the body's T-
cell count. The National Aids Convention of South Africa (NACOSA), a national and provincial
network of Aids service organisations, non-governmental organisations and concerned
individuals, warned the public to be wary of such claims.
Notes: 1 copy
Gray, G. E., McIntyre, J. A., & Lyons, S. (1995). The effect of breastfeeding on vertical
transmission of HIV-1 in Soweto. Lancet, -, 13.
Ref ID: 294
Keywords: antenatal clinic/Baragwanath/breastfeeding/clinic/cohort/health/health
policy/impact/medical/policies/policy/transmission/vertical transmission/women
Abstract: Breastfeeding has been implicated in the transmission of HIV from mother to infant.
The timing of transmission postnatally is of crucial importance for public health policy as regards
infant feeding and weaning policies in the developing world. This study followed a cohort of HIV
positive mother-infant pairs from birth to eighteen months of age to assess the impact of feeding
(formula or breast) on vertical transmissions.
Pregnant HIV positive women were recruited from the antenatal clinic at Baragwanath Hospital
and were enrolled after counselling. They self-selected into either breastfeeding or formula
feeding groups. The mother-infant pairs were followed up at three monthly intervals to eighteen
months of age. Follow up included a detailed medical history, full clinical assessment, and
monitoring of CD4 counts and PCR analysis.
Interim analysis of the data of 174 mother-infant pairs was made. There were not significant
194

differences in the demographic profiles of the feeding groups. There were no significant
differences in the mode of delivery between the two groups or in their mean CD4 counts.
53(30,4%) infants were exclusively formula fed. The mean duration of breastfeeding was 3
months (range 1 week to 18 months). Significantly more of the breastfed infants were infected as
compared to the formula fed infants (9/53 [17%] vs 46/121 [38%]). 17.4% (8/46) of transmission
in the breastfed group occurred after 6 months of age. Overall transmission in the cohort was
31,6%.
The study concluded that exclusive formula feeding significantly reduced transmission of HIV in
this cohort. Reductions in vertical transmission can occur if mothers in this setting are advised to
formula feed. Weaning before the age of six months can prevent late postnatal transmission.
Notes: 1 copy
care, 1, 5-10.
Ref ID: 53
Green, J. (1989). Counselling for HIV Infections and AIDS: The past and the future. AIDS
Keywords: drug-users/model/pregnancy/pregnant/review/theory/women
Abstract: The history of counselling in HIV infection and AIDS is reviewed and the stage in the
development of the area are set out. The way in which the area has developed in the West is
related to local circumstances and the need for the development of models suited to local
circumstances elsewhere in the world is stressed. There are many areas of HIV/AIDS
counselling where considerable uncertainty about the right approach remains, for instance with
injecting drug users and with HIV-infected pregnant women. There is a great and largely unmet
need for further research in the area and some of the questions which need to be addressed are
set out.
Notes: 1 copy
Green, J. (1996). Counselling in Developing countries. In J.Green & A. MacCreaner
(Eds.), Counselling in HIV infection and AIDS (2nd edition ed., pp. 241-269). Cornwall: Blackwell
science.
195

Ref ID: 52
Keywords: care/culture/Developing countries/disease/education/Europe/failure/health/health
education/HIV/AIDS counselling/infection/medical/population/poverty/response/Uganda/Zambia
Abstract: The term "developing countries" covers a vast range of circumstances. Not only do
countries classified as "developing" differ in terms of income, distribution of wealth and levels of
poverty, they also differ in geography, culture and climate. From a health point of view they differ
in the levels and types of service available to the population, the percentage of the population
with access to health care, and the diseases which are common. Health is not just a matter of
the provision of medical services, it is also inextricably linked to adequate nutrition and the
provision of a safe water supply.
Because developing countries differ, it is not possible to set out a blueprint for HIV/AIDS
counselling services which will fit all countries. Successful programmes in different countries, like
TASO in Uganda, the Copperbelt Health Education programme in Zambia or the brothel outreach
programme in Belize, have been successful because they have developed to fit local conditions
and local needs, building on local strengths. The great failures have been attempts to import
wholesale models from the USA or Europe, forgetting that these were themselves build around
local conditions in their home countries. In western countries the model of counselling used is,
inevitably, a response to local conditions. It tends to have certain characteristics which can be
difficult to apply in most developing countries.
Notes: 1 copy
Green, J. (1996). Counselling in Developing countries. In J.Green & A. MacCreaner
(Eds.), Counselling in HIV infection and AIDS (2nd ed., pp. 241-269). Cornwall: Blackwell
Science.
Ref ID: 395
Keywords: culture/Developing countries/Europe/health education/HIV/AIDS counselling
Abstract: In the years since the first edition of this book was published, there has been a
tremendous growth in HIV counselling services in developing countries. The information from
published reports on these services has provided a major contribution to our knowledge about the
196

impact of, and constraints on, HIV counselling.
The term " developing countries" covers a vast range of circumstances. Not only to countries
classified as "developing" differ in terms of income, distribution of wealth and levels of poverty,
they also differ in geography, culture and climate. From a health point of view they differ in the
levels and types of service available to the population, the percentage of the population with
access to health care, and the diseases which are common. Health is not just a matter of the
provision of medical services, it is also inextricably linked to adequate nutrition and the provision
of a safe water supply.
Because developing countries differ, it is not possible to set out a blueprint for HIV/AIDS
counselling services which will fit all countries. Successful programmes in different countries, like
TASO in Uganda, the Copperbelt Health Education programme in Zambia or the brothel outreach
programme in Belize, have been successful because they have developed to fit local conditions
and local needs, building on local strengthens. The great failures have been attempts to import
wholesale models from the USA or Europe, forgetting that these were themselves built around
local conditions in their home countries.
In western countries the model of counselling used is, inevitably, a response to local conditions.
It tends to have certain characteristics which can be difficult to apply in most developing countries
Notes: 1 copy
Greenblat, C. S., Katz, S., Gagnon, J. H., & Shannon, D. (1989). An innovative Program
of counselling Family members and friends of seropositive Haemophiliacs. AIDS care, 1, 67-74.
Ref ID: 563
Keywords: communication/family/health/infection
Abstract: This paper describes current efforts to construct a set of innovative educational and skill
building materials targeted at groups of persons with HIV infection, those at risk for HIV, their
families and friends, and health professionals. The encounters family of interactive simulations is
designed to provide participants with the necessary communication and behavioral skills to
deepen their understanding of HIV, to improve their interaction with others in their interpersonal
environment, and to more effectively manage stress generated by HIV concerns the encounters
197

family of simulations are built on the principles of role play, but adds to them principles of
simulation gaming. The former technique is strengthened by offering active participation for all
group members, increased structure, and the opportunity for participants to take different
perspectives on an issue of concern in supportive small group environment.
Notes: 1 copy
Ref ID: 460
Greer, G. (1997). A family's journey. Positive outlook, 4, 4-5.
Keywords: counsellor/counsellors/family/response/training
Abstract: I was interested in what role AIDS counsellors had played in preparing Betty and Paul
for the road ahead of seeing their son dying with HIV/AIDS.
"Counsellors are well meaning but they all have a standard response to your questions. They are
not trained to look at the specific case and advise accordingly" said Betty. Are our counsellors
really trained not to think - only trained to give set answers? If that is the case, I believe that we
have to revisit our training and counselling methods. AIDS cannot be dealt with by a series of
standard responses. Each case is different and we must respond to the needs of the people
concerned.
Notes: 1 copy
Gresenguet, G., Bassirou, B., Sehounou, J., Malkin, J. E., & Belec, L. (2000). Experience
of the voluntary anonymous HIV testing center of Bangui, Central African Republic, over a three-
year period (1997-1999). In (pp. 31).
Ref ID: 251
Keywords: Africa/barrier/barriers/client/clients/counsellor/counsellors/government/HIV testing/HIV
transmission/infection/information/knowledge/medical/NGO/population/post-test/sub-
Saharan/Sub-Saharan Africa/transmission/WHO
Abstract: Issues: In 1997, the French NGO Medecins du Monde in accordance to the
government of the Central African Republic (CAR) have established an Anonymous Testing
Center (ACT) for the general population in the city of Bangui in order to promote HIV counselling
198

and testing as means to prevent HIV transmission.
Description: From September 97 to December 99, anonymous HIV testing and counselling was
provided by 3 trained counsellors at the ATC of Bangui. All clients were given adequate pretest
counselling including knowledge about HIV/AIDS, individual risk of acquiring HIV and anticipation
of the attitude of the client when receiving the result. After consent was obtained, blood is drawn
and tested for HIV. After a one-week period, a post test counselling was conducted in which
result is given to the client with risk reduction information. HIV seropositive individuals received
emotional support and then referred to specific social or medical structures. Seronegative clients
are asked to come back for serological follow-up.
Conclusion: 4,675 clients coming from various areas of Bangui and other cities of the CAR
attended the ATC. Ninety percent of the attenders came back to the center for the post test
counselling and agreed to receive the result. Eighty percent of the 1,200 seropositive individuals
who were referred to specific structures were seen in those structures. Thirty-three percent of the
seronegative clients came back at the 3 months follow-up. This experience clearly clearly
demonstrates that HIV counselling and testing for adult African is possible despite numerous
cultural barriers. It should be replicated in other cities of Sub-Saharan Africa with high level of
HIV infection.
Notes: 1 copy
Gresenguet, G., Sehounou, J., Bassirou, B., Longol, J. D., Malkin, J. E., Brogan, T. et al.
(2002). Voluntary HIV counseling and testing: Experience among the sexually active population in
Bangui, Central African Republic. Journal of Acquired immune deficiency syndromes, 31, 106-
114.
Ref ID: 8823
Keywords: population/sexually transmitted disease/disease/VCT/infection/HIV
testing/clients/client/knowledge/medical/prevention/gender/women/education/symptom/condom/c
ondom use/men/seroconversion/sexual partner/Africa
Abstract: OBJECTIVES: In July 1997, the National Reference Center for Sexually Transmitted
Diseases of Bangui, Central African Republic (CAR), was expanded by the creation of an
199

anonymous and voluntary counseling and testing (VCT) unit for HIV infection, the Anonymous
Surveillance Unit (Unite de Depistage Anonyme [UDA]). The goal of the UDA was to initiate and
promote voluntary HIV testing in the general adult population of Bangui. We carried out an
observational and comprehensive survey over a 4-year period to document and analyze the
experience of VCT in the UDA, with special attention to risk factors associated with HIV infection.
METHODS: All clients for VCT were given adequate pretest counseling by trained counselors
focused on knowledge about HIV infection and sexually transmitted infections, individual risks of
acquiring HIV, and anticipation of the client's attitude about test results. After consent was
obtained, a blood sample was drawn and tested for HIV by two ELISAs in parallel. The client paid
a standard cost of $1.20 at the initial visit. After a week, test results were given to the client during
the posttest visit, at which time HIV-seropositive individuals received emotional support and were
referred to specific social or medical structures. Seronegative clients received reinforcement of
prevention messages and were asked to come back for serologic follow-up free of charge after 3
(M3) and 12 (M12) months. RESULTS: From July 1997 to March 2001, 5686 individuals aged 14
to 65 years (mean age, 27 years) had an initial visit for VCT (V1). Peaks of UDA visitation (250-
450 clients) were observed on the annual AIDS Day in the CAR, at which time HIV serologic
testing was offered free of charge. A total of 5060 (89%) clients came back for a second visit (V2)
to receive test results. Among those, 18.3% were infected with HIV type 1. Multivariate analysis of
risk factors demonstrated marked association of HIV seropositivity with age, female gender,
widowed/divorced women, poor or low education level, occupations such as civil servants or
merchants, presence of symptoms of sexually transmitted infections, and lack of systematic
condom use. Single young women were at higher risk for HIV infection compared with men of the
same age (OR = 7.7 for women aged 15-24 years, 95% CI: 4.0-14.0; OR = 2.8 for women aged
25-34 years, 95% CI: 1.7-4.5). Widowed women older than 44 years of age were more likely to be
HIV-seropositive than men (OR = 10.0; 95% CI: 1.7-83.6). A total of 885 (21%) HIV-seronegative
individuals returned for follow-up at 3 months (M3; 0.45% rate of seroconversion). Seventy-nine
(9%) individuals returned at 12 months (M12), without any new cases of HIV infection. HIV-
negative clients consulting at M3 and M12 showed a significant reduction in unprotected
200

intercourse with occasional sexual partners. CONCLUSION: This experience demonstrates that
VCT for HIV infection is feasible in Central Africa.
Grimwood, A., Crewe, M., & Betteridge, D. (2000). South African Health Review 2000.
Ntuli A., Crisp, N., Clarke, E., and Barron, P. 2000.
Ref Type: Unpublished Work
Ref ID: 8808
Keywords: health/South Africa/Africa/response/treatment/confidentiality/VCT/HIV-
status/family/counsellors/counsellor/Zimbabwe/disclosure/women/impact/government
Abstract: South Africa has one of the highest incidence and prevalence rates of HIV/AIDS in the
world. the fact that these numbers have been increasing during the period when the national
AIDS response was being mustered and implemented is of particular concern. This chapter looks
at some of the reasons why efforts to stem the epidemic have not been as successful as hoped.
The HIV/AIDS and STD strategic plan 2000 - 2005 is analysed as are issues such as access to
treatment, voluntary testing and counselling, confidentiality and notification and the controversial
debate around the link between HIV and AIDS. Recommendations are given regarding the way
from here. VCT at district level is encourage by the government as a way for people to come
forward for counselling and testing and ongoing support. It is hoped that HIV/AIDS test will be
normalised and contribute to people disclosing their HIV status to partners, families and
associates. To achieve this plan counsellors need to be trained - this does not seem to be the
case. Evidence from Zimbabwe indicates stigma attached with use of VCT services. In addition
disclosure may not be what people wish to do if there is no treatment available. VCT can only
work where there is some support and treatment following diagnosis. Ussing data obtained from
annual surveys of pregnant women, the current and future size and impact of HIV/Aids epidemic
was estimated
Notes: Chapter 14
Grinstead, O., Van der Straten, A., & The voluntary HIV-1 Counselling and Testing
Efficacy study group (2000). Counsellors' perspectives on the experience of providing HIV
201

counselling in Kenya and Tanzania: the Voluntary HIV-1 Counselling and Testing Efficacy Study.
AIDS care, 12, 625-642.
Ref ID: 330
Keywords: behaviour change/community/confidentiality/counsellor/Developing
countries/Kenya/political/research/Tanzania/training/voluntary counselling and testing
Abstract: Demand for HIV counselling services is increasing in developing countries, but there
have been few previous studies that describe counsellors' roles and experience providing HIV -
related counselling and thereby improve counselling services. As a sub-study of the Voluntary
Counselling and Testing Efficacy Study, we conducted focus groups and individual interviews
with 11 counsellors and counselling supervisors providing HIV counselling services in Kenya and
Tanzania. Counsellors told us that their jobs were both rewarding and stressful. In addition to
their obligation in the counselling relationship (providing information, protecting confidentiality and
being non-judgmental), they perceived pressure to provide information and be good role models
in their communities. Additional stresses were related to external (economic and political)
conditions, "spillover" of HIV issues from their personal lives and providing counselling in a
research setting. Counsellor stress might be reduced and their effectiveness and retention
improved by (1) allowing work flexibility; (2) providing supportive, non-evaluative supervision; (3)
offering alternatives to client behaviour change as the indication of counsellor performance; (4)
acknowledging and educating "emotional labour" in counselling; (5) providing frequent information
updates and intensive training; and 6 encouraging counsellor participation in the development of
research protocols.
Notes: 1 copy
Grinstead, O., Gregorich, S. E., Choi, K. H., & Coates, T. (2001). Positive and negative
life events after counselling and testing: the voluntary HIV-1 Counselling and Testing Efficacy
Study Group. AIDS, 15, 1045-1052.
Ref ID: 329
Keywords: cost-effectiveness/couples/Developing countries/family/health/HIV prevention/HIV
testing/life events/VCT/voluntary counselling and testing/women
202

Abstract: Introduction: The results of the Voluntary HIV-1 counselling and Testing Efficacy Study
support the efficacy and cost-effectiveness of HIV voluntary counselling and testing (VCT) for
reducing risk behaviors in three developing countries.
Methods: This report explores the social consequences of HIV VCT by examining the incidence
of positive and negative life events at the first follow-up ( an average of 7.3 months after
recruitment). The incidence of positive and negative live events was compared between: (I)
those who were randomly assigned to HIV VCT versus health information (H); (ii) those who
tested seronegative and those who tested seropositive; and (iii) those who disclosed their
serostatus and those who did not.
Results: The occurrence of most negative life events was rare (0-4%); positive life events were
more common (17 - 39%). With the exception, those assigned to HIV VCT were no more likely to
experience negative life events than those who were assigned to HI. For individuals, positive
serostatus was associated with increased support from health professionals, the break-up of a
marriage and being neglected or disowned by their family. Serodiscordant couples with an HIV-
positive woman were most likely to report the break-up of a marriage (20 versus 0 - 7 % for other
groups) and the break - up of a sexual relationship (45 versus 22 - 39% for other groups).
Disclosure was associated with strengthening of a sexual relationship except for HIV -
seropositive women.
Conclusion: These findings, in combination with findings supporting the efficacy and cost -
effectiveness of HIV VCT, support the dissemination of HIV VCT with appropriate support
services in developing countries.
Notes: 1 copy
Grown, D. (2001). Start triple-drug HIV treatment later, say expects: For all their life-
extending qualities, potent multiple- drug combinations have health risks and shouldn't be used
earlier than necessary. Star.
Ref ID: 1850
Keywords: conference/government/guidelines/health/infection/medical/physician
Abstract: New guidelines for human immunodeficiency virus-afflicted persons being released
203

yesterday by the US federal government advises physicians to start triple-drug treatment for
the disease later than previously recommended . This suggests reflects the realisation that for
all their life-extending wonders, the potent multiple-drug combinations introduced five years ago
have health hazards and should not be used earlier than necessary. Those hazards include
elevations of cholesterol and other bloodstream fats, a shift in the distribution of body fat,
toxicity to the liver and pancreas, painful nerve damage in the extremities and possible loss of
bone mineral. Combination drug treatment for HIV, once started, must be continued for life,
which magnifies these risks considerably. Although the recommendation seems revolutionary in
a field in which only a few years ago the treatment advice "hit hard, hit early" was a battle cry,
experts say it's actually a natural step and unlikely to be controversial. "This is the way HIV
practices has been heading. I don't think this is a sea change, said Oren Cohen, assistant
director for medical affairs at the National Institute of Allergy and Infectious Diseases, the part of
US National produce the guidelines. The guidelines are to be released at the start of the eight
Conference on Retroviruses and Opportunistic Infections, the annual AIDS meeting held in the
US. The key changes in the 108 - page document are cut off values for two key blood tests at
which doctors should strongly consider offering antiviral treatment to a patient.
Notes: 1 copy
Gunase, K. (1993). AIDS, privacy and autonomy - Legal issues in consensual and non-
consensual HIV Antibody testing. Submitted for Degree of Masters of Law University of
Witwatersrand (UWITS) School of law., 010 HEALTH SCIENCE.
Ref ID: 195
Keywords: autonomy/ethics/legal/mandatory testing
Abstract: Legislators have an important role to play in the handling of the AIDS crisis. It is not
inconceivable that as public pressure mounts regulations will be introduced that confer wide
powers on state officials. This has already happened in South Africa and can be evidenced from
both the pieces of legislation introduced to date. The threat that legislation will impose draconian
restrictions on the personal freedom of AIDS sufferers and seropositive persons poses both
practical and legal dangers. Provisions for mandatory testing and quarantine might discourage
204

individuals engaging in high-risk activities from seeking voluntary testing, treatment, and
counselling thereby undermining research efforts and the goal of reducing HIV transmission.
However, it is imperative that an acceptable balance be struck between the interests of AIDS
sufferers and seropositive persons and the public interest in curbing HIV infection.
Notes: 1 copy
Gysels, M., Pool, R., & Nyanzi, S. (2000). Attitudes to voluntary counselling and testing
for HIV among pregnant women and maternity staff in rural South West Uganda. In (pp. 13).
Ref ID: 232
Keywords: Africa/clinic/confidentiality/health/intervention/medical/transmission/Uganda/vertical
transmission/voluntary counselling and testing/women/VCT
Abstract: Background: Vertical transmission rates in Africa are 21-43%, and most infants
acquire HIV during peripartum period. A recent trial of nevirapine in Uganda showed a reduced
risk of HIV transmission of almost 50% during the first 14-16 weeks of life. Although provision of
nevirapine to all pregnant women may be potentially cost effective, ideally HIV positive pregnant
women should be targeted in poor resource countries. This requires voluntary counselling and
testing (VCT). The attitudes of women and maternity staff to VCT are important to the success of
such interventions.
Methods: 24 focus group discussions (FGDs) were carried out with 208 women attending
maternity clinics, 5 FGDs were held with 25 maternity staff, and in-depth interviews were held
with 8 traditional birth attendants and 26 women recognised by the community as being
knowledgeable about issues relating to pregnancy in 3 sites in rural SW Uganda.
Results: Almost all women were willing in principle to take an HIV test in the event of pregnancy,
and to reveal their HIV status to maternity staff. They were anxious, however, about
confidentiality, and there was a widespread fear that maternity staff might refuse to assist them
when the time came to deliver if their status were known. This applied more to TBAs than to
biomedical health staff. There were also rumours about medical staff intentionally killing HIV
positive patients in order to stem the spread of the epidemic. Maternity staff were adamant that
they would treat knowledge of a patient's HIV status confidentially. Although they claimed that
205

they would treat HIV positive women the same as anyone else during delivery, they expressed
much anxiety about the possibility of getting infected. especially due to lack of proper clothing and
gloves.
Conclusions: Although VCT during pregnancy is acceptable in principle, much will need to be
done to ensure confidentiality and allay women's fears of stigmatisation and discrimination during
delivery. Maternity staff will also need to be trained and resources made available for adequate
protection.
Notes: 1 copy
Ref ID: 5379
Hagen, H. (1999). Treatment of Aids effective: claim. The Citizen.
Abstract: HIV/Aids, if diagnosed early enough could be treated effectively and sufferers could
enter long productive lives if they remained active within the workplace. The company
maintained that several myths needed to be dispelled, because of the disease being
"exceptionally manageable". If therefore did not represent a death sentence. The LifeSense
Group private sector health care company, announced a major new initiative in the ongoing fight
against HIV/ Aids when launching its specialist care division. LifeSense Disease Management
(LDM). LDM's affordable and responsible treatment for HIV sufferers showed that a long-term
managed database of about 2 000 HIV/Aids sufferers were responding"extremely well". "From
the entire database to date, only seven deaths and 16 hospitalisations have been recorded. Our
treatment is best described as a holistic long-term anti-retroviral therapy," said LDM managing
director Andre van Bassen. "We measure and treat with two or three key combinations two key
areas, namely the patient's CD4 cell count and overall viral load as well as nutritional, exercise
and long-term care needs. Mr Van Bassen said LifeSense was setting new standards by its
managed benefits to patients at a drug cost of as little as R 650 a month to medical schemes.
He explained that the lower the CD4 cell count of a person, the more advanced HIV had become.
At a CD4 count 500 per millilitre of blood, monthly treatment costs could be R 650 but with a CD4
count dropping down to 300, monthly costs go up to R1 423. Compared to annual private
hospitalisation costs of R60 312 for an untreated CD4 patient with a 300 count, the LDM anti-
206

etroviral therapy would cost the patient's medical scheme only about R17 000. Similarly, therapy
costs of R45 600 pa would be dramastically less than the costs for sufferers with a CD4 cell count
of 100
Notes: 1 copy
Haidet, P. (2002). When risk is low: Primary care physicians counselling about HIV
prevention. Patient Education and Counselling, 46, 21-29.
Ref ID: 355
Keywords: communication/condom use/gay/health promotion/HIV prevention/HIV testing/HIV
transmission/homosexual men/infection/physician/prevention/primary health care/primary
prevention/response/seroconversion/sex/transmission
Abstract: To explore the conceptualization of risky by primary care physicians about behaviors
associated with a relatively low risk of HIV transmission, we performed open-ended telephone
interviews with 59 primary physicians throughout the United States. During the interviews,
physicians were asked to respond to a series of clinical vignettes presenting situations where the
risk of HIV transmission is relatively low or unknown. We performed a qualitative content analysis
of physicians' responses to these clinical vignettes. We found that relatively few information-
gathering statements were made in an effort to elicit the patients perspective regarding risk, and
that risk counselling by physicians often followed an "all or nothing" heuristic that manifested itself
as the advice to take maximum precautions under situations of any perceived risk, no matter how
small. In addition, HIV testing was often completely explained. When combined with the all or
nothing heuristic, this created advice that was potentially harmful by using testing as means to
achieve zero risk and forgo protective strategies in settings where patients may potentially be in
HIV negative "window" phase of infection.
Notes: 1 copy
Halkett, R. (1999). HIV/AIDS and the care of children. Braamfontein, South African
national council for child and family welfare.
Ref Type: Unpublished Work
207

Ref ID: 494
Keywords: care/caregiver/community/disease/policies/policy
Abstract: A disease more debilitating, dehumanizing and degrading than AIDS is difficult to
imagine and degrading than AIDS is difficult to imagine. The AIDS sufferer not only undergoes a
slow and painful physical deterioration but can have feelings of fear and loneliness as AIDS is a
socially unacceptable disease accompanied by stigma, isolation and rejection. All persons in the
life-space of the AIDS sufferer are detrimentally affected by this disease. This is especially true
for children. Children are vulnerable, dependent and lack the ability to sufficiently comprehend
what is happening to them and therefore to make wise choices. The younger the child the fewer
powers they have to influence, let alone determine, their circumstances. Children are at the
mercy of caregivers, the community, the institutions of society, law and policy makers and service
providers. The plight of children affected by AIDS is a highly intensified one and the tragedy of
children suffering because of AIDS, an even greater tragedy. Childhood is a time of life which
should contain joy and slaughter and the promise of a bright future. Instead, children become
violently ill because of AIDS; die horrible deaths because of AIDS; and are being orphaned and
abandoned because of AIDS. Children in their millions are scorched by the disease and by our
own inhumanity and neglect as adults to respond to the disease.
Notes: 1 copy
Hamilton, J. D. (1992). Early treatment with AZT delays progression to AIDS; survival
improvements are doubtful. N Engl J Med, 326, 437-443.
Ref ID: 432
Keywords: AZT/guidelines/infection/quality of life/therapy/treatment
Abstract: A four year multicentre randomised double-blind trial undertaken in 338 patients do
determine the best time to initiate AZT treatment has not produced clear guidelines on when to
introduce AZT in patients with symptomatic HIV infection and CD4+ counts higher than 0.2 .10 9
per litre (200 per cubic millimeter).
The authors believe the early AZT therapy is an option that warrants consideration in
symptomatic or asymptomatic patients with CD+4 counts of less than 0.5 . 10 9 per litre (500 per
208

cubic millimetre) because initiating therapy at that point clearly delays progress to AIDS.
On the other hand the long-term effect of AZT on the quality of life, cumulative drug toxicity, the
development of drug resistance and the cost of therapy have not been full clarified.
Because of the uncertainty about long-term effects and because no survival benefit was
observed, the authors believe that AZT therapy can be delayed in patients whose condition is
stable and whose CD4+ counts are between 0.2x109 and 0.5 x 10 9 and 0.5 x 10 per litre ( 200
and 500 per cubic milimetre.
Notes: 1 copy
Health Reporter (1997). Council to work with researchers to investigate possible
Virodene trials. The star.
Ref ID: 8296
Keywords: researchers
Abstract: Virodene's researchers have agreed to share their findings and research with the
Medicines Control Council, which will review their work and decide if the Anti-Aids drug can be
used in phase 1and 2 clinical trial.
Notes: 1 copy
Health Systems Trust. (1999). South African Health: review 1999.
Ref Type: Unpublished Work
Ref ID: 523
Keywords: health/human rights/poverty
Abstract: The paper talks about poverty, human rights and health of South African people
Notes: 1 copy
Health Systems Trust. (1999). Health Research in South Africa.
Ref Type: Unpublished Work
Ref ID: 524
Keywords: Africa/care/health/medical/research/South Africa
209

Abstract: Well prioritised health research that produces results which can be converted into action
can improve the health status of the people in South Africa. However, much as the past
dispensation resulted in unequal distribution of healthcare resources and fragmentation of health
care delivery, so too has the over emphasis on expensive, high technology medical research
contributed to the inequity in, and sometimes dubious value of, research in this country.
Health Systems Trust. (2002). Health Systems Trust Review 1995.
Ref Type: Unpublished Work
Ref ID: 515
Keywords: Africa/antibody/infection/population/South Africa/transmission/vertical
transmission/Virus/health
Abstract: Human immunodeficiency Virus (HIV) is transmitted in three ways, namely sexually, via
blood and blood products, and vertically, that is, from an infected mother to her infant. As is the
case in many industrialised countries, the first cases of AIDS reported in South Africa, in 1982,
were among homosexuals. Over the next few years a few cases of medically acquired HIV
infection among recipients of unscreened blood (or blood products) were reported. However,
since the development of HIV antibody tests in 1985 and the implementation of rigorous
screening of all blood donations by the South African Blood Transfusion Services, safe blood
supplies have been maintained. Currently, the major mode of transmission of HIV is through
sexual intercourse (approximately) 90%) and concomitant vertical transmission, that is, from
infected mother to infant. The rest of this section elaborates upon the spread of this epidemic
among the heterosexual population of South Africa.
Notes: 1 copy
Health Writer (2001). Fighting on all fronts: in the absence of a cure, prevention pays
dividends. Cape Argus.
Ref ID: 5161
Abstract: A multi-pronged strategy is in place in the Western Cape to tackle the HIV/AIDS
pandemic in ibid to prevent further spread of the disease, and to care for and support those
210

already infected.
Dr Fareed Abdullah, head of the provincial AIDS strategy, calls it a "military operation" with a
clear line of command and clear leadership.
It is the only way, he says, to address incidences which, according to national ante-natal figures,
went up from 7,1% to 8.7% in a year last year. Estimates are that there are more than 100 000
HIV-infected people in the Western Cape. The "centrepiece" of the provincial strategy is the
province's mother -to-child transmission prevention programme. The Khayelitsha programme,
which gives AZT to HIV-positive pregnant women, has been running for three years, reaching
7000 women a year. Since the beginning of the year women in Gugulethu have been getting
Nevarapine to prevent transmission of HIV to their unborn children, and this month the
programme was rolled out to Paarl, Worcester, George and Langa. We'll be reaching 30 000
women across the province and we estimate that we are now addressing about 50% of all HIV
positive pregnancies. "Twelve months from now we will be offering the drugs to 100% of infected
pregnant women" Abdullah says. AZT and Nevarapine have both been shown to reduce
transmission of HIV from mother to child by 50%. Treating sexually-transmitted diseases and
delaying the average age of the first sexual experience are two important ways to bring down the
overall HIV prevalence rate. Each, says Abdullah, can lower the rate by as much as 2%. Private
general practitioners are being trained, and medication for patients is provided by the province, in
a bid to address the problem of women with STDs who are happy to be treated in the public
sector but men who prefer to go to private GPs. Abdullah says that half of all STS cases are
treated in the private sector so the collaboration is essential. These three strategies are aimed at
reducing the number of new HIV infections, but for those already infected, the province has
opened 20 dedicated AIDS clinics across the province. Although most are not open all day, every
day, they do offer" a package"of services to specifically address opportunistic infections
associated with HIV. Free Fluconazole supplied as part of a national deal with manufacturer
Pfizer, to treat oesaphageal thrush and cryptococcal meningitis, has already been supplied to 400
people in the past four weeks. Patients also get Bactrim three times a week, and antibiotic
prophylaxis known to reduce opportunistic infections by up to 50%. Antitrovirals are currently
211

dispensed only in the mother - to- child transmission prevention programmes, and to people who
have been raped and those who have needlestick injuries. Non-government organisations, being
funded by the province to the tune of R 10 million a year, are working tirelessly in the areas of
homebased care, counselling and condom distribution. Condoms, says Abdullah, remain the
most effective method for preventing HIV infection - but all evidence points to the fact that few
people in fact using them. "At present, the (health) department distributes some 15 million
condoms each year. "Our aim is to trouble that number but also to ensure that the condoms
distributed are actually used. " The lifeskills programme is aimed at teaching teenagers to
negotiate the sexual encounter- almost always with a view to using a condom, he says.
Voluntary counselling and testing is another vital part of the strategy as Abdullah says knowing
your HIV status is important to behaviour change and safer sex practices. A total of R 3.7m has
been allocated to improve voluntary counselling and testing services and anyone can be
counselled and tested at 58 hospitals, 64 community health centres and the majority of local
authority clinics across the Western Cape.
Notes: 1 copy
Heath, J. (1994). The Psychosocial needs of HIV and women (immune Deficiency).
University of Calgary (Canada).
Ref Type: Unpublished Work
Ref ID: 8786
Keywords: women/disclosure/WHO
Abstract: This exploratory study was designed to examine the psychosocial needs of HIV positive
(HIV+) women in Southern Alberta. The study employed qualitative and quantitative methods to
examine a sample of 15 HIV+ women who volunteered to respond to an anonymous
questionnaire. The questionnaire was developed by the researcher and was based on the
literature review, discussions with professionals in the field, and an HIV+ woman. Six of the
women were also interviewed and the interviews were taped, transcribed and coded for themes.
A number of dominant themes emerged: issues around self-esteem, stigma, power and control,
212

and disclosure. A majority (86%) of the women wanted more contact with other HIV+ women. The
need for more counselling and services specific to women and mothers was also expressed.
Three interviewees were older widows whose husbands had died of AIDS. They appeared to
have some unique issues.
Heyns, M. (1992). Hurdles and voids encountered in the battle against AIDS.
Rehabilitation in S.A./Rehabilitasie in S.A., June 1992, 60-64.
Ref ID: 58
Keywords: barriers/barrier/prevention/health systems/quality of care/patient
care/attitudes/acceptability/support/social
Abstract: The first AIDS case that was reported in South Africa in 1982 introduced the pre-
epidemic phase of the disease to our country. Since then a constant increase in the number of
cases and deaths has been recorded. The problem is only seen in perspective when a person
realises that distinction has to be made between the Human Immunodeficiency Virus (HIV) and
the AIDS syndrome- which comprises the final stage of infection. Eight to ten years may lapse
before the latter is reached. This means that the numbers of AIDS cases thus far known are an
indication of an epidemic in reality approximately ten years ago. AIDS, not being a notifiable
medical condition, according to the Health Act, 1977( Act 63 of 1977), gives rise to a gross
underestimation of the true situation. The extent of underestimation can be anywhere between
41 per cent to 90 per cent. Furthermore it must be borne in mind that the epidemic is fed by HIV
carriers spreading the virus whilst they themselves remaining asymptomatic and spread the virus
unknowingly. Indicators are that South Africa already has reached the early epidemic stage which
means that the high risk groups exceeds 1 per cent and also that a rapid increase in the number
of new infections outside of the high risk groups is taking place. The HIV epidemic will cause
sickness and death of many adults in South Africa and could have the following critical effects:
Many of those affected will be skilled and educated persons in the workplace and this will have
an impact on productivity and training. It is likely that health care facilities will be placed under
severe pressure, and difficult policy decisions will be required for the treatment of persons with
AIDS. Many family units will be affected, causing large numbers of orphans, and a noticeable
213

change in the expected age structure of the population. The crucial question therefore arises: Is
South Africa ready to handle an epidemic? Will we be able to succeed curbing the impact?
When evaluating the complexity of hurdles and voids encountered in the battle against AIDS one
can only come to the conclusion that South Africa is grossly unprepared for the handling of the
seemingly devastating consequences.
Notes: 1 copy
Heywood, M. (2001). Code of Good Practice on HIV/AIDS and Employment - launched at
last. AIDS Analysis Africa, 11, 10-11.
Ref ID: 190
Keywords: employee/employer/ethics/good practice/guidelines/legal/South Africa/workplace
Abstract: If you linked on the World AIDS Day 2000, you will probably have missed the low-key
launch by the minister of Labour and the National Economic Development and Labour
Council(Nedlac), of the Code of Good practice: Key Aspects of HIV/AIDS and Employment. This
is a pity because unlike many other World AIDS Day activities, this was one with a past and a
future (rather than hatched at the last minute for the sake of the day. It also, if properly received,
has the potential to be useful guide to responding to HIV/AIDS in the workplace.
The code is the culmination of a process of lobbying and advocacy for such a guideline, that
began in 1994, when the AIDS Law project (ALP) and AIDS consortium published a draft Code of
Best Practice and submitted it to Nedlac in 1995 for consideration. This catalysed alternative
codes, produced by Business South Africa (BSA) and the South African Chamber of
Business(SACOB) which, in particular, sought to protect employer powers in relation to
discrimination in access to employment(via HIV testing) and employee benefits. These two
dispute areas became the basis for protracted wrangling between employers, trade unions and
business.
Notes: 1 copy
Ref ID: 6139
Highfield, R. (1995). Going back to nature in search for a cure. Sunday Times.
214

Keywords: Europe/health/infection/treatment
Abstract: The road towards an effective treatment for Aids is littered with so many
disappointments that one can be forgiven for treating any scientific announcements with a lot of
scepticism. But recently, there have ben several intriguing advances that place new emphasis on
harnessing the natural ability of the body to fight infection and combat HIV, the virus that causes
AIDS. Researchers in the US and Europe announced that they had discovered a number of
antidotes to the virus in the bloodstream. The potential implications" are substantial" , according
to Dr Anthony Fauci of the US National Institutes of Health, Maryland: at the very least, they will
help reveal how the disease develops and provide a framework of therapy and vaccine
development. Some suspect the activity of these antidotes in the body may explain why more
HIV-positive patients progress more slowly to full-blown" Aids than others.
Notes: 1 copy
Ref ID: 56
Higson-Smith, C. (1994). AIDS counsellor training evaluation. AIDS Bulletin, 3, 14-15.
Keywords: counsellor/counsellors/evaluation/guidelines/post-test/pre-test/training
Abstract: Virtually every organisation concerned about spread of HIV/AIDS has at some stage
considered training lay counsellors to do pre-test, post-test and ongoing supportive counselling
for people with HIV/AIDS. These people are often nurses and social workers who wish to
develop existing skills so as to be able to provide a broader service, or volunteers from the
community itself. Given the enormous numbers of people challenged by HIV testing and/or living
with HIV/AIDS every year, lay counsellors are a vital component of the fight against this disease.
Of course, not all trainees train as counsellors. Many work as educators and in other areas. The
issues raised in this article refer only to those people trained to offer counselling services.
Notes: 1 copy
Hingson, R., Strunin, L., & Berlin, B. (1990). Role of Physicians in Adolescent Aids
Counselling. Pediatrics, 85, 24-29.
Ref ID: 278
215

Keywords: adolescents/physician/drugs/teenagers/knowledge/HIV
transmission/transmission/media/sex/condom/condom use/medical/sexual
practice/WHO/education
Abstract: Adolescents are at high risk for exposure to HIV-infection because they are often
beginning sexual activity and experimenting with illicit drugs. In 1986, the first statewide
telephone survey of teenagers' knowledge and behaviour was conducted in Massachusetts. This
article reports on a follow-up study after two years during which AIDS instructions programmes
were introduced for middle and high schools. Approximately 2000 teenagers between the ages
of 16-19 years participated in the second study. This study showed that teenagers' knowledge
and reports of concern about HIV transmission increased as a result of increasing school, media
and parental discussion of AIDS. Intravenous drug use declined and safer sex practices
increased ( e.g.. condom use increased from 2 to 19%). However, many adolescents still did not
take adequate protective measures.
The authors believe that the medical profession can help stimulate safer sexual practices among
adolescents. In this survey, 80% of teenagers reported seeing a physician during the year before
the interview, while only 13% discussed AIDS with a physician. Those who consulted their
physicians about AIDS, were more likely to adopt behaviours to avoid risk than those that did not.
According to the authors, this survey underscores the opportunity that physicians have to be
more involved in preventive counselling to adolescent patients at risk of HIV education. This will
require the introduction of continuous physician education, appropriate time for counselling and
testing patients, and reimbursement for services.
Notes: 1 copy
Hoffman, M. (1993). Multiculturalism as a force in counselling clients with HIV-related
concerns. The counselling psychologist, 21, 712-731.
Ref ID: 55
Keywords: Cross-cultural counselling/culture/model/psychology/social
Abstract: Multiculturalism has been described as a "fourth force" in understanding human
behavior. This perspective recognizes the importance of cultural variables, such as gender and
216

ethnicity, in all clinical work. A multicultural perspective is particularly important in understanding
human immunodeficiency virus(HIV) disease because acquired immunodeficiency syndrome (
AIDS) epidemic has been defined by cultural variables. This is so both in terms of the
transmission of the virus and in the psychosocial issues that have emerged. The purpose of this
article is threefold. First, an existing model for assessing and counselling clients with HIV-related
concerns is presented with an emphasis on how an increased focus on multicultural issues might
enhance this model. This is supported by an overview of the literature on HIV from a multicultural
perspective. Next, clinical cases are presented to show how counselling interventions might be
enhanced by recognizing multicultural issues. Finally, an examination of institutional responses
to HIV-related multicultural issues is presented.
Notes: 1 copy
Ref ID: 407
Holt, R. (1998). The role of disclosure in coping with HIV infection. AIDS care, 10, 49-60.
Keywords: disclosure/disease/HIV-status/infection/men/policies/policy/sex
Abstract: A qualitative investigation was conducted to explore the role of disclosure in HIV
infection. Forty homosexual and bisexual men completed a short demographic questionnaire and
participated in a one-to-one, semi-structured interview. The interview was designed to address a
variety of personal, interpersonal and organizational issues related to their HIV status and
participants were invited to talk about their personal experiences from immediately prior to their
diagnosis to the time of the interview. The results from the interviews are presented in three
sections: immediately post-diagnosis, asymptomatic phase and symptomatic/AIDS phases. The
data revealed that disclosing one's HIV status was an acute and recurrent stressor. Immediately
post-diagnosis, individuals were more likely to adopt a policy of non-disclosure and this provided
them with the reactions of others. After this, there was evidence that individuals increasingly
uses disclosure as a mechanism for coping with the disease. Disclosure of one's status was
used to increase both practical and emotional support, share responsibility for sex and to facilitate
self-acceptance of one's condition. The results from this investigation revealed that disclosure
had a dual role in HIV infection acting as both a stressor and a mechanism by which individuals
217

contend with their infection.
Notes: 1 copy
Ref ID: 3370
Hosken, G. (2001). AIDS scare for needle prick victim. Daily News.
Keywords: drugs/men/women
Abstract: Two women claim to have been pricked with contaminated blood on a Durban bus and
one of them is now confirmed HIV positive. The other, Sarah ( not her real name), is waiting for
more tests after being treated with Anti-HIV/AIDS drugs. Sarah said she was on a bus returning
home from her office in Umbilo when thee attack occurred. " My friend and I were standing in the
aisle when the bus stopped and several passengers boarded. As one of the men passed me I
felt a prick on my arm, "Said Sarah.
Notes: 1 copy
Ickovics, J. R., Morrill, A. C., Beren, S. E., Walsh, U., & Rodin, J. (1994). Limited Effects
of HIV Counselling and Testing for Women. JAMA, 272, 443-448.
Ref ID: 273
Keywords: clinic/community/condom/health/intervention/prevention/women
Abstract: Objectives: To assess the consequences of human immunodeficiency virus (HIV)
counselling and testing for seronegative women in terms of sexual behavior and psychological
outcomes.
Design: The design is prospective and longitudinal, using repeated measures. Participants were
interviewed at recruitment, 2 weeks later (when tested women received results), and 3 months
later.
Setting: Four community health clinics in Southern Connecticut; all provide HIV counselling and
testing and other specialized and primary health care services.
Study participants: A sequential sample of women were recruited for two study groups: those
seeking HIV counselling and testing( n=152), and a comparison group never tested for HIV ( n=
78), matched by clinic, race and age.
218

Main Outcome Measures : A composite measure of sexual risk was developed, based on sexual
activity, condom use, and partner risk factors. Psychometrically valid and reliable measures of
general psychological functioning and acquired immunodeficiency syndrome (AIDS)-specific
psychological indicators were also used.
Results: Average level of Sexual risk was lower for tested than nontested women at all three
interviews. For both groups, there was no significant change in sexual risk from baseline to 3
month follow - up. At the individual level, there was no difference in the number of women who
decreased or increased sexual risk. For tested women, intrusive thoughts about AIDS and
estimated chance of getting AIDS decreased after counselling and testing.
Conclusion: Behavioral and psychological consequences of HIV counselling and testing for
women at risk for HIV were limited. These results have implications for further prevention
interventions.
Notes: 1 copy
Ijsselmuiden, C. B., Steinberg, M. H., Padayachee, G. N., Schoub, B. D., Strauss, S. A.,
Buch, E. et al. (1988). AIDS and South Africa - Towards a comprehensive strategy. South African
Medical Journal, 73, 455-460.
Ref ID: 217
Keywords: Africa/confidentiality/HIV infection/infection/South Africa/strategy
Abstract: In this, the first of a three-part series of articles in which we propose steps towards a
comprehensive strategy for the control of HIV infection, we consider briefly the world-wide
experience with the HIV epidemic. Our objective is to highlight the problems and controversial
issues which are pertinent to strategies for the control of HIV infection. We focus on problems of
case-definition, differences between "African" and "Western" AIDS and the implications for South
Africa and problems with sensitivity and specificity of tests used at present, particularly in the
context of false positivity in a community with a low prevalence of HIV infection. We consider
some of the ethical issues, including the need for adequate counselling, and the centrality of
confidentiality, particularly in the context of possible victimization and neglect of HIV-positive
individuals. Differences between "notification" and "reporting" are emphasized.
219

Recommendations are made regarding these problems.
Notes: 1 copy
Irinoye, O. O. (2001). Counselling strategies of nurses : a case study of nurses in Osun
State, Nigeria. Africa Journal of nursing and midwifery, 3, 35-38.
Ref ID: 8826
Keywords: strategy/Nurse/case study/Nigeria/knowledge/infection/care/clients/client/youth
Abstract: Investigates nurses knowledge of basic counselling strategies as such may be
predictive of their ability to determine focused counselling for sexually transmitted infections
(STIs) and HIV/Aids care among clients paying emphasis on youth and other high-risk groups.
Includes summaries in French and Portuguese. Illustrates with tables.
Isaacs, G. & Miller, D. (1985). AIDS - its implications for South African homosexuals and
the mediating role of the medical practitioner. South Africa Medical Journal, 68, 327-330.
Ref ID: 59
Keywords: guidelines/health worker/health workers/medical/physician/psychology/social
Abstract: The concerns of people affected by the current AIDS scare are discussed from a holistic
point of view, incorporating medical, psychological and social factors. Parameters of homosexual
experience are described fully. The medical practitioner is encouraged to obtain an extensive
psychosexual history from concerned patients on the guidelines presented. AIDS is a community
health issue in which the medical practitioner plays a pivotal role in diagnosis, counselling,
referral and patient education.
Notes: 1 copy
Isaacs, G. (1990). Counselling persons with AIDS and their families. Medical Sex Journal
of South Africa, 1, 19-21.
Ref ID: 60
Keywords: family/guidelines/theory
Abstract: The author's experience is drawn, inter alia, from therapeutic sessions with several
male bisexual persons who were diagnosed HIV sero-positive. Therapy commenced from the
220

onset diagnosis, and in some cases terminated as a result of the death of the patient. This paper
will seek to address a) common therapeutic features that embody HIV + status, ARC distress,
and full blown AIDS. b) Clinical management, and c) techniques.
Notes: 1 copy
Ref ID: 61
Isaacs, G. (1990). Counselling and HIV infection / AIDS. AIDS Scan, 2, 3.
Keywords: barrier/barriers/guidelines/theory/training
Abstract: All forms of counselling are based upon the relationship between a counsellor and the
client system. It is the relationship that is crucial in bringing about any form of change.
Relationship building, in whatever context, is fluid and not without conflict. In the context of AIDS
prevention and care, counselling strategies have often been contaminated by attitudinal
responses. Stereotypical misinformation and fears related to intimacy and human sexuality. In
order to counsel, be it on a micro-level to deal with psychological morbidity, or on a macro-level-
dealing with education and social action, the counselling effort would need to take cognisance of
the interrelationship between all forces that contribute to our understanding of AIDS prevention
and care. Articles in this issue of AIDS Scan highlight the importance of preparative training for
people involved in AIDS counselling at an individual or community level. In this respect the book:
AIDS and the Health Care system, edited by Lawrence O. Gostin also reminds us that AIDS is
still a challenge to those of us dealing with people in need of care. Counselling cannot be
effectively undertaken unless we analyse our own responses to health policy, legislation, ethics
and clinical research. Counselling strategies should include, not only assessment, intervention
and termination mechanisms, but incorporate an holistic response to the wider implications of the
meaning and metaphor of AIDS as well.
Notes: 1 copy
Jacobs, B., Berege, Z. A., Schalula, P. J., & Klokke, A. H. (1994). Safer donor
populations in high HIV prevalence communities in East Africa. East African Medical Journal, 71,
6-7.
221

Ref ID: 429
Keywords: East Africa/population
Abstract: Blood transfusion is the third most important mode of HIV transmission in sub - Saharan
Africa; the most affected population being children aged below 5 years mainly suffering from
malaria related anaemia. This study, undertaken in Mwanza town, on the shores of Lake Victoria
in Northwestern Tanzania - a region with an adult prevalence of HIV infection to 11.8% , aimed to
investigate the appropriateness of enrolling secondary school students as voluntary non -
remunerated blood donors by assessing their level of infectious agents ( HIV, Hepatitis B and
Treponema pallidum). Two thousand three hundred and forty-five consecutive donors were
enrolled in the study, 22.4% were voluntary donors (VD) from the student group and 77.65% were
relative donors (RD). Females represented 22.9 % and 5.9% of the VD and RD respectively. All
VD were aged 24 years or less, allowing comparison between VD and RD or the same age 20.0
years and 33.9 years for the RD aged 25 years or more.
The lowest seroprevalence rates of anti-HIV-1 occurred among males VD aged 15 - 19 years;
0.7%. For HBsAg and anti HBc the lowest TPHA prevalence rates, 1.3%. The highest
prevalence rate of anti-HIV-1, 24.0%, occurred among females RD, aged 20-29 years and the
highest prevalence rate of HBsAg, 17.3%, while anti-HBc prevalence increased gradually with
age from 35.7% among female VD aged 15-19 years to 89.5% among male RD aged 50-54
years. The low number of female RD donors did not allow for comparison with the VD of the
same sex.
The study showed some promise in choosing lower risk donors as the prevalence rate of HIV
antibodies among the voluntary donor group was 0.7% and 3.4% for male and females aged 15-
19 years respectively and 1.7% among males aged 20-25. This compares to 1991 data provided
by the Tanzanian National AIDS programme which showed an HIV prevalence among male and
female remunerated blood donors of 3.4 % and 5% respectively.
Comment from Prof Anthon Heyns, Medical Director, SA Blood Transfusion Service,
Johannesburg:
The South African Blood Transfusion service has for five years followed a similar programme to
222

enlarge the base of low-risk blood donors amongst the black population. This approach
combined with an intensive pre-donation education and counselling programme by a trained
health-care professional, has made it possible to increase the number of low-risk donations from
the black population. This is the cornerstone of a policy to address the unsustainable situation in
South Africa where more than 90% of blood is procured from white, Asian and mixed ancestry
population groups, whilst maintaining the safety of the blood supply.
Our records show that the lowest risk donors amongst blacks are the males scholars aged 16
years ( prevalence of HIV antibody positives 0,0% and 17 years (0,38%). Thereafter the
prevalence in this group increases steadily with age: 18 years (1,2%); 19 years (1,4%) and 20
years (3,0%)
The prevalence of HIV seropositivity is much higher among black females, thus making them less
suitable as potential blood donors: 16 years (2,8%), 17 years (2,7%); 18 years(4,3%);
19years(9,5%) and 20 years (7,1%). We have noted that over the last five years there is a
disturbing trend that HIV infection tends to occur in a younger age group of scholars. The peak
prevalence has shifted about one year earlier.
Notes: 1 copy
Ref ID: 4417
Jacobs, H. (2001). Regering en sakesektor se veldtog teen vigs begin. Burger.
Abstract: Kaapstad- Die regering het onlangs die eerste samewerkings program goedgekeur om
saam met 'n private onderneming en 'n nie regeringsorganisasie vigs op 'n nasionale grondslag in
die landelike gebiede te bekamp. Die program is daarop gemik om gedragsverandering en die
gevolge van vigs te bestuur. Ons ken die omvang van die probleem en ons moet nou eenvoudig
net optree, het mnr. Louis Harris, voorsitter van 'n Mosselbaaise ingenieursfirma John Daniel
Containers (JDC), gese.
Harris het gese 'n groot aantal sake-ondernemings en internasionale organisasies is reeds as
potensiele borge vir die projek geidentifiseer. Volgens hom word goedkeuring eersdaags van die
Suid- Afrikaanse Inkomstediens verwag dat alle donasies wat vir vigsprojekte geskenk word.
100% teen belasting afskryfbaar is. Die nie-regeringsorganisasie. Light of hope Trust. Onder
223

voor sitterskap van mnr. Aggrey Klaaste, redakteur van sowetan, is reeds sedert die laat jare
sewentig betrokke by vigsprogramme. Volgens Harris is die ken van die veldtog die aanwending
van spesiale vragmotors van sowat 14 met gesofistikeerde beligting en kommunikasietoerusting
vir vigs-opvoerings en die aanbied van vigs-bewusmakingsprogramme. Die vragmotors word
deur JDC in Mosselbaai vervaardig en staan as 'n "Gig Rig" bekend. Die "Gig Rig's" kan gebruik
word om as verhoog vir buiteligkonserte te dien - een persoon kan die verhoog deur 'n hidroliese
knoppie te druk binne 20 minute oprig. Eweneens kan die "Gig Rig's" vervaardig word om
omskep te word in dagsorgsentrums waar onder meer beradingsessies gehou kan word. Die
"Gig Rig" is geskik om in 'n landelike omgewing te funksioneer waar daar meestal 'n tekort aan
basiese infrastruktuur soos water, elektrisiteit en tegniese vaardighede is. Voorts word 'n
werldwye bekendstelling van die projek vir Julie beplan, het Harris gese.
Notes: 1 copy
Ref ID: 1214
Jaffer, M. (2001). Muslims, with positive action on HIV. Cape Times.
Keywords: research
Abstract: Ahmed is passionate about his mission, as are the other members of Positive Muslims,
He and the Rehana Kader, a clinical psychologist who does a lot of the soul-sapping, emotional
draining support work, say AIDS is a growing phenomenon among Muslims in the Cape. Among
a list of people they work with are four HIV - positive clergymen. The seed for the formation of
the group was planted early last year, while Ahmed, a UCT student, was doing his thesis on the
impact of AIDS on Muslims in the Cape, and gender commissioner Farid Esack was doing similar
research work. In the course of their work, they met up with a remarkable woman, Faghmeda
Miller from Belhar, the first muslim woman to go public about her HIV status. Miller motivated
strongly for the setting up of a support group and the result was that positive Muslims was
launched in June last year (2000).
Notes: 1 copy
224

Ref ID: 2778
Janneker , A. (2000). Govt gives HIV test pointers. The Citizen.
Keywords: disease/health/Department of Health/HIV-status/HIV testing/impact/medical/National
policy/policies/policy/post-test/pre-test/transmission/WHO
Abstract: The department of health has emphasised the importance of HIV testing to promote
health and prevent the transmission. The department's draft National Policy on Testing for HIV
recommended that all HIV tests should involve voluntary consent with pre and post-test
counselling. They discouraged any testing that did not allow for counselling before and after and
encouraged people to be tested only at health facilities that offered counselling. The department
also recognised the medical, ethical, legal social, economic and psychological implications of
being tested for the disease and the impact it may have on people's lives. Pre-test counselling
helped people to prepare for their HIV test and in the event of a positive result. Post-test
counselling helps people come to terms with the end result and provides support for them.
Individuals who received adequate pre and post-test counselling were able to cope with their HIV
status far better and were able to improve their health and change their behaviour than those who
did not, a spokesman for the Health Department said.
Notes: 1 copy
Jha, P., Nagelkerke, N. J. D., Ngugi, E. N., Prasado Rao, J. V. R., Willbond, B., Moses,
S. et al. (2001). Reducing HIV Transmission in Developing Countries. Science, 292, 224-225.
Ref ID: 191
Keywords: Developing countries/intervention/prevention/response/transmission
Abstract: The global response to the HIV/AIDS epidemic, which has already infected more than
50 million people, has been inadequate, particularly in the developing world. In many countries,
blood screening was delayed, partly because of the initial misconception that HIV rarely causes
AIDS. The importance of heterosexual intercourse and breast feeding in HIV transmission was
downplayed for years. Patchy surveillance has frustrated efforts to predict the course of the
epidemic, and cohort studies, essential for good epidemiology, are rare in developing countries.
Nevertheless, there have been successes. One of the main, largely unsung, achievements is
225

that interventions have been developed that have the capability to reduce HIV incidence and
relevant risky behaviours by up to 80%. Unfortunately, these interventions have in general not
been implemented at a wide enough scale to have significant impact.
Notes: 1 copy
Jochelson, K., Mothibeli, M., & Leger, J. P. (1991). HIV and migrant labour in South
Africa. International Journal of Health Services 21[1], 157-173.
Ref Type: Abstract
Ref ID: 6A
Keywords: labour/migrant/mining industry/risk/sexual behaviour/South Africa/transmission
Reprint: Not in File
Abstract: The author investigate the impact of the migrant labour system on heterosexual
relationships on South Africa mines and assessed the implications for the future transmission of
HIV infection.
Notes: 1 copy
Ref ID: 62
Jones, M. (1999). HIV tests in developing world communities. Tropical doctor, 29, 193.
Keywords: barrier/barriers/community/culture/guidelines/training
Abstract: Pre-test counselling for HIV has been surrounded by mystique and has now become an
emergent speciality. This has deterred some medical practitioners in the developed world and
more especially in hard pressed hospitals in the developing world form discussing HIV with their
patients. In the UK the mystique is disappearing, encouraged by a change in HIV testing
guidelines issued by the Department of Health in 1996. Discussion and testing should be
incorporated into mainstream medical care and the term "counselling" is best replaced by
"discussion", which implies the need for a process of dialogue in which information and consent is
obtained as well as information passed on. These recommendation are slowly taking effect in the
UK, but in the developing world many patients do not get tested, simply because staff do not have
the time or because they are not part of the elite team whose task it is to perform pre-test
226

counselling. In this issue, a plea for the concept of community- informed consent for HIV testing
in healthcare settings in the developing world. Western cultures are generally individualistic in
contrast to the relational collectivism of developing world cultures. Collectivist cultures are the
ones in which people from birth onwards are integrated into strong cohesive groups which
throughout a lifetime continue to provide protection in exchange for unquestioning loyalty. The
individualism of western cultures has powerfully affected the medical ethical formulations that
many Westerners wrongly assume are globally appropriate. However, important issues remain to
be thought through. How can the validity of a privileged relationship of trust between a
community and a healthcare facility be tested? What about individuals who live in the community
but are alienated from its structures? Is it safe to assume that such a deep sense of community
exists in the multi-tribal mix of large third world cities? Cultures evolve and their values change.
It is a sad fact of modernity that to some extent the community values of developing world
cultures are gradually being replaced by Western individualism. Values that are safely assumed
to be held today may no longer be so widely accepted in 10 years time. By whatever process
community-informed consent is deemed to exist it will need periodic review and perhaps specific
nurturing.
Notes: 1 copy
Kaleeba, N., Kalibala, S., Kaseje, M., Ssebbanja, P., Anderson, S., Van Praag, E. et al.
(1997). Participatory evaluation of counselling, medical and social services of the AIDS support
organisations(TASO) in Uganda. AIDS care, 9, 13-26.
Ref ID: 66
Keywords: evaluation/medical/NGO/participatory research/social/Uganda
Abstract: The AIDS support organization(TASO) is an indigenous non-governmental
organisation(NGO) of HIV-infected and affected people in Uganda. TASO provides counselling,
social support, medical and nursing care for opportunistic infections at 7 centres affiliated to
district hospitals in Uganda. Between 1993 and 1994, the services provided by TASO were
evaluated through a participatory approach between staff and client. TASO counselling services
helped clients and their families to cope with HIV and AIDS, with 90.4% of clients revealing their
227

serostatus, and 57.2% reporting consistent use of condoms in the past 3 months. TASO was
also the main source of medical care for clients with opportunistic infections in the last 6 months(
63.8%. As a result of counselling, over half of the clients (56.9%) made plans for the future and
51.3% wished to make wills. There was a high level of acceptance of people living with HIV/AIDS
(PWAs) by families(79%) and the community (76%). Care was provided to PWAs at home mainly
by women(86.2%). TASO has demonstrated that individuals and their families are able to live
positively with HIV/AIDS. Through counselling, medical care and material support to clients and
their families, TASO has demonstrated a strong capacity to overcome four problems that haunt
AIDS care in most places: (1) revealing one's HIV-serostatus to relevant others; (2) accepting
PWAs in family and community; (3) seeking early treatment; and (4) combining prevention and
care. In general, TASO has shown that specialized services to meet AIDS care needs can be
added to existing health services at district levels. As a result of the participatory evaluation, a
well - accepted monitoring system was established.
Notes: 3 copies
Kalichman, S. C., Sikkema, K. J., & Somlai, A. (1996). People living with HIV infection
who attend and do not attend support groups: a pilot study needs, characteristics and experience.
AIDS care, 8, 589-599.
Ref ID: 406
Keywords: support group/infection/intervention/people living with AIDS/social
support/strategy/Virus/WHO
Abstract: People living with Human Immunodeficiency virus (HIV) confront a myriad of stressors
over the course of their infection. Social support groups offer a means of addressing the support
needs of people living with HIV. In the present study, 34 persons who had attended HIV support
groups and 29 who had no attended groups completed measures of distress, coping, and social
connectedness, and participated in open-ended interviews concerning their support group
experiences. Results showed that those who attended support groups knew they were HIV-
seropositive for a longer time, reported less emotional distress, and had more social contact than
did non-attenders. However, non-attenders endorsed avoidant coping strategies to a greater
228

extent. Analyses showed that time since testing positive accounted for differences between
groups in social connectedness but not differences in anxiety, depression, or avoidance coping.
Thus, HIV-seropositive persons become socially reconnected with time, but individuals with
avoidant coping styles experience greater emotional distress and are unlikely to seek support
groups. A sizeable proportion of people with HIV may therefore need supportive interventions,
particularly nearer to the time that they test HIV-seropositive.
Notes: 1 copy
Kalichman, S. C., Sikkema, K. J., & Somlai, A. (1996). HIV support groups: how useful
are they? AIDS Bulletin, 5, 27.
Ref ID: 441
Keywords: support group/intervention/strategy/WHO
Abstract: People living with HIV face many different stressors. Support groups offer a means of
addressing their support needs. A recent study conducted in the USA looked at the support
group needs of people. Thirty four people who had attended HIV support groups completed
measures of distress, coping and social connectedness and participated in open-ended
interviews concerning their support group experiences. The results showed that those who had
attended support groups knew they were HIV positive for a longer time, reported less emotional
distress, and had more social contact that did non - attenders. Non-attenders endorsed avoidant
coping strategies to a greater extend. Analyses showed that time since testing positive
accounted for differences between groups in social connectedness but not differences in anxiety,
depression or avoidance coping. Thus, HIV-positive persons become socially reconnected with
time, but individuals with avoidant coping styles experience greater emotional distress and are
unlikely to seek support groups. A sizeable proportion of people with HIV may therefore need
supportive interventions, particularly near to the time that they test HIV positive.
Notes: 1 copy
Kaliki, K. (2000). Factors affecting voluntary counselling and testing an experience from
mongu western province of Zambia. In (pp. 111-11).
229

Ref ID: 230
Keywords: church/post-test/prevention/response/voluntary counselling and testing/Zambia
Abstract: Background: 22 VCT centres were established in Zambia in 1999 to promote
voluntary counselling and testing for HIV as part of prevention strategies and offer support to
those already infected. One of the centres established in February, 1999.
Method: Players in the security were intensified. These are politicians, Chiefs, Village, Church
leaders and government leaders, to help disseminate information at the availability of the service.
Information team and counsellors sensitised the community and offered pretest counselling,
testing, post test counselling and formation of post test clubs.
Results: There was a good response from the community . 600 clients turned for VCT, by
October 1999. Post test clubs were formed (support groups). But later support group members
started dropping out. Number of clients for testing reduced.
Conclusions/ Lessons learned: In VCT programmes could not succeed because of the long
distances to the centre and lack of continuity in funding to enable the staff operate effectively.
Information about the service was localised to the urban areas. Due to increasing poverty
support group members droped out and opted to join well funded projects.
Notes: 1 copy
Kamali, A., Nabaitu, J., & Kinsman, J. (2000). A randomised controlled community
intervention trial to reduce HIV-1 infection in rural Uganda. In (pp. 28-28-).
Ref ID: 248
Keywords: Africa/condom/condoms/evaluation/health/infection/intervention/Sub-Saharan
Africa/Uganda/women
Abstract: Background: To develop and implement a behavioural change (IEC) intervention alone
and in combination with STD syndromic management and determine their impact on HIV
incidence and other STDs.
Methods: Since 1994, a 3-arm randomised controlled HIV - intervention trial with 6 community
clusters in each arm has is being conducted in rural SW Uganda ( IEC, IEC + STD management
and control). IEC aims at knowledge acquisition, skills development,motivational support and
230

attitude development to all ( 64,000) in intervention clusters. The STD intervention targets both
government and private health sectors aiming at improved STD intervention case management
using the syndromic approach. There is social marketing of condoms and voluntary HIV
counselling and testing in all arms. The impact assessment is through 3 serological and KABP
surveys 18-24 months apart on all adults in 3-5 villages in each cluster ( about 5000 adults per
arm).
Results:Over 500 community educators (43% women ) have been trained and on average reach
each member of the target population2-3 times each year through various channels ( drama/
video shows, community meetings, one-to- one discussions, and distribution of information
leaflets). About 60% of those reached are aged below 25 years. In 4 1/2 years of intervention
over 8000 STD cases (20% contacts) have been treated, of whom 15% were seen in the private
sector. Overall reported STD cure rate among those available for follow-up is approximately
70%. Encouraging trends towards prompt STD treatment have been observed. Of the eligible
baseline population 70% were enrolled and a similar proportion were seen at the first follow - up
survey. Over 90% of those seen at either of these two surveys have participated in the final
survey, which is nearing completion.
Conclusion: A large HIV- intervention trial targeting behavioural change and STDs has been
established in a rural Ugandan setting. The extent of the intervention components has been
sufficient to make an impact on HIV incidence feasible. Overall impact evaluation results will be
available in mid-2000 and will contribute greatly to designing future HIV/STD control programmes
in Sub-Saharan Africa.
Notes: 1 copy
Kamb, L., Fishbein, M., Douglas, J. M., Rhodes, F., Rogers, J., Bolan, G. et al. (1998).
Efficacy of Risk - Reduction Counselling to prevent Human Immunodeficiency Virus and Sexually
Transmitted Diseases. JAMA, 280, 1161-1167.
Ref ID: 272
Keywords: clinic/condom/infection/intervention/men/prevention/women
Abstract: Context: The efficacy of counselling to prevent infection with the human
231

immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) has not been
definitively shown.
Objective: To compare the effects of 2 interactive HIV/STD counselling interventions with
didactic prevention messages typical of current practice.
Design: Multicenter randomized controlled trial (Project Respect), with participants assigned to 1
of 3 individual face - to - face interventions.
Setting: Five public STD clinics (Baltimore, Md; Denver, Colo; Long Beach, Calif; Newark, NJ;
and San Francisco, Calif) between July 1993 and September 1996.
Participants: A total of 5758 heterosexual, HIV-negative patients aged 14 years or older who
came for STD examinations.
Main outcome measures - Self-reported condom use and new diagnoses of STDs (gonorrhea,
chlamydia, syphillis, HIV) defined by laboratory tests.
Results: At the 3- and 6-month follow-up visits, self-reported 100% condom use was higher
(p

Abstract: Project RESPECT was a randomised controlled trial conducted in five public STD clinics
in the United States, specifically designed to assess the efficacy of HIV prevention counselling in
reducing high-risk sexually transmitted infections. The study included counselling approaches
believed by experts to have the highest likelihood for success, and thus evaluated risk reduction
counselling models that used and interactive feasibility and coverage of the interventions, and
thus, interventions were studied that were acceptable to participants and able to be replicated in
busy public clinic settings. This project evaluated one- on one HIV/STD prevention counselling
models - one with four sessions (200 minutes total) and the other with two sessions (40 minutes
total). The counselling models were compared with each other and with brief, didactic messages
that approximate the one - on - one prevention approach typically used in STD clinics and other
HIV test sites.
Notes: 1 copy
Kamenga, M. C., Ryder, R. W., Jingu, M., Mbuyi, N., Mbu, L., Behets, F. et al. (1991).
Evidence of marked sexual behavior change associated with low HIV-1 seroconversion in 149
married couples with discordant HIV-1 serostatus: experience at an HIV counselling center in
Zaire. AIDS, 5, 61-67.
Ref ID: 68
Keywords: condom/condoms/couples/efficacy/sexual behaviour/sexual behaviour
change/VCT/voluntary counselling and testing/Zaire
Abstract: To determine the effect of an HIV-1 counselling program on 149 married Zairian couples
with discordant HIV-1 serology, the rates of HIV-1seroconversion and reported condom utilization
have been observed during 382.4 person-years of follow-up (minimum follow-up time per couple
of 6 months). Before determination of HIV-1 serostatus and counselling, less than 5% of these
couples had ever used a condom. One month after notification of HIV-1 serostatus and
counselling, 70.7% of couples reported using condoms during all episodes of sexual intercourse.
At 18 months follow-up, 77.4% of the 140 couples still being followed reported continued use of
condoms during all episodes of sexual intercourse. At the time of notification of HIV-1 serostatus,
18 couples experienced acute psychological distress. Home-based counselling by trained nurses
233

esolved these difficulties in all but three couples who subsequently divorced. Intensive
counselling following notification of HIV-1 serostatus led to low rates of HIV-1 seroconversion (
3.1% per 100 person-years of observation) in Zairian married couples with discordant HIV-1
serostatus who voluntarily attended an HIV counselling center.
Notes: 1 copy
Kamenga, M. C., Sweat, M. D., De Zoysa, I., Dallabetta, G., Coates, T., Grinstead, O. et
al. (2000). The voluntary HIV-1 counselling and testing efficacy. Study: Design and methods.
AIDS and Behavior, 4, 5-14.
Ref ID: 67
Keywords: Developing countries/intervention/Kenya/prevention/primary prevention/randomised
control trial/sexual behaviour/Tanzania/training/Trinidad/VCT/voluntary counselling and testing
Abstract: While HIV counselling and testing has been promoted as potentially effective for
prevention, few controlled studies have been conducted. The Voluntary HIV counselling and
Testing Efficacy study was randomized clinical trial of the effectiveness of HIV counselling and
testing in reducing sexual risk behavior in three developing countries: Tanzania, Kenya, and
Trinidad. The trial will provide crucial information regarding effectiveness, cost, and
consequences of HIV counselling and testing for prevention. This paper describes the design
and methods of the Voluntary HIV Counselling and Testing Study. Following a discussion of the
study objectives, the design and methods of the study are presented. Recruitment, consent,
randomization, intervention, assessment, follow-up, training, and quality assurance procedures
are described. Issues raised in the design and anticipated in the interpretation of the study
outcomes are discussed, as well as potential policy and service delivery implications of the study
findings.
Notes: 3 copies
(pp. 19).
Ref ID: 238
Katongola, E. M. (2000). Voluntary counselling and testing of HIV in Mufulira- Zambia. In
234

Keywords: church/counselling and testing/post-test/transmission/voluntary counselling and
testing/Zambia
Abstract: Objectives: To encourage the community to come for free counselling and testing of
HIV test.
To encourage the community to know the importance of knowing their status
To reduce the spread of HIV
To improve the quality of life for people living with AIDS
Methodology: Massive sensitisation was introduced in the community e.g. churches, work
places, markets, schools and at every gathering, by the post test club members and counsellors.
Strategies: used to carry out HIV/AIDS awareness are: Education, including drama, songs
dances, role plays, poems, video shows with HIV/AIDS messages, personal testimonies and peer
education.
Results: The post test club (P.T.C) was established to provide these services within the
communities they live in.
All clients who have been counselled and tested regardless of their status are eligible to join.
Since April 1999 to date, 810 have been tested on voluntary basis, 150 members have joined the
club and 30 are active members.
In addition to receiving services club members are active community HIV/AIDS educators and
aim to raise HIV/AIDS awareness in the community.
Conclusion: Stigma in the community reduced
Post test club members are partners in educating the community through massive sensitisation
on voluntary counselling and testing of HIV.
These efforts have contributed to acceptance of HIV counselling and testing services.
Lessons Learnt: The community was deprived of a service they required in order to know their
status and in reducing the transmission.
Notes: 1 copy
Ref ID: 1465
Kaunda, P. (2001). Herbs no "cure" - Mkhize. Independent on Saturday.
235

Keywords: drugs/education/health/infection/medical/traditional healer/traditional healers
Abstract: KwaZulu-Natal Health Minister Sr Zweli Mkhize has warned that it is dangerous to think
that traditional medicine can"cure" AIDS. "It is unfair to subject the public to speculations that
have not been proven and so create false hope to desperate people", said Mkhize. "People will
ignore AIDS education if they think that they will be cured by someone once they catch the virus,"
he added. Mkhize encouraged traditional healers to get their herbs tested first before spreading
the news that their plants had medicinal properties. "However, he conceded that traditional
healers had an important role to play in treating patients who chose to go to them. "Unlike
medical doctors, traditional healers never give up on their patients, " said Mkhize. He said that
while doctors in hospitals might say the disease was incurable, traditional healers kept on giving
their patients hope and moral support. "More than healing the symptoms of AIDS they helped
people psychologically ," he added, explaining that counselling assisted patients a lot. "Some
traditional healers are able to make people have a will to live, which boosts their immune
systems," he said Mkhize said that when people believed that they were going to be healed by a
certain healer, half of the work towards healing was already done. Their belief that they would
recover strengthened their bodies and they began to feel much better even without drugs.
Mkhize said that the Department of Health planned to register traditional healers so they could be
given the recognition they deserved. When traditional healers were registered, this would help
restore their dignity and eliminate con artists who were merely on a money-making mission.
Registering healers would also be a measure to control them and prevent illegal practices.
Healers would also be taught how to avoid spreading infections through the use of items like
razor blades.
Notes: 1 copy
Keeble, S. J. (1988). Awareness and impact of acquired immune deficiency syndrome in
organisations in South Africa. Submitted for Degree Masters in Business Administration
University of the Witwatersrand (UWITS).
Ref ID: 196
Keywords: attitudes/business/employee/employer/impact/policies/South Africa/workplace
236

Abstract: Investigates the level of awareness and degree on impact AIDS has had and is
predicted to have on South African organisations. The study investigates what policies and
strategies South African organisations have developed to cope with the AIDS threat as well as
management attitudes to recognised workplace issues surrounding AIDS. An overview of the
literature on work related issues concerning AIDS is presented. Some of the main factors are
discussed in conjunction with the literature. For management to analyse, control and attempt to
lessen the impact of AIDS on their organisations, an awareness and understanding of AIDS is
necessary. The background to overseas and local trends of AIDS is discussed. Further pertinent
aspects are the policies and procedures necessary to implement a strategy for coping with AIDS.
The issues investigated include the level awareness of AIDS amongst a sample of South African
managers, how the organisations of the managers view strategies, policies and operational plans
with respect to AIDS and local developments with respect to AIDS in the workplace. The
research data used was collected from a questionnaire mailed to 300 managers in a cross
section of industries in South Africa. These were analysed in relation to the issues described.
The results indicate that South African managers are generally well informed about AIDS. A
substantial number favour bringing the issues into the open and offering assistance and
counselling to employees, while a significant number favour firing staff and the implementation of
strict control measures such as medical testing and the isolation of infected employees. The
research clearly indicated, however, that to date South African organisations have done little to
develop policies and strategies of any type regarding AIDS.
Notes: 1 copy
Keeling, R. P. (1993). Commentary: education and counselling about HIV in the Second
Decade. Journal of counselling and Development, 72, 306-309.
Ref ID: 405
Keywords: community/counsellor/counsellors/Virus
Abstract: The authors of the articles in this special feature confront the most important and
challenging questions about the current educational and counselling issues related to HIV
(Human immunodeficiency virus). As educators and counsellors, we must look closely at both the
237

characteristics and determinants of human behavior, direct our efforts at both individuals and their
communities, work respectfully in all communities to produce humane change, and foster self-
esteem for all individuals and group pride in all communities. Education and counselling will
become critically cross-linked in effective programs.
Notes: 1 copy
Keenan, P. A. & Keenan, J. M. (2001). Rapid HIV Testing in Urban Outreach: A strategy
for Improving Posttest counselling rates. AIDS Education and Prevention, 13, 541-550.
Ref ID: 357
Keywords: clients/failure/HIV testing/infection/on-site/performance/population/rapid HIV
testing/rapid testing/WHO/United States/therapy/client
Abstract: In 1993, 48% of persons who had HIV testing at publicly funded sites in the United
States failed to return for test results and posttest counselling. Opportunities for timely HIV
therapy were lost; valuable resources were wasted. This study tested the hypothesis that rapid
HIV testing enables a high percentage of high-risk outreach clients to learn their serostatus. We
did on-site counselling and rapid HIV testing at community-based organizations(e.g., chemical
dependency programs, homeless shelters) in North Minneapolis. The project tested 735 persons.
All but one (99.9%) learned their HIV serostatus. African Americans made up 79% of subjects.
Rapid testing has a role to play in HIV outreach. It is useful in population who are at high risk of
HIV infection, who currently are not accessing HIV testing, and who have high failure to return
rates. Future developments in rapid testing technology will make this testing option more
convenient and cost-effective.
Notes: 1 copy
Ref ID: 4685
Keeton, C. (1998). Rape victims need anti-HIV drug. Sowetan.
Keywords: government/HIV-drugs/rape/South Africa/transmission
Abstract: Rape survivors in South Africa should have access to anti-HIV drugs to lessen their
danger of HIV infections resulting form rape. The use of anti-retroviral drugs within 48 hours of
238

ape is thought to reduce the risk of HIV transmission to the survivor, but this option is not known
or available to most South Africans at present. The public should be informed about this
treatment and the Government should pay for the drugs, argued speakers at the workshop,
including HIV-specialist Dr Desmond Martin.
Notes: 1 copy
Ref ID: 6E
Keir, D. (1991). AIDS: The impact on the employers. In.
Keywords: benefits/business/care/conference/employee/employer/insurance
Abstract: This conference paper was presented by Mr Douglas Keir, Swiss SA Insurance at the
JCI/Alexander Forbes Health Care Seminar on the 26th of September 1991. The article explores
some of the employee's benefits which are related in one way or another to employees' health,
and the author also mentions the intolerable discriminatory attitude towards AIDS.
Kelly, K. (2000). Communicating for action. Department of Health. Sentinel site
monitoring and evaluation project .
Ref Type: Unpublished Work
Ref ID: 486
Keywords: adolescents/Africa/communication/impact/information/research/sexual
behaviour/South Africa
Abstract: In conceptualising this research two important aspects were considered. Firstly, there is
a considerable lack of HIV/AIDS behavioural research in South Africa. Few studies have been
conceptualised to give insight into sexual behaviours and practices of adolescents and young
adults as they apply to a range of contexts. Such research is vital to the development of
HIV/AIDS communication and other strategies.
Secondly, it is recognised that HIV/AIDS information reaches target audiences through diverse
sources and it is more important to understand impacts within the context of this diversity, than is
to attempt to extract the impact of specific campaigns. This research therefore sets out to
provide a vital cornerstone to the understanding of adolescents and young adults with regard to
239

ehaviours and practices that are relevant to communication strategy development.
Notes: 1 copy
Kelly, K. & Parker, W. (2001). From people to places: Prioritising contextual research for
social mobilisation against HIV/AIDS. CADRE. -, 1-16. South Africa, CADRE. -.
Ref Type: Organisational research report
Ref ID: 65
Keywords: Africa/evaluation/family/intervention/prevention/research/response
Abstract: This analysis is based on a number of studies of the contextual mediators of public
response to HIV/AIDS, in nine sites across South Africa. Data is presented in support of the
argument that sustainability of behaviour change is contingent upon factors which are largely not
within the scope of individual decision making. The knowledge, attitudes and practices of
individuals, rather than the affordances of their environments, have been the primary concern of
most social researchers, whilst the contextual determinants of behaviour in the areas of
prevention and care have been given scant attention. It is argued that research priorities need to
move from a focus on individuals to a focus on the environment within which people live.
Interpretation of the data presented leads to the suggestion of the need for a social development
framework to support behaviour change activities. This would provide a platform for social
mobilisation which is currently abundantly present in sentiment, but lacking in substance. The
paper argues for greater emphasis on a research driven approach to programme development. It
is suggested that the failure to use research in programme development has wasted time and
resources. Even located interventions and mass media campaigns have been costly, but have
left significant areas of the mediating context largely untouched and the narrow emphasis on
individuals has obscured the importance of social contexts. It is argued that in a mature epidemic
there is a need to move beyond awareness raising and to focus on providing information and
resources that orient individuals, families, communities and social formations to appropriate forms
of action. A model based on research, monitoring and evaluation at district and community level
is recommended as the surest path to fast-tracking response to the epidemic.
Notes: 1 copy
240

Kelly, K., Parker, W., & Oyosi, S. (2001). Paths to Action: HIV/AIDS prevention, children
and young people in South Africa. CADRE. [-], 1-80.
Ref Type: Unpublished Work
Ref ID: 474
Keywords: Africa/prevention/response/South Africa/Young people
Abstract: There appears to be a pervasive belief in South African society, that young people have
not responded to HIV/AIDS. This report is an attempt to take stock of what has happened in
respect of the response to HIV/AIDS by children and young people in South Africa, as well as the
societal response to the needs of young people.
Notes: 1 copy
Kelly, K., Ntabati, P., & Oyosi, S. v. d. R. M. P. W. (2002). Making HIV/AIDS our problem:
young people and the development challenge in South Africa. CADRE. [-], 1-62.
Ref Type: Unpublished Work
Ref ID: 475
Keywords: Africa/case study/community/HIV
prevention/intervention/prevention/research/response/South Africa/Young people/youth
Abstract: During 2001, save the children commissioned a number of studies related to HIV/AIDS,
children and young people in South Africa. This includes the development of a literature review
of young people's responses to HIV/AIDS in South Africa entitled: pathways to action: HIV/AIDS
prevention, children and young people in South Africa. Running parallel to this study was the
exploration, through formative field research, of approaches to engaging youth response to
HIV/AIDS. This involved the development of two action research interventions - one in Amatole
Basin, a rural community in the Eastern Cape, and the other at Sibonile School for the Blind,
located at Klipriver in Gauteng. The overall aim was to examine in detail, through two case
studies, the challenges facing the community and young people in particular, in developing a
sustained and effective response to HIV prevention.
Notes: 1 copy
241

Ref ID: 461
Kelly, M. (1994). Who comes for voluntary counselling and testing. AIDS Bulletin, 3, 27.
Keywords: VCT/voluntary counselling and testing/Zambia/sexual behaviour/WHO/post-
test/male/pregnancy/men/women/health/sexual partner/strategy/condoms/condom
Abstract: A study conducted in Zambia tried to establish why people present themselves for
voluntary counselling and testing and whether they had been helped to change their sexual
behaviour. The study involved interviewing 500 people who presented for voluntary counselling
and testing. Further interviews were carried out at the time or post-test counselling and at 3 - 6
months' fol low-up. Of those interviewed, 70% were male and the most common reason for
wanting to be tested was to be able to make plans for the future - including marriage, planning a
pregnancy and overseas study. Men wanted to be tested largely because of their previous
sexual behaviour while women frequently stated the illness or death of their husband as their
reason for wanting to be tested. Many people felt that they knew what the result would be and in
69% of cases their prediction was accurate. Many of those who were HIV-positive felt that being
tested would help them with their health problems; however, less than 50% felt able to share their
result with their sexual partner. Fifty per cent returned for follow-up counselling at 3 - 6 months.
Various behavioural strategies (including the use of condoms and abstinence) had been adopted.
Notes: 1 copy
Kenyon, C., Heywood, M., & Conway, S. (2002). South African Health Review 2001. Ntuli
A., Suleman, F, Barron, P., and McCoy, D.
Ref Type: Unpublished Work
Ref ID: 8815
Keywords: health/HIV prevalence/human rights/VCT/evaluation/WHO/HIV-status/HIV
transmission/transmission/counsellors/counsellor/failure/infection/policies/policy
Abstract: HIV prevalence seems to increase despite a comprehensive national HIV/AIDS
strategic plan for SA, which indicates inadequate implementation of plan. The human rights
approach was explicitly endorsed as being one of the guiding principles of the plan.The success
of implementing VCT has varied greatly. The evaluation of VCT to one of the three key
242

programmes in the NIP is based on a considerable body of evidence that shows that increasing
the proportion of persons who know their HIV status will help reduce the HIV transmission rates.
A national VCT programme led by the leaders of all sectors of South African society would help to
undermine the stigmatisation and denial that is helping fuel the epidemic. Two positive
innovations that have been introduced are the use of lay counsellors and rapid HIV tests. The
failure of health workers to promote VCT has been a further challenge.
It is widely accepted that openess and acceptance of HIV/AIDS and breaking down denial will
only be achieved by campaigns to protect and advance the human rights of people living with HIV
and AIDS.This is known as the "AIDS paradox" by protecting the rights of people with HIV, you
reduce the risk of infection to uninfected people. HIV policies and laws have not been adequately
implemented and have not impacted significangtly on the ground. Stigma and poor access to
justify deter people from seeking redress for institutional human rights violations
Notes: Chapter 9 - Mainstreaming HIV/AIDS progress and challenges
Ref ID: 533
Khumalo, G. (2001). Community health workers in the front line. AIDS feature.
Keywords: care/caregiver/community/disease/family/health/Home care/Home based care
Abstract: Due to the rapid increase in the number of people suffering from HIV/AIDS, it has
become necessary to consider how best to provide care for people and this is where the
community health workers are playing a crucial role in providing care for people with terminal
diseases and their families.
Community health workers are chosen by their own communities and they then receive training in
counselling and home-based care. Home care is defined as the provision of health services by
formal and informal caregivers in the home in order to promote, restore and maintain a person's
maximum level of comfort, function and health, including care, towards a dignified death.
Notes: 1 copy
Kiarie, J., Nduati, R., Koigi, K., Musia, J., & John, G. (2000). HIV-1 testing in pregnancy:
acceptability and correlates of return for test results. AIDS, 14, 1468-1470.
243

Ref ID: 118
Keywords: acceptability/positive status/pregnancy/pregnant/VCT/voluntary counselling and
testing/women
Abstract: Mother -to -child transmission of HIV-1 is a major public health concern; particularly in
sub-Saharan Africa where 90% of the 1.2 million infected children live. The use of antiretroviral
agents and the avoidance of breast-feeding can prevent mother-to child transmission of HIV-1.
However, these interventions require the identification of HIV-1- infected women during
pregnancy. Studies in Europe and North America suggest that women who perceive themselves
as at risk of HIV-1 are more likely to accept HIV-1 seropositive are less likely to return for test
results than those who are seronegative. It is likely that in settings where HIV infection is
stigmatized and treatment is not readily available HIV-1 testing appeals less to those who
perceive themselves to be at high risk. To implement strategies for the prevention of perinatal
HIV-1 transmission, it is necessary to optimize the process of voluntary counselling and testing
for HIV-1 during pregnancy.
Notes: 1 copy
Killewo, J., Kwesigabo, G., Comoro, C., Lugalla, J., Mhalu, F. S., Biberfeld, G. et al.
(1998). Acceptability of voluntary HIV testing with counselling in rural village in Kagera, Tanzania.
AIDS care, 10, 431-439.
Ref ID: 331
Keywords: acceptability/education/health/HIV-status/HIV testing/HIV
transmission/intervention/post-test/pre-test/Tanzania/transmission
Abstract: A pilot study on acceptability of voluntary HIV testing with counselling was performed in
a rural village in Kagera, Tanzania as a potential intervention against HIV transmission. Village
residents were prepared by their leaders and subsequently invited to health education group
meetings acceptance of the offer followed by pre-test counselling and taking of a blood sample
for subsequent HIV testing. Two months later, the results of the test were returned with post-test
counselling coupled with a short interview of a random sample of adults in the village. Of the 245
adults responding to the call, 137 (55.9%) subsequent volunteered. The main reason for
244

volunteering was to know the HIV status ( 96%). Among those who were aware of the offer, the
main reason for not volunteering was that they felt unlikely to catch AIDS, implying that they had
a false perception of being at low risk. In this study a significant proportion were willing to
volunteer for the HIV test and to receive the results, indicating a moderate level of acceptability.
The results also indicate the need for developing innovative ways of enhancing acceptability of
voluntary HIV testing with counselling. However, the relationship between knowledge of HIV
status and behavioural change is complex and therefore several potential mechanisms may exist
by which HIV testing in combination with counselling can influence bahaviour. For this reason,
people should be given the choice of knowing their HIV status since it may constitute a potential
mechanism for influencing behaviour towards reduction of HIV transmission
Notes: 1 copy
Kim, Y. M., Marangwanda, C., & Kols, A. (1997). Quality of counselling of young clients in
Zimbabwe. East African Medical Journal, 74, 514-518.
Ref ID: 63
Keywords: patient care/quality of care/Young people/youth/Zimbabwe
Abstract: Researchers observed 418 consultations with clients aged 12-24 at 38 health facilities
throughout Zimbabwe and interviewed both the clients and providers. Less than one per cent of
clients at these facilities were aged 12-24 years; between 5% and 20% were aged 15-19 years.
Compared with older clients, those aged 12-16 years came more often for antenatal care and
medical problems and less other for family planning. In sessions with 12-16 years, the most
common topics were STDs (48%) and school (46%), while sessions with older clients focused
more on family planning (56-68 %). Providers rarely discussed adolescence or non-sexual
problems such as alcohol and drugs. Younger clients were less likely than older clients to ask
questions without prompting( 16%), expressed their concerns( 27%), and they were more likely to
appear embarrassed (58%) and shy(64%). Most service providers believed that the parents
should be notified if a young, unmarried client was pregnant (89%), had HIV/AIDS (74%), or
engaged in sex at "an early" age (73%). The findings suggest that young people may be
reluctant to seek advice at health facilities because of legitimate concerns about privacy,
245

providers' attitudes, and narrow focus on reproductive health.
Notes: 1 copy
Kinnell, A. M. K. & Maynard, D. W. (1996). The delivery and receipt of safer sex advice in
pretest counselling sessions for HIV and AIDS. Journal of contemporary Ethnography., 24, 405-
437.
Ref ID: 271
Keywords: clinic/counsellor/research/sex
Abstract: Advice can be highly problematic, especially in pretest counselling sessions for HIV and
AIDS where the advice concerns the already highly charged topic of sexual behavior. However,
there is surprisingly little research examining the delivery and receipts of advice. Using detailed
transcripts obtained during twenty-five pretest counselling sessions in a clinic that tests for HIV,
this study examines the various ways that counsellors deliver advice to clients and the ways that
clients respond to the advice. Analysis concerns structures of advice giving that are
collaboratively produced to maintain an ambiguity between the giving of advice and the giving of
information. Implications of these findings both for counselling and for ethnography and
conservation analysis are discussed.
Notes: 1 copy
Kinnell, A. M. K. (2001). So why are you here: assessing risk in HIV prevention and test
decision counselling. Sociology of Health and illness, 23, 447-477.
Ref ID: 374
Keywords: prevention/risk assessment
Abstract: This paper examines how counsellors attempts to assess clients' risks for contracting
HIV when they come in for HIV testing. Starting with Maynard's (1989) proposal that a analysis of
social problems should begin with an analysis of talk-in-interaction, I examine how a client's
"problem" of being at-risk for HIV is made visible or not in HIV prevention and test decision
counselling sessions. First, I analyse counsellors' use of open-ended questions as a method for
making the problem of at-risk for HIV visible within the interaction and how clients respond to
246

those questions. Second, I analyse how the meaning of the clients' risks is negotiated in the
interaction as counsellors support or contest clients' accounts for getting an HIV test.
Notes: 1 copy
Kinnier, R. T. (1986). The need for Psychosocial Research on AIDS and Counselling:
interventions for AIDS Victims. Journal of counselling and Development, 64, 472-
474.
Ref ID: 210
Keywords: counselling and testing/health/intervention/men/psychological
issues/psychosocial/research
Abstract: The acquired Immune Deficiency Syndrome (AIDS) is fast becoming a major epidemic
and a psychological emergency" in our society. Since 1979, the incidence of AIDS has doubled
about every 6 months, and it has been predicted that the number of people diagnosed with AIDS
will exceed 8,000 during 1985. Although AIDS was once portrayed by the popular press (and
probably perceived by most people) as an threat only to specific subpopulations( most notably,
homosexual men), it is now clear that AIDS can be acquired by anyone and can be transmitted
through heterosexual sex. Another ominous aspect of the AIDS epidemic is that the disease can
have a latency period of several years, during which time infected individuals unknowingly may
infect others. Much remains unknown about exactly how the disease is acquired and spread, but
what is known suggests that we have only seen the beginning of what could become a "black
plague" of the 20th century. The disease is presently considered to be incurable, on the rise, and
a potential threat to millions of people. AIDS has received much attention in the medical literature
and popular press, but little has appeared in the psychological and social sciences journals. This
is unfortunate, because mental health professionals can contribute much to alleviating the fear,
pain and stress associated with catastrophic illnesses. In the November 1984 issue of the
American Psychologist, a forum of psychologists and an AIDS victim addressed the issue of how
mental health professionals can play an important role in helping those affected directly and
indirectly by AIDS. In this review I first suggest what counsellors can learn from catastrophic
epidemics of the past and then summarize several of the salient psychological needs of AIDS
247

victims, individuals suffering from"pre-AIDS" syndrome, and a growing class of individuals known
as the "worried well". I also discuss counselling interventions and promising areas of
psychosocial research.
Notes: 1 copy
Kinsman, J., Nakiyingi, J., Kamali, K., Carpenter, L., Quigely, M., Pool, R. et al. (2001).
Evaluation of a comprehensive school-based AIDS education programme in rural Masaka,
Uganda. Health Education Research, 16, 85-100.
Ref ID: 402
Keywords: Africa/condoms/intervention/Masaka/Sub-Saharan Africa/training/Uganda
Abstract: A 19 activity extracurricular school- based AIDS education programme lasting 1 year
was conducted in rural southwestern Uganda using specially trained teachers, and was evaluated
using mutually supportive quantitative and qualitative methods. In total, 1274 students from 20
intervention schools and 803 students from 11 control schools completed questionnaires at
baseline, and their classes were followed up. In addition, 93 students from five of the intervention
schools participated in 12 focus group discussions. The programme had very little effect - seven
of the nine key questionnaire variables showed no significant increase in score after the
intervention. Data from the focus group discussions suggest that the programme was
incompletely implemented, and that key activities such as condoms and the role-play exercises
were covered only very superficially. The main reasons for this were a shortage of classroom
time, as well as teachers' fear of controversy and the unfamiliar. We conclude that large-scale
comprehensive school-based AIDS education programmes in sub-Saharan Africa may be more
completely implemented if they are fully incorporated into national curricula and examined as part
of life-skills education. This would require teachers to be trained in participatory teaching
methods while still at training college.
Notes: 1 copy
Kipp, W., Kabagambe, W., & Konde-lule, J. (2001). Low impact of a community - wide
HIV testing and counselling program on sexual behavior in rural Uganda. AIDS Education and
248

Prevention, 13, 279-289.
Ref ID: 186
Keywords: community/condom/condom use/efficacy/impact/prevention/risk
reduction/Uganda/VCT/voluntary counselling and testing
Abstract: Study results on the assessment of a community - wide HIV counseling and testing
program are presented. The aim of this study was to elucidate whether HIV counselling and
testing was effective in reducing high risk sexual behavior of a rural population in Uganda. From
a total of 2,267 persons of Kigoyera Parish, Western Uganda, who were HIV tested and
counseled, 495 persons were selected and interviewed about their sexual behavior. Persons
who were HIV tested showed no difference in sexual behavior compared to those who were not
tested ( condom use 4.3% vs5.5 %, mean number of sexual partner in the past three months 1.8
vs 2.0). The conclusion is that only knowing the HIV serostatus is not enough to reduce high risk
behavior. The study results also showed that there is a demand for HIV counselling services
without being HIV tested.
Notes: 1 copy
Kipp, W., Kabagambe, W., & Konde-lule, J. (2002). HIV Counselling and testing in rural
Uganda:Communities attitudes and perceptions towards an HIV Counselling and tsting
programme. AIDS care, 14, 699-706.
Ref ID: 8819
Keywords: community/qualitative research/HIV/AIDS
counselling/Uganda/WHO/counsellors/counsellor/health/sexual behaviour/condom/condom use
Abstract: Study results on the assessment of a community wide HIV/AIDS testing and counselling
programme are presented. The aim of this qualitative study was to elucidate whether HIV/AIDS
counselling was acceptable to a rural community and whether they expressed a need for it. From
a total of 2,267 persons of Kigoeyera Parish, Western Uganda, who were HIV tested and
counselled, a 171 persons participated in 17 focus group discussions. Most participants
expressed a strong need for HIV/AIDS counselling and testing. The counsellors were seen as
competent and confidential. Community health workers were favoured as the preferred provider
249

of HIV/AIDS services. However, participants stressed that they should not come from the same
community. Most participants felt that an HIV/AIDS programme available only once is not enough
and did not induce a change in sexual behaviour and condom use. They requested counselling
services that are continuously offered. The study results also showed that there is a demand for
HIV/AIDS counselling services without being HIV tested.
Ref ID: 187
Klugman, B. (2000). The role of NGOs as agents for change. Development Dialogue, 1.
Keywords: Africa/health/NGO/South Africa/Southern Africa/women
Abstract: This article by Barbara Klugman takes a thorough look at the possibilities and limitations
of NGOs activism in Southern Africa and, particularly, in South Africa during a time which was
very special and saw rapid political developments. The author has since 1991 been the Director
of the Women's Health project at the Development of Community Health of the University of
Witwatersrand in Johannesburg and has in this central position been involved in many important
NGO campaigns and activities in the field of women and health. The article was originally
presented as a paper to the Dag Hammarskjold Seminar on Equity in Health: Policies for
Survival in Souther Africa. It has since been revised and updated. It presents and deliberated on
two case studies of NGO activism, one national and on international. It ends by discussing at a
general level as well as at the Southern African sub-regional level the factors that facilitate- and
those that constrain - NGO involvement in the policy-making process. The article enriches in a
convincing way the discussion of a subject whose importance seems to grow steadily by the
month.
Notes: 1 copy
Ref ID: 8293
Korrespondent (2000). MIV/Vigs: duurder om te behandel. Beeld.
Abstract: Kaapstad - Dit kos tot tien keer meer om 'n baba met MIV/vigs te behandel as om
voorkomende vigsmedisyne aan swanger vroue met vigs the verskaf, blyk uit navorsing van 'n
magisterstudent aan die universiteit van Kaapstad wat pas bekend gemaak is. Me Jolene
250

Skordis, wat vandeesweek 'n magistergraad in ekonomie aan die UK gekry het, het die Koste om
MIV-besmette vroue met middels soos AZT en Nevirapine te behandel, ondersoek. Haar
navorsing vind aansluiting by die oproep van talle medicien navorsers dat Nevi-rapine aan
swanger vroue wat met die virus leef beskikbaar gestel moet word om die oordrag van die virus
van ma na kind te voorkom. Volgens Skordis se navorsing kan babas met 'n behandeling van
AZT en formule-aanvullings gered word teen 'n koste van sowat R 5 243,51 per kind en teen
altesame R 1 436,76 per kind as Nevirapine toegedien word. Hierteeenoor sal die staat R 17
158,30 moet opdok om 'n baba met MIV te behandeling van opportunistiese infeksies in nie.
Navorsing het gewys dat middels soos Nevirapine en AZT die oordrag van MIV/vigs met sowat
die helfte verminder. Vie vigssepidemie het wereldwyd al meer as 15 miljoen lewens geeis.
Meer as 40 miljoen mense, onder wie 34 miljoen Afrikane, is MIV - positief. In Suud Afrika, waar
die epidemie die vinnigste ter wereld groej, sal vigs wesies teen 2010 tussen 9% en 12 " van die
bevolking uitmaak.
Notes: 1 copy
Krabbendam, A. A., Kuijper, B., Wolffers, I. N., & Drew, R. (1998). The impact of
counselling on HIV-infected women in Zimbabwe. AIDS care, 10, s25-s37.
Ref ID: 184
Keywords: client/disclosure/efficacy/positive status/support/women/Zimbabwe
Abstract: The objective of this study was to examine the impact of counselling provided for HIV-
infected women in Zimbabwe. Qualitative research was used for data collection. In total, 44
important role in the first counselling session, because tests to diagnose HIV-infection are done in
the hospital. Interviewed women mention slow disclosure of status as the most comforting way to
hear the news. The HIV-infected women experience strong emotions directly after diagnosis.
Counselling at this moment is of major importance to reduce fear and can prevent suicide.
Women should be prevented from discovering their status on their own. Counselling given once
is found not to be effective. First, if only one counselling session is given, the women may not
hear or remember all that is said. Second, in case of depression, access to counselling is
important role in providing this continuous counselling. Another advantage of the counselling
251

provided by HIV-positive women of a support group is that the counsellors function as examples.
Notes: 1 copy
Krasnik, A. & Fouchard, J. R. (1990). Knowledge, attitudes and Experiences of Health
workers determine their anxiety about AIDS. Scand J Soc Med, 18, 103-113.
Ref ID: 283
Keywords: health worker
Abstract: In this study conducted among, 2,561 medical doctors nurses and nursing aids in
hospitals and primary care centres, negative attitudes towards homosexual men and HIV positive
persons are shown to have an important impact on anxiety related the health work concerning
HIV/AIDS.
Anxiety was reduced by HIV educational experiences but attitudes have a dominant position in
the interaction with knowledge. The authors recommend that educational programmes on
HIV/AIDS for health care workers should therefore aim at reducing anxiety by focussing on
developing positive attitudes and norms rather than just communicating basic information, which
has only a slight impact on anxiety. While including gay men and HIV positives educational
programmes is useful, a single encounter does not provide sufficient impact to have a positive
effect on attitude. A more intensive is required
Notes: 1 copy
Ref ID: 2982
Krautkramer, R. (2000). Can doctors refuse to treat HIV patients? The Cape Times.
Keywords: infection/medical/Nurse
Abstract: Complex issue which often poses a question is that of the doctor or nurse's obligation to
treat HIV-positive patients, or those dying of AIDS. May a doctor or a nurse refuse to treat a
patient, for fear of infection? Conversely, may a patient require confirmation that his doctor or a
nurse is not HIV positive, before being treated? There is no legal obligation on a doctor or nurse
to attend to a patient, as such. Doctors take the Hippocratic oath which merely confirms that
obligation to treat is merely an ethical one. The question of a legal duty is one which is complex
252

and as such best left for an article on its own. Hence, I prefer to deal only with the ethical duty.
Hospitals require their staff to treat anyone who requires medical attention.
Notes: 1 copy
Kumaranayake, I. & Watts, C. (2000). The costs of scaling -up HIV prevention and care
interventions in sub-Saharan Africa. In (pp. 16).
Ref ID: 235
Keywords: Africa/condom/health/HIV prevalence/Home based
care/infection/intervention/media/MTCT/prevention/sex workers/Sub-Saharan
Africa/transmission/voluntary counselling and testing
Abstract: Background: While there are strong HIV/AIDS interventions across Africa, few are
implemented at a national scale. A key priority is the rapid expansion of activities . Despite this,
resources to address HIV/AIDS have been relatively limited- external spending on HIV/AIDS in
Africa was approximately US$ 165 million in 1998. A key question is how much would it cost to
scale-up different HIV/AIDS prevention and care strategies to a national level. A model-based
approach is used to develop a methods to calculate costs, and to obtain estimates of the
resource requirements of scaling -up HIV/AIDS interventions.
Methods: The model combines requirements data taken from cost-studies, with data from 34
Sub-Saharan African countries on sexual behavior, HIV prevalence and other epidemiological,
demographic and health systems variables. The model estimates the size of groups that could
be potentially reached by: youth interventions, interventions focused on sex workers and their
clients, condom social marketing, increased public sector condom provision, improved STD
management, voluntary counselling and testing, workplace interventions, blood safety measures,
prevention of mother -to-child transmission, mass media, palliative care, clinical management of
opportunistic infections, home-based care, care for HIV -infected infants, support for orphans,
psychosocial support and counselling. Unit costs are then used to the total annual cost of
implementing the scale-up interventions at different levels of coverage.
Results: We estimate the regional annual costs of scaling-up HIV prevention and care activities
range from $1.29 to $2.57 billion( US 2000 dollars).
253

Conclusions: The findings are limited by available data. However, they suggest that the
resource requirements are substantial but not unreasonable . The relative costs of prevention
and care highlight the importance of investing in prevention. If action is delayed the costs of care
will continue to rise.
Notes: 1 copy
KwaZulu-Natal Provincial VCT Committee. (1998). Voluntary HIV counselling and testing.
KwaZulu-Natal, KwaZulu-Natal Provincial VCT Committee.
Ref Type: Unpublished Work
Ref ID: 478
Keywords: Voluntary HIV counselling and Testing/VCT/benefits/information/voluntary counselling
and testing
Abstract: This booklet is about voluntary HIV counselling and testing (VCT) and is aimed at
helping to understand what it is and how it can benefit you. Whether you are infected with HIV or
not, because finding out how to live positively with HIV is one of the main benefits of VCT, we
also give you some information on how to stay as healthy as possible for as long as possible.
Lastly, we've put a resource list together so that you can access a voluntary counselling and
testing site near you.
Notes: 1 copy
Kwitshana, T. (1999). Report on the national counselling programme.
Ref Type: Unpublished Work
Ref ID: 560
Abstract: In providing guidance and leadership to provinces, it has been necessary to hold regular
provincial meetings with all stakeholders involved. The process involved discussing each phase
per meeting, reaching and formulating a plan of action.
Notes: 1 copy
Lachenicht, L. G. (1993). A sceptical argument concerning the value of a behavioural
solution for AIDS. South African Journal of Psychology, 23, 15-20.
254

Ref ID: 75
Keywords: intervention/psychology/risk/social
Abstract: A thought experiment was developed in which it is demontrated that frequently recurring
temptations are hard to resist even if the risks of succumbing to the temptation are well
understood. Behavioural programmes against AIDS are primarily concerned with making the
risks of unprotected sex known to groups of people at risk of contracting HIV. But these target
groups are also shown to engage in very frequent sex and this, combined with the thought
experiment suggest that behavioural programmes may be less effective than desired. Structural
interventions may be more successful than behavioural programmes. Some limitations of the
thought experiment are considered.
Notes: 1 copy
Ladner, J., Lerol, V., Msellati, P., Nyiraziraje, M., De Clercq, A., Van de Perre, P. et al.
(1996). A cohort study of factors associated with failure to return for HIV post-test counseling in
pregnant women: Kigali, Rwanda, 1992-1993. AIDS, 10, 69-75.
Ref ID: 71
Keywords: acceptability/barrier/barriers/positive status/post-
test/pregnancy/pregnant/Rwanda/VCT/voluntary counselling and testing/women
Abstract: This paper identifies the factors associated with failure to return for HIV post-test
counseling in pregnant women in Kigali (Rwanda). Concerning the subjects and methods: In the
context of a study on the impact of HIV infection on pregnancy, HIV-1-antibody testing was
offered to all pregnant women attending the antenatal clinical of the centre Hospitalier de Kigali
from July 1992 to August Two weeks later, we formally enrolled all HIV-positive women and a
corresponding number of HIV-negative women in a Cohort. At this visit, post-test counseling
was given to those wishing to be informed of their HIV serostatus. Level of knowledge about
modes of HIV transmissions and condom use were recorded. Four months after delivery, another
interview was conducted to determine the proportion of women who used condoms regularly.
The results were: A total of 1233 pregnant women were screened. The HIV seroprevalence was
34.4 % [95% confidence interval (Cl), 31.7-37.1]; 271 ( 63.9 % ) out of 424 HIV-positive and 577(
255

71.3 % ) out of 809 HIV-negative women asked for their HIV serostatus (p= 0.008). In
multivariate analysis, the only variable significantly associated with failure to return for post-test
counseling was a positive HIV test result (odds ratio, 0.7; 95%Cl, 0.5-0.9; p=0.009),
independently of obstetrical history and socioeconomic characteristics. Among the 848 women
who had post-test counseling, 50.9% of the HIV-positive women and 94.6% of the HIV-negative
women stated that they planned to inform their partner of their serostatus (p=0.009),
independently of obstetrical history and socioeconomic characteristics. Among the 848 women
who had post-test counseling, 50.9% of the HIV-positive women and 94.6% of the HIV-negative
women stated that they planned to inform their partner of their serostatus (= 0.0001). More than
95% of the women interviewed knew about sexual and parenteral transmission of HIV, but half
were unaware of mother-to-child transmission. More than 80% of the women had seen a condom
before, but 14% only had used it at least once. Among women who were sexually active 4
months after delivery, 8.8% of the HIV-positive and 3.9% of the HIV-negative women reported
using a condom (p= 0.04). It has been concluded that innovative approaches for HIV testing and
counseling programs are needed and the importance of psychosocial and cultural factors
associated with HIV testing should be emphasized in African populations.
Notes: 2 copies
Lagarde, E., Pison, G., & Enel, C. (1997). Improvement in AIDS knowledge, perceptions
and risk behaviors over a short period in a rural community of Senegal. International Journal of
STD & AIDS, 8, 681-687.
Ref ID: 73
Keywords: attitudes/community/knowledge/risk/Senegal/sexual behaviour
Abstract: The objective of this paper is to assess knowledge, perceptions and Behavioural
changes in response to AIDS in a rural community in the South of Senegal, comparing 2 cross-
sectional surveys using standardized questionnaires and performed in 1990-1992 and 1994. An
AIDS - related knowledge score was built using 4 questions about routes of HIV transmission,
ranging from 0 to 4. The score increased between the 2 surveys from 1.6 to 2.1 for men (hp=
0.006) and from 0.8 to 2.6 for women(p < 10 ). The proportion of those who responded ' I don't
256

know' to the 4 questions dealing with routes of AIDS transmission decreased from 24% to 14%
on the average for men and from 66% to 20% on the average for women. The proportion of men
who declared casual sex partners in the past 12 months decreased from 39 % to 21% (P = 0.01).
However, the proportion remained stable for women (from 15% to 18%). These results show that
despite a relatively low level of HIV infection (0.8% of all adults), AIDS-related knowledge
increased and at-risk behavior decreased in a rural area of West Africa.
Notes: 1 copy
Ref ID: 304
Lamond, N. (1996). Psychological issues and HIV/AIDS. Positive outlook, 3, 10-13.
Keywords: caregiver/conference/counsellor/psychological issues
Abstract: Who do you approach if you have a problem that is troubling you? Usually somebody
who you consider understands the various aspects of your problem and trust not to belittle you in
any way. On the other hand, if you are playing the role of true counsellor, what is your reaction
when your client prefers the assistance of an individual who is less informed than yourself so that
the situation becomes a case of the blind leading the blind? Factual options are not clearly
presented and the final choice of action may be less rational, however comforting emotionally.
This complex dilemma is well presented and documented in the literature from the XIth
conference on HIV/ AIDS held in Vancouver.
When facing any situation involving HIV/AIDS, thoughts of illness and possible death clouds a
person's insight. Counselling is a delicate balance between factual information, subjective
attainable opinions brought to the meeting place by all participants, and the effect of the emotions
aroused during the sessions. The more sensitive the issue, the more this requires careful control.
Denial and disbelief appear to further complicate the situation because some underlying problems
include: how it is possible that folk who are so vital, fit and full of life can be the carriers of a fatal
disease, how it is possible that modern scientific research fails to come up with drugs or vaccines
to cure the condition or at least prevent its spread; and why the actions of parents should be
visited on their babies? In this era of scientific discovery and technological change, values and
traditional practices no longer sustain and support the bewildered members of any populace. It is
257

not surprising therefore to find a multiplicity in approach and method when addressing the
practice called counselling.
A wealth of data highlighted so many issues at the conference. Information-giving at the
conference. Information - giving was depicted, identifying the importance of this being
appropriate to the enquirer. Information itself is, of course, not counselling, but forms a part of
what the counsellor uses. The depth of the counselling is seen as most effective when it matches
the need of the participant. The range of presenters at the conference is of interest. Professional
counsellors from various backgrounds have developed their skills in the HIV/AIDS ambit.
Religious leaders lend their spiritual emphasis to those who respond to that approach.
Admiration and humility is aroused when one reads the reports of the courage and sensitivity that
PWAs and caregivers bring, with their commitment to understand and support fellow sufferers
who are in the process of developing their own faith and hope for the days to come.
One concludes that the approach, type, depth, extent, length, and duration of counselling in the
ideal situation needs to be "custom built" and individualised, so that the atmosphere for
presentation of options is made as perfect as possible. It is clearly understood that counselling is
a vital skill that must be exercised in a wide variety of ways in order to address the epidemic, and
that the concept of counselling itself will continue to lie in the field of building self-esteem, self-
confidence and independence of spirit to enable the individual to make choices from the available
options.
Notes: 1 copy
Landis, S. E., Schoenbach V.J., & Webber, D. J. (1992). Partner notification trial shows
public health counsellors are more effective than the index HIV-infected patient in advising at risk
partners. N England Journal Med., 326, 101-106.
Ref ID: 431
Keywords: counsellor/counsellors/Department of Health/infection/male/medical/partner
notification/sex
Abstract: This study was directed at comparing two methods of notifying sex partners of subjects
infected with HIV or persons who had shared needles with them; (a) "patient referral" in which the
258

esponsibility for notifying partners was left to the patient, and (b) "provider referral", in which
trained public health counsellors attempted to notify partners. During the notification process,
counsellors always preserve the anonymity of the index patient.
In this study conducted at three large county health departments in North Carolina, 534 HIV-
positive persons were identified of whom 46% did not return for counselling after the test. Of the
162 persons invited to participate in the study 54% declined. The subjects were mostly male,
black, homosexual or bisexual and had a median age of 30 years. Thirty-nine were assigned to
the "provider referral " group and 35 to the "patient referral' group. In the "provider referral" group
78 of 157 partners (50%) were successful notified, whereas in he "patient referral" group only 10
of 153 (7%) were notified. Of the partners notified by the counsellors, 94% were not aware that
they had been exposed to HIV. Overall, 23% of the partners notifies and tested were HIV
positive.
Despite the fact that North Carolina law requires that partners be notified, patient referral is quite
ineffective. Counsellors who notify the partners of an infected patient can refer them to
educational, medical and support services target to persons at high risk for HIV infection and may
encourage the adoption of less-risky behaviour.
Notes: 1 copy
Laver, S. M. L., Van der Borne, & Kok, G. (1994). Using theory to design an intervention
for HIV/AIDS prevention in farm workers in rural Zimbabwe. International Quarterly of Community
Health Education, 15, 349-362.
Ref ID: 404
Keywords: farm workers/Zimbabwe
Abstract: A variety of primary prevention strategies are used in HIV prevention programs in Africa.
However, these are often developed through intuition and the theoretical basis for many
interventions is limited to the knowledge/attitude model. This article illustrates how research
findings from a base-line survey are combined with Paulo Freire's social change theory and the
Ecological Model for Health Promotion to develop a participatory intervention for HIV/AIDS
prevention in farm workers in Zimbabwe. The article addresses the need to focus attention on
259

the process of change at the inter-personal level, organizational and policy levels of the
community. Dialogue is central to the range of strategies proposed for the intervention. The
effect will be measured through process and outcome evaluation.
Notes: 1 copy
Leaity, S. (2000). Repeat HIV testing: high-risk behaviour or risk reduction strategy?
AIDS, 14, 547-552.
Ref ID: 403
Keywords: clinic/heterosexual/HIV-status/HIV testing/information/men/prevention/sex/sexual
behaviour/women
Abstract: Objective: To examine the characteristics of repeat and first-time HIV testers and
consider their implications for HIV testers and consider their implications for HIV test counselling.
Methods: An anonymous questionnaire was completed by nearly 1500 people seeking an HIV
test between September 1997 and July 1998 at a same-day HIV testing clinic in London, United
Kingdom. Repeat testers were those people who had previously tested HIV negative and were
returning for another test. Information was collected on self-reported unprotected penetrative sex
(UPS) in the previous 3 months and reasons for seeking the present test.
Results: Overall, 50.6% (721/1446) of all clinic attenders were repeat testers: gay men 71.%
(337/470), heterosexual men 42.1% (208/494) and heterosexual women 38.6% (186/482). No
significant differences were found between repeat and first time testers in the frequency of UPS
(p> 0.06). However, gay men ( but not heterosexual men and women) reporting three or more
previous HIV tests were significantly more likely to report higher-risk UPS (i.e. with a partner
whose HIV status was either positive or unknown) (42.2%) than those who had one-two or no
previous tests (25.3 and 25.4%, respectively; p=0.002). Over half the heterosexual men and
women, and one thirds of gay men said they were seeking the current HIV test in preparation for
a new relationship; these proportions did not differ significantly between repeat and first-time
testers (p>0.1).
Conclusion: In this London HIV testing clinic, no significant differences were found in the
frequency of UPS between repeat and first-time testers with the exception of gay men with a
260

history of three or more previous HIV tests, who reported elevated levels of high-risk sexual
behaviour. For many people, repeat HIV testing has become part of a risk reduction strategy to
establish seroconcordance with a regular partner. HIV test counselling provides the opportunity
both to address high-risk behaviour and to reinforce personal risk-reduction strategies.
Notes: 1 copy
Cape Times.
Ref ID: 8777
Legum, M. (2001). Under-funded volunteers and churches square up to AIDS horror.
Keywords: church/medical/research/women
Abstract: With the publication of the Medical Research Council report; no one can be in any doubt
about the horror of the AIDS pandemic. Nor, however can we under-estimate what is needed to
deal with it. Thousands of people on the ground is what it will need working at the level of
individuals and their attitudes to sex, to women and to the value of their own lives.
Notes: 1 copy
Independent.
Ref ID: 8467
Lemon, T. J. (2001). Care-givers the only ammunition against "this thing". The Sunday
Keywords: Cape Town/caregiver/clinic
Abstract: In the heartland of KwaZulu- Natal, AIDS patients are sent home to die as confortably
as possible. In Cape Town, patients go home from a clinic to lead an active life.
Notes: 1 copy
Lempp, H. (1995). Burnout associated with caring for people living with HIV/AIDS.
Nursing times, 91, 34-35.
Ref ID: 81
Keywords: burnout/counsellor/counsellors/guidelines/health worker/health workers/stress
Abstract: Burnout has been one of the major concerns among health professionals when caring
for people living with HIV/AIDS. Having been clinically involved with this client group in hospital
261

and community settings for over 10 years the author considers what has helped her to avoid
becoming physically and emotionally exhausted.
Notes: 1 copy
Lerole, B. (1994). Some considerations for child and youth care regarding HIV and AIDS.
Social Work practice, 1, 9-13.
Ref ID: 453
Keywords: youth
Abstract: Vigs sal toenemend alle aspekte van die menslike bestaan benadeel. Kinders word op
verskeie wyses daardeur geraak, bv Wanneer dit hulle wees laat. Inrigtingsversorging sal
waarkynlik slegs tot die beskikking van hoe risikogroepe en ernstige sick kinders wees. Multi-
professionele spanwerk sal op 'n ongekende skaal benodig word. Finansiele voorsiening aan en
bemagtiging van gemeenskapsteunstelsels soos aannemende en pleegouers is noodsaak lik.
Aspkte soos toetsing vir Vigs en konfidensialiteit is verbonde met etiese vrae. Potensiele
konflikterende standpunte sal versoen moet word. Die doel van die artikel is nie om duideline
antwoorde te gee nie, maar om die debat te bevorder rakende die kwessies wat aangeraak word.
Notes: 1 copy
Lie, G. T. & Biswalo, P. M. (1994). Perceptions of the appropriate HIV/AIDS counselor in
Arusha and Kilimanjaro regions of Tanzania: Implications for hospital counseling. AIDS care, 6,
139-151.
Ref ID: 72
Keywords: acceptability/counsellor/counsellors/culture/patient
care/research/social/Tanzania/VCT/voluntary counselling and testing
Abstract: The objective of the study is to identify key characteristics of an HIV/AIDS counselor
who would prove to be culturally acceptable for the particular problems associated with HIV/AIDS
in Arusha and Kilimanjaro, Tanzania. HIV/AIDS counseling in the hospitals is recommended by
the Tanzania Ministry of Health and by WHO. There was a need to check whether theories of
counseling, developed in Western societies, would be valid in an African context. Few research
262

eports exist on counseling in Africa. No previous studies have been conducted to identify locally
important characteristics relevant for the Tanzanian HIV/AIDS hospital counselor. A qualitative
research approach is used. Methods of data collection are interviews and focus groups. A
phenomenological and hermeutical mode of analyzing the data is utilized. In spite of differences
in the cultural context, the data fit Western theories on client-centred counseling. Informants
were more concerned with the social consequences of the disease than with the technical facts of
AIDS. Stigma and fear of rejection are seen as major problems of HIV/AIDS. The findings
indicate that confidentiality is central and that hospital counselors must balance the fact-giving
approach with a person-scented approach, exploring the client's problem conception and
identifying who in the client's problem conception and identifying who in the client's network can
give the further necessary psycho-social support.
Notes: 2 copies
Lindegger, G. (1994). Boundaries in HIV/AIDS counseling: Where does counselling end
and therapy begin? AIDS Bulletin, 3, 22-23.
Ref ID: 74
Keywords: psychology/theory/therapy
Abstract: While counseling people with various difficulties, including HIV/AIDS, the question often
arises of where counseling ends and (psycho) therapy begins. This raises the whole issue of the
distinction or boundary between counseling and psychotherapy. The answer to this question has
potentially important implications for therapeutic intervention with HIV-positive people and people
with AIDS. This article will address this question from both a theoretical perspective and in terms
of its implication to HIV/AIDS counseling. Psychotherapy. These theories would argue that even
some of the processes claimed to be distinctive of psychotherapy, e.g. transference
interpretations, occur in counseling. The lumpers might also be tempted to argue for a power -
based motive in the midst of the splitters (usually mental health professionals), with obvious
economic advantages. The lumpers would probably recognize a continuum between lay
counseling and professional psychotherapy, rather than seeing these as quite distinct processes.
Notes: 1 copy
263

Lindegger, G. & Wood, G. (1995). The AIDS crisis: review of psychological issues and
implications, with special reference to the South African situation. South African Journal of
Psychology, 25, 1-11.
Ref ID: 76
Keywords: health systems/model/psychology/South Africa/theory
Abstract: AIDS represents a major challenge to the health care industry. The Behavioural
sciences, especially psychology, have important contributions to make to various aspects of AIDS
and its prevention. This article reviews the stages in the development of AIDS, examining the
psychological issues and implications at each stage. Special attention is given to the unique
South African situation with respect to AIDS. The article concludes by examining the present
and prospective position of psychology in South Africa with respect to AIDS.
Notes: 3 copies
Organisation.
Lindsey, E. (2000). Fact Sheets on HIV/AIDS: a desktop reference. World Health
Ref Type: Unpublished Work
Ref ID: 503
Keywords: WHO
Abstract: This factsheet gives information on HIV/AIDS: the infection, the global HIV/AIDS
epidemic, continuum of care, nursing care of adults with HIV-related illness, care of HIV-infected
and affected children, HIV/AIDS:fear, stigma and isolation, counselling and HIV/AIDS, HIV
palliative and terminal care, teaching and learning about HIV/AIDS, women and HIV and mother-
to-child transmission, HIV and the workplace and Universal Precautions, strategies for prevention
of HIV.
Notes: 1 copy
Livingstone, B. J. (1989). Health workers in the frontlines of the AIDS Crisis. South
African family practice, 10, 109-116.
Ref ID: 77
264

Keywords: counsellor/counsellors/health worker/health workers/model/South Africa/theory
Abstract: The role of the health worker in AIDS education and in counseling of the AIDS victim in
South Africa is discussed. A model of counseling intervention is proposed as well as the
requirements for an effective counselor.
Notes: 1 copy
Ref ID: 182
Lockyer, I. K. (1999). HIV-positive test results. South African Medical Journal, 89, 922.
Keywords: insurance/positive status/South Africa
Abstract: To the editor: This is a short report back on the HIV testing process in the insurance
industry. This figures quoted here are a selected sample and will differ significantly from
prevalence rates in the general population of South Africa.
I was not able to obtain accurate up to date industry figures, so I used the figures of a large life
assurer, which are reflected in table 1. It must be noted that a percentage of applicants are able
to obtain cover below a certain limit with an option of an HIV test or an AIDS exclusion with a
higher premium. This may explain why the number of tests performed has decreased from 1996.
The true incidence rate is therefore probably significantly higher. An estimate for industry figures
is approximately 4% overall.
For comparative purposes a figure for the USA was quoted recently in discussion by the vice-
president of world-wide medical research and development of an international reassurance
company as being 4/ 10 000, which is approximately 50 times lower than the 1998 figure quoted
above. It must be borne in mind, however, that HIV testing in the USA is conducted at much high
levels, and this makes it difficult to draw comparisons. To provide readers with an overview of the
HIV testing process as conducted by the Life Office's Associations of South Africa, I would advise
as follows. The member companies of the LOA have conducted approximately 3.6 million HIV
tests since the institution of HIV testing as part of the underwriting process. This process has
contributed significantly to AIDS education of the general population. When viewed from this
perspective, the logistics of one-on one pre-test counselling are not practical. This is reinforced
by the fact the vast majority of insurance clients are satisfied with counselling by document. By
265

way of international comparison, counselling in other countries around the world is done
exclusively by document. The insurance industry does acknowledge that there is a small
percentage of clients who prefer one-on-one pre-test counselling. Recognising this need,the LOA
has proactively been in consultation with the Department of Health, the South African Medical
Association and other interested parties to devise a strategy to accommodate individual
preferences. All serological abnormalities emanating from the HIV consultation process are
treated sensitively, empathetically and confidentially by the industry in the ensuing
communication with the client and the doctor. The post-test counselling session is funded by the
insurance industry. At this session confirmatory testing can be performed as indicated.
Alternative financial advice and products are available to HIV-positive clients.
Notes: 1 copy
Lockyer, L. (1996). Alert to doctors - what to do when post-test counselling after an HIV
test for insurance purposes is positive. South African Medical Journal, 86, 984.
Ref ID: 302
Keywords: client/insurance/policies/policy/post-test/pre-test/response
Abstract: "The insurance industry is concerned about the lack of response by doctors to letters
written to them asking them to contact their patients for confirmatory testing and/or post-test
counselling, when the client has been refused a policy because of HIV positivity. In this situation
the industry pays the fee of one post-test counselling consultation, where the salient details can
be discussed. We appeal to our colleagues for a very pro-active stance to be taken, since this
will facilitate the containment of the AIDS epidemic.
Notes: 1 copy
London, L., Naidoo, K., Woolf, L., & Diedricks, H. (1995). AIDS prevention programmes in
the workplace. South African Medical Journal, 85, 539-540.
Ref ID: 126
Keywords: business/employee/employer/policy/prevention/workplace
Abstract: This letter to the editor outlines a study conducted on AIDS prevention activities in the
266

workplace. This pilot telephonic survey covered 50 randomly drawn companies in the
manufacturing sector. Results indicate that there is considerable scope for intensifying AIDS
prevention activities in the workplace, particularly around improved STD management and
increased worker participation.
Notes: 1 copy
Louw, D. (1990). Ministering and counselling the person with AIDS. Journal of theology
for Southern Africa., 71, 37-51.
Ref ID: 166
Keywords: church/minister/positive status/psychological reactions/psychology/religion
Abstract: In a way, AIDS can be described as a radical with radical consequences for the patient,
his family and the community. Every serious disease is usually accompanied by such emotions
as fear, anxiety, distress, depression, helplessness, hopelessness, meaninglessness and
loneliness. The difference between the AIDS-patient and other patients lies in the fact that the
emotional trauma and social crisis are more intense and far reaching. We realize at once that in
the case of serious disease ministering to a patient can be extremely difficult. The
communication crisis in the case of a cancer patient is severe. In the case of an AIDS patient an
ethical problem is also involved. Because of this connection between AIDS and ethics,
counseling the person with AIDS is much more complicated than with any other disease.
Notes: 1 copy
Louw, J., Alt, J., Soldin, R., & Hoffman, M. (1995). HIV test counselling at a tertiary
hospital. South African Medical Journal, 85, 512-514.
Ref ID: 78
Keywords: attitudes/barrier/barriers/medical/medical students/post-test/pre-test/South
Africa/training/VCT/voluntary counselling and testing
Abstract: A questionnaire was distributed to 64 of the 78 interns working at a teaching hospital in
Cape Town in August 1992 to examine their attitudes and practice in respect of HIV test
counseling. The questionnaire was completed by 61 interns. Thirteen per cent of those who
267

esponded counseled all patients, 49% counseled some patients and 38% counseled no patients.
Thirty-four per cent stated that they felt that pre-test counseling was always necessary and 57%
that post-test counseling was always necessary. The most frequently stated reasons for not
counseling patients were language barriers, time constraints, feelings of incompetence on the
part of the intern and the fact that the patient was too ill. It is recommended that standard
counseling procedures be established in each ward and formal under- and postgraduate
counseling training for medical students and interns be instituted.
Notes: 3 copies
Louw, J., Alt, J., Soldin R., & Hoffman, M. (1995). 34% of South African medical interns at
a tertiary hospital believe pre-test counseling should always be necessary. South African Medical
Journal 85, 512-514.
Ref Type: Abstract
Ref ID: 79
Keywords: barriers/medical/medical students/post-test/pre-test/research/training
Abstract: A questionnaire was distributed to 64 of the 78 interns working at a teaching hospital in
Cape Town in August 1992 to examine their attitudes and practice in respect of HIV test
counseling. The questionnaire was completed by 61 interns. Thirteen percent of those who
respondent counseled all patients, 49% counseled some patients and 38% counseled no
patients. Thirty-four percent stated that they felt that pre-test counseling was always necessary
and 57% that post-test counseling was always necessary. The most frequently stated reasons
for not counseling patients were language barriers, time constraints, feelings of incompetence on
the part of the intern and the fact that the patient was too ill. It is recommended that standard
counseling procedures be established in each ward and formal under and postgraduate
counseling training for medical students and interns be instituted.
Notes: 1 copy
Ref ID: 6996
Lund, T. (1996). Department of Health will not fund anti-Aids "cocktails". The star.
268

Keywords: drugs/government/health/infection/medical/therapy/treatment/Virus/WHO
Abstract: Minister of Health Nkosazana Zuma says the government will not consider subsidising
the new R4 000-a- month "cocktail" therapy at this stage, even though the treatment is being
lauded for curbing the Aids virus. Zuma's comment followed mounting pressure from Aids lobby
groups for the Government to pay for the treatment, which is now available in SA. Although
permission is still needed to import protease inhibitors, one of the three ingredients needed, the
Medical Control Council said the drug should be registered and freely available early next year.
But only to those who can afford it. The drugs, which have to be taken every day for life, have
given Aids sufferers new hope. They claim Zuma has a responsibility to subsidise the cocktails.
A statement from Zuma's office said:"This therapy is for people who are already infected. It is not
a vaccine and, if available would not influence the number of new infections occurring daily. In
the light of other health issues which need to be addressed, the department is not likely to
prioritise this treatment".
Notes: 1 copy
Ref ID: 6974
Lund, T. (1996). Aids sufferer's life centres on drug cocktail. The star.
Abstract: Since Allan began taking the new R4 000-a-month "cocktail" therapy for Aids three
weeks ago his life has revolved around his daily drug schedule. "I have always taken news of
new drugs and cures with a pinch of salt. But the hope that they will be effective keep one
going," said Allan who was put on a disability pension by his company when he was diagnosed
with Aids four years ago.
Notes: 1 copy
Ref ID: 7000
Lund, T. (1996). Aids groups call on Government to subsidise new therapy. The star.
Keywords: Africa/drugs/government/South Africa
Abstract: Aids lobby groups and doctors in South Africa have called for the Government to
subsidise newly available Aids"cocktail" therapies-a combination of drugs that are said to knock
269

out the virus and are having dramatic effects overseas. The drawback for South Africans is that
the "cocktails" cost R4 000 each and have to be taken once a month for life. Already 40 people
are playing this amount for the treatment. They are not subsidised. Permission to import one of
the three drugs needed for the "cocktail" is still needed from the Medical Control Council (MCC)
as it is a registered medicine. But Aids experts said getting permission takes a "few minutes" and
all ingredients would be available, to those who could afford it. In view of statistics, which show
that 700 people in South Africa are being infected with the virus everyday, Aids organisations
claim that the Government has a responsibility to make the treatment more accessible.
Notes: 1 copy
Luppi, C. G., Elufneto, J., Sabino, E., Buccheri, V., Barreto, C., & Ungaro, A. B. S. (2001).
Late diagnosis of HIV-infection in women seeking counselling and testing services in Sao-Paulo,
Brazil. AIDS Patient Care and STDs, 15, 391-397.
Ref ID: 364
Keywords: cohort/condom/condom use/counselling and testing/disease progression/Hepatitis
C/HIV testing/infection/men/sex/sex workers/women
Abstract: We investigated whether women positive for human immunodeficiency virus (HIV)
infection were late in seeking an anonymous HIV counselling and testing service, and the factors
associated with a low CD4 count, in Sao Paulo, Brazil. Seventy-one consecutive HIV-1-
seropositive women were interviewed by means of a structured questionnaire. Blood samples
were collected for CD4 (+) T-lymphocytes count and determination of HIV-1 subtypes. Hepatitisc,
syphillis, human T-cell lymphotrophic virus type 1 (HTLV-1), and HTLV-11 infections were
assessed by serologic tests. More than ;70% of the women had less than 500 CD4 (+) cells/mm
(3) (20% below 200). Low CD4 count was significantly associated with sex work history, condom
use in the last 6 months, and seropositivity to HTLV-1 and syphillis. There are no relation
between low CD4 count and HIV-1 subtypes. These results indicate that in Sao Paulo many
women are seeking an anonymous testing service late in the course of HIV infection. The main
purposes of anonymous HIV testing services early diagnosis of infection, and counselling to
prevent infection - are not being achieved. Another strategy for reducing the internal between
270

infection and diagnosis in women must be addressed.
Notes: 1 copy
Lwihula G., Dahlgren, L., & Killewo, J. (1993). AIDS epidemic in Kagera region, Tanzania
- the experiences of local people. AIDS care, 5, 347-357.
Ref ID: 436
Keywords: community/government/HIV
transmission/infection/intervention/male/men/response/risk
behaviour/Tanzania/transmission/women
Abstract: The study is part of a collaborative study of HIV infection and AIDS which was launched
in 1987 in the Kagera region, Tanzania. This region is characterized as one of the areas most
affected by the AIDS epidemic. In order to describe and analyse the epidemiology of HIV
infection in the area and also to contribute to the intervention process, a long-term population-
based project was initiated. The study was launched in January 1989 as an in-depth behavioral
study to describe the people's attitudes, perceptions, responses and norms relevant to AIDS-
related problems. The data were collected through tape recorded interviews, focus group
discussions and direct observations of risk behaviour. The interviews were conducted in 10
villages, in urban and rural Bukoba as well as in Muleba districts. In each village five households
were selected and visited once a week for 6 months. The focus group discussions were held
mainly with young males, females, married women and married men, elders and religious
leaders, government and party leaders, and other key informants. Perceptions, attitudes and
patterns of behaviour among the local people are described in the context of HIV transmission in
the people perceive and interpret AIDS? How do they react to AIDS? How do they judge causes
and risks? What are the attitudes to people with AIDS and those suspected to have AIDS? What
are the implications of these values in affected communities
Notes: 1 copy
5, 12.
Maartens, G. (1996). Prolonged HIV infection without disease progression. AIDS Bulletin,
271

Ref ID: 93
Keywords: disease/disease progression/positive status
Abstract: In the initial phase of the HIV epidemic patients were identified because they were
already sick. These patients either had full-blown AIDS or developed it within a few years.
Relentless deterioration of their immune system occurred with frequent opportunistic infections
and tumours. AIDS was fatal finally cases with the average time to death being approximately
one year. As the epidemic unfolded, however, the true spectrum of HIV infection became known.
It is now apparent that there is a small group of HIV-infected patients who do not show disease
progression despite being infected for a long time. They account for 5 to 10% of all HIV-infected
patients.
Notes: 1 copy
The Citizen.
Ref ID: 1109
Mabuza, K. (2000). HIV attack points to murder: Needle jab charge may be changed.
Abstract: An attempted murder charge opened by police against a woman who allegedly jabbed a
12 - year -old girl with a needle could be withdrawn and new charge of assault opened, should
medical tests fail to prove any trace of HIV on the substance. This stage until the results are
released we are treating this case as an attempted murder, because we believe the action goes
beyond stabbing but, should results prove otherwise, an assault case would be opened, said
Johannesburg Superintendent Chris Wilken.
Notes: 1 copy
Machael, K. (1999). Best practices: A review of company activity on HIV/AIDS in South
Africa. AIDS Analysis Africa, 10, 5-6.
Ref ID: 165
Keywords: business/company/review/South Africa/workplace
Abstract: It is currently estimated that 11% of the South African workforce is infected with HIV and
0.6 are sick with AIDS. The future of South African business and labor looks worrying in the light
272

of the AIDS epidemic. The impact on business in South Africa will be substantial, not only in
terms of the loss of productive labor but also the potential cost implications as AIDS affects the
workforce. As the epidemic progresses, growing numbers of employees will take sick leave.
Companies may also observe sharp increases in mortality rates. Those companies with inhouse
primary medical care facilities will face higher medical costs, and other may have to pay
increased contribution to medical aid schemes. Life insurance will also be hit by a sharp rise in
the number of AIDS-related deaths.
Machekano, R., Mcfarland, W., Mbizvo, M. T., Bassett, M. T., Katzenstein, D., & Latif, A.
S. (1998). Impact of HIV counseling testing on HIV seroconversion and reported STD incidence
among male factory workers in Harare, Zimbabwe. Central African Journal of Medicine, 44, 98-
101.
Ref ID: 168
Keywords: efficacy/employee/factory workers/male/seroconversion/VCT/voluntary counselling
and testing/Zimbabwe
Abstract: Objective: To assess the impact of HIV counseling and testing on HIV seroconversion
and incidence of reported sexually transmitted diseases (STDs) among male factory works in
Harare, Zimbabwe. Design: Prospective, observational study among men recruited to
participate in a future workplace based AIDS prevention intervention. Methods: Participants
provided STD histories and blood for HIV antibody testing at enrollment and six month intervals
during visits to factories. Participants received HIV test results, post test counseling, and free
STD services at the project clinic. Results: Between March 1993 and June 1995, 2414 men
were enrolled with 85% follow up. Overall HIV sero-incidence was 2.60 per 100 person- years;
the incidence of reported STDs was 10.19 per 100 person-years. Men who obtained their HIV
test results had significantly higher HIV sero- incidence and incidence of reported STDs
compared to men who did not obtain their results ( IRRs: 1.87, 3.47, respectively). Among men
who obtained test results compared to before obtaining HIV test result (p=0.18). The incidence of
reported STDs, however, increased by 30% after obtaining HIV test results (p=0.10).
Conclusion: Decreased HIV sero- incidence in the face of increased reported STD incidence
273

suggests that timely treatments of STDs may decrease the risk of acquiring HIV even in the
absence of behavior change. In population with high rates of HIV and STDs, the greatest benefit
of HIV counseling and testing may be achieved by simultaneously offering STD screening and
treatment services.
Notes: 1 copy
Madott, A. (1990). Living with aids: Counselling needs (immune Deficiency).
Ref Type: Unpublished Work
Ref ID: 8785
Abstract: What are the counselling needs of individuals directly affected by the AIDS epidemic?
This study is of the opinion that individuals directly affected by this phenomenon are the best
suited to outline the aspects of their experience that could enhance understanding of the
counselling needs. The overall goal of the study was to gain understanding of the needs and
process experienced by individuals affected by the epidemic as a way of establishing counselling
needs. Five major themes emerges - the need to talk, stigma, fatigue, death and dying and
service needed.
Notes: University of Alberta (Canada)
Magongo, B., Magwaza, S., Mathambo, V., & Makhanya, N. (2002). VCT sites
assessment in South Africa.
Ref Type: Unpublished Work
Ref ID: 8791
Keywords: VCT/South Africa/Africa/WHO/quality of care/care/HIV-status/clinic
Abstract: Key questions of assessment are sites ready and prepared to offer VCT service? Who
uses VCT service? What are views on quality of care of VCT service? What are challenges of
delivering and organising the VCT service? What are the long term plans and how these
reconcile with the current status of VCT service. Outcome of study - Many people want to know
their HIV status. There is no clinic that does not need VCT in this country. Rural areas are
274

neglected with no facilities. Strategically located VCT is the pillar for all HIV/Aids programmes in
the country.
press.
Ref ID: 4545
Makharamedzha, P. (1998). I don't know if I can cure AIDS, says traditional healer. City
Keywords: doctor/traditional healer
Abstract: Well known traditional healer Dr Sosobala Mbatha is not sure whether he can treat
AIDS, he told City Press this week - amid claims that 158 medical doctors have testified to his
ability to cure the dreaded disease. Speaking from his home in Nquthu, Mbatha said:" I have a
big problem with medical doctors. "When people who have AIDS come to me with test results
showing they are HIV positive, I treat them. "When they return to medical doctors to be retested,
they are harassed and told that a traditional healer can't cure Aids. Doctors refuse to release
results showing that a patient's test results showing that a patient's test results have changed to
HIV negative". Mbatha claims medical doctors refuse to release negative results because
they"want to hide the fact that I can cure AIDS". He claims doctors are against him because they
want to become the first to cure the disease.
Notes: 1 copy
Makhubele, B. & Pronky, P. M. (2000). The introduction of Rapid HIV Testing at the
Primary Health Care Level in Rural South Africa- will the system cope? In (pp. 34).
Ref ID: 254
Keywords: Africa/evaluation/health/rapid HIV testing/HIV testing/infection/prevention/South
Africa/training/voluntary counselling and testing
Abstract: Issues: South Africa remains in the phase of exponential increase in the rate of HIV
infection. The vast majority of those infected with the virus remain unaware of their status.
Improved access to voluntary Counselling and Testing (VCT) services has been identified by the
National Department of Health as an important prevention and control strategy. However, access
to VCT remains limited. Testing remains hospital based and reserved for those presenting in late
275

stage of disease. Counselling services are often poor and queues who present for testing never
follow-up for results.
Description: The Agincourt sub-district of South Africa's rural Northern Province is the site of a
National HIV/TB pilot initiative. A baseline assessment of existing HIV services was carried out.
All health workers in the sub-district underwent training in the provision of VCT services, including
the use of rapid HIV testing. A subsequent quantitative evaluation of testing services was
performed. Additional focus group discussions and semi-structured interviews with health
workers.
Conclusions: This paper will present the initial results of an impact assessment on the
effectiveness of introducing VCT services at the PHC level. In particular, it will explore the
process of introducing these services in an historically marginalised rural area where pre-existing
infrastructure is poor, baseline HIV services under developed, and testing unavailable to most.
Its focus will be on determining the health sector impact, and the perceptions of health workers
within the pilot site on the advantages and constraints of more widely integrating VCT within a
core package of PHC services.
Maman, S., Mbwambo, J., Hogan, M., Kilonzo, G., Sweat, M., & Weiss, E. (2001). HIV
and partner violence.
Ref Type: Unpublished Work
Ref ID: 8798
Keywords: voluntary counselling and testing/VCT/clients/client/women/HIV
testing/disclosure/WHO/communication/counsellors/counsellor/partner
notification/community/research
Abstract: An important component of HIV voluntary counselling and testing VCT programs is
encouraging clients to inform partners of their serostatus. Findings of this study revealed that
many women lack autonomy to make decisions about HIV testing. Disclosure to partners by HIV-
positive women has increased over time but is still significantly less than that for HIV negative
women. Parner violence is a serious problem among female VCT clients. A small proportion of
women who disclosed their serostatus to partners reported a negative reaction. Women's HOIV
276

status is strongly associated with partner violence. Recommendations were to encourage couple
communication about HIV/AIDS and HIV testing when promoting VCT. To train HIV counsellors to
ask questions about partner violence and to encourage disclosure when appropriate. To ensure
that clients are the ones to make decisions about partner notification of test results.Instute
community based efforts to address sexuality and violence should be introduced. Further
research on HIV and violence should be conducted.
Maman, S., Mbwambo, J., Hogan, M., Kilonzo, G., & Sweat, M. (2001). Women's barriers
to HIV - 1 testing and disclosure: Challenges for HIV-1 voluntary counselling and testing. AIDS
care, 13, 595-603.
Ref ID: 172
Keywords: barrier/couple/couples/disclosure/positive status/prevention/Tanzania/VCT/voluntary
counselling and testing/women
Abstract: In view of the ever - increasing HIV/AIDS epidemic in Sub-Saharan Africa, the
expansion of HIV-1 voluntary counseling and testing (VCT) as an integral part of prevention
strategies and medical research is both a reality and an urgent need. As the availability of HIV-1
VCT grows two limitations need to be addressed, namely: low rates of HIV-1 serostatus
disclosure to sexual partners and negative outcomes of serostatus disclosure. Results from a
study among men, women and couples at an HIV - 1 VCT clinic in Dar es Salaam, Tanzania are
presented. The individual, relational and environmental factors that influence the decision to test
for HIV-1 and to share test results with partners are described. The most salient to HIV-1 testing
and serostatus disclosure described by women include fear of partners' reaction, decision-making
and communication patterns between partners, and partners' attitudes towards HIV-1 testing.
Perception of personal risk for HIV - 1 is the major factor driving women to overcome barriers to
HIV - 1 testing. The implications of findings for the promotion of HIV-1 programmes, the
implementation of partner notification policies and the development of post-test support services
are discussed.
Notes: 1 copy
277

Mankazana (1999). Pre-test counseling for HIV - short and friendly please. South African
Medical Journal, 89, 11.
Ref ID: 84
Keywords: guidelines/model/pre-test/VCT/voluntary counselling and testing
Abstract: This paper just gives the comments concerning the article which highlights the key
areas regarding an insurance medical examination. He goes on to express the difficulties felt
with the document on " New HIV test pre-counseling document.
Notes: 1 copy
450.
Ref ID: 188
Mankazana, M. (2000). HIV-positive test results. South African Medical Journal, 90, 449-
Keywords: education/insurance/positive status
Abstract: To the editor: The letter by I K Lockyer on HIV-positive test results reveals an
enormous number of points of contact between member companies of the Life Offices'
Association and the clients they serve. Contact of this magnitude could potentially present
important opportunities for education our people on HIV and AIDS. A figure of 3.6 million HIV
tests (clients tests and not episodic tests) accompanied by verifiable AIDS education would put
the insurance companies in the forefront as far as sensitising the public to the dangers of AIDS/
HIV.
I would be happy if the author could provide some validation of his claim that' this process has
contributed significantly to AIDS education of the general population". Given that the LOA self
pre-test counselling leaflet is not reader-friendly, is he referring to such a leaflet providing
relevant health information or facilitating appropriate attitudinal/Behavioural change? He
continues with another challenging statement, that '.....the vast majority of insurance clients are
satisfied with counselling by document". How was this ascertained? One hopes that there is
objective, unbiased information to back these claims. If not, there will be another missed
opportunity to sensitise the public to AIDS/ HIV.
I would also like to add that unexpected HIV seropositivity could be a severe 'loss' to a client,
278

creating a sense of bewilderment which should usually require more than 'the post -test
counselling session' which is all the insurance company feels obliged to finance. My experience
in counselling patients who are told for the first time that they are HIV- positive is that their
immediate need is mainly psychological support, and that they usually require more than one
counselling session to regain control of themselves. Only later will they feel the need for, and be
able to take advantage of, financial advice.
Notes: 1 copy
Cape Town.
Ref ID: 243
Mapekula, L. R. (1996). Psychosocial explanations in HIV/AIDS counselling. University of
Keywords: Cape Town/culture/health/HIV/AIDS counselling/research/training/transmission
Abstract: This research aims to explore people's explanations of the aetiology, transmission and
course of Human Immuno- Deficiency Virus (HIV) and Acquired Immuno- Deficiency Syndrome
(AIDS). It investigates the extent to which explanations of HIV/AIDS are shared or differ between
African health workers who offer counselling and their African clients who are affected with
HIV/AIDS.
The primary hypothesis is that HIV counselling and training enculturates people within a particular
view of illness which may not be shared by their clients. People's explanations of HIV/AIDS will
be based on theoretical frameworks with the view that the explanations of illness are largely,
culturally construed. These frameworks, which consider the role of culture, will reflect the
effectiveness of the counselling process. The analysis will help exploring people's understanding
of HIV/AIDS but will also explore how this understanding related to the counselling objectives.
The study was undertaken to investigate explanations in HIV/AIDS counselling of the participants
from the Cape Town area. It elicits the explanation models of illness of two sets of participants,
those who had received training in counselling and the clients, who had received HIV/AIDS
279

counselling and were diagnosed with HIV/AIDS.
Notes: 1 copy
Ref ID: 4372
Marry, M. (1999). Give us this day our daily Meds. Newsweek..
Keywords: Africa/South Africa
Abstract: With AIDS at crisis proportions, South Africa passed on controversial law meant to give
its people access to expensive therapies. Drugmakers, backed by the United States, say it
threatens their patents and won't work anyway.
Notes: 1 copy
Martin-Herz, S. P., Katzenstein, D., Shetty, A. K., Mhazo, M., Ley, C., Machekano, R. et
al. (2000). Predictors of acceptance of HIV testing and counselling by pregnant women in
Zimbabwe. In (pp. 1).
Ref ID: 257
Keywords: benefits/clinic/HIV
testing/infection/intervention/prevention/research/transmission/women/Zimbabwe
Abstract: Purpose: To evaluate predictors of acceptance of HIV counselling and testing (HCT)
by pregnant women in Zimbabwe.
Methods: 186 pregnant women( age = 24+5 yrs ) attending an antenatal clinic in Chitungwiza,
Zimbabwe participated. All were offered free HCT. A standardized questionnaire was
administered in Shona by a bilingual research assistant. The questionnaire investigated
sociodemographics, beliefs about risks and benefits of HCT, and perceived risk of HIV infection.
Composite risk and benefit scores were calculated bay summation of items endorsed. Highest
possible scores were 35 and 24.
Results: The mean rating for likelihood of HIV infection was 3.2 (1- infected, 5 -not infected).
Average risk and benefit scores were 18+ 6 and 17+4, respectively, and a significant negative
correlation existed (r =-.29,p>.001). 43 women(23%) consented to HCT. 16 (37%) were HIV
positive. Logistic regression revealed composite risk scores (B = -.09, p>.005) and stillbirth/death
280

of a child (B = 1.15, p>.002) as significant predictors of consent to HCT. Women who saw HIV
testing as high risk (risk scores >mean) were less likely to be tested (OR = .37, 95 % CI.19-.72).
Women who had a still birth or child die were twice as likely to perceived risk of being HIV
positive (U = 1952, p>.05). Benefits associated with HCT, perceived risk of being HIV positive,
and personal risk behaviors were not significant predictors.
Conclusion: Only 23% of women consented to HCT. Although women endorsed multiple
benefits, perceived risks associated with HCT and knowing one's HIV serostatus appear to
outweigh benefits for most. Women who had a stillbirth die perceived their risk of being HIV
positive as higher and were presumably motivated to receive HCT by the potential benefit to AZT
intervention studies. Interventions to increase voluntary HCT are imperative for the progress of
perinatal transmission prevention.
Notes: 1 copy
Marum, E., Barnaba, A., Rayfield, M., Campbell, C., Dillon, B., Fridlund, C. et al. (2000).
Whole blood rapid HIV tests and same day counselling results in Malawi. In (pp. 1). Durban.
Ref ID: 219
Keywords: client/clients/counsellor/counsellors/evaluation/on-site/on-site testing/rapid
tests/VCT/WHO
Abstract: Background:The Malawi AIDS Counselling and Resource Organisation(MACRO) has
been providing Voluntary Counselling and testing(VCT) since 1992, and now operates centres in
Malawi's two largest cities, Lilongwe and Blantyre. A standard counselling protocol involving a
discouraging wait for two weeks for results has been used, approximate 25% of clients do not
receive their results. Methods: In late 1999, a total of 175 blood samples were tested at Queen
Elizabeth Central Hospital in Blantyre using both the standard hospital algorithm of two ELISA
tests( Behring and Vironistika) and for evaluation purposes, who rapid tests( Determine and
HemaStrip). Western Blot tests were also conducted on all samples. On January 20, 2000,
MACRO began an evaluation of on-site testing using Determine and HemaStrip, and the
provision of "same day results" following a revised counselling protocol. All lab technicians and
counsellors were trained to conduct rapid whole blood tests and provide same day results.
281

Results: Preliminary results indicate a 100% rate of concordance between central lab results
and the on-site rapid test results using a two-test algorithm. Clients stated that they were more
likely to believe the results as they actually saw their own test performed, and many clients began
turning up at the centres specifically requesting same day results. Counsellors report a high rate
of satisfaction with this approach. Conclusions: A combination of two rapid tests is feasible to
conduct in a counselling centre and gives excellent rates of sensitivity and specificity. Fingerprick
samples simplify procedures for handling and disposal of blood samples, and since counsellors
can be trained to perform these tests, this service can be provided at sites which do not have
laboratories. Adoption of these methods will make provision of VCT in Malawi more accessible to
rural sites and more acceptable to clients.
Notes: 1 copy
Ref ID: 7085
Maseko, S. (1999). Modern sangoma tackles AIDS: Woman to woman. City press.
Keywords: traditional healer/traditional healers
Abstract: Nana Makhanya had learnt to live with the apparent contradictions in her life and
accepts that she is a subject of fascination to many. When she is expected to turn up at meetings
in goat skin and beaded outfit. When she conducts workshops with traditional healers she uses
both prayer and impepho to open the proceedings. And instead of a bag of divining bones as a
constant companion, you are likely to find her with files under her arm or behind a computer
punching in reports, recommendations and other information of interest to the department
gleaned from her workshops. "Most people expect to see a traditional healer as a person who is
dirty, covered in animal skins, hiding out in the bush, bundu or forest. But they are also
urbanites. I don't know how people see us," she says. For Makhanya, stradding life with one foot
in the world of ancestors and spirits and another in the formal world of institutions, meetings,
presentations and reports has been the norm for the better part of her life.
Notes: 1 copy
282

Mashu, A., Mbizvo, M. T., Makura, E., Bopoto, R., Madzime, S., Chipato, T. et al. (1997).
Evaluation of rapid on-site clinic HIV test, combined with counselling. AIDS, 11, 932-933.
Ref ID: 323
Keywords: clinic/Developing
countries/evaluation/health/infection/intervention/prevention/treatment
Abstract: It is essential to have rapid, cost-effective assay methods to detect HIV, particularly in
some developing countries where sophisticated equipment is not readily available. Early on-site
serodiagnosis of HIV infection should be possible at the peripheral of the health-care system
where it may be an advantage to enable patients to make informed decisions and health workers
to decide on early prophylactic treatment and management strategies. This would also facilitate
on-site counselling where relevant and benefit studies on epidemiological patterns and prevention
interventions.
Common screening tests for HIV are enzyme-linked immunosorbent assays (ElISAs) which are
suitable for batch testing of large numbers of specimens, but impractical for field conditions in
some developing countries. They are time consuming (2-24 h), require access to running water,
electricity, and entail the purchase and maintenance of sophisticated equipment. These tests
may not be suitable or cost-effective for laboratories handling relatively small numbers of
specimens.
Notes: 1 copy
Ref ID: 303
Matenga, E. (1996). AIDS experiences in Zimbabwe. Counselling, -, 4.
Keywords: education/health/prevention/Zimbabwe
Abstract: The first AIDS cases in Zimbabwe were identified and reported in 1985. A variety of
surveillance and control measures were instituted the same year. These measures were not
formally coordinated. The main activity in this regard was the screening of blood used for blood
transfusion.
In August 1987 the Ministry of Health formulated a short term plan for the prevention and control
of HIV and AIDS. The plan focused on health education; development of donated blood
283

screening facilities at BTS laboratory. Some of the objectives of the short term Plan were not
realised due to constraints such as inadequate resources and the poor organisation of the STD
control Programmes.
The cumulative number of cases reported had risen from 119 in 1987 to 1 632 by end of
December 1989.
Male to female ratio of 1.1 to 1 indicates heterosexual transmission. 22,5% of cases reported in
1989 were children less than 5 years old indicated vertical transmission during pregnancy.
BTS laboratory has been screening donated blood for HIV since 1985. The prevalence of HIV
infection among blood donors has risen from 2, 34% in 1986 to 5,18% in 1989.
Notes: 1 copy
Ref ID: 6154
Mathiane, N. (1999). Positive test " death sentence". Business day.
Keywords: care/confidentiality/disease/employee/information/medical/myth/quality of
life/therapy/treatment/Virus/WHO/workplace
Abstract: Testing HIV-positive is no longer a death sentence. There is medication available
which, if prescribed and taken early on, will extend the duration and the quality of life.
Demystifying myths and fallacies about HIV and about the effects of AIDS, LifeSense Disease
Management MD Andre van Bassen said it was important the disease was diagnosed early
because if one waited too long, then the immune system could be damaged by the HIV virus.
LifeSense Disease Management is part of the LifeSense Group which covers all aspects of
healthcare, including human resources, legal consulting and actuarial, to providing management
services for big and small compaines. It deals particularly with the treatment of people who have
tested HIV - positive and who are members of medical schemes or employees of a company
contracted to the LifeSense Group. The programme has 13 specialists doctors, a team of clinical
consultants and has 1,2 million people in its database, of which about 2 000 infected people are
receiving treatment. Of those there have been seven deaths and 16 admissions to hospital. The
treatment looks at the patient's CD4 cell count and overall viral load as well as nutritional,
exercise and long-term care needs. The programme, Van Bassen said, was designed to help
284

keep people at work and out of hospital. He said the programme was monitored and
confidentiality of paramount importance. There were myths that the disease was a death
sentence and that the available medical treatment was unffordable. "HIV is today managed with
antiretroviral therapy- and if it is addressed correctly, it no longer had to mean debilitation..."Van
Bassen said. LifeSense Disease Management will be targeting schools, employees and their
employees to inform them about their product as well as their rights as workers and as medical
aid scheme members. This includes information such as the fact that people with HIV/AIDS may
not be discriminated against in the workplace, and that they are protected by the constitution and
the Labour Relations Act from arbitrary and unfair discrimination.
Notes: 1 copy
Ref ID: 5909
Mathiane, N. (2000). Sangoco seeks strategies to fight poverty. Business day.
Keywords: conference/employment/government/policies/Sangoco
Abstract: The SA National Nongovernmental Organisation Coalition ( Sangoco) is meeting in
Durban to map out strategies to build its capacity to fight poverty. The three day conference
launched was to look at ways to transforming the economic situation of SA to benefit the poor in
light of the failure of the state to deliver on its promises. It was said that government's growth,
employment and redistribution strategy ( Gear) had failed to alleviate poverty. Instead it
perpetuated the racial dimensions of the past and was geared towards the interest of national and
international business. The State has abdicated its social and developmental responsibility
towards the poor and is more interested in creating an environment for investors. The critical
issue facing Sangoco was to organise itself to respond to challenges that include the
nondevelopmental character of the state, as well as the results of government's privatisati on
policies.
Notes: 1 copy
Matovu, J., Nakabiito, C., Kintu, K., Byogero, R., Mwebaza, D., Musoke, P. et al. (2000).
The impact of HIV post-test club in the postnatal clinic in Mulago hospital -Kampala. In (pp. 1).
285

Ref ID: 258
Keywords: behaviour
change/clinic/communication/condom/condoms/counsellor/counsellors/couples/education/health/
health education/negotiation/post-test/pregnancy/prevention/strategy/transmission/voluntary
counselling and testing/WHO/women
Abstract: Background: Through general observation made by counsellors some women who
were positive became pregnant even after knowing their results. Many HIV positive women were
exposed to domestic violence after disclosing their sero status to their husbands/partners and this
resulted into broken marriages/homes.
Objectives: Formation of post-test club was to involve and encourage husbands of HIV+ women
get voluntary counselling and testing as a strategy to improve communication between women
and their husbands/ partners, reduce broken marriages /homes, promote behaviour change and
positive living.
Methods: More than 1000 pregnant women were given health education, counselled and tested
for HIV. Positive women were enrolled in perinatal trials. Emphasis was put on prevention of
transmission, positive women were empowered with negotiation and communication in an
attempt to bring husbands/partners for voluntary counselling and testing. Free distribution of
condoms was also carried out.
Results: Beginning of 1998 we started with two couples. Due to intensive health education,
counselling and home visiting in post test club, we perceived more husbands responding to
voluntary counselling and testing. By 1999 we had twenty one couples in the post test club.
Conclusion: Combined effort of the counsellors, healthy visitors, HIV infected women and their
husbands/ partners in the post test club has helped to reduce subsequent pregnancies, breakage
of marriages, and has enhanced behaviour change.
Notes: 1 copy
Matovu, S., Ekideit, A., Chimulwa, T. N., & Sendi, E. K. (2000). AIDS counselling as a
strategy to prevention of HIV vertical transmission. In (pp. 36).
Ref ID: 256
286

Keywords: clinic/condom/condoms/infection/post-test/prevention/sexual
behaviour/transmission/vertical transmission/women
Abstract: Background: Statistics indicate that unless preventive measures are taken, 15-20% of
the HIV positive women who become pregnant are expected to give birth to an HIV infected child,
thereby increasing the number of HIV positive children.
Methods: A group of 60 anonymous mothers who were attending the antenatal clinic in old
Mulago were recruited on study for a period of six months with the main objective of risk of HIV
infection and the means of preventing vertical HIV transmission and, to promote responsible
sexual behaviour of all mothers. The mothers were exposed to HIV counselling, each time they
reported to the clinic.
Results: After a period of 4 months, all mothers had taken the HIV test and a total of 19 mothers
were HIV positive while 41 mothers were HIV negative post test counselling and follow up studies
were continuously done. At the end of the six months 11 HIV positive mothers had decided to
use condoms to prevent further spread of HIV, 8 mothers (HIV positive) were undecided out of
the 41 HIV negative mothers 11 opted for abstinence, and 27 opted for condom use till their
partners accepted to take HIV tests. The remaining 3 mothers were undecided.
Conclusion: AIDS counselling to mothers attending the antenatal clinic helped to curb the
transmission of HIV from mother to child by promoting positive sexual behaviours and increasing
the mothers HIV risk perception.
Notes: 1 copy
Mattson, M. & Roberts, F. (2001). Overcoming Truth Telling as an obstacle to Initiating
Safer Sex - clients and health Practitioners planning Deception During HIV Test Counselling.
Health communication, 13, 343-362.
Ref ID: 360
Keywords: clients/communication/failure/health/infection/information/partner notification/positive
status/prevention/disclosure/sex
Abstract: This article considers how deception, as a strategy for handling delicate interpersonal
situations, is raised and responded to during HIV pretest as potential obstacles to initiating safer
287

sex practices with long-term relational partners (because reinitiating safer sex with such partners
would entail admission of the extrarelational encounters). Close analysis of spoken interaction
reveals that CLS display their resistance to initiating safer sex by animating, through hypothetical
dialogue, their long-term partners' requests for explanation of the disruption in their usual intimate
behaviors, health practitioners attempt to overcome this obstacle of "truth telling" by suggesting
deception in its place. This study extends current understandings of the formulation and planning
of deceptive messages in the course of actual health promotion interactions. The implications of
this investigation suggest that deception may pose a viable, albeit controversial, option when
promoting disease prevention behaviours, especially in delicate interpersonal interactions such as
not wanting to admit an extrarelational affair.
Notes: 1 copy
Matyu and ECN, J. (2001). "People living with AIDS need tender care, love". Eastern
Province Herald.
Ref ID: 7781
Keywords: babies/care/church/community/conference/government/NGO/parents
Abstract: More than 500 000 people in the Eastern Cape are living with HIV/AIDS, metro
councillor Melvin Manentsa said yesterday. An estimated 10 500 babies were born with AIDS in
the province last year. Mr Manentsa was speaking at the veeplaas community Centre yesterday
during the visit of the Social Development Minister Dr Zola Skweyiya on the final leg of a two-day
Eastern Cape Tour to promote community sensitivity to people living with HIV/AIDS. Dr Skweyiya
urged the community to show the, support, solidarity and care to those people- especially children
- living with AIDS as they were voters and SA citizens.
"We should give them love, protection, assistance, educate them to ensure that they grow in a
more friendly environment and keep them in our families", he said.
Dr Skweyiya said he visited the house of Resurrection, an AIDS haven, in Salsoneville and was
amazed by the wonderful work the "mothers" were doing there.
He said the stated had to assist foster parents caring for these orphans, adding that the delivery
of social services needed to be accelerated urgently to assist them. Addressing a Conference for
288

the Aged in Grahamstown last night, Dr Skweyiya said he was considering withdrawing pension
pay-outs contracts to private companies following reports that the companies were cheating the
elderly. He also strongly criticised local and provincial governments for their "tediousness" and
reluctance to use NGOs and church organisations for service delivery
Notes: 1 copy
Ref ID: 2702
Mbanjwa, S. (2001). Unfilled posts impede AIDS centre's work. Natal Witness.
Keywords: clinic/health/medical/training
Abstract: AIDS Training Information and Counselling Centre (ATICC) staff have expressed
concerns over four senior posts which have been left vacant since September; 1999, which they
say has increased their workload.
The position are the manager the training and counselling officer and an outreach officer, while a
post for a senior clerk has not been filled since ATICC began operations. Fikisiwe Madlopa was
employed as a manager and she is now with the Department of Welfare, with Heidi Van Rooyen
was a training and counselling officer who, according to staff, left the organisation for personal
reasons. The other post was vacated by Elathea Mkhize whose reasons for resignation are not
clear. Speaking on condition of anonymity, staff at the clinic said they have raised some
concerns with the city's medical officer of health Julie Dyer and provincial Head of the HIV/STD
Directorate wonder Mthembu. They said they were promised that the problem would be attended
to. This was confirmed by Dyer, who said her department was about to advertise the posts in
May or June last year but was stopped by the provincial department of Local Government and
Traditional Affairs, which froze the posts.
Notes: 1 copy
Ref ID: 5529
Mbete, T. (1999). Ancient art of healing could help in fight against Aids. Sunday World.
Keywords: Africa/care/conference/health/medical/medicine/Zambia
Abstract: Traditional medicine should form an important and substantial part of the war arsenal to
289

fight the Aids epidemic in Africa. This appeal was made by Dr Roland Msisika, the chief
technical advisor on HIV/AIDS to the United Nations Development Programme, at the 11th
International Conference on Aids in Lusaka, Zambia. Although he was trained in the West
Msisika said the mission to find an Aids cure should not be the prerogative of the western
scientific medical fraternity. "Traditional medicine represents the largest indigenous resource
base for caring for the people of Africa. It is the oldest art of healing on this continent and is
therefore integrated in the socio-cultural and religious world views of many of our people," said
Msisika. Like other facets of life, traditional medicine had not remained static, in that it tended to
selectively assimilate some aspects of western medicine, and Western medicine had been
hierarchical- not equal. In the view of many within the health care system , biomedicine was
rational and objective - therefore "superior" - whereas traditional medicine was considered a
collection of superstitutious and irrational beliefs, he said to loud applause from the delegates.
This stereotype should be challenges as it could be standing in the way of progress which could
be achieved through marrying Western and traditional ways of curing.
Notes: 1 copy
McCarthy G.A. (1992). Women-only STD and HIV clinics encourage better use and
compliance. Genitourin Medicine 68, 386-389.
Ref Type: Abstract
Ref ID: 7B
Keywords: barriers/clinic/gender/women
Abstract: A special women-only clinic, operating as an evening clinic because of the difficulty of
excluding men from the community waiting room during the day, was evaluated after a 7 month
period. All the staff in the clinic are women. Compliance and use of clinic was seen to improve in
women-only as opposed to mixed gender settings.
Notes: 1 copy
McCoy, D. (1995). Appropriate HIV Testing and Counseling: Making the best use of limits
resources. AIDS Scan, 7, 3.
290

Ref ID: 85
Keywords: barrier/barriers/resource/resources/South Africa
Abstract: This paper discusses the issues of counseling and HIV testing in a rural South African
setting. The opinions in this paper come from experience in a rural health district of the former
Kwa Zulu in South Africa.
Notes: 1 copy
Ref ID: 1900
McGibbon, C. (2001). The herb of life. Independent on Saturday.
Keywords: clinic/conference/government/medical/research/traditional healer
Abstract: The country's top traditional healer has challenged the state's research council to test a
new herbal tablet which appears to improve the quality of life of people with AIDS. Globally -
respected healer and visionary Dr Credo Mutwa is shocked that the State research council is
dragging its heels in testing a new herbal tablet made from an indigenous plant. The tablet,
made from Sutherlandia frutescens sub species microphylla has helped people attending an
AIDS clinic in Empangeni to regain lost weight and renew their energy. But the state body, the
Medical Research Council, has declined to test the tablet. Said Mutwa: "The government seems
to be paralysed in the face to this ultimate horror: " At the World AIDS conference in Durban last
year our aim was to show the world this amazing herb. It needs to be cultivated on a international
scale. It works. How , we don't know , but work it does. Mutwa said the plant had been used by
healers since before Shaka.
Notes: 1 copy
3, 14-15.
Ref ID: 305
McIntosh, E. (1999). HIV testing: the confessional of the 90s. African Sexology Journal,
Keywords: confidentiality/education/HIV testing/HIV transmission/infection
Abstract: The increase in awareness and education around the issue of HIV transmission and
infection has led to more people being aware of the risks they take when indulging in unprotected
291

sexual activities. We have become aware of a group of clients who present for HIV testing
following an incident of extramarital sex, contact with a sex worker or homosexual contact in a
man who presents to the world as being heterosexual.
Anonymity vs confidentiality - often clients won't go to their own doctor because they feel the
doctor knows the rest of his family and the information will be not confidential. The SAIMDC
describes a doctor's duty to keep information confidential:" (no practitioner may) divulge verbally
or in writing any information which ought not to be divulged regarding the ailments of a patient
except with the express consent of the patient or in the case of a minor, with the express consent
of the guardian, or in the case of a deceased patient, with the consent of the next of kin or
executor of his estate." Despite the guarantee of confidentiality that this clause offers, it is cases
such as the McGeary case (where the patient's HIV status was disclosed by his doctor to a
dentist on the golf course) that cause patients to doubt the reality of this confidentiality.
Notes: 1 copy
Ref ID: 86
McKay, A. (1993). Safer Sex and Gender Identity. Critical Health, 44, 67-72.
Keywords: barrier/barriers/gender/men/sexual behaviour/women
Abstract: The paper talks about the understanding of gender. The common comments are that if
AIDS educators are to really address the problem of safer sex, they need to know more about
gender and the practice of safer sex. He also identifies the issues such as factors influencing
safer sex, safer sex and communication, sexuality and education. And finally he looks at home
based care issue, whether it is viable, the community's role, the clinical and social advantages of
home based care.
Notes: 1 copy
Mckenna, S., Muyinda, G. K., Roth, D., Mwali, M., Nga'ndu, N., Myrick, A. et al. (1997).
Rapid HIV testing and counselling for voluntary testing centers in Africa. AIDS, 11, s103-s110.
Ref ID: 176
Keywords: Africa/attitudes/clients/couples/perceptions/prevalence/prevention/VCT/voluntary
292

counselling and testing/Zambia
Abstract: Objective: Voluntary HIV testing and counselling (VCT) has been shown to reduce the
incidence of HIV in cohabiting couples who now represent the majority of new infections in many
African cities. Community and client perceptions of a 1-day voluntary testing and counselling
program in Lusaka, Zambia, were assessed, and a rapid HIV-testing algorithm was evaluated for
VTC centres. Methods and design: Between May 1995 and June 1996, outreach workers
distributed written invitations door to door. The day 1-day program was held 6 days/week
including weekends. Transport, child care and lunch were provided. Community and client
surveys followed in July 1996. Results: Over 3500 couples married for a median of 4-5 years
requested testing: 23% were HIV+/+, 57% were HIV-/- and 20% were discordant with one HIV+
and one HIV -partner. Sixty-eight per cent of couples surveyed had made the decision to be
tested before attending the 1-day programme and 80% had not previously known where to obtain
HIV testing. Knowledge that couples could show discordant results rose from 29 before to 88%
after pretest counseling. Clients reported high levels of satisfaction with the services and 90%
out of 99( 92%) preferred to receive their results the same day. Clients at another center who
waited 10 dates for their results reported more fear, and 19 out of 31 (61%) would have preferred
to get their results the same day. Over 99% of those who attended the program thought active
promotion of voluntary HIV testing in the community was a positive thing, as did 90% of those
who were invited but did not attend. Sensitivity and specificity of the rapid test algorithm were
both 99.4% in this setting. Conclusion: Active promotion of voluntary HIV testing and
counselling in couple is needed to reduce the spread of HIV in high-prevalence areas. The use of
rapid, on-the HIV testing allows clients to receive result-specific counseling in a single visit.
Ongoing quality control of a subset of samples at an outside laboratory is essential.
Notes: 1 copy
Mckinnon, K., Cournos, F., & Herman, R. (2002). HIV among people with chronic mental-
illness. Psychiatric quarterly, 73, 17-31.
Ref ID: 359
Abstract: Rates or HIV infection, STDs, and sexual and drug-use risk behaviors are high among
293

people with severe mental illness. Clinicians often are in the best position to connect psychiatric
patients to the particular HIV-related services they need. These may include prevention
interventions, risk assessment, antibody test counselling, and medical care. This review article
describes the AIDS epidemic and its underpinnings in this population in an effort to help clinicians
to recognize when their patients are at risk for acquiring or transmitting the virus and to intervene
appropriately and effectively with an array of relevant services. The importance of training to
enhance clinicians' skills and comfort in delivering these services is emphasized. The lives and
well-being of psychiatric patients are threatened by the AIDS epidemic, and there is much
clinicians can do to minimize the devastating impact of HIV and AIDS on clients in hospitals,
clinics, and other psychiatric treatment settings.
Notes: 1 copy
Medical Research Council, KwaZulu Department of Health, & Department of National
Health and Population Development (1991). Results of first population-based HIV prevalence
study in South Africa released. In (pp. 10-11).
Ref ID: 6B
Keywords: Department of Health/epidemiology/KwaZulu-Natal/research/seroprevalence/South
Africa
Reprint: Not in File
Abstract: This conference paper presented at the Epidemiology Congress in Cape Town, July
1991, presents the results of an HIV/AIDS seroprevalence study undertaken by the Medical
Research council in conjunction with Kwa-Zulu Department of Health and the Department of
National Health and population Development. HIV is seen to be more common in areas close to
industrialised centres as compared to rural centres, in women when compared to men and
among individuals with greater mobility. Further research and targetted interventions for these
focal areas is recommended.
Notes: 1 copy
294

Medscheme. (2002). Aid for Aids Overview 2001.
Ref Type: Unpublished Work
Ref ID: 8817
Keywords: medical/disease/education/awareness/knowledge
Abstract: What are the implications of the HIV/AIDS epidemic? A large amount of people are
unaware that they are infected. There will be a dramatic increase in morbidity and mortality
among the economically active members of our society.This article looks at the current situation
related to HIV and medical Scheme act. It recommends a disease management programme as
the best way of managing HIV/AIDS. Clinical assistance in this programme is essential.
Knowledge, Attitudes and Practices surveys, education and awareness programmes are some of
the elements of this model
Merson, M. H., Dayton, J. M., & O'reilly, K. (2000). Effectiveness of HIV prevention
interventions in developing countries. AIDS, 14, S68-S84.
Ref ID: 275
Keywords: Developing countries/VCT/voluntary counselling and testing
Abstract: Objective: To review the effectiveness of projects and programs in developing countries
that aim to reduce sexual transmission of HIV infection or transmission of HIV infection or
transmission related to injection drug use.
Design: We identified 34 published studies undertaken in 18 developing countries that met
rigorous inclusion criteria. These criteria included the length of follow-up, use of statistical
analysis, the inclusion of a comparison group, and type of outcomes measured.
Results: we found that behavioral change interventions are effective when targeted to populations
at high risk, particularly female sex workers and their clients. Few studies have evaluated harm
reduction interventions in injecting drug users(IDUs). Evidence on the effectiveness of voluntary
counselling and testing programs was promising. Treatment of sexually transmitted diseases
(STD) appears highly effective in reducing HIV/STD transmission, particularly in the earlier stages
of the epidemic.
Conclusions: This review demonstrates that HIV prevention interventions can be effective in
295

changing risk behaviors and preventing transmission in low and middle-income countries. When
the appropriate mix of interventions is applied, they can lead to significant reductions in the
prevalence of HIV at the national level. Additional research is needed to identify effective
interventions, particularly in men who have sex with men, youth, IDUs and HIV-infected persons.
Structural and environmental interventions show great promise, although more evaluation is
needed.
Notes: 1 copy
Meursing, K. (1999). Barriers to sexual behavior change after an HIV diagnosis in sub-
Saharan Africa. In Resistances to Behavioural change to Reduce HIV/AIDS infection (pp. 35-39).
Melbourne.
Ref ID: 161
Keywords: barriers/behaviour change/Sub-Saharan Africa
Abstract: This longitudinal, in-depth study of sexual behavioral of 96 HIV-positive individuals in a
Sub-Saharan country where HIV is heavily stigmatized, showed that even with counseling and
free condoms, most people with HIV did not succeed in maintaining long-term, consistent condom
use. Their condom use depended on fluctuations in their health status, and the anticipated or
actual reaction of their social environment. People with HIV encountered the same barriers to
safer sex as the community in general: women's lack of sexual decision-making power; men's
dislike of condoms; denial of HIV, especially in men; and child-wish. In addition, HIV-positive
people who did not disclose their HIV status feared that proposing to use condoms would raise
partner's suspicions, and lead to social rejection and stigma. Results suggestthat
HIV testing
and counseling programs will not achieve prevention of secondary HIV spread when they are
preceded and supported by strong measures promoting acceptance and openness with regard to
HIV.
Notes: 1 copy
Meursing, K. & Sibindi, F. (2000). HIV Counselling - a luxury or necessity? Health Policy
and Planning, 15, 17-23.
296

Ref ID: 332
Keywords: community/condom/condoms/Developing countries/guidelines/health/HIV-status/HIV
prevention/HIV testing/infection/intervention/policies/post-test/pre-and post-test
counselling/prevention/qualitative research/research/UNAIDS/Zimbabwe
Abstract: Who and UNAIDS have consistently promoted HIV counselling as a routine part of HIV
testing in developing countries. Nevertheless, in many countries counselling is not considered a
crucial accompaniment of testing services, and patients are tested without access to counselling
during and after testing. Thus, information on the need for and results of counselling in needed to
convince policy-makers and service managers to give greater priority to the development of
counselling services.
This qualitative study describes informational, social and emotional needs and problems of newly
diagnosed seropositive patients attending public health services in Zimbabwe. Their basic factual
information on HIV/AIDS was reasonable, but may patients equaled HIV to AIDS and
conceptualized their infection as "social and physical death". This seriously impeded their
capacity to use knowledge of their test results in a constructive way, and stimulates coping by
denial and/or secrecy about their HIV status. These avoidant coping strategies discouraged
clients from using condoms, seeking social support and taking measures to protect their
vulnerable health.
The complex and changing nature of client's needs indicates that common short -cuts in
counselling (e.g. giving brief information before and after the HIV test) are seriously flawed as a
strategy to prepare clients for effective coping. Comprehensive pre-and post-test counselling are
an essential preparation for coping effectively during immediately after testing. Availability of
supportive counselling beyond this first phase is essential to assist clients with needs and
problems which will appear over time. Development of counselling interventions should be
guided by research into their effectiveness and by national policy guidelines. Replacing fear-
inducing HIV campaigns with interactive, constructive information about HIV prevention and care
will increase the preparedness of the community as a whole for effective living with HIV.
Notes: 1 copy
297

Mhazo, M., Moyo, S., Von Lievin, A., Maponga, C., & Bassett, M. T. (2000). HIV
counselling and testing amongst antenatal women using lay community volunteers: Experience
from urban Zimbabwe. In (pp. 14).
Ref ID: 233
Keywords: church/communication/confidentiality/family/health/medical/pre-
test/response/training/transmission/women/Zimbabwe
Abstract: Issues: Lower cost anti - retroviral regimens may make feasible government
programmes for reduction of mother to child HIV transmission in poor countries, but expansion of
HIV counselling and testing poses a substantial challenge. Use of community lay volunteers may
offer an alternative to creation of a new professional cadre that may health systems cannot afford.
Can lay volunteers offer reliable, confidential, quality services?
Description: Volunteers were recruited from church groups, the Red Cross and PLHIV/AIDS
support groups in Chitungwiza, a working class urban area. All counsellors were >25 years,
literate in English and committed to 4 hours counselling per week plus weekly Friday staff
meetings. Incentives included a uniform and badge and $ US 20 monthly stipend. A two week
course reviewed AIDS facts, systemic counselling approach and practical counselling techniques
using scripts and role play. Local politicians officiated at a pledging of confidentiality ceremony.
19 of 20 completed training. Over six months they were present for 146 hours/week with only 6
hours missed. A total of 247 clients have been pre-test counselled , 171 counselled for test
results, 40 more than once.
Discussion: Counsellors maintained a high professional standard of promptness and
confidentiality. They handled challenging family situations (examples will be given) and most
often requested medical facts, not counselling advice, to answer client questions. Weekly
supervision with professional counsellors was essential to quality and morale. Counsellors noted
improved communication at home. Use of lay counsellors appears effective, low cost and may
contribute to the community response to the epidemic
Notes: 1 copy
298

Miles, L. (1992). Women, AIDS, power and heterosexual negotiation: A discourse.
AGENDA, 15, 14-27.
Ref ID: 87
Keywords: discourse/gender/sexual behaviour/South Africa/women
Abstract: Gender, power and sexuality are intimately connected with one another, sexuality is one
of the main areas in which gender inequality is manifested in our society. How does this
inequality affect how women negotiate safer sex in a time of the AIDS epidemic? What happens
if a woman asks a new ( or established) lover to use a condom or practice non- penetrative sex?
How do women feel about making these requests? How much space is there in heterosexual
relationships -short or long-term- to negotiate safer sex? These questions were the basis of an
exploratory study I completed in 1991 at the University of Cape Town. This qualitative study set
out to examine how the social construction of sexuality, AIDS, and discourses of sexuality and
gender, impact on practices of safer sex. The study was done within a feminist poststructuralist
framework.
Notes: 1 copy
Miles, M. (2000). Therapy frequently asked questions.
Ref Type: Unpublished Work
Ref ID: 513
Keywords: information/therapy/WHO
Abstract: So many people have asked me questions about therapy that I decided to write this
therapy FAQ. Its purpose is to help people who are not in therapy but would like to try it out. I
want to emphasize the fact that this is a document that is subject to change and revision, and
might not be hundred percent accurate. Due to the fact this is written from the position of a
person who has been in therapy for people considering therapy, it is only meant to focus on
information relevant to the therapist/client relationship. My FAQ is based on my experience and
thus it does and will always differ from the opinions and emphasis that other information about
therapy have.
Notes: 1 copy
299

Miller, K., Donegan, E., Curran, P., Shelley, T. J., & The Transfusion Safety Study Group
(1990). Effects of counselling on knowledge about HIV-1 among transfusion recipients and their
partners. AIDS care, 2, 155-163.
Ref ID: 90
Keywords: couples/knowledge/negative status/positive status/prevention/transfusion
recipients/transmission/VCT/voluntary counselling and testing
Abstract: The present study determined how much HIV-1- positive persons knew about AIDS,
and HIV-1 transmission and prevention, in comparison with HIV-1- negative controls in a
predominantly heterosexual control cohort. The subjects were blood donors, blood recipients,
hemophiliacs, and their sexual partners. A 16-item questionnaire about AIDS, HIV-1
transmission, and knowledge of safe sexual practices was administered to 228 subjects to
determine background information. The HIV-1- positive cohort answered more questions
correctly( mean=8.5) than did the HIV-1- negative cohort (mean=6.5), largely as a result of
general information about AIDS among HIV-1 transmission and safe sexual practices. Thus,
there is a great need for effective counselling.
Notes: 1 copy
68, 9-10.
Miller, R. & Bor, R. (1992). Pre-HIV antibody testing too much fuss? Genitourin Medicine
Ref Type: Abstract
Ref ID: 7A
Keywords: medical/pre-test/United Kingdom
Abstract: This article proposes that the time has come to consider the place and purpose of pre-
test counselling, particularly in the face of the increasing demand and need for HIV test.
Increasing test levels and knowledge of HIV in the patient community should mean that HIV
testing can take its place with other tests and procedures routinely performed by doctors.
Specialist counsellors for postive patients is still advocated.
Notes: 1 copy
300

Miller, R., Bor, H., Salt, H., & Murray, D. (1991). Counselling patients with HIV infection
about laboratory tests with predictive values. AIDS care, 3, 159-164.
Ref ID: 562
Keywords: antibody/care/communication/disease/disease
progression/health/infection/medical/treatment
Abstract: Laboratory tests, including CD4, p24 antigen, raised levels of B2 microglobulin,
neopterin and CMV antibodies, have been established as important predictive markers of disease
progression in patients with HIV infection. As HIV antibody testing becomes more accepted in
medical practice, counselling about these laboratory predictors of progression can help patients
and doctors plan together the patients' care and treatment. Addressing patients' main concerns
at each stage of investigation and illness may help them to plan ahead of crises, reduce stress,
and enhance communication between patients and health care providers.
Notes: 1 copy
9-10.
Ref ID: 306
Miller, R. & Bor, R. (1992). Pre-HIV antibody testing too much fuss? Genitourin Med, 68,
Abstract: This editorial from a prominent AIDS counselling Unit in the United Kingdom argues that
it is timely to reconsider the place and purpose of pre-test counselling, particularly in the face of
the increasing demand and need for HIV testing.
While acknowledging that little research has been done on the ideal circumstances and process
for pre-HIV test counselling, the article points out that increasing test levels and knowledge about
HIV in the patient community should result in HIV-testing taking its normal place with other tests
and procedures that doctors in their daily practice discuss with their patients. Pre-HIV test
discussion should form part of this consultation and differential diagnosis process and not be
divorced from routine medical care.
The article points out however, that special provision must still be made for specialist counsellors
to help with HIV positive patients. All doctors who feel they are not able to provide adequate pre-
test discussion due to lack of facilities or skills, should refer patients to a professional colleague
301

such as a specialist counsellor.
The author suggest three levels of information giving and counselling practice. At one level, there
are some patients in particular settings where it may be sufficient to provide brief face-to-face
discussion, accompanied by printed material or videotape recordings giving information about the
test and what follow-up is available. On a second level more detailed discussion is required
through taking a medical history to establish a risk or making a provisional diagnosis prior to
testing.
The third level of pre-test counselling is where even more detailed, time-consuming discussion is
indicated in order to obtain informed consent as part of the diagnosis process. An example of this
is when a HIV diagnosis is likely, but general fear and anxiety impedes the patient's decision-
making or testing is refused. Consulting or referring the patient to a specialist counsellor may be
necessary. With these three levels of pre-test counselling, and the back-up of expert colleagues,
the emphasis could then focus on establishing whether or not a person wishes to be tested and if
he or she is sufficiently prepared and informed for the result.
Brief counselling approaches can be developed. New approaches to HIV pre-test counselling
and the effect they have on decisions about testing will have to be subjected to rigorous
assessment. No one can yet claim that one approach or style is better than another. As people
who receive treatment live longer professional counsellors will find increasing pressure to work
with those living with HIV disease, their contacts and family. A lengthened lifespan does not
necessarily decrease personal distress or anxiety about the future, and some patients may feel
more inclined to take risks that could lead to HIV transmission.
Notes: 1 copy
infection. In.
Ref ID: 6C
Miller, S. (1991). Developing comprehensive medical care systems for people with HIV
Keywords: guidelines/health systems/patient care/policy
Abstract: This paper was presented at an HIV/AIDS Care and Support Workshop by Dr Steve
Miller on the 26th of July 1991. This paper makes an urgent call for an out-patient model of care
302

for HIV infected patients suffering from early clinical events to more severe disease and those
with AIDS in order to minimise hospitalisation in dedicated HIV- in -patient units.
Miller, S. & Rees, H. (1992). Investigation and management of HIV infection in the
primary care setting. CME, 10, 621-632.
Ref ID: 91
Keywords: guidelines/health/physician/post-test/pre-test/primary health care/South Africa
Abstract: The first case of AIDS was diagnosed in South Africa in 1982. Until recently the
monitoring and clinical care of HIV-infected persons was done in hospitals, and more especially in
tertiary care hospitals, and more especially in tertiary care hospitals. With the number of HIV-
infected people 100000 and 1 million people, the burden of clinical care will soon shift from the
hospitals to the primary care setting. As is the case with any other illness, patients with HIV
infection will present first to primary care physicians, and it is they who will be requesting initial
HIV testing. They will be the clinicians responsible for the ongoing monitoring of the disease,
and will take decisions about when to introduce drug therapy. At present many primary health
care (PHC) clinicians have never tested for, diagnosed or cared for patients with HIV infection.
They feel inadequate and scared to face the task of managing HIV-positive patients. This article
aims to give HPC clinicians the information they need to take on this challenge, which will
inevitably become their responsibility, with confidence.
Notes: 3 copies
Ministry of Health. (2002). Voluntary counselling and testing business plan 2002/3.
Ref Type: Unpublished Work
Ref ID: 536
Keywords: Africa/care/counselling and testing/government/health/medical/primary health
care/South Africa/transmission/treatment/VCT/voluntary counselling and testing
Abstract: HIV/AIDS is a major public health concern in South Africa, which has one of the fastest
growing epidemics in the world. The mission of the HIV/AIDS/STI programme of the Department
of Health is to reduce the transmission of HIV and other STI and provide appropriate treatment,
303

care and support for those infected and affected, through collaborative efforts within all levels of
government, using the National HIV/AIDS Strategic plan as the terms of reference.
There has been limited access to voluntary counselling and testing services in the Eastern Cape
Province. Currently there are eight VCT sites, six medical and two non-medicals. In the East
London District there is a PMTCT pilot programme as well as the TB/HIV pilot programme where
VCT is being offered by the surrounding primary health care facilities. Rietvlei Hospital is also a
PMTCT site in the Umzimkulu area which is a rural site.
Notes: 1 copy
Ref ID: 2993
Misbach, W. (2000). Govt still says no to AIDS drugs. Sowetan.
Keywords: clinic/drugs/government/health/women
Abstract: The Government will not provide expensive anti-AIDS drugs in public hospitals because
the cost was too high and has promised to continue its fight against pharmaceutical companies to
provide cheaper medicines to the public, Health Minister Manto Tshabalala-Msimang said
yesterday. The minister also promised to expand services for women needing abortions, but did
not respond specifically to recent reports that health workers were refusing on moral grounds, to
provide this service in almost half of the country's registered abortion clinics and hospitals.
Notes: 1 copy
Mkaya-Mwamburi, D. M., Qwana, E., Williams, B., & Lurie, M. (2000). HIV status in South
Africa: Who wants to know and why? In (pp. 6).
Ref ID: 225
Keywords: Africa/HIV prevalence/HIV testing/Informed consent/post-test/pre-test/response/South
Africa/voluntary counselling and testing
Abstract: Background: Voluntary Counselling and Testing (VCT) is gaining prominence in South
Africa as an important strategy to help raise awareness about and combat the spread of
HIV/AIDS. This study aims to determine the proportions of people who wanted and those who
did not want to know their HIV results and HIV prevalence among these two groups.
304

Methods: Participants in an ongoing cohort study on the role of migration in the spread of
HIV/STD are offered and encouraged to test for HIV. After informed consent is obtained and pre-
test counselling counselling done participants are tested for HIV by Quick Test and all positives
confirmed by double ELISA. At 10-day follow-up those who wanted their results are post-test
counselled and their results given. In a separate biomedical and social survey of 2,500 people in
Carletonville participants were offered free test but were not actively encouraged to get tested.
These participants could not be counselled because of the size of the sample, they were however
promised an anonymous test with full counselling.
Results: Of 343 participants recruited to date in the cohort study, significantly more participants
320( 67.1%) wanted to know their HIV results than did not 113(32.9%). 43(18.7%) of those who
wanted their results were HIV positive as compared to 29(25.7%) of those who did not. Of those
who participated in the survey in Carltonville, nobody out of sample of 2500 people asked for an
HIV test.
Conclusions: A significant number of people who were part of the cohort study did want to know
their HIV status while no-one who participated in the survey wanted to know their status. It is
clear that peoples response to offers of HIV testing depend strongly on the circumstances in
which the offer is made and the time that is spent explaining to people exactly what this entails.
This study raises important issues of VCT.
Notes: 1 copy
Mkhize, N. (1991). Is the western model of counselling appropriate to the South African
cultural and socio-economic context? AIDS Bulletin, 3, 9-10.
Ref ID: 89
Keywords: culture/model/psychology
Abstract: This article covers the issue of cross-cultural counselling. The author therefore begins
by defining culture. A brief overview of 'relevance' is followed by an examina tion of counselling
assumptions, client expectations, and 'world-view'. Psychological universals are seen to be
coloured by the client's meaning system, and it is important to understand such systems. The
305

author concluded with suggestions towards enhancing counselling appropriateness.
Notes: 1 copy
Mkhize, N. (2000). Is the Western model of counselling appropriate to the South African
cultural and socio-economic context? International/Africa Focus., -, 9-10.
Ref ID: 307
Keywords: Cross-cultural counselling/culture
Abstract: Essentially, the topic pertains to cross-cultural counselling. I therefore begin by defining
culture. A brief overview of "relevance" is followed by an examination of counselling
assumptions, client expectations, and "world-view". Psychological universals are seen to be
coloured by the client's meaning system, and it is important to understand such systems. I
conclude with suggestions towards enhancing counselling appropriateness.
Notes: 1 copy
Ref ID: 2050
Mkhize, P. (2001). Traditional African ways help patients. Sowetan Sunday World.
Keywords: benefits/community
Abstract: Maggie Ramaota has been counselling HIV-positive people for 15 years, she has about
500 patients including Busi Mkhwanazi. A traditional healer, aromatherapist and AIDS
counsellor, she fuses all three disciplines to treat her patients with HIV and AIDS. She does not
claim to cure AIDS, but says her treatment is of great benefits to there patients. "I have had a lot
of consultations with people with HIV-AIDS and because there were no support structures in Kwa
Thema I decided to form one. I also decided to train as an AIDS counsellor and joined the AIDS
consortium to provide a service that is so desperately needed by the community, especially the
youth," said Ramaota. First sessions are often difficult. "The patients come to me very stressed
and depressed. It is even more difficult if they have not spoken to anyone about their status "
Ramaota usually starts with counselling. " The counselling session is followed by a long oil
massage. This relaxes the patient and reduces depression . Some patients open up after the
massage. Once they are relaxed they are able to discuss their fears detail. Ramaota says she
306

gives patients traditional medicine to take home to strengthen the immune system. The
medecine is a mixture of a herbs the grows in her garden, but Ramaota will not disclose the
exact ingredients, saying pharmaceutical companies rip off traditional African remedies.
Ramaota has treated Mkhwanazi since she was mine. "Sometimes I feel tired and my bones
ache but after taking Maggie's treatment I feel better Mkhwanazi said.
Ref ID: 2051
Mkhize, P. (2001). Busi defies worst odds to tell it like it is. Sowetan Sunday World.
Keywords: counsellor/traditional healer
Abstract: The article is all about the testimony of Busi Mkhwanazi who is considered to be a
symbol of hope to many young people. She was diagnosed with the deadly AIDS virus as a nine-
year-old. 11 years ago, Mkwanazi, is a picture of health though she has never taken any of the
anti-retroviral drugs that offer a life-line to many AIDS sufferers. And this hope came from the
traditional healer and counsellor from Kwa Thema, Ramaota who has been treating the young
girl.
Notes: 1 copy
Ref ID: 531
Mkhulise, B. A. (2001). Women staying away from AIDS testing at Edendale. Echo.
Keywords: mother-to-child transmission/MTCT/rapid testing/transmission/women
Abstract: Trials to test the effectiveness of the anti-retroviral drug Nevirapine in preventing
mother-to-child transmission (MTCT) of the HI-virus have hit a snag at Edendale hospital with
pregnant women reportedly shying away from being tested.
Gynaecology and Obstetrics department matron Thembekile Mvemve told Echo this week that
they are worried about the low number of pregnant women coming testing.
" Since the MTCT pilot project began in June, 379 pregnant women have agreed to come for
counselling but 255 were unwilling to undergo the testing, saying they needed time to think about
it but they have never come back" she said. Mvemve said that some women are afraid to know
their status. She said another problem could be a lack of publicity about the programme and as a
307

esult, many women do not know about its existence at the hospital. Provincial HIV/AIDS Action
Unit spokesman Chris Mokolatsie acknowledged that while in other testing areas there's been a
50 to 100% turn-out, at Edendale the percentage is very low with a reluctance by pregnant
women to undergo the test. "We are aware that there's a problem at the hospital but have not yet
identified it. Edendale is the only place where people are refusing to go for the test. "Our co-
ordinator is to visit Edendale Hospital to observe the process so that we can find out exactly what
is causing this reluctance," he said. Mvemve assured women that the whole process is strictly
confidential and people are counselled individually. She said they do rapid testing which allows a
person to know their status in 15 minutes. She said pregnant women testing positive are given a
pill which they take home and must swallow when they feel the onset of labour pains.
Notes: 1 copy
Ref ID: 532
Mkhulise, B. M. (2001). First Aids centre for Estcourt. Echo.
Keywords: care/clinic/counselling and testing/government/health/infection/mother-to-child
transmission/prevention/symptom/transmission/treatment/VCT/voluntary counselling and
testing/women
Abstract: As part of a programme to increase the number of AIDS prevention and care centres,
the Provincial HIV/AIDS Action Unit (Paau) launched the first voluntary counselling and testing
(VCT) centre in Estcourt on Tuesday. The move is aimed at encouraging people to come forward
for testing in order for the government to better manage the pandemic. Pregnant women will be
given anti-retroviral treatment at the time at labour in order to prevent mother-to-child
transmission of the HIV.
Paau spokesman Chris Mokolatsie said the launch of the clinic in Estcourt has brought to 12 the
number of sites in the province that offer full counselling and testing services. "The Estcourt
centre is the first of eight sites identified for the second phase," he said. The other sites include
the Child Survival Project in Bergville, Umzinto Clinic, Hlabisa Hospital, Valley Trust in Botha's
Hill, Sibongile Township Administration offices in Dundee, Newcastle Centre, and Demonia Road
Clinic in Vryheid.
308

Mokolatsie said VCT has been shown to contribute significantly to the reduction of risky
behaviour and destigmatisation of HIV/AIDS.
He said VCT sites are intended to be the first entry point for prevention and care where signs and
symptoms of opportunistic infections can be recognised and treated early to prevent mother-to-
child transmission.
The VCT services sites established during the first phase are Tugela Ferry-Church of Scotland,
Empangeni AIDS Centre, Phaphamani Clinic in Ezakheni, Thokozani Clinic-Enseleni, Pongola
Health Centre, Enduduzweni Drop in Centre-Groutville, prince Mshiyeni Hospital-Umlazi,
KwaMashu Poli-clinic and Benedictine Hospital in Nongoma. The Estcourt opening was part of
Paau's activities ahead of World AIDS Day celebrations which in the province will culminate in a
concert at Ezakheni Stadium in Ladysmith in December.
Notes: 1 copy
Modiba, P., Gilson, L., & Schneider, H. (2002). South African Health Review 2001.
Ref Type: Unpublished Work
Ref ID: 8816
Keywords: health/confidentiality/pre-test/failure/WHO/care/post-test/clinic/treatment/drugs
Abstract: HIV positive people may seek repeated tests in the hope that they were previously
incorrect. Although not universal amongst all HIV positive users, several experienced being
tested without consent, broken confidentiality with test results being revealed to others, poor pre-
test counselling, and failure of providers to inform users about test results. Those HIV positive
users who were satisfied with their initial experience of care, hinted that the quality post-test
counselling was a key factor. Godd counselling enabled them to come to terms with their
diagnosis and to overcome denial. Care was seen as positive when it was experienced as being
of good technical quality, and was accompanied by a positive provider attitude, courtesy and
confidentiality. By and large positive perceptions were linked to dedicated HIV clinics rather that
general clinics. Common negative experiences of care in general clinics were victimisation of HIV
positive users, callous treatment from Health providers, poor confidentiality, overcrowding, long
309

waiting times, limited hours of service and shortage of drugs.
Notes: Chapter 10 - Voices of Service Users
Moeketsi, N. X. (2000). An evaluation of the Esselen street community AIDS centres:
HIV/AIDS counselling training programme. Dissertation, University of Witwatersand.
Ref ID: 207
Keywords: community/evaluation/HIV/AIDS counselling/training
Abstract: This study is an evaluation of the two weeks HIV/AIDS counselling training programme
offered by the Esselen Street Community AIDS Centre(Johannesburg ATICC). This was a
response to the looming threat against ATICCs. The core function of JHB ATICC has been the
provision of counselling to people coming for the HIV antibody testing, and the training of
HIV/AIDS counsellors. This evaluation sought to determine the extent to which the goals and the
intended objectives of the course were being met. It was a search for responses to the
questions: does the HIV counselling training course equip trainee counsellors with knowledge
about HIV/AIDS counselling which results in attitudinal changes around HIV/AIDS, and does it
provide them with the necessary skills to provide HIV/AIDS counselling? Linney and
Wandersman's (1991) four steps prevention plus III" model was adapted for use in the current
study. The study is both quantitative and qualitative in nature. An non-experimental design
[quantitative KABV study] was used because of its appropriateness in conducting any type of
evaluation where outcome and causality questions are not critical. Secondly, a descriptive
research investigation method was used. This enabled the researcher to describe what
transpired during the training course. The study is qualitative because it draws more on the
trainees' opinions and evaluation of the training course, puts an emphasis on understanding why
people think and behave as they do. Quantitative and qualitative techniques were employed in
the collection and analysis of data( e.g. structured questionnaires and in-depth interview). Eleven
of the twelve trainee counsellors, and the course's facilitators who are employes of the JHB
ATICC participated in the study. The greatest limitation of this study has been the researcher's
inability to monitor the sequence of events during the course of the training course, resulting in a
strong reliance on questionnaires and one-to-one interview. This situation could have been
310

enhanced by the use of the participant observation technique. The study also lacked a clear
method for measuring the transfer of knowledge and skills. It relied solely on the trainees'
perceptions. Despite these limitations, the results of this study indicate that the training course
has fulfilled its stated objectives. Both trainees and facilitators have expressed satisfaction with
the training programme. Compared to the available body of literature on training courses, the
JHB ATICC's training programme seem to rate favourably. Whilst the real and ultimate impact of
the training programme, its immediate impacts has been evidenced by the wide usage among
ATICCs of the JHB ATICC's training programme. The first impact will be fully realized by
recognizing the crucial role counselling plays in the dealing with the AIDS epidemic. It therefore
goes without saying that more training opportunities should be created for people aspiring to
become HIV/AIDS counsellors. The results of this study can provide policy- makers and funding
sources with information which can result in the strengthening of the ATICC as envisaged by the
HIV/AIDS activists.
Notes: 1 copy
Ref ID: 4513
Mokoena M. (2000). Healers need more. City press.
Keywords: clinic/counsellor/traditional healer/traditional healers
Abstract: AMID claims they can cure HIV/AIDS, traditional healers still need to know all the
realities about the disease and to embark on awareness campaigns. This was said by traditional
healer Anna Tsotetsi during the presentation of certificates to 20 young people who were trained
as HIV/AIDS counsellors at Refengkgotos near Vereeniging. The function was hosted by the
Fadimela HIV/AIDS project. Tsotetsi said it was time for traditional healers healers to start
attending HIV/AIDS project. Tsotetsi said it was time for traditional healers to start attending
HIV/AIDS workshops, where they would get all the necessary knowledge about the epidemic.
"Many traditional healers still don't understand the importance of holding workshops and
seminars with HIV/AIDS organisations and even local clinics. "They think by doing that they will
be sacrificing their supernatural powers and revealing their secrets. There should be a working
311

elationship between us and local clinics" she said.
Notes: 1 copy
Ref ID: 3138
Mokoena, M (2001). Traditional healer works wonders with HIV/AIDS patients. City press.
Keywords: traditional healers
Abstract: HIV/AIDS victims who where hopeless after many consultations to the doctors, testify of
feeling better, getting stronger and gaining weight after having a treatment from the traditional
healers.
Notes: 1 copy
Ref ID: 1176
Molaken S. (2001). Church gathers to empower people. Sowetan.
Keywords: Africa/church/family/men/South Africa
Abstract: The young men's Guild of the Methodist Church of South Africa has announced ways of
economically empowering communities and counselling people living with HIV. The decisions
were taken last weekend at the 31st convention of the guild held at Zola township in Soweto. The
four-day gathering started last Thursday ended on Sunday. Families in Zola provided
accommodation for the 1993 delegates who came from areas around Johannesburg and from as
far afield as Lichtenburg and Vryburg in North West. The delegates spent the days at the
convention held in a marquee. At night, they retired to beds in the homes of the neighboring
hosts. "It' fellowship and sharing our life experiences, " says Tshidiso Sibi, president of the
central district. Such gregariousness underpins the church's motto of 'One heart, One way". It
also extends to the deliberations held at the convention where utilisation of land, job creation and
self-development were discussed. "People have land so we will identify experts to help them,"
said Sibi. "we will train counsellors for people living with HIV-AIDS and their families". The
gathering was punctuated by the passionate singing that characterises sessions of the Methodist
church sessions.
Notes: 1 copy
312

No 5, 3, 12-13.
Ref ID: 88
Moloantoa, C. (1991). The AIDS pandemic: A challenge to the Christian community. Inter
Keywords: christian/church/community/intervention/support
Abstract: There is no question that the gospel of Jesus and our Christian Tradition require an
ethic of love and compassion. In the light of HIV/AIDS epidemic it is imperative to understand
how Christians can move beyond fear, hysteria and indifference to concern and commitment.
The paper talks mainly about the response of the Church to the AIDS phenomenon. The
involvement of the church in addressing the AIDS phenomenon is of vital importance at all level
i.e. on national, regional, diocesan and parish levels. The Pastoral Response includes the church
as an educator, the church as provider of services, the church as advocate and the church as
resource centre.
Notes: 1 copy
Morar, N. S. & Ramjee, G. (2000). Impact of voluntary HIV counselling and testing among
sex workers. In (pp. 4).
Ref ID: 222
Keywords: barriers/behaviour change/condom/condoms/family/HIV testing/post-test/pre-
test/women
Abstract: Introduction: In the absence of a vaccine or cure for AIDS, people who are vulnerable
to HIV and AIDS through high-risk behaviour such as sex work require appropriate counselling.
Additionally, there are social, economic and cultural barriers in promoting change. Our objective
in this study was to assess the impact and limitations of monthly HIV testing and counselling
among sex workers who were part of a microbicide phase III trial.
Methods: A group of 120 sex workers from truck stops participated in this observational study
between 1997 and 1999. Face to face interviews were conducted using open-ended questions.
Findings: All women consented to the monthly HIV test after receiving pre-test counselling.
During post-test counselling women chose whether or not they wanted their HIV test result.
Those who received either a positive or negative result continued to work at the truck stops and
313

practice unsafe sex. Clients paid half the money for sexual services when requested to use male
condoms. Majority of the steady partners refused to use condoms. Women who seroconverted
during the trial refused to receive their HIV result when they were informed that there was a
change in their HIV status since the previous test. However, they consented to the monthly test.
They reported that knowledge of their positive status would result in mental anguish and threaten
their relationship with the steady partners. Clients would not seek their services resulting in low
income. Women who seroconverted continued with sex work as they needed the money to
support themselves and their families.
Conclusion: Women are willing to be tested for HIV but majority did not want a HIV positive
result disclosed to them as behaviour change was difficult. They continued with sex work and
unsafe sexual practices. Counselling services should consider such social and economic barriers
when promoting behaviour change.
Notes: 1 copy
Ref ID: 94
Morgan, J. (1997). Bereavement counselling. Positive outlook, 4, 20-21.
Keywords: bereavement/death/family/grief/guidelines
Abstract: The grief and mourning that accompanies the death of a loved one is an appropriate
and natural response to loss. However the psychological tasks of coming to terms with the grief
can present survivors with many difficulties, challenges, and opportunities for growth, as they
struggle to cope with a wide range of overwhelming and frightening feelings. Not all bereaved
people will require bereavement counselling, but because of the social stigma which still
unfortunately surrounds the AIDS epidemic, survivors of an AIDS death may experience their
grief as "disenfranchised grief" as their loss is not acknowledged or socially supported. They
therefore need permission to grieve and need to be encouraged to express their grief openly.
They require support and do not need to be shunned by a society that is already uncomfortable
with death, as this will lead to further complications in the grief process.
Notes: 1 copy
314

Morril, A. C. (1996). Safer Sex: social and psychological predictors of behavioral
maintenance and change among heterosexual women. Journal of consulting and clinical
psychology, 64, 819-828.
Ref ID: 400
Keywords: heterosexual
Abstract: Women of diverse backgrounds from community health clinics in Southern Connecticut
were involved in a longitudinal, prospective study (n= 189). Data from interviews 3 months apart
were used for the current analyses. The purpose of this study was to develop predictive models
of safer sexual behavior among heterosexual women. Specifically, there was an interest in
identifying factors to predict the maintenance or initiation of safer behavior over time.
Relationship involvement and attitudes toward condoms were important in both models. Beyond
this, differences in explanatory models emerged, reflecting the importance of examining behavior
maintenance and change independently. Depression, health locus of control, and outcome
efficacy belief made significant contributions to understanding the maintenance of safer sexual
behavior. HIV counselling and testing, partner risk, and optimism helped to explain the initiation
of safer sexual behavior. Implications for future interventions are discussed.
Notes: 1 copy
Morris, C. N. & Cheevers, E. J. (2001). A package of Care for HIV in the Occupational
setting in Africa: results of a Pilot Intervention. AIDS Patient Care and STDs, 15, 633-640.
Ref ID: 369
Keywords: impact/infection/tuberculosis
Abstract: We describe a package of care including prevention, education, and therapeutics for
human immunodeficiency virus (HIV) infection in the occupational setting in sub-Saharan Africa
and evaluate the outcomes of this package over 1 year. A prospective cohort study was done
between 1999 and 2000 in a sugar mill employing 386 men in Kwa-Zulu Natal in South Africa. A
package of care for HIV in the occupational setting was developed and implemented in 1999.
This response included prevention, education, and therapeutic components. Outcomes
measured included condoms distributed, sexually transmitted infections treated, numbers of HIV-
315

infected individual counselled and tested for HIV. HIV prevalence in this population was 27. 15%
in January 1999. Between 1999-2000 in this workforce of 386,58 of 102 (54%) individuals with
HIV were identified through voluntary counselling and testing. Of these, 48 (82.8%) voluntarily
entered the HIV treatment pathway. Condom distribution in the sugar mill increased 400% and
the number of sexually transmitted infections treated at the mill decreased by 88% during this
time period. Using AVERT software to model HIV infection over time a decrease in incidence of
91.67% from that expected in this population was calculated. 11 HIV infections were averted in a
single year of this program. HIV/acquired immune deficiency syndrome (AIDS) is prevalent in the
occupational setting in South Africa. This setting can provide a venue for HIV care and
prevention. A package of care for HIV including prevention, education, and therapeutics can be
effective in both providing care for HIV-infected individuals and preventing new infections.
Notes: 1 copy
Moses, S., Kiragu, D., Fusallah, S., Wamola, I. A., & Piot, P. (1990). Impact of single
session post-partum counselling of HIV infected women on their subsequent reproductive
behaviour. AIDS care, 2, 247-252.
Ref ID: 116
Keywords: condom/condoms/contraception/positive status/pregnancy/pregnant/VCT/voluntary
counselling and testing/women
Abstract: During an ongoing study investigating the impact of maternal HIV infection on
pregnancy outcome at a large maternity hospital in Nairobi, Kenya, asymptomatic HIV positive
women who had recently delivered were informed of their HIV sero-status and counselled by a
trained nurse regarding contraception and reproductive behaviour in a single session. Both HIV
infected women and a comparison group of uninfected women matched for pregnancy outcome
were followed up after an interval of one year. Contraceptive use, condom use and pregnancy
rates were similar in both groups. Only 37% of HIV infected women had informed their partners
of their sero-status. The single session of counselling for the HIV positive women did not seem to
influence decisions on subsequent condom use or reproductive behaviour. More intensive
approaches to counselling need to be developed and evaluated, but may be difficult to implement
316

in the busy maternity and antenatal clinics commonly found in developing countries.
Notes: 1 copy
Moses, S. & Plummer, F. A. (1994). Health education, counselling and the underlying
causes of the HIV epidemic in sub-Saharan Africa. AIDS care, 6, 123-127.
Ref ID: 401
Keywords: Africa/health education/population/sub-Saharan/Sub-Saharan Africa
Abstract: Over the past decade, AIDS has grown from a disease that primarily affected specific
subsets of the population of Western countries to a pandemic that, directly or indirectly, now
affects must of the world's population. The countries of sub-Saharan Africa are facing growing
epidemics in their adult and pediatric populations (piot et., 1993). More recently, explosive
growth of the epidemic has occurred in South and Southeast Asia (Global Programme on AIDS,
1993). It now may be said that AIDS is a major public health concern in virtually every country in
the world, and that controlling this epidemic is perhaps the greatest challenge to public health this
century. It is a challenge that has not yet been successfully met.
Notes: 1 copy
Moses, S., Plummer, F. A., & Nagelkerke, N. D. J. (2000). Reducing HIV-1 in Kenya and
Tanzania. Lancet, 356, 1602-1604.
Ref ID: 96
Keywords: barrier/barriers/cost-effectiveness/Developing
countries/intervention/Kenya/prevention/Tanzania
Abstract: There is a pressing need to identify cost-effective interventions for HIV-1 prevention in
less-developed countries makes the paper by Michael Swear and colleagues ( July 8, p 113) on
the cost-effectiveness of voluntary counselling and testing (VCT) of great importance.
Notes: 1 copy
Motsepe, J. & Perry, J. (2000). Pilot study on the Buddy system of support and care for
people infected. Urban Health and Development Bulletin, 3, 52-58.
Ref ID: 446
317

Keywords: health/primary health care/research
Abstract: The article describes the outcomes of the pilot study on developing models of care for
people living with AIDS (PWAs), initiated by the institute of Urban Primary Health care (TUPHC)
and the friends for life (FFL) in Alexandra, Gauteng. The intention was to support, institute and
pilot the FFL" buddy system" of providing care for people living with AIDS, with the aim to
produce recommendations for appropriate models of care for PWAs. The process and outcomes
of the implementation of the buddy system were strictly monitored through research activities
over almost a year. The article will explain what is already under way in terms of support and
provision of care for PWAs in Alexandra, with a view towards understanding the issues
confronting care providers and PWAs.
Notes: 1 copy
Ref ID: 884
Mpofu, B. (1997). HIV gives woman "new life". The Saturday paper.
Keywords: women
Abstract: A young Durban woman who cried in her wardrobe after finding she had the Aids virus
has found new meaning in her life after coming out into the open. For Musa Njoko, 25, from
KwaMashu, revealing that she has the virus which causes Aids has been like rebirth. It has also
created a new spiritual being in her.
Notes: 1 copy
Ref ID: 549
Mpumalanga Department of Health (2001). Background information on VCT.
Keywords: barrier/care/community/counselling and testing/HIV-
status/infection/information/intervention/knowledge/medical/risk
behaviour/transmission/VCT/Virus/voluntary counselling and testing
Abstract: The provision of HIV voluntary counselling and testing services has been shown to
decrease risk behaviours and therefore result in decreased transmission of HIV. This means
that, as more people choose to be tested, they will realise that they are vulnerable to HIV, gain
318

knowledge about their HIV status and decrease the risk of being infected or infected others. It is
hoped that this realisation will make people to regard the HIV like other infections, and thus,
decrease the stigma associated with HIV and AIDS in the communities.
Additionally, people infected with HIV will benefit from early detection of the virus by living healthy
lives and also by accessing medical interventions and other barrier methods. They will also
benefit early from a system of ongoing care and support through the counselling services offered
by VCT, thus enabling them to cope living with the HI Virus.
The provision of VCT services is of necessary in the province especially because Mpumalanga
has a very high infection rate of HIV. The prevalence of HIV infections is at an average of 30% in
the age groups of 15 to 49.
Notes: 1 copy
Mukombo, D. & Ayles, H. (2000). Mobilisation for VCT in high density residential area in
Lusaka. In (pp. 9).
Ref ID: 228
Keywords: communication/men/prevention/transmission/Zambia
Abstract: Aim: To increase the number of people coming for Voluntary HIV counselling and
testing in a high residential area in Lusaka, Zambia.
Methods: 1. Assessment of community knowledge- Questionnaires were administered to assess
knowledge of local community about the availability of services for HIV prevention, counselling
and testing. Information was also gathered regarding prevention of TB, a service being offered
by the local counselling centre. A total of 400 questionnaires were administered half prior to the
mobilisation and the other half after the mobilisation. 2. Mobilisation (a) Drama: A drama group
was hired to perform in five different places in the area. The performances were based on
transmission, prevention and symptoms for HIV/AIDS and TB. The audience and the performers
discussed the plays afterwards. (b) Person to person communication: Mobilisers were hired to
inform the community about the presence of the counselling centre and to invite them to come to
the counselling Centre. Here they attended a video and verbal discussion on STIs, HIV/AIDS and
were offered VCT.
319

Results: 1. Mobilisation: A total of 343 people were mobilised. 87.5% were male and 12.5%
female. The minimum age was 16, with median 20.83.8% accessed VCT but only 59% came for
results. 18.1% tested positive .2. Community knowledge: there was no difference between the
pre and the post questionnaires on knowledge of services.
Discussions: 1. Community is not informed about VCT services in the area. There is a great
need for advertising and sensitisation of community workers. 2. Mobilisation -though there are as
many female mobilisers than men the number of males mobilised was more than females. A
strategy must be worked out to reach this more vulnerable group in the future.
Notes: 1 copy
Muller, O., Barugahare, L., Schwartlander, B., Byaruhanga, E., Kataaha, P., Kyeyune, D.
et al. (1992). HIV prevalence, attitudes and behaviour in clients of a confidential HIV testing and
counselling centre in Uganda. AIDS, 6, 869-874.
Ref ID: 95
Keywords: attitudes/behaviour
change/couples/information/knowledge/prevalence/prevention/sexual
behaviour/transmission/Uganda/VCT/voluntary counselling and testing
Abstract: The study has been carried out to describe clients and impact of an African public HIV
testing and counselling centre. The analysis of samples from clients attending the AIDS
information Centre (AIC) in Kampala, Uganda in early 1991. The study demonstrated the
demand for and the feasibility of confidential HIV testing and counselling services in Uganda, and
illustrates the value of these services in achieving behaviour changes. Such services should be
considered an additional approach for the reduction of HIV transmission in Africa, especially in
areas with high HIV seroprevalence rates.
Notes: 3 copies
1, 8.
Ref ID: 213
Munyika, V. (1999). Report: The AIDS situation in Namibia. New South African outlook,
320

Keywords: epidemiology/HIV infection/HIV prevalence/infection/Namibia/resources/response
Abstract: Between 1986 - the first reported HIV case - and 1997, the AIDS epidemic has caused
1539 deaths in Namibia; more than tuberculosis (847) and malaria(723) combined. By 1998,
Namibia had the world's third highest rate of infection, with at least on HIV related death every 24
hours at Katutura hospital and 10-20 people buried every weekend in Katutura alone.
Awareness of the facts about HIV/AIDS must be transformed into concrete and joint action by all
sectors of society. Unfortunately, many Namibians remain judgmental with regard to those
infected, and action is taking place only on an ad hoc basis. The churches share the blame for
being either too slow to react to or too silent about the crisis, leaving the search for a solution to
medical practitioners- as though it were purely a clinical issue. But AIDS remains a serious
challenge requiring the concerted effort of all sectors of society, including governments, research
institutions and faith communities. "There is a role for everyone...[and] there is no excuse to
delay action any more". Based on its theological convictions, the church is specifically called to;
.be a healing community, standing in solidarity with the rejected and the stigmatized, where love
and concern for the other is radiated and all are accepted unconditionally.
.Help create an environment where love and goodness can prevail, and discourage those actions
which harm oneself, others or the rest of creation:
. Confront the idea that HIV/AIDS or indeed any other infectious decease or misfortune is a direct
punishment from God.
. demonstrate mutual acceptance forgiveness and saving of lives in action.
. acquire sufficient and up-to- date information and weight different, even conflicting views and
interests in the light of biblical witness, prayer and faith convictions.
Increasingly confronted with infected and affected persons by HIV/ AIDS in need of support and
solidarity, the credibility of the church is at stake in its response. It must work hard to create room
for people infected to tell their stories and share their experiences. This exercise can enhance
lives of the members of the community of faith, demonstration the possibility of affirming life even
in the face of physical limitations and death. Sickness and death are not the standards by which
life is measured; rather the quality of life, whatever its length. So the best the church can do is to
321

present itself as a community where all people feel welcome to relate their stories and share their
experiences. Such a welcoming atmosphere brings people into the very presence of God. The
Church needs to train its members for pastoral care and counselling empowering and enabling
them to face their particular situations and so reduce, even prevent, HIV transmission.
Notes: 1 copy
Mutemi, R., Forsythe, R., & Arthur, G. (2000). Financial requirements of providing VCT
throughout Kenya's health centres. In (pp. 15).
Ref ID: 234
Keywords: health/intervention/Kenya/training/transmission/voluntary counselling and
testing/VCT/counsellors/counsellor/government
Abstract: Background: Voluntary counselling and testing (VCT) has been effective in limiting the
transmission of HIV. In Kenya's most recent DHS, 63% of adults indicated a willingness to be
tested for HIV. However, VCT is available in only a limited number of locations. Therefore this
economic analysis was performed to assess the financial feasibility of scaling-up VCT to health
centres throughout Kenya.
Methods: To develop estimates of the financial requirements necessary for scaling -up VCT to a
national level, the cost of VCT at 2 rural and 1 urban health centre where VCT has recently been
introduced were used. Data from these health centres was used to estimate costs for providing
VCT throughout Kenya.
Results: The annual recurrent cost of maintaining VCT in Kenya is approximately US $ 6,600
per health centre. In order to provide VCT in all 579 health centres throughout Kenya, it would
cost approximately US $ 3.8 million per year. (This cost excludes the cost of training and other
start-up costs). Of this amount, approximately US $ 3,3 million would be incurred for the salaries
of full-time counsellors and US $ 0.5 million would be incurred of materials ( including rapid test
kits). This total recurrent cost of CVT would consume approximately 2 percent of Kenya's health
budget.
Conclusions: Scaling -up VCT so as to provide services throughout Kenya's 579 health centres
appears to be a feasible option, although Kenya may nee to consider a combination of financing
322

options. These options include cost sharing, government subsidies and donor support. In order
to assure the effectiveness of an intervention t scale-up VCT services in Kenya and to overcome
Kenya's shortage of qualified HIV/AIDS counsellors, it is likely that additional external finances
will still be required from international donors, particularly in providing initial training and
retraining of HIV/AIDS counsellors.
Notes: 1 copy
Muyinda, H., Makerere, U., Kengeya, J., Pool, R., & Whitworth, J. (2001). Traditional sex
counselling and STI/HIV prevention among young women in rural Uganda. Culture, Health and
sexuality, 3, 353-361.
Ref ID: 8820
Keywords: community/education/knowledge/prevention/research/sex/Uganda/women
Abstract: This study examined the potential of traditional ways of passing on sexual knowledge
from adult to younger women (the senga institution) among the Baganda of central Uganda, as a
potential tool for STI?HIV prevention today. Traditional and contemporary forms of the institution
were studied, and their strengths and weaknesses assessed. Data were collected using
qualitative research methods. The senga institution comprises 4 components: social
responsibility, moral authority, appropriate knowledge and a suitable socio-economic
environment. Although senga practices have been weakened and the way in which they are
viewed by adolescent girls and the community in general has changed, the institution can still be
exploited to develop more culturally appropriate forms of sex education for girls, particularly out of
school girls and adolescent mothers.
Myeni, Z. (1998). How to establish VCT services: voluntary counselling and testing
guidelines. 1-36.
Ref Type: Unpublished Work
Ref ID: 482
Keywords: behaviour change/care/client/clients/guidelines/HIV-
status/intervention/prevention/transmission/VCT/Virus/voluntary counselling and testing
323

Abstract: Voluntary Counselling and Testing (VCT) has been recently considered an important
entry point to HIV/AIDS prevention and care interventions. Previously counselling and testing has
been basically used as a diagnosis strategy for symptomatic individuals, pre-operatively or as a
pre-employment test. The present context of VCT is based on the individual wish to know one's
HIV status for the purpose of behaviour change. In other sites, linked or free standing, VCT is
carried out as a prerequisite for other services. The National Programmes for prevention of
mother to child transmission (PMTCT) is one of the services that require clients to undergo
Voluntary Counselling and Testing. The VCT strategy may also serve to increase openness and
decrease HIV/AIDS stigma as more people get to know their HIV virus.
Ref ID: 7680
Mzolo, B. (1998). Approaching HIV/Aids positively. The Natal Witness.
Keywords: community/family
Abstract: What disturbs HIV/Aids workers the most, says Madlopha, is that often when some of
the people who are living with HIV/Aids tell communities about their conditions, some people do
not believe them, believing that they have been paid to say what they are saying. " The appeal to
all communities is to believe these people. Madlopha appeals to the families and friends of those
that have been diagnosed, to show them unconditional love and care "if we turn our backs to
them, who is going to care for them? " We need to believe the people living with Aids because
they are trying to help the community to see that Aids is a reality and that people may make
informed decisions and take responsible action. People need to change their attitudes and
realise their own brothers, sisters, aunts, and uncles are all at risk as well, therefore we need to
stop discriminating against those affected or infected," she says. My appeal is that we should
work together to combat the spread of HIV/Aids and its impact on our society.
Notes: 1 copy
Ref ID: 2996
Mzolo, B. (2002). No plans yet to import AIDS drug. Sowetan.
Keywords: Africa/AZT/conference/government/health/South Africa/Uganda
324

Abstract: Health Minister Manto Tshabalala- Msimang yesterday rejected media speculation that
pregnant mothers who are HIV positive would soon have access to a new drug to prevent them
from infecting their babies. Tshabalala-Msimang, who was speaking at the healthcare writers
forum in Johannesburg, said the drug Nevirapine, had not even been registered for that purpose
by the Medicines Control Council. She said the only country which had announced its results on
Nevirapine was Uganda, and she would be an irresponsible Health Minister to have such a drug
ordered based on a single testing. In the face of the Government saying it could not afford anti-
AIDS drug AZT because it was expensive, a number of people started to call on it to provide
Nevirapine. One dose of Nevirapine costs R26 while AZT costs 400 a month. "We need more
studies to be done to have the drug considered , "Tshabalala - Msimang said. She also
dismissed as untrue reports that President Thabo Mbeki had said HIV did not lead to AIDS. "All
the President said was that there was a need to understand the epidemic in the context of South
Africa and not that of the United Kingdom, the US or Uganda, she said. Tshabalala-Msimang
said for instance South Africa a had a high incidence of malaria which these countries did not
have. "In Hlabisa, KwaZulu-Natal, we are beginning to see a link between malaria and HIV/AIDS,
a problem which some of the countries have not studied,"she said. The minister criticised AIDS
experts for saying there was no need to re-look HIV/AIDS in the South African context "If they
had all the answers, they would not be attending conferences on AIDS." She said the reason
they did it was because there was always new information coming in as this was a new epidemic.
Notes: 1 copy
NACTT project.
NACTT Project. (1999). Children living with HIV/AIDS in South Africa - A Rapid Appraisal.
Ref Type: Unpublished Work
Ref ID: 502
Keywords: South Africa/Africa/intervention/care
Abstract: This pamphlets explores interventions and models of care for children infected with or
affected by HIV/AIDS.
Notes: 1 copy
325

Nadasen, S. & Gray, A. (2003). South African Health Review- 2000. Ntuli A., Crisp, N.,
Clarke, E., and Barron, P.
Ref Type: Unpublished Work
Ref ID: 8807
Keywords: health/sex/Home based care/care/community
Abstract: Health legislation
The health sector strategic framework includes an effective HIV/AIDS programme has
overwhelmed other health areas such as improved water supply. Measures that are known to
achieve safer sex practices must be scaled up and the capacity for home based care, through a
network of community structures supported by health staff must be set up. The Department
indicates that tis success in reaching objectives is based on the ability to reverse HIV/AIDS
epidemic
Notes: Chapter 3
Ref ID: 7438
Naidoo, N. (2000). Picking up the pieces. Natal Witness.
Abstract: Being an AIDS counsellor is a daunting task but sister Jabu Gezane feels that she
offers a desperately needed service to the community.
Notes: 1 copy
Ref ID: 7648
Naidoo, Y. (1996). Caring for people with Aids. Sundat tribune.
Keywords: Africa/health/KwaZulu-Natal/Nurse/South Africa/therapy/WHO
Abstract: A British nurse opened Durban's first drop-in centre for people with HIV and AIDS this
week. British immigrant Mark Dobson who visited South Africa a year ago on holiday and fell in
love with Kwazulu Natal, officially launched the "open Door" in central Durban. It is a centre of
support for anyone with HIV or AIDS.
Although open Door has not been launched officially, people have been visiting the centre. News
of the drop-in-centre has spread like wildlife by word of mouth". Mr Dobson, who worked as a
326

psychiatric nurse specialising in mental health and HIV and AIDS, said when he visited Durban
he realised the need for a drop-in centre. "People living with HIV or AIDS go through very
traumatic periods after their diagnosis. Emotionally it is very hard to reconcile with death, and
victims also have to deal with the rejection from the community". Mr Dobson said Open Door was
a haven for people living with AIDS and was aimed at providing basic counselling and support
services. "We are not a hospice. Nobody will be admitted overnight. We help with the
transitional period. When people infected with HIV or AIDS have to deal with the news of their
diagnosis". He said free holistic and complementary therapies, such as reflexology, massage,
physiotherapy and Reiki therapy,were available to HIV positive people who visited the centre.
Notes: 1 copy
Namwebya, J. H., Turyagyenda, J., Baryarama, F., Murana, E., Kalule, J., Mukasa, R. et
al. (2000). Discordance rates among Ugandan couples seeking VCT services before having sex
together. In (pp. 33).
Ref ID: 253
Keywords: benefits/couples/infection/transmission/Uganda/voluntary counselling and
testing/women
Abstract: Background: In a high prevalence setting where most HIV infected people do not
know their serostatus , there is a great risk of HIV transmission when a person with previously
unidentified HIV infection initiatives a new sexual relationship. Preventing this transmission of
HIV to a new partner is a high priority and one of the potential benefits of HIV voluntary
counselling and testing (VCT).
Methods: Individuals and couples who come to AIDS information Center in Uganda for VCT are
interviewed to obtain demographic and sexual history data. Data for the period January to
September 1999 were merged and analysed.
Results: Of 4646 couples, 3218 (69%) reported that they had never had sex together but were
intending to marry or to start a sexual relationship. Of these, 2945 couples (92%) were
concordant HIV negative, 31 (1%) were both HIV positive and 242(8%) were HIV discordant.
Among the discordant couples, the male partner was HIV positive in 95 couples ( 39%) and the
327

female partner HIV positive in 147 (69%). Among 124 couples where the man was HIV positive,
95% (75%) of the prospective female partners were HIV negative; among the 178 couples where
the woman was HIV positive, 147 (83%) of the prospective male partners were HIV negative.
Thus, among these AIC clients, the probability of a man with HIV infection intending to have sex
with a new partner who is HIV negative is 0.75 and among the HIV positive women the probability
is 0.83.
Conclusions: Our data on couples intending to get married or to start a sexual relationship
indicates that there is a high probability that persons who are HIV positive will develop sexual
relationships with a high probability that persons who HIV positive will develop sexual relationship
with HIV negative partners and unknowingly transmit HIV. If VCT is not readily available, there
would be a high risk of HIV transmission. AIDS education messages need to emphasize the
benefits of VCT before marriage and before new sexual relationships.
Notes: 1 copy
National Department of Health Draft National integrated plan for children infected and
affected by HIV/AIDS. (in press).
Ref ID: 568
Abstract: This paper contains the draft of national integrated plan for children infected and
affected by HIV/AIDS.
Notes: 1 copy
Ref ID: 8801
National Department of Health (2002). VCT progress report.
Keywords: VCT/counsellors/counsellor/policy/policies/health
Abstract: There are 438 operational sites the target is 1200 sites by the end of 2003.Each site
should be manned by two counsellors.There are currently shortages of counsellors. HIV rapid test
distributedto all sites. Reasons for not reaching target: 1. First phase of developing policy took
longer than expected
2. Provinces having problems with districts.
328

3. Problems with submission of statistics from sites
4. High drop out rate of nurses/counsellors
5. Delays due to administrative systems in Provinces
6.Infra structure problems
7. Have not been able to expand VCT to non health facilities
8. Difficulties for Province to get a buy in from the hospital management.
Ncayiyana, D. J. (1998). South African HIV/AIDS research- barking up the wrong tree?
AIDS Scan, 10, 13-14.
Ref ID: 399
Abstract: " Much has been said and written about HIV infection and AIDS in South Africa, and
much good research has been accomplished, yet the epidemiological information necessary for
an effective and focused promotive and preventive campaign remains largely elusive. Is our
research thrust misdirected? In South Africa, we tend to assume that the characteristics of the
HIV epidemic in, say, Uganda, can be directly extrapolated to the South African situation.
However, Dr Peter Piot of UNAIDS points out that there are huge differences in the way the
epidemic develops in different countries in the same region. Speaking to Jacqui Wise of the BMJ,
Dr Piot observed that in sub-Saharan Africa, "very few countries have reliable data on HIV
infection and some, notably Nigeria and South Africa, have virtually none' (BMJ; 315: 1486)
What sort of knowledge is lacking ?For one thing, there are no country-wide population based
data from which size and shape of the HIV epidemic can be mapped out reliably. The best and
only national statistics we have appear to the national surveys conducted on women appear to be
the national surveys conducted on women attending the antenatal clinics. These figures are
quoted widely and often uncritically in just about every major publication on HIV/AIDS, and have
come to command near-biblical authority. Who are women? What are their demographic
characteristics, and what segment of the population do they represent? Surely not the cross-
section of the pregnant population, let alone that of the South African population at large.
There are no case-control studies to identify the commonest risk factors, or the groups at greatest
risk of infection in our particular settings. Although the migrant labour system is said to be one of
329

the major conduits in the spread of the infection, there is a singular lack of data on the HIV status
of migrant workers. Truck drivers, who are also frequently credited with spreading the virus, have
hardly been studied. The actual trail of the infection from the city to the rural areas has not been
properly traced. Epidemiological studies on male populations have been very few, very small and
very far between. Lack of this sort of information hinders the planning of nuanced preventive and
promotive campaigns beyond randomly throwing condoms at the problems.
The gaping discrepancy in prevalence between KwaZulu-Natal and, say, the Eastern Cape right
across the border remains unelucidated. Is it a because the Xhosa circumcise (and are therefore
less prone to genital ulcers), whereas the Zulu do not? There are few data on the time lag
between infection and disease, and without this knowledge, we can neither estimate the gravity of
the epidemic nor plan effective health services to deal with it over the next decade. Experience
teaches that the HIV/AIDS epidemic is best contained in those populations where the epidemic is
well studied and well understood, such as the San Francisco gay community. The South African
HIV/AIDS research community owes us appropriate qualitative and quantitative epidemiological
information, without which we cannot hope to contain this disease".
Notes: 1 copy
Ndayishimiye, F., Birantagaye, J., Barampenda, P., & Nkurunziza, S. (2000). Involvement
and empowerment of the rural community in HIV/AIDS prevention and care: An approach for
sustainability and more effectiveness. In (pp. 10).
Ref ID: 229
Keywords: prevention/response/training/care/community/WHO/information/education/organisation
Abstract: Issues : Prevention and care in rural area have been neglected when the HIV/AIDS
epidemic is becoming higher and higher in rural communities. The community needs to be
involved and empowered in HIV/AIDS prevention and care, in order to more effective and for
sustainability of developed programmes and action. Those who are conceiving the programmes
often omit the involvement of the concerned target in the community when programming for
action. The involvement and empowerment of the leaders in the community and the community
development based workers is a way for a better community response.
330

Description: A project of involvement and empowerment of community Development based
Workers(CDWs) and the leaders have been developed in the community where Action Aid is
working. A programme and an adapted adult training methodology have been conceived and
used in the targeted community . Basic information and definition on HIV/AIDS, prevention in the
community by the community members, community based care, voluntary testing and counselling
and the peer education methodology have been progressively developed first for the community
development based workers, secondary for the leaders in the community. The Participatory
Rural Appraisal methodology (PRA) have been used.
Results: In 1992, 22 CDWs and 516 leaders of the community have been involved empowered
and trained in HIV/AIDS community prevention and care. Each of the 516 persons is now
working in his/her community. As result of their work: 3 community-based organisations are
formed in that community. They have developed income generating activities on their own
initiative, people leaving with HIV/AIDS organised a support group and are more open and helpful
in prevention and counselling in their community.
Conclusion: Involvement and empowerment of the community development based workers and
the leaders of the community, in HIV/AIDS programme are to be promoted and supported for
more effectiveness and future sustainability. Experience shows that with that approach, more
openness in the community and acceptation of PLWA in that Community is becoming effective
where HIV/AIDS was taboo.
Notes: 1 copy
Ref ID: 4354
Ndiyane, E. (2001). Healer helps AIDS victims. Daily News.
Keywords: clinic/disease/health/KwaZulu-Natal/medical/research/traditional healer/traditional
healers/treatment
Abstract: AIDS sufferers are flocking to the home of an Umlazi herbalist. Renowned traditional
healer claims to have discovered a herb that many including a prominent medical expert - feel
minimises the effect of AIDS. The revelation has transformed traditional healer Mr Lulu
Ngubane's modest home in B-section, Umlazi, into a bustling mini-clinic , with people from far
331

afield as Namibia, Mozambique and Lesotho coming to seek his treatment. Hundreds of people
queue outside from morning until midnight and, significantly, some of them said they were
referred to Ngubane by hospitals and local clinics. And while the formal medical establishment is
reluctant to give credence to Ngubane's herbal remedies, the head of the virology department at
King Edward VIII Hospital, professor Alan Smith said yesterday: "I have been some of his
patients and they are getting stronger and stronger. Other patients were actually bedridden and,
two months after Ngubane dealt with them, they were up and running. His medication has cured
some conditions I know were AIDS related," Smith said.
A spokeswoman for the KwaZulu-Natal Department of Health, Miss Mabel Dlamini, said there
was no scientific, proven cure for AIDS and the department encouraged research into the
disease, whether by scientists or traditional healers.
"We cannot rule out anything because we do not know where the cure will come from, " she said.
The province has budgeted about R 40- million for AIDS programmes that includes awareness
campaigns.
Notes: 1 copy
Ref ID: 6924
Ndlovu, C. (2000). Are those with AIDS new elite? City press.
Keywords: benefits/South Africa/treatment/WHO
Abstract: Now that South African Airways has received its just desserts for unfairly treating an
AIDS sufferer, it may be prudent to enquire whether this group (those inflicted with AIDS) is not
South Africa's new privileged elite (like the whites of yesterday) what with it being an almost
unpardonable sin to even refuse to extend privileges to them. What is the rationale behind the
special grants being offered to AIDS sufferers most of whom are in the predicament they are in
simply because of them following their own immoral lifestyles, for example by forming
homosexual (euphemistically termed "same sex") relationships and drug addiction in the form of
sharing tainted syringes? Are the grants now available to these miscreants not some sort of
reward for the plight they are in from their anti-social activities just like criminals who, if they are
injured when detained by the police, are dispatched to the finest private hospitals for treatment
332

while the criminals ' victims are compelled to make do with the service on offer at provincial
hospitals? Why are victims of crime, most of whom are innocent parties to this social ill, further
not considered for similar benefits in our society which is well on the way to succeeding in
completely jettisoning centuries - old values in favour of promiscuity and permissiveness with
their predictable consequences which include the destruction of the moral fibre of society?
Notes: 1 copy
Nduba, V. N., Mutemi, R., Odhiambo, J., Ngatia, G., Arthur, G., & Gilks, C. (2000). Health
centre based voluntary counselling and testing (VCT) services in resource poor settings: are
users a high risk client group? In (pp. 20).
Ref ID: 239
Keywords: clinic/condom/health/men/pre-test/prevention/sexual behaviour/sexual
partner/voluntary counselling and testing/women
Abstract: Background: Improving access to VCT is now recognised as a crucial strategy for HIV
prevention and care in resource poor settings. Health centre based VCT services can provide
improved coverage but may attract a lower risk client group. Partner specific sexual behaviour
data of health centre based VCT clients from a baseline bahavioural change survey are
presented.
Methodology: A survey of all consenting clients from 3 health centre based ( 1 urban and 3
rural) VCT services was conducted as part of a 6 month follow-up study investigating the impact
of VCT on behavioural change. Interviews, conducted after pre-test counselling but before
results were issued, collected information on socio- demographics, reported STI symptoms (past
6 months), number of sexual partners and partner specific rates of condom use.
Results: Of 549 clients enrolled (65% of all VCT clients, mean age 27 years (SD11), 50%
female) seroprevalence was 20% (15% ( rural), 30% (urban). 36% of clients reported STI
symptoms. 15% of female clients reported 2 or more partners compared with 39% of male
clients. 37% reported having ever used a condom. Over the previous 2 months unprotected sex
with non-primary partners was reported by 17% of men and 13% of women.
Conclusion: Seroprevalence rates comparable to sentinel surveillance figures for clinic
333

catchment areas suggests clinic based services may not reach the highest risk populations.
However significantly high rates of multiple partners than national averages, low condom use and
high reported STI symptoms suggests clients attending local health centre VCT services is
required to assess the appropriateness of this means of implementation.
Notes: 1 copy
Nebie, Y. (2002). Sexual and reproductive life of women informed of their HIV
seropositivity - A prospective cohort study in Burkina-Faso. Journal of Acquired immune
deficiency syndromes, 28, 367-372.
Ref ID: 361
Keywords: acceptability/Africa/Burkina Faso/contraception/Cote d'
Ivoire/disclosure/fertility/impact/infection/pregnancy/VCT/vertical transmission/women
Abstract: Background: In the context of the DITRAME-ANRS 049 research program that
evaluated interventions aimed at reducing mother-to-child transmission of HIV(MTCT) in Bobo-
Dioulasso (Burkina Faso), Voluntary HIV counselling and testing (VCT) services were established
for pregnant women. HIV - infected women were advised to disclose their HIV serostatus to their
male partners who were also offered VCT, to use condoms to reduce sexual transmission, and to
choose an effective contraception method to avoid unwanted pregnancies. This study aimed at
assessing how HIV test results were shared with male sexual partners, the level of use of modern
contraceptive methods, and the pregnancy incidence among these women informed of the risks
surrounding sexual and reproductive health during HIV infection.
Methods: From 1995 to 1999, a quarterly prospective follow-up of a cohort of HIV-positive
women.
Results: Overall, 306 HIV-positive women were monitored over an average period of 13.5
months following childbirth, accounting for a total of 389 person-years. The mean age at
enrollment in the cohort was 25.1 (standard deviation, 5.2 years). In all, 18% of women informed
their partners, 8% used condoms at each instance of sexual intercourse to avoid HIV
transmission, and 39% started using hormonal contraception. A total of 48 pregnancies occurred
after HIV infection was diagnosed, an incident of 12.3 pregnancies per 100 person-years.
334

Pregnancy incidence was 4 per 100 person-years in the first year of monitoring and this rose
significantly to 18 per 100 person-years in the third year. The only predictor of the occurrence of
a pregnancy after HIV diagnosis was the poor outcome of the previous pregnancy ( stillbirth,
infant death). Severe immunodeficiency and change in marital status were the only factors that
prevented the occurrence of a pregnancy after HIV diagnosis.
Conclusion: Our study shows a poor rate of HIV test sharing and a poor use of contraceptive
methods despite regular advice and counselling. Pregnancy incidence remained comparable
with the pregnancy rate in the general population. To improve this situation, approaches for
involving husbands or partners in VCT and prevention of MTCT interventions should be
developed, evaluated, and implemented.
Notes: 1 copy
Nefale, M. C. (1999). The health belief model and motivations for/against HIV-testing. MA
Dissertation, University of Natal(UN) (Department of psychology).
Ref ID: 203
Keywords: health/HIV testing/health belief model
Abstract: Attempts to explore the psychological factors that motivate individuals into opting for or
against undertaking an HIV test. The Health Belief Model is used to ascertain its predictive
powers regarding the motivating such a test. The focus of this dissertation is on voluntary HIV
testing. The sample that has been used for this study comprises antenatal mothers who have
been offered HIV/AIDS education and then presented with an option of undertaking the HIV test.
The results of the study indicate that the Health Belief Model had failed in its predictive powers.
However, the study provides valuable psychological factors that are associated with the decision
to undertake the HIV test.
Notes: copy
Ref ID: 8788
Nel, M. (2003). Living with Aids: Counselling needs (Immune deficiency).
335

Nel, R. (1992). Die akkommodering van die vigs-verskynsel in die etiese kode vir
sielkundiges. Randse Afrikaanse Universiteit.
Ref ID: 204
Keywords: ethics/family/guidelines/knowledge/population/prevention/psychology/South
Africa/training
Abstract: The Psychological Association of South Africa (PASA) is, at present, in a transition
phase in that the profession is striving unite under one single controlling body. As a
consequence, the Association is seeking to establish a set of inclusive, scientific, academic and
ethical standards that will be recognized by all psychologists. With this purpose in mind, the
Association is currently revising its ethical code. Since the Association commits itself to both the
prevention and treatment of AIDS, part of its agenda is to include the handling of the disease in
this code.
The purpose of this study is to make a contribution to the revision of the ethical code by exploring
the ethics surrounding the handling of the AIDS- dilemma by psychologists, and to make
recommendations in this regard. AIDS should therefore be handled responsibly in the ethical
code in such a way that it is acceptable to all practicing psychologists in South Africa.
Methodology: The nature of the study is a qualitative exploratory analytical study that relies on
rational cognitive processes. Literature concerning ethics in psychology was explored together
with the way in which it is translated in the ethical code. Ethical dilemmas that result from the
handling of the AIDS- phenomenon are identified and grouped together by describing both real
and hypothetical ethical problems. A critical rational analysis of the ethical code then follows.
Finally, logically argued proposals are made in order that identified shortcomings be eliminated.
Findings and recommendations: Although most ethical dilemmas can be aptly handled by
applying a step by step process of ethical decision making, the social and fatal nature of this
disease has created certain ethical problems that are not adequately cover by the present ethical
code.
Because AIDS has taken on epidemic proportions and is essentially a fatal disease, the central
dilemma is therefore the profession's involvement in the prevention of the syndrome. This
336

concept is not described at all in the ethical code. identified shortcomings are therefore also
shortcomings in both preventative action and in the protection of the population. Psychologists
dealing with the ethical handling of the disease should therefore be primarily involved in the
prevention thereof so that societal needs can be met. The traditional ethical code focuses on the
one-to -one therapeutic relationship dealing with already manifested problems, and thus a
paradigmatic shift is proposed in that societal protection through prevention should now become
the central focus.
It is thus recommended that a fourth fundamental ethical principle of prevention be added to the
ethical code. The principle of prevention would prescribe that psychologists become proactive in
terms of preventative action when dealing with social dilemmas that are potentially physically or
psychologically damaging to individuals. The principle will also make clear the fact that
psychologists will no longer be able to use as an excuse a lack of knowledge and skills so as not
to become involved in the handling of the AIDS-dilemma. Instead they will be obliged to expand
their knowledge and skills to be able to deal with the phenomenon in an appropriate preventative
manner. In the study, recommendations are also with regard to shortcomings in the handling of
the syndrome in the three basic ethical principles, and the ten rules of conduct. Finally,
recommendations are made regarding the implementation of the findings, and possible areas of
future research are proposed. Firstly, it is recommended that PASA should seriously consider
adopting the research findings into its ethical code as they allow for the inclusion of AIDS therein.
Secondly, it is proposed that at the 1993 annual progress, a workshop be established during
which time the paradigmatic shift as proposed by the research be discussed.
The third recommendation is that all psychologists in South Africa be asked by means of a
questionnaire to give their opinions regarding these research findings. Thereby, the profession
as a whole is provided the opportunity to give its opinion in this regard. Research findings should
be tested internationally too. All other disciplines involved in the handling of AIDS could be
consulted, so that more comprehensive and expansive ethical guidelines can be formulated.
Fourthly, it is recommended that the handling of the AIDS dilemma be included in the future
training of all psychologists. This training should include both the ethics of dealing with AIDS, and
337

the counselling of the sufferers of the disease together with their families.
Finally, as a result of the relevance of the topic, and the fact that the disease is on the increase, it
is recommended that research in this field be continued, possibly in the form of a doctoral study.
Nell, M. A. (1991). Pedagogies-verantwoorde evaluering van voorligtingsinligting vir die
voorkoming van die verworwe immuniteit gebreksindroom (vigs) = Pedagogically justifiable
evaluation of counselling information for the prevention of the acquired immuno deficiency
syndrom (AIDS). M ED Thesis, University of Pretoria (UP).
Ref ID: 202
Keywords: evaluation/prevention/research/University of Pretoria
Abstract: The purpose of this study dissertation is to discuss the evaluation of counselling
information used for the prevention of AIDS. In order to show the importance of prevention, this
sickness was viewed form different perspectives. The impact of AIDS on the society was
stressed. Communication plays an important role in conveying counselling information. The
communicative nature of counselling information is explained . The importance of all
communication components during the process are stressed. Counselling for the prevention of
AIDS is part of the basic principles of pedagogics. In order to be effective in the prevention of
AIDS, counselling information must comply with certain criteria. These are thoroughly discussed
and a point scale used to evaluate each counselling information piece, was developed. A total
evaluation point on an evaluation scale gives an overall impression of quality of the counselling
information concerned. A sample was chosen at random from available counselling information
and evaluated in terms of pedagogic criteria. After this evaluation, it is clear that certain of the
information pieces used for counselling are inadequate in some areas. This can be rectified by
applying scientifically accountable criteria. Counselling information was then compared with each
other and with the different criteria. After that it was possible to identify the counselling
information piece which achieved the best results. These results can now be used as guidelines
by authors and counsellors while preparing counselling information of a high standard.
Recommendations are made regarding the role realisation opportunities may play in the
338

prevention of AIDS, and guidelines to which counselling information should comply are supplied.
Notes: 1 copy
Ref ID: 438
Nesbitt, W. H. (1996). Burnout among HIV/AIDS workers. AIDS Bulletin, 5, 25.
Keywords: burnout/grief/health
Abstract: Burnout in volunteer workers in the HIV/AIDS area often results in the loss of dedicated
personnel, consequently further straining care delivery systems. A recent study conducted in the
USA described the role of grief in HIV/AIDS volunteer burnout. The study found no direct
relationship between grief and burnout but pointed out that burnout in volunteers may be different
from that in health care professionals because volunteers choose to work in the HIV/AIDS arena
and are internally motivated to do so; they have control over the time spent volunteering; and they
can terminate their involvement at any time. The best predictors of grief are time spent as a
volunteer and volunteer hours per week, where those who spent the most hours volunteering
experience less grief. The data from this study suggest that in order to reduce grief, special
attention should be paid to allowing volunteers freely to express problems with emotional
overload and workload adjustments, and providing clear emotional support as a reward.
Notes: 1 copy
Ngatia, G., Arthur, G., Mutemi, R., Odhiambo, J., & Gilks, C. (2000). Voluntary
counselling and testing (VCT): developing a mobilisation strategy for primary health care (PHC)
clinic based services. In (pp. 1).
Ref ID: 264
Keywords: barriers/benefits/clinic/confidentiality/Developing
countries/health/Kenya/men/prevention/research/VCT/voluntary counselling and testing/women
Abstract: Issues:VT is becoming a vital component of HIV prevention and care in developing
countries. Most sexually active results in Kenya don't know their status. Low uptake of VT is
partly due to poor access to VT services. However once local services are in place, many
challenges remain at community level to convert service access into service uptake.
339

Description: An operational research project exploring integration of VT into PHC clinics in
Kenya introduced VT services into 2 rural clinics and 1 urban clinic. After initial implementation,
uptake was low so 18 community focus group discussions.( FGDs) were conducted with men,
women and youth to identify major barriers to uptake. These suggested the community were
afraid incase others learnt their results. They were unfamiliar with the benefits of knowing one's
status and feared stigma both of being tested and being HIV positive. Following this, field
mobilisers were trained in issues of stigma and the pros and cons of testing. In community
discussions the role of videos with fearful, stigmatising images was reduced. In group
discussions, key messages regarding confidentiality, realistic pros and cons of testing and the
countering of misplaced fears about VT were introduced
Conclusion: FGDs suggested sensitisation needed to target confidentiality and privacy issues ,
improved understanding of the potential benefits of testing and also a reduction in stigma
associated with VT/HIV status. After these issues were better addressed in community
mobilisation, a general trend of increased uptake was observed. Once local VT services are
implemented, targeted community sensitisation may play a crucial role in promoting uptake.
Notes: 1 copy
Ref ID: 80
Ngubane, G. (1995). Counselling in a multicultural context. Positive outlook, 3, 17.
Keywords: counsellor/counsellors/culture/model
Abstract: The individual will make sense of life through observing their environment as well as
beliefs learnt. When the person is given an opportunity to talk about life concerns and thoughts in
an environment that is conducive and relevant to the individual he or she will be able to make
decisions. This paper has outlined the context in which counselling should take place.
Notes: 1 copy
Nguyen, V. K., Lee, S., & O'malley, J. (1996). Nongovernmental organizations. In
J.M.a.T.D.J.M.Mann (Ed.), AIDS in the world II: global dimensions, social roots, and responses:
the global aids policy coalition (pp. 341-361). New York, Oxford: Oxford University Press.
340

Ref ID: 385
Keywords: community/government/NGO/policies/policy/prevention/response
Abstract: To slow the spread of HIV, people need to change their most personal and private
behaviours. Likewise, the most important aspect of care for people with HIV/AIDS is at an
interpersonal level- ensuring self-respect, freedom from discrimination, and love and support.
Thus, the heart of HIV/AIDS prevention and care is at the community level, where people help
people, often through groups - typically known as CBOs (Community-based organizations). In
addition to CBOs that are formed within ( and are accountable to) particular communities, many
other groups outside government are involves in responding to HIV/AIDS. Collectively, such
groups are referred to as NGOs (nongovernmental organizations).
Notes: 1 copy
Ref ID: 5000
Nhlapo, T. (2001). Loving care, the best medicine. City press.
Keywords: traditional healers
Abstract: Traditional healers agree that patient care, nutrition and a positive attitude are the best
way to treat HIV/AIDS
Notes: 1 copy
Ref ID: 8789
Nichols, S. E. (1983). Psychiatric aspects of AIDS. Psychosomatics, 24 , 1083-1089.
Keywords: disease/physician/training/emotional reactions/intervention
Abstract: AIDS has been reported to the Centers for Disease Control (CDC) in June 1981.The
article looks at some of the possible causes of HIV/Aids and therapeutic needs of AIDS patients.
The importance for physicians to be aware and use resources in their own communitites, training
of crisis counselors and volunteers to assist patients. Emotional reactions of Aids patients is
shock, guilt, denial, fear, anger. sadness, bargaining and resignation (based on Kubler-Ross).
The overall goal of intervention is to help patients accept their illness and to regain the ability to
manage their lives.
341

Ref ID: 443
no author (1996). Pre- and Post-test counselling. Health and Hygiene, 7, 14-15.
Keywords: post-test
Abstract: The HIV test is like no other. It carries with it enormous emotional, practical and social
implications. According to registered psychologist, Grania Christie, no test should ever be given
without counselling. She offers the following points( such as reason for testing, facts about AIDS,
Information about the test, implications of the test result, anticipation of result, risk reduction,
confidentiality, informed consent, informing of result etc..) as guidelines for pre - and post - test
counselling.
Notes: 1 copy
Noko, K., Mzezewa, V., Kelly, C., Latif, A. S., Shetty, A. K., & Bassett, M. T. (2000).
Sexually transmitted disease treatment clinics as priority settings for HIV counselling and testing:
experience among Zimbabwean male factory workers. In (pp. 29).
Ref ID: 249
Keywords: clinic/HIV testing/infection/medical/men/Zimbabwe/Voluntary HIV counselling and
Testing/VCT/WHO/sexually transmitted
disease/disease/workplace/education/treatment/male/awareness/population
Abstract: Background: Voluntary HIV counselling and testing ( VCT) is not widespread in
Zimbabwe. Men who are treated for sexually transmitted diseases (STDs) are at increased risk
for HIV infection. Are they more likely to accept HIV testing? We examined this in a workplace
peer education that offers free treatment for STDs and free VCT.
Methods: Medical record review at the study clinic identified men with STDs. These were linked
to the HIV testing logs.
Results: In the workforce generally, only 441(3.3%) of about 12,500 men agreed to HIV testing.
Of these, 327 (74%) were offered screening in the workplace and 117 ( 26%) at the clinic. Of
those tested, 117 (26%) initially had a clinical complaint. Between March 1999 and January 2000
a total of 529 men were seen with STD diagnosed and 117 (22%) requested HIV testing. Among
men with urethral discharged and genital ulcers, 22% and 24% respectively had an HIV test.
342

Records suggest that an HIV test would more likely be requested when an STD did not respond
to initial treatment or the patient had previous STDs.
Conclusion: Acceptance of VCT was low among Zimbabwean male factory workers attending a
STD clinic. Our data underscore the need for enhanced education on HIV/AIDS awareness and
improved VCT services in this population. In resource -poor settings, offering VCT in STD clinics
should be accorded priority.
Ref ID: 540
North West Department of Health Draft VCT Business plan for 2002 / 3. (in press).
Keywords: VCT/business plan/business
Abstract: This paper is just a VCT Bussiness plan for VCT North West for the year 2002 / 2003
Notes: 1 copy
2004.
Northern Cape Department of Health. (2000). Voluntary, Counselling and testing 2000 -
Ref Type: Unpublished Work
Ref ID: 556
Keywords: care/client/clients/counselling and
testing/counsellor/training/counsellors/evaluation/health/HIV testing/medical/rapid HIV
testing/VCT
Abstract: Vision: The Department of Health's vision is to achieve excel lent, holistic, people-
centred and affordable health care in the Northern Cape.
Mission: We are committed to achieving our vision through a decentralized, accountable,
accessible and constantly improving health care system within available resources. Our caring,
multi-skilled, effective personnel will use evidence-based, informative health care and maturing
partnerships for the benefit of our clients and patients.
Goal:
We envisage expanding our counselling and testing programme in our province. We plan to
increase our current medical sites and counsellors. In addition we will introduce rapid HIV testing
343

and non-medical testing sites in the province. Our provincial VCT plan will consist of the following
elements for the first year 2000/2001:
1. Counsellor training
2. Mentorship
3. Placement of counsellors
4. Use of rapid HIV test
5. Introduction of non-medical testing sites
6. Advocacy of VCT programme
AIM: We aim at providing equitable counselling and testing services within the Northern Cape
Province.
7. Monitoring and evaluation.
Notes: 1 copy
Ntlabati, P., Kelly, P., & Makayi, A. (2001). The first time: An oral history of sexual debut
in a deep rural area. In (pp. 1-18). AIDS in Context Conference,University of The
Witwatersrand,April 2001: Centre for AIDS Development, Research and Evaluation (CADRE).
Ref ID: 82
Keywords: contraception/culture/gender/health education/pregnancy/pregnant/sexual
behaviour/sexual debut/women/Young people/youth
Abstract: This study involves an analysis of accounts of first and subsequent early sexual
experiences in a deep rural area of the Eastern Cape in South Africa. The study explores the
period from 1950 to the present and describes the changing nature of sexual experimentation and
sexual debut. Contextual factors mediating these changes are explored with special emphasis on
the changing regulatory practices around early sexual experience. The introduction of female
injectable contraceptive methods is understood to have significantly changed the context of early
sexual identified as having contributed to a sexual culture where male involvement in sexual and
reproductive health decision making has become negligible. This is seen as an important factor
to be taken into account in understanding male receptivity to condom use messages. Previously
344

anxiety about the social consequences of pregnancy were a significant disincentive to sexual
intercourse, and men accepted the need to practice non-penetrative forms of sex. Strong cultural
support for such practices has now all but disappeared. Low rates of condom use and very early
onset of sexual intercourse are attributed to changes in the regulatory practices surrounding
youth sexuality. Implications for HIV/STD prevention are discussed in this paper.
Notes: 1 copy
McCoy, D.
Ntuli A. (2003). South African Health Review 2001. Ntuli A., Suleman, F, Barron, P., and
Ref Type: Unpublished Work
Ref ID: 8813
Keywords: health/care/counsellors/counsellor/primary health care
Abstract: There is no doubt that HIV/AIDS is impacting on health service delivery in a myriad of
ways, some positive and some negative.Users of PHC with positive experience of health services
have found care facilities in HIV counsellors and support groups linked to primary health care
facilities as being of great importance.Staff bring to work their own needs arising from being
personally affected by the epidemic an/or find their jobs increasingly stressful as they feel
themselves to be helpless in the face of the growing incidence of HIV. A lack of resources is
hampering the fulfillment of potential improvement of quality care.
Nyblade (2001). Population-based HIV testing and counselling in Rural Uganda:
participation and risk characteristics. Journal of Acquired immune deficiency syndromes, 28, 463-
470.
Ref ID: 358
Keywords: HIV-status/HIV testing/male/men/sexual partner/Uganda/VCT/women
Abstract: Objectives: To assess self-selection in a population-based voluntary HIV testing risk
characteristics of users and counselling (VCT) program by comparing the HIV risk characteristics
of users and nonusers of VCT in rural Uganda.
Design: 1 1994 to 1995 community-randomized trial in the Rakai District of Uganda enrolled
345

adults aged 15 to 59 years and ascertained their HIV status, sociodemographic characteristics,
risk behaviors, and AIDS-associated symptoms. All subjects were offered confidential individual
VCT at no cost.
Methods: We compared users and nonusers of VCT among 10,950 participants (4764 male and
6186 female) enrolled as baseline using multivariate logistic regression.
Results: Women were significantly less likely to receive VCT than men (31.5% vs.34.8%,
p

Results: A total of 400 truck drivers were interviewed from June to August 1999. In Marianhill
118, Tugela 42, Reids 59, Ladysmith 56, Newcastle 66.90% of truck drivers consented to HIV
testing respectively and in November to December 1999, 85% of truck drivers received their test
results. In Tugela, truck drivers had negative attitude towards HIV testing due to educational
level and race. In Marianhill, most truck drivers refused HIV testing because they knew their HIV
status but after intensive counselling those who consented were HIV positive and they frequently
returned for HIV results than HIV negative truck drivers. Foreigner truck drivers consented for
testing but could not return for results due to migration.
Conclusion: Future implementation of intervention to reduce migration transmission of HIV
require truck stop condom promotion, counselling and HIV testing, to solve issue of acceptability
of HIV testing by truck drivers. Involvement of Department of Transport, Department of health,
and Truck owners, will control the spread of HIV/AIDS in South Africa.
Notes: 1 copy
O' Donnell, M. R., Knight, S., Campbell, L., & Van Andel, P. (2001). Knowledge, Attitudes
and Beliefs of patients accepting and refusing HIV Voluntary Counseling and testing in a hospital-
based TB clinic. 1-1-2001.
Ref Type: Unpublished Work
Ref ID: 8780
Keywords: care/clinic/counsellor/HIV testing/HIV
transmission/knowledge/strategy/transmission/treatment/VCT/WHO
Abstract: The examination of the knowledge, attitudes and beliefs(KAB) of TB patients regarding
HIV VCT. The aim of the study is to Identify which factors make patients likely to accept or refuse
VCT. To refine counseling strategies and better understand the KAB about AIDS. To monitor the
introduction of AIDS treatment modalities on KAB.
Data was collected by questionnaires that were given to patients, in Zulu by a trained counsellor.
TB patients that refuse VCT were compared with a control group of TB patients that accepted
VCT.Preliminary results revealed that TB patients who refused VCT were younger, better
educated, more female, more informed about HIV transmission, less likely to have had sufficient
347

information/privacy to make a decision. Most were willing to take a test if they had access to
treatment. TB patients who accepted HIV testing - older/less educated/ more males/ uninformed
about HIV transmission/felt they would receive better care if tested.
O'Reilly, K. R., Msiska, R., Mouli, C. V., & Islam, M. (1999). Behavioral interventions in
Developing Nations. In L.Gibney (Ed.), Preventing HIV in developing Countries: Biomedical and
Behavioral approaches (pp. 137-153). New York: Plenum Press.
Ref ID: 276
Keywords: community/Developing countries/evaluation/HIV prevention/intervention/prevention
Abstract: Though it has been a devastating event in most ways, the AIDS epidemic has had the
positive effect of forcing public to broaden its horizons and consider new approaches to
prevention. A rich epidemiological and behavioral literature now exists where previously only
outdated and incomplete information was available. An acceptance and growing understanding
of the need and the approaches required for meaningful behavioral change also now exist.
Within the area of behavioral interventions, new directions are developing, including prevention
efforts that take into account the broader societal context of risk and risk behaviors. These are
increasingly being used in conjunction with the more individual approaches that were borrowed
from cardiovascular disease or smoking prevention and characterized the earliest prevention
efforts. Most importantly, perhaps, is the increasing exchange of information and ideas between
industrialized and developing nations in the area of HIV prevention. Whereas previously the
developing world benefited from the guidance of industrialized countries especially in the design
of individual interventions, the industrialized world can now benefit from the creative societal and
structural approaches being developed and implemented in the developing world as well.
In this chapter, we review the evidence from the developing world, focusing our attention first on
the more traditional individual approaches and then on community approaches, including those
that address structural factors that relate to HIV risk behavior. We restrict our attention to those
interventions for which good evaluation data, focusing at least on behavior change, can be found
in the published literature. By doing so, we overrepresent intervention studies and unfortunately
underrepresent much of the behavior change efforts that take place in national HIV prevention
348

programs. In the process, we briefly review as well the evolving understanding of determinants of
HIV risk behaviors, in an attempt to help the reader understand the rationale and justification for
the creative approaches being tried in the developing world.
Notes: 1 copy
Okee- Obong, J. M. (2001). A comparative analysis of the social and historical roots of
the HIV/AIDS epidemic in Uganda and South Africa. Ludwig Boltzman Insitute for sociology of
health and medicine, University of Vienna. 1-18.
Ref Type: Organisational research report
Ref ID: 97
Keywords: comparative analysis/epidemiology/social/South Africa/Uganda
Abstract: The explosion of HIV/AIDS infection in Southern Africa makes it Africa's most threaten
region medically, socially and economically. In spite of the considerable body of bio-medical
research illuminating the causes and course of the disease, there is no equivalent level of
understanding of the social factors which have helped fuel the rapid expansion of HIV/AIDS in the
region. Regretfully, all too often the discussion of social factors does not proceed beyond
evoking a crude and un-differentiated role of poverty and/or migration. The specific interaction of
historical, social, political and cultural factors which have shaped the epidemic have neither been
explored nor specified.
Through the analysis of various literature on the evolution of the epidemic, this paper attempts to
fill the knowledge gap by examining and discussing the various views of the origin of HIV/AIDS,
the similarities and differences( including possible linkages) in the factors and ways in which it
has spread in the epidemiological environments of Uganda and South Africa. The findings not
only highlight and deepen our understanding of the similarities and differences of the historical
context of the spread of the disease in the countries, but also reveals a possible significant
linkage between the epidemic in Uganda and that in South Africa. The paper concludes that, in
spite of the possible linkage, the two countries have different epidemic and therefore should be
settings specific tailed to meet the local needs and problems.
Notes: 1 copy
349

Onifade, I. (1999). Unmet reproductive health needs of adolescents: Implications for
HIV/AIDS prevention in Africa. The continuing HIV/AIDS epidemic in Africa., 63-73.
Ref ID: 98
Keywords: intervention/Nigeria/prevention/reproductive health/sexual behaviour/Young
people/youth
Abstract: The foundations for sexuality, reproductive health and genders relations are laid very
early in life and these are influenced by the interplay of socio-cultural and economic factors, peer
pressures, mass media influences and familial forces which impinge on the lives of adolescents in
the society. Adolescents of today constitute one of the most dynamic human resource bases.
Unfortunately, they are missing out in the area of education about sexual and reproductive health.
This is despite their strong desire to participate in activities geared towards their reproductive
health and social development needs. Adolescents to WHO is the period of progression from the
appearance of secondary sexual characteristics ( puberty) to sexual and reproductive maturity,
the development of adult mental processes and adult identity as well as the transition from total
socio-economic dependence to relative independence. Adolescents are aged 10 to 19 years and
they constitute 20 per cent of the world's population. This sheer size of the adolescent population
should justify seriously addressing adolescent health issues, but this is not the case in developing
countries. The author of this paper did a study in Nigeria to find out the unmet needs of
adolescents, and the result was that there was an indication of the urgency of addressing the
unmet needs of adolescents.
Notes: 1 copy
45.
Ref ID: 8825
Oosthuizen, H. (2001). National Policy on Testing for HIV : review. Geneeskunde, 43, 43-
Keywords: National policy/policy/policies/Informed consent/HIV testing/South Africa/Africa
Abstract: Focuses on informed consent and the Draft National Policy on Testing for HIV.
Highlights the circumstances under which HIV testing may be conducted. Refers briefly to the
HIV/AIDS Strategic Plan for South Africa
350

Ouedraogo, H., Cartoux, M., Boncoungou, J., Reghini, M., & Van der Per (2000).
Seropositivity and polygamy: a necessity, break the silence. In (pp. 12).
Ref ID: 231
Keywords: Africa/family/infection/men/women
Abstract: Objectives: To identify what are problems that prevent to share the result of a positive
test in polygamous families.
Methods: As part of impact assessment of the counselling on the screening for HIV, a
psychosocial follow though is proposed to polygamists HIV+ each 3 months during one year.
During the counselling, the patient speaks about his everyday experiences with his partners:
break or keep silence?
Results: Twenty five polygamists have been followed (10 men and 15 women). Five are died
before one year (2 men and 3 women). One man has informed his partner about his
seropositivity. The other men (7) prefer to inform another member of his family( uncle, brother,...)
rather than their partners. Reasons of this silence are above all the fear of divorce and the
incapacity of women to keep the secret. Women prefer to keep silence (8 women in 12) because
of the fear of discrimination, divorce and guilty.
Conclusion: Polygamy is an important factor in the progress of HIV infection in Africa. Fight
against AIDS in Africa require to break the silence around HIV in every family, particularly in
polygamous families.
Notes: 1 copy
Own correspondents (2001). Homegrown immune booster: Age-old traditional herb
harnessed to help people deal with HIV. Independent on Saturday.
Ref ID: 1464
Keywords: clinic/health/medical/traditional healer/traditional healers
Abstract: Could indigenous plants hold the secrets to dealing with our AIDS pandemic? A
marriage between traditional healers, medical professionals and botanists had led to the birth of
an immune-boosting drug which has improved the quality of the life of some rural KwaZulu-Natal
people who are living with AIDS. Anecdotal evidence shows that weight gain of up 15 kg and
351

enewed vigour has been experienced by people attending the AIDS clinic attached to
Ngwelezane Hospital in Empangeni who receive the tablets monthly. However, KwaZulu-Natal
Health Minister Zweli Mkhize has warned that the breakthrough should not be seen as a signal
that indigenous herbs are a cure of AIDS. The country's most senior traditional healer, Dr Credo
Mutwa, is part of the multi-disciplinary team behind the drug which has been developed from an
indigenous plant who potent medicinal qualities were known in early times by Khoi, San and Zulu
healers.
Notes: 1 copy
Scan, 3, 3-15.
Ref ID: 108
Padayachee, N. & Evian, C. (1991). A relook at AIDS prevention in South Africa. AIDS
Keywords: attitudes/education/intervention/knowledge/media/prevention/research/South Africa
Abstract: As we approach the end of the first decade after identifying the first cases of AIDS in
South Africa it is appropriate to look at initiatives to deal with AIDS/HIV epidemic and assess the
success or failures of these initiatives, and to further identity important lessons learned about the
local epidemic. It is clear that the epidemic which was predominantly affecting the male
homosexual community has shifted significantly to the heterosexual population. In an epidemic
form it will affect predominantly those in the lower socio-economic groups and in South Africa this
affects predominantly the black population with the major expected impact on women and
children. Information from the AIDS knowledge, attitude and practice surveys published on
specific subgroups have revealed generally high basic awareness about the presence of the
disease, however there remains much ignorance of the facts about the disease, how it is spread
and how it is prevented. The studies further show that there is much negative perception towards
people infected with the disease and misconceptions about the manner in which the virus is
spread from one to another, denial of self risk for personal changes or intended changes towards
safer sexual practices. The limited studies on trends of the HIV epidemic indicate there has been
no major impact of education and awareness campaigns on the epidemic in general.
Notes: 2 copies
352

Painter, M. (2001). Voluntary Counselling and Testing for Couples: A high-leverage
intervention for HIV/AIDS prevention in Sub-Saharan Africa. Social Science and Medicine, 53,
1397-1944.
Ref ID: 362
Keywords: Africa/behavioural interventions/condom promotion/couples/couples
counselling/Developing countries/gender/Hetrosexual transmission/VCT/voluntary counselling
and testing/women
Abstract: Most HIV infections in sub-Saharan Africa occur during heterosexual intercourse
between persons in couple relationships. Women who are infected by HIV seropositive partners
risk infecting their infants in turn. Despite their salience as social contexts for sexual activity and
HIV infection, couple relationships have not been given adequate attention by social/behavioral
research in sub-Saharan Africa. Increasingly studies point to the value of voluntary HIV
counselling and testing (VCT) as a HIV prevention tool. Studies in Africa frequently report that
VCT is associated with reduced risk behaviors and lower rates of seroconversion among HIV
serodiscordant couples. Many of these studies point out that VCT has considerable potential for
HIV prevention among other heterosexual couples, and recommend that VCT for couples be
practiced more widely in Africa. However, follow-up in the area of VCT for couples has been
extremely limited. Thus, current understandings from social/behavioural research on how
couples in sub-Saharan Africa manage HIV risks as well as HIV prevention interventions to
support couples' HIV prevention efforts have remained underdeveloped. It appears that
important opportunities are being missed for preventing HIV infection, be it by heterosexual
transmission or mother-to-child HIV transmission by mothers who have been infected by their
partners. Based on an overview of documentation on VCT in sub-Saharan Africa, this paper
proposes that increased attention to couples-focused VCT provides a high leverage HIV
prevention intervention for African countries. The second half of the paper indicates areas where
VCT needs to be strengthened, particularly with respect to couples. It also identifies areas where
applied social/behavioral research is needed to improve knowledge about how couples in sub-
353

Saharan Africa deal with the risks of HIV infection.
Notes: 1 copy
Palmer, D., Mason, P. R., Pasi, C., & Tobiwa, O. (2000). Value of Mandatory Testing for
Human Immunodeficiency virus in a Sub-Saharan Hospital Population. Clinical Infectious
Diseases, 31, 1258-1268.
Ref ID: 101
Keywords: mandatory testing/medical/patient care/quality of care/Sub-Saharan Africa
Abstract: Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (
AIDS) are currently hyperendemic in Sub-Saharan Africa. HIVand AIDS have a special impact on
working -age populations, economic resources, certain illnesses, and health care facilities.
Assessment of HIV serostatus of hospitalized patients is rarely performed, however, because of a
reluctance to intrude on patient confidentiality, a perceived lack of benefit ( no antiretroviral
therapist available), and societal denial. We evaluated the effect on health care of HIV testing of
patients routinely admitted to medical wards in the 2 major city hospitals in Harare, Zimbabwe.
OF 196 patients tested, 58% were HIV positive with strong associations with infectious diseases,
and with youth and weight loss, but not with cardiac, pulmonary, endocrinologic, or renal
diagnoses, and not with rural versus urban location, occupation, sex, morality, or cost of
hospitalisation. The clinical estimate of patients' HIV serostatus was largely inaccurate.
Mandatory HIV testing of all hospitalized patients would improve diagnosis of infectious diseases,
clarify patient prognosis, allow for individual counselling with regard to HIV prevention, and focus
national health efforts by providing alarming, realistic statistics.
Notes: 1 copy
Parker, W. & Kelly, K. (2001). Writing the epidemic: The role of the South African media
in shaping response to HIV/AIDS. In (pp. 1-7). Presented at the AIDS in Context Conference,
University of the Witwatersrand, April 2001: Centre for AIDS Development Research, and
Evaluation (CADRE).
Ref ID: 107
354

Keywords: conference/discourse/media
Abstract: HIV/AIDS issues are prominently located in the mass media, and the presence of HIV/
AIDS content has escalated along with the epidemic. The South African press has followed this
trend. The role of the press in the AIDS epidemic is a prominent area of discourse amongst AIDS
workers and activists. Emerging research has tended to focus mainly on frequency and content
analyses of HIV/AIDS reporting. Little research has focussed on analysing the role of the press
with regard to developing an understanding of a proactive and strategic response to the epidemic.
This paper reviews reporting on HIV/AIDS in South Africa's mainstream press. If further reviews
the role of specialised health media projects- the Beyond Awareness Campaign's mediaworker's
project, the electronic Health-e news service, and the Cadre mass media advocacy programme.
A critical analysis of press response is utilised to develop a conceptual framework for a strategic
and appropriate mass media response to AIDS.
Notes: 1 copy
Parker, W., Fawcett, C., Stein, J., & Neves, D. (2001). HIV/AIDS and the Media: a
bibliographic review. CADRE. [-], 1-51.
Ref Type: Unpublished Work
Ref ID: 471
Keywords: Bibliographic review/media
Abstract: This document forms part of a range of activities conducted by Cadre as part of our
HIV/AIDS and Media Advocacy Programme. It represents a companion document to a literature
review of the titles listed. It contains abstracts which are a combination of author developed
abstracts, where these have been available, and original abstracts by the authors of this
Bibliographic review.
Notes: 1 copy
91, 448.
Ref ID: 180
Pawinski, R. (2001). Community attitudes to HIV/AIDS. South African Medical Journal,
355

Keywords: acceptability/attitudes/community/South Africa
Abstract: This letter refers to the editor: I refer to David Wilkinson's letter. It is to some extent a
relief to hear that the HIV/AIDS message appears to be reaching impoverishing (poor) areas of
an HIV-ravaged province like KwaZulu-Natal. In particular, statistics such as 95% of mothers
attended antenatal care' are most comforting and give the impression that health education is
reaching our poorest populations. I feel however, that the health practitioner in Kwa Zulu-Natal
should not be led astray by these inspiring statistics in an over-investigated population. I am sure
that many health workers in rural areas would not agree with the impression left by the author.
We are currently working at six sites in Kwa Zulu-Natal, and have come across a rather different
impression of the community's attitude. In a review of notes on 726 HIV-positive patients
attending infectious diseases clinics at Edendale and Nkonjeni hospitals, it was found that 65%
and 92% of patients, respectively, who had received pre- and post- test counselling had never
informed anyone in their community regarding their status. I feel that readers should be cautious
in interpreting Dr Wilkinson's letter and extrapolating the results to other rural communities in
South Africa. It is clear from the Ugandan experience and that in other HIV-ravaged areas that
although it is difficult to quantity the impact of health interventions accurately in these affected
areas, many adhoc programmes appear to improve situations to a beneficial and quantifiable
degree as opposed to no, or little, intervention. It is particularly encouraging that some
interventions in Hlabisa are making some positive impact. I hope that Dr Wilkinson's work will be
an inspiration to other communities in South Africa, and pave the path for behaviour-changing
interventions, as well as encouraging policy changes in the long term to facilitate this crucial
transformation.
Notes: 1 copy
Peers, I. S. & Johnston, M. (1994). Theory, utility and stakeholders: methodological
issues in evaluating a community project on HIV/AIDS. In M.Boullon (Ed.), Challenge and
innovation: methodological advances in social research on HIV/AIDS. (pp. 179-199). London:
Taylor & Francis.
Ref ID: 398
356

Keywords: community/education/evaluation/research/response/youth
Abstract: In has often been argued that evaluation is useless, and at times worse than useless.
Evaluation criteria that seem relevant at the outset may well prove more hindrance than help to a
project that is breaking new ground and exploring way of communicating on sensitive matters. By
working closely alongside the various activities of a community youth education project on HIV,
we have been able to find ways of tailoring our approach to their circumstance and needs. At the
same time, in the course of evaluating and innovative and developing project, we have been
obliged to reassess evaluation approaches. In consequence, our experience has highlighted
several dilemmas and contradictions, and moreover we think we have gone some way towards
devising and approach that combines the demands of objectivity and accountability with the need
for a sensitive and adaptable response. In this chapter, we describe the project and the
evaluation approach we adopted, and the discoveries we made in the course of our attempts to
apply the latter.
Notes: 1 copy
Ref ID: 3155
Peete, F. (2001). Plea for State, traditional healers to work together. Pretoria News.
Keywords: Africa/America/condom/conference/Europe/medical/research/South Africa/traditional
healers
Abstract: Traditional healer and author Credo Mutwa said that the attitude of medical that the
attitude of medical practitioners and the government towards traditional healers was denying
South Africa a possible breakthrough in finding an HIV/AIDS cure. Mr Mutwa, who will speak on
the role of traditional medicines in South African society next week at the first national conference
on HIV/AIDS by traditional healers, said the government's attitude was demonstrated when
traditional healers, said the government's attitude was demonstrated when traditional healers
were locked out of the Durban conference on AIDS. He said co-operation between medical
practitioners and traditional healers was needed to find the solution to HIV/AIDS. The impact of
AIDS, he said, did not need the divisions existing in South African society because it affected
everyone. Mr Mutwa, who will speak on the role of traditional medicines in South African society
357

next week at the first national conference on HIV/AIDS by traditional healers, said the
government's attitude was demonstrated when traditional healers were locked out of the Durban
conference on AIDS. He said co-operation between medical practioners and traditional healers
was needed to find the solution to HIV/AIDS. The impact of AIDS, he said did not need the
divisions existing in South African society because it affected everyone. Mr Mutwa said
traditional healers had a role to play in the fight against AIDS because they had discovered the
herb Sutherlandia, also known as Kankerbos, which needed to be investigated by medical
researchers to find out if it could be helpful. He said people with AIDS who had been " sent home
to die" because medical doctors could not do anything about their conditions, had been treated
with Sutherlandia by traditional healers and had improved. " We therefore need each other in the
interest of the people we claim to be caring for " We just help them without asking who came up
with the solution. There is no need for others to claim credit while our people are dying" Mr
Mutwa said. Traditional healers had been demonised and yet they could easily cure other AIDS -
related diseases, he said. "A person with HIV usually develops thrush, which can easily be cured
by a herb called for traditional healers. "So why can't we work together of fight this common
enemy? " he asked. Mr Mutwa said everything that came from Europe or America was regarded
as the best and everything from Africa the worst. "The use of condom is nothing new to Africans,
but today people speak about them as if they were never used for birth control by people in
Africa. " The difference here is that today people are using a rubber, while Africans used a gall
bladder". He said Dr Sydney Tembo of Mendusa would speak about the importance of research
on traditional medicine at the conference, which was being hosted by the Nyangazezizwe
Traditional Healers Organisation in the city from March 19 to 21. " We intend to use the
conference to inform those who are interested in working together to find the cure for HIV/ AIDS, "
Mr Mutwa said. "We hope to destigmatise AIDS and will add our voice to encourage people to
use condoms".
Notes: 1 copy
Peltzer, K., Hira, S. K., Wadhawan, D., & Kamanga, J. (1989). Psychosocial counselling
of patients infected with human immunodeficiency virus(HIV) in Lusaka, Zambia. Tropical doctor,
358

19, 164-168.
Ref ID: 106
Keywords: model/positive status/prevention/psychology/social/stress/transmission/Zambia
Abstract: We describe a method of psychosocial counselling that we have used with HIV-infected
patients in Zambia. The protocol included providing the patient with factual information about HIV
infection, understanding the patient's concept of their illness, and teaching the need to change
sexual behaviour, reduce alcohol consumption, prevent stress, and adjust to family changes. Our
aims have been to enable HIV-infection persons to avoid behaviour that might damage their own
health, to minimize further transmission of HIV, and to prolong the period of transmission of HIV,
and to prolong the period of asymptomatic of HIV, and to prolong the period of asymptomatic HIV
infection and life expectancy.
Notes: 1 copy
Perakyla, A. & Bor, R. (1990). Interactional problems of addressing 'dreaded issues' in
HIV - counselling. AIDS care, 2, 325-338.
Ref ID: 103
Keywords: communication/conversation analysis/counsellor/counsellors/model/patient care
Abstract: Addressing the patient's fears about the future is an essential task in HIV counselling.
The paper examines with conversation analytical methods the interactional dynamics of such
discussions in video- and audio- taped counselling sessions with patients coming for an HIV test
and other diagnosed as HIV antibody positive. Two communication formats were found to be
used in the session, one based on information delivery made by the counsellor and the other on
interviewing the patient. The interactional tasks in the use of the interview format include
persuading the patient to produce his/her own views of the future and moving from mere
expression of troubles towards their management.
Notes: 1 copy
Perkel, A. K., Strebel, A., & Joubert, G. (1991). The psychology of AIDS transmission-
issues for intervention. South African Journal of Psychology, 21, 143-152.
359

Ref ID: 105
Keywords: attitudes/intervention/knowledge/psychology/South Africa/transmission
Abstract: In this study various aspects of AIDS amongst a sample of students at the University of
the Western Cape in South Africa are examined. A modified version of the World Health
Organisation Survey on knowledge mediating between knowledge and behaviour change, were
used. Included were psychological defences of denial, rationalization and repression, social
variables of peer pressure and sexual self-concept, and locus of control. Results indicated a
number of significant relationships among variables. These are discussed together with their
implications for appropriate intervention strategies.
Notes: 1 copy
Perry, S. (1991). Effectiveness of Psychoeducational interventions in reducing emotional
distress after Human Immunodeficiency Virus antibody testing. Arch Gen Psychiatry, 48, 143-
147.
Ref ID: 465
Keywords: antibody/intervention/prevention/training/treatment/Virus
Abstract: To examine the effectiveness of three psychoeducational interventions in reducing
emotional distress after voluntary sorologic testing for human immunodeficiency virus-1, 307
physically asymptomatic adults were randomly assigned to standard counselling, counselling plus
a three-session interactive video program, or counselling plus six individual sessions of stress
prevention training. Subjects were evaluated using five standardized distress measures
decreased significantly after all three interventions without differential treatment effects. Among
the 103 human immunodeficiency virus-seropositive subjects, mean distress measures
decreased significantly after the stress prevention training and did not significantly increase in the
other two interventions. We conclude that stress prevention training is particularly helpful after
notification of human immunodeficiency virus seropositivity.
Notes: 1 copy
360

Perry, S. W. & Markowitz, J. C. (1988). Counselling for HIV Testing. Hospital and
Community Psychiatry, 1-13.
Ref ID: 110
Keywords: confidentiality/guidelines/post-test/pre-test/prevention/primary prevention/secondary
prevention/support/VCT/voluntary counselling and testing
Abstract: Recommendations are presented for counselling individuals who wish to know if they
have been infected by the human immunodeficiency virus (HIV). Pretest counselling includes
explaining the antibody tests and the limits of confidentiality, assessing the patients potential
strengths, vulnerabilities, coping capacity, and supportive resources, and mutually deciding if the
test is advisable. Populations that have been identified as at risk for HIV infection are listed, and
four case vignettes that illustrate the complexity of the decision to be tested are provided. Post-
test counselling includes notification of test results, reducing the immediate distress of
seropositive patients, educating about how HIV is and is not spread, explaining methods to
prevent transmission, advising the patient about who should be told the test results, and
arranging follow-up care.
Notes: 2 copies
Perry, S. W., Jacobsberg, L. B., Fishman, B., Weiler, P. H., Gold, J. W. M., & Frances, A.
J. (1990). Psychological responses to serological testing for HIV. AIDS, 4, 145-152.
Ref ID: 703
Keywords: impact/post-test/response/symptom
Abstract: To determine the emotional impact of serological testing for HIV, 218 physically
asymptomatic adults were evaluated in a confidential clinical setting 2 weeks before HIV test
notification, immediately before and after notification, and 2 and 10 weeks later. All received
extensive pre- and post-test counselling. The 179 seronegatives reported one or more HIV risk
behavior: homosexual intercourse (n=111), heterosexual intercourse with possibly infected
partners (n=62), intravenous drug use ( n=20). Immediately after notification, seronegatives
significant decreases in visual analogue scale (VAS) measures of anxiety, depression , fear of
getting AIDS, and fear of having infected others. Reductions were sustained at both follow-up
361

assessments and were complemented by significant reductions on standardized self-reported
measures of anxiety, depression and psychiatric symptoms as well as by clinical ratings of
depression. Of 39 seropositives, 35 had homosexual risk behavior, seven had been intravenous
drug users, and one was a female partner of an IVDU. Immediately after notification. VAS
measures of their anxiety were not significantly increased, and at 10 weeks after notification, their
VAS measures of distress and mean scores on BDI, SAI and BSI were significantly lower than at
entry. Their HDRS ratings were not significantly increased.
Notes: 1 copy
Ref ID: 5312
Keywords:
Phahlane., C. (2001). Treatment of AIDS a top DA priority. Cape Argus.
Africa/conference/drugs/government/Johannesburg/medical/Parliament/policies/policy/political/pr
evention/South Africa/treatment/Virus/WHO
Abstract: The Democratic Alliance has taken advantage of the government vacuum in providing
AIDS treatments to launch its own draft policy on HIV/AIDS in the Western cape which focuses
on treatment of patients.
DA leader Tony Leon, addressing a one-day DA conference on HIV/AIDS held in Parliament
yesterday, said South Africa needed leadership in the fight against HIV/AIDS and the nearly 5
millions South Africans with the ease could not wait any longer for President Thabo Mbeki, who
has questioned the causal link between HIV and AIDS. Leon said the conference concentrated
on the treatment regime since it was "not clear" what the government's treatment regime was.
But prevention of the spread of the virus was still crucial.
"Two weeks ago, when I visited Johannesburg General Hospital, It was shocked to be told that of
the weekend admissions, 50% of pediatric admissions and 80% of general medical admissions
are HIV positive.
"With sufficient political will, the DA believes it would be possible to implement an effective,
comprehensive anti- retroviral treatment programme in South Africa, " Leon said.
The DA policy requires the provision of cheap anti-retroviral drugs, a process where the
362

government is folding its hands, he said.
Notes: 1 copy
Phili, R. & Abdool Karim, Q. A. (2000). Enhancing programmatic intervention to reduce
mother -to-child transmission (MTCT) of HIV: The role of rapid HIV antibody tests. In (pp. 1).
Durban.
Ref ID: 220
Keywords: Africa/antibody/clinic/evaluation/health/health worker/HIV
testing/intervention/MTCT/prevention/training/transmission/women
Abstract: Background: A number of rapid HIV antibody assays have been developed over the
past few years. These vary in sensitivity and specificity when compared to standard enzyme
immunoassays (ELA). In settings such as primary health care clinics (PHC), where the laboratory
infrastructure is limited or non-existent, rapid assays could be an important component of HIV
prevention programmes. A field evaluation of the Abbot Determine (tm) RHAT was undertaken at
an urban PHC.
Methods: The study population consistent of pregnant women at Kwa Dabeka PHC and st Mary's
clinic near Durban(South Africa) who had consented to HIV testing after care providers at this
facility. These health care workers had previously received training on how to conduct the test.
Whole blood was used and internal performance control is built into each essay. An EIA was
repeated on specimens from each participant. Results from the RHAT were compared with the
EIA.
Results: Preliminary analysis of the 40 specimens tested thus far indicate a 100% correlation
between EIA and Determine in conducting RHAT.
Conclusion: Determine (tm) has high correlation with EIA, ease of use, internally controlled,
stable and can be stored at PHCs. It could be an important tool of HIV testing at PHC and
settings with limited laboratory infrastructures as well as where follow-up visits to obtain results
can pose problems for patients.
Notes: 1copy
363

Philips, K. A. & Coates, T. (1995). HIV counselling and testing: research and policy
issues. AIDS care, 7, 115-125.
Ref ID: 104
Keywords: barrier/barriers/evaluation/policy/prevention/research/VCT/voluntary counselling and
testing
Abstract: The research and policy issues pertaining to HIV counselling and testing ( C& T) have
evolved since 1985, when a test to detect HIV antibodies first became available. In this paper we
examine current and future research and policy issues relevant to C& T. We divide our
discussion into three general areas which provide an illustration of key issues: (1) barriers to
testing, (2)the role of public policy; and (3) the role of C& T in HIV prevention.
Notes: 1 copy
Phirri, P., Nzawa, C. E., Chimzizi, R. K., Faussett, G. P., & Hargreaves, N. J. (2000).
Introducing clinical services at a voluntary counselling and HIV testing centre in Malawi, as part of
the protest initiative. In (pp. 1).
Ref ID: 255
Keywords: condoms/family planning/HIV testing/infection/medical/pre-test
Abstract: Issues: The Malawi AIDS counselling and Resource Organisation (MACRO) is a non-
government organisation providing voluntary counselling and HIV testing (VT) services in Malawi.
It currently has two VT centers, one in Blantyre and one in Lilongwe. Services offered to clients
at the Lilongwe centre were expanded by employing a full-time clinical officer to provide on-site
treatment for common medical problems.
Description: MACRO- Lilongwe is based in a residential suburb of Lilongwe, the capital of
Malawi, a city with a population of 1.3 million people and an ante-natal seroprevalence of 26%. In
1999 1579 male clients, and 431female clients attended for pre-test counselling, of whom 14%
were HIV-positive. This paper will describe the utilisation of the medical services provided at the
centre by VT clients. Screening for TB and sexually- transmitted infections was introduced,
family planning methods in addition to condoms were provided, treatment for sexually transmitted
infections and common opportunistic infections became available. The profile of clients
364

accessing the new medical services will be compared with the profile of all clients registering at
MACRO-Lilongwe. The experience of screening, drug requirements, and the range of clinical
problems encouragement encountered at this VT centre will be presented.
Conclusions: There is considerable demand for clinical services in this resource-poor setting,
even amongst a group of clients that access VT services for primarily non-medical reasons.
Notes: 1 copy
Pickering, H., Quigley, M., Pépin, J., Todd, J., & Wilkins, A. (1993). The effects of post-
test counselling on condom use among prostitutes in The Gambia. AIDS, 7, 271-273.
Ref ID: 100
Keywords: condom/condoms/efficacy/intervention/post-test/prostitutes/sexual behaviour/The
Gambia/VCT/voluntary counselling and testing
Abstract: Prostitutes in the Gambia, as in other African countries, constitute a reservoir of HIV
infection . The prevalence of HIV infection in the general Gambian population in 1988 was 1.7%,
versus 26.2% and 30.7% in prostitutes in 1988 and 1989, respectively. The provision of condoms
and education about the necessity of their use with all sexual contacts is the most practical
intervention in these high-risk populations. There has been some debate about the advantage
and disadvantages of informing people of their HIV status when full counselling and follow-up
care cannot be provided. It has been suggested that without concomitant counselling, individuals
who are told that they are HIV-positive may suffer severe psychological disturbance or put sexual
partners at risk. A study was done in The Gambia with an objective to determine the effect of
counselling on condom use by prostitutes. Thirty-one (12 HIV -positive and 19 HIV - negative)
prostitutes participated in the study. The result of the study, was that the overall, counselling had
no effect on condom use. And it has been concluded that scarve resources should be directed
towards providing condoms in bars rather than counselling.
Notes: 3 copies
Ref ID: 3103
Pienaar, A. (2001). 50 000 in SA gebruik kankerbos teen vigs. Beeld.
365

Keywords: drugs
Abstract: Sowat 50 000 mense in Suid-Afrika word reeds met 'n tabletvorm van kankerbos teen
MIV/vigs behandel. Dr Nigel Gericke van Stellenbosch het gese hy en 'n groep kollegas werk
reeds geruine tyd saam met tradisionele genesers, onder andere die Afrika- skrywer en filosoof
Credo Mutwa, om "wyer waardering" van tradisionele kruiemedisy ne te bevorder. Mutwa het
vandes week gese kankerbos word al jare deur tradisionele genesers gebruik vir die behandeling
van onder meer griep en nou ook MIV/vigs. Volgens Gericke is die plant reeds op vier
kommersiele plase in Suid Afrika aangeplant. "Ons behandel tans sowat 50 000 mense per
maand met 'n tablevorm van kankerbos wat deur Impilo Drugs, 'n geregistreerde farmaseutiese
vervaardiger in Durban, vervaardig word. Ons beoog om teen volgende jaar 'n miljoen mense
per maand te behandel."
' n Maand se hehandeling met die tablet kos R 70 by 'n apteek. Hulle hoop om dit heelwat
goedkoper regstreeks aan werkgewers en ander organisasies te verskaf. Volgens Gericke is
kankerbos nie 'n kuur vir MIV/vigs nie, maar bied dit pasiente 'n kans op 'n beter lewensgehalte.
Volgens gebruikers berbeter dit nie net die eetlus nie, maar verhoog ook die witbloedseltellings.
Kankerbos is in 1918 se groot griep deur Zoeloes gebruik en is nou nog gewild. "Ons kan nie
kliniese toetse bekostig nie en het die regering en die Mediese Navorsingsraad versoek om die
moontlikheid te ondersoek. "Die Medisynebeheerraad het na twee versoeke die afgelope jaar
steeds nie na ons teruggekom nie," het hy gese. "Ons wil nie vals hoop gee aan die publiek nie.
Die behandeling van MIV/vigs verg 'n holistiese benadering waar Westerse vigs medisyne in
kombinasie met die traditionele gebruik word."
Notes: 1 copy
Pietermaritzburg-city Health department. (2002). AIDS Protocol.
Ref Type: Unpublished Work
Ref ID: 526
Keywords: Pietermaritzburg
Abstract: The paper outlines the aspects which should be taken into consideration when
366

counselling a possible AIDS clients.
Notes: 1 copy
Pinching, A. J. (1996). AIDS research: solidarity? rivalry? fraternity? In
M.J.a.T.D.J.M.Mann (Ed.), AIDS in the world II: global dimensions, social roots, and responses:
the global AIDS policy coalition. (pp. 205-211). New York, Oxford: Oxford University.
Ref ID: 383
Abstract: People looking at AIDS research from the outside - whether they are from the media,
from advocacy groups, or are researchers in other fields - have often failed to grasp the nature of
the research process in general and how it has been applied to AIDS. They have tended instead
to focus on a few big issues, which have not been representative of the bulk of research being
done and which often have been caricatured beyond all recognition.
Notes: 1 copy
Ref ID: 109
Pinto, I. (1993). Guidelines for partner notification. AIDS Bulletin, 2.
Keywords: confidentiality/couples/guidelines/partner/partner notification/positive status
Abstract: This article suggests guidelines for partner notification mainly in the context of STDs
other than HIV. There are some important differences and similarities between partner
notification for STDs and partner notification for HIV which should be noted. Both STDs and HIV
are health problems which must be handled with self respect and respect for others and with a
sense of responsibility. Patients should be made aware of the effects on themselves and others
so that they can assume ownership of the problem. The most important difference between other
STDs and HIV is that STDs are usually treatable and do not elicit the same fear, suspicion and
prejudice that HIV infection does. Partner notification in case of HIV, for which there is no
curative treatment, must therefore take cognisance of these fears and ensure confidentiality and
anonymity.
Notes: 1 copy
367

Pitts, M. & Jackson, H. (1993). Press coverage of AIDS in Zimbabwe: a five-year review.
AIDS care, 5, 223-231.
Ref ID: 99
Keywords: education/health/health education/media/Zimbabwe
Abstract: Five years of newspaper coverage of HIV and AIDS in Zimbabwe is examined. Both
the number of items and the amount of space devoted to the topics has increased steadily over
the 5 years. The nature and content of the items show a continuing bias towards issues more
closely associated with western patterns of the epidemic, and comparative neglect of personal
stories, local issues and items with a counselling focus. Language is also examined and found to
reflect a victim and war imagery. The implications for health education in the country are
considered and specific recommendations for more constructive media coverage are made.
Notes: 2 copies
Pool, R., Nyanzi, S., & Whitworth, J. A. G. (2001). Attitudes to voluntary counselling and
testing for HIV among pregnant women in rural South -West Uganda. AIDS care, 13, 605-615.
Ref ID: 102
Keywords: attitudes/barrier/barriers/confidentiality/pregnancy/pregnant/Uganda/VCT/voluntary
counselling and testing/women
Abstract: This paper describes the results of a study exploring the attitudes of women attending
maternity clinics to voluntary counselling and testing during pregnancy in rural areas in South-
West Uganda. It was a qualitative study using focus group discussions (FGDs). Twenty -four
FGDs were carried out with 208 women attending maternity clinics in three sites in rural South
West Uganda. The FGDs were recorded and transcribed, and analysed using standard computer
-based qualitative techniques. Almost all women were willing in principle to take on HIV test in
the event of pregancy, and to reveal their HIV status to maternity staff might refuse to assist them
when the time came to deliver if their status were known. This applied more to transitional birth
attendants than to biomedical health staff. There were also rumours abut medical staff
intentionally killing HIV-positive patients in order to stem the spread of the epidemic. Women
were concerned that if their husbands found out they were HIV-positive they would be blamed
368

and separation or domestic violence might result. In Conclusion: although VCT during pregnancy
is acceptable in principle, much will need to be done to ensure confidentiality and allay women's
fears of stigmatisation and discrimination during delivery. Community sensitisation will be
necessary and male partners will have to be involved if interventions are to be acceptable.
Notes: 1 copy
Ref ID: 454
Price, I. (2000). Tygerbergse vigssentrum "sal hospitale se las verlig". Die Burger.
Abstract: Kaapstad - Die joan cousin MIV/vigs-sending wat pas sy deure in Kasselsvlei Weg 30,
Bellville-Suid oopgemaak het, kan die las vermy van hospitale en klinieke om dat al meer mense
daar raad en leiding oor MIV en vigs soek. So het die stigter van die sentrum, mnr. David van
Neel, gese. "Medici kan nou pasiente hierheen verwys vir berading, maat skaplike dienste soos
die verkryging van ongeskiktheidspensioen en ander dienste soos die toesting van bloed. 'n
opgeleide span beraders verskaf ook, waar nodig, tuisversorsing." Die vigssending wil veral
voorligting gee aan mense in die werkplek en by skole, kerke en gevangenisse. Van Neel se
boek HIV/aids and the workplace het onlangs verskyn en word gratis reg oor Suid-Afrika versprei.
Die boek het ook al belangstelling uit die buiteland, veral Amerika ontlok. Wes- Kapenaars kan in
die sentrum gratis bloedtoetse kry, berading ontvang en opgelei word om mense met vigs te help.
" Ons het ook 'n voedingskema vir behoeftige vigs lyers," het Van Neel gese. Volgens hom toon
die jongste syfers dat 18% van mense in die provinsie MIV- positief is of vigs het. Die
persentasic neem geweldig vinnig toe, hoofsaaklik weens onkunde. Hy het op maatskappye 'n
beroep gedoen om hul personeel in te lig oor MIV en vigs en so kennis in die stryd teen vigs te
gebruik. Die Vigssending maak aanstaande maand nog twee takke oop - in Elsiesrivier en op
Piketberg - en wil teen April ook in Khayelitsha en kleinvlei gevestig wees. Nog inligting of
telefoniese en tuisberading is in kantoorure gratis beskikbaar by 0800448243. Van aanstaande
maand kan mense van 8vm.tot 10 nm.be.`
Notes: 1 copy
369

Pronyk, P. M., Kim, J. C., Makhubele, M. B., Hargreaves, J. R., Mohlala, R., & Hausler,
H. (2002). The introduction of Voluntary Counselling and Rapid Testing for HIV in rural South
Africa - from theory to practice. University of the Witwatersrand and National Department of
Health and Welfare (pretoria). [-], 1-13.
Ref Type: Organisational research report
Ref ID: 334
Keywords: counsellor/rapid testing/South Africa/VCT/voluntary counselling and testing/women
Abstract: Expanding access to voluntary counselling and testing (VCT) for HIV is an important
first step in the development of a comprehensive package of HIV services. This paper describes
the introduction of VCT among five primary health care (PHC) facilities in a rural South African
setting, alongside a multidimension impact assessment as part of a national pilot programme. A
baseline review of services demonstrated low levels of VCT, which were predominantly hospital-
based. Health workers in 5 PHC facilities were trained to provide VCT using rapid-testing assays.
The feasibility of VCT introduction and its overall acceptability to clients and providers were
evaluated using clinic testing registers, semi-structured interviews with counsellors and mock-
client encounters. One year after its introduction, a major increase in the quantity of HIV testing,
the proportion of clients who receive their results, and the proportion who present voluntarily was
observed. The majority of those presenting were women, and 18-34 year old predominated.
There was a high level of acceptance among health workers, and the quality of VCT was rated
very good in mock-client encounters. This work demonstrates one effective model for improving
access to VCT through existing primary health care services in a rural South African context.
Notes: 1 copy
VCT Budget.
Provincial administration Western Cape. (2000). Provincial administration Western Cape
Ref Type: Unpublished Work
Ref ID: 573
Keywords: VCT/Western Cape province
370

Abstract: This paper contains only the provincial administration Western Cape VCT budget
Notes: 1 copy
Provincial HIV/ AIDS Action Unit (2001). VCT- Live longer
-Live better. Sowetan.
Ref ID: 7002
Keywords: VCT
Abstract: The article gives the definition of VCT, of counselling. It outlines the three kinds of HIV
counselling, pre-test, post-test and ongoing. The kinds of HIV antibody test used, and the VCT
goals are mentioned.
Notes: 1 copy
Provincial HIV/AIDS Action Unit (2002, January 1). Voluntary Counselling and Testing
live better, live longer with VCT. Natal Witness.
Ref ID: 8805
Keywords: voluntary counselling and testing/VCT/benefits
Abstract: An Advertisement by the Provincial HIV/AIDS Action unit listing the benefits of VCT and
contact details of VCT resource sites
Sunday Times.
Ref ID: 2218
Rabinowitz, R. (1998). The Aids epidemic can be controlled by protecting the public.
Keywords: health/health policy/policies/research
Abstract: It is up to politicians to decide on the treatment of Aids. However, it is the responsibility
of those involved with health policies to be well informed about the wide range of treatments
available and to be extensively briefed on all possible cures. Most research into Aids has been
done in the field of allopathic medicine in an attempt to curb the virus itself, but since Aids is a
disease that suppresses the immune system , we need to investigate ways of stimulating
immunity, if not to cure the disease, at least to delay the onset of full-blown Aids.
Notes: 1 copy
371

Rachier, C., Arthur, G., Doyle, V., & Muteni, R. (2000). HIV/AIDS prevention and care
(HAPAC) project: counselling services: how can quality be assured? In.
Ref ID: 240
Keywords: clinic/confidentiality/counselling and testing/evaluation/health/HIV/AIDS
counselling/Kenya/post-test/prevention/research/training/voluntary counselling and testing
Abstract: Issues: Counsellors world wide have been providing HIV/AIDS counselling for many
years with the assumption that they are helping clients. Although training has been standardised,
little is known about counselling practice post qualification and supervision is rare. This is
dangerous because counselling has no neutral effect- it is indeed for better or worse.
Measurable quality indicators and accurate assessment methods need to be established.
Description: This work was carried out for an operational research project integrating voluntary
counselling and testing services into primary health clinics in Kenya. Currently 885 clients have
received counselling in 3 clinic based VCT services. Clinic counsellors hold recognised
counselling certificates of above 150 hours. The supervisor has a counselling MA, training and
supervision experience. This paper will examine 100 counselling sessions to compare 3
approaches to evaluating quality: client exit interviews, counsellor self-assessment questionnaires
and supervisor evaluation of audio taped sessions. Clients expectations and priorities, derived
from FGDs with post-test clients, were used to identify suitable variables. These corroborated
counselling theories and included the welcome, confidentiality, listening, understanding, honesty,
respect and HIV/AIDS information giving. Clients, counsellors and supervisor, using
questionnaires with comparable 5 point scales for each variable, independently rated the session.
Levels of quality and inter-rater differences are reported.
Conclusion: Ratings by clients, counsellor and supervisor broadly concurred and suggested
sessions were high quality. Counsellors tended to under-rate their effectiveness where as clients
and supervisor ratings were very closely matched. This suggests that quality assurance in
counselling could be conducted cheaply and effectively using client exit interviews.
Notes: 1 copy
372

Ref ID: 6153
Rademeyer, A. (1999). 'Almal moet weet wat HIV-status is'. Beeld.
Keywords: HIV-status
Abstract: Sentrums landwyd waar mense hulle vir HIV/vigs kan laar toets en waar hulle ook
berading kan kry, is van die prioriteite waarna die departement van gesondheid in die toekoms
sal moet kyk. Dit is uiters noodsaaklik dat mense wat HIV/vigs het van hul status bewus is sodat
hulle nie in onkunde voortgaan on die virus te versprei nie. So het dr. Manto Tshabalala-
Msimang, minister van gesondheid, gister in Pretoria gese waar sy die media toegespreek het
oor die eerste viering van die Vennootskap teen Vigs. Pres. Thabo Mbeki het die projek verlede.
Hy het toe gese die mag om die verspreiding van HIV/vigs te bekamp le in vennootskappe.
Verskeie sektore van die samelewing, organisasies en individue het hulle toe daartoe verbind om
op te tree teen die epidemie. Tshabalala- Msimang het gister 'n weeklange program, wat van
Vrydag tot 9 Oktober sal duur, aangekondig waarby verskillende vennote teen HIV/vigs betrokke
sal wees. Die tema vanjaar is " Ons oprede tel". Van 1 tot 3 oktober sal geestelike leiers
nasionaal in eredienste en op alle plekke van aanbidding die boodskap van voorkoming,
ondersteuning, die versorging en aanvarding van mense met die siekte bring. "As geestelike
leiers is dit ons plig om mense aan te moedig om aan die veldtog teen die siekte deel te neem en
aan ouers en kinder te se die stryd teen HIV/vigs begin in elkeen se huis. "Ons moet aan ouers
se dis hul verantwoordelikheid om openlik met hul kinders oor seksualiteit te praat voordat ons dit
onderwerpe in Sondagskole maak," het dr.Jo Seoka van die Anglikaanse Kerk gese. Seoka het
gese HIV/vigs is 'n kwessie wat met opvoedig verband hou. "En ons moet dit nou aanpak,
voordat die situasie in KwaZulu-Natal, waar nou meer mense sterf as wat gebore word,
'werklikheid in die res van die land word," het hy gese. Seoka het ook gese hy glo die enigste
boodskap aan die jeug is "geheelonthouding". Die geestelike leiers van die Muti-Faith
organisation kom vandag in Johannesburg byeen om hul veldtog bekend te maak. Van die ander
bedrywighede wat vir die komende week beplan word, is werksessies vir tersiere instellings op 1
en 2 Oktober by die Koanong-hotel in Benoni, 'n " Oproep tot Aksie" om 12:00 op 8 Oktober oor
die radio en TV, 'n konsert deur bekende kunstenaars op 8 Oktober van 12:00 tot 15:00 in
373

Carletonville en 'n gemeenskapsgeselligheid op 9 Oktober van 11:00 tot 13:00 in Mendusa se
sportsaal.
Notes: 1 copy
Ref ID: 3482
Radinku, D. (2001). Patient must be told about counselling. City press.
Keywords: post-test/pre-test
Abstract: Vaal, AIDS would like to appeal to local doctors, general practitioners and hospital-
based doctors doing blood tests, especially the HIV/AIDS test, that such patients must be
referred to pre-test counselling before undergoing the best. If the results are positive, the
patient must be referred for post-test counselling. This principle applies to community members
as well. People should not just accept their blood being taken for HIV/AIDS tests without
counselling. Everyone has a right to accept or refuse the request for a blood test, irrespective of
the seriousness of the illness. People undergoing blood tests without counselling might become
very depressed by a possible result, unable to cope with the repercussions for a long time.
Notes: 1 copy
Ramakhula, S. (1991). AIDS: Planning and Maintaining a Helping Service. South African
Black Social Workers Association Journal, 7, 16-17.
Ref ID: 111
Keywords: guidelines/service delivery/support
Abstract: The paper describes the planning and maintenance of a helping service. It is an
objective account and uses the analogy of an AIDS service where applicable. The paper is
divided into two sections. The first section identifies and describes important factors to consider
when setting up a helping service. These include missions, goals, objectives and steps. The
second section focuses on maintaining the service and describes a cyclic process which covers
several aspects that need to be considered when maintaining the service on an on-going basis.
Notes: 1 copy
374

Ramjee, G. & Gouws, E. (2001). Targeting HIV-prevention efforts on truck drivers and
sex workers: Implications for a decline in the spread of HIV in South Africa. AIDS Bulletin, -, 14-
15.
Ref ID: 280
Keywords: HIV prevention/sex workers/Southern Africa/truck drivers
Abstract: The role of mobile populations in the spread of the human immunodeficiency virus(HIV)
has been documented in several countries worldwide. The role of truck drivers and sex workers
in the spread of HIV has been studied in Afrika, India, and the USA. Due to the migratory nature
of their occupation, truck drivers tend to have multiple sexual partners. The potential roles of
truck drivers and sex workers in the spread of HIV in Southern Africa are being explored through
a combination of qualitative and quantitative studies among these population groups in South
Africa. Ten sex workers from five truck stops (van Reenen, Reids, Tugela, Newcastle and
Warden) in the KwaZulu-Natal Midlands were recruited as field workers. They were trained to
obtain informed consent, administer a questionnaire to obtain socio-demographic data and collect
a saliva sample for an HIV test from men they have sex with. HIV prevalence and demographic
data for 194 women sex workers operating from these truck stops were obtained from ongoing
vaginal microbicide trial among sex workers
Notes: 1 copy
Ramothoada, P. (2001). Don't jump! The HIV virus can be managed: HIV positive people
often turn to suicide to end their suffering, writes. City press.
Ref ID: 7764
Keywords: suicide
Abstract: How many people in this country try to commit suicide or actually succeed in doing so
every week? And why to they do it? Well, everyone has his or her own reasons. But something
struck me when I read an article in last week's City Press about a man in Kwa-Zulu-Natal who
tried to commit suicide because be was HIV positive. This was not a surprise. It is now
becoming common for people who test positive to think suicide is the answer for their sufferings.
I am a person living with HIV and when I first found out I was positive I thought of killing myself. I
375

elieved I was dead anyway . But if you really look at it, killing yourself is not a solution. I am not
a psychologist, but I believe the thoughts of suicide are a symptom of the confusion and
frustration and helplessness people feel when they find out they have tested positive to HIV. To
try to make it simple, it is like this: Before we go to test for HIV most of the things we hear about
HIV are negative. Some will say" unmanageable disease that is equivalent to death". Who is not
afraid of death? We are all afraid of death, but when people start implying that when you have
HIV you are no longer welcome in your community, then killing yourself is a better solution.
When you are HIV positive, like me, you will later develop AIDS which is likely to cause your
death. But this does not happen overnight. What many people do not know is that people who
are HIV positive do not move from HIV to AIDS in a minute. In my experience as a person living
with HIV and who works with many people who have just discovered their status, I believe people
die because of stress levels cause by little information and a lack of understanding that HIV is not
a death sentence. Finding out you are HIV positive is difficult and stressful, mainly for those who
do not know a thing about it. HIV is still treated as an equivalent to death because of a lack of
information on subject......
Notes: 1 copy
Rankin, J. & Gilbert, A. (2000). "Umhlangabezi mncedisi woluntu": Challenging
traditional notions of counselling. In (pp. -).
Ref ID: 262
Keywords: health/medical/training
Abstract: This paper describes the theory and practice that informed the training of 130 health
professionals as counsellors in the Eastern Cape during 1999. The sexual Health Counselling
Project, Rhodes University, East London was funded by the Department of Health to address the
HIV/AIDS epidemic in largely under -resourced Eastern Cape Province. The training programme
challenges traditional notions of one-to-one models of counselling, the expert and powerful role of
the counsellor, and the deficit and pathology based orientation of the medical model. This
programme encourages building upon local and contextual relevant knowledge and community
resources. The Xhosa title of the paper demonstrates a counsellors reconstruction of the role of
376

the counsellor arising during the course of the training. Translated it means "meeting halfway to
help the community ". The paper will share the techniques and principles of the programme
informed by narrative theory and practice and activity theory.
Notes: 1 copy
Rankin, J. & Gilbert, A. (2000). Changing the social practices of public health counsellors
in the Eastern Cape: Tension, uncertainties and achievements. In (pp. 1).
Ref ID: 265
Keywords: health/intervention/Nurse/training
Abstract: In 1999, 130 public health nurses and their managers were trained as HIV/AIDS
counsellors by Rhodes University, for the Eastern Cape Department of Health. The programme
attempt to challenge the traditional public health model of the expert giving advice to the naive.
Building on narrative and activity theory the programme was committed to the respect of local
knowledge and resources, and a non-hierarchical intervention between health professionals and
those whose use their services. It attempted to model, with participants, ways of addressing local
practices that foster stigma and silence and provide a supportive network for counsellors working
in isolated and resource - poor environments. The paper describes the goals of the training
programme and its structure and processes. Drawing on data provided by participants, district
managers, trainers and field observations, the paper explores the outcomes of the programme.
Among the central issues examined are: the selection of counsellors; the challenges for
counsellors in changing practices in the under-resourced and bureaucratic work context; the
supportive structures needed for counsellors particularly those working in rural communities; the
social practices that inhibit and facilitate shifting from one-to-one to a community-based initiative;
and the prospects and challenges of moving from a purely "prevention" model to a "living - with -
HIV/AIDS" model, for counselling practice.
Notes: 1 copy
Ref ID: 1252
Rapoo, T. (2001). Use traditional healers to fight AIDS. Sowetan.
377

Keywords:
Africa/clinic/communication/community/condom/condoms/government/health/media/medical/politi
cal/population/research/sex/South Africa/traditional healer/traditional healers
Abstract: As little Nkosi Johnson lies in his bed, mortally ill from AIDS-related diseases. It should
awaken everyone to the fact that there are thousands if not millions of other faceless and
nameless little Nkosis whose plight we don't know about.
It should give us reason to step back and review our current campaign strategies against AIDS,
which have come to rely heavily on experience but ineffective television, radio and newspapers
advertisements. AIDS is rapidly turning into a disaster of historical proportions for
underdeveloped Africa, where inferiour public infrastructures such as road, telephone networks
and healthcare facilities stand in the wary of dealing effectively with AIDS. Because of inferior
information dissemination facilities in many countries, including South Africa, direct
communication between health workers, public officials and political leaders on the one hand, and
our communities in remote, impoverished and inaccessible communities in impossible. As a
result many public messages about and warnings against the dangers of AIDS continue to miss
their target. It is therefore vital for African governments to review their AIDS campaigns, which
rely too much on modern, expensive an sleek adverts that are not reaching all the people. It is
time for us to utilise alternative traditional means of communication among our communities. We
need to utilise people who understand these communities. And African traditional healers are
absolutely vital and critical in the fight against AIDS.
The government's AIDS campaigns are not working as effectively as we would like. I believe the
campaign strategy is too dependent on expensive, glossy, smart and sleek television, newspaper
and radio adverts, which do not reach the critical sections of the population at risk, especially the
youth. Most of the TV and radio ads are often designed for the urban areas. Where healthcare
facilities and information dissemination are fairly adequate and literate urban youths have plenty
of access to the mass media. In fact, various research findings have confirmed that the majority
of impoverished African households in South Africa rely on radio for information. But we cannot
rely on radio alone, however effective and wide-spread in our AIDS campaigns. We need more
378

drastic steps. If only political parties in South Africa could take AIDS as seriously as they take
elections- by regularly flooding the country with poster warnings against the dangers of AIDS and
unsafe sex - we would be miles ahead in our awareness campaigns.
Admittedly, many traditional healers are still ignorant of the epidemic. That's why some of them
claim they can cure AIDS. There is a positive role traditional healers can play, though, in current
campaign strategies against AIDS. Traditional healers still command respect and wield a lot of
authority and influence in communities. Many blacks trust traditional healers more than Western
medical doctors. In fact, nine out of 10 black South Africans are likely to consult traditional
healers before consulting modern doctors even for simple ailments that can be cured with a
simple visit to a local clinic or an aspirin. The government should therefore utilise them in public
awareness campaign to distribute information pamphlets against AIDS. They could also be
utilised to distribute free condoms among our people, who will constantly engage in unprotected
sex because of the inaccessibility of clinics where condoms and other vital information about
sexually transmitted diseases are supposed to be obtainable. Surely, utilising the inter-personal
skills of African traditional healers and their considerable experience and knowledge of their
communities , local traditions and customs should be more effective and less expensive
compared to the current over-reliance on modern glossy, expensive advertisements and
television dramas.
Notes: 1 copy
Renzi, C., Zantedeschi, E., Signorelli, C., & Osbourn, J. F. (2001). Factors associated
with HIV testing: results from an Italian General-population Survey. Preventive Medecine, 32, 40-
48.
Ref ID: 367
Keywords: condom/condoms/HIV testing/infection/men/population/prostitutes/sexual
behaviour/sexual partner/women
Abstract: Background: HIV testing, with appropriate counselling, can help prevent the spread of
HIV infection. This study is the first national survey in Italy that examines factors with serotesting
among Italian heterosexual and is part of a European Concerted Action.
379

Methods: In 1998, a cross-sectional telephone survey was conducted on a random sample (n =
2,603) of the Italian population ages 18-49 years. Associations between HIV testing and risky
behaviors (multiple sexual partners in the parts 5 years, intercourse with prostitutes, not always
using condoms with a new sexual (partner) and sociodemographic variables are examined
separately for men and women using multiple logistic regression.
Results: The prevalence of having ever been tested for HIV, whether voluntarily or not, among
heterosexual men and women is 27.0 and 32.8, respectively. Voluntary testing is reported by
8.4% of heterosexual men and 6.1% of heterosexual women. Multivariate analysis shows that
having multiple sexual partners significantly increases the odds of testing (Men: OR = 2.10; 95%
CI: 1.3-3.4. Women: OR = 3.03; 95% CI: 1.7-5.4). Multiple logistic regression, controlling for
risky behavior, shows also that persons ages 30-39 years have significantly higher probability of
being tested than younger subjects (Men: OR = 3.30; 95% CI: 1.4-7.9. Women: OR= 2,61; 95%
CI: 1.1-6.4). Better educated women tend to have a higher probability of testing, but this increase
is not significant at the 5% level.
Conclusions: The prevalence of voluntary serotesting in Italy is lower than in other countries.
Risky sexual behaviour is associated with higher odds of testing; however, a high proportion of at-
risk heterosexuals never sought testing. Particular attention should be dedicated to younger
persons and to less educated women.
Notes: 1 copy
Richter, L. M., Durrheim, K., Griesel, D., Solomon, V., & van Rooyen, H. (1999).
Evaluation of counsellor service provision within the South African context (within specific
reference to HIV/AIDS counselling): intervention linked research and pilot projects in the area of
HIV/AIDS care, counselling and support: contract report submitted to the Department of Health.
Tender no: RT 724 SP, 1-157. Pietermaritzburg, University of Natal.
Ref Type: Unpublished Work
Ref ID: 700
Keywords: care/counsellor/Department of Health/evaluation/guidelines/health/HIV/AIDS
counselling/intervention/pilot projects/prevention/research
380

Abstract: The evaluation was based on a acknowledgement of:
* The unique role of HIV/AIDS counselling in prevention, care and support, and the ways in which
HIV/AIDS counselling differs from traditional individual or group mental health counselling;
*The diversity of beneficial counselling approaches that might have developed in a country
consisting of heterogenous people, conditions of life, and circumstances under which services
came to be established;
*The importance of a participatory approach to defining issues and perspectives in the field of
HIV/AIDS counselling.
The evaluation was conceived of in five stages such creating the framework for the investigation,
a postal survey of HIV/AIDS counselling services, site visits to a range of facilities across the
country, analysis of the data collected in the investigation, and development of implementation
guidelines. And the major findings of the evaluation were given.
Notes: 1 copy
Richter, L. M., Van Rooyen, H., Solomon, V., Griesel, D., & Durrheim, K. (2001). Putting
HIV/AIDS counselling in South Africa in its place. Society in transition, 32, 148-154.
Ref ID: 338
Keywords: Africa/ATICC/counselling and testing/government/health/HIV/AIDS
counselling/policies/response/South Africa/voluntary counselling and testing/VCT
Abstract: HIV/AIDS counselling services within South Africa are surveyed within the context of a
general review of the HIV/AIDS policy response. Data indicate that South Africa under served by
counselling and testing facilities, critically so in Mpumalanga, Northwest Province and the Eastern
Cape. Government provides the majority of counselling and testing services, primarily through
health services and indirectly through the Antics. Despite high expectations of the role of
voluntary counselling and testing it is found that these services are thinly-stretched but that they
provide welfare services unavailable from other sources.
Notes: 1 copy
381

Roberston, B. A. (1990). Report on the 5th international conference on AIDS in Africa.
Southern Africa Journal Child Adolescent Psychiatry, 3, 44-46.
Ref ID: 308
Keywords: conference/Africa
Abstract: The article presents a summary report on the 5th International Conference on AIDS in
Africa.
Notes: 1 copy
Ref ID: 310
Roche, S. M. (1996). Counselling gay men: special issues? AIDS, -, 20-21.
Keywords: counsellor/male/men/research
Abstract: At the outset it is necessary to challenge the entrenched attitude that gay men form a
psychologically homogenous group of people. This attitude has its origins and longevity in a
history of psychological research which compared samples of gay and non-subjects on a
multitude of variables and all but ignored variability within such samples. At the risk of sounding
redundant, gay men are as diverse as their non-gay counterparts in all aspects of human
functioning, and requests for counselling emanate from a wide variety of sources. The point
being stressed is that counsellors must not lose sight of the importance of individual histories and
phenomenologies when dealing with gay male clients under any circumstances.
Notes: 1 copy
Ref ID: 6361
Rodwell, B. (2000). Marchers want life-saving drugs. Sunday World.
Keywords: drugs/infection/protesters
Abstract: When protesters take to Durban Streets many on the Global March for Access to HIV-
AIDS treatment, promise Mthembu marched for her life and the lives of the 35 million HIV-positive
people worldwide. Mthembu tested HIV positive in 1995. Like most HIV-positive South Africans,
she has no access to appropriate medicines. " I do not take retroviral drugs because I simply
cannot afford them. The only treatment I get, from a public hospitals, is for open infections, I was
382

offered trials, but resisted them. There are drugs that have been proved to be working and
should be made available. Why should poor people be the guinea pigs for trying out new drugs,
which they later cannot afford?
Notes: 1 copy
Ross, M. & Hlongwa, B. (2000). Counselling to HIV seropositive women with regard to
feeding their babies. In (pp. 1).
Ref ID: 245
Keywords: breastfeeding/Developing countries/infection/sexual partner/transmission/voluntary
counselling and testing/women
Abstract: The message around feeding choices conveyed to mothers during Voluntary
Counselling and Testing for HIV, particularly in the developing countries, carry an ethical
component which is an ongoing and controversial debate being undertaken by the scientific
community. It is widely accepted that breastfeeding is critical for optimal nutrition and
development of children, however the finding the breadfeeding accounts for a substantial
proportion (+_ 14%) of transmission of HIV from mother -to-infant had led to recommendations for
infected women is usually made after Voluntary, Confidential Counselling and Testing for HIV.
Therefore, a qualitative study was undertaken to assess the knowledge, attitudes and practices of
HIV seropositive pregnant women towards breast-or formula-feeding their infants. The subjects
(n=38) were participants in a trial to reduce mother-to-child transmission of HIV and had been
counselled and tested for HIV. The results revealed that Voluntary Counselling and Testing had
the following impact on the women, the distribution of feeding choices in this study were equally
divided between breast formula feeding. Knowledge about HIV and the methods of transmission
were poor. There was some confusion evident about the eventual HIV status of their infants and
the effects of the vitamin A tablets in reducing transmission. Thirty-seven percent of the women
who were breastfeeding said they were unemployed and therefore unable to afford formula feed
for their babies; they felt unhappy that they were unable to avoid the increased risk of HIV
infection to their infants. Those women who were formula-feeding, expressed anxiety about not
fulfilling their role of nurturing mothers, as determined by their cultural beliefs. A significant
383

number of the women (87%) were involved in a "relationship" with their sexual partners, and had
fears of repercussions associated with disclosure. Women's knowledge was drawn from cultural
perspectives and prior experience. These results indicate, firstly, that HIV infected women's
choices to breast or formula feed are influenced by Voluntary Counselling and Testing but these
choices are circumscribed by their prevailing socio-economic conditions, and secondly, that the
advocacy role of counselling per se should be encouraged.
Notes: 1 copy
Rossouw, j. (1994). The impact of an AIDS training program on the knowledge and
attitudes of healthcare workers.
Ref ID: 387
Keywords: condom/condom use/condoms/impact/knowledge/training
Abstract: In this study the author examined knowledge about and attitudes towards AIDS in a
group of healthcare workers attending training course in AIDS-related counselling. Measurement
of knowledge and attitudes took place before the course, directly after the course and three
months later. The results are regarded as positive findings, since their Aids awareness showed
the subjects were well informed and had formulated this knowledge from a relatively objective
point of view. After attending the training course six categories of attitudes were studied, that is,
attitudes towards AIDS and AIDS patients, attitudes towards homosexuality, attitudes towards the
sexuality of white people, attitudes towards the sexuality of black people, attitudes towards ethical
issues as well as attitudes towards condoms and condom use. Significantly more positive
attitudes towards AIDS and Aids patients as well as towards condoms and condom use were
present at the measurement directly after the course with when compared with attitudes held
directly before the course. The difference on these scales, however, was not significant when
comparing attitudes at the three-month follow-up with attitudes held directly before the course. A
significant change in attitude to being more sensitive towards the needs of the infected patient
(ethical issues scale) occurred when comparing the measurement before the course with both
measurement directly after the course as well as measurement at the three-month follow-up. A
significant gain in knowledge was detected when comparing the measurement before the course
384

with measurement after the course.
Attitudes towards homosexuality had a substantial negative relationship with attitudes towards
AIDS, a finding common to other studies. Attitudes towards AIDS were related to the sexuality of
black people, as well as the sexuality of white people. It is shown that attitudes towards AIDS in
this group were also substantially determined by historically rooted attitudes concerning the
sexuality of marginalized groups and people of different cultural groupings. Attitudes towards
AIDS were also related to knowledge about AIDS, attitudes towards condoms and condom use
as well as attitudes towards ethical issues. It is concluded that, apart from knowledge about
AIDS, attitudes towards AIDS in the group studied were substantially determined by other
attitudes concerning condoms and condom use as well as ethical sensitivity. The implications of
these findings as an additional component in training of healthcare workers are pointed out.
The healthcare workers who attended courses were actively involved in counselling of AIDS
patients at the three-month follow-up. They evaluated the course they attended and the course
facilitators favourably. The importance of follow-up and supervision after completion of courses
are also pointed out.
Notes: 1 copy
Roth, D. L., Stewart, K. E., Clay, O. J., Van der Straten, A., Karita, E., & Allen, S. (2001).
Sexual practices of HIV discordant and concordant couples in Rwanda: Effects of a testing and
counselling programme for men. International Journal of STD and AIDS., 12, 181-188.
Ref ID: 177
Keywords: couple/couples/disclosure/men/Rwanda/sexual partner/sexual practice/VCT/voluntary
counselling and testing
Abstract: As part of a longitudinal investigation, the husbands and cohabiting male partners of
684 Rwandan women were recruited to participate in an HIV testing and counselling programme.
All of the women and 256 of the men (37%) had previously received standard testing and generic
counselling services. In this project, all of the men participated in an extensive, male-focused
counselling for the first time. This included 428 men who were receiving testing and counselling
for the first time. Interview responses indicated that rates of condom use during sexual
385

intercourse increased dramatically at the one-year follow-up assessment for the serodiscordant
couples. This effect was especially strong for couples whose male partners were receiving
testing and counselling for the first time. Rates of condom use also increased substantially in
seroconcordant HIV-positive couples whose partners had both been tested previously. Women in
couples with at least one seropositive partner reported lower rates of coercive sex by their male
partners after they completed the counselling programme. Male-focused and couple-focused
testing and counselling programmes appear to be effective in reducing risky sexual behaviours in
heterosexual couples, even if one or both partners have received testing and counselling services
previously.
Notes: 1 copy
Roux, P. (2001). Informed Consent for Voluntary Counselling and Testing for HIV
infection in South African Mothers and Children. MA Dissertation, University of Cape Town (
Philosophy).
Ref ID: 206
Keywords: children/ethics/Informed consent/mother/South Africa/VCT/voluntary counselling and
testing/women
Abstract: The HIV/AIDS epidemic is devastating Africa. The continent lacks the material
resources to treat infected persons or to support those affected by the epidemic. One great
resource in Africa is the cohesive strength of families. Because of a fear of stigma, HIV infected
persons tend not to disclose their diagnosis to their families. This non- disclosure perpetuates
stigma, because ordinary people do not discover that their own family may be affected by the
epidemic. Non-disclosure also results in the loss of specific family support to infected individuals
and the loss of general family support as a national resource. The standard method of taking
informed consent prior to HIV testing of pregnant mothers has the effect of enhancing non-
disclosure, because of its inherent focus on the patient as an isolated, autonomous decision
maker. This dissertation advances the thesis that an alteration in the process of informed
consent, to involve the family in deliberation prior to consent, will facilitate disclosure of an HIV-
positive diagnosis to the family. Disclosure will have the positive effects firstly of giving the
386

mother access to the emotional support of her family and secondly of serving to educate the
family, and through the family society as a whole, that ordinary, virtuous women can be infected
with HIV.
Notes: 1 copy
Saba, J. (1997). Identification of HIV infection in pregnancy: Another era. Acta
Paediatrics, 421, 65-66.
Ref ID: 114
Keywords: community/intervention/pregnancy/pregnant/vertical transmission/women
Abstract: In order to be successfully implemented, some interventions to prevent vertical
transmission of human immunodeficiency virus (HIV) will require prior identification of HIV-
infected women. The testing and counselling of pregnant women should therefore be promoted.
Promoting testing and counselling within prenatal clinics would be a good strategy; however,
additional data on the social and economic implications of HIV testing are needed to demonstrate
the relevance of such a strategy. Promotion of testing and counselling should be developed in
collaboration with community-based organizations, non-governmental organizations and people
living with HIV, in order to increase the involvement and understanding of the community at large.
Notes: 1 copy
Sahly, T., Kassa, E., Agonafer, T., Tsegaye, A., De Wit, T. R., Gebremarium, H. et al.
(1999). Sexual behaviours, perceptions of risk of HIV infection, and factors associated with
attending HIV post-test counselling in Ethiopia. AIDS, 13, 1263-1272.
Ref ID: 127
Keywords: Ethiopia/post-test/risk/risk behaviour/sexual behaviour/VCT/voluntary counselling and
testing
Abstract: The objective of this study is to describe sexual behaviour, perception of risk of HIV
infection, and factors associated with attending HIV post-test counselling (PTC) among Ethiopian
adults. The methods: Data on socio-demographic characteristics, knowledge of HIV infection,
sexual history, medical examination, and HIV and syphilis serological status were compared,
387

through uni-and multivariate analysis, in relation to attending PTC within 60 days of HIV testing.
Results: Between February 1997 and June 1998, 751 factory workers were enrolled in a cohort
study of HIV infection progression. Despite reporting high-risk sexual behaviours, mainly for
males 64% of males and 6% of females had more than five sexual partners in their lifetime, 16%
of males and 2% of females reported having had recent casual partners), and knowing that HIV is
commonly transmitted heterosexually in Ethiopia (97 % of answers being correct, both genders
combined), only 17% of males and 2% of females acknowledged having had activities which had
put them at risk of HIV infection. HIV prevalence was 12%, and did not differ by gender. Of all
study participants, 327(43.5%) returned for PTC within 60 days of HIV testing. PTC attendance
did not differ by age, gender, or HIV serological status. Factors independently associated with
PTC attendance in males were: good knowledge of HIV infection, lodds ration (OR)=1.66], belief
that medical follow-up improves the course of HIV infection, [OR=2.02], recent history of genital
symptoms (OR=2.83), positive syphillis serology (OR=2.6], recently weight loss (OR=1.89), and,
with a negative association, being a manual worker (OR=0.40), and history of recent casual
sexual relationships (OR= 0.35). In women, belief that HIV/AIDS can be cured (OR=3.16), never
having been married (OR=5.o2), having five or less children (OR=2.16), having been raped
(OR=3.42), and having used health facilities in the past year (OR= 1.73) were all positively and
independently associated with PTC attendance. Conclusion: Study participants reported high-
risk sexual behaviours, yet had a low perception of individual risk. Men attended for PTC
because of their knowledge of HIV infection, their past sexual history or their current health
status. Women attended for PTC because of their plans for the future, marriage and/or children
rather than their past sexual exposure. Only in cases of rape were they willing to learn of their
HIV status.
Notes: 1 copy
Sangiwa, M. G., Van der Straten, A., Grinstead, O., & VCT Study Group (2000). Client's
perspective of the role of Voluntary Counselling and Testing in HIV/AIDS prevention and care in
Dar es Salaam, Tanzania: The Voluntary Counselling and Testing. Efficacy Study. AIDS and
Behavior, 4, 35-48.
388

Ref ID: 277
Keywords: Developing countries/qualitative research
Abstract: There is a growing body of evidence that voluntary HIV counselling and testing (VCT) is
effective for the primary prevention of HIV as well as for the care and support of individuals
affected by HIV in developing countries. This qualitative study offers an additional perspective:
the experiences and perceptions of men and women receiving VCT, 81 study participants at the
Tanzania study site who were randomized to VCT at baseline were interviewed at the time of
their 6-month follow-up. Findings are based on textual analysis of the following themes: HIV in
the context of other life issues, motivations for receiving services, positive and negative
consequences of VCT, and the role of VCT in risk reduction. Implications for service provision in
developing countries are discussed.
Notes: 1 copy
Ref ID: 5633
Sapa (1995). Aids groups urge reform of laws on marijuana. The Cape Times.
Keywords: conference/health/men/research
Abstract: Sydney - Aids groups here are pressing for the reform of drug laws following new
evidence that marijuana is being used by AIDS patients who believe it relieves their symptoms.
The latest study, showing one in five HIV-positive homosexual men use the drug for therapeutic
purposes, is to be presented to a major AIDS care conference in Australia this week with a plea
for urgent new research into its effects. Although there is little or no research to support, many
Aids patients and health workers, including doctors, believe marijuana has proved effective in
relieving or reducing pain, nausea, stress and depression. Scientific papers have long shown
marijuana to be effective in helping prevent nausea and vomiting in cancer patients, but little is
known about its harmful effects.
Notes: 1 copy
Ref ID: 3574
Sapa (1996). More aggressive treatment urged in new HIV cases. The Citizen.
389

Keywords: benefits/conference/guidelines
Abstract: Vancouver - More aggressive treatment should be given to people recently exposed to
the Aids virus or to those in the early stages of the disease, according to the new guidelines
issued by expert panel. Health care workers who risk needle pricks and people who have
recently shown the first symptoms of being HIV positive often fever and chills- should receive
drug therapies recently made available, said the International Aids Society in new guidelines for
doctors released late. In the past, these people often for no treatment for fear that the sometimes
considerable side effects and costs of the drug would outweigh the benefits. " My personal
approach is that treating a primary infection is the best opportunity,"said Douglas Richman, a
pathology professor at the University of California at San Diego, at the 11th International
Conference on Aids.
Notes: 1 copy
Ref ID: 2151
Sapa (1998). Health dept support for oxytherapy stance. The Citizen.
Keywords: Department of
Health/health/medicine/research/Johannesburg/treatment/information/therapy/supervision/medica
l/doctor
Abstract: The Gauteng health department came out in support of the Medicines Control council's
stance on the illegal use of oxytherapy on HIV-positive patients by the Genesis Research Centre
in Johannesburg. The department said in a statement it was aware that the MCC had advised
the centre that its use of oxytherapy was, in the present circumstances, illegal and that it should
immediately stop this form of treatment. The MCC's action followed Press reports in which
details were provided of the experimental oxytherapy - on HIV positive patients - taking place at
the centre in southern Johannesburg. As a result of these reports, MCC officials and a doctor
from the Gauteng health department visited the centre on Tuesday. Based on the information
gathered during and after this visit, the department fully supported the MCC's position as the
therapeutic value of ozone, particularly in relation to people with Aids, had not yet been proven
and the treatment itself carried high risks. "It is for this reason that we believe the therapy should
390

only be administered under the most careful supervision and with the requisite clinical backup",
the statement said. "When we visited the Genesis Centre with the MCC this week, people were
undergoing treatment without a single medical doctor on the premises. There was no equipment
to deal with any emergency which might arise from an adverse reaction to ozone-which is an
extremely toxic substance.
Notes: 1 copy
Ref ID: 7004
Sapa (1998). Little Togo lends big helping hand. The Daily News.
Keywords: Africa/disease/drugs/therapy/Togo/treatment/WHO
Abstract: Togo may be tiny in size and short on cash but it is way ahead of the rest of Africa-and
some European countries-when it comes to providing Aids patients with the best treatment at the
best prices. In Togo, treatments combining two or even three anti-viral drugs are available more
cheaply than anywhere else in Africa, and they are also cheaper than in France. A course of two
drugs works out at $250 (1200) a month and the three-drug therapy costs $ 690 (3 300) a month.
These knock-down prices are the result of fierce bargaining with the laboratories on the part of
Kpante Bassabi, the doctor who heads Togo's national Aids programme. Togo was the first
country in Africa to set up special structures to deal with the Aids threat in 1985 and its Aids-
fighting programme was set up in 1987 when many countries were still down-playing the spread
of the disease.
Notes: 1 copy
Ref ID: 2952
Sapa (2001). African herb to fight AIDS. Star.
Keywords: Africa/government/medicine/men/Nigeria/South Africa/traditional healer/traditional
healers/WHO/women
Abstract: While the battle between pharmaceutical companies and the government about
medicine prices continues, traditional healers yesterday called for a fair investigation into their
claim that an indigenous herb may improve the condition of AIDS patients - if not cure them.
391

People whom doctors had sent home to die showed significant signs of recovery due to the herb
sutherlandia, known as kankerbos in Africaans, said credo Mutwa, an executive of the
Nyangazezizwe traditional Healers' Organisation of South Africa. " I don't aim cl this is the cure,
but what it does to people is amazing. Men and women who have been sent home to die are
alive now because of an ancient African herb," Mutwa said. Mutwa said Dr Nigel Gerlicka, who,
with several other scientists and Mutwa's help, is researching the plant. Gerlicka said a Nigerian
government official was already treating patients in that country with extracts from the plant. A
pilot trial would also be conducted in South Africa. -
Notes: 1 copy
Ref ID: 4672
Sapa- AFP (2000). AIDS victims "need pets for support". The Citizen.
Keywords: conference/pets
Abstract: Pets are a boon to people with HIV or AIDS providing them with companionship and a
means of social contact according to a crusading Californian group taking part in the International
AIDS Conference. When are afraid to touch you, it is no small thing that your dog is always there
to nuzzle your hand and be perfect. When your friends and relatives seem to disappear your cat
will still be your best friend and confidant says the group PAWS ( Pets Are Wonderful Support).
Notes: 1 copy
Ref ID: 5072
Sapa-AFP (2000). Pets a lifeline for those waiting to die. The star.
Keywords: conference
Abstract: Durban- Pets are a boon to people living with HIV/AIDS, providing them with
companionship and a means of social contact, according to a crusading Californian group taking
part in the 13 the International AIDS conference. "When People are afraid to touch you, it is no
small thing that your dog is always there to nuzzle your hand and be petted. " When your friends
and relatives seem to disappear your cat will still be your best friend and confidant" says the
392

group PAWS( Pets Are Wonderful Support).
Notes: 1 copy
Sauka, M. & Lie, G. T. (2000). Confidentiality and disclosure of HIV - infection - HIV -
positive Persons Experience with HIV testing and coping with HIV infection in Latvia. AIDS care -
psychological and socio-medical aspects of AIDS/HIV 2000, 12, 737-743.
Ref ID: 370
Keywords: partner notification/prevention/confidentiality/disclosure/infection/HIV testing
Abstract: The objective of the study was to explore retrospectively HIV-infected individuals'
experience with HIV testing counselling and the issue of confidentiality in the Latvian context. A
qualitative study using grounded theory approach and based on semi-structured in-depth
interviews was implemented thirteen HIV-positive individuals above 18 were selected, using
purposeful sampling, from the 63 HIV-positive individuals registered in Latvia between 1987 and
1997. HIV-infected people are worried that doctors sometimes disrespect confidentiality.
Confidentiality was found to be a basic prerequisite for building trusting relationships between
HIV-infected individual and a doctor within the counselling process from the fist visit to follow-up
counselling and as one of the most important factors of the formation and proper functioning of
the physician-patient relationship. Trusting relationships will not be established in situations when
an HIV-infected individual is not seen by a doctor as a human being with needs, worries and
without understanding his or her situation. Breaches of confidentiality should be seen as
shortsighted and can diminish the public's trust in physicians. Counselling should be sensitive to
the cultural, historical traditions and prevailing public health practices, social values and political
differences in attitude reward the importance of treating someone as a private individual.
Notes: 1 copy
Saunders, D. S. & Burgoyne, R. W. (2001). Help-seeking patterns in HIV/AIDS
outpatients. Social work in health care, 32, 65-80.
Ref ID: 368
Keywords:
393

clinic/community/disease/employment/family/gender/health/infection/performance/physician/qualit
y of life/social support/symptom
Abstract: This study investigates factors associated with requests for professional services, made
by newly registered HIV/AIDS clinic outpatients, referred by general practice physicians to a large
urban hospital serving a broad metropolitan/rural area in Canada. Professional service requests
were divided into two primary help-seeking categories: practical support (assistance with
financial aid, housing, medication costs, etc.) and emotional support ( i.e., psychological
counselling). Slightly more than half of the sample (51% ) of people living with HIV/AIDS (PHA)
requested professional services. Service requests are indistinguishable from non - requesters on
a large number of variables, including age, gender, family awareness of HIV/AIDS diagnosis, time
elapsed since diagnosis, employment status, spousal status, overall support network size,
physical health indicators (Karnofsky Performance Status, CD4 count, symptoms, opportunistic
infections) and receipt of community support services elsewhere. Similarly, requesters and non-
requesters report comparable levels of overall perceived social support and quality of life.
However, requesters and non-requesters of practical support services report significantly fewer
friends, lower emotional-informational social support and poorer quality of life due to body pain
than non-requesters. Requesters of emotional support services report experiencing significantly
lower positive social interaction compared to nonrequesters. Implications for the provision of
practical and emotional support services for PHA are discussed.
Notes: 1 copy
Saunders, D. S. & Burgoyne, M. R. (2001). Help - seeking Patterns in HIV/AIDS
outpatients. Social work in health care, 32, 65-80.
Ref ID: 373
Keywords:
clinic/community/employment/family/gender/health/infection/performance/physician/quality of
life/social support/symptom
Abstract: This study investigates factors associated with requests for professional services, made
by newly registered HIV/AIDS clinic outpatients, referred by general practice physicians to a large
394

urban hospital serving a broad metropolitan/rural area in Canada. Professional service requests
were divided into two primary help-seeking categories: practical support (assistance with
financial aid, housing, medication costs, etc.) and emotional support (i.e., psychological
counselling). Slightly more than half of the sample (51%) of people living with HIV /AIDS (PHA)
requested professional services. Service requesters are indistinguishable from non-requesters
on a large number of variables, including age, gender, family awareness of HIV/AIDS diagnosis,
time elapsed since diagnosis, employment status, spousal status, overall, support network size,
physical health indicators (Karnofsky Performance Status, CD4 count, symptoms, opportunistic
infections) and receipt of community support services elsewhere. Similarly, requesters and non-
requesters report comparable levels of overall perceived social support and quality of life.
However, requesters of practical support services report significantly fewer friends, lower
emotional - informational social support and poorer quality of life due to body pain than non-
requesters. Requesters of emotional support services report experiencing significantly lower
positive social interaction compared to nonrequesters. Implications for the provision of practical
and emotional support services for PHA are discussed
Notes: 1 copy
Schneider, H. & Stein, S. (1997). From policy on paper to action on the ground:
Contextual issues affecting implementation of the NACOSA/National AIDS plan. (Rep. No. 3).
Ref ID: 124
Keywords: NACOSA/National AIDS Plan/policy/policy implementation/South Africa
Abstract: In October 1992, nearly 450 people representing the widest possible range of
organisations, attended the launching conference of the National AIDS Co-ordinating Committee
of South Africa (NACOSA). NACOSA was established as a joint initiative of the African National
Congress and the then Department of Health. Despite the unresolved political negotiations of the
time, they invited representatives of labour, business, church and civic structures to consider
national co-ordination of AIDS activities. In keeping with the spirit of the initiative, Nelson
Mandela opened the conference with the words "the key to our success is our own collective
effort". The conference resolved to develop a National AIDS strategy and task teams were
395

mandated to take forward the process. Following on the conference, regional NACOSA meetings
were held and structures established. A draft AIDS strategy was formulated which culminated in
the publication of a comprehensive and detailed National AIDS plan in June 1994.
Notes: 1 copy
Schneider, H. & Russel, M. (2000). Models of community-based HIV/AIDS care and
support in South Africa. The Southern African Journal of HIV Medicine, 1, 14-17.
Ref ID: 455
Keywords: Africa/Baragwanath/community/family/health/impact/medical/South Africa
Abstract: Over the past few years, the previously largely silent HIV epidemic in South Africa has
shifted to a visible AIDS epidemic. The impact on health services, families and communities is
emerging rapidly. In 1997, 20% of all patients admitted to the paediatric wards at Chris Hani
Baragwanath Hospital were HIV-infected, and in 1998, more than half (54%) of the admissions to
the medical wards at King Edward VIII Hospital in Durban were HIV-related. By the year 2005,
conservative predictions are that there will be nearly 1 million children orphaned by AIDS in the
country, clearly overwhelming the current capacity of the welfare system.
Notes: 1 copy
Schneider, H. & Stein, J. (2001). Implementation AIDS policy in post-apartheid South
Africa. Social Science and Medicine, 52, 723-731.
Ref ID: 390
Keywords: Africa/government/NGO/policies/policy/political/response/South Africa
Abstract: In common with the rest of the Southern African sub-continent, South Africa is currently
experiencing a serious HIV epidemic. When it came into power in 1994, the new, Mandela-led
government immediately mobilised funds and adopted a far-reaching AIDS plan for the country.
However, the implementation of AIDS policy in the first four ways after 1994 has been
characterised by a lack of progress and a breakdown of trust and co-operation, both within
government and between government and NGOs. This paper outlines the political context which
shaped the development of the AIDS Policy, then examines the difficulties of implementing a
396

comprehensive response to AIDS in a country undergoing restructuring at every level. It
questions the notion of "inadequate political will" as an explanation for lack of progress.
Involvement by politicians, has, in fact, been experienced as a double-edged sword in South
Africa, with inappropriate, "quick-fix" actions creating conflict and hampering a more longer- term,
effective response. The paper also highlights the importance of groupings outside of government
in promoting effective policy actions, and the types of leadership required to mobilise a broad
range of actors around a common vision. It concludes by emphasising the need to develop
approaches to policy implementation rooted in the possibilities and constraints of the local
situation, rather than relying on universal blue-prints developed out of context.
Notes: 2 copies
Schneider, H. (2001). Community-based care for HIV/AIDS is affordable but not cheap.
Johannesburg, Centre for Health Policy.
Ref Type: Unpublished Work
Ref ID: 500
Keywords: Africa/care/community/family/health/health policy/Home based
care/impact/NGO/South Africa
Abstract: Over the last few years, the previously largely silent epidemic of HIV in South Africa has
shifted to a visible epidemic of AIDS. The impacts on health services, families and communities
are emerging at a rapid. In responding to these impacts, hospital facilities have started to ration
care for people with HIV/AIDS:"home-based initiatives have emerged to meet the massive health
and social needs generated by the HIV epidemic. These initiatives often operate from a religious
or NGO base, but work in close cooperation with local formal health, welfare and other social
sectors. They provide a spectrum of services, from support activities to palliative home-based
care and orphan placement.
Notes: 1 copy
School of Psychology. (2002). Proposal for HIV/AIDS counselling skills module within
Open Learning Programmes.
397

Ref Type: Unpublished Work
Ref ID: 514
Keywords: Africa/community/counsellor/training/counsellors/education/HIV/AIDS
counselling/impact/intervention/knowledge/policies/policy/research/response/South
Africa/Virus/WHO
Abstract: There is a desperate need for HIV/AIDS counsellors to join the fight against the AIDS
epidemic. Research ( Grover, Indrayan, Sharma and Kannan, 1998; Meursing and Sibindi, 2000)
has shown that counselling results in an improvement in both knowledge and attitudes with
regards to the virus. Without a vaccine, counselling is one of the most important interventions in
dealing with the complex issues around HIV/AIDS.
According to research evaluating HIV/AIDS counselling in South Africa, undertaken by Professor
Linda Richter (1999), counselling services remain underdeveloped. One of the factors
contributing to the limited impact of counselling services was cited in this study as being a
shortage of well-selected and trained counselling staff. The shortage of counsellors is directly
linked to a shortage of counsellor training programs.
The HIV/AIDS counselling skills module is seen as a direct response to the shortage of counsellor
training both regionally and nationally. Furthermore, it is in line with the University of Natal's
policy of social responsiveness, which calls for the serving of the needs of the community and for
support for the fight against the AIDS epidemic. Finally, by placing this module squarely within
the Open Learning Programmes, adult learners who are seeking to upgrade or retool, and who
may not have ordinarily had exposure to the University of Natal, may be given the opportunity to
further their education.
Notes: 1 copy
Schopper, D., Van Praag, E., & Kalibala, S. (1996). Psycho-social care for AIDS patients
in Developing countries. Psychology and the developing world, -, 173-179.
Ref ID: 349
Keywords: Africa/America/Developing countries/family/health/Sub-Saharan Africa
Abstract: As the number of AIDS patients increased dramatically during the first ten years of the
398

pandemic in sub-Saharan Africa, existing health services were overstained and unable to cope
with an increasing countries, the health sector suffered already from limited budgets and lack of
trained personnel before the AIDS epidemic. Trained "counsellors" hardly existed, and very few
countries had welfare schemes. Thus, the additional demand for counselling, for care of patients
in their home, and for financial support to families could not be met within existing structures. As
consequence, innovative new approaches to providing psycho-social care to AIDS patients were
first developed in sub-Saharan Africa, followed by the creation of similar services in Asia and
Latin America. This chapter will review the special psycho-social needs of HIV-infected people,
and the ways in which these needs have been addressed in developing countries.
Notes: 1 copy
Schwenk, A., Burger, B., Ollenschlager, G., Stutzer, H., Wessel, D., Diehl, V. et al.
(1994). Evaluation of nutritional counselling in HIV-associated malnutrition. Clinical Nutrition, 13,
212-220.
Ref ID: 347
Keywords: disease/evaluation/impact/intervention/treatment/WHO
Abstract: In HIV-infected patients, the outcome of counselling as the first step of a nutritional
intervention programme was evaluated, in order to identify clinical and nutritional predictors for its
efficacy.
75 HIV-infected patients were investigated, most with advanced disease,. Nutritional status was
determined by body weight, bioelectrical impedance and 7-day food intake record.
Prior mean weight loss was 10% (range=+4% to - 31%). Counselling facilitated weight gain in
40/75 patients (1-4 months later, overall mean difference +1.4 +or - 6.2%) and in 14/34 patients
(8-11 months later, overall mean difference -1.4% + or - 9.0%). Weight changes correlated with
changes in body cell mass (r2= .69, p

patients. More than half of patients gain weight without other nutritional treatment. Whereas the
severity of malnutrition is influenced by the underlying disease, fever, and diarrhea, the course of
weight change after nutritional intervention is not. Counselling may reduce the nutritional impact
of these risk factors. In patients with low spontaneous intake, efficacy of counselling alone is
limited, but it may help to identify those who require more invasive nutritional treatment.
Notes: 1 copy
Seeley, J., Wagner, U., Mulemwa, J., Kengeya-Kayondo, J., & Mulder, D. (1991). The
development of a community-based HIV/AIDS counselling service in a rural area in Uganda.
AIDS care, 3, 207-217.
Ref ID: 115
Keywords: community/culture/model/research/service delivery/Uganda
Abstract: This paper describes the evolution of a counselling service in the context of an
HIV/AIDS research programme in rural Uganda. The background to AIDS counselling both in
Europe/America and in Africa is outlined first, and the cultural context of the programme
explained. The evolution of the counselling procedure is then described and village case studies
are used to illustrate the development and the difficulties that have been faced in finding an
appropriate counselling model. It is noted that the Euro-American model of person-to-person
counselling needs to be adopted to the rural African setting, by placing the emphasis on support
for the family. It is emphasized that the approach to counselling needs to remain flexible and
sensitive to the sociocultural context in which it is developed.
Seely J., Wagner, U., Mulemwa, J., Kengeya-Kayondo, J., & Mulder, D. (1991). The
development of a community-based HIV/AIDS counselling service in a rural area in Uganda. Hard
copy available. AIDS care 3[2], 207-217.
Ref Type: Abstract
Ref ID: 45
Keywords: community/culture/model/Uganda
Abstract: This paper describe the development of a counselling service and informational support
400

for HIV positive/AIDS affected persons and their families as part of an HIV/AIDS research
programme in rural Uganda. The background of AIDS counselling both in Europe/America and in
Africa is outlined first, and the cultural context of the programme explained. The time- consuming
evolution of the counselling procedure is described and village case studies used to illustrate the
development and the difficulties that has been faced in finding an appropriate counselling model.
It is noted that the Euro-American model of person-to-person counselling needs to be adapted to
the rural African setting, by placing the emphasis on support for the family. It is emphasized that
the approach to counselling needs to remain flexible and sensitive to the socio cultural context in
which it is developed.
Notes: 1copy
Seely, J., Wagner, U., & Mulemwa, J. (1992). Community-based HIV/AIDS counselling
service in a rural area in Uganda. AIDS Scan 4[2], 5.
Ref Type: Abstract
Ref ID: 123
Keywords: culture/model/Uganda
Abstract: This paper describes the development of a counselling service and information support
for HIV positive/AIDS affected persons and their families as part of an HIV/AIDS research
programme in rural Uganda. The background to AIDS counselling both in Europe/America and in
Africa is outlined first, and the cultural context of the programme explained. The time-consuming
evolution of the counselling procedure is described and village case studies used to illustrated the
development and the difficulties that have been faced in finding an appropriate counselling model.
It is noted that the Euro-American model of person-to-person counselling needs to be adapted to
the rural African setting, by placing the emphasis on support for the family. It is emphasized that
the approach to counselling needs to remain flexible and sensitive to the sociocultural context in
which it is developed.
Notes: 1 copy
401

Sefulano, K. (2000). VCT Business Plan for the North West Province.
Ref Type: Unpublished Work
Ref ID: 557
Keywords: benefits/business plan/care/community/infection/knowledge/prevention/sexual
behaviour/transmission/treatment/VCT/voluntary counselling and testing/WHO
Abstract: Voluntary counselling and testing is an integral part of all prevention programme for
HIV/AIDS. It is, therefore, important to ensure that this service is available and accessible to all
the people of the Province.
The benefits of the service may not be obvious to consumers but are enormous and need to be
communicated openly. For HIV sero-positive individuals, these include, among others; Choices
on protection and care, including treatment of opportunistic infections and mother to child
transmission; informed reproductive choices, personal and dependents care plan and access to
support services.
For those who turn out negative, knowledge of this will reinforce efforts to remain uninfected.
Other stress related ailments (psychosomatic) and behaviours (risky sexual behaviour)
associated with the worried well are prevented.
When the service is known to exist within the community, members get used to it and HIV/AIDS
becomes a "normal" issue and stigma and discrimination are reduced. It becomes an easy
subject to discuss; thereby causing that all people know and protect themselves. Those who
seek to be counselled and tested are in better position to accept their situation, whatever the
outcome, given the environment of support and acceptance that prevail.
Notes: 1 copy
Segar, S. (2001). Panel fails to agree on cause of epidemic: Govt won't change AIDS
policy. Natal Witness.
Ref ID: 3801
Keywords: Africa/health/HIV
testing/infection/intervention/medical/policies/prevention/research/South Africa
Abstract: President Thabo Mbeki's controversial AIDS advisory panel yesterday released its long-
402

awaited interim report- with the conclusion that the government should not deviate from its
present approach to AIDS. Health minister Manto Tshabalala- Msimang told a post-cabinet
media briefing that more research will have to be done before the government can change its
five-year plan to deal with the epidemic. The panel, which consisted of experts representing a
range of divergent views, appears to have failed to reach a unanimous agreement on the cause,
prevention and treatment of HIV/AIDS and on the use of anti - retrovirals. Tshabalala - Msimang
kept her stance on the debate as to whether HIV causes AIDS. "We won't say yes, we won't say
no until the signs are conclusive, " she told journalists. "The SA HIV/AIDS pattern differs from
that in most other countries - we have a complex mixture of various strains of the virus, while
most countries experience a single viral strain. This has implications for the vaccine development
initiative in this country," and means more debate is necessary, she said. The minister said that
despite division among panelists on the cause of AIDS, certain commonly held views emerged
regarding intervention. "In particular, the significant impact of developmental issues such as
poverty, literacy, gender relations, nutrition and sanitation were taken into account and
acknowledged in a more far reaching way than hitherto," she said. The minister said that despite
division among panelists on the cause of AIDS, certain commonly held views emerged regarding
interventions. " In particular, the significant impact of development issues such as poverty,
literacy , gender relations, nutrition and sanitation were taken into account and acknowledged in a
more far-reaching way than hitherto, " she said. Recommendations in the report include a need
for extensive future research. Panelists identified a critical need for social and behavioural
research, including a probe into risk- taking and health seeking behaviour. "A task team has
been sep up by the Medical Research Council, the Department of Home Affairs and Stats SA to
gain a better understanding of mortality trends over the last 18 months and the degree to which
AIDS impacts on them. "The impact of other infections is also being monitored, including the
close relationship between HIV and TB," the minister said. Research currently under way
includes a three phase investigation into HIV testing. "Phase 1 aims to establish the quality,
reliability and validity of HIV testing in South Africa. "Phase 2 will seek to establish the
robustness of HIV tests - their ability to yield consistent results. "Phase 3 will focus on building
403

capacity in South Africa to synthesise, purify and use molecular beacons. This technology will
then be applied to the blood samples collected in phase 1 to further define what HIV testing
actually establishes. Additional avenues for future investigations include the "stark contrast"
between the patterns of HIV/ AIDS in the West and in Africa, which suggests the possible role of
genetic factors needs to be probed.
Notes: 1 copy
Ref ID: 120
Sellick, R. (1998). Counselling patients with life-threatening illnesses. CME, 16, 835-840.
Keywords: guidelines/model
Abstract: In the absence of a cure or definitive treatment, medical practitioners are often called
upon to counsel and support patients who are faced with life-threatening diseases and the
resultant psychological impact. The doctor's overall goal is to ensure good medical management
and to help the patient develop healthy behavioural practices and coping strategies in the
absence of a medical cure. Many doctors feel frustrated and defeated in their attempts to provide
this kind of counselling. This article focuses chiefly on patients who are HIV-positive or who have
AIDS and attempts to highlight some of the principles concerning the psychological impact of a
life-threatening illness on the patient and patient management principles within the context of
counselling and support.
Notes: 1 copy
Ref ID: 8205
Sentle, S. (1997). Aids patients fight for Virodene. Pretoria News.
Keywords: clinic/infection/knowledge/medicine/treatment/WHO
Abstract: Thousands of Aids patients are putting pressure on their doctors to fight for the use of
Virodene as a treatment. Dr Yaggan Leeuw, who deals with HIV Aids-related matters and does
consultations in the city and at Ga-Rankuwa clinic, said he could no longer stand the presence
put on him by thousands of his Aids patients needing the drug. The patients are very desperate
and are in need of Virodene. The need is growing every day and the Medicines Control Council
404

(MCC) must view this is a serious light. "Patients say they are tired of standing around while the
council makes decisions about their lives. The council banned the drug Virodene P058 earlier
this year. Last month MCC head Professor Peter Folb said the Council had serious concerns,
based on the best available scientific knowledge and advice, that Virodene was unsafe and
potentially dangerous to humans when given as medication for HIV infection and Aids.
Notes: 1 copy
Sewpaul, V. & Mahlalela, T. (1998). The power of the small group from crisis to
disclosure. AGENDA, 39, 34-43.
Ref ID: 463
Keywords: babies/health/prevention/research/women
Abstract: Drawing on the lived experience of women, this article discusses the psychosocial
consequences of the receipt of HIV positive (HIV+) diagnoses by placing HIV/AIDS within the
crisis framework; the effects of patriarchy on HIV+ women; the implications of women's economic
dependence in the management and prevention of HIV and women's perception of health
personnel. This work is based on research findings with a group of 15 HIV+women, all of whom
have babies with symptomatic HIV or AIDS. The study explores the psychosocial consequences
of HIV+ diagnoses for mother and their babies, especially in a context where women learned
about their own HIV+ status through the diagnoses of their children.
Notes: 1 copy
Ref ID: 452
Sher, R. & Moralo, M. (1994). HIV/AIDS counselling. Modern Medicine, 19, 57-65.
Keywords: education/HIV/AIDS counselling/infection/insurance
Abstract: As a direct result of the AIDS survey that Modern Medicine conducted last year, it
became apparent that general practitioners would welcome a practical series of articles on
HIV/AIDS. We therefore commissioned leaders in the field of HIV infection to ....for us. Southern
Life also approach Modern Medicine after the survey as they noted the request by GPs for AIDS
education and were keen to make a contribution. They will cover AIDS as it affects the Insurance
405

Industry.
We plan to take you from counselling through early HIV infection - late HIV infections - virology -
paediatric HIV - female HIV, etc.
Notes: 1 copy
Bulletin, 3, 17.
Ref ID: 457
Shermann, J. & Bassett, M. T. (1994). Training teachers in AIDS prevention. AIDS
Keywords: adolescents/community/information/prevention/training/Zimbabwe
Abstract: With proper training teachers can play a vital role in assisting adolescents in protecting
themselves against HIV and AIDS. The Department of community Medicine at the University of
Zimbabwe has piloted a training programme for teachers in 17 schools. The workshops are
aimed at enabling the teachers to talk freely about relationships with young adolescents,
providing accurate information on AIDS and STDs and developing ways of strengthening ties
within the community in the fight against AIDS. The participatory approach used encourages the
formation of student drama groups and resources centres.
Notes: 1 copy
Ref ID: 705
Shutte, S. (2000). Transmitting hope in Khayelitsha. ChildrenFirst, 32-34.
Keywords: AZT/babies/clinic/Department of Health/health/women
Abstract: During 1998, the then Minister of Health ruled that the State would not be able to afford
the anti-retroviral drug, AZT, for HIV positive patients. The Western Cape Provincial Department
of Health, nevertheless, decided to put some of its budget towards AZT for pregnant HIV positive
women. It was a brave move. The doctor involved was a loyal ANC supporter and knew that he
risked the disapproval of comrades in authority. But he was moved by the plight of the HIV
positive mothers and babies whom he saw regularly in the township clinics.
Notes: 1 copy
406

Siegl D. & Morse, J. M. (1994). Tolerating reality: the experience of parents of HIV
positive sons. Soc Sci Med, 38, 959-971.
Ref ID: 435
Keywords: parents
Abstract: In this study, the experience of parents as they discover that their son is HIV+ or has
AIDS, witness their deterioration and death, is described. Using the methods of grounded theory,
13 parents (8 mothers and 5 fathers) were interviewed and a model depicting the basic social
psychological process (BSSP), keeping reality at a tolerable level, was developed. Six stages of
tolerating reality are: Suspecting; taking it in; Going along with the changed reality; Being swept
along with symptoms; Beating down the denial; and Learning to live with it. Parents engaged in a
number of strategies aimed at keeping reality at a tolerable level, so they could function in their
"comfort zone" and cope with day-to-day horror, fear and uncertainty while attending to their son.
Notes: 1 copy
, -.
Ref ID: 311
Keywords: clinic
Sifris, D. (1996). Prospect of having to tell patient he is HIV positive "faced by all". AIDS, -
Abstract: The difficult task of telling a patient that they are HIV positive is something that we will
all face at some time. Many practitioners have simply avoided the issue by getting their
receptionist to phone the result through to the patient at work, and as was the case with one of
our clinic patients, to leave a message with switchboard operator to inform Mr X that his AIDS test
was positive. There are many such horror stories from the clinic, and I need not elaborate on the
repercussions. Under ideal circumstances, the patient will have had pretest counselling and will
have been prepared for a positive result. But even with adequate pretest counselling the results
always come as a shock.
Results should always be given face to face even when the results are negative. Giving a
negative result should be used as a reinforcement for the need for safer sex practices. There is
no easy way to break the bad news. I have found that my patients respond to a direct, honest
407

approach. I tend to tell them they are HIV positive in the same way that I would tell a patient that
they are diabetic or hypertensive. Many of my patients appreciate this almost matter of fact
approach and it tends to keep the whole concept of HIV infection in perspective. After all, what
we are dealing with is a long term, chronic, manageable infection.
Silverman, D. (1989). Making sense of a precipice: Constituting identity in an HIV clinic.
In P.Aggleton, G. Hart, & P. Davies (Eds.), AIDS: Social representations, social practices (pp.
101-125). New York, Philadelphia, London: The Farmer Press.
Ref ID: 393
Keywords: clinic/infection/response
Abstract: This chapter reports on an observational case-study of a clinic offering services to
people with HIV infection. It identifies four styles of patient self-presentation and examines the
role of "positive thinking" in patients' responses to their condition. The data presented here
suggests that in the course of their interactions with one another, patients deferred to culturally-
shared moral forms whereas doctors emphasized the boundary between "bodies" and "minds" as
well as practical matters about the organization of care. These issues are discussed within the
context of boundary policing and conceptions of "good adjustment".
Notes: 1 copy
Silverman, D., Perakyla, A., & Bor, R. (1992). Discussing safer sex in HIV counselling:
Assessing three communication formats. AIDS care, 4, 69-82.
Ref ID: 397
Keywords: communication/counsellor/counsellors/information/research/sex
Abstract: Although it is acknowledged that counselling can be an important factor in behavior
change, we lack information on how HIV counselling works in practice. Research is reported
based on transcriptions of audio-tapes of counselling drawn from seven hospital centres in
England and the USA. It is shown that communication occurs in the context of three different
formats. Certain formats and conversational strategies used by counsellors produce far greater
patient participation. Such participation may hold out the prospect of greater behavioral change
408

than simply listening to information and advice.
Notes: 1 copy
Sliep, Y. (1996). Care - Counselling model for AIDS patients in rural Malawi.
Ref Type: Unpublished Work
Ref ID: 472
Keywords: care/information/knowledge/Malawi/training
Abstract: This work is written to give an overview of the theoretical grounding on which the Care
counselling model is based. The information in this work is especially relevant to trainers of the
Care counselling model. Parts of the chapter may be taken up in the training programme by the
trainers depending on the educational background of the participants. The objectives are:
- to create a working knowledge on the Care counselling model regarding: background, overview
of the model, the difference between the care counselling model and other counselling models.
Notes: 1 copy
Ref ID: 312
Smart, R. (1994). AIDS programmes in Africa - A Bird's eye view. Positive outlook, -, 16.
Keywords: Africa/Kenya/South Africa/Uganda/women
Abstract: From the dingy airport at Lusaka, our first introduction to Zambia's desperate, dusty
poverty, to Uganda, Africa's nursery, struggling to emerge from war and economic chaos, to
Kenya when within sight of Lake Victoria, women spend eight hours a day carrying water to their
homes, we learned about AIDS, and, in doing so, had a privileged vision of what the future may
hold for South Africa. Some people were chosen on October 3rd 1993, eight people chosen to
participate in a UNICEF-sponsored Study Tour of AIDS Programmes elsewhere in Africa. This
article will give you a glimpse of the tour in the form of extracts form the report .
Notes: 1 copy
Smart, R. (2000). Children living with HIV/AIDS in South Africa: a rapid appraisal. Interim
National HIV/AIDS Care and Support Task Team (NACTT). [-], 1-106.
Ref Type: Organisational research report
409

Ref ID: 492
Keywords: Africa/education/government/health/South Africa
Abstract: There are 16.3 million in South Africa, 61% of whom live in poverty. Examination of
their status (health, welfare, and education etc) reveals severe shortcomings in all areas. With
the advent of the HIV/AIDS epidemic the situation is worsening and any hard won gains for
infants and children are threatened. In recognition of this, Government has called for a national
strategy on children and HIV/AIDS. The strategy will cover children who are infected with HIV,
children who are vulnerable to becoming infected and children who are affected, with the main
emphasis being on affected children, including AIDS orphans.
Notes: 1 copy
Smetherham, J. A. (2001). Garlic proves potent in treating antibiotic-resistant infections in
HIV children. Cape Times.
Ref ID: 5406
Keywords: Africa/drugs/infection/research
Abstract: It's smelly and cheap- but garlic is providing a prize warrior in HIV -positive children's
battle against opportunistic infections. The availability of the puntent herb means it could become
an important weapon in Africa' fight against HIV/AIDS. Allacin, an extract of garlic, is being used
with excellent results at Red Cross Children's Hospital to treat children with drug-resistant
infections of candida in their mouths and throats.
Peter de Wet, head of research technology in the department of paediatric surgery at Red Cross
Children's Hospital, said allacin had been used only in "problem cases" when conventional drugs
had failed, but it had healed almost all of these children. " We have used garlic to treat 50
patients with candida in their mouths and throats who were not responding to conventional
antibiotics," he said yesterday. "It took between two and five days for the infection to vanish. We
are entering the age of multi- antibiotic- resistant organisms and we need alternatives.
We wet also isolated 77 samples of the fungus that proved resistant to conventional drugs and
found that allacin killed of all the samples.
Scientific studies have proved allacin has anti-viral properties, making it highly effective in fighting
410

the herpes virus. It had also been found to have immune-boosting qualities and " almost seems
too good to be true", De Wet said.
He had wondered whether allacin might help prevent HIV developing into AIDS by strengthening
patients' immune systems, but believed research on this question would have to wait. "We need
to crawl before we start running, " he said.
Allacin's anti -fungal activities have important implications as thrush is present in the intestines of
even healthy people, but candida can spread to other organs in the blood-stream of HIV-positive
people, leading to blood poisoning.
De wet said much of the proof of garlic's healing powers was anecdotal, but it was reputedly first
used by the Chinese about 5 000 years ago. Slaves of the Egyptians were reportedly so assured
of its potency that they downed tools and refused to work on the pyramids when their garlic ration
was cut. Allacin could be administered in place of other drugs only if it was registered, De Wet
said. He is drawing up a plan for a study in which the progress made by a group treated with
allacin would be compared with that of a group given conventional drugs. "Then we could
perhaps permission of a full-blown study with a view to registering allacin, " he said.
Mark Beale, head of infectious diseases at Tygerberg Hospital, confirmed that garlic's antibiotic
properties had been well documented.
Notes: 1 copy
Smillie, M. (1994). A case study of the development of a counseling skills training
program for Kenyan nurses in the prevention of sexually transmitted diseases. The University of
Manitoba (Canada): 0303.
Ref Type: Unpublished Work
Ref ID: 8787
Keywords:
clients/community/condom/disease/health/intervention/Kenya/knowledge/Nurse/prevention/primar
y prevention/research/sex/sexual behaviour/sexual practice/sexually transmitted
disease/strategy/training
Abstract: Control of Sexually Transmitted Diseases, including AIDS, relies on primary prevention
411

strategies which encourage individuals to practice disease preventive sexual behaviours. In
Kenya counselling is regarded as a potentially effective intervention to assist people to practice
safer sex behaviours. To assess the merits of counselling as an intervention to encourage safer
sex practices among clients diagnosed with an STD, nine community health nurses in Nairobi
were trained in a simple approach to counselling. Ninety STD clients received counselling and
responded to a pre-counselling and post-counselling questionnaire of knowledge, attitudes and
intentions to change sexual practices. Results of the study indicate a short training programme in
counselling can influence nurses' counselling practices. A brief counselling intervention does not
by itself lead to clients changing sexual practices but may be effective to teach clients how to use
a condom and reinforce safer sex messages. More research is needed to evaluate counselling as
a primary prevention strategy to control STD and AIDS.
Ref ID: 8124
Keywords: AZT
Smith A. (2000). G. F. Jooste brei uit vir beter diens. Die Burger.
Abstract: Manenberg.- Die G.F. Jooste Hospital se nuwe vleuel vir buite pasiente, met 'n
spesiale MIV/vigs kliniek, sal maandeliks aan sowat leen. Dis teen 'n koste van 10 miljoen voltooi
en is een van talle projekte wat die hospitaal vanjaar aangepak het vir beter diense. 'n
Gespesialiseerde sentrum waar vroue klagte oor verkragting kan indien en mediese behandeling
kan ontvang, is vroeer vanjaar hier geopen. Die G.F.Jooste, die Skiereiland, bedien die kaapse
Vlakte, Mitchells Plain, Khayelitsha en 'n groot deel van Athlone. Die hospitaal behandel jaarliks
ongeveer 55 000 pasiente, van wie twee derdes noodgevalle en die restraumagevalle is. Dit is
vier jaar gelede van 'n trauma- noodeenheid omgeskakel. 'n Hospitaalwoordvoerder, mnr. Isaac
Ngermi, het gese die laaste maande het die verkragtingslagoffers toegeneem. Die sentrum kry
maandeliks sowat vyftig van hulle, en die hospitaal bestee maandeliks R5 000 aan die
vigsteenmiddel AZT. Hoewel die nuwe geriewe nie met die oog op hoofsaaklik vigslyers geopen
is nie, is hospitaalpersoneel nogtangs gereed vir pasiente uit die groep, het Ngermi gese. Die
dubbel verdiepingvleuel is gefinansier uit die Hop-kas. Dit betaan uit twaalf spreekkamers. twee
behandelings kamers en 'n klein teater. Volgens dr Gil bert Lawrence, waarnemende direkteur
412

van die wes-Kaapse Gesondheidsdepartment, sal die klem geplaas word op eendaagse
chirurgie. "Die buitepasient - afdeling sal voorsiening maak vir 'n ortopediese kliniek, sowel as
chirurgie, pediatrie en ginekologie. Die hospital het daarby 'n geestesgesondheidspan vir
psigiatriese dienste aan die gemeenskap." Behoorlike geriewe vir die G.F. Jooste se personeel -
soos 'n eetsaal, ruskamers en 'n opleidingsentrum - is ook ingerig. VolgensLawrence is die
behoefte in die verlede afgeskeep ter wille van pasientesorg.
Notes: 1 copy
Ref ID: 3165
Soal, J. (1998). New signs of hope in a time of HIV. The Cape Times.
Keywords: Africa/conference/Developing countries/drugs/medical
Abstract: Everyone who is anyone in the field of Aids has gathered in Geneva for the 12th World
Aids Conference, which has its theme" bridging the Gap" between developed and developing
countries in the fight against HIV. This and other recent developments show that the world and
its drug companies, its medical aids and its first-world therapies are starting to take more
seriously their responsibility to people with HIV in developing countries.
Powerful anti-HIV drugs have changed the face of the Aids epidemic in countries that can afford
them, but have been almost unheard of in Africa which is home to 70% of people with HIV. Yet
there are signs of hope: Some medical schemes have started to pay for the expensive anti-Aids
drug" cocktails", the price of these drugs has dropped dramatically and South Africans taking part
in clinical trials are receiving treatments they could never otherwise afford. Admittedly, the
number of people who have access to the treatments doesn't touch the sides of our HIV
epidemic, but it is a start-a life changing one for the individuals involved-and Aids activists are
confident it can go further.
Notes: 1 copy
Ref ID: 288
Soal, J. (1999). Cells infected with Aids virus forced to commit suicide. The Cape Times.
Keywords: suicide
413

Abstract: Scientists said this week they had harnessed a protein that can force cells infected with
the Aids virus to "commit suicide". They "smuggled" this protein into some infected cells using
new technology that might be used to fight other bugs, such as the viruses that cause hepatitis
and herpes, and the parasite that causes malaria. "This is the first example of protein therapy"
said Steven Dowdy of Washington University in St Louis. The protein can be delivered as an
aerosol-something like a nose spray.
Many other health scientific findings have been mentioned in the article.
Notes: 1 copy
Soal, J. (2000). "Primitive" messages slated: Aids organisation blames family killing on
fear-inducing campaigns. Daily News.
Ref ID: 5124
Keywords: AZT/drugs/education/family/infection/prevention
Abstract: People are not told that they can live productive lives for many years after contracting
HIV. Everywhere one goes, one hears that HIV/AIDS is a death sentence," the treatment Action
Campaign (TAC), a group that lobbies for treatment for peoples with HIV, said in a statement
yesterday. "One worse, we are told there is no cure, that education and prevention are the only
protection. From these primitive messages millions of people learn fear; hopelessness,
loneliness and anger" The statement said that AIDS education campaigns failed to tell the
millions of people living with HIV that they could live full and productive lives for many years after
contracting the virus and that most AIDS-related infections could be cured. "Above all, they all
ignore the fact that millions of lives could be saved if people with HIV/AIDS had access to
treatment with anti-retroviral drugs". In countries where retro-retroviral drugs, like AZT, are widely
available, the number of people dying of AIDS had dropped dramatically.
Notes: 1 copy
Ref ID: 391
Soal, J. (2002). Cape Town to get AIDS project. The Daily News.
Keywords: Cape Town
414

Abstract: Nobel Peace Prize winner Medecins sans Frontiers (Doctors without Borders) MSF) has
chosen Cape Town as the site for a comprehensive HIV prevention and treatment project that
includes the provision of life saving anti-AIDS drugs. The international humanitarian group which
won the Nobel prize last year for its commitment to human rights and provision of medical care in
conflict situations has presented the Western Cape Health department with a proposal to extend
an existing HIV project in Khayelitsha. Health MEC Nick Koornhof said that no final decision on
the proposal had yet been taken by the Western Cape government, but the proposal was being
viewed "very positively".
According to the document, MSF will provide the funds, drugs, training, support and technical
assistance to develop a model of AIDS prevention and care in Khayelitsha that can be used
throughout Southern Africa. The research will include the so-called "triple combination anti-
retroviral therapy- the drugs that have saved the lives of millions of people living with HIV- for a
group of participants, as well as treatment to prevent mother-to-child transmission of the virus for
all pregnant women with HIV, medication for AIDS-related infections, home-based care and post-
rape counselling and treatment. No financial cost has been put on the project yet, but the
organisation that operated with a R1.7bn budget last year says it is prepared to make the
necessary investment. "Our plan is very concreted; we have been working on it for months,"
MSF president Mr James Orbinski said. Orbinski was in Cape Town last week to visit the clinics
in Khayelitsha where the research will be conducted. "We are just waiting for the go-ahead from
the health authorities. After all, why should people in South Africa not have the same
medications as people in other parts of the world?" Anti-Aids like AZT have changed HIV from a
fatal disease into a manageable one in developed countries, but are unaffordable to the majority
of people living with Aids.
SoRelle, R. (2000). Botswana wants to make HIV reporting Mandatory and Push
counselling to reduce AIDS Chaos. American Heart Association, 102, 1 of 4-3 of 4.
Ref ID: 322
Keywords: Botswana/health/HIV transmission/sexual partner/transmission/UNAIDS
Abstract: Botswana, one of the nations hardest hit by the African AIDS epidemic, is proposing a
415

new law that would require people infected with HIV to disclose their health problem to sexual
partners, according to a report from the British Broadcasting System. In this nation in which 1 in
3 adults carries the virus associated with AIDS, the law is intended to change sexual behavior,
said Botswana's health minister Joy Phumaphi to officials of the United Nations. The health
minister is also proposing a door-to-door AIDS counselling program that would start in September
and is anticipated to cost $ 4,5 million. The AIDS disclosure law was pronounced unworkable by
officials of UNAIDS, the agency charged with fighting the epidemic. However, they said the
counselling effort is likely to be more successful in reducing the rate of HIV transmission in the
beleaguered nation.
Notes: 1 copy
South African Government. (1999). Technical co-operation by the Government of Japan
Proposal: by the Government of South Africa to the Government of Japan for the supply of
equipment.
Ref Type: Unpublished Work
Ref ID: 584
Keywords: Africa/clinic/education/government/health/Department of Health/health
education/mother-to-child transmission/MTCT/South Africa/training/transmission/VCT/Voluntary
HIV counselling and Testing
Abstract: The South Africa requests the assistance of the Japanese Government for the purchase
of educational equipment for the nine provincial health departments' for use in HIV/AIDS
programmes. These educational equipment will mainly be for the use of the Voluntary HIV
counselling and Testing (VCT) programme, as well as the mother-to-child transmission (MTCT)
programme. The education equipment will be used for training of healthcare workers, as well as
health education within clinics that offer the VCT and MTCT programmes. HIV/AIDS provincial
coordinators, master trainers and site trainers will use the equipment.
Notes: 1 copy
416

South African Medical Journal (1994). Management and treatment of HIV disease: Cross-
cultural counselling. South African Medical Journal, 84.
Ref ID: 319
Keywords: medical/treatment/South Africa/Africa/culture/community/health/Cross-cultural
counselling
Abstract: Much of South African medical practice is cross-cultural. As the nation enters a new era
centred on the rights of the individual, the medical profession is called to reflect on its current
practices, and to look at ways in which clients, irrespective of their background, may be given
sufficient, understandable information about their medical condition and be able to make informed
decisions about their treatment. Western medicine practised in South Africa has traditionally
been problem-centred, rather than people-centred, whereas traditional African culture is strongly
centred on the community. The challenge is therefore to learn from the cultures we serve by
listening and engaging the full human being rather than merely diagnosing and treating medical
ailments. Health, after all, is more about wholeness than it is about the absence of symptoms.
Notes: 1 copy
Spielberg, F., Kurth, A., Gorback, P. M., & Goldbaum, G. (2001). Moving from
apprehension to action: HIV counselling and testing preferences in three at-risk populations.
AIDS Education and Prevention, 13, 524-540.
Ref ID: 333
Keywords: barriers/clinic/HIV testing/men/policies/population
Abstract: This study sought to identify factors influencing HIV testing decisions among clients at a
sexually transmitted disease clinic, gay men, and injection drug users. Focus group and intensive
interview data were collected from 100 individuals. The AIDS Risk Reduction Model was adapted
to describe factors that affect best decisions. Testing barriers and facilitators were grouped as
factors affected by "individuals" beliefs, "system" policies and programs, " testing" technology,
and "counselling" options. Individual factors (fear of death and change), system factors
(anonymous test availability, convenience), and counselling and testing factors(rapid results,
counselling alternatives) interact to determine whether an individual does not test ("
417

apprehension") or does test("action), and ultimately, tests routinely (" integration). In conclusion,
traditional HIV testing presents barriers to some populations at risk for HIV. These findings
suggest several strategies to improve HIV test acceptance: acknowledge fears, address system
barriers, utilize available test technologies, and expand counseling options.
Notes: 1 copy
Spielberg, F. (2001). Moving from Apprehension to Action: HIV counselling and testing
preference in 3 at-risk populations. AIDS Education and Prevention, 13, 524-540.
Ref ID: 356
Keywords: barriers/clients/clinic/HIV testing/infection/knowledge/men/policies/policy/population
Abstract: This study sought to identify factors influencing HIV testing decisions among clients at a
sexually transmitted disease clinic, gay men, and injection drug users. Focus group and intensive
interview data were collected from 100 individuals. The AIDS Risk Reduction Model was adapted
to describe factors that affect test decisions. Testing barriers and facilitators were grouped as
factors affected by "Individual" beliefs, "system" policies and programs, " testing" technology, and
"counselling" options. Individual factors (fear of death and change), system factors (anonymous
test availability. In conclusion, traditional HIV testing presents barriers to some populations at risk
for HIV. These findings suggest several strategies to improve HIV test acceptance: acknowledge
fears, address system barriers, utilize available test technologies, and expand counseling options.
Notes: 1 copy
Ref ID: 7476
St Leger, C. (1996). High price for synthetic dagga. Sunday Times.
Keywords: Africa/research/South Africa
Abstract: Scientists have spent millions of rands and years of research to produce a synthetic
version of one of South Africa's most easily grown plants - dagga. Called Elevat, the artificially
manufactured version of the real thing is being produced in pill form to treat Aids and cancer
patients. It helps them get back their appetites, gain weight and fight nausea. Elevat has been
registered in South Africa as a schedule 7 drug. It induces the same high in its users as does the
418

natural product, but costs many times the streets price of dagga in this country. The trade price
to pharmacists is R472,73 of 20 5mg tablets or R363, 64 for 30 25 mg tablets. The mark-up to
the customer is usually 50 percent. Dosages range from one to four tablets a day. Marie
Kleingeld, the product manager of Lagamed, which imports Elevat from the US, said this week
synthetic cannabis was needed as no medicines control body anywhere in the world would
register dagga. She said the manufacturer could guarantee the consistent strength of the drug
only through an expensive process of artificial production. So difficult has it been to register
Elevat in South Africa that it has taken at least double the normal two years, and pharmacists are
required to keep stocks under lock and key. Trials in the US involving 139 a significant
improvement in appetite. Patients on regular dosages also experienced a decrease in nausea, a
greater sense of weellbeing and enhanced self-esteem. No sings of abuse or personality
changes were noted, despite the inclusion in the study of patients with a past history of drug
abuse. During a trial of cancer patients with severe nausea, 40 of 55 patients did not feel sick
while on the drug. Elevat has been on the market in the US since 1985 for cancer therapy. Its
registration was extended to cover AIDS patients in 1992.
Notes: 1 copy
Ref ID: 4954
Staff reporter (2001). AIDS counselling threat concerns medical fraternity. Cape Argus.
Keywords: health/medical
Abstract: The medical world has reacted with surprise to a report that the Department of Health
intends to make it a criminal offence for a medical practitioner not to offer counselling to a patient
with HIV/AIDS.
Notes: 1 copy
Standing, H. (1992). AIDS: Conceptual and methodological issues in researching sexual
behaviour in Sub-Saharan Africa. Social Science and Medicine, 34, 475-484.
Ref ID: 119
Keywords: prevention/research/sexual behaviour/Sub-Saharan Africa
419

Abstract: This paper describes some of the conceptual and methodological issues encountered in
the course of a study of mainly anthropological secondary source materials on sexual behaviour
in Sub-Saharan Africa. Its aim was to survey and review existing literature and other secondary
sources available both outside and within Anglophone Sub-Saharan Africa and to evaluate their
usefulness to AIDS research and prevention. The review cautioned against the uncritical use of
anthropological sources without due regard for their conceptual and methodological status. At
the same time it demonstrated important ways in which anthropological insights can inform AIDS
research.
Steel, A. D., Bezuidenhout, S., du Toit, J. D., & Lecatsas, G. (1993). HIV-2 at Ga-
Rankuwa Hospital. South African Medical Journal, 83, 530-531.
Ref ID: 130
Keywords: epidemiology/hospital/positive status/South Africa
Abstract: This letter to the editor outlines the epidemiology and progression of HIV-2 at Ga-
Rankuwa Hospital in South Africa.
Notes: 1 copy
Stein, J. & Brouard, P. (1994). Distinguishing counselling from advice and instruction: A
discussion of skills, techniques and approaches. AIDS Bulletin, 3, 12-13.
Ref ID: 125
Keywords: approach/approaches/counsellor/counsellors/guidelines/model
Abstract: According to the British Association of Counselling, "the task of counselling is to give
the client an opportunity to explore, discover, and clarify ways of living more satisfyingly and
resourcefully." The philosophy behind this definition is one of client self-determination. The role
of the counsellor in the process of counselling is facilitative; to provide the conditions and where
necessary, the information in terms of which clients may best effect a positive relation to their own
behavioural resources. Thus, the first thing we are told at any course on HIV/AIDS counselling is
that, despite what you may read in the dictionary, 'to counsel' is anything but 'to advice'. We are
taught that to advice people is more to tell them what to do. To counsel, on the other hand, is to
420

enable people to make and act on, their own decisions and choices. This process of 'enabling'
the client is commonly called'empowerment'. It involves the adoption of a non -judgmental and
non-prescriptive attitude, and also sometimes referred to as 'unconditional positive regard. This
is all very well and proper, but how, the would-be counsellor may well wonder, does that
contribute to the prevention of HIV/AIDS? After all, when it comes to HIV/AIDS prevention, it is
often precisely what people do, or choose not to do, that is the problem.
Notes: 3 copies
Stein, J. (1996). Coping with HIV infection: First world theory and third world practice.
Ref Type: Unpublished Work
Ref ID: 389
Keywords: Africa/HIV/AIDS counselling/Johannesburg/qualitative research
Abstract: A qualitative study was conducted in order to gain insight into HIV positive patients'
conceptions regarding appropriate coping behaviours. Unstructured interviews with 30 HIV-
positive patients at the Johannesburg General HIV outpatient clinic in Johannesburg. South
Africa were conducted in order to elicit participants' descriptions of their coping behaviors.
Findings suggest that the dominant tendency reported by participants is to favour avoidance
coping over more active coping strategies. In this regard, avoidance coping in seen to include the
rejection of negative ideation regarding HIV, and the attempt to present oneself as "a normal"
rather than an HIV infected person. The preferred coping strategies reported by participants can
therefore be seen to fly in the face of HIV/AIDS counselling theory, which assumes the beneficial
effects of active or non-avoidance as opposed to avoidance coping. Implications for the
management of the disease by way of counselling and other supportive interventions are
considered. It is argued that counselling may often be a place of struggle until counsellor and
client develop a shared understanding of what it means to cope with HIV.
Notes: 1 copy
Stein, J. (1998). Facing up to gender in sexuality transmitted disease counselling.
Ref Type: Unpublished Work
421

Ref ID: 469
Keywords: Africa/clinic/disease/gender/health/intervention/partner notification/prevention/primary
health care/qualitative research/sexually transmitted disease/South Africa/care
Abstract: A qualitative study was conducted at a primary health care clinic in Alexandra
Township, an overcrowded urban slum in South Africa, to explore and assess counselling
interventions designed to improve partner notification rates for sexually transmitted disease
patients. All counselling sessions conducted over a three month period were tape-recorded and
a random sample of 53 counselling sessions were transcribed verbatim and interpreted into
English for the purposes of analysis. Results indicate that gender plays a critical role in
determining both the form and content of counselling interventions. In particular, the fundamental
role of gender inequality in undermining counselling objectives needs to be acknowledged and
negotiated if counselling interventions for sexually transmitted disease prevention are to be
improved.
Notes: 1 copy
Ref ID: 414
Stein, J. (2000). Going one step further reaps results. AIDS Bulleting, -, 8-9.
Keywords: disease/HIV prevention/infection/prevention/sexually transmitted
disease/Tanzania/treatment/Virus/women
Abstract: The Lesedi project, which started in the Free State Province in 1996, has introduced an
approach to the treatment of sexually transmitted diseases and HIV prevention that has never
been tried before anywhere in the world.
Effective sexually transmitted disease (STD) treatment is essential in the fight against HIV/AIDS.
The Mwanza study is Tanzania showed that improved STD care can reduce the rate of HIV
infection by 40%. This is because the presence of other STDs makes it twice as easy for the HI
Virus to move from one person to another during sexual intercourse.
The Lesedi project took STD treatment one step further than it had ever been taken before by
introducing periodic presumptive treatment (PPT). PPT is when women at high risk of STDs are
offered STD treatment or not. The treatment consists of a single monthly dose of an antibiotic
422

called azithromycin which is effective against many STDs.
Notes: 1 copy
Stein, J., Ellison, G., & Moniez, V. (2000). Understanding the limited efficacy of patient-
centred lay-counselling for improving partner notification for sexuality transmitted diseases -
qualitative results from a randomised controlled trial.
Ref Type: Unpublished Work
Ref ID: 468
Keywords: lay counselling/partner notification/disease/health/sexually transmitted disease/primary
health care/clinic/South Africa/Africa/research/impact/training/health worker
Abstract: A study with both qualitative and quantitative components was designed to establish the
relative efficacy of patient-centred lay-counselling, as opposed to a standardized health message
for improving partner notification by sexually transmitted disease patients at Alexandra Health
Centre, a primary health care clinic in South Africa. Results from the quantitative component of
the research indicate that lay-counselling was not more efficacious than a standardized health
message for effecting successful partner notification. Complementary qualitative findings indicate
that the limited impact of lay-counselling in this study can be attributed to the fact that the delivery
of a standardised health message requires less skill and expertise and has less scope for error or
omission than lay-counselling. While the general move towards the training of primary health
care workers in basic counselling skills is supported, it is also necessary to define what can
realistically be achieved in resource-constrained settings and to respect the maxim: it is far better
to do a simple thing well than a difficult thing badly.
Notes: 1 copy
Ref ID: 279
Keywords: VCT
Stein, J. (2001). In search of voluntary HIV testing and counselling. AIDS Bulleting, -, 16.
Abstract: Voluntary HIV testing and counselling is essential for HIV prevention but, as yet, few
health facilities in South Africa provide the service. The national health department's Directorate
423

for HIV/AIDS and STDs does not have accurate recent figures regarding available voluntary
counselling and testing (VCT) services but the bottom line, says Ms Thembela Masuku, Deputy-
Director of counselling Programmes, is that it is still limited. According to Masuku, however,
public demand for VCT is equally limited and there is no pressure on the few services that do
exist. But people should encouraged to have the test, says Brett Anderson of the Western Cape
Business Forum, who voluntary went for a test and was diagnosed HIV positive last year. He
says only about 10 per cent of South Africans who are infected know that they are HIV positive.
The other 90 per cent are infecting other people and infecting themselves with other strains of the
virus.
Notes: 1 copy
Stein, J. (2001). HIV/AIDS and the Media: a literature review. CADRE. [-], 1-18.
Ref Type: Unpublished Work
Ref ID: 470
Keywords: culture/education/health/information/media/population/response
Abstract: The role of the media in confronting the HIV/AIDS epidemic cannot be overestimated.
The 1998 London declaration made by the World Summit of Ministers of Health stated that:" In
the absence at present of a vaccine or cure for AIDS, the single most important component of
national AIDS programmes is information and education". Since the media exists to provide
information and education (as well as entertainment) to populations worldwide - it is a powerful
tool that can be mobilized against HIV/AIDS. The occupational culture of journalism promotes
neutrality which provides a countervailing pull against an advocacy or social change agenda
within the media. Despite this, media coverage nevertheless ensures that HIV/AIDS is seen as
an important issue requiring a coherent national polity response. Indeed, it has the power to set
the agenda in this regard. This document forms part of a range of activities conducted by Cadre
as part of our HIV/AIDS and Media Advocacy Programme.
Notes: 1 copy
424

Stein, J. (2001). HIV/AIDS and the South African Media: workplace policies and
programmes. CADRE. [-], 1-43.
Ref Type: Unpublished Work
Ref ID: 476
Keywords:
employee/evaluation/guidelines/impact/media/policies/policy/prevention/research/response/workp
lace
Abstract: This exploratory study has been designed to provide preliminary data regarding whether
and to what extent South African media institutions have responded to the need to develop
corporate policies and strategies to delimit the impact of HIV/AIDS and to protect the rights of
employees with HIV/AIDS. An evaluation of media workplace policies and programmes is long
overdue. This report explores the extent to which media institutions have thus far developed a
proactive response to managing the epidemic through the introduction of workplace policies and
programmes, and the extent to which these contribute to prevention as well as to upholding the
rights of employees in relation to HIV/AIDS. It also sets out to ascertain whether HIV/AIDS is
recognised by management as a threat to business which impacts directly on productivity, costs
and markets. The research findings are supplemented by a set of basic recommendations and
guidelines, resource documents and sample policies for the promotion of appropriate policies and
practice within media formations.
Notes: 1 copy
Steinberg, M. (1990). AIDS Action now: Information, prevention and support in
Zimbabwe. New Ground, -, 15.
Ref ID: 216
Keywords: Africa/counselling/guidelines/HIV
transmission/infection/information/policies/prevention/Southern Africa/support/Zimbabwe
Abstract: This practical book about AIDS in Southern Africa is long overdue. Helen Jackson
describes the complex and contentious issues around AIDS and provides insights into
counselling, prevention and policy. Her knowledge is gained largely from her own experience in
425

the field, she lectures at Harare's school of Social Work and is a founder member of Harare's
AIDS Counselling Trust (ACT).
The book is aimed at anyone suffering from or working with AIDS. The most accessible and
informative chapters are those dealing with how to avoid infection by HIV and those with discuss
counselling, support and self-help, and public attitudes, awareness and policy. The extent and
progression of the disease in Southern Africa are inadequately presented, the author is perhaps
affected by the climate of information suppression which has surrounded the disease in her
country. Jackson's preventive education experience shows clearly in her sensitive discussion of
ways to avoid sexual transmission of AIDS. She gives useful guidelines for assessing personal
risk of infection and arguments for and against being tested for the disease. Guidelines for
effective counselling chapter six, deal with the emotional reactions of sufferers. Here again her
strength lies in her obvious first hand experience. AIDS Action now should prove to be a useful
resource for healthworkers and organisations.
Notes: 1 copy
11, 5-6.
Ref ID: 129
Steinberg, M. (1993). HIV infection in South Africa. Child Care Worker/ Kinderversorger,
Keywords: epidemiology/South Africa
Abstract: AIDS cases represent the end stage of HIV infection, and are therefore inappropriate for
assessing the current status of the HIV epidemic. Additional problems with AIDS case include
controversy about the definition of an AIDS case and inexperience among health workers about
recognising the signs and symptoms of AIDS defining conditions. AIDS cases, however, have
provided us with some information about the epidemic. This includes the predominance of a
heterosexual, as opposed to a homosexual epidemic, the firmer establishment of the epidemic,
the firmer establishment of the epidemic in specific areas of the country, and the concentration of
cases in the younger reproductive age group. This article will discuss a further approach to
monitoring the HIV/AIDS epidemic namely the assessment of currently infected persons who do
426

not necessarily show any signs or symptoms of the disease.
Notes: 1 copy
Steinberg, M., Allwood, M., Karstead, C., & Brouard, P. (1997). Nurse - counsellors
perceptions regarding HIV/AIDS: counselling objectives at Baragwanath hospital. CADRE. 1-7.
Ref Type: Organisational research report
Ref ID: 388
Keywords: Africa/Baragwanath/counsellor/counsellors/health/HIV/AIDS
counselling/information/Nurse/South Africa/training
Abstract: In this study, an attempt is made to gain insight into the ways in which nurse-
counsellors at Baragwanath, a large South African hospital in an area of high HIV endemicity,
understand HIV/AIDS counselling objectives. Semi-structured interviews, with all nurse-
counsellors who had at least one year's experience ( n=8), were conducted in order to elicit
participants' descriptions of their counselling role. Findings suggest that to the extent that ( a) the
provision of emotional support is interpreted as the alleviation of immediate distress, and (b) the
facilitation of health promotion is interpreted as the provision of information and advise, the
HIV/AIDS counselling goals of emotional support and health promotion are set at variance in
unsuspected ways. It is suggested that the development of adequate standards for the initial
training and ongoing supervision of HIV/AIDS nurse - counsellors in South Africa, as elsewhere,
is imperative.
Notes: 1 copy
Steinberg, M., Kinghorn, A., Söderland, N., Schierhout, G., & Conway, S. (2000). South
African Health Review 2000. Ntuli A., Crisp, N., Clarke, E., and Barron, P.
Ref Type: Unpublished Work
Ref ID: 8811
Keywords: health/HIV prevention/prevention/sexual behaviour/intervention/impact
Abstract: HIV prevention requires sustained efforts of social mobilisation towards healthier and
safer sexual behaviour. Once effective interventions are adopted their actual success will depend
427

on how they are implemented and sustained. Implementing agents require the organisational
support, staffing and skills, sufficient resources and technical assistance in order to achieve the
desired impact of the intervention.
Notes: Chapter 15
12.
Ref ID: 281
Strachan, K. (2000). The role of organisations outside government. HST UPDATE, -, 11-
Keywords: government
Abstract: The HIV/AIDS epidemic in South Africa has got to the stage where countless people are
now beginning to die, but still the efforts of government are focused almost exclusively on
awareness and prevention. The burden of the dying and of the orphans they leave behind, is
falling on the shoulders of those outside of government. The resources available fall far short of
the need, but some organisations, such as the South Coast Hospice in Port Shepstone, KwaZulu-
Natal, are showing a way to face the problem.
Notes: 1 copy
Strebel, A. (1994). Counselling women with a focus on their specific needs: Examining
pregnancy, abortion and paediatric issues. AIDS Bulletin, 3, 16-17.
Ref ID: 128
Keywords: abortion/children/pregnancy/pregnant/reproductive health/women
Abstract: As elsewhere in Sub-Saharan Africa, South Africa women make up an increasing
percentage of those infected with HIV. While the first national HIV survey of women attending
antenatal clinics in 1990 revealed an estimated infection rate of 0.76%, this had risen to 4.69 %
by 1993. By the end of 1993 it was estimated that women, mostly in the 15-24 year age group,
accounted for over half of the total of about 566000 HIV-infected people. Furthermore, forecasts
of HIV prevalence among all adult females are about 4% for 1995, 12,5% by 2000 and 20,5% by
2500. Recent research has begun to produce a clearer picture of the impact. Firstly, women
appear to have a greater risk of HIV infection through heterosexual contact than men. While the
428

easons for this are not yet clear, there is evidence of the possibility of a greater physiological
vulnerability in women. They are also often infected up to 10 years younger than men, with about
80% of female cases in women of childbearing age. And perhaps most significantly, women may
pass the virus on to their infants, during or after birth. Although rates of such transmission vary
world-wide, roughly 30% of babies of HIV-positive mothers are infected. These factors clearly
pose important and often difficult questions for women, which would require sensitive and specific
counselling. Probably the most controversial issues are those linked to the reproductive choices
of all women, and especially those who are HIV infected. To start with, there is the complex
matter of possible transmission to infants. Women who are themselves infected are usually
advised to avoid pregnancy and there have even been calls for the mandatory testing of all
women wishing to fall pregnant. However, in the absence of a vaccine, these are clearly not
realistic long-term options and place considerable constraints on women
Notes: 1copy
Supplied by Department of Health (2001). KZN moves ahead with second phase of VCT
programme. Natal Witness.
Ref ID: 8804
Keywords: VCT/HIV/AIDS counselling/voluntary counselling and testing
Abstract: VCT stands for voluntary counselling and testing. VCT is when a person chooses to
undergo HIV/AIDS counselling so that they can make an informed decision about whether to be
tested for HIV. The article gives a definition of voluntary, counselling and testing. It also
describes the Provincial HIV/AIDS Plan listing where sites have been established and where they
are planned to be launched in the near future.
Ref ID: 6877
Swanepoel, T. (1996). Nuwe vigsmiddel buite bereik van SA. Beeld.
Keywords: AZT/South Africa
Abstract: 'N DEURBRAAK in die behandeling van vigs - 'n soort mengelmiddel - is vir die meeste
van die sowat honderdduisend Suid-Afrikaners met die gevreesde siekte buite bereik. Die
429

department van Gesondheid oorweeg dit nie om die terapie te subsidieer nie. 'n Sekere
kombinasie van vigsmiddels ( Aids cocktail) onderdruk die virus byna heeltema en waarborg 'n
gehalte-lewe. Die vordering in die behandeling daarvan is op 'n internasionale vigs konferensie
in Birmingham, Engeland, bekend gemaak, berig sapa-Ap.
Dit beteken vigs kan dalk 'n chroniese, beheerbare siekte word. Verskeie vigs- drukgroepe het 'n
beroep gedoen op die Suid-Afrikaanse regering om kombinasie-terapie geldelik te steun.
Volgens dr. Dave Johnson, Suid-Afrikaanse vigskenner, word 'n paar eksperimentele programme
met kombinasieterapie reeds hier gebied. "Die resultate is belowend. Die behandeling is egter
ongelooflik duur. Dit kos sowat R4 800 per maand."
Dis juis die koste wat die departement in ag neem. 'n Woordvoerder se daar is ander
gesondheidskwessies wat eerder aandag verg. Daarbenewens is daar nog nie uitsluitsel oor die
lange duur nie . " Die behandeling is ook net daar vir mense wat reeds vigs her. Dit is nie 'n
entstof nie."
Indien die departement behandeling met net een middel aan die HIV besmette bevolking
beskikbaar stel, sal dit tot R10 miljard per jaar kos, se dr. Robin Wood van die HIV-kliniek by die
somerset-Hospitaal in Kaapstad. "Kombinasieterapie is heelwat duurder. Dit blyk dus net
beskore te wees vir die rykes en die wat deelneem aan kliniese toetse." Daar is sowat veertig
mense wat nou self daarvoor betaal.
Dr. Johnson bevraagteken die etiese implikasie van die toetse. "Ons moet onself afvra of dit
geregverdig is om die toetse te doen in 'n land waar die middels eenvoudig nooit bekostigbaar sal
wees nie."
Drukgroepe vra ook staatsondersteuning vir die behandeling van swanger vroue met een of meer
vigsmiddels, soos AZT en 3 TC. Die behandeling in die laaste trimester van swangerskap kos
sowat R1 000
Notes: 1 copy
Ref ID: 2769
Swanepoel, T. (1997). Aids drug firms face human rights row. The Citizen.
Keywords: Africa/drugs/health/medical/physician/South Africa
430

Abstract: If you are Aids patient undergoing trials with combination therapy in South Africa,
chances are the drugs company will tell you to pack up and move on once the trials are over
never mind that your health may have improved. Increasing numbers of hopeful Aids and HIV
positive patients in South Africa are being left in the lunch after drugs tests, prompting a debate
throughout the medical fraternity. And pharmaceutical companies are coming under fierce attack
from medical investigators and ethicists who accuse them of violating human rights "a lot of
patients doing very well on combination therapy became very sick when the drugs were
withdrawn at the end of trial," says Dr David Spencer, a senior physician at Witwatersrand
University.
Notes: 1 copy
Ref ID: 6156
Keywords: AZT
Swanepoel, T. (1999). Vigsmiddels se pryse skiet so die hoogte in. Beeld.
Abstract: Vigsmiddels is nie goedkoop nie. In 1996 het Britse navorsers al geskat dit sou tussen
R 612 miljard en R969 miljard kos om almal wat daarvoor kwalifiseer in Afrika suid van die
Sahara met 'n Kombinasie van drie vigsmiddels te behandel. Die koms van 'n nuwe gelsag
vigsmiddels het die hoop onder mense met HIV/vigs laat opvlamtotdat hulle na die prysetiket kyk.
Volgens die Britse navorsers Katherine Floyd en Charles Gilks is die anti-retrovirale (ARV)
middels die belangrikste kostekomponent van die hehandeling van iemand met HIV/vigs. As die
koste van die middels dus verlaag word, sal dit 'n groot impak he op die algehele
behandelingskoste. AZT slurp byvoorbeeld tussen 58% en 77% van die totale jaarlikse
behandelingskoste op. In die geval met 'n kombinasie van drie middels) kos die medisyne tussen
86% en 91% van die behandeling. Die eerste ARV middel, AZT, is in 1987 in Amerika
goedgekeur. In 1991 het diet tweede verskyn ( ddl, oftewel Videx), en in 1995 die eerste
protease-inhibeerder, Invirase(Saquinavir). Daar is nou drie soorte ARV middels: nukleodsied
omkeerbare transkriptase- inhibeerders ( AZT, ddl/Videx, ddC/Hivid, 3TC/Epivir en d4T/Zerit),
nie-nukleosied omgekeerde transkriptase-inhibeerders( nevirapine/Viramune) en Protease -
inhibeerders (saquinavir/Invirase, ritonavir/Norvir, indivavir/Crixivan), Die ideale behandeling vir
431

mense met HIV/vigs is die gesamentlike gebruik van 'n protease-inhibeerder en twee
omgekeerde transkriptase-inhibeerders. Mnr. Andre van Bassen, besturende direkteur van
LifeSense Disease Management( LDM), se gesonde mense se CD4-telling (selle wat infeksie
beveg) is tussen 800 en 1200. Sodra mense met die HI-virus se telling daal tot tussen 300 en
500, begin simptome voorkom en wanneer dit tot onder 200 daal, het die pasiente vigs. Die
verloop van die siekte is gewoonlik baie stadig en pasiente verloor tussen 80 en 100 CD4-selle
per jaar. "Die koste van behandeling styg drasties namate die CD4-telling daal.Navorsing deur
die maatskappy het getoon iemand met 'n CD4-telling van meer as 500kan behandel word teen
R650 per maand. Wanneer die telling egter tot minder as 100 daal, kos dit R3 587 per maand."
Mense met HIV/vigs begin volgens internasionale riglyne met behandeling sodra die vlak van die
virus in die bloed tussen 10 000 en 20 000 kopiee bereik en die CD4-telling tot onder 500 gedaal
het, of wanneer daar duidelik simptome is. Mense wat die siekte reeds in 'n gevorderde stadium
het, moet trippelterapie kry omdat behandeling met net twee middels nie veel sal help nie. Dr.
Leon Regensberg, kliniese koordineerder van Medscheme se Aid for Aids-program en senior
mediese adviseur by Pharmacy Benefit Management, se behandeling met twee ( nukleosied
nukleodsied omkeerbare transkriptase- inhibeerders) middels is taamlik doeltreffend, maar hou
net sowat twee jaar. Toe die protease-inhibeerders in 1995 die lig gesien het, is trippel-terapie
geborc. Die nie-nukleosied omkeerbare transkriptase-in hibeerders het kombinasieterapie 'n
bietkie goedkoper gemaak. Regensberg se die gehandeling van swanger vroue met AZT om te
verhinder dat die HI-virus na die baba oorgedra word, kos minstens R600 per maand.
Behandeling met twee middels wissel van R1 308 per maand (AZT en Videx) tot R2 o56 (Zerit en
3TC/Epivir). Die aid for Aids-program laat die behandeling toe omdat dit as bekostigbaar en
doeltreffend beskou word. "Die enigste nadeel is egter dat dit nie so lank doeltreffend bly nie." In
die Afrika-konteks is behandeling met 'n kombinasie van 'n ARV -middel (Videx) en hydrox urea
(Hydrea), 'n teenkankermiddel wat die werking van Videx verhoog aan te beveel. "Dit is
besonder opwindend omdat die kombinasie net sowat R700 per maand kos en dit lyk nie of die
virus weerstand daarteen opbou nie. Hydrea is nie geregistreer vir gebruik teen HIV/vigs nie.
maar word wel gebruik. 'n Newe-effek van die kombinasie is dat die bloed-telling dopgehou moet
432

word omdat dit inwerk op die beenmug."
Die koste van trippelterapie wissel van R2 627 per maand tot R3 375 (Zerit, 3TC en Nevirapien),
afhanged van watter middels gebruik word. Die duurste behandeling is die klassieke
trippelterapie, 'n kombinasie van tree nukleosied omkeerbare transkriptase-in-der. Die prys
wissel tussen R3 553 en R4 301 per maand.
Notes: 1 copy
Ref ID: 6150
Swanepoel, T. (1999). Die debat oor die koste van HIV-behandeling. Beeld.
Abstract: Regening in talle ontwikkelingslande, ook in Suid-Afrika, is onder toenemende druk om
te betaal vir antiretrovirale terapie vir mense met HIV/vigs. Die middels kan die mense se
gesondheid drasties verbeter en selfs hul lewe verieng. Maar dis perpeduur en moelik om te
gebruik, wat dit buite die bereik van die meeste mense met HIV/vigs plaas.
Notes: 1 copy
Sweat M., Gregorich, S., Sangiwa, G., Furlonge, C., Balmer, D., Kamenga, M. C. et al.
(2000). Cost-effectiveness of voluntary HIV-1 counselling and testing in reducing sexual
transmission of HIV-1 in Kenya and Tanzania. Lancet, 356, 113-121.
Ref ID: 117
Keywords: cost-effectiveness/efficacy/Kenya/Tanzania/transmission/VCT/voluntary counselling
and testing
Abstract: Access to HIV-1 voluntary counselling and testing (VCT) is severely limited in less-
developed countries. We undertook a multisite trial of HIV-1 VCT to assess its impact, cost, and
cost-effectiveness in less-developed country settings.
Methods: The cost-effectiveness of HIV-1 VCT was estimated for a hypothetical cohort of 10000
people seeking VCT in urban east Africa. Outcomes were modelled based on results from a
randomised controlled trial of HIV-1 VCT in Tanzania and Kenya. Our aim outcome measures
included programme cost, number of HIV-1 infections averted, cost per HIV-1 infection averted,
and cost per disability-adjusted life-year (DALY) saved. We also modelled the impact of targeting
433

VCT by HIV-1 prevalence of the client population, and the proportion of clients who receive VCT
as a couple compared with as individuals. Sensitivity analysis was done on all model
parameters.
Findings: HIV-1 VCT was estimated to avert 1104 HIV-1 infections in Kenya and 895 in
Tanzania during the subsequent year. The cost per HIV-1 infection averted was US$ 249 and
346, respectively, and the cost per DALY saved was $12.77 and $17.78. The intervention was
most cost-effective for HIV-1-infected people and those who received VCT as a couple. The
cost-effectiveness of VCT was robust, with a range for the average cost per DALY saved of
$5.16-27.36 in Kenya, and $6.58-45.03 in Tanzania. Analysis of targeting showed that increasing
the proportion of couples to 70% reduces the cost per DALY saved to $10.71 in Kenya and
$13.39 in Tanzania, and that targeting a population with HIV-1 prevalence of 45% decreased the
cost per DALY saved to $ 8.36 in Kenya and $11.74 in Tanzania. Interpretation : HIV-1 VCT is
highly cost-effective urban east Africa settings, but sightly less so than interventions such as
improvement of sexually transmitted disease services and universal provision of nevirapine to
pregnant women in hi-prevalence settings. With the targeting of VCT to populations with high
HIV-1 prevalence and couples the cost-effectiveness of VCT is improved significantly.
Notes: 1 copy
Ref ID: 2904
Taitz, L. (2000). AIDS dissidents enraged. Sunday Times.
Keywords: drugs/prevention/transmission
Abstract: The "dissident" scientists who oppose the view that HIV causes AIDS are said to have
"thrown their toys out the cot"after scientists supporting the orthodox view appeared to dominate
the first day of discussions of the presidential AIDS Advisory Panel in Pretoria. Although the
meeting of 30 scientists and HIV/AIDS specialists took place behind closed doors, the Sunday
Times has learned that it was less than cordial. The scientists were each allowed five minutes to
present their views, after which the meeting broke into three groups tasked with exploring:
. The causes of AIDS
. Treatment; and
434

. Prevention.
During report back on these discussions it became clear that the orthodox view had dominated
discussion in all three groups. The group dealing with the causes of AIDS reported a link
between HIV and AIDS, while those dealing with treatment reported that AIDS drugs were
effective and beneficial in preventing mother - to -child transmission of the virus.
Notes: 1 copy
Ref ID: 131
Tallis, V. (1994). Pre- and post-test counselling. AIDS Bulletin, 3, 1-2.
Keywords: counsellor/guidelines/insurance/patient care/post-test/pre-test/primary health
care/VCT/voluntary counselling and testing
Abstract: This article is an analysis of the debate on the appropriateness and feasibility of pre and
post test counselling in health care and insurance settings.
Notes: 1 copy
Ref ID: 132
Taylor, G. (1994). Conundrums in HIV/AIDS counselling. AIDS Bulletin, 3, 6.
Keywords: counsellor/counsellors/guidelines
Abstract: There are a number of problems facing HIV/AIDS counsellors which, if not dealt with
sensitively, could have serious repercussions for both counsellor and client. A number of these
are discussed in this article, e.g. the refusal to notify sexual partners, deliberate infection and
counselling as a luxury.
Notes: 1 copy
Chronicle, 67.
Ref ID: 133
Taylor, G. (1995). The vexing problems that face HIV/AIDS counsellors. Medical
Keywords: counsellor/counsellors/guidelines
Abstract: There are a number of problems facing HIV/AIDS counsellors which if not dealt with
sensitively, could have serious repercussions for both counsellor and client. A number of these
435

are discussed in AIDS bulletin, published by the Medical Research Council: Refusal notify sexual
partner(s), deliberate infection, counselling as a "luxury".
Notes: 1 copy
Taylor, G. (2000). Counselling, testing, training and education in prisons. Publishing
organisation not known. - .
Ref Type: Unpublished Work
Ref ID: 134
Keywords: prisons/training
Abstract: According to annual surveys of U.S. federal, state and local correctional systems by the
U.S. Department of Justice, there was a sharp increase in mandatory HIV screening among
correctional systems in the years 1986-1987. This was the apparent result of internal demands
by prisons' staff and inmates and intense public and political pressure. The attitude of "we need
to know in order to protect ourselves", was in other words, the bottom line of many of these policy
decisions. The mandatory testing of new entrants as well as serving inmates led in turn to a
segregated housing policy in order to isolate the infected and, it was hoped, to protect the further
spread of the virus.
Notes: 1 copy
Temmerman, M., Ndinya-Achola, J., Piot, P., & Ambani, J. (1995). The right not to know
HIV test results. Lancet, 345, 969-970.
Ref ID: 295
Keywords: Africa/antenatal clinic/guidelines/HIV testing/Informed consent/post-test/pre-
test/research/suicide/women
Abstract: Large numbers of pregnant women in Africa have been invited to participate in studies
on HIV infection. Study protocols adhere to guidelines on voluntary participation after pre-test
and post-test counselling and informed consent; nevertheless, women may consent without fully
understanding the implications of being tested for HIV.
As part of a study examining the effect of maternal HIV infection on pregnancy outcome in
436

Nairobi, 7893 pregnant women from 2 ante-natal clinics were tested for HIV-infection between
January 1989 and March 1992.
During the first two years of the study, 5274 women were tested for HIV and given an
appointment one week later to collect their results. Over 90% of women returned to the clinic as
instructed and invited to participate in a study of HIV infection and pregnancy outcome. More
than 25% dropped out immediately before counselling could be provided and never returned to
the clinic. Out of 243 women invited to participate and counselled on at least two occasions, only
66 (27.2% ) communicated the test result to their partner, of whom 21 showed up with their
partner to be tested and counselled. Five (23.8%) of these partners were HIV seronegative.
Eleven women were chased away from their house or replaced by another wife, 7 were beaten
up, and 1 committed suicide. Most of these women (13 out of 19) had informed their partner as
instructed by the research staff.
Alarmed by the violence against women as a consequence of their being identified as HIV
positive, the authors changed their policy on counselling. For the last year of the study they
continued providing information on HIV and STDs to pregnant women waiting at the antenatal
clinic, but after the blood test they did not give them an appointment for collection of results.
Instead the patients were told they could go in at any time and ask for their status.
Only 109 out of 311 (35%) women with a positive test during the third year of the study ever
called for the result or asked at subsequent pre-natal visits. Of the 9 partners who came to the
clinic, 2 were seronegative. Violence related to the HIV testing was reported by 6 women.
Throughout the study, the results of the blood test were requested at equal rates by HIV-
seropositive and HIV- sero negative women, suggesting that this population did not consider
themselves at special risk.
Notes: 1 copy
Ref ID: 1942
Keywords: AZT
Tempelhoff, E. (1999). Fondse moet plan maak met HIV/vigs. Beeld.
437

Abstract: Moet in minimum - pakket ingesluit word AZT sal nie "vrylik" beskikbaar wees.
Notes: 1 copy
The partnership against AIDS in action. (2000). Caring for people with HIV/AIDS.
Ref Type: Unpublished Work
Ref ID: 493
Keywords: Africa/America/Europe/information/Virus
Abstract: The information in this supplement provides most of what we know already about
HIV/AIDS. However, many more people have died of AIDS in Africa than in countries like
America or Britain or other so called "first world" countries. This has caused our leaders to begin
asking questions about why so many Africans die as a result of AIDS. Questions that seem
easier to answer in America or Europe about the HIV virus are harder to answer when we think
about Africa.
Notes: 1 copy
The volunteer Centre. (1999). Volunteer Centre: Western Cape. Western Cape, The
Volunteer Centre.
Ref Type: Pamphlet
Ref ID: 501
Abstract: The Volunteer Centre's mission statement is to motivate and develop effective
volunteering through consultation, training, information, training, information and placement
services for the benefit of all.
Notes: 1 copy
Ref ID: 1334
Thom, A. (2000). Decision on Aids drugs to be reviewed. The star.
Keywords: Africa/drugs/government/South Africa
Abstract: Health Minister Manto Tshabalala-Msimang has expressed a willingness to reconsider
the government's decision not to supply anti -retroviral drugs to pregnant women. Tshabalala-
Msimang said she had not shut the door on supplying these drugs to pregnant women. She also
438

confirmed she was exploring the appointment of about 30 African and international experts,
expected to meet in South Africa before the end of the month, as part of an expert advisory panel
in HIV/AIDS. The panel will be asked to suggest viable therapeutic options for HIV/AIDS in
Africa. This would include the treatment of HIV/AIDS and opportunistic infections, general
prevention of the disease, prevention of mother-to-child infection, prevention of HIV infection
following rape or needle-stick injuries, and local evidence regarding the causes and diagnosis of
AIDS. Tshabalala-Msimang said she would reconsider the government decision on anti-retroviral
drugs if the expert panel came to an other conclusion. "But it would require an ingenious solution
to the funding challenges," she said. She was, however, still convinced that the government's
decision was right, given "the available evidence and special circumstance in our country". While
admitting that South Africa's response to the AIDS epidemic would always be "too little and too
late" for those infected or affected, Tshabalala-Msimang said the government had taken a step
towards finding treatment solutions to the disease. The minister denied claims that the
establishment of the panel and possible inclusion of so-called dissidents meant that she had
doubts about the existence of AIDS. "The dreadful statistics speak for themselves, but we would
be foolish to exclude anybody from the debate, " she said.
The minister added that once the panel had been briefed, its findings would be published on the
internet within six to eight weeks.
Notes: 1 copy
Ref ID: 7245
Thom, A. (2001). Historic Cape forum giving children with AIDS a voice. Star.
Keywords: Cape Town/family/grief/policies/response
Abstract: Ninety children, in one way or another severely and personally affected by the AIDS
epidemic, made their voices heard this week by sharing their stories of grief, hope sadness and in
with adults. The children met in Cape Town for three days as part of the National Children's
Forum on HIV/AIDS. Today, several children aged between 7 and 18, who have been nominated
by the group, were due to meet 70 representatives from relevant national government
departments, ministries and parliamentary committees to speak about the impact of HIV/AIDS on
439

their lives and to draft proposals to address problems. The forum, the first of its kind in this
country, aims to provide children who are infected or affected (by losing a close family member)
with a chance to be heard. Forum organiser Sonja Giese, of the children's Institute at the
University of Cape Town, said they were also aiming to increase awareness of the epidemic's
impact on children. They also aimed to provide feedback and information from children's
perspective on the implementation and development of policies and programmes designed to
address the impact of HIV/AIDS. A memorandum of action, which summarises the issues raised
by the children and ensures commitment from decision makers to address these issues, will be
produced. None of the ministers who were invited to the forum are attending. The children,
many of whom live in abject poverty and might go without food for days, come from both urban
and rural areas. "We have to acknowledge the courage of the children who have come here,
many of whom head households", said Giese. "This courage needs to be respected, and the
best way to do it is a decent response to their needs and concerns.
Notes: 1 copy
Ref ID: 1377
Thompson, C. (2001). Churches help in AIDS war. Citizen.
Keywords: Africa/barriers/church/condom/condoms/medical/ministering/policies/response/South
Africa
Abstract: More and more mainstream Christian churches in South Africa are taking on the burden
of caring for and counselling HIV and AIDS sufferers as the scale of the epidemic exhausts the
facilities of public healthcare, and organisations like Hospice. Ever - increasing involvement in,
for instance the plight of Aids orphans has been accompanied by a significant policy shift on the
part of many churches. The Christian church fraternity has been accused of being aloof and
vague on the subject of AIDS in the past, but activist and community workers say this has
changed dramatically. "I am not aware of any residential facility for sufferers that is not church-
based,"says Ms Jenny Marcus, director of community AIDS Response. Other community
workers concur, and list homes set up by, amongst others, the Catholic, Anglican and Rhema
churches to care for sufferers. Some have existed for the past 10 to 15 years or more. There are
440

eports of ministers and pastors approaching care centres and offering their services or asking
experts to give talks during their services. Inter-denominational groups are also responsible for
various initiatives, while churches "give a lot of support to AIDS orphans," according to a medical
expert who deals with AIDS patients. While Ms Marcus acknowledges churches are still a "mixed
bag" in terms of their individual responses to HIV and AIDS, she has noted a "vast improvement
in the last little while". "When it comes to principles and policy, the senior echelons of all
churches have made it known they adhere t a policy of non-judgmental ministering and caring.
But there are still barriers to be overcome, because congregants and parishioners are fearful of
the social stigma of declaring their HIV status. "Church leadership needs to talk more openly
from the pulpit about sex, love and self-esteem," added Ms Marcus, who is also a member of the
St Luke's (Anglican) Aids Team.
Mr Thanduxolo Doro, spokesman for the National Association of People Living with HIV/AIDS,
feels mainstream churches "are still in denial"about AIDS. "They seem to think it belongs to
people who are criminals. Churches not talk about condoms, and that is a barrier towards
education." Mr Doro said teachings on sexual issues remained a taboo subject. If churches took
care for the greater society, a difference would be seen,"he added.
Notes: 1 copy
Torimiro, N., Tita, I. N., Mbuagbaw, J. N., Bourgeois, A., Mougnutou, S. R., & Mpoudi, N.
E. (2000). Breaking the silence. In (pp. 8).
Ref ID: 227
Keywords: caregiver/clinic/family/HIV prevalence/HIV testing/Informed consent/post-test/pre-
test/prevention/research
Abstract: Issues: This paper summarizes our experience as care-givers to people Living with
HIV/AIDS (PLWHA) and the importance of Pre-and Post-HIV Test Counselling. Of 33 million
people and more living with hIV in the world today, only a few of them know that they are infected.
Pre- and Post- HIV Test counselling has not been a routine practice in many AIDS Clinics in
Cameroon. It is strongly held that knowing that one is HIV-infected, attracts stigmatisation,
rejection and contempt, and thus the silence is maintained. Fifteen years after the first HIV case
441

was diagnosed in Cameroon, majority of care-givers and PLWHA still find it difficult to break the
silence. Refusal to inform people that they are HIV sero-prevalence in the general population has
been reported.
Description: Project PRESICA ( prevention du SIDA au Cameroon), is a clinical research
project, in which the impact of generic variability of HIV Type 1 on the prognosis and
pathogenesis of HIV disease among PLWHA in Cameroon, is the main objective. We describe
here, two approaches used to affirm that HIV testing can be made voluntary in Cameroon.
(1) One-to-one Pre-HIV test Counselling: this approach was used in a study to investigate HIV
prevalence among military. Group education and information and STS/AIDS was done, followed
by voluntary testing.
(2)Pre-test Counselling and Informed Consent: this is the approach used in the clinical follow-up
study, that has been going-on for more than three years in Cameroon. Every client who visit our
clinic is offered pre-test counselling (One-to-one), followed by Post-test counselling to the client,
and the family (as the need arises).
Conclusions: Breaking the silence ( by the care-giver and/or PLWHA), may remove
stigmatisation and bring freedom and a wish to live positively, and light up a greater awareness of
HIV disease within the family and the community. We have successfully broken the silence to
more than two thousand people in Caremeroon through and "One-to-one Counselling" approach
and thus supported then to live positively with HIV disease. Breaking the silence early, can save
a soul. We encourage you to break the silence and be part of the team of the care continuum of
PLWHA. Let us together break the silence and make HIV disease real to live with
Notes: 1 copy
Ref ID: 2701
Tribune reports (2001). Child's rape "the last straw". Sunday Tribune.
Keywords: drugs/men
Abstract: A traumatised seven-year- old girl has had to receive anti-Aids drugs after she was
allegedly gang-raped this week. The child is to also receive specialises counselling from
childline experts this coming week. The alleged incident has shocked and enraged the Phoenix
442

community, which has threatened to take the law into its own hands. As emotions ran high
yesterday, community leaders tried to restore calm and the police warned people against vigilante
action. Three men been arrested and police are still looking for three more suspects. The grade
two pupil was waiting for her sister in a schoolyard on Thursday when she was allegedly
abducted dragged to a nearby field and raped. She managed to escape and sought help at her
school. She was rushed to Addington Hospital and examined by a district surgeon. Members of
the Child Protection Unit arrested two men, aged 27 and 28, on Thursday . The 27- year - old is
believed to be known to the child surgeon. A third suspect, a 39-year-old former policeman, was
arrested on Friday. They will appear in court tomorrow on charges of rape, abduction and
indecent assault. Chairman of the Phoenix community policing forum, sayed Rajack, said the
community was furious. "They are talking about helding a kangaroo court to ensure that justice is
done. It seems that this has been the last straw. "Residents want to send a clear message to all
criminals: Child abusers will face the wrath of the community". The policing forum was trying to
restore calm" because we don't want to become criminals ourselves". A police spokesman,
captain Vishnu Naidoo, said: " Bringing all the accused to court is a top priority for us."
Responding to threats by the local community to take the law into their own hands, he appealed
to them not to break the law by applying their own form of justice. People will be liable for
prosecution if they resort to vigilantism," he warned.
Notes: 1 copy
Tricket, R. (1994). Counselling AIDS patients: the salvation army response. Positive
outlook, -, 18-19.
Ref ID: 313
Keywords: Africa/family/Johannesburg/rehabilitation/response/sex/Southern Africa
Abstract: The first salvation Army Oasis Centre in Southern Africa was opened in Mayfair,
Johannesburg, in July 1992. This is a place of quiet understanding for people living with HIV and
AIDS, and particularly for their partners, friends and families. The Oasis Centre functions as a
drop-in place every Saturday from 3 pm to 7pm. Light refreshments are served and confidential
counselling is provided when desired. This is a part of fulfilling the mission of the Salvation Army;
443

"It's mission is to preach the Gospel of Jesus Christ, supply basic human needs, provide personal
counselling and undertake the spiritual and moral regeneration and physical rehabilitation of all
persons in need who come within it's sphere of influence, regardless of race, colour, creed, sex or
age."
Notes: 1 copy
of Health. 1-11.
Tsabalala-Msimang, e. a. (2000). HIV/AIDS Strategic plan for South Africa. Department
Ref Type: Unpublished Work
Ref ID: 491
Keywords: Africa/HIV prevalence/infection/mother-to-child
transmission/population/response/sex/sex workers/South Africa/transmission/UNAIDS/youth
Abstract: According to the United Nations Population Division, South Africa's population in 1999
was 39,900,000. Adults, aged 15 to 49, the group most likely to engage in high-risk behavior for
HIV infection, represented approximately 53 percent of the total population. The HIV prevalence
rate among this group was estimated by UNAIDS to be 19.94 percent. By the end of 1999,
4,200,000 adults and children were living with HIV and AIDS in South Africa and more than
420,000 children had been orphaned due to AIDS.
In response to the epidemic, South Africa developed the HIV/AIDS/STD strategic plan for South
Africa, 2000-2005. According to our overview of this plan, South Africa had developed strategies
and programs in 16 different areas to address the epidemic. Some examples of those activities
are programs that focus on poverty, illiteracy, sexual behavior, vaccine development and mother-
to-child transmission of HIV. Special programs have have developed to target youth and
commercial sex workers.
Notes: 1 copy
1990).
TSHABALALA-MSIMANG. (2002). National policy for health act, 1990 (Act no.116 of
Ref Type: Unpublished Work
444

Ref ID: 551
Keywords: care/health/health worker/HIV testing/infection/Informed
consent/medical/policies/policy/post-test/pre-test/regulations
Abstract: Testing for HIV infection presents serious medical, legal ethical economic and
psychological implications in the health care setting. Because HIV infection is a life threatening
condition, reasonable persons or health care workers will attach significance to the outcome of an
HIV test, especially a positive diagnosis. For these reasons, and in accordance with the
constitutional guarantees of freedom and security of the person, and the right to privacy and
dignity, the following HIV testing policy shall constitute national policy. This policy applies to
persons able to give consent, as well as to those legally entitled to give proxy consent to HIV
testing in terms of the law. The circumstances under which HIV testing may be conducted are
given as well as informed consent, pre-test counselling and post-test counselling regulations.
Notes: 1 copy
Tsu-RC (2002). Telephone vs face-to-face Notification of HIV results in High-Risk youth.
Journal of Adolescent Health, 30, 154-160.
Ref ID: 354
Keywords: adolescents/homeless/Los Angeles/telephone counselling/youth/HIV testing/HIV
prevalence/population
Abstract: Purpose: To increase the number of high-risk and homeless youth who receive human
immunodeficiency virus(HIV) test results and posttest counselling.
Methods: Oral HIV testing and counselling were offered to high-risk and homeless youth at sites
at which youth congregate throughout Portland, subjects were randomized to receive test results
and posttest counselling either in face-to-face manner or with the option of telephone notification.
Self-reported demographic and risk-behavior information was collected prior to HIV testing. The
differences in the proportion of youth who received their tests results were analyzed according to
the notification method and demographic characteristics using SPSS.
Results: Among the 351 youth who were tested, 48% followed up to receive test results and
posttest counselling. Adolescents most likely to receive their results were female, older (19-24
445

years), and white and those who reported high risk behaviors. Those given the option of
telephone notification were significantly more likely to receive their results than those required to
have face-to-face notification (odds ratio = 2.301, 95% confidence interval of 1.499, 3.534). This
was true regardless of age, race, history of previous HIV testing, or presence of high-risk
behaviors. Two youths tested positive for HIV corroborating previous reports of low HIV
prevalence in this population. Both were assigned to the face-to-face notification group and,
therefore, no HIV positive results were given by telephone.
Conclusions: The option of telephone notification significantly increased the proportion of youth
who received posttest counselling and results following community-based testing.
Notes: 1 copy
(pp. 18).
Ref ID: 237
Tyawa, M. (2000). Planning for marriage and HIV counselling and testing in Uganda. In
Keywords: couples/Uganda
Abstract: Background: The AIDS information Centre(AIC) in Uganda has been providing
anonymous HIV counselling and testing(CT) since 1990 and by end 1997, over 350,000 clients
have been served.
Methods: Routine data have been collected on all client requesting CT services, including
reasons why clients come for CT. Data for 1997 have been analyzed for clients reporting
marriage planning as the reason for testing compared with all other reasons given.
Results: There was a steady increase in demand for CT for marriage plans from 6% in 1992,
17% in 1993, 21% in 1994, 28% in 1995, 33% in 1997 and 35% in 1998. In 1997 of those coming
because they wanted to get married, 64% came with their prospective partners. Males coming
for pre-marital testing were slightly younger (29 years vs 31) than males coming for other
reasons, and the same trend was observed amongst females, (22 years vs 29). Seropositivity
was much lower among clients intending to get married (6.3% vs 25%).
Conclusion: In Uganda, there is growing trend among parents and clergy to demand that
intending couples get tested for HIV before marriage. The increasing numbers of AIC clients
446

equesting pre-marital CT reflect these social pressures; and most (94% in 1997) learn that they
were not infected. Pre-marital CT at AIC helps couples make informed and adopt risk reduction
strategies.
Notes: 1 copy
Ref ID: 135
UNAIDS UNAIDS policy on HIV testing and counseling. UNAIDS policy, (in press).
Keywords: benefits/care/health/HIV testing/prevention/UNAIDS
Abstract: Voluntary HIV testing accompanied by counselling has a vital role to play within a
comprehensive range of measures for HIV/AIDS prevention and support, and should be
encouraged. The potential benefits of testing and counselling for the individuals include improved
health status through good nutritional advice and earlier access to care and treatment/prevention
for HIV-related illness; emotional support;better ability to cope with HIV-related anxiety;
awareness of safer options for reproduction and infant feeding; and motivation to initiate or
maintain safer sexual and drug-related behaviours. Other benefits include safer blood donation.
Notes: 1 copy
UNAIDS. (1997). Counselling and HIV/AIDS. UNAIDS. [-], 1-8.
Ref Type: Organisational research report
Ref ID: 576
Keywords: community/evaluation/family/HIV testing/HIV
transmission/knowledge/transmission/Uganda/UNAIDS
Abstract: HIV counselling has been proved effective in various ways. An evaluation of the AIDS
service Organisation (TASO) in Uganda has shown that it helps people accept and cope with the
knowledge of being HIV-positive, and furthermore encourages acceptance from families and
communities. A Rwandan study had proved that HIV counselling can help people make
decisions about HIV testing, as well as reduce HIV transmission. Yet there is a reluctance among
some policy-makers and service managers to give counselling its proper due as a discipline in
which trained practitioners can produce measurable, useful results. For this reason it is under-
447

esourced and not fully appreciated
Notes: 1 copy
UNAIDS. (1998). Expanding the global response to HIV/AIDS through focused actioning.
UNAIDS. UNAIDS Best Practice collection , 3-16.
Ref Type: Unpublished Work
Ref ID: 136
Keywords: care/community/global
response/impact/knowledge/population/prevention/response/social support/transmission/UNAIDS
Abstract: More than a decade and a half since the beginning of the HIV/AIDS epidemic and over
a decade after the inception of the Global AIDS strategy, a dual gap continues to grow
relentlessly between the rapid spread of the HIV epidemic and the limited prevention efforts; and
between the rising needs for care, Support, and impact-alleviation, and the insufficient response
to these needs. As the HIV pandemic pursues its course largely unabated, it has become
fragmented and now consists of multiple, concurrent epidemics. Its impact is particularly severe
on the developing world and on marginalized populations in industrialized countries. Yet enough
knowledge and experience have been gained from prevention and care efforts to demonstrate
that the rate of transmission of HIV can be reduced and the onset of AIDS- related complications
can be delayed significantly if well designed and sustainable programmes are undertaken. The
response to the epidemic has not taken full advantage of this accumulated knowledge. There are
too few partnerships among those participating in this response. Coordinated, 'scaled - up' is
lacking. And the involvement of civil society in the design and implementation of HIV/AIDS
programmes is limited. Continuing initiatives tend to focus on responding to immediate needs for
prevention, but for most of the affected populations, these responses are inadequate. Even more
significantly, they have not focused adequately on strategies for providing HIV/AIDS care and
social support and for alleviating the impact; they have also shied away from addressing the root
causes of the epidemic in societies and communities. To contain the HIV/AIDS epidemic and
mitigate ist impact we need to expand the response considerably. This expansion has two
elements. First, there must be the simultaneous enhancement and improvement in the quality,
448

scope and coverage of continuing prevention, care, support and impact-alleviation efforts, which
target individuals and populations seen to be at particular risk. Secondly, there must be
combined with actions directed towards societal factors that lower people's vulnerability to
HIV/AIDS. This paper proposes a conceptual framework for an expanded response to HIV/AIDS
and suggests the dimensions along which this response needs to proceed.
Notes: 1 copy
UNAIDS. (1999). Counselling and voluntary HIV testing for pregnant women in high HIV
prevalence countries: elements and issues. Geneva, UNAIDS.
Ref Type: Unpublished Work
Ref ID: 507
Keywords: benefits/HIV prevalence/HIV
testing/infection/population/prevention/transmission/women
Abstract: Counselling and voluntary testing for HIV have benefits beyond the prevention of
transmission from mother to child. Counselling services have been slow to gain acceptance in
many countries, especially where HIV is heavily stigmatized and access to services and support
for the HIV-infected is limited. Indeed, HIV testing has often been used as a diagnostic tool to
confirm symptomatic AIDS. But a growing number of studies attests to the value of counselling
and voluntary HIV testing in largely healthy populations. These services have been shown to
contribute to an increase in safe behaviour at the individual level, and are likely also to reduce the
ignorance, fear and stigma associated with HIV infection in the population at large.
Notes: 1 copy
UNAIDS. (2000). Tools for evaluating HIV voluntary counseling and testing. UNAIDS.
UNAIDS Best Practice collection -[-], 1-52.
Ref Type: Unpublished Work
Ref ID: 173
Keywords: benefits/guidelines/intervention/prevention/research/transmission/tuberculosis
Abstract: It is only recently that Voluntary Counseling and Testing (VCT) services have been
449

considered important as an entry point for prevention and care interventions for HIV/AIDS.
Access to VCT services, however, remains limited and demand is often low. In many high -
prevalence countries VCT is not widely available and people are often afraid of knowing their
serostatus because there is little care and support available following testing. Furthermore, the
quality and benefits of VCT, in particular with regard to confidentiality, counseling and access to
clinical and social support, vary enormously.
Setting up VCT and ensuring a quality that will create demand is thus a considerable challenge
Building in self-assessments, monitoring and regular evaluation is an important tool to enhance
the quality of VCT.
This document provides guidance on monitoring and evaluation of the various aspects of
planning and implementing VCT. It provides tools for the evaluation of VCT as part of a national
programme, as well as VCT services at specific institutions, independent sites and services for
special groups, including community - based non-government organizations (NGOs). It includes
monitoring and evaluation of VCT services associated with the prevention of mother -to-child
transmission of HIV(MTCT) and tuberculosis preventive therapy(TBPT). This document revises
and adapts previous draft guidelines and incorporates relevant operational research findings.
Notes: 2 copies
UNAIDS. (2000). UNAIDS Technical update: Voluntary Counselling and Testing(VCT).
UNAIDS. UNAIDS Best Practice collection -[-], 1-12.
Ref Type: Unpublished Work
Ref ID: 175
Keywords: family planning/intervention/MTCT/prevention/transmission/UNAIDS/voluntary
counselling and testing/women
Abstract: Many approaches to HIV prevention and care require people to know their HIV status.
The importance of voluntary counselling and testing (VCT) in achieving this end has been
acknowledged in the recent wider promotion and development of VCT services. VCT has an
important role in HIV prevention to help people make changes in their sexual behaviour so as to
avoid transmitting HIV to sexual partners if seropositive, and to remain seronegative if negative.
450

The other major role of VCT is in facilitating the early and appropriate uptake of service for those
people testing HIV positive and negative, including medical care, family planning, emotional and
social support, legal advice and counselling for positive living. VCT is also an essential if women
and their families are to benefit from interventions to prevent mother-to-child transmission of HIV.
Increasing access to VCT can also be important in challenging stigma, promoting awareness and
supporting human rights.
Notes: 1 copy
UNAIDS. (2000). Voluntary counselling and Testing. Geneva, UNAIDS.
Ref Type: Unpublished Work
Ref ID: 509
Keywords: care/HIV prevention/HIV
transmission/infection/intervention/knowledge/medical/prevention/sexual
partner/transmission/VCT/voluntary counselling and testing/WHO/women
Abstract: HIV voluntary counselling and testing (VCT) has been shown to have a role in both HIV
prevention and, for people with HIV infection, as an entry point to care. VCT provides people with
an opportunity to learn and accept their HIV serostatus in a confidential environment with
counselling and referral for ongoing emotional support and medical care. People who have been
tested seropositive can benefit from earlier appropriate medical care and interventions to treat
and/or prevent HIV associated illnesses. Pregnant women who are aware of their seropositive
status can prevent transmission to their infants. Knowledge of HIV serostatus can also help
people to make decisions to protect themselves and their sexual partners from infection. A recent
study has indicated that VCT may be a relatively cost effective interventions in preventing HIV
transmission.
Notes: 1 copy
UNAIDS. (2001). The impact of Voluntary Counseling and Testing: a global view of the
benefits and challenges. UNAIDS. UNAIDS Best Practice collection UNAIDS Best Practice
Collection[-], 1-94.
451

Ref Type: Organisational research report
Ref ID: 174
Keywords: benefits/conference/Developing countries/evaluation/intervention/prevention
Abstract: Many approaches to HIV prevention and care require people to know their HIV status.
The importance of voluntary counseling and testing (VCT) has brought about the wider promotion
and development of VCT services. However, since the majority of countries where HIV has a
major impact are also the poorest, the lack of resources has meant that VCT is often still not
widely available in the highest-prevalence countries . For VCT services to be prioritized and for
resources to be provided for their development, demonstrating the effectiveness of VCT is
essential. One of the difficulties in evaluating VCT's effectiveness is the complexity of the VCT
process and the wide range of possible outcomes. The term VCT has also been used in many
contexts to cover a broad spectrum of interventions. In this article it includes interventions that
comprise a minimum of pre-and post-test counseling associated with testing. However, it
acknowledges that many VCT services offer ongoing/supportive counseling.
This paper examines the diverse roles of VCT, considers the various outcomes of VCT that can
be evaluated and discusses the limitations and difficulties associated with VCT evaluation.
Drawing on published and unpublished literature, conference abstracts and case studies, this
paper concentrates on information from developing countries. While some examples from
industrialized countries are mentioned, this information is not exhaustive, hence review articles
providing more complete information are cited.
Notes: 1 copy
HIV/AIDS.
UNAIDS. (2001). Investing in our future: Psychosocial support for children affected by
Ref Type: Unpublished Work
Ref ID: 473
Keywords: Africa/case study/sub-Saharan/Sub-Saharan Africa/Tanzania
Abstract: When considering the basic needs of a child one is inclined to think in terms of food,
shelter, clothing, love, and security, a combination of the material and psychological needs.
452

Children infected and affected by HIV/AIDS have similar needs, except the fulfillment of these
needs is potentially in jeopardy when a parent or carer becomes ill and eventually dies. Meeting
these needs is important for the growth and ability of a child to succeed through life. According to
the United Nations Convention on the Rights of the Child, meeting the psychosocial needs of
children is not only a privilege, but also a right of the child. Organizations in sub-Saharan Africa
have begun to address the rights and needs of children affected by HIV/AIDS; however, many of
them deal solely with material aid, such as school fees and food supplies. Monetary aid is also
required as stated by a HIV positive mother from Tanga. United Republic of Tanzania, "there is
nothing as bad as a spouse dying and then not being able to pay school fees." Nevertheless,
how a child feels cannot be overlooked
Notes: 1 copy
UNAIDS. (2002). UNAIDS Policy on HIV testing and counselling. UNAIDS. 1-8.
Ref Type: Unpublished Work
Ref ID: 559
Keywords: UNAIDS/policy/policies/HIV testing
Abstract: This statement summarizes UNAIDS' position on HIV testing and on counselling issues
related to HIV testing. It is addressed to national authorities and is meant to facilitate the
development or strengthening of national policies on the subject.
Notes: 1copy
Ref ID: 776
Underhill, G (1998). "How Somerset saved my life. Cape Argus.
Keywords: Somerset hospital
Abstract: " If I hadn't been put on the AIDS drugs in this clinical trial, I would have been dead by
now. I was sick I weighed 35kg when I was brought to Somerset Hospital in a wheelchair. I have
been on the clinical trial drugs for two years and I now weigh 78kg. I feel well and I am looking
for a job to support my nine-year old daughter.
Notes: 1 copy
453

Uys, L. R. (2001). Evaluation of the integrated community-based Home Care model.
Curationis, 24, 75-82.
Ref ID: 421
Keywords: care/clinic/community/evaluation/Home care
Abstract: In 1999-2000 the Integrated Community-Based Home Care model for the care of people
with AIDS in communities were implemented in seven cities sites across the country. The post-
implementation evaluation showed that most respondents felt that the model could be replicated if
a functioning and informed network including all partners, and a strong management team were
in place. The effects of the project were mainly positive for all stakeholders (hospice, clinic,
hospital, PWA and their carers, professionals and other community members). Hospitals and
community-based services became more aware of and involved in the need of PWA and felt that
the model enabled them to address these needs. PWA and their carers felt supported and
respected.
Notes: 1 copy
Uys, L. R. (2002). The practice of community caregivers in a Home-based HIV/AIDS
project in South Africa. Journal of Clinical Nursing, 11, 99-108.
Ref ID: 371
Keywords: Africa/caregiver/client/clinic/clinic staff/community/Community caregivers/Home
care/South Africa/symptom
Abstract: The aim of this study was to describe the practice of community caregivers in a home-
based AIDS care project at seven sites in South Africa. The community caregivers felt positive
about the contribution they made, but found it difficult to cope with the poverty and complexity of
problems they were faced with.
They visited each client an average of five times per month, and their care usually involved
counselling and informing symptom control, psychosocial support and welfare assistance. The
caregivers worked in close collaboration with the South African Hospice Association and clinic
staff, and each site developed a work pattern suitable to its resources.
Notes: 1 copy
454

Uys, L. R. M. J. (2000). Standards of palliative care and their measurement in South
Africa. WHO. [-], 1-30.
Ref Type: Unpublished Work
Ref ID: 490
Keywords: Africa/care/guidelines/health/Home care/research/South Africa
Abstract: In 1998 the SA Hospice Association submitted a tender proposal to the Department of
Health to develop and field test guidelines on palliative care for persons with terminal HIV/AIDS.
This tender was accepted, but the researchers were asked to work on general palliative care
standards, rather than to concentrate only on HIV/AIDS care and the research was done during
1999. It was envisaged that the standard will be applicable both in institutions and in home care
settings. The specific objectives were:
1. to validate existing palliative care standards.
2. to develop criteria to measure each standard
3. do develop instruments to measure the adherence to these standards and criteria.
4. to test the instruments for reliability and validity
.
Notes: 1 copy
Van der Berg, A. M. (1992). Psigologiese simptome van VIGS en die rehabiliterende
effek van Kreatiewe ervarings. Rehabilitation in S.A., 36, 52-55.
Ref ID: 137
Keywords: mental health/psychological reactions/psychology/quality of care/quality of life/support
Abstract: A confirmed diagnosis about HIV infection or AIDS can cause a wide range of
psychological reactions with on evidence or universal responses. These symptoms must be
understood by the patient and his caretakers- people affected by AIDS need to feel secure, and
feel that their identity is recognised and confirmed as worthwhile by others. An important aspect
of psychological support is to promote mental health. The purpose of rehabilitation therefore is to
enhance energizing qualities of personhood: creativity, independence, responsibility,
assertiveness, expressiveness and hope. I a person is able to find meaning in his circumstances
455

y means of creative expression, then hope, as well as feelings of self-worth and a sense of
fulfillment about life will generally ensue.
Notes: 1 copy
Ref ID: 439
Van der Linde, I. (1996). Hormonal contraception and HIV. AIDS Bulletin, 5, 27.
Keywords: Africa/Baragwanath/contraception/health/HIV transmission/medical/research/South
Africa/transmission/women
Abstract: The effect of hormonal contraceptives on HIV transmission is still unclear. A number of
recent trials have provided some evidence that hormonal contraceptives increase the risk of HIV
transmission. However, these findings have been contradicted in other trials. In an article in the
South African Medical Journal Dr James McIntyre, co-director of the Reproductive Health
Research Unit of the Department of Obstetrics and Gynaecology at Baragwanath Hospital, was
quoted as saying that this is particularly relevant in South Africa where 80% of black women who
use hormonal contraception use the injection. Two recent studies from the USA and Ethiopia
which investigated the relationship between injectable contraceptives and HIV transmission
produced inconsistent results. McIntyre pointed out that a major study will be needed to
investigate all the underlying factors.
Notes: 1 copy
Ref ID: 146
Van der Merwe, A. E. (1993). Future AIDS Care in South Africa. AIDS Scan, 5, 3-4.
Keywords: economy/patient care/South Africa/support
Abstract: Since the late 1980's South Africa has experienced the consequences of an ever
increasing AIDS epidemic. Looking back at past experience, several pertinent issues require our
attention. The first issue is if we, as South Africans, have learned from what has already
happened, and if we as a society are implementing all the necessary precautionary measures to
limit the impact of this disease? Logical reasoning predicts that any responsible society will take
notice of the potential disastrous effects of an uncontrolled epidemic, and try to prevent it
456

wherever possible. Unfortunately our track record in this respect leaves room for improvement
but it will serve no purpose to blame past errors. We cannot change what is history, however, the
future belongs to us and the future is our responsibility. All South Africans must therefore take up
the challenge and accept personal responsibility to prevent this disease. It is in the interest of
everybody to contain this epidemic as far as possible. This is regarded no as a matter of choice,
but as a matter of survival.
Notes: 1 copy
Van der Perre, P. (2000). HIV voluntary counselling and testing in community health
services. The LANCET, 356, 86-87.
Ref ID: 701
Keywords: community health services/VCT
Abstract: HIV Voluntary Counselling and Testing (VCT) has been given low priority as a possible
strategy for combating HIV in developing countries because of the high demands on logistics and
skills, the view that individuals have low motivation to know their test results and modify behavior,
and the non-existence of medical care that could make a difference. In this issue of the Lancet,
the Voluntary HIV-1 counselling and testing efficacy study group reports on a multicentre study
that was designed as rigorously as a controlled clinical trial and that compared two groups of
individuals randomly assigned VCT or health education focused on reproductive health. As
ascertained by a measurable decline in the incidence of sexually transmitted diseases,
remarkable changes in sexual behaviour occured in the VCT group compared with those in the
health-education group in three very different social and cultural contexts - urban Kenya,
Tanzania, and Trinidad. These reliable and convincing measurements of the benefits of VCT are
a substantial contribution to VCT research.
Notes: 1 copy
Van der Riet, M. (2001). Embedding sexual practice in communities of practice: practice
the contribution of activity theory. In (pp. 1-11). Paper presented at: AIDS in Context: Explaining
the social, cultural and historical roots of the epidemic in Southern Africa. University of
457

Witwatersrand, Johannesburg, South Africa. 4-7 April 2001..
Ref ID: 139
Keywords: activity theory/behaviour change/community/conference/model/prevention/sexual
practice
Abstract: Recent critiques of the individualism inherent in behaviour change models have
highlighted the need for alternative ways of examining sexual behavior. Contextually sensitive
and contextually situated theoretical models in HIV/AIDS prevention work are sorely needed to
understand the relationship between individuals and context. This paper argues that human
behaviour is part of continuously collectively constructed systems of activity. Understanding
sexual behaviour as an activity system, and analysing it using activity theory, provides a means
for explicating the embeddedness of individual choices in social context. It provides the means
the means for understanding how choices about action are made within conventions defined
beyond the individual, how actions are embedded in communities of practice.
This paper draws on accounts of significant sexual relationships in a deep rural area of the
Eastern Cape to illustrate the application of the activity theory framework. The initiation of sexual
relationships and the negotiation of sexual activity between partners are examined in relation to
mediating contextual factors. This paper will demonstrate how applying the activity theory
framework defines and analyses the way the system is organised, identifying contradictions with
and between activity systems as the source of change and development of that system. Activity
theory, drawn from the socio-cultural historical school in psychology, provides a significantly
different framework for examining the situatedness of the individual's sexual practices and is
particularly relevant for framing interventions in the South African context.
Notes: 1copy
Van der Straten, A., King, R., Grinstead, O., Serufilira, A., & Allen, S. (1995). Couple
communication, sexual coercion and HIV risk reduction in Kigali, Rwanda. AIDS, 9, 935-944.
Ref ID: 143
Keywords: cohort/condom use/counsellors/couple/couples/disclosure/risk/risk
reduction/Rwanda/sexual coercion/sexual practice/VCT/voluntary counselling and testing/women
458

Abstract: The study was done to describe sexual interaction and HIV-related communication in
Rwandan couples and to examine their relationship to HIV testing and condom use. The study
design is a cross-sectional survey of a longitudinal cohort. Methods: In 1988, women recruited
for an epidemiological study of HIV, and interested male partners, received confidential HIV
testing and counselling. Two years after enrollment, 876 women reporting one steady partner in
the past year completed a questionnaire addressing sexual and HIV-related communication,
sexual motivation and violence in the partnership. Women with HIV-positive partners were more
likely to report being physically abused. Condom use was more common if the man had been
previously tested, and if women reported discussing or negotiating condom use. HIV-negative
women will untested or seronegative partners were the least likely to use condoms or to discuss
or attempt to negotiate condom use. The conclusions: Participation of the male is crucial for
successful HIV risk reduction in couples. HIV testing and counselling of couples has beneficial
long term effects on condom use and HIV -related communication. Couple communication is
associated with condom use, but only when the discussion is specific (sexually transmitted
disease risks and using condoms). Seronegative women with untested partners are at increased
risk for HIV as they are the least likely to discuss or attempt to negotiate condom use.
Notes: 1 copy
Van der Velde (1991). An evaluation of an AIDS Education Programme in industry.
Dissertation, University of Cape Town (Department of Psychology).
Ref ID: 209
Keywords: business/education/employee/evaluation/industry/knowledge/myth/Western Cape
province
Abstract: This study evaluates a small group educational programme on AIDS using a Solomon -
Four group design. The research was conducted in 16 randomly selected Western Cape stores
of a national supermarket chain. These stores were stratified into northern, central, southern
suburbs and outlying districts. Each group of 4 stores was assigned at random to either the
treatment or control group of each component of the Solomon- four according to their suburb
stratification. 16 randomly selected weekly paid employees (8 males and 8 females) at each
459

store were interviewed, by social work students, using an adapted version of the Temoshok
(1987) questionnaire assessing knowledge and personal opinions about AIDS. Subjects were
interviewed either pre and post education or post education only depending on which store (and
hence which treatment group) they were working in. A model to examine the probability of any
subject knowing the "correct" answer to each item of the questionnaire was used in an item
analysis of 16 knowledge questions and 22 personal opinion items using BMDP logistic
regression programme for binary data. Odds ratios and exact p values are reported for each item
to determine the strengths and weaknesses of the education programme and to pinpoint areas in
the programme which need revision. Results indicated a significant improvement in knowledge in
terms of the myths surrounding casual transmission of (HIV) AIDS and an improvement in
knowledge on certain factual items. A statistically significant negative effect of education was
evident in the section of the programme dealing with blood transfusions and contamination.
Results also suggest a shift towards more desirable responses, on the personal opinion items
which linked up with the educational programme. 67 subjects from the original sample who had
received education were re-interviewed 2 months after the programme using all the knowledge
questions and selected personal opinion items to determine what respondents had remembered
or forgotten. These results suggest that the gains in knowledge were maintained on items
dealing with casual transmission, and that the shifts towards more desirable responses on certain
items were also maintained over the 2 month period. Recommendations for adjustments to the
content of the programme are outlined
Notes: 1 copy
Ref ID: 1038
Van der Vent, M. (1998). Verkloses doen berading oor vigs. Die Burger.
Abstract: Bellville - Die altesame 31 werkloses wat verlede jaar die Metropool se eerste leke
vigsberaderskursus gevolg het, het onlangs hul sertifikate ontvang en sal binnekort uitgeplaas
word in die verskeie gemeenkappe waar hulle sal werk. Die groep sal onder meer help om die
verspreiding van die epidemie te beheer deur berading, ondersteuning en primere
gesondheidsopvoeding. Volgens die nuurste statistieke het Suid-Afrika, met 90 000 nuwe HIV-
460

infeksies elke jaar ( 20 000 hievan is kinders), rede tot kommer. Mev. Joan Fortuin,
projekkoordineerder, het by die sertifikate-plegtigheid gese epidemies soos vigs, tuberkulose en
seksueel oodraagbare siektes het so drasties toegeneem dat die onderskeie rolspelers nie meer
in die behoefters van al die mense wat met die virusse besmet is, kan voorsien nie. "Ons glo dat
die leke-beraders 'n nuwe oplossing is om die behoeffe an te vul," het Fortuin gese. Die projek
is geinisieer deur nie- regeringsorganisasies (NRO's) met gesondheidsbelange.
Die 31 leke-beraders wat verlede jaar uit 350 aanssoekers in die Metropool gekies is, moes 'n
intensiewe kursus van vier weke bywoon voordat hulle hul as leke-beraders kon bekwaam. Met
die kes van die 31 beraders, was daar verskeie kriteria waar-volgens die suksesvolle kandidate
gekeur is.
Die voorkeur is gegee aan vrywillige verkers van NRO's, Xhosasprekendes, mense wat saam
met HIV-lyers woon, werkloses en inwoners van gemeenskappe met groot getalle vigslyers," het
Fortuin gese. Hoewel die Wes-kaap se statistieke van HIV- infeksies die laagste in die land is,
word daar voorspeldat dit binne vierjaar dieselfde sal wees as die van Kwazulu-Natal.
Drie doelstellings
Volgens me, Tembela kwitshana, nasionale koordineerder van die landwye vigsprogram, is die
mobilisering en vereniging van die provinsiale, nasionale en internasionale hulpbronne een van
die drie doelstellings van die program. "Sie voorkoming van die verspreiding van die HIV-virus en
ander seksueek oordragbare siektes moet ook aandag kry," het kwitshana gese.
Notes: 1 copy
Ref ID: 7058
Van der Walt, D. (1997). Siekefondse takel vigs. Finansies and Tegniek.
Abstract: In SA het 'n groot deel van die bevolking nog altyd volstruis gespeel met vigs. Dit is 'n
siekte wat maar eintlik in die res van Afrika hoogty vier, is geglo, of as dit dan in SA voorkom, is
dit iets wat beslis nie 'n probeem in ons gegoede voorstede sal wees nie.
Notes: 1 copy
461

Van Dyk, A. C. (1995). From curing to caring: nursing and counselling the HIV infected
patient. Nursing, 19, 18-19.
Ref ID: 419
Keywords: caregiver/counsellor/guidelines/infection/Nursing
Abstract: Nothing can be more stressful and draining on the nurse's resources than caring for
patients with AIDS. To be faced with so much pain, suffering and inevitable death, leave many
nurses with a sense of powerlessness and with a feeling that they have very little to offer their
patients. To empower nurses and give them the strength to face the AIDS challenge, the
emphasis of nursing the AIDS patient should shift from curing to caring (Christie & Hickson,
1990). The historic role of the nurse as compassionate caregiver was never more relevant than
today in the context of AIDS for which no cure exists. With the emphasis on caring, nurses will
have a new, achievable goal to help patients, that is to live with AIDS in a meaningful way.
Caring for patients with HIV infection or AIDS, involves physical, emotional and psychological
care. The nurse is, therefore, not only caregiver, but also counsellor and educator. The purpose
of this article is to give guidelines on how to care for, and how to counsel, patients living and
dying with AIDS.
Notes: 1 copy
Van Dyk, A. C. (1991). Voorkoming van vigs: Psigo-sosiale voorspellers van houdings.
Gedrag en gedragsverandering= Prevention of AIDS: Psycho-social predictors of attitudes,
behaviour and behavioural change. PH D Dissertation, University of South Africa (UNISA).
Ref ID: 201
Keywords: attitudes/behaviour/behaviour change/prevention/psychology/psychosocial/social
Abstract: The objective of this study was to devise a psycho-social model to predict attitudes
toward AIDS, sexual behaviour, the use of condoms and sexual behaviour change. Possible
cultural and gender differences, relevant to the variables included in the model, were established.
An AIDS-prevention model was compiled based on the following models and theories: the health
belief model, the health promotion model, attribution theory, health locus of control and theory of
reasoned action. The AIDS-prevention model includes factors unique to AIDS, such as myths,
462

attitudes, anxiety, fear of contact with AIDS and obstacles in changing sexual behaivour. A
survey was conducted and data collected through questionnaires. A sample of 1 494 adults was
randomly selected from the population of UNISA students. Although cultural groups differ from
one another, in tolerant attitudes are chiefly predicted by myths, fear of contact, perception of the
serious consequences of AIDS, attributions about the the causes of AIDS and unfavourable
attitudes toward homosexual persons. High risk behaviour is associated with perceptions of the
obstacles in changing sexual behaviour, low interest in personal health, fear of AIDS and
perceptions of susceptibility to HIV-infection. Condom use and sexual behaviour change are
predicted by favourable attitudes toward condom use, fear of AIDS and fear of contact with HIV-
positive people. Recommendations based on the research findings are given for AIDS-
prevention programmes.
Notes: 1 copy
Van Dyk, A. C. (1992). 'n Ekologiese benadering tot die skepping van 'n positiewe
rehabilitasie-omgewing vir die HIV/VIGS-Iyer in Suid-Afrika. Rehabilitation in S.A, 36, 44-47.
Ref ID: 138
Keywords: ecological approach/family/health worker/prevention/South Africa/support
Abstract: HIV/AIDS present unique problems for families, medical and helping professions, and
health care workers in South Africa. Current prevention programmes in South Africa do not take
into account how HIV/AIDS, and other factors, are interconnected. According to the ecological
approach the HIV/AIDS sufferer is inseparable from the environment. It is only within this
approach that a multitude of factors within the South African context can be addressed and a
positive environment for the rehabilitation of the HIV/AIDS sufferer can be created.
Notes: 1 copy
: -.
Ref ID: 379
Van Dyk, A. C. (1994). AIDS counselling in the South African context. In - (pp. 247-269). -
Keywords: counsellor/counsellors
463

Abstract: In 1981 a new calamity assaulted the world: AIDS. The initial optimism that the medical
science would sooner or later find a solution to AIDS has been shattered. The fact that AIDS
always ends in death and the fact that there is little hope of treatment, together with the ignorance
associated with the illness, have occasioned irrational fears, panic, anxiety, distrust, hatred,
prejudices, stigmatisation and rejection worldwide. It is against this scenario of ignorance, fear,
discrimination, rejection and sickness that AIDS counsellors have to offer their services.
Notes: 1 copy
Van Dyk, A. C. (2001). Why me and not my neighbour?" HIV/AIDS care and counselling
in a traditional African context. Curationis, 24, 4-11.
Ref ID: 422
Keywords:
Africa/caregiver/community/condom/condoms/confidentiality/counsellor/counsellors/education/he
alth/Nurse/Nursing
Abstract: HIV/AIDS in Africa places a tremendous burden on the nursing professional. Hospitals
are inundated with very sick and dying AIDS patients and nurses often find that their role as
healers has shifted to a great extent to that of caregivers, counsellors and educators. AIDS also
calls for nurses to go beyond the strict Western-based bio-medical model to be able to help and
understand patients who come from a traditional African background. This article discusses
relevant aspects of the traditional African worldview by explaining what health, sickness and
sexuality mean in traditional Africa. Traditional African perceptions of the causes of illness (God,
ancestors, witches, pollution and germs,) perceptions of sexuality, the importance of having
children, cultural beliefs inhibiting the usage of condoms, the importance of community life, as
well as the controversial issue of confidentiality in Africa are discussed. The implications for AIDS
care and counselling in Africa are explored and suggestions on how to use traditional beliefs and
customs to the advantage of AIDS education, are offered.
Notes: 1 copy
464

Ref ID: 1303
Van Eyssen, B. (1999). Babies get a loving touch. The Sunday Independent.
Keywords: babies/benefits/care/caregiver/family/government/policies/policy/quality of
care/UNISA/WHO
Abstract: Wenham is at pains to prove her theory that "exercise in babyhood is much more
effective than later in life" and to promote the benefits of sometimes playful physical contact for
these children, childcare field workers who share her thinking stress that meeting the needs of
children is an enormous task. "The government cannot substitute a family," says Laura Harris
Dewey, a social worker with the National Council for Child and Family Welfare. There are clear
advantages to singing, talking and touching a child, the crucial developmental period being from
birth to five, says Unisa psychology lecturer Dr Elsje Cronje. Establishing a secure attachment t
a regular caregiver could eliminate future behavioural disorders such as problems with individual
identity, forming relationships, or a general apathy and a lack of trust. Evidence also exists that
babies and toddlers raised with little or no physical affections are more likely to display chronic
illness. Government policy reforms geared at improving the quality of care for institutionalised
children could provide alternatives to the problem.
Notes: 1 copy
van Rensburg, D., Viljoen, R., Heunis, C., Hanse van Rensburg, E., & Fourie, A. (2000).
South African Health Review 2000. Ntuli A., Crisp, N., Clarke, E., and Barron, P.
Ref Type: Unpublished Work
Ref ID: 8806
Keywords: Africa/behaviour
change/care/clinic/community/condom/condoms/confidentiality/counsellor/counsellors/disclosure/
disease/family/health/HIV-status/HIV testing/Home based
care/impact/infection/response/sex/South Africa/transmission/treatment/VCT/women/Zimbabwe
Abstract: Annual review of the health sector in South Africa with frequent reference to HIV/
AIDS in many chapters.
PHC
465

Availability of HIV testing at fixed clinics remains low, with the turn-around time for HIV testing at
fixed facilities has shrunk meaningfully from eight to six days since 1998. The availability of
condoms has increased for 79% in 1998 to 86% in 2000.
Notes: Chapter 1
Van Rooyen C.C. (2000). Promotion quality counselling and training in South Africa: The
development of the National HIV/AIDS Counselling Accreditation Committee. In (pp. 27).
Ref ID: 247
Keywords: Africa/HIV/AIDS counselling/policies/prevention/South Africa/training
Abstract: Concerns regarding the quality, promotion and maintenance of standards in HIV/AIDS
counselling in South Africa, together with the need for recognition of the work of counsellors had
led to the development of a national minimum standards process. This process had recently
culminated in the launch of a National HIV/AIDS counselling Accreditation Committee. This
process has involved extensive consultation at a national and provincial level over a two year
period. A policy setting minimum standards for HIV/AIDS counsellor selection, training, curricula,
continuing education and accreditation has been consensually endorsed by all process
participants. A structure to implement the process has similarly been endorsed together with an
interim membership of the National HIV/AIDS counselling Accreditation committee. The process
of policy development will be discussed emphasising the delicate and difficult accomplishments in
respect of a truly participatory and consultative policy process. The content of the policy will be
presented in brief and the workings of the structure described. Discussion will highlight both the
process and content factors which have allowed the development of a consensual endorsed
policy across professional and para-professional boundaries as well as across disciplinary
boundaries. The National HIV/AIDS Counselling Accreditation Committee and the process of its
development may represent a powerful non-government foundation for the promotion,
maintenance and development of quality counselling and training. The development of both
policy and the structure may also present as a potential model for other psycho-social service
domains to adopt to bring coherence to similar professional and non-professional activities such
466

as trauma counselling, rape counselling, suicide prevention counselling and the like.
Notes: 1 Copy
Van Rooyen, C. A. J. & Sewpaul, V. (1993). Guidelines for AIDS-related social work
education in South Africa. Social work/Maatskaplike Werk, 29, 223-232.
Ref ID: 140
Keywords: education/guidelines/social workers/South Africa
Abstract: Contemporary social workers function in a world confronted with the multifaceted
challenges of AIDS. If social work as a profession is to make a significant and appropriate
response to the multitude of AIDS- related challenges, it is imperative that the professional
education of future social workers should take cognisance of the impact of the disease on the
society. 'Social work educational institutions are ideally placed, if not morally bound, to take up
the AIDS challenge through the appropriate education of their students'. This article will propose
a set of broad and flexible guidelines for AIDS-related social work education. The guidelines are
in no way intended to be complete or rigid, but should merely be seen as suggestions or pointers
towards the process of educating social work students for practice in a society facing the
challenges of AIDS.
Notes: 1 copy
Van Rooyen, C. A. J. & Bernstein, A. J. (1992). AIDS education for student social
workers in South Africa: are social workers being educated to meet the needs of the society in
which they function? Social work, 28, 48-61.
Ref ID: 141
Keywords: education/social workers/South Africa
Abstract: There is no doubt that acquired immune deficiency syndrome (AIDS) has become an
issue of worldwide significance. Statistics of varying accuracy and intent about, illustrating past,
present and future scenarios. AIDS is an issue that is currently topical and the focus of much
attention. This paper examines AIDS within a specifically South African context. Particular
attention is paid to the role of social work education as part of the South African response to
467

AIDS. An exploratory study which examines the responses of social work educational institutions
in South Africa to the AIDS challenge is described. The authors suggest that social work
educational institutions need to respond in a concerted, contextual and proactive way. Without
such action future social workers will not be in a position to respond appropriately to the needs of
the communities they serve.
Notes: 1 copy
Van Rooyen, H. & Wood, G. (1997). The importance of HIV test counselling.
Occupational Health Southern Africa, 3, 23.
Ref ID: 142
Keywords: health/health worker/post-test/pre-test/sexual behaviour/training/VCT/voluntary
counselling and testing
Abstract: In the last issue of Occupational Health, the rationale for the management of a person
with sexually transmitted disease was discussed with an insert on national guidelines. In this
issue the role of HIV test counselling is discussed and an insert on the 4 C's of HIV counselling is
included. As a result the AIDS training, information and counselling Centres(ATICCs)"pick up the
pieces" following insensitive or incomplete counselling of patients tested for HIV. In addition
appointments made for patients who have tested HIV positive are often not kept. These patients
may remain in state of shock and disbelief, often unsupported and denying their HIV positive
status. A diagnosis of the presence of HIV infection, or the suspicion or recognition of the
possibility of infection, brings with it profound emotional, social, behavioural and medical
consequences. The approach to counselling is outlined in the insert. Counselling promotes an
atmosphere of acceptance and encourages a person to make their own decisions. It challenges
the immediate response of denial and provides a realistic appraisal of the individual's
vulnerability. Counselling assists persons to remain active in their work, families and amongst
friends and reduces their dependence on health and social services. It may decrease physical,
psychological and problems and may delay the onset of AIDS-related symptoms. Counselling not
only provides support in times of crisis but may also inform and assist HIV positive persons in
making decisions relating to safer sexual behaviour and responsible relationships. pre-test
468

counselling should provide information on the HIV test as well as the legal implication of being
diagnosed as either HIV positive or negative . Issues such as confidentiality, the persons coping
capacity and supportive mechanisms should be discussed. In addition pre-test and post-test
counselling is an opportunity to educate and counsel on safer sexual behaviour.
Notes: 1 copy
Ref ID: 427
Van Rooyen, H. (1997). Why the fuss about supervision. Positive outlook, 4, 20.
Keywords: supervision/counsellors/evaluation
Abstract: I sound like my mother when it comes to the issue of the importance of supervision for
HIV/AIDS counsellors. I recall her with a certain well-intentioned, caring expression on her face,
mingled with her years of experience, telling me what she knew would be good or bad for me to
do. And so, with similar kinds of mannerisms and intentions, I advise counsellors on the benefits
and importance of supervision for them. And just like my mother, I expect that because of my
experience, they could heed my advice. In many places where supervision is available (either on
an individual or a group level), counsellors mostly remain resistant to supervision. There may be
many reasons for this..maybe they don't adequately understand what supervision involves, what
would be expected of them, they fear the assessment and evaluation component of supervision,
they don't feel comfortable with their supervisor, who might also be a line manager and worry
whether he or she would be able to maintain their separate roles, etc. These are all valid
concerns that anyone entering supervision for the first time or for the umpteenth time might have.
They are to be expected and can be dealt with within the supervision context.
Notes: 1 copy
Van Rooyen, H. (1999). HIV/AIDS and STDs: South African review.
Ref Type: Unpublished Work
Ref ID: 525
Keywords: Africa/Developing countries/failure/health/HIV prevention/human
rights/intervention/prevention/response/South Africa/therapy/UNAIDS
469

Abstract: Estimates by the Joint United Nations Programme on HIV/AIDS (UNAIDS) indicate that
the epidemic of HIV in South Africa is one of the fastest growing in the world. Unless a cure is
found or therapy to prolong life is made available, the majority of the 3.6 million South Africans
already infected with HIV will die within the next ten years. If there is no success with
interventions to reduce the spread of HIV, an additional 550 000 persons will become infected
each year. This will have a major on all aspects of life in South Africa.
The failure of the programmatic response to change unsafe behaviour in developing countries
has led to the "expanded response" to HIV prevention. This has moved HIV/AIDS from the health
domain to one that is intimately tied with development and human rights.
The programmatic response fails to take account of the social context that influences behaviour.
Many South Africans have little control over their lives and circumstances. Thus, messages to
promote safe behaviour are often inappropriate and ineffective.
Notes: 1 copy
Ref ID: 5070
Van Wyk (2001). Knoffel ingespan in stryd teen vigs. Rapport.
Abstract: Nuwe navorsing dui daarop dat knoffel verlighting kan bring vir kinders wat aan
MIV/vigs en sekondere infeksies ly.
'n Informele studie deur die Instituut vir kindergeneeskunde by die Rooikruis-kinderhospitaal toon
dat die bolplant moontlik ingespan kan word om die virus se ontwikkeling te vertraag. Die
helende eienskappe van knoffel is lankal bekend. Die helende eienskappe van knoffel is lankal
bekend. Die wonderkuur is vyfduisend jaar gelede deur die Chinese gebruik om infeksies te
bekamp. Navorsers by die instituut is so beindruk met die resultate dat hulle nou 'n raamwerk
opstel waarvolgens die doeltreffendheid van die bol klinnies getoets kan word. Dit sal beteken
dat knoffel as geneesmiddel geregistreer sal kan word. Die mediese etiek bepaal dat slegs
geregistreerde middels aan pasiente voorgeskryf mag word. Dokters by die Rooikruis-hospitaal
gebruik knoffel dus saam met ander geregistreerde middels.
Sover bekend sal dit die eerste formele studie in sy soort wees en beloof dit om veral in Afrika
goedkoop verligting te bring in gevalle waar konvensionele antibiotika nie beskikbaar is nie.
470

Die aktiewe bestanddeel in knoffel (Allium sativum) staan bekend as allicin en is 'n effektiewe
natuurlike antibiotikum teen swamen bakteriele infeksies. Wereldwyd is mense besig om weens
die oormatige gebruik van konvensionele antibiotika weerstand op te bou, en MIV/vigs- lyers is
geen uitsondering nie. Konvensionele antibiotika is duur en kan selfs tot die ontwikkeling van
sproei bydra. Een van die mees algemene sekondere infeksies is candida, 'n swaminfeksie wat
sproei veroorsaak. Dit tas veral die mond en keel van die pasient aan wat dit vir die lyer
ongemaklik maak om te eet. Dit is lewensgevaarlik as dit met die bloedstroom na die res van die
organe versprei, waar dit bloedvergiftiging kan veroorsaak. Volgens mnr. Peter de Wet,
hoofnavorsingstegnoloog by die instituut, is die voordele in die behandeling van infeksies met
knoffel legio. " Laboratoriumtoetse dui daarop dat dit swamme binne 48 uur vernietig. Dit is
beskikbaar, dit is maklik om toe te dien, dit is goedkoop en die gebruiker ervaar bene wens'n
slegte asem, geen noemens-waardige newe-effekte nie," se hy. De wet maak 'n ekstrak aan
deur die knoffelhuisies fyn op te kap, dit met koue water te meng, te week en te dreineer.
Notes: 1 copy
Ref ID: 145
Verghses P.M (2001). Voluntary counselling and testing for HIV-1. Lancet, 357, 144-145.
Keywords: condom use/cost-effectiveness/VCT/voluntary counselling and testing
Abstract: This is a letter to the editor responding to the publication by Michael Sweat and
colleagues from the Voluntary Counselling and Testing Efficacy Study Group. The letter lauds
the authors for their contributions to a better understanding of the the role of VCT in Africa and
asks the authors to clear up some questions as to their cost and effectiveness claims. The
authors' reply is also included.
Notes: 1 copy
Ref ID: 2150
Verster, I. (1998). Oksiterapie bied ongelooflike kans op herstel, se vigspasient. Beeld.
Abstract: Sonder oksiterapie sou hy vandag "ongetwyfeld dood" gewees het. Om mense met
vigs die kans op die behandeling te ontneem, is "om duisende 'n kans op 'n nuwe lewe te
471

ontneem". Marek, 'n 29-jarige man van johannesburg wat drie jaar gelede as HIV- positief
gediagnoseer is, is een van die gesiglose, desperate massa wat na enige strooihalm sal gryp in
die stryd teen die gevreesde sickte, Hy het gister aan Beeld vertel van die "ongelooflike kans op
herstel" wat die omstrede oksiterapie-kliniek suid van Johannesburg hom gebied het. Mark het
"halfpad dood" by die kliniek ingestap. Na ses maande onder die hande van mnr. Shawn
Stewart, kliniekhoof, was hy "so gesond, dat (hy) geen rede meer gehad het om terug te gaan"
kliniek toe nie. Hy kon binne 'n maand 'n verbetering sien. Hy het sy energie en gesonde
verkleur herwin, terwyl die jeukerigheid in sy oe, die pynlike swelling in sy oksels en lieste en die
sere op sy tong verdwyn het. Vir langer as 'n jaar het daar nog geen smptome van die virus
teruggekeer nie, se hy.
Die toekoms van die kliniek, wat tot dusver ongeregistreer was, is nou in die gedrang na 'n
onlangse inspeksie deur die Medisynebeheeraad. Die navorsers verwag om vandag uitsluitsel
hieroor te kry. As iemand wat self aan vanklik erg skepties jeens die onbekende behandeling
was, verstaan Mark die omstredenheid rondom oksiterapie. Gebrekkige kennis hieroor is egter 'n
onaanvaarbare rede vir die sluiting van die kliniek, meen hy. " Daar is geen kuur vir vigs nie om
die desperate mense daarbuite die behandeling te ontneem, sou amper wees soos moord".
Ooks Jane (21) van Benoni- eens 'n sistemiese lupus eritematose (SLE) lyer -sien haar as een die
wandelende wonderwerke van die kliniek. Sy is in Oktober 1996 met die vernietigende siekte
gediagnoseer wat 'n oorproduksie van witbloedselle behels en stelselmatig byna alle
ligaamsorgane aanval en wegvreet. Jane het gesukkel met 'n pynlike veluitslag en erge
gewrigpyne - so erg dat sy skaars kon loop. Volgens haar het 'n jaar van konvensionele
behandeling met onder meer malariateenmiddels, kortisoon en chemoterapie egter weinig meer
as kwaai allergiese reaksies ontlok en haar nie gehelp nie.
Op 'n vriendin se aanbeveling het sy in Desember 1997 met behandeling, "sonder enige newe-
effekte", byStewart begin. "Ek het onmiddellik alle medikasie gestop. Na net vier weke kon ek
reeds 'n definitiewe verbetering sien en was my witbloedtelling reeds laer." Na drie maande se
behandeling het bloedtoeste getoon dat sy negafief vir LSE getoets het.
Notes: 1 copy
472

Ref ID: 2215
Verster, I. (1998). MBR - voorsitter by omstrede kliniek. Beeld.
Abstract: Die Medisynebeheerraad (MBR) het gister ondersoek ingestel by die ongeregistreerde
oksiterapie kliniek wat glo 'n "vigs-wonderkuur" bied. 'n Ondersoekspan van ses lede het sowat
vier uur by die kliniek in die suide van Johannesburg deurgebring, het mnr. Paul Erasmus,
betrokke by die Genesis na vorsingsprojek, gese. Hulle het glo veral belang gestel in die
omstrede oksiterapie wat hier toegepas word en het bygestaan terwyl 'n pasient met vigs op die
wyse behandel is. Kommer is vroeer in verkskeie wetenskaplike en mediese kringe onder meer
deur nie Gautengse gesondheidsdepartment - uitgespreek oor die binneaarse toediening van
waterstofperoksied in pasiente. Erasmus het gese die kliniek het nou dokumente gekry om
aansoek te doe vir registrasie. "Ons wag nou op hete kole vir die raad se bevingig". Sowat
veertig pasiente met verskeie lewensge vaarlike siektes is in die afgelope ses maande in die
geheim hier behandel. Gister se besoek van die MBR volg op 'n waarskuwing deur dr. Helen
Rees, voorsitter, dat die kliniek hom blootstel aan vervolging deur met ongetoetste, potensieel
gevaarlike behandelingsmetodes voort te gaan. Mnr, Shawn Stewart, evangelis en klinikekhoof,
het daarna aangedui hulle gaan aansoek doen om kliniese toetse op die behandelingsmetode.
Die raad is ook uitgenooi om die kliniek te besoek. In die lig van die groot getal mense wat in die
behandeling belang stel, het Rees gewaarskuteen valse verwagtings oor 'n "vigskuur" voordat
kliniese toetse gedoen is. Sy kon nie gisteraand teen druktyd vir kommentaar opgespoor word
nie.
Notes: 1 copy
Ref ID: 2227
Verster, I. (1998). Kliniek oorval vanwee "vigswonderkuur". Beeld.
Abstract: Die ongeregistreerde oksiterapie kliniek wat 'n sogenaamde "wonderkuur" vir vigs bied,
word oorval met oproepe van honderde hoopvolle vigspasiente. Sedert die Saturday Star berig
het oor die beweerde suksesse van die kliniek in die suide van Johannesburg waar die Genesis-
navorsings projet gebaseer is, het die selfoon van mnr. Paul Erasmus nog nie ophou lui nie.
Onder die" horde desperate oproepe" was glo die van mense wie se hele gesin met die virus
473

gesmet is, dokters en 'n topwetenskaplike. Volgens Erasmus was een van die mees tragiese
oproepe die van 'n man wat uit pure desperaattheid met 'n geweer langs sy kop gesit het tewyl hy
oor die telefoon om hulp gesmeek het. Hy het gedreig om self-mood te pleeg as hulle hom nie
help nie. Mnr. Shawn Stewart, hoof van die kliniek, beweer dat hul oksiterapie HIV/vigs in Suid-
Afrika binne die volgende vyf jaar kan uitwis "mits die volle ondersteuning van die regering verkry
word". 'n Soortelyke voedgolf navrae wat maklik vyf maande aangehou het -ook van oorsee-het
verlede februarie die virodene-navorsers getref na die nuus van die middel as 'n moontli ke
vigskuur in koerante, het mev. Olga Visser, een van die oorspronklike navorsers, gese.
"Die reaksie is totaal te verwagte. Daar is 'n enorme klomp desperate mense wat ervaar hoe hul
lewe wegkwyn, maar wat niks daaraan kan doen nie". Visser het die Genesis-navorsers "uit
ervaring" gewaarsku om hulle nie dubbele moeite op die hals te haal deur nie die korrekte
wetenskaplike kanale te volg nie. Visser hulle het vroeer 'n boutjie met die mediese professie
geloop nadat hulle na die kabinet toe is met hul bevindings. Stewart gaan nou aansoek doen om
kliniese toetse op hul behandelingsmetode nadat dr. Helen Rees, voorsitter van die
Medisynebeheerraad, hom gister gewaarsku het dat die raad verplig sal wees om teen die kliniek
op te tree.
"Intussen gaan ons voort om ons huidige pasiente, teenoor wie ons tog 'n verantwoordelikheid
het, te behandel. Ons sal regsadvies inwin oor die inname van nuwe pasiente", het Stewart
gese, 'n dokter van die Selbpark-mediese sentrum ingedien. Berigte dat dr. Nkosazana Zuma,
minister van gesondheid, deur me , Winnie Madikizela-Mandela oor die kliniek ingelig is en
voornemens is om dit te besoek, is totaal ongegrond, het mnr. Vincent Hlongwane, haar
woordvoerder, gister gese. Madikizela- Mandela het vroeer volgens die navorsers haar steun
aan die kliniek toegese.
Notes: 1 copy
Ref ID: 5981
Viall, J. (1998). A killer making its presence felt. The Daily News.
Keywords: Africa/community/insurance/research/South Africa
Abstract: People are getting sick and dying communities are losing their most productive
474

members. The silent phase of the epidemic is over in many parts of South Africa, especially
KwaZulu-Natal where almost 27% of pregnant women are HIV positive. A generation of orphans
is being created, babies are being born HIV-positive. Aids is expected to have a huge impact on
business as productivity drops, sick leave increases and insurance claims are made. In the
Western Cape the epidemic is still in its early stage. In the latest research 6,1% of pregnant
women were infected. "But nowhere near that number of people are sick," Said Dr Wood, "It is a
time bomb waiting to go off." For Mrs Fielder, 13 years of daily confrontation with the effects of
the HIV-virus have changed her view on life.
"HIV patients have taught me how to live for the moment, because they do," she said. "Now we
can at least give them more hope, and hope helps them to stay well."
Notes: 1 copy
Viljoen, R., Heunis, C., Janse van Rensburg, E., van Rensburg, D., Engelbrecht, M.,
Fourie, A. et al. (2000). The National Primary Health Care Facilities: survey 2000. -. University of
Free State, Centre for Health Systems Research and Development.
Ref Type: Unpublished Work
Ref ID: 495
Keywords: care/clinic/drugs/health/primary health care/supervision
Abstract: The National Primary Health Care Survey 2000 constitutes a follow-up of the 1997 and
1998 surveys as part of an ongoing monitoring exercise of the status of PHC provided in fixed
clinics. The 2000 survey also establishes a baseline of data on the status of PHC provided by
satellite and mobile clinics. It also mirrors the status of PHC provision in the country, and
highlights major differences between provinces and in urban and rural settings. The survey
focuses on the following aspects of PHC: range of services, human resources, equipment,
infrastructure, drugs and supplies, supervision, record keeping and support. A random sample of
445 clinics (10% per province) was drawn, stratified proportionally according to the actual number
of fixed, satellite and mobile clinics. Despite vast variations amongst the provinces, the 2000
survey generally indicates progress towards equity in service provision.
Notes: 1 copy
475

Viney, L. L., Allwood, K., & Stillson, L. (1991). Reconstructive group therapy with HIV-
affected people. Counselling psychology Quarterly, 4, 247-258.
Ref ID: 467
Keywords: client/clients/community/group therapy
Abstract: This paper describes reconstructive group therapy with people affected by AIDS. It
begins with the therapeutic need as we defined it in the AIDS-affected community and the
practicalities of the group therapies we offered. The reconstructive perceptive, based on personal
construct theory, is then explored and applied to interpret both the psychosocial functioning of
AIDS-affected people and group therapy. The group therapy process is described: client
engagement and group beginnings, goals, group rules, leadership roles, group experiments,
group issues and endings. Some problems that arose are then identified; and a sample of group
process is provided. Finally, the appropriateness of the reconstructive perspective and of group
therapy for these clients is discussed, together with the identification of the major ethical issues
and some recommendations for its use.
Notes: 1 copy
Visser, M. (1996). Evaluation of the First AIDS Kit, the AIDS and lifestyle education
programme for teenagers. South African Journal of Psychology, 26, 103-113.
Ref ID: 144
Keywords: attitudes/community/education/evaluation/knowledge/school/sex
education/teachers/teenagers/Young people/youth
Abstract: The impact of the First AIDS Kit, an AIDS and lifestyles education programme, on
secondary school students' behavioural intentions, their knowledge of AIDS as well as attitude
towards people with AIDS, was evaluated. The programme was presented by counselling
teachers in 11 school involving 339 students in Std 6 to 9. The programme was evaluated by
means of a questionnaire before and after the programme, as well as by focus group discussions
with students and interviews with the presenters of the programme. Although the programme
was not presented in ideal circumstances, it had a positive effect on student's knowledge of
AIDS, their attitude towards people with AIDS and although not statistically significant, some
476

aspects of their behavioural intentions. Students evaluated the programme positively, as
preparing them for life and giving them more control over their lives. Students gave suggestions
to improve the programme with regard to the content, presenter, educational techniques, role of
parents and how to address moral issues. It is recommended that AIDS education should form
part of long-term life skills and sex education and the focus should be on behavioural change.
Community education and participation are also key elements in the effectiveness of school-
based AIDS education programmes.
Notes: 1 copy
Vollmer, N. A. a. V. J. J. (1999). A psychological epidemiology of people seeking
HIV/AIDS counselling in Kenya: an approach for improving counsellor training. AIDS, 13, 1557-
1567.
Ref ID: 8778
Keywords: Africa/client/clients/clinic/counsellor/training/counsellors/disease/East Africa/HIV/AIDS
counselling/information/Kenya/male/post-test/pre-test/tuberculosis/WHO
Abstract: Objective: this study develops a typology of psychological problems reported during
HIV/AIDS counselling. This typology provides a framework for training paraprofessional
counsellors (PPCs) in East Africa.
Design: Study participants included 307 Kenyans tested for HIV at any six clinics in Nairobi
specialising in STDs, tuberculosis and other infectious diseases. Pre-test, post-test, and follow-
up counselling was provided by 16 PPCs who are themselves HIV-positive. Data consisted of
demographic, physical and psychological information reported by 168 clients who sought follow-
up counselling.
Methods: Counselling data were coded using an ipsative method; a unique code was assigned to
every distinct topic. Factor analysis with a varimax rotation reduced the original psychological
variables into logical groupings. Multivariate analysis examined the relationship of factors and
demographic characteristics.
477

Results: Clients reported 1-10 physical and 1-23 psychological complaints in a single session.
Sixty-five percent of female clients reported >eight psychological problems; 49% of males
reported > eight psychological problems. Factor analyses allowed the 109 reported psychological
events to be assigned to 15 categories of problems. Multivariate analyses explained little of the
variance in the relationship between each client's demographic profile and the psychological
factors.
Conclusions: Training for PPCs should be relevant to problems encountered during counselling.
Results indicate that PPCs can expect clients to present one or more of the 15 factors during
counselling. Demographic characteristics explained small amounts of variance in the distribution
of factor scores. The 15 factors produced in this study, although descriptive and preliminary,
could form the basis of a training curriculum for HIV PPCs.
Notes: 1 copy
Volunteer South Africa. (2001). Volunteer South Africa 2001: let's build a national that
cares. Volunteer South Africa.
Ref Type: Unpublished Work
Ref ID: 504
Keywords: Africa/care/community/impact/South Africa
Abstract: Volunteers are often not seen rarely make headlines, but their impact is immense. They
pull communities together by helping those in need. They promote self-help initiatives and take
up worthy causes, such as protecting the environment. People from all over the world have
various motives for voluntary service based on their cultural, religious and social norms.
Volunteers invest their time as their own expression of goodwill - enriching the individual
volunteer and global volunteerism. Voluntary service is cause for celebration. It warrants special
recognition, hence the International Year of Volunteers 2001 (IYV2001). The United National
General Assembly proclaimed the Year to highlight the achievements of volunteers worldwide
and to encourage more people to encourage in volunteer activity.
Notes: 1 copy
478

Walt, G. & Gilson, L. (1994). Reforming the health sector in developing countries: The
central role of policy analysis. Health Policy and Planning, 9, 353-370.
Ref ID: 147
Keywords: Developing countries/health/health policy/policy analysis
Abstract: Policy analysis is an established discipline in the industrialized world, yet its application
of reform, to developing countries has been limited. The health sector in particular appears to
have been neglected. This is surprising because there is a well recognized crisis in health
systems, and prescriptions abound of what health policy reforms countries should introduce.
However, little attention has been paid to how countries should carry out reforms, much less who
is likely to favour or resist such policies. This paper argues that much health policy wrongly
focuses attention on the content of reform, and neglects the actors involved in policy reform ( at
the international, national and sub-national levels), the processes contingent on developing and
implementing change and the context within which policy is developed. Focus on policy content
diverts attention from understanding the processes with explain why desired policy outcomes fail
to emerge. The paper is organized in 4 sections. The first sects the scene, demonstrating how
the shift from consensus to conflict in health policy established the need for a greater emphasis
on policy analysis. The second section explores what is meant by policy analysis. The third
investigates what other disciplines have written that help to develop a framework of analysis. And
the final section suggests how policy analysis can be used not only to analyze the policy process,
but also to plan.
Notes: 1 copy
Wangalwa, S., Namwebya, J. H., Baryarama, F., Kalule, J., Turyagyenda, J., Magombe,
J. B. et al. (2000). Challenges of extending counselling and testing services to rural areas in
Uganda. In (pp. 1).
Ref ID: 244
Keywords: counselling and testing/health/NGO/prevention/Uganda
Abstract: Issues: HIV Counselling and testing (CT) is an essential component of a
comprehensive strategy for AIDS prevention. While available in many urban location in Uganda,
479

extension of CT to rural areas in needed. In 1996 the AIDS information Centre began
implementing a strategy of capacity building for the local Ministry of Health authorities to offer CT
services to rural areas previously with no CT services. AIC trained counsellors and laboratory
technicians who are now offering CT services in 47 rural health facilities in 22 districts of Uganda.
Description: The number of clients served at each site was routinely monitored and 1998 data
from 35 operational sites were analyzed. Factors affecting utilization were identified through 24
focus group discussions held with community leaders and clients and 30 key informant
interviews held with district leaders, site personnel, and local leaders in 8 districts. The number of
clients served during the first year at each site had a median of 232 with a range of 40 to 1803.
Reasons for the variation and low performance of some sites included involvement of other
NGOs, utilization of cost sharing fees, support of local leaders, monitoring and supervision, and
operating outreach activities in the catchment area of the site.
Conclusion: Extension of CT services to rural areas is feasible, particularly through partnerships
between NGOs and the Ministry of Health. Service utilization highly depends upon involvement
of other NGOs; utilization of cost sharing fees; support of local leaders; and monitoring and
supervision. Support and care are needed so that referrals can be made for HIV positive clients.
Notes: 1 copy
Ref ID: 320
Wardell, R. & Radebe, J. (1994). Counselling beyond the individual. Positive outlook, -, 6.
Abstract: Rose and Joyce are two overworked counsellors who deal with the realities of AIDS
each day, their work takes them beyond the individual counselling paradigm, and into situations
that are more complicated. Many counsellors have expressed the need to be trained in dealing
with couples and families. ATICC has scheduled a short course in couples counselling during
June.
Notes: 1 copy
17.
Watts, C., Zwi, A., & Wilson, D. (1994). New statistical method tested. AIDS Bulleting, 3,
480

Ref ID: 458
Keywords: condom/condom use/HIV prevention/knowledge/men/population/prevention/sex/sex
workers/women/Zimbabwe
Abstract: A statistical method known as "capture recapture" may help to provide estimates of the
size of marginalised or inaccessible groups such as sex workers. The method was tested by
seeing whether it could be used to assess the coverage of community-based HIV prevention
programmes focused on sex workers in Mutare, Zimbabwe. The technique uses comparisons
made between different samples of the population to estimate its size and to obtain confidence
intervals around this estimate. Standard interviews with sex workers were also conducted at a
random sample of locations where men commonly meet women, weighed according to the
estimated levels of commercial sex occurring at each site. Preliminary results indicated that there
were approximately 2000 women selling sex from bars in Mutare corresponding to 6% of the
female sexually active population. It was also found that programme contact with sex workers
was high and that knowledge about HIV and condom use related strongly with the degree of
programme contact.
Notes: 1 copy
Weeks, J. (1989). AIDS: The intellectual agenda. In P.Aggleton, G. Hart, & P. Davies
(Eds.), AIDS: social representations, social practices (pp. 1-19). New York, Philadelphia, London:
The Farmer Press.
Ref ID: 392
Abstract: All diseases have social, ethical and political dimensions. Disease affect individuals,
not abstract entities or collectivities, and affect them in variable ways, according to their general
social condition and bodily health. What makes disease culturally and historically important, is
the way in which meanings are attached to illness and death, meanings and interpretations which
are refracted through host of differing, and often conflicting and contradictory social possibilities.
These shape the ways we interpret illness, and therefore organize the ways in which we respond.
Notes: 1 copy
481

Weinhardt, L. S., Carey, M. P., Johnson, B., & Bickham, L. N. (1999). Effects of HIV
Counseling and Testing on Sexual Risk behavior: A Meta- Analytic Review of Published
Research, 1985-1997. American Journal of Public Health, 89, 1397-1405.
Ref ID: 169
Keywords: efficacy/meta-analysis/review/VCT/voluntary counselling and testing
Abstract: Objectives: This study examined whether HIV counseling and testing leads to
reduction in sexual risk behavior. Methods: The meta - analysis include 27 published studies
that provided sexual behavior outcome data, assessed behavior before and after counseling and
testing, and provided details sufficient for the calculation of effect sizes. The studies involved
19597 participants. Results: After counseling and testing, HIV - positive participants and HIV-
serodiscordant couples reduced unprotected intercourse and increased condom use more than
HIV- negative and untested participants. Participants' age volition for testing, and injection drug
use treatment status, as well as the sample seroprevalence and length of the follow - up,
explained the variance in results. Conclusions: HIV counseling and testing appears to provide
an effective means of secondary prevention for HIV-positive individuals but, as conducted in the
reviewed studies, is not an effective primary prevention strategy for uninfected participants.
Theory - driven research with attention given to the context of testing is needed to further
explicate the determinants of behavior change resulting from HIV counseling and testing, and the
effectiveness of specific counseling approaches.
Notes: 1 copy
Weinhardt, L. S., Carey, M. P., Johnson, B., & Bickham, N. L. (1999). Effects of HIV
Counselling and Testing on Risk Behaviour- a meta-analysis of American and African experience
(Kenya, Zaire, Uganda and the Gambia). A Meta-analytic Review of published Research., 89,
1397-1405.
Ref ID: 286
Keywords: Africa/America/Europe/Kenya/risk behaviour/sexual behaviour/The
Gambia/Uganda/Zaire
Abstract: HIV counselling and testing (HIV-CT) is the largest and most costly HIV prevention
482

effort in the United States. Expanded use of HIV-CT as a prevention strategy has also been
advocated in developing countries. The primary objectives of the HIV - CT system are:
.To provide an opportunity for persons to learn their HIV serostatus and, if infected, to obtain
referrals for medical and psychosocial care, and
. To provide counselling so that clients might change their behaviour to avoid infection or, if
already infected to avoid transmitting the virus to others.
To achieve the later objective, the Centres for Disease Control and prevention (CDC) recommend
a client-centred counselling approach, including personalised risk assessment, development of a
personalised risk reduction plan, and referrals appropriate to the client's test results. This article
focused on the effectiveness of HIV-CT in achieving this objective.
As of 1992 approximately 60 million Americans (one third of the adult population) had been tested
for HIV antibodies, 50% of the tests were performed at publicly funded sites. From 1989 to 1995,
more than 2 million people were tested annually at public sites, with 1 million people tested for
the first time each year. A cost-benefit analysis of the CDC's national HIV-CT program revealed
that over $100 million is allocated annually by the CDC to more than 5000 sites across the United
States and its territories. Clearly, HIV-CT provides an opportunity to perform individualised HIV
risk behaviour interventions with more people than any other single HIV prevention program. It is
crucial that such a widespread and costly program fulfills its purpose and that its effectiveness be
evaluated.
Previous reviews of the HIV-CT literature have conducted that couples who are serodiscordant
for HIV, when tested and counseled together, reduce their risk behaviour, but that the effects of
HIV-CT on sexual risk behaviour in other groups remain largely uncertain because of
inconsistencies review of studies examining the effects of HIV-CT on HIV risk behaviour was
published more than 7 years ago, and new data are now available. Moreover, confidence in the
conclusions of earlier review is limited because they were guided by qualitative interpretations
483

ather than empirical synthesis.
This article presents a comprehensive meta-analytic review of the effects of HIV-CT on sexual
behaviour that places the participants at risk for HIV infection.
Twenty-seven studies, representing a total of 19597 participants, met the inclusion criteria. The
number of tested participants in the studies ranged from 14 to 4524. Sixty-eight percent of the
studies reported attrition rates, which ranged from 5% to 89% (mean = 33%). Nineteen (70%) of
the studies were conducted in North America, 6 (22%) were conducted in Africa, and 2(8%%) in
Europe.
Time lapsed prior to the first follow-up assessment ranged from 16 days to 4 years (median = 180
days)
Notes: 1 copy
Wellcome Foundation. (1993). Workshop report: community-based AIDS prevention and
Care in Africa: Building on local initiatives. -, 1-8. Berlin, Wellcome Foundations.
Ref Type: Unpublished Work
Ref ID: 527
Keywords: Africa/care/conference/government/Kenya/population/prevention/sub-
Saharan/Tanzania/Uganda/Zambia/Zimbabwe
Abstract: Representatives from community-based AIDS prevention and care programmes in five
sub-Saharan African countries (Kenya, Tanzania, Uganda, Zambia, and Zimbabwe) spoke about
their programmes ' strengths, shortcomings and hopes for the future at a meeting entitled
"community - based AIDS prevention and Care in Africa: Building on local initiatives", organised
by the population council with the support of the Wellcome Foundation's positive Action
Programme. The meeting took place on June 5, 1993 in Berlin just prior to the IXth International
Conference on AIDS. The participants' experiences and insights demonstrated the tremendous
ingenuity and imagination that communities have generated to prevent the spread of HIV and
AIDS and how they have taken action where governments' activities have fallen short. The
workshop brought representatives of these programmes together with the staff of governmental
and nongovernmental organisations, funding institutions, technical assistance agencies, and
484

national and international AIDS prevention programmes to present their experiences. Discussion
focused on strategies to strengthen community-based AIDS prevention and care in Africa.
Notes: 1 copy
Western Cape Province: HIV/AIDS Directorate. (2002). Business Plan for Voluntary
Counselling and Testing for 2002 / 2003.
Ref Type: Unpublished Work
Ref ID: 541
Keywords: business plan/client/clients/counsellor/counsellors/NGO/training/VCT/voluntary
counselling and testing/WHO
Abstract: Within the Western Cape, Voluntary Counselling and Testing (VCT) is being offered by
91 trained lay counsellors at -120 sites throughout the Province. Each of these counsellors have
been trained by accredited training institutions to provide counselling and are contracted to 13
NGO's who are responsible for mentoring the counsellors. The counsellors work four days per
week and counsel on average -6-8 clients per day. They receive ongoing training and mentoring
on the fifth day.
Notes: 1 copy
McCoy, D.
Whelan, P. (2002). South African Review 2001. Ntuli A., Suleman, F, Barron, P., and
Ref Type: Unpublished Work
Ref ID: 8814
Keywords: prevention/care/business/intervention/information
Abstract: There is a complex array of mechanisms through which resources destined for
HIV/AIDS flow to provincial departments, the key site of delivery of a number of HIV/AIDS
prevention and cares services chapter looks at how national quantifies and identifies these these
resources through which the provinces are required to access them, and suggests that some of
these resources seem to be inequitably distributed require considerable budget and business
planning abilities to direct these resources effectively. Given the lack of coherent strategic plans
485

with provincial HIV/AIDS units, these skills seem to be lacking. As many of the interventions being
introduced at provincial level are new, well functioning and activity sensitive financial control and
monitoring systems need to be put in place to evaluate and improve the interventions and the
spending patterns behind them. The structure of the financial information management systems
is such that detailed activity reporting is difficult.
Notes: Chapter 8 - HIV/AIDS Financing
White, D. A. C. (1992). Counselling health care workers after exposure to blood from an
HIV-positive patient. CME, 10, 181-187.
Ref ID: 155
Keywords: guidelines/health worker/Nurse
Abstract: With the rising prevalence of human immuno-deficiency virus(HIV) infection in our
communities, health care workers (HCWs) have an increased risk of exposure to blood from HIV-
infected patients through accidental injury or contamination. The HCWs' fear of HIV contagion
has focused attention on the issue of patients' right versus the rights of HCWs. Vigorous debate
continues on issues such as consent for HIV testing, confidentiality and management strategies
for HIV-positive patients. Despite the existence of policies that address these issues and offer
guidelines aimed at preventing injury and contamination in the working arena, the risk to HCWs
has not been eliminated and accidents in hospitals are being reported. HCWs at risk include not
only doctors and nurses but paramedical staff such as laboratory technicians and non-medical
staff such as domestic workers. It is therefore important to note that HCWs may come from
diverse socio-economic, educational and cultural backgrounds.
Notes: 1 copy
Whiteside, A. & Barnett, T. (1996). HIV and AIDS.
Ref Type: Unpublished Work
Ref ID: 516
Keywords: Africa/disease/government/health/Department of
Health/intervention/NGO/response/sexually transmitted disease/South Africa/WHO
486

Abstract: The past year has not been particularly good one for combating the HIV epidemic in
South Africa. The prevalence of HIV continues to rise at an alarming rate in the country ( Table
15.1), with the Health Department estimating that there were 1.8 million South Africans infected
with HIV at the beginning of the year. Evidence shows that we are deep in the epidemic with
worse still to come.
The Department of Health has made intervention against AIDS one of its top priorities. However,
although the HIV/AIDS and sexually transmitted diseases (STD) Control programme of the
Department of Health has expanded its staff, some have argued that it has taken time to get off
the ground and find its direction. In addition, although the budget doubled, the amount of money
allocated to the programme is woefully inadequate when compared to the projected need. Non-
governmental organisations (NGOs) also have an important role in combating the epidemic.
However, the capacity for many of them to respond has been hampered by reduced funding as
money is diverted away from them and directed towards the new government.
The response to the epidemic has been further hampered by the Sarafina 2 debacle which
damaged government credibility, demoralised many people working in the field, and soured
relations with donors. The far-reaching implications of this controversy are dealt with in more
detail in Chapters 12 and 18.
This 1996 review of the HIV/AIDS epidemic will argue that there are two key issues that need to
be addressed:
.the issue has to be addressed beyond its biomedical features (and solutions). Social factors that
drive behaviour must equally be recognised and addressed.
. the issue of those already HIV infected South Africans who will become ill requires more
attention, both from the health and the national development points of view.
Notes: 1 copy
Ref ID: 489
Whiteside, A. (1998). AIDS and the transport sector. AIDS Analysis Africa, 8, 1-12.
Keywords: Africa/disease/economy/impact/infection/response/sexual partner
Abstract: There is a close connection between mobility and the spread of HIV infection. Being
487

away from home and traditional social networks and constraints makes people more likely to
have sexual partners others than their spouse or regular partner. The transport sector plays an
important role in facilitating the movement of people. Indeed, improving transport is a
development goal throughout the world and an efficient transport system is regarded as a
necessary precondition for economic growth. However, when looking at a the transport sector,
we been do consider its role in the spread of the HIV infection. This article outlines how transport
may facilitate the spread of HIV infection, suggests possible responses, and looks at the effect
that AIDS, the disease, may have on the sector.
Notes: 1 copy
2.
Ref ID: 449
Whiteside, A. (1999). AIDS, anonymity and AZT on the agenda. AIDS Analysis Africa, 10,
Keywords: Africa/AZT/health/knowledge/mother-to-child transmission/rape/South
Africa/transmission/women/WHO
Abstract: The latest HIV data from South Africa are horrific, especially since the country has a
good HIV survey system and there can be little doubt that the data are accurate. AIDS is
beginning to be apparent on the streets of South African cities, with a number of emaciated young
adults. As AIDS analysis Africa enters its tenth year of publication, South Africans are finally
being forced to confront the true horror that is AIDS in Africa. In May the press reported the
leaked results of an anonymous survey at the University of Durban - Westville which found that
25% of those tested were HIV-positive, causing a furore. The students who took part in the
survey now have to live with the knowledge that one-quarter of them are infected. One can only
hope that all of them will choose to be counselled and tested again in order to ascertain their
individual statuses. The 75% who are not infected have a real incentive to remain that way. For
the rest, one can only hope that South will provide a supportive and caring environment. In this
regard, the call by SADC Ministers of Health to make HIV notifiable does not bode well.
Meanwhile, the issues of AZT continues to dominate the consciousness of many. There have
been calls by citizens that it should be made available to rape victims, by doctors that it should be
488

available to pregnant women, and by politicians that it should be cheaper. the reality is that if it is
given to rape victims and those exposed through occupational injury, it does significantly reduce
the chance of transmission; it can also prevent mother-to-child transmission. These uses should
be encouraged, and the state should provide the drug. It is, however, expensive. What AZT
does not do is cure AIDS; that miracle drug has not yet been found. When it is, must be
affordable.
star.
Ref ID: 7361
Whitfield, N. (1996). Home for dying children brings respite from harshest realities. The
Abstract: This article talks about how babies with Aids are dying every single day. "Nine little
ones have died since centre opened last November - six in two weeks.
Notes: 1 copy
WHO. (1994). -. WHO. [-], 8.07-8.08.
Ref Type: Organisational research report
Ref ID: 317
Keywords: counsellor/HIV transmission/prevention/transmission
Abstract: Counselling is a key component in AIDS control and prevention
WHO: It is the ongoing dialogue and relationship between client and counsellor that has as an
objective the prevention of HIV transmission and the provision of psycho-social support for those
affected directly and indirectly by HIV.
Notes: 1 copy
WHO & UNAIDS. (2000). Key elements in HIV/AIDS care and Support. The World
Health Organisation (WHO) and UNAIDS.
Ref Type: Unpublished Work
Ref ID: 496
Keywords: care/community/information/intervention/UNAIDS/WHO
Abstract: This document attempts to bring key issues on HIV/AIDS care in one practical and
489

concise publication. It is intended to provide guidance to all partners in the provision of HIV care
and support in resource-constrained settings. The purpose of this document is to identify the key
elements and interventions in provision of care and support for PLHA and affected communities.
Each element of care is discussed and references for more information on how this element of
care is discussed and references for more information on how this element should be
implemented are provided as much as possible. These references will be interactive for those
documents having an electronic file available in WHO or in UNAIDS Secretariat websites. These
references are practical publications useful for the implementation of the key elements of
HIV/AIDS care. This document also covers structural elements for service delivery. Finally, it
discusses prioritization of the various elements of HIV/AIDS care: these two sections are helpful
in the process of prioritization and implementation of HIV/AIDS care interventions listed in this
document.
Notes: 1 copy
Widdus, R. (1996). Who sets the global research agenda for biomedical science. In
M.J.a.T.D.J.M.Mann (Ed.), AIDS in the world II: global dimensions, social roots, and responses:
the global AIDS policy coalition. (pp. 202-203). New York, Oxford: Oxford University Press.
Ref ID: 382
Keywords: science/global research agenda
Abstract: Worldwide, when research agendas in biomedical science are set, the dominant
influence involves what can loosely be termed"economic" factors. Because research resources
are disproportionately available in the industrialized countries, their scientists and policymakers
set the research agendas. This is true in both the public and private sectors, although the driving
mechanisms differ. Even the small fraction of biomedical research funding allocated to HIV/AIDS
in developing countries goes primarily to research areas determined by industrialized countries.
This reality highlights the industrialized world's responsibility to ensure that the research agenda
will help people everywhere - and as soon as possible.
Notes: 1 copy
490

Wiess, E., Mantell, J. E., Adeokun, L., Delano, G. E., Jagha, T., & Isola, G. (2000).
Evaluating the feasibility of promoting dual protection in Nigerian family planting clinics. In (pp.
45).
Ref ID: 263
Keywords: clinic/condom/family/family planning/health/HIV
prevalence/intervention/Nigeria/prevention/sexual behaviour/training/women
Abstract: Issues: HIV/STI prevention has not been usually part of family planning (FP)
counselling due to the compartmentalisation of HIV, STI and FP services, the belief that FP
clients are at low risk, and the absence of a practical model of HIV/STI risk assessment and
prevention counselling. Thus, most FP clients are not given adequate information, motivation, or
the means for HIV/STI protection. Given the rapidly rising HIV prevalence among childbearing
age women in Nigeria, this is a serious challenge for reproductive health services.
Description: To evaluate the feasibility of integrating a dual protection (DP) intervention to
prevent both unwanted pregnancy and HIV/STIs, client-level and system-level modifications were
made in 6 PF clinics in Ibadan, Nigeria. Client -level modifications included the introduction of
structured DP counselling with a flip chart guide to help women evaluate their personal
vulnerability to HIV/STIs, select a DP approach, and develop skills to practice DP. System- level
changes included the training of clinical and managerial staff, integration of the female condom
with the existing the contraceptive method mix, use of newly- developed DP IEC materials, and
the incorporation of DP objectives into the clinics" reporting systems. Prior to intervention
implementation, clinic management site assessments of provider training were conducted. These
assessment will be repeated after 6 months of intervention experience to evaluate program
outcomes. DP acceptors will be followed up at 6 months to document their experience and
continued DP use.
Conclusions: Information from the project has demonstrated that it is feasible to integrate DP
within routine FP services. Providers have integrated the DP risk assessment and counselling
approach in their practice and managerial staff has been receptive to the required system
changes. Clients have reacted favorably to providers asking questions about their high-risk
491

sexual behaviour and to DP counselling. While baseline assessments indicated that clients'
knowledge of HIV/STIs and condom use were low, whether the intervention actually has a
positive impact on increasing clients' DP use has not yet been determined
Notes: 1 copy
Wilkins, H. A., Alonso, P., Baldeh, S., Chan, M. K., Corrah, T., Hughes, A. et al. (1989).
Knowledge of AIDS, use of condoms and results of counselling subjects with Asymptomatic HIV2
Infection in the Gambia. AIDS care, 1, 247-257.
Ref ID: 159
Keywords: condom/condoms/infection/The Gambia/women
Abstract: A questionnaire administered to subjects seen during a serological survey in the
Gambia revealed that knowledge of AIDS and HIV infection was limited. Males, those with a
secondary education and people who lived in urban areas had a better understanding but only
17% of women seen in rural areas had any knowledge of the condition. Only 8% of the subjects
seen had used condoms in the preceding 12 months; during this time half of them had done so
on less than five occasions. Subjects with a secondary education were more likely to have used
condoms. A counsellor met 31 asymptomatic seropositive subjects identified during this survey
on two occasions. In the majority, the information given caused anxiety rather than modification
of behaviour and, at the time of the second interview, only one subject had discussed the
situation with the partner and begun using condoms. Some of the cultural factors which may
affect the outcome of counselling in an African society are discussed in the light of these findings.
Notes: 1 copy
Wilkinson, D., Habgood, L. C., & Scrace, M. (1994). Paediatric HIV infection in a rural
Zululand hospital. South African Medical Journal, 84.
Ref ID: 181
Keywords: children/hospital/paediatric/seroprevalence/South Africa
Abstract: To the editor: The Natal/Kwazulu region has the highest seroprevalence of HIV
infection in South Africa. As part of local efforts to monitor the epidemic we are measuring HIV
492

seroprevalence in various groups . Since 15% of all patients who have tested HIV-positive in this
hospital over the last 5 years were young children. W are monitoring rates of infection in children
admitted to the paediatric ward.
Between 1 September 1992 and 31 July 1993, 1091 children were admitted to the paediatric
medical ward. Three hundred and four 17% were tested for HIV infection after pre-test
counselling of the mother or other care-giver, post or kwashiorkor were tested, as were most
children with severe, life-threatening pneumonia (assessed clinically). A less well-defined group
who had chronic diarrhoea, or whose failure to thrive(FTT) did not respond to conventional
therapy, or who had pneumonia and FTT, or whose mothers exhibited signs of HIV infection,
were also tested. Overall 55 of 304 (18%) tested HIV-positive; this gives a minimum figure of 55
of 1091( 5%, 95% confidence interval3,7-6,3) for all admissions. HIV-positive children were twice
as likely to be aged 1year or less as HIV - negative children. Stratified analysis of mortality for
age showed HIV-positive children to be almost 3 times as likely to die during their admission as
HIV-negative children (39%). A third of all HIV-positive children presented with an AIDS-defining
illness. Stratified analysis for age confirmed findings from a previous report that significantly
more marasmic children than children with kwashiorkor were HIV-positive.
Many symptoms and signs of HIV infection in children are nonspecific and may be seen in other
common childhood illnesses. An important characteristic is that they are often persistent or
recurrent. Weight loss or failure to thrive, chronic diarrhoea or severe pneumonia are all common
presentations. Hepatosplenomegaly, lymphadenopathy or oral candidiasis may also be seen. As
described here, infected children were more likely to be aged less than 1 year, commonly
presented with AIDS-defining illnesses and had very high mortality rates during admission.
These findings are reported to emphasise the need to consider HIV infection in children
presenting with severe or recurrent childhood illnesses. As the diagnosis is often the first
indication of maternal HIV infection, it also offers the opportunity for counselling, and possible
limitation of further spread of infection.
Notes: 1 copy
493

Wilkinson, D., Wilkinson, N., Lombard, C., Martin, D., Smith, A., Floyd, K. et al. (1997).
On-site HIV testing in resource-poor settings: is one rapid test enough? AIDS, 11, 377-381.
Ref ID: 157
Keywords: cost-effectiveness/evaluation/post-test/rapid tests
Abstract: This paper is to determine the feasibility, accuracy and cost-effectiveness of a rapid, on-
site, HIV testing strategy in a rural hospital, and to assess its impact on test turnaround time and
the proportion of patients post-test counselled. The design: prospective comparison of two
testing strategies and an economic evaluation. Setting: Hlabisa Hospital, a rural South African
district hospital. Patients: A total of 454 consecutive adult inpatients requiring and consenting to
HIV testing as part of their clinical management. Main outcome measures: Concordance
between rapid tests, and between the rapid and ELISA strategies, test turnaround time,
proportion of patients post-test counselled, and cost-effectiveness. Results: HIV seroprevalence
was 49.6%. Both rapid tests were concordant in all patients. The rapid strategy was 100%
sensitive and 99.6% specific compared with the ELISA strategy. The mean interval between
ordering a test and post-test counselling fell from 21 days prior to the introduction of the rapid test
strategy to 4.6 days after its introduction. The proportion of patients post-test counselled
increased to 96% from 17% after the introduction of the rapid test strategy. By using a double
rapid test strategy the cost per patient post-test counselled was almost halved to US$ 11.
Accuracy of the rapid strategy was not substantially increased by performing two tests. In
conclusion, in high prevalence, resource-poor settings, rapid, on-site HIV testing is feasible,
accurate and highly cost-effective, substantially increasing the number of patients post-test
counselled. A single rapid test may be sufficient.
Notes: 3 copies
Wilkinson, D. & Wilkinson, N. (2001). Acceptability of prenatal, voluntary HIV counselling
and testing and interventions to reduce mother-to-child transmission of HIV infection in rural
South Africa. South African Medical Journal, 91, 48-49.
Ref ID: 189
Keywords: acceptability/ARV/children/mother/MTCT/paediatric/prevention/transmission/voluntary
494

counselling and testing
Abstract: To the editor: The burden of paediatric HIV infection in sub-Saharan Africa is
substantial, which more than 90% of these infections caused by mother -to-child transmission
(MTCT). Recently, short and cheap courses of antiretroviral drugs that reduce MTCT have
emerged. However, little is known about the acceptability of HIV counselling and testing and
MTCT interventions in the prenatal setting. We aimed to explore the likely acceptability of HIV
testing and MTCT interventions in rural South Africa.
Notes: 2 copies
Willson M. and Sapa (2001). Protesters in "lie-in" at Parliament: Treatment Action
Campaign hands over memorandum at AIDS demonstration. Business day.
Ref ID: 1894
Keywords: Cape
Town/care/drugs/government/health/Johannesburg/medical/medicine/Parliament/policies/policy/p
olitical/protesters/treatment
Abstract: Cape Town: The treatment Action Campaign delivered a memorandum to Parliament
yesterday calling for the development of an HIV/AIDS treatment plan by June 16. HIV/AIDS
activist Zachie Achmat said: " we will be back on June on 16 and will take all necessary action
until we receive a satisfactory answer" He asked all protesters to lie down on the pavement
outside Parliament to symbolise the hundreds of HIV/AIDS sufferers dying every day due to lack
of affordable treatment in SA. The lobby group called for a reduction in military expenditure and
apartheid debt repayments, and for government and for government to redirect this expenditure
to health care infrastructure. Achmat said:" we must not waste money on arms, which is just
scrap metal, but should rather invest in the lives of all South Africans. " He said SA had a lacked
political will. Achmat made a special appeal to Democratic Alliance leader Tony Leon and all
other opposition parties to support government in litigation instigated by pharmaceutical
companies, as well as in policy on the treatment of HIV/AIDS. Led by Anglican Archibishop
Njongonjulu Ndungane, the group made its way through the streets of Cape Town to Parliament,
where Achmat delivered the memorandum to health portfolio chairman Abe Nkomo. The
495

memorandum called for among other things - Health Minister Manto Tshabala - Msimang to
accept the necessity and the responsibility of carrying out a a treatment plan based on generic
antiretroviral before June 16 this year. The march followed an interfaith service at St George's
Cathedral, where Ndungane called on pharmaceutical companies to lower the price of anti- AIDS
drugs or to issue licences for the production of generic drugs in a bid to fight the HIV/AIDS
pandemic. He said the pandemic would not be beaten until people could openly declare their
status without fear of reprisal, and receive medical at affordable prices. The lobby group said at
the service that it would urge government to take over a pharmaceutical factory in Midrand, north
of Johannesburg, to produce affordable anti-AIDS drugs. Achmat, the group's chairman said this
drive for the local manufacture of generic anti retroviral drugs would form the major part of its
2001 campaign. The owner of the plant, international pharmaceutical group Glaxo SmithKline,
plans to shut down the production line and convert it into a packaging facility by the end of 2003.
Ndungane said: "If the pharmaceutical companies fear that by drastically reducing the cost of
anti-HIV/AIDS drugs they lay themselves open to pressure to do this with all medicines, I would
urge them instead to contribute the sum of money they would lose towards our battle against
AIDS". After witnessing the demonstration, Nkomo said he would pass the memorandum on to
higher powers. Achmat replied that the action from government was not enough and that it did
not lack the resources, but rather the political will to step up the fight against the HIV/AIDS.
Notes: 1 copy
Wilson, C. & Stewin, L. L. (1993). The importance of levels of knowledge in developing a
unified theory for HIV/AIDS counselling: A comparison of two culturally different samples.
International Journal for the Advancement of Counselling, 16, 281-289.
Ref ID: 156
Keywords: culture/education/knowledge/model/prevention/theory
Abstract: This paper qualitatively compares the responses concerning knowledge about
HIV/AIDS prevention methods that were obtained from two cross-culturally different samples of
students who were of a sexually active age. Canadian and Zimbabwean education students were
sampled. The responses are presented and analyzed with the main purpose of placing the
496

findings in the context of Balmer's 1991) proposal of a unified theory for HIV/AIDS counselling.
The major focus of this paper is on HIV/AIDS infection prevention strategies. The differences in
responses across the two groups sampled suggest that it would be important to begin individual
and group-based prevention strategies with exploration of individual levels of knowledge. Finally,
implications for research are discussed.
Notes: 3 copies
Wilson, D. & Lavelle, S. (1993). AIDS prevention in South Africa. South African Medical
Journal, 83, 668-674.
Ref ID: 154
Keywords: Africa/prevention/South Africa
Abstract: We have many of the social and biological insights needed to control HIV. In many
countries, the opportunity to transform this knowledge into timeous, comprehensive policy and
programmes has already been lost. What is needed is total commitment, sweeping policy reform
and extensive programmes, not fragmented, descriptive studies or small scale projects innocent
of epidemiological insight. As Potts et al. note:" In the next few years, it is unlikely that any new
knowledge will emerge to change our understanding of how best to control HIV. Moreover,
knowledge that has been available for 5-6 years is still not being fully applied to policy setting and
programme design. This is the paramount lesson for South Africa: before all else, we must truly
apply what we already know. No group dare allow the constitutional agenda to eclipse AIDS-
thus adding South Africa to those countries who have lost opportunities that will never return.
Notes: 1 copy
Wilson, T., Levinson, R. A., Jaccard, J., Minkoff, H., & Endias, R. (1996). Testing for HIV
and other sexually Transmitted Diseases: Implications for risk behavior in women. Health
Psychology, 15, 252-260.
Ref ID: 350
Keywords: HIV testing
Abstract: A sample of 808 non pregnant women residing in an area of high prevalence of sexually
497

transmitted diseases (STDs) was studies with respect to sexual risk behaviors in the 4-month
period before and after testing for a series of STDs. All women were tested for both Chlamydia
trachomatis and Trichomonas vaginalis and were given the option of also taking a test for the HIV
antibody. Neither the experience of receiving a negative HIV test resulted in significant mean
changes in self-reports of STD or HIV susceptibility, condom use consistency, or number of
sexual partners during 4 months following testing. However, perceived susceptibility was found
to predict when women would decrease the consistency with which they used condoms as a
function of HIV testing.
Notes: 1 copy
Ref ID: 153
Windsor, J. M. (1993). Serological diagnosis of HIV infection. The Leech, 61, 6-8.
Keywords: diagnosis/positive status/post-test
Abstract: Contrary to popular understanding, there is no such thing as a test for AIDS. What
many mistakenly refer to as the "AIDS test" is in fact a test to determine whether or not an
individual has been infected by Human Immunodeficiency Virus(HIV). Once infected by HIV the
individual may then gradually develop an Acquired Immune Deficiency Syndrome (AIDS),
approximately 50% of infected persons taking 10-20 years to reach this stage. The erroneous
use of term"AIDS test" or describing someone as "testing positive for AIDS" therefore creates a
serious misinterpretation of that person's health status and may produce adverse psychological
and sociological effects. However, it is important that persons found to be HIV-positive are
informed during post-test counselling that this means that they are now latently infected with the
virus, may therefore develop AIDS at some future date, and must thenceforth consider
themselves to be potentially infectious to others via blood, sexual contact or, in the case of
women of child-bearing, by birth.
Notes: 3 copies
Wingood, G. M. & DiClemente, R. J. (1999). The use of psychosocial models for guiding
the Design and implementation of HIV prevention interventions: translating theory into practice.
498

In L.Gibney (Ed.), Preventing HIV in developing countries: biomedical and behavioral approaches
(pp. 187-203). New York: Plenum Press.
Ref ID: 396
Keywords: Developing countries/research/medical/drugs/impact/prevention/infection/HIV
prevention/intervention/gender/women
Abstract: Despite advances in biomedical research (e.g., the emergence of protease inhibitors as
an effective therapy), there is still no preventive vaccine or medical cure for HIV/AIDS. Further,
biomedical advances, such as new antiretroviral drugs, are not likely to have a marked impact in
many developing countries given their lack of availability and their prohibitive costs.
Consequently, prevention programs designed to decrease or eliminate HIV risk behaviors remain
the only available means to prevent HIV infection and reduce the burden of human suffering and
medical care and expenditures.
In this chapter we discuss the applicability of psychosocial and social structural theory for guiding
the design and implementation of HIV prevention interventions aimed at motivating individuals to
adopt and/or maintain HIV preventive practices. Initially, we will them familiarize the reader with
two theories, the social cognitive theory and the theory of gender and power. The social cognitive
theory is perhaps the most influential psychosocial theory guiding intervention design in many
parts of the world, while the theory of gender and power is a relatively new social structural theory
that holds considerable promise for interventions targeting women. To illustrated how theory can
be used in designing a prevention program, we present a case study, based on our own
research, demonstrating how these theories were used in developing an HIV prevention
Notes: 1 copy
Wittenberg, G. H. (1993). Counseling AIDS patients: Job as a paradigm. Journal of
theology for Southern Africa, 61-69.
Ref ID: 162
Keywords: church/patient care/religion/support
Abstract: The challenge of the AIDS pandemic has not yet been sufficiently realized by the
Church. As the diseases spreads and starts to disrupt communities it will increasingly become a
499

dominant issue for ministers who take their calling as counselors seriously. The basic
requirement for the counselor of AIDS patients is the recognition that the illness involves three
dimensions of suffering, the physical, the psychiatric and the social, which, taken together,
characterize it as a major calamity. There is first of all the physical side, the illness itself, which
for those tested HIV positive will perhaps not be immediately apparent but which will become
more important as the virus breaks down the immune system of the patient who needs to cope
with the awareness that there is no cure for the illness, that death is its sure goal. The third
dimension of suffering is social, the problem of rejection by family and friends, perhaps loss of job
and ostracism in society. A recognition that AIDS patients are hurting in all three dimensions is a
precondition for any deeper understanding of its problematic. What is the goal of counseling in
such situation? The counselor needs to mobilize the spiritual resources to enable the patients to
cope with their physical pain, to understand themselves and their suffering and to be liberated
from their social isolation in an atmosphere of acceptance. One of the most important tools of the
Christian counselor is the Bible. It tells the story of people in many different situations of suffering
and their experiences with God. It thus offers paradigms with which patients today can identify.
Notes: 1 copy
ATIC.
Wood, G. (1993). Counselling: First World luxury or third world necessity? ATIC. 1-8.
Ref Type: Organisational Publication
Ref ID: 148
Keywords: insurance/medical/model/post-test/pre-test
Abstract: Wood says since he joined ATICC, he has had to deal with numerous requests from
medical practitioners and insurance brokers to pick up the pieces of insensitive and failed
attempts to treat HIV as "as just another illness". Doctors who have "routinely tested for HIV "
without any pre-test counselling have assured me that their distressed patient will be coming to
see me for post-test support. Not one of these cases has turned up for their appointment at
ATICC. They are out there somewhere, disbelieving, shocked, unsupported and denying their
situation. Often such denial means deliberately not introducing changes in behaviour, for this
500

would be admitting vulnerability.
Notes: 1 copy
Ref ID: 316
Wood, G. (1993). Counselling, Insurance and the Battlefront. Positive outlook, -, 6.
Keywords: insurance/policies/pre-test
Abstract: There is a talk of one large insurance company attempting to meet a social
responsibility by requiring that the prospective insurance clients receive pre-test counselling when
going for the compulsory HIV test, prior to being accepted for life cover. Practical and financial
implications are currently being negotiated, but hopefully this will result in the first step toward
others paying more attention to the rights and needs of their prospective clients. Congratulations
to Metropolitan Life who have taken a decision to include AIDS under the illnesses they cover in
their life policy.
Notes: 1 copy
Wood, G. (1994). The role of psychology in the AIDS epidemic in South Africa:
Dissemination of skill or "Third world"cop-out? In ATIC (Ed.), (pp. 1-17). Paper presented at The
Psychology and Societal Transformation Conference, University of the Western Cape, January
1994: ATIC.
Ref ID: 149
Keywords: government/psychology
Abstract: Throughout the world the prevalence of HIV has increased in poorer and
underresourced communities which offer the path of least resistance. For this reason the virus
has become a form of social barometer, highlighting not only the social and economic imbalances
within societies, but also such imbalances between countries and national economies. The
heterosexual spread of the virus continues virtually unabated in the developing world, and
particularly in Sub-Saharan Africa, which is estimated to house million of the projects 13 million
HIV positive people globally. This paper provides an overview of the HIV/AIDS epidemic in South
Africa and the response of state and non-government organisations. The role of psychologists in
501

the epidemic in discussed from a critical viewpoint, and it argued that traditional cognitive theories
of preventive behaviour in health with apply to individual health problems are insufficient when
applied to the spread of HIV. A proposal is made for the adoption of a more social transformatory
approach by behavioural scientists, and the example of HIV test counselling is provided to moot
the point. Some tentative suggestions are provided in order to elicit further discussion about
these viewpoints.
Notes: 2 copies
Wood, G. (1994). Improving the quality of counselling through the standardisation of
counsellor training. AIDS Bulletin, 3, 11.
Ref ID: 152
Keywords: counsellor/counsellors/education/post-test/pre-test/quality of care/training
Abstract: Although the need for informed consent and pre-and post-test counselling is
recommended by the South African Medical and Dental council, standards of counselling in the
public and private sector vary considerably. Difficulties which currently limit adequate counselling
provision include a lack of adequate training, evaluation and ongoing support to counsellors. In
these settings, counselling is usually provided by primary health care workers as part of the
comprehensive care they offer to their patients. Notwithstanding this, the principles of respecting
the client, affording them choice, assuring their rights, and addressing their real mental and
physical vulnerabilities need to be respected. In doing so, counselling needs to be culturally
relevant and appropriate to the needs of the individuals in the communities served. This provides
a challenge to produce comprehensive and practically applicable training approaches for
prospective counsellors.
Notes: 1 copy
6-7.
Ref ID: 315
Wood, G. (1995). Confidentiality, secrecy and the disclosure debate. Positive outlook, 2,
Keywords: clinic/confidentiality/health/health worker/KwaZulu-Natal/NACOSA/policies
502

Abstract: With the immensely successful launch of the KwaZulu-Natal NACOSA Aids
implementation Plan in October, many dedicated people have been working hard to get the plan
off paper and into practise. The first part of the plan to be implemented was the presentation of
an HIV/AIDS Policy on Confidentiality, Testing and HIV infected Health care workers , which look
place at the launch. Although the policy was accepted, Dr Hackland, acting deputy director of
health in the Province, pointed out that the practical implementation of the policy in all hospitals
and clinics would be time-consuming. Although transgressions are going to be a reality early-on,
we hope to see it implemented as soon as possible.
Many people, particularly doctors who are responsible for treating infected people in rural areas,
feel that too much emphasis is placed on "secrecy" rather than confidentiality, and that this is
further stigmatising AIDS.
Notes: 1 copy
Ref ID: 420
Wood, G. (1995). HIV/AIDS counselling and primary Health care. Positive outlook, 2, 6-7.
Keywords: HIV/AIDS counselling/primary health care/South Africa
Abstract: This article raises the issue of the prevalence of widespread mental health problems in
developing countries. Studies completed in South Africa have confirmed that psychological and
emotional problems are common, especially in communities that have had little access to
adequate mental health care and education due to the imbalances of apartheid. Grossly under-
resources communities, economic hardship, poor and cramped living conditions, political and
social oppression, inadequate education, high unemployment, political violence, and an incredibly
high crime rate have taken their toll on individuals, traditional family systems and society as a
whole. Many individuals try to function with serious psychiatric and personality disorders, without
knowing how to recognise and act upon their distress, or having very few options available to
them if they do recognise symptoms of mental disorders or psychological problems.
Notes: 1 copy
503

Wood, R. (1992). Social work responses to AIDS: A programme for social work education
in South Africa. Social work, 28, 37-46.
Ref ID: 150
Keywords: education/social work/social workers/South Africa
Abstract: Human sexuality is an often neglected issue in social work curricula, largely because of
the emotive nature of human sexuality, differences in prevailing values and morality, and the
widespread ambivalence toward the recognition of sexual functioning in one for or another in
every person's life". Since the early 1970's, and particularly in the USA, various calls have been
made for schools of social work to address this lack, yet none of their pleas have been as
effective in introducing sexuality to social work curricula as the emergence of and devastating
consequences brought about by a tiny organism, the Human Immunodeficiency Virus.
Notes: 1 copy
2.
Ref ID: 151
Wood, R. (1996). HIV care and support at an HIV clinic in Cape Town. AIDS Bulletin, 5,
Keywords: clinic/patient care/quality of care/quality of life/resources/support
Abstract: `The HIV clinic at New Somerset Hospital was started by the Dr Frank Spracklen in
1984 and in 1990 a second sister clinic was started at Groote Schuur Hospital, Cape Town.
Patients numbers have continued to increase and have attained a cumulative total of over 1500
patients. The predominant transmission pattern has changed from homosexual to become
largely a heterosexual epidemic. The majority of patients are dependent on the provincial
authorities for their medical care with 56% of patients being unemployed and only 13% belonging
to a medical aid scheme. The Western Cape shares with other regions the challenge to
supplying medical care to an increasing HIV-infected population while the health care budget is
decreasing. The Western Cape also has specific problems resulting from the development of the
HIV epidemic in a population with the highest reported tuberculosis prevalence in the world.
Studies at the clinic have shown that measures of quality of life decline significantly early in the
course of HIV infection, before the onset to physical symptoms. Outpatient counselling services
504

have therefore been considered an important component of management. Counselling support
from the time of diagnosis is organised by a psychology lecturer, seconded from the University of
Cape Town, who supervises 3-4 final year clinical psychology student who spent 3 month
internships at the clinic
Notes: 2 copies
World Health Organisation. (1989). Developing strategies: channels of communication,
institutional networks, activities. WHO AIDS series [5], 37-46.
Ref Type: Organisational research report
Ref ID: 192
Keywords: communication/culture/family/health/information/strategy
Abstract: Channels of communication, institutional networks and programme activities are the
elements of a strategy designed networks and programme activities are the elements of a
strategy to reach and engage target audiences. The reasons for selecting particular channels,
networks, and activities are discussed below.
Channels of communication and institutional networks: Target audiences are more receptive to
some methods and sources of communication than to others. People generally have particular
institutional networks with which they are associated, such as school systems, religious
organizations, sports clubs, or bars, and favoured information sources that they use habitually,
such as radio stations, newspapers or, for health matters, family doctors. Try to identify which
particular channels and institutional networks can be used to reach specific target audiences.
Strategic planning includes determining which channels and institutions can be employed and in
what combination to reach target audiences best. Information on communication channels and
institutional networks should include the extent of their contact with the specific audiences.
Membership data are often available from organizations. Newspapers, radio and television
stations, marketing firms, and ministries of information often have detailed audience data,
including peak radio and television listening and viewing times.
Different channels of communication are generally believed to have particular strengths and
weaknesses, but simple generalization about what a channel can do best are often misleading:
505

they should be carefully weighed against the many other factors in the local culture and
environment. Most health promotion professionals prefer to use several channels in order to
reach a more extensive network than any single channel can provide.
Notes: 1 copy
World Health Organisation. (1990). What is counselling? Prevention of sexual
transmission of human immunodeficiency virus. [2], 10-22. Geneva, WHO AIDS. WHO AIDS
series 6.
Ref Type: Organisational Publication
Ref ID: 32
Keywords: guidelines/primary prevention/secondary prevention
Abstract: This chapter gives the answers to the question what is counselling, why is counselling
about HIV necessary. It gives also the main functions of counselling such as prevention, primary
prevention, secondary prevention. It also gives the requirements of counselling such essential
features of counselling, time, acceptance, Accessibility, consistency and accuracy, confidentiality,
etc.
Notes: 1 copy
World Health Organisation. (1990). Guidelines for counselling about HIV infection and
disease. WHO AIDS series -[8], 1-38.
Ref Type: Unpublished Work
Ref ID: 158
Keywords: health/health worker/infection/research/training
Abstract: The World Health Organisation places high priority on developing strategies to prevent
and control infection with the human immunodeficiency virus( HIV), in which information,
education and communication(IEC) play a fundamental role. Counselling is recognized as a vital
part of an overall IEC- based strategy, but work with over 160 Member States in support of
national programmes to combat acquired immunodeficiency syndrome has shown that this is a
relatively new concept in may parts of the world, especially when proposed as a routine service.
506

To facilitate the development of counselling services and to provide a standardized basis for
counselling, WHO has instituted a series of training and operational research activities. The
present guidelines have been prepared to provide counsellors, health care workers, and others
with a model for use in counselling people affected directly or indirectly by HIV infection and
AIDS. The guidelines describe the nature, role, and principles of counselling, the psychosocial
repercussions of HIV infection and associated disease, and special situations in which
counselling is called for. They should be adapted to the human and technical resources and,
particularly, the cultural traditions of the societies in which they are used.
Notes: 1 copy
World Health Organization (WHO). (1995). Counselling for HIV/AIDS: a key to caring: for
policy-makers, planners and implementers of counselling activities.
Ref Type: Unpublished Work
Ref ID: 561
Keywords: communication/education/guidelines/health/HIV/AIDS
counselling/information/policies/policy/training/WHO
Abstract: These guidelines are intended to provide policy-makers and planners working in health
and social service organizations with information to enable them to develop policies that will
stimulate, encourage and support the development of appropriate HIV/AIDS counselling services
and plan for this service.
This document presents general policy issues in the area of HIV/AIDS counselling. The aim is to
encourage countries to develop programme-linked policies and operational guidance for the
provision of counselling. It is not intended to give detailed guidance on how to set up and
manage HIV/AIDS counselling services or how to design, implement and evaluate training,
education or communication programmes. Such guidance is available in other GPA material
referenced in the appropriate sections of publication.
The guidelines are intended to reflect experiences and insights that have been gained in the field
of HIV/AIDS counselling since the first version of WHO AIDS Series 8 was published in 1990. As
countries develop their counselling services, new ideas and experience will in turn guide the
507

further refinement of services and revision of policies
Notes: 1 copy
Yacoob, A., Pillay, C., & Air, Y. (1998). report on evaluation of the effectiveness and
impact of ATICC's counselling and mentorship programme in KwaZulu-Natal.
Ref Type: Unpublished Work
Ref ID: 488
Keywords: evaluation/impact/ATICC/KwaZulu-Natal
Abstract: This report deals with the evaluation of ATICC's counselling and mentorship programme
in KwaZulu-Natal.
Notes: 1 copy
Ref ID: 301
Zoysa, I. (2000). Prevention squarely on the agenda. AIDS Bulletin, -, 30-33.
Keywords: HIV prevention/HIV transmission/South Africa
Abstract: We have heard many reports of the changing face of the epidemic in many countries of
the affluent North. HAART continues to impact disease progression and mortality in settings
where it is available to people living with HIV/AIDS (PLWHA). Some have even suggested that
the use of HAART may have an impact in reducing HIV transmission at the population level,
because of its effect in reducing HIV viral load in semen and vaginal secretions. Despite this
hope, there is evidence of an upturn in HIV transmission at the population level because of its
effect in reducing HIV viral load in semen and vaginal secretions. Despite this hope, there is
evidence of an upturn in HIV transmission in some areas of the North particularly among
vulnerable groups such as young men who have sex with men, IDUS and women of colour.
It is clear that even in the North access to both HIV prevention and treatment services is not
uniform. In the south there are many epidemics. Some have stabilised while others are still
expanding. We are witnessing the unfolding of potentially devastating epidemics in South Africa
and other countries in this region.
Explanations for the diversity and unpredictability of the HIV pandemic still elude us. There have
508

een many discussions here about sexual behaviour risk patterns, gender - power dynamics,
manifested, for example, in age differences between partners, and other factors that may help us
comprehend where we are going. Other factors that are undoubtedly important, such as social
disruption, migration, and other structural factors, may offer some answers but are more difficult
to investigate.
Notes: 1 copy
Ref ID: 236
Zulu, F. (2000). Counselling: an effective strategy in HIV/AIDS prevention. In (pp. 1).
Keywords: intervention/prevention/response/Zambia
Abstract: Issues: Counselling has emerged as an effective intervention strategy in addressing the
HIV/AIDS epidemic in Zambia with now an estimated 20% of its population infected with the
disease. Many organisations involved in HIV/AIDS prevention have incorporated counselling
activities to educate and support infected and affected people. Yet, despite the availability of
institutional counselling services, the problem of HIV/AIDS continues to grow.
Currently, counselling services have been mainly restricted to institutional settings as opposed to
extending the service to people's home within the community. This has led to many people
avoiding attending counselling sessions at counselling at counselling centres in view of the
stigma and cultural factors associated with HIV/AIDS. However, it is only when in desparate
situations do people approach counselling centres.
Description: This paper will discuss counselling strategies used in the University Teaching
Hospital in Lusaka, Zambia and provide an analysis of community response to this service. It will
be based on personal experiences as an HIV/AIDS counsellor both in the hospital and the
community.
Conclusion: The proliferation of counselling centres in Zambia is evidence of the important role
counselling plays in HIV/AIDS prevention. This paper will explore counselling strategies used in
the hospital, and will underscore the need to shift emphasis from institutional -based counselling
to a home-based intervention strategy.
Notes: 1 copy
509

Ref ID: 160
Zuma, B. (1996). Cross-cultural counselling. Positive outlook, 3, 25.
Keywords: counsellor/counsellors/Cross-cultural counselling/culture/South Africa
Abstract: In South Africa there have been a lot of changes, and a lot more change is still expected
in socio-economic and political spheres. This has an impacted tremendously on culture, which
can be defined as being a continuum from traditional to modern, and vice-versa. Cross-cultural
counselling is a relationship between a counsellor and client who are from different cultural
backgrounds. Culture is a particular way of life discovered and developed by a group, community
or society in order to reach internal and external harmony. In cross-cultural counselling the
culturally -different counsellor needs to do his or her utmost to regard issues, experiences and
what are appropriate coping mechanisms for the client's perspective. I believe that counselling
needs to encompass cultural elements in order to facilitate an effective therapeutic encounter.
Counselling can be regarded as a client-centered approach where clients and their partners are
the focus of the relationship. The emphasis seems to be on the relationship between the client
and counsellor, hence it is important for them to fully appreciate and understand each others
issues and culture. This is even more important in our AIDS counselling context at its simplest
level.
Notes: 1 copy
510