Assessing health-related knowledge, attitudes and behaviours of HIV-positive Africans accessing services in Gugulethu Township, Cape Town

Zinto, Mantombi Doreen (2005-12)

Assignment (MPhil)--Stellenbosch University, 2005.

Thesis

ENGLISH ABSTRACT: HIV prevalence in the Western Cape, traditionally the lowest in South Africa, has jumped to higher than 10 percent for the first time – from 8,6 percent in 2001 to 12,4 percent in 2004. However, the statistic is not totally unexpected, considering the pandemic in the province is running five or six years behind the rest of the country. The figure comes from the 2002 national HIV antenatal survey. The Western Cape may continue to record the lowest rate in South Africa, but prevalence is obviously climbing fast. In addition, 19 of the 25 health districts in the Western Cape had recorded increases in the HIV rate (Department of Health, Western Cape). Syphilis rates in this province however, continued to drop, from 2,9 percent of pregnant women surveyed in 2001, to two percent in the most recent figures. Extrapolations based on a model developed by the national health department estimate that 5,3 million South Africans were HIV positive at the end of last year – up from 4,74 million in 2001. It is estimated that last year 2,95 million women between the ages of 15 and 49, and 2,3 million men in the same age group, were infected with HIV. Nearly 100 000 babies became infected too, via mother-to-child transmission. In her preface to the report, national health minister The Hannan Crusaid ARV Treatment Centre is the result of a partnership between the Western Cape government and UK-based HIV/Aids fundraising organisation Crusaid (Department of Health, 2004). The facility is rendering services such as counseling and the supply of the ARV treatment to the people of Gugulethu and surrounding communities. Approximately 38 000 of Gugulethu's 340 000 population could be HIV-positive. The provincial government donated R3,2-million towards building the site, while Crusaid invested R5,6-million (Department of Health, Western Cape: 2004). Various services run by the statutory and voluntary sector have been set up to help meet the increasing demand for HIV related support and care amongst this population. However, there is relatively limited data on HIV-related knowledge, sexual attitudes and practices amongst Africans living with HIV in the township. Similarly, their access to HIV-related services within the district remains relatively undocumented. The aims of this project were to collect preliminary data regarding HIV related knowledge, attitudes and practices (KAP) amongst HIV positive Africans accessing services in Gugulethu Township. To assess the feasibility of collecting KAP data amongst this population, qualitative and quantitative methods were used in a synergistic fashion, allowing a methodology to emerge in line with the real lives of HIV positive African residents and providers in the district. The methodology was closely linked to user-consultation with HIV-positive Africans who played a key role in defining and developing the research questions and the eventual survey tool.

AFRIKAANSE OPSOMMING: Die voorkoms van MIV in die Wes-Kaap, tradisioneel die laagste in Suid-Afrika, het vir die eerste keer gestyg tot hoër as 10 persent – van 8,6 persent in 2001 tot 12,4 persent in 2004. Hierdie statistiek is nietemin nie total onverwags nie, aangesien die pandemie in die provinsie se ontwikkeling vyf of ses jaar agter die res van die land is. Hierdie syfer kom van die 2002 nasionale MIV opname van swanger vroue. Die Wes-Kaap mag wel die laagste koers in Suid-Afrika bly opteken, maar die voorkoms van MIV klim klaarblyklik vinnig. Boonop het 19 van die 25 gesondheidsdistrikte in die Wes-Kaap ‘n toename in MIV koerse vermeld (Departement van Gesondheid, Wes-Kaap). Sifilis koerse in hierdie provinsie het egter bly afneem, van 2,9 persent van swanger vroue in ’n 2001 opname, tot 2 persent volgens die mees onlangse syfers. Ekstrapolasies gebaseer op ’n model ontwikkel deur die nasionale gesondheidsdepartement beraam dat 5,3 miljoen Suid-Afrikanes teen die einde van verlede jaar MIV-positief was – ’n styging van 4,74 miljoen in 2001. Dit word beraam dat 2,95 miljoen vroue tussen die ouderdomme van 15 en 49, en 2, 3 miljoen mans in dieselfde ouderdomsgroep, verlede jaar met MIV besmet is. Min of meer 100 000 babas is ook via moeder-tot-kind transmissie besmet. Die Hannan Crusaid ARV Behandlings Sentrum is die uitslag van ’n vennootskap tussen die Wes-Kaapse regering en VK-gebaseerde MIV/VIGS fondsinsamelings organisasie. (Departement van Gesondheid, 2004). Hierdie fasilitiet lewer diense soos berading en die lewering van ARV behandeling aan die mense van Gugulethu en die nabygeleë gemeenskappe. Ongeveer 38 000 van Gugulethu se 340 000 inwoners kan MIV-positief. Die provinsiale regering het R3.2-miljoen geskenk vir die bou van die perseel, terwyl Crusaid R5.6-miljoen belê het (Departement van Gesondheid, Wes-Kaap: 2004). Verskeie diense, wat deur die statutêre en voluntêre serktore bestuur word, is aan die gang gesit om die groeiende vraag vir MIV-verwante steun en sorg onder hierdie mense to voorsien. Nogtans, daar is relatief beperkte data oor MIV-verwante kennis, seksueke houdings and praktyke onder Swart inwoners met MIV in die nedersetting. Insgelyks, hul toegang tot MIV-verwant dienste in die distrik bly relatief ongedokumenteer. Die doelwitte van hierdie projek was om preliminêre data te versamel met betrekking tot MIV-verwante kennis, houdings en praktyke (KAP) onder MIV-positiewe Swart inwoners wat diense in Gugulethu gebruik. Om die uitvoorbaarheid van die versameling van KAP data onder hierdie inwoners te skat is kwalitatiewe en kwantitatiewe metodes synergisties gebruik, om ’n metodologie te laat ontstaan wat in lyn is met die aktuele lewens van HIV-positiewe Swart inwoners en besorgers in die distrik. Die metodologie was nou gekoppel aan gebruikers-konsultasie met MIV-positiewe Swart inwoners wie ’n sleutelrol gespeel het in die definieering en ontwikkeling van die navorsingsvrae en eventuele opname gereedskap.

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