Browsing School of Public Health by Subject "Positive prevention"

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Between HIV diagnosis and initiation of antiretroviral therapy: Assessing the effectiveness of care for people living with HIV in the public primary care service in Cape Town, South Africa

Scott, Vera; Zweigenthal, Virginia; Jennings, Karen (Wiley-Blackwell, 2011)

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Abstract:

BACKGROUND: While much is written about the scale up of HIV counselling and testing (HCT) and antiretroviral therapy (ART), little research has been done on the expansion of routine preART HIV care. OBJECTIVE: To assess the quality of preART care in Cape Town and its continuity with HCT and ART. METHODS: The scale up of the HCT, preART and ART service platform and programmatic support in Cape Town is described. Data from the August 2010 routine annual HIV/TB/STI evaluation, from interviews with 133 facility managers and a folder review of 634 HCT s who tested positive and 1115 clients receiving preART HIV care are analysed. RESULTS: Historically the implementation and management of preART care has been relatively neglected compared with the scale-up of HCT and ART. The CD4 count was done on 77.5% positive HCT clients and 46.6% were clinically staged - crucial steps that determine the care path. There were: gaps in quality of care - 32.2% of women had a PAP smear; missed opportunities for integrated care - 67% were symptomatically screened for tuberculosis; and positive prevention - 48.3% had contraceptive needs assessed. Breaks in the continuity of care of preART clients occurred with only 47.2% of eligible clients referred appropriately to the ARV service. CONCLUSION: While a package of preART care has been clearly defined in Cape Town, it has not been fully implemented. There are weaknesses in the continuity and quality service delivered that undermine the programme objectives of provision of positive prevention and timeous access to ART.

URI:

http://hdl.handle.net/10566/261

Files in this item: 2

Scott_2011_HIV and VCT.pdf (156.2Kb)

ScottPreART2011.pdf (5.794Mb)

An exploration into the determinants of noncommunicable diseases among rural-to-urban migrants in periurban South Africa

Stern, Ruth; Puoane, Thandi; Tsolekile, Lungiswa (Centers for Disease Control and Prevention, 2010)

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Abstract:

Introduction Noncommunicable diseases are increasing in developing countries, exacerbated by growing urbanization. We examined the experiences and perceptions about noncommunicable diseases of people who migrated from rural areas to urban Cape Town, South Africa. Methods We conducted a qualitative study in an impoverished periurban township that has a noncommunicable disease prevention program, including health clubs. We used in-depth interviews, participatory reflection and action groups, and focus group discussions. Results Participants described changes in eating patterns and levels of physical activity. These changes were a result of socioeconomic and environmental constraints. However, respondents were not concerned about these changes. Despite hardships, they were pleased with their urban lifestyle. Furthermore, they approved of their weight gain because it signified dignity and respect. Participants who attended health clubs found them informative and socially and emotionally supportive. Conclusion The study highlighted the complexity of the risk factors for noncommunicable diseases and the need to develop prevention strategies that extend beyond the traditional focus on diet and exercise.

URI:

http://hdl.handle.net/10566/292

Files in this item: 1

PuoaneExplorationNCD2010.pdf (381.1Kb)

The Feasibility of implementing a sexual risk reduction intervention in routine clinical practice at an ARV clinic in Cape Town: a case study

Dewing, Sarah; Matthews, Catherine; Schaay, Nikki; Cloete, Allanise; Simbayi, Leickness; Chopra, Mickey (Springer, 2011)

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Abstract:

This case study with one lay adherence counsellor assessed the implementation of Options for Health, a sexual risk-reduction intervention based on Motivational Interviewing (MI), in an antiretroviral clinic in Cape Town, South Africa. In most cases Options was not delivered with fidelity and less than one-third of intended recipients received it; the counsellor often forgot to do Options, was unsure how to deal with particular cases and felt that there was not always time to do Options. Options was not implemented in a way that was consistent with MI. Revisions to the implementation plan and training programme are required.

URI:

http://hdl.handle.net/10566/473

Files in this item: 1

DewingAntiretroviralClinic2011.pdf (162.5Kb)

Impact of the HIV/AIDS pandemic on non-communicable disease prevention

Puoane, Thandi; Hughes, Gail (South African Medical Association, 2005)

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Abstract:

HIV/AIDS continues to ravage sub-Saharan Africa, and in South Africa accounts for 30% of all mortality, making it the leading cause of death. The epidemic has had other negative effects, which have not been fully realised. Among these is the fact that, paradoxically, the awareness programmes implemented to prevent major spread of HIV/AIDS have complicated the prevention of non-communicable diseases (NCDs).

URI:

http://hdl.handle.net/10566/283

Files in this item: 1

HIV and NCDs m_samj_v95_n4_a6.pdf (219.2Kb)

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Browsing School of Public Health by Subject "Positive prevention"

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