Programming for HIV prevention in South African schools: A report on program implementation

An evaluation study conducted in KwaZulu Natal, South Africa, provides important insights into whether learners who participated in a fact-based, interactive course had more knowledge about HIV risks, prevention, and care practices; more positive attitudes toward prevention practices and people living with HIV and AIDS; and a higher prevalence of reported safe behaviors than comparable learners who did not participate in the course. Results show that the Life Skills Grade 9 Curriculum had a positive impact of students’ knowledge of HIV/AIDS, attitudes about abstinence, and intention to use condoms. There was, however, no evidence of increased adoption of such protective behaviors as abstinence and condom use. Teachers’ skills, comfort level, and effectiveness are likely to improve with experience. A number of recommendations emerged from the study that aim to improve teacher preparation and support as well as the overall program

Pilot community-based intervention to address the needs of elderly caregivers in the Eastern Cape Province, South Africa

The HIV epidemic in South Africa has placed a substantial burden on elderly caregivers, mainly women, who are often tasked with caring for their grandchildren who are orphaned and rendered vulnerable by the death or illness of their parents. The Medical Research Council (MRC), Age-in-Action, and the Horizons Program conducted formative research, as described in this research summary, to assess the needs of elderly caregivers in the Eastern Cape Province of South Africa in 2005. The investigations revealed that elderly caregivers faced a number of challenges including difficulty communicating with youth, fears and a sense of hopelessness around matters regarding youth, barriers to accessing health care, insufficient funds to cover basic needs, and difficulty accessing social service grants. Based on these findings, Horizons, MRC, and Age-in-Action developed an intervention study to explore and test whether a health education program would effectively lead to: 1) Improved care and support provided by elderly caregivers; 2) Improved psychosocial outcomes for the caregivers themselves; and 3) Increased capacity on the part of health service providers to enhance the care they provide to the elderly

Reducing HIV infection among youth: What can schools do? Key baseline findings from Mexico, South Africa, and Thailand

Although many program planners see schools as a convenient location for HIV-prevention programs, there is controversy about whether school programs can ever be strong enough to go beyond improving knowledge and attitudes to increasing the adoption of safe sexual behaviors. Evaluations of school programs in Mexico, South Africa, and Thailand focus on this question: Can school HIV programs change behavior? In each country, local organizations have worked with educators on teacher training and course design to ensure high-quality school interventions. Researchers surveyed students’ knowledge, attitudes, norms, and reported behavior before the intervention, immediately after the intervention, and again several months later to measure retention of program effects. In all three sites comparable control groups are compared to the intervention group. The mean age and age ranges for the three study groups are: 16 years and 13–23 for the Mexican study group; 15 years and 8 months and ages 12–21 for the South African study group; and 20 years and ages 17–31 for the Thai study group. This report is a summary of key baseline findings from these studies

The Impact of a Community-based Pilot Health Education Intervention for Older People as Caregivers of Orphaned and Sick Children as a Result of HIV and AIDS in South Africa

The increasing HIV and AIDS epidemic in South Africa poses a substantial burden to older people, in particular older women who mainly provide care for sick adult children and their grandchildren who have become orphaned and rendered vulnerable by the death or illness of their parents. In this study, 202 isiXhosa speaking older caregivers from Motherwell in the Eastern Cape Province of South Africa were trained to provide care for grandchildren and adult children living with HIV or AIDS. Based on a community needs assessment, a health education intervention comprising four modules was designed to improve skills and knowledge which would be used to assist older people in their care-giving tasks. Some topics were HIV and AIDS knowledge, effective intergenerational communication, providing home-based basic nursing care, accessing social services and grants, and relaxation techniques. Structured one-on-one interviews measured differences between pre-intervention and post-intervention scores among those who attended all four modules vs. those that missed one or more of the sessions. The results demonstrated that older people who participated in all four workshops perceived themselves more able and in control to provide nursing care. The participants also showed a more positive attitude towards people living with HIV or AIDS and reported an increased level of HIV and AIDS knowledge. The results provided valuable information upon which the development of future interventions may be based and psychosocial and structural needs of the older caregivers may be addressed by relevant stakeholders

Programming for HIV prevention in South African schools

As national education programs incorporate HIV prevention into school curricula, policymakers and educators need to know what they can expect from these initiatives. Can such courses influence the behavior of students as well as their knowledge and attitudes? If not, what can these courses reasonably be expected to accomplish, and what part can they play in overall HIV programming for youth? To help answer these questions, the Medical Research Council of South Africa and the Horizons Program studied the Life Skills Grade 9 Curriculum, a school-based HIV/AIDS initiative, as it was introduced in the Pietermaritzburg region of KwaZulu Natal Province in 2001. The 16-hour Grade 9 Curriculum is taught at least once a week over two school terms as part of the Life Orientation subject. The national and provincial South African departments of education, health, and social welfare collaborated on the curriculum design, teacher training, and course introduction. Horizons assessed the life skills program in KwaZulu Natal using both a population-based survey and an evaluation of the course curriculum. This brief focuses on the impact of the curriculum that was being introduced to ninth-grade students

Explaining perceived ability among older people to provide care as a result of HIV and AIDS in South Africa

In South Africa, older people have become the primary caregivers of children and grandchildren infected or affected by HIV and AIDS. This study explores the determinants of the perceived ability to care for children and grandchildren in the domains of providing nursing care, communicating with (grand) children, generating income and to relax. Structured one-on-one interviews were conducted among 409 isiXhosa speaking older people in two sites in the Eastern Cape Province of South Africa. Results showed that perceived ability among older people to provide nursing care was primarily dependent on the level of knowledge on accessing grants and personal norm towards providing care. Perceived ability to communicate effectively with children and grandchildren was most strongly predicted by a positive attitude towards communication and perceived ability to provide income was influenced by a more negative attitude towards people living with HIV or AIDS. Perceived ability to relax was dependent on more negative attitudes towards communication, lower perceived responsibility to provide income and a higher perceived behaviour control over providing nursing care. The findings of this study add relevant information to understanding the psychosocial context in which older people provide HIV and AIDS related care and support the development of targeted programmes to assist older people in their role as caregiver

Correlates of grief among older adults caring for children and grandchildren as a consequence of HIV and AIDS in South Africa

Objectives: Over the past few years, older people have become the main caregivers for their sick adult children and orphaned grandchildren due to HIV/AIDS in South Africa. This article aims to investigate the scope of care provided by older people, with a specific focus on the experience of grief due to multiple losses and its correlates. Methods: Quantitative interviews were conducted among 820 isiXhosa speaking caregivers of 60 years and older in the Eastern Cape of South Africa. Results: Older persons are involved in a wide range of care activities with several dependents to care for. Grief among older adults is most strongly predicted by perceived stigma around HIV and AIDS and worries about providing the care. Discussion: This study provides insight into correlates of grief among older caregivers and results in useful information to inform the development of interventions to assist older persons in coping with their responsibilities as caregivers