Browsing by Author "Cloete, Allanise"

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    The Feasibility of implementing a sexual risk reduction intervention in routine clinical practice at an ARV clinic in Cape Town: a case study
    (Springer, 2011) Dewing, Sarah; Mathews, Catherine; Schaay, Nikki; Cloete, Allanise; Simbayi, Leickness; Chopra, Mickey
    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.
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    From research to practice: Lay adherence counsellors' fidelity to an evidence-based intervention for promoting adherence to antiretroviral treatment in the Western Cape, South Africa
    (Springer Verlag, 2013) Dewing, Sarah; Mathews, Catherine; Cloete, Allanise; Schaay, Nikki; Shah, Madhvi; Simbayi, Leickness; Louw, Johann
    In the Western Cape, lay counsellors are tasked with supporting antiretroviral (ARV) adherence in public healthcare clinics. Thirty-nine counsellors in 21 Cape Town clinics were trained in Options for Health (Options), an evidence-based intervention based on motivational interviewing (MI). We evaluated counsellors’ ability to deliver Options for addressing poor adherence following 5 days training. Audio-recordings of counselling sessions collected following training were transcribed and translated into English. Thirty-five transcripts of sessions conducted by 35 counsellors were analysed for fidelity to the Options protocol, and using the Motivational Interviewing Treatment and Integrity (MITI) code. Counsellors struggled with some of the strategies associated with MI, such as assessing readiness-to-change and facilitating change talk. Overall, counsellors failed to achieve proficiency in the approach of MI according to the MITI. Counsellors were able to negotiate realistic plans for addressing patients’ barriers to adherence. Further efforts aimed at strengthening the ARV adherence counselling programme are needed.
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    "It's important to take your medication everyday okay?" An evaluation of counselling by lay counsellors for ARV adherence support in the Western Cape, South Africa
    (Springer, 2013) Dewing, Sarah; Mathews, Catherine; Schaay, Nikki; Cloete, Allanise; Simbayi, Leickness; Louw, Johann
    There is growing interest in standard care programmes for antiretroviral (ARV) adherence support. In South Africa, individual counselling following ARV initiation is a main strategy for supporting adherence in the public sector. Egan’s client-centred ‘‘Skilled Helper’’ counselling model is the predominant model used in HIV counselling in this context. This study evaluated counselling delivered by lay ARV adherence counsellors in Cape Town in terms of adherence to Egan’s model. Thirty-eight transcripts of counselling sessions with non-adherent patients were analysed based on the methods of content analysis. These sessions were conducted by 30 counsellors. Generally counsellors’ practice adhered neither to Egan’s model nor a client-centred approach. Inconsistent with evidence-based approaches to counselling for ARV adherence support, counsellors mainly used informationgiving and advice as strategies for addressing clients’ nonadherence. Recommendations for improving practice are made. The question as to how appropriate strategies from developed countries are for this setting is also raised.
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    The invention of moffie life in Cape Town, South Africa
    (University of the Western Cape, 2018) Cloete, Allanise; Becker, Heike
    This dissertation is an ethnography of the figure of the moffie as a performance of same sex desire amongst gender non-conforming men, as it is celebrated in the 'coloured' ('coloured' is a constructed racial category, similar to 'white' and 'black' designated onto South Africans during the system of legislated racial segregation) townships of Cape Town. In this dissertation I demonstrate that the moffie is central to the lives of gender non-conforming men living in the 'coloured' townships of Cape Town. Through historical and contemporary ethnography, I show how moffie life is a representation of same sex desire amongst men that is highly visible. I reveal how moffie life is socially sanctioned through feminine self-styling, embodied through that of the gay hairdresser, annual gay beauty pageant competitions and Gay Pride events.
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    "Things were better then": an ethnographic study of the violence of everyday life and remembrance of older people in the community of Belhar"
    (University of the Western Cape, 2005) Cloete, Allanise; Nadasen, Krishnavelli; Faculty of Arts
    This minithesis provides an ethnographic account of the life world of older people in the community of Belhar in the Cape Peninsula, which was historically categorised as a 'coloured' community during the implementation of the Group Areas Act. By content analysing newspaper articles published in the early 1980s and specifically during the implementation of the Group Areas Act I found that many of the residents reported that they lived in fear of their lives, in what was once known as a 'prestige suburb'. At the present time the community of Belhar is an intensely gang-infested area. From preliminary research done by myself at a senior citizen centre in Belhar, the high incidence of violence was a recurring theme throughout discussions with older people. In fact when I posed the question Why do you come to the centre five days a week? to a group of older people they answered without hesitation It is unsafe for an older person to be alone during the day. Answers like these to many of the questions that I posed would almost always be followed with Things were better then. It also was apparent that the older people in this community remember (or perhaps reconstruct) the past in the context of their present living situation. This became the leading theme in my study and is also the background against which I had formulated my research questions. However this study not only focused on the impact of the high incidence of violence on the community of older people but also essentially looked at elderly residents; everyday lived experiences in Belhar. The research sample consisted of twenty elderly residents and four key informants. The latter provided mainly infrastructural data on the community. Primary data was collected by using ethnographic techniques of inquiry which included participant observation and unstructured interviews. Results revealed that older people occupy a liminal space both in the community and in their households. I also found that the elderly stroke victim is twice silenced and marginalized due to the constraints brought on by their chronic illness and their status as an older person in the community.