UWCScholar :: Browsing by Author "Simbayi, Leickness"

Browsing by Author "Simbayi, Leickness"

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Collective efficacy and HIV Prevention in South African Townships
(National Institute of Health, 2013) Cain, Demetria; Pitpitan, Eileen V.; Mwaba, Kelvin; Eaton, Lisa; Carey, Kate B.; Carey, Michael P.; Mehlomakulu, Vuyelwa; Harel, Ofer; Simbayi, Leickness; Kalichman, Seth C.
South African townships have high HIV prevalence and a strong need for collective action to change normative sexual risk behaviors. This study investigated the relationship between perceptions of individuals about collective efficacy in the community’s ability to prevent HIV and their personal HIV risk behaviors. Men (n=1581) and women (n=718) completed anonymous surveys within four Black African Townships in Cape Town, South Africa from June 2008 to December 2010. Measures included demographics, alcohol use, attitudinal and behavioral norms, sexual health communications, and sexual risk behaviors. In multivariate logistic regressions, men were more likely to endorse collective efficacy if they were married, drank less often in alcohol serving establishments, believed that fewer men approve of HIV risk behaviors, talk more with others about HIV/AIDS, and had more sex partners in the past month. Women were more likely to endorse collective efficacy if they drank alcohol less often, talked more with others about HIV/ AIDS, had more sex partners in the past month, but reported fewer unprotected sex acts in the past month. Community level interventions that strengthen collective efficacy beliefs will have to consider both protective and risk behaviors associated with believing that the community is ready and capable of preventing HIV.
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.
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.
Health care-seeking behaviour for sexually transmitted infections in South Africa
(University of the Western Cape, 2003) Jooste, Sean Edwin; Simbayi, Leickness
The main aim of this study was to investigate the health care-seeking behaviour of patients who were diagnosed at primary health care clinics having a sexually transmitted infection (STI). It further aimed to discover whether any significant differences exist between rural and urban populations and between males and females in their health care-seeking behaviour. The study made use of an existing database. The methodology used in this study is referred to as secondary analysis. The data used in this study was obtained from 126 semi-structured interviews conducted with STI patients at 24 chronics, in all nine provinces. In addition, in-depth interviews were conducted with 28 STI patients. This sample consisted of 20 females and eight males. Interviews were unstructured and were aimed at discovering patients' perceptions, experiences and health care-seeking behaviour relating to STIs. All 126 participants were found to be symptomatic when they presented at the clinic sites. The most popular reason given for attending the clinic sites was convenience. Most participants reported that they waited less than 7 days before they presented at the clinic sites. No significant differences were associated with delay in health care-seeking. Most participants had negative emotions regarding their illness. Few participants engaged in alternative treatment strategies. Some of the 28 STI patients who received in-depth interviews stated that they would not reveal their STI status for fear of the stigma associated with the disease. Use of alternate remedies and treatment options of were mentioned. The concern of persuading partners to seek treatment was also highlighted. The implications of these findings for improving the management of sexually transmitted diseases and reducing the spread of the disease are discussed.
The HIV epidemic in South Africa: Key findings from 2017 national population-based survey
(MDPI, 2022) Zuma, Khangelani; Simbayi, Leickness; Igumbor, Ehimario
South Africa has the largest number of people living with HIV worldwide. South Africa has implemented five population-based HIV prevalence surveys since 2002 aimed at understanding the dynamics and the trends of the epidemic. This paper presents key findings from the fifth HIV prevalence, incidence, and behaviour survey conducted in 2017 following policy, programme, and epidemic change since the prior survey was conducted in 2012. A cross-sectional populationbased household survey collected behavioural and biomedical data on all members of the eligible households. A total of 39,132 respondents from 11,776 households were eligible to participate, of whom 93.6% agreed to be interviewed, and 61.1% provided blood specimens. The provided blood specimens were used to determine HIV status, HIV incidence, viral load, exposure to antiretroviral treatment, and HIV drug resistance. Overall HIV incidence among persons aged 2 years and above was 0.48% which translates to an estimated 231,000 new infections in 2017.
"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.
Predictors of knowledge about tuberculosis: results from SANHANES I, a national, cross-sectional household survey in South Africa
(BioMed Central, 2016) Naidoo, Pamela; Simbayi, Leickness; Labadarios, Demetre; Ntsepe, Yoliswa; Bikitsha, Nwabisa; Khan, Gadija; Sewpaul, Ronel; Moyo, Sizulu; Rehle, Thomas
BACKGROUND: South Africa is one of the 22 high tuberculosis burden countries that contribute 80 % of the global tuberculosis cases. Tuberculosis is infectious and due to its rapid and easy transmission route poses a threat to population health. Considering the importance of social and psychological factors in influencing health outcomes, appraising knowledge and awareness of tuberculosis, remain vital for effective tuberculosis control. The main aim of this study was to investigate the factors that predict knowledge about tuberculosis among 18–64 year old adults in South Africa. METHODS: A cross-sectional survey method was used. Multi-stage disproportionate, stratified cluster sampling was used to select households within enumeration areas stratified by province and locality type. Based on the Human Sciences Research Council 2007 master sample, 500 Enumerator Areas representative of the socio-demographic profile of South Africa were identified and a random sample of 20 households was randomly selected from each Enumerator Area, yielding an overall sample of 10 000 households. The tuberculosis module contained in the South African National Health And Nutrition Examination Survey I was the only module that examined the social determinants of an infectious disease. This module was questionnaire-based with no biomarkers obtained to screen for the presence of tuberculosis disease among the participants. Data was collected by administering a researcher developed individual level questionnaire. Simple and multiple linear regression was used to determine the independent variables associated with tuberculosis knowledge. RESULTS: Half the sample (52.6 %) was female and the majority of the respondents were black African (76.5 %). More than two thirds (68.0 %) resided in urban areas, 56.9 % did not complete high school and half were not in formal employment. Significant predictors of tuberculosis knowledge were race, sex, completion of high school, being in employment, having a diagnosis of the disease in ones’ life-time and learning about tuberculosis from television, brochures, health workers, and teachers. CONCLUSION: To reduce the burden of tuberculosis in South Africa, media campaigns targeting both rural and urban communities should include conveying accurate information about the disease. Policy makers should also address structural barriers that vulnerable communities face.
The quality of care for sexually transmitted infections in primary health care clinics in South Africa: an evaluation of the implementation of the syndromic management approach
(2003) Shabalala, Nokuthula Joy; Strebel, Ann-Marie; Simbayi, Leickness
Sexually transmitted infections (STIs) are a problem for both developed and developing countries. Sub-Saharan Africa has the highest rates in the 15-49 years old group. The discovery that these infections playa vital role in the transmission of HIV raised their profile and made their control one of the central strategies of stopping the HIV/AIDS epidemic. In response to the challenge of improving the quality of care for people infected with STIs in the public health sector, the South African Ministry of Health adopted the syndromic management approach, recommended by the World Health Organisation as suitable for resource-poor settings, for use in primary health care clinics. In addition to providing guidelines on clinical management of STIs, the syndromic approach requires health providers to counsel and educate patients about STIs, encourage patients to complete treatment even if symptoms abate, promote condom use and the treatment of all sexual partners. While the management guidelines are clear and detailed around the diagnostic and medication issues, the processes of education and counseling are not as clearly outlined. Furthermore, although the syndromic approach is a viable way of providing good quality care to larger sections of the population than could be serviced through dedicated STI clinics, it requires health providers working in primary health care clinics, most of whom are professional nurses, to perform some tasks for which they may not be adequately trained. This study evaluated the quality of care for persons infected with ST!s by examining the extent to which the syndromic approach was being implemented in primary health care clinics. Interviews, using semi-structured interview schedules, were conducted with STI patients and health providers in twenty-four clinics located in four provinces. Indepth qualitative interviews were also conducted with a sub sample of the patients. For further triangulation the methods of participant observation, through the use of simulated patients, and focus group discussions with various community groups were used. The findings of the study indicate that although primary health care clinics in South Africa are well-resourced, the management of patients with STI's is inadequate. Adherence to the various aspects of syndromic management was poor. Similar to other studies in South Africa, the attitudes of health providers towards patients with ST!s were found to be problematic, a finding that has implications for health-seeking behaviours. The thesis argues that a large part of the problem is related to the multiple roles that nurses have to play in primary health care settings, as well as the content and methodology of the training of nurses who manage STI patients. It further argues for the constitution of the basic health team at primary health clinics to be multi-disciplinary, and for a multi-disciplinary input in the training of health providers.
Randomized community-level HIV prevention intervention trial for men who drink in South African alcohol-serving venues
(2013) Kalichman, Seth C.; Simbayi, Leickness; Cain, Demetria; Carey, Kate B.; Carey, Michael P.; Eaton, Lisa; Harel, Ofer; Mehlomakulu, Vuyelwa; Mwaba, Kelvin
South African alcohol-serving establishments (i.e., shebeens) offer unique opportunities to reduce HIV risks among men who drink. Purpose: To test an individual- and a social structural-level HIV prevention intervention for men who drink in shebeens. Methods: Twelve matched pairs of township neighbourhoods were randomized to receive either (i) an HIV prevention intervention (guided by Social Action Theory) to reduce sexual risk and increase risk reduction communication in social networks, or (ii) an attention-matched control intervention that focused on the prevention of relationship violence. At the individual level, the interventions delivered skills building workshops focused on sexual risk reduction. At the social structural level, the intervention aimed to increase conversations about safer sex among men in the shebeens, distributed small media and implemented community educational events. Individual-level outcomes were assessed by following the workshop cohorts for 1 year (N = 984), and community-level outcomes were examined through cross-sectional community surveys conducted for 1 year in the shebeens (N = 9,678). Results: Men in the HIV prevention workshops demonstrated greater condom use, more HIV prevention-oriented conversations and greater perceptions of safer sex norms than men in the comparison workshops. Changes at the community level demonstrated significant differences in condom use, although the pattern was not consistent over time. Conclusions: Multi-level interventions that target men who drink in South African shebeens may help reduce risks for HIV and other sexually transmitted infections.

Browsing by Author "Simbayi, Leickness"

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