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A growing body of research in South Africa has focused on fathers but few have included men from various racial backgrounds. The aim of this study is to capture the experiences of young fathers from a range of racial backgrounds that are residing in the urban areas of Durban. This study draws on qualitative data collected from interviews conducted with 20 young men. The interviews suggest that the experience of becoming a father was not easy; however, none of the young men denied paternity. Instead, they accepted responsibility and quickly adapted to their role. The fathers made a concerted effort to extend their role beyond that of a breadwinner by providing care for their children and maintaining a presence in their lives. Cultural barriers limit fathers from engaging with their children; however, maternal grandmothers ensured that young men were able to maintain family relations with their children. Thus, young men are redefining the narrative of fatherhood by making an effort to be involved in the lives of their children and as a result, they are challenging existing stereotypes and perceptions. More efforts are needed to encourage young men to assume responsibility for their children and to develop stronger family relations. [ABSTRACT FROM AUTHOR]

Background: Trust is an important cornerstone of patient-provider communication. Accurate reporting of pre-exposure prophylaxis (PrEP) adherence is vital for providers to determine who needs adherence support, especially adolescent girls and young women (AGYW) disproportionately affected by newly diagnosed HIV. Methods: This is a secondary analysis of the HPTN 082 open-label PrEP demonstration trial. From 2016–2018, 451 AGYW aged 16–25 years were enrolled in South Africa (Cape Town and Johannesburg) and Zimbabwe (Harare). PrEP was initiated by 427, and 354 (83%) had month three patient-reported adherence responses and intracellular tenofovir diphosphate (TFV-DP) measurements. The patient-reported adherence response to 'In the past month, how often did you take the tablet?' was dichotomized as 'high' if the response was every day or most days, and 'low' if some days or not many days or never. The biomarker marker evidence of adherence in dried blood spots was defined as 'high' if TFV-DP ≥ 700, and 'low' if < 350 fmol/punch. We used multinomial logistic regression to examine if trust in the PrEP provider was associated with concordance between patient-reported adherence and intracellular tenofovir-diphosphate (TFV-DP). Results: AGYW who reported trust in their providers were almost four-fold (aOR 3.72, 95% CI 1.20–11.51) more likely to have concordant adherence (high self-reported adherence and high TFV-DP concentrations) compared to discordant non-adherence (high self-reported adherence and low TFV-DP concentrations). Conclusion: Education and training of providers to build trusting relationships with AGYW may lead to more accurate reporting of PrEP adherence. With accurate reporting, adequate support can be provided to bolster adherence. Trial registration: ClinicalTrials.gov Identifier: NCT02732730. [ABSTRACT FROM AUTHOR]

Providers must be knowledgeable on policy, systems and products to provide a person centred service and prescribe the most appropriate assistive product for each user. This study aimed to determine to what extent teaching and learning on assistive products are included in undergraduate curricula of the Health science faculties at three universities in the Western Cape Province of South Africa. Data were gathered through a cross sectional survey. Fifteen programmes were approached of whom eight participated. Information on teaching on assistive products was sourced from purposively identified key informants, through e-mail questionnaires. Descriptive analysis was done. A total of 104 assistive products were included in the eight programmes. Manual wheelchairs were the only product for which teaching was underscored by policy guidelines. Handheld mobility devices and wheelchairs were covered by five programmes. Teaching on assistive products for self-care, participation in domestic life, indoor and outdoor activities, employment and leisure was limited. Thirty seven products listed on the GATE List of 50 were taught by at least one of the programmes. Teaching and examination were theoretical in nature and occurred in professional silos. Clinical exposure was often incidental. For many products none of the four service delivery steps were covered. Assistive products were included in all the participating undergraduate programmes. The range of included products and the level of training were insufficient to prepare graduates to effectively address user's needs. Newly appointed graduates will require early in-service training to ensure appropriate assistive product service delivery. Undergraduate teaching on assistive products is provided in professional silos. Not all products on the GATE APL of 50 are included in under graduate teaching. Teaching does not always ensure a proficiency level that will support graduates to provide an independent AT service. [ABSTRACT FROM AUTHOR]

Background: There is a need for information and healthcare support for the fertility desires and contraceptive needs of people living with HIV (PLHIV) in order to provide safer conception support for sero-discordant couples wanting to safely conceive. A model to integrate sexual and reproductive health and HIV services was developed and implemented in a district hospital and six clinics in the eThekwini District, South Africa.Methods: To evaluate the model's success, a cross-sectional survey was conducted before and after implementation of the model. As part of this evaluation, fertility desires of PLHIV (both male and female), and providers' perspectives thereof were explored. Changes in desires and attitudes after integration of services were investigated.Results: Forty-six healthcare providers and 269 clients (48 male, 221 female) were surveyed at baseline, and 44 providers and 300 clients (70 male, 230 female) at endline. Various factors including relationship status, parity and antiretroviral treatment (ART) access influenced PLHIVs' desires for children. Concerns for their own and their child's health negatively impacted on PLHIV's fertility desires. These concerns declined after integration of services. Similarly, providers' concerns about PLHIV having children decreased after the implementation of the model.Conclusions: Integrated services are important to facilitate provision of information on contraceptive options as well as safer conception information for PLHIV who want to have children. [ABSTRACT FROM AUTHOR]

High levels of HIV and unwanted pregnancies have renewed interest in sexual and reproductive health (SRH) services integration. A district-based model for integrating SRH and HIV services was developed and implemented in a district hospital and six feeder clinics in eThekwini District, South Africa. A cross-sectional survey was conducted before and after implementation of this model and explored training and SRH service integration. Forty-six providers participated in baseline, and 44 in an endline survey. Data were descriptively analysed using SPSS. Overall, training undertaken did not change between baseline and endline. The proportion of providers performing HIV testing when providing other SRH services, and those counselling on family planning during HIV counselling and testing and STI services increased at endline. The proportion offering family planning counselling to HIV infected and antenatal clients decreased at endline. Overall, service integration improved modestly after integration model implementation, which could impact positively on uptake of SRH services. [ABSTRACT FROM AUTHOR]