‘I am extremely proud of this great achievement,’ said Dr Sabina Medal Govere who graduated with a PhD in Public Health.
‘The PhD journey was a test of my perseverance and commitment and I am glad I prevailed. My aspiration is to become an epidemiologist focusing on policy evaluation in the research space,’ she added.
Supervised by Professor Moses J. Chimbari, Govere’s study investigated the factors that influence the acceptability and efficacy of rapid Antiretroviral therapy (ART) initiation by patients’ following a confirmed HIV diagnosis. It also analysed healthcare workers’ perceptions of the implementation of Universal Test and Treat (UTT) policy, including patients’ clinical outcomes and retention in care following rapid or deferred ART initiation.
The study aimed to identify gaps in implementing same-day ART initiation to assist in benchmarking rapid ART initiation processes at facilities in diverse geographical settings.
‘Uptake of rapid ART initiation increased; however, the evidence showed poor retention in care after six months among those who initiated ART on the day of HIV diagnosis. The results highlight the need to not only streamline processes to increase rapid ART uptake, but also to strengthen retention in care and adherence procedures in order to achieve the 95-95-95 targets,’ said Govere. The study also showed that while training on UTT and rapid ART initiation was conducted at the inception of the implementation of the policy, the level of understanding and interpretation varied among clinicians and non-clinical healthcare providers. Denial, feeling healthy, fear of disclosure, limited knowledge of ART, and fear of ART side effects, stigma and discrimination were among the factors healthcare workers identified as hindering the uptake of rapid ART initiation. These findings concur with some of the reasons advanced by patients, with fear of disclosure and side effects frequently mentioned by those who deferred rapid ART initiation.
Govere’s interest in research, policy evaluation and impact assessment motivated her to study public health which fits with her work in HIV prevention, testing and treatment management.
‘My PhD journey was exciting and challenging at the same time. I was working full-time in a clinical research institution, calling for discipline and time management,’ she said.
She added that the lack of social life and sleepless nights were worth it. ‘I’m grateful to my family for their sacrifices, tolerance, understanding and endless encouragement.’
‘Having been born in Zimbabwe and losing my parents at a young age, I always believed that education would emancipate me. I’m forever grateful to my late parents for the sacrifices they made to provide the best foundation for my education. I know they are proud of me for this achievement which I believe they would have loved to witness.’
With six degrees already under her belt, Govere is currently registered for a seventh – a masters in Clinical Psychology at UKZN. ‘My decision to further my studies in Psychology was driven after witnessing the severe mental health challenges in communities during data collection for my PhD. Four male participants I enrolled in my study committed suicide, which highlighted the need to merge my public health expertise and mental health, with men as my population of interest.’
Words: Nombuso Dlamini
Photograph: Abhi Indrarajan