Heidi van Rooyen

Bio: Heidi van Rooyen is an academic researcher from Human Sciences Research Council. The author has contributed to research in topics: Acquired immunodeficiency syndrome (AIDS) & Population. The author has an hindex of 27, co-authored 61 publications receiving 2415 citations. Previous affiliations of Heidi van Rooyen include Johns Hopkins University & University of the Witwatersrand.

Project Accept (HPTN 043): a community-based intervention to reduce HIV incidence in populations at risk for HIV in sub-Saharan Africa and Thailand.

Abstract: Conclusions: The provision of mobile services, combined with appropriate support activities, may have significant effects on utilization of voluntary counseling and testing. These findings also provide early support for community mobilization as a strategy for increasing testing rates.

High HIV testing uptake and linkage to care in a novel program of home-based HIV counseling and testing with facilitated referral in KwaZulu-Natal, South Africa.

Abstract: Objective: For antiretroviral therapy (ART) to have a population-level HIV prevention impact high levels of HIV testing and effective linkages to HIV care among HIV-infected persons are required. Methods: We piloted home-based counseling and testing (HBCT) with point-of-care CD4 count testing and follow-up visits to facilitate linkage of HIV-infected persons to local HIV clinics and uptake of ART in rural KwaZulu-Natal South Africa. Lay counselor follow-up visits at months one three and six evaluated the primary outcome of linkage to care. Plasma viral load was measured at baseline and month six. Results: 671 adults were tested for HIV (91% coverage) and 201 (30%) were HIV-infected of which 73 (36%) were new diagnoses. By month three 90% of HIV-infected persons not on ART at baseline had visited an HIV clinic and 80% of those eligible for ART at baseline by South African guidelines (CD4 less than or equal to 200 cells/mL at the time of the study) had initiated ART. Among HIV-infected participants who were eligible for ART at baseline mean viral load decreased by 3.23 log10 copies/mL (p0.001) and the proportion with viral load suppression increased from 20% to 80% between baseline and month six. Conclusions: In this pilot of HBCT and linkages to care in KwaZulu-Natal 91% of adults were tested for HIV. Linkage to care was ~90% both among newly-identified HIV-infected persons as well as known HIV-infected persons who were not engaged in care. Among those eligible for ART a high proportion initiated ART and achieved viral suppression indicating high adherence and reduced infectiousness.

Universal HIV testing of infants at immunization clinics: an acceptable and feasible approach for early infant diagnosis in high HIV prevalence settings.

Abstract: OBJECTIVE: To determine the acceptability and feasibility of universal HIV testing of 6-week-old infants attending immunization clinics to achieve early diagnosis of HIV and referral for HIV treatment and care services DESIGN: An observational cohort with intervention METHODS: Routine HIV testing of infants was offered to all mothers bringing infants for immunizations at three clinics in KwaZulu Natal Blood samples were collected by heel prick onto filter paper Dried blood spots were tested for HIV antibodies and if present were tested for HIV DNA by PCR Exit interviews were requested of all mothers irrespective of whether they had agreed to infant testing or not RESULTS: Of 646 mothers bringing infants for immunizations 584 (904%) agreed to HIV testing of their infant and 332 (568%) subsequently returned for results Three hundred and thirty-two of 646 (514%) mothers and infants thereby had their HIV status confirmed or reaffirmed by the time the infant was 3 months of age Overall 247 of 584 (423%) infant dried blood spot samples had HIV antibodies indicating maternal HIV status Of these 54 (219%) samples were positive for HIV DNA by PCR This equates to 92% (54/584) of all infants tested The majority of mothers interviewed said they were comfortable with testing of their infant at immunization clinics and would recommend it to others CONCLUSION: Screening of all infants at immunization clinics is acceptable and feasible as a means for early identification of HIV-infected infants and referral for antiretroviral therapy

The Ecology of Human Development

Abstract: This chapter explores the ecology of human development, those forces in the person's environment that affect and influence development. Urie Bronfenbrenner's model of the human ecosystem guides the discussion, making connections between children in families and in communities and the larger society that surrounds them. The human ecosystem model is much like the study of the natural ecology, focusing on the interactions between subjects at various levels of the environment as they affect each other. The interaction between individual and environment forms the basis of an ecological approach to human development. This view sees the process of development as the expansion of the child's conception of the world and the child's ability to act on that world. Risks to development can come from both direct threats and the absence of opportunities for development. Sociocultural risk refers to the impoverishment in the child's world of essential experiences and relationships.

The Social Psychology of Groups

Abstract: The Social Psychology of Groups. J. W Thibaut & H. H. Kelley. New York: alley, 1959. The team of Thibaut and Kelley goes back to 1946 when, after serving in different units of the armed services psychology program, the authors joined the Research Center for Group Dynamics, first at M.LT and then at the University of Michigan. Their continued association eventuated in appointments as fellows at the Center for Advanced Study in the Behavioral Sciences, 19561957. It is during these years that their collaboration resulted in the publication of The Social Psychology of Groups. The book was designed to "bring order and coherence to present-day research in interpersonal relations and group functioning." To accomplish this aim, the authors introduced, defined, and illustrated basic concepts in an effort to explain the simplest of social phenomena, the two-person relationship. These basic principles and concepts were then employed to illuminate larger problems and more complex social relationships and to examine the significance of such concepts as roles, norm, power, group cohesiveness, and status. The lasting legacy of this book is derived from the fact that the concepts and principles discussed therein serve as a foundation for one of the dominant conceptual frameworks in the field of family studies today-the social exchange framework. Specifically, much of our contemporary thinking about the process of interpersonal attraction and about how individuals evaluate their close relationships has been influenced by the theory and concepts introduced in The Social Psychology of Groups. Today, as a result of Thibaut and Kelley, we think of interpersonal attraction as resulting from the unique valence of driving and restraining forces, rewards and costs, subjectively thought to be available from a specific relationship and its competing alternatives. We understand, as well, that relationships are evaluated through complex and subjectively based comparative processes. As a result, when we think about assessing the degree to which individuals are satisfied with their relationships, we take into consideration the fact that individuals differ in terms of the importance they attribute to different aspects of a relationship (e.g., financial security, sexual fulfillment, companionship). We also take into consideration the fact that individuals differ in terms of the levels of rewards and costs that they believe are realistically obtainable and deserved from a relationship. In addition, as a result of Thibaut and Kelley's theoretical focus on the concept of dependence and the interrelationship between attraction and dependence, there has evolved within the field of family studies a deeper appreciation for the complexities and variability found within relationships. Individuals are dependent on their relationships, according to Thibaut and Kelley, when the outcomes derived from the existing relationship exceed those perceived to be available in competing alternatives. Individuals who are highly dependent on their relationships are less likely to act to end their relationships. This dependence and the stability it engenders may or may not be voluntary, depending on the degree to which individuals are attracted to and satisfied with their relationships. When individuals are both attracted to and dependent on their relationships, they can be thought of as voluntarily participating in their relationship. That is, they are likely to commit themselves to the partner and relationship and actively work for its continuance. Thibaut and Kelley termed those relationships characterized by low levels of satisfaction and high levels of dependence "nonvoluntary relationships. …