Dissertations / Theses on the topic 'AIDS (Disease) – Treatment'
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1
Hoffmann, Toinette. "The right of the HIV/AIDS patient to treatment." Thesis, University of Port Elizabeth, 2001. http://hdl.handle.net/10948/277.
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The objective of this treatise is to establish whether a right to social security exists in South Africa, which would entitle HIV positive persons in South Africa citizens to medical care. A study was made of various articles in journals and on the Internet to determine the South African government's policy on a right to social security and to providing medical treatment. It was found that South Africa lacks an integrated, holistic approach to social security and does not guarantee the right to social security, merely the right to have access to social security. The same was found with the right to medical care. Although there seems to be a general right to medical care which extends to and includes HIV-positive patients, the state merely guarantees the right to apply for medical treatment but does not guarantee the granting thereof. It is submitted that the Department of Health's refusal to implement a vertical transmission prevention programme and the failure to offer treatment as an alternative, for whatever reason, is "penny wise and pound foolish". In the long run more money is spent dealing with pediatric AIDS. It was further found that although the government attempted to lay a groundwork with the formulation and acceptance of the national AIDS plan, the successful implementation thereof is seriously hindered due to the lack of inter- and intra-departmental collaboration, essential health services and funding.
2
McKallip, Robert James. "The immunomodulatory properties of AZT used in the treatment of AIDS." Thesis, This resource online, 1994. http://scholar.lib.vt.edu/theses/available/etd-06102009-063223/.
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Makhubele, Jabulani Calvin. "The impact of culture on the prevention and treatment of HIV/AIDS amongst people in low-resourced areas :a social work perspective." Thesis, University of Limpopo, 2004. http://hdl.handle.net/10386/2027.
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Thesis (M. A. (Social Work)) -- University of Limpopo, 2004.The aim of this study was to explore the impact of culture on the prevention and reatment of HIV/AIDS amongst people in low-resourced areas like Malamulele. he study focused on the lifestyles, beliefs, attitudes and perceptions around ultural elements and practices, which might impact negatively on the prevention nd treatment of the HIV/AIDS epidemic. There were three groups of research espondents namely: learners from three high schools in Malamulele, some arents of the learners and the traditional/cultural leaders. The researcher ollected both qualitative and quantitative data. The data was gathered through he use of an interview schedule (questionnaire), focus group discussions and ound-table discussion sessions. The data was presented, analysed and nterpreted by means of tables and charts. t was found that people in low-resourced (rural) areas have little knowledge about HIV/AIDS, causes, symptoms and how the disease is transmitted. Despite the fact that awareness and educational campaigns and programmes are being rendered, people in low-resourced (rural) areas have little knowledge and needed skills about prevention and treatment of the pandemic. Polygamy and extra-marital relations by men is still highly valued and viewed at high esteem. Religious structures seem to be detached to the issue of HIV/AIDS as they mentioned that talking about HIV/AIDS is immoral and against their principles. The study also tried to explore the extent to which people in low-resourced areas view and use condoms as a protective means.
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Garanganga, Eunice. "Palliative care needs of children suffering from AIDS, Zimbabwe." Thesis, [S.l. : s.n.], 2009. http://dk.cput.ac.za/cgi/viewcontent.cgi?article=1030&context=td_cput.
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Albougy, Hany Ahed. "A systematic review of the management of oral candidiasis associated with HIV/AIDS." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/52713.
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On t.p.: Degree MSc Dental Science (Community Dentistry)Thesis (MSc)--Stellenbosch University, 2002.
ENGLISH ABSTRACT: The purpose of this review was to investigate the management of oral candidiasis in HIV/AIDS patients and to evaluate the different guidelines that are available for its management. To achieve this aim, three objectives were identified: (i) to identify and report on the different interventions used to manage oral candidiasis, in patients with HIV/AIDS, (ii) to determine the efficacy of these interventions, and (iii) to provide guidelines for management. A thorough systematic search of the literature was carried out and all relevant papers were graded into three levels of evidence (A, B, and C) and scored for quality according to set criteria. A number of topical and systemic antifungal medications are used to treat oral candidiasis in HIV-positive patients. These include the poleyne antibiotics, nystatin and amphotericin B. Milder episodes of oral candidiasis respond to topical therapy with nystatin, clotrimazole troches or oral ketoconazole. Fluconazole has been extensively evaluated as a treatment for candidiasis. With HIV-infection, a cure rate of 82% has been achieved with a daily oral dose of 50 mg. Fluconazole was found to be a better choice of treatment for relapsing oropharyngeal candidiasis, resulting in either better cure rates or better prevention of relapse. Intravenous amphotericin B has been found to be effective therapy in azole refractory candidiasis where it was shown to be safe and well tolerated. Topical therapies were found to be effective treatment for uncomplicated oropharyngeal candidiasis, however patients relapsed more quickly than those treated with oral systemic antifungal therapy. Overall, nystatin appears less effective than clotrimazole and the azoles in the treatment of oropharyngeal candidiasis. With regard to the resolution of clinical symptoms, clotrimazole was found to be just as effective as the azoles, except when patient compliance was poor. Fluconazole-treated patients were more likely to remain disease-free during the fluconazole follow-up period than with those treated with other interventions. Relatively few studies were qualified to address the provision of guidelines for the management of oral candidiasis in primary health care settings. Most of the studies found were of moderate and low quality level of evidence. These studies included the assessment of different guidelines for identification, treatment and dental needs. They stressed that patients with HN need dentists who will act as primary health care providers, together with other providers to ensure adequate overall care. Given the level of interest and importance of candidiasis associated with treatment of HN -positive patients, it is surprising to find that little high quality research has been undertaken. As such, it is hoped that this review would provide researchers, oral health care workers and other health care providers with an overview of the management of oral candidiasis associated with HN/AIDS.
AFRIKAANSE OPSOMMING: Die doelstelling van die oorsig was om ondersoek in te stel na die hantering van orale kandidiase in HIV/AIDS pasiënte asook om die verskillende beskikbare riglyne vir die behandeling daarvan te evalueer. Ter verwesenliking van hierdie doelstelling is drie doelwitte geïdentifiseer: (i) om die intervensies wat gebruik word in die hantering van orale kandidiase behandeling te identifiseer, (ii) om die effektiwiteit van hierdie intervensies te identifiseer en (iii) om op grond hiervan riglyne vir die hantering voor te stel. 'n Sistematiese literatuursoektog is uitgevoer en alle relevante artikels is in drie groepe geklassifiseer (A, B en C) op grond van die data kwaliteit. 'n Verskeidenheid topikale en sistemiese antifungale middels word gebruik om orale kandidiase in HIV-positiewe pasiënte te behandel. 'n Sukseskoers van 82% is met die gebruik van 'n daaglikse dosis van 50 mg medikament gerapporteer. Fluconazole was die beter keuse van middel vir die behandeling van terugkerende orofaringeale kandidiase. Topikale behandeling was effektief in die behandeling van ongekompliseerde orofaringeale kandidiase, hoewel die kans op terugkeer van die toestand groter was as met die sistemiese middels. Pasiënte wat met flukonasool behandel is, het 'n groter kans gehad om siektevry te bly vergeleke met pasiënte op die ander intervensies. Meeste van die studies was van middelmatige tot lae kwaliteit en gevolglik was dit moeilik om behandelingsriglyne te stel. Wat egter wel duidelik is, is dat HIV pasiënte primêre mondsorg benodig wat saam met ander versorging omvattende sorg sal verseker.
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Marais, Melanie. "A descriptive study to evaluate the effect of guidelines used by counsellors to improve adherence to antiretroviral therapy in the private sector." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&.
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Rushing, R. Mark. "An outpatient facility for the treatment of HIV/AIDS." Thesis, Georgia Institute of Technology, 1998. http://hdl.handle.net/1853/23302.
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Walker, Blain S. "The diagnosis and treatment of major depression in AIDS patients : effect of counselor experience and attitude toward people with AIDS." Virtual Press, 1999. http://liblink.bsu.edu/uhtbin/catkey/1137581.
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This study was an investigation into the clinical judgments made by counseling psychologists when faced with a patient who had major depression and AIDS. Two hundred and eighty one counseling psychologists evaluated one of four vignettes depicting an individual with major depression. In three of the vignettes the individual also had AIDS but the vignette varied on how the virus was contracted (unprotected gay sex, IV drug abuse, hemophilia). In the fourth vignette (the control group) the individual did not have AIDS. Results of the study suggested, that the presence of AIDS overshadows the evaluation and treatment decisions made by counseling psychologists when their patient has major depression and AIDS. Three factors-counseling psychologists' general experience with people who have AIDS, their clinical experience with AIDS patients and how the AIDS virus was contracted-were investigated for possible moderating effects of the overshadowing bias. How the AIDS virus was contracted was used as an indirect measure of clinician attitude toward people with AIDS. Neither general or clinical experience with AIDS patients appeared to have an effect on the diagnostic or treatment decisions made by counseling psychologists when evaluating depressed patients with AIDS. As with experience, method of contracting the AIDS virus did not have a moderating effect on the overshadowing bias. Implications of these results for the evaluation and treatment of depression in AIDS patients, as well as future research are discussed.Department of Counseling Psychology and Guidance Services
9
Uwimana, Jeannine. "Met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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The aim of this study was to investigate met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda. The achieve this aim, the study, firstly, identified the palliative care needs of people living with HIV/AIDS, secondly, it identified the health care services available to meet these needs, and thirdly, it determined the extent to which palliative care needs were met.
10
Nikisi, Joseph. "Access to antiretroviral treatment in the public sector, in Zambia /." Access to E-Thesis, 2005. http://upetd.up.ac.za/thesis/available/etd-04282009-163207/.
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Ejigu, Amsalework Ayele. "Mathematical modelling of HIV/AIDS transmission under treatment structured by age of infection." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/6628.
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Thesis (MSc (Mathematical Sciences))--University of Stellenbosch, 2011.Includes bibliography.
ENGLISH ABSTRACT: This thesis takes into account the different levels of infectiousness of the human immunodeficiency virus (HIV) infected individuals throughout their period of infection. Infectiousness depends on the time since infection. It is high shortly after the infection occurs and then much lower for several years, and thereafter a higher plateau is reached before the acquired immunodeficiency syndrome (AIDS) phase sets in. In line with this, we formulated a mathematical model which is structured according to the age of infection. To understand the dynamics of the disease, we first discuss and analyse a simple model in which the age of infection is not considered, but progression of the HIV-AIDS transmission is taken into consideration by introducing three stages of infection. Analysis of these models tells us that the disease can be eradicated from the population only if on average one infected individual infects less than one person in his or her infectious period, otherwise the disease persists. To investigate the reduction of the number of infections caused by a single infectious individual to less than one, we introduce different treatment strategies for a model which depends on the age of infection, and we analyse it numerically. Current strategies amount to introducing treatment only at a late stage of infection when the infected individual has already lived through most of the infectious period. From our numerical results, this strategy does not result in eradication of the disease, even though it does reduce the burden for the individual. To eradicate the disease from the population, everyone would need to be HIV tested regularly and undergo immediate treatment if found positive.
AFRIKAANSE OPSOMMING: Hierdie tesis hou rekening met die verskillende aansteeklikheidsvlakke van die menslike immuniteitsgebreksvirus (MIV) deur besmette individue gedurende hulle aansteeklikheidstydperk. Die graad van aansteeklikheid hang af van die tydperk sedert infeksie. Dit is hoog kort nadat die infeksie plaasvind en daarna heelwat laer vir etlike jare, en dan volg n hoer plato voordat uiteindelik die Verworwe-Immuniteitsgebreksindroom (VIGS) fase intree. In ooreenstemming hiermee, formuleer ons n wiskundige model van MIV-VIGSoordrag met n struktureer waarin die tydperk sedert infeksie bevat is. Om die dinamika van die siekte te verstaan, bespreek en analiseer ons eers n eenvoudige model sonder inagneming van die tydperk sedert infeksie, terwyl die progressie van MIV-VIGS-oordrag egter wel in ag geneem word deur die beskouing van drie stadiums van infeksie. Analise van die modelle wys dat die siekte in die bevolking slegs uitgeroei kan word as elke besmette mens gemiddeld minder as een ander individu aansteek gedurende die tydperk waarin hy of sy self besmet is, anders sal die siekte voortduur. Vir die ondersoek oor hoe om die aantal infeksies per besmette individu tot onder die waarde van een te verlaag, beskou ons verskeie behandelingsstrategiee binne die model, wat afhang van die tydperk sedert infeksie, en ondersoek hulle numeries. Die huidige behandelingstrategiee kom neer op behandeling slegs gedurende die laat sta- dium van infeksie, wanneer die besmette individu reeds die grootste deel van die aansteeklikheidsperiode deurleef het. Ons numeriese resultate toon dat hierdie strategie nie lei tot uitroeiing van die siekte nie, alhoewel dit wel die las van die siekte vir die individu verminder. Om die siekte binne die bevolking uit te roei, sou elkeen gereeld vir MIV getoets moes word en indien positief gevind, dadelik met behandeling moes begin.
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Shands, Nancy. "The lonely voyage: support or isolation for gay men with AIDS?" Thesis, Virginia Tech, 1987. http://hdl.handle.net/10919/43893.
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Twenty-five gay men, 20 with Acquired Immune Deficiency
Syndrome (AIDS) and 5 with either AIDS Related Complex (ARC)
or who tested positive for the AIDS virus, were asked in
semi-structured interviews whether they felt supported or
isolated. Areas covered included society in general,
employment, housing, health care, insurance, religion,
families of origin, ex-wives, children, friends and lovers.
Subjects indicated that fear of AIDS, homophobia, and death
anxiety were all present in certain circumstances, but there
was no attempt to differentiate between these three possible
causes of social isolation in this exploratory study.Master of Science
13
Petoumenos, Kathy Public Health & Community Medicine Faculty of Medicine UNSW. "Treatment experience and HIV disease progression: findings from the Australian HIV observational database." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/24937.
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The Australian HIV Observational Database (AHOD) is a collaboration of hospitals, sexual health clinics and specialist general practices throughout Australia, established in April 1999. Core data variables collected include demographic data, immunological and virological markers, AIDS diagnosis, antiretroviral and prophylactic treatment and cause of death. The first electronic data transfer occurred in September 1999 followed by six monthly data transfers thereafter. All analyses included in this thesis are based on patients recruited to AHOD by March 2004. By March 2004, 2329 patients had been recruited to AHOD from 27 sites throughout Australia. Of these, 352 (15%) patients were recruited from non-metropolitan clinics. The majority of patients were male (94%), and infected with HIV through male homosexual contact (73%). Almost 90% of AHOD patients are antiretroviral treatment experience, and the majority of patients are receiving triple therapy as mandated by standard of care guidelines in Australia. Antiretroviral treatment use has changed in Australia reflecting changes in the availability of new treatment strategies and agents. The crude mortality rate was 1.58 per 100 person years, and of the 105 deaths, more than half died from HIV-unrelated deaths. The prevalence of HBV and HCV in AHOD was 4.8% and 10.9%, respectively. HIV disease progression in the era of highly active antiretroviral treatment (HAART) among AHOD patients is consistent with what has been reported in developed countries. Common factors associated with HIV disease progression were low CD4 cell count, high viral load and prior treatment with mono or double therapy at the time of commencing HAART. This was demonstrated in AHOD in terms of long-term CD4 cell response, the rate of changing combination antiretroviral therapy and factors predicting death. HBV and HCV coinfection is also relatively common in AHOD, similar to other developed country cohorts. Coinfection does not appear to be serious impediments to the treatment of HIV infected patients. However, HIV disease outcome following HAART does appear to be adversely affected by HIV/HCV coinfection but not in terms of HIV/HBV coinfection. Patients attending non-metropolitan sites were found to be similar to those attending metropolitan sites in terms of both immunological response and survival.
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Vandormael, Alain Marc. "Civil society and democracy in post-apartheid South Africa the Treatment Action Campaign, government and the politics of HIV/AIDS /." Pretoria : [s.n.], 2005. http://upetd.up.ac.za/thesis/available/etd-10182005-115602.
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Moore, Alison Rotha. "The discursive construction of treatment decisions in the management of HIV disease." Australia : Macquarie University, 2003. http://hdl.handle.net/1959.14/46321.
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Thesis (PhD)--Macquarie University, Division of Linguistics & Psychology, Department of Linguistics, 2003.Bibliography: p. 397-424.
Introduction -- Models of shared decision-making in medicine -- Framing the study -- The analytic goals of modelling agency -- The context of treatment decision-making in HIV -- Agency and alignment -- Study conclusions and implications.
The quality of doctor-patient communication has been shown to influence treatment uptake, adherence and effectiveness in HIV medicine and elsewhere. Increasingly, it is considered essential that doctors and patients jointly participate in decisions concerning treatment. There is a growing body of literature describing joint decisionmaking and suggesting guidelines for its practice. Few of these studies, however, relate their descriptions of medical decision-making as a social process to the ways in which patterns of verbal interaction realize or foreclose on joint decision-making. -- Dominant models of medical decision-making view shared decision-making as a midpoint between enlightened paternalism and informed choice. Based on a corpus of HIV consultations audio-recorded in Sydney in the late 1990s, this thesis argues that it can be better modelled as a particular type of social process, which differs across a number of dimensions from other styles of medical decision-making, specifiable as contextual parameters of meaning. The thesis then identifies ways in which specific discursive practices realize these contextual parameters. -- A major component of the thesis focuses on agency, and a model is presented in the form of a socio-semantic network, drawing on work by van Leeuwen (1996) and others, which relates a range of grammatical features, not only transitivity patterns, to ways of construing social agency. The thesis then considers the way in which doctors and patients mobilise these and other resources for bringing together potentially conflicting points of view in framing and articulating treatment decisions. Here I draw on notions of mutual alignment (e.g., Goffman 1981) but expand the analysis of what is aligned to account for speakers' implicit discourse orientation, as well as more overt markers. -- Findings emphasise the relationship between representing and enacting agentive roles; the importance of doctors and patients mutually projecting each other's voices; and the variable and iterative character of shared decision-making. The research demonstrates how doctors and patients negotiate a complex, interactionally and symbolically mediated agency, and shows that patients often take the lead in developing more collaborative decision-making practice. There are still institutionally and socially determined limits to the degree of control patients may exercise within the consultation, many of which are of course well founded.
Mode of access: World Wide Web.
xvii, 533, [22] p. ill
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Akpabio, Charles G. "An Assessment of factors associated with adherence to antiretroviral treatment in Albert Horsfall Medical Center, Abuja, Nigeria." Thesis, University of the Western Cape, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7192_1256206209.
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The aim of the study is to determine the characteristics associated with ART adherence to , in Albert Horsfall Medicacal Center (AHMC), Abuja, Nigeria. The Objectives are to measure the adherence to ART, assess the association of the demographic characteristic of patients on ART with adherence to medications in the facility
and to establish patients' perspectivesto adherence and impediments to compliance to ART in the center.
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Idahosa, Kenudi Christiana. "Bayliss-Hillman adducts as scaffolds for the construction of novel compounds with medicinal potential." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1006763.
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This project has focused on exploring the application of Baylis-Hillman (BH) {a.k.a. Morita-Baylis-Hillman (MBH)} scaffolds in the construction of various compounds with medicinal potential. A series of 2-nitrobenzaldehydes has been treated under BH conditions, with two different activated alkenes, viz., (MVK) and methyl acrylate, using (DABCO) or (3-HQ) as catalyst. While most of the BH reactions were carried out at room temperature, some reactions were conducted using microwave irradiation. The resulting BH adducts have been subjected to dehydration, conjugate addition and allylic substitution to obtain appropriate intermediates, which have been used in turn, to synthesize possible lead compounds, viz., cinnamate esters as HIV-1 integrase inhibitors, 3-(aminomethyl)quinolines and quinolones as anti-malarials and cinnamate ester-AZT conjugates as dual-action HIV-1 integrase-reverse transcriptase (IN-RT) inhibitors. Conjugate addition reactions of methyl acrylate-derived BH β-hydroxy esters with the amines, piperidine, propargylamine and 2-amino-5-(diethylamino)pentane, has afforded a range of products as diastereomeric mixtures in moderate to excellent yields. Catalytic hydrogenation of the aminomethy β-hydroxy esters derivatives, using a palladium-oncarbon (Pd-C) catalyst, has afforded the corresponding, novel 3-aminomethyl-2- quinolone derivatives in moderate yields. Effective allylic substitution reactions of the MVK-derived BH β-hydroxy ketones (via a conjugate addition-elimination pathway) using in situ-generated HCl has afforded the corresponding α-chloromethyl derivatives, which have been reacted with various amines, including piperidine, piperazine, propargylamine and 2-amino-5-(diethylamino)pentane, to yield α-aminomethyl derivatives. Catalytic hydrogenation of selected α-aminomethyl derivatives, using a Pd-C catalyst, has afforded the corresponding, novel 3- (aminomethyl)-2-methylquinoline derivatives in low to moderate yields. A bioassay, conducted on a 6-hydroxy-2-methyl-3-[(piperidin-1-yl)methyl]quinoline isolated early in the study indicated anti-malarial activity and prompted further efforts in the synthesis of analogous compounds. Reaction of the methyl acrylate-derived BH adducts with POCl3 has provided access to α-(chloromethyl)cinnamate ester derivatives, which have been aminated to afford α- (aminomethyl)cinnamate ester derivatives as potential HIV-1 integrase inhibitors. The α- (propargylaminomethyl)cinnamates were used, in turn, as substrates for the “click chemistry” reaction with 3'-azido-3'-deoxythymidine (AZT– an azide and an established reverse transcriptase HIV-1 inhibitor) to afford cinnamate ester-AZT conjugates as potential dual-action HIV-1 integrase-reverse transcriptase (IN-RT) inhibitors. Computer modelling and docking studies of a cinnamate ester-AZT conjugate into the HIV-1 integrase and reverse transcriptase active-sites revealed potential hydrogen-bonding interactions with amino acid residues within the receptor cavities. The isolated products have been appropriately characterized using IR, 1- and 2-D NMR and HRMS techniques, while elucidation of the stereochemistry of the double bond in the BH-derived halomethyl derivatives has been assigned on the basis of NOE, computer modelling and X-ray crystallographic data.
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Mallon, Patrick William Gerard School of Medicine UNSW. "Clinical and molecular aspects of HIV-associated lipodystrophy." Awarded by:University of New South Wales. School of Medicine, 2006. http://handle.unsw.edu.au/1959.4/33048.
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HIV-associated lipodystrophy (HIVLD) syndrome is a condition comprising abnormalities in distribution of body fat and metabolism of lipids and glucose that arises in HIV-infected patients on long-term antiretroviral therapy. This thesis describes clinical research into aspects of the natural history and treatment of HIVLD, as well as molecular research into its pathogenesis centred on subcutaneous adipose tissue. Results demonstrate HIVLD to be a treatment-induced syndrome characterised by initial gains in body fat followed by selective, progressive loss of limb fat. Exposure to thymidineanalogue nucleoside reverse transcriptase inhibitors (tNRTI) induces lipoatrophy through mitochondrial dysfunction of which inhibition of mitochondrial RNA expression, rather than mitochondrial DNA depletion, is an early feature. Mitochondrial dysfunction is associated with decreases in expression of peroxisome proliferatoractivated receptor gamma (PPAR??), an adipocyte transcription factor, which helps explain how tNRTI exposure leads to the loss of adipocyte function. Once established, lipoatrophy is characterised by mitochondrial DNA depletion, although this depletion occurs throughout the mitochondrial genome, suggesting an underlying cause other than inhibition of DNA polymerase gamma. HIVLD is a difficult syndrome to treat. Lipoatrophy is resistant to treatment with rosiglitazone, an agonist of PPAR??, which is ineffective in the setting of ongoing tNRTI therapy and mitochondrial dysfunction. Dyslipidaemia is also difficult to treat as use of pravastatin in the setting of ongoing exposure to protease inhibitors results in only modest declines in fasting cholesterol concentrations. Gains in central fat, such as that seen in patients with buffalo hump, are associated with insulin resistance and diabetes, but only occur in a relatively small percentage of treated patients, suggesting a role for genetic factors in its development. Use of strategies such as avoidance of tNRTI in firstline ART, genetic screening to identify those at risk of toxicities and targeted selection of interventions in subgroups of affected patients, may help prevent this syndrome occurring and better treat those patients in which it has already occurred.
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Terblanche, Lauren Muriel. "The knowledge about HIV/AIDS and antiretroviral treatment of patients receiving antiretroviral therapy." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20131.
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Thesis (MCur)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Many HIV positive patients are on antiretroviral therapy (ART) to assist in decreasing the replication of the HIV virus within the body. Adherence to this medication is important, as non- adherence can have serious repercussions. Therefore, the patients’ knowledge of ART and their disease is crucial in ensuring good adherence. A range of barriers to patient education were suspected by the researcher in this community of Delft. The high influx of patients into the clinic everyday minimized consultation time and thereby diminished the opportunity for effective patient education. Consequently, adherence to medication which is closely related to the knowledge and understanding of patients about the disease may be affected. The following research question was therefore explored: What is the knowledge of infected HIV/AIDS patients who are receiving antiretroviral treatment about HIV/AIDS and ART? The objectives set were to evaluate the patient’s knowledge of HIV/AIDS, evaluate the knowledge of ART and to determine whether there are statistical differences between the dependant and independent variables within the study. A quantitative descriptive correlational research design was applied and a convenience sample of n= 200 (8.5%) patients was selected from a population of N= 2349 at the Delft Community Health Centre. A multiple choice questionnaire comprising of mainly closed ended questions with multiple responses was used in individual interviews conducted by either the researcher or fieldworker. Reliability and validity was ensured through the consultation of experts in the fields of research methodology, statistics, HIV/AIDS and the Health Research Ethics Committee of Stellenbosch University. Permission to conduct this study was granted by the Health Research Ethics Committee of Stellenbosch University, the Provincial Regional Head for Primary Health Care Services, as well as the head of the Delft Community Health Centre. Data revealed that the participants were mainly female (n=145/72.5%), and the mean age was 37.5 years. Participants were mostly Xhosa speaking and literate, and the majority (n=112/56%), of the participants had a highest education level between grade 9 and grade 12. Many (n=73/36.5%) of the participants had been living with HIV for more than 5 years, but had been on ART for between 1 to 3 years. Knowledge was assessed by asking questions about various aspects of HIV and ART throughout the study. Scores for the 14 critical questions revealed that (n=0/0%) of the participants had good knowledge, (n=40/20%) of the participants had average knowledge and (n=160/80%) of the participants had poor knowledge. The average score for all participants for all 20 knowledge testing questions was (12.6/63%). The findings showed that the overall knowledge (n=160/80%) is poor. Basic terms and principles of HIV/AIDS and ART were not understood and serious misconceptions regarding the disease were revealed.
AFRIKAANSE OPSOMMING: Baie MIV positiewe pasiënte is op antiretrovirale terapie (ART) om te help met die vermindering van die replisering van die HIV virus in die liggaam. Gebruik van hierdie medikasie is belangrik omdat versuiming van inname ernstige gevolge kan hê. Dus, is die pasiënte se kennis van ART en hul siekte van deurslaggewende belang om volgehoue inname te verseker. ’n Reeks van hindernisse om pasiënte te onderrig, is deur die navorser in die Delftgemeenskap vermoed. Die hoë toestroming van pasiënte na die kliniek elke dag het die konsultasietyd tot die minimum beperk en daardeur die geleentheid vir effektiewe pasiëntonderrig laat verminder. Gevolglik, kan die nakoming om die medikasie te neem wat ’n noue verband toon met die kennis en begrip wat pasiënte het oor die siekte, geaffekteer word. Die volgende navorsingsvraag is gevolglik ondersoek: Wat is die kennis van geïnfekteerde HIV/VIGS pasiënte wat antiretrovirale behandeling ontvang oor HIV/VIGS en ART? Die doelwitte wat gestel is, is om die pasiënt se kennis van HIV/VIGS te evalueer, die kennis van ART te evalueer en te bepaal of daar ’n statistiese verwantskap tussen onafhanklike en afhanklike veranderlikes binne die studie is. ’n Kwantitatiewe beskrywende korrelerende navorsingsontwerp is toegepas en ’n gerieflikheidsmonster van n= 200 (8.5%) pasiënte is geselekteer uit ’n bevolking van N = 2349 by die Delftgemeenskap Gesondheidssentrum. ’n Veelkeusige vraelys wat hoofsaaklik uit geslote vrae met veelkeusige response bestaan het, is gebruik in individuele onderhoude wat deur of die navorser of veldwerker gevoer is. Betroubaarheid en geldigheid is verseker deur oorlegpleging met spesialiste op die gebied van navorsingsmetodologie, statistiek, HIV/VIGS en die Gesondheidsnavorsing se Etiese Komitee van die Universiteit van Stellenbosch. Toestemming om die navorsing te doen, is gegee deur die Gesondheidsnavorsing se Etiese Komitee van Stellenbosch Universiteit, die Provinsiale Streekshoof vir Primêre Gesondheidsdienste, asook die hoof van die Delftgemeenskap Gesondheidssentrum. Data het bewys dat die deelnemers hoofsaaklik vroulik is (n=145/72.5%) en die gemiddelde ouderdom 37.5 jaar. Deelnemers is meestal Xhosasprekend en geletterd en die meerderheid (n=112/56%) van die deelnemers se hoogste opleidingsvlak is tussen graad 9 en graad 12. Baie (n=73/36.5%) van die deelnemers het met HIV geleef vir 5 jaar, maar was op ART vir tussen 1 tot 3 jaar. Kennis is geassesseer deur vrae te stel oor verskeie aspekte van HIV en ART dwarsdeur die ondersoek. Puntetelling vir die 14 kritiese vrae het aan die lig gebring dat (n=0/0%) van die deelnemers goeie kennis het, (n=40/20%) van die deelnemers beskik oor gemiddelde kennis en (n=160/80%) van die deelnemers se kennis is gering. Die gemiddelde puntetelling vir al die deelnemers van al 20 kennisvrae wat getoets is, is (12.6/63%). Die bevindinge bewys dat die algehele kennis (n= 160/80%) gering is. Basiese terminologie en beginsels van HIV/VIGS en ART word nie begryp nie en ernstige wanopvattinge aangaande die siekte is geopenbaar.
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Wong, Mei-wan Farah, and 黃美雲. "Financial burden for HIV/AIDS patients to access antiretroviral therapy in Asian developing countries." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193826.
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Background: Since the beginning of 21st century, several Asian countries started implementing their national free antiretroviral therapy (ART) programs to tackle one of the most striking public health issues in Asia – HIV/AIDS. Despite the efforts being made, the treatment coverage remains as low as 44% in 2010. Previous studies have identified financial constraint is a major barrier in accessing ART and an important reason of poor ART adherence in Asia. The purpose of this literature review is to explore the extent of financial burden experienced by people living with HIV (PLHIV) where free ART policy is implemented, and to provide valuable information for policy-making in reducing financial barriers and improve uptake of ART.
Methods: Literature search was performed by entering keywords in PubMed and Medline. Articles were screened and selected for in-depth review according to the inclusion and exclusion criteria. A process on data synthesis was performed on the final eligible papers.
Results: Five studies from four Asian countries describing the out-of-pocket health expenditure incurred by PLHIV during the delivery of ART were included in this review.
Findings: Out of all direct medical costs, the cost of drug was most important in contributing to the total costs for patients without health insurance, while the cost of transportation was more important for patients covered by health insurance. Direct medical costs increased with advancing stage of disease. Rural patients would have spent up to 1,173% of their monthly income per capita, or more than 100% of their total household expenditure even when ART was provided free-of-charge. Patients have also highlighted free ARV drugs were sometimes not available in the health facility and they had to turn to the private market. Hence, the extent of financial burden in this review might be underestimated.
Conclusion: Based on the data available, we concluded that increased accessibility of free ART should be accompanied with sustained ARV drugs supply and increased financial support for PLHIV.published_or_final_version
Community Medicine
Master
Master of Public Health
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Lu, Hang. "The synthesis and structure-activity relationship study of azo dye related HIV replication inhibitors : Part 2: Plant isolation of signalling pathways inhibitors as anti-cancer agents." Diss., Georgia Institute of Technology, 1994. http://hdl.handle.net/1853/27436.
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Aucamp, Charle M. "The use of complementary and alternative therapies among adult HIV positive patients in an outpatient setting." Thesis, Link to the online version, 2008. http://hdl.handle.net/10019/758.
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Gilbert, Hannah. "Rallying resources : strategies of therapeutic engagement among patients living with HIV in Senegal." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=79769.
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In recent years there has been a worldwide recognition of the disparity of HIV treatment available in the West and in Sub-Saharan Africa. The West African nation of Senegal was early to implement measures that allowed for the distribution of highly effective anti-HIV therapy known as Antiretroviral (ARV) therapy to a limited number of patients. This thesis explores how patients living in Senegal who are infected with HIV have engaged in various negotiations to obtain access to treatment and other resources to meet the needs posed by their infection. These negotiations are framed by various historically embedded notions of how to engage relationships in the search for care. Strategies are also shaped by the biopolitically-laden discourse that guides the distribution of ARV therapy. This thesis traces the structure, evolution, and effects of patients' strategic negotiations in response to the introduction of this therapeutic technology.
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Mphana, Mateboho Patricia. "HIV/AIDS prevention and care for learners in a higher education institution in Lesotho." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5307.
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Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: HIV/AIDS is considered as a global problem with the number of people living with HIV infection continuing to increase. At the end of 2007 HIV/AIDS had already claimed 25 million lives. Of all new HIV infections 71% were diagnosed in the Sub-Saharan region in 2008, remaining the worst affected region globally. UNAIDS (2008:43) indicated that heterosexual intercourse remained the main origin for HIV infection in the Sub-Saharan region. Therefore the researcher is of the opinion that prevention strategies should focus mainly on sexual transmission of the disease. HIV/AIDS affects mainly people between the ages 15-24 years, notably the age group of most of the learners in Higher Education Institutions (HEIs). Lesotho, a country in the Sub- Saharan region, presents with the third highest HIV adult prevalence (23.2%) in the world and in the region. In an attempt to address the prevailing situation, Lesotho has a number of programmes geared towards addressing HIV/AIDS in the country. However, all these attempts exclude the learners in HEIs, yet the majority of learners are found within the most affected age group. It is also to be noted that Higher Education provides the bedrock for socio-economic and political development in Africa. Some studies have identified insufficient knowledge as being at the root of the increasing HIV infections among youth. However, other studies have shown that there is adequate knowledge among the young people, but still a challenge remains and that is to facilitate changes in behavioural patterns as a component to be linked to the knowledge. Studies conducted in other African countries have shown that there are anti-AIDS programmes and clubs for learners in HEIs where learners are involved in the fight against HIV/AIDS. No publication indicating the same for Lesotho’s HEIs could be found, except for the National University of Lesotho (NUL) that only launched its HIV/AIDS policy for learners in 2009. The researcher is of the opinion that HEIs in Lesotho are not doing enough to combat HIV/AIDS and hence intends to focus on HEIs in Lesotho. This study had two objectives namely: To determine the knowledge of learners in a specific HEI in Lesotho regarding HIV/AIDS prevention and care. To explore the needs of learners in a specific HEI in Lesotho regarding HIV/AIDS prevention and care. This mixed method study was conducted, comprising of both quantitative and qualitative designs. Quantitative phase used a questionnaire for determining the knowledge of learners. The questionnaire was adopted from a study that was performed to determine knowledge of South African educators in public schools with some modifications. The qualitative phase was used to explore the needs of the learners through the focus group discussions with the leaders of the learners. Sample was drawn from the entire population using stratified random sampling for the quantitative phase. The qualitative phase used the purposive sampling to obtain in-depth information concerning learners’ needs. Quantitative data was analysed through the use of statistical package for social sciences (SPSS) and qualitative data was analysed using the thematic analysis and open-coding. All ethical principles were adhered to especially the principle of respect for persons. The findings from the quantitative phase of the study showed that learners had adequate knowledge regarding HIV/AIDS prevention and care and the findings from the qualitative phase showed the various needs of the learners with regards to prevention and care of HIV/AIDS in a specific HEI in Lesotho. Recommendations have been proposed based on the findings from the two phases of the study. Limitations observed by the researcher have also been identified. In conclusion the objectives of the study were met and the research questions had been answered.
AFRIKAANSE OPSOMMING: MIV/Vigs word as ‘n internasionale probleem erken, siende dat daar ‘n verhoging in die toename van MIVgeïnfekteerde indiwidue tans is . Einde 2007 het MIV/Vigs het reeds 25 miljoen lewens ge-eis . In 2008 is 71% van al die nuwe MIV-infeksies in die Sub-Sahara streek gediagnoseer, wat aandui dat die streek die mees geaffekteerde streek tans is. UNAIDS (2008:43) het aangedui dat heteroseksuele omgang die hoofoorsaak van MIV-oordrag in die Sub-Sahara-streek is. Laasgenoemde het daartoe gelei dat die navorser van mening is dat voorkomende strategieë meestal op seksuele oordrag van die siekte moet fokus. MIV/Vigs affekteer meestal mense in die ouderdomsgroep 15-24, opmerklik is dit die ouderdomsgroep waarby meesste leerders in Hoëronderwysinstellings (HOI) is. Lesotho, ‘n land in die Sub-Sahara-streek, het tans die derde-hoogste MIV-voorkoms (23.2%) in die wêreld en in die streek. Lesotho het verskeie programme ontlont om MIV/Vigs te bekamp in ‘n poging om die huidige situasie te beredder . Nieteenstaande sluit al die programme leerders in HOI uit, alhoewel die leerders in die ouderdomsgroep van die mees-geaffekteerde groep val. Dit is ook duidelik dat Hoëronderwys die fondasie vir sosio-ekonomiese- en politieke ontwikkeling in Afrika verskaf. Sommige studies het onvoldoende kennis as die wortel van die verhoging van MIV-infeksies onder die jeug geïdentifiseer. Ander studies, daarenteen, wys dat kennis voldoende is onder jeug, alhoewel veranderinge in gedragspatrone om by die kennis aan te sluit ‘n uitdaging bly. Studies uit ander Afrikalande dui daarop dat daar anti-Vigs programme en klubs is waarby HO leerders betrokke is om teen die verspreiding van MIV/Vigs te veg. Geen publikasies in hierdie verband word in Lesotho aangetref nie, behalwe ‘n MIV/Vigs-beleid wat in 2009 deur “National University of Lesotho’ (NUL) gepubliseer is. Dus is die navorser van mening dat HOI nie genoeg doen om MIV/Vigs te beveg nie, daarom fokus sy op HOI in Lesotho. Hierdie studie het twee doelstellings ten doel gehad, naamlik om die leerders in ‘n sekere HOI in Lesotho se kennis aangaande MIV/Vigs voorkoming en sorg te bepaal en die behoeftes van die leerders aangaande MIV/Vigs voorkoming en sorg te verken. ‘n Studie met beide kwantitatiewe- en kwalitatiewe metodes is gebruik om die doelstellings te verwesenlik. In die kwantitatiewe fase is ‘n vraelys gebruik om leerders se kennis te bepaal. Die vraelys is verkry uit ‘n vorige studie wat in RSA gedoen is, maar aangepas om in die Lesotho-konteks te gebruik. Gedurende die kwalitatiewe fase is fokusgroep besprekings met die leiers van die leerders gehou om die behoeftes indiepte te verken. Die steekproef was uit die totale populasie getrek deur van gestratifiseerde streekproefneming gebruik te maak in die kwantitatiewe fase en ‘n doelgerigte steekproefneming is in die kwalitatiewe fase te gebruik. Die navorser het ‘n kwantitatiewe data-analise sagteware (SPSS)gebruik om kwantitatiewe data te ontleed en tematiese- oopkodering is gedurende die kwalitatiewe fase gebruik. Etiese kode is ten volle gerespekteer, veral die respek vir mense gedurende navorsing. Bevindinge van die kwantitatiewe fase het bewys dat leerders voldoende kennis aangaande die voorkoming en sorg van MIV/Vigs besit en die kwalitatiewe bevindinge het die behoeftes van leerders met betrekking tot die voorkoming en sorg van MIV/Vigs in ‘n spesifieke HOI in Lesotho geopenbaar. Die aanbevelings is gemaak, gebaseer op die bevindinge uit die twee fases. Beperkinge in die studie is uitgelig. Ter afsluiting is die doelstellings in die studie bereik en die navorsingsvrae beantwoord.
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Norris, Gerard Benedict. "Counterfeiting of HIV/AIDS medicines : implications for global epidemic : recommendations for workplace programs." Thesis, Stellenbosch : Stellenbosch University, 2005. http://hdl.handle.net/10019.1/50307.
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Thesis (MPhil)--Stellenbosch University, 2005.ENGLISH ABSTRACT: multiple therapeutic categories of medicines have been increasingly targeted for counterfeiting. According to Van Niekerk [Van Niekerk, Anton. (2001). Moral and social complexities of AIDS in Africa. University of Stellenbosch], “it is commonplace to identify and bewail a plethora of problems in the developing world generally, and in Africa in particular. Poverty, illiteracy, famine, political instability, natural disasters, and many more misfortunes dominate the history of this part of the world over the past 50 years. It was therefore adding uncalled (undeserved?) insult to already overwhelming injury when HIV/AIDS visibly struck the world since mid-1980. In spite of all the other calamities that Africa has to deal with, it nevertheless is no exaggeration to claim that HIV/AIDS nowadays constitutes the most serious health and social crisis and challenge that has ever befallen the continent”. Similar patterns involving HIV/AIDS are now emerging on other continents. One objective of this recent research study was to explore possible relationships between the growing scourges of the worldwide counterfeiting of medicines and parallels with the expanding global HIV/AIDS pandemic - as well as to examine potential relationships and risks associated with other diseases that have been observed to have ‘special associations’ with HIV and AIDS [e.g. sexually transmitted infections (STI’s), Tuberculosis (TB) and Malaria] - and possible impact on the “World of Work”. A second and important objective was to develop Recommendations for Workplace Programs. The information gathered has also been used to propose future studies regarding HIV/AIDS and counterfeiting. In the developing world, antibiotics and anti-parasitic medicines are included among the counterfeiters’ favorite targets. Strong parallels exist between locations where counterfeiting of medicines is taking place/product being distributed/sold and where HIV/AIDS is most prevalent and/or where the epidemic is expanding progressively. Counterfeiting of medicines used for treating HIV/AIDS raises the possibility of additional future complications developing in managing other global diseases such as Malaria and Tuberculosis, not to mention exacerbating the potential for developing resistance and encouraging mutation of the HI virus itself. It is also noteworthy that certain medical devices have also been found to be counterfeit. Global demographics and with particular reference to projected growth rates of populations of the developing world are of specific relevance to this subject of anticounterfeiting and medicines used for the treatment of HIV and AIDS. Indeed, next generations of humanity appear to be at unnecessary risk of being caught up in a confluence of forces whereby the practice of the counterfeiting of medicines could result in significant complications and unforeseen consequences regarding management of the global HIV/AIDS crisis. Following the research, recommendations for workplace programs were developed. The research study concludes with a comprehensive set of references.
AFRIKAANSE OPSOMMING: Die problamatiek aangaande die vervalsing (namaak) van medisyne word nou wereldwyd ervaar en het ‘n impak op beide die geindustrialiseerde en die ontwikkelende wereld. Menige medisyne in terapeutiese kategoriee is tot op hede as vervals geidentifeseer, met die direkte resultaat dat hulle ‘n minemale of geen terapeutiese uitwerking het nie. Wat nog erger is, is dat hierdie middels uiters gevaarlik is om te gebruik en selfs lewensgevaarlik kan wees. Dit is van groot betekenis dat ook medisyne wat bestem is om persone met HIV/VIGS te behandel, as vervals aangetoon is – en soedoende tot nog toe onbekende gevolge vir pasiente, die werkomgewing en ongekende risiko’s vir wereldwye gesondheidsorg en internasionale veiligheid en sekuriteit inhou. In hierdie studie word die onderwerp in taamlike besonderhede bestudeer en daar word afgesluit met aanbevelings oor programme in die werkplek wat ontwerp is om sorg en ondersteuning te bied aan werkers met HIV/VIGS. Verdere studie word ook aanbeveel om die tergende probleme wat volg op die vervalsing van medisyne in die behandling van persone met HIV/VIGS, en die implikasies hiervan, die hoof te bide.
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Zheve, Georgina Teurai. "Neuroprotective mechanisms of nevirapine and efavirenz in a model of neurodegeneration." Thesis, Rhodes University, 2008. http://hdl.handle.net/10962/d1003285.
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AIDS Dementia Complex (ADC) is a neurodegenerative disorder implicated in HIV-1 infection that is associated with elevated levels of the neurotoxin, quinolinic acid (QA) which causes a cascade of events to occur, leading to the production of reactive oxygen species (ROS), these being ultimately responsible for oxidative neurotoxicity. In clinical studies, Non-nucleoside reverse transcriptase inhibitors (NNRTIs), efavirenz (EFV) and nevirapine (NVP) have been shown to potentially delay the progressive degeneration of neurons, thus reducing the frequency and neurological deficits associated with ADC. Despite these neuroprotective implications, there is still no biochemical data to demonstrate the mechanisms through which these agents offer neuroprotection. The present study aims to elucidate and further characterize the possible antioxidant and neuroprotective mechanisms of NVP and EFV in vitro and in vivo, using QA-induced neurotoxicity as a model. Research has demonstrated that antioxidants and metal chelators have the ability to offer neuroprotection against free radical induced injury and may be beneficial in the prevention or treatment of neurodegeneration. Hence the antioxidant and metal binding properties of these agents were investigated respectively. Inorganic studies, including the 1, 1-diphenyl-2 picrylhydrazyl (DPPH) assay, show that these agents readily scavenge free radicals in vitro, thus postulating the antioxidant property of these agents. The enhancement of superoxide radical generation and iron mediated Fenton reaction by QA is related to lipid peroxidation in biological systems, the extent of which was assayed using the nitroblue tetrazolium and thiobarbituric acid method respectively. Both agents significantly curtail QA-induced lipid peroxidation and potentially scavenge superoxide anions generated by cyanide in vitro. Furthermore, in vivo results demonstrate the ability of NVP and EFV to protect hippocampal neurons against lipid peroxidation induced by QA and superoxide radicals generated as a consequence thereof. The alleviation of QA-induced oxidative stress in vitro possibly occurs through the binding of iron (II) and / or iron (III), and this argument is further strengthened by the ability of EFV and not NVP to reduce iron (II)-induced lipid peroxidation in vitro directly. In addition the ferrozine and electrochemistry assay were used to measure the extent of iron (II) Fe[superscript 2+] and iron (III) Fe[superscript 3+] chelation activity. Both assays demonstrate that these agents bind iron (II) and iron (III), and prevent redox recycling of iron and subsequent complexation of Fe[superscript 2+] with QA which enhances neuronal damage. Both NNRTIs inhibit the endogenous biosynthesis of QA by inhibiting liver tryptophan 2, 3-dioxygenase activity in vivo and subsequently increasing hippocampal serotonin levels. Furthermore, these agents reduce the turnover of hippocampal serotonin to 5-hydroxyindole acetic acid. NVP and not EFV increase 5-hydroxyindole acetic acid and norepinephrine levels in the hippocampus. The results of the pineal indole metabolism study show that NVP increases the synthesis of melatonin, but decreases N-acetylserotonin, 5-hydroxyindole acetic acid and 5-hydroxytryptophol levels. Furthermore, it shows that EFV decreases 5-hydroxyindole acetic acid and melatonin synthesis. Behavioural studies using a Morris water maze show that the post-treatment of rats with NVP and EFV significantly improves QA-induced spatial memory deficits in the hippocampus. This study therefore provides novel information regarding the neuroprotective mechanisms of NVP and EFV. These findings strengthen the argument that these NNRTIs not only have antiviral effects but possess potential neuroprotective properties, which may contribute to the effectiveness of these drugs in the treatment of ADC.
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Awortwe, Charles. "Pharmacokinetic herb-drug interaction study of selected traditional medicines used as complementary and alternative medicine (CAM) for HIV/AIDS." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96796.
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Thesis (DMed)--Stellenbosch University, 2015ENGLISH ABSTRACT: Introduction The increasing intake of traditional medicines among HIV/AIDS patients in sub-Saharan Africa needs urgent consideration by clinicians and other healthcare providers since the safety of such medications are unknown. The pharmacokinetic parameters - Absorption, Distribution, Metabolism and Elimination (ADME) play important role in the safety evaluation of drugs, thus implicating drug metabolizing enzymes and transporters as critical indicators for herb-drug interactions. The objective of this study was to evaluate the risk potential of seven herbal medicines commonly consumed by HIV/AIDS patients for drug interactions applying in vitro models. In this study, inhibition and induction effects of the herbal medicines on cytochrome P450s (CYPs) 1A2, 2C9, 2C19, 2D6 and 3A4 as well as P-glycoprotein (P-gp) were investigated. Methods Herbal medicines – Lessertia frutescens, Hypoxis hemerocallidea, Kalanchoe integra and Taraxacum officinale were sourced from Medico Herbs, South Africa were identified by experts from Compton Herbarium, South African National Biodiversity Institute, Cape Town. Moringa oleifera, Echinacea purpurea and Kalanchoe crenata were obtained from the repository of the National Centre for Natural Product Research (NCNPR), University of Mississippi, USA. Reversible inhibitory effect of aqueous and methanol herbal extracts were evaluated in recombinant CYPs applying the fluorescent metabolites at specified excitation/emission wavelengths; CYP1A2 (3-cyano-7-hydroxycoumarin (CHC); 405/460 nm), CYP2C9, CYP2C19 and CYP3A4 (7-hydroxy-4-(trifluoromethyl)-coumarin (HFC); 405/535 nm) and CYP2D6 (7-hydroxy-4-(aminomethyl)-coumarin (HAMC); 390/460 nm). Comparative studies in human liver microsomes (HLM) and recombinant CYPs were conducted to investigate the inhibitory effect of methanol herbal extracts and fractions on 6β testosterone hydroxylation activity. Time dependent inhibitory (TDI) effect of the herbal extracts were evaluated applying the IC50 shift fold, normalized ratio and the NADPH-, time- and concentration-dependent approaches. Influence of herbal extracts on metabolic clearance of testosterone was assessed in both HLM and human hepatocytes. The effects of each herbal extract on expression of CYP1A2, CYP3A4 and MDR1 genes were evaluated in activated human pregnane X receptor (PXR) co-transfected HepG2 cells. Finally, the inhibitory effect of herbal extracts on P-gp was assessed using the calcein-acetoxymethyl ester (calcein-AM) uptake and the digoxin radiolabelled substrates in MDCKII-MDRI cells. Results The aqueous extracts of Moringa oleifera, Kalanchoe integra, Kalanchoe crenata, Echinacea purpurea and Lessertia frutescens demonstrated high risk of in vivo inhibition on CYPs 3A4 and 1A2 with Cmax/Ki >1.0. Methanol extracts of these herbal medicines also indicated potential risk of reversible drug interaction. The methanol extracts of M. oleifera, K. crenata and L. frutescens showed strong TDI effect on CYP3A4 with IC50 shift fold >1.5 and normalised ratio <0.7. Moringa oleifera intermediately reduced intrinsic clearance of testosterone in human hepatocytes (2 ≤ AUC ratio ≤ 5) when scaled up to humans. Methanol extracts of Echinacea purpurea up-regulated the expression of CYP1A2, CYP3A4 and MDR1 genes in activated PXR. Kalanchoe crenata and Echinacea purpurea indicated strong inhibition on P-gp by reducing transport of digoxin across hMDR1-MDCKII cell monolayer from basolateral to apical with IC50 values of 18.24 ± 2.52 μg/mL and 24.47 ± 4.97 μg/mL, respectively. Conclusion The herbal medicines especially M. oleifera, K. integra and E. purpurea have the potential to cause herb-drug interaction in vivo if sufficient hepatic concentration is achieved in humans.
AFRIKAANSE OPSOMMING: Inleiding Die verhoogde inname van tradisionele medisynes onder MIV/VIGS-pasiënte in sub-Sahara-Afrika verg dringend oorweging deur klinici en ander gesondheidsorgverskaffers, aangesien die veiligheid van sodanige medikasies onbekend is. Die farmakokinetiese parameters – Absorpsie, Distribusie, Metabolisme en Eliminasie (ADME) – speel ’n belangrike rol by die veiligheidsevaluering van geneesmiddels, en impliseer gevolglik geneesmiddel-metaboliserende ensieme en vervoerders as kritiese indikators vir krui-geneesmiddel-interaksies (HDI). Die oogmerk van hierdie studie is om die risikopotensiaal van sewe kruiemedisynes wat algemeen deur MIV/VIGS-pasiënte geneem word, vir geneesmiddel-interaksies te evalueer deur in vitro-modelle te gebruik. In hierdie studie is die inhiberings- en induseringsuitwerkings van die kruiemedisynes op sitochroom P450’s (verkort na CYP’s) 1A2, 2C9, 2C19, 2D6 en 3A4, sowel as P-glikoproteïen (P-gp), ondersoek. Metodes Kruiemedisynes – Lessertia frutescens, Hypoxis hemerocallidea, Kalanchoe integra en Taraxacum officinale – is van Medico Herbs, Suid-Afrika, bekom en deur kundiges van die Compton-herbarium, by die Suid-Afrikaanse Nasionale Biodiversiteitsinstituut, Kaapstad, geïdentifiseer. Moringa oleifera, Echinacea purpurea en Kalanchoe crenata is van die bewaarplek van die Nasionale Sentrum vir Natuurlike Produknavorsing (NCNPR) aan die Universiteit van Mississippi in die VSA verkry. Die omkeerbare inhiberende uitwerking van kruie-ekstrakte in water en metanol is in rekombinante CYP’s geëvalueer deur die gebruik van die fluoresserende metaboliete op gespesifiseerde opwekkings-/emissiegolflengtes; CYP1A2 (3-siaan-7-hidroksikumarien (CHC); 405/460 nm), CYP2C9, CYP2C19 en CYP3A4 (7-hidroksi-4-(trifluoormetiel)-kumarien (HFC); 405/535 nm) en CYP2D6 (7-hidroksi-4-(aminometiel)-kumarien (HAMC); 390/460 nm). Vergelykende studies van menslikelewermikrosome (HLM) en rekombinante CYP’s is uitgevoer om die inhiberende uitwerking van metanolkruie-ekstrakte en -fraksies op 6β-testosteroonhidroksileringsaktiwiteit te ondersoek. Die tydafhanklike inhiberende uitwerking (TDI) van die kruie-ekstrakte is geëvalueer deur gebruikmaking van die IC50-verskuiwingsvou-, die genormaliseerdeverhoudings- en die NADPH-, tyd- en konsentrasieafhanklike benaderings. Die invloed van kruie-ekstrakte op metaboliese testosteroonverheldering is in beide HLM en menslike hepatosiete geëvalueer. Die uitwerkings van elke kruie-ekstrak op die uitdrukking van CYP1A2-, CYP3A4- en MDR1-gene is in geaktiveerde menslike pregnaan-X-reseptor(PXR)-, ko-getransfekteerde HepG2-selle geëvalueer. Laastens is die inhiberende uitwerking van kruie-ekstrakte op P-gp geëvalueer, met gebruikmaking van die kalsien-asetoksimetiel-ester (kalsien-AM)-opname en die digoksien- radiogemerkte substrate in MDCKII-MDRI-selle. Resultate Die ekstrakte in water van M. oleifera, K. integra, K. crenata, E. purpurea en L. frutescens het ’n hoë risiko van in vivo-inhibering op CYP’s 3A4 en 1A2 met Cmaks/Ki >1.0 getoon. Ekstrakte van hierdie kruiemedisynes in metanol het verder potensiële risiko van omkeerbare geneesmiddelinteraksie getoon. Die ekstrakte van M. oleifera, K. crenata en L. frutescens in metanol het sterk TDI-uitwerking op CYP3A4 met IC50-verskuiwingsvou >1.5 en genormaliseerde verhouding <0.7 getoon. M. oleifera het intermediêre vermindering van intrinsieke testosteroonverheldering in menslike hepatosiete (2 ≤ AUC verhouding ≤ 5) tot gevolg wanneer die skaal na mense verhoog word. Ekstrakte van E. purpurea in metanol het die uitdrukking van CYP1A2-, CYP3A4- en MDR1-gene in geaktiveerde PXR opgereguleer. K. crenata en E. purpurea het sterk inhibering van P-gp getoon deur die vervoer van digoksien deur die hMDR1-MDCKII-selmonolaag van basolateraal tot apikaal met IC50-waardes van onderskeidelik 18.24 ± 2.52 μg/mL en 24.47 ± 4.97 μg/mL te verminder. Gevolgtrekking Kruiemedisynes, veral M. oleifera, K. integra en E. purpurea, het die potensiaal om HDI in vivo te veroorsaak indien voldoende hepatiese konsentrasie by mense bereik word.
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De, Vos Marieta. "Critical factors in NACOSA’s success as a network organisation in the HIV and AIDS sector." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96802.
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Thesis (MPhil)--Stellenbosch University, 2015.ENGLISH ABSTRACT: NACOSA had an eventful history spanning 22 years. The first phase between 1992 and 2001 is labeled Great Expectations as the composite multi-sectoral structure started a groundbreaking initiative on HIV and AIDS in South Africa and believed that the first AIDS plan drafted by them would be implemented as planned. Expectations came to nothing as government struggled to find its feet through a decade of blunders leading to the demise of the structure by end 2001. The next phase between 2001 and 2010 is labeled Starting Over as the Western Cape branch of NACOSA reinvented itself as a community mobilisation network for the province. Within a period of ten years Western Cape NACOSA developed into a successful national network with a large membership fully involved through its networking, capacity building and promoting dialogue functions. The third phase between 2010 and 2015 is labeled Rapid Growth as NACOSA developed into a large training and grant management agency with strong systems providing funding to its members through sub-granting. Networking continued at a slower pace but is still highly important for the organisation. The network contributes to localised social capital through shared learning and collaboration. NACOSA‟s sustainability has been developed through the ability to raise long-term funds for network activities, capacity building of members and coordinated service delivery on the ground. NACOSA also has a culture of identifying and acting fast on opportunities and adapting to change when it is needed. Strategic factors attributing to the success of NACOSA are a sector based approach promoting diversity in its membership; a consistently focused and shared purpose throughout the years; a community agent approach believing in and advocating for community systems strengthening; obtaining a mandate from network members for main strategy changes; strategic partnerships; a strong capacity building approach focussing on organisational and programmatic competencies; not competing with network members but acting as main weaver; creating specialist networks for specific HIV-related causes; a committed representative executive committee and skilled staff; bringing groups together on a regular basis for discussions and strategising; a variety of social media; and a network mindset intent on a culture of learning and building trust between member organisations.
AFRIKAANSE OPSOMMING: NACOSA het 'n gebeurtenisvolle geskiedenis wat strek oor 'n periode van 22 jaar. Die eerste fase tussen 1992 en 2001 word genoem Groot Verwagtinge, verwysende na die saamgevoegde multi-sektorale struktuur wat ontstaan het as die eerste groot MIV en VIGS inisiatief in Suid-Afrika. Hulle het verwag dat hul eerste VIGS-plan geïmplementeer sou word soos wat hulle dit beplan het. Hul verwagtinge het egter skipbreuk gely as gevolg van die regering wat oor die dekade heen hul voete gesleep en foute gemaak het wat uiteindelik gelei het tot die struktuur se ondergang in 2001. Die volgende fase tussen 2001 en 2010 word genoem Oorbegin verwysende na die Wes-Kaap tak van NACOSA wat hulself herskep het as „n gemeenskapsmobiliseringsnetwerk. Wes-Kaap NACOSA het binne tien jaar weer ontwikkel in 'n suksesvolle nasionale netwerk met 'n groot ledetal wat volledig ingeskakel is by die organisasie se netwerk, kapasiteitsbou en bevordering van dialoogaktiwiteite. Die derde fase tussen 2010 en 2015 word genoem Snelle Groei verwysende na NACOSA se ontwikkeling in 'n groot opleidings- en fondsbestuursagentskap met sterk stelsels wat befondsing aan hul lede verskaf. Netwerkskakeling het voortgeduur teen 'n stadiger pas maar is steeds baie belangrik vir die organisasie. Die netwerk dra by tot die bou van plaaslike sosiale kapitaal deur middel van samewerking en saam leer. NACOSA se volhoubaarheid het ontwikkel deur hul vaardigheid om langtermynfondse in te samel vir netwerkaktiwiteite, kapasiteitsbou en gekoördineerde dienslewering op grondvlak. NACOSA het ook 'n kultuur om geleenthede vinnig te identifiseer en daarop te reageer, asook om aan te pas by veranderinge wanneer nodig. Strategiese faktore wat bygedra het tot NACOSA se sukses sluit in 'n wye sektorbenadering met diverse lidmaatskap; 'n konsekwente gedeelde doelwit oor die jare; die bevordering van sterk gemeenskapstelsels; die verkryging van 'n mandaat by netwerklede vir strategie-veranderinge; strategiese vennootskappe; 'n sterk kapasiteitsboubenadering wat fokus op organisatoriese en programmatiese vaardighede; geen kompetisie met lede-organisasies maar eerder die rol van “hoofwewer”; skep van spesialisnetwerke vir spesifieke MIV-verwante kwessies; 'n toegewyde raad en vaardige personeel; gereelde bymekaarbring van groepe vir dialoog en strategie bou; 'n verskeidenheid van sosiale media; en 'n netwerk denkpatroon gefokus op 'n leerkultuur en die bou van vertroue tussen lede.
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Visser, Daniel Finsch. "Isolation and evolution of novel nucleoside phosphorylases." Thesis, Rhodes University, 2010. http://hdl.handle.net/10962/d1004031.
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Approximately 33.4 million people are living with HIV/AIDS. Of those, 97% live in low and middle income countries, with 22.4 million in sub-Saharan Africa. Only 42% of the people who require anti-retrovirals (ARVs) in low to middle income countries are receiving anti-retroviral therapy (ART). There is a need to develop novel and cost effective methods for producing antiretroviral drugs. Stavudine and azidothymidine (AZT) were identified as potential targets because they could both be produced through a common intermediate – 5 methyluridine (5-MU). It has been established that the biocatalytic production of 5-methyluridine is possible through a reaction known as transglycosylation, in a process which has not previously been demonstrated as commercially viable. A selection of biocatalysts were expressed either in recombinant E. coli strains or in the wild type organisms, purified and then screened for their ability to produce 5-MU. A combination of Bacillus halodurans purine nucleoside phosphorylase 1 (BHPNP1) and E. coli uridine phosphorylase (EcUP) gave the highest 5-MU yield (80%). This result represents the first combination of free enzymes from different organisms, giving high yields of 5-MU under high substrate conditions. Both enzymes were purified and successfully characterised. The established pH optimum was pH 7.0 for both enzymes. Temperature optima and stability data for BHPNP1 (70 C and t1/2 at 60 C of 20.8 h) indicated that the biocatalytic step was operating within the capabilities of this enzyme and would operate well at elevated temperatures (up to 60 C). Conversely, the temperature optimum and stability data for EcUP (optimum of 40 C and t1/2 at 60 C of 9.9 h) indicated that the enzyme remained active at 40 C for the duration of a 25 h biotransformation, but at 60 C would only be operating at 20% of its optimum activity and would lose activity rapidly. BHPNP1 and EcUP were used in a bench scale (650 ml) transglycosylation for the production of 5-MU. A 5-MU yield of 79.1% was obtained at this scale with a reactor productivity of 1.37 g.l-1.h-1. Iterative saturation mutagenesis was used to rapidly evolve EcUP for improved thermostability. A moderately high throughput colorimetric method was developed for screening the mutants based on the release of p-nitrophenol upon phosphorolysis of a pyrimidine nucleoside analogue. By screening under 20 000 clones the mutant UPL8 was isolated. The mutant enzyme showed an optimum temperature of 60 C and improved stability at 60 C (t1/2 = 17.3 h). The increase in stability of UPL8 is due to only 2 mutations (Lys235Arg, Gln236Ala). These mutations may have caused an increase in stability due to interactions with other structural units in the protein, stabilization of the entrance to the binding pocket, or by decreasing the flexibility of the α-helix at the N-terminus. Transglycosylation experiments showed that the mutant enzyme UPL8 is a superior catalyst for the production of 5-MU. A 300% increase in reactor productivity was noted when free enzyme preparations of UPL8 was combined with BHPNP1 at 1.5% m.m-1 substrate loading. The high yield of 5-MU (75-80% mol.mol-1) was maintained at 9% m.m-1 substrate loading. A commercially viable productivity of 31 g.l-1.h-1 was thus realised. Further optimisation of the process could produce still higher productivities. Future work in directed evolution of nucleoside phosphorylases is envisaged for improved stability and enhanced substrate range for application to other commercially relevant transglycosylation reactions.
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Hogan, Paula Jaye. "A constructivist study of social work's involvement with HIV/AIDS." CSUSB ScholarWorks, 1995. https://scholarworks.lib.csusb.edu/etd-project/1079.
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Jung, Joo-Yong. "Biologic effects of lavendamycin analogs on cultured cells and HIV-RT." Virtual Press, 2001. http://liblink.bsu.edu/uhtbin/catkey/1217381.
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The purpose of the study was to determine if perceived severity of the consequences of physical inactivity is an important component for exercise motivation in college students. The participants of the study were 581 college students who had enrolled in HSC 160, Fundamentals of Human Health, at Ball State University during the spring semester of 2001. Using a cross-sectional data collection process, participants completed a survey instrument consisting of the stages of change for exercise scale, the perceived severity of the consequences of physical inactivity scale, and demographic questions.The data were analyzed using both univariate and bivariate analyses. Specific descriptive and inferential statistic analyses were used to: 1) determine the degree of association between the participants' perceived severity and their identified stages of change for exercise, 2) examine the relationship between the stages of change for exercise and the participants' demographic characteristics, and 3) determine the difference between perceived severity of consequences of physical inactivity and the Participants' demographic characteristics.The results indicated that those who perceived the threat of a health condition as a result of not being physically active to be high were more likely to exercise regularly. Males and females differed in their exercise stage of change with males being more likely in the maintenance stage whereas females were more likely to be in the preparation stage. Also, perceived severity of the consequences from the lack of physical activity was greater in females than males, suggesting that those men who exercise regularly do so, but not exclusively for preventing negative health conditions.The results of this study should be useful to health and physical education instructors to assist them with organizing and tailoring appropriate physical activity lecture topics and emphasizing the severity of the consequences to those who are not physically active.Finally, additional research should be conducted in order to determine what factors affect perceived severity of a health threat as it relates to physical inactivity such as demographics, sociopsychological, and structural variables, to help identify all the possible factors that could impact future program planning efforts.Department of Biology
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Mkosi, Barbara Nomsa. "Confidentiality as value in the management of HIV/AIDS in South Africa." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51663.
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Thesis (M.Phil.)--Stellenbosch University, 2000.ENGLISH ABSTRACT: AIDS is the most important threat to world health. Recent years have seen a dramatic spread of HIVand AIDS in South Africa. Health education directed at modifying risk behaviour appears to be the only way in which the disease can be contained. Controlling AIDS is not only by controlling the virus, but also involves tackling social, economic and political issues and putting AIDS into the broader context of sexuality and gender roles. This requires a broader understanding of this aspect of HIV-AIDS ranging from population dynamics, through to research on individual behaviour and its socio-economic impact; so that we can dispel the myths and rumours that surround AIDS and answer searching questions that will be asked by the community. In South Africa, HIV-AIDS remains a stigmatized disease. There have been calls from courageous and influential people for those who are living with HIV-AIDS to be open about their status and to destigmatise the disease. Institutions too have been drawn into the controversy about whether to remain silent or speak out. Southern African Anglican bishops, as well as some politicians declared their intention to undergo testing for HIV status in order to sensitise the public to the seriousness of the epidemic. Were AIDS not regarded as intolerable, the entire issue of confidentiality would fall away. Calls to destigmatise the disease through openness cannot stand alone. Government must put effective treatment programmes in place. In the absence of treatment, AIDS may represent only frustration and hopelessness to those who test positive; and fear, danger and resultant animosity to those who are HIV negative. The text is in four chapters. Chapter 1 focuses on confidentiality as an important principle in the management of disease. In HIV -AIDS, confidentiality is a more sensitive issue as AIDS is particularly viewed as a social stigma, accompanied by discrimination and harassment. The chapter also addresses HIV infection, transmission, counseling and screemng. Chapter 2 deals with the principles of biomedical ethics namely, autonomy, to enable the patient to determine his/her course of treatment; informed consent, designed to protect the interests of patients from exploitation and harm, and encourage health professionals to act responsibly; beneficence and nonmaleficence, to protect the welfare of others; and justice, to ensure access to health care for all. It also highlights the aspects of and limitations to confidentiality. Chapter 3 discusses broadly the ethical dilemmas pertammg to professional-patient relationships, women and HIV-AIDS, religion, prisoners and employer-employee relationships. When the AIDS epidemic started, very few people suffered from the disease, and the disease was treated with great caution and confidentiality. Today, AIDS is a pandemic and emphasis should shift from the ethic of autonomy and confidentiality, to a social ethic, which emphasizes the responsibility of minimizing the risk of spread of infection. The chapter also examines the role of the Department of Health, the participation of health professional bodies and the legal aspects relating to confidentiality in HIV-AIDS. Chapter 4 attempts to construct an argument to destigmatise HIV-AIDS by arguing the responsibility of the government to make sufficient resources available for the treatment and control of the pandemic. Health professionals are challenged to engage their expertise and skills in the service of the sick with dignity and respect. The community is encouraged to support the drive towards controlling the spread of HIV infection and enable people living with AIDS to disclose their status without fear of harassment.
AFRIKAANSE OPSOMMING: Vigs is die gevaarlikste bedreiging van wéreldgesondheid. Die afgelope paar jaar het 'n dramatiese verspreiding van mv en VIGS in Suid-Afrika plaasgevind. Gesondheidsopvoeding wat gemik is op die verandering van risiko-gedrag is skynbaar die enigste metode wat die siekte kan beheer. Die kontrolering van VIGS is nie net die kontrolering van die virus nie, maar dit betref ook herbesinning oor sosiale, ekonomiese en politiese en geslagsrolle. Dit vereis 'n omvattender verstaan van hierdie aspek van HIV-VIGS, wat strek vanaf van bevolkingspatrone tot by die navorsing oor individuele gedrag en die sosio-ekonomiese impak van 19. So kan ons hopelik help om die mites rondom VIGS te besweer. In Suid-Afrika bly mV-VIGS 'n gestigmatiseerde siekte. Daar rus 'n veranbtwoordelikheid op invloedryke mense wat met mV-VIGS leef en wat as rolmodelle sou kon dien, om hul mv -status te openbaar en sodoeonde te help om die siekte te destigmatiseer. Instansies is ook by hierdie twispunt betrek om vas te stelof die mense moet praat of swyg. Suider-Afrikaanse Anglikaanse Biskoppe, asook somige politici het hulle intensies aangekondig om die mv -toets te ondergaan om sodoende die publiek te help opvoed oor die gevaar van hierdie epidemie. Oproepe om die siekte te destigmatiseer deur openbaarheid kan nie in isolasie funksioneer nie. Die staat moet effektiewe kuratiewe en voorkomingsprogramme hier rondom loods en kontinueer. In die afwesigheid van 'n geneesmiddel, sal VIGS slegs frustrasie, hopeloosheid, en vrees skep by diegene wat positief getoets is, sowel as vyandigheid onder diegene wat nie mv positief is nie. Die teks het vier hoofstukke. Hoofstuk 1 fokus op vertroulikheid as 'n belangrike beginsel in die bestuur van die siekte. In mV-VIGS is vertroulikheid 'n meer sensitiewe beginsel aangesien VIGS in die besonder as 'n sosiale skandvlek, aangevreet deur diskriminasie, gesien word. Die hoofstuk bespreek ook mv -infeksie, transmissie, raadgewing en toetsing. Hoofstuk 2 gaan oor die beginsels van die biomediese etiek, naamlik, outonomie, waaronder ingeligte toetstemming, ontwerp om die belange van die pasiente te beskerm teen eksploitasie en gevaar: om gesondheids professionele aan te moedig om hulle op 'n verantwoordelike manier te gedra. Ander beginsels is goedwilligheid en niekwaadwiligheid om die welsyn van ander te beskerm, asook geregtigheid, om toegang tot gesondheidshulp vir almal te verseker. Dit beklemtoon ook die aspekte verwant aan beperkinge tot vertroulikheid. Hoofstuk 3 bespreek breedweg die etiese dilemmas met betrekking tot die verhouding tussen pasiënye en professionele gesondheidswerkers, vrouens en mV-VIGS, godsdiens, gevangenes en werkgewer-werker verhoudings. Toe die VIGS-epidemie begin het, het min mense aan die siekte gely, en die siekte is met groot sorg en vertroulikheid behandel. Vandag is VIGS 'n pandemie en die klem moet geskuif word vanaf outonomie en vetrouilikheid na 'n sosiale etos wat verantwoordlikheid en die vermindering van die risiko van die verspreiding van die infeksie beklemtoon. Die hoofstuk kyk ook na die rolle van gesondheidsdepartmente, deelname van gesondheids professionele organisasies en die juridiese aspekte met betrekking tot vertroulikheid van HIV-VIGS. Hoofstuk 4 poog om 'n argument te ontwikkel wat daartoe sou kon bydra dat HIV-VIGS gedestigmatiseer sal word. Klem word gelê op die verabtwoordelikheid van die staat om soveel moontlike bronne beskikbaar te stel vir die behandeling van en beheer oor hierdie pandemie. Gesondheids professionele word uitgedaag om hulle deskundigheid en bekwaamheid in die diens van die siekes met waardigheid en respek te gebruik. Die gemeenskap word aangemoedig om die poging tot die beheer van die verspreiding van die HIV -infeksie te ondersteun en om die mense wat met VIGS leef in staat te stelom hul status sonder die dreigement van stigmatisering bekend te maak.
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He, Xi, and 何溪. "The impact of lopinavir/ritonavir (Kaletra) on blood lipids in HIV/AIDS antivirus treated naïve patients in China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46936129.
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Phalafala, Mathatho Samuel. "The effects of HIV status disclosure on antiretroviral treatment adherence." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96973.
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Thesis (MSc)--Stellenbosch University, 2015.ENGLISH ABSTRACT: Successful antiretroviral therapy (ART) depends on appropriate use of antiretroviral agents; which ultimately prevents replication of Human Immunodeficiency Virus (HIV) thus delaying clinical progression of the disease. This study explored how HIV status disclosure affects adherence to antiretroviral therapy at Mamelodi Hospital, using a convenience sampling method with a sample size of 50 adults above 18 years who were on treatment for a minimum of two years prior to the study. An interview protocol was used to uncover patients’ demographics, sexual orientation, and HIV status disclosure, adherence to antiretroviral drugs, drug side effects, how often they missed their doses and how HIV status disclosure / non-disclosure affected their adherence to treatment. Patients’ medical records were assessed to validate and correlate the information obtained from the interviews. The scientific test results used were the CD4count and Viral loads which are used to monitor the HIV/AIDS disease progression. All partakers involved in the study made their HIV status known and reported taking their medicines regularly. The patients’ CD4 count and VL were verified, the CD4 count has shown an upward trend while the VL load showed a downward trend in keeping with patients who are adhering to ART. The majority of participants (54% or 27 patients) reported they had never skipped taking their medication. The participants also reported they had taken their medicine in front of other people and they constituted 74% (37) of the group. Of this 74%, 78.38% (29 patients) said it was because they had disclosed their status. This observation supports the fact that if you have disclosed your HIV status, you have better chances of adhering to prescribed medication. Findings from the study at Mamelodi Hospital revealed that for as long as one has disclosed their HIV status, the outcome of treatment adherence will be better. The only shortfall noted was lack of partakers who did not divulge their HIV status thus a comparison could not be done. It was acknowledged that some participants in the study might have reported disclosure of their HIV status to be in good favour of the researcher to create an impression that they are adhering to their medication. The study has confirmed the existence of a relationship between HIV status disclosure and adherence to ART.
AFRIKAANSE OPSOMMING: Suksessvolle antiretrovirale terapie (ART) hang af van die toepaslike gebruik van antiretrovirale middels, wat replikase van die MI-virus verhoed, en dus die kliniese vordering van die siekte vertraag. Hierdie studie het ondersoek hoe die bekendmaking van MIV-status die gehoorsaamheid tot ART beïnvloed het by die Mamelodi Hospitaal. ‘n Gerieflikheid-streekproef met ‘n groote van 50 volwassenes bo 18 jaar is gebruik en die deelnememers moes ten minste vir twee jaar voor die studie reeds op behandeling gewees het. Data is deur middel van onderhoude ingesamel, met die doel om pasiënte se demografiese inligting, seksuele orientasie, MIV-status, gehoorsaamheid tot ART en newe-effekte van ART in te samel. Pasiënte se mediese rekords is nagegaan om die inligting wat uit die onderhoude verkry is te bevestig. Die wetenskaplike toetse wat gebruik is, was die CD4-telling en virale lading wat gebruik word om MIV/Vigs te monitor. Al die deelnemers het hul MIV-status bekend gemaak en aangedui dat hul hul medikasie gereeld gebruik. Die pasiënte se CD4-tellings en virale lading is bevestig, die CD4-tellings het ‘n opwaartse neiging getoon terwyl die virale lading ‘n afwaartse neighing getoon het. Die meerderheid van die deelnemers (54%) het aangedui dat hul nog nooit hul medikasie oorgeslaan het nie. 74% van die deelnemers het aagedui dat hul hul medikasie voor ander mense neem - hul noem dat dit as gevolg van die feit is dat hul hul status bekend gemaak het. Dit ondersteun die feit dat mense wie hul status bekend maak beter kanse het om gehoorsaam hul medikasie te gebruik. Die studie by die Mamelodi Hospitaal toon dat solank mense hul MIV-status bekend maak, hul meer gehoorsaam is teenoor die gebruik van hul medikasie. Die studie bevestig dus die verband tussen bekendmaking van MIV-status en gehoorsaamheid tot ART.
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Le, Roux Rhonddie. ""Acts of disclosing" : an enthnographic investigation of HIV/AIDS disclosure grounded in the experiences of those living with HIV/AIDS accessing Paarl Hospice House seeking treatment." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/16610.
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Thesis (MPhil)--University of Stellenbosch, 2005.ENGLISH ABSTRACT: Paarl, in the Western Cape, has been identified as one of the 15 national sites where antiretroviral treatment (ARVs) would be made available to people living with HIV/AIDS. Paarl Hospice initiated a support group for people to deal with this disease in 2003. Since February 2004 Paarl Hospice has been recruiting people from the surrounding informal settlements for ARVs. By means of participant observation I explored how HIV/AIDS-related disclosure experiences unfolded in places, spaces and events associated with the support group in the context of factors enabling and preventing people from accessing Hospice House. I did this by considering the insights drawn from an anthropological approach. I found the meanings of disclosure in the majority of studies to be limited and restricted. Available studies approached disclosure in a top-down fashion by regarding the definition of disclosure as the announcement of HIV-positivity at the time of diagnosis only. These studies have not considered social differences relating to disclosure neither did they focus on the actual process of disclosure. By means of a constructivist approach to grounded theory I seek to broaden the definition of disclosure to account for the range of ways in which disclosure practices take place. I found that disclosure could not be separated from the situational context in which it occurs and that it can only be understood in relation to the circumstances and relationships in which it takes place. In this study, disclosure was an ongoing process, situated somewhere between active, public announcement of an HIV-status and complete secrecy and somewhere between voluntary and involuntary revealing of the disease.
AFRIKAANSE OPSOMMING: Paarl in die Wes-Kaap is geïdentifiseer as een van die 15 nasionale areas waar antiretrovirale medikasie beskikbaar gestel sou word aan mense wat leef met MIV/VIGS. Paarl Hospice het gedurende 2003 ʼn ondersteuningsgroep geїnisieer om aan MIV/VIGS aandag te gee. Sedert Februarie 2004 is Paarl Hospice in die proses om mense te werf uit die omliggende informele behuisingsgebiede vir antiretrovirale behandeling. Met behulp van antropologiese insigte en deelnemende waarneming kon ek nagaan hoe verskillende maniere van MIV/VIGS-verwante bekendmaking ontvou in plekke, ruimtes en gebeurtenisse wat verband hou met die ondersteuningsgroep. MIV/VIGSverwante bekendmaking is ondersoek te midde van inhiberende en fasiliterende faktore wat mense verhoed of aanhelp om Paarl Hospice te besoek. Ek het bevind dat die definisie van bekendmaking in die meeste navorsing gebrekkig is. Beskikbare navorsing het bekendmaking volgens ‘n bo-na-onder-wyse benader as die openbare bekendmaking van ‘n MIV-status na afloop van diagnose alleenlik. Met behulp van ‘n konstruktiewe benadering van die begronde teorie het ek gepoog om die definisie van bekendmaking uit te bou om sodoende die verskeidenheid maniere waarop bekendmaking plaasvind te akkommodeer. Ek het vasgestel dat bekendmaking onlosmaakbaar deel is van die situasionele konteks waarin dit plaasvind en dat dit slegs begryp kan word in verband tot die verhoudings en omstandighede waarin dit plaasvind. In hierdie studie was bekendmaking ʼn voortdurende proses, gesitueer tussen aktiewe openbare bekendmaking en volledige geheimhouding van ʼn MIVstatus, asook tussen volkome vrywillige en onvrywillige bekendmaking van ʼn MIVstatus.
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Chipangura, Sheila. "An investigation into the manifestation of stigma and discrimination and its consequences on HIV/AIDS prevention and treatment efforts amongst people living with HIV/AIDS." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/79945.
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Thesis (MPhil)--Stellenbosch University, 2013.ENGLISH ABSTRACT: The AIDS epidemic has brought out both the best and the worst in people. The disease brings out the best when individuals group together in solidarity to combat the consequences of HIV/AIDS and to support and care for PLWHA. HIV/AIDS also brings out the worst when individuals are stigmatized and ostracized by their loved ones, their family and their communities and discriminated against individually as well as institutionally. This research has reviewed available scientific literature on HIV/AIDS stigma and discrimination. The research has also established HIV/AIDS stigma and discrimination comes in different forms and occurs in different contexts. Stigma and discrimination play a significant role in HIV/AIDS prevention and treatment efforts. Analysis of this research indicates stigma and discrimination has a negative impact on HIV/AIDS prevention and treatment efforts.
AFRIKAANSE OPSOMMING: Die VIGS-epidemie het beide die beste en die slegste in mense. Die siekte bring die beste wanneer individue groep saam in solidariteit die gevolge van MIV / VIGS te bestry en te ondersteun en sorg vir PLWHA. MIV / VIGS bring ook die ergste wanneer individue gestigmatiseer en verstoot deur hul geliefdes, hul familie en hul gemeenskappe en teen gediskrimineer individueel sowel as institusioneel. Hierdie navorsing het hersien dat die beskikbare wetenskaplike literatuur oor MIV / VIGS stigma en diskriminasie. Die navorsing het ook vasgestel dat MIV / VIGS stigma en diskriminasie kom in verskillende vorms voor en kom in verskillende kontekste. Stigma en diskriminasie speel 'n belangrike rol in MIV / VIGS voorkoming en behandeling pogings. Ontleding van hierdie navorsing dui daarop dat stigma en diskriminasie het 'n negatiewe impak op MIV / VIGS voorkoming en behandeling pogings.
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Liswaniso, Christine Mulemwa. "The effect of corruption on HIV/AIDS donor funds a case study of Namibia." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/98121.
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Thesis (MPhil)--Stellenbosch University, 2015.ENGLISH ABSTRACT: This study is qualitative research that aims to identify the effect of corruption on HIV/AIDS donor funds in Namibia in order to provide guidelines to policy makers in relations to the regulation of HIV/IDS donor funding. Henceforth, in–depth interviews with open ended questions were used with Government, civil society and donor agencies’ senior officials to obtain data. Additionally, institutional permission was granted from the identified institutions who participated in the research. An inductive analysis was used which required data to be categorised and developing themes from the data. Respondents reported lack of national donor specifications in the field of HIV/AIDS as a serious problem to donor funds in Namibia. However, respondents indicated their organisations had proper management systems in place which included, annual audits, sufficient personnel and monitoring and evaluation. Withdrawal of donor funding has been on the increase due to corrupt practices in some funded organisation and this is mostly affecting people living with HIV/AIDS. Respondent reported there is a need to strengthen the existing umbrella body and improve accountability. The findings of the study show the effect of corruption on HIV/AIDS donor funds in Namibia is the withdrawal of HIV/AIDS donor supports by several donor agencies which has led to numerous donor funded institutions closing down and a number of employee losing their employment. Lack of national HIV/AIDS donor specifications is viewed as a loophole for corruption for many funded organisations as there are no national accountability systems in place in relation to HIV/AIDS donor funds in Namibia.
AFRIKAANSE OPSOMMING: Nie beskikbaar.
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Zimba, Zibonele France. "Challenges faced by traditional healers when treating people living with HIV and AIDS: the case of Intsika Municipality, Eastern Cape province." Thesis, University of Fort Hare, 2014. http://hdl.handle.net/10353/d1015357.
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The aim of the study was to examine the procedures followed by traditional healers treating people living with HIV and AIDS in the Instika Municipality and the challenges faced by them in this endeavour. Using the qualitative research method, in-depth interviews and focus group discussions were conducted with twenty traditional healers. Among the significant findings of this study were the hardships encountered by traditional healers in terms of finance, the transport needed to collect medicinal plants, the shortage of medicinal plants, the lack of co-operation from the formal health care sector and the discrimination and abuse suffered at the hands of members of the community, with Christians and members of the SAPS being among the chief antagonists. It is also acknowledged in this study that traditional healers have been trained by the Department of Health concerning issues of hygiene and that traditional healers have knowledge of the symptoms of HIV and AIDS. It can therefore be concluded that traditional healers have a significant role to play in preventing the spread of HIV and AIDS if they employ preventative measures such as the use of protective gloves and limiting the use of a blade to one patient only. However, traditional healers are not supplied with safety kits or condoms to distribute to patients who consult them for treatment of STIs.
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Fourie, Linda. "Pain control in palliative care : a South African nursing perspective." Thesis, [S.l. : s.n.], 2008. http://dk.cput.ac.za/cgi/viewcontent.cgi?article=1029&context=td_cput.
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Machethe, K. F. "The level of antiretroviral drug resistance at Nkensani Hospital Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome Treatment Site." Thesis, University of Limpopo, 2014. http://hdl.handle.net/10386/1227.
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Wapinduka, Tendai. "Rural livelihoods and adherence to HIV and AIDS antiretroviral therapy in Chivanhu Settlement, Nemamwa Village in Masvingo District, Zimbabwe." Thesis, Rhodes University, 2013. http://hdl.handle.net/10962/d1003743.
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The Human Immunodeficiency Virus (HIV) and Acquired Immuno Deficiency Syndrome (AIDS) epidemic has had massive detrimental impacts on rural communities across Africa including in Zimbabwe. In response to the HIV and AIDS epidemic, the government of Zimbabwe has developed and adopted comprehensive programmes to address HIV and AIDS prevention, care and support. One of the critical components of these programmes relates specifically to treatment of the HIV infected given that HIV and AIDS is increasingly seen as a manageable threatening disease. However the success and effectiveness of the treatment regimen (involving antiretroviral drugs or ARVs) is dependent heavily on complete adherence to the rigid and complex regimens. It is against this background that this thesis studies a particular rural community in Zimbabwe called Chivanhu (in Masvingo Province) in terms of the relationship between rural livelihoods and HIV and AIDS (particularly HIV treatment and treatment adherence). Unlike other rural communities (notably in communal areas), Chivanhu is an informal and unstable community with a turbulent history. Most rural studies of HIV and AIDS in Zimbabwe and elsewhere in the region have focused on well-established and stable communities in which agricultural production is still of some significance. In such communities, the impact of HIV and AIDS on livelihoods is severe but, in more informal settlements, the vulnerability of households to the epidemic (and challenges pertaining to treatment adherence) is even more pronounced. Using a rural livelihoods framework, this thesis seeks to identify, understand and analyse the conditions which shape levels of adherence to HIV and AIDS in the informalsettlement of Chivanhu in Zimbabwe.
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Rashamuse, Thompho Jason. "Studies towards the synthesis of novel, coumarin-based HIV-1 protease inhibitors." Thesis, Rhodes University, 2008. http://eprints.ru.ac.za/1332/.
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Fisher, Julian Marcus. "A study at the Brooklyn Chest Hospital to assess the change in the oral carriage of Candida species in patients co-infected with HIV and TB, before and after antifungal therapy." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/52706.
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Thesis (MSc)--Stellenbosch University, 2002.ENGLISH ABSTRACT: The aim of this study at the Brooklyn Chest Hospital (BCH) was to assess the change in the oral carriage of Candida species in twenty-nine patients co-infected with the Human Immunodeficiency Virus (HIV) and Tuberculosis (TB), before and after anti-fungal treatment. Each patient accepted onto the study underwent a comprehensive oral and peri-oral examination where the presence, site and clinical features of all oral and peri-oral lesions were recorded. The purpose of the examination was to provide a clinical diagnosis of oral candidasis. Each patient was also asked to provide a sample of oral fluid for laboratory analysis. This was collected using an oral rinse. The results of a variety of laboratory investigations were used to identify the species of Candida obtained from the oral rinse. Both the oral and peri-oral examination and the oral rinse procedure were repeated after one month and at three months. A sample from each oral rinse was inoculated on CHROMagar Candida chromogenic medium (CHROMagar Candida, France, Paris). CHROMagar is used for the isolation and presumptive identification of Candida sp. from other yeasts on the basis of strongly contrasted colony colours, which are produced by the reactions of species-specific enzymes with a proprietary chromogenic substrate. After forty-eight hours the CHROMagar plate was examined for growth, when a record of colony morphology and colour was made. A single sample from each different colour-coded colony was taken and streaked onto a Sabouraud plate (Oxoid, Basingstake, England) and then incubated for forty eight hours at thirty-seven degrees centigrade. A variety of laboratory investigations were subsequently carried out on a single colony taken from the Sabouraud agar plate (Oxoid). The results of these tests were used to identify the individual species of Candida isolated from each oral rinse. Oral candidasis was the most prevalent oral lesion observed on admission and at three months. Six different species of Candida were identified during this study, namely Candida albicans, Candida dubliniensis, Candida krusei, Candida glabrata, Candida parapsilosis, and Candida tropicalis. C.albicans was the most commonly identified species in study population. Candida dubliniensis was isolated and identified for the first time in a South African HIV population. Each specimen of Candida sp. identified by laboratory analysis was tested for sensitivity to Nystatin, Amphotericin B and Fluconazole anti-fungal agents. An additional sensitivity test was performed using Ajoene and Allicin (extracts of garlic) to assess the comparative antifungal properties of these compounds.
AFRIKAANSE OPSOMMING: Die doelwit van hierdie studie by die Brooklyn Borshospitaal (BCH) was om die verandering in orale draerstatus van die Kandida spesies in nege-en-twintig HIVfTB koïnfekteerde pasiënte vas te stel, voor- en na antifungale behandeling. Elke pasiënt in die studie het 'n volledige intra- en ekstra-orale ondersoek ondergaan. Die teenwoordigheid, area en kliniese voorkoms van alle letsels is noteer. Die doel van die ondersoek was om 'n kliniese diagnose van orale kandidiase te verkry. 'n Monster orale vloeistof is geneem van elke pasiënt vir laboratorium analise. Die monster is in die vorm van 'n mondspoel geneem. Verskeie toetse is gedoen om die verskillende Kandida spesies in elke monster te identifiseer. Die orale- en ekstra-orale ondersoek sowel as die mondspoelmonster is na 1 en 3 maande herhaal. Elke mondspoelmonster is op CHROMagar Kandida chromogene medium (CHROMagar Candida, France) inokuleer. CHROMagar word gebruik vir die vermoedelike identifikasie en isolasie van Kandida spesies teenoor ander swamme. Dit word gedoen op die basis van kontrasterende koloniekleure, wat teweeggebring word deur spesie-spesifieke ensiemreaksies op 'n chromogene substraat. Die CHROMagar plate is na 48 uur ondersoek vir groei en die kolonie-morfologie en - kleur is noteer. 'n Enkel monster. is geneem van elke verskillende kolonie (geskei op kleur) en is uitgestreep op 'n Saboraud plaat (Oxoid, Basingstoke, England). Dit is dan vir 48 uur inkubeer teen 37°C. Verskeie laboratorium ondersoeke is daarna uitgevoer op 'n enkel kolonie geneem vanaf die Saboraud agar plaat (oxoid). Die resultate van die ondersoeke is gebruik om individuele spesies van Kandida te identifiseer. Orale Kandidiase was die mees algemene orale letsel geïdentifiseer by toelating en 3 maande ondersoeke. Ses verskillende spesies Kandida is identifiseer tydens die studie, naamlik: Kandida albicans, K.dubliniensis, K.Krusei, K.glabrata, K.parapsilosis en K.tropicalis. K.albicans was die mees algemeen identifiseerde spesie in die studiepopulasie. K.dubliniensis is vir die eerste keer in Suid-Afrika in 'n HIV<+lpopulasie isoleer en geïdentifiseer. Elke monster van identifiseerde Kandida spesies is getoets vir sensitiwiteit teenoor Nistatien, Amfotensien B en Flukonasool. Addisioneel is ook getoets vir sensitiwiteit teenoor Ajoene en Allicin (knoffelekstrakte).
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Barford, Kirsty-Lee. "Illustrated medicines information for HIV/AIDS patients: influence on adherence,self-efficacy and health outcomes." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1015678.
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South Africa has an estimated 920 000 patients on antiretrovirals (ARVs), the largest number of patients in any country. ARV therapy demands adherence levels in excess of 95% to avoid development of drug resistance, but adherence to ARV therapy is estimated to be only between 50% and 70%. Poor medication adherence is acknowledged as a major public health problem, reducing the effectiveness of therapy and promoting resistance to ARVs. More than two thirds of the South African population have marginal reading skills and this significantly influences a patient’s ability to read and understand health-related information. Patient education materials tailored for the South African population could be a useful aid in facilitating communication with patients and perhaps impact positively on their medicine-taking behaviour. This behaviour is influenced by patient knowledge, beliefs, attitudes and expectations and includes self-management, self-efficacy and adherence. Self-efficacy, which refers to patient confidence in the ability to self-manage medicine taking, is a key factor influencing adherence. This study aimed to develop illustrated patient information leaflets (PILs) and medicine labels for all first-line ARV regimens used in the public health sector in South Africa and, using a randomised control study design, to investigate the impact of these illustrated information materials on knowledge, medication-taking behaviours and health outcomes in HIV/AIDS patients taking ARVs. To achieve this aim, the objectives were to assess HIV/AIDS and ARV-related knowledge, as well as self-efficacy and adherence to ARV therapy; to assess the influence of demographic variables on knowledge, adherence and self-efficacy; to assess the influence of the information materials on knowledge, self-efficacy and adherence and to assess the association of knowledge with health outcomes. Medicine labels and PILs, both English and isiXhosa, were developed for ARV regimens 1a, 1b, 1c and 1d. The 8-item Morisky Medication Adherence Scale (MMAS-8) and HIV Treatment Adherence Self Efficacy Scale (HIV-ASES) instruments for measuring respectively adherence and self-efficacy, were modified to optimize clarity, simplicity and cultural acceptability and were translated into isiXhosa using a multi-stage translation-back translation. The questions and the rating scales, for both the MMAS and HIV-ASES, underwent preliminary qualitative evaluation in focus group discussions. Patients were recruited from local Grahamstown clinics. A pilot study to evaluate applicability of the instruments was conducted in 16 isiXhosa AIDS patients on ARVs and the results from this study informed further modifications to the instruments. One hundred and seventeen patients were recruited for the randomised control trial and were randomly allocated to either control group (who received standard care) or experimental group (who received standard care as well as pictogram medicine labels and the illustrated PIL). Interviews were conducted at baseline and at one, three and six months. Data were analysed statistically using the t-test, chi-squared test and ANOVA (Analysis of Variance) at a 5% level of significance. Correlations were determined using Pearson and Spearman rho correlations. Approval was obtained from Rhodes University Ethical Standards Committee, Settlers Hospital Ethics Committee and the Eastern Cape Department of Health. The results of this research showed that illustrated PILs and medicine labels enhanced understanding of HIV/AIDS and ARV information, resulting in a mean overall knowledge score in the experimental group of 96%, which was significantly higher than the 75% measured in the control group. Variable knowledge scores were measured in three areas: baseline knowledge of general HIV/AIDS-related information was good at 87%, whereas knowledge scores relating to ARV-related information (60%) and side-effects (52%) were lower. These scores improved significantly in the experimental group over the 4 interviews during the 6 month trial duration, whereas in the control group, they fluctuated only slightly around the original baseline score. There was no significant influence of gender on knowledge score, whereas health literacy, education level and age tested (at one and three months) had a significant influence on knowledge. Self-efficacy and adherence results were high, indicating that the patients have confidence in their ability to adhere to the ARV therapy and to practice optimal self-care. Age, gender and education, in most cases, significantly influenced self-efficacy, but were found to have no effect on adherence. The CD4 count improved over the trial duration which may have been influenced by a number of factors, including better knowledge of ARVs and improved adherence. No significant parametric correlation was found between knowledge score and change in CD4 count, however, Spearman's rho showed significance (rs=0.498; p=0.022). Both patients and healthcare providers were highly enthusiastic about the illustrated labels and PILs, and indicated their desire for such materials to be routinely available to public sector HIV/AIDS patients. The isiXhosa version of the PIL was preferred by all the patients. These simple, easy-to-read leaflets and illustrated medication labels were shown to increase understanding and knowledge of ARVs and HIV/AIDS in low-literate patients, and their availability in the first-language of the patients was central to making them a highly useful information source.
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Thaw, Htwe Min Punnee Pitisuttithum. "Evaluate the efficacy of nevirapine based regimen and boosted Pi based regimen followed by nevirapine based regimen in treatment naive advanced HIV patients /." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd388/4838795.pdf.
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Thematic paper (M.C.T.M. (Clinical Tropical Medicine))--Mahidol University, 2006.LICL has E-Thesis 0012 ; please contact computer services. LIRV has E-Thesis 0012 ; please contact circulation services.
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Das, C. R. "Causes of non-adherence to antiretroviral therapy in Wellness Clinic, Tshepong Hospital, Klerksdorp." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/97161.
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ENGLISH ABSTRACT: HIV/AIDS is the leading cause of death in Sub-Saharan Africa. According to 2001 estimates, there are 28.5 million people living with HIV in Africa, comprising more than 70% of the world’s HIV-infected population. HIV/AIDS remains one of the most important social and public health threats in Sub-Saharan Africa. UNAIDS 2006 estimates that 5.5 million people are living with HIV, and almost 1,000 AIDS deaths occur every day in South Africa. South Africa is currently one of the most severely affected countries in the world. Antiretroviral therapy (ART) is currently the only treatment available for HIV. It does not cure HIV infection, but reduces HIV related mortality and morbidity.AFRIKAANS ABSTRACT: No abstract available
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Thobias, Anna. "Exploration of Factors Associated with Poor Adherence amongst Patients Receiving Antiretroviral Therapy at Katutura State Hospital Communicable Disease Clinic in Khomas Region in Namibia." Thesis, University of the Western Cape, 2008. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7058_1273775927.
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Background: HIV/AIDS affects the health of millions of people world wide. According to the Joint United Nations Program on HIV/AIDS [UNAIDS], the number of people living with HIV globally has risen from 26 million in 2001 to 33.2 million in 2007. It is estimated that 2.5 million people were newly infected with HIV in 2007. The introduction of anti-retroviral therapy [ART] has brought hope to millions of people living with HIV and AIDS. More recently, the increased availability of treatment in many countries including Namibia has dramatically improved survival rates and lowered the incidence of opportunistic infections among HIV patients. Adherence to antiretroviral therapy (ART) is a fundamental attribute of excellent clinical HIV care and a key aspect in determining the effectiveness of treatment. Strict adherence to ART is vital to maintain low viral load and to prevent the development of drug resistant virus. Poor adherence is one of the key obstacles to successful ART for HIV positive patients. Literature has shown that there are various factors that hinder adherence to ART such as patient, service, community, family, socio-economic and work-related factors. Aim: This study aimed to describe the experiences of patients in the ART programme at Katutura State Hospital, Communicable Disease Clinic (CDC), in the Khomas region of Namibia and to explore factors that contribute to poor adherence.
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Cysique, Lucette Adeline Juliette St Vincent's Hospital UNSW. "Aids dementia complex in the era of highly active antiretroviral therapy: a neuropsychological study." Awarded by:University of New South Wales. St. Vincent's Hospital, 2005. http://handle.unsw.edu.au/1959.4/22074.
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The aim of the thesis was to undertake an evaluation of the neuropsychological functioning of non-demented and demented patients with advanced HIV-infection who have been treated with Highly Active Antiretroviral Therapy (HAART) for several years. One hundred and one non-demented HIV-infected individuals and 23 patients with mild or moderate AIDS Dementia Complex (ADC), from the outpatient clinics and Neurology department at St. Vincent's Hospital, Sydney, Australia were randomly selected to participate in a prospective study of the neurological and neuropsychological complications of HIV disease. All had advanced HIV-infection and all had been on HAART for five years on average. Thirty-one seronegative controls were recruited as controls. All participants completed a standard neuropsychological examination assessing nine cognitive domains. Non-demented advanced HIV-infected individuals participated in three follow-up visits. In addition, we report the results of a multi-centre cohort of 78 patients with mild to moderate ADC on HAART (Abacavir ADC trial). The main findings of our research were that the prevalence of neuropsychological impairment in advanced HIV-infected individuals remains equivalent to the era that preceded the introduction of HAART. Moreover, while complex attention / psychomotor speed remained a marker of HIV-related neuropsychological impairment in the HAART era, impairment in learning, memory and aspects of complex attention may be new indicators of HIV-associated neurocognitive impairment. While progression of neuropsychological impairment is associated with past HIV-related history of brain involvement, we demonstrated that deterioration does not occur in a linear fashion and that over a 27 month period neuropsychological performance stabilizes in the majority. Stabilization of performance may be related to relapses in the course of HIV-associated neurocognitive impairment and HAART optimization especially with antiretrovirals that have good brain tissue penetrance. Our research showed that plasma viral load and current CD4 cell count were generally not associated with the neuropsychological performance, but rather that nadir CD4 cell count was associated with neuropsychological performance suggesting a relation between past immune deterioration and current cognitive status. Cerebrospinal markers of immune and virological activity were found to be partly dissociated from current neurological in contrast to what was observed in the pre-HAART era. Future studies will need to evaluate new factors for underlying HIV-associated neurocognitive impairment as well as factors for underlying partial recovery.
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Morphet, Marilynn Norma. "Method for identification of effective first-line treatment for HAART naïve HIV/AIDS patients." Thesis, Queensland University of Technology, 2002.
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Hodes, Rebecca. "Siyayinqoba/Beat it! : HIV/AIDS on South African television c. 1999-2006." Thesis, University of Oxford, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.670010.
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