A dissertation submitted to the Faculty of Science under the School of Molecular and Cell Biology, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master in Science. Johannesburg, June 2017. / In South Africa, the anti-HIV-1 activity of various indigenous plants has not been studied extensively. Most of the phytochemical screening work has focused on anti-cancer activity with less attention given to infectious diseases. A large proportion of South Africans (70-80%) still rely on traditional medicines for treatment of various ailments. And, therefore, there is a need to evaluate and validate the effectiveness of the traditional medicines. The aim of this study was to identify, screen, phytochemically characterize and isolate bioactive compounds from a South African herbal extract that exhibit the best anti-HIV-1 activity. Three extracts were prepared: an ethanol extract, a dereplicated ethanol extract and an aqueous extract from a herbal concoction comprised of a mixture of six plants. These herbal concoctions were investigated for anti-HIV-1 subtype C activity. Phytochemical profiling of the ethanol- and dereplicated ethanol- extracts from the herbal concoctions showed the presence of intermediate polar compounds (flavonoids, alkaloids, sugars and terpenes) for both extracts, while the aqueous extract contained predominantly highly polar compounds. Anti-HIV-1 screening of the three extracts showed that the ethanol and dereplicated ethanol herbal- extracts had the best anti-reverse transcriptase activity. The ethanol extract had mean IC50 values of 56.53, 53.96 and 55.39 μg/ml against MJ4, Du179 and CM9 HIV-1 subtypes C isolates, respectively. The dereplicated ethanol extract had mean IC50 values of 51.87, 47.56 and 52.81 μg/ml against MJ4, Du179 and CM9 HIV-1 isolates, respectively. The aqueous extract was inactive against HIV-1 activity. Moreover, both the ethanol- and dereplicated ethanol- extracts showed activity against HIV neutralization. The ethanol- and dereplicated ethanol- extracts had mean IC50 values of 36.33 and 32.06 μg/ml, respectively. Furthermore, they also potently neutralized Vesicular stomatitis virus (VSV) yielding mean IC50 values of 24.91 and 20.82 μg/ml for ethanol- and dereplicated ethanol- extracts, respectively. All extracts were inactive against Murine leukemia virus (MLV). The isolation and phytochemical characterization of the bioactive compound(s) was done by utilizing various chromatographic and spectroscopic methods. Four homoisoflavanoids were isolated and tested for anti-HIV-1 subtype C activity. Three compounds (1, 3a and 3b) were inactive while compound 2 was found to be bioactive against HIV-1 reverse transcriptase (RT) and yielded mean IC50 values of 7.23 ± 1.88, 12.83 ± 0.41 & 12.81 ± 0.10 μg/ml for MJ4, CM9 and Du179 HIV-1 subtype C isolates, respectively. Compound 2 had a mean CC50 value of 23.08 ± 0.1981 μg/ml against HEK293T cells. Overall, the data suggested that ethanol- and dereplicated ethanol- herbal extracts possess direct and indirect anti-HIV-1 activity. They possess a cocktail of phytochemicals that can inhibit HIV-1 RT, HIV-1 entry. Furthermore, these extracts possess phytochemicals that can lower the activation of inflammatory responses during an infection and, hence, reduction in the number new cells infected during the course of HIV-1 infection. Moreover, they possess phytochemicals that have antioxidant activity which, in relation to HIV infection, results in a boosted immune system response in order to ward off the virus. / MT 2017

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.

Thesis (MTh)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: In South Africa young women in the age group 10 – 24 are the largest group infected with HIV. Those most at risk are young women living in South African townships where a multitude of factors reinforce the possibility of them becoming infected. Once infected, they are often abandoned or left alone, with no support system. This thesis uses the following four tasks of Practical Theology, - the descriptive-empirical task: Priestly listening, - the interpretive task: Sagely wisdom, - the normative task: Prophetic discernment and - the pragmatic task: Servant leadership, to analyze how pastoral group care could help these young women. The problem is investigated and set into the reality of Khayelitsha, a township in Cape Town. By offering young women the possibility of belonging to a peer group, they are met within their cultural and social system. As the members of the group are all HIV positive, the stigma which often prevents people from socializing or talking about their sickness, is removed. The important role of the leader of such a group is also investigated. / AFRIKAANSE OPSOMMING: In Suid-Afrika is jong vroue in die ouderdomsgroep 10 – 24 jaar díe groep wat die hoogste aantal MIV infeksies het. Die hoogste risiko om deur die MI virus aangesteek te word, is by jong vroue wat in ‘n Suid-Afrikaanse township lewe. ‘n Verskeidenheid faktore speel saam om hulle kwesbaarheid te verhoog. Sodra dit bekend word dat hulle die MI virus dra, word hulle dikwels verwerp en sonder enige ondersteuning alleen gelaat. Na aanleiding van die volgende vier take van Praktiese Teologie nl.: - die beskrywend-empiriese taak: Priesterlike luister, - die interpreterend-hermeneutiese taak: Verstandige wysheid, - die normatiewe taak: Profetiese onderskeiding en - die pragmatiese taak: Dienskneg leierskap., word hierdie problem ondersoek binne die raamwerk van Khayelitsha, ‘n township van Kaapstad. Die tesis argumenteer dat pastorale groepssorg ‘n gepaste wyse is waarbinne daar na hierdie jong vroue omgesien kan word. Deur aan hulle die moontlikheid te bied om aan ‘n portuurgroep te behoort, kan hulle binne hulle eie sosiale en kulturele raamwerk tereg kom. Aangesien die lede van die groep almal MIV positief is, word die stigma, wat dikwels mense verhinder om te sosialiseer of om oor hulle siekte te praat, verwyder. Die belangrike rol van die leier van so ‘n groep word ook ondersoek.

No description available.

This study captures the process and methods used in selecting and organising content for an ontology. In the Information and Communication Technology (ICT) field ontology refers to a way of organising and storing information and facilitating interaction between the system and its users. Ontologies are being used more frequently to provide services that deal with complex information. In this study, I record my experience of developing content for an HIV and AIDS ontology for Rhodes University students. Using several different methods, I started the process of selecting and organising HIV and AIDS information, free of scientific jargon and prescriptive language, and consisting only of relevant information. I used data derived from interviews with six HIV and AIDS experts to develop questions for a survey that was open to all Rhodes University students. The 689 people who responded to the survey indicated that they needed more information on testing, treatment and living with HIV. Responses also showed that students had a lot of information on HIV prevention and transmission. Four focus group discussions revealed that students were tired of repetitions of the „same‟ information on HIV and AIDS and wanted to know more about life after contracting HIV. Using this data, I propose some guidelines to populate HIV and AIDS ontology. Ontologies can be customized for particular groups of users, for example according to gender, race, year of study etc. Another advantage of the ontology is that it can be expanded or contracted depending on the scope of one‟s intervention.

The present study explores Rhodes students' perceptions and attitudes towards HIV/Aids issues. This study focuses on risk behaviour, stigmatisation, social perceptions and voluntary counselling and HIV testing (VCT). There is a lack of research on student attitudes, knowledge and behaviour at Rhodes University. It was therefore deemed pertinent to research this topic in that context. It was envisaged that the study would provide insights to be used in the formulation of improved strategies for HIV/Aids programs and education, ultimately impacting on the exponential increase of the pandemic in the Southern African region. A sample of six hundred and seventy five Rhodes University undergraduates completed a survey and its findings were interpreted in terms of relevant literature. A mixed methods approach using qualitative and quantitative methods was used. A focus group consisting of seven post-graduate students informed the development of the survey along with relevant literature. Four departments from the faculties of Commerce, Humanities, Science and Law were randomly sampled for the survey phase. Statistica was used to calculate descriptive statistics while the chi-square statistic was applied to examine the relationships between the variables. The findings show that the majority of students have high intention levels in planning to use preventative behaviour. However, in practise, this may not be the case. Many students feel that they belong to high or medium risk groups, as opposed to the low-risk groups. In terms of motivation levels, only sixty three percent of students are highly motivated to protect themselves from HIV/Aids and one third of respondents felt that they could not ask their partner to accompany them for an HIV/Aids test. In addition, students who had received VCT were more likely to be positive about the counselling process.

MPH / Department of Public Health / Background: South Africa presently has a very high HIV burden. It has adopted the UNAIDS “90-90-90 targets” to curb its HIV burden. This target aims to attain sustained viral suppression in 90% of all persons receiving antiretroviral therapy. This is supported by several studies. Studies to observe if patients are achieving and sustaining viral suppression in Limpopo, South Africa, are few. Objective: To investigate the viral and immunologic responses of patients in Vhembe District to highly active antiretroviral therapy (HAART) between the 1st of January 2004 and 31st of July 2016. Methodology: This was a retrospective medical record review conducted in Vhembe District in rural Limpopo. It included the medical records of 1247 individuals from Thohoyandou Community Health Centre. Analysis was done using SPSS 24.0. To model the factors associated with virologic and immunologic responses, each independent variable was tested for association with the dependent variable (viral suppression and CD4 count increase of ≥ 50 cells/μL from baseline to 6 months). The independent variables included age, year of initiation, gender, marital status, baseline BMI, haemoglobin, clinical stage and estimated creatinine clearance. The Pearson Chi square (X2) was used for all categorical independent variables and the t-test, for all continuous independent variables, to test for association. The estimate used was a 95% confidence interval, and a p-value of < 0.05 was considered significant. Results: The study showed that 52.6% of individuals were in clinical stage I at baseline. Viral suppression (viral load < 50 copies/ml) at 6 months was 64% (n = 648), 72% (n =193) at 60 months and 94% (n = 16) at 132 months. Fifty-nine percent had consistent viral suppression for a period of at least 6 months. Consistent viral suppression (viral load < 50 copies/ml on at least one consecutive occasion without any intervening viral load > 50 copies/ml) for at least 54 months was only 14%, while 2.3% had a delay in switching from a failing regimen. The mean CD4 count at baseline was 227 cells/μL, and 538 cells/μL at 60 months. The mean CD4 cell count increase from baseline to 6 months was 190 cells/μL. The immuno-virologic discordance was 27%. Patients with higher baseline CD4 count and females were significantly (p = 0.001 and 0.031 respectively) more likely to achieve viral suppression at 6 months. Those below 45 years and females were v significantly (p = 0.011 and 0.043 respectively) more likely to achieve adequate CD4 count increase at 6 months. Conclusions: The proportion of individuals with viral suppression in the District increased from 6 months onwards, and is fairly adequate. However, sustainability of viral suppression, once attained, is low. Adequate immunologic response, however, seems high. Males and age group above 45 years appear to have poorer responses to HAART.

Thesis (MSc)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: This study aims to explore the existing knowledge, attitudes and practices regarding HIV/AIDS among Congolese refugees living in Cape Town in order to create awareness and suggest possible measures to avert the spread of the pandemic among them. The target population are Congolese refugees living in Cape Town, with a refugee or an asylum seeker status. Due to the total population and difficulties in contacting them, the participants (50) were randomly selected among traders and hair dressers. The study used a quantitative research design. The Desk Top Market train station in Cape Town is an open market place where most Congolese traders sell their goods to the public. The data were collected at this market area in Cape Town using a questionnaire. To avoid any possible discrimination or stigmatisation resulting from being identified as a refugee in the study, the Congolese were contacted from the market place without screening them on the basis of their status. The participants were, however, required to tick their status in a box provided on the questionnaire. Furthermore, strict confidentiality was maintained to avoid the possible stigmatisation arising from the Congolese traders’ refugee status. According to the findings Congolese refugees have knowledge about HIV/AIDS and the route of transmission. The majority knows how to protect themselves against HIV/AIDS but it seems this protection discontinue shortly after a quick trust between them and their partners. It is may be because most refugees are in need of financial protection on their arrival so they do not have any other choice than to let it go. During the process of data collection there was an opportunity to discuss with some of them protection and most of them stated that condom use is not safe as condoms breaks often. Many Congolese do not believe in male circumcision for the reduction of risk because 100% of them are circumcised and some still have contracted HIV/AIDS. Some of Congolese does believe HIV can be cured because they have seen people who were cured through prayers. The findings also indicate the level of awareness is very low in this community because they still believe they can just by looking at other individuals they can detect if someone is HIV positive or not. / AFRIKAANSE OPSOMMING: Hierdie studie was daarop toegespits om die bestaande kennis, houdings en praktyke met betrekking tot MIV/vigs onder Kongolese vlugtelinge in Kaapstad te ondersoek ten einde bewustheid te wek en moontlike maatreëls voor te stel om te keer dat die pandemie onder hulle versprei. Die teikenpopulasie was Kongolese wat in Kaapstad woon en oor vlugteling- of asielsoekerstatus beskik. Weens die groot omvang van die ondersoekpopulasie en uitdagings om met hulle in verbinding te tree, het die navorser lukraak vyftig (50) deelnemers uit die geledere van handelaars en haarkappers gekies. Die data is met behulp van ’n vraelys by die Desk Top-mark op Kaapstad-stasie ingesamel. Die studie het van ’n kwantitatiewe navorsingsontwerp gebruik gemaak. Die Desk Top-mark by Kaapstad-stasie is ’n buitelugmark waar die meeste Kongolese handelaars hul goedere aan die publiek verkoop. Om te voorkom dat enigeen wat in die studie as ’n vlugteling geïdentifiseer word enige moontlike diskriminasie of stigma ervaar, het die navorser voor die voet onderhoude met Kongolese by die mark gevoer sonder om hulle na hul verblyfstatus uit te vra. Die deelnemers moes egter hul status op die vraelys aandui deur die toepaslike blokkie te merk. Voorts is streng vertroulikheid gehandhaaf om enige moontlike stigma vanweë die respondente se vlugtelingstatus te voorkom. Die bevindinge toon dat Kongolese vlugtelinge wél oor ’n mate van kennis van MIV/vigs en die verspreiding daarvan beskik. Die meeste respondente weet hoe om hulself teen MIV/vigs te beskerm, hoewel daardie beskerming oënskynlik gestaak word kort nadat hulle ’n vertrouensverhouding met hul bedmaats ontwikkel. Dít kan daaraan toegeskryf word dat die meeste vlugtelinge met hul aankoms in die land finansiële beskerming nodig het en dus nie anders kan as om veilige sekspraktyke te laat vaar indien hul bedmaats daarop aandring nie. Gedurende die proses van data-insameling was daar geleentheid vir gesprek met die respondente, waaruit geblyk het dat kondoomgebruik na hulle mening nie juis veilig is nie, aangesien kondome dikwels breek. Min Kongolese glo dat manlike besnydenis die gevaar van MIV/vigs verminder, aangesien hulle almal besny is, maar sommige steeds MIV/vigs opdoen. Sommige glo dat MIV/vigs genees kan word, omdat hulle getuies was van hoe mense deur gebed gesond geword het. Die bevindinge dui ook op ’n baie lae bewustheidsvlak in hierdie gemeenskap: Baie glo steeds dat ’n mens met die blote oog kan bepaal of iemand MIV-positief is of nie.

This study involves an analysis of accounts of first and subsequent early sexual experiences in a deep rural area of the Eastern Cape in South Africa over the last forty years. Through interviews and focus group discussions, the enculturation of youth into sexual activity in the community of interest is explored. The study looks into sexual experiences from childhood, through early adolescence to adults of up to sixty five years old, allowing an analysis of the changing forms of sexual experimentation and sexual debut in this context. Contextual factors mediating these changes are explored, with special emphasis on the changing regulatory practices around early sexual experiences and the effect thereof on behaviors connected to HIV infection risk. Practices that were previously important mediators of sexual behavior were: anxiety about the social consequences of pregnancy, which was previously a significant disincentive to sexual intercourse; men's previous acceptance of the need to practice non-penetrative forms of sex and girls postponing sexual debut for as long as possible. All these were culturally endorsed, but are now noted to have changed due to changes in the regulatory practices surrounding youth sexuality. The context of early sexual experiences and the surrounding cultural practices have also changed significantly, and this needs to be taken into account in understanding receptivity to condom use messages. Implications for HIV/AIDS prevention are discussed. Among other interventions, the study describes a participatory, community-based, multi-sectoral approach that takes social conditions into account as a way of empowering the community to strengthen its response to the pandemic. This incorporates different sectors of the community, including youth, parents, religious and traditional leaders, and various other structures, services and institutions that make up the community.

Department of Public Health / MPH