M.A. / Although there are approximately 40 million people in the world infected with AIDS, 4.7 million of whom live in South Africa, very little research concerning non-medical modes of treatment has been conducted in South Africa. The use of antiretroviral drugs for the treatment of HIV/AIDS recently came under the spotlight when AIDS dissident Robert Giraldo argued that antiretroviral drugs induce rather than treat AIDS. Extensive research concerning medical interventions for AIDS has been conducted, but to date the field of psychoneuroimmunology and it’s principles have been left largely unexplored in the South African context. Psychoneuroimmunology (PNI) is a field of mind-body medicine that examines the relationship between the mind, the emotions and the body. Mind-body medicine is based on the premise that mental and emotional processes can affect physiological functioning. PNI is the study of the interrelations between the central nervous system and the immune system. It focuses on the influence of cognitive images on the nervous system and consequent interactions with the immune system. It incorporates but is not limited to, biofeedback, the impact of thought and belief on physiology and the effects of stress on physical and emotional functioning. The current research attempts to draw parallels between the fields of PNI and Dance/Movement therapy (D/MT). Dance Movement therapy (D/MT) is an art and a science that involves the use of nonverbal communication through the medium of movement and dancing. It is partnered with the practices of psychiatry and psychology. D/MT is based on the idea that the body and mind are inseparable. It is a form of psychotherapy, which utilizes psychomotor expression as its major mode of intervention. The basic premise of D/MT is that body movements reflect inner emotional states and changes in movement can lead to changes in the psyche, promoting health. One of the fundamental principles, and moreover a central purpose, of dance/movement therapy is the unity and balance of mind and body. Furthermore, the use of D/MT as a healing tool is rooted in the idea that the body and mind are inseparable. The premise that the mind and body have an interdependent relationship is not limited to the theory and practice of D/MT. The field of psychoneuroimmunology also maintains that mental and emotional processes of the mind can affect physiological functioning within the body. In addition, research has shown that certain psychological constructs such as stress, social support, self-esteem, and optimism and pessimism can affect the functioning of the immune system. The constructs discussed and targeted in the field of PNI are just some of the elements that are addressed in the practice of D/MT. Effective psychological intervention can assist the individual to manage and alter stressful conditions. Furthermore, group therapy, which is often employed in the practise of D/MT, provides an effective, efficient and economical system of peer support and hope from other individuals facing the same situation. D/MT is a psychotherapeutic treatment that uses body awareness, expression and acceptance to facilitate physical, emotional, cognitive and spiritual integration to heal disorders of the body and the mind. Other psychological and physical improvements that have been attributed to D/MT include enhanced self-esteem, greater social support, an increased sense of control, and a greater ability to cope with stressful events. Because the elements of PNI discussed above have been shown to affect the physiological functioning and immunity of individuals, they are important constructs that need to be considered in the treatment of disease. Further, as D/MT has been shown to effectively address these factors, it follows that when treating individuals for a disease from the perspective of PNI, D/MT may be an appropriate intervention. In the current research, the aforementioned elements of PNI and how they are affected by the application of D/MT are discussed. Because the present investigation is focused on an area that has yet to be explored in South Africa, very little information concerning the topics in question is available. Consequently, the researcher focused on assembling information in the form of a literature review regarding D/MT and the possibility of using this means of therapy as an intervention for HIV. As such, the research design employed in the current investigation was exploratory in nature.

M.Tech.

The acquired immunodeficiency syndrome (AIDS) in humans, which is caused by the human immunodeficiency virus type 1 (HIV-1) remains among the leading causes of death worldwide. Although HAART has reduced HIV mortality significantly, adhering to the recommended drug schemes, significant toxicities experienced by treated patients, and the high mutation rate of the virus that seem to easily circumvent the action of these drugs emphasize the need for alternative treatment strategies. Medicinal plants are a good source for the discovery of novel antimicrobial chemotherapeutic agents. Reverse transcription is the most essential step for viral replication to succeed successfully. This makes reverse transcriptase the prime target for antiviral therapy against HIV. Emphasis was placed on the discovery of plants with inhibitory activity against HIV-1 reverse transcriptase. Crude extracts from the active plant(s) was screened in vitro for their ability to suppress HIV replication in suitable cell systems. The potential of isolating and identifying the active principle(s) was also investigated. Crude extracts from different parts of Gunnera perpensa showed similar amounts of inhibition: aqueous extracts (97% „b 0.110%SD), methanol/chloroform extracts (94% „b 2.374%SD), rhizome extracts (96% „b 0.475%SD), stem extracts (94% „b 3.723%SD), leaf extracts (96% „b 1.097% SD). Crude extracts were found to be significantly (P„T0.027) non-toxic to CEM.NKR.CCR5 cells and PBMCs at 5 ƒÝg/ml. In acutely infected CEM.NKR.CCR5 cells, acutely infected PBMCs, and chronically infected PBMCs Gunnera perpensa extracts did not significantly (P>0.05) increase cell viability or reduced HIV core protein content, over 4 days. The in vitro test did therefore not reflect the findings with the reverse transcriptase assay. Activity-guided fractionations of Gunnera perpensa rhizome extract lead to the collection of a significantly active fraction. NMR studies revealed the presence of an epimeric mixture of glucose ¡§contaminants¡¨ in this active fraction. The presence of these ¡§contaminants¡¨ concealed the true structure of the active principle. Gunnera perpensa was identified as containing a potential active principle that significantly inhibits recombinant HIV reverse transcriptase. Unfortunately, in vitro experiments could not confirm this finding. The identity and structure of the active principle remains unidentified. Future studies will be concerned with in vitro antiviral studies of the pure active principle. Furthermore, preliminary tests indicated that some of the original collection of crude extracts had anti-bacterial and anti-malarial activities. These findings can be investigated in future. / Dr. D. Meyer

M. Tech / HIV/AIDS is currently one of the most devastating conditions affecting the health of millions throughout the world. In South Africa it is estimated that 4,74 million individuals between 15-49 years are infected with HIV despite the intensive HIV prevention programs that are in place. KwaZulu Natal (KZN) province of South Africa has the highest HIV prevalence in the country (Statistics South Africa, 1996; South African DOH, 2001). Only in August 2003, the South African government announced that it would provide anti-aids drugs free of charge in the public sector. Previously this was unavailable to most HIV-infected South Africans. However despite the governments plan to roll out the provision of ARVs, there are mammoth logistical and human capacity challenges confronting the implementation of a treatment program of this magnitude. Furthermore due to the rapid spread of HIV/AIDS, the high cost of treatment and the association of symptomatic treatment with emergence of drug resistance, many patients with HIV/AIDS are seeking help from alternative systems of medicine. With the worldwide sales of homoeopathic products in 1997 estimated to be $1.5 billion, homoeopathy is growing and becoming an important aspect of healthcare. However in South Africa homoeopathy is relatively new and there seems to be a limited awareness of homoeopathy amongst the public and healthcare authorities. For this reason the Technikon Witwatersrand’s’ (TWR), Department of Homoeopathy has instituted a 3 Phase HIV/AIDS Research strategy in order to identify alternative remedies and support structures that could be useful in controlling the HIV/AIDS pandemic. This study aims to achieve phase one of the TWR’s 3 phase strategy. This study initiated the collection of basic data on the extent homoeopaths are treating HIV/AIDS, the current approaches utilised by the homoeopaths in KwaZulu Natal in the treatment of HIV/AIDS and the need for additional training for homoeopaths with regards to HIV/AIDS. The study was carried out by using the survey method and the measuring tool was a self-administered questionnaire as well as an interview. The study population (n = 59) comprised only registered homoeopathic practitioners of KwaZulu-Natal (KZN). The study was completed in four stages. Stage 1 comprised mailing a covering letter together with the questionnaire and self addressed stamped return envelope. Stage 2 and 3 involved the mailing of reminder letters to the study population. Stage 4 which was only carried out when the data from the questionnaire was analyses consisted of either a face to face or telephonic interview of practitioners. The data was analysed by means of descriptive statistics using the SPSS version 11.0 statistical program. The Mann-Whitney test, Kruskal-Wallis Test (non-parametric ANOVA) and Dunn’s Multiple Comparison Test which was used as a post-test to the Kruskal-Wallis and the Spearman Rank Correlation were used to test the association between various factors in the questionnaire. On analysing the results it can be seen that the demographics of practitioners who treat HIV-positive patients have been influenced by the political-legal and training history of Homoeopathy in South Africa. The majority of respondents in this survey are graduates of Durban Institute of Technology are White and have had less than ten years experience. It has been found that locality of the practice, race of the practitioner and the number of years in practice has an influence on the number of HIV-positive patients that the practitioner treats. Homoeopaths who practice in rural areas rather than urban, treat larger numbers of HIV-positive patients. Black homoeopaths see more HIV-positive patients than white homoeopaths. The longer a practitioner was in practice the more HIV-positive patients are seen. Homoeopathic simplex was the most frequently used treatment for HIV/AIDS patients. This was followed by vitamin supplementation and the use of homoeopathic complex. In addition, it was found that more than 90% of the respondents felt the need for further training with regards to HIV/AIDS. Specific topics that should be addressed were evaluated. This study raised many areas of concern with regards to the treatment of HIV/AIDS using homoeopathy and strongly highlights the need for more information and further research. / Professor A. N. Smith Dr. N. Wolf

Magister Commercii - MCom / This study proposed a modification of the traditional cost-of-illness approach. It considered additional indirect cost parameters that yield a comprehensive cost structure for human capital at a micro level. Although HIV/AIDS is an epidemiological problem, it has enormous direct and indirect economic costs. Arguably, the most important cost associated with HIV/AIDS results from the high rates of morbidity and mortality among working age adults, the vast majority of those infected. These are essentially losses in an economy's existing stock and potential accumulation of human capital, implying lower levels of labor productivity and eventually loss of labor. These impacts are accounted for in existing macroeconomic and microeconomic impact studies. Indirect costs, such as forgone earnings due to illness, are included whereas forgone earnings of caregivers in the household are unaccounted for. / South Africa

Master of Public Health - MPH / There are estimated to be 840,000 people living with HIV in China (1) of whom 65% are estimated to be in the 16-29 year age group. Since the end of the Cultural Revolution and the opening of China to Western influence, traditional cultural norms have rapidly eroded and China is described as being in the middle of a sexual revolution (2). People are increasingly engaging in behaviours exposing them to the risk of contracting HIV which is spreading from the traditionally high risk populations to the general population via the heterosexual route (3). Comprehensive prevention strategies are necessary to prevent further spread (4). There is evidence that the observed increase in sexual activity is not accompanied by adequate knowledge of HIV transmission. 79% of 18-25 year olds know that HIV/AIDS can be transmitted by sexual intercourse, but a mere 30% know that correct and consistent condom use can protect against HIV transmission (5). This exploratory study investigated the factors that influence safe sexual practices amongst female Chinese university students, enabling or preventing them from taking responsibility for their reproductive health. The literature search revealed this to be a largely unexplored area. The study was undertaken amongst third year male and female students, recruited from the Department of Comparative Literature and Media Studies at the Zhongshan University in Guangzhou, China. Data was predominantly collected using two male and two female focus group discussions. Three key informant interviews supported and contextualised the findings. The study revealed that the factors influencing female students’ ability to adopt safe sexual practices are complex. The recognised shortcomings of sex education in China (6) are compounded by the taboo of sex and the pressure placed on students for the achievement of good grades. The university environment exerts a powerful influence. The ease with which mutually beneficial same sex friendships develop in the dormitory can be contrasted with the difficulties faced by couples attempting to conduct relationships. The restrictive university environment has the effect of driving relationships underground. Gender roles are deeply entrenched. The need to conform to the ideal pure, naïve, and non-inquiring female stereotype affects a female student’s ability to source sexual health information, negotiate safe sex, and to adopt safe sexual practices. Two distinct male stereotypes emerged: the traditional more gender equal male, and the liberal male who believes in an earlier age of sexual initiation and condones multiple sexual partners. All students are aware of HIV but have misconceptions about the specifics of HIV transmission, believing that HIV can be transmitted by kissing, from unclean baths and from doctors. Some students were of the belief that poor personal hygiene is an indicator of possible HIV positive status. Students were confused by condom quality issues. As they had received no formal condom training students relied on reading the package instructions or working it out for themselves.This small exploratory study resulted in the production of rich and surprising findings. These are incorporated into recommendations for future research and a comprehensive sex education programme at the university. Abstinence and mutual monogamy should be emphasised. Gender stereotypes that influence behaviour and choice of sex education materials should be acknowledged. Negotiation skills training should be incorporated together with condom and contraceptive advice. A sexual health page on the student website and a training programme for students to become peer-to-peer sex educators should be introduced. / South Africa

Master of Public Health - MPH / This study focused on perceptions and experiences of pregnant women who opted in against those who opted out of voluntary antenatal HIV counseling and testing. The pregnant women's perceptions and experiences were assessed in order to gain insight into their views towards voluntary antenatal counseling and testing. / South Africa

Magister Artium - MA / This study was concerned with the social construction of HIV/AIDS at the policy level in contemporary South Africa, and how such constructions shape the manner in which the epidemic is understood in popular discourse. / South Africa

Magister Scientiae (Physiotherapy) - MSc(Physio) / With the increase in the number of persons suffering from HIV/AIDS, physiotherapists are often required to treat these patients who present with respiratory and neurological complications. Although physiotherapists are at a lower risk of HIV infection in the workplace than nurses and doctors, it is necessary to determine their knowledge and perceptions of the risks, fears of HIV transmission and their attitudes towards patients with the disease. The aim of the study was to determine the physiotherapists knowledge of, and their attitudes towards patients with HIV/AIDS. It also explored whether the physiotherapists knowledge influences attitudes towards HIV/AIDS patients in Lusaka, Zambia. / South Africa

Magister Scientiae - MSc / Although the under-five mortality rate in Malawi has been declining since 1960, it still remains one of the highest in the world. In order to appropriately target interventions to achieve substantial reductions in deaths among children under the age of five years in Malawi, there is an ongoing need for better knowledge of the proportion of cause-specific under-five mortality in the country. The aim of this study was to estimate the direct contribution of HIV/AIDS to the observed level of under-five mortality in Malawi during the period 2000 to 2004. / South Africa