The background. HIV and AIDS is a huge problem in sub-Saharan Africa where an estimated 22.5 million people were living with HIV in 2007.1 South Africa has the worst epidemic in the world.1 There were about 5.5 million people living with HIV and 1000 AIDS deaths daily in South Africa by the end of 2005.17 In 2007 the number of people living with HIV in South Africa increased to 5.7 million.1 The HIV prevalence in Umkhanyakude district, KwaZulu Natal, where Hlabisa subdistrict is situated, amongst public antenatal clinic attenders was 39.8% in 2007.19 AIDS is the cause of 50.0% of deaths in the Hlabisa sub-District.15 In 2003 the South African government decided to provide antiretroviral therapy (ART) in the public health sector, giving hope to thousands of people who are in need of this intervention to improve their quality of life and reduce premature deaths.7,13 However adherence to antiretroviral drugs is essential for successful treatment. Adherence to antiretroviral therapy in South Africa as in other African countries was expected to be low31 (<95.0%), however, in a study that was done in Cape Town during 1996 – 2001, the authors concluded that adherence was high.28 The aim of that study was to identify predictors of low adherence (<95.0%) and failure of viral suppression (>400 HIV copies/mm3). Pill counts and records of treatment refills from pharmacy were used to measure adherence.28 The results revealed no significant difference in adherence between patients on protease inhibitor based regimens and/or those on nonnucleoside based regimens nor with socioeconomic status, sex and HIV stage. Independent predictors of low adherence were English language speaking, age, and three times per day dosing. The following were found to be independent predictors of failure of viral suppression: baseline viral load, <95.0% adherence, age and dual nucleoside therapy.28This study however was done in an urban area before the antiretroviral therapy (ART) roll out in South Africa when the cost of treatment limited the accessibility of ART. These patients may have been different to patients who access free treatment in public health facilities today. Other South African studies have also reported good adherence rates.39,40 In another study in Soweto, South Africa, adherence was high, 88.0% of patients achieved > 95.0% goal, 9.0% achieved 90.0-95.0% adherence and only 3.0% achieved <90.0%.39In a study done at Khayelitsha, adherence was also high, viral load level was < 400 in 88.1%, 89.2%, 84.2%, 75% and 69.7% of patients at 3, 6, 12, 18 and 24 months.40 However, Soweto and Khayelitsha are urban and different from Hlabisa, and it is difficult to generalize these results to the sub-district. This study intended to assess how adherent patients are to antiretroviral therapy in a typical rural district in order to inform policy to enhance adherence to ART. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2008.

<p>The current study aimed to describe the extent and reasons for substituting and switching HAART at the Katutura Intermediate Hospital in Windhoek, Namibia</p>

<p>Sub-Saharan Africa is home to two thirds of the 33 million HIV infected individuals worldwide. In 2007 there were an estimated 1.5 million Kenyans infected with HIV, and 166 000 new infections in 2008. The introduction of antiretroviral therapy [ART] brought new hope to HIV patients. It has transformed a fatal disease to a chronic manageable condition. Kenya has made great strides in ensuring access to ART and by 2009, 308 610 patients in the country were receiving ART - which is the second highest number worldwide. The success of ART requires a sustained adherence rate to medication of more than 95% to prevent viral replication and the development of drug resistant HIV strains. Identifying the factors that influence adherence, is essential for the long-term success of public ART programmes. The current study explored patient, socio-economic, cultural, and religious and health systems factors that influence adherence to ART at the Coast Provincial General Hospital [CPGH] in Mombasa, Kenya.</p>

Thesis ((Ph.D. (Physiology))--North-West University, Potchefstroom Campus, 2010.

Acquired Immunodeficiency Syndrome (AIDS) is characterized by the progressive destruction of a person’s immune system and is the latest and most serious stage of Human Immunodeficiency Virus (HIV) infection. Botswana currently has the highest estimated prevalence of HIV infection in the world. Botswana has a relatively young population structure, with about 60% of the approximately 1,8 million people aged less than 45 years. HIV prevalence for pregnant women aged 15–45 years in Botswana did, however, decrease marginally from 36,2% in 2001 to 35,4% in 2002. It is estimated that about 258 000 Botswana are now living with HIV and AIDS, and high morbidity and mortality rates due to HIV/AIDS have seen Botswana slip down the United Nations Development Plan (UNDP) Human Development Index rankings from 71 in 1996, to 122 in 1999/2000. In 2002 Botswana initiated public antiretroviral therapy (ART) at four sites initially to provide treatment to HIV/AIDS patients before expanding the programme to the rest of the country. The specific objective of the study was to investigate the prescribing patterns of ARV drugs at Sekgoma Memorial Hospital ARV therapy clinic (SMH–IDCC) in the central district of Botswana for a two–year period from 2005 to 2006. Data from 1717 patients were obtained from the SMH–IDCC electronic database regarding ARV drugs prescribed during the study period, CD4–Tcell count (cells/?L) at the commencement of therapy and after six months from the commencement of therapy and side effects necessitating change of therapy for the study period 2005 until 2006. The study showed that there were eight antiretroviral therapy (ART) regimens prescribed: zidovudine plus lamivudine plus efavirenz (AZT/3TC/EFV), zidovudine plus lamivudine plus nevirapine (AZT/3TC/NVP), Combivir® plus efavirenz (CBV/EFV), Combivir® plus nelfinavir (CBV/NFV), Combivir® plus nevirapine (CBV/NVP), stavudine plus lamivudine plus efavirenz (D4T/3TC/EFV), stavudine plus lamivudine plus nelfinavir (D4T/3TC/NFV), and stavudine plus lamivudine plus nevirapine (D4T/3TC/NVP). The most prescribed ART regimen for adult patients was Combivir® plus efavirenz (CBV/EFV) (51,37%). This was broken down as 17,20% of females and 34,17% of males. The second most prescribed ART regimen was Combivir® plus nevirapine (CBV/NVP)(36% of the total study population (N=1717). This represented 34,17% of females and 1,98% of males. The most prescribed ART regimen in children was zidovudine plus lamivudine plus efavirenz (AZT/3TC/EFV) (3,73% of the total population), broken down as 1,05% of females and 2,68% of males. The second most prescribed regimen in this group was zidovudine plus lamivudine plus nevirapine (ZDV/3TC/NVP) (3,50% of total population). The findings from this study indicated that all eight the ART regimens prescribed at the study site were in accordance with the Botswana national ART guidelines. There were thirteen different types of side effects necessitating change of therapy, including pregnancy, treatment failure and poor adherence. The average CD4–Tcell count change (155.63 cells/?L, ± 204.08 cells/?L) for the study population was more than 100% after six months from commencement of therapy, indicating success of therapy in terms of CD4–Tcell count. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

With great appreciation, I would like to accentuate the substantial contributions of the following people who made this project possible: To Dr. CMT Fourie (my supervisor), Prof. JM van Rooyen (my co–supervisor) and Prof. AE Schutte (my co–supervisor) whose gracious advise, patient guidance, commitment and support have enabled me to plan, analyse, interpret and write this project in a scientific manner. It has been an educational experience for me, thank you. To Mr. LS Wyldbore for the language editing of this dissertation. I thank all the participants, researchers, field workers and supporting staff of the PURE study. The financial assistance of the National Research Foundation (DAAD–NRF) towards this research is hereby acknowledged. A special thanks to my parents, sister, Albert, family and friends, thank you for the never–ending love, support, patience and understanding that you gave me throughout this project. Last, but not the least, a special thank to God for giving me the opportunity, talent, determination and endurance to complete this project. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2012.

Thesis ((Ph.D. (Physiology))--North-West University, Potchefstroom Campus, 2010.

Acquired Immunodeficiency Syndrome (AIDS) is characterized by the progressive destruction of a person’s immune system and is the latest and most serious stage of Human Immunodeficiency Virus (HIV) infection. Botswana currently has the highest estimated prevalence of HIV infection in the world. Botswana has a relatively young population structure, with about 60% of the approximately 1,8 million people aged less than 45 years. HIV prevalence for pregnant women aged 15–45 years in Botswana did, however, decrease marginally from 36,2% in 2001 to 35,4% in 2002. It is estimated that about 258 000 Botswana are now living with HIV and AIDS, and high morbidity and mortality rates due to HIV/AIDS have seen Botswana slip down the United Nations Development Plan (UNDP) Human Development Index rankings from 71 in 1996, to 122 in 1999/2000. In 2002 Botswana initiated public antiretroviral therapy (ART) at four sites initially to provide treatment to HIV/AIDS patients before expanding the programme to the rest of the country. The specific objective of the study was to investigate the prescribing patterns of ARV drugs at Sekgoma Memorial Hospital ARV therapy clinic (SMH–IDCC) in the central district of Botswana for a two–year period from 2005 to 2006. Data from 1717 patients were obtained from the SMH–IDCC electronic database regarding ARV drugs prescribed during the study period, CD4–Tcell count (cells/?L) at the commencement of therapy and after six months from the commencement of therapy and side effects necessitating change of therapy for the study period 2005 until 2006. The study showed that there were eight antiretroviral therapy (ART) regimens prescribed: zidovudine plus lamivudine plus efavirenz (AZT/3TC/EFV), zidovudine plus lamivudine plus nevirapine (AZT/3TC/NVP), Combivir® plus efavirenz (CBV/EFV), Combivir® plus nelfinavir (CBV/NFV), Combivir® plus nevirapine (CBV/NVP), stavudine plus lamivudine plus efavirenz (D4T/3TC/EFV), stavudine plus lamivudine plus nelfinavir (D4T/3TC/NFV), and stavudine plus lamivudine plus nevirapine (D4T/3TC/NVP). The most prescribed ART regimen for adult patients was Combivir® plus efavirenz (CBV/EFV) (51,37%). This was broken down as 17,20% of females and 34,17% of males. The second most prescribed ART regimen was Combivir® plus nevirapine (CBV/NVP)(36% of the total study population (N=1717). This represented 34,17% of females and 1,98% of males. The most prescribed ART regimen in children was zidovudine plus lamivudine plus efavirenz (AZT/3TC/EFV) (3,73% of the total population), broken down as 1,05% of females and 2,68% of males. The second most prescribed regimen in this group was zidovudine plus lamivudine plus nevirapine (ZDV/3TC/NVP) (3,50% of total population). The findings from this study indicated that all eight the ART regimens prescribed at the study site were in accordance with the Botswana national ART guidelines. There were thirteen different types of side effects necessitating change of therapy, including pregnancy, treatment failure and poor adherence. The average CD4–Tcell count change (155.63 cells/?L, ± 204.08 cells/?L) for the study population was more than 100% after six months from commencement of therapy, indicating success of therapy in terms of CD4–Tcell count. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

With great appreciation, I would like to accentuate the substantial contributions of the following people who made this project possible: To Dr. CMT Fourie (my supervisor), Prof. JM van Rooyen (my co–supervisor) and Prof. AE Schutte (my co–supervisor) whose gracious advise, patient guidance, commitment and support have enabled me to plan, analyse, interpret and write this project in a scientific manner. It has been an educational experience for me, thank you. To Mr. LS Wyldbore for the language editing of this dissertation. I thank all the participants, researchers, field workers and supporting staff of the PURE study. The financial assistance of the National Research Foundation (DAAD–NRF) towards this research is hereby acknowledged. A special thanks to my parents, sister, Albert, family and friends, thank you for the never–ending love, support, patience and understanding that you gave me throughout this project. Last, but not the least, a special thank to God for giving me the opportunity, talent, determination and endurance to complete this project. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2012.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.