It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. Infectious Diseases Society of America considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances. Coccidioidomycosis, also known as San Joaquin Valley fever, is a systemic infection endemic to parts of the southwestern United States and elsewhere in the Western Hemisphere. Residence in and recent travel to these areas are critical elements for the accurate recognition of patients who develop this infection. In this practice guideline, we have organized our recommendations to address actionable questions concerning the entire spectrum of clinical syndromes. These can range from initial pulmonary infection, which eventually resolves whether or not antifungal therapy is administered, to a variety of pulmonary and extrapulmonary complications. Additional recommendations address management of coccidioidomycosis occurring for special at-risk populations. Finally, preemptive management strategies are outlined in certain at-risk populations and after unintentional laboratory exposure.

Stroke is the most common cause of acquired epilepsy in persons 35 and older. The massive increase in extracellular glutamate during stroke causes a cascade of intracellular events that can lead to cell death or the molecular changes that initiate the development of epilepsy. In addition, many studies point to a modulatory role of the endocannabinoid system in controlling seizures. Animal models of stroke induced acquired epilepsy have been difficult to develop. Therefore, this dissertation was initiated to develop an organotypic hippocampal slice culture model of acquired epilepsy and examine the changes in distribution and function of the endogenous CB1 receptor system. We utilized 4-aminopyridine and glutamate to induce separate excitotoxic injuries to slice cultures. Both injuries produced significant cell death acutely following the injury. After a latency period, we observed a significant increase in the number of slice cultures that displayed electrographic seizures in both injury models. Western blot analysis demonstrated that the cannabinoid CB1 receptor protein was significantly upregulated following injury with glutamate. Immnohistochemical studies demonstrated that this receptor upregulation was likely specific to the glutamatergic terminals. Electrophysiological experiments were performed to study endocannabinoid modulation of inhibitory and excitatory signaling in the CA3 pyramidal cells. We demonstrated that depolarization induced suppression of excitation (DSE) was enhanced in slice cultures that had undergone glutamate injury. This indicated that the upregulation of CB1 receptors following glutamate injury was physiologically functional, as it enhanced cannabinoid control of the excitatory signaling. These studies support the hypothesis that there is a functional alteration of CB1 receptors in the epileptic state that acts to suppress seizures. The development of an organotypic hippocampal slice culture model of stroke acquired epilepsy provides a unique tool to study the neuronal plasticity changes associated with epileptogenesis. It also provides a practical model to study pharmacological agents that may be useful in preventing or treating epilepsy.

Acquired Brain Injury (ABI) can result in significant and long lasting additional needs for children, their families and the professionals tasked with supporting them (Middleton, 2001b; Walker & Wicks, 2005). This paper reports the two parts of a small scale study, the aim of which was to illuminate the factors (areas of good practice, issues & challenges) involved in educating children after ABI. The first paper explores the views and experiences of children and young people with ABI and their parents. It identifies how children describe their experiences of school since injury, their parent’s experience of the injury and schooling thereafter, as well as what areas of need exist in terms of improvement in support for this group of children and young people. The second part explores the views and experiences of school based practitioners as well as professionals from a range of external agencies that work with children, young people, their families and schools. The main aims were to stimulate discussion of what roles school staff and external agency professionals have in supporting children with ABI, the ways in which they work together and with children, young people and families and what, if any, improvements were thought to be important. Together, both parts of this research seek to illuminate pertinent factors for those involved, in order to inform future practice for Educational Psychologists (EPs) and the professionals they work with in schools and external agencies.

Doctor of Philosophy / Department of Agricultural Economics / John A. (Sean) Fox / The objective of this thesis is to investigate three design issues in experimental auctions: 1) the effects of allowing negative bids for a privately valued good, 2) the effects of introducing additional alternatives (substitutes) for the auctioned good in an endowment auction, and 3) respondent behavior in acquiring information. The thesis consists of three papers examining those issues. The first paper examines participants’ bidding behavior when negative bids are allowed for privately valued goods in an experimental auction. We focus on two questions: i) whether subjects with negative values tend to bid strategically – either overbidding or underbidding in an effort to enhancing earnings, and ii) the performance of random nth and 5th price auctions. We find that: a) WTP bids are demand revealing, b) subjects tend to underbid WTA values, c) controlling for risk attitude partially explains the bias in WTA bids, and d) negative values from random nth auctions tend to be below those from 5th price auctions. In the second paper we 1) investigate the effect of the availability of varying numbers of alternatives (substitutes) for a privately valued good on participants’ bidding behavior, and 2) identify whether the availability of additional alternatives: a) impacts the value of product information, and b) impacts the effect of new information on product valuations. We find that: a) allowing additional alternatives in a private value auction does not significantly decrease subjects’ bids, and b) the presence of additional alternatives in the auction decreases both the value and effect of product information. The third paper examines the effect of acquired information on auction participants’ bidding behavior. We focus on three questions: i) how subjects choose/value different types of information, ii) whether the value of acquired information about a product influences the subsequent valuation of the product itself, and iii) whether the effects of acquired information differ from those of exogenously provided information. We find that: a) subjects’ behaviors of acquiring different types of information about the product are influenced by their heterogeneous characteristics (i.e. prior beliefs, risk attitudes, prior knowledge, etc.), b) subjects place more weight on acquired information than on provided information in their decision-making process, and c) individual subjects have different values of information which caused different impacts on product valuation.

A research report submitted to the School of Public Health, University of the Witwatersrand (Johannesburg, South Africa) in partial fulfilment of the requirements for the degree of Master of Public Health for the year 2014 / Introduction: After 12 years of implementing the national Prevention of Mother-to-Child Transmission of HIV (PMTCT) programme in South Africa, interventions to prevent MTCT of HIV are now offered in more than 95% of public antenatal and maternity facilities country-wide free of charge (MRC, 2010), even though HIV/AIDS-related diseases are said to be a major cause of death in young children (UNICEF, 2011). The context within which women make decisions about PMTCT participation depends on, amongst other things, the level of their knowledge about HIV/AIDS (Leonard et al, 2001; Sematimba et al, 2004). The concept of behavior-based programming is central to a behavior change approach to reducing Mother-to-Child Transmission of HIV. This places behaviours at the centre of the program design process (Moore, 2003). Understanding the providers and users of the PMTCT interventions’ knowledge and experience on HIV and PMTCT is therefore important to ensure appropriate interventions to address beliefs, attitudes, myths and misunderstandings. Methodology: Semi-structured interviews were conducted with users of the PMTCT programme, while structured survey questionnaires were collected with the providers of the PMTCT programme in early 2012. Users of the PMTCT programme were asked questions regarding HIV knowledge, experience of HIV testing in pregnancy, PMTCT knowledge and experience of the PMTCT programme. We also asked questions on infant feeding choices and practices. Forty six interviews were carried out with participants at three ANC Clinics with PMTCT services in Soweto - Gauteng. Thirty were users of PMTCT programme and sixteen were providers of PMTCT service. Results: All participants understood that HIV was a virus that affected the immune system. Results show that there is generally a good understanding of HIV and how it is transmitted. In addition there was a good understanding on methods to prevent acquiring HIV. There was a general feeling that a lot of people were afraid of being tested. Interestingly, most participants believed that people who were pregnant or sick had no choice but to get tested. Most of the participants believed that education should be a tool used to motivate more people to get tested for HIV. Most users in this study disclosed their HIV status and PMTCT programme use. Overwhelmingly the decision to participate was based on the desire not to infect their infants. Women had been informed that mixed feeding increased the risk of transmission by breast feeding. There were a few participants who believed that HIV infected women should not breastfed. It was found that almost two-thirds of the women in this study were formula feeding their infants. Reason cited for formula feeding was that they did not want to infect their infants. As far as PMTCT knowledge was concerned, it was found that almost all health care providers knew that the most common route of HIV acquisition was through heterosexual sexual practices. All the HCWs knew that prolonged breastfeeding increased the risk of transmission. Reassuringly all HCWs knew not to use invasive delivery procedures and that risk of transmission was decreased with low maternal viral load. Only 50% of the HCWs indicated that the first choice of WHO- recommended mother-to-child regimen for antiretroviral prophylaxis in PMTCT was Zidovudine (ZDV) and Nevirapine (NVP) (WHO, 2012). The HCWs understood that infant formula did not provide superior nutritional support or antibody protection. They also knew that formula feeding carried increased risk of diahorrea or bacterial infections. There was confusion regarding the duration of exclusive breast feeding. Only half of the HCWs stated that post-natal infant-feeding counselling and follow-up are required whenever a mother decides to change her feeding practice. HCW participants felt that most patients fail to adhere to their medication requirements. This was cited to be mainly due to the fact that patients may not have disclosed their HIV status to the household members. Baby feeding choices are cited as the strongest barriers to the success of the PMTCT programmes. Mothers who have not disclosed their HIV status to their household members find it difficult to comply with the chosen feeding choices especially bottle feeding; they therefore opt for exclusive breastfeeding –which family members attempt to interrupt with mixed feeding practices for a number of reasons. Conclusion: Contrary to studies cited in the literature review, health systems failure was not a major problem in Soweto and therefore was not a factor that could impact on either the knowledge or the experience of users and providers. Even though disclosure rates were high amongst the users interviewed in this study, participants believed that the biggest barrier to people participating in the PMTCT programme was because of stigma, ignorance, and fear that they may be recognised while accessing services by people they may know. Although women had been provided with information on exclusively breastfeed, most users of the PMTCT programme interviewed were bottlefeeding – not due to stigma, but due to fear of transmission. In terms of barriers – adherence was noted as a major problem by providers. This linked to issues of feeding practices - if mothers bottle-feed they are stigmatised and opt for exclusive feeding, but are then forced by family to supplement with the bottle for various reasons. Mothers do not reveal their status, which jeopardises their success on the programme

This research investigated the ethical and legal issues that impact on the urgent implementation of Nurse Initiated and Managed Anti-Retroviral Treatment (NIMART) in South Africa, which is part of the task-shifting strategy recommended by the World Health Organization (WHO) to deal with the human resource shortage that has negatively impacted access to Anti-Retroviral Treatment (ART) in developing countries (WHO;2006). The objectives were to review and analyse the existing legal framework and provisions for NIMART in South Africa; and to identify ethical issues and implications of NIMART within the current legal framework. It analysed the legal issues that impact on the implementation of NIMART within the public health service in South Africa, as well as the ethical basis and implications of NIMART on the practice of nurses in the scale-up of Anti-Retroviral Treatment in Primary Health Care (PHC). A comparative analysis was done with case studies of task-shifting in other developing countries and evidence-based recommendations for an enabling and long-term sustainable ethico-legal approach to task-shifting were established. The research concluded that despite the existing legal framework for NIMART in South Africa being firmly founded in the Constitution and further enabled by health policy, challenges exist in implementation of certain critical aspects of the enabling legislation relating to nurse training and accreditation required for full authorization to practice NIMART and that these technical challenges if not attended to could threaten the long-term sustainability of NIMART.

Adults with mild to moderate acquired brain injury (ABI) often pursue post-secondary or professional education after their injuries in order to enter or re-enter the job market. An increasing number of these adults report problems with reading-to-learn. The problem is particularly concerning given the growing population of adult survivors of ABI. Combat-related brain trauma and sports concussions are two factors contributing to increases in traumatic brain injuries, while higher incidences of stroke in young adults and better rates of survival after brain tumors are contributing to increases in non-traumatic brain injuries. Despite the rising need, empirical evaluation of reading comprehension interventions for adults with ABI is scarce. This study used a within-subject design to evaluate whether adult college students with ABI with no more than moderate cognitive impairments benefited from using a multi-component reading comprehension strategy package to improve comprehension of expository text. The strategy package was based on empirical support from the cognitive rehabilitation literature that shows individuals with ABI benefit from metacognitive strategy training to improve function in other academic activities. Further empirical support was drawn from the special education literature that demonstrates other populations of struggling readers benefit from reading comprehension strategy use. In this study, participants read chapters from an introductory-level college Anthropology textbook in two different conditions: strategy and no-strategy. The results indicated that providing these readers with reading comprehension strategies was associated with better recall of correct information units in two free recall tasks: one elicited immediately after reading the chapter, and one elicited the following day. The strategy condition was also associated with better efficiency of recall in the delayed task and a more accurate ability to recognize statements from a sentence verification task designed to reflect the local and global coherence of the text. The findings support further research into using reading comprehension strategies as an intervention approach for the adult ABI population. Future research needs include identifying how to match particular reading comprehension strategies to individuals, examining whether reading comprehension performance improves further through the incorporation of systematic training, and evaluating texts from a range of disciplines and genres.

RESUMO A lesão medular acarreta conseqüências trágicas à vida de uma pessoa. Essa lesão causa a paraplegia (parte inferior do tronco) ou tetraplegia (paralisia dos quatro membros), além de significativas alterações nas funções motoras e sensitivas, porque a medula é um centro regulador que controla importantes funções dentre as quais as atividades sexuais. A sexualidade foi eleita como temática central deste estudo, por que ela constitui-se em um aspecto relevante das perdas sofridas pelos lesados medulares. Tais perdas são constatadas empiricamente, nos atendimentos, pela equipe de reabilitação, quando o paciente traz expectativas e ansiedades em relação a seus problemas pessoais e conjugais. Esse estudo teve como objetivo conhecer e compreender especificidades do lesado medular em suas relações afetivas e sexuais, tendo em vista contribuir para a qualidade de vida individual e familiar dos mesmos, bem como auxiliar profissionais e políticas de reabilitação. Trata-se de uma pesquisa trilhada pela metodologia qualitativa fenomenológica ancorada na perspectiva da psicologia existencial humanista e na ontologia da filosofia do diálogo de Martin Buber. Participaram dez homens com lesão medular adquirida, na faixa etária de 24 a 50 anos, casados e solteiros, que recebem atendimento em uma clínica de fisioterapia na cidade de Ribeirão Preto São Paulo, com disponibilidade para responder questões semi estruturadas com a finalidade de oferecer dados para caracterizar o perfil de cada colaborador e como também para participar de uma ou mais entrevista, gravada, mediante sigilo de identificação. Essa entrevista foi mediada pela questão: Descreva-me acerca da sua sexualidade ao longo de sua vida e, em especial, após a lesão medular. Os depoimentos foram submetidos aos momentos de análise que se constituem em: leitura global de todos; releitura de cada um - apreensão das unidades de significados; agrupamento em categorias; convergências e divergências dos significados e analise compreensiva e análise geral do fenômeno indagado. Os resultados apontam para análise compreensiva das cinco categorias: 1ª) A vivência da sexualidade antes da lesão medular adquirida; 2ª) Percepção de estar com uma lesão medular adquirida; 3ª)O relacionamento com a companheira;4ª) A vivência da sexualidade após o corpo adquirir a lesão medular; 5ª) A pessoa com lesão medular adquirida e seus projetos de vida. A interpretação dos depoimentos revela desolamento, solidão, revolta, dores pela desestruturação da vida pessoal, familiar e profissional desencadeada pela lesão. Essa realidade remete-os a um modo de ser identificado pela ontologia buberiana de superficial e impessoal. A reabilitação é apontada como uma possibilidade de integração e replanificação do projeto de vida pessoal, familiar e profissional. Palavras Chave: 1.Sexualidade. 2.Lesão medular adquirida. 3.Fenomenologia / ABSTRACT Medullar lesion causes tragic consequences to a persons life. This lesion causes paraplegia (paralysis of the lower part of the trunk) or tetraplegia (paralysis of the four limbs), in addition to significant alterations in the motor and sensitive functions, because the medulla is a regulating center that controls important functions, within which the sexual activities. Sexuality was chosen as the central theme of this study, because it constitutes a relevant aspect of the losses suffered by men with acquired medullar lesion. Such losses are verified empirically in the assistance given by the rehabilitation team, when the patient brings expectancies and anxieties in relation to his personal and marital problems. What is this, the sexuality of men with acquired medullar lesion? It is a research based on the phenomenological qualitative methodology anchored on the perspective of humanist existential psychology and on Martin Bubers ontology of dialogue philosophy. Ten married and unmarried males with acquired medullar lesion, at the age range of 24 to 50 years, who receive assistance in a physiotherapic clinic in the city of Ribeirão Preto, state of São Paulo, participated in the research with the objective of offering data to characterize the profile of each collaborator, as well as to take part in a recorded interview, under the condition of secrecy in their identification. Such interview was mediated by the request: Talk about your sexuality along your life and, especially, after the occurrence of your medullar lesion. Their statements were submitted to the moments of analysis of phenomenological reduction, which are composed of: a global reading of all of them; a rereading of each one;an aprehension of the units of meanings; a grouping into categories; convergences and divergences of the meanings and a comprehensive analysis of the following five categories: 1st) The experience of sexuality before the occurrence of the medullar lesion; 2nd) The perception of having an acquired medullar lesion; 3rd) The relationship with his mate after the occurrence of the acquired medullar lesion; 4th) The experience of sexuality after his body acquired the medullar lesion; 5th) The male individual with acquired medullar lesion and his life projects. The interpretation of the statements reveals desolation, loneliness, indignation, resentment for the disruption of their professional, familiar and personal lives, brought about by the lesion. This reality places them in a way of being identified by the Buberian ontology as superficial and impersonal. Their rehabilitation is pointed out as a possibility of integration for a professional, familiar and personal life project.

RESUMO A lesão medular acarreta conseqüências trágicas à vida de uma pessoa. Essa lesão causa a paraplegia (parte inferior do tronco) ou tetraplegia (paralisia dos quatro membros), além de significativas alterações nas funções motoras e sensitivas, porque a medula é um centro regulador que controla importantes funções dentre as quais as atividades sexuais. A sexualidade foi eleita como temática central deste estudo, por que ela constitui-se em um aspecto relevante das perdas sofridas pelos lesados medulares. Tais perdas são constatadas empiricamente, nos atendimentos, pela equipe de reabilitação, quando o paciente traz expectativas e ansiedades em relação a seus problemas pessoais e conjugais. Esse estudo teve como objetivo conhecer e compreender especificidades do lesado medular em suas relações afetivas e sexuais, tendo em vista contribuir para a qualidade de vida individual e familiar dos mesmos, bem como auxiliar profissionais e políticas de reabilitação. Trata-se de uma pesquisa trilhada pela metodologia qualitativa fenomenológica ancorada na perspectiva da psicologia existencial humanista e na ontologia da filosofia do diálogo de Martin Buber. Participaram dez homens com lesão medular adquirida, na faixa etária de 24 a 50 anos, casados e solteiros, que recebem atendimento em uma clínica de fisioterapia na cidade de Ribeirão Preto São Paulo, com disponibilidade para responder questões semi estruturadas com a finalidade de oferecer dados para caracterizar o perfil de cada colaborador e como também para participar de uma ou mais entrevista, gravada, mediante sigilo de identificação. Essa entrevista foi mediada pela questão: Descreva-me acerca da sua sexualidade ao longo de sua vida e, em especial, após a lesão medular. Os depoimentos foram submetidos aos momentos de análise que se constituem em: leitura global de todos; releitura de cada um - apreensão das unidades de significados; agrupamento em categorias; convergências e divergências dos significados e analise compreensiva e análise geral do fenômeno indagado. Os resultados apontam para análise compreensiva das cinco categorias: 1ª) A vivência da sexualidade antes da lesão medular adquirida; 2ª) Percepção de estar com uma lesão medular adquirida; 3ª)O relacionamento com a companheira;4ª) A vivência da sexualidade após o corpo adquirir a lesão medular; 5ª) A pessoa com lesão medular adquirida e seus projetos de vida. A interpretação dos depoimentos revela desolamento, solidão, revolta, dores pela desestruturação da vida pessoal, familiar e profissional desencadeada pela lesão. Essa realidade remete-os a um modo de ser identificado pela ontologia buberiana de superficial e impessoal. A reabilitação é apontada como uma possibilidade de integração e replanificação do projeto de vida pessoal, familiar e profissional. Palavras Chave: 1.Sexualidade. 2.Lesão medular adquirida. 3.Fenomenologia / ABSTRACT Medullar lesion causes tragic consequences to a persons life. This lesion causes paraplegia (paralysis of the lower part of the trunk) or tetraplegia (paralysis of the four limbs), in addition to significant alterations in the motor and sensitive functions, because the medulla is a regulating center that controls important functions, within which the sexual activities. Sexuality was chosen as the central theme of this study, because it constitutes a relevant aspect of the losses suffered by men with acquired medullar lesion. Such losses are verified empirically in the assistance given by the rehabilitation team, when the patient brings expectancies and anxieties in relation to his personal and marital problems. What is this, the sexuality of men with acquired medullar lesion? It is a research based on the phenomenological qualitative methodology anchored on the perspective of humanist existential psychology and on Martin Bubers ontology of dialogue philosophy. Ten married and unmarried males with acquired medullar lesion, at the age range of 24 to 50 years, who receive assistance in a physiotherapic clinic in the city of Ribeirão Preto, state of São Paulo, participated in the research with the objective of offering data to characterize the profile of each collaborator, as well as to take part in a recorded interview, under the condition of secrecy in their identification. Such interview was mediated by the request: Talk about your sexuality along your life and, especially, after the occurrence of your medullar lesion. Their statements were submitted to the moments of analysis of phenomenological reduction, which are composed of: a global reading of all of them; a rereading of each one;an aprehension of the units of meanings; a grouping into categories; convergences and divergences of the meanings and a comprehensive analysis of the following five categories: 1st) The experience of sexuality before the occurrence of the medullar lesion; 2nd) The perception of having an acquired medullar lesion; 3rd) The relationship with his mate after the occurrence of the acquired medullar lesion; 4th) The experience of sexuality after his body acquired the medullar lesion; 5th) The male individual with acquired medullar lesion and his life projects. The interpretation of the statements reveals desolation, loneliness, indignation, resentment for the disruption of their professional, familiar and personal lives, brought about by the lesion. This reality places them in a way of being identified by the Buberian ontology as superficial and impersonal. Their rehabilitation is pointed out as a possibility of integration for a professional, familiar and personal life project.

Introdução: A adolescência é um dos períodos mais intensos da vida, pelos desafios, descobertas e oportunidades de exploração nela presentes e, por isso, se constitui um determinante da vulnerabilidade ao HIV/AIDS. Objetivo: identificar as evidências científicas da literatura sobre os elementos da vulnerabilidade de adolescentes ao HIV/AIDS. Metodologia: Revisão sistemática da literatura, na modalidade de denominada revisão integrativa. A busca de dados foi realizada nas seguintes bases e bancos de dados: CINAHL, PUBMED, SCOPUS, LILACS, ADOLEC, DEDALUS, Biblioteca Digital de Teses e Dissertações -BDTD, portal de teses da USP, no período de 1996 a 2006. Após avaliação do rigor metodológico dos estudos previamente selecionados, foram incluídos como amostra para análise 41 estudos realizados em diferentes países. Resultados: foram apresentados em duas etapas: a caracterização dos estudos e as evidências científicas dos elementos de vulnerabilidade. Os elementos identificados são iguais ou muito semelhantes nos diferentes países em que foram realizados os estudos, sendo diferente a forma como a vulnerabilidade se expressa, bem como a associação entre os elementos que a compõem. Foram identificados 33 elementos de vulnerabilidade, agrupados segundo três temas centrais: \"comportamentos e conhecimentos sobre o HIV/AIDS\", \"normas sociais\", \"condições socioeconômicas\" e \"gestão de serviços de saúde\". Os elementos da dimensão individual foram identificados com maior freqüência, seguidos pelos da dimensão social e programática. Os elementos da dimensão individual foram: grau e qualidade das informações que o adolescente possui sobre HIV, capacidade de assimilar e incorporar essas informações a sua vida, desconhecimento de sua vulnerabilidade, confiança na monogamia do parceiro, não adoção de práticas de proteção, uso de drogas, recusa ou incômodo em utilizar o preservativo, dificuldade de negociação de adolescentes femininas sobre uso do preservativo, gravidez como maior preocupação da conseqüência do ato sexual desprotegido, relações de gênero, representações da aids (doença do outro). Na dimensão social identificou-se: pobreza, violação dos direitos humanos, relações de gênero (aspectos culturais, exploração sexual, prostituição como meio sobrevivência), esgarçamento de laços familiares, acesso aos meios de escolarização e informação, desemprego, violência e falta de expectativas quanto ao futuro. Os elementos da dimensão programática envolveram: relação entre o usuário adolescente e o profissional (discriminação), qualidade do aconselhamento, teste para HIV, acessibilidade aos serviços de saúde, (descontinuidade das ações preventivas e falta de integração com outros serviços no planejamento e desenvolvimento das ações). Conclusões: a revisão integrativa permitiu identificar evidências científicas dos elementos constantes das três dimensões da vulnerabilidade, descritas no conceito de vulnerabilidade, assim como outros elementos, como a falta de percepção do adolescente sobre sua vulnerabilidade ao HIV/AIDS e a falta de perspectiva quanto ao futuro. A contribuição deste estudo para as práticas de saúde é relevante, uma vez que explicitou por meio das evidências científicas, os elementos da vulnerabilidade do adolescente ao HIV/AIDS, que devem ser considerados no planejamento das ações de prevenção para esse segmento social. Além disso, permitiu identificar lacunas de conhecimento sobre a temática, bem como a qualidade do conhecimento produzido, que também devem ser levados em conta em pesquisas futuras / Introduction: Adolescence is one of the most intense periods of life, because of the challenges, discoveries and chances that are present, and it is also a period of vulnerability infection to HIV. Objective: This study\'s goal is to identify the scientific evidences of literature on the elements of vulnerability of adolescents to the HIV/AIDS. Method: Systematic literature review called integrative review. The search of data was carried through in the following bases and data bases: CINAHL, PubMed, SCOPUS, LILACS, ADOLEC, DEDALUS, Capes- BDTD, portal of thesis of USP, in the period of 1996 to 2006. 661 studies, carried out in different countries, were previously selected to be evaluated for its methodology rigor. After evaluation the methodological rigor of the studies previously selected 41 of those studies were chosen as sample. Results: Where presented in two stages: the characterization of the studies and the scientific evidences of the vulnerability elements. The identified elements were equal or very similar, in the different countries where the studies had been carried through, being different the way that vulnerability was expressed as well as the association between such elements. Thirty- three elements of the vulnerability had been identified and grouped according to the central subject of each element: \"social behaviors and knowledge about HIV/AIDS\", \"social rules\", \" socioeconomical conditions \"and \"management of health services\". The elements of the subjective dimension were identified more frequently, followed by the ones of the social and programmatical dimension. The elements of the individual dimension were: the how much adolescent learns about aids ; the ability to assimilate and incorporate this knowledge to his/her your life; not knowing that he/she is vulnerable; trusting in his partner\'s monogamy; not adopting protection practices; use of drugs, uncomfortable or refusal to use condoms; difficulty in negotiating with her partner on the use of condom; pregnancy as the most undesirable consequence of the unprotected sexual act; gender relations; aids like a disease of other. The following social elements were identified: poverty; human rights violation; gender relations (cultural aspects), sexual exploitation (prostitution as a way of living) weakening of family bonds; access to school and information; unemployment, violence and hopelessness in the future. The following programmatical elements, are pointed out: relation between the adolescent patient and the health professional (discrimination); quality of counseling, testing for HIV, accessibility to health services, lack of preventive actions and lack of integration with other services in planning and development prevention actions for this social segment. Conclusions: This integrative review allowed identifying scientific evidences of vulnerability elements in the three dimensions, described in the vulnerability concept, as well as other elements, like the lack of perception of the adolescent on their own vulnerability to HIV/AIDS infection and the lack of perspective about their future. The contribution of this study for the health practices is relevant, once had proved by means of the scientific evidences, the elements of the vulnerability of the adolescent to the HIV/AIDS, that must be considered in the planning of the actions prevention for this social segment. Moreover, it allowed to identify knowledge gaps on the thematic one, as well as the quality of the produced knowledge, that also must been considered in future research