Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2009. / Includes bibliographical references (leaves 80-85). Also available online.

Documentation of neurological complications and neuropathological findings arising in most AIDS patients has stimulated the need for an investigation of the brain-behaviour relationship associated with human immunodeficiency virus (HIV) infection. This study aimed to verify the hypothesis that a chronic subclinical AIDS dementia exists in view of the neurotropic quality of HIV. Participants were 59 male homosexuals distributed as follows: 17 healthy HIV seronegative, 14 healthy HIV seropositive, 14 AIDS-Related Complex, and 14 AIDS. They were administered a comprehensive battery of neuropsychological tests, including measures of attention, cognition, memory, language, executive, and sensorimotor functions. An examination of the emotional and psychological concomitants was performed using questionnaires of personality (MMPI), anxiety (STAI), and health-related behavioural dysfunction (SIP). Group comparisons were conducted on the basis of Health Status (Healthy vs Nonhealthy) and Medical Diagnosis (HIV-, HIV+, ARC, & AIDS). Results revealed a significant Health Status effect overall, as well as evidence for a deterioration of higher mental abilities occuring with progression of HIV infection. These findings appear to be independent of the emotional and psychological factors, which are felt to be an integrative part of the AIDS-Dementia Complex (ADC). / Graduate

The purpose of this study was to investigate how rural Ugandan women engage with discussions of HIV and AIDS on community radio. It explored how this audience may relate such broadcast discussions to their own lived experience of HIV and AIDS. It is explained in the study that, while the Uganda government has an official policy of openly discussing matters of HIV and AIDS, health communication strategies still operate within a context where there is an underlying "culture of silence" that discourages openness about sexual matters. It is also pointed out that there are widespread gender disparities among rural communities, which severely limit women's ability to make use of health communication initiatives aimed at educating them. Against this backdrop, the study sets out to explore audience responses to a particular example of Speak Out and Listen, a weekly programme broadcast on Mama FM, a Kampala-based radio station managed by the Uganda Media Women's Association (UMWA). The study maps out responses to the programme by a particular group of rural women. It is argued that these research participants' comments confirm the importance, noted in literature dealing with health education, of drawing for content on what members of an audience have to say about their own lived context. It is proposed that, despite the existence of a 'culture of silence', the women's comments demonstrate an ability to speak with confidence about their experience of living with HIV and AIDS. Thcy are able, more particularly to discuss the constraints placed by gendered power relations on women's ability to draw on the educational content of programming that targets people living with HIV and AIDS. As such, the comments that such women offer represent a valuable resource for HIV and AIDS related programming. The principal conclusion of the study is that health communication initiatives such as Speak Out and Listen would benefit from facilitating conversations with their target audience about their lived experience of HIV and AIDS, and incorporating such discussion into their programmes

This qualitative study using a phenomenological design, aimed at exploring and describing and exploring the experiences of HIV positive clients defaulting Isoniazid Preventive Therapy services in the Bhisho Primary Health Care Services. The emphasis was on the factors leading clients to default. An in- depth unstructured face to face interviews were done on 14 participants from 4 clinics or facilities under Bhisho Primary Health Care Services. From the respondents’ responses it can be noted that work and family related issues, ignorance of patients, side effects, and negligence of nurses and denial of HIV status were identified as reasons for defaulting. Having knowledge about the treatment and health providers’ attitudes to patients also played a role in patients defaulting their treatment.Many suggestions were then put forward by the respondents to curb defaulting among patients. These included the use of text message reminders, not to discrimination HIV patients because of their status, to use consulting rooms for privacy and also nurses and caregivers to control their attitudes when dealing with patients.

M.Tech. (Homoeopathy) / Please refer to full text to view abstract

M.Sc. / Background: The continuous emergence of drug resistant strains of HIV as a result of errors made by reverse transcriptase coupled with undesirable side effects of available drugs, latency problems, cost etc, warrants the continuous search for new drug candidates. Chrysotherapy which is the use of gold compounds for the treatment of various ailments has been practiced since 2500 BC. The use of gold compounds such as auranofin for the treatment of rheumatoid arthritis has lead to remission of this disease. Gold compounds such as auranofin not only prevented the progression of arthritis but also increased the CD4+ count of an HIV positive patient who was not on antiretrovirals. These compounds have been implicated in the treatment of cancers, autoimmune diseases and microorganism infections. Objectives: In this work, novel gold compounds were evaluated with the aim of identifying lead compound(s) that can eventually serve as anti-HIV agents. Materials and Methods: Eleven gold (I) phosphine complexes, four of their corresponding ligands (compound without gold atom), and a gold (III) complex were tested for the ability to inhibit reverse transcriptase (RT) and protease (PR) in direct enzyme assays. Uptake of the compounds by host cells was evaluated with inductively coupled plasma atomic emission spectrometry (ICP-AES). Potential toxicity of the gold compounds was screened for by viability dyes and flow cytometry assays. To determine inhibition of whole virus by other mechanisms in addition to RT or PR, p24 production by infected cells was evaluated. Prior to all these analysis, stability of compounds in solution was determined by 31P nuclear magnetic resonance (NMR) and UV-visible spectroscopy. Results: The compounds were shown to be stable in solution over a one week period and were taken up by both continuous cell lines and primary cells. Eight of the gold compounds significantly inhibited HIV-1 reverse transcriptase at concentrations of 25 and 250 μM while four compounds and the four ligands did not. In a fluorogenic assay against HIV-1 PR, four of the gold compounds demonstrated inhibitory activity. The gold compounds were toxic to cells lines but not to primary cells. One of the complexes (EK231) significantly reduced p24 (p=0.0042) production at a concentration of 25 μM. Conclusion: Data provided here suggests that the therapeutic benefits of these gold containing compounds as potential HIV-1 reverse transcriptase and protease inhibitors should be considered.

Until now, emerging viral diseases have been posing ongoing threats to the global public health. Among the notorious viruses, the HIV that causes the AIDS has been spreading continuously since it was first identified in 1981 and is the most quickly spreading disease of the century. Although considerable advance has been made by drug discovery groups, the therapeutic management is still challenged by the rapid mutations of the virus to yield resistant strains, so as the emergence of side effects. Therefore, the development of novel potent anti-HIV agents is urgently sought. Owing to the chemical diversity, we believe that natural products may serve as potential "lead" compounds for discovery of anti-HIV drugs.;In order to search for novel naturally occurring compounds with potent inhibitory effects against HIV, we began with isolation of natural products from two medicinal plants of Justicia by means of silica gel column chromatography, and preparative HPLC, namely, J. gendarussa that displayed potent anti-HIV activity in our initial screening, and J. procumbens, and their chemical structures and determinated by spectroscopic and chemical methods such as IR, UV, HRESIMS, 1H NMR and 13C NMR spectrometry (including DEPT, 1H-1H COSY, and HMBC techniques). Upon the complete identification of compounds, we focused on the synthesis of one potential lead compound isolated from J. gendarussa, patentiflorin A (3). Nevertheless, we evaluated all the isolated natural compounds and synthetic 3 via bioactivity screening for anti-HIV activity.;In the phytochemical investigation of J. gendarussa, a rare, shade-loving, quick-growing, evergreen scented shrub collected in Vietnam, the bioassay-directed fractionation of the methanol extract of the roots and stems of the plant led to the isolation two new arylnaphthalide lignan glycosides, named justiprocumins A and B (1--2), together with a known one, patentiflorin A (3). On the other hand, the phytochemical investigation of the methanol extract of the aerial parts of J. procumbens resulted in the isolation of four novel arylnaphthalide lignans, procumbenosides G (4), H (5), I (6) and J (7), along with 23 known compounds, namely, tuberculatin (8), procumbenoside B (9), procumbenoside E (10), ciliatoside B (11), ciliatoside A (12), 5-methoxy-4, 42-di-O-methylsecolariciresinol (13), secoisolariciresinol dimethyl ether (14), 2, 3-bis(3, 4-dimethoxybenzyl)-4-hydroxybutyl acetate (15), secoisolariciresinol (16), hemiariensin (17), ariensin (18), secoisolariciresinol dimethyl ether diacetate (19), hinokinin (20), justicidin E (21), justicidin D (22), justicidin C (23), cilinaphthalide A (24), 5'-methoxy-4'-O-methyllariciresinol (25), 3, 5, 7, 32, 42, 52-hexamethoxyflavone (26), 3, 5, 7, 8, 32, 42-heptamethoxyflavone (27), 3, 5, 7, 8, 32, 42, 52-heptamethoxyflavone (28), methyl ferulate (29) and loliolide (30). In addition, the compound 3 was totally synthesized with a yield of 68.3%;In the anti-HIV evaluation for all the isolated compounds using the defective HIV-based pseudotyped assay, patentiflorin A (3) was found to have anti-HIV activity with an IC50 value of 26.9 nM, while justicin E (21) showed 65.4 % inhibitory effect against HIV replication at 2.5 μg/mL. In the evaluation for the broadness of the spectrum of anti-HIV activity using a standardized human PBMC assay, 2 gave IC50 values of 14-21, and 3 gave IC50 values 24-37 nM in inhibiting the particle production of all the four HIV-1 isolates [BAL and SF162 (both are M-tropic), LAV0.04 (T-tropic), and 89.6 (dual tropic)], while the synthetic 3 showed quite similar activity as that of natural 3. In the test of cytotoxicity, natural 3 exhibited no apparent cytotoxicity at 19.0 mM in A549 and Hela cells, and the synthetic 3 displayed much lower cytotoxicity (CC50: 75.5 mM) than that of the natural 3 (CC50: 18.4 mM) in PBMC cells. That means 2 and 3 have great potentials as anti-HIV lead compounds for further drug development.;In conclusion, natural compounds isolated from medicinal plants serves as one of the most important sources of potentially anti-HIV compounds, which can be employed as "lead" compounds to develop novel therapeutic drugs against HIV.

Magister Curationis / A problem was identified at Aid for AIDS (AfA) whereby some doctors requested a change in treatment within less than a year after their patients started antiretroviral therapy. The requests were normally based on treatment failure. It appears that in most cases where the desired treatment outcome is not achieved is due to poor adherence to therapy. AfA is a HIV / AIDS disease management company offering access to antiretroviral therapy (ART), prevention of opportunistic infections, treatment and blood results monitoring, treatment support through adherence coordinators and expert clinical support and advice to healthcare providers. They monitor treatment adherence through claims history, CD4 and viral load (VL) results as well as telephonic contact with the client. Factors that could contribute to poor adherence are side - effects, barriers e.g. work environment, non - disclosure, lifestyle, lack of client commitment, limited contact between the client and treatment support counsellor, limited funds, stigmatisation and a lack of clear adherence guidelines to improve treatment outcome. Method: A comparative study was done to assess the impact of an intervention to improve patient adherence to ART. The researcher postulates that by the implementation of guidelines to counsellors, client adherence to therapy would increase. A comparative study was used to assess whether structured guidelines can improve client adherence to therapy. Results: The results have proven that guidelines used by treatment support counsellors does improve adherence to ART. Recommendations: It is recommended that treatment support counsellors, to improve their clients’ adherence to ART, should apply adherence guidelines. / South Africa

Magister Public Health - MPH / The district health report for Livingstone, Zambia, outlined an increasing prevalence of HIV/AIDS iun the district. In 1998 the prevalence wsas at 29%, in 2000 at 30%, in 2002 at 31.8% and in 2004 at 31%. This was above the national prevalence of 20% according to CBoH statistics of 2004. The district has been implementing the HIV/AIDS prevention in various organizations during the past 3 years. Most of the organizations implementing the HIV/AIDS preventive activities do not work collaboratively with other sectors and this has resulted in un-coordinated activities and wstage of the limited resources. This exploratory qualitative study aimed at undestanding participants' perceptions of factors influencing coordination between different organizations that are involved in the implementation of HIV/AIDS activities, and to note the impact that this had in the implementation of activities in a multisectoral approach to HIV/AIDS prevention. / South Africa

Magister Scientiae - MSc / The 24-item scale has been used extensively to assess the attitudes towards AIDS precautions. This study investigated the usefulness and validity of the instrument in a South African setting, fourteen years after the development of the instrument. If a new structure could be found statistically, the HIV/AIDS prevention strategies could be more effective in aiding campaigns to change attitudes and sexual behaviour. / South Africa