Thesis (M.Sc.)--Boston University, Henry M. Goldman School of Graduate Dentistry, 1977 (Dental Public Health). / Includes bibliographical references: (leaves 6,13).

No description available.

Décadas se passaram desde que os pesquisadores iniciaram investigações sobre a patogênese da infecção pelo HIV. Atualmente, é possível identificar vários desfechos clínicos após a exposição ao vírus, entre eles estão indivíduos expostos não infectados e indivíduos que após a infecção progridem rápida ou lentamente para a aids. No entanto, a identificação de fatores que permitam diferenciar e monitorar estes desfechos continua um desafio. Neste contexto, citocinas parecem ser marcadores promissores de acompanhamento da progressão para a aids. Neste estudo, avaliamos indivíduos HIVpositivo fenotipicamente (níveis plasmáticos das citocinas IL-2, IL-4, IL-6, IL-10, IL- 17A, TNF-α, IFN-γ) e geneticamente (variantes polimórficas) com o objetivo de contribuir para o melhor entendimento da patogênese da infecção e trazer novas perspectivas às questões clínicas e terapêuticas. Nossos resultados sugerem uma associação entre o aumento dos níveis plasmáticos de IL-6 e IL-10 no estágio pré-aids em progressores rápidos (p<0,05) e lentos para a aids (p<0,05). Assim, o aumento dos níveis de IL-6 e de IL-10 podem indicar um estado inflamatório crítico, podendo ser utilizados como marcadores do curso da infecção em indivíduos HIV-positivo. Os genótipos IL10-592 AA+AC (OR 1.89, IC 95% 1,10-3,14, p<0,01) e IL17A-692 TC+CC (OR 1.61, IC 95% 0,99-2,71, p<0,05) foram associados à susceptibilidade a infecção pelo HIV em indivíduos eurodescendentes. Além disso, quando analisados em conjunto, SNPs nos genes IL4, IL6, IL10 e TLR9 mostraram efeitos aditivos significativos (p<0,01). Já em indivíduos afrodescendentes, observou-se um efeito protetor dos genótipos TLR9-1237 TC+CC (OR 0.47, IC 95% 0,23-0,96, p = 0,038), e um efeito epistático significativo entre TLR9 e IL4 (p<0,01). Estes resultados contribuem para a compreensão dos mecanismos envolvidos na resposta imune à infecção pelo HIV. Nossas análises mostram que a origem étnica tem grande influência nas associações entre as variantes genéticas e os desfechos da infecção pelo HIV. Adicionalmente, verificou-se que análises de interação gênica, avaliadas através da redução multifatorial de dimensionalidade (MDR), contribuem para a compreensão dos efeitos dos SNPs e podem ser muito úteis na identificação de redes gênicas que influenciam na susceptibilidade e/ou em diferentes cursos clínicos da infecção pelo HIV. / Decades have passed since researchers began investigations on the pathogenesis of HIV infection. Currently, it is possible to identify many clinical outcomes after exposure to the virus, which includes individuals exposed but uninfected, and rapid or slow progressors to AIDS. However, the identification of factors that allows to differentiate and monitor these outcomes remains a challenge. In such context, cytokines seem to be promising markers for monitoring the progression to AIDS. This study evaluated phenotypically (plasmatic levels of cytokines IL-2, IL-4, IL-6, IL-10, IL-17A, TNF-α, IFN-γ) and genetically (polymorphic variants) HIV-positive individuals as a contribution to a better understanding of the pathogenesis of infection and bring new perspectives to clinical and therapeutic issues. Our results suggest an association between increased serum levels of IL-6 and IL-10 in the pre-AIDS stage for rapid progressors (p<0.05), and for slow progressors to AIDS (p<0.05). Thus, the increase of IL-6 and IL-10 levels may indicate a critical inflammatory condition, and they can be used as course markers of infection in HIV-positive individuals. The genotypes IL10-592 AA+AC (OR 1.89, 95% CI 1.10-3.14, p<0.01) and IL17A-692 TC+CC (OR 1.61, 95% CI 0.99-2.71, p <0.05) have been associated with susceptibility to HIV infection in European-descendents individuals. Moreover, when analyzed together, SNPs in genes IL4, IL6, IL10 and TLR9 showed significant additive effects (p <0.01). Already in African-descendant individuals, a protective effect was observed in genotypes TLR9-1237 TC+CC (OR 0.47, 95% CI 0.23-0.96, p=0.038) and a significant epistatic effect between TLR9 and IL4 (p<0.01). These results contribute to the understanding mechanisms involved in the immune response to HIV infection. Furthermore, the analysis show that ethnic origin has a heavy influence on associations between genetic variants and the outcomes of infection by HIV. The interaction through the multifactor dimensionality reduction (MDR) contributed to the understanding the SNP effects and can be very useful to identify genes which has influence on susceptibility networks and / or different clinical courses.

A epidemia de HIV/AIDS, que sofreu grandes mudanças em seus padrões clínicos e epidemiológicos, atingiu neste século sua estabilidade. Durante estes 30 anos os profissionais de saúde aprenderam muito sobre a doença e hoje esse aprendizado reflete-se em maior eficiência no diagnóstico e no tratamento da infecção pelo vírus e de suas manifestações oportunistas. As lesões orais associadas ao HIV são motivo de estudo desde os primeiros relatos da doença no início dos anos 80, e foram relacionadas ao sexo, idade, naturalidade, forma de exposição ao vírus e a padrões virológicos e imunológicos. Mas a pressão exercida pelas mudanças das características demográficas da epidemia sobre as manifestações bucais oportunistas do HIV não foi levada em consideração. A estabilidade da epidemia e o amadurecimento do conhecimento proporcionam um terreno propício para a avaliação da real prevalência dessas manifestações. Esta pesquisa tem como objetivo verificar como está este panorama no Brasil. Cento e quatro pacientes HIV+ em início de TARV foram avaliados clinicamente, e foram colhidos dados demográficos e exames laboratoriais, além da execução de sialometria e índice CPO-D. A população avaliada foi predominantemente masculina (78,8%) com média de 37,8 anos de idade. A via de transmissão do HIV foi sexual, sendo 57,7% através do sexo homo/bissexual e 38,4% com sexo heterossexual. 52,9 % souberam de sua soropositividade a menos de um ano. O CD4 médio foi de 223 céls/mm³ e a CV de 121.400 cópias/ml. As lesões extraorais foram diagnosticadas em 10,6% dos pacientes, sendo as hiperpigmentações de pele e mucosa (9,6%) e o aumento de glândulas salivares (0,96%) as lesões mais encontradas. A candidíase oral (49%) e a leucoplasia pilosa (41,3%) foram as lesões intraorais mais prevalentes. A xerostomia foi queixa de 46,6% e a hipossalivação foi diagnosticada em 18% e 48% dos pacientes, dependendo da metodologia utilizada para avaliação. O índice CPOD foi de 14,4, considerado alto pela OMS. A presença de lesões orais, candidíase e leucoplasia pilosa foram associadas à baixa imunidade e a presença de lesões orais e candidíase a cargas virais altas. A hipossalivação, avaliada através do fluxo salivar estimulado e representando principalmente a saliva da parótida, foi relacionado com níveis de CD8 alterados. Comparado com a literatura revisada, a prevalência de lesões orais associadas ao HIV apresenta-se alterada neste estudo, principalmente pela ausência de diagnóstico de neoplasias malignas e baixa prevalência de outras lesões orais associadas à aids. / HIV/AIDS epidemic, which has undergone major changes in their clinical and epidemiological patterns, in this century reached its stability. During these 30 years, much has been learned about the disease by health care professionals and nowadays, all this knowledge is reflected in greater efficiency in the diagnosis and treatment of virus infection and its opportunistic manifestations. HIV oral related lesions have been studied since the first reports of the disease in the earlies 80\'s, and were related to gender, age, place of birth, route of virus exposure, and virological and imunological patterns. Demographic changes of the disease over oral HIV opportunistic diseases have not been taken into consideration. The stability of epidemics and maturing of knowledge provide a fertile ground for the evaluation of the real prevalence of these manifestations. This research aims to verify this scenario in Brazil. A hundred and four HIV+ patients starting HAART were evaluated clinically, and demographic data and laboratory tests were collected, in addition to performing sialometry and DMFT index. The population was predominantly male (78,8%), average of 37,8 years old. The route of HIV transmission was sexual, 57,7% through homo/bisexual sex, and heterosexual sex, with 38,4%. 52,9% knew their HIV sero status to less than one year. The average CD4 was 223 cell/mm3 and CV of 121,400 copies/ml. Extra oral lesions were observed in 10,6% of patients, the skin and mucosal hyperpigmentation (9,6%) and enlargement of salivary glands (0,96%) were the lesions diagnosed. Oral candidiasis (49%) and oral hairy leukoplakia (41,3%) were the most prevalent intraoral lesions. Xerostomia was a complaining of 46,6% and hyposalivation was diagnosed in 18% and 48% of patients, depending on the methodology applied. The DMFT index was 14,4, considered high by WHO. Oral lesions, oral candidiasis and oral hairy leukoplakia were associated to low immunity and high viral load levels. Hyposalivation, evaluated by stimulated salivary flow (mainly, representing the saliva produced by parotid gland) was associated with altered levels of CD8. Compared to reviewed literature, oral lesions prevalence was considered altered in this research, notably the lack of diagnosis of malignant neoplasias and low prevalence of other lesions associated with aids. .

A epidemia de HIV/AIDS, que sofreu grandes mudanças em seus padrões clínicos e epidemiológicos, atingiu neste século sua estabilidade. Durante estes 30 anos os profissionais de saúde aprenderam muito sobre a doença e hoje esse aprendizado reflete-se em maior eficiência no diagnóstico e no tratamento da infecção pelo vírus e de suas manifestações oportunistas. As lesões orais associadas ao HIV são motivo de estudo desde os primeiros relatos da doença no início dos anos 80, e foram relacionadas ao sexo, idade, naturalidade, forma de exposição ao vírus e a padrões virológicos e imunológicos. Mas a pressão exercida pelas mudanças das características demográficas da epidemia sobre as manifestações bucais oportunistas do HIV não foi levada em consideração. A estabilidade da epidemia e o amadurecimento do conhecimento proporcionam um terreno propício para a avaliação da real prevalência dessas manifestações. Esta pesquisa tem como objetivo verificar como está este panorama no Brasil. Cento e quatro pacientes HIV+ em início de TARV foram avaliados clinicamente, e foram colhidos dados demográficos e exames laboratoriais, além da execução de sialometria e índice CPO-D. A população avaliada foi predominantemente masculina (78,8%) com média de 37,8 anos de idade. A via de transmissão do HIV foi sexual, sendo 57,7% através do sexo homo/bissexual e 38,4% com sexo heterossexual. 52,9 % souberam de sua soropositividade a menos de um ano. O CD4 médio foi de 223 céls/mm³ e a CV de 121.400 cópias/ml. As lesões extraorais foram diagnosticadas em 10,6% dos pacientes, sendo as hiperpigmentações de pele e mucosa (9,6%) e o aumento de glândulas salivares (0,96%) as lesões mais encontradas. A candidíase oral (49%) e a leucoplasia pilosa (41,3%) foram as lesões intraorais mais prevalentes. A xerostomia foi queixa de 46,6% e a hipossalivação foi diagnosticada em 18% e 48% dos pacientes, dependendo da metodologia utilizada para avaliação. O índice CPOD foi de 14,4, considerado alto pela OMS. A presença de lesões orais, candidíase e leucoplasia pilosa foram associadas à baixa imunidade e a presença de lesões orais e candidíase a cargas virais altas. A hipossalivação, avaliada através do fluxo salivar estimulado e representando principalmente a saliva da parótida, foi relacionado com níveis de CD8 alterados. Comparado com a literatura revisada, a prevalência de lesões orais associadas ao HIV apresenta-se alterada neste estudo, principalmente pela ausência de diagnóstico de neoplasias malignas e baixa prevalência de outras lesões orais associadas à aids. / HIV/AIDS epidemic, which has undergone major changes in their clinical and epidemiological patterns, in this century reached its stability. During these 30 years, much has been learned about the disease by health care professionals and nowadays, all this knowledge is reflected in greater efficiency in the diagnosis and treatment of virus infection and its opportunistic manifestations. HIV oral related lesions have been studied since the first reports of the disease in the earlies 80\'s, and were related to gender, age, place of birth, route of virus exposure, and virological and imunological patterns. Demographic changes of the disease over oral HIV opportunistic diseases have not been taken into consideration. The stability of epidemics and maturing of knowledge provide a fertile ground for the evaluation of the real prevalence of these manifestations. This research aims to verify this scenario in Brazil. A hundred and four HIV+ patients starting HAART were evaluated clinically, and demographic data and laboratory tests were collected, in addition to performing sialometry and DMFT index. The population was predominantly male (78,8%), average of 37,8 years old. The route of HIV transmission was sexual, 57,7% through homo/bisexual sex, and heterosexual sex, with 38,4%. 52,9% knew their HIV sero status to less than one year. The average CD4 was 223 cell/mm3 and CV of 121,400 copies/ml. Extra oral lesions were observed in 10,6% of patients, the skin and mucosal hyperpigmentation (9,6%) and enlargement of salivary glands (0,96%) were the lesions diagnosed. Oral candidiasis (49%) and oral hairy leukoplakia (41,3%) were the most prevalent intraoral lesions. Xerostomia was a complaining of 46,6% and hyposalivation was diagnosed in 18% and 48% of patients, depending on the methodology applied. The DMFT index was 14,4, considered high by WHO. Oral lesions, oral candidiasis and oral hairy leukoplakia were associated to low immunity and high viral load levels. Hyposalivation, evaluated by stimulated salivary flow (mainly, representing the saliva produced by parotid gland) was associated with altered levels of CD8. Compared to reviewed literature, oral lesions prevalence was considered altered in this research, notably the lack of diagnosis of malignant neoplasias and low prevalence of other lesions associated with aids. .

PhD thesis, Faculty of Health Sciences, University of the Witwatersrand, 2008 / This thesis centres around the issues concerning HIV/AIDS and physiotherapy education, curriculum and practice. In particular, this thesis examines which HIV specific content should be included in a physiotherapy curriculum and ultimately presents a conceptual framework for HIV input into the curriculum. There is a vast body of literature available on HIV. For physiotherapists, however, apart from a brief review given by Nixon and Cott (2000) using the ICIDH, no comprehensive literature is available that places information on HIV into a framework that speaks to physiotherapists as part of the rehabilitation fraternity. The literature on impairments is descriptive and buried in the medical model as symptoms. Section one of the literature review placed the literature in such a framework and provided a comprehensive description using the ICF and related aspects that concern physiotherapists. The ICF captures all the elements of current rehabilitation theory and practice and the literature is presented in an ICF framework. In addition, important background information on prevalence, its determinants, treatment approaches and subsequent impacts were reviewed. As most of the literature available still remains in the medical model, the conditions that manifest and from which patients develop impairments, were reviewed. The effects of HIV on body systems are extensive and pervasive. In each body system HIV has direct effects on mature and maturing cells e.g. progenitor cells and mature muscle cells. In the musculoskeletal system HIV impacts on functional systems and organs resulting in pathophysiological changes that manifest as impairments such as muscle wasting. Conditions manifesting in all body systems were reviewed and outlined. Impairments such as pain, breathlessness and proximal muscle weakness were reported in the literature. In addition to impairments, analysis of the literature revealed studies that had found high levels of functional and activity limitations as well as impacts on Health-related Quality of Life in HIV. The literature also presents the current status of physiotherapy interventions. Many studies have reported that exercises are a safe and effective mode of intervention not-withstanding the limitations encountered. The second part of the literature review focussed on aspects concerned with curriculum. Previous studies have focused on establishing baseline knowledge, attitudes and practices (KAP) to HIV and the impact of training programmes on KAP. What the actual content was for health workers, in particular physiotherapists and the approach to incorporating HIV into curricula is a gap in the literature. To inform the overall aim, with context-appropriate HIV content, this study undertook a number of studies in order to obtain the necessary information on HIV, specific to physiotherapy. Therefore the overall approach was a mixed methods one employing both a quantitative and qualitative study mix. The first and second studies informed the clinical picture and were both cross-sectional and descriptive. In both studies descriptive statistics were used to analyse data, especially in determining the absence or presence of conditions. Study 1 sought to establish the level of referral to physiotherapy by retrospectively examining the patient records of patients admitted with HIVrelated conditions over a period of one year. Of the 732 patient records reviewed, 139 (19%) had diagnoses considered suitable for physiotherapy and 3% were referred to physiotherapy. Study 2 aimed to establish a relevant overview of the functional and participation limitations of people living with HIV. Two groups of patients were studied i.e. an in-patient group and an outpatient group. The out-patient group was from a well resourced mining out-patient setting. The ICF checklist was utilised to collect the data and statistical analysis was performed to indicate the presence or absence of impairments, activity limitations and participation restrictions. A logistic regression was done to determine the odds of activity, limitation or participation restriction given certain levels of domains. Both groups showed high levels of impairment. For the in-patient group loss of muscle power 75%(n=60) energy and drive 75%(n=60), disturbed sleep 71%(n=56), emotional problems 62%(49), mild-severe pain 80%(66), weight maintenance difficulties and diarrhoea were apparent. In the out-patient mining group memory problems, energy and drive functions 36%(n=18), sleep 24% (n=12) and emotional functions 28% (n=14), seeing 32% (n=17), hearing, vestibularproblems 28%(n=14) and pain 55%(n=28), blood pressure and respiratory problems 24%(n=12), weight maintenance 63%(n=32), sexual functions 22%(n=11) and reduced proximal muscular power 24%(n=12) were encountered. The in-patient group had high levels of activity limitations and participation restrictions, while the out-patient mining group did not. There was association between the different domains and in the in-patient group gender (p=0.02) and marital status (p=0.01) were likely to influence the activity and participation levels and the experience of the environment. The remaining three studies involved aspects related to informing the curriculum component of this thesis. Study 3 audited the universities’ curricular documents to establish what the current curriculum included. Seven of the eight universities that offer physiotherapy training were reviewed and their curricula were generally scanty on information regarding HIV/AIDS. When compared to the areas outlined as a result of the literature review, the study of the patients and focus groups with clinicians and academic staff, revealed some gaps, in particular; the types of conditionsand the influence of HIV on other body systems which are pertinent to the clinical reasoning process for the physiotherapist: The philosophy of care and approach to management and the physiotherapists’ role in HIV prevention, treatment and care were evident gaps. Study 4 sought to develop a framework of HIV content for a physiotherapy curriculum. This was done by integrating the results found so far and verifying and enriching this data by gaining clinicians’ and academics’ insights and perceptions around HIV, based on their clinical and educational experience. Focus group discussions were conducted and a qualitative approach was undertaken for data analysis. A framework for curricula content emerged from this exercise. In study 5 the framework of HIV content was used to develop a questionnaire that was sent out in the Delphi survey to academic staff with the aim to test the level of consensus. Eighty three components of the curriculum under four outcome areas (Appendix 7.2) were sent to 68 academic staff who were identified. Of the 68 academic staff, 58 were available and 47 responded and consented to participate. All but two topics obtained consensus set at 80% and the remaining two obtained consensus in the second round. The final chapter discusses the results of these studies and illustrates how these results on HIV affect and can be applied to the physiotherapy curriculum, when applied to the UNAIDS mainstreaming criteria. Applying the mainstreaming principles to the process of including HIV content into the curriculum, ensures that the process is not done in a piece meal fashion but encompasses all important facets which were identified. The programme, if systematically implemented, could result in a coordinated outcome accounting for all the important facets. A conceptual framework is drawn from the results of this thesis illustrating the three levels of curriculum taxonomy: At the micro level, through the body systems, the meso level through the role of physiotherapy, dealing with internal and external domains and teaching approaches. The macro level is accounted for by the facilitatory activities such as advocacy among clinicians and academics and forming strategic partnerships at all levels.

Thesis (M.A.) (Development Studies) --University of Limpopo, 2009. / HIV/AIDS poses a challenge to every person, community and organization to such an extent that nearly every organization should have some policies and programmes to deal with the epidemic. The church as one of the organizations seems to be exempted from the fight against the disease whereas it is the only organization that is more in touch with people in the community than any other organization. The purpose of this study is to explore the role that churches can play in HIV/AIDS prevention in order assist the Bushbuckridge churches on how they can fight against HIV/AIDS so as to help reduce the high rate of infections as well as stop the new infections.

Thesis (MPH)--University of Limpopo, 2010. / Background: Antiretroviral therapy led to a revolution in care of patients with HIV/AIDS in a developed world. Treatment is not a cure but it also presented with new challenges of side effects, drug resistance and it also dramatically reduces rate of mortality and morbidity and it also improves quality of life to people living with HIV/AIDS, and it also now considered as manageable chronic diseases. Aim: Aim of the study is to establish and describe reasons for treatment and regimen change in a cohort of HIV positive patients on ART enrolled in the pharmaco-epidemiological survey at Tshepang wellness clinic. Objectives: is to determine reasons for treatment and regimen change, types of treatment and regimen change among patients on ART who are enrolled in pharmacoepidemiological survey at Tshepang wellness clinic. Design and Methods: Study is a retrospective cohort study, and sample size of 301 medical records of a cohort of HIV positive patients on ARVs enrolled in a longitudinal pharmaco-epidemiological survey from November 2006-May 2007 reviewed. Data extraction tool used to collect data and software called SPSS 17.0 used to analyze data and relevant themes were extracted to determine distribution of variables. Results: Results of this study indicated that 91 (85%) were males and (87.8%) 191 were females. Age was grouped as teenagers (15-25yrs), young adults (26-49yrs) and adults (50- 70yrs). Results also shows reasons of treatment and regimen change of which majority of patients 134(44.8%) changed due toxicity followed by 16 (5.4%) who changed because of pregnancy, and the other 4(1.3%) changed because of resistance, and the last 2(0.7%) which are regarded as minorities change because of T.B. Conclusion and Recommendations: Results shows that majority of pharmacovigilance patients were initiated Regimen 1 compared to other regimens. Toxicity appear as the main reason of treatment and regimen change on this study as 140(46.4%) reported toxicities (peripheral neuropathy, lactic acidosis, lipodystrophy and lipoatrophy). Implementation of monitoring of adherence needed for prevention of resistance and virological failure.

Thesis (MPH)--University of Limpopo, 2009. / Background: An understanding of the effectiveness of the hospital-based palliative care programme and the extent to which it changes the way patients are managed in the general medical wards is required, in order to develop evidence-based palliative care guidelines for Public Hospitals on the management of HIV/AIDS patients. Purpose: The study aimed to identify and describe the effectiveness of the Palliative Care programme on the management of HIV/AIDS patients at Chris Hani Baragwanath Hospital. The objectives of the study included to: • Determine the proportion of HIV positive patients admitted into Chris Hani Baragwanath general medical wards accessing services of a hospital-based palliative care team • Identify the care and support needs experienced by HIV positive patients • Compare the frequency of the met and unmet needs of HIV positive patients in those referred as opposed to those not referred to the hospital-based palliative care team Methods: Non-random quota sampling of 50 HIV positive patients confirmed by an ELISA test, and admitted with HIV related illnesses were selected from admission records of medical wards in Chris Hani Baragwanath Hospital. 8 (16%) of the patients were too ill to communicate, 12 (24%) declined the interview and 30 (60%) gave consent to be interviewed. The data was collected using researcher administered questionnaires, and captured on Microsoft Excel 2003. Descriptive statistics were analyzed using STATA 10. Participants were assessed for enrolment into the hospital-based palliative care programme, common palliative care needs experienced and the frequency of identification and provision of palliative care needs provided for patients in the medical wards with focus on physical symptoms, pain, psychosocial problems, integration of care and counselling needs. The group was further divided into those under a palliative care program and those not under palliative care, for further data analysis. Results: Findings revealed that very few patients (27%) with HIV&AIDS were accessing services of the hospital-based palliative care. Significant proportion (67%-77%) of HIV infected patients were experiencing physical symptoms, pain and psychosocial problems requiring palliative care interventions. Further findings revealed that for those participants who were not referred for the palliative care programme, symptoms and pain complaints were not effectively identified and treated by health personnel. Provision of psychosocial and spiritual support was inadequate and that the quality of life for HIV/AIDS patients was compromised due to lack of comprehensive and integrated holistic care. These components were found to be effectively addressed amongst the referred group. iv Conclusion and recommendations: Hospital-based palliative-care has limited effectiveness due to the small size of the team which is working against demands from increasing numbers of HIV positive patients. All health providers working in medical wards need to be trained in palliative care, to develop a capacity to integrate palliative care principles into the routine medical care of HIV/AIDS patients.

Thesis (MPH)--University of Limpopo, 2010. / Introduction: Men living with HIV and AIDS generally do not participate in support groups even though evidence supports their effectiveness as a source of valuable support for people living with HIV and AIDS PLWHA). Study Aim: The aim of the study was to explore reasons for the reluctance of HIV positive men to attend support groups and examine their perceptions and understanding of the benefits of attending support groups for PLWHA Methods: A qualitative descriptive approach was used for this study. A total of five (5) focus group discussions was conducted with HIV positive males receiving ART from Infectious Disease Clinic (IDC) at King Sabata Dalindyebo Municipality in Mthatha Data analysis: Thematic content analysis was used to analyse data from the focus groups, using Nvivo8 a qualitative soft ware used for data analysis and coding revealed 10 themes with their sub categories. Findings: Findings of the research indicate that participants perceive support groups as being helpful to PLWHA. Participants have a broad and positive understanding of the benefits of participation in support groups. Reported barriers to participate in support groups included lack of access to support groups in local communities which affected the distance travelled to support groups, inconvenient and awkward timing of the support group sessions and attending mixed gender support groups which was not acceptable for participants. Personal reasons for non participation included fear of potential disclosure of HIV status due to lack of confidentiality in support groups and perception that support from families and friends was adequate. Recommendation: The study recommends the introduction of men only support groups facilitated by male to enhance men’s participation in HIV and AIDS programmes, and thus create an enormous contribution in the curb of the spread of the disease.