This research project examined the changing expectations and knowledge of Managers in the Department of Health who attended the Sexual Health Counselling Project offered by Rhodes University, East London, South Africa. These managers came from contexts in which the hierarchical medical model is firmly entrenched. The Sexual Health Counselling Project, drawing on theoretical principles from Narrative and other theories,presented a challenge to the standard management practices used by the managers. It also challenged how they dealt with clients. This research explored changes in expectations and knowledge prior to and during a two- week training course that the managers attended. A personal awareness and shift in knowledge occurred for many managers who examined their current practices. Some managers, who were firmly entrenched in the hierarchical model,found it difficult to change their ways of working.

Made available in DSpace on 2015-06-24T12:29:06Z (GMT). No. of bitstreams: 2 priscilla_valente_iff_mest_2014.pdf: 843517 bytes, checksum: 5d0b8b8c520f337225a522fe642dbd04 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2014 / Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Departamento de Ensino. Programa de Pós-Graduação em Saúde da Criança e da Mulher. Rio de Janeiro, RJ, Brasil. / Introdução: A evolução da epidemia de AIDS no Brasil, afeta cada vez mais as mulheres. Uma parcela considerável dos diagnósticos na população feminina ocorre durante o período gestacional. Segundo as recomendações do Ministério da Saúde (MS) a triagem sorológica para o vírus, no primeiro e no terceiro trimestres de gestação, é preconizada a todas as gestantes. A indicação a realização do teste rápido para HIV no momento do parto é restrito a situações especificas. Objetivos: Analisar a utilização do teste rápido para diagnóstico do HIV em gestantes em maternidades vinculadas ao SUS no município do Rio de Janeiro. Estimar o perfil sóciodemográfico e a proporção de gestantes que realizaram o teste rápido em maternidades do RJ. Comparar a prática observada no estudo com as diretrizes do MS para a realização do teste rápido de HIV em gestantes. Estimar o tempo que poderia ser evitado na realização do teste rápido de HIV desnecessário em maternidades do município do Rio de Janeio. Metodologia: Estudo transversal realizado em quatro maternidades, entre julho e dezembro de 2013 analisando a utilização do teste numa amostra de 384 gestantes. Após coleta das informações foi realizada a classificação das gestantes em grupos, baseada nas recomendações do MS para a realização do TR para HIV no momento do parto. O primeiro grupo foi considerado referência e foi formado por gestantes que realizaram o teste com indicação do MS. Todos os outros três grupos incluíram mulheres sem indicação de realizar o exame. Resultados: No total, 351 mulheres (91,4%) entrevistadas realizaram pré-natal dentre essas, 297 (84,6%) mulheres realizaram a sorologia para HIV na gestação. Somente 93 (31,3%) gestantes realizaram sorologia para HIV no primeiro e no terceiro trimestre de gestação. 54 (15,4%) mulheres que realizaram o pré-natal não foram testadas para HIV. Foram classificadas no grupo 1, 14,6% (n=56) do total de participantes do estudo. Foram incluídas nos demais grupos 85,4% das participantes, sendo 12,2% (n=47) no grupo 2, 70,3% (n=270) no grupo 3A e 2,9% (n=11) no grupo 3B. Os resultados encontrados indicam uma sobre-utilização dos testes rápidos nas maternidades públicas do município do Rio de Janeiro. O TR para HIV realizado nas maternidades é uma ótima alternativa para prevenir a transmissão vertical do vírus para o recém-nascido, entretanto esta prática deve ser utilizada quando indicada. / Introduction: The evolution of the SIDA epidemic in Brazil, affects women increasingly. A considerable number of diagnoses in the female population occur during pregnancy. According to the recommendations of the Ministry of Health (MS), serological screening for the virus in the first and third trimesters of pregnancy is recommended to all pregnant women. The indication to the rapid testing for HIV at birth is restricted to specific situations. Objectives: Analyze the use of rapid test for diagnosis of HIV in pregnant women in maternity hospitals of the Unified Health System in the city of Rio de Janeiro. Estimate the socio-demographic profile and the proportion of these women. Compare the practice observed in the study with the guidelines of the Ministry of Health. Estimate the time that could be avoided in the rapid testing of HIV unnecessary in hospitals in the city of Rio de Janeiro. Methods: Cross-sectional study in four hospitals between July and December 2013, which included the calculation of avoidable time in conducting this examination in pregnant women who have no indication to perform it according to the guidelines of the MS. The study included 384 pregnant women. After collecting the information, classification of pregnant women was carried into categories, based on the recommendations of MS for the rapid test for HIV at birth. The first group was considered reference and was formed by pregnant women who took the test with indication of MS. All the other three groups included women with no indication of the exam. Results: In total, 351 women (91.4%) interviewed had received prenatal care. 297 women underwent HIV testing during pregnancy. Only 31.3% (n = 93) of pregnant women received HIV testing in the first and third trimester of pregnancy. 54 (15,4%) women who underwent prenatal care were not tested for HIV. Were classified in group 01, 14.6% (n = 56) of the total study participants. 85.4% of participants were included in the other groups, with 12.2% (n = 47) in group 02, 70.3% (n = 270) in 3A and 2.9% (n = 11) in group 3B. The results indicate an over-use of rapid tests in public hospitals in the city of Rio de Janeiro. The rapid test for HIV performed in hospitals is a great alternative to prevent vertical transmission of the virus to the newborn, but this practice should be used when indicated.

Similar to cancer cells, HIV-infected cells differ from HIV-uninfected cells in that they have altered interferon signaling pathways, the apparent reason for the selectivity of certain oncolytic viruses (OVs). Therefore, it was hypothesized that use of an OV, such as recombinant Maraba virus (MG1), may be a potential approach to eliminate latently-infected cells constituting the HIV reservoir while sparing HIV-uninfected cells. This was studied in U1, ACH-2, OM-10 and J1.1 cells and their respective HIV-uninfected parent cell lines in addition to CD4+CD25-HLADR- cells from HIV-infected individuals on effective antiretroviral therapy. Although MG1 infected and killed latently HIV-infected U1 cells to a greater degree than the HIV-uninfected parent U937 cells, this was not observed in the other HIV-infected cell lines and their respective parent cell lines. Furthermore, results from primary cells suggest that MG1 alone does not appear to eliminate cells which comprise the major HIV reservoir. Challenges of studying the HIV reservoir and priorities for future studies examining the use of OVs as a potential strategy to eliminate the HIV reservoir are discussed.

Theses (MPH.) -- University of Limpopo, 2017 / INTRODUCTION: Since the introduction of Anti-retroviral therapy, People Living With HIV/AIDS (PLWHA) now live longer and present with various opportunistic neuro-musculoskeletal and cardio-pulmonary conditions among other complications. This has led to a surge in the number of patients that visit the physiotherapy department presenting with many complications which include mobility problems, neurological deficits, muscle weakness and developmental delay in children among others as experienced by the researcher in the work place. AIM: To determine the knowledge of physiotherapists with regard to HIV/AIDS and their attitude towards HIV/AIDS patients in the Kingdom of Swaziland. METHOD: In this study a quantitative, descriptive cross-sectional survey was used to determine the knowledge and attitudes of Physiotherapists in the management of HIV/AIDS in the Kingdom of Swaziland. RESULTS: The results of the study revealed that physiotherapists in the Kingdom of Swaziland have a good knowledge and a positive attitude towards people living with HIV/AIDS. Amongst other attributes that were looked at in the study it was reported that 100% of the participants were knowledgeable on the complications associated with HIV/AIDS and 94% of the physiotherapists reported that they are familiar with complications that will benefit from physiotherapy. On the attributes related to attitude of physiotherapist towards HIV/AIDS patients the study found that 100% of the physiotherapists reported that they would take precautions and continue seeing the patients. There was no statistical significant relationship between years of experience and attitude (Pearson chi-square =0.25, p-value =0.61), familiarity with commonly used ARVS (Pearson chi square =1.13, p-value =0.76) and familiarity with Universal Precautions (Pearson chi-square =2.55, p-value =0.46).There was no statistically significant relationship between knowledge and attitude (Pearson chi square =1.000, p-value =0.61). CONCLUSION: The study revealed that the physiotherapists have good knowledge on HIV/AIDS and they also have positive attitude towards managing People Living with HIV/AIDS at their respective departments. There is need for the physiotherapy training schools to include HIV/AIDS in their curricula since some of the schools of physiotherapy where the participants trained did not include it during their time of training and the practising physiotherapists need continuing health education on HIV/AIDS. There is a need for the work setting libraries where physiotherapists work to have current books and journals for the physiotherapists to update themselves on issues pertaining to HIV/AIDS and internet access in the departments. The physiotherapists are also encouraged to take the initiative to utilise the libraries in their work settings and get information on HIV/AIDS. Keywords: Knowledge; attitudes; Physiotherapists; HIV/AIDS; Patients

A variety of host factors influence the ability of Human Immunodeficiency Virus (HIV)- type-1 to access and subsequently replicate within the cellular immune system. Understanding these factors is a crucial step in the development of novel therapeutic strategies including both chemotherapeutic treatments and vaccines. Although it has recently been reported that the CC chemokines RANTES, MIP-la and MIP-10 are the major HIV-1 suppressive factors derived from CD8+ T lymphocytes, this work demonstrates that these factors are not active at the level of transcriptional control and do not share identity with HIV-1 suppressive factors as measured in a transcriptional control assay. These other remaining factors are produced not only by CD8+ T lymphocytes, but by CD4+ T lymphocytes and cell lines derived from the other major leukocyte subsets. These factors are fractionable by standard chromatographic methodologies, and are active in models of both replication and transcription oflaboratory and primary HIV-1 isolates. This work should form the basis for several areas ofresearch related to modulation of HIV-1 replication and transcription. / Thesis / Master of Science (MSc)

INTRODUÇÃO E OBJETIVOS: Uma fonte secundária e não convencional de peptídeos que se ligam as moléculas MHC de classe I tem sido descrita como responsável por produzir peptídeos crípticos. Esses peptídeos são imunogênicos e portanto, capazes de induzir uma resposta imunológica por células T e assim, contribuir com a resposta total exercida pelas células T CD8+, colaborando na pressão que leva HIV-1 ao processo de mutação, e consequentemente ao escape viral. Alguns pacientes, que correspondem a menos de 5% da população infectada, são capazes de naturalmente controlar a progressão da doença, mantendo a contagem de célula T CD4+ acima de 500 células/uL ou mantendo a carga viral abaixo de 2.000 cópias/mL, por ao menos 12 meses, sem ser submetido a tratamento com antirretrovirais ou esquema HAART. Avaliar a resposta imunológica destes pacientes, controladores da infecção, contra peptídeos crípticos pode nos fornecer informações importantes que colaborem com o desenvolvimento de novas estratégias preventivas. METODOLOGIA: A resposta imunológica contra peptídeos crípticos, estes derivados da transcrição da seqüência consenso e da seqüência inversa do gene do HIV-1, foram avaliados em vários conjuntos (pools), utilizando amostras coletadas de pacientes controladores, tanto avirêmicos, também conhecidos como controladores de elite (carga viral < limite de detecção), bem como virêmicos (carga viral < 2.000 cópias/mL) e, de pacientes progressores. Foi observada que a resposta imunológica contra peptídeos crípticos é mais freqüente, com maior amplitude e magnitude entre os pacientes controladores comparados ao que foi observado entre pacientes progressores. Esta resposta, entretanto, parece inverter ao longo da infecção, como observada utilizando as amostras coletadas em momento tardio da infecção, onde os controladores parecem perder sua capacidade de responder aos peptídeos crípticos, enquanto que os progressores desenvolveram resposta, ressaltando que os pools indutores de resposta nas duas fases foram diferentes. Sugerindo que a resposta imunológica contra peptídeos crípticos pode exercer papel importante de pressão sobre o vírus, levando-o ao processo de escape viral. CONCLUSÔES E IMPORTÂNCIA: Peptídeos crípticos são capazes de induzir resposta imunológica e colaborar para explicar como ocorre a seleção de alguns vírus, seja este devido à mudança na expressão das proteínas principais do HIV-1, seja diretamente gerando vírus defeituoso e não infectante. Os peptídeos crípticos podem ser incluídos em desenhos de vacina, com o intuito de aumentar a amplitude e a magnitude da resposta imunológica por células T e consequentemente, aumentar a proteção contra infecção ou progressão da infecção pelo HIV-1 / BACKGROUND: A second and unconventional source of peptides that bind to MHC class I molecule has been described to produce cryptic peptides, which are immunogenic and are able elicit T cell response, that contributes to total CD8+ T cell immune response and then exert mutation pressure on HIV-1, leading to virus escape. Some rare patients, less than 5% of infected population, are naturally able to control disease progression, either maintaining CD4+ T cells over 500 cells/uL or viral load under 2,000 copies/mL, without being treated with HAART, for at least 12 months. Understanding their immune response to cryptic peptides might be a great value to help on developing better prevention strategies. METHODOLOGY: Immune response to cryptic peptides, derived from sense and antisense transcription of HIV-1, was evaluated in pools using samples from Elite (aviremic) or HIV (viremic, < 2,000 copies/mL) controllers and progressors. Immune response to cryptic peptides are more frequent, with a larger breadth and of greater magnitude in controllers than in progressors, and this response is inversed seen in a later time point, when controllers seems to lose this response, while progressors developed it, showing cryptic peptides immune response to different pools, suggesting that immune response to cryptic peptides might play some role in pressuring the virus mutation escape. CONCLUSIONS AND SIGNIFICANCE: cryptic peptides can elicit immune response and help to explain how some virus selection happens, either by changing expression of crucial HIV-1 proteins or generating defective virus. They can be included in vaccine design for enhancing the magnitude and breadth of T cell immune response and consequently the protection against infection or progression of HIV-1 infection

Thesis (M.A. (Clinical Psychology)) --University of Limpopo, 2013 / Studies have indicated that help-seeking behaviour of people living with HIV is not predictable and linear and may entail the utilization of western medicine, traditional medicine and/or complementary medicine. The aim of this study was to explore pre- and post- HIV diagnosis help-seeking behaviour by patients receiving antiretroviral treatment at Witbank Hospital in Mpumalanga Province (South Africa).A qualitative, descriptive phenomenological approach was utilized in the study. Ten participants (male = 5; female = 5, and aged between 30 and 50 years)diagnosed with HIV and who came to the hospital to collect their treatment and for medical review were interviewed using semi-structured interviews. Interpretive analysis method was used to analyse the data. The results suggest the preference for western medicine pre-and post-HIV diagnosis. The results further suggest that help-seeking behaviour is a dynamic process embedded mainly in the conceptualization of the health problem, perception of its severity, the treatment given, and social support experienced.

No description available.

INTRODUÇÃO E OBJETIVOS: Uma fonte secundária e não convencional de peptídeos que se ligam as moléculas MHC de classe I tem sido descrita como responsável por produzir peptídeos crípticos. Esses peptídeos são imunogênicos e portanto, capazes de induzir uma resposta imunológica por células T e assim, contribuir com a resposta total exercida pelas células T CD8+, colaborando na pressão que leva HIV-1 ao processo de mutação, e consequentemente ao escape viral. Alguns pacientes, que correspondem a menos de 5% da população infectada, são capazes de naturalmente controlar a progressão da doença, mantendo a contagem de célula T CD4+ acima de 500 células/uL ou mantendo a carga viral abaixo de 2.000 cópias/mL, por ao menos 12 meses, sem ser submetido a tratamento com antirretrovirais ou esquema HAART. Avaliar a resposta imunológica destes pacientes, controladores da infecção, contra peptídeos crípticos pode nos fornecer informações importantes que colaborem com o desenvolvimento de novas estratégias preventivas. METODOLOGIA: A resposta imunológica contra peptídeos crípticos, estes derivados da transcrição da seqüência consenso e da seqüência inversa do gene do HIV-1, foram avaliados em vários conjuntos (pools), utilizando amostras coletadas de pacientes controladores, tanto avirêmicos, também conhecidos como controladores de elite (carga viral < limite de detecção), bem como virêmicos (carga viral < 2.000 cópias/mL) e, de pacientes progressores. Foi observada que a resposta imunológica contra peptídeos crípticos é mais freqüente, com maior amplitude e magnitude entre os pacientes controladores comparados ao que foi observado entre pacientes progressores. Esta resposta, entretanto, parece inverter ao longo da infecção, como observada utilizando as amostras coletadas em momento tardio da infecção, onde os controladores parecem perder sua capacidade de responder aos peptídeos crípticos, enquanto que os progressores desenvolveram resposta, ressaltando que os pools indutores de resposta nas duas fases foram diferentes. Sugerindo que a resposta imunológica contra peptídeos crípticos pode exercer papel importante de pressão sobre o vírus, levando-o ao processo de escape viral. CONCLUSÔES E IMPORTÂNCIA: Peptídeos crípticos são capazes de induzir resposta imunológica e colaborar para explicar como ocorre a seleção de alguns vírus, seja este devido à mudança na expressão das proteínas principais do HIV-1, seja diretamente gerando vírus defeituoso e não infectante. Os peptídeos crípticos podem ser incluídos em desenhos de vacina, com o intuito de aumentar a amplitude e a magnitude da resposta imunológica por células T e consequentemente, aumentar a proteção contra infecção ou progressão da infecção pelo HIV-1 / BACKGROUND: A second and unconventional source of peptides that bind to MHC class I molecule has been described to produce cryptic peptides, which are immunogenic and are able elicit T cell response, that contributes to total CD8+ T cell immune response and then exert mutation pressure on HIV-1, leading to virus escape. Some rare patients, less than 5% of infected population, are naturally able to control disease progression, either maintaining CD4+ T cells over 500 cells/uL or viral load under 2,000 copies/mL, without being treated with HAART, for at least 12 months. Understanding their immune response to cryptic peptides might be a great value to help on developing better prevention strategies. METHODOLOGY: Immune response to cryptic peptides, derived from sense and antisense transcription of HIV-1, was evaluated in pools using samples from Elite (aviremic) or HIV (viremic, < 2,000 copies/mL) controllers and progressors. Immune response to cryptic peptides are more frequent, with a larger breadth and of greater magnitude in controllers than in progressors, and this response is inversed seen in a later time point, when controllers seems to lose this response, while progressors developed it, showing cryptic peptides immune response to different pools, suggesting that immune response to cryptic peptides might play some role in pressuring the virus mutation escape. CONCLUSIONS AND SIGNIFICANCE: cryptic peptides can elicit immune response and help to explain how some virus selection happens, either by changing expression of crucial HIV-1 proteins or generating defective virus. They can be included in vaccine design for enhancing the magnitude and breadth of T cell immune response and consequently the protection against infection or progression of HIV-1 infection

Bakgrund Hiv, humant immunbristvirus, är en kronisk sjukdom orsakad av ett retrovirus som försvagar kroppens immunförsvar. I dag finns antiviral medicinsk behandling som kan göra att virusnivån knappt är mätbar och personer som lever med hiv kan ha ett vanligt liv. Syfte Att beskriva personers upplevelser av att leva med hiv.   Metod Systematisk litteraturstudie. Åtta artiklar som belyste personers upplevelser av att leva med hiv analyserades med kvalitativ innehållsanalys för att finna synliga mönster i beskrivningarna. Resultat Studiens resultat består av sex kategorier vilka beskriver upplevelser av att leva med hiv. Många personer har upplevt stigmatisering och avståndstagande vilket medförde att de isolerade sig från omgivningen. De påverkades även emotionellt både av själva sjukdomen och stigmatiseringen och nedvärderade sig själva. Många personer beskrev betydelsen av stöd, från familj, vänner och hivspecifika stödgrupper. Infektionen kunde även medföra ett nytt perspektiv att se på livet där det värderades högre och fick en annan mening. Slutsats Personer som lever med hiv kan ha ett fullt fungerande liv och risken för att smitta andra är liten. Ändå utsätts de för stigmatisering och ett avståndstagande, både från samhället och från vården vilket kan ge konsekvenser för de personerna.