Magister Scientiae (Physiotherapy) - MSc(Physio) / The use of high active antiretroviral therapy in people living with HIV/AIDS is increasing worldwide. In Rwanda, above 70 % of people in need of antiretroviral therapies is getting them. This drug therapy is associated with abnormal fat redistribution and metabolic complications which increase the risks of cardiovascular and diabetes diseases among these patients. The best recommended preventive and treating modality for these complications is physical activity participation. Despite this recommendation, there is lack of information about physical activity in HIV individuals under high active antiretroviral therapy. The current study aims to determine physical activity levels among people living with HIV treated with high active antiretroviral therapy in Kigali, Rwanda. A cross-sectional design using quantitative method was used. The participant's levels of physical activity participation and their association with anthropometric profiles were measured, using a structured self-administered questionnaire adapted from the Sub-Saharan Africa Activity Questionnaire. Based on a scientific calculation, 407 clients passing through the clinics were included in the study. A convenient sample of people attending the clinics approached to participate voluntarily in the study. The statistical package for social sciences version 19.0 and descriptive statistics were used to analyze the data. Inferential statistics like Chi-square test was used to determine the associations between physical activity levels and anthropometric profiles (p<0.05). Of the participants, 77% were female with a mean age of 38.82 years (SD=8.9. According to body mass index and weight hip ration, approximately 40% and 43% were obese and overweight respectively. Obesity was more common amongst the females (45%). The study found a high prevalence of inactivity in the following activities, of leisure-time (82.6%), household (71%), walking to/from work (61.7%) and work related physical activities (75%). Obesity was found to be strongly associated with inactivity in all types of activity. The findings of the current study highlighted the lack of motivation, lack of time and fear of worsening the disease amongst the strong barriers to physical activity participation. The current study recommends education about the benefits of physical activity participation and encouragement of patient treated with high active antiretroviral therapy in Rwanda to be emphasized on to improve their lives. / South Africa

No description available.

archives@tulane.edu / Concurrency is defined as overlapping sexual partnerships where sexual intercourse with one partner occurs between two acts of intercourse with another partner. The behavior is frequently reported in the literature and can be considered normative within certain groups around the world. Despite this, there are many unanswered questions on the topic, which can impact HIV prevention and control service-delivery programs. Three studies were conducted among a group of newly HIV-diagnosed persons identified by the New York City Department of Health and Mental Hygiene. First, bivariate analyses were conducted in order to address the differences between those who named their sexual partners and those who did not as well as those who reported sexual partner concurrency and those who did not among those who named their sexual partners. Tests of trend over the ten-year time period were conducted in order to assess trends in both the elicitation of sexual partners, self-report of anonymous sexual partners, and sexual partner concurrency. In the next study, bivariate analyses were conducted in order to identify differences in sexual risk behaviors between those reported sexual partner concurrency and those who did not. Both crude and adjusted logistic regression analyses were conducted in order to determine which sexual risk behaviors were predictors of sexual partner concurrency. In the final study, an additional set of bivariate analyses were conducted to determine differences in substance use behaviors between those who reported sexual partner concurrency and those who did not. Crude and adjusted logistic regression analyses were conducted in order to determine which substance use behaviors were predictors of sexual partner concurrency. Of the 16345 newly HIV-diagnosed persons eligible for a partner services interview, the majority (83%) were interviewed. Of these 13697 patients, just over half named their sexual partners (N=6943). Of these, approximately 15% self-reported engagement in sexual partner concurrency. The first study indicated that several demographic differences existed between those who named their sexual partners and those who did not, as well as those who reported sexual partner concurrency and those who did not. In addition, trends indicate that the elicitation of sexual partners is decreasing over time, as is the trend in those reporting sexual partner concurrency. However, there is no linear trend in the self-report of anonymous sexual partners. The second study showed significant differences between those who reported sexual partner concurrency and those who did not with regard to HIV sexual-risk behavior. Further, several of these behaviors acted as predictors of sexual partner concurrency in both the crude and adjusted models. The third study also showed that there were several significant differences between those who reported sexual partner concurrency with regard to substance use behavior. Several of these behaviors acted as predictors of sexual partner concurrency in both the crude and adjusted models. However, contrary to the hypothesis, more stigmatized drug use (drug use other than or addition to marijuana and injection drug use) did not result in a stronger relationship with sexual partner concurrency compared to less stigmatized drug use. Concurrent partnerships and accompanying relationship dynamics have implications for HIV programs including prevention, treatment, partner tracing, and notification. The results from this dissertation can be used to improve our understanding of relationship dynamics. This can be used to improve upon HIV service delivery programs, both future and those already in existence. / 1 / Nicole Burton

Includes bibliography. / This thesis is based on a series of interviews with key informants and a census of orphan households in Nguludi Mission Community, Southern Malawi, in 2000. The thesis argues that although HIV/AIDS is a relatively recent phenomenon, any contemporary understanding of the epidemic must be informed by an understanding of the past. The impact of the HIV/AIDS epidemic and the "orphan problem" at the local level, is, therefore, situated within the broader socio-economic context of the history of the region.

A dissertation submitted to the Faculty of Arts in partial fulfilment of the requirements for the degree of Master of Arts in Community Work; in the Departmnet of Social Work, 2004. / In this study the researcher investigated care of children affected and infected by HIV/AIDS at Khayelihle Children's Home. The principal aim of the study was to offer a diagnostic, evaluative assessment of the care for children at Khayelihle Children's Home. Survey methodology was adopted for this research- Stratified sampling technique was used in selecting a sample of the respondents to participate in the study. Three strata of: children: aunts/grandmothers: and the international volunteers were selected from the total population at Khayelihle children's home. Sixty people drawn from the stratas participated in the study. Data was collected by use of structured interviews. Documentary sources and observations were utilised as complementary methods to data collection. Data collected was analysed using descriptive analysis. Tables and pie - charts were used to enter specific types of data and show-relationships between variables. The findings from the study indicated that the care of children at Khayelihle Children's Hume was not effective. Several reasons are advanced for this phenomenon. These include: inability to protect children from exploitation, abuse, and neglect: inability of fostering the development of a close and secure relationship with caregiver- as well as allowing a close relationship with the remaining family members. Other reasons include: little emphasis in helping children understand the imminent death of a parent: their identity; uniqueness and a sense of personal continuity especially in the maintenance of a close link with the cultural community: and failure in encouraging children expression of emotions a prerequisite for psychosocial development. It was concluded that the care for children at Khayelihle children's needed to promote psychosocial development and resilience in children for them to be able to deal with the imminent challenges of life as orphans in the face of HIWAIDS epidemic. The study recommends that, the care (or children at Khayelihle should put in perspective the underlying values advocated by the Convention on the Rights of the Child, which should serve as a constant reference for die implementing and monitoring all efforts to care, promote, fulfil and protect children's right-.

Thesis (MPH)--University of Limpopo, 2011. / INTRODUCTION: The human immune deficiency virus (HIV) leads to the acquired immune deficiency syndrome (AIDS). AIDS was first identified in the 1980’s and since then has spread globally causing one of the most dreaded pandemics of modern time. The issue of stigma is very important in the battle against HIV/AIDS as it affects attendance at health centres for obtaining ARV and regular medical check-ups, adherence of patients to ARV treatment. The fear of stigma further helps to fuel a culture of secrecy, silence, ignorance, blame, shame and fear of victimization. AIM: The aim of this study was to determine if there was any external stigmatization of HIV positive patients by health care workers (HCWs) at King Edward VIII Hospital. OBJECTIVES: To determine if the knowledge of HCWs regarding HIV/AIDS and its transmission affect the way they supply a service towards HIV positive patients at King Edward VIII Hospital and to determine the comfort level and the attitude of the HCWs in rendering care to a HIV positive patient. METHODOLOGY: This was a cross sectional survey where data was collected using an anonymous selfadministered structured questionnaire with closed ended questions on personal and professional characteristics, disease knowledge, and discriminatory practices such as attitudes and comfort levels towards people living with HIV/AIDS (PLWHA). A total of three hundred and thirty four HCWs from different units at the King Edward VIII hospital participated in this study. FINDINGS Overall the HCWs have an above average knowledge about HIV/AIDS and its transmission with only 1.8% scoring below average in the knowledge questions regarding HIV and its transmission, although some knowledge gaps were identified regarding occupational exposure risks. Evidently from the results is that HCW with higher levels of education are more knowledgeable on issues relating to HIV/AIDS. The implication is that a HCW with a better education is better equipped with the cognitive knowledge to deal with HIV/AIDS, highlighting iv the importance of education related to external stigmatization. Even though HCWs were knowledgeable about HIV/AIDS most still felt uncomfortable in performing some occupational duties on PLWHA like assisting a woman in labour and performing invasive surgical operations. Most of the HCWs showed a positive attitude towards PLWHA believing that they are not to be blamed for their condition but that individuals in the community who are perceived to be promiscuous men or women are the ones responsible for the spread of HIV/AIDS. Procedures like patients being tested without their consent and patients required to do a HIV/AIDS test before surgery that could be perceived as stigmatization have been observed in King Edward VII hospital. Patient confidentiality is also compromised in that gossiping by HCWs about the HIV/AIDS results of patients has been noted. Fortunately a significant number of HCWs are willing to report their colleagues to a higher authority if any form of stigmatization or discrimination towards PLWHA is seen at King Edward VIII Hospital. CONCLUSION Although the knowledge, attitude and comfort of the HCWs at King Edward VIII Hospital was above average continuing medical education and continuing professional development should be mandatory in the management of HIV/AIDS so that HCWs can have the needed knowledge to keep up with the changing world of HIV/AIDS medicine and also about universal precautions to take so as to reduce occupational exposures. Psychological support to the HCW is needed in dealing with PLWHA so that patients can be provided with quality and compassionate care irrespective of their HIV/AIDS status as this will eventually help in the reduction of stigma.

Aim Stress among healthcare workers (HCWs) working with HIV/AIDS patients is an important deterrent to provision of services to HIV patients. The main aim of this study was to determine the prevalence of stress levels among HCWs in Polokwane Municipality HIV clinics. Method Forty-four HCWs in four different clinics completed a self administered questionnaire. Questionnaire consisted of demographic info, the Maslach Burnout Inventory, the AIDS Stress scale and the stressors and rewards of HIV/AIDS work. Results The majority of the healthcare workers (HCWs) in this study were female (77%) and married (64%). The biggest professional group were nurses (46%) followed by lay counsellors (25%). The mean age of the HCWs was 39. The results of this study revealed that half of the respondents (52%) had high level of emotional exhaustion and depersonalization. A total of 27% of HCWs had moderate to severe AIDS stress as measured by AIDS Stress Scale. An overwhelming majority (95%) of HCWs reported that they enjoy their work with HIV/AIDS patients. Conclusion Despite the high levels of burnout, the majority of HCWs in the HIV clinics find HIV/AIDS work rewarding. Workplace related stressors rather than the actual work with HIV/AIDS patients is a major source of stress.

No description available.

The HIV-1 envelope glycoprotein (Env) is the primary focus of prophylactic HIV vaccine development. However, the unusually low density of Env spikes on the virion (≈14 spikes/virion) is unfavourable for eliciting high titre, long-lasting antibody responses. It is possible that increasing the Env spike density of particulate vaccine candidates generated by protein body formation or via the display of Env on nanoparticles could improve the induction of long-lasting neutralising antibodies (NAbs). For this thesis, two different nanoparticle approaches were therefore investigated. The HIV-1 Env sequence used for both approaches was derived from the superinfecting subtype C CAP256 virus. This was truncated to remove the transmembrane domain, and engineered to contain a flexible linker (FL) in place of the furin cleavage site and an I559P mutation to generate soluble, stable and cleavageindependent gp140 proteins. The first approach investigated the impact of genetically fusing a 27 kDa proline-cysteine-rich domain of the ɣ-zein maize seed storage protein - Zera® - to either the N- or C-terminus of CAP256 gp140. Fusion of Zera® to a protein of interest can promote the self-assembly of large protein bodies (PBs) containing the protein of interest, thereby improving yields of the recombinant protein and enabling easy isolation using gradient ultracentrifugation. The purification of Zera-induced Env PBs from infiltrated Nicotiana benthamiana plants was not optimal. Consequently, the generation of Zera®-induced gp140 protein bodies was evaluated in a mammalian expression system. Stable HEK293 cell lines expressing Zera®-gp140 or gp140-Zera® were generated. A mixture of small PB-like structures was observed in cells expressing gp140-Zera®. However, no PB-like structures were seen in cells expressing Zera®-gp140. The immunogenicity of Zera®-gp140 and gp140-Zera® was evaluated by in rabbits. Binding and Tier 1A neutralising serum titres were higher for gp140-Zera® than for Zera®-gp140. Neither gp140-Zera® nor Zera®-gp140-specific sera neutralised a Tier 1B pseudovirus or the autologous Tier 2 CAP256SU pseudovirus, suggesting that Zera® might have compromised the structure of the Zera®-tagged gp140 proteins. The second approach investigated the two-component SpyCatcher/SpyTag technology. The stable HEK293 cell line expressing CAP256 gp140-SpyTag (gp140-ST) was generated, and trimers were purified to homogeneity using gel filtration. SpyCatcher (SC)-AP205 VLPs were produced in E. coli and purified by ultracentrifugation. The gp140-ST trimers and the SCAP205 VLPs were mixed in varying molar ratios to generate VLPs displaying the glycoprotein (AP205-gp140-ST particles). SDS-PAGE, dynamic light scattering and negative stain electron microscopy indicated that gp140-ST was successfully bound to the VLPs, although not all potential binding sites were occupied. The immunogenicity of the coupled VLPs was evaluated in a pilot study in rabbits. One group was injected four times with coupled VLPs. The second group was primed with DNA vaccines expressing Env and a mosaic Gag, followed by modified vaccinia Ankara expressing the same antigens and then boosted twice with coupled VLPs. Encouragingly, gp140-ST displayed on SC-AP205 VLPs was an effective boost to heterologously primed rabbits, leading to induction of autologous Tier 2 neutralising antibodies in 2/5 rabbits. These results demonstrate that careful selection of a geometrically-suitable nanoparticle scaffold to achieve a high-density display of HIV-1 envelope trimers is an important consideration and that this could improve the effect of nanoparticle-displayed gp140.

In Canada, queer men (or ‘men who have sex with men’) continue to be disproportionately affected by HIV/AIDS, representing at least 50% of all people living with HIV/AIDS (Public Health Agency of Canada, 2012). Every year, thousands of new infections significantly increase the toll that HIV/AIDS takes on queer men and their communities. With this epidemiological reality as context, I set out to explore how my subjectivity (as a gay, HIV-positive man) was and is shaped, specifically with respect to the following HIV/AIDS-related, socio-cultural phenomena: activism, community service, ‘safer’ sex, diagnosis and criminalization. These five phenomena provide focal points (or themes) for the presentation and analysis of my experience of living with HIV/AIDS, both before and after becoming infected. Through insider knowledge, my research examines three decades of personal stories, using critical reflexivity to increase my awareness (as well as my reader’s) of the myriad challenges and complexities of living one’s life in the midst of the ongoing pandemic. / Thesis / Master of Social Welfare (MSW)