Background Cash plus interventions augment cash transfers with other empowering interventions to influence behaviours. This research assesses the Women of Worth (WoW) program and evaluates the effectiveness of a cash transfer (CT) of ZAR300 ($22USD22) conditional on attending 12-session customised empowerment interventions to improve SRH/HIV outcomes in young women (19-24yrs) in Cape Town, South Africa. Methods A multiphase, mixed-methods, experimental study targeting 10 000 Participants in two subdistricts was conducted. Participants were randomised 1:1 to receive the interventions with CT ("cash + care" or C+C) or without CT (“Care”). Phase 1a piloted the interventions, Phase 1b implemented an adapted intervention, and Phase 2 was an open label C+C only scale up demonstration phase. Logistic regression models were fitted with subject-specific random mixed effects, to estimate changes in self-reported HIV, behavioural and structural SRH risks from baseline to (a) end of WoW and (b) follow up (6-30months post-exposure) irrespective of WoW completion. Mixed research methods were used to optimise engagement, evaluate implementation fidelity and determine the pathways of effectiveness for the interventions. Results The Women of Worth empowerment programme was implemented with adequate fidelity however adaptative research methods were essential for ensuring a sustained programme. 8765 (87,7%) of the 9995 WoW initiators were evaluated with 904 (10,3%); 4212 (48,1%) and 3649 (41,6%) women in Phases 1a, 1b and 2 respectively. In Phase 1a & 1b, participants in the “C+C” group were 60 times (OR 60.37; 95%CI: 17.32; 210.50.p

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According to the CDC (2015), Hispanics/Latinos in the United States accounted for 23% of all new HIV infections in the year 2013. Undocumented individuals are likely underrepresented in this statistic. There are many that may be wary of talking to researchers and therefore are not represented when data is collected. The focus of this pilot study is to understand the level and type of knowledge of HIV preventative strategies for Hispanic men and women. An ethnographical qualitative method, using in-depth interviews, with participants was performed to gather this information. Ten participants were interviewed in and around Atlanta, Georgia. An ethnographic approach was used to study the various cultural factors that may hinder or encourage HIV prevention strategies. The targeted population was Hispanic adults, both male and female, living in the United States ten years or less, and aged between 18-50 years. The results revealed a need for increased knowledge of HIV and closing the gap between having that information and having access to prevention methods.

HIV-1 integrase is an essential enzyme in the HIV replication cycle and is a validated target for antiretroviral drugs. Due to the inevitable emergence of drug resistance of HIV-1 strains to all currently approved FDA antiretroviral drugs, antivirals with new mechanisms of action are continuously investigated. As such, this study aimed to reposition existing drugs as HIV-1 integrase inhibitors by screening the NIH Clinical Collection compound library comprising 727 compounds. Recombinant integrase was expressed in bacterial cells, purified by nickel affinity chromatography, and used to set up a Scintillation Proximity Assay (SPA). The SPA was subsequently amended to an automated system to allow for rapid screening of compounds. The complete compound library was successfully screened using the newly established automated SPA. Overall, only two compounds were identified as HIV-1 IN inhibitors: cefixime trihydrate and a previously identified HIV integrase inhibitor, epigallocatechin gallate. These compounds exerted IC50 values < 10μM in the automated SPA. Cefixime trihydrate was not toxic to mammalian cells (CC50 > 200μM) while no appreciable antiretroviral activity was observed in in vitro phenotypic inhibition assays (23% inhibition of viral replication), thus concluding that this compound was non-selective. By contrast, epigallocatechin gallate was toxic to mammalian cells at the evaluated ranges (CC50 = 23 + 1μM) and therefore could not be validated as an integrase inhibitor in in vitro phenotypic inhibition assays. Overall, this study resulted in the establishment of an automated SPA, the successful screening of 727 compounds, and the availability of a platform to expedite the future screening of potential HIV-1 integrase inhibitors.

Thesis (MSc.(Clinical Psychology))University of Limpopo, 2009. / The aim and objective of this investigation is to explore, on a preliminary basis, the psychological and social effects on a sample of women of having disclosed their positive HIV diagnosis. The study was conducted in KwaZulu-Natal, South Africa. A convenience sampling approach was used to collect the sample. Inclusion criteria included female, older than 18, with a positive HIV status. Participants’ disclosure of a positive HIV status (defined as having voluntarily disclosed to sexual partners, intimate or immediate family, extended family and or friends) was a key inclusion criterion. Semi-structured interviews were used in the collection of data. Interviews were audio-recorded and transcribed verbatim. Through collaboration with other trained researchers, the data was analyzed and interpreted using investigator triangulation. The independent clinicians identified and established the categories, themes or recurring processes separately using content analysis. The themes in the transcripts as well as from the literature review were utilized as a guide. The results of this study suggest that there are various factors that influence whether disclosure of a positive HIV diagnosis takes place, largely based on the initial adjustment to the positive HIV diagnosis, the individual’s socio-cultural context and the weighing of potential reactions (whether positive or negative) that disclosing a positive HIV diagnosis can induce. The psychological effects of disclosing a positive HIV diagnosis that were identified in this study were anger, fear of stigma/discrimination, shock and disbelief and a false sense of acceptance of the diagnosis. The social effects of disclosing a positive HIV diagnosis were satisfaction with support received following disclosure. However lack of partner support as well as experiences with stigma/discrimination were identified following disclosure.

Thesis (Ph. D.)--Lehigh University, 2000. / Includes vita. Includes bibliographical references (leaves 83-100).

Background: HIV was added to the British Columbia list of reportable diseases on 1 May 2003 which included enhanced contact tracing by public health. A sensitive/less-sensitive (S/LS) algorithm using a modified EIA anti-HIV assay was employed to evaluate enhanced partner notification by comparing the proportion of newly diagnosed cases of HIV presenting within 6 months of becoming infected before and after HIV Reporting. Methods: Banked HIV positive samples, collected between 1 Jan 2000– 30 Apr 2003 (pre-reporting group) and 1 May 2003 – 23 Aug 2006 (post-reporting group) were re-tested using the bioMérieux Vironostika HIV-1-S/LS tests. Samples were classified by the S/LS EIA (detuned test) as a recent seroconversion (RSC) (infected for <170 days) or established infection (>170 days). Data was linked to the BC HIV Surveillance and AIDS databases. The proportion of RSC in the pre-reporting group was compared to the proportion of RSC in the post-reporting group using a 2-sided z-test of independent proportions. Similarly, the proportion of new cases of HIV presenting with AIDS was compared between groups. A Kappa statistic was calculated to determine the level of agreement between clinical assessment of HIV staging was compared and the detuned test results. Finally, characteristics of RSC were examined. Results: Serum was available for 1111 newly positive HIV cases in the pre-reporting group and 470 in the post-reporting group. RSC in the pre and post reporting group were 311 (28%; CI: 25.36%, 30.73%) and 136 (29%; CI: 24.87%, 33.27%) respectively (p= 0.70). There was no significant difference in the proportion of cases presenting with AIDS between groups (pre-reporting: 6.7% [CI: 5.4%, 8.1%]; post-reporting: 7.6% [CI: 6.3%, 9.1%]) (p=0.31). Sex work is independently associated with being RSC (AOR 1.78 [CI:1.09, 2.91]). There is an inverse association between being 41-60 yrs old, Asian and/or mixed ethnicity and RSC. Conclusions: The bioMérieux Vironostika HIV-1-S/LS test is an effective tool to objectively evaluate public health interventions and in identifying sub-populations likely to be RSC. This underpowered study demonstrated a slight increase in RSC post reporting which was not statistically significant. Similarly there was no difference in the proportion of cases presenting with AIDS.

Inducible LAK cell responses were studied in HIV-seropositive individuals lacking clinical symptoms, and overt AIDS patients. Inducible LAK cell responses have been operationally defined as, non-MHC-restricted and antigen-nonspecific cytotoxic activity observed following IL-2 stimulation. HIV-seropositive asymptomatic individuals exhibited an enhanced LAK cell response against HIV-infected targets while lysis of uninfected targets remained at control levels. LAK activity of AIDS patients however, was significantly diminished when compared to healthy controls. Immunomagnetic negative selection depletion experiments indicated that LAK cell activity is mediated primarily by CD56-expressing lymphocytes, both at the progenitor and effector cell level. Of interest, in HIV-seropositive asymptomatic individuals we observed the emergence of a second CD8-expressing cytotoxic population that mediates IL-2-induced non-MHC-restricted and antigen-nonspecific cytotoxicity. Overall we demonstrated that CD56-expressing LAK cells of HIV-seropositive patients exhibited a decreased ability to mediate cytotoxicity on a per cell basis against a panel of different targets. In vivo, this inhibition may be amplified by decreases in absolute numbers of CD56-expressing lymphocytes per ml of blood. HIV-infection therefore results in dramatic changes on the number, function and phenotype of the effector cells mediating IL-2 inducible LAK cell responses.