KwaZulu-Natal has the highest prevalence of HIV in South Africa. The prevalence of dual infection in a normal-risk population in this region is unknown. Dual HIV infection has important implications for diagnosis, treatment response and vaccine development. This cross-sectional study aimed to establish and optimize methods for subtyping and detection of dual infection in KZN. Samples were from chronically-infected patients on ARV treatment within the ARV Rollout Programme, from sites throughout KZN. Subtyping of the samples was performed using HMA. Four samples had indeterminate results by HMA and were then cloned and sequenced. Phylogenetic analysis showed that one of the four samples was a dual infection. This study showed 1/46(2%) samples to be dually infected which suggests that the prevalence of dual infection is low in the sample population. The low prevalence of dual infection reported could be due to the low-risk profile of the sample population. It was concluded that the low prevalence of dual infection is unlikely to have a considerable impact on HIV management. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, 2007.

Introduction. The Human Immunodeficiency Virus (HIV) is the main contributor to rising child mortality in South Africa. Although prevention of mother-to-child transmission programmes have been implemented in the country, little is known about the clinical and loss to follow-up outcomes of infants born to HIV-infected women attending these programmes. Purpose. The purpose of the study was to describe the clinical and loss to follow-up outcomes of HIV-exposed infants whose mothers had received antiretroviral therapy or prophylaxis during their pregnancy at the Prevention of Mother-to-Child Transmission programme at McCord Hospital. Furthermore, maternal socio-demographic characteristics associated with these outcomes were determined. Methods. An observational retrospective cohort study design was used. The study population consisted of infants whose mothers had received antiretroviral prophylaxis or therapy at McCord Hospital, and were delivered at McCord Hospital, and/or were brought back to McCord Hospital, following delivery from 1 May 2008 to 31 May 2009. Results. Data on 265 infants was analysed. Of the 220 infants who were tested, the HIV transmission risk was 2.7% (n=6; 95% Cl: 1.0% to 5.8%) at 6 weeks of age. Overall, 40.4% of infants in the cohort were lost to follow-up (n=105, 95% Cl: 34.4 to 46.6). In the multivariable model (n=253), late booking for first antenatal visit at or after 28 weeks of gestation (adjusted hazard ratio (AHR) 2.3; 95% Cl: 1.0 to 5.1, p=0.044) was a risk factor for loss to follow-up. Compared to having an emergency caesarean section, having an elective caesarean section (AHR 1.9; 95% Cl: 1.1 to 3.5) or normal vaginal delivery (AHR 2.5; 95% Cl: 1.4 to 4.5) was significantly associated with loss to follow-up of infants. Discussion. The substantial attrition of infants born to HIV-infected mothers in the Prevention of Mother-to-Child Transmission programme at McCord Hospital undermined the goals of the programme, and underestimated the effect of infectious disease morbidity, mortality and HIV transmission risk associated with these infants. Recommendations. Counselling mothers on the health benefits to their HIV-exposed infants of attending the follow-up clinic and tracing of infants who have been lost to follow-up is vital to the operational effectiveness of the Prevention of Mother-to-Child Transmission programme at McCord Hospital. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2011.

The purpose of this Qualitative study was to explore HIV related stigma experienced by women enrolled in the Prevention of Mother to Child (PMTCT) prgramme in the EThekwini District, Kwazulu Natal. Descriptriptive phenomenology informed the study design, data collection and analysis. Despite increasing access to Prevention of Mother to Child Transmission initiatives, including anti-retroviral drugs, the Stigma of being HIV positive, particularly for women, largely outweigh the potential gains from available treatments. HIV/AIDS related stigma drives the epidemic underground and is one of the main reasons that people do not wish to know their HIV status Purposeful sampling was used to select seven women attending PMTCT programme in the EThekwini District. These women were selected in four clinics in the District. Data was collected through in-depth interviews lasting about 45 minutes to an hour. These interviews were tape recorded and later transcribed to aid analysis. The Colaizzi method of data analysis was utilized. Four themes emerge from the data, each with three to eight subthemes confirming the experiences and presence of stigma during programme participation. All participants reported incidence of being stigmatized, particularly in the Health care setting. They took great strides to keep their HIV status confidential to a point of going against programme directives to ensure secrecy of their status thus avoid HIV related stigma. Number of recommendations were made in relation to the PMTCT programme and if accepted will assist in mitigating stigma in HIV related stigma in the PMTCT progarmme and thus reduce vertical transmission. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.