A series of the Baylis-Hillman adducts have been obtained by reacting protected O-benzylated and unprotected substituted salicylaldehydes with methyl acrylate or tertbutyl acrylate, respectively, using DABCO as catalyst. Treatment of the Baylis-Hillman adducts with HCl in a mixture of acetic acid and acetic anhydride afforded the corresponding 3-(chloromethyl)coumarin derivatives with yields of up to 94%. Similar use of HI afforded the corresponding 3-(iodomethyl)coumarins but, depending on the reaction time, the reduced 3-methyl analogues could also be obtained. Arbuzov reactions of the 3-(halomethyl)coumarin derivatives have been undertaken to afford 4-phosphorylated and 1’-phosphorylated derivatives, regioselectivity being dependent on the halide-leaving group. The 3-(chloromethyl)coumarin derivatives have been subjected to nucleophilic (SN) attack by benzylamine to give the corresponding 3- [(benzylamino)methyl]coumarin derivatives in yields of up to 74%. Further treatment of the 3-[(benzylamino)methyl]coumarin derivatives with chloroacetyl chloride afforded the chloroacetamide derivatives, which exhibit hindered rotation about the amine C(O)-N bond. The acetamide derivatives have also been subjected to Arbuzov reaction conditions to afford the phosphorylated derivatives in yields of up to 86%. In a preliminary modelling study, hydrolysed analogues of the synthesized phosphorylated derivatives have been docked into the active site of the HIV-1 protease enzyme using the Cerius-2 Ligandfit software module to provide an insight into potential receptor-ligand hydrogen bonding interactions.

Magister Scientiae - MSc / The first two official AIDS cases were diagnosed in South Africa in 1982. During the same period of the 1980s, the black/African population was experiencing an accelerated fertility decline, following a period of accelerated mortality decline. Demographers invoked the demographic transition theory to explain the observed mortality and fertility decline. According to the demographic transition theory, mortality and fertility rates would continue declining to low, post transitional levels with increasing modernization. The relatively higher prevalence of HIV/AIDS estimated among black/African South Africans is expected to alter their demographic transition. This research investigated the impact of HIV/AIDS on the demographic transition of black/Africans by 2021. / South Africa

A Síndrome da Imunodeficiência Adquirida (AIDS) é doença causada pelo vírus da imunodeficiência humana. Apesar dos benefícios proporcionados pela terapia de supressão viral, algumas doenças como lipodistrofia, doenças cardiovasculares e infertilidade aumentaram a sua prevalência. No paciente com AIDS, considera-se a carga viral e o uso de terapia antirretroviral como possíveis agentes de genotoxicidade. Apesar do espermograma não poder detectar a causa precisa da infertilidade, o mesmo ainda é o exame mais realizado para averiguar a qualidade seminal. Por outro lado, a integridade do DNA do espermatozóide tem sido proposta como um parâmetro adicional de qualidade do sêmen. O ensaio cometa alcalino detecta a genotoxicidade de células germinativas humanas e pode ser usado para demonstrar a capacidade de uma substância interagir com o material genético das células gonadais. O presente estudo incluiu 50 pacientes com AIDS, atendidos no Ambulatório de Infectologia do Município de Caxias do Sul e no Ambulatório da Universidade de Caxias do Sul, sendo analisados dois grupos: usuário de terapia antirretroviral e naive. Realizou-se espermograma e o ensaio cometa alcalino, comparando com o número de linfócitos T CD4+, a carga viral, a idade, etc. Os dados demonstraram que o uso de antirretrovirais reduziu a genotoxicidade espermática, mas não se encontrou correlação com o espermograma. O presente trabalho demonstra que o ensaio cometa alcalino é um método eficiente para mensurar a genotoxicidade espermática dos pacientes portadores do vírus da imunodeficiência adquirida. / The Acquired Immune Deficiency Syndrome (AIDS) is a disease caused by the human immunodeficiency virus. Despite all the benefits provided by the viral suppression therapy, some diseases such as lipodystrophy, heart diseases and infertility increased their prevalence. In patients with AIDS, viral load and anti-retroviral therapy are possible agents for genotoxicity. The World Health Organization guidelines are reference for semen analysis and sperm DNA integrity has been proposed as an additionalparameter for semen quality and a potential predictor of fertility. The alkaline comet assay has the potential to detect genotoxic human germ cells and can be used to demonstrate the ability of a substance or metabolite to interact directly with the genetic material of gonadal cells. The study has included 50 patients with AIDS treated at the Outpatient Center for Infectious Diseases and at the University of Caxias do Sul Clinical Center, evaluated as two groups: one treated with anti-retroviral therapy and the other was a naive group. Semen and sperm genotoxicity were analysed by alkaline comet assay, comparing CD4 cell count, viral load, age and other factors of potential genotoxicity between the two groups. Data showed that the use of any anti-retroviral class has reduced sperm genotoxicity. This study shows that the alkaline comet assay is a eficcientmethod to measure sperm genotoxicity in patients infected with the human immunodeficiency virus.

No description available.

Thesis (MPH.) -- University of Limpopo (Medunsa Campus), 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 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.

Thesis (M. A. (Clinical Psychology)) -- University of Limpopo, 2016 / In this study, the researcher aimed to discover stigma associated with people living with HIV and AIDS in Mahwelereng, Limpopo province. The researcher sampled five males and five females and they were between the ages of 18 and 35. In-depth interviews were a method of choice during data collection. Thematic content analysis was used to analyse data. The results show negative perceptions towards PLWHA. The community discriminate PLWHA because of fear of being infected, with females being at a higher risk because they are perceived to be promiscuous. Participants also highlighted that black people lack knowledge of how to treat and behave towards HIV/AIDS infected individuals. It is recommended that there should be studies that focus on availability of interventions that aim to combat HIV/AIDS stigma. Lastly, the future studies should explore which race groups have more knowledge and perception about HIV and AIDS. KEY CONCEPTS: Acquired Immune Deficiency Syndrome; Human Immunodeficiency Virus; People Living with HIV and AIDS; Stigma. / National Research Foundation (NRF)

Worldwide uneven health outcomes based on race/ethnicity is a well-documented phenomenon and conversations relating to health disparities are well underway. In the United States, rates of new infections of HIV among African American and Hispanic men who have sex with men (MSM) have realized an upward trend over the past decade whilst rates among other demographic groups have realized noteworthy declines. The present study presents a quantitative analysis of sexual health communication and behavioral indicators with a view toward identifying whether African American and Hispanic MSM engage in fundamentally different sexual health communication and behaviors such that the divergent trends in new infections of HIV make sense. Through a series of descriptive, chi-square, binary and ordinal logistic statistical methods, the degree to which sexual health communication and behaviors differed between groups of respondents in the New York City area were analyzed. The results showed a significant divergence in sexual health communication and behavior, based on race/ethnicity, education, age and other indicators. In the overall sample (n = 212), African American and Hispanic MSM were found to be significantly less likely to adhere to HIV medication regimens, use protection, ask about partners’ HIV status and disclose their own HIV status compared to members of other racial/ethnic groups. Other similarly significant findings suggested a need to address the underlying causes of divergent sexual health communication and health maintenance-related behaviors that contribute to disproportionality in new infections of HIV among African American and Hispanic MSM.

Thesis(M.A.(Nursing)) -- University of Limpopo, 2020 / The purpose of the study was to identify and explore the challenges faced by mothers with HIV positive children and who were admitted to Pietersburg Hospital, Limpopo Province, South Africa, during the period of study. A qualitative research methodology was used in the study based on exploratory and descriptive designs. The population for the study included all mothers of children who are HIV positive and had been admitted to the Paediatric Ward of Pietersburg Hospital, Limpopo Province, during the period of study. Non-probability purposive sampling was used to draw a sample of twelve (12) HIV positive participants from the research population. Data was collected from twelve participants through the use of semi-structured in-depth interviews, guided by an interview schedule. Fields notes were captured for non-verbal communication and a voice recorder was used to capture all the audio record of the interview sessions. Ethical clearance for the study was obtained from Turfloop Research Ethics Committee (TREC); and permission to collect data at the Pietersburg Hospital was obtained from the Limpopo Department of Health as well as the hospital’s Chief Executive Officer and from the Operational Manager of the Paediatric Ward. The findings from the study indicated that mothers of HIV positive children experienced numerous psychosocial and economic challenges on a daily basis. These challenges include accepting their own and their children’s HIV positive status; and also disclosing the status to their children. They also had to deal with opportunistic infections that the HIV positive children are more susceptible to, as well as challenges of ensuring that their children did not default on the medication schedules. Poverty and the lack of finances to pay for the various special needs of HIV positive children were also other key challenges experienced by the mothers. In light of these findings the study recommends the need for HIV/AIDS education, support from families and significant others as well as from the government. The study also recommends that well-coordinated and integrated inter-departmental intervention programmes are required to help mothers cope with their challenges.

Thesis (M.Sc.) -- University of Limpopo, 2016 / Purpose of the study The purpose of this study was to investigate the experiences of couples on disclosure of their HIV-positive status to each other. Research methodology Qualitative, Phenomenology, exploratory descriptive and contextual research was conducted to identify the experiences and to determine the strategies that address non-disclosure of couples on their HIV-positive status. The population comprised 12 participants (six (6) couples). Purposive sampling was used to select eight (8) participants (four (4) couples) who participated in the study. Semi-structured interviews were used to collect data until data saturation was reached. Study findings Data were analysed using Tesch’s open-coding method. Five themes emerged, namely, fear of being HIV-positive, disclosure of HIV-positive status is a difficult process, acceptance of HIV-positive status, relations between partners post knowledge of HIV-positive results and encouragement pertaining to disclosure of HIV-positive status. Strategies were developed to address the experiences identified. Recommendations were made for the Department of Health, clinic staff, future researchers, patients and community members. Conclusion Although couples disclosed their status to one another disclosure was found to be a difficult process. Acceptance of HIV status was also found to be one of the challenges that led to delayed disclosure of the status. Support system from both family and community is a very important factor which might increase HIV status acceptance and disclosure from couples. Keywords: Couples, experiences, disclosure, HIV-positive status.

Thesis (MPH.) -- University of Limpopo, 2020 / Background: In South Africa, the Choice on Termination of Pregnancy Act (CTOP) (No. 92 of 1996) promotes a woman's reproductive right and choice to have an early, safe and legal abortion. Pregnancy termination among young women constitutes a public health problem particularly in South Africa where high prevalence of abortion has been recently recorded. HIV acquisition is increased two to four-fold during pregnancy, due to biological and behavioural factors including immunological changes, hormonal changes affecting the genital tract mucosa, higher frequency of unprotected sex and incident sexually transmitted infections (STIs) during pregnancy. There is a growing interest in exploring maternal mental health effects of unintended pregnancies. However, the evidence base from a small number of available studies is characterized by considerable variability, inconsistency and inconclusive findings. Therefore, the primary objective of this study was to investigate the prevalence of HIV and its association with termination of pregnancy at Seshego Zone 4 clinic in Limpopo Province. Methodology: A cross-section descriptive retrospective review study in which convenience sampling of the records of women who terminated pregnancies was used in this study. The key variable of interest in this study was HIV results and all patients records without evidence of HIV testing, and the associated results were excluded. A self-designed data extraction tool was used to extract the data from patients records and tool covered variables such as the age of the women, educational status, marital status, occupational status, year and month of termination of pregnancy, gestational age, parity, and gravidity, method of contraceptive used, HIV status, ARV and ARV regimens. Data analysis was done using the STATA statistical software version 12 for Windows (STATA Corporation, College Station, Texas). vi Results: The mean age was 24.98 years SD±14.4 and majority of women who terminated pregnancies were in the age group 20 – 24 years at 35.7% and the least number of women who terminated pregnancies were in the age groups ≥ 40 years and ≤ 14 years at 2.3% and 0.3% respectively. Majority of the women who terminated pregnancies had parity of 1 – 2 at 47.4% followed by parity of zero at 42.3% and 3 – 4 at 9.9%. Majority of the women who terminated pregnancies were in gravida 1 at 42.8% followed by those with gravida 2 at 27.1% and those who were pregnant between the 3rd and 4th time were 26.9%. There was a statistical significance difference (p<0.001) of the use of contraceptives by age groups and also in relation to parity and similarly to gravidity. The prevalence of HIV amongst women who terminated pregnancies in the current study was found to be 11.6% and this was high in 2018 at 10.5% followed by 2019, 2015 and 2016 at 10.3%, 9.2% and 9.1% respectively. The prevalence of HIV amongst women who terminated pregnancies increased with increasing level of education from 4.1% amongst women who had primary or no educational level the followed by 9,0% and 13.6% in women who had secondary and tertiary educational level respectively. The risk of women who terminate pregnancies being HIV positive in the current study increased significantly with increasing age as older women were 1.9 times more likely to be HIV positive as compared to younger ones (p=0.004) Conclusion: The findings of this study highlight the need to address the structural socio-economic drivers of the HIV epidemic among women of child-bearing age. Women of child-bearing age in this setting have large unmet reproductive health needs. Structural interventions, such as increasing contraceptive use which may be useful for reducing the burden of unplanned pregnancies. Key concepts Human immunodeficiency virus, Acquired immunodeficiency syndrome, Termination of pregnancy, Parity and Gravidity.