The aim of the study was to gain in-depth understanding of teachers ’experiences with regard to the provision of care and support to school children on antiretroviral therapy in Swaziland in order to recommend approaches for enhancing support and care offered to children on ART by teachers. The study explored the experiences of teachers providing care and support to school children on antiretroviral therapy in Swaziland. The study used interpretative phenomenological analysis design. The study population was primary schools teachers in Swaziland. Data were collected through individual semi structured interviews from 16 purposively selected teachers. Data were analysed using interpretative phenomenological analysis framework for data analysis. Three superordinate themes emerged from data analysis namely: (1) Increased responsibility, (2) inadequate support and (3) psychological impact. The increased responsibility is related to ensuring that children who are on antiretroviral therapy have eaten before taking antiretroviral treatments, are properly dressed, receive proper education and health care and protected from bullying and social exclusion. Inadequate support for teachers makes caring for the learners very challenging. The psychological impact of caring for these learners are sense of accomplishment, demotivation; helplessness and emotional pain. Recommendations are made to ensure support for teachers rendering care and support to children on antiretroviral therapy. / M.A. (Nursing Science) / Health Studies

This study was conducted to determine retention rate and factors associated with loss to follow-up (LTFU) of adult pre-ART patients in St. Luke hospital, Ethiopia. Cross-sectional study with quantitative and qualitative data collection techniques was used. Review of patient records, focus group discussions and review of program guidelines was conducted to determine level of adherence among pre-ART patients. In addition, pre-ART service quality and perceived reasons for discontinuation was explored. The study revealed that only 38.2% of the 335 patients enrolled in the pre-ART care were retained after 12 months of follow-up in the program. More than half (55.6%), of the LTFU occurred during the first 6 months of follow-up. Fear of discrimination, high transportation cost and mistrust in the pre-ART service were perceived reasons for LTFU. Absences of clear pre-ART service package and implementation guideline were also identified as important factors that may be related to LTFU. The findings call for improved quality of care and a better pre-ART service packaging that will address the gaps identified in order to increase patient retention. / Health Studies / MA (Public Health)

The purpose of the study was to assess the impact of HIV/AIDS programmes at the workplace. The case study used both quantitative and qualitative methods (Triangulation) to determine the level of awareness and evaluate the impact of the programmes implemented at the workplace. The data was collected using a pilot tested structured questionnaire which was distributed to a purposive sample (n=60), involving all the departments at the company. Semi structured interviews involving purposively identified participants (n = 3) were conducted to clarify and explain issues in relation to questionnaire responses. The data from the structured questionnaire was analyzed using a statistical package for social sciences (SPSS).The findings revealed that the organization had achieved 90% awareness and 75% positive impact. The study also revealed that social background, individual values and religion influenced sexual behaviour, hence the recommendation for more preventive oriented programmes to influence positive behavioural change amongst employees / Health Studies / M.A. (Public Health)

L’infection par HIV-1 représente un des problèmes de santé publique majeurs de notre société actuelle. Le traitement HAART (Highly Active AntiRetroviral Therapy) inhibe le cycle réplicatif viral mais ne permet pas l’éradication du HIV-1. La principale cause de cet échec thérapeutique est la persistance de réservoirs cellulaires infectés de manière latente par HIV-1, qui, lors de l’arrêt du traitement HAART, sont à l’origine d’un rebond de la charge plasmatique virale. Le défi actuel est donc de découvrir de nouvelles méthodes d’élimination des cellules réservoirs. Une des stratégies envisagées est de forcer l’expression virale dans les cellules infectées de manière latente afin d’entraîner leur destruction suite à leur détection par le système immunitaire ou suite aux effets cytopathiques viraux. Parallèlement, le traitement HAART serait maintenu afin de limiter la propagation des virions néo-synthétisés. Plusieurs éléments sont impliqués dans la répression transcriptionnelle associée à la latence post-intégrationnelle du virus HIV-1 :la nature du site d’intégration ;l’absence de facteurs cellulaires inductibles tels que NF-κB ;la structure chromatinienne du provirus et les modifications post-traductionnelles des histones ;l’absence de niveaux suffisants de la protéine trans-activatrice Tat. De plus, notre laboratoire a précédemment mis en évidence un lien entre deux de ces éléments, en démontrant, dans une lignée modèle de latence post-intégrationnelle, que la cytokine pro-inflammatoire TNFα, un activateur de la voie de signalisation NF-κB, permet une réactivation synergique de l’expression virale combinée à l’inhibiteur d’histone-désacétylases (HDACI) TSA. Cependant, l’utilisation thérapeutique du TNFα et de la TSA est inenvisageable en raison de leurs toxicités.<p>\ / Doctorat en Sciences / info:eu-repo/semantics/nonPublished

La vitesse de réplication du HIV-1(Human Immunodeficiency Virus type 1), qui semble corrélée de manière directe à la vitesse de progression de la maladie vers le stade SIDA, est essentiellement contrôlée au niveau transcriptionnel. La transcription du HIV-1 est régulée par la structure chromatinienne, des éléments agissant en cis localisés dans les LTRs, des facteurs de transcription agissant en trans et par la protéine virale trans-activatrice Tat (revu dans Quivy et al. 2007, Bisgrove et al. 2005, Rohr et al. 2003, Rabson and Graves 1997). En plus de l’enhancer localisé dans le LTR5’ du HIV-1, un enhancer intragénique, localisé dans le gène pol du HIV-1, inductible par le phorbol 12-myristate 13-acétate (PMA) a été identifié. La localisation progressive de l’activité enhancer a permis de définir deux domaines distincts et indépendants dans cet enhancer intragénique :les fragments 5103 et 5105 localisés respectivement dans la partie centrale du gène pol et dans une région couvrant la fin du gène pol, le gène vif, le gène vpr et le premier exon codant des gènes tat et rev (Verdin et al. 1990). Les fragments 5103 et 5105 se comportent tous deux comme des enhancers inductibles par le PMA lorsqu’ils sont clonés en amont du promoteur de la thymidine kinase dans un vecteur rapporteur en cellules HeLa. Notre laboratoire a précédemment identifié trois sites de liaison pour les facteurs de transcription AP-1 dans le fragment 5103 (Van Lint et al. 1991). <p><p>Au cours de notre thèse, nous avons poursuivi la caractérisation de ces sites de liaison AP-1 et avons montré que les facteurs c Fos, JunB et JunD interagissent in vitro avec ces motifs. Pour chaque site, nous avons identifié des mutations qui abolissent la liaison des facteurs AP-1 sans altérer la séquence en acides aminés sous-jacente de la transcriptase inverse. Par des expériences de transfection transitoire, nous avons démontré que les sites AP 1 intragéniques sont entièrement responsables de l’activité enhancer PMA-dépendante du fragment 5103. De plus, l’activité PMA-inductible du fragment 5103 est inhibée par le mutant dominant négatif A-Fos à condition que les sites ne soient pas mutés. A l’inverse, l’expression ectopique de dimères forcés AP-1 affecte positivement l’activité enhancer du fragment 5103. Enfin, nous avons étudié le rôle biologique des sites AP-1 intragéniques dans la réplication virale et avons montré que ces sites contribuent positivement à l’infectivité du virus.<p><p>Durant la seconde partie de notre thèse, nous avons entamé la caractérisation physique et fonctionnelle du fragment 5105. Nos résultats de transfection transitoire montrent que l’activité PMA inductible du fragment 5105 est localisée dans le dernier tiers de ce dernier :le sous fragment 5105.3. L’analyse bioinformatique de cette région a permis de mettre en évidence un site de liaison pour les facteurs AP-1 in vitro. Des mutations ponctuelles permettent d’abolir la liaison des facteurs à leur site mais altèrent la séquence en acides aminés sous-jacente codant pour les protéines Tat et Rev. Nous avons montré que ce site est impliqué dans l’activité transcriptionnelle de ce fragment. L’expression ectopique du mutant dominant négatif A-Fos inhibe l’activité transcriptionnelle PMA-inductible du fragment 5105. Une analyse bioinformatique plus large nous a ensuite permis d’identifier in vitro, par retard de migration sur gel, 5 sites de liaison pour le facteur YY1 et 2 sites de liaison pour le facteur PU.1 dont les implications pour le virus restent encore à déterminer.<p> / Doctorat en Sciences / info:eu-repo/semantics/nonPublished

This thesis aims to look at the agreement on Trade Related Intellectual Property Rights (TRIPS) with specific reference to their impact on South Africa's ability to combat HIV and AIDS. It begins by looking at the history of patents and intellectual property rights and illustrates why and how the TRIPS Agreement came into existence. The TRIPS Agreement exemplifies the disparities between developed and developing countries and this can clearly be seen with regard to the provision of anti-HIV and AIDS drugs. The developing world deals with the bulk of the HIV and AIDS epidemic whilst the developed world holds most of the patents on the medication needed to treat those living with HIV and AIDS. This situation lends itself to a rift between patient rights on the one hand, and patent rights on the other. Traditionally the state has been the provider of rights such as health, but TRIPS alters this to include strong patent protection that is in line with neo liberal doctrine. The thesis examines these tensions with specific reference to South Africa's ability successfully to implement programmes to combat HIV and AIDS.

HIV and AIDS still challenges the best efforts of public health and medical establishments and continues to ravage communities around the world. While measures have been put in place to preclude it from further spread, recent studies in the field of HIV and AIDS prevention intimate that for more efficacious intervention to be realized, it is critical to understand and address the social and cultural practices which influence sexual behavior, particularly understanding how issues of masculinity plays a role in the perpetuation of these behavior. Relying on Bourdieu’s theory of social practice, this study explores the inherent enduring nature of habitus and its role in the production and maintenance of masculine and sexual identities that predispose young men to HIV and AIDS. The study was conducted in Rundu Urban Constituency in Kavango Region of Namibia to gain insight into male youth’s masculinity and conceptions of risk and vulnerability to HIV and AIDS. The study design was qualitative and interpretive in nature. Data collection strategies included focus group discussions and individual interviews. Twelve male youth aged 17-20 years in two secondary schools (six in each) were selected to participate in the study. Four focus group discussions and fourteen individual interviews were conducted. Institutional ethical clearance from both regional education office and the schools were obtained before undertaking the study. Participants also signed written consent forms before interviews started. The findings of this study revealed that young men from this community were under constant pressure to conform to dominant masculine norms and values. Key in the case of youth in the study was the need to procreate as a dominant marker of one’s masculine and sexual identity because it represented a primary source of a ‘real’ man’s social identity in this community. This masculine and sexual identity seemed in itself to be constructed along paternal lines and cultural beliefs, which youth preserved by not only complying, but also reproducing. The sexual activities they reported that would secure their position as `real` men were often those that put them at risk and made them vulnerable to the epidemic.

No description available.

Department of Public health / MPH

MSc (Microbiology) / Department of Microbiology