The study explores pertinent issues around a comprehensive provision of antiretroviral drugs to HIV positive pregnant women in South Africa from a human rights perspective. Although these drugs have been proven to significantly reduce the transmission of HIV from a pregnant mother to her newborn baby/babies at birth, the South African government for over five years refused to roll them out in the public health sector. Reasons that were provided in this regard were multifaceted and have included claims regarding their alleged toxicity, potential side effects, huge cost, inadequate infrastructure, etc until March 2004 when it announced to start a national rollout program. It is in light of this that the study sets out to explore some of the key positions within the government and amongst activist groups on the health rights of HIV positive pregnant women, and how these different positions have evolved in response to each other. In particular, the paper aims at examining how discourses of human rights were employed, and how they have impacted on the Social Work discipline. It further focuses on developing a Social Work perspective on the human rights of HIV positive pregnant women in South Africa, thereby contributing to the discipline’s professional value base and body of knowledge, which inform, inter alia, its advocacy role and social action approach. The research project was embedded in a theoretical framework often referred to as ‘standpoint research’. An archival study of local and international literature and policy documents was conducted. This was complemented with a limited qualitative study. Semi-structured interviews were conducted with a purposive sample of five interviewees representing a cross-section of positions on the topic. This data was analyzed using a three step coding procedure that allowed for categorizing, connecting, and systematically relating the gathered data to each other and to the reviewed literature. The research findings indicate that the South African government’s absence of consistency and apparent lack of political will to rollout the drugs have contributed to the deterioration of the right of HIV positive pregnant women to access health care services. The role of civil society organizations in helping to realize, promote and protect the health and related human rights of this group is emphasized. It was also found that the different strategies employed to this end speak well to Social Work’s value base, and some of its methods and approaches to practice. Social Work is therefore well placed to join and support those efforts of other segments of civil society that have been investigated in this paper. The paper concludes by making recommendations towards, inter alia, the need for the South African government to adhere to the values enshrined in the country’s Constitution; to work closely and transparently with different organs of civil society; and simultaneously implement the said ARV rollout program while building and strengthening its infrastructural capacity. The various roles Social Work could, and should, assume with regards to improving the human rights of HIV positive pregnant women in this regard are also highlighted.

No description available.

The 2013 case report of the “Mississippi baby,” who was started on antiretroviral therapy (ART) within 30 hours of life and maintained off-treatment remission for 27 months before HIV was once again detectable, generated renewed interest in the benefits of early ART, as well as optimism that HIV remission is a possibility if ART is started very early. The overarching goal of this dissertation was to advance our understanding of the relationship between early ART and three outcomes – the possibility of HIV remission, improved viral outcomes, and epigenetic changes – in HIV-infected infants and young children. First, a systematic review was conducted to assess current published data in support of the possibility of very early ART leading to HIV remission in infants. Evidence from this review suggested that although early ART does appear to be associated with better sustained virological control and smaller reservoir size, there are limited data at this time to support a strong link between early ART and HIV remission. Second, the association between age at ART initiation and virologic outcomes after ART initiation was empirically assessed using data from five cohorts of HIV-infected infants and young children initiating ART before 2 years of age in Johannesburg, South Africa. In three cohorts, there was no consistent evidence of an association between early ART initiation and rates of initial viral suppression. However, there was a consistent benefit of early treatment initiation on long-term viral control in two cohorts. Finally, an epigenome-wide association study was conducted to identify differential DNA methylation patterns between ART-treated HIV-infected and HIV-uninfected South African children. A total of 1,309 differentially methylated CpG sites associated with HIV status were selected (FDR q-value <0.05; |Δβ| >0.05), after adjustment for age, sex, and cell type proportions. In addition, 315 differentially methylated regions associated with HIV status were selected (Stouffer p-value <0.05, maximum |Δβ| change in the region >0.05, and containing at least two or more CpG sites). Many of the genes identified in both the site and region approaches were located in the major histocompatibility complex (MHC) region on chromosome 6, a region that plays an important role in the adaptive immune system. This novel study provided evidence of an association between perinatally-acquired HIV infection and a large number of changes in DNA methylation in school-aged children on ART, and highlighted potential new lines of investigation into the biologic pathways influenced by HIV and its treatment. Overall, this dissertation increased our understanding of the timing of early ART initiation in HIV-infected infants and addressed gaps in our knowledge relevant to outcomes associated with early ART initiation. As public health practice continues to move towards infant diagnosis of HIV at birth and early life initiation of ART, these findings help to inform future research that will guide HIV care in infants.

"As a partial requirement for Master of Arts (Animation & Interactive Media) by Research Project 25th March 2002, studied at Centre for Animation and Interactive Media, School of Creative Media, Faculty of Art, Design and Communication" Typescript (photocopy) Bibliography: leaves 66-67. Internet access at: http://www.hivaids.webcentral.com.au/

Thesis (Ph. D.)--University of Chicago, Dept. of Psychology, Committee on Human Development, June 1999. / Includes bibliographical references. Also available on the Internet.

Thesis (Ph. D.)--University of California, San Diego, and San Diego State University, 2004. / Vita. Includes bibliographical references (leaves 86-93).

Thesis (M.S. in human nutrition)--Washington State University. / Includes bibliographical references.

Thesis (M.A.(Psychology))--University of Pretoria, 2009. / Includes bibliographical references.

Thesis (PhD(Social Work))--University of Pretoria, 2009. / Includes bibliographical references.

There is limited knowledge on the psychosocial implications of HIV/AIDS in serodiscordant heterosexual couples in sub-Saharan Africa. Several studies have indicated that there is an increase in the number of such couples on the African continent, yet there are minimal or no services offered to support such couples. The aim of the study was to explore the psychosocial challenges faced by heterosexual serodiscordant couples who were married. Ecosystems and biopsychosocial approaches were used as a framework to guide the study. A qualitative study was conducted in Durban, South Africa. Purposive sampling was used, comprising of four married couples and two individuals who were married but participated individually and not as a couple. Semi-structured interviews were undertaken. Both inductive and deductive approaches were carried out to analyse interview transcripts. None of the participants had received satisfactory explanations of their serodiscordant results. The discovery of serodiscordance resulted in difficulties with disclosure to families and children, maintaining safer sex, achieving intimacy due to lack of communication and bearing children due to fears associated with infection. Serodiscordance resulted in positive partners constantly fearing that their negative partners would leave them. Participants in discordant relationships had difficulties dealing with the changes that discordance brought into their lives. This resulted in enormous stress in their relationships including feelings of isolation, confusion and despair. Acceptance of serodiscordant status and support from family members were positive coping mechanisms used by discordant couples to alleviate stress. Avoidance was a negative coping mechanism used by some couples in dealing with the challenges of discordance. Factors contributing to the negative participants remaining in the relationship included love and companionship, children, commitment to the relationship and acknowledgement of the existence of HIV. The findings also indicated that none of the participants received on-going counseling and there were no programs catering for serodiscordant couples. This study supports the view of other researchers who believe that there is a dire need for service provision for serodiscordant couples. Based on the findings of this study, micro, mezzo and macro intervention strategies are recommended. / Thesis (M.A.)-University of KwaZulu-Natal, 2007.