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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

Posttraumatic stress in adolescents with HIV and its relationship with treatment adherence : the role of health beliefs /

Weinberger, Beverley Slome. Kloss, Jacqueline D., January 2010 (has links)
Thesis (Ph.D.)--Drexel University, 2010. / Includes abstract and vita. Includes bibliographical references (leaves 78-91).
12

Epidemiology of HIV-associated risk factors and acquisition of HIV among high-risk women in southern Vietnam

Komatsu, Ryuichi. January 2004 (has links)
Thesis (Ph. D.)--University of Hawaii at Manoa, 2004. / Includes bibliographical references (leaves 174-184).
13

Ethnicity and the experience of stress, coping, social support, and depressive symptoms in persons infected with HIV /

Cherner, Mariana, January 1997 (has links)
Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 1997. / Vita. Includes bibliographical references (leaves 116-132).
14

Does a participatory sharing and learning approach make an effective HIV provider training program?

Salas, Daniela. January 2007 (has links)
Thesis (M.P.H.)--Georgia State University, 2007. / Title from file title page. Michael Eriksen, committee chair; Betty Apt, Marshall Kreuter, committee members. Electronic text (121 p. : ill. (some col.), col. maps)) : digital, PDF file. Description based on contents viewed Oct. 25, 2007. Includes bibliographical references (p. 109-115).
15

Epidemiology and prevention of sepsis in young infants and the potential impact of maternal HIV infection on neonatal sepsis

Cutland, Clare Louise January 2016 (has links)
A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Doctor of Philosophy Johannesburg, South Africa 2016 / Introduction: Neonatal infections contribute to 25% of all neonatal deaths, which account for approximately 44% of all under-5 childhood deaths globally. Pathogens responsible for sepsis in neonates and young infants can be acquired vertically prior to or during labour, or from the environment (community or hospital). This project evaluated the burden and aetiology of sepsis in neonates and young infants (≤90 days), and explored this association to in-utero exposure to human immunodeficiency virus. The study also included a specific focus on the epidemiology of invasive Group B Streptococcal disease in young infants. Additionally, we assessed the efficacy of intrapartum chlorhexidine vaginal washes for: (i) preventing early-onset neonatal sepsis; and (ii) vertical transmission of potentially pathogenic bacteria to the newborns. Furthermore, we evaluated risk factors for poor outcomes due to neonatal sepsis. Materials and methods: (i) A bacterial surveillance system was established at Chris Hani Baragwanath Academic Hospital (CHBAH) from 2004-2008 to identify young infants with bacterial sepsis hospitalised in the neonatal and paediatric wards. Medical and microbiological records were utilised to obtain clinical and laboratory data. Maternal HIV results were obtained from antenatal testing records or admission records. (ii) A blinded, randomised, placebo-controlled trial of 0.5% chlorhexidine maternal vaginal intrapartum wipes and newborn skin wipes was conducted at CHBAH between 2004 and 2007. Consented, eligible participants were randomised during labour to receive either chlorhexidine vaginal wipes or water external genitalia wipes. Newborns received either chlorhexidine full-body wipes (intervention arm) or foot wipes (control arm). Maternal and infant participants were followed up for admissions during the first month after delivery/ birth. A subset of 5144 maternal participants had an intrapartum lower vaginal swab collected, and skin swabs were collected from their newborns to assess colonisation with potentially pathogenic bacteria (Group B streptococcus, Escherichia coli and Klebsiella pneumoniae). Results: Group B streptococcus (GBS) was the most commonly isolated bacterial pathogen, causing 35.2% of culture-confirmed sepsis in infants ≤90 days, 41.6% of early-onset disease (EOD, 0-6 days), 40.5% of late-onset neonatal disease (LOD, 7-27 days) and 18.7% of young-infant community-acquired disease (YI-CAD, 28-90 days). Staphylococcus aureus (S. aureus), Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) contribute 16.2%, 12.2% and 3.4% to sepsis in young infants. Overall, incidence (per 1000 live births) of invasive GBS disease was 2.72 (95% confidence interval [95% CI]: 2.46 to 3.01), including an incidence of 1.50 and 1.22, respectively, in infants 0-6 days and 7-90 days of age. HIV-exposed infants were at greater risk of EOD (Relative risk [RR]: 1.69; 95% CI: 1.28-2.24) and LOD (RR= 3.18; 95% CI: 2.34-4.36) than HIV-unexposed infants. GBS serotypes Ia and III caused 84.0% of invasive GBS disease in young infants. Intrapartum chlorhexidine interventional wipes was not efficacious in prevention of any of: (i) vertical transmission of pathogenic bacteria (54% vs. 55%; efficacy -0.05, 95% CI: -9.5 to 7.9) to the newborns; (ii) sepsis in first 3 days of life (3% vs. 4%; p=0.65,); (iii) sepsis in the later neonatal period (both <1%; p=0.4444); or (iv) maternal puerperal sepsis(both <1%; p=0.56). Conclusion: GBS, S. aureus, E. coli and K. pneumoniae are the most commonly isolated bacterial pathogens in neonates and infants ≤90 days old. HIV-exposed infants are at greater risk of GBS sepsis. Intrapartum chlorhexidine intervention was not efficacious in reducing vertical transmission of pathogenic bacteria, neonatal or maternal sepsis. Alternative interventions to prevent sepsis in young infants, including maternal immunisation, need to be investigated in setting such as ours where there is a high prevalence of maternal HIV infection. / MT2017
16

The economic burden of HIV/AIDS upon households in Nepal

Poudel, Ak Narayan January 2015 (has links)
This study is concerned with the economic burden of HIV/AIDS in Nepal. It focuses on the direct costs of seeking treatment, productivity costs (before and after adjustment for coping strategies), catastrophic and impoverishing impacts, the coping strategies used by households and the socio-economic impacts of stigma and discrimination. The study was cross-sectional and employed a mixed-methods approach. The survey questionnaire (quantitative study) with 415 respondents and in-depth interviews (qualitative study) with 30 participants were conducted in six treatment centres in six different districts. Total costs due to HIV/AIDS (the sum of direct costs and productivity costs before adjustment for coping strategies) were an average of Nepalese Rupees (NRs) 2,233 per month (US$ 30.2/month), 28.5% of the household income. The main determinants of direct costs were found to be cluster of differentiation 4 (CD4) level, household income, occupation, whether the people living with HIV/AIDS (PLHA) was accompanied, and district. The main determinants of productivity costs were found to be self-reported health status, ethnicity, sexual orientation, and district. The most frequently used coping strategies were the use of savings or income, taking a loan and sale of assets. Nearly 75% of households faced catastrophic impacts due to direct and productivity costs. The study concluded that HIV/AIDS has caused a significant economic burden for (PLHA) and their families in Nepal. The study has helped fill the knowledge gap about the extent, nature and determinants of this economic burden. It has also involved methodological innovation, particularly in the measurement of productivity costs. The major limitations were a concentration on respondents attending treatment centres, the lack of a control group, the possibility of recall bias and restrictions on the type of analysis conducted because of time constraints. The study has a number of policy implications for different stakeholders and sets a further research agenda.
17

A retrospective review of the relationship between peritonsillar abscess and HIV

Variava, Imraan 12 October 2010 (has links)
MMed (Otorhinolaryngology), Faculty of Health Sciences, University of the Witwatersrand / HIV/AIDS continues to be an important public health challenge in sub Saharan Africa. It is estimated that approximately 68% of people living with HIV in the world are from this region [1]. South Africa has the largest infected population in the world, the adult (15-49 years) HIV prevalence is estimated at 17.64% [2]. It has been estimated that 40 - 70% of such HIV positive individuals present with head and neck manifestations, which include infection, inflammation and tumours, and are often the only and initial presenting sign [3,4]. Peritonsillar abscess is the most common deep infection of the head and neck in young adults and can occur in all age groups, but the highest incidence is in adults 20 to 40 years of age [5]. The aim of this study was to assess the relationship between peritonsillar abscess and the HIV status of patients. Method: An analytical cross sectional study utilising retrospective clinical data from ward registers, patient records, treatment registers and National Health Laboratory System (NHLS) databases. This study was conducted in the adult ENT ward at the Chris Hani Baragwanath Hospital and sample consisted of patient records over a 4 year period from January 2005 to December 2008. All patients admitted to the ENT ward with the discharge diagnosis of peritonsillar abscess that have been tested for HIV were included in this study. In this study period 450 patient files were reviewed of which 291 fulfilled the inclusion criteria. The demographic details, clinical presentation which included head and neck manifestations of HIV, the HIV status, management and complications of peritonsillar abscess were recorded. This data was analysed using STATA-10 software. Results: The age ranged from 15 to 63 years with a mean (SD) 29.3 years (9.58). From the 291 patients, 86 (29.55%) were HIV positive. This is significantly higher than the adult (15-49years) HIV prevalence rate of 17.64% [6]. The male: female ratio of HIV positive patients 1:1.53. Forty-nine (16.84%) patients presented with cervical lymph nodes of which 65.31% were HIV positive (P< 0.001). From the 86 HIV positive patients oral candida was present in 15.12% (P<0.001), lymphoma in 6.98% (P<0.001), oral hairy leukoplakia in 2.33%, Kaposi’s sarcoma in 1.16% and complications (parapharyngeal abscess) 3.48%. There was no statistical significance in the management of HIV positive patients, however hospital stay was longer with a mean of 3.802 days (P<0.001). From this study sample the HIV prevalence of 29.55% suggests that peritonsillar abscess may be an early clinical marker of HIV infection. Due to the high incidence of head and neck manifestations in HIV positive patients identifying a clinical marker (quinsy) in the earlier stages of HIV infection would allow for better screening, earlier diagnosis and treatment of HIV infection.
18

Vasculitides in HIV-infected children: a case series & literature review

Dempoulos, Despina 27 January 2012 (has links)
M.Med.(Paediatrics), Faculty of Health Sciences, University of the Witwatersrand, 2011 / Medium and large vessel vasculopathy in HIV-infected patients is an uncommon but important cause of mortality and morbidity in both adult and paediatric patients. The estimated frequency in children from the current literature is 1-2%. The overall HIV prevalence among children 18 years of age and younger in South Africa is currently 2.9%. This series reports on medium and large vessel vasculopathy in children with HIV. Six HIV infected children seen at three Johannesburg hospitals between 2000 -2006, are described, all presenting with complications arising from medium and/or large vessel involvement. Additional cases are reviewed from the literature. A description of the clinical presentation, radiological investigations, the possible aetiology, pathophysiology and management of these patients is presented. The case series and literature review compares HIV vasculopathy and Takayasu’s arteritis. Both entities can present with multiple aneurysms and a diagnosis of tuberculosis, thus a possible link in the pathogenesis is explored. Most patients with HIV vasculopathy present while severely immunosuppressed. However, some patients in the case series and literature review present despite adequate viral suppression, suggesting the possibility of an immune-reconstitution inflammatory syndrome in the pathogenesis of this vascular complication. Medical management and in selected cases, surgery, has been used in the management of patients with HIV vasculopathy. The outcomes thus far are good.
19

Demographic profile of pregnant HIV-positive women in Postmasburg, South Africa

Kalonji, Kabasele Muboyayi Hubert January 2011 (has links)
Thesis (MPH)--University of Limpopo (Medunsa Campus), 2011. / Background: South Africa hosts the largest number of pregnant HIV-positive women, accounting for almost 15% of the global total. Many amongst these HIV-positive pregnancies are unplanned and may be related to reproductive unmet needs, sexual risky behaviours, and/or community, contextual and individual factors that may determine and/or make these HIV-infected women to fall pregnant. The occurrence of an HIV-positive pregnancy in our region implies however the practice of unprotected sex, and is associated with the risk of reinfection with a different strain of HIV as well as with the risk of HIV transmission to an uninfected male partner and to the offspring. Knowing the demographic profile of HIV-infected women who become pregnant and experience parenthood as well as the circumstances of occurrence of their pregnancies is necessary for developing policies and interventions aimed at addressing the reproductive needs of this subpopulation, thus preventing HIV-positive unintended pregnancies as well as the horizontal and vertical transmission of HIV. Objectives: This study had three objectives. The first objective was to describe the demographic profile of pregnant HIV-positive women attending antenatal care (ANC) in public sector clinics in Postmasburg, South Africa. The second study objective was to determine the proportion of these pregnant HIV-infected women who were aware of their HIV-positive status prior to the occurrence of their current pregnancy. Lastly, the third objective sought to describe the circumstances of occurrence of their current pregnancy. Methodology: We used a quantitative descriptive design to collect data on 41 consecutive pregnant HIV-positive women who attended ANC at three public sector clinics in Postmasburg, from September to December 2010. Participants were administered a structured pre-tested questionnaire in their home language by trained interviewers. The study instrument was designed to collect data related to participants‘ socio-demographic characteristics, the time-period of HIV- v positive diagnosis relative to their current pregnancy, and the circumstances of occurrence of their current pregnancy. Results: The analyses of the study results showed that pregnant HIV-positive women attending ANC in Postmasburg were likely to be young (mean age, 27.71 ± 5.72 years), never married (56.10%), Afrikans (65.9%) and Setswana speakers (58.52%) of low socioeconomic status, with no or one child (65.85%). The majority of participants (63.4%) were from a predominantly informal settlement; 78% were unemployed while 61% were either devoid of any income or were living with Rands 500 or less. Sex mixing was common in the 15-19 years-old, involving 80% of respondents of this age category. Most of respondents (78.05%) became aware of their HIV-positive diagnosis during their current pregnancy that was unplanned in 73.17%. The study findings also revealed low levels of pregnancy intendedness (31.71%), hormonal contraceptives use (24.9%) and condoms uptake (34.15%), with high rates of condoms failure among users (87.12%). Respondents also reported other circumstances of occurrence of their current pregnancy, including, irregular condoms use (14.29% of condom users), partner refusal to use condom (10%), stopping contraceptives use because of side effects (50% of users), partner‘s pressure (12% of participants), coerced sex (2.4%) and having had sex under the influence of alcohol (2.4%). Conclusion: These results highlight the need for improving the reproductive health services that are offered to HIV-positive individuals. Integrating PMTCT and Family planning services, training health workers in issues related to the reproductive rights and reproductive health of HIV-infected individuals, systematically offering HIV counseling and testing to women of childbearing age who come into contact with health facilities for any reason and adequately informing HIV-positive women of childbearing age about available reproductive options, planned conception and safer motherhood, are necessary for preventing unintended HIV-positive pregnancies as well as the horizontal and vertical transmission of HIV.
20

The Emotional experiences of HIV-positive married women wanting to bear children: An exploratory study

Nkambule., Jeaniffer Dekeledi. January 2012 (has links)
Thesis (MSc (Clinical Psychology)) -- University of Limpopo, 2012. / Recent literature on childbearing and HIV has indicated a plethora of evidence suggesting that many women living with HIV continue to desire children, become pregnant and give birth after knowing their HIV status. This desire to have children has been associated with the availability of HAART and PMTC interventions and its improvement in the quality of life for HIV-positive women. This study aimed at exploring the emotional experiences of HIV-positive married women wanting to bear children. A qualitative research design was used to explore the above mentioned aim. Through the use of semi-structured interviews a sample of 12 HIV-positive married women were purposefully selected. The participants were chosen from Tshepang clinic at Dr. George Mukhari Hospital situated in the township of Ga-Rankuwa using a purposive sampling design. Semi-structured interviews using interview guide were conducted to explore their unique and subjective emotional experiences of being HIV, married and in need of a child. The process of data analysis in the current study was guided by phenomenological approach in order to allow the inherent meaning of the data to emerge without being distorted. The findings of these study revealed that the experiences surrounding HIV positive diagnosis, marriage and childbearing proves to be associated with overwhelming emotional experiences for women in the current study. Most of the participants in this study viewed motherhood as a unique, subjective and a personal fulfilment for all women irrespective of their HIV status. Participants felt that children stabilise a marriage by giving it meaning. A decision to conceive for some participants is influenced by pressure as a result of their marital, social and situational context

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