Diss. (sammanfattning) Stockholm : Karolinska institutet, 2010.

Thesis (Ph.D.)--Memorial University of Newfoundland, 2002. / Restricted until October 2003. Bibliography: leaves 148-161.

Not available / text

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: An estimated 34 million people worldwide are infected with HIV with 52% of them being women (UNAIDS, 2011), of this figure, an estimated 3.4 million are said to be children below the age of 15years. Sub Saharan Africa accounts for up to 90% of this burden in children. Nigeria, the most populous nation is Saharan African still contributes up to 30% of the global burden of mother to child transmission of HIV which is a major source of infection in children. According to the Federal ministry of health 2010 ANC survey report, the country has a prevalence of 4.1%. The Federal Capital Territory (FCT) where Karu village is located ranked 5th among the 36 states and Federal capital territory in Nigeria with a prevalence of 8.7%. Urban prevalence is 8.6% while the rural prevalence is 8.2%. An exploratory descriptive study was conducted among women of child bearing age (18 to 49years) living in Karu village, Abuja, FCT, North central Nigeria. A semi structured questionnaire designed to assess the knowledge, attitude and practices of prevention of mother to child transmission of HIV was administered by the researcher on 120 women of child bearing age living in Karu village after obtaining their consent. The study received an ethical review and approval from FCT human research ethics committee at the Health Department of the Federal capital development agency and Stellenbosch University, ethic committee. Findings from the 120 women who gave consent to participate showed that 28.33% had sufficient knowledge of how MTCT can occur with 77% having insufficient knowledge of how MTCT occur, 51.67% of them have sufficient knowledge of how PMTCT can be achieved while 48.33% do not. Of the participant surveyed, 89.17% of them have ever been pregnant while 24.17% were pregnant at the time of the survey, the bulk of the participants were between the ages of 18 to 34 with only 22.5% of them within the age of 35 – 49 years. From this study, women in Karu village were identified to have high level of general knowledge regarding MTCT and PMTCT of HIV but in-depth knowledge of both is still insufficient among a large group of women. Health workers and mass media were identified as key sources of information regarding MTCT and PMTCT of HIV and majority of women have favourable attitude towards PMTCT interventions but practices of these interventions is still relatively low. / AFRIKAANSE OPSOMMING: Ongeveer 34 miljoen mense is wêreldwyd aangetas deur MIV, waarvan 52% vroue is (UNAIDS, 2011). Hiervan is ongeveer 3.4 miljoen na bewering kinders onder die ouderdom van 15 jaar. Tot 90% van hierdie infeksie by kinders kom in sub-Sahara-Afrika voor. Nigerië, die digsbevolkte staat in sub-Sahara-Afrika, dra tot 30% van die globale las van moeder-tot-kind-oordrag van MIV, wat ’n groot bron van infeksie onder kinders is. Volgens die Federale Ministerie van Gesondheid 2010 ANC-opnameverslag het die land ’n voorkomssyfer van 4.1%. Die Federal Capital Territory (FCT), waar die dorp Karu geleë is, is as 5de van die 36 state in Nigerië geklassifiseer met ’n voorkomssyfer van 8.7%. Die stedelike voorkomssyfer is 8.6% teenoor die landelike voorkomssyfer van 8.2%. ’n Ondersoekende, beskrywende studie is uitgevoer onder vroue van vrugbare leeftyd (18 tot 49 jaar) wat in die dorp Karu, Abuja, FCT, Noord-sentrale Nigerië, woon. ’n Halfgestruktureerde vraelys is ontwerp om die kennis, houdings en voorkomingspraktyke van moeder-tot-kind-oordrag (MTCT) van MIV te beoordeel. Dit is deur die navorser toegepas op 120 vroue van vrugbare leeftyd wat in die dorp Karu woon nadat hul toestemming daartoe verkry is. Die studie het ’n etiese oorsig en goedkeuring van die FCT mensenavorsing-etiekkomitee by die Departement van Gesondheid van die federale hoofstad se ontwikkelingsagentskap en die Universiteit Stellenbosch se etiekkomitee ontvang. Bevindings van die 120 vroue wat ingestem het om deel te neem het getoon dat 28.33% toereikende kennis gehad het van hoe MTCT kan voorkom, met 77% wat onvoldoende kennis gehad het van hoe MTCT voorkom. Van hulle het 51.67% genoegsame kennis gehad van hoe PMTCT verkry kan word, terwyl 48.33% nie oor hierdie kennis beskik het nie. Van die deelnemers wat waargeneem is, was 89.17% al swanger, terwyl 24.17% tydens die opname swanger was. Die meerderheid van die deelnemers was tussen 18 en 34 jaar oud, met slegs 22.5% wat in die ouderdomsgroep 35 – 49 jaar geval het. Uit hierdie studie het geblyk dat vroue van die dorp Karu geïdentifiseer is as mense wat ’n hoë vlak van algemene kennis omtrent MTCT en PMTCT van MIV gehad het, maar dieptekennis van albei sake is steeds ontoereikend by ’n groot groep vroue. Gesondheidswerkers en die massamedia is geïdentifiseer as sleutelbronne van kennis oor MTCT en PMTCT van MIV en die meeste vroue het ’n gunstige houding teenoor PMTCT-intervensies, maar die toepassing van hierdie intervensies is nog betreklik laag.

This thesis examines HIV disease natural history and response to antiretroviral treatment (ART) in patients from The TREAT Asia HIV Observational Database (TAHOD), a mulitcentre, prospective observational cohort of HIV-infected patients from countries in the Asia-Pacific region. By September 2005, 2979 patients have been recruited to TAHOD from 15 participating sites. The majority were male (73%), median age 37 years. Chinese (37%), Thai (25%) and Indian (17%) were the main ethnicities. Most patients reported HIV infection through heterosexual (59%) and homosexual contact (23%); 5% injecting drug use. At baseline, 41% of patients were diagnosed with AIDS defining illness, and 77% were being treated with highly active antiretroviral therapy (HAART). Baseline and retrospective data suggest that the overall response to HAART in TAHOD is similar to that seen in western cohorts, with mean CD4 count increase of 115 cells/μL and 69% achieving a viral load less than 400 copies/mL six-month after HAART initiation. Baseline CD4 count was the strongest predictor of short-term disease progression. Prognostic models based on routine clinical data and haemoglobin gave a good estimation of disease progression. The rate of new AIDS defining illness was 26% in the first 90 days after HAART initiation, which may partly be due to immune reconstitution syndrome occurring shortly after treatment. The most frequently used first-line ART combination was stavudine/lamivudine/nevirapine. Approximately 22% of patients receiving this treatment changed or stopped at least one drug in the first year, with adverse effect (including lipodystrophy, hepatitis, rash and peripheral neuropathy) the major reasons. The rates of discontinuation of efavirenz or nevirapine as part of HAART were similar (16 vs. 20/100 person years). Older age and positive HCV antibody were associated with an elevated liver function (ALT) test. Both prevalence of HBV and HCV coinfection with HIV were approximately 10%. The impact of hepatitis coinfection on immunological and virological responses to ART and HIV disease progression was not statistically significant. Both HBV and HCV remained independently associated with elevated ALT in the multivariate models. The overall HIV disease progression and response to ART in TAHOD patients were similar to those seen in the western countries.

Source: Masters Abstracts International, Volume: 46-05, page: 2669. Adviser: Jan M. Risser. Includes bibliographical references.

BACKGROUND:In Eastern and Southern Africa (ESA), adolescent girls’ and young women’s (AGYW, aged 15-24 years) disproportionate HIV risk is fueled by age-disparate sex (partners >5 years older). Older men typically acquire HIV from same-aged partners; they then transmit HIV to AGYW, who then transmit HIV to older men as they age, creating a cycle of transmission. Adolescent boys and young men (ABYM, aged 15-24 years) have lower HIV incidence rates, and their risk starts increasing around age 20 due to same-aged partners and age-disparate sex. Developing ABYM’s preventative behaviors may proximally and distally reduce their and AGYW’s HIV risk. HIV risk perception (HIV RP) is a theoretical motivator for initiating and using risk-reduction strategies. However, this relationship remains temporally and empirically equivocal in AGYW and ABYM, who are in a developmentally and socially dynamic stage of life. To increase and improve HIV risk-reduction strategies among AGYW and ABYM in ESA, this dissertation aimed to elucidate temporal trends, determinants, and effects of HIV RP. METHODS:This dissertation employed three aims to examine 1) longitudinal HIV RP literature, 2) HIV RP trajectories and predictors, and 3) HIV RP’s association with health outcomes. Secondary analyses used data collected (2010 [T1], 2011 [T2], 2012 [T3]) from the control arm (714 AGYW, 635 ABYM) of a school-based trial in KwaZulu-Natal, South Africa. Aim 1 evaluated longitudinal quantitative studies examining HIV RP among AGYW and ABYM in ESA. A scoping review synthesized data from peer-reviewed articles published between 1995-2022 to elucidate studies’ geo-spatial distributions, temporal data patterns, sample characteristics, and HIV RP definitions, analytic findings, and theoretical underpinnings. A proposed HIV RP conceptual framework was created by synthesizing findings and theories. Aim 2 described gender-specific patterns and determined predictors of HIV RP in AGYW and ABYM. Trajectories were created based on cumulative reports of high HIV RP. After, these trajectories were characterized using sociodemographic, knowledge, attitudinal/perceptual, biological, experiential, and behavioral factors. Using models stratified by ever-sex status, overall predictive analyses explored factors prospectively associated with high HIV RP. Aim 3 tested the hypothesis that high HIV RP increased chances of HIV testing and decreased cumulative acquisition of HIV/HSV-2. Directed acyclic graphs identified potential confounders using current literature. Predictive analyses estimated high HIV RP’s gender-specific confounder-adjusted association with HIV testing and HIV/HSV-2 incidence over 1-year periods. RESULTS:In Aim 1, synthesis of 38 longitudinal studies offered limited insights on AGYW’s and ABYM’s HIV RP due to geographic homogeneity, abundance of intervention-related studies, and minimal reporting of RP definitions and HIV status. Most (~75%) studies analyzed data collected before 2015, highlighting the evidence gap of HIV RP in current epidemic conditions or prevention options. Studies assessed AGYW when their risk is peaking and provided little detail on pre-risk periods; ABYM were rarely included in analyses. Elevated HIV RP was mostly positively associated with AGYW’s self-initiated outcomes, but HIV RP’s formulation was understudied. Aim 2 found HIV RP was temporally dynamic, as most (60% AGYW, 65% ABYM) changed their level of HIV RP at least once. AGYW’s and ABYM’s Persistent (high HIV RP at all timepoints) trajectories were primarily differentiated by negative prevention attitudes. While sexual risk behaviors were relatively high in AGYW’s and ABYM’s Persistent trajectories, HSV-2 and becoming/getting others pregnant increased in lower RP trajectories, implying potential contradictions between actual and perceived risk. Analyses showed sociodemographic factors (grade repetition, mother-led households) mostly predicted high HIV RP in AGYW, while prevention attitudes differentially (i.e., attitudes and associations largely shifted from negative to positive over time) affected ABYM’s high HIV RP. Behaviors (transactional sex, not knowing partners’ status, older partners, alcohol use [ABYM only]) predicted high HIV RP in both groups. Aim 3 highlighted that age, grade, financial insecurity, HIV/pregnancy-related knowledge, attitudes, perceptions, experiences, and service-seeking and risk-taking behaviors potentially confounded relationships between HIV RP and outcomes (HIV testing, HIV/HSV-2 acquisition). AGYW with high HIV RP at T1 were more likely to HIV test (aRR=1.48 [1.12-1.95]) and acquire HIV/HSV-2 (aRR=1.83 [1.03-3.25]) by T2, associations that did not persist in T2-T3’s analyses. There were no significant associations between any factor and HIV RP in ABYM. CONCLUSION:This dissertation highlights the temporal and associative complexities of HIV RP among AGYW and ABYM in ESA. HIV RP in these groups was variable and primarily predicted by sociodemographic (AGYW), attitudinal (ABYM), and behavioral factors, elucidating need and opportunities for multi-level, age- and risk-appropriate interventions. Structural insecurities and age- and gender-driven power differentials may inhibit AGYW’s prevention behaviors. For both groups, earlier intervention would reach AGYW before their risk escalates and reinforce and/or instill ABYM with potentially lasting assets. Additional high-quality, detailed studies are needed to combat the current evidentiary dearth, optimize prevention interventions, and increase the likelihood of ending HIV/AIDS by 2030.

Thesis (MSc)--University of Stellenbosch, 2002. / ENGLISH ABSTRACT: HIV has attained a global distribution and the number of infected people reached an estimated 28.1 million in sub-Saharan Africa at the end of 2001. HIV-1 subtype C is overwhelmingly prevalent in Botswana and South Africa and to date no interventions have been successful enough to curb the rapid spread of the virus. A number of HIV-1 vaccine strategies are being developed, however the breadth and efficacy of such candidate vaccines, many of which are based on the HIV-1 structural genes pol, gag and env, have mostly been found to be inadequate. The HIV-1 accessory genes are attractive components of HIV vaccines due to their role in viral pathogenesis, early expression and the high ratio of conserved CTl epitopes. Yet, because of undesirable properties questions regarding their safety as vaccine components are raised. In this study candidate tat, rev and nefmutants were assessed for efficient expression and inactivation of undesirable functionality. / Plasmid constructs that encode the South African HIV-1 subtype C consensus Tat, Rev and Nef proteins were constructed. The coding sequences of the genes were codon-optimised for optimum protein expression and these synthetic genes were constructed using overlapping 50-mer oligonucleotides. Furthermore, the proteins were mutated at previously described sites by PCR-based site-directed mutagenesis to render them inactive for their respective functions. Corresponding wild-type Tat, Rev and Nef constructs were also made from viral isolates that were least dissimilar to the respective consensus amino acid sequences. tn vitro expression of the different constructs were assessed in 293 cells by Western blotting with polyclonal mouse sera, which were generated by DNA immunisation with one of the Tat, Rev and Nef constructs. The transactivation activity of Tat variants and Rev-mediated nuclear export activity of RRE-containing transcripts were studied in cotransfection experiments using reporter-gene-based assays while Nef functionality was assessed in a cotransfection assay with subsequent flow cytometric analysis of surface CD4 and MHC-I expression on 293 cells. Sequence analysis of the South African HIV-1 subtype C consensus sequences of Tat, Rev and Nef revealed a high degree of similarity with a consensus sequence that was drawn up from a large number of viruses from southern Africa. These consensus sequences were also closer to individual viral isolate sequences than any individual sequences were, indicating that the use of a consensus sequence may serve to reduce genetic diversity between a vaccine and circulating viruses. Expression levels of the sequence-modified tat and nef gene constructs were not significantly higher than the wild-type constructs, however, the codon-optimised rev mutant exhibited markedly higher expression than the wild-type rev construct. Immunoreactivity of the protein with the mouse sera demonstrates expression and immunogenicity of the Tat, Rev and Nef immunogens in mice. In the background of the subtype C Tat, a single C22 mutation was insufficient to inactivate l TRdependent CAT expression in 293T and Hela cells. Yet, this activity was significantly impaired using the single mutation, C3?, or the double mutation, C22C3? Compared to the wild-type Rev, the function of the Rev with a double mutation, M5M10, was completely abrogated. Similarly, while the wild-type Nef and native, codon-optimised consensus Nef proteins mediated CD4 and MHC-I downregulation, CD4 downregulation was completely abrogated in one of the mutants, while both Nef mutants were entirely deficient for MHC-I downregulation. These data demonstrate the high expression levels and impaired functionality of sequence-modified HIV-1 subtype C consensus Tat, Rev and Nef DNA immunogens that may be used as single-standing vaccine components or form part of a multicomponent HIV-1 vaccine. / AFRIKAANSE OPSOMMING: Sedert die eerste gevalle van MIV in die vroeë 1980's beskryf is het die virus wêreldwyd versprei en 'n beraamde 28.1 miljoen mense in sub-Sahara Afrika was teen die einde van 2001 geïnfekteer. MIV-1 subtipe C kom verreweg die meeste voor in Botswana en Suid-Afrika en tans is daar geen suksesvolle tussenkoms wat die vinnige verspreiding van die virus kan stuit nie. 'n Aantal MIV-1 subtipe C entstofstrategieë word tans ontwikkel maar die spektrum en effektiwiteit van sulke entstowwe, waarvan baie op die MIV strukturele gene gag, pol en env gebaseer is, is tans onvoldoende. Die MIV-1 bykomstige gene is aantreklike entstofkomponente omdat hulle vroeg uitgedruk word, 'n belangrike rol in virale patogenese speel en omdat hulle 'n hoë verhouding van gekonserveerde sitotoksiese T-limfosiet (STL) epitope tot grootte besit. Vanweë hierdie gene se verskeie ongewenste eienskappe word vrae ten opsigte van hul veilige insluiting in enstofstrategieë geopper. Hierdie studie omskryf die evaluasie van kandidaat tat, reven nef mutante vir doeltreffende proteïenuitdrukking en funksionele onaktiwiteit. Plasmiedkonstrukte wat vir die Suid-Afrikaanse MIV-1 subtipe C konsensus Tat, Rev en Nef proteïene kodeer is saamgestel. Die koderingsvolgordes van die gene is geoptimiseer vir optimale uitdrukking en die sintetiese gene is van oorvleuelende 50- mer oligonukleotiede vervaardig. Deur van PKR-gebaseerde site-directed mutagenese gebruik te maak is hierdie proteïene gemuteer op posisies wat voorheen geïdentifiseer is. Ooreenstemmende wilde-tipe Tat, Reven Nef konstrukte is gemaak vanaf virale isolate waarvan die aminosuurvolgordes die meeste ooreenstem met dié van die konsensusvolgorde. In vitro uitdrukking van die konstrukte in 293 selle is met behulp van immunoklad met poliklonale muissera bepaal. Die serum is gegenereer deur DNS immunisasie van muise met een elk van die Tat, Reven Nef konstrukte. Die transaktiverings-aktiwiteit van Tat variante en Rev bemiddelde uitvoer van RREbesittende transkripte uit die nukleus is in verklikkergeen kotransfeksie-eksperimente bestudeer. Nef se funksionaliteit is deur kotransfeksie en die daaropvolgende vloeisitometriese analise van 293 selle se oppervlak-CD4 en MHC-I uitdrukking bestudeer. Nukleotiedvolgorde-analise van die Suid-Afrikaanse MIV-1 subtipe C konsensus Tat, Reven Nef proteiëne toon 'n hoë vlak van ooreenkoms met 'n konsensusvolgorde wat afgelei is vanaf 'n groot aantal suider-Afrikaanse virusse. Hierdie konsensusvolgordes is ook meer soortgelyk aan individuele virale isolate as enige individuele volgordes. Vanuit hierdie data kan afgelei word dat die gebruik van so 'n konsensusvolgorde die genetiese diversiteit tussen 'n entstof en sirkuierende virusse kan verminder. Uitdrukkingsvlakke van die volgorde-geoptimiseerde tat en nef geenkonstrukte is nie merkbaar hoër as die van die wilde-tipe konstrukte nie. In teenstelling het die volgorde-geoptimiseerde rev mutant merkbaar hoër uitdrukkingsvlakke as die wildetipe getoon. Immunoreaktiwiteit van die proteïene met die muissera demonstreer dat die Tat, Reven Nef proteïene uitgedruk word en immunogenies in muise is. 'n Enkele C22 mutasie in Tat is nie genoeg om lTR-afhanklike CAT uitdrukking in 293T en Hela selle te inaktiveer nie. In teenstelling is hierdie aktiwiteit geïnhibeer vir Tat proteïene met die enkel mutasie C37 en die dubbel mutasie C22C37. In vergelyking met die funksionele aktiwiteit van die wilde-tipe Rev is dié van die Rev mutant M5M10 heeltemal geïnhibeer. Die wilde-tipe en geoptimiseerde, konsensus Nef proteïene het seloppervlak-CD4 en -MHC-I uitdrukking verlaag, maar hierdie effek van afregulering van CD4 uitdrukking was heeltemaal opgehef in een Nef mutant en van MHC-I uitdrukking in beide Nef mutante. Hierdie data demonstreer die hoë uitdrukkingsvlakke en geïnhibeerde funksionaliteit van volgorde-gemodifiseerde MIV-1 subtipe C konsensus Tat, Reven Nef DNS immunogene wat as enkelstaande enstof kan optree of deel kan uitmaak van 'n multi-komponent MIV-1 entstof.

Thesis (MSc)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: While antiretroviral therapy decreases HIV/AIDS morbidity and mortality, long-term treatment results in insulin resistance and cardiovascular diseases. A possible cause of such adverse effects may be an increase in oxidative stress resulting from protease inhibitor (PI)-induced mitochondrial dysfunction. We therefore hypothesized that PI treatment, specifically Lopinavir/Ritonavir, results in increases in myocardial reactive oxygen species (ROS), leading to downstream outcomes, i.e. elevated apoptosis. Moreover, we proposed that increased ROS levels in this instance might occur as a result of PI-mediated induction of the non-oxidative glucose pathways (NOGPs). In light of this, we also investigated the effect of PI treatment on the NOGPs by employing both in vitro and in vivo samples. For the in vitro work we employed a rat cardiomyoblast cell line, while tissues (heart, liver) were collected from two separate experimental models, i.e. a) Group A exposed to PIs via mini-osmotic pump for a period of eight weeks, and b) Group B administered PIs via a jelly-based method for 16 weeks. We found that PIs increased mitochondrial ROS levels in vitro but that this was not accompanied by a parallel rise in programmed cell death. Moreover, we found no induction of the NOGPs in response to PI exposure (for both in vitro and in vivo models here employed). However, we found that the AGE pathway was significantly down-regulated in the liver of Group A. Investigation into a proposed mechanism for this observation proved inconclusive and further studies are thus required to clarify the significance in terms of metabolic dysfunction found in the Group A model. Our study thus shows that PIs can increase ROS levels (in vitro) but that compensatory antioxidant mechanisms may prevent this in vivo. Subsequently, downstream effects were limited i.e. we did not observe NOGP induction and programmed cell death. An intriguing finding emerged, however, i.e. that PIs can elicit an impact on the AGE pathway. We propose future studies with modifications to the current rat and cell models in order to evaluate the downstream effects of PIs on the NOGPs and programmed cell death. / AFRIKAANSE OPSOMMING: Terwyl antiretrovirale terapie MIV/VIGS morbiditeit en mortaliteit verlaag, veroorsaak langtermyn behandeling insulienweerstandigheid en kardiovaskulêre siekte. 'n Moonltike oorsaak van sulke newe-effekte kan 'n toename in oksidatiewe stres veroorsaak deur die protease inhibeerder (PI)-geïnduseerde mitochondriale wanfunskionering. Ons hipotetiseer dat PI behandeling, spesifiek Lopinavir/Ritonavir, versoorsaak 'n toename in miokardiale reaktiewe suurstofspesies (ROS), wat aanleiding gee tot afstroom uitkomste, i.e. verhoogde apoptose. Verder, stel ons voor dat verhoogde ROS vlakke in hierdie geval onstaan as gevolg van PI-gemedieerde induksie van die nie-oksidatiewe glukose weë (NOGWe). In die lig hiervan het ons ook die effek van PI behandeling op die NOGWe ondersoek deur beide in vitro en in vivo monsters te gebruik. Vir die in vitro werk het ons van 'n rot kardio-mioblastsellyn gebruik gemaak, terwyl weefsels (hart, lewer) versamel is van twee afsonderlike eksperimentele modelle, i.e. a) Groep A blootgestel aan PIs via mini-osmotiese pomp vir 'n periode van agt weke, en b) Groep B PIs is toegedien via 'n jellie gebaseerde metode vir 16 weke. Ons het bevind dat die die PIs mitochondriale ROS vlakke in vitro verhoog maar dat dit nie vergesel is met 'n paralelle toename in apoptose. Verder is geen induksie van die NOGWe in reaksie op PI blootstelling waargeneem (vir beide in vitro en in vivo modelle). Hoewel ons het bevind dat die AGE weg in die lewer van Groep A beduidend afgereguleer is. Ondersoek na 'n moontlike megansime vir hierdie waarneming was onoortuigend en verdere ondersoek is nodig om die betekenis in terme van die metaboliese wanfunskionering in die Groep A model vas te stel. Ons studie toon dus aan dat PIs, ROS vlakke (in vitro) verhoog, maar dat kompensatoriese anti-oksidant meganismes in die hierdie in vivo model verhoed word. Gevolglik is die afstroom effekte beperk i.e. ons het geen NOGWe induksie en aptoptose waargeneem nie. 'n Interesante bevinding het wel uitgestaan, i.e. PIs kan 'n impak hê op die AGE weg. Ons stel dus voor dat toekomstige studies met modifikasies, tot die huidige rot- en sel-modelle gemaak word om die afstroomeffekte van PIs en apoptose te evalueer.

This study focused on perceptions and experiences of pregnant women who opted in against those who opted out of voluntary antenatal HIV counseling and testing. The pregnant women's perceptions and experiences were assessed in order to gain insight into their views towards voluntary antenatal counseling and testing.