Source: Dissertation Abstracts International, Volume: 70-07, Section: B, page: 4122. Adviser: John Michael Swint. Includes bibliographical references

This study has involved the design, synthesis and evaluation of novel HIV-1 enzyme inhibitors accessed by synthetic elaboration of Baylis-Hillman adducts. Several series of complex coumarin-AZT and cinnamate ester-AZT conjugates have been prepared, in high yields, by exploiting the click reaction between appropriate Baylis-Hillman derived precursors and azidothymidine (AZT), all of which have been fully characterised using spectroscopic techniques. These conjugates, designed as potential dual-action HIV-1 inhibitors, were tested against the appropriate HIV-1 enzymes, i.e. HIV-1 reverse transcriptase and protease or HIV-1 reverse transcriptase and integrase. A number of the ligands have exhibited % inhibition levels and IC50 values comparable to drugs in clinical use, permitting their identification as lead compounds for the development of novel dual-action inhibitors. In silico docking of selected ligands into the active sites of the respective enzymes has provided useful insight into binding conformations and potential hydrogen-bonding interactions with active-site amino acid residues. A series of furocoumarin carboxamide derivatives have been synthesised in four steps starting from resorcinol and these compounds have also been tested for HIV-1 integrase inhibition activity. The structures of unexpected products isolated from Aza-Baylis-Hillman reactions of N-tosylaldimines have been elucidated by spectroscopic analysis, and confirmed by single crystal X-ray analysis. A mechanism for what appears to be an unprecedented transformation has been proposed. Microwave-assisted SeO₂ oxidation of Baylis-Hillman-derived 3-methylcoumarins has provided convenient and efficient access to coumarin-3-carbaldehydes, and a pilot study has revealed the potential of these coumarin-3-carbaldehydes as scaffolds for the construction of tricyclic compounds. The HCl-catalysed reaction of tert-butyl acrylate derived Baylis-Hillman adducts has been shown to afford 3-(chloromethyl)coumarins and α-(chloromethyl)cinnamic acids, the Zstereochemistry of the latter being established by X-ray crystallography. ¹H NMR-based experimental kinetic and DFT-level theoretical studies have been undertaken to establish the reaction sequence and other mechanistic details. Base-catalysed cyclisation on the other hand, has been shown to afford 2H-chromene rather than coumarin derivatives.

Despite the current interventions to avert contagions and AIDS-related deaths, sub-Saharan Africa is still the region most severely affected by the HIV/AIDS pandemic, where clade C is the dominant circulating HIV-1 strain. The pol-encoded HIV-1 protease enzyme has been extensively exploited as a drug target. Protease inhibitors have been engineered within the framework of clade B, the commonest in America, Europe and Australia. Recent studies have attested the existence of sequence and catalytic disparities between clades B and C proteases that could upset drug susceptibilities. Emergence of drug-resistant associated mutations and combinatorial explosions due to recombination thwarts the attempt to stabilize the current highly active antiretroviral therapy (HAART) baseline. The project aimed at identifying the structural and molecular mechanisms hired by mutants to affect the efficacies of both FDA approved and Rhodes University (RU)-synthesized inhibitors, in order to define how current and or future drugs ought to be modified or synthesized with the intent of combating drug resistance. The rationale involved the generation of homology models of the HIV-1 sequences from the South African infants failing treatment with two protease inhibitors: lopinavir and ritonavir (as monitored by alterations in surrogate markers: CD4 cell count decline and viral load upsurge). Consistent with previous studies, we established nine polymorphisms: 12S, 15V, 19I, 36I, 41K, 63P, 69K, 89M, and 93L, linked to subtype C wild-type; some of which are associated with protease treatment in clade B. Even though we predicted two occurrence patterns of M46I, I54V and V82A mutations as V82A→I54V→M46I and I54V→V82A→M46V, other possibilities might exist. Mutations either caused a protracted or contracted active site cleft, which enforced differential drug responses. The in silico docking indicated susceptibility discordances between clades B and C in certain polymorphisms and non-polymorphisms. The RU-synthesized ligands displayed varied efficacies that were below those of the FDA approved protease inhibitors. The flaps underwent a wide range of structural motions to accommodate and stabilize the ligands. Computational analyses unravelled the need for these potential drugs to be restructured by (de novo) drug engineers to improve their binding fits, affinities, energies and interactions with multiple key protease residues in order to target resilient HIV-1 assemblages. Accumulating evidences on contrasting drug-choice interpretations from the Stanford HIVdb should act as an impetus for the customization of a HIVdb for the sub-Saharan subcontinent.

This research study endeavoured to explore and describe the experiences of women who participated in the Prevention of Mother-To-Child Transmission (PMTCT) of HIV Programme. Data relating to evaluation of the PMTCT Programme in the piloted sites compiled by other researchers in the Department of Health focus on the process, progress and extent of service implementation. There appears to be a dearth of information available from women participants in the PMTCT Programme. The objectives of the study were to: · Explore and describe postnatal women’s experiences of the PMTCT Programme offered in the East London Hospital Complex. · Propose recommendations into the existing guidelines for midwives who implement the PMTCT Programme in the health services to ensure optimal implementation of this programme. The research population included postnatal women who participated in the PMTCT of HIV Programme at the East London Hospital Complex (Frere site). Permission to conduct the research was obtained from the Eastern Cape Department of Health Ethics Committee, Chief Executive Officer of the hospital complex and the Advanced Degrees Committee and Human Ethics Committee at the Nelson Mandela Metropolitan University. The research study was qualitative, exploratory, descriptive and contextual in design. Data collection was carried out by face-to-face semi-structured interviews with postnatal women at the East London Hospital Complex (Frere site). The tape-recorded interviews were transcribed verbatim with the aid of field notes. Data analysis was done according to Tesch’s method of data analysis (in De Vos et al, 2000:343). Themes were identified from the transcriptions and finalised after consensus discussions with an independent coder who was experienced in qualitative research. Literature control, guided by the themes identified in the interviews, was carried out to compare and verify the findings of the study. Three major themes with sub-themes were identified during data analysis. The major themes were identified as follows: · The participants expressed feelings of being devastated by the results that confirmed their HIV positive status. · The participants expressed a thirst for knowledge on how to live with the diagnosis and on how to continue with the PMTCT Programme. · The physical environment where counselling and testing were done, as well as the practical arrangements, were not conducive to the full implementation of the PMTCT Programme at the antenatal clinic. Conclusions were drawn and recommendations were made in the form of additional guidelines for midwives implementing the PMTCT Programme in the antenatal clinic health services. Guidelines for further midwifery-related research were formulated.

This research report is submitted in partial fulfilment of the Master of Arts in Demography and Population Studies at the University of the Witwatersrand, March 2017 / Background: Evidence shows that circumcised men are less likely to be infected with HIV compared to their uncircumcised counterparts. However, critics have argued that adopting male VMMC as part of the comprehensive HIV prevention strategy might lead circumcised men to believe that they are completely protected against HIV. Consequently, this could cause them to neglect other HIV protective measures, such as consistent condom use. This study investigated the association between male circumcision and consistent condom use among sexually active men in South Africa. Methodology: The analyses were done using nationally representative cross-sectional secondary data drawn from the 2012 Third National HIV Communication Survey. The study sampled a total of 1899 single black men who were sexually active and were aged between 16-55 years. The management and analysis of the data were carried out using STATA version 14. Descriptive statistics were computed to describe the levels of male circumcision and consistent condom use in South Africa, and crosstabulations and a Pearson Chi-square test were used to assess associations between patterns of male circumcision and consistent condom use by selected variables. Bivariate and multivariate binomial logistic regressions were used to examine the socio-demographic determinants of male circumcision, as well as the association between male circumcision and consistent condom use. Results: The main findings showed that circumcised men were more likely (OR=1.18; C.I, 1.171 - 1.182) to consistently use condoms, compared to uncircumcised men. Furthermore, place of residence, education, occupation status and socioeconomic status were positively associated with consistent condom use. On the other hand, men who believed that they would get HIV, and those who were older than 24 years were less likely to consistently use condoms. While circumcision rates were lower in all the provinces compared to the Eastern Cape; Kwa-Zulu Natal and North West had the lowest odds of circumcision of all the provinces. However, both these provinces had the highest odds of consistent condom use compared to all the other provinces. Conclusion: This study found a positive association between male circumcision and consistent condom use. The findings revealed that, contrary to concerns that circumcised men may have a false sense of protection and therefore use condoms less consistently, circumcised men were more likely to consistently use condoms compared to uncircumcised men. There is, therefore, no evidence of risk compensation associated with circumcision. As a result, male circumcision should continue to be rolledout nationally, as part of an effective and comprehensive HIV prevention strategy. On the other hand, it is also evident that HIV prevention education targeting men is crucial, as men who believe that they will get infected with HIV and those older than 24 years need to be encouraged to practice safe sexual and HIV protective behaviours such as consistent condom use. / XL2018

A quantitative, explorative, descriptive research approach was used to investigate why HIV positive people have a problem with disclosing their status. The HIV infection spread is increasing globally, nationally and locally and disclosing would help reduce the spread of infection through preventive measures. Interviews were conducted with 106 respondents at Kagiso primary health care clinics in the West Rand Health Region. Reasons given by the respondents for non-disclosure of the HIV status were: discrimination, stigma to the HIV positive person and the family by the community, isolation and rejection by the family members, discrimination and possible dismissal at the workplace, fear of losing a partner. The findings illustrate that a large percentage of the population know about HIV and its spread and know that by disclosing, one can get support from health resources and family, but people will not make their status public unless stigmatisation is addressed / Health Studies

A quantitative, explorative, descriptive research approach was used to investigate why HIV positive people have a problem with disclosing their status. The HIV infection spread is increasing globally, nationally and locally and disclosing would help reduce the spread of infection through preventive measures. Interviews were conducted with 106 respondents at Kagiso primary health care clinics in the West Rand Health Region. Reasons given by the respondents for non-disclosure of the HIV status were: discrimination, stigma to the HIV positive person and the family by the community, isolation and rejection by the family members, discrimination and possible dismissal at the workplace, fear of losing a partner. The findings illustrate that a large percentage of the population know about HIV and its spread and know that by disclosing, one can get support from health resources and family, but people will not make their status public unless stigmatisation is addressed / Health Studies / M.A. (Health Studies)

A epidemia da Síndrome da Imunodeficiência Adquirida (aids) já atingiu aproximadamente 40 milhões de indivíduos em todo o mundo. O controle adequado da infecção pelo HIV através do tratamento anti-retroviral proporciona menor resistência viral, níveis mais baixos de carga viral, diminuindo, assim, a probabilidade da transmissão do HIV. A adesão ao tratamento anti-retroviral é importante para o sucesso do tratamento. A depressão é um transtorno psiquiátrico com prevalência elevada na população geral e nos portadores do HIV/Aids. Sabe-se que a depressão é um fator limitante para boa adesão. Neste trabalho, estudou-se a associação entre a adesão e a depressão em 164 pacientes portadores do HIV/Aids, em acompanhamento médico num serviço especializado, no período de outubro de 2002 a outubro de 2003. Foram aplicados os seguintes instrumentos: SCID/DSM-IV (Strutured Clinical Interview/Diagnostic and Statistical Manual of Mental Disorders), HAM-D (Hamilton Rating for Depression), MMSE (MiniMental State Examination - Miniexame do Estado Mental), questionário sócio-demográfico, laboratorial, da doença e tratamento e questionário de adesão. A média de idade foi 39 anos, e 72% da amostra eram do sexo masculino. Mais de 85% dos pacientes se infectaram com o HIV através de relações sexuais. Apenas 7,9% eram usuários de drogas injetáveis. A média de CD4 foi 404,8 e carga viral 3,55 (log). A prevalência de depressão atual foi 17,7%, com diferença estatisticamente significante entre os mais jovens. Setenta e cinco pacientes (45,73%) apresentaram episódio depressivo passado. Dos 164 pacientes, 137 faziam uso de anti-retrovirais. Pacientes que tomavam 95% dos anti-retrovirais foram considerados pacientes que aderiram ao tratamento. A adesão foi avaliada através de questionário e 79,56% dos pacientes aderiram ao tratamento. A adesão foi maior entre os homens e os mais velhos. A carga viral também apresentou associação com a adesão e com antecedente pessoal de depressão. A adesão não mostrou associação com depressão / Approximately 40 million individuals are infected by HIV/acquired immunodeficiency syndrome (AIDS) in the word. The control of the HIV infection by the antiretroviral treatment provides lower viral resistance; lower viral load levels and diminishes the probability of the transmission of the HIV. The adherence to antiretroviral treatment is important for the success of the treatment. Depression is a psychiatric disorder with high prevalence in general population and in HIV/AIDS infected patients. Depression seems to be a limitation for good adherence. In this study, the association between adherence and depression was assessed in 164 HIV/AIDS infected patients in a specialized service, in the period of October of 2002 and October of 2003. The following instruments were applied: SCID/DSM-IV (Structured Clinical Interview/Diagnostic and Manual Statistical of Mental Disorders), HAM-D (Hamilton Rating for Depression), MMSE (MiniMental State Examination), sociodemographic, laboratorial, disease and adherence questionnaires. The mean age was 39 years-old and 72% of the sample were men. More than 85% of the patients were infected by sexual contact and 7.9% were injecting drug users. The mean of CD4 was 404.8 and viral load 3.55 (log). The prevalence of current depression was 17.7%, with higher prevalence among youngest. Seventy five patients (45.73%) had a lifetime depressive episode. Of the 164 patients, 137 were treated with antiretroviral. Patients who took at least 95% of the antiretroviral medications had been considered adhered to treatment. The adherence was evaluated through questionnaire and was presented in 79.56% of the patients. The adherence was higher among men and oldest. The viral load also showed association with adherence and lifetime depression. The adherence was not associated to depression

by Lam Tin Lun. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 131-151). / Abstracts in English and Chinese. / Acknowledgment --- p.I / Table of content --- p.II / List of Tables --- p.IX / List of Figures --- p.XI / Abbreviation --- p.XIII / Abstract --- p.XIV / 論文摘要 --- p.XVI / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter 1.1 --- Acquired immunodeficiency syndrome (AIDS) --- p.1 / Chapter 1.1.1 --- History of AIDS --- p.1 / Chapter 1.1.2 --- Definition of AIDS --- p.2 / Chapter 1.1.3 --- HIV/AIDS Around the World --- p.4 / Chapter 1.1.4 --- HIV/AIDS in Hong Kong --- p.4 / Chapter 1.1.4.1 --- Hong Kong AIDS Update --- p.4 / Chapter 1.1.4.2 --- AIDS Transmission --- p.6 / Chapter 1.1.4.3 --- Main AIDS Complications Occur in Hong Kong --- p.6 / Chapter 1.2 --- Human Immunodeficiency Virus (HIV) --- p.7 / Chapter 1.2.1 --- Classification of HIV --- p.7 / Chapter 1.2.2 --- The Structure of HIV Virion --- p.9 / Chapter 1.2.3 --- The HIV Genome --- p.11 / Chapter 1.2.4 --- The Life Cycle of HIV --- p.12 / Chapter 1.2.4.1 --- Invasion of the Cells --- p.12 / Chapter 1.2.4.2 --- Integration into cell genome --- p.13 / Chapter 1.2.4.3 --- Protease and assembly to the virus --- p.13 / Chapter 1.2.5 --- Three Essential Enzymes for HTV-1 Replication --- p.16 / Chapter 1.2.5.1 --- HIV-1 Reverse Transcriptase (HIV-1 RT) --- p.16 / Chapter 1.2.5.2 --- HIV-1 Integrase (HIV-1 IN) --- p.17 / Chapter 1.2.5.3 --- HIV-1 Protease (HIV-1 PR) --- p.18 / Chapter 1.2.6 --- The Different Stages of HIV Infection --- p.19 / Chapter 1.3 --- AIDS therapy --- p.23 / Chapter 1.3.1 --- Drugs Approved by US Food and Drug Administration (FDA) --- p.23 / Chapter 1.3.2 --- Vaccine --- p.26 / Chapter 1.3.3 --- Chemokine Receptor Inhibitor --- p.27 / Chapter 1.3.4 --- Antisense Oligonucleotides Therpay --- p.28 / Chapter 1.3.5 --- Traditional Chinese Medicine (TCM) --- p.29 / Chapter 1.4 --- Objective of My Project --- p.32 / Chapter CHAPTER 2 --- SCREENING OF TRADITIONAL CHINESE MEDICINAL PLANTS FOR HIV-1 PROTEASE INHIBITION --- p.33 / Chapter 2.1 --- Introduction --- p.33 / Chapter 2.2 --- Materials and Methods --- p.35 / Chapter 2.2.1 --- Materials --- p.35 / Chapter 2.2.2 --- Extraction Methods --- p.36 / Chapter 2.2.2.1 --- Aqueous Extraction --- p.36 / Chapter 2.2.2.2 --- Methanol Extraction --- p.37 / Chapter 2.2.3 --- Preparation of Recombinant HIV-1 Protease --- p.37 / Chapter 2.2.3.1 --- Selection of Appropriate Clone --- p.37 / Chapter 2.2.3.2 --- Large-scale Expression of Recombinant HIV-1 Protease --- p.38 / Chapter 2.2.2.3 --- Purification of Recombinant HIV-1 Protease by DEAE Sepharose CL-6B Chromatography --- p.38 / Chapter 2.2.3.4 --- Purification of Recombinant HIV-1 Protease by Mono-S Cation Chromatography --- p.39 / Chapter 2.2.3.5 --- Refolding of Purified Recombinant HIV-1 Protease --- p.40 / Chapter 2.2.3.6 --- Protein Concentration Determination --- p.41 / Chapter 2.2.3.7 --- Sodium Dodecyl Sulfate Polyacrylamide Gel Electrophoresis (SDS-PAGE) --- p.41 / Chapter 2.2.4 --- Characterization of HTV-1 Protease --- p.42 / Chapter 2.2.4.1 --- HIV-1 PR Fluorogenic Assays --- p.42 / Chapter 2.2.4.2 --- HIV-1 PR Assay by Reverse Phase HPLC Separation of Cleavage Products of the Synthetic Peptide Substrate --- p.43 / Chapter 2.3 --- Results --- p.44 / Chapter 2.3.1 --- Functional Analysis of Recombinant HIV-1 PR Activity --- p.44 / Chapter 2.3.2 --- Screening of Crude Extracts for Inhibition of HIV-1 PR Activity --- p.48 / Chapter 2.4 --- Discussion --- p.53 / Chapter CHAPTER 3 --- ISOLATION AND CHARACTERIZATION OF ACTIVE CONSTITUENTS FROM METHANOL EXTRACTS OF WOODWARDIA UNIGEMMATA AGAINST HIV-1 PROTEASE --- p.56 / Chapter 3.1 --- Introduction --- p.56 / Chapter 3.2 --- Materials and Methods --- p.57 / Chapter 3.2.1 --- Materials --- p.57 / Chapter 3.2.2 --- Methods --- p.58 / Chapter 3.2.2.1 --- Methanol Extraction --- p.58 / Chapter 3.2.2.2 --- Removal of Tannins --- p.60 / Chapter 3.2.2.3 --- Glucosidase Digestion --- p.60 / Chapter 3.2.2.4 --- Analytical Thin Layer Chromatographic (TLC) --- p.61 / Chapter 3.2.2.5 --- A cid Hydrolysis --- p.62 / Chapter 3.2.2.6 --- Electrospray Mass Spectrometry --- p.62 / Chapter 3.2.2.7 --- Dose-response Curve --- p.63 / Chapter 3.2.2.8 --- Kinetic Studies --- p.63 / Chapter 3.2.2.9 --- Activity of the HPLC-purified principle (s) on Other Aspartyl Proteases --- p.63 / Chapter 3.3 --- Results --- p.66 / Chapter 3.3.1 --- Purification of Methanol Extracts of Woocdwardia unigemmata --- p.66 / Chapter 3.2.2 --- Removal of Tannins --- p.70 / Chapter 3.2.3 --- Glucosidase Digestion --- p.73 / Chapter 3.2.4 --- Acid Hydrolysis --- p.73 / Chapter 3.2.5 --- Analytical Thin Layer Chromatography --- p.74 / Chapter 3.2.6 --- Electrospray Mass Spectrometry --- p.80 / Chapter 3.2.7 --- Dose-response Inhibition of HIV-1 Protease --- p.80 / Chapter 3.2.8 --- Kinetic Studies --- p.85 / Chapter 3.2.9 --- Effects of HPLC-purified Active Principle on Other Aspartyl Proteases --- p.87 / Chapter 3.3 --- Discussion --- p.89 / Chapter CHATPER 4 --- IDENTIFICATION OF SELECTIVE RNA APTAMERS AGAINST HIV-1 PROTEASE BY SYSTEMATIC EVOLUTION OF LIGANDS BY EXPONENTIAL ENRICHMENT (SELEX) --- p.95 / Chapter 4.1 --- Introduction --- p.95 / Chapter 4.2 --- Materials and Methods --- p.101 / Chapter 4.2.1 --- Materials --- p.101 / Chapter 4.2.2 --- Methods --- p.102 / Chapter 4.2.2.1 --- PCR Amplification for the Generation of a Double-Stranded DNA Library --- p.103 / Chapter 4.2.2.2 --- Preparation of RNA Pools --- p.104 / Chapter 4.2.2.3 --- In vitro Selection of RNA Ligands --- p.104 / Chapter 4.2.2.4 --- Reverse Transcription Reaction of Selected RNA --- p.108 / Chapter 4.2.2.5 --- Cloning of the Amplified cDNA pools --- p.108 / Chapter 4.2.2.6 --- Subcloning of the digested DNA product into pBluescript® IIKS (-) --- p.108 / Chapter 4.2.2.8 --- RNA Labeling with Digoxigenin (DIG) --- p.109 / Chapter 4.2.2.9 --- Binding Affinity of RNA Ligands for HIV-1 PR --- p.109 / Chapter 4.2.2.10 --- Competition Binding Reactions --- p.111 / Chapter 4.2.2.11 --- HIV-1 PR Inhibitory Activities of the Selected RNA Ligands --- p.112 / Chapter 4.3 --- Results --- p.113 / Chapter 4.3.1 --- In Vitro Selection of RNA Ligands --- p.113 / Chapter 4.3.2 --- Sequences of RNA Ligands --- p.114 / Chapter 4.3.3 --- Binding Affinity of RNA Ligands --- p.114 / Chapter 4.3.4 --- Inhibitory Activity of RNA Ligands --- p.119 / Chapter 4.4 --- Discussion --- p.122 / Chapter CHAPTER 5 --- GENERAL DISCUSSION --- p.128 / REFERENCES --- p.132

A epidemia da Síndrome da Imunodeficiência Adquirida (aids) já atingiu aproximadamente 40 milhões de indivíduos em todo o mundo. O controle adequado da infecção pelo HIV através do tratamento anti-retroviral proporciona menor resistência viral, níveis mais baixos de carga viral, diminuindo, assim, a probabilidade da transmissão do HIV. A adesão ao tratamento anti-retroviral é importante para o sucesso do tratamento. A depressão é um transtorno psiquiátrico com prevalência elevada na população geral e nos portadores do HIV/Aids. Sabe-se que a depressão é um fator limitante para boa adesão. Neste trabalho, estudou-se a associação entre a adesão e a depressão em 164 pacientes portadores do HIV/Aids, em acompanhamento médico num serviço especializado, no período de outubro de 2002 a outubro de 2003. Foram aplicados os seguintes instrumentos: SCID/DSM-IV (Strutured Clinical Interview/Diagnostic and Statistical Manual of Mental Disorders), HAM-D (Hamilton Rating for Depression), MMSE (MiniMental State Examination - Miniexame do Estado Mental), questionário sócio-demográfico, laboratorial, da doença e tratamento e questionário de adesão. A média de idade foi 39 anos, e 72% da amostra eram do sexo masculino. Mais de 85% dos pacientes se infectaram com o HIV através de relações sexuais. Apenas 7,9% eram usuários de drogas injetáveis. A média de CD4 foi 404,8 e carga viral 3,55 (log). A prevalência de depressão atual foi 17,7%, com diferença estatisticamente significante entre os mais jovens. Setenta e cinco pacientes (45,73%) apresentaram episódio depressivo passado. Dos 164 pacientes, 137 faziam uso de anti-retrovirais. Pacientes que tomavam 95% dos anti-retrovirais foram considerados pacientes que aderiram ao tratamento. A adesão foi avaliada através de questionário e 79,56% dos pacientes aderiram ao tratamento. A adesão foi maior entre os homens e os mais velhos. A carga viral também apresentou associação com a adesão e com antecedente pessoal de depressão. A adesão não mostrou associação com depressão / Approximately 40 million individuals are infected by HIV/acquired immunodeficiency syndrome (AIDS) in the word. The control of the HIV infection by the antiretroviral treatment provides lower viral resistance; lower viral load levels and diminishes the probability of the transmission of the HIV. The adherence to antiretroviral treatment is important for the success of the treatment. Depression is a psychiatric disorder with high prevalence in general population and in HIV/AIDS infected patients. Depression seems to be a limitation for good adherence. In this study, the association between adherence and depression was assessed in 164 HIV/AIDS infected patients in a specialized service, in the period of October of 2002 and October of 2003. The following instruments were applied: SCID/DSM-IV (Structured Clinical Interview/Diagnostic and Manual Statistical of Mental Disorders), HAM-D (Hamilton Rating for Depression), MMSE (MiniMental State Examination), sociodemographic, laboratorial, disease and adherence questionnaires. The mean age was 39 years-old and 72% of the sample were men. More than 85% of the patients were infected by sexual contact and 7.9% were injecting drug users. The mean of CD4 was 404.8 and viral load 3.55 (log). The prevalence of current depression was 17.7%, with higher prevalence among youngest. Seventy five patients (45.73%) had a lifetime depressive episode. Of the 164 patients, 137 were treated with antiretroviral. Patients who took at least 95% of the antiretroviral medications had been considered adhered to treatment. The adherence was evaluated through questionnaire and was presented in 79.56% of the patients. The adherence was higher among men and oldest. The viral load also showed association with adherence and lifetime depression. The adherence was not associated to depression