Made available in DSpace on 2014-06-12T18:33:19Z (GMT). No. of bitstreams: 2 arquivo8162_1.pdf: 2706638 bytes, checksum: 6b4dbb27d9d0698de9b044a187aec26d (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2007 / O objetivo deste estudo foi avaliar a prevalência de lesões anais mediadas pelo HPV em um grupo de 60 pacientes do sexo masculino com diagnóstico de HIV/Aids. Foram analisados os aspectos demográficos, hábitos de vida, estado clínico da infecção pelo HIV e comportamento sexual. Os pacientes foram submetidos à citologia oncótica anal, à anuscopia sob visão colposcópica e à biópsia anal. A média de idade do grupo foi de 41,9 anos e o tempo médio de diagnóstico do HIV de 6,8 anos. Dos pacientes avaliados, 88,3% faziam uso da terapia com anti-retrovirais potentes (TARV) por um tempo médio de 6,5 anos. Os homens que se referiram como homossexuais representaram 43,3% da amostra; os heterossexuais, 41,7% e os bissexuais, 15%. A maioria dos indivíduos (63,3%) referia história de relação anal receptiva e 35,0% informaram ter tido mais de 10 parceiros sexuais masculinos em toda a vida. A prevalência das lesões anais pela anuscopia sob visão colposcópica, citologia anal e histologia foram, respectivamente: 35,0%, 16,7% e 23,3%. Dos pacientes com biópsia anormal, 85,7% eram homossexuais ou bissexuais e 14,3% eram heterossexuais (p = 0,02), e 78,6% referiram mais de 10 parceiros sexuais. A dosagem de linfócitos T CD4 +, carga viral e o uso de TARV não mostraram associação com o diagnóstico de lesão anal. A ocorrência da lesão anal foi elevada nos indivíduos com HIV/Aids, sendo mais prevalente em homossexuais e bissexuais, embora tenha ocorrido também nos heterossexuais

This qualitative research study focuses explicitly on understanding the experiences and perceptions of urban Aboriginal women living with HIV/AIDS. Stigmatizing attitudes and language have serious impacts upon the lives of HIV-positive Aboriginal women. The ways our society presently addresses the women needs to change. With the insights and assistance of four Aboriginal women living with HIV, this project adds to the presently sparse qualitative literature in this research area. Current research indicates that there are many factors associated with urban Aboriginal women being at higher risk for infection and lower physical and mental health, such as race, socio-economic conditions, isolation, oppression and violence, family history, substance abuse, discrimination, and often the responsibilities of childrearing. However, current research analysis and presentation is insufficient, and more in-depth questions arise. Material was collected using semi-structured, open-ended questioning conversations with the participants. Two guiding research questions were asked: 1) What is it like for you, living with HIV right now? and 2) What would you want other people to learn from your experiences? The women’s stories provide an avenue for participants to voice some of their triumphs and challenges about being an Aboriginal woman living with HIV/AIDS. For the community at large, this is also an opportunity to hear first hand, important information such as this. In this work, I have tried to adhere to the tenets of Indigenous methodologies by allowing the life-stories to resonate as holistic representations. Rather than deconstructing the women’s stories through naturalistic analysis (which continues to categorize and to objectify participants), the stories are viewed through a Health Narrative Topography whereby thematic genres such as Restitution, Chaos, and Quest are illuminated, while also being critically aware of some of the limitations to this framework. Three overarching themes are revealed through the women’s stories: 1) the empowerment and resiliency demonstrated by the participants; 2) the need for cultural competency in a society that continues to stigmatize Aboriginal and HIV-positive women; and, 3) the need for a more holistic approach within society when it comes to education, learning, and healing. / Graduate Studies, College of (Okanagan) / Graduate

The psychology service programme was implemented at the Kalafong Paediatric HIV Clinic. The students from the Department of Psychology from the University of Pretoria were involved. The aim of the study was to explore, explain and describe the experiences of the personnel at the Clinic during the implementation of the programme in terms of an interpretive narrative framework. A qualitative research design was used. The primary source of data collection was through interviews. Interpreting experience took place at Reissman’s five levels of representation and Labov’s six elements for data reduction and interpretation were used. The emerged interpretive categories were presented as questions. The study found that the multidisciplinary team identified the need for psychological intervention, more so during the time when some of the adolescent patients had discovered that they were HIV positive. The patients were struggling to cope with the reality of accepting the diagnosis. The study noted the challenges that were experienced during the implementation, as well as the highlights. Availability of the psychology students seemed to be the greatest challenge as well as the issue of arranging psychological consultations to coincide with the same date for other consultations among other challenges. This study exhibited a mutual feeling that the implementation of the psychology service programme was a good initiative and ought to be continued at the Clinic. / Dissertation (MA)--University of Pretoria, 2013. / gm2014 / Psychology / unrestricted

Master of Public Health - MPH / Increased uptake of VCT services by pregnant women may be attributed to the development of counseling services and increased availability of rapid tests at the study clinics by the Namibian Health and Social Services. A high knowledge and understanding of HIV and VCT services by pregnant women also probably contributed. / South Africa

Philosophiae Doctor - PhD / This study formed part of the broad theme on the impact of HIV and AIDS on school-going learners sponsored by the Dynamics for Building a Better Society programme of the University of the Western Cape and the VLIR Partnership. HIV and AIDS poses a unique challenge to society in that it is a private disease transmitted mainly through unprotected sex that still has no known cure. A challenge to society invariably challenges schools. Primary school principals are obligated to respond because learners in the 5 to 14 year age range provide an opportunity for education, advocacy, prevention, treatment and support. This study aimed to contribute to a better understanding of school leaders and their responsibility towards HIV and AIDS and poverty. / South Africa

Magister Curationis - MCur / Women, who are HIV-positive, may transmit the virus to their babis during labour and through breast milk. HIV-positive mothers have to be counselled and encouraged to make informed decisions about the feeding of their babies to avoid this transmission. The feeding choices are exclusive breast-feeding , exclusive formula feeeding or modified feeding. this study focused on the perceptions, knowledge and experiences of breastfeeding women living with HIV/AIDS in the Oshakati district, Northern Namibia. A qualitative descriptive research design was used to conduct the study. The sresaerch was conducted at the Prevention of Mother-to-Child Transmission (PMTCT) Clinic, in the intermediate Hospital, Oshakati. The Medical Superitendant of the Hospital gave the researcher permission to conduct the study at the PMTCT clinic. A purposive sample was used consisting of 14 breastfeeding women who are HIV-positive and aged between 15-49 years. the ages of their babies were between one day and six months. The data collected through individual face-face-interviews. The interviews were tape-recorded with the permission of the respondents. The interviews were transcribed verbatim and data were analysed by thematic content analysis. The Health Belief Model guided the description and interpretation of the data. Th study revealed that some women had inadequate knowledge about the transmission of HIV through breastfeeding. Their breastfeeding choices were influennced by their knowledge and perceptions while their experiences were shaped by their relationships with their partners and family. / South Africa

Magister Legum - LLM / This mini-thesis seeks to provide a substantiation for the need for a new legal framework for South Africa in order to address prostitution. It will argue that the current legal framework has failed in its desired aims and in addressing prostitution effectively. This mini-thesis critically analyses the underlying reasons for prostitution in South Africa and discovers that it is influenced by a myriad of interrelated factors. The current level of poverty and the prevailing socio-economic paradigm in South Africa have contributed to its complex nature. The demand for prostitution acts as a catalyst for both the further exploitation of prostitutes and women, while making them vulnerable to sexually transmitted diseases. I establish that criminalisation alone is not sufficient to address prostitution, especially given the HIV/AIDS epidemic. / South Africa

Philosophiae Doctor - PhD / Methods to improve women’s health have become an urgent global priority. Development of clinical guidelines is viewed as a way of improving the quality of health care in South Africa. At present there are no physiotherapy guidelines for women post-caesarean section delivery (CSD) and post-hysterectomy, which are the most common procedures performed by obstetricians and gynaecologists. South African women have the highest HIV-prevalence rates in the world, but there is a global dearth of literature on common postoperative complications for this cohort of women. The aim of this study was to provide evidence supporting the development of physiotherapy clinical guidelines relevant for HIV-infected and HIV non-infected women following caesarean section delivery and hysterectomy. The overall design of the study was prospective, descriptive and explanatory, with longitudinal, comparative and cross-sectional components incorporated at the different phases of the study. An amalgamated four-phase conceptual framework with specific objectives per phase was used to achieve the study aim. Phases 1 and 2 were conducted at four public hospitals in KwaZulu-Natal. Phase 1 identified the long-term complications and quality of life for HIV-infected and non-infected women post-CSD (N=310) and hysterectomy (N=101) over a six- month period; phase 2, which was cross-sectional in nature, identified treatment strategies and complications described by physiotherapists (N=31) for this cohort of women. Purposive probability sampling and purposive convenient sampling was used to select potential participants for phases 1 and 2. A self-administrated questionnaire with close and open-ended questions was used in the first two phases of the study. During phase 3, a systematic review and Delphi method (N=12) were used to investigate current management strategies of representative physiotherapists. Purposive sampling was used to select the participants who are considered as experts in the field of women’s health, for the Delphi study. The information from phases 1 to 3 was collated in phase 4 to provide the evidence to inform the development of the clinical guidelines. Phase 1 revealed that physical health complications commonly persisted for at least six months and negatively affected the quality of life of women post-CSD or post-hysterectomy. Phase 2 showed that very few patients post-CSD and hysterectomy were being referred for physiotherapy, and of those referred, the main problem being treated was respiratory complications. A systematic review of the literature yielded only one article relevant to the outcome of management of patients post- hysterectomy, thus illustrating the dearth of literature in this area. The experts who were consulted for the Delphi study suggested treatment techniques for the postoperative complications identified in phase 1, and consensus was reached on the techniques in the second Delphi round. The results were then collated in the final phase and presented in tables containing the identified problem, treatment and best available evidence to move towards the development of the guidelines. The common postoperative morbidities that were identified in this study can be prevented or treated with physiotherapy, but information is needed in this area to guide treatment practices. The prevention of postoperative complications can result in a decrease in demand for services, thereby reducing the current strain on the health system. The current study contributed to 18 of the 23 criteria in the appraisal of guidelines for research and an evaluation tool. The conceptual framework used to generate the evidence can also be employed in other facets of health care. In order to improve the quality of health care rendered to women, health care professionals require a complete picture of their patient. This research adds to the body of knowledge in an area where there is a dearth of literature and provides a platform to develop clinical guidelines. No national research exists that compares the postoperative complications of HIV-infected and non-infected women, which is essential to enable comprehensive care of HIV-infected women. The guidelines that will be developed can improve the quality of health care rendered to women, and establish the role of physiotherapists in this area.

Magister Chirurgiae Dentium - MChD / Lesotho has the third highest prevalence of HIV in the world with an estimated 23% of the adult population infected. At least 70% of people living with HIV/AIDS (PLWHA) present with oral manifestations of HIV as the first sign of the disease. While Lesotho has a population of fewer than 2 million people, it is faced with the harsh reality of a dire shortage of health care workers including oral health care workers (OHCWs). The high prevalence of HIV is of major concern to oral health workers who regularly encounter patients presenting with oral lesions associated with HIV disease. Oral health care workers need to have adequate knowledge of these conditions for effective management thereof. To determine the knowledge, attitudes and practises of oral health care workers (OHCWs) of Lesotho regarding the management of oral manifestations of HIV/AIDS. A descriptive cross-sectional survey was conducted on all 46 OHCWs in 26 public and private care facilities in all ten districts of Lesotho. A self–administered questionnaire was used to gather information on demographic characteristics of OHCWs and their knowledge, attitudes and practices regarding the management of oral lesions associated with HIV. A visual aid depicting seven colour images of lesions strongly associated with HIV was used to assess knowledge. Data was analysed using Microsoft Excel® and the R statistical package. The outcome of the study was then presented using tables and charts as appropriate. Frequencies, means and 2x2 contingency tables were generated and Fisher‟s exact tests were used for associations. A significance level of (p<0.05) was used.

>Magister Scientiae - MSc / In clinical trials, adherence of the participants to the dosing instructions is a major challenge. Many researchers have identified medication adherence as a topic to further explore in order to obtain good, usable and reproducible results. In order to gain an understanding of on-the-ground issues in clinical research a survey was conducted, isolating the issue of medication adherence among participants as a discussion point. The research was conducted specifically at clinical trial sites that are involved in HIV pre-exposure prophylaxis research. The survey was conducted at clinical trial sites across South Africa among health care workers in the clinical research sector. The principle issue to be identified was the perceptions of staff and researchers with regards to the current approach to adherence measurement and possible suggestions from them on future adherence interventions strategies. This research was conducted as a qualitative analysis from February to March 2014. Eighteen responses were received. Among the respondents were investigators, medical officers, nurses and pharmacists. The results of the survey suggest that healthcare workers have a strong understanding of the importance adherence monitoring and intervention. They have many ideas on which measurement tools work and which don’t, but most importantly feel that the self-report or interview techniques are the most useful. Researchers also feel that much more can be done in order to improve the perception of the clinical research institutes in the eyes of the community and that a more active role should be taken in the community in order to improve the acceptance of the participants to the use of the product.