Considerable research supports an association between negative psychosocial functioning and adverse health outcomes. The biobehavioral model is well supported and posits that these effects occur via alterations in physiological response and health damaging behaviors. Evidence is accumulating about potential benefits of positive psychosocial functioning; however, less is known about the mechanisms of these effects. The broaden-and-build model of positive emotions holds that positive emotions can undo the physiological and behavioral restrictions associated with negative emotions and promote resource development. The present correlational study sought to explore whether cortisol, medication adherence, and health behaviors (smoking, alcohol use, physical activity, and nutrition) mediated relations between trait positive affect and negative affect and health status in persons living with HIV infection. A moderating role of trait positive affect on the relation between negative affect and mediating variables was also hypothesized, yet an unexpectedly high correlation between trait positive and negative affect precluded the evaluation of this hypothesis. HIV-infected participants (N = 53) collected salivary cortisol five times over the course of one day at home and completed interview the following day. Clinical staff provided HIV symptom ratings, and virologic and immunologic indicators were collected by chart review. Results showed that high trait positive affect was associated with lower total cortisol concentration, and total cortisol mediated the relation between trait positive affect and CD4+ percent. High trait negative affect was associated with poorer medication adherence, and percent adherence mediated the relation between trait negative affect and CD4+ percent and viral load. Mediation hypotheses for health behaviors were not confirmed. Trait positive affect was, however, associated with decreased alcohol intake, increased physical activity, and better nutrition habits. Because this study used cross-sectional design, causation cannot be determined. However, findings provide preliminary evidence on mechanisms by which trait positive affect could be related to HIV disease markers, and findings support existing evidence on mechanisms of trait negative affect in HIV disease. Results also support use of the biobehavioral model and the broaden-and-build model of positive emotions as theoretical frameworks in studying the relation between psychosocial functioning and health outcomes in persons with HIV.

Thesis (Ph.D.) - University of Queensland, 2004. / Includes bibliography.

Sleep health is a good indicator to a person’s overall health status and general well-being. Proper sleep is one of the most important factors to healthy immunity. Protecting and restoring sleep quality are vital to well-being. Problems such as insomnia, obstructive sleep apnea, fatigue, and hypersomnia can all affect the quality of a person’s sleep. There are over 35 million people living with HIV/AIDS infection in the world. These people suffer from many of the same sleep problems and often have more frequent or more severe symptoms. It is not clear if this is from the disease, the medications, or some other factors. HIV-positive persons need good sleep quality to maintain their immune system and help keep the disease from progressing. Treatments for sleep disorders in HIV need to be considered carefully. Interventions should start with the least invasive progress to more invasive therapies and be monitored carefully.

Problem: The United States of America has one of the highest number of HIV infections in the world; approximately 1.3 million people in North America were living with HIV in 2007. Factors influencing HIV survival are essential to disease management and care. Research findings suggest religion and spirituality may be essential components to health and well-being in individuals with HIV-Disease. Purpose: This study was designed to determine how well spirituality predicted health status in a convenience sample of 39 adults diagnosed with HIV-Disease. Procedure: A model building approach was used to explore relationships among the five variables of the Neuman Systems model. The following were used to collect data: (physiological) 1993 Revised CDC Classification System for HIV Infection, Revised HIV Center Medical Staging Scale (rHMCSS), lowest ever CD4+T-lymphocyte count, current CD4+T-lymphocyte count, AIDS status, and viral load; (spiritual) Spiritual Well-Being Scale (SWBS), Brief Religious Coping Scale (RCOPE), Religious Commitment Index—10, and religious affiliation; (psychological) Sense of Coherence—13 Scale (SOC) and mental health history; (sociocultural) ethnicity, income, and relationship status; (developmental) date of birth.Results: Income, the Meaningfulness subscale of the SOC-13 scale, age, and the Existential Well-Being subscale of the SWBS had significant relationships with the current rHCMSS score and explained 28.3% (p = .027) of the variance. The model that included EWB, Negative RCOPE, and the interaction of Negative RCOPE and EWB, in which an adjustment for income had been made, explained 32.9% (p = .011) of the variance in health status.Conclusions: The five variables of the NSM provided a well supported, holistic framework for investigating how much spirituality contributed to health status in PLWHA. The best explanatory model included: EWB, Negative RCOPE, income, and the interaction between EWB and Negative RCOPE. The existential component of spirituality, and especially the element of meaning, modified by negative religious coping, is an essential contributor to the health status of people living with HIV-Disease.Software: This document was created in Microsoft Word 2000. Power analysis was done using nQuery 6.0 Software and SPSS 15.0 © Statistical Software program was used for other statistical analyses.

Context & Rationale: Individuals with similar CD4 cell counts and RNA levels can vary considerably with regards to clinical progression. This variation is likely the result of a complex interplay between viral, host and environmental factors. This study aimed to characterize and identify predictors associated with disease progression to AIDS or death in Saskatoon, Saskatchewan. Methods: This is a retrospective cohort study of 343 seroprevalent HIV positive patients diagnosed from Jan 2005 to Dec 2010. Of these, 73 had an estimated seroconversion date. Data was extracted from medical charts at two clinics specialized in HIV/AIDS care. Disease progression was measured as time from HIV diagnosis (or seroconversion) to immunological AIDS and death. The Cox hazard model was used. Results: The 3-year and 5-year immunological AIDS free probability was 53% and 33%, respectively. The 3-year and 5-year survival probability was 89% and 77%, respectively. Among the seroconversion cohort, the 3-year immunological AIDS free probability was 76%. Due to multicollinearity, separate models were built for IDU, hepatitis C and ethnicity. A history of IDU (HR, 3.0; 95%CI, 1.2-7.1), hepatitis C coinfection (HR, 2.9; 95%CI, 1.2-6.9), baseline CD4 counts (HR, 0.95; 95%CI, 0.92-0.98, per ever 10 unit increase), ever on ART, and year of diagnosis were significant predictors of progression to immunological AIDS among the seroprevalent cohort. Age at diagnosis, sex and ethnicity were not. For survival, only treatment use was a significant predictor (HR, 0.34; 95%CI, 0.1-0.8). Hepatitis C coinfection was marginally significant (p=0.067), while a history of IDU, ethnicity, gender, age at diagnosis, and year of diagnosis were not. Among the seroconversion cohort, no predictors of progression to immunological AIDS were identified. Ethnicity, hepatitis C coinfection and history of IDU could not be assessed. Conclusion: Our study found that IDU, HCV coinfections, baseline CD4 counts, and ART use were significant predictors of disease progression. This highlights the need for increased testing and early detection and for targeted interventions for these particularly vulnerable populations to slow disease progression.

Context & Rationale: Individuals with similar CD4 cell counts and RNA levels can vary considerably with regards to clinical progression. This variation is likely the result of a complex interplay between viral, host and environmental factors. This study aimed to characterize and identify predictors associated with disease progression to AIDS or death in Saskatoon, Saskatchewan. Methods: This is a retrospective cohort study of 343 seroprevalent HIV positive patients diagnosed from Jan 2005 to Dec 2010. Of these, 73 had an estimated seroconversion date. Data was extracted from medical charts at two clinics specialized in HIV/AIDS care. Disease progression was measured as time from HIV diagnosis (or seroconversion) to immunological AIDS and death. The Cox hazard model was used. Results: The 3-year and 5-year immunological AIDS free probability was 53% and 33%, respectively. The 3-year and 5-year survival probability was 89% and 77%, respectively. Among the seroconversion cohort, the 3-year immunological AIDS free probability was 76%. Due to multicollinearity, separate models were built for IDU, hepatitis C and ethnicity. A history of IDU (HR, 3.0; 95%CI, 1.2-7.1), hepatitis C coinfection (HR, 2.9; 95%CI, 1.2-6.9), baseline CD4 counts (HR, 0.95; 95%CI, 0.92-0.98, per ever 10 unit increase), ever on ART, and year of diagnosis were significant predictors of progression to immunological AIDS among the seroprevalent cohort. Age at diagnosis, sex and ethnicity were not. For survival, only treatment use was a significant predictor (HR, 0.34; 95%CI, 0.1-0.8). Hepatitis C coinfection was marginally significant (p=0.067), while a history of IDU, ethnicity, gender, age at diagnosis, and year of diagnosis were not. Among the seroconversion cohort, no predictors of progression to immunological AIDS were identified. Ethnicity, hepatitis C coinfection and history of IDU could not be assessed. Conclusion: Our study found that IDU, HCV coinfections, baseline CD4 counts, and ART use were significant predictors of disease progression. This highlights the need for increased testing and early detection and for targeted interventions for these particularly vulnerable populations to slow disease progression.

Magister Public Health - MPH / Voluntary HIV counselling and testing (VCT) programmese have been regarded as an important strategy in the management of the HIV/AIDS pandemic. This is in light of having statistics showing only one in five South Africans who know about voluntary counselling and testing also went for testing.The aim of this study was to get a better understanding of the barriers whoch prevented student nurses from participating in voluntary HIV counselling and testing, explore their knowledge of the VCT process, explore factors which influence their decision to test or not to test and their perception of the VCT programme in their college. / South Africa

Thesis (M.Cur.) --University of Limpopo, 2013 / Previous research about people living with HIV and AIDS has highlighted social support as an important determinant of health outcomes; i.e. perceived support to be associated with adjustment and coping in relation to HIV diagnosis, as well as its potentially chronic and disability course . The purpose of the study is to determine the effects of HIV and AIDS on the socio-economic status of people infected with HIV and AIDS at the village of Ga-Mathabatha in the Capricorn District of the Limpopo Province, South Africa. In this study, a qualitative, descriptive, exploratory and contextual design is used. A non-probability purposive sampling technique was used to carefully select the sample based on the knowledge that the participants had about the phenomena studied. Semi-structured, one-on-one, in-depth interview with a schedule guide were conducted until saturation of data was reached. To initiate each interview, a central question was was asked: “Describe the effects that HIV and AIDS have on your socio-economic status”. Participants were given an opportunity to describe their experiences with regard to the effects of HIV and AIDS on their socio-economic status. Field notes of semi-structured, one-to-one, in-depth interview session were recorded. A voice recorder was used to capture all the semi-structured, one-to-one, in-depth interviews. The recorded interviews were transcribed verbatim, using Tesch’s qualitative data analysis method. Trustworthiness was ensured by using Guba’s model criteria; i.e. credibility, transferability, confirmability, and dependability. The results indicate that HIV and AIDS have an effect on the socio-economic status of HIV-positive people. Ethical standards for nurse researchers were adhered to, namely permission to conduct the study was obtained from the Medunsa Research and Ethics Committee. Permission to conduct the research project was granted by the Limpopo Turfloop Campus, Limpopo Provincial Department of Health and Social Development, and the ART clinic management at the Ga-mathabatha Relebogile Wellness and ART Clinic. To ensure confidentiality and anonymity, written informed consent was obtained from each participant before he/she could participate in the study. The quality of the research was also insured. Five themes and their sub-themes, and the literature control are presented in the discussion of the research findings. The findings of this study have a central story line which reveals that participants are sharing similar experiences in terms of socio-economic factors after they have tested HIV-positive which are related to several factors; including the involvement of family and friends in their care, changes encountered which affect their social life, household income, and their living conditions. The following five themes and their sub-themes have emerged during data analysis: Theme 1: Different sources of income of HIV-positive people; Theme 2: Living conditions of HIV-positive people; Theme 3: Consequences related to HIV and AIDS disease progression; Theme 4: Support and care to HIV-positive people; and Theme 5: Disclosure versus non-disclosure of HIV-positive status. The results of this study are limited to the Relebogile Wellness and ART Clinic in the Ga-Mathabatha area of the Capricorn District in the Limpopo Province, South Africa. The study findings cannot be generalised to all clinics that are issuing ARVs in the Capricorn District. Study conclusions emphasise the fact that there is a need for HIV and AIDS positive patients to receive continuous support from family, friends, and the community with the purpose of enabling them to cope emotionally, socially, and economically. It also reveals the importance of participants to take their treatment as prescribed with the aim of improving their immune systems. The recommendations emphasise the fact that there is a need for HIV and AIDS patients to receive continuous support from family, friends, and the community with the purpose of enabling them to cope emotionally, socially, and economically. TERMINOLOGY Human Immunodeficiency Virus (HIV) HIV is a virus which has a known and distinct capacity to cause Acquired Immune Deficiency Syndrome once it has entered the body. It attacks a person’s immune system (Kaushik, Pandey & Pande, 2006:43) Acquired Immunodeficiency Syndrome (AIDS) It is the fourth stage of HIV infection and it is usually characterised by a CD4 count of less than 200. It is not a specific illness but rather a collection of illnesses that affect the body to such an extent that the weakened immune system struggles to respond effectively (Kaushik et al., 2006:43) Effects Effects are consequences that are brought about by a cause (Kaushik, Pandey & Pande, 2006:56). Examples of effects are changes in the health status, and standard of living of a population as a result of a programme, project or activity. In this study, effects refer to changes in the socio-economic status of a population that have occurred as a result of the breadwinner in a family who has become unable to go to work due to a weakened immune system that results from HIV and AIDS. Epidemic It is the occurrence of cases of an illness (or an outbreak) in a specific population with a frequency clearly in excess of the normal probability (Giesecke, 2007:19). In this study, an epidemic refers to the effect HIV and AIDS has on the population. Socio-economic status Socio-economic status refers to the standardised way of grouping a population in terms of parental occupation, income, power, prestige, and education (Kirsh, 2006:287). In this study, socio-economic status defines a person’s monthly income, education, and occupation. Family A group of people living together in a permanent arrangement, separated from the rest of the world by the walls of the family dwelling and by societal guarantees of family privacy (Bachmann & Booyens, 2006:4). In this study, a family denotes those people who are living under the same roof with a breadwinner who is HIV-positive.

Human immunodeficiency virus (HIV) is globally spread virus without available cure. Since its life-long presence, virus is carefully monitored as well as patient's immunological status. Replicative fitness of the virus is one of important aspects which can be taken into account, when monitoring HIV. Here, we are measuring HIV replicative fitness of gag recombinant viruses and comparing the results with replicative fitness of primary isolates. Further, we are comparing our findings of replicative fitness change over time with disease progression in the patient. We found that gag can be major contributor to overall fitness, although not in all cases. Additionally, we observed a correlation of replicative fitness development and slope of patient's CD4+ T cells. Moreover, this relation was even more noticeable in patients with slow disease progression or in carriers of protective alleles. In summary, our results extend the understanding of replicative fitness and its role in disease progression; and pave the way to use the recombinant HIV for replicative fitness measurement in clinical practice. Keywords: HIV, replicative fitness, recombinant virus, HIV disease progression, gag

Prior to 1996, the prognosis of HIV disease was near-certain death; however, biomedical advancements in the past 20 years established HIV as a chronic manageable disease with a nearly normal life span. Recent advancements suggest the potential for a cure. One outcome of current medical treatments is that 50% of all HIV positive individuals are older (-?¥ 50years), and a substantial number of those individuals are long-term (-?¥ 20 years) survivors. Existing research Qualitative research has provided little insight about what older long-term HIV survivors believe about their disease circumstances and aging with the disease. A qualitative method in the phenomenological tradition was used to explore older long-term HIV survivors' notions about aging with HIV and an HIV cure. The self-regulation model of illness representations and the preventive and corrective, proactivity (PCP) model of aging with HIV disease for older adults guided the study. Using strategically placed flyers in HIV services environments, 12 older long-term HIV survivors volunteered to describe their beliefs about aging with HIV and an HIV cure. Participants' statements were entered into discrete cells in an electronic spreadsheet (Excel) and were coded, sorted, and categorized. The categories were sorted for commonality, and emergent themes and subthemes were identified. Older long-term HIV survivors believed they had few issues aging with HIV, expected to live a long time, and believed that finding a cure would have little effect on their lives. These research findings may be beneficial to healthcare providers and researchers who provide quality of life interventions and information to older adults living long-term with HIV who are concerned about aging, longevity, and a cure.