A sequência de 35 aminoácidos da alça V3 da gp120 do gene env do HIV-1 é o principal determinante do tropismo viral pelos correceptores CCR5 ou CXCR4, utilizados pelo HIV-1 para a entrada na célula. O desenvolvimento de estratégias antirretrovirais baseadas no uso dos correceptores representa um avanço importante para o controle da progressão da infecção. Entretando, o uso clínico dos antagonistas de CCR5 implica na determinação do tropismo das cepas virais do indivíduo infectado e os programas preditores de bioinformática para a determinação do tropismo poderiam ser uma alternativa mais acessível para a triagem dos candidatos ao uso dos antagonistas de CCR5. Este estudo teve como objetivo utilizar ferramentas de bioinformática para a predição de tropismo e avaliar sua aplicabilidade na prática clínica. Foram coletadas amostras de sangue periférico de 101 indivíduos infectados pelo HIV-1 e sob acompanhamento clínico, dos quais foram extraídas amostras de DNA proveniente de PBMCs. As amostras de DNA foram amplificadas por PCR para a região da alça V3, das quais foram obtidas 94 sequências. Os sistemas preditivos foram avaliados utilizando 185 sequências com tropismo conhecido provenientes de banco de dados. Com base nesta análise foi possível elaborar um algoritmo para a predição do tropismo com 94% de confiabilidade. Assim, a predição das 94 amostras demonstrou uma prevalência de 80% (n=75) de cepas R5 e 20% (n=19) de cepas X4. Os sistemas preditivos de tropismo podem representar uma importante estratégia para a triagem dos candidatos ao uso dos antagonistas de coreceptor, porém, não são capazes de substituir completamente os ensaios padrão-ouro para a determinação do tropismo. / The 35 amino acids of the V3-gp120 of HIV-1 env gene is the main determinant of viral tropism by the coreceptors CCR5 and CXCR4 used for HIV-1 cell entry. The development of antiretroviral strategies based on the coreceptor usage represents an important step to control the infection progression. However, the clinical application of CCR5 antagonists involves the coreceptor usage determination of viral strains in the infected individual. The bioinformatics predictive programs for coreceptor usage determination could be a more available alternative for screening candidates to receive CCR5 antagonists. This study aimed to employ bioinformatics tools to predict tropism and assess its applicability in clinical practice. Peripheral blood samples were collected from 101 individuals infected with HIV-1 and under clinical follow-up. DNA samples were extracted from PBMCs. The DNA samples were amplified by PCR and 94 V3 sequences were obtained. The predictive systems were evaluated using 185 sequences of known tropism from a database. This analysis provides the construction of an algorithm showing 94% of reliability. Thus, the 94 sample prediction showed a prevalence of 80% (n=75) of R5 strain and 20% (n=19) of X4 strain. The predictive systems could be an important strategy in the screening of the tropism. Nonetheless, they are not able to fully replace the coreceptor usage gold-standard assays.

Objetivo: Analisar fatores socioeconômicos, demográficos e as características do pré-natal das gestantes infectada pelo HIV, de acordo com o momento do seu diagnóstico. Métodos: Realizou-se estudo transversal com 199 gestantes infectadas pelo HIV que tiveram seu atendimento pré-natal em três centros públicos de referência de Porto Alegre, no período de julho de 2005 a janeiro de 2006. O questionário avaliou informações sócio-econômicas, demográficas e do prénatal. Durante a análise, elas foram divididas em 2 grupos: Grupo1 composto de 135 gestantes (68%) que sabiam previamente a gestação o seu diagnóstico para HIV e o Grupo 2 com 64 gestantes (32%) que conheceram o diagnóstico naquele pré-natal. Resultados: A mediana de idade das gestantes foi 26 anos (variando 15 a 42 anos). Quanto à escolaridade, 59% (n=117) delas não chegaram a concluir o ensino fundamental. 74% (n=147) não tinham nenhum tipo de renda. Em termos conjugais, 81% (n=153) das gestantes possuíam um relacionamento estável com o pai da criança e 66% (n=132) possuíam menos de 20 anos de idade quando tiveram a primeira gestação. O número mediano de gestações prévias foi 3 (variando de 1 a 13 gestações), e 37% (n=73) tiveram pelo menos um aborto prévio. Comparando os grupos, observou-se que o início do prénatal no primeiro trimestre e o desejo de realizar ligadura tubária foi significativamente mais freqüente no Grupo 1 do que no Grupo 2. p=0,005 e p=0, 012, respectivamente. Conclusões: Não houve diferenças estatisticamente significante entre os grupos nos aspectos sócio-demográficos, todavia as gestantes que já tinham o seu diagnóstico para HIV prévio a gestação iniciaram mais precocemente seu pré-natal e mais freqüentemente requisitavam a ligadura tubária.

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CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / A maternidade exige da mulher adaptaÃÃes fÃsicas, psicolÃgicas e sociais. Para a puÃrpera soropositiva para o HIV alÃm de todas estas adaptaÃÃes, a nova mÃe vivencia experiÃncias delicadas e difÃceis como o nÃo amamentar, o isolamento, a discriminaÃÃo e o estigma que sofre por si mesma, pelos familiares e pela equipe de saÃde que presta cuidados. O medo de morrer e de ter contaminado seus filhos, somado ao nÃo amamentar sÃo fatores que levam a comportamentos de distanciamento, prejudicando a atitude de apego entre o binÃmio mÃe e bebÃ. O apego à essencial para a formaÃÃo do vÃnculo afetivo e da personalidade, podendo prejudicar o desenvolvimento da crianÃa, caso esta seja privada da figura de apego. Nosso trabalho teve como objetivo construir um vÃdeo educativo para a promoÃÃo do apego entre mÃe soropositiva para o HIV e seu filho. O estudo foi do tipo metodolÃgico, ensaio clÃnico, randomizado. Para a construÃÃo e validaÃÃo do vÃdeo educativo, a pesquisa passou por cinco etapas: Desenvolvimento do roteiro; AvaliaÃÃo do roteiro por dois especialistas de conteÃdo e dois da Ãrea tÃcnica; GravaÃÃo e EdiÃÃo do vÃdeo; ExibiÃÃo do vÃdeo e AvaliaÃÃo da InteraÃÃo MÃe e BebÃ. A coleta de dados ocorreu entre maio e outubro de 2008, em uma maternidade do municÃpio de Fortaleza. As participantes foram divididas aleatoriamete em Grupo Controle e Grupo de IntervenÃÃo, totalizando uma amostra de 24 participantes. A populaÃÃo era composta por 27 gestantes soropositivas, sendo que trÃs nÃo obedeceram aos critÃrios de inclusÃo do estudo. Utilizamos como instrumentos para coletar os dados: questionÃrio para avaliaÃÃo do roteiro; formulÃrio do perfil sÃcioeconÃmico; diÃrio de campo e o Protocolo da AvaliaÃÃo da InteraÃÃo MÃe e Bebà de 0 a 6 meses. Para anÃlise dos dados usamos o Teste EstatÃstico Kolmogorov-Smirnov com (p<0,05). Os especialistas concordaram com o desenvolvimento do vÃdeo como estratÃgia educativa, solicitando modificaÃÃes: reduÃÃo do nÃmero de cenas; SubstituiÃÃo de termos tÃcnicos por linguagem coloquial; Efeitos computadorizados de figuras e maior interaÃÃo entre os personagens. ApÃs a criaÃÃo do vÃdeo, o mesmo foi transmitido para as participantes do Grupo de IntervenÃÃo. Foram observados sentimentos como alegria, esperanÃa e ansiedade. ApÃs a entrevista com as participantes dos dois grupos, agendamos de acordo com a data provÃvel do parto, a avaliaÃÃo da interaÃÃo entre mÃe e bebÃ. Nessa etapa participaram trÃs juÃzas que filmaram a dÃade e avaliaram a interaÃÃo entre os mesmos. Os resultados foram mais satisfatÃrio para o Grupo de IntervenÃÃo, ou seja, as mulheres que haviam assistido o vÃdeo e recebido orientaÃÃes da pesquisadora. Para avaliaÃÃo da interaÃÃo entre o binÃmio, o protocolo usado preconiza os seguintes critÃrios para avaliaÃÃo: verbalizaÃÃo; contato visual; atenÃÃo geral da mÃe; afeto positivo; eficiÃncia para consolar; reaÃÃo da mÃe ao choro do bebÃ; resposta ao comportamento social Intensidade da resposta; sensitividade; contato corporal; afeto negativo e intrusividade. Dos comportamentos avaliados os Ãnicos que nÃo tiveram diferenÃas estatÃsticas para os dois grupos foram a verabalizaÃÃo; o afeto negativo e intrusividade. Assim, consideramos importante a criaÃÃo de estratÃgias educativas que visem a promoÃÃo do apego, ressaltamos ser este vÃdeo um apoio para os profissionais que trabalham com esta clientela especÃfica. / The maternity demands from the woman physical, psychological and social adaptations. To the HIV positive person the HIV beyond all these adaptations, the new mother lives deeply delicate and difficult experiences as not to suckle, the isolation, the discrimination and the stigma that suffers for same herself, for the familiar ones and the team of health that cares. The fear to die and to have contaminated her children, added to not suckling are factors that take the distant behaviors, harming the attitude of attachment between the binomial mother and baby. The attachment is essential for the formation of the affective bond and the personality, being able to harm the development of the child, in case she is put off to the attachment figure. Our work had as objective to construct an educative video for the promotion of the attachment between HIV positive mother and her son. This was a methodological type study, clinical assay, randomized. To the construction and validation of the educative video, the research went through five stages: Development of the script; Evaluation of the script for two specialists of content and two of the technique area; Writing and Edition of the video; Exhibition of the video and Evaluation of the Interaction Mother and Baby. The collection of data occurred between May and October of 2008, in a maternity of the city of Fortaleza. The participants had been divided randomized in Group Control and Group of Intervention, totalizing a sample of 24 participants. The population was composed for 27 HIV positive pregnant, where three had not obeyed the criteria of inclusion of the study. We use as instruments to collect the data: questionnaire for evaluation of the script; form of the socioeconomic profile; field diary and the Protocol of the Evaluation of the Interaction Mother and Baby of 0 the 6 months. For the analysis of the data we use the Statistical Test Kolmogorov-Smirnov with (p<0, 05). The specialists had agreed to the development of the video as educative strategy, requesting modifications: reduction of the number of scenes; Substitution of terms technician for colloquial language; computerized effect of figures and greater interaction between the personages. After the creation of the video, it was transmitted for the participants of the Group of Intervention. Feelings had been observed as joy, hope and anxiety. After the interview with the participants of the two groups, we set appointments in accordance with the probable date of the childbirth, the evaluation of the interaction between mother and baby. Three female judges who had filmed dÃade and had evaluated the interaction between the same ones took part in this stage. The results had been more satisfactory for the Group of Intervention, that is, the women who had attended the video and received orientations from the researcher. For evaluation of the interaction between the binomials, the used protocol praises the following criteria for evaluation: verbalization; visual contact; general attention of the mother; positive affection; efficiency to console; reaction of the mother I cry to it of the baby; reply to the social behavior Intensity of the reply; sensitivity; corporal contact; negative affection and intrusivity. Of the evaluated behaviors only that they had not had statistical differences for the two the groups had been the verbalization; the negative affection and intrusivity. Thus, we consider important the creation of educative strategies that aim at the promotion of the attachment; we believe to be this video a support for the professionals who work with this specific clientele.

nÃo hà / A gravidade clÃnica e a demanda social de pacientes coinfectados HIV/tuberculose exigem mudanÃas no saber e no fazer da enfermagem diante dos cuidados em saÃde, especialmente de promoÃÃo a saÃde. Neste contexto, este estudo objetivou: elaborar e validar o conteÃdo de um instrumento de consulta de enfermagem direcionado para pacientes com coinfecÃÃo HIV/TB baseada em na Teoria de Orem; avaliar a efetividade da consulta de enfermagem na adesÃo e qualidade de vida de portadores de HIV/aids durante o tratamento da tuberculose. Desenvolveu-se a pesquisa em dois momentos. Inicialmente, mediante o delineamento desenvolvimental, elaborou-se instrumento de consulta de enfermagem baseado na Teoria de Orem, o qual foi submetido à validaÃÃo de conteÃdo por experts. Utilizou-se o Coeficiente Kappa para avaliar o nÃvel de concordÃncia das respostas inter-avaliadores, no intuito de proporcionar um instrumento de consulta de enfermagem adequado aos coinfectados HIV/TB. No segundo momento, desenvolveu-se estudo com delineamento quase-experimental, comparando-se a intervenÃÃo que constou da aplicaÃÃo da consulta de enfermagem fundamentada na Teoria de Orem (grupo exposto - 1) durante o seguimento de seis meses do tratamento da TB com outro grupo (grupo nÃo exposto- 2) em cujo tratamento utilizou-se a consulta de enfermagem sem uso de teorias. Para comparaÃÃes entre os grupos adotou-se a avaliaÃÃo de qualidade de vida (HAT-QoL) e o Teste de Moriski e Green e avaliaÃÃo da dificuldade para adesÃo (TMG e ADA). Participaram do estudo 96 portadores de coinfectados HIVTB, constituindo-se dois grupos (48=grupo exposto e 48= grupo nÃo exposto) acompanhados no Hospital SÃo Josà de DoenÃas Infecciosas (HSJ), de outubro de 2009 a setembro de 2010. Para anÃlise dos dados, foram empregados testes estatÃsticos apropriados para as comparaÃÃes entre os grupos. Em relaÃÃo aos achados da aplicaÃÃo da consulta de enfermagem, observaram-se dÃficits de autocuidado principalmente quanto ao apoio social inadequado (66,7%); de dificuldade de acesso ao serviÃo por carÃncia de transporte (60,4%) e de falta de conhecimento sobre a doenÃa e tratamento (43,8%). Pela HAT-QoL, no inÃcio do acompanhamento observaram-se escores baixos e homogÃneos na comparaÃÃo entre os grupos. Verificou-se diferenÃa no domÃnio relacionado as preocupaÃÃes financeiras (p=0,001). No final do acompanhamento houve melhora da qualidade de vida do grupo exposto nos domÃnios funÃÃo geral (p=0,002), preocupaÃÃo com a saÃde (p=0,000), aceitaÃÃo do HIV (p=0,000), satisfaÃÃo com a vida (p=0,000) e confianÃa no profissional (p=0,032). No inerente à adesÃo nÃo se identificou diferenÃa entre os grupos. Entretanto, na avaliaÃÃo da dificuldade para adesÃo, ao final do tratamento, constataram-se melhores escores no grupo exposto. Apesar dos baixos escores da HAT-QoL, percebeu-se incremento significativo na qualidade de vida dos pacientes do grupo exposto. E, ainda: teve-se melhoria para a adesÃo ao tratamento e menor Ãndice de abandono no grupo submetido à consulta de enfermagem utilizando-se o modelo de Orem. / The clinical severity and social demand of patients co-infected with HIV/tuberculosis demand changes in nursing knowledge and actions for health care, especially health promotion. In this context, this study aimed to: elaborate and validate the contents of a nursing consultation instrument for patients co-infected with HIV/TB based on Oremâs Theory; to assess the efficacy of the nursing consultation for adherence and quality of life of HIV/aids patients during tuberculosis treatment. The research involved two moments. Initially, through a developmental design, a nursing consultation instrument was elaborated based on Oremâs Theory, which was submitted to content validation by experts. The Kappa Coefficient was used to assess the inter-rater agreement level, with a view to achieving an adequate nursing consultation instrument for HIV/TB co-infected patients. Next, a quasi-experimental study was developed, comparing the intervention through the application of the nursing consultation based on Oremâs Theory (exposed group â 1) during six months of follow-up for TB treatment, with another group (non-exposed group â 2) for whose treatment the nursing consultation was used without theories. For inter-group comparisons, quality of life assessment (HAT-QoL) and the Moriski and Green Test were applied, as well as adherence difficulty assessment (TMG and ADA). Study participants were 96 HIV/TB co-infected patients, constituting two groups (48=exposed group and 48=non-exposed group) monitored at Hospital SÃo Josà de DoenÃas Infecciosas (HSJ) between October 2009 and September 2010. For data analysis, appropriate statistical tests were used for inter-group comparisons. As for the findings resulting from the nursing consultation application, self-care deficits were observed, mainly regarding inadequate social support (66.7%); service access difficulty due to lack of transportation (60.4%) and lack of knowledge on the disease and treatment (43.8%). According to the HAT-QoL, at the start of the follow-up, inter-group comparison showed low and homogeneous scores. A difference was found in the domain related to financial concerns (p=0.001). At the end of the follow-up, the exposed group demonstrated improved quality of life in the general function (p=0.002), health concern (p=0.000), acceptance of HIV (p=0.000), satisfaction with life (p=0.000) and trust in the professional (p=0.032) domains. Regarding adherence, no inter-group difference was identified. When assessing adherence difficulty at the end of treatment, however, better scores were found in the exposed group. Despite low HAT-QoL scores, a significant increase in quality of life was perceived among patients from the exposed group. Also, treatment adherence improved and abandonment rates dropped in the group submitted to nursing consultations using Oremâs model.

Giraldi, I.M.E. Representações sobre o período da primeira internação hospitalar na perspectiva de mulheres HIV positivas, 2011 A aids foi relatada pela primeira vez em 1981 e atualmente a Organização Mundial da Saúde estima que aproximadamente 36 milhões de pessoas estejam infectadas pelo HIV em todo o mundo. No Brasil, entre as mulheres tem sido verificado o aumento da incidência de infecção a partir da segunda década da epidemia, indicando não apenas as dificuldades para oferecer respostas institucionais ao controle da epidemia, mas também, evidenciando as questões de gênero, em particular nas relações conjugais, como relações sexuais desprotegidas por falta de poder de negociação do preservativo e os comportamentos de risco adotados por seus parceiros, cuja assimetria provoca a vulnerabilização das mulheres à infecção. O adoecimento dessas mulheres leva a uma perspectiva preocupante, pois muitas vezes este adoecimento vem associado a responsabilidade dos cuidados de um parceiro e/ou de possíveis filhos infectados. Porém, quando os sintomas começam a aparecer, surgem ansiedade e medos que estavam aparentemente controlados. O processo de internação pode ocasionar reações que agravam o quadro dos pacientes internados. Neste sentido, este projeto teve por objetivos identificar, entre mulheres soropositivas para o HIV, algumas representações sociais sobre a primeira internação hospitalar motivada por manifestação de sintomas, adoecimento devido a fragilidade do sistema imunológico e/ou efeitos colaterais associados ao tratamento. Este estudo foi realizado com 10 mulheres soropositivas, com idade entre 32 e 46 anos, internadas numa unidade de tratamento específica - UETDI. A análise temática de conteúdo das transcrições de entrevistas individuais, semiestruturadas, audiogravadas foi sintetizada em Categorias e Subcategorias empíricas. Durante a internação, concretiza esta nova fase, sintomática, levando as participantes a encontrar novas formas de enfrentamento, representação do próprio corpo, novas perspectivas e, via contato com uma equipe adequada às suas necessidades e familiares, poder sair dessa hospitalização com novas possibilidades e representações de saúde. Por fim, pode-se indicar algumas reflexões acerca da complexidade da adesão do portador de HIV ao tratamento. / Giraldi, I.M.E. Representations about the first hospitalization period in the perspective of HIV-positive women, 2011 Aids was first reported in 1981; nowadays, the World Health Organization estimates that 36 million people are infected by the HIV worldwide. In Brazil, an increase of the infection\'s incidence has been observed in women since the epidemic\'s second decade. Such phenomenon indicates not only the difficulties for offering institutional responses in order to control the epidemics, but, also, it evidences genderrelated and more specifically conjugal questions, such as unsafe sexual relations occurring due to a lack of negotiation power for the use of condoms and risky behaviors adopted by partners, whose asymmetry leads to the increase of women\'s vulnerability to the infection. Women\'s process of sickening portrays a worrying panorama, for such process is associated to the responsibility for offering care to a partner or possible infected children. With the appearance of initial symptoms, though, anxiety and fears that were apparently under control arise, in contrast to an initial healthy state without weighty worries. In such context, the hospitalizing process can lead to reactions that aggravate the state of patients. The present study aimed to indentify some social representations of HIV-positive women regarding their first hospitalization due to symptom manifestation, immunologic fragility and/or treatment-related side effects. Ten women took part of the study, with ages between 32 and 46 years old, who were hospitalized in a specific treatment unity (UETDI). Thematic analysis of the recorded individual, semi-structured interviews\' contents was synthesized in empirical Categories and Subcategories. During hospitalization, a new, symptomatic stage becomes real, leading participants to find new strategies for coping, representing their own bodies, developing perspectives and, through the contact with health staff and family members, exiting the hospital with new possibilities and health-related representations. At last, some reflections are indicated regarding the complexity of adhesion to treatment process by people with HIV.

Background : Host protein beta-2 microglobulin (β2m) is incorporated into the human immunodeficiency virus (HIV) -1 coat during budding. Antibodies directed to R7V, an epitope contained in β2m, increased with the duration of infection in long term non-progressor patients (LTNPs). Purified R7V antibodies neutralized HIV isolates and did not bind to human cells. These data suggested potential for R7V antibodies to be developed as therapeutic tools or prognostic markers and the R7V epitope as a vaccine candidate. However, the literature on R7V is still incomplete. For example, most published work on this epitope make no direct reference to HIV subtypes. The rationale for this study is the lack of information on whether all HIV-1 subtypes incorporate R7V and elicit immune responses to the same extent. In particular the response of HIV-1 subtype C infected individuals to R7V antigen is evaluated here. Methodology and results : A synthetic peptide of the R7V epitope of HIV-1 was synthesized and an “in-house” enzyme-linked immunosorbent assay (ELISA) developed. The peptide was able to detect antibodies generated during natural HIV-1 subtype C infection when used as antigen in the ELISA. This response was not as strong as that reported in the literature. A significantly lower ELISA response was observed for uninfected compared to infected sera (probability, p, value ≤ 0.000152), whereas no differences were noticed between antiretroviral (ARV) treated individuals compared to those who were treatment naïve or LTNPs compared to progressors. These data hold promise for the use of these antibodies as diagnostic rather than prognostic indicators. Polyclonal R7V antibodies produced in rabbits and recombinant R7V antibody fragments did not neutralize an HIV-1 subtype C isolate (Du151.2). However, the latter antibodies neutralized an HIV-1 subtype B strain (SF162), suggesting that the R7V epitope may be more exposed in this subtype. The recombinant R7V antibodies did not neutralize a vasicular stomatitis virus (VSV-G), indicating that no nonspecific neutralization occurred. Human immunodeficiency virus type 1 subtype C infected sera containing R7V antibodies (positive response in the R7V ELISA) neutralized Du151.2 while archive sera containing strong HIV-1 subtype C neutralizing antibodies did not recognize the R7V antigen ELISAs. The R7V peptide exogenously added to HIV-1 infected peripheral blood mononuclear cells (PBMCs) did not stimulate proliferation in vitro nor the production of interferon (IFN) gamma which if produced by CD8+ T-cells would have been indicative of a cellular immune response. The parent protein β2m could not initiate these responses either. Conclusion : Data collected here support a diagnostic rather than a prognostic application for R7V antibodies. R7V conjugated to keyhole limpet hemocyanin (KLH) induced non-neutralizing antibodies in rabbits, suggesting that other modifications (branching, lipid conjugation, etc.) may be needed before this epitope can be successfully utilized in vaccine studies. / Dissertation (MSc)--University of Pretoria, 2010. / Biochemistry / unrestricted

Class of 2006 Abstract / Objectives: The HIV/AIDS Awareness series aims to broaden the College of Pharmacy’s impact and service to the community by educating and increasing awareness about the many facets of HIV/AIDS not only locally, but also globally. Our innovative educational series entitled “AIDS Awareness Week,” will enable many students and faculty to come together to learn in a community forum setting. Our purpose is to describe the general activities included in the Week, as well as to describe the general reaction to the program. Methods: A questionnaire was developed and administered every day of the week long series from November 28 – December 1 2005 at the University of Arizona, College of Pharmacy. Results: Data was utilized for a total of 222 participants to the 2005 AIDS Awareness Week educational series. Of the 222, 41.4% (n=92) were male, and 59% (n=130) were female. The following faculties were represented during the week; College of Pharmacy 72.5% (n=161), the College of Nursing 14% (n=30), the College of Medicine 7.2% (n=16), the College of Public Health 1.4% (n=3), and those from “other” programs at 1.4% (n=3). Of those in attendance, 94% (n=209) were students, 2.3% (n=5) were faculty, 2.3% (n=5) fell into the “other” category, and 1.4% (n=3) were health professionals. Of significance was the number of “return” participants to the different 2005 educational series. The number of “return participants” was as follows: On day 2, 63.3% (n=38) of the 60 in attendance had been to the previous day. On day 3, 48% (n=30) of 63 participants had been to Day 1, and 62% (n=39) had also attended Day 2. On Day 4, 52% (n=26) of the 50 in attendance had attended Day1, 58% (n=29) for Day 2, and 44% (n=22) for Day 3. Implications: Overall, the series went very well and attendance was high. Positive feedback regarding the events was taken via anecdotal comments and that people returned to each session. This program is easily duplicated and can be used as a template in any university setting to promote awareness of sensitive subjects as well as foster community learning and relationships between the professions. It is hoped that this educational series will aid in bridging the gap within healthcare professionals, as well as provide an open forum for students from different backgrounds to come and learn the information together.

Mother To Child Transmission (MTCT) of HIV is a major challenge in Sub-Saharan Africa due to a variety of socio-economic and political factors. In South Africa, for example, there was element of denialism by government on the fact that treatment could assist in reducing the likelihood of transmitting the virus to the baby. It was only in 2001 after the Treatment Action Campaign took the South African government to court that they were ordered to develop a programme to prevent the transmission of HIV from mother to child. The South African government established a PMTCT programme that aligned itself with the United Nations’ Millennium Goal of ensuring that all HIV positive pregnant women receive treatment in an effort to eliminate babies born with HIV. This study, therefore, explored the experiences of HIV positive mothers who enrolled on PMTCT programme at Tonga hospital. The researcher explored the participants’ understanding of the programme prior to enrolment, the extent to which they experienced the programme, the nature of support and services they received while on the programme as well as challenges they faced. All this was done with the intention and commitment to strengthening the intervention strategies for the HIV pregnant women, thereby ensuring that they receive top quality services from a group of multi skilled professionals. To achieve this, the study applied a collective case study within a qualitative approach. The population for the study was HIV positive mothers who enrolled on the PMTCT programme between June 2011 and July 2012. The sample consisted of 12 HIV positive mothers who took part in the PMTCT programme at Tonga hospital. For data collection purposes, the researcher applied semi-structured interview. Informed by the findings, the study concluded that there is lack of knowledge and understanding of the programme in the community. It further established that the clinic is situated under the ward where HIV positive patients are treated and that psycho social services are not offered to the HIV positive pregnant women. It also concluded that the women’s husbands or partners are not encouraged to be part of the programme. Consistent with the above, the study recommended that the PMTCT programme should be provided in a holistic and well integrated manner, where all health care disciplines contribute as required to make the participants’ experiences on the programme more comfortable both socially and emotionally. There should be a way to get the male counterparts of the participants more involved in the programme so as to afford them the opportunity to get first-hand information about pregnancy and what is expected of them as partners. Each health worker’s role should be clearly defined and a referral system be developed so that all services are easily accessible. / Dissertation (MSW)--University of Pretoria, 2013. / am2014 / Social Work and Criminology / unrestricted

PhD (Microbiology) / Department of Microbiology