The medico-scientific advances made in the treatment of HIV and AIDS, which emerged in the mid 1990s, were significant. The Highly Active Anti-Retroviral Treatments (HAART) or anti- HIV treatments have been positioned as resources that changed the way HIV is now medically and socially constructed. Although HIV remains incurable, it is now constructed as a chronic disease that is treatable, manageable and people are no longer positioned as living with a ‘death sentence’. The research on which this thesis is based explores the subjective lived experiences of people with HIV living in urban Australia in the context of this change. The effects that the treatments have had on corporeality have also changed the ways people are now living with HIV in the post-treatment era. It is an era in which treatments for HIV are taken-for-granted, but issues, doubts and concerns relating to treatment use are firmly embedded in the everyday life of people with HIV. The findings suggest that whilst AIDS-related mortality has decreased since the availability of effective treatments, the notion of ‘quality of life’, as subjectively constituted and defined, is an ongoing negotiation that is predicated on people locating meaningfulness in their everyday lives. Despite the decreased threat of failing health and death, the findings also suggest that people are continuing to be confronted by, and therefore positioned as, having to make sense of complex issues embedded in living with a disease for which there is no cure. / Doctor of Philosophy (PhD)

"8th July 2002." / Includes bibliographical references (leaves 276-308) / vi, 308, [57] leaves : charts ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Examines the systematics (taxonomy, phylogeny, and epiemiology) of the genus Candida using a combination of traditional and contemporary methodologies. Assesses these methods to determine their diagnostic potential to unequivocally identify and characterise species and strains of this medically and dentally important yeast genus. / Thesis (Ph.D.)--University of Adelaide, Dept. of Dentistry, 2002

Acquired Immune Deficiency Syndrome (AIDS) has become the world's foremost health threat and is the number one killer in Zimbabwe. Acquired Immune Deficiency Syndrome impacts not only the individual who has AIDS, but on nuclear and extended families, and all aspects of society in Zimbabwe. Since studies have indicated that counseling could be an effective tool in preventing the spread of Human Immuno Deficiency Virus (HIV) and helping those who are already impacted by the virus, it would be important for counselors to be knowledgeable about HIV/AIDS and have positive attitudes towards people with HIV/AIDS. Therefore, the main purpose of this study was to investigate eight practicing Zimbabwean counselors' attitudes towards and knowledge of HIV/AIDS. Additionally, the study explored the emotions the counselors experienced while counseling HI V/AIDS clients, their beliefs about the origin of HI V/AIDS, and their perceptions about HI V/AIDS counseling in Zimbabwe. Eight practicing counselors in Zimbabwe participated in this study. A mixed method Model III with a sequential exploratory design was used amid phenomenological underpinnings. The counselors provided information through a mailed (electronic mail) questionnaire and telephone interviews. Follow-ups to the interviews were carried out through the electronic mail. Results indicated that the counselors in the study were generally knowledgeable about HIV/AIDS, had positive attitudes toward people with HIV/AIDS, and did not think that the origin of HIV/AIDS was important and that it was better to focus on the solutions to the problem. The counselors experienced a wide variety of feelings while counseling HIV/AIDS clients. The counselors reported more negative than positive feelings, but most of the feelings were not directed toward the client. The counselors revealed that HIV/AIDS counseling was complex and difficult. The counselors thought counselor training in Zimbabwe was too limited and that counselors in Zimbabwe in general lacked both support and supervision services. Despite the difficulties of, and the lack of support and supervision, the counselors found meaning in counseling HIV/AIDS clients. / Graduation date: 2004

Thesis (Ph. D.)--University of Chicago, Dept. of Economics, August 2003. / Includes bibliographical references. Also available on the Internet.

Source: Masters Abstracts International, Volume: 47-06, page: 3554. Adviser: Thomas Giordano. Includes bibliographical references.

The focus of the research study is to explore chronically ill African American, Latino, and White patients' causal attributions of symptoms of depression and factors that predict depression care treatment preferences among these groups. Research has demonstrated that perception of illness impacts what treatments a person will deem appropriate for their mental health problems and from whom they will seek treatment. Research also indicates that certain ethnic groups are more likely to seek treatment for their symptoms of depression in the primary care setting. Yet, it is unclear how they actually perceive their symptoms and what best predicts the treatments that they are likely to consider acceptable. A convenient sample of 109 HIV+ adults, 79 diabetic adults, and 3 adults with both conditions were recruited for this study. Participants had to be receiving services for either HIV, diabetes, or both conditions in one of the three central Austin facilities and be a representative from one of three racial/ethnic groups: African Americans, Latino, and White. Differences were found across ethnicity with regard to causal beliefs and treatment preferences for the symptoms of depression both among the HIV and the diabetic subgroups. Latinos in both groups were more likely than Whites to prefer counseling or a single form of treatment over combined treatment methods. Diabetic Latinos were more likely to prefer counseling for symptoms of depression. HIV seropositive individuals who reported the least number of symptoms of physical illness were more likely to attribute their symptoms of depression to stressful life events, whereas those who reported the greatest number of symptoms of physical illness were more likely to attribute their symptoms of depression to their medical illness. Additionally among the HIV subgroup, individuals who reported high stress tended to predict the preferences for treatment provided by a psychiatrist/psychologist and Whites scored highest on this factor. Finally, differences in depression scores across race/ethnicity were also revealed. The utility of assessing a patient's understanding of symptoms of depression in order to determine how personal illness models impact treatment preferences and knowledge of patient's causal attributions can aid medical social workers and physicians in collaborative management of chronic illness and depression are discussed.

M. Tech. Nursing / Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) related stigma has been reported as a major barrier of HIV control and prevention globally. It creates social inequalities that distance people living with HIV and AIDS (PLWHA) from social interactions and support, impacting negatively on prevention and care. The purpose of this study was to develop guidelines to reduce HIV and AIDS stigmatisation in Soshanguve. The objectives were to explore the perceptions of PLWHA regarding stigmatisation of their illness and the impact on their daily living; describe the reactions of the community members towards PLWHA and develop guidelines to reduce HIV and AIDS stigmatisation in Soshanguve.

Title: Case Management and Clinical Outcomes of People Living with HIV and Admitted to a State-aided District Hospital in Durban, South Africa in 2007. Introduction: A proportion of the many patients who have advanced AIDS in South Africa present for the first time requiring admission to hospital, the number of which are limited by the availability of beds. Novel ways were developed to offer subacute inpatient care at Siyaphila, a facility linked to McCord Hospital in Durban to provide expedited or immediate antiretroviral therapy (ART) (exposed) for patients with advanced disease before their discharge (ART group) . Different components of palliative care were offered for those who did not enter the inpatient ART programme or who were terminally ill (non-ART group) (non-exposed) . Aim: The aim of the study is to describe the clinical condition, inpatient case management and outcomes before discharge of people living with HIV admitted to Siyaphila in order to assist in developing appropriate protocols for inpatient care. Methods: This was an observational, analytic, cohort study using a convenience sample of all patients consecutively admitted to Siyaphila during nine months in 2006/2007. Prevalence of AIDS defining conditions at Siyaphila, time taken to progress from one stage of care to another and outcomes for the two groups before discharge were determined. Univariate and multivariate logistic regression analysis was performed on the ART group to identify risk factors for mortality before discharge. A comparison between the ART and non-ART group was also undertaken. Results: Among the cohort of 405 PLHIV enrolled at Siyaphila during the study period only 171 (42%) were initiated on ART immediately. In all patients, tuberculosis (251; 62%) was the most common opportunistic infection followed by cryptococcal meningitis (68; 17%) and Pneumocystis pneumonia (28; 7%). The mean baseline CD4 cell count was 84 celis/uL for the non-ART group and 55 celis/uL for the ART group. (p <0.01) The median time from initial admission until discharge was 13 days in the non-ART group and 18 days in the ART group. The mortality before discharge among the non-ART group was 24% compared to 6% among the ART group. (p =0.001). The median number of days before ART was initiated was 14 days. Immune reconstitution inflammatory syndrome was diagnosed in seven patients (4%) among the admissions but caused no deaths. In the multivariate analysis, the odds ratio for mortality for patients under 40 years was 0.1 (95% Confidence Interval: 0.01 - 0.9). Conclusions: Subacute care offered at Siyaphila provides an entry point into the ART programme for non-ambulatory patients who in the KwaZulu-Natal context have low ART uptake after discharge. The findings of this study should be adopted as the best clinical practice for PLHIV and AIDS admitted in the late stages of the disease. 0Nords 423) Title: Case Management and Clinical Outcomes of People Living with HIV and Admitted to a State-aided District Hospital in Durban, South Africa in 2007. Introduction: A proportion of the many patients who have advanced AIDS in South Africa present for the first time requiring admission to hospital, the number of which are limited by the availability of beds. Novel ways were developed to offer subacute inpatient care at Siyaphila, a facility linked to McCord Hospital in Durban to provide expedited or immediate antiretroviral therapy (ART) (exposed) for patients with advanced disease before their discharge (ART group) . Different components of palliative care were offered for those who did not enter the inpatient ART programme or who were terminally ill (non-ART group) (non-exposed). Aim: The aim of the study is to describe the clinical condition, inpatient case management and outcomes before discharge of people living with HIV admitted to Siyaphila in order to assist in developing appropriate protocols for inpatient care. Methods: This was an observational, analytic, cohort study using a convenience sample of all patients consecutively admitted to Siyaphila during nine months in 2006/2007. Prevalence of AIDS defining conditions at Siyaphila, time taken to progress from one stage of care to another and outcomes for the two groups before discharge were determined. Univariate and mUltivariate logistic regression analysis was performed on the ART group to identify risk factors for mortality before discharge. A comparison between the ART and non-ART group was also undertaken. Results: Among the cohort of 405 PLHIV enrolled at Siyaphila during the study period only 171 (42%) were initiated on ART immediately. In all patients, tuberculosis (251; 62%) was the most common opportunistic infection followed by cryptococcal meningitis (68; 17%) and Pneumocystis pneumonia (28; 7%). The mean baseline CD4 cell count was 84 celis/uL for the non-ART group and 55 celis/uL for the ART group. (p <0.01) The median time from initial admission until discharge was 13 days in the non-ART group and 18 days in the ART group. The mortality before discharge among the non-ART group was 24% compared to 6% among the ART group. (p =0.001). The median number of days before ART was initiated was 14 days. Immune reconstitution inflammatory syndrome was diagnosed in seven patients (4%) among the admissions but caused no deaths. In the mUltivariate analysis, the odds ratio for mortality for patients under 40 years was 0.1 (95% Confidence Interval: 0.01 - 0.9). Conclusions: Subacute care offered at Siyaphila provides an entry point into the ART programme for non-ambulatory patients who in the KwaZulu-Natal context have low ART uptake after discharge. The findings of this study should be adopted as the best clinical practice for PLHIV and AIDS admitted in the late stages of the disease. (Words 423) / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2011.

Dating and sexual relations are basic processes in the lives of most human beings. However, dating and sexual relationships in HIV positive peoples’ lives are fraught with challenges. Limited knowledge of these challenges is recorded. Studies focusing on the challenges of serodiscordance, ARVS, adherence, side effects of ARVS, condoms, reproduction, disclosure and stigma are plentiful, however studies addressing dating and sexual challenges of HIV positive people are sadly lacking. The study described and explored the dating and sexual challenges faced by HIV infected people. The systems and ecosystems approach provided the theoretical framework for the study. A descriptive and exploratory design was chosen for this study. Purposive and snowball sampling was utilised to access respondents for this study. Data was collected qualitatively, using semi-structured interviews with 12 HIV positive respondents. The interviewed lasted between 1 to 2 hours. This study found that People living with HIV (PLHIV) experience many challenges in their dating and sexual lives. The challenges varied amongst the respondents. The challenges were divided into the following themes: disclosure; stigma; rejection and discrimination; dating options to pursue; serosorting or abstaining; guilt; anger; blame; social disconnection; negative self esteem and fear; physical, medical and psychological factors; impact of ARVS; sexual changes/sexual dysfunction; reproduction; community/society; the media; counselling, awareness and education about dating and sexual relationships; government and the consequences of relationships ending. The study encouraged further research on the topic. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.

The intervention of Voluntary Counselling and Testing (VCT) for the Human Immunodeficiency Virus (HIV) is rapidly gaining ground as an essential component in the health care system in an effort to combat and confront the spread of this disease. In South Africa where this intervention is gradually being introduced the application of VCT and the benefits and consequences likely to ensue from the application of the procedure were evaluated in-depth using a grounded theory and quantitative approach to describe the psychosocial dynamics. The interactive transfer of information embodied in VCT forms an integral part of the intervention and will continue to do so even when antiretroviral dnugs are uniformly available throughout the South African healthcare service. The way in which the women who will undergo this procedure internalise and respond to the information imparted to them during the counselling is highly significant from an educational and empowering perspective, regardless of the outcome of the test result. The aim of the counselling is primarily to promote a rising consciousness amongst patients and subsequently within their communities in an endeavour to move away from what is termed 'exceptionalism' and towards 'normalisation' of the treatment of HIV/AIDS. Communicating the facts about HIV will help to dispel the myths and stigma which still surround the disease. A convenience sample of one hundred and twelve women were interviewed whilst attending antenatal clinics at four different sites in KwaZulu-Natal. In addition a small cross-sectional sample of service providers and key informants in communities situated near to the chosen sites were interviewed to explore the perceptions of VCT and HIV in the current health service and community environment. The findings revealed that there is to date no mandatory policy which offers VCT routinely at any of the health centres primarily due to the cost of testing, lack of posts for trained counsellors and timeous laboratory facilities. Confusion amongst health personnel regarding current policies of treatment regimens for HIV/AIDS patients, as well as differing opinions about feeding options for infants, can undermine counsellors' confidence to handle complex issues competently from an informed position. Recommendations are that trained counsellor posts with opportunities for updating of current policies, easily accessible laboratory facilities and suitable space for confidential counselling (both oral and visual) be implemented as a priority in the health service. A more comprehensive service should be universally implemented, not just in antenatal and communicable disease clinics for ethical reasons of equity between all members of society. In the same vein the networking and cumulative energy of NGOs, religious groups and health professionals must be harnessed to work synergistically to provide sustainable solutions for those living with HIV and those at risk of becoming infected. / Thesis (M.A.)-University of Natal, Durban, 2001.