<p>Tuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in deaths of approximately 2 million people a year. South Africa (SA) has one of the highest annual&nbsp / TB incidences with an estimate of 558 per 100 000 population (2003) and the situation shows no sign of abating. TB remains the most common opportunistic infection and cause of death&nbsp / amongst HIV- infected patients. Both TB and HIV treatment depend exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload&nbsp / due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics maybe compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may&nbsp / not be aware of the consequences when a formulation is modified during multi-drug therapy administration. As the custodian of medicines, pharmacists are ideally placed to monitor therapy.&nbsp / Clinicbased training programmes which are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic outcome of TB and HIV drug regimens could be closely monitored. </p>

<p>Tuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in deaths of approximately 2 million people a year. South Africa (SA) has one of the highest annual&nbsp / TB incidences with an estimate of 558 per 100 000 population (2003) and the situation shows no sign of abating. TB remains the most common opportunistic infection and cause of death&nbsp / amongst HIV- infected patients. Both TB and HIV treatment depend exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload&nbsp / due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics maybe compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may&nbsp / not be aware of the consequences when a formulation is modified during multi-drug therapy administration. As the custodian of medicines, pharmacists are ideally placed to monitor therapy.&nbsp / Clinicbased training programmes which are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic outcome of TB and HIV drug regimens could be closely monitored. </p>

Magister Pharmaceuticae - MPharm / Tuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in deaths of approximately 2 million people a year. South Africa (SA) has one of the highest annual TB incidences with an estimate of 558 per 100 000 population (2003) and the situation shows no sign of abating. TB remains the most common opportunistic infection and cause of death amongst HIV- infected patients. Both TB and HIV treatment depend exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics maybe compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may not be aware of the consequences when a formulation is modified during multi-drug therapy administration. As the custodian of medicines, pharmacists are ideally placed to monitor therapy. Clinicbased training programmes which are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic outcome of TB and HIV drug regimens could be closely monitored. / South Africa

Magister Artium (Child and Family Studies) - MA(CFS) / HIV/AIDS is one of the major challenging illnesses globally and is increasingly recognised as an illness that affects families and not just the individual. While HIV/AIDS has brought many challenges to infected individuals and their families, the focus has primarily been on individuals with HIV/AIDS in relation to their needs. Families often provide most of the emotional and physical care to a family member with HIV/AIDS, placing a huge strain on them that could lead to tension between family members. There is a paucity of research exploring the phenomenon of being a member of a family affected by HIV/AIDS. Therefore, the aim of this study was to explore the lived experiences of family members adjusting to HIV/AIDS disclosure within their families.

Magister Pharmaceuticae - MPharm / Tuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in deaths of approximately 2 million people a year. South Africa (SA) has one of the highest annual TB incidences with an estimate of 558 per 100 000 population (2003) and the situation shows no sign of abating. TB remains the most common opportunistic infection and cause of death amongst HIV- infected patients. Both TB and HIV treatment depend exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics maybe compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may not be aware of the consequences when a formulation is modified during multi-drug therapy administration. As the custodian of medicines, pharmacists are ideally placed to monitor therapy. Clinic based training programmes which are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic outcome of TB and HIV drug regimens could be closely monitored. Aims The primary and secondary aims of the study were to: • Assess current practice patterns of TBI/HIV at primary healthcare clinics in the Western Cape, • Assess the need for a clinic-based TBIHIV training among final year pharmacy students in UWC. Objectives To achieve the primary aim the researcher; 1. Conducted a baseline study at Ravensmead Community Health Centre(CHC) to assess current TBIHIV practice among HCP's and co-infected patients, 2. Assessed current practice patterns at Delft South ARV clinic and Elsies River TB clinic (pre-intervention), 3. Designed and implemented a clinic-based TBIHIV intervention tool for potential use by pharmacists at Delft South and Elsies River clinics (intervention phase), 4. Evaluated patient receptivity of the intervention tool amongst patients at Delft South and Elsies River clinics (post-intervention phase). Results and discussion Findings from the baseline study indicate the need for involvement of a trained pharmacist in TB and HIV management. Even though three-quarters (77.8%; 14) of the patients preferred receiving their TB information from the clinic nurse, almost two-thirds (63.2%; 12) of the patients believed that pharmacists assisted with their treatment provision. Patient data obtained from the clinic record card showed that almost two-thirds of the patients reported that they had experienced side effects (64.4%); the therapy of more than one-quarter (26.4%) showed drug-drug interactions and onset of adverse effects (1.1 %). Post-intervention, the data showed that patients' viewed the pharmacist's role more positively. Almost all responses (97.5%; 39) favoured the services of a pharmacist in the clinic. In conclusion, findings from the post-intervention patient study clearly underpin that a clinic-based role for the pharmacist is imminent. All seven (100%) of the experimental students passed the assessment and had marks in the range between 26 and 45 and more than three-quarters (78.4 %; 29) of the control students passed with marks within this range. Conclusion A trained pharmacist would be competent to work alongside nursing staff in optimizing care provision in the clinical management of TB and HIV in patients. The existing clinic based TB/HIV programme could be supplemented with theoretical concepts in the final year of undergraduate pharmacy training.

Esse estudo teve por objeto a construção da identidade psicossocial dos adolescentes que vivem com o vírus da imunodeficiência humana (HIV) e/ou a síndrome da imunodeficiência humana adquirida (aids). Esse objeto de investigação constitui um fenômeno de representação social, uma vez que é elaborado e compartilhado entre os adolescentes soropositivos ao HIV a partir das interações que se processam entre estes e os outros indivíduos ao conviverem em sociedade. Nesse sentido, os objetivos que nortearam a condução dessa pesquisa foram: analisar a construção da identidade psicossocial de adolescentes que vivem com HIV/aids e as representações sociais que o grupo tece sobre si próprio, analisar como essas representações interferem na construção da identidade psicossocial, identificar as especificidades identitárias do adolescente associadas à condição de soropositividade ao HIV e discutir as demandas que a identidade psicossocial do adolescente que vive com HIV/aids propicia para o cuidado de enfermagem e saúde. Trata-se de pesquisa qualitativa, referenciada à luz da perspectiva processual da Teoria das Representações Sociais, bem como pela Teoria da Identidade Social e a Teoria Ego-ecológica. A pesquisa foi autorizada pelo Comitê de Ética em Pesquisa por meio do CAAE número 13650213.9.0000.5259. O estudo foi desenvolvido em um hospital de referência para o tratamento de HIV/aids, localizado na cidade do Rio de Janeiro. Os participantes do estudo foram 42 adolescentes soropositivos ao HIV, com idades compreendidas entre 15 e 22 anos, atendidos no ambulatório da referida instituição de saúde. Os dados foram coletados a partir de um instrumento de contextualização dos sujeitos e um roteiro composto por uma pergunta aberta e uma adaptação do Inventário Multifásico de Identidade Social. A apresentação e discussão dos dados fundamentaram-se nas proposições metodológicas da Teoria Ego-ecológica e da análise de conteúdo temática. Os resultados indicaram que a construção da identidade dos adolescentes soropositivos é mediada por representações sociais elaboradas sobre si e sobre os outros indivíduos, a partir de um processo dialógico psico-contextual, caracterizando-se por traços positivos e negativos que se refletem, tanto em sua saúde quanto na forma de ser e se posicionar no mundo. Esse processo transcorre em meio a um contexto de vivências de adversidades, através do qual o estigma social exerce influência negativa sobre as representações que os adolescentes constroem sobre si, quando se comparam aos outros grupos sociais com os quais interagem em suas relações cotidianas. Conclui-se que tanto a identidade socialmente construída, quanto os impactos ocasionados pela soropositividade precisam ser valorizados pelas autoridades governamentais e pelos profissionais que realizam atendimento nos diversos cenários de atenção à saúde. Essa valorização se faz necessária à medida que configura uma possibilidade de estabelecer percursos que possam dar o necessário amparo e resolutividade às demandas de saúde identificadas entre os adolescentes soropositivos ao HIV, bem como para seus respectivos familiares ou cuidadores. / The objective of this study was the psychosocial identity construction of adolescents living with human immunodeficiency virus (HIV) and/or human acquired immunodeficiency syndrome (aids). This investigation objective is a phenomenon of social representation, since it is produced and shared among HIV-positive adolescents from interactions processed between them and other individuals interacting in the society. In this sense, the objectives guiding this research were: to analyze the psychosocial identity construction of adolescents living with HIV/aids and the social representations that the group has about themselves, to analyse how these representations that adolescents living with HIV/aids develop about themselves, to analyze how the representations interfere with the construction of psychosocial identity, to identify the specific identity of the adolescent related to HIV condition, to discuss the psychosocial identity demands that adolescents living with HIV/aids provides for nursing and health care. This is qualitative research, referenced based on the procedural perspective of the Theory of Social Representations, and the Theory of Social Identity and Ego-ecological Theory. The research was authorized by the Ethics Committee in Research through CAAE number 13650213.9.0000.5259. The study was developed in a referral hospital for the treatment of HIV/aids, located in the city of Rio de Janeiro. Study participants were 42 adolescents positive to HIV, 15 to 22 years old, assisted at the clinic of the health institution. The data were collected from an instrument contextualization of the subjects and a script consisting of an open question and an adaptation of the Multiphase Inventory of Social Identity. The data presentation and discussion were based according to the methodological propositions of Ego- ecological Theory and to the thematic content analysis. The results showed that the identity construction of adolescents with HIV is mediated by social representations made about themselves and about other individuals, from a dialogic psycho-contextual process, characterized by positive and negative features that reflect both in their health and in the way of being and to position in the world. This process occurred in experiences of adversity context, which the social stigma, generally attributed to people living HIV/aids, has a dark influence about the representations that adolescents build about themselves, when comparing to other social groups they interact in their everyday relationships. It is concluded that both the socially constructed identity as the impacts caused by HIV must be valued by governmental authorities and by professionals who perform services in several health care areas. This valorization is necessary as it shows a possibility of establishing routes that can give the necessary protection and efficaciousness to health demands identified in HIV adolescents, as well as to their family members or caregivers.

Esse estudo teve por objeto a construção da identidade psicossocial dos adolescentes que vivem com o vírus da imunodeficiência humana (HIV) e/ou a síndrome da imunodeficiência humana adquirida (aids). Esse objeto de investigação constitui um fenômeno de representação social, uma vez que é elaborado e compartilhado entre os adolescentes soropositivos ao HIV a partir das interações que se processam entre estes e os outros indivíduos ao conviverem em sociedade. Nesse sentido, os objetivos que nortearam a condução dessa pesquisa foram: analisar a construção da identidade psicossocial de adolescentes que vivem com HIV/aids e as representações sociais que o grupo tece sobre si próprio, analisar como essas representações interferem na construção da identidade psicossocial, identificar as especificidades identitárias do adolescente associadas à condição de soropositividade ao HIV e discutir as demandas que a identidade psicossocial do adolescente que vive com HIV/aids propicia para o cuidado de enfermagem e saúde. Trata-se de pesquisa qualitativa, referenciada à luz da perspectiva processual da Teoria das Representações Sociais, bem como pela Teoria da Identidade Social e a Teoria Ego-ecológica. A pesquisa foi autorizada pelo Comitê de Ética em Pesquisa por meio do CAAE número 13650213.9.0000.5259. O estudo foi desenvolvido em um hospital de referência para o tratamento de HIV/aids, localizado na cidade do Rio de Janeiro. Os participantes do estudo foram 42 adolescentes soropositivos ao HIV, com idades compreendidas entre 15 e 22 anos, atendidos no ambulatório da referida instituição de saúde. Os dados foram coletados a partir de um instrumento de contextualização dos sujeitos e um roteiro composto por uma pergunta aberta e uma adaptação do Inventário Multifásico de Identidade Social. A apresentação e discussão dos dados fundamentaram-se nas proposições metodológicas da Teoria Ego-ecológica e da análise de conteúdo temática. Os resultados indicaram que a construção da identidade dos adolescentes soropositivos é mediada por representações sociais elaboradas sobre si e sobre os outros indivíduos, a partir de um processo dialógico psico-contextual, caracterizando-se por traços positivos e negativos que se refletem, tanto em sua saúde quanto na forma de ser e se posicionar no mundo. Esse processo transcorre em meio a um contexto de vivências de adversidades, através do qual o estigma social exerce influência negativa sobre as representações que os adolescentes constroem sobre si, quando se comparam aos outros grupos sociais com os quais interagem em suas relações cotidianas. Conclui-se que tanto a identidade socialmente construída, quanto os impactos ocasionados pela soropositividade precisam ser valorizados pelas autoridades governamentais e pelos profissionais que realizam atendimento nos diversos cenários de atenção à saúde. Essa valorização se faz necessária à medida que configura uma possibilidade de estabelecer percursos que possam dar o necessário amparo e resolutividade às demandas de saúde identificadas entre os adolescentes soropositivos ao HIV, bem como para seus respectivos familiares ou cuidadores. / The objective of this study was the psychosocial identity construction of adolescents living with human immunodeficiency virus (HIV) and/or human acquired immunodeficiency syndrome (aids). This investigation objective is a phenomenon of social representation, since it is produced and shared among HIV-positive adolescents from interactions processed between them and other individuals interacting in the society. In this sense, the objectives guiding this research were: to analyze the psychosocial identity construction of adolescents living with HIV/aids and the social representations that the group has about themselves, to analyse how these representations that adolescents living with HIV/aids develop about themselves, to analyze how the representations interfere with the construction of psychosocial identity, to identify the specific identity of the adolescent related to HIV condition, to discuss the psychosocial identity demands that adolescents living with HIV/aids provides for nursing and health care. This is qualitative research, referenced based on the procedural perspective of the Theory of Social Representations, and the Theory of Social Identity and Ego-ecological Theory. The research was authorized by the Ethics Committee in Research through CAAE number 13650213.9.0000.5259. The study was developed in a referral hospital for the treatment of HIV/aids, located in the city of Rio de Janeiro. Study participants were 42 adolescents positive to HIV, 15 to 22 years old, assisted at the clinic of the health institution. The data were collected from an instrument contextualization of the subjects and a script consisting of an open question and an adaptation of the Multiphase Inventory of Social Identity. The data presentation and discussion were based according to the methodological propositions of Ego- ecological Theory and to the thematic content analysis. The results showed that the identity construction of adolescents with HIV is mediated by social representations made about themselves and about other individuals, from a dialogic psycho-contextual process, characterized by positive and negative features that reflect both in their health and in the way of being and to position in the world. This process occurred in experiences of adversity context, which the social stigma, generally attributed to people living HIV/aids, has a dark influence about the representations that adolescents build about themselves, when comparing to other social groups they interact in their everyday relationships. It is concluded that both the socially constructed identity as the impacts caused by HIV must be valued by governmental authorities and by professionals who perform services in several health care areas. This valorization is necessary as it shows a possibility of establishing routes that can give the necessary protection and efficaciousness to health demands identified in HIV adolescents, as well as to their family members or caregivers.

Magister Pharmaceuticae - MPharm / Tuberculosis and mv Tuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in the deaths of approximately 2 million people a year. South Africa (SA) has one ( of the highest annual TB incidences with an estimate of 558 per 100 000 population (2003) and the situation shows no sign of abating. TB remains the most common opportunistic infection and cause of death amongst HIV- infected patients. Both TB and HIV treatment depends exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics may be compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may not be aware of the consequences when a formulation is modified during multi-drug therapy administration. As the custodian of medicines, pharmacists are ideally placed to monitor therapy. Clinic-based training programs that are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic the outcome of TB and HIV drug regimens could be closely monitored. XVll Aims The primary and secondary aims of the study were to: • Assess current practice patterns of TBIHIV at primary healthcare clinics in the Western Cape, • Assess the need for a clinic-based TBIHIV training among final year pharmacy students in UWC. http://uwc.ac.za Objectives To achieve the primary aim the researcher; 1. Conducted a baseline study at Ravensmead Community Health Centre(CHC) to assess current TBIHIV practice among HCP's and co-infected patients, 2. Assessed current practice patterns at Delft South ARV clinic and Elsies River TB clinic (pre-intervention), 3. Designed and implemented a clinic-based TBIHIV intervention tool for potential use by pharmacists at Delft South and Elsies River clinics (intervention phase), 4. Evaluated patient receptivity of the intervention tool amongst patients at Delft South and Elsies River clinics (post-intervention phase). XVlll To achieve the secondary aim the researcher; 5. Introduced a clinic-based training for seven final year pharmacy students, 6. Designed and administered an assessment to both control and experimental students, 7. Assessed scores between students who received the training (experimental group) with those who did not receive the training (control group). Results and discussion Findings from the baseline study indicate the need for the involvement of a trained pharmacist in TB and HIV management. Even though three-quarters (77.8%; 14) of the patients preferred receiving their TB information from the clinic nurse, almost two-thirds (63.2%; 12) of the patients believed that pharmacists assisted with their treatment provision. Patient data obtained from the clinic record card showed that almost two-thirds of the patients reported that they had experienced side effects (64.4%); the therapy of more than one-quarter (26.4%) showed drug-drug interactions and onset of adverse effects (1.1 %). Post-intervention, the data showed that patients' viewed the pharmacist's role more positively. Almost all responses (97.5%; 39) favored the services of a pharmacist in the clinic. In conclusion, findings from the post-intervention patient study underpin that a clinic-based role for the pharmacist is imminent. All seven (100%) of the experimental students passed the assessment and had scores in the range between 26 and 45 and more than three-quarters (78.4 %; 29) of the control students passed with marks within this range. Conclusion A trained pharmacist would be competent to work alongside nursing staff in optimizing care provision in the clinical management of TB and HIV in patients. The existing clinic-based TB/HIV program could be supplemented with theoretical concepts in the final year of undergraduate pharmacy training.

Magister Scientiae (Medical Bioscience) - MSc(MBS) / Background: Despite the effort of scientific research on HIV therapies and to reduce the rate of HIV infection, AIDS remains one of the major causes of death in the world and mostly in sub-Saharan Africa. To date, neither a cure nor an HIV vaccine had been found and the disease can only be managed by using High Active Antiretroviral Therapy (HAART) if detected early. The need for an effective early diagnostic and non-toxic treatment has brought about the necessity for the discovery of additional HIV diagnostic methods and treatment regimens to lower mortality rates. Antimicrobial Peptides (AMPs) are components of the first line of defense of prokaryotes and eukaryotes and have been proven to be promising therapeutic agents against HIV. Methods: With the utility of computational biology, this work proposes the use of profile search methods combined with structural modeling to identify putative AMPs with diagnostic and anti-HIV activity. Firstly, experimentally validated anti-HIV AMPs were retrieved from various publicly available AMP databases, APD, CAMP, Bactibase and UniProtKB and classified according to super-families. Hidden Markov Model (HMMER) and Gap Local Alignment of Motifs (GLAM2) profiles were built for each super-family of anti- HIV AMPs. Putative anti-HIV AMPs were identified after scanning genome sequence databases using the trained models, retrieved AMPs, and ranked based on their E-values. The 3-D structures of the 10 peptides that were ranked highest were predicted using 1-TASSER. These peptides were docked against various HIV proteins using PatchDock and putative AMPs showing the highest affinity and having the correct orientation to the HIV -1 proteins gp120 and p24 were selected for future work to establish their function in HIV therapy and diagnosis. Results: The results of the in silica analysis showed that the constructed models using the HMMER algorithm had better performances compare to that of the models built by the GLAM2 algorithm. Furthermore, the former tool has a better statistical and probability explanation compared to the latter tool. Thus only the HMMER scanning results were considered for further study. Out of 1059 species scanned by the HMMER models, 30 putative anti-HIV AMPs were identified from genome scans with the family-specific profile models after the elimination of duplicate peptides. Docking analysis of putative AMPs against HIV proteins showed that from the 10 best performing anti-HIV AMPs with the highest E-scores, molecules 1,3, 8, and 10 firmly bind the gp120 binding pocket at the VIN2 domain and the point of interaction between gp120 and T cells, with the 1st and 3rd highest scoring anti-HIV AMPs having the highest binding affinities. However, all 10 putative anti-HIV AMPs bind to the N-terminal domain of p24 with large surface interaction, rather than the C-terminal. Conclusion: The in silica approach has made it possible to construct computational models having high performances, and which enabled the identification of putative anti-HIV peptides from genome sequence scans. The in silica validation of these putative peptides through docking studies has shown that some of these AMPs may be involved in HIV/AIDS therapeutics and diagnostics. The molecular validation of these findings will be the way forward for the development of an early diagnostic tool and as a consequence initiate early treatment. This will prevent the invasion of the immune system by blocking the VIN2 domain and thus designing of a successful vaccine with broad neutralizing activity against this domain.

Antiretroviral drugs were introduced into Uganda during the past decade and have revolutionised the treatment of AIDS. However, in as much as success was recorded, new challenges emerged. One such challenge was the continued use of condoms. This study investigated existing knowledge, attitudes and practices of condom use in a time of highly active antiretroviral therapy in a rural area. A quantitative, cross sectional design, with probability sampling form the general population was utilised. A self-designed questionnaire was used to collect data which was then analysed at the descriptive statistics level. The results indicated that: knowledge of HIV, its transmission, condoms and antiretroviral drugs were high among the respondents; condom acceptance and use were low; and respondents would not intentionally engage in unprotected sexual intercourse because of availability of ARVs. However it was acknowledged that some people taking ARVs have engaged in risky sexual behaviours that would expose others to infection. / Health Studies / M.A. (Public Health)