This study sought to explore and describe the perceptions and beliefs of physicians about adherence to antiretroviral treatment by patients in the South-East district of Botswana. The Health Belief Model (Naidoo & Willis 2003:222) was adapted to suit and be used in the study. A descriptive, exploratory qualitative design was used. Unstructured interviews and unstructured observation data collection methods were applied. Informed consent was obtained prior to data collection. For triangulation purposes, observations were done following interviews, and data analysis was done by two different people. The findings of the study revealed that the perceptions and beliefs of treating physicians contributed towards adherence. Physicians perceived adherence as an important aspect in the success of antiretroviral treatment. Giving patients correct information, personal motivation, patients' understanding of treatment, traditional and religious beliefs were among other factors perceived by physicians to be impacting on adherence. / Health Studies / M.A. (Public Health)

Puberty rites are practised in many countries including South Africa. In South Africa the puberty rites have different names and different practices. This study focused on vukhomba among the Manchangana/Vatsonga. Vukhomba is conducted exclusively for girls who have reached menarche. The purpose of this study was to explore the possibility of utilising vukhomba for the improvement of the health status of women. The study design is a qualitative, exploratory, descriptive contextual research study conducted in the Northern region of the Northern Province among Vatsonga\Manchangana in four selected areas. The ethnographic strategy was used to gain access to the vukhomba to view and describe the rite from an emic perspective. The sample included all girls who were initiates during January 1998 and December 1999 in the four selected areas, as well as Vadzabi, varileri, initiated girls, initiated women and vukhomba elders who attended the initaitions. The techniques for data collection included participant observation, semi-structured interviews, focus group discussions, key informant interviews and feedback workshops. The findings indicate that vukhomba is conducted during the school holidays in order to cater for girls who are still attending school. The sexuality education in this rite is mainly about encouraging initiates to maintain their virginity for their future husbands. Vukhomba therefore teaches girls attending the initiation the facts of life. It was however, found that girls often attend the initiation for material gain and respect for elders. The content of sexuality education information given to girls during the rite is inadequate. Initiated women and girls wanted to gain more knowledge about their bodies, their health, menstruation, child bearing and pregnancy, contraceptives and pregnancy. After reviewing the findings of the research an intervention programme was developed and discussed with the initiated women and initiated girls. Vukhomba elders accepted the intervention programme, however, certain topics were not approved e.g. contraception. The intervention programme is expected to form part of the initiation programme in the future. Initiated community members will be trained to facilitate the activities of this programme. / Health Studies / D.Litt. et Phil.

HIV/AIDS is a global challenge and its impact is evident. This places a burden on hospitals and health professionals. To ease this burden there are home-based care programmes which, through home-based caregivers, provide patients living with HIV/AIDS with physical and palliative care. However, these HBCGs face various challenges such as poverty, discrimination and stigma when caring for PALHIV, and their own emotional strain, which becomes burdensome without sufficient support from the home-based care centre. The qualitative study undertaken investigates the challenges and coping mechanisms of the HBCGs. Thirteen research participants were drawn from a centre in Mamelodi. Data was gathered through interviews and observations, categorised into themes and analysed. Major findings revealed that social challenges faced by HBCGs include poverty, stigmatisation and discrimination. Emotions experienced by HBCGs include guilt, anger, hopelessness, but they have spiritual reliance through prayer as one of their coping mechanisms. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

The purpose of this study is to explore the EAP environment and provide a better understanding of the related roles of the Employee Assistant Practitioners/Professionals (EAPs) in respect of their treatment of various forms of illnesses in the workplace – particularly HIV and AIDS. The EAP role is not aligned to any individual profession, as it is designed to match employees’ holistic needs. It is in this context that the repertoire of EAP roles would include caring, psycho-social, therapeutic and technical skills. The EAP role is therefore endowed with the potential to meet a range of inter-departmental and multi-disciplinary needs – such as Nursing, Allied Health Professions, and Healthcare Sciences. A generic Assistant Practitioners Performance Management system (scorecard) had to be developed and agreed to with the City of Johannesburg’s (CoJ) Management in order to maintain consistency when developing APE programmes and roles. Notwithstanding the fact that the Employee Assistant Practitioners do also address the growing HIV/AIDS concerns in the workplace – including psycho-social problems of employees and their families – there is minimal acknowledgment of the EAPs’ roles, and little recognition of their welfare and well-being programmes. Drawing eclectically from various inter-related disciplinary terrains, the study centripetally explores the roles of EAPs as well as HIV/AIDS frameworks in the workplace. Quantitative and qualitative descriptive research methods were employed to assess challenges encountered by the City of Johannesburg (C.o.J) employees and their dependants. Questionnaires were used for the data collection of this study. The repertoire of participants in the study (n=55) comprised of doctors, social workers, nurses, HR officers, and other CoJ employees themselves. vi The questionnaire became the pivotal quantitative data analysis reference point ias it focused on numbers or quantities, and less on the qualitative analysis, which focused on differences in quality. The results of the study are based on numeric analysis and statistics to quantify the qualitative analysis. The prevalence of fewer participants was largely influenced by the depth of the data collection process, which did not allow for large numbers of research participants. The findings of the study revealed, amongst other factors, that there was an unsurpassed need to integrate different HIV/AIDS frameworks in order that the roles of EAPs becomes more effectively and efficiently defined and executed. The roles of EAPs were hitherto not well defined, resulting in duplication and confusion of service delivery to some employees utilising the EAP services. However, some of the EAP roles are highly appreciated and increasingly supported by managers and employees. Based on the findings of the study, recommendations were made for clarifying and extending the criticality of EAP roles and functions. / Health Studies / Ph. D. (Health Studies)

Neste estudo, busca-se compreender o existir da criança com aids no mundo da vida de uma Casa de Apoio, sob o olhar da Teoria de Enfermagem Humanística de Paterson e Zderad. Trata-se de uma pesquisa qualitativa com abordagem existencial-fenomenológico-humanística proposta por Paterson e Zderad, tendo como cenário uma Casa de Apoio a Crianças com HIV/aids, na cidade de Santa Maria, Rio Grande do Sul. A Casa abriga crianças portadoras ou não do vírus HIV/aids, as quais são privadas do núcleo da família biológica por seus pais serem portadores do HIV e não terem condições de cuidá-las. O estudo obteve aprovação do Comitê de Ética em Pesquisa do Centro Universitário Franciscano-UNIFRA. Os participantes da pesquisa foram três crianças com aids, que residem ou já residiram nessa Casa. Para a coleta das informações, utilizaram-se a entrevista fenomenológica e o desenho como recurso, que emergiram quatro unidades de significação: criança mostra que brincar é um modo de estar-melhor; criança se percebe no mundo com os outros; criança visualiza a família como parte do seu existir; criança preocupa-se com o estar-melhor e o vir-a-ser.A interpretação das informações foi fundamentada na Nursology de Paterson e Zderad. Assim, este estudo possibilitou compreenderem-se as necessidades expressas pela criança com aids que vive ou viveu em uma Casa de Apoio, na qual o cuidado de Enfermagem possibilita a criança ser-mais no mundo da vida. Espera-se que este estudo auxilie os cuidadores em saúde e, em especial, em Enfermagem a lançarem um outro olhar para essas crianças, com o intuito de perceberem que, nelas, há um ser humano com sentimentos singulares, que tem potencialidades para vir-a-ser, limitações de não-ser e que necessita do outro para realizar-se no mundo. Por fim, apresentam-se recomendações nas áreas da pesquisa, do ensino, da extensão e do cuidado em Enfermagem. / In this study, one searchs to understand existing of the child with AIDS in the worldlife of a House of Support, under the look of the Theory of Humanistic Nursing of Paterson and Zderad. One is about a qualitative research with existentialphenomenological- humanist boarding, having as scene a House of Support the Children with HIV/aids, in the city of Santa Maria, Rio Grande Do Sul. The House shelters carrying children or not of the HIV/aids virus, which finishes being private it nucleus of the biological family for its parents to be carrying of the HIV and not there are conditions to take care of them. The study it got approval of the Committee of Ethics in Research of the University Center Franciscano-UNIFRA. The partners of the research had been three children with AIDS and its familiar ones, that they inhabit or already they had inhabited in this House. For the collection of the information, they had used it phenomenological interview and the drawing as resource, that four units, of unification had emerged: child sample that to play is a way to be-good; child if perceives in the world with the others; child visualizes the family as part of its to exist; child is worried about being-good and come-the-to be. The interpretation of the information was based on the Humanistic Nursology of Paterson and Zderad. Thus, this study it made possible to understand the express necessities for the child with AIDS that lives or lived in a House of Support, in which the care of Nursing makes possible the child to be-more in the world of the life. One expects that this study it assists the cuidadores in health and, in special, in Nursing launching one another look for these children, with intention to perceive that, in them, it has a human being with singular only feelings e, that have potentialities come-the-to be, limitations of not-being and that needs the other to become fullfilled itself in the world. And so, we point to proposals in areas of search, teaching, extension and nursing taking care / En este estudio nosotros buscamos comprender el existir del niño portador de la sida en el mundo del vida de una Casa de Apoyo, bajo la mirada de la Teoría de Enfermage Humanística de Paterson y Zderad. El escenario en que se desarrolló fue el de una Casa de Apoyo para niños con AIV/Sida, en la ciudad de Santa Maria, Río Grande del Sur. La Casa abriga niños, portadoras o no del virus del HIV/Sida, los cuáles acaban por ser privados de la familia biológica una vez que sus padres son portadores del HIV e no tienen condiciones de cuida-los. Los participantes de la encuesta han sido tres niños con Sida y sus familiares, que residen o ya residieron en esa Casa. Para la coleta de las informaciones, fue utilizada la entrevista fenomenológica y la observación. La interpretación de los datos fue fundamentada en la Teoría Humanística de Paterson y Sderad. El estudio obtuvo aprobación del Comité de Ética en Pesquisa. Emergieron cuatro categorías: el niño muestra que brincar es un modo de estar-mejor; el niño que se percibe en el mundo con los otros, habla de sus amiguitos, de su familia, de la escuela y de la Casa de Apoyo como un lugar de cuidados; el niño muestra que la familia hace parte de su existir; las manifestaciones de la enfermedad causan en el niño la preocupación con el estarmejor y con el venir-a-ser. Este estudio posibilitó comprender las necesidades expresas por el niño con Sida que vive o vivió en una Casa de Apoyo, en la cual el cuidado de Enfermage hace el niño ser-más en el mundo de la vida. Sin embargo, se espera que ayude los cuidadores en salud y, en especial, en Enfermage, a tener un mirar diferenciado a eses niños, con el intuito de percibieren que existe un ser humano con sentimientos únicos y singulares, que tienen potencialidades de venir-aser, limitaciones de no-ser y que necesita del otro para realizar-se en el mundo. Como recomendaciones, quedan propuestas en las áreas de la pesquisa, de la enseñanza de la extensión y del cuidado en Enfermage.

Submitted by Maria Suzana Diniz (msuzanad@hotmail.com) on 2015-11-13T15:03:06Z No. of bitstreams: 1 arquivototal.pdf: 1784577 bytes, checksum: 45a5338416ec6fd122f654a04ea42a30 (MD5) / Made available in DSpace on 2015-11-13T15:03:06Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1784577 bytes, checksum: 45a5338416ec6fd122f654a04ea42a30 (MD5) Previous issue date: 2015-02-23 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Introduction: The sexual behavior of the elderly over the sixties is marked by myths and taboos and has suffered several changes that altered the epidemiological profile of some diseases such as aids, making the elderly more vulnerable. It is well known that the construction of nursing diagnosis statements stimulate discussions about the planning of health initiatives directed to the needs of the elderly people and also the prevention, control and care of the elderly in a context of vulnerability. Objective: The present study aims to build nursing diagnosis statements for the elderly in the context of vulnerabilities to the HIV/Aids. Methodology: It is a descriptive explanatory study carried out with 20 elderly in a Family Health Unity in João Pessoa/Paraíba from June to July/2014. The data collection was made through semi-structured interview. All the information was organized and analyzed by the categorical theme technique of content analysis. After the identification of theme categories and subcategories, a term database was built in order to cross map the information with the terms of the International Classification for Nursing Practice (ICNP® 2013). Finally, the present study built nursing diagnosis statements based on the Seven Axes Model of ICNP®2013 and classified them according to the vulnerability conceptual framework. Approved by the ethics committee by the judgment nº 084/14. CAEE: 27945014.0.0000.5188. Results: Among the studied population there was a prevalence of elderly women (55%), married (55%), Catholic (70%), with a family income of one minimum wage (80%), age group from 60 to 65 years old (45%) and low education (40%). Two term database were built, one with terms present in the CIPE® 2013 and the other with non CIPE® 2013 terms; these two groups resulted in the construction of 24nursing diagnosis statements according to the following thematic categories:1) Social Conditions category, 10 nursing diagnosis statements were built, such as health knowledge, appropriate; family knowledge about the disease, present; health knowledge, damaged; sadness; fear of death; lifespan, conflictive; anguish; ability to talk about the death process, present; anxiety to death; communication service, damaged; health pursuit, damaged; 2) Cognitive Conditions, 7 nursing diagnosis statements were built: awareness of prevention measures; risk of exposure to contamination; self knowledge about the disease, present; lack of knowledge about the disease; prevention role, inadequate; fear of exposure to contamination and lack of knowledge about sexual behavior; 3)Behavioral Conditions, 7 nursing diagnosis statements were built: sexual performance, present; sexual performance, absent; denial of adherence to safety measures (condoms); gender role, damaged; fear of contamination; risky sexual relation; ability to protect, damaged. Conclusion: By describing conceptions and behaviors in a context of vulnerability to the HIV/Aids it was clear, in a broad way, that aids is connected with different types of vulnerabilities. Constructing the nursing diagnosis statements brought to light the needs of the health care, such as reflexions about the elderly health needs in a context of vulnerabilities to the HIV/Aids that will allow the planning of a systematic nursing care, benefit the nurse in his practices and also help to improve health initiatives to this age group. / Introdução: O comportamento sexual a partir dos sessenta anos de idade, no ser humano é marcado por muitos mitos e tabus, e o mesmo tem sofrido mudanças que tem alterado o perfil epidemiológico de doenças como a aids, tornando a população idosa mais vulnerável a contaminação pelo HIV. Acredita-se que a construção de enunciados diagnósticos de enfermagem instigue discussões acerca do planejamento de ações de saúde direcionado às necessidades da pessoa idosa, na prevenção, controle e cuidado a pessoa idosa no contexto da vulnerabilidade ao problema. Objetivo: Construir enunciados de diagnósticos de enfermagem para idosos no contexto de vulnerabilidades ao HIV/Aids. Método: Trata-se de um estudo exploratório descritivo, realizado com 20 idosos numa Unidade de Saúde da Família no município de João Pessoa/Paraíba, no período de junho à julho de 2014. Para coleta de dados foi utilizada uma entrevista semiestruturada. As informações foram organizadas e analisadas pela técnica de análise de conteúdo temática categorial. Após a identificação de categorias e subcategorias temáticas, foi construído um banco de termos para mapeamento cruzado com termos da Classificação Internacional para a Prática de Enfermeiros (CIPE® 2013). Por fim, foram construídos enunciados diagnósticos de enfermagem com base no modelo de sete eixos da CIPE® 2013. Aprovado pelo comitê de ética, mediante o parecer nº 084/14. CAEE: 27945014.0.0000.5188. Resultados: Dente a população estudada houve uma prevalência de mulheres idosas (55%), casadas (55%), de religião católica (70%), com renda familiar de um salário mínimo (80%), faixa etária entre 60-65 anos (45%) e com baixa escolaridade (40%).Foi construído dois bancos de termos, um com termos constantes na CIPE® 2013 e um com termos não constantes CIPE® 2013, que resultaram na construção de 24 enunciados diagnósticos de Enfermagem, por categorias temáticas:1) Condições sociais com 10 enunciados - Conhecimento em saúde, adequado, Conhecimento da família sobre a doença, presente, Conhecimento em saúde, prejudicado, Tristeza, Medo da morte, Expectativa da morte, conflituosa, Angústia, Capacidade para falar sobre o processo morte/morrer, presente, serviço de comunicação, prejudicado e comportamento de busca em saúde, prejudicada; 2) Condições cognitivas com 07 enunciados - Conhecimento sobre medidas de prevenção, Risco de exposição à contaminação, Autoconhecimento sobre a doença, presente, Falta de conhecimento sobre a doença, Papel de prevenção, inadequado, Medo de exposição à contaminação e Falta de conhecimento sobre comportamento sexual; 3) Condições comportamentais que apresentou 07 enunciados - Relação sexual, presente, Relação sexual, ausente, Não à adesão a medida de prevenção (preservativo), Papel de gênero, prejudicado, Medo de contágio, Relação sexual de risco e Capacidade para proteger, prejudicado. Conclusão: Descrever concepções e comportamentos de idosos no contexto de vulnerabilidades ao HIV/Aids, observou-se de uma forma ampla que a aids está atrelada com distintos tipos de vulnerabilidades, e a construção de enunciados diagnósticos de enfermagem, detectou-se as necessidades de saúde, como reflexões acerca das necessidades de saúde da pessoa idosa no contexto de vulnerabilidades ao HIV/Aids, que permitirão o planejamento da assistência de enfermagem sistematizada, beneficiando o enfermeiro em suas práticas, como também em ações de saúde.

Au cours de leur développement, les cellules du système hématopoïétique sont très exposées aux dommages à l’ADN qui peuvent avoir une origine exogène ou endogène. Les organismes vivants ont développé de nombreux mécanismes de réparation pour y faire face, et leur dysfonctionnement est responsable de maladies rares mais sévères chez l’Homme. Un des deux mécanismes de réparation des cassures double-brin (CDB) de l’ADN joue un rôle prépondérant dans le développement du système immunitaire (SI) des mammifères. Il s’agit de la voie de réparation des extrémités non-homologues (NHEJ) qui est absolument essentiel au bon déroulement de la recombinaison V(D)J dans les progéniteurs lymphocytaires de la moelle osseuse et du thymus. En effet, la formation de CDB de l’ADN est une étape clé de ce remaniement. De même, bien que dans une moindre mesure, le NHEJ intervient pour réparer les cassures induites par AID lors de la commutation de classe des immunoglobulines (Ig- CSR). Notre équipe a précédemment identifié un nouveau facteur du NHEJ, Cernunnos (ou XLF), responsable chez l’Homme de déficit immunitaire combiné sévère (DCIS) associé à une sensibilité aux rayonnements ionisants (RI) et à une microcéphalie. Afin de mieux comprendre le rôle de Cernunnos dans le système hématopoïétique et dans le développement des lymphocytes en particulier, nous avons créé un modèle murin invalidé pour ce gène. De façon surprenante, le développement lymphocytaire se fait quasi normalement dans ces souris, le seul défaut observé est une diminution du nombre de lymphocytes. Cependant, l’analyse fine du répertoire des cellules T a permis de mettre en évidence un biais dans l’utilisation des segments variables V et J de la chaîne α du récepteur (TCRα). Ce serait là la signature d’un défaut de survie des thymocytes, passant par une activation chronique de la voie de l’apoptose dépendante de p53 en réponse à l’accumulation de dommages de l’ADN. Certaines sous- populations de lymphocytes T, comme les iNKTs et les MAITs, seraient ainsi affectées. Par ailleurs, notre équipe poursuit la caractérisation génétique et fonctionnelle de pathologies chez des patients dont le tableau clinique laisse penser qu’il existe un déficit immunitaire ou hématologique primaire associé à un défaut de réparation de l’ADN. Nous nous sommes intéressés à un patient dont le tableau clinique combinant déficit hématopoïétique et instabilité génomique suggère une origine génétique forte. Grâce aux techniques de séquençage haut- débit et à l’étude de ségrégation au sein de la famille nous avons pu isoler plusieurs mutations dont une nous a interpellé plus particulièrement / Throughout their development, hematopoietic cells are exposed to many DNA damages of either exogenous or endogenous origin. Living organisms evolved a variety of DNA repair mechanisms in order to face those threats, and their impairment leads to rare but severe diseases in human. Of the two mechanisms involved in the repair of DNA double-strand break (DSB) repair, one plays a major role in mammal’s Immune System (IS). The non-homologous end joining (NHEJ) pathway is essential for the correct proceeding of V(D)J recombination in lymphocyte progenitors from bone marrow and thymus. Indeed, the formation of DNA DSB is a key step of the rearrangement. In similar fashion, though to a lesser degree, NHEJ is involved in repair of AID induced breaks during immunoglobulin class switch recombination (Ig-CSR). Our team previously identified a new NHEJ factor, Cernunnos (or XLF), as being responsible for a human syndrome of severe combined immunodeficiency (SCID) associated with ionizing radiation (IR) sensitivity (RS-SCID) and microcephaly. To better understand Cernunnos role in the hematopoietic system and particularly in lymphocyte development, we engineered a knock-out (KO) mouse model for this gene. Surprisingly, lymphocyte development is almost normal in these mice, the only defect observed being a decrease of lymphocyte number. However, a refined analysis of T cell repertoire allowed us to uncover a bias in the use of V and J segments from the receptor’s α chain (TCRα). This is the signature of a survival defect in thymocytes, caused by chronic activation of the p53 dependent apoptosis pathway in response to DNA damage. Some discrete T cell populations, such as iNKTs and MAITS, would be affected. In the meantime, our team pursues the uncovering of genetic diseases and their functional description in patients showing signs of immune or hematopoietic deficiency combined to impaired DNA repair. We focused on a patient harboring clinical signs of genomic instability and hematopoietic defects with strong evidence for genetic cause. Thanks to high-throughput DNA sequencing technology and whole genome association study (WGAS), we identified several mutations, one of them striking us as pertinent

Magister Psychologiae - MPsych / The aim of the study was to establish what the perceptions and attitudes are of employees at different levels of the organisation with regard to HIV/AIDS testing. A further aim was to identify possible reasons for the poor employee response to voluntary HIV/AIDS testing. It was thus important for this research to gauge employee knowledge, attitude and behaviour toward HIV/AIDS in order for organisations to develop strategies for effective HIV/AIDS counselling and testing programmes.

Magister Artium (Social Work) - MA(SW) / The burden of HIV disease is concentrated in sub-Saharan Africa and South Africa (SA) is particularly affected. Whilst there have been many studies conducted on the biomedical and socio-psychological aspects of HIV and AIDS, insufficient attention has been paid to the quality of life of those infected with the virus. The primary purpose of this study was to determine the predictors of quality of life enjoyment and satisfaction (Q-LES) of individuals living with HIV and or AIDS and those on anti-retroviral treatment or being prepared for it. Further, the study determined the relationship between psychological distress and Q-LES of HIV positive individuals because psychological distress is reported to contribute substantially to the burden of the disease in sub-Saharan Africa, including SA. This quantitative study used a battery of questionnaires administered to 121 participants in an out-patient clinic setting. The main hypothesis tested in this study is: psychological distress is a strong predictor of Q-LES. The Hospital Anxiety and Depression Scale (HADS) was used to screen for psychological distress and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) to assess the various components of QoL. A purposive sampling strategy was used to recruit participants into the study. Data analysis included descriptive and inferential statistics using SPSS to test the hypothesis. Of the total sample (N=121), 74% were females. The study found that a large proportion (49.5%) of the sample within the age group 25-49 years old had significant presence of psychological distress. Those not on ART yet were significantly affected (66%). The relationship between Q-LES subscales and psychological distress was significant (p< 0.01). The results show that psychological distress was significantly prevalent among HIV positive individuals and it was the strongest predictor of Q-LES among the study participants. Modifying the current psychological intervention programmes, in the public health clinics, for individuals vi infected with the HI virus will assist in improving the current health outcomes and also help to achieve better Quality of Life outcomes.

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) is a worldwide pandemic that affects the lives of millions of people across all ages. Its devastating effects are far-reaching and affect all aspects of an individual’s daily life. HIV/AIDS is responsible for widespread clinical manifestations involving the head and neck. Disorders of the auditory and vestibular systems are often associated with HIV/AIDS, however the extent and nature of these vestibular manifestations is still largely unknown. The main aim of this research study was to investigate vestibular functioning and pathology in adults with HIV/AIDS. This was achieved through three main research steps: a systematic literature review of the body of peer-reviewed literature on HIV/AIDS related vestibular manifestations and pathology, a description and comparison of vestibular involvement in adults with and without HIV/AIDS and an investigation to determine if HIV/AIDS influence the vestibulocollic reflex (VCR) pathways. For the first study a systematic literature review related to vestibular findings in individuals with HIV infection and AIDS was conducted. A varied search strategy was used across several electronic databases to identify relevant peer-reviewed reports in English. Several databases (Medline, Scopus and PubMed) and search strategies were employed. Where abstracts were not available, the full paper was reviewed, and excluded if not directly relevant to the study’s aims. Articles were reviewed for any HIV/AIDS associated vestibular symptoms and pathologies reported. For the second and third study, a cross-sectional, quasi-experimental comparative research design was employed. A convenience sampling method was used to recruit subjects. The sample consisted of 53 adults (29 male, 24 female, aged 23-49 years, mean = 38.5, SD = 4.4) infected with HIV, compared to a control group of 38 HIV negative adults (18 male, 20 female, aged 20-49 years, mean = 36.9, SD = 8.2). A structured interview probed the subjective perception of vestibular complaints and symptoms. Medical records were reviewed for cluster of differentiation 4+ (CD4+) cell counts and the use of antiretroviral (ARV) medication. An otologic assessment and a comprehensive vestibular assessment (bedside assessments, vestibular evoked myogenic potentials, ocular motor and positional tests and bithermal caloric irrigation) were conducted on all subjects. The systematic literature review identified 442 records, reduced to 210 after excluding duplicates, reviews, editorials, notes, letters and short surveys. These were reviewed for relevance to the scope of the study. There were only 13 reports investigating vestibular functioning and pathology in individuals affected by HIV/AIDS. This condition can affect both the peripheral and central vestibular system, irrespective of age and viral disease stage. Post-mortem studies suggest direct involvement of the entire vestibular system, while opportunistic infections such as oto- and neurosyphilis and encephalitis cause secondary vestibular dysfunction resulting in vertigo, dizziness and imbalance. The second study showed an overall vestibular involvement in 79.2% of subjects with HIV in all categories of disease progression, compared to 18.4% in those without HIV. Vestibular involvement increased from 18.9% in the Centers for Disease Control and Prevention (CDC) category 1 to 30.2% in category 2. Vestibular involvement was 30.1% in category 3. There was vestibular involvement in 35.9% of symptomatic HIV positive subjects and 41.5% in asymptomatic HIV positive subjects. Individuals with HIV were 16.6 times more likely to develop vestibular involvement during their lifetime, than among individuals without this disease. Vestibular involvement may occur despite being asymptomatic. The third study showed that abnormal cervical vestibular evoked myogenic potentials and caloric results were significantly higher in the HIV positive group (p=.001), with an odds ratio of 10.2. Vestibulocollic reflex and vestibulo-ocular reflex involvement increased with progression of the disease. There were more abnormal test results in subjects using ARV therapies (66.7%) compared to those not using ARV therapies (63.6%), but this difference was not statistically significant. Vestibular involvement was significantly more common in subjects with HIV than among those without this disease. This disease and its associated risk profile include direct effects of the virus on the vestibular system as demonstrated by postmortem studies. Opportunistic infections may compromise the functioning of the sensory and neural structures of hearing and the vestibular system indirectly, causing vertigo, dizziness or disequilibrium. Ototoxicity may also be related to vestibular dysfunction, due to the ototoxic nature of certain ARV medications. HIV/AIDS influence not only the vestibulo-ocular reflex, but also the vestibulocollic reflex pathways. Primary health care providers could screen HIV positive patients to ascertain if there are symptoms of vestibular involvement. If there are any, then they may consider further vestibular assessments and subsequent vestibular rehabilitation therapy, to minimize functional limitations of quality of life. / Thesis (DPhil)--University of Pretoria, 2014. / lk2014 / Speech-Language Pathology and Audiology / DPhil / Unrestricted