Embora a velhice seja uma realidade biológica, os significados que lhe são atribuídos são construções sociais e históricas e se constitui em categoria de análise complexa e heterogênea. O aumento de casos de HIV/Aids entre pessoas acima de 60 anos e adultos tem sido reportado por pesquisadores e tido ampla repercussão na mídia, pois os dados mostram o aumento de casos proporcionais de HIV/Aids entre idosos e adultos comparado as outras faixas de idade. Entre as razões para esse aumento figuram a maior oferta de fármacos contra disfunção erétil, o baixo uso de preservativos nessa geração e o atraso no diagnóstico. A velhice é cercada por uma série de preconceitos e estereótipos (ageism) em razão da idade ou geração e o HIV/Aids nessa fase da vida gera perplexidade, pois rompe com o estereótipo da velhice como uma fase marcada pela assexualidade, recolhimento e passividade. O objetivo deste trabalho foi o de apresentar experiências de pessoas acima de 60 anos convivendo com HIV/Aids em uma cidade histórica de Minas Gerais, colocando em cena dois aspectos pouco estudados, que iluminam duas dinâmicas importantes da epidemia: a interiorização e o aumento dos casos em pessoas nessa faixa etária. A pesquisa foi realizada principalmente a partir de entrevistas com mulheres e homens, acima de 60 anos que eram acompanhados no Centro de Testagem e Aconselhamento em DST/aids (CTA) e com diagnóstico sorológico positivo para o HIV/aids. Participaram da pesquisa três mulheres e um homem, com idades variando entre 60 e 76 anos, com pouca escolaridade, renda e com um tempo de diagnóstico variando de 5 a 9 anos. As entrevistas foram gravadas e transcritas e os conteúdos foram submetidos à análise de conteúdo. A análise dos resultados mostra diferentes estratégias adotadas para o enfrentamento da questão do viver com HIV/Aids, sendo a principal delas a tática do silêncio, do segredo e da ocultação da condição de pessoa convivendo com HIV/Aids, como forma de evitar ainda mais as situações de estigma e discriminação que ocorrem de maneira mais evidente nas relações familiares e na vida cotidiana por meio de diversos constrangimentos. Um aspecto específico do conviver com HIV/Aids nessa fase da vida é o agravamento da diminuição gradual da rede de relações sociais freqüente entre os idosos. Este trabalho mostra que as dimensões sociais de vulnerabilidade, especialmente a pobreza, as desigualdades de gênero, o estigma e a discriminação marcam a experiência de conviver com HIV/Aids na velhice. A superação de tais dimensões constitui-se em processo histórico de transformações amplas nas estruturas sociais, políticas e econômicas, nas relações sociais de gênero e na desconstrução de preconceitos e estigmas. / Although old age is a biological reality, the meanings ascribed to it are social and historical constructions and constitute a complex and heterogeneous analysis category. Increase in HIV/AIDS cases among people over 60 years old and adults has been reported by researchers, gaining wide repercussion in media, since data show a proportional increase in HIV/AIDS cases among elders and adults compared to other age brackets. Amongst the reasons for such increase are: a greater supply of medicines for erectile dysfunction, low use of condoms in such generation, and delayed diagnosis. Old age is surrounded by a number of prejudices and stereotypes (ageism) because of age or generation and HIV/AIDS in such period of life causes perplexity, since it breaks with the stereotype of old age as a period characterized by asexuality, withdrawal, and passiveness. The purpose of this project was to present experiences of people over 60 years old who live with HIV/AIDS in a historical city in Minas Gerais, drawing the attention to two aspects that have little investigation, lighting up two important dynamics of epidemic: internalization and increase in cases of people in such age bracket. The research has been carried out mainly from interviews with women and men over 60 years old who were followed up at DST/AIDS Testing and Counseling Center (CTA) and had HIV/AIDS-positive serological diagnosis. Three women and one man aged between 60 and 76 years old, with little education, income, and diagnosis time varying from 5 to 9 years have participated in the research. The interviews have been recorded and transcribed, and the contents have been submitted to analysis. The analysis of the results shows different strategies used for confrontation of the matter of living with HIV/AIDS, and the main one is the tactic of silence, secrecy and concealment of the condition of persons living with HIV/AIDS as a way to avoid even more stigma and discrimination situations that occur more evidently in family relationships and daily life through several constraints. A specific aspect of living with HIV/AIDS in such period of life is the aggravation of social relationships network fading, often among elders. This project demonstrates that the social dimensions of vulnerability, especially poverty, gender inequalities, stigma and discrimination define the experience of living with HIV/AIDS in old age. Overcoming these dimensions is a historical process of wide transformations in social, political, and economic structures, in gender social relationships, and in the deconstruction of prejudices and stigmas.

Magister Artium - MA / Twenty years into democracy and South Africa like many of the world‟s nations still faces manifold challenges in dealing with HIV/AIDS. This disease affects millions of people in various forms; socially, economically and politically. HIV/AIDS is considered to be a global pandemic (UNAIDS, 2011). The largest group at risk appears to be people between the ages of 15 and 24. One crucial way of dealing with this pandemic is through education since the emphasis is on prevention. It is against this background that this study explored the challenges teachers face in implementing HIV and AIDS initiatives and programmes in two primary schools in Crossroads, in the Nyanga region, in the Western Cape. It appears that research on this topic is not normally carried out in primary schools. I therefore start from the premise that literature on the topic, especially in this empirical field (primary schools), is limited. The conceptual lens used to understand this complex issue is the Bio-ecological Systems Model of Bronfrenbrenner (1977). Teachers operate within various contexts and their teaching is often influences by their experiences, knowledge and attitudes (Tayob, 2010:3). Furthermore, it appears that the implementation of HIV/AIDS initiatives and programmes at primary school level is dependent on the relationship between many systems. The complexities of understanding these relationships warrant the use of this model within this study. Methodologically, this study employed a qualitative case study research design to investigate this contemporary phenomenon. I employed in-depth qualitative data collection procedures which included: a questionnaire, semi-structured interviews, and document analysis. The findings indicate that educators are seriously constrained by lack of support from school management and parents when engaging in HIV/AIDS initiatives or programmes at respective primary schools. The study also reveals that educators are not well trained to offer counselling to deal with HIV/AIDS related matters and it becomes worse with those infected. In addition, this study reveals that embedded cultural beliefs play a huge impeding factor in attempts to participate in HIV/AIDS initiatives and programmes, which are aimed to empower both educators and learners. The study therefore recommends a need for stronger financial muscle and support from schools management team to ensure that time set aside for life orientation classes be utilised effectively for the benefit of learners with priority on HIV/AIDS studies and initiative programmes. A strategic inclusion of parents, religious and traditional leaders with the Department of Basic Education and all relevant partners is very critical to achieve the fight against the struggle with HIV/AIDS through means of education at all levels within the sector and beyond.

Magister Public Health - MPH / In recognition of high dual burden of tuberculosis (TB) and Human Immunodeficiency virus(HIV) in Sub-Saharan Africa, the World Health Organization (WHO, 2004) provided guidance for implementing integrated HIV/TB services. This strategy has been implemented using different models ranging from partial to fully integrating, and evaluations of these models have been conducted to determine their effectiveness. The aim of this study was to describe and contrast the effectiveness of different models of implementation of HIV and TB integration at primary care level within the Tuberculosis (TB) programme in Livingstone District, Zambia The specific objectives of the study included; 1. To describe the models of integrated HIV and TB services that are currently implemented at four health facilities within the TB programme in Livingstone District at primary health care level. 2. To describe and contrast the coverage and quality of HIV diagnosis in the Tuberculosis(TB) programme achieved in the different facilities representing fully and partially integrated models of service delivery. 3. To describe and contrast the coverage and quality of HIV prevention activities in the Tuberculosis (TB) programme achieved in the different health facilities representing fully and partially integrated models of service delivery. 4. To describe and contrast the coverage and quality of HIV care activities received by coinfected clients in the Tuberculosis (TB) programme in the different facilities representing fully and partially integrated models of service delivery. 5. To describe the quality and outcomes of TB diagnosis and treatment in the different facilities representing fully and partially integrated models of service delivery. A research design using quantitative methodologies: a cross sectional survey and structured observations or review of patient records (quantitative) were used. The records of 814 TB clients notified in 2010 served as the study population while the sample of 464 (232 from partially and 232 from fully integrated) were randomly selected. Two data collection tools namely: patient record and HIV/TB register review; facility staff interviews (key informant interviews) were used and the results were analyzed using Epi info statistical package. In the study, all respondents gave informed consent and no personal information was collected from the retrospective record review. The HIV prevention interventions in this study were rated below 30% except for of HIV education (97%). Statistically significant differences (p-value<0.001) existed for condom provision at facility level. Poor performance reported for STI screening (below 2%) and PMTCT information (below 15%). The HIV testing rate was 94% among TB clients which was higher than the counseling coverage of 88%. Statistically significant differences (p value <0.001) at facility level existed for clients who received HIV test results. Sixty three percent (63%) of TB clients were also co- infected with HIV. ART assessment for TB clients was below 40% and statistically significant differences (p value=<0.001) between facilities were identified for this indicator. ART assessment of TB clients at the same facility they tested for HIV was above 50% for all facilities. The continuation of cotrimoxazole was poor at 38% and statistically significant differences (p value=<0.001) were identified for this indicator between facilities. Sputum testing was 85% while the cure rate was poor at 28% average for all facilities. Statistically significant differences (p-<0.001) were noticed at model level for clients cured. Although HIV prevention and care services were introduced in the TB program in Livingstone,they were not comprehensive enough to respond to the high HIV and TB co-infectivity. For HIV prevention, other than HCT and HIV education, the rest of the critical interventions such as condom provision, STI screening and treatment, and PMTCT intervention were neglected. The HIV care services such as ART assessment and CPT implementation were also poor. There is need to put in place systems to improve these services in the district to improve treatment outcomes. The differences that were noted in performance for the majority of the indicators were mainly at facility level as being a fully integrated facility did not guarantee effective integration or better performance.

Magister Public Health - MPH / Background: The hallmark of HIV infection is immunosuppression which predisposes to unusual infections and malignancies generally known as opportunistic diseases (ODs). Globally, ODs are the major cause of morbidity and mortality in people living with HIV (PLHIV). Since the advent of Highly Active Antiretroviral Therapy (HAART), a significant decline in AIDS progression and ODs has been observed globally. However, most of the evidence suggesting sustained decline in AIDS progression and ODs has come from high-income settings with relatively less burden of ODs in the pre-HAART era. The findings of studies in high-income settings may not be generalizable to resource-limited settings. Lack of information regarding the burden of ODs in HAART-experienced populations in Nigeria and the risk factors for their occurrence has made it difficult to fully assess the sustained efficacy of HAART in the country. The aim of this study was to investigate the prevalence of and risk factors for HIV-related opportunistic diseases amongst HAART patients at the Federal Medical Centre (FMC) in Owerri, Nigeria. Study design and setting: A quantitative, cross-sectional descriptive and analytical study was conducted with 354 adult HIV-infected patients 15 years and above, who were on HAART for a minimum of 12 weeks at the HIV clinic of the FMC, Owerri, South-east Nigeria. Patients currently manifesting an OD whose onset ante-dated the commencement of HAART were excluded. The participants were recruited by simple random sampling. Data collection: Using a structured questionnaire, data was collected by clinicians through interviews, physical and laboratory examinations for patients that provided informed consent and met the study criteria. The questionnaire captured patient’s socio-demographic information and other relevant clinical/laboratory data. Data Analysis: The data was analysed using Epi info version 3.5.1 and Open Epi Version 2.2.1. Descriptive statistics for HIV-related ODs were carried out using percentages and frequencies tables for categorical variables and means (SD) or medians (IQR) for numerical variables. In univariate analysis, the Chi-square test was used to determine significance of association between OD and socio-demographic and clinical variables while the Student "t"-test was used to compare group means. Logistic regression model (multivariate analysis) was used to determine the independent risk factors for the occurrence of ODs using parameters that had a p-value of <0.25 on univariate analysis. All reported p-values <0.05 were considered statistically significant. Results: The mean age of the participants was 41.1 ± 10.0 years; and females were in the majority (65.8%). Over 40% of them were rural dwellers, 50.4% belonged to the lower socioeconomic class, and 55% had a monthly household income less than 20,000 Naira. Fifty percent (50%) of them had advanced immunosuppression at first presentation. The median duration of HAART (3 years) paralleled the median duration of HIV diagnosis (3.4 years) and HAART adherence rate was 78%. The overall prevalence of ODs was found to be 22.4%. Among the 76 patients diagnosed with ODs, the leading conditions were candidiasis (38.2%), TB (34.2%), dermatitis (25%), chronic diarrhoea (6.6%) and sepsis (6.6%). The independent risk factors for the occurrence of ODs were household income less than 20,000 Naira (Adjusted odds ratio [AOR] = 2.4, 95% CI 1.1-5.1), HIV duration of less than 3 years (AOR= 2.1, 95% CI 1.1- 4.2), advanced WHO clinical stage at baseline (AOR= 8.1, 95% CI 4.0-16.4), baseline haemoglobin less than 10 g/dl (AOR= 2.9, 95% CI 1.3-56.1), current CD4 cell count less than 200 cells/μl (AOR= 3.0, 95% CI 1.14-6.2), and HAART non-adherence (AOR= 5.4, 95% CI 2.6-11.2). Past history of TB was found to be a strong predictor of TB (AOR= 5.3, 95% CI 1.4-20.2). Conclusions: Opportunistic diseases are common in patients receiving HAART in Nigeria and candidiasis and TB remain the leading conditions. Late presentation and HAART non-adherence are among the strongest risk factors for ODs in patients receiving HAART. Others include duration of HIV diagnosis less than 3 years, presence of anaemia at the time of first presentation and having a low CD4 cell count while on HAART. Beyond these clinical risk factors, poverty increases the risk of developing an OD during HAART and may emerge a strong determinant of HIV-related ODs in developing countries. Recommendations: A high index of suspicion for ODs remains necessary in HAART patients. Health education on HIV screening and early presentation should be intensified. PLHIV who are anaemic before commencement of HAART, those with low CD4 cell count despite HAART use, and low-income earners should become target groups for a more aggressive evaluation for ODs. Prophylaxis for TB and fungal infections in the absence of active disease should be widely implemented in developing countries. HAART adherence should be intensified.

The purpose of this study was to evaluate the impact of a HIV/AIDS module, taught for approximately 24 hours over eight weeks in six schools, on the knowledge, behaviour and attitudes of grade 11 biology learners, and to identify problems their teachers had in teaching the module. The module contains detailed scientific content on HIV/AIDS and outcomes-based assessment activities. The answers written by each learner in a pre-, post- and retention test and questionnaire that included both open and closed questions on general and functional knowledge, attitudes and skills were analysed for significant changes. A narrative written by each learner was analysed to determine how the module had dealt with issues that affected his I her life. A structured interview was conducted with each teacher to identify difficulties he I she experienced in implementing the module. Classroom observations were used to monitor the implementation of the intervention in order to provide information to verify the findings of the tests, questionnaires, narratives and interviews. Analysis of the tests and questionnaires showed a significant improvement in the means scored in the pre, post- and retention tests. An ANOVA showed that the difference was unlikely to be attributable to chance. Narrative analysis resulted in a number of common themes being identified. The learners were profoundly glad to have been taught this information and many of them provided evidence of how the module impacted on their lives and sexual behaviour. Their knowledge has empowered and motivated them to control their own lives. The teacher interviews established some of the common difficulties that the teachers experienced in teaching the module. These were verified by the classroom observations. The main problems were the lack of facilities and limited time to teach about HIV/AIDS. / Dissertation (MEd (Curriculum and Instructional Design and Development))--University of Pretoria, 2006. / Curriculum Studies / unrestricted

The introduction of highly active antiretroviral therapy (HAART) has resulted in a significant decrease in the mortality and morbidity associated with the acquired immunodeficiency syndrome (AIDS). Several problems are associated with HAART and include high costs of treatments, poor availability of drugs in low-income countries, poor compliance, severe adverse effects and drug resistance. Therefore, the focus of current research is the development of new antiretroviral drugs, improved treatment strategies and the discovery of new drugs derived from plants. Green tea (GT) and its active constituent epigallocatechin gallate (EGCg) have been found to be protective against cancer, cardiovascular and neurodegenerative diseases and were found also to have antimicrobial, antimalarial and more importantly antiviral activity. EGCg, in vitro has been shown to inhibit the human immunodeficiency virus (HIV) viral enzymes reverse transcriptase and protease, destroy viral particles and interfere with the attachment of gp120 to cellular receptor CD4. The aims of this study were firstly to investigate the in vitro antiretroviral activity of GT and EGCg on the LP-BM5 defective murine leukemia virus (MuLV) that induces a disease in C57BL/6 mice similar to AIDS in humans and secondly to investigate the effects of GT and EGCg on the in vitro cytotoxicity and antiretroviral activity of current antiretroviral drugs zidovudine (AZT), indinavir (IDV), hydroxyurea (HU) and chloroquine (CQ). To achieve the above aims an in vitro model that represents cell-to-cell spreading of the LP-BM5 MuLV was developed. Firstly the presence of the LP-BM5-defective virus in the BM5 cell line was confirmed using transmission electron microscopy (TEM) to identify viral particles, PCR and RT-PCR were used to determine the presence of viral DNA and RNA respectively and viral infectivity was confirmed in C57BL/10 mice. The cytotoxicity of each drug and combination was evaluated with the MTT assay in the SC-1 cell line, the predominant cell type in the in vitro cell culture model. GT was the least cytotoxic, followed by AZT, IDV, EGCg, HU and CQ. Co-cultures (BM5:SC-1, 1:10000) that represented cell-to-cell transmission of the virus were established. Real time PCR for proviral DNA revealed that IDV, AZT and HU completely suppressed, CQ dose dependently reduced while GT and EGCg had no effect on viral transmission. Findings using AZT and IDV thus validated the use of this in vitro co-culture model for first line screening of new drugs and plant extracts. The effect of GT or EGCg in combination with AZT, IDV, HU or CQ was also evaluated as GT or EGCg could enhance the antiretroviral effects or decrease cellular toxicity of these drugs. For GT with AZT a mix of synergism and antagonism on cell toxicity was observed with little to no effect on the antiretroviral activity of AZT. Antagonism on cell toxicity was observed for GT with IDV, with no effect on the antiretroviral activity of IDV. In contrast EGCg significantly reduced the antiretroviral activity of IDV. A strong antagonistic effect was observed for GT with HU, with GT reducing the antiretroviral effect of HU. For combinations of AZT with EGCg and HU with EGCg a similar effect was observed as for AZT and HU respectively combined with GT. Synergism in cytotoxicity was observed between GT and CQ associated with a significant decrease in viral loads while EGCg combined with CQ had an opposite effect at higher concentrations. In conclusion, the in vitro co-culture model of BM5 and SC-1 cells was successfully used to evaluate combinations of GT and EGCg with AZT, IDV, HU and CQ. Interesting and often contradicting effects were observed, such as seen for IDV in combination with GT and EGCg as well as CQ in combination with GT and EGCg. These effects may be of clinical relevance and further investigation is warranted. / Dissertation (MSc)--University of Pretoria, 2009. / Anatomy / unrestricted

AIDS is a leading high-risk disease with multiple-faceted impact worldwide. It is impacting on a number of sectors. This subject was chosen because of personal interest, and also because of lack of research on the subject in the South African Post Office (SAPO). The researcher’s work in Durban, at the SAPO as an Employee Assistance Professional for two years, has exposed her to an increasing number of employees infected and affected by HIV/AIDS. As an Employee Assistance Professional the researcher is expected to support these employees. Through working with employees who are infected and affected by HIV/AIDS the researcher felt interested in the subject, especially in investigating how HIV/AIDS is affecting SAPO. The researcher also wanted to contribute to increasing the knowledge base, and to contribute to the development of the organization. This study will assist management to gain insight into the impact of HIV/AIDS on the workplace, and then to be able to plan for the future. This study was focused on the impact of HIV/AIDS in the SAPO in Durban. It was designed to understand the psychosocial impact of HIV/AIDS on both the infected and the affected employees. The aim of the study was to explore the impact at in individual level and at the organization as a whole. A particular area of interest was on the impact caused by HIV/AIDS on their benefits and the execution of work of the employees. Data was gathered by a questionnaire through a sample of 33 supervisors and 10 managers from the Post Offices around Durban who were selected using systematic random sampling. Efforts were made to ensure that cultural diversity in the Post Office is represented in the sample. A literature review was conducted on the subject of HIV/AIDS and its impact in the workplace. Key concepts of the study were the following; Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS), and impact. The study found that both the infected and affected employees were affected physically and psychologically by HIV/AIDS in different ways. It was indicated that the impact was also experienced in different ways. The impact depended on the type of a job of an infected employee. Employees were found to be at various stages and relapsing to and from backward stages, most of the time. As a final product of the applied research used for this study, some guidelines to make a difference to the impact are proposed. Proposals constitute future broad guidelines with regard to HIV/AIDS services to be provided by the Employee Assistance Professional and management, and the support to be provided to both the HIV infected and affected employees. / Dissertation (MSD (EAP))--University of Pretoria, 2005. / Social Work and Criminology / unrestricted

Human immunodeficiency virus (HIV) is currently the most significant infectious pathogen and the causative agent of acquired immune deficiency syndrome (AIDS). Unfortunately, due to lack of resources, delivery of antiretroviral therapy (ART) to countries where they are most needed, such as South Africa, Botswana, Lesotho, Malawi and Swaziland, is limited and inefficient. Moreover, the short supply and high cost of antiretroviral drugs have caused researchers to turn to plants as prospective therapies in the search for alternative anti-HIV or immunomodulatory compounds. In an African context, traditional medicines are of great importance, not so much as an alternative to treatment, but in many cases as the only source of treatment. There are various South African plants used medicinally which possess phytochemical constituents that target certain mediators of inflammation and the immune system. In African regions where patients do not have access or financial capability to obtain conventional antiretroviral treatment, traditional herbal medicines are used as primary treatment of HIV/AIDS, regardless of the fact that the safety, toxicity and efficacy of these products are not yet fully understood and that a risk for adverse effects exists. Hypoxis hemerocallidea Fisch&C. A. Mey. (Hypoxidaceae) as well as Sutherlandia frutescens L. R. Br. (Leguminosae) have various effects on the immune system and due to claims about their immune boosting properties, they are two of the most common African herbal compounds being used for HIV management in South Africa. In this study, the immune modulating properties of H. hemerocallidea and S. frutescens were investigated in order to determine whether anectodal claims made about these plants could be supported. Differentiated THP-1 and U937 macrophages were treated with aqueous extracts of H. hemerocallidea and S. frutescens as well as with solutions of compound standards reputedly isolated from these plants such as beta-sitosterol, found in H. hemerocallidea, canavanine, pinitol and gammaaminobutyric acid (GABA) which are present in S. frutescens Cytotoxicity of the test compounds was determined using the 3-(4,5-dimethylthiazol- 2-yl)-2,5-dephenyl tetrazolium bromide (MTT) assay. Antioxidant capacity was assessed using the Trolox equivalence antioxidant capacity (TEAC) and Oxygen radical antioxidant capacity (ORAC) assays. Determination of prostaglandin E2 (PGE2) concentration in treated THP-1 and U937 cell culture supernatants was performed by ELISA. Concentrations of cytokines (IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, TNF-á and IFN-ϒ) in treated THP-1 and U937 cell culture supernatants were determined by flow cytometry. Curcumin, a well-known immunomodulatory compound, was used as a positive control. Results of cytotoxicity assessments showed that H. hemerocallidea (0.1 – 1.9 mg/ml), S. frutescens (0.1 – 1.6 mg/ml), beta-sitosterol (0.2 – 25 ìM), canavanine, pinitol and GABA (1.5 – 200 ìM) were not cytotoxic to THP-1 and U937 macrophages and had cytotoxicity profiles comparable to that of the positive control, curcumin (0.8 - 25 ìM). The TEAC and ORAC assays showed different results in the antioxidant capacities of the test compounds. The purported antioxidant activity of H. hemerocallidea was confirmed by the TEAC assay with antioxidant effects equivalent to 0.2 mg/ml Trolox. Canavanine showed antioxidant activity equivalent to approximately 0.17 mg/ml Trolox and comparable to that of curcumin in the ORAC assay, suggesting its involvement in the inhibition of peroxyl radical-induced oxidation. Flow cytometry results showed that curcumin (20 ìg/ml and 10 ìg/ml) and beta-sitosterol (25 ìg/ml and 12.5 ìg/ml) reduced IL-1â and IL-8 production and significantly (p<0.05) decreased the production of TNF-á. This suggests that betasitosterol could indeed possess anti-inflammatory properties, with effects comparable to the known anti-inflammatory effect of curcumin in terms of cytokine profiles. Beta-sitosterol (25 ìg/ml) and pinitol (50 ìg/ml) significantly (p<0.001) decreased extracellular PGE2 levels in U937 macrophages by 233.4 pg/ml and 281.7 pg/ml, respectively and were the only two compounds showing greater reductions in PGE2 than curcumin. In conclusion, results of this study do not provide enough evidence to support all anecdotal claims about the ‘immune boosting’ properties of S. frutescens and H. hemerocallidea, but the compounds canavanine, beta-sitosterol and pinitol were found to have modulatory effects on certain aspects of the immune system. / Dissertation (MSc)--University of Pretoria, 2011. / Pharmacology / unrestricted

A Síndrome da Imunodeficiência Adquirida (AIDS) é doença causada pelo vírus da imunodeficiência humana. Apesar dos benefícios proporcionados pela terapia de supressão viral, algumas doenças como lipodistrofia, doenças cardiovasculares e infertilidade aumentaram a sua prevalência. No paciente com AIDS, considera-se a carga viral e o uso de terapia antirretroviral como possíveis agentes de genotoxicidade. Apesar do espermograma não poder detectar a causa precisa da infertilidade, o mesmo ainda é o exame mais realizado para averiguar a qualidade seminal. Por outro lado, a integridade do DNA do espermatozóide tem sido proposta como um parâmetro adicional de qualidade do sêmen. O ensaio cometa alcalino detecta a genotoxicidade de células germinativas humanas e pode ser usado para demonstrar a capacidade de uma substância interagir com o material genético das células gonadais. O presente estudo incluiu 50 pacientes com AIDS, atendidos no Ambulatório de Infectologia do Município de Caxias do Sul e no Ambulatório da Universidade de Caxias do Sul, sendo analisados dois grupos: usuário de terapia antirretroviral e naive. Realizou-se espermograma e o ensaio cometa alcalino, comparando com o número de linfócitos T CD4+, a carga viral, a idade, etc. Os dados demonstraram que o uso de antirretrovirais reduziu a genotoxicidade espermática, mas não se encontrou correlação com o espermograma. O presente trabalho demonstra que o ensaio cometa alcalino é um método eficiente para mensurar a genotoxicidade espermática dos pacientes portadores do vírus da imunodeficiência adquirida. / The Acquired Immune Deficiency Syndrome (AIDS) is a disease caused by the human immunodeficiency virus. Despite all the benefits provided by the viral suppression therapy, some diseases such as lipodystrophy, heart diseases and infertility increased their prevalence. In patients with AIDS, viral load and anti-retroviral therapy are possible agents for genotoxicity. The World Health Organization guidelines are reference for semen analysis and sperm DNA integrity has been proposed as an additionalparameter for semen quality and a potential predictor of fertility. The alkaline comet assay has the potential to detect genotoxic human germ cells and can be used to demonstrate the ability of a substance or metabolite to interact directly with the genetic material of gonadal cells. The study has included 50 patients with AIDS treated at the Outpatient Center for Infectious Diseases and at the University of Caxias do Sul Clinical Center, evaluated as two groups: one treated with anti-retroviral therapy and the other was a naive group. Semen and sperm genotoxicity were analysed by alkaline comet assay, comparing CD4 cell count, viral load, age and other factors of potential genotoxicity between the two groups. Data showed that the use of any anti-retroviral class has reduced sperm genotoxicity. This study shows that the alkaline comet assay is a eficcientmethod to measure sperm genotoxicity in patients infected with the human immunodeficiency virus.

Master of Public Health - MPH / PMTCT is an effective strategy in preventing paediatric HIV infection. In Zimbabwe the success of PMTCT is entirely dependent on pregnant women accessing antenatal care services and through that, getting linked to PMTCT. Failure of pregnant women to book for antenatal care through the course of pregnancy presents a missed opportunity for PMTCT and a high risk for maternal HIV transmission. It is therefore important to determine the burden of unbooked women and the factors associated with it, if elimination of maternal HIV transmission is to be achieved in the country.