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.

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) that subsequently develops remain major health concerns even after three decades since the first cases were reported. Successful therapeutic measures to address HIV/AIDS consist mostly of combinations of drugs targeting viral enzymes including reverse transcriptase (RT), protease (PR) and integrase (IN) as well as entry steps of the viral life cycle. The remarkable benefits (e.g. improved quality of life) derived from the use of these agents are unfortunately limited by toxicity to the host and the development of drug resistant viral strains. Drug resistance limits the repertoire of drug combinations available. Unfortunately, because latent forms of the virus exists, therapy has to be life-long and with new infections occurring every day, resistant strains tend to spread. To circumvent these problems, new drugs that inhibit resistant strains or work against new viral targets have to be developed. The history of gold compounds as potential inhibitors of HIV prompted this study in which twenty seven compounds consisting of gold(I), gold(III) and precursors from five classes were tested for drug-likeness, anti-HIV and immunomodulatory effects using wet lab and in silico methodologies. Cytotoxicity determination was done using viability dyes and flow cytometry. Cell proliferation profiles were monitored using the carboxyflourescein succinimidyl ester dye dilution technology and a real time cell analyser for confirming viability dye findings. The compounds’ effects on viral enzymes was determined using direct enzyme assays and in silico molecular modelling techniques. H and P nuclear magnetic resonance spectroscopy studies for determining stability revealed that the backbone chemical shifts of the compounds were relatively unchanged after one week (-20 and 37 ºC) when dissolved in dimethylsulfoxide. Eight of the gold compounds had drug-like properties comparable to clinically available drugs when in silico predictions were performed. The 50% cytotoxic dose of the compounds in human cells was between 1 and 20 μM (clinically relevant concentrations for gold compounds). Three gold(I) compounds inhibited viral infectivity at non-toxic concentrations and two gold(III) compounds did so at cytostatic (anti-proliferative mechanism that is also antiviral) concentrations. In the immunomodulatory assay, cytokine levels were altered by five compounds with one gold(I) and a gold(III) compound significantly reducing the frequency of CD4+ cells (an anti-viral function) from HIV+ donors (p= 0.005 and 0.027 respectively) when multi-parametric flow cytometry was performed. Inhibition of RT activity was predicted in in silico studies to be through interactions with the ribonuclease (RNase) H site although with poor stereochemical orientation while favourable binding predictions with the IN cofactor binding site were observed for some gold(III) complexes. Compounds predicted to interact with the RNase H site of RT and the IN cofactor site require structural modification to improve drug-likeness and binding affinity. The drug-like compound(s) which inhibited viral infectivity and lowered CD4+ cell frequency have potential for incorporation into virostatic cocktails (combination of cytostatic and directly anti-viral agent). Cytostatic agents are known to be less prone to drug resistance and because they lower CD4+ cell frequency, such compounds can potentially limit HIV immune activation. / Thesis (PhD)--University of Pretoria, 2011. / Biochemistry / unrestricted

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Este estudo discute a AIDS enquanto um fenômeno simbólico para indivíduos a partir da experiência clínica e do referencial teórico da psicologia analítica.A técnica utilizada foi a análise de registros de sonhos. Durante 22 meses foram registrados 125 sonhos de 9 de pessoas infectadas pelo HIV, e os sintomas relacionados à AIDS. Destes foram selecionadas três séries oníricas totalizando 74 sonhos, segundo os critérios: idade, sexo, orientação sexual, escolaridade, nível sócio-econômico, período de infecção, período de coleta de dados, local de atendimento e número e qualidade dos sonhos registrados. A análise foi realizada primeiro, a partir das associações e dos dados coletados durante as sessões, procurando verificar as relações entre os sonhos e o momento de vida do indivíduo. A seguir, identificou-se a constelação arquetípica mais presente em cada série, amplificando-a a nível arquetípico e relacionando-a com a situação psicológica do sujeito. Procurou-se também averiguar o movimento de compensação e/ou adaptação do inconsciente à experiência de vida marcada pela AIDS. E por último, analisou-se as três séries em conjunto procurando destacar os pontos relevantes para a compreensão do fenômeno da AIDS como um todo. A análise dos dados indica que a AIDS, enquanto fenômeno simbólico, pode ser inserida em um movimento de reestruturação amplo da personalidade. A compensação parece dar-se dentro deste processo e não em relação ao evento da AIDS isoladamente. Porém, foram registradas constelações do Self durante os eventos somáticos mais graves, o que pode indicar um esforço compensatório frente a uma situação de ameaça à vida. Os sintomas menos graves foram acompanhados pela emersão de conteúdos da sombra com os quais parecem ter uma relação simbólica. As várias referências ao mito de Dioniso ao longo das séries pode indicar, que a nível coletivo, a epidemia da AIDS faz parte de um movimento compensatório à cultura judaico-cristã-apolínea, que visa redimensionar a consciência, através da integração dos elementos instintivos da psique. / This study focuses on AIDS while a symbolic phenomenon in individuals, based on clinical experience supported by the analytical psychology theory. The technique used in this work was dream analysis. In a period of 22 months it was registered 125 dreams of 9 people infected with HIV, as well as the symptoms related to AIDS. It was selected three series of dreams totaling 74 dreams according to: age, sex, sex orientation, scholarship, social-economic level, period of infection and data registration, counseling place and amount of registered dreams. First, the analysis was made, from the associations and therapy sessions' data, in order to verify the relations between dreams and the individual situation. Next it was identified the archetypal constellation present in each series. This archetypal constellation was amplified at archetypal level and related to the psychological situation of the individual. It was also verified the compensation and the adaptation movement in relation to AIDS. Finally, the three series were analyzed all together and the significant aspects to the comprehension of AIDS phenomena were discussed. The data analysis suggests that AIDS, while a symbolic phenomenon, can be understood as part of a great movement of personality change. The compensation movement seems to take place in this process and not in relation to AIDS. However, Self constellations were registered during the most serious somatic events, what can denote a compensation in face of a threatening life situation. Less serious somatic events were followed by the emergence of shadow contents, with which they seem to have a symbolic relation. Many references to Dioniso myth can indicate at a collective level, a compensatory movement against the Judaic-Christian-Apolinean culture that aims the consciousness transformation by integrating the instinctive elements of the psyche.

As ações de prevenção ao HIV/aids na ESF foram objetos desse estudo, cujo objetivo foi analisá-las, sob a ótica da vulnerabilidade na sua dimensão programática, identificar como as equipes de saúde da família reconhecem a vulnerabilidade ao HIV/aids nos seus territórios; descrever as ações de prevenção direcionadas às populações reconhecidas pelas equipes como vulneráveis e caracterizar as dificuldades, as potencialidades e os desafios na prevenção ao HIV/aids na ESF. Para alcançar tais objetivos optou-se por um estudo exploratório, com abordagem qualitativa, utilizando-se a metodologia do Estudo de Caso. O conceito de vulnerabilidade, em sua dimensão programática, foi usado como quadro teórico. A coleta de dados foi realizada por meio de entrevistas semi-estruturadas com gerentes de UBS de Saúde ou pessoas indicadas por eles e mediante técnica de grupo focal com equipes de saúde da família. O estudo foi conduzido no período de junho a dezembro de 2009, em 11 Unidades do distrito de Capão Redondo, região sul do Município de São Paulo, Brasil. Os resultados apontam que as equipes reconhecem a vulnerabilidade ao HIV/aids em seus territórios atrelada à dimensão individual, fundamentada na noção de risco da epidemiologia tradicional, identificando grupos ou comportamentos de risco. Fundamentadas nos mesmos conceitos, percebeu-se o predomínio de intervenções informativas, de caráter prescritivo e normativo, que tinha como principal finalidade a mudança de comportamento do indivíduo. Ações fortemente baseadas no modelo biomédico hegemônico. Como dificuldades encontradas destacaram-se àquelas relacionadas ao processo de trabalho das equipes, que apontam sobrecarga de trabalho pelas demandas dos programas prioritários; alta rotatividade dos profissionais e falta de capacitação dos mesmos para a prevenção ao HIV. A maior potência da ESF na prevenção da aids encontra-se no princípio da longitudinalidade, que permite qualificar o reconhecimento da vulnerabilidade do território e planejar as ações de prevenção de acordo com as necessidades da população. O maior desafio apontado pelas equipes está em reconhecer o processo de produção e reprodução social como determinante da vulnerabilidade ao HIV. Por fim, conclui-se que o modelo técnico-assistencial vigente na atenção básica, apesar de sua reconhecida potencialidade, ainda apresenta práticas embasadas na noção de risco e no modelo biomédico hegemônico, determinando, assim, a vulnerabilidade programática na prevenção ao HIV/aids. / Actions to prevent HIV/AIDS in the FHS were objects of this study, whose objective was to analyze them from the perspective of vulnerability in its programmatic dimension, to identify how the family health teams recognize the vulnerability to HIV/AIDS in their territories; describe the preventive actions directed to the populations recognized by the teams as vulnerable and characterize the problems, potentiality and challenges in the prevention of HIV/AIDS. To achieve these goals was chosen an exploratory study with a qualitative approach, using the methodology of the Case Study. The concept of vulnerability in its programmatic dimension, was used as a theoric framework. Data collection was conducted through semi-structured interviews with managers of Basic Health Units or people appointed from them and through focus group technique with family health teams. The study was conducted from June to December 2009, in 11 units in the district of Capão Redondo, south of São Paulo city, Brazil. The results show that teams recognize the vulnerability to HIV / AIDS in their territories linked to the individual dimension, grounded in the notion of risk in traditional epidemiology, identifying risk groups or risk behaviors. Reasoned on the same concepts, it was noted the predominance of interventions informational, and normative and prescriptive character that had as main purpose to change the behavior of individual. Actions strongly based on the hegemonic biomedical model. As difficulties faced stood out to those linked to the process of work teams, which aim to work overload by the demands of the priority programs, high turnover and lack of professional training to prevent HIV/AIDS. The biggest potential of the FHS is in the principle of longitudinality, which allows to qualify the recognition of the vulnerability of the territory and to plan preventive actions according to the needs of the population. The biggest challenge is appointed by the teams in recognize the process of social production and reproduction as a determinant of vulnerability to HIV/AIDS. Finally, we conclude that the current technical health care model in primary care, despite its recognized potential also presents practices based in the notion of risk and the hegemonic biomedical model, thus determining the programmatic vulnerability in preventing HIV/AIDS.