HIV/AIDS CHARACTERISATION AND VIROLOGY

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Chapter 2 Literature review

INTRODUCTION

According to Polit et al (2004:53, 124-139), a quantitative study is carried out within the context of prior knowledge. A detailed review of the literature provides the foundation on which the new knowledge will be based, and this is usually done before any data are collected. The same authors further stress that familiarity with the relevant research literature can assist in establishing the basis for a study that is significant, for example,for nursing. The literature study is thus the initial task for the majority of quantitative researchers. The literature review provides readers with the background necessary to understand the current knowledge on a topic and clarifies the importance of a new study. Literature reviews serve an integrating function and facilitate the accumulation of knowledge. In order to substantiate the study and provide a background with regard to the present knowledge of the topic, a literature review was carried out on some aspects related to HIV/AIDS. The following aspects will be dealt with: a historical overview,characterisation and virology of HIV/AIDS; causes and transmission; physical, mental and social consequences of HIV/AIDS; and prevention measures.

THE CONCERN ABOUT HIV/AIDS

Worldwide, and in particular within sub-Saharan Africa, HIV/AIDS is the epidemic that presents the major concern for governments and communities. This virus assumes a particularly powerful threat, as the large financial inputs by governments and corporations and the efforts undertaken by scientists have not yet led to a major breakthrough in terms of vaccines or medication to combat this virus. HIV/AIDS continues decimating populations. Statistical data are frightening and women are the victims or belong to the most vulnerable group in relation to AIDS.

HISTORICAL OVERVIEW

AIDS has as its etiologic agent the HIV virus, of which the origin at present is still unknown. This virus has placed the world in a desperate situation as regards its cure. According to Baptista and Gomes (2000:13), the history of human being is the history of the struggle against his own misery. Going back in time, one looks at a past permeated by disagreements and conflict, either against nature – after all, human being has confronted nature, rather than working side by side with it as might have been expected – or against himself. Wars, hunger, unfavourable weather and inclement diseases –above all infectious diseases, have attenuated and exhausted mankind in an overwhelming manner. Baptista and Gomes (2000:14-15) point out that the first cases of HIV/AIDS were reported in 1981 by the Centre for Disease Control and Prevention (CDC) of Atlanta in the United States, an American entity engaged in the control and investigation of new and already known diseases which affect the population. At the time, a number of cases of deaths by pneumocystosis (a type of pneumonia) started being registered amongst young male homosexuals in the city of Los Angeles. In June of that same year, the CDC published an article entitled “Pneumonia by pneumocystis, Los Angeles”, in which five cases of illness were reported. Soon after, the occurrence of a tumour, the Kaposi sarcoma, until then considered as rare, was registered amongst young male homosexuals, some of whom were victims of pneumocystosis. This was, therefore, the occurrence of something new, a serious deficiency of the defence mechanisms in this group of male homosexual individuals, which manifested itself through the appearance of infection and rare tumours in people who were otherwise apparently healthy.An investigation of the new epidemic was initiated. In August 1981. An American federal law was approved which made it compulsory to register all cases of the epidemic. Two months later, the CDC compiled and applied a questionnaire containing 500 questions,with the aim of trying to define the characteristic profile of the patients (Baptista & Gomes 2000:14).After that, according to the same authors, it was a race against time in an attempt to try to discover the mystery of the epidemic; and, in the meanwhile, the cases were increasing. Composites such as amyl nitrite (used as an “aphrodisiac”) and infectious agents such as cytomegalovirus (a type of virus) were exposed as the causes, but in an inconclusive manner. After the comprehensive analysis of the data available at the time,it was presumed that the new syndrome would be an infectious disease, with a probable viral aetiology, transmitted through sexual intercourse. As well as in young male homosexuals, cases also started being detected amongst haemophiliacs treated with blood and its derivates. A year and a half after the first cases, at the end of 1982, the CDC “baptised” the new disease, calling it AIDS, Acquired Immune Deficiency Syndrome in English, having published the first definition of the case. The disease was almost libellously labelled GRID: “Gay Related Immunodeficiency”. This did not go undetected by the lay press, which often referred to the disease as “gay cancer” in its sensational headlines.AIDSPortugal (2005:4) made a presentation about the CDC publication (1983:101-3), including the first recommendations related to the prevention of AIDS. The CDC started working with sectors more representative of society, both government and the community, together with the media, the economic and religious sectors and community associations, with a view to informing the public about the disease, to put an end to myths and to lead the nation to take preventative actions. The prevention efforts involved the public in general, through information campaigns and programmes aimed at special-risk groups. The reaction to HIV/AIDS in the United States, more than in any other situation in history, demonstrated the need for cooperation between public entities and the affected communities. In Angola the first case was diagnosed in 1985. The war situation made it difficult to carry out a population census as well as doing studies on HIV; thus information about the HIV prevalence in Angola is considered scarce (MINSA (Ministry of Health in Angola) 2003-08:9).With regard to the diagnosis of the virus, during 1984 one of the first publications of a French group was entitled “Lymphadenopathy Associated Virus” (LAV), through the journal Science. The same group raised the possibility that the new virus could be associated with the Acquired Immune Deficiency Syndrome (AIDS). Soon after this publication, the same agent was identified in a French patient with AIDS (Kaposi sarcoma), thus establishing a strong link between the virus and the syndrome. The virus was called LAV: from Lymphadenopathy Associated Virus. A test was then developed to detect antibodies in serum, which was called RIPA: “Radio Immunoprecipitation Assay”. Following this, the first ELISA tests – from: “Enzyme linked immunoabsorbent assay” – were carried out for LAV, showing that other patients with AIDS and with lymphadenopathy had antibodies against this virus, i.e., that this virus provoked a reaction from the organism: the production of antibodies against the invader. However, the war was lost, as the virus when multiplying also destroyed the defence cells, and the antibodies merely functioned as indicators of the existence of the infection (Baptista & Gomes 2000:18; Metcalf & Venables 1997:177-185; Varella 2005:35-37).

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Chapter 1 Orientation to the study
1.1 INTRODUCTION
1.2 BACKGROUND
1.3 SOCIAL CHARACTERISTICS OF THE PROVINCE OF LUANDA 
1.4 PROBLEM STATEMENT 
1.5 OBJECTIVES
1.6 ASSUMPTION
1.7 SIGNIFICANCE OF THE STUDY
1.8 LIMITATION OF THE STUDY FIELD
1.9 RESEARCH METHODOLOGY 
1.10 POPULATION
1.11 SAMPLE
1.12 DATA COLLECTION INSTRUMENT
1.13 VALIDITY
1.14 RELIABILITY
1.15 DATA COLLECTION 
1.16 DATA ANALYSIS 
1.17 PRE-TESTING THE DATA COLLECTION INSTRUMENT 
1.18 PERMISSION TO CONDUCT THE RESEARCH
1.19 DEFINITION OF TERMS
1.20 ETHICAL CONSIDERATIONS 
1.21 LIMITATIONS OF THE STUDY
1.22 LAYOUT OF THE STUDY
1.23 CONCLUSION
Chapter 2 Literature review
2.1 INTRODUCTION 
2.2 THE CONCERN ABOUT HIV/AIDS
2.3 HISTORICAL OVERVIEW
2.4 HIV/AIDS CHARACTERISATION AND VIROLOGY
2.4.1 Causes and transmission of HIV/AIDS
2.4.2 Causes of HIV infection
2.4.3 Transmission of HIV
2.5 CONSEQUENCES OF HIV/AIDS
2.5.1 Physical consequences
2.5.2 Psychological consequences
2.5.3 Social consequences
2.6 MEASURES TO PREVENT HIV/AIDS INFECTION
2.6.1 Barriers against the virus
2.6.2 Information, education and communication
2.6.3 Role of the authorities and/or government
2.7 CONCLUSION
Chapter 3 Research methodology
3.1 INTRODUCTION 
3.2 RESEARCH DESIGN
3.3 POPULATION 
3.4 SAMPLE
3.5 LIMITATION OF THE STUDY FIELD
3.6 PERMISSION TO CARRY OUT THE RESEARCH
3.7 DATA COLLECTION INSTRUMENT
3.7.1 Validity
3.7.2 Reliability
3.8 PRE-TESTING THE DATA COLLECTION INSTRUMENT 
3.9 DATA COLLECTION
3.10 ETHICAL CONSIDERATIONS 
3.11 DATA ANALYSIS
3.12 CONCLUSION
Chapter 4mData analysis
4.1 INTRODUCTION 
4.2 DATA ANALYSIS 
4.3 RESULTS
4.3.1 Section 1: Biographical data
4.3.1.1 Age
4.3.1.2 Marital status
4.3.1.3 Educational level of respondents
4.3.1.4 Religion
4.3.1.5 Contraception
4.3.1.6 Wage/salary
4.3.1.7 Types of jobs performed
4.3.1.8 Relationship to the child that is ill
4.3.2 Section 2: Obstetric history
4.3.2.1 History of the pregnancy
4.3.2.2 Total number of biological children
4.3.2.3 Causes of death of children
4.3.2.4 Use of contraceptives during sexual intercourse
4.3.3 Section C: Knowledge about sexually transmitted diseases
4.3.3.1 Acquisition of sexually transmitted diseases
4.3.3.2 Condom
4.3.3.3 Human immune deficiency virus (HIV)
4.3.3.4 AIDS
4.3.3.5 Concern about AIDS
4.3.3.6 Preventing infection with HIV
4.3.3.7 HIV transmission from mother to child
4.3.3.8 Factors increasing the risk of HIV transmission
4.3.3.9 Physical appearance of full-blown AIDS
4.3.3.10 Cure for HIV/AIDS
4.3.3.11 Risk of being infected with HIV without knowing
4.3.3.12 Precaution to take when living with a person with HIV/AIDS
4.3.3.13 HIV tested
4.3.3.14 Vertical transmission of HIV
4.3.3.15 Prevention of HIV transmission from mother to child
4.4 CONCLUSION
Chapter 5 Results, conclusions and recommendations
5.1 INTRODUCTION 
5.2 OBJECTIVES 
5.3 RESULTS
5.3.1 Biographical information
5.3.2 Obstetric history
5.3.3 Knowledge of sexually transmitted diseases (STIs), Human Immune Deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS)
5.4 CONCLUSIONS 
5.4.1 Biographical information
5.4.2 Obstetric history
5.4.3 Knowledge of STIs, HIV and AIDS
5.5 RECOMMENDATIONS 
5.6 RECOMMENDATIONS FOR ADDITIONAL RESEARCH 
5.7 LIMITATIONS OF THE STUDY
5.8 CONCLUSION
BIBLIOGRAPHY

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