Experiences of youths participating in combination social protection and HIV prevention programme in resource constrained settings of Gauteng Province in South Africa: a collective case study design
- Authors: Zibengwa, Enock
- Date: 2023-04
- Subjects: HIV infections -- Prevention , HIV (Viruses) , HIV infections -- Africa
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/27347 , vital:66944
- Description: South Africa continues to experience unacceptably high Human Immunodeficiency Virus HIV incidence rates among youths aged 15 to 24 years. Remarkably, this is despite the numerous youth HIV prevention programmes that have been implemented in the country. Unfortunately, the programmes have not significantly curbed the spread of HIV due to the partial and fragmented nature of their implementation. The programmes are also observed to be weak in addressing complex economic factors recognised as important structural drivers for vulnerabilities that put youths at risk of HIV infection. To address this challenge, there is increased adoption and implementation of the Combination Social Protection introduced in this research as the CSP by Non-Governmental Organisations NGOs. The CSP is a youth empowerment programming strategy whose critical foundations are entrenched in combining economic strengthening interventions and HIV prevention education. CSP could provide youths with a set of indispensable life skills that enhance their competencies and agency to make informed and effective decisions regarding their health and economic lives. Despite its growing traction, little is known regarding links between the CSP and its abilities to improve HIV prevention outcomes for youths. Given the paucity of research, this study aimed to explore the experiences of youths participating in the CSP and HIV prevention programme, with a particular focus on the resource-constrained settings of Gauteng Province in South Africa. This study employed a collective case study design, within the qualitative approach, and was exploratory. In-depth individual interviews were conducted with 30 youths from six established NGOs in the City of Johannesburg (CoJ). Qualitative thematic analysis was employed as a data analysis strategy. Focus groups were separately with six practitioners from the same six NGOs, and five officials from the Department of Social Development (DSD). Both phases of data collection were guided by interview themes, which were aligned with the objectives of the study. The findings of the study point to the fact that the CSP’s innovative and holistic approach offered numerous transformative and empowering benefits to youths. It equipped them with basic informational resources, capabilities, and social assets to safeguard their health and aid their economic advancement. The programme’s mixedgender sessions provided space, freedom, and support for youths to engage on issues of gender, differential access to health and socio-economic opportunities. Another major finding of the study was that improvement of economic aptitude (brought about by financial literacy education), employability, and entrepreneurship training stirred a sense of agency and purposefulness among youths, which in turn, prompted them to be more focused on achieving long-term objectives instead of indulging in risky sexual practices. Conversely, findings revealed that the programme had limited opportunities and did not create an adequate supportive environment for youths to develop successful entrepreneurial or income-generating projects. There was also no structure to assist youths to access apprenticeship and employment markets. The study specifically recognised that the programme’s efforts to develop youths’ entrepreneurship and employability capabilities were curtailed by a lack of mentorshipnand access to financial capital for start-up costs. With these findings in mind, recommendations are made for the creation of an enabling environment by purposefully engaging youths, establishing collaborative relations with communities, and building networks with businesses and financial institutions that can help youths with capital, mentorship, and linkages to internship and wage employment. Such collaborations could be fundamental in unravelling the impact of the programme on building livelihoods and reducing HIV among youths. Hence, this study proposes a model with strategies to support the successful implementation of economic strengthening interventions for youths. , Thesis (PhD) -- Faculty of Social Sciences and Humanities, 2023
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- Date Issued: 2023-04
A self-emulsifying delivery system loaded with efavirenz: The case for flax-seed oil
- Authors: Mazonde, Priveledge
- Date: 2021-10-29
- Subjects: Drug delivery systems , Linseed oil , Antiretroviral agents , HIV (Viruses) , Drug carriers (Pharmacy) , Solubility , High performance liquid chromatography , Efavirenz
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10962/192944 , vital:45283
- Description: The feasibility of incorporating efavirenz (EFV), an antiretroviral agent against HIV into a lipid-based self-emulsifying drug delivery system (SEDDS) containing vegetable oils was investigated. EFV has poor aqueous solubility and is classified under the Biopharmaceutical Classification System (BCS) as a class II compound with highly permeability, its aqueous solubility is less than 10 mg/ml and is defined as a practically insoluble compound with a consequent poor bioavailability of approximately 40%, and erratic dissolution behaviour. SEDDS formulations have been shown to improve the aqueous solubility and consequently the bioavailability of BCS II compounds such as EFV. EFV is a first line antiviral agent used in combination with other agents in antiretroviral therapy (ART). Among the number of NNRTIs approved for use in HIV treatment, EFV is one of the most commonly prescribed drug. Statistical methods and Design of Experiments (DoE) using Response Surface Methodology (RSM), specifically a Central Composite Design (CCD), were used to facilitate the development of a reversed-phase high performance liquid chromatographic (HPLC) method for the quantitation of EFV during formulation product and process development studies. A rapid, accurate, precise and sensitive HPLC method with ultraviolet (UV) detection was developed, optimised and validated for the in-vitro analysis of EFV in a total run time under 10 minutes for the elution of both EFV and loratidine which was used as the internal standard (IS). The method was then successfully applied to the determination of EFV in commercially available tablets. Excipient screening was undertaken using solubility studies and revealed that EFV had highest solubility in flaxseed oil in comparison to soybean, macadamia, grapeseed, sunflower and olive oils. The non-ionic Tween® 80 and Span® 20 were selected as surfactant and co-surfactant, respectively with ethanol co-solvent as they exhibited improved miscibility with co-solvent. Pre-formulation studies were undertaken to investigate the compatibility of the API with excipients and to identify a nano-emulsion region and other emulsion types using pseudoternary phase diagrams. The phase behaviour of crude cold pressed flaxseed oil with the selected non-ionic surfactants revealed an area within pseudo-ternary phase diagrams for different surfactant-mixtures formed gels/semisolid structures which can be exploited for other drug delivery strategies that require such properties. Fourier transform infrared spectroscopy (FT-IR), powder x-ray diffraction (XRD) and Raman spectroscopy were used to identify and assess the compatibility of EFV with chosen excipients. 2 A reduction in the peak intensity was observed for EFV when combined with each hydrophobic/lipid excipient evaluated revealing that there was a marked reduction in the crystallinity of the EFV. A decrease in crystallinity in comparison with the bulk API may indicate that EFV were amorphous or sequestered in a molecular dispersion and exhibited an increased solubility for the molecule. Flaxseed oil was used as the oil phase in studies for the optimization of surfactant mixtures undertaken using DoE, specifically a D-optimal mixtures design with the flaxseed oil content set at 10% m/m was performed. Solutions from the desired optimization function were produced based on desirability and five nanoemulsion formulations were produced and characterized in terms of in vitro release of efavirenz, drug loading capacity, Zeta Potential, droplet sizes and polydispersity index (PDI). Kinetically stable nanoemulsions containing 10% m/m flaxseed oil were successfully manufactured and assessed. Droplet sizes ranged between 156 and 225 nm, Zeta Potential between −24 and −41 mV and all formulations were found to be monodisperse with polydispersity indices ≤ 0.487. SEDDS formulations of EFV in nano-sized carriers were developed and optimised, in vitro drug release varied with varying amounts of ethanol in the formulation producing formulations that exhibited differently modulated drug in-vitro release profiles that may be further manipulated for better performance and therapeutic outcomes in terms of solubility and possibly bioavailability of EFV when delivered using SEDDS rather than using tablets which in turn may lead to better therapeutic outcomes for patients with HIV. , Thesis (MSc) -- Faculty of Pharmacy, Pharmacy, 2021
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- Date Issued: 2021-10-29
Synthesis of peptidomimetic compounds as HIV-1 protease inhibitors
- Authors: Kayembe, Jean-Pierre
- Date: 2020
- Subjects: Protease inhibitors , HIV (Viruses) , HIV infections Treatment , Peptidomimetics
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/124397 , vital:35604 , DOI https://dx.doi.org/10.21504/10962/124397
- Description: This research project has involved the design, synthesis and evaluation of novel peptidomimetics compounds as HIV-1 protease inhibitors. Here is presented one-step, two-step and three-step syntheses and the in vitro bio-assay studies of a series of fully characterized peptidomimetics as HIV-1 protease inhibitors candidate using the shortest and most cost effective synthetic routes. The first series of compounds were accessed via a synthetic elaboration of Morita-Baylis-Hillman adducts by a Michael addition with benzylamine, proline or glycine esters to afford a series of β-amino-β’-hydroxycarboxylate esters in moderate to good yields. Base-catalyzed cyclization of non-benzylated aza-Michael adducts afforded a series of coumarin-3-hydroxy-2-methylenepropanoate esters in moderate yields. The uncatalyzed direct amidation of diethyl tartrate/tartaric acid and tartaric acid osazone with selected amines/amino acids afforded a series of C2-symmetrical and unsymmetrical 1,2-dihydroxycarboxylates in moderate to very high yields. All the synthesized compounds were fully characterized using spectroscopic techniques. These conjugates, designed as potential HIV-1 inhibitors, were tested against the HIV-1 protease enzyme. A number of these ligands have exhibited inhibition levels and IC50 values comparable to ritonavir, permitting, therefore, their identification as lead compounds for the development of novel inhibitors. , Thesis (PhD) -- Faculty of Science, Chemistry, 2020
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- Date Issued: 2020