Browsing by Author "Parker, Gary."

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Effects of a reduced dose of Stavudine on the incidence and severity of peripheral neuropathy in HIV-infected adults in South Africa.
(International Medical Press., 2011) Pahuja, Meera.; Grobler, Anna Christina.; Glesby, Marshall J.; Karim, Farina.; Parker, Gary.; Gumede, Sizwe.; Naidoo, Kogieleum.
BACKGROUND—Although recent WHO guidelines recommend withdrawing stavudine (d4T) from first-line ART therapy, it remains commonly used in resource-constrained settings. In 2006, WHO recommended decreasing the dose of d4T from 40mg to 30mg to mitigate toxicities. We compared the incidence and severity of peripheral neuropathy (PN) by d4T dose in a retrospective cohort study. METHODS—Patients’ charts from an ART-naïve population at a rural clinic in KZN, South Africa were retrospectively reviewed for signs and symptoms of incident PN and were graded for severity using the DAIDs scale. Patients enrolled prior to the WHO guideline change were enrolled if they were on d4T 40mg for at least 6 months. After the guideline change all patients were initiated on d4T 30mg. RESULTS—A total of 475 patients were analyzed; 235 in the 40mg cohort (152.7 person-years [py]) and 240 in the 30mg cohort (244.7py). Incidence of peripheral neuropathy was 90.4/100 py (95% CI:75.9–106.8) in the 40mg cohort versus 40.5/100py (95% CI:32.9–49.3) in the 30mg group (incidence rate ratio [IRR]=0.45, p<0.0001). There was no difference in proportion of severe peripheral neuropathy cases (grade 3/4) between the cohorts; 8.3% in the 40mg group and 8.9% in the 30mg group (p=1.0). In a multivariate analysis risk of peripheral neuropathy was associated with increasing age (HR=1.65 95% CI:1.24–2.19), 40 mg dose (HR=2.1, 95% CI:1.61–2.74) and concurrent tuberculosis therapy (HR= 1.41 95% CI:1.06–1.87). CONCLUSION—Incidence of peripheral neuropathy in the 40mg cohort was extremely high and though lower in the 30mg cohort, the rate was nonetheless unacceptably high.
Identifying social network correlates of HIV testing behaviour (VCT uptake) amongst UKZN students.
(2010) Parker, Gary.; Solomon, Vernon Philip.
South Africa has the highest burden of HIV and AIDS in the world, yet most of these infected people are unaware of their HIV status. HIV voluntary counselling and testing is shown to have manifold benefits in improving the quality and duration of life of those infected with HIV as well as preventing the spread of infection to HIV negative people. There is a clear need for research into this area. This study therefore investigates the relationship between the social network correlates of HIV testing behaviour amongst a sample of the student population of the University of Kwa-Zulu Natal, Pietermaritzburg campus, using social network analysis and the theories of social learning and social influence as the lens through which to interpret the results. This was an empirical study using data that was collected using an anonymous, self-complete, all-of-campus student survey. Five hundred and sixty-six participants completed the survey. This study employed a cross sectional design and is based on a secondary data analysis of a larger project. The data were analysed using a stepwise multiple regression. The findings show that social network size and residential diversity of participants‟ social networks were significantly associated with VCT uptake. Participants with the smallest network size were more likely to have tested for HIV than those with the largest network size, while those with the most residentially diverse networks were more likely to have tested than those with the least diverse networks. The findings suggest that some aspects of students‟ social networks influenced the likelihood of having tested for HIV, but social learning and social influence are not bound exclusively to an enabling or constraining role on VCT uptake. In order to better understand their influence, the prevailing social norms and information within a social network need to be established.