Suchergebnisse

This study provides a profile of 866 people living with HIV/AIDS (PLWHA) in three provinces in rural China and identifies factors associated with per-capita income in AIDS-affected households. The majority of the participants were female, married, had completed primary school, and were 30-49 years of age. Thirty percent of respondents lived in a household with at least one other HIV/AIDS patient and 15% had experienced the death of a household member due to HIV/AIDS. Therefore, health professionals should be aware of issues of grief and caregiver burnout among rural PLWHA and their families. Three-quarters of the respondents continued to work after being diagnosed with HIV/AIDS. Household per capita income was significantly higher for married individuals and those still working. Possible government and workplace policy initiatives that endeavor to increase income and mitigate the economic impact of HIV/AIDS on households are discussed.

Yuqing Song,1,* Huan Wang,2,* Yao Yin,3 Anliu Nie,4 Hui Yang,5 Ying Liu,1 Lin Tao,6 Hua Zhong,1 Liao Zhang,1 Hong Chen1 1West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China; 2Department of Nursing, the Third Hospital of Mianyang, Sichuan Mental Health Centre, Mianyang, Sichuan Province, 621000, People's Republic of China; 3Department of Neurology/Evidence-Based Nursing Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China; 4Emergency Department, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, People's Republic of China; 5Nursing Department, the First Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, People's Republic of China; 6Department of Breast Surgery, West China Hospital /West China School of Nursing, Sichuan University, Chengdu, 610041, People's Republic of China*These authors contributed equally to this workCorrespondence: Hong Chen, West China School of Nursing/West China Hospital, Sichuan University, No. 37, Guoxuexiang, Wuhou District, Chengdu, Sichuan, 610041, People's Republic of China, Email 1366109878@qq.comPurpose: Previous studies revealed that informal caregivers for persons living with HIV/AIDS (PLWHA) experience perceived caregiver burden. Although Liangshan prefecture is one of the areas with the fastest growing HIV/AIDS epidemics in China, little is known about burden of informal caregivers for PLWHA. This study aimed to evaluate caregiver burden and these predictors among informal caregivers of PLWHA in Liangshan prefecture, China.Methods: This was a cross-sectional study conducted from August to December 2017. We used convenience sampling to recruit informal caregivers of PLWHA. A total of 222 participants completed questionnaires including demographic information, caregiving-related information, and caregiver burden (measured by Zarit Burden Interview, ZBI). SPSS software was used to analyze the data. Independent student's t-test, one-way analysis of variance (one-way ANOVA), Spearman rank correlation, and multiple linear regression analysis were performed.Results: The mean ZBI score was 40.61 (SD = 14.47), and 199 (89.6%) informal caregivers had a mild or above caregiver burden. Multiple linear regression analysis revealed that older age (P=0.003), caregivers with poor health (P=0.002), parent-caregivers (P=0.001), poorer ability in 'balancing caregiving needs and their own needs' (P< 0.001), and 'managing emotional needs' (P=0.014) were significantly associated with higher level of caregiver burden.Conclusion: The majority of informal caregivers had perceived caregiver burden in Liangshan prefecture of China. Findings emphasize that health-care providers, medical institutions and government should develop educational programs and policy to improve caregiver's ability to cope with caregiving for PLWHA, and take more attention to caregivers with health problem, at older age, parent-caregivers. These may contribute to reducing caregiver burden among informal caregivers of PLWHA.Keywords: caregiver burden, family caregiver, informal caregiver, persons living with HIV/AIDS

Background: The aim of the study was to highlight the political economy of HIV/AIDS in people living with HIV/AIDS (PLWHA) through use of relevant literature and administration of self-administered questionnaires. The study was carried out in the south-western region of Nigeria, using patients attending the HIV/AIDS clinic at the Lagos University Teaching Hospital, Lagos Nigeria. Method: The questionnaires were distributed in the HIV/AIDS clinic and respondents were interviewed by the Principal Investigator and medical students. Results were collated and analysed using EPI INFO 6 statistical software. Chi Square analysis was used to test for association between categorical variables at a P value of 0.05. Results were presented in tables and charts. Further, the study determined the socio-demographic pattern of the patients, the changes in marital status, employment status and residential status since diagnosis. In addition, the study sought to determine areas of stigmatization as well as the fraction of monthly income spent on HIV/AIDS care. Results: Literature showed that employers were not willing to employ a person with HIV/AIDS and that vulnerable employment was the predominant form of employment in sub-Saharan Africa. This was re-affirmed by the study. Thirteen (13%) respondents lost their jobs after diagnosis and about 75 (75.0%) of respondents were in vulnerable employment. Sixty-four (64%) of the respondents were married before diagnosis and 53 (53.0%) still married after diagnosis, five of the respondents spouses had died, three had been divorced, and four had been separated from their spouses (P < 0.05). Sixty-one (61.0%) of the respondents got their financial support from their family. Stigmatization increased with the number of people that knew of their diagnosis (P < 0.05). Conclusion: Loss of job occurred in respondents when the employers knew of the diagnosis. The household income spent on HIV/AIDS care ranged from one-third to half of the monthly income. It was recommended that the government provide incentives for employers to hire PLWHA. Efforts should be made to reduce stigmatization through health education. Health education should target employers, religious organizations and family members. Self-sustaining financing schemes should be developed for PLWHA and their families.

The purpose of this study was to determine how the role of NGOs in handling HIV-AIDS in Kendari City and to find out how to handle NGOs in handling HIV-AIDS in Kendari City. The subjects in this study were the Southeast Sulawesi Province Board of Directors consisting of the Director of Laha, Laha Staff, PLWHA in Kendari City, PLWHA Community, Social Service Apparatus, and Health Service Apparatus The type of research used is descriptive qualitative. The results of the research show that NGO LAHA plays a role as a Facilitator, Broker, Mediator, Defender, Protector in Dealing with HIV-AIDS In the city of Kendari, the HIV-AIDS Management Program, namely Improving Communication,. Information and Education of HIV-AIDS, increases efforts to reduce the prevalence of infectious diseases sexually, increasing universal awareness in the provision of health services and cooperation between the Kendari City Government and the NGO LAHA still lacking in the handling of HIV-AIDS that occurred in Kendari CityKeywords :Handling, HIV-AIDS, NGO, Laha. Role

Teaching about the sociology of HIV/AIDS involves teaching about the causes and effects of stigma. We describe a Sociology of HIV/AIDS course at the University of Alabama in which stigma reduction was assessed as a primary objective. The syllabus involved theory-based instruction, class visits, service learning, and student research on community attitudes toward HIV/AIDS. We report on how stigma affected the service learning and other elements of the course, calling for adjustments to our pedagogical approach. We also report how the course was evaluated in a pretest/posttest assessment on attitudes toward people living with HIV/AIDS [PLWHA] (enacted stigma) and hypothetical reactions to being diagnosed with HIV (felt stigma). The results indicated greater tolerance for PLWHA following the class but also greater awareness of HIV stigma and its outcomes. We offer recommendations to help instructors avoid stigma-related materials and events that could jeopardize service learning and course objectives for sensitive topics such as HIV/AIDS.

To assess the prevalence and correlates of perinatal depression, 200 HIV-positive pregnant/post-partum women receiving antiretroviral therapy (ART) were interviewed at eight government ART centers in four states across India. 52.5% (105) participants had depressive symptomology (Edinburgh Postnatal Depression Scale score > 13) while 23% of the participants reported thoughts of self-harm; there was no difference between pregnant and postpartum participants. Poor illness perception was associated with depression (AOR, 1.09; 95%CI, 1.05, 1.14); there was no association between adherence and depression in this population.

IntroductionAntiretroviral therapy (ART) has rendered HIV and AIDS a chronic condition for individuals in many parts of the world. Adherence, however, is integral to achieving chronicity. Studies have shown both relatively high ART adherence rates in sub‐Saharan Africa and the importance of community home‐based care (CHBC) to facilitating this process. In light of diminished HIV and AIDS funding globally and increased reliance on CHBC throughout Africa, a better understanding of how CHBC may strengthen ART adherence is essential to improving patients' quality of life, tending to the needs of care supporters and achieving healthier populations.MethodsThis article reports findings from a qualitative study of a CHBC organiztion serving an estimated 2500 clients in rural Swaziland. Semi‐structured questionnaires with 79 HIV‐positive clients [people living with HIV and AIDS (PLWHA)] yielded data on diverse aspects of being HIV positive, including insights on whether and how PLWHA perceived care supporters to facilitate ART adherence in a high stigma and structurally impoverished setting.ResultsNinety‐two percent of participants said their health had improved since care supporters came into their lives. A major finding was that an estimated 53% of participants said they would have died, a few from suicide had the care supporter never intervened. More than one in four participants (27.9%) sought HIV testing after a care supporter began visiting them. Nearly a third (31%) commenced ART after and largely as a consequence of care supporter intervention. Approximately one in four (23%) reported that their care supporter had helped them to disclose their HIV‐positive status to family members. Twenty‐seven percent said they had felt discouraged or had been discouraged from taking ART by members of their family or community.DiscussionGeneral inductive analysis of participant reports suggested two social mechanisms of CHBC impact on ART adherence: (i) cultivating client‐care supporter "talk" to enhance treatment uptake and literacy, reduce felt stigma and challenge social pressures to desist from ART and (ii) real‐time interactions between clients and care supporters whereby the care "relationship" was itself the "intervention," providing lay counsel, material and financial assistance, and encouragement when clients suffered stigma, side effects and other obstacles to adherence. These social dynamics of adherence generally fall outside the purview of conventional clinical and public health research.ConclusionsPLWHA reports of care supporter practices that enabled ART adherence demonstrated the pivotal role that CHBC plays in many PLWHA lives, especially in hard to reach areas. Relative to clinic personnel, care supporters are often intensely engaged in clients' experiences of sickness, stigma and poverty, rendering them influential in individuals' decision‐making. This influence must be matched with on‐going training and support of care supporters, as well as a clear articulation with the formal and informal health sectors, to ensure that PLWHA are correctly counselled and care supporters themselves supported. Overall, findings showed that PLWHA experiences of CHBC should be captured and incorporated into any programme aimed at successfully implementing the Joint United Nations Programme on HIV and AIDS (UNAIDS) Treatment 2.0 agenda Pillar 4 (increasing HIV testing uptake and care linkages) and Pillar 5 (strengthening community mobilization).

AIDS is an extraordinary kind of crisis; it is both an emergency and a long-term development issue. In 2003, the Global PLWHA was 38 million out of which 2/3 (25 million) are in Sub-Saharan Africa. In Ethiopia, there are an estimated 1.5 million PLWHA with a prevalence of 4.4 % in 2003. In Tigray, Northern Ethiopia, the adult prevalence of HIV/AIDS is 4.4 % with an estimated 100,000 PLWHA in 1997 E.C. The Epidemic is reversing the social and development gains and deepening poverty. The Government of Ethiopia initiated the response in 1985. The response include the establishment of NTF, HIV/AIDS prevention and control department at MOH,HIV/AIDS prevention and control council and HAPCO ,development of HIV /AIDS policy and NSF. The objective of this study is to assess the community and organizational response against the impact of HIV/AIDS and to draw best practices and weaknesses in Tigray region. Data were collected from February –April 2006 in five districts of Tigray region using in-depth interview, FGD, document review and observation. Four zones were selected conveniently and from that five woredas were selected on lottery method .All available organizations in the five woreda were eligible for the study. viii Generally, the effort to curb HIV/AIDS epidemic is very poor. Absence of workplace HIV/AIDS policy, implementation guideline, misunderstanding of the concept and method of mainstreaming, lack of leadership commitment, lack of capacity and poor NGO and community involvement are among the major findings. Development of workplace HIV/AIDS policy and implementation guideline, repeated sensitization efforts to enhance high level commitment, rewriting of the role and responsibility of the FPP, financing mainstreaming and strengthening the capacity of coordinating organization.

The association of human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) with stigma and discrimination remain a challenge in combating HIV/AIDS. It pushes people to remain hidden with the potential to manifest in the future. This study aims to examine the agencies and mechanisms of social inclusion and exclusion among people living with HIV/AIDS (PLWHA) in the state of Mizoram. The study covers two districts of Mizoram, Lunglei and Saiha districts, selected purposively. Respondents were identified through different gateways like non-governmental organisations (NGOs) and hospital. A total of sixty respondents were interviewed, thirty respondents from each district selected proportionately. The study reveals that the same agencies which cater to the inclusion of PLWHA can also exclude them through different mechanisms. Agencies at primary and secondary level adopted a mixture of both inclusionary and exclusionary measures. At tertiary level NGOs, hospitals staff are seen to be more inclusionary than social institutions such as the church and youth associations. The study highlights the need for greater awareness on HIV/AIDS at the individual and community level.

Stigma toward people living with HIV/AIDS (PLWHA) has impeded the response to the disease across the world. Widespread stigma leads to poor adherence of preventative measures while also causing PLWHA to avoid testing and care, delaying important treatment. Stigma is clearly a hugely complex construct. However, it can be broken down into components which include internalized stigma (how people with the trait feel about themselves) and enacted stigma (how a community reacts to an individual with the trait). Levels of HIV/AIDS-related stigma are particularly high in sub-Saharan Africa, which contributed to a surge in cases in Kenya during the late twentieth century. Since the early twenty-first century, the United Nations and governments around the world have worked to eliminate stigma from society and resulting public health education campaigns have improved the perception of PLWHA over time, but HIV/AIDS remains a significant problem, particularly in Kenya. We take a data-driven approach to create a time-dependent stigma function that captures both the level of internalized and enacted stigma in the population. We embed this within a compartmental model for HIV dynamics. Since 2000, the population in Kenya has been growing almost exponentially and so we rescale our model system to create a coupled system for HIV prevalence and fraction of individuals that are infected that seek treatment. This allows us to estimate model parameters from published data. We use the model to explore a range of scenarios in which either internalized or enacted stigma levels vary from those predicted by the data. This analysis allows us to understand the potential impact of different public health interventions on key HIV metrics such as prevalence and disease-related death and to see how close Kenya will get to achieving UN goals for these HIV and stigma metrics by 2030.

HIV/AIDS mengancam eksistensi manusia, sehingga perlu dilakukan tindakan pencegahan penularannya. Tujuan penelitian adalah mengidentifikasi faktor-faktor yang memengaruhi tindakan pencegahan penularan HIV oleh ODHA. Desain penelitian adalah deskriptif analitik cross sectional. Teknik pengambilan sampel adalah consecutive sampling. Penelitian dilakukan pada dua rumah sakit Pemerintah dan satu Klinik Yayasan Sosial Agustinus di Sorong Papua Barat. Jumlah responden yang diperoleh 75 orang. Hasil penelitian menunjukkan bahwa faktor yang berhubungan dengan tindakan pencegahan penularan HIV adalah umur (p= 0,040; α= 0,05). Pada analisis regresi logistik ganda diketahui bahwa umur merupakan faktor yang paling mempengaruhi tindakan pencegahan penularan HIV (p= 0,031; α= 0,05; 95% CI: 1.169-26.423). Umur muda berisiko menularkan HIV karena cenderung melakukan seks tidak aman. Perawat dalam memberikan asuhan keperawatan harus berfokus pada intervensi konseling bagaimana menghindari perilaku seks tidak aman. Abstract Age People with HIV AIDS (PLWHA) Precautions in Connection with HIV Infection. HIV/AIDS has threaten the human existence, so it necessary to actions to prevent the HIV transmissions. The aim of this study was to determine the factors that influence the act of HIV transmission prevention by PLWHA. The study design was cross sectional analytic descriptive approach. The sampling technique is consecutive. The study was conducted at two government hospitals and one private clinic in Sorong. The number of respondents is 75 people. The results showed that factors correlated to the prevention of HIV transmission is age (p= 0,040; α= 0,05). In multiple logistic regression analysis it is known that age is a factor that most influences the actions of prevention of HIV transmission (p= 0,031; α= 0,05; 95% CI: 1.169-26.423). The young age due to become infected with HIV were more likely to perform unsafe sex. The provision of nursing care shlould be focused on the interventions counseling how to avoid unsafe sex. Keywords: HIV transmission, PLWHA, prevention

IntroductionHope is an essential dimension of successful coping in the context of illnesses such as HIV/AIDS, because positive expectations for the future alleviate emotional distress, enhance quality of life and have been linked to the capacity for behavioural change. The social environment (e.g. family, peers) is a regulator of hope for people living with HIV/AIDS (PLWHA). In this regard, the dual aim of this article is (1) to analyze the influence of a peer adherence support (PAS) intervention and the family environment on the state of hope in PLWHA and (2) to investigate the interrelationship between the two determinants.MethodsThe Effective AIDS Treatment and Support in the Free State study is a prospective randomized controlled trial. Participants were recruited from 12 public antiretroviral treatment (ART) clinics across five districts in the Free State Province of South Africa. Each of these patients was assigned to one of the following groups: a control group receiving standard care, a group receiving additional biweekly PAS or a group receiving PAS and nutritional support. Latent cross‐lagged modelling (Mplus) was used to analyse the impact of PAS and the family environment on the level of hope in PLWHA.ResultsThe results of the study indicate that neither PAS nor the family environment has a direct effect on the level of hope in PLWHA. Subsequent analysis reveals a positive significant interaction between family functioning and PAS at the second follow‐up, indicating that better family functioning increases the positive effect of PAS on the state of hope in PLWHA.ConclusionsThe interplay between well‐functioning families and external PAS generates higher levels of hope, which is an essential dimension in the success of lifelong treatment. This study provides additional insight into the important role played by family dynamics in HIV/AIDS care, and it underscores the need for PAS interventions that are sensitive to the contexts in which they are implemented.

This study determined the clients' perception and satisfaction with the quality of antiretroviral therapy services in Ekiti State, Nigeria. A prospective cross-sectional study design was carried out to yield quantitative data on clients' perception and satisfaction with the quality of ART services in Ado-Ekiti Local Government Area. The study targeted PLWHA who assess health care in Ado-Ekiti local government area. The sample size for the study was 400 PLWHA. Primary Data were collected using pre-tested and semi-structured questionnaires. The research assistants such as Nurses were trained to administer the questionnaire to ensure accuracy of the data obtained. The data obtained were analysed descriptively through descriptive statistics. The findings of this study revealed that the majority of HIV/AIDS clients in Ado-Ekiti local government area have a good perception about the services they receive. Similarly, almost all of them are satisfied with the quality ART services. It was recommended among others that it is important to establish a system of regularly getting clients' feedback on different aspects of the services provided, in order to improve on them and serve clients better. Keywords: Perception, Satisfaction, Antiretroviral Therapy Services, ; SPECIAL ISSUE: 9, VOL.#2, SEPTEMBER 2020.

Based on 14 months of ethnographic research in Grahamstown, South Africa, I argue that economic inequalities and structural barriers have created dire situations in which people living with HIV/AIDS (PLWHA) often are forced to choose between economic security and health security. While the rollout of antiretroviral treatment (ART) has been initiated in various stages throughout the country, the availability of treatment has created unanticipated and adverse responses. Many PLWHA who are too sick to work rely solely on social assistance grants as their only form of income. To qualify for what are locally known as "disability grants," patients must demonstrate and maintain a CD4 count of 200 or below, which ironically, also is the marker to begin ART. This has created a complex dilemma as patients have begun to modify their adherence to and/or refuse ART to maintain low CD4 counts, in an effort to continue to receive their "disability grant," thereby sustaining their economic and food security. Future HIV/AIDS programs must develop initiatives that do not conflict with patient treatment and prevention strategies but, rather, provide a holistic approach to economic and health security, particularly in resource‐poor communities.

PurposeThe purpose of this paper is to examine the patterns of self‐disclosure of HIV/AIDS infection and reasons respondents did not disclose their serostatus to their children.Design/methodology/approachConvenience sample of 151 people living with HIV/AIDS (PLWHA) in Lomé, Togo, was used. Semi‐structured interviews were administered.FindingsUnlike studies conducted in the USA, it was found that although all of the respondents had disclosed their status to HIV/AIDS service providers from whom they received help and support, they had low rates of disclosure to their significant others. For instance, only 12 per cent of the participants had disclosed to their mothers and 16 per cent had disclosed to their children. Additionally, reasons given by respondents for non‐disclosure of their infected status to their children were varied. Regardless of the age of the children, half of the parents believed that the children were either too young or were minors and should not know about their HIV infected status.Research limitations/implicationsImplications for helping people with HIV/AIDS, their service providers, and policy makers are discussed.Originality/valueThe study shows that HIV/AIDS service providers need to understand the family dynamics of PLWHA in Africa in order to appropriately help them to disclose.