MÖJLIGHETER OCH HINDER INOM PREVENTIVT HIV/AIDS-ARBETE : En intervjuundersökning, i Zambia, om rådgivares upplevelser

HIV/Aids är ett av de största globala problemen och utmaningar av idag. Södra Afrika är särskilt drabbat och detta påverkar många olika delar av mänskligt liv. Syftet med denna uppsats har varit att söka ökad förståelse för hur maktstrukturer, utifrån fem rådgivares upplevelser, påverkar det preventiva HIV/Aids arbetet. Vilka faktorer som utgör möjligheter och hinder samt ifall maktstrukturer bidrar till att inte förändring av beteende sker trots kunskap om dess risker, har getts stort fokus. Det geografiska området för studien var södra Zambia. Det finns inget givet svar på vår forskningsfråga, utan resultatet visar snarare på motsatser och komplexitet. Vår utgångspunkt har varit att det inte finns något självklart rätt eller fel och inte heller en enda sanning. Dock är vår slutsats att de möjligheter som finns kan basera sig i att ta hänsyn till lokala förhållanden och maktstrukturer.

Sjuksköterskans kunskap och attityder vid omvårdnad av HIV/AIDS patient

Abstract Bakgrund: Totalt har nästan 30 miljoner avlidit sedan första AIDS- fallet diagnostiserades år 1981. Ovissheten och hotet om sjukdom och för tidig död innebär stora psykiska påfrestningar på individen. Sjuksköterskans attityder och sätt att vara spelar en viktig roll för etablering av en terapeutisk relation. Syfte: Syftet var att belysa sjuksköterskans attityder till patienter med HIV- infektion. Metod: Genom en litteraturstudie av tidigare forskning har 16 vetenskapliga artiklar granskats. Dessa fann vi på databaserna PubMed och Cinahl. Resultat: Sjuksköterskor upplevde rädsla vid omvårdnad av patienter med HIV/AIDS på grund av dess smittrisk. De ansåg att de behövde mer utbildning och support och professionell support mellan kollegor för att orka med sitt arbete. Från forskarnas observationer sågs ett fysiskt undvikande av patienter, som att vårdpersonalen inte svarade på patientens ringningar, de undvek att gå in till patienten. Sjuksköterskestuderande som hade en rädsla för HIV/AIDS har mer homofobier, de ansåg att det var ett straff för deras oordnade sexliv och att de förtjänade sitt öde. Slutsats: Vi anser att många av dessa attityder skulle kunna undvikas om personalen får mer kunskap om smitta, sexuallitet och droger, hur sjukdomsförloppet ser ut, och vilka funderingar en HIV/AIDS smittad kan ha. Detta skulle bidra till att sjuksköterskor/vårdpersonal vågar möta patienten och utveckla en god relation till denne.

Examining the Role of Vocational Rehabilitation on Access to Care and Public Health Outcomes for People Living with HIV/AIDS

The purpose of this study is to examine the role of vocational rehabilitation services in contributing to the goals of the National HIV/AIDS strategy. Three key research questions are addressed: (a) What is the relationship among factors associated with the use of vocational rehabilitation services for people living with HIV/AIDS? (b) Are the factors associated with use of vocational rehabilitation also associated with access to health care, supplemental employment services and reduced risk of HIV transmission? And (c) What unique role does use of vocational rehabilitation services play in access to health care and HIV prevention? Survey research methods were used to collect data from a broad sample of volunteer respondents who represented diverse racial (37% Black, 37% White, 18% Latino, 7% other), gender (65% male, 34% female, 1% transgender) and sexual orientation (48% heterosexual, 44% gay, 8% bisexual) backgrounds. The fit of the final structural equation model was good (root mean square error of approximation = .055, Comparative Fit Index=.953, Tucker Lewis Index=.945). Standardized effects with bootstrap confidence intervals are reported. Overall, the findings support the hypothesis that vocational rehabilitation services can play an important role in health and prevention strategies outlined in the National HIV/AIDS strategy.

SOCIAL CULTURAL FACTORS IN HIV/AIDS TRANSMISSION AMONG WOMEN IN RWANDA

This study examines the social cultural factors that influence HIV/AIDS transmission among women in RWANDA and especially in RUGALIKA sector. Some of those social cultural factors we can say marriage, polygamy, early marriage, poverty, religious beliefs, lack of access to productive resources and lack of education and training. The objectives of the study were to identify the social cultural factors which influence in HIV transmission among women and the constraint of HIV/AIDS among women and to find out how those constraint can be overcome and also to identify the measures that could be take for more prevent the spread of HIV infection to the women and to the all people in general. The research contains 5chapters which are: 1st chapter: general conclusion; 2nd chapter: literature review; 3rd chapter: research methodology; 4th chapter: data analysis and interpretation and the 5th chapter is general conclusion and recommendation. This research was conducted in RUGALIKA sector which has about 2990 women aged between 21 35 years old and thus a sample of 290 women was selected in different region of RUGALIKA sector. After the interpretation of the findings; the most vulnerable group is the women aged between 31-35 years; the vulnerability is due to different factors but most of them we have: poverty issues, polygamy, lack of access to productive resources, lack of education and training, religious beliefs and we cannot forget the physiological factors. After the genocide of 1994, Rwanda has known many orphans; and in RUGALIKA sector young women and girls are often to be sexual exploited in order to survive.

Immunologic response to antiretroviral therapy in hepatitis C virus-coinfected adults in a population-based HIV/AIDS treatment program

BACKGROUND: We sought to characterize the impact that hepatitis C virus (HCV) infection has on CD4 cells during the first 48 weeks of antiretroviral therapy (ART) in previously ART-naive human immunodeficiency virus (HIV)-infected patients. METHODS: The HIV/AIDS Drug Treatment Programme at the British Columbia Centre for Excellence in HIV/AIDS distributes all ART in this Canadian province. Eligible individuals were those whose first-ever ART included 2 nucleoside reverse transcriptase inhibitors and either a protease inhibitor or a nonnucleoside reverse transcriptase inhibitor and who had a documented positive result for HCV antibody testing. Outcomes were binary events (time to an increase of > or = 75 CD4 cells/mm3 or an increase of > or = 10% in the percentage of CD4 cells in the total T cell population [CD4 cell fraction]) and continuous repeated measures. Statistical analyses used parametric and nonparametric methods, including multivariate mixed-effects linear regression analysis and Cox proportional hazards analysis. RESULTS: Of 1186 eligible patients, 606 (51%) were positive and 580 (49%) were negative for HCV antibodies. HCV antibody-positive patients were slower to have an absolute (P<.001) and a fraction (P = .02) CD4 cell event. In adjusted Cox proportional hazards analysis (controlling for age, sex, baseline absolute CD4 cell count, baseline pVL, type of ART initiated, AIDS diagnosis at baseline, adherence to ART regimen, and number of CD4 cell measurements), HCV antibody-positive patients were less likely to have an absolute CD4 cell event (adjusted hazard ratio [AHR], 0.84 [95% confidence interval [CI], 0.72-0.98]) and somewhat less likely to have a CD4 cell fraction event (AHR, 0.89 [95% CI, 0.70-1.14]) than HCV antibody-negative patients. In multivariate mixed-effects linear regression analysis, HCV antibody-negative patients had increases of an average of 75 cells in the absolute CD4 cell count and 4.4% in the CD4 cell fraction, compared with 20 cells and 1.1% in HCV antibody-positive patients, during the first 48 weeks of ART, after adjustment for time-updated pVL, number of CD4 cell measurements, and other factors. CONCLUSION: HCV antibody-positive HIV-infected patients may have an altered immunologic response to ART.

Oral manifestations of HIV/AIDS in China: a review

PURPOSE: The purpose of this study is to review the Chinese-language medical and dental literature from 1982 to 2008 on oral manifestations (OMs) of patients with HIV/AIDS for introducing the spectrum of OMs of the patients in China. MATERIALS AND METHODS: All data were extracted from 18 references which had used diagnostic criteria for HIV/AIDS. Four of the references had used the EC-Clearinghouse classification for oral lesions in HIV infection. The feasible overall rate and 95% confidence interval (95%CI) of the data on OMs were calculated. RESULTS: Risk group analysis revealed that, of 203 patients, 64.3% were men and 35.7% were women (age range, 5 months to 64 years; mean age in three studies, 34.0, 34.3, and 36.1 years). Of these patients, 22.2% were infected by sexual contacts, 11.8% by intravenous drug use (IDU), 59.6% by blood or its products, 2.9% by mother to child transmission, and 3.4% were unclear. In 203 patients, oral candidiasis (OC) was the most common lesion (66%, 95%CI = 59.48-72.52%), followed by herpes simplex (HS) (22.2%, 95%CI = 16.48-27.92%), ulcerative stomatitis (14.8%, 95%CI = 9.92-19.68%), salivary gland disease (11.3%, 95%CI = 6.94-15.66%), oral hairy leukoplakia (OHL) (9.8%, 95%CI = 5.71-13.89%), necrotizing gingivitis (5.9%, 95%CI = 2.66-9.14%), Kaposi's sarcoma (2.9%, 95%CI = 0.59-5.21%), other malignant tumors (2.9%, 95%CI = 0.59-5.21%), and linear gingival erythema (2.0%, 95%CI = 0.07-3.93%). CONCLUSIONS: The spectrum of OMs reported from China is similar to that described in the international literature. Present data are useful to supplement international resources of HIV/AIDS research.

KIWAKKUKI - Women fight against HIV/AIDS. An encouraging example for social work in Tanzania

For 20 years, AIDS has continued its relentless spread across the globe. By the end of the year 2000, the United Nations’ Joint Programme on HIV/AIDS reported that 36.1 million men, women, and children around the world were living with HIV and 21.8 million had died of it. Though AIDS is now found in every country, it has most seriously affected sub-Saharan Africa - home to 70 % of all adults and 80 % of all children living with HIV, and the continent with the least medical resources in the world. Today, AIDS is the primary cause of death in Africa and it has had a devastating impact on villages, communities and families. In many African countries, the number of newly infected persons is increasing at a rate that is threatening to destroy the social fabric. Life expectancy is decreasing rapidly in many of these countries as a result of AIDS related illnesses and socioeconomic problems. Of the approximately 13.2 million children orphaned by HIV/AIDS worldwide, 12.1 million live in Africa.

HIV/AIDS policy for employers in religious communities

Surveys of national religious denominational offices and of churches in Texas were conducted to evaluate the prevalence of HIV/AIDS policies for members and employees, and to get feedback on a proposed HIV/AIDS policy. Most religious organizations in Texas do not have a HIV/AIDS policy for their employees. Analysis of the data from 77 church questionnaire surveys revealed only 17 (22.1%) policies in existence. From the current data, policies for employees were most prevalent among Catholic churches with 8 (47.1%) and Baptist churches with 7 (41.2%). Nine of the churches (52.9%) who had HIV/AIDS policies for their employees were categorized as having 2501-5000 members. In 1994 and 1995 the largest number of policies developed by churches totaled 8 (47.1%). The findings of this exploratory study in Texas were consistent with the survey of 7 national denominational offices which demonstrated that only the Lutheran church had a policy (14.3%). The literature is consistent with the finding that some churches have decided no separate HIV/AIDS policy is needed for employees. More than half of the employers reporting a HIV/AIDS related experience still feel they do not need a specific policy (CDC, 1992). The range of number of employees in churches varied widely from a high of 54.5% of churches with 15-50 employees to a low of 7.8% of churches with more than 100 employees. Seventy-one of the churches (92.2%) reported that they had no employees infected with HIV/AIDS, while 1 church (1.3%) reported having more than 1 employee infected with HIV/AIDS. This indicates that churches are reacting to incidence of the HIV/AIDS infection rather than preparing ahead. The results of this study clearly indicate the need to develop a comprehensive HIV/AIDS policy for employees in religious communities. Church employees must carefully consider all the issues in the workplace when adopting and implementing a HIV/AIDS policy. A comprehensive policy was developed and guidelines are suggested. ^

Performing AIDS. The Film-maker Rosa von Praunheim between HIV/AIDS-Communities in Germany and the USA

This paper explores the works of German film-maker Rosa von Praunheim during the AIDS crisis. In the 1980ies and 1990ies he produced several films portraying the gay communities in Germany and the USA in the face of AIDS. First, this paper analyses the cinematic techniques von Praunheim uses to criticise the German gay community and present the American practices of performing community as a role model for AIDS-activism. In a second step, the focus is put on von Praunheim’s autobiography and the rhetoric strategies he uses to participate in New York’s HIV-community, while being HIV-negative himself.

Performing AIDS. The Film-maker Rosa von Praunheim between HIV/AIDS-Communities in Germany and the USA

The paper explores the works of German film-maker Rosa von Praunheim during the AIDS crisis, who worked in Germany and the USA in the 1980ies and 1990ies and produced several films portraying the gay communities in both countries in the face of AIDS. The first part of the paper analyses how von Praunheim’s films show different forms of performing community in the two countries. It discusses the filmic techniques utilized to criticize the reaction of the German gay community to the appearance of AIDS and to present Amercian traditions of forming and performing a community as a role model for AIDS-activism. The second part focuses on von Praunheim’s autobiography „40 Years of Perversity. The Sentimental Memoirs of Rosa von Raunheim“ (1993) and the rhetoric strategies he – being HIV-negative himself – uses to become part of New York’s HIV-community. The paper examines the hypothesis that von Praunheim’s rhetoric is constructing and performing a „participative identity“ (Alois Hahn). The paper finally discusses the use and adaption of terms and symbols originating from the context of German National Socialism (e.g. the pink triangle) within the process of forming and performing New York’s AIDS-Community and how they are reused and readapted by Rosa von Praunheim.

OLDER WOMEN LIVING WITH HIV/AIDS

The purpose of this study is to fill a gap in the literature by investigating how an ignored population of women, women over age 50, copes with HIV/ AIDS. Older women are referred to as "invisible victims" with regard to HIV/AIDS. Previous research on coping with HIV/ AIDS focuses mostly on men. Of the research that does focus on women, older women are often overlooked. Although older women are a minority compared to other HIV-infected populations in the US, they are just as deserving of recognition and care as any other population. Data was collected through open-ended, in-depth interviews with four women individually. Recruitment of the sample is from several health institutions serving HIV/AIDS populations. The major topics discussed in the interviews include: demographics, what it is like to live with HIV or AIDS, and way of coping with HIV/ AIDS, including social support, religion, and health behaviors. The data analysis process is a qualitative one, with exploration of major themes and presentation of rich descriptions to illustrate those themes. Results from the data show that in terms of coping, all four participants found it most difficult to cope with a different aspect of living with HIV. Regardless of this finding, participants still employed similar coping strategies. As hypothesized, social support and religious/ spiritual support are important aspects in coping with HIV for all participants. The use of education as a coping mechanism was not an anticipated result. Yet, education was a constant theme, whether it was educating oneself about the disease to better understand it or educating others as to prevent them from contracting HIV. A variety of different positive coping strategies were employed by the participants in coping with their HIV, including altering negative health habits and staying optimistic. Negative coping strategies were also employed, but these seemed to be discussed less throughout the interviews. Overall, the results of this study demonstrate the resilience of these women in terms of finding ways of living with HIV instead of dying from HIV.