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Stigma has long been associated with disease and illness, whether communicable or non-communicable, chronic or acute. In a medical context where the physical signs of disease and ‘sick’ behaviours help everyday people and medical professionals identify and segregate the infected from the uninfected, stigmatizing behaviours can sometimes be productive because they can limit the spread of disease and save lives. And yet, scholarly research and everyday discussions about health-related stigma often emphasize its counterproductive outcomes, such as when stigma discourages or undermines testing, treatment and other public health interventions. Like people living with HIV/AIDS, zombies, vampires and werewolves which are found in fictional narratives experience a variety of stigmatizing behaviours. They are diagnosed as ‘sick’ or ‘diseased’, labelled and stereotyped as dangerous and contagious, and separated physically as well as rhetorically from human beings. They are also quarantined, ridiculed, experimented on, and executed by medical professionals, military and law enforcement officials, and everyday citizens. While the zombie narrative has been useful for understanding the outbreak of disease and the spread of a global pandemic, when the nature of a disease changes from acute to chronic and is of a prolonged nature, these narratives are less useful. Instead, more sympathetic ‘monsters’ such as the vampire and the werewolf can act as a vehicle for understanding that disease does not equal death. Using the vampires and werewolves of the Anita Blake, Vampire Hunter series as a case study, this research explored the role of monster metaphors and storytelling in popular culture as a health communication intervention strategy for challenging the counterproductive stigma outcomes experienced by those living with a chronic, transmissible disease. The analysis of the Anita Blake series conducted in this dissertation clarifies how stigma could be presented in popular culture narratives to account for both the experience of stigma and the stigmatized experience of those living with chronic, infectious diseases like HIV/AIDS. In particular, three criteria were identified in the series that lay the foundation for creating a productive learning opportunity for understanding chronic, transmissible illness and disease: the use of health-related indicators linking ‘monstrous’ conditions with the diagnosis of illness or disease; the presence of all of the steps in the stigma process; and, the inclusion of a variety of differential and discriminatory responses to ‘monstrous’ characters by the medical, legal and social systems present within the fictional world. When these criteria are met, monster narratives can achieve three objectives. First, they can demonstrate how structural and public stigma behaviours – whether differential or discriminatory – impact individuals and groups who are recipients of such treatment through the generation of self-stigma. Second, they draw attention to the counterproductive stigma outcomes that result from self-stigma sentiments. Third, they can show how groups and individuals generate productive stigma outcomes through a variety of stigma management practices. This analysis also led to important precisions to the existing understanding of the process of health-related stigma and stigma-related behaviours that may not have been possible without popular culture. In particular, it was determined that for those being stigmatized, it matters little whether treatment is differential or discriminatory for the effect on the individual or group is the same – the internalization of stigma and the generation of self-stigma sentiments. It was also confirmed that stigma management practices can result in both counterproductive and productive outcomes and, finally, it was possible to identify four personas that emerged from these outcomes: ‘villains’, ‘victims’, ‘survivors’ and ‘thrivers’.

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AIDS Dementia Complex (ADC) is a common neurological complication of HIV/AIDS. ADC is characterized by cognitive, behavioral, and motor impairments including slowed thinking, decreased concentration, forgetfulness, apathy, irritability, anxiety, clumsiness, leg weakness, and altered handwriting. Symptoms progress into pronounced verbal and motor slowing, extensive thought disturbances, profound disorientation, hostility, ataxia, incontinence, and eventually a near vegetative state. Presently, no cure is available for ADC. However, treatment with the antiretroviral drug, zidovudine (AZT), has been shown to slow the progression of ADC and improve functioning. Other promising pharmacological treatments under investigation include newer antiretroviral drugs, combination use of protease inhibitors and zidovudine, calcium channel blocking agents, receptor antagonists for excitatory neurotransmitters, and antagonists of cytokines and inflammatory agents. Psychosocial interventions for managing patients in the early stages of ADC focus on preserving independence, promoting self-esteem, and assisting patients to compensate for cognitive changes. During the later stages of ADC, interventions deal with adapting patients' environments to ensure safety and maintain structure, routine, and simplicity. Prompt intervention is essential to improving the quality and length of these patients' lives.

Honors Project--Smith College, Northampton, Mass., 2009. / Includes bibliographical references (p. 79-87).

Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: HIV/AIDS is considered as a global problem with the number of people living with HIV infection continuing to increase. At the end of 2007 HIV/AIDS had already claimed 25 million lives. Of all new HIV infections 71% were diagnosed in the Sub-Saharan region in 2008, remaining the worst affected region globally. UNAIDS (2008:43) indicated that heterosexual intercourse remained the main origin for HIV infection in the Sub-Saharan region. Therefore the researcher is of the opinion that prevention strategies should focus mainly on sexual transmission of the disease. HIV/AIDS affects mainly people between the ages 15-24 years, notably the age group of most of the learners in Higher Education Institutions (HEIs). Lesotho, a country in the Sub- Saharan region, presents with the third highest HIV adult prevalence (23.2%) in the world and in the region. In an attempt to address the prevailing situation, Lesotho has a number of programmes geared towards addressing HIV/AIDS in the country. However, all these attempts exclude the learners in HEIs, yet the majority of learners are found within the most affected age group. It is also to be noted that Higher Education provides the bedrock for socio-economic and political development in Africa. Some studies have identified insufficient knowledge as being at the root of the increasing HIV infections among youth. However, other studies have shown that there is adequate knowledge among the young people, but still a challenge remains and that is to facilitate changes in behavioural patterns as a component to be linked to the knowledge. Studies conducted in other African countries have shown that there are anti-AIDS programmes and clubs for learners in HEIs where learners are involved in the fight against HIV/AIDS. No publication indicating the same for Lesotho’s HEIs could be found, except for the National University of Lesotho (NUL) that only launched its HIV/AIDS policy for learners in 2009. The researcher is of the opinion that HEIs in Lesotho are not doing enough to combat HIV/AIDS and hence intends to focus on HEIs in Lesotho. This study had two objectives namely:  To determine the knowledge of learners in a specific HEI in Lesotho regarding HIV/AIDS prevention and care.  To explore the needs of learners in a specific HEI in Lesotho regarding HIV/AIDS prevention and care. This mixed method study was conducted, comprising of both quantitative and qualitative designs. Quantitative phase used a questionnaire for determining the knowledge of learners. The questionnaire was adopted from a study that was performed to determine knowledge of South African educators in public schools with some modifications. The qualitative phase was used to explore the needs of the learners through the focus group discussions with the leaders of the learners. Sample was drawn from the entire population using stratified random sampling for the quantitative phase. The qualitative phase used the purposive sampling to obtain in-depth information concerning learners’ needs. Quantitative data was analysed through the use of statistical package for social sciences (SPSS) and qualitative data was analysed using the thematic analysis and open-coding. All ethical principles were adhered to especially the principle of respect for persons. The findings from the quantitative phase of the study showed that learners had adequate knowledge regarding HIV/AIDS prevention and care and the findings from the qualitative phase showed the various needs of the learners with regards to prevention and care of HIV/AIDS in a specific HEI in Lesotho. Recommendations have been proposed based on the findings from the two phases of the study. Limitations observed by the researcher have also been identified. In conclusion the objectives of the study were met and the research questions had been answered. / AFRIKAANSE OPSOMMING: MIV/Vigs word as ‘n internasionale probleem erken, siende dat daar ‘n verhoging in die toename van MIVgeïnfekteerde indiwidue tans is . Einde 2007 het MIV/Vigs het reeds 25 miljoen lewens ge-eis . In 2008 is 71% van al die nuwe MIV-infeksies in die Sub-Sahara streek gediagnoseer, wat aandui dat die streek die mees geaffekteerde streek tans is. UNAIDS (2008:43) het aangedui dat heteroseksuele omgang die hoofoorsaak van MIV-oordrag in die Sub-Sahara-streek is. Laasgenoemde het daartoe gelei dat die navorser van mening is dat voorkomende strategieë meestal op seksuele oordrag van die siekte moet fokus. MIV/Vigs affekteer meestal mense in die ouderdomsgroep 15-24, opmerklik is dit die ouderdomsgroep waarby meesste leerders in Hoëronderwysinstellings (HOI) is. Lesotho, ‘n land in die Sub-Sahara-streek, het tans die derde-hoogste MIV-voorkoms (23.2%) in die wêreld en in die streek. Lesotho het verskeie programme ontlont om MIV/Vigs te bekamp in ‘n poging om die huidige situasie te beredder . Nieteenstaande sluit al die programme leerders in HOI uit, alhoewel die leerders in die ouderdomsgroep van die mees-geaffekteerde groep val. Dit is ook duidelik dat Hoëronderwys die fondasie vir sosio-ekonomiese- en politieke ontwikkeling in Afrika verskaf. Sommige studies het onvoldoende kennis as die wortel van die verhoging van MIV-infeksies onder die jeug geïdentifiseer. Ander studies, daarenteen, wys dat kennis voldoende is onder jeug, alhoewel veranderinge in gedragspatrone om by die kennis aan te sluit ‘n uitdaging bly. Studies uit ander Afrikalande dui daarop dat daar anti-Vigs programme en klubs is waarby HO leerders betrokke is om teen die verspreiding van MIV/Vigs te veg. Geen publikasies in hierdie verband word in Lesotho aangetref nie, behalwe ‘n MIV/Vigs-beleid wat in 2009 deur “National University of Lesotho’ (NUL) gepubliseer is. Dus is die navorser van mening dat HOI nie genoeg doen om MIV/Vigs te beveg nie, daarom fokus sy op HOI in Lesotho. Hierdie studie het twee doelstellings ten doel gehad, naamlik om die leerders in ‘n sekere HOI in Lesotho se kennis aangaande MIV/Vigs voorkoming en sorg te bepaal en die behoeftes van die leerders aangaande MIV/Vigs voorkoming en sorg te verken. ‘n Studie met beide kwantitatiewe- en kwalitatiewe metodes is gebruik om die doelstellings te verwesenlik. In die kwantitatiewe fase is ‘n vraelys gebruik om leerders se kennis te bepaal. Die vraelys is verkry uit ‘n vorige studie wat in RSA gedoen is, maar aangepas om in die Lesotho-konteks te gebruik. Gedurende die kwalitatiewe fase is fokusgroep besprekings met die leiers van die leerders gehou om die behoeftes indiepte te verken. Die steekproef was uit die totale populasie getrek deur van gestratifiseerde streekproefneming gebruik te maak in die kwantitatiewe fase en ‘n doelgerigte steekproefneming is in die kwalitatiewe fase te gebruik. Die navorser het ‘n kwantitatiewe data-analise sagteware (SPSS)gebruik om kwantitatiewe data te ontleed en tematiese- oopkodering is gedurende die kwalitatiewe fase gebruik. Etiese kode is ten volle gerespekteer, veral die respek vir mense gedurende navorsing. Bevindinge van die kwantitatiewe fase het bewys dat leerders voldoende kennis aangaande die voorkoming en sorg van MIV/Vigs besit en die kwalitatiewe bevindinge het die behoeftes van leerders met betrekking tot die voorkoming en sorg van MIV/Vigs in ‘n spesifieke HOI in Lesotho geopenbaar. Die aanbevelings is gemaak, gebaseer op die bevindinge uit die twee fases. Beperkinge in die studie is uitgelig. Ter afsluiting is die doelstellings in die studie bereik en die navorsingsvrae beantwoord.

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