published_or_final_version / abstract / Speech and Hearing Sciences / Master / Master of Science in Audiology

In sub-Saharan Africa - the region with some of the world's highest levels of HIV prevalence - AIDS has reached pandemic proportions. At present, the highest rates of infection are in the region where the main route of transmission is heterosexual intercourse. Although HIV/AIDS is a major concern for all age groups, to date there has been very little exploratory research conducted on the population aged 50 and above. This dissertation seeks to analyse older people's perceptions of health services and their health seeking behaviour in the era of HIV/AIDS. This study utilized both qualitative and quantitative methodologies for data collection. The qualitative data relies on focus group discussions and the quantitative data from the exit interviews. In total, two hundred interviews were conducted and two focus group discussions were conducted: one with men only and one with women only. For the purpose of the study, older people referred to those persons aged 50 years and above. The study found that awareness of HIV/AIDS was relatively high. The majority of older people were aware of the main routes of HIV transmission and also the measures that they can use to protect themselves. An important source of information is public health facilities. Few older men and women perceived a medium or high risk of HIV infection. This is likely to have influenced their attendance at HIV/AIDS services. Few respondents reported ever using HIV/AIDS services. There are a number of factors inhibiting use of HIV/AIDS services including perceptions of health services, stigma and discrimination, high transportation costs and poor interpersonal relationships with providers. For the HIV/AIDS interventions to be successful, the task remains to address these factors influencing health-seeking behaviours. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2008.

Magistro darbo objektas – ŽIV/AIDS problematika žiniasklaidoje. Darbo tikslas – ištirti ir nustatyti ŽIV/AIDS problematikos nagrinėjimo žiniasklaidoje ypatumus. Darbo uždaviniai: atskleisti ŽIV/AIDS problematikos, kontrolės ir prevencijos sąsają; ištirti žiniasklaidos vaidmenį pateikiant ŽIV/AIDS problematiką, jos įtaką visuomenės nuomonei ir informacijos sklaidai; išnagrinėti ŽIV/AIDS problematikos pateikimo Lietuvos žiniasklaidoje tendencijas; išanalizuoti ir palyginti ŽIV/AIDS problematikos nagrinėjimo žiniasklaidoje privalumus ir trūkumus, remiantis ŽIV/AIDS srities specialistų nuomone. Išanalizavus mokslinę literatūrą, atlikus ŽIV/AIDS problematikos nagrinėjimo žiniasklaidoje tyrimą remiantis kiekybinės turinio analizės ir kokybinio ekspertų interviu metodais, teigtina – ŽIV/AIDS problematika, kontrolė ir prevencija yra glaudžiai susiję dalykai ir reikia bendro vientiso požiūrio į jų sprendimą. Žiniasklaida atlieka svarbų daugialypį vaidmenį nušviečiant ŽIV/AIDS problematiką – tai yra žiniasklaida ne tik atspindi trupalaikį ir planuojamą poveikį turinčią informaciją bet ir linkusi domėtis ir gilintis į ŽIV/AIDS problematiką, prisidėti prie ŽIV/AIDS prevencijos siekių įgyvendinimo, įtakoti visuomenės grupių socializacijos procesus, padėti „apsibrėžti realybę“, pažintinius aspektus, kas yra pasiekiama žinant jos įtaką visuomenės nuomonei. Žiniasklaida, veikianti kaip svarbus socializacijos proceso agentas, yra linkusi įtakoti ilgalaikius poveikio efektus, prisidėti... [toliau žr. visą tekstą] / Because of it‘s importance in public life, mass media has incomparable opportunity to inform and educate general population on HIV/AIDS issues and protect from danger to get infected with HIV. Therefore, it is important to find out and assess peculiarities of HIV/AIDS coverage in mass media. This aim was pursued by the following work tasks: to display relations among HIV/AIDS topic, control and prevention; to evaluate the role of mass media in covering this topic; to research the trends of HIV/AIDS coverage in Lithuanian mass media; to analyse and compare advantages and shortcomings of the topic coverage in mass media by means of specialists’ opinion. Work object was HIV/AIDS coverage in mass media. Analysis of scientific printed matters and available research results allow to conclude that HIV/AIDS topic, control and prevention are tightly related as these issues require general integral point of view. Role of mass media and its impact onto prevention of epidemics and reduction of prevalence is obvious, possible potential to perform this role is also well-seen. Quantitative content analysis and quality expert interview used to assess HIV/AIDS coverage in mass media resulted into following conclusions: professional HIV/AIDS coverage in mass media depends on comprehensive complex point of view, and not only on attention and possibilities of the mass media but also on effective cooperation with interested institutions and population groups to affect targeted dissemination of... [to full text]

Bakgrund: HIV är en infektionssjukdom som kan överföras vid bland annat oskyddade samlag, via blod och transplanterad vävnad. Då det idag finns antivirala läkemedel ses HIV inte längre som en dödlig utan en kronisk sjukdom. Personer med HIV/AIDS upplever att sjukdomen påverkar den fysiska och psykiska hälsan negativt. Sjuksköterskor har bristande kunskaper om sjukdomen samt är ovilliga att ge omvårdnad till dessa personer. Syfte: Syftet med litteraturöversikten var att beskriva personers upplevelser av att leva med HIV/AIDS. Metod: Litteraturöversikten baserades på 13 artiklar med kvalitativ design som analyserades enligt Fribergs femstegsmodell. En induktiv ansats användes. Resultat: Huvudtemat stigmatisering identifierades tillsammans med temat transition med tillhörande fem underteman samt temat rädsla med tillhörande tre underteman. Slutsats: Personerna med HIV/AIDS upplevde sig stigmatiserade av närstående, i samhället och i kontakt med hälso- och sjukvården. För att stigmatiseringen ska upphöra behöver sjuksköterskor mer kunskap om HIV/AIDS. För att nå ett personcentrerat förhållningssätt behöver sjuksköterskor se personerna bakom sjukdomen samt medvetandegöra sina attityder och förutfattade meningar mot personerna som lever med HIV/AIDS. / Background: HIV is an infectious disease which can be transmitted through for example unprotected sexual intercourse, through blood and transplanted tissues. Because of today’s antiviral drugs HIV is seen as a chronic disease instead of a mortal. People with HIV/AIDS experience that the disease affects the physical and mental health negatively. Nurses have poor knowledge about the disease and are reluctant to give care to these people. Aim: The aim of the literature review was to describe people's experiences of living with HIV/AIDS. Method: The literature review was based on 13 articles with qualitative design which were analyzed according to Friberg’s five-step model. An inductive approach was used. Results:  The main theme stigma was identified along with the theme transition with five sub- themes and the theme fear with three sub- themes. Conclusion: People with HIV/AIDS felt stigmatized by family, society and in contact with health services. To reduce stigma nurses need more knowledge about HIV/AIDS. To reach a person-centered approach nurses need to see the people behind the disease and raise awareness of their attitudes and prejudices against people living with HIV/AIDS.

M.Cur

M.A. (Community Development) / The statistics on HIV/Aids in this study overwhelm the imagination. It has great social and economical consequences for individuals, families and communities. The generation of between 15-24 years are vulnerable to infection especially women. From the population of about 46 million in South Africa, 5.7 million were HIV positive by the end of 2007 with about 1000 deaths every day. Sub-Saharan Africa appeared to be the most hit by this tragedy as indicated by statistics in this study. When parents die of Aids, the burden of orphaned children is left with relatives and extended families to look after those children. The number of orphans is escalating due to increasing death rate of parents. A detailed discussion on the extended families which includes their origin, roles they play as well as challenges they face in caring for orphaned children is included as well. Challenges include having to deal with grief and changing behaviour of the orphaned children. The goal of this study was to conduct an analysis of extended families affected by HIV/Aids taking care of orphans, living in the Kyasands informal settlement in order to improve service delivery. The main objectives of the study included exploring the needs of these extended families caring for orphaned children in terms of social, emotional and material aspects as well as challenges they face and how they manage to survive. A qualitative method was used in conducting this study with the use of semi-structured interviews to collect information. The main central question asked was, how do you manage to live with an additional member within your family. The main findings in this study were reported which included the strength and composition of assets and the extended families’ resources to make a living and adjust to shocks of life. Family was seen as the most trusted asset in this study by the respondents. Just to mention a few, most of the families owned shacks, battery operated radios and televisions since they live in formal settlement without any permanent infrastructures.

M.Ed. (Education) / Please refer to full text to view abstract

[pt] Este estudo busca analisar a lógica que rege a inserção de mulheres soropositivas no mercado de trabalho, a partir das experiências das mulheres no grupo de ajuda-mútua Viva a Vida, do Hospital dos Servidores do Estado do Rio de Janeiro. Nesse sentido buscou-se compreender como a lógica do capitalismo contemporâneo promove uma interface entre a inserção das mulheres no mercado de trabalho, as relações de gênero e a epidemia de AIDS. O presente texto, portanto, sistematiza-se a partir das categorias trabalho, gênero e AIDS, que subsidiaram uma pesquisa de caráter quanti-qualitativo, privilegiando a história de vida destes sujeitos. Os resultados do estudo evidenciam que a lógica do capital, longe de excluir as mulheres do trabalho apropria-se das especificidades e vulnerabilidades inerentes ao gênero e à  AIDS, inserindo-as em um mercado de trabalho informal e precarizado, a partir de necessidades tanto mercantis, quanto individuais. / [en] This study searchs to analyze the logic that conducts the insertion of HIV infected women in the work market, from the experiences of the women in the Viva a Vida Group (Alive the Life) , of the Hospital dos Servidores do Estado do Rio de Janeiro (Hospital of the Servers of the State of Rio de Janeiro). In this direction one searched to understand as the logic of the contemporary capitalism promotes an interface enters the insertion of the women in the work market, the relations of kind and the epidemic of AIDS. This text, therefore, systemizes from the work, kind and AIDS categories, that had subsidized a research of quanti- qualitative character, privileging the history of life of these citizens. The results of the study evidence that the logic of the capital, regardless excluding the women of the work, assume of the especificities and inherent vulnerabilities to the kind and the AIDS, inserting them in an informal and insufficient work market, from mercantile necessities, how much in such a way individual.

Introdução: A infecção pelo HIV associada com o adoecimento por tuberculose influencia na dinâmica de ambas patologias.Objetivo: Avaliar a prevalência e fatores associados da coinfecção HIV/tuberculose em indivíduos com tuberculose no período de 2003 a 2011, notificados no município de Ribeirão Preto - SP. Metodologia: Trata-se de um estudo descritivo, transversal, retrospectivo; tendo como sujeito todos os indivíduos com a coinfecção HIV/tuberculose, residentes no município de Ribeirão Preto, que foram diagnosticados, e tiveram seu caso notificado e cadastrado no programa TBweb. Os dados foram obtidos inicialmente a partir do Sistema de Informações para tuberculose no Estado de São Paulo, TBweb. Após a seleção, foi realizado a técnica de \"linkage\" entre os bancos de dados SINAN, SISCEL e SICLOM que contem informações do HIV/aids. Os dados foram analisados por meio do programa Statistical Package for the Social Sciences (SPSS), versão 17.0 for Windows, utilizando-se estatística descritiva, teste qui- quadrado e Odds Ratio. Resultados: Dos 1.277 indivíduos com tuberculose cadastrados no TBweb entre 2003 e 2011, 338 apresentavam a coinfecção HIV/tuberculose, mostrando uma prevalência de 26,5%. Em relação às características demográficas, 244 (72,2%) eram do sexo masculino, a faixa etária predominante foi de 35 a 44 anos (45,0%). Quanto à raça/cor, 151 (44,7%) eram branca. Quanto ao tipo de caso, 308 (91,1%) dos casos eram novos. Referente ao encerramento do caso, a maioria dos indivíduos (58,9%) com a coinfecção HIV/tuberculose obteve cura. A forma clínica mais encontrada foi a pulmonar em 201 (59,5%) casos, seguida pela extrapulmonar em 90 (26,6%) indivíduos. No que diz respeito à identificação de qual doença foi notificada em primeiro lugar, evidenciou- se que a maioria 246 (72,8%) teve o registro do caso de HIV/aids antes de ter a notificação de tuberculose. Com relação à contagem de linfócitos TCD4+, 189 (55,9%) apresentaram taxas menores que 200 células/mm³ de sangue, 201 (59,5%) faziam uso de terapia antirretroviral e 102 (30,2%) apresentaram carga viral entre 1.001 e 100.000 cópias. Conclusão: A prevalência de indivíduos coinfectados foi de 26,5% taxa superior a nacional, sendo a maioria do sexo masculino, com faixa etária predominante em idade produtiva, com baixa contagem de linfócitos TCD4+, com o diagnóstico do HIV/aids anterior ao de tuberculose, evidenciando a necessidade de mais ações voltadas para a prevenção de ambas as doenças / Introduction: HIV infection associated with tuberculosis affects the dynamics of both pathologies. Objective: To assess the prevalence and factors associated with HIV/tuberculosis co-infection in individuals with tuberculosis between 2003 and 2011, registered in the municipality of Ribeirão Preto - SP. Methodology: This is a descriptive, cross-sectional, retrospective study; the subjects were all individuals with HIV/tuberculosis co-infection, residents of the municipality of Ribeirão Preto, who had been diagnosed, notified and registered in the TBweb program, the tuberculosis information system of the state of São Paulo. Data were initially obtained from TBweb. After the selection, the database was created using the linkage technique between the TBweb, SINAN, SISCEL and SICLOM databases, which contain information on HIV/Aids. Data were analyzed by means of the Statistical Package for the Social Sciences (SPSS), version 17.0 for Windows, using descriptive statistics, chi-square test and Odds Ratio. Results: Out of the 1277 individuals with tuberculosis registered in the TBweb between 2003 and 2011, 338 presented HIV/tuberculosis co-infection, showing a prevalence of 26.5%. Regarding demographic characteristics, 244 (72.2%) were male and the predominant age range was between 35 and 44 years (45.0%). As for race/skin color, 151 (44.7%) were Caucasian. A total of 308 (91.1%) cases were new. Regarding the outcome of the case, most of the individuals (58.9%) with the HIV/tuberculosis co-infection were cured. Pulmonary tuberculosis was the most common clinical form of the disease, found in 201 (59.5%) cases, followed by extrapulmonary tuberculosis in 90 (26.6%) individuals. With regard to the identification of which disease was notified first, most cases, 246 (72.8%), had records of the HIV/aids case prior to the notification of tuberculosis. A total of 189 (55.9%) individuals had a CD4-Positive T-Lymphocyte count lower than 200 cells/mm³ of blood, 201 (59.5%) followed antiretroviral therapy and 102 (30.2%) had a viral load between 1,001 and 100,000 copies. Conclusion: The prevalence of co-infected individuals was 26.5%, which is above the national rate. Most individuals were male, in a productive age and had a low CD4-Positive T- Lymphocyte count, with a prior diagnosis of HIV/aids to that of tuberculosis, evidencing the need for more actions aimed at the prevention of both diseases

A epidemia da aids afeta a vida de crianças e jovens, independentemente da presença do HIV/Aids, através do adoecimento, perda dos pais, estigma, discriminação, entre outros. Este estudo teve como objetivo compreender o significado de ser órfão para jovens que perderam um ou ambos os pais em decorrência da aids e compreender os processos de estigmatização decorrentes dessa morte. Foram analisadas 19 entrevistas em profundidade realizadas com jovens órfãos, com idade entre 15 e 22 anos, residentes na cidade de São Paulo, entre os anos de 2005 e 2007. O sentido atribuído à morte e todo o ritual que a cerca é concebido como socialmente construído e a morte em decorrência da aids permeada pelo estigma que acompanha a aids desde o início da epidemia. Foram encontrados cinco significados associados à orfandade: dificuldade de falar sobre a orfandade ligada à aids; sentir falta do cuidado materno; o desafio de ser independente; não se sentir órfão e sentir tristeza em decorrência da morte. Os processos de estigmatização foram divididos em estigma sentido e efetivado e aconteceram na escola, na casa de amigos, na rua e com a namorada. Todos os relatos e cenas de estigma foram de estigma por associação, pois decorriam da causa da morte do(s) pai(s). Percebe-se que a orfandade em decorrência da aids impacta a vida dos jovens. Eles convivem com as adversidades com apoio da família, na maioria das vezes, materna. Não se conhece muito sobre os órfãos, principalmente se eles não viverem com HIV/Aids, pois os serviços de saúde perdem o contato a partir do momento que a pessoa da família que vive com aids morre. É importante que os programas de aids incorporarem as visões e as perspectivas destes jovens em seus projetos para garantir-lhes seus direitos. / The aids epidemic affects the life of children and youngs, not only because of the presence of HIV/Aids, but also because of the sickness, death of parents, stigma, discrimination, and others. This research had the main intention of understanding the meaning of being an orphan to young people that have lost one or both parents in result of aids and the stigma that is included in this process. Nineteen interviews were studied and the public included youngs between 15 and 22 years old, living in São Paulo, between 2005 and 2007. In this report, the meaning attributed to death and all the ritual involving it was concepted as social constructed and the death regarding aids was studied with the stigma that around aids since the beginning of the epidemic. It was pointed 5 issues related to orphanhood: difficulties related with speaking about parents death by AIDS; missing of mothers care; the challenges of being independent; do not feel as an orphan and feeling sadness because of death. The process of stigma was divided as felt stigma and enacted stigma and happened at school, at friends house, at the streets and with a date. All the stores and scenes of stigmas were courtesy stigma, because were related with parents death. With this report it is possible to realize that beeing an orphans in result of aids affects direct youngs living. They get used to live with adversity, family support, mainly by mothers family. Not too much is known about orphans, even less if they do not live with HIV/AIDS, because health services do not keep contact after the person in the family with AIDS dies. It is very important that aids programs includes the expectations and the way of seeing life of those people in their programs, so they can guarantee respect and theirs rights.