Bakgrund: Hiv/aids är en kronisk infektionssjukdom som drabbar immunförsvaret. Viruset smittar via blod, sädesvätska, slidsekret och via förlossning eller amning. Det är vanligt att hiv/aids smittade utsätts för stigmatisering. Stigmatisering innebär diskriminering och nedvärdering av redan utsatta grupper.   Syfte: Syftet med studien var att undersöka hiv/aids smittade personers upplevelser av stigmatisering.   Metod: En litteraturstudie av kvalitativ ansats gjordes och den grundades på fem självbiografier. Innehållsanalysen var baserad på en metod gjord av Dahlborg-Lyckhage (2012).   Resultat: I resultatet fann författarna tre huvudkategorier: Hur drabbade stigmatiserar sig själva, Hur hiv/aids drabbade upplevde allmänhetens stigmatisering och Bristande förståelse från omgivningen. Det finns många olika typer av rädslor hos de som lever med hiv/aids, vilket bidrar till självstigmatisering och självvald isolering. Det framkom även att de drabbade utsätts för stigmatisering från allmänheten, t.ex. genom särbehandling, utanförskap och genom andra åtgärder som de drabbade upplevde som kränkande. Detta kunde ofta härledas till bristande förståelse för sjukdomen eller okunskap.   Slutsats: Studien visar att självstigmatisering och stigmatisering från allmänheten är vanligt förekommande. Dock krävs det vidare forskning för att kunna styrka studiens resultat och överförbarhet. / Background: HIV/AIDS is a chronic infectious disease of the immune system. The virus is transmitted through blood, semen, vaginal secretions and through childbirth or breastfeeding. It is common that persons living with HIV/AIDS are exposed to stigma. Stigma is defined as discrimination and denigration of already vulnerable groups.  Objective: The aim of this study was to examine the HIV/AIDS infected people's experiences of stigma.  Method: A literature study of qualitative approach was made and it was based on five autobiographies. The content analysis was based on a methodology made of Dahlborg-Lyckhage (2012).  Results: In the results, the authors found three main categories: How persons living with HIV/AIDS stigmatize themselves, how HIV/AIDS infected people sufferers as a result of experienced public stigma and lack of understanding from the environment. There are many different types of fears from those living with HIV/AIDS, which contributes to self-stigma and self-imposed isolation. It also emerged that the victims are subjected to stigmatization by the public, such as special treatment, exclusion and by other measures that the victims experienced as insulting. This could often be traced to a lack of understanding of the disease or ignorance.  Conclusion: The study shows that self-stigma and stigma from the public is common. However, it requires further research to justify the study's results and transferability.

ABSTRACT Background: HIV/AIDS is a worldwide disease and exists documented in over 150 countries. There are 25 million infected people with HIV/AIDS in Africa, those stands for almost 71 % of all infected people around the world. This study is an opportunity to take a more important part of the care process that gives an overview of nurse’s experiences. Aim: The aim of this study was to describe registered nurses experiences of caring for patients with HIV/ AIDS in Dar es Salaam. Method: The study is empirical and it took place at Muhimbili National Hospital and Buguruni Health Center in Dar es Salaam, Tanzania. A convenient sample of seven nurses with experiences of caring for patients with HIV/AIDS participated in this study. Their experiences were investigated through interviews. Interviews were analysed with qualitative content analysis. Results: Three categories were formulated as the: Importance with a cooperative relationship, importance with confirmatory meetings and Challenges and stressful work condition. The sub-categories were counted as six and formulated as To achieve good cooperation, To create a close relationship, To obtain confirmation as a nurse, Striving to strengthen the patient through education, To manage heavy workload and stress and To manage difficult meetings. Cooperation and close relations are of great importance when it comes to nurse’s experience of caring for patients living with HIV / AIDS. To perceive confirmation and management maintain the high quality of caring. Conclusions: The nurses who participated in the study described their experiences in the care of patients with HIV/AIDS as confirmatory, cooperative and developing. Despite this, these nurses faces intractable challenges and encounters experienced tough and stressful.

This thesis presents the findings of a small-scale, qualitative study of attitudes toward AIDS and AIDS education campaigns in the village of Sota in central Benin. Through a language ideology framework, this study reviews the overlap and disparity between AIDS discourse and other systems of meaning in Sota, particularly rumors and religious beliefs. The portrait that emerges from this analysis of the social construction of AIDS by multiple discourses suggests that the impact of AIDS education may be limited only in part because the intended recipients fail to understand the information being provided. More importantly, the context and underlying assumptions of educational presentations about HIV/AIDS are not formulated in ways that are compatible with, or directly meaningful to, lived experience.

This study aimed to review the use of lay counsellors and rapid HIV tests in a voluntary testing and counselling (VCT) service in the UGU South health district of KwaZulu Natal. The study ran from September 1999 to April 2001. In early 1999, UGU South was selected as a pilot site as part of an international initiative. This initiative aimed to promote testing for HIV by using VCT service as an entry point into a range of HIV/AIDS and TB prevention and care programmes and was termed the ProTEST Initiative. Four such ProTEST sites were developed in South Africa and all offered rapid HIV testing and prophylactic drugs (Isoniazid and Cotrimoxazole) for HIV infected people. VCT was prioritised at all sites, however UGU South was unique in providing lay counsellors. Traditionally a lay counsellor (who is not a trained health care worker), offered only pre and post- test counselling. Lay counsellors had been used in South Africa, however their impact had not been formally assessed. In accordance with the Health Professional Council ruling on testing blood, lay counsellors could not carry out a rapid HIV test procedure. The decision to use lay counsellors in UGU South, was based on a review of the capacity of existing health care workers to expand a VCT service. Ten female lay counsellors, who fulfilled pre-employment selection criteria, were employed. In 1999, VCT was prioritised by the South African Department of Health and a Strategic Plan on HIV/AIDS & STDs was developed. The aim was to test 12.5% of the adult population for HIV before the year 2005. The proposed VCT service was to be based at health facilities and was to utilize existing health care workers. The capacity of existing health care workers to cope with an expansion in VCT services had not been explored. The reasons why clients accessed VCT and the demographic profiles of such clients were poorly understood. The Department of Health also planned to use rapid HIV tests at health facilities. Literature on the use of rapid HIV tests in South Africa was limited. This study aimed to address gaps in knowledge around VCT in South Africa and specific objectives were to: * Assess the capacity of existing health care workers to expand a VCT service *Review the need for rapid HIV tests *Develop and evaluate a training, support and mentorship programme for lay counsellors *Review the reason why clients use a VCT service and the demographic profiles of such clients *Monitor the impact of lay counsellors on numbers of cases of TB diagnosed and treated *Make recommendations for the use of lay counsellors and rapid HIV tests in an expanded integrated HIV/TB Control Programme. The study was prospective, descriptive and was based at ten health facilities in UGU South. The health facilities offered counselling, rapid HIV tests and prophylaxis for HIV infected people (Isoniazid or Cotrimoxazole). The study population was all nurses, lay counsellors and clients involved with the VCT service at these sites. Both qualitative and quantitative methods of study were employed in this study including: *Postal survey * Interviews *Focus group discussion *Review of patient records, literature and questionnaires * Analysis of registers from the National TB Control Programme. Results from three independent reviews clearly indicated that nurses in UGU South did not have the capacity to offer an expanded VCT service due to a heavy workload commitment. The nurses considered that VCT was a necessary service and supported the introduction of lay counsellors. Quantitative reviews concluded that a third of people tested for HIV using a hospital based testing system never returned for their results and that the turn-around time for an HIV test result was as much as three weeks. Rapid HIV tests increased access to an HIV test result and were acceptable to health care workers. There was no review of the opinions of clients on the rapid HIV tests. A training, support and mentorship programme was developed for lay counsellors and both nurses and counsellors considered that the programme was largely effective. The lay counsellors were trained to offer a more comprehensive service than traditional lay counsellors; in particular lay counsellors were expected to screen clients for symptoms of TB disease and support clients taking TB medication. Evaluation of the programme concluded that the content should be more practical and there should be a dedicated supporter for the lay counsellors available at their place of work. Results suggested that access to VCT services increased due to the presence of lay counsellors. The lay counsellors were acceptable to health staff, however there was no review of the opinions of clients on the lay counsellors. Half of the 7 475 people tested were infected with HIV. Most clients were medically referred for VCT and had "AIDS defining" illnesses. The clients who self-referred were ill or knew someone who had died recently. The proportion of clients who self-referred increased and health education was the main reason why people self-presented. More women than men were tested and women were more likely to test HIV positive. Review of the TB registers indicated that the TB Control Programme in UGU South was not optimal. The impact of lay counsellors on numbers of TB cases diagnosed and on treatment could not be determined from this study. Before the use of lay counsellors is expanded, there should further review of the capacity of other health care workers to offer VCT. Issues such as conditions of employment, salaries and a job description for lay counsellors should be clarified. There should be an independent assessment of the quality of counselling offered and a review of the cost of the lay counsellors. The impact of using men and younger lay counsellors should be reviewed. VCT services should be based at clinics, rather than hospitals and consideration should be given to developing freestanding VCT sites. Education programmes on VCT should be expanded beyond health facilities. Prior to expanding the use of rapid HIV tests, there should be a review of the cost of rapid HIV tests and systems should be in place for ordering, delivery and for stock control. The opinions of clients on rapid HIV testing should be ascertained. Consideration should be given to lay counsellors performing the rapid HIV test or an alternative method of testing (not involving blood) should be introduced. There should be ongoing training in TB and monitoring of the TB Control Programme in UGU South. Specific indicators should be developed to monitor the impact of lay counsellors on the diagnosis and treatment of TB and to measure collaboration between HIV/AIDS and TB Control Programmes. / Thesis (M.Med.Sc.)-University of Natal, Durban, 2002.

Set in the mining sector, the aim of this study was to explore the experiences, insights and reflections of a particular group of peer educator's with regard to their organisation’s peer education programme. Using the PRECEDE-PROCEED Model (Green & Kreuter, 1991) as an organising framework, this study explored the pre-disposing, enabling and reinforcing factors that had an impact on this HIV/AIDS peer education programme. The specific objectives to be assessed in this study were the peer educator’s perceived impact on attitude and behaviour change amongst employees; the perceived organisational barriers and supports that peer educators encountered in programme delivery as well as further training needs of the peer educators. Using an interpretivist paradigm, the study was concerned with describing and interpreting people’s feelings and experiences with qualitative depth. Interviewees comprised of a non-probability saturation sample of five current adult peer educators and one adult ex-peer educator, employed in the Eastern Region of the Organisation (KwaZulu-Natal). In addition the regional manager and the human resource manager were interviewed. Semi-structured tape recorded interviews were used to collect data from the peer educators, and the data was transcribed verbatim from the digital recording. Themes were induced and coded by looking for reoccurring peer educator views, following which the researcher was able to induce potential predisposing, enabling and reinforcing factors that the peer educators faced in programme delivery. Based on the findings of the study, appropriate recommendations are offered with a view to improving programme delivery and quality. Finally, the main constraints which limited the study findings are considered. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Abdool Karim (Daily News, 02 December 2009) aptly states that one of the daunting social development challenges facing our young democracy in South Africa is the HIV and AIDS pandemic which has seriously impacted on the increase of HIV infected children. The study explored the experiences of social workers in the provision of reconstruction services to HIV infected children. This research study used a qualitative descriptive methodology. There were two sample groups: one consisted of five social workers from five institutions and the second consisted of six social workers from two child welfare organizations. Data was collected by means of semi-structured in- depth interviews with the institutional social workers. One focus group was held with child welfare social workers for the purpose of enhancing the reliability, validity and trustworthiness of the study. Globalization has had a substantial impact on social work services which has been further articulated through ‘new managerialism’, whereby welfare states are becoming cost effective businesses (Dominelli, 2002). Both welfare agencies and social workers pursuant to “new managerialism” have to justify their existence on a day to day basis due to the market principles that have been applied to the profession; it has to be ‘economically sound’ to be a social worker and to continue to be employed. The findings show that there were five key themes and various sub-themes that emerged from the in-depth interviews and the focus group interviews that posed as challenges for social workers. The lack of resources, high staff turnover, the recruitment of foster families emerged as factors that contributed to the challenges experienced by both institutional and child welfare social workers. Despite the many constraints placed on social workers several initiatives have been taken by institutional and child welfare social workers in the implementation of various services and programmes provided to families, communities and children infected or affected by the HIV and AIDS pandemic. In the face of “new managerialism” it is recommended that social workers need to accept that structural forces such as the economy, political, poverty and unemployment have a profound impact on organizations therefore it is necessary for social workers to advocate and lobby for adequate resources such as vehicles, access to telephones and computers and regular supervision, in the provision of reconstruction services. Furthermore social workers must have an updated knowledge regarding relevant policies and legislation that impact service delivery. The Department of Social Development should work in collaboration with the Department of Health and Education so that efforts could be made to ensure that HIV infected children continue with schooling, thereby developing them into more independent individuals. Finally an additional subsidy should be provided by the National Department of Social Development to institutions for services to accommodate family and prospective foster parents who stay over at institutions. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Syfte: Att beskriva sjuksköterskors kunskap och attityder gentemot patienter som lever med HIV eller AIDS samt beskriva eventuella skillnader i kunskap och attityder mellan yngre och äldre sjuksköterskor. Metod: Föreliggande empiriska studie hade en kvantitativ ansats med en beskrivande jämförande design. Urvalsmetoden var ett bekvämlighetsurval där totalt 63 sjuksköterskor deltog och enkäter skickades ut till nio avdelningar på tre olika sjukhus. Resultat: Majoriteten av sjuksköterskorna hade god kunskap om HIV och AIDS, positiva attityder samt en vilja att vårda denna patientgrupp. En del av sjuksköterskorna uttryckte dock en rädsla för att smittas av HIV, ett behov av mer utbildning och negativa attityder gentemot vissa specifika grupper med sjukdomen. Yngre sjuksköterskor hade positivare attityder än äldre då det fanns en signifikant skillnad i attityder mellan dessa åldersgrupper. Slutsats: Trots att sjuksköterskorna hade god kunskap, positiva attityder och en vilja att vårda denna patientgrupp förelåg en rädsla att bli smittad av HIV och därför behövs mer utbildning om HIV och AIDS för sjuksköterskor. Yngre sjuksköterskor hade även positivare attityder än äldre. Vidare forskning bör även genomföras då få studier belyser detta område i Sverige. / Aim: To describe nurses knowledge and attitudes towards patients who are living with HIV or AIDS and to describe potential differences in knowledge and attitudes between younger and older nurses. Method: The present empirical study had a quantitative approach with a descriptive comparative design. The sampling method was a convenience sample in which a total of 63 nurses participated and questionnaires were sent to nine divisions in three different hospitals. Results: The majority of the nurses had good knowledge of HIV and AIDS, positive attitudes and a willingness to care for this group of patients. Some of the nurses, however, expressed a fear of contracting HIV, a need for more education and negative attitudes towards specific groups with the disease. There was a significant difference in attitudes between age groups, the younger nurses had a more positive attitude than the older nurses. Conclusion: Although the nurses had good knowledge, positive attitudes and a willingness to care for this group of patients, there was a fear of contracting HIV and therefore more education about HIV and AIDS is needed for nurses. Younger nurses had more positive attitudes than older nurses. Further research is also needed since just a few studies illustrate this in Sweden.

The objective of this thesis is to undertake a cost analysis of an HIV/AIDS prevention programme targeting vulnerable groups in Benin. The AIDS-3 project (Projet Sida 3), a project targeting Female Sex Workers (FSWs), which was implemented from 2001 to 2005, is used as a case study to see how costs vary with location, volume of activities, and HIV prevalence rate. Activities and delivery modes were documented, and cost data have been collected both retrospectively (data on previous “Projet Sida 3” costs already available) and prospectively, using an ingredients-based costing methodology to consider both the financial and economic costs. Output measures were compiled directly from the intervention, and are related to the efficient delivery of different components of the intervention. Average cost per output or per outcome was estimated and cost variation within and between health centres over time was assessed. Results reveal that only the volume of activity is a prominent factor that affects the average cost. The location of the project and the experience of the staff also affect costs as well, but their significance is low. Field work activities that are more efficient in urban areas than in rural communities appear to be paramount in the fight against HIV as far as costs are concerned. / HIV/AIDS Cost analysis

Objectives. Explore and describe the impact of premature life-threatening illness, stigma, multiple loss of significant others, decreased vocational choice and mobility and decreased financial security among young gay men living with AIDS. It was hypothesized that young gay men with AIDS and the elderly experience similar physical, social, and psychological changes, but the cognitive adaptation to these changes are hindered by the non-normative timing of these events. / Methods. Thirty-two self-identified gay men with AIDS between the ages of 22 to 44 years were recruited from an out-patient clinic in Montreal. These participants were asked to complete a comprehensive questionnaire, which assessed the respondent's daily stress, impact of HIV, health-related quality of life, ways of coping, multiple loss, dependency on informal and formal supports, and preparation for death. Quantitative methods were used to analyse the data. / Results. The hypothesis was confirmed. Respondents reported relatively low levels of health-related quality of life, significant concern over health and financial security, considerable multiple loss, increased dependency on informal and formal supports, proportionally greater use of active coping strategies, and significant concern about discrimination. / Conclusions. A comprehensive method of intervention which addresses all of the biopsychosocial aspects to care is proposed. It is suggested that a coordinated multidisiciplinary approach to clinical and research endeavors should be adopted to address the multidimensional obstacles facing young gay men with AIDS.

HIV/AIDS care needs to be comprehensive and holistic (UNAIDS, 2002). Counselling has proved to be one of the most effective behavioral tools in the global anti-HIV/AIDS fight by equipping people mentally, emotionally, psychologically and socially for the disease (Anon, 2000). Over the past two decades researchers identified cultural factors, race, gender and class as leading inequitable treatments in general counselling situations (Coleman, 1995). This challenge happened to be the same in HIV/AIDS counselling, especially because the counselor work with sensitive information. Nurses who forms the back-bone of HIV/AIDS counselling, are all trained on a Western model of HIV/AIDS counselling. Herbst (1990) also pointed out that knowledge concerning cultures and subcultures and its implications has become a major issue for the nurse to deliver health care in South Africa. Faced with the history of South Africa and the diverse cultures it was my personal experience as a professional nurse, counselor and researcher while I was working on the *Ufe health train, that the knowledge of culture is one of the most important factors of HIV/AIDS counselling. This motivated me to embark on this research. This research aims at providing an analytical description of the experience of counselling for African (Batswana) counselees and their counselors with specific reference to HIV/AIDS counselling with view to improve this interaction. The objectives of this research was to: a) analyse the counselling done by Western and African counsellors in the health system, with a particular focus on HIV/AIDS counselling, b) establish how acceptance and decision-making is promoted, understanding of the counselee is established and psychosocial support is given, and c) develop a middle -range theory that describes appropriate HIV/AIDS counselling for African counselees. Glaser's (1965; 1967; 1992) grounded theory approach was used to guide this research. Multiple data collection methods were used, which took place concurrently with the descriptive analysis. Glaser's conceptual analysis paradigm for qualitative data analysis was utilised. Based on the results of this research the importance of an HIV/AIDS counselling approach for Africans is emphasised. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2004.