A systematic review of studies pertaining to employment interventions for consumers with HIV/AIDS was conducted in order to ascertain what programs and services have resulted in employment for people in this population. Research shows that programs specifically designed for individuals with HIV/AIDS have been beneficial for this population in regards to obtaining employment. This study discusses four employment interventions for people with HIV/AIDS including participation rates and employment outcome for program participants. A review of literature pertaining to employment interventions for individuals with HIV/AIDS is presented. Additionally, the systematic review methodology and results are presented. Finally, I discuss the results, limitations in regards to conducting the study, current research and recommendations for future research.

Submitted in partial fulfilment of the requirements for the degree PhD (Community Psychology) in the School of Psychology in the Faculty Arts at the University of Zululand, 2010. / Many communities in South Africa are faced with difficulties which include poverty, violence and lack of resources. HIV and AIDS add to this burden. Although many families, organizations, and government try to help, resources are never enough to fill all the gaps. However, there are many untapped resources within the communities; many people with gifts, talents, and other assets that go unnoticed and therefore unavailable. Studies have shown that the involvement of community members in community development activities improves the chances of the development initiatives of being sustainable and less fragmented (Bouwer, 2008). The current study firstly focused on assessing whether Asset-Based Community Development as a community development method is able to tap into those unutilized and undeveloped assets. Secondly, whether it is able to provide a more empowering and sustainable answer to the needs of people in communities where HIV and AIDS is prevalent. In light of the above, Sinosizo, a Non-Governmental Organization (NGO), stated their willingness to form part of the Asset-Based Community Development project. The community of Sundwini in the Amanzimtoti area was selected as the target community for the current research project because it has the least resources among the six communities assisted by Sinosizo. In response to the growing needs and difficulties faced by people living with HIV and AIDS and their families, Sinosizo Home Based Care (HBC) was established in 1995. They also form part of the Durban Aids Care Commission (CADACC). The current research included a preliminary study, an Asset-Based Community Development (ABCD) initiative, and an evaluation of the development process. The use of Community- Based Participatory Research (CBPR) was considered to be the appropriate method to use for this study and focus group discussions as a qualitative research method were used to gather the necessary data for the current study. A thematic analysis technique was used to analyze the data. The results indicated that the community and its members did indeed benefit from the Asset-Based Community Development process. The ABCD process allowed the participants to critically reflect on several aspects of community development in general and Asset-Based Community Development in particular. The community members initially thought that their community was one of the poorest communities with very limited or no resources; however their perception changed to an awareness that all communities and people have skills, gifts, assets, and resources that can contribute to community development. Apart from recognizing the assets, the community was also able to utilize the assets, making the community more self sufficient. Rather than being solely dependent on the well-meaning efforts from government and organizations outside of the community, they realized that they could take an initiative and draw from their own strength. This did not mean that outside help was of no value, but rather that the valuable resources could be allocated where needs in the community were critical. Despite several barriers experienced during the process, the Asset-Based Community Development process has shown itself as a flexible process and took into consideration the unique character of the community. The participants were also able to identify possible solutions to the barriers they identified.

Dissertation submitted in partial fulfilment of the requirements for the degree of Master of Arts (Clinical Psychology) in the Department of Psychology, University of Zululand, 2011. / Compassion fatigue and burnout have the potential to compromise the ability of caregivers to work effectively, while compassion satisfaction may serve a protective function. This study investigated levels of compassion fatigue, burnout and compassion satisfaction among caregivers, and explored relationships between these and caregivers’ personal attributes. Eighty-three caregivers working in the field of HIV and AIDS in the uMngeni Municipality in the Kwa Zulu-Natal midlands completed two self-report questionnaires, the Professional Quality of Life Scale (ProQOL, Stamm, 2009), and another regarding their personal attributes. Respondents showed an overall pattern of relatively high Compassion Satisfaction, average level of Burnout, and a very high level of Secondary Traumatic Stress, a profile usually associated with people working in situations of armed conflict. Compassion Satisfaction was negatively correlated with Burnout and Secondary Traumatic Stress, while Burnout was positively correlated with Secondary Traumatic Stress. Significant effects were found with the following personal attributes: (1) gender; (2) role clarity; (3) perceived efficacy; (4) secondary stigma; (5) social support; (6) personal history of HIV or AIDS; (7) access to counselling or therapy; (8) organisational support; and (9) self-care. Implications of these findings are discussed with reference to sustainable care, intervention and further research.

Background: Human immunodeficiency virus (HIV) is a deadly retrovirus that has no cure. After a long period of time without HIV treatment advances the disease to a more dangerous stage called acquired immunodeficiency syndrome (AIDS). The HIV/AIDS epidemic has claimed over 34 million lives of people worldwide. The recent studies have shown concordant results of treating and preventing the disease but have shown lack of knowledge on how patients experience living with HIV/AIDS.     Aim: The purpose of this study is to describe the patient’s experience of living with HIV/Aids.   Methodology: A descriptive literature study review that based on fourteen scientific articles which include both qualitative and quantitative studies.   Key findings: The results show that after the diagnosis of HIV, patients tend to experience both psychological and physiological challenges. Stigma and discrimination were found to be the major causes of mental health problems. Patient’s financial insecurities, fear of being stigmatised and impairments were among other factors that prevented patients from engaging in care. Good treatment from caregivers, trustworthy relationships, education, positive coping strategies, friends and family support enabled patients to live a healthier life with their disease.    Conclusions: The patient’s experience of living with HIV/AIDS was highly influenced by both the patient and society’s knowledge about the disease, their location, gender, economic status, and the kind of support that was rendered by friends, family, or the health system. Stigma and discrimination continued to be the leading factor that prevented patients from testing for HIV and engaging in care. / Bakgrund: Humant immunbristvirus (HIV) är ett dödligt retrovirus som inte går att bota. Efter en lång tid utan HIV-behandlingen avancerar sjukdomen till ett farligare stadium som kallas för AIDS (acquired immune deficiency syndrome). HIV/AIDS-epidemin har dödat över 34 miljoner människors över hela världen. De senaste studierna har visat överensstämmande resultat gällande förebyggning och behandlingen av sjukdomen, men saknar kunskapen om patientens’ erfarenheter av att leva med hiv/aids.   Syfte: Att beskriva patientens erfarenheter av att leva med HIV/AIDS.   Metod: En beskrivande litteraturstudieöversikt baserad på fjorton vetenskapliga artiklar som innehåller både kvalitativa och kvantitativa studier.   Huvudresultat: Resultaten visar att efter HIV diagnosen, patienterna upplever både psykologiska och fysiologiska utmaningar. Stigma och diskriminering relaterad till HIV diagnosen var de främsta orsakerna till psykisk ohälsa. Patienternas dåliga ekonomi, rädsla för att bli stigmatiserad och funktionsnedsättningar var bland dessa faktorer som hindrade HIV/AIDS patienter från att söka vård. Bra bemötande från vårdgivare, pålitliga relationer, utbildning, positiva copingstrategier, vänner och familjestöd gjorde det möjligt för patienter att leva ett hälsosammare liv med sin sjukdom.   Slutsats: Patientens upplevelse av att leva med hiv/aids påverkades av både patientens och samhällets kunskap om sjukdomen, deras lokalisering, kön, ekonomiska status och vilken typ av stöd som gavs av vänner, familj eller hälsosystemet. Stigma och diskriminering fortsatte att vara den ledande faktorn som hindrade patienter från att testa sig för HIV och söka vård.

Student Number: 0501772G - MA research report - School of Social Sciences - Faculty of Humanities / Development Communication theories suggest that media plays a critical role in the transformation of societies (Melkote, 2003). In line with this thesis, this research discusses the extent to which news media can provide a platform for social change for women’s health issues for the development of South Africa, in the context of the prevention of mother-to-child transmission of HIV (PMTCT). With approximately 29.5% of women attending antenatal clinics throughout the country being HIV-positive, PMTCT is one issue that demonstrates the socio-economic and political complexities of women’s health in the context of development. The qualitative methodological approach involves a thematic content analysis of the news media’s coverage around issues of PMTCT between July 1, 2004 and July 1, 2-005 in two South African newspapers The Star and The Mail and Guardian. The methods also involve a thematisation of interview responses from various stakeholders within news media and the case of PMTCT in South Africa. Empirical studies associate women’s access to media with better health and fertility outcomes, irrespective of various income and education levels (“Ch. 10: The Media”, 2002). This research report explores the extent to which a commercially driven news media can be for development; particularly for HIV-positive pregnant women can voice their perspectives and make empowered decisions for their health.

ABSTRACT The Ministry of Health in South Africa has launched massive campaigns to try and prevent the spread of HIV/AIDS. However, South Africa still has more people infected with HIV/AIDS than any other country in the world. This has led to government and health care planners re-evaluating neglected traditional health systems as potential contributors to health care delivery. This report highlights some areas where traditional healers can play a role in the prevention of HIV/AIDS as told by traditional healers themselves. In discussing these roles, the report raises the need for supportive government policy. Up to now government policies on HIV/AIDS have relied largely on biomedical explanations of illness and ignored other popular explanations. This poses a serious problem in a country like South Africa, where a large proportion of the population consults traditional healers first before consulting the medical sector. Such policies also impact on collaborative measures between the two sectors. Thus far, almost all prevention programmes are run by clinics with very little interaction with other sectors. The report then goes on to discuss the perceptions on HIV/AIDS as discussed by traditional healers. In so doing, the report begins to touch on the role of traditional practices that relates to sexual behaviour in HIV/AIDS prevention. As custodians of traditional culture, traditional healers have a huge role to play in re-inventing such practices in a manner that raises awareness about HIV/AIDS and at the same time preventing the spread of the disease.

Bakgrund: Idag lever miljontals av människor runt om i världen med Humant immunbristvirus (hiv). Hiv-positiva patienter är en utsatt patientgrupp som ständigt blir bemötta med fördomar, rädsla och skam vilket kan resultera i ett avståndstagande till att söka vård. Behandling med antivirala läkemedel förebygger smittspridning och genom en god följsamhet till behandling kan patienter numera leva ett gott och livslångt liv. Syfte: Att belysa sjuksköterskors förhållningssätt vid vårdandet av hiv-positiva patienter. Metod: En allmän litteraturstudie användes som metod för att samla in data från tio resultatartiklar varav sex kvalitativa och fyra kvantitativa. Analyseringen av resultatartiklarna genomfördes enligt en modell av Popenoe et al. (2021). Resultat: I resultatet presenteras fyra huvudkategorier följt av fyra underkategorier. Resultat påvisade en stor kunskapsbrist bland sjuksköterskor runt om i världen. Utifrån okunskap genererades rädsla och fördomar vilketresulterade i negativa attityder kring sjukdomen. Högre kunskap kring sjukdomen, tidigare livserfarenheter och religiöslivsskådning visade sig var bidragande faktorer bland sjuksköterskorna till ett mer accepterande förhållningsätt gentemot hiv-positiva patienter. Konklusion: För att förbättra sjuksköterskans kompetensområde och skapa ett mer positivt förhållningssätt gentemot hiv-positiva patienter krävs det större förståelse kring sjukdomen, mer arbetsresurser följt av flerutbildningsmöjligheter. / Background: Millions of people all over the world are currently living with hiv. These patients are vulnerable and live a life facing prejudices, fear, and shame which in turn may cause a reluctance in receiving treatment. Early treatment with antiviral medicines reduces the spread of the virus and through good adherence to treatment it enables the patient to live a long and healthy life. Purpose: The purpose of the study was to illustrate nurses’ approach while caring for hiv-positive patients. Method: A general literature study based on six qualitative and four quantitative articles. The analysis of the research articles was conducted according to Popenoe et al. (2021). Result: Four main categories followed by four subcategories was identified.The results indicate a major lack of experience and hiv related knowledgeamong nursesglobally. This generated fear and prejudices which resulted in negative viewpoints of the disease, followed by a stigmatizes and discrimination when encountered. Knowledge and competence, previous life experienceand religion were the major contributing factors to a more accepting approach towards hiv-positive patients. Conclusion: In order to improve nurse’s competencies and create a more positive outlook of the disease,more resources are required in the workplace as well as better comprehensionand knowledge followed by increased educational opportunities.

[pt] Esta tese intitulada: As tendências do processo de descentralização para o tratamento de pessoas que vivem com HIV/AIDS no município do Rio de Janeiro, propõe uma análise do processo de descentralização para o tratamento das pessoas que vivem com HIV/AIDS no município do Rio de Janeiro/RJ, como meio de elucidar a questão de como se dá a atual configuração do tratamento da pessoa que tem HIV/AIDS nesse modelo de atendimento. Atualmente tem-se a descentralização da assistência ao HIV/AIDS para a atenção básica de saúde como redefinição da sua linha de cuidado. Apresentamos a trajetória do HIV/AIDS no Brasil, contextualizamos a política de saúde no país, debatemos a descentralização para o tratamento das pessoas que vivem com HIV/AIDS no município do Rio de Janeiro, discorremos sobre as Unidades Básicas de Saúde como locais de tratamento para o HIV/AIDS e apresentamos os dados oriundos da pesquisa de campo, revelando as tendências e os limites do processo de descentralização do tratamento de HIV/AIDS no município. Identificamos também como se dá esse processo para os usuários, médicos e gerentes das unidades de saúde. Campany et al. (2021, p. 376) explicitam as tendências recentes apresentadas pela epidemia do HIV/AIDS no Brasil – heterossexualização, feminização, juvenilização, pauperização e interiorização (em relação às regiões brasileiras). Essas tendências se articulam com questões de classe, gênero e raça, se conectando com a complexificação da questão social no Brasil. Esta tese tratou-se de uma pesquisa com abordagem qualitativa. Utilizamos a entrevista semiestruturada (in loco) para coletar os dados dos profissionais, usuários e gestores. Contextualizamos e situamos a Política de Atendimento em HIV/AIDS e como ela vem funcionando de uma forma que responda às demandas dos seus pacientes. Apresentamos uma caracterização desses usuários, identificando quem são os pacientes do serviço e em que condições eles vivem. Como resultados, verificamos que, em sua maioria, os usuários, gerentes e médicos não encontram grandes dificuldades na operacionalização e vivência da Política de atendimento. A grande questão girou em torno da necessidade do sigilo do diagnóstico, para a preservação social do usuário e a solidão decorrente dele, que dificulta a sua vivência com o HIV/AIDS. O silenciamento do diagnóstico impõe à equipe de atendimento que sejam feitos arranjos e caminhos alternativos dentro do serviço para garantia do acesso à saúde, tendo em vista o segredo do diagnóstico do paciente, inclusive para alguns profissionais de saúde dentro da própria unidade. A hipótese central desenvolvida nesta tese consistiu em identificar o sigilo do diagnóstico como uma necessidade contraditória, decorrente do persistente preconceito em torno da AIDS, que mesmo tendo evoluído nos aspectos de prevenção e tratamento, ainda é carregada de negatividade. O principal problema disso é o constrangimento e, de certa forma, a imposição social pelo silêncio que impede o ser humano que vive com HIV/AIDS de ser quem é, abdicando desse direito que deveria ser simples. Trata-se de um modo alienado de viver. / [en] This thesis entitled: The decentralization process trends for the treatment of people living with HIV/AIDS in the city of Rio de Janeiro, proposes an analysis of the decentralization process for the treatment of people that live with HIV/AIDS in the city of Rio de Janeiro/RJ, as a way to clarify how the current configuration of the treatment of the person who has HIV/AIDS takes place in this attendance model. Currently, there is the decentralization of HIV/AIDS assistance to basic health attention as a redefinition of its care line. We present the HIV/AIDS trajectory in Brazil, we contextualize the health policy in the country, we debate the decentralization for the treatment of people living with HIV/AIDS in the city of Rio de Janeiro, we discuss about the Basic Health Units as treatment places for the HIV/AIDS and we present data from field research, revealing the trends and the decentralization process limits of HIV/AIDS treatment in the city. We also identified how this process takes place for users, doctors and managers of health units. Campany et al. (2021, p. 376) explain the recent trends presented by the HIV epidemic in Brazil – heterosexualization, feminization, juvenilization, impoverishment and interiorization (in relation to Brazilian regions). These trends are articulated with issues of class, gender and race, connecting with the complexification of the social issue in Brazil. It was a qualitative approach research. We used the semi-structured interview (in loco) to collect data from the professionals, users and managers. We contextualize and situate the HIV/AIDS care policy and how it has been working in a way to attend the demands of its patients. We present a characterization of these users, identifying who are the users of the service and in which conditions they live. As results, we identified that the most part of users, managers and doctors do not find great difficulties in the operationalization and experience of the Service Policy. The big issue revolved around the need for confidentiality of the diagnosis, for the social preservation of the user and the loneliness resulting from it, which makes it difficult to live with HIV/AIDS. The silencing of the diagnosis requires the care team to make arrangements and alternative paths within the service to guarantee access to health, in view of the secrecy of the patient s diagnosis, including for some health professionals within the unit itself. The central hypothesis developed in this thesis consisted of identifying the confidentiality of the diagnosis as a contradictory need, resulting from the persistent prejudice around AIDS, which, despite having evolved in the aspects of prevention and treatment, is still loaded with negativity. The main problem with this is the embarrassment and, in a way, the social imposition by silence that prevents the human being living with HIV/AIDS from being who they are, abdicating this right that should be simple. It is an alienated way of living.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O presente estudo tem como objetivo compreender o impacto de questões relacionadas ao HIV/Aids na vida dos adolescentes e jovens, ativistas da REDE NACIONAL DE ADOLESCENTES E JOVENS VIVENDO COM HIV/AIDS (RNAJVHA) e da REDE ESTADUAL DE ADOLESCENTES E JOVENS VIVENDO COM HIV/AIDS DO RIO DE JANEIRO (REAJVHA-RJ), na faixa etária de 18 a 24 anos, infectados pela transmissão do vírus HIV, independentemente da via de contaminação, que fazem parte da construção do ativismo social da 3. fase da epidemia, momento pós acesso universal e gratuito aos tratamentos e medicamentos antirretrovirais na saúde pública, política exitosa promovida pelo Ministério da Saúde, fornecidos pelo Sistema Único de Saúde. Para tanto, usou-se como metodologia as narrativas das suas histórias de vida, como instrumento de pesquisa, buscando compreender: sentimentos, motivações, processos de composição e recomposição de identidades, gestão de riscos à saúde, forma de relacionamento com as diversas redes sociais, integração da história individual na história coletiva mais ampla do movimento social, na busca de ampliar as oportunidades de compreender e refletir sobre o impacto da epidemia de HIV/Aids nesses adolescentes e jovens que fazem parte da RNAJVHA e REAJVHA-RJ. Reconstruir as experiências individuais históricas de suas vidas e de suas culturas, identificar os momentos desses adolescentes e jovens antes e posteriormente a sua entrada no ativismo juvenil, identificar, ainda, os momentos de enfrentamento dos fatos da vida como portador de sorologia positiva para o HIV. Estas condições e conquistas guiaram e influenciaram seus cursos de vida, focando assim os dinâmicos processos de mudanças, orfandade, negociações, lidar com o preconceito, sexualidade, solidariedade com o outro, reformulações, articulações e adesão ao tratamento. Analisamos as movimentações presentes na vida social e na existência do adolescente e jovem, como indivíduos de direitos e deveres que exercem suas funções de atores/autores de suas próprias histórias de vida através do ativismo e militância jovem em HIV/Aids. Esta pesquisa traz o reinventar de um novo ativismo em HIV/Aids.

Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: Chronic drug therapy has been fraught with many issues such as adherence, drug intolerance, long-term toxicity and resistance. In HIV/AIDS care, adherence is a major problem due to the fact that for success of the therapy, adherence must be in the region of ninety five percent. If this is not maintained the virus begins to mutate and resistant moieties appear, and this in turn leads to failure of the therapy. This high level of adherence is very difficult to maintain especially in patients who begin antiretroviral therapy (ART) for various reasons such as persuasion by health workers and family, and not due to their own conviction. They usually tend not to adhere to the therapy when symptoms resolve and they start feeling better. There are a number of factors that promote adherence and these are incorporated into HIV care for the programme to succeed. The research was intended to explore and describe factors causing patients to default ART on the Copper belt in Ndola at Ndola Central Hospital and to ultimately propose appropriate interventions to ensure improved return rates of patients on ART. Qualitative tools i.e. interviews and focus group discussions respectively were used, taking into account ethical considerations and data collected was then analyzed. Factors causing patients to default on ART were found to be poor social economic background, inadequate finance, unavailability of food, poor or little understanding of instructions, poor quality of counseling or low literacy levels, high pill burden, unpalatability of drugs and patient readiness to life time commitment to taking ARVS. / AFRIKAANSE OPSOMMING: Chroniese medisyneterapie is gepaard gaande met vele kwessies soos trou bly, weerstandsgebrek aan medisyne, langtermyn toksisiteit en weerstand. In MIV/Vigs sorg, is trou bly 'n groot probleem weens die feit dat vir sukses in terapie moet dit oor vyf-en-negentig persent wees. As dit nie gehandhaaf word nie sal die virus begin verander en weerstand weestandbiedende gedeeltes sal verskyn, en dit op sy beurt lei tot die mislukking van die terapie. Hierdie hoë vlak van trou bly is baie moeilik om te handhaaf veral in pasiente wie antiretrovirale terapie (ART) vir verskeie redes begin het soos oorreeding deur gesondheids werkers en familie, en nie deur hul eie oortuiging nie. Hulle neig gewoonlik om die terapie te laat vaar wanneer simptome verminder en hulle begin beter voel. Daar is verskeie faktore wat trou bly bevorder en wat ingelyf word in MIV sorg om die program te laat slaag. Die doel van hierdie navorsing was om die faktore te beskryf wat veroorsaak dat pasiente op die Copperbelt in Ndola by Ndola Sentrale Hospitaal hul ART verpligtinge nie nakom nie en om uiteindelik geskikte intervensies voor te stel om verbeterde terugkeer koerse van pasiente op ART te verseker. Kwalitatiewe insrumente, dit is, onderhoude en fokusgroupe is gebruik, met in agneming etiese kwessies, en data is daarna geanaliseer.