O presente estudo tem como objeto de pesquisa, discutir, a partir da experiência adquirida com o Programa Redução de Danos, novas compreensões de vida e cuidado a partir da epidemia HIV/Aids. A partir disso, propõe na interface com a teologia, alternativas de ação pastoral que resgatem e promovam o respeito à dignidade humana não somente das pessoas que vivem e/ou convivem com HIV/Aids, mas todas aquelas que por uma razão ou outra encontram-se vulneráveis e/ou privadas dos seus direitos, independente da esfera em que se encontram na sociedade. São objetivos dessa pesquisa, apresentar a proposta do Programa de Redução de Danos, bem como perceber como se deu a construção de dignidade humana a partir dessa proposta juntamente com a teologia e ação pastoral para os/as ministros/as da Igreja Evangélica de Confissão Luterana no Brasil (IECLB) que atuaram no programa de Redução de Danos. Após socializar as experiências dos/as obreiros/as, apresenta-se e reflete-se sobre uma experiência de comunhão de mesa no modelo de Jesus Cristo, a partir de uma pessoa com Aids atendida pelo programa Redução de Danos. Por fim, são construídos e propostos subsídios como resultado da proposta de Redução de Danos em diálogo com a Teologia, contribuindo para a construção de novas compreensões de vida e cuidado a partir da epidemia de HIV/Aids. Como metodologia, a pesquisa ocorreu em dois momentos. A primeira bibliográfica, que perpassa obras que discutem os problemas das drogas na relação com a epidemia da Aids e descreve o contexto em que surge a redução de danos, obras que trazem para a discussão as comunhões de mesas contemporâneas, a prática do cuidado, e a discussão sobre uma possível Teologia da Aids. Num segundo momento, foi realizada pesquisa de campo, apresentando entrevistas realizadas com quatro pastores/as da IECLB para entender os significados que a proposta de redução de danos lhes proporcionou, tanto para sua vida particular, como para a atividade pastoral realizada em suas comunidades. Concluindo, são apresentadas, a partir do conhecimento empírico da redução de danos frente ao tema do HIV/Aids, novas propostas de vida e cuidado para que as igrejas contemporâneas possam, a partir da realidade de suas comunidades, promover a vida e a dignidade humana. / The present study‟s research object is to discuss, from the experience acquired with the Harm Reduction Program, new understandings of life and care from the HIV/AIDS epidemic. Starting with this, it proposes in the interface with Theology, pastoral action alternatives that rescue and promote respect for human dignity not only for people living with HIV/AIDS and/or living together with people living with HIV/AIDS, but all who for one reason or another are vulnerable and/or have their rights violated, no matter which sphere of society they are part of. The goals of this research are to present the proposals of the Harm Reduction Program, as well as see the way it constructed the concept of human dignity from this proposals together with Theology and pastoral work by ministers of the Igreja Evangélica de Confissão Luterana no Brasil (IECLB) who worked in the Harm Reduction Program. After presenting the experiences of those ministers, an experience of table communion in the model of Jesus Christ, with a person with Aids attended by the Harm Reduction Program is presented and reflected upon. At last, contributions are constructed and proposed as a result of the Harm Reduction Program in dialogue with Theology, contributing to the construction of new understandings of life and care from the HIV/AIDS epidemic. Concerning methodology, the research took place in two moments. The first one is bibliographic, dealing with works that discuss the issues of drugs in relation to the Aids epidemic and describe the context in which the Harm Reduction emerges, works that discuss contemporary table communions, works that discuss a possible Theology of Aids. In a second moment, a field research was accomplished, presenting interviews with four pastors from the IECLB to understand the meanings the harm reduction proposals offered them, for their private lives as well as for the pastoral work accomplished in their congregations. In conclusion, from the empirical knowledge of harm reduction in face of the theme of HIV/AIDS, new proposals for life and care are presented so that contemporary churches may, from the reality of their congregations, promote life and human dignity.

Esta pesquisa teve como objetivo estudar o cuidado na prática pastoral desenvolvida frente às pessoas com o HIV e AIDS e assim enriquecê-la através da leitura de textos que refletem sobre esta prática. Na leitura buscouse uma abordagem interdisciplinar. O estudo pergunta pela Igreja, considerando que as pessoas com o HIV e AIDS, são parte de seu corpo. Buscando assim, pelo posicionamento das igrejas avaliar a postura que as mesmas deveriam assumir no enfrentamento da epidemia. No confronto com a literatura, numa leitura crítica tenta dar pistas, ser auxílio para o cuidador na sua prática pastoral. Cuidando da vida cuidar de si, cuidar do outro, ser cuidado por Deus, assim termina este primeiro momento. Na descrição da prática pastoral desenvolvida no Hospital Centenário de São Leopoldo-RS, hospital público, é apresentada a formação de visitadores e a organização do serviço de visitação espiritual no hospital. Por fim este estudo quer destacar os desafios que a doença coloca para as igrejas como comunidades de fé, como cristãos pessoas individuais e sociedade. Vê a necessidade da Igreja em redescobrir a si mesma, sua teologia, os meios da palavra que lhe foram concedidas, em como acolher, ouvir, perdoar, tocar, permitir a vida, ser fiel ao seu chamado hoje e permitindo a cura da vida. / This study aimed to reflect the care in the pastoral practice developed with the people who live with HIV/Aids and enrich it with texts that reflect on this practice. In this study an interdisciplinary approach was used. The study also reflects about the church, considering that the people, who live with HIV/Aids, are parts its body. In this perspective the question about the persons position as well as the position of the Church in combating the epidemic was raised. By revising the literature, a critical reading has been done, looking for ways to help the caregiver in his/her pastoral practice. Taking care of life, taking care of himself, taking care of another and be cared by God thats how this first moment envy. The description of the pastoral practice developed at the public hospital Hospital Centenário in São Leopoldo, RS, is introduced with the training of visitors and the organization of the spiritual visitation in the hospital. Lastly, this study intent to show the challenges that the illness (sickness) brings to the Church as a faith community, Christians individual persons and society. There is a need for the Church to reflect about herself, her theology; the ways the Word was conceded, how to care, listen, forgive, touch, and allow life and to be faithful to her call today, allowing the cure of life.

Made available in DSpace on 2014-07-29T15:04:34Z (GMT). No. of bitstreams: 1 Gisella Souza Pereira.pdf: 1104181 bytes, checksum: fdb5e4c27cf258e1a9b94e4932fda7dd (MD5) Previous issue date: 2008-12-04 / To investigate the clinical and epidemiologic profile of HIV/aids carriers in Goiânia, Goiás, data of 583 individuals HIV-positive seeking a referral hospital were collected from January to December of 2006. The majority were black (75.6%), men (56.6%), with 20 to 49 yers old (62.6%), with less than five years of schooling (54.1%), and residents in the metropolitan area of Goiânia. Unprotected sex (34.7%), HIV-positivity partner (19.9%), use of illicit drug (16.3%), and sex with individual of the same sex (14.8%) were the most frequent risk factors reported. Opportunistic diseases were diagnosed in 249 individuals, being esophagitis by Candida sp. and consumptive syndrome predominant. Positivity for HBsAg (n=422), anti-HBc (n=324), anti-HBs (n=247) and anti-HCV (n=349) were found in 3.6%, 23.1%, 23.5% and 6.5% individuals, respectively. The majority had LT CD4+ count less than 350 cels/mm3. Further, those with at least 50 years old (G2) had lower average of LT CD4+ when compared with those aged less than 40 years old (G1) (241.91 vs. 371.84 cels/mm3) (p<0.05). In addition, G1 had higher probability of remaining alive after 365 days when compared with G1 (84.8% vs.78.4%; log-rank=0.09). The findings of this study show the maturity of the HIV/aids epidemic in Goiás, with an increasing in women, heterosexuals, individuals with lower education level and those with at least 50 years old. The high frequency of late diagnosis of HIV infection, mainly in older individuals, and the high frequency of early death in HIV/aids carriers, suggest the necessity of intensify public strategies for early diagnosis, but also educational campaigns to prevent HIV infection including elderly people. / Para investigar o perfil clínico e epidemiológico dos indivíduos infectados pelo HIV/aids em Goiânia, Goiás, foram coletados dados de 583 indivíduos, sem tratamento anti-retroviral prévio, admitidos no hospital de referencia dessa cidade, de janeiro a dezembro de 2006. A maioria era homem (56,6%), com 20 a 49 anos de idade (62,6%), com menos de cinco anos de escolaridade (54,1%), de cor negra ou parda (75,6%) e residente na área metropolitana de Goiânia. Relação sexual desprotegida (34,7%), parceiro anti-HIV positivo (19,9%), uso de drogas ilícitas (16,3%) e sexo com parceiro do mesmo sexo (14,8%) foram categorias de risco mais relatadas. Doenças oportunistas foram diagnosticadas em 249 indivíduos, sendo esofagite por Candida sp. e síndrome consuptiva as mais freqüentes. Positividade para o HBsAg (n=422), anti-HBc (n=324), anti-HBs (n=247) e anti-HCV (n=349) foi encontrada em 3,6%, 23,1%, 23,5% e 6,5% dos indivíduos, respectivamente. A maioria dos indivíduos apresentou contagem de linfócitos T CD4+ (LT CD4+) inferior a 350 céls/mm3 na primeira visita clínica. Verificou-se também que a média de LT CD4+ foi menor em indivíduos com idade igual ou superior a 50 anos (G2) quando comparados aos com menos de 40 anos (G1) (241,91 vs.3 71,84 céls/mm3) (p<0,05). Mais ainda, no G1 a probabilidade de indivíduos permanecerem vivos após 365 dias foi de 84,8%, enquanto no G2 foi de 78,4% (log-rank=0,09). Os achados deste estudo mostram o amadurecimento da epidemia do HIV/aids em Goiás, com avanço de casos em mulheres, indivíduos heterossexuais, de baixa escolaridade e com idade acima de 50 anos. A freqüência elevada de diagnóstico tardio da infecção, principalmente, em indivíduos em idade mais avançada, e o elevado índice de morte prematura em portadores do HIV/aids, indicam a necessidade de intensificação de estratégias públicas para o diagnóstico precoce e campanhas educativas para prevenção da infecção pelo HIV que incluam a população idosa.

Magister Artium - MA / Despite wide acceptance of Voluntary Counselling and Testing (VCT) as a crucial entry point for the prevention, treatment, care and support of HIV-infected persons; the prevalence of testing in Ethiopia remains very low. A review of the literature identifies the set of factors that influence HIV testing of individuals to include socio-economic and demographic factors, knowledge of HIV/AIDS, risk perception, fear of stigma, social capital and the perceived benefit of VCT. By drawing assumptions based on the known literature, this mini-thesis explores the relationship between VCT usage and the above factors in order to explain the status of HIV testing in Moher and Aklil district, Gurage Zone, Ethiopia. The study hopes to address the dearth of material on VCT and contribute to it in a non-clinical and rural context.

The aim of this study was to explore how effectively educators in primary schools in the Thabo Mofutsanyana district (rural QwaQwa area, Free State province) affected by the HIV/AIDS pandemic can be supported to cope more resiliently with the pandemic's challenges, using the Resilient Educators programme (REds). REds has been piloted with urban educators previously, but not with rural educators. In order for me to achieve this aim, I used mixed methods to gather data: qualitative and quantitative data were gathered in the pre- and post-tests (before and after the implementation of REds) to comment on participant empowerment. I interpreted the data to comment on whether and how the REds programme supported educators affected by HIV/AIDS. Previous Reds piloting was done with urban educators. My piloting would explore if and how REds would enable rural educators. To actualise the study, I recruited ten participants (two males and eight females), but only the eight females completed the study. My participants were Sesotho-speaking educators frorn one of the primary schools in the rural area in the Thabo Mofutsanyana district (QwaQwa area) and all were affected by the pandemic. My findings indicated that REds was a meaningful intervention, but that it needs to be improved as regards the following: • Facilitators should take note of the strengths that participants have relating to HIV/AIDS. • Future REds should encourage positive interpersonal relationships. • The entire staff and different stakeholders in the community should be involved in future REds participation. • REds should be an ongoing intervention strategy for supporting infected educators and those otherwise affected by the pandemic. / M.Ed., North-West University, Vaal Triangle Campus, 2010

The aim of this study was to explore how effectively educators in primary schools in the Thabo Mofutsanyana district (rural QwaQwa area, Free State province) affected by the HIV/AIDS pandemic can be supported to cope more resiliently with the pandemic's challenges, using the Resilient Educators programme (REds). REds has been piloted with urban educators previously, but not with rural educators. In order for me to achieve this aim, I used mixed methods to gather data: qualitative and quantitative data were gathered in the pre- and post-tests (before and after the implementation of REds) to comment on participant empowerment. I interpreted the data to comment on whether and how the REds programme supported educators affected by HIV/AIDS. Previous Reds piloting was done with urban educators. My piloting would explore if and how REds would enable rural educators. To actualise the study, I recruited ten participants (two males and eight females), but only the eight females completed the study. My participants were Sesotho-speaking educators frorn one of the primary schools in the rural area in the Thabo Mofutsanyana district (QwaQwa area) and all were affected by the pandemic. My findings indicated that REds was a meaningful intervention, but that it needs to be improved as regards the following: • Facilitators should take note of the strengths that participants have relating to HIV/AIDS. • Future REds should encourage positive interpersonal relationships. • The entire staff and different stakeholders in the community should be involved in future REds participation. • REds should be an ongoing intervention strategy for supporting infected educators and those otherwise affected by the pandemic. / M.Ed., North-West University, Vaal Triangle Campus, 2010

Master of Arts / Department of Sociology, Anthropology, and Social Work / Dana M. Britton / Even after 28 years the AIDS epidemic continues to affect the American population and HIV/AIDS remains a social problem. Living with HIV affects every aspect of an individual’s life. It involves a personal negotiation at the onset of diagnosis, a social negotiation when one decides to disclose to others, and finally, a communal negotiation when individuals seek formal support via ASOs (AIDS service organizations), and/or informal support through family members and friends. The purpose of this research is to investigate these negotiations over the course of HIV infection, how these processes inform decisions to disclose, how stigma influences lived experiences, and the importance of the HIV community. The data come from eighteen HIV+ individuals, ten men and eight women, living in various locations throughout the Midwest. Drawing on the experiences of these men and women, I explore reactions after diagnosis, disclosure patterns, experiences of stigma, and the importance of the HIV community.

This dissertation focuses on the role of the church as a social conscience in its quest for human dignity. It specifically explores the role played by the Anglican Church of Southern Africa in the restoration of human dignity through the contributions made by the various bishops and archbishops in addressing the challenges of socio-economic and political injustice faced by society. Furthermore, this dissertation explores the practical mission and ministry of the parish of St Thomas in Kagiso 1, Krugersdorp in its quest for human dignity aimed at addressing the contextual socio-economic and political injustices and to alleviate suffering. Special emphasis in this dissertation is put on the biblical and theological substantiation which necessitated the various prophetic mission and ministries. / Systematic Theology and Theological Ethics

This thesis presents an analysis of the dynamic process of economic growth, national welfare and the HIV/AIDS epidemic. An assessment of the methodological designs of applied growth research is undertaken in order to polarise the limitations associated with cross-sectional growth regressions. The cross-country cross- sectional methodology that has been the dominant feature of empirical growth analysis may suffer from an endogeneity and omitted variable bias. A panel data approach is adopted in order to address the econometric issues associated with cross-sectional study designs. To highlight the discrepancies between theory and empirics, a rudimentary description of the Solow model is offered. Extensions of the Solow paradigm are also discussed and form the basis of the theoretical foundations of the research. The relationship between health and economic growth within the existing literature has considered the consequences of poor population health in determining national income levels. Disease-specific effects have been included in growth regressions to capture the output losses associated with the widespread reduction in human capabilities. This thesis contributes to the existing literature by testing the empirical relationship between economic growth and the HIV/AIDS epidemic for a broad cross-section of countries. Previous empirical studies have not presented a unified account of the epidemic's effects in determining cross- country productivity differentials. The way in which the epidemic might impede economic prosperity is considered by drawing upon the existing literature. The strengths and limitations of previous study estimates are considered in relation to the study design. A more robust empirical estimator for growth regressions is proposed in the form of a system Generalised Method of Moments estimator. The research extends on previous study estimates by considering the epidemic's effect across the conditional quantiles of the growth distribution. A central prediction of the neoclassical growth paradigm relates to the convergence hypothesis in which poorer economies are considered to achieve faster growth rates. By drawing upon the distributional changes in national income over time for the entire cross-section of countries, this thesis will assess the potential barriers that may violate the theoretical predictions of the convergence hypothesis. An empirical assessment of the role of convergence clubs, mortality and poverty traps will be presented through an analysis of the changes in health and income inequality over time. The distributional shifts that have occurred over the period under analysis consider the consequences of growth as a measure of national welfare.

Background: Countries in sub-Saharan Africa are scaling up access to Voluntary Counselling and Testing (VCT) services as a strategy for HIV prevention, treatment, care and support. The international and national push to achieve targets for anti-retroviral therapy scale up has emphasised VCT as an entry point to treatment, with follow-up mostly directed at those who test positive. Yet over 60% of those testing are HIV negative. Limited understanding of how HIV voluntary counselling and testing, and receipt of a negative result impact on sexual behaviour has resulted in underdeveloped support for those testing HIV negative. Aims: To gain the perspective of those who have tested HIV-negative on the following: (1) the decision making process that precedes attendance for voluntary counselling and testing; (2) how voluntary counselling and a negative test result influence sexual behavioural intentions and reported subsequent behaviour; and (3) support systems and networks that would enhance the respondent’s ability to remain HIV negative. Method: Qualitative longitudinal study utilising semi-structured interviews, six months apart, with people who have tested negative and three one-off focus group discussions with counsellors. Participants were purposively sampled from VCT centres in two mining towns in Zambia. Interviews were digitally recorded, transcribed verbatim and analysed thematically with the aid of the qualitative data analysis software, Nvivo7. Cross-sectional analysis of all data sets was conducted and paired transcripts were analysed longitudinally to assess change over time. Results: Forty-two HIV-negative people were interviewed, with thirty-one returning for the follow-up interview (74% return rate). VCT was perceived as ‚testing for HIV‛. Before attending VCT most participants had gone through a protracted period of angst, resulting in a resolution to reduce number of partners, use condoms or abstain from sex. Counselling affirmed life choices, rather than initiating them. Although perception of the risk of HIV increased, misconceptions about HIV transmission persisted post-counselling. The negative test result provided impetus and resolve to implement or maintain life change. Themes identified were: (1) recognising personal susceptibility to HIV infection; (2) emotional and cognitive engagement with the problem of testing; (3) a driving need to know status (regardless of test result); and (4) empowerment and being in control providing the ability to plan for the future. Analysis of post-test support needs revealed two further themes: (1) reinforcement of behaviour change through additional knowledge, supportive networks, and life-skills training; and (2) access to recreational activities. There was no reported post-test increase in unsafe sexual behaviour among those that returned for the follow-up interview. Focus group findings reinforced those from interviews. Conclusions: This study has shown that in this population of people who tested HIV-negative: 1. the majority made life changes before attending VCT and used VCT to know their status 2. counselling consolidated pre-test decisions about risk behaviour and testing provided motivation to adopt safer behaviour and to maintain previous low- or no-risk behaviour and 3. there is a felt need for post-testing recreational activities, further HIV/AIDS education and participation in HIV prevention activities. Recommendations include: (1) the promotion of community-based interactive one-to-one and group information, education and communication (IEC) (to aid understanding and progression to the point where testing appears to be of optimum benefit) ; (2) referral to post-test support options such as support groups and inclusion on a text messaging list should be made available; and (3) post-test intervention strategies, for example, provision of result-specific IEC materials and active involvement in prevention activities should be developed and evaluated.