Thesis (Ph.D.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Faculty of Nursing. Title from pdf file main screen (viewed on October 10, 2009). Includes bibliographical references.

Thesis (Ph. D.)--Deakin University, 2002. / Title from PDF t.p. (viewed on Dec. 25, 2005). Includes bibliographical references (p. 286-307).

Health Studies / M.A. (Health Studies)

This study deals with the impact of HIV/AIDS on women living in chronic poverty. The question arises: Do we focus on their HIV/AIDS stories only or do we include their other lived experiences? This phenomenological study, on two sets of three generations of women infected and affected by HIV/AIDS and living in poverty, is an attempt at understanding the way the women experience their lifeworlds, not only their HIV/AIDS stories. One set includes a grandmother, her daughter who is living with full-blown AIDS, and her granddaughter, while the other includes a grandmother, her daughter and her granddaughter infected with HIV. The initial focus of the study was on the women’s HIV/AIDS narratives. However as the study progressed, especially during the interviews, it became apparent that the women’s generational poverty or chronic poverty was of greater concern to them than the HIV/AIDS that they were experiencing. Of the six participants, only one woman centred her life story on HIV/AIDS. This finding echoes other studies on HIV/AIDS among poor women: that chronic poverty is more threatening to the women than the risk or reality of AIDS. As a phenomenological researcher my aim was to focus on the participants’ own interpretations of the studied phenomenon. However, this was inadequate in accounting for the role that social structures play in shaping and informing the women’s subjective consciousness and experience. For this reason, I used feminist ideas to understand and interpret the women’s patriarchal experiences.

HIV/AIDS has been an obstacle to socio-economic development and a major cause of loss of human life. It has also caused vast inequities and frustration to the public health sector. One of the significant efforts made by the public health sector to combat the epidemic is the implementation of a mandatory HIV/AIDS testing policy to scale-up HIV treatment. This dissertation examines the impact of this policy on the human rights of people infected with and affected by HIV/AIDS. Coercive government policies aimed at controlling the AIDS pandemic often infringe on the rights of individuals known to be or suspected of living with HIV/AIDS and this decreases the effectiveness of public health measures. The research methodology involved the study of written literature and a comparative literature study of the law and practice obtaining in South Africa, Uganda and Canada. It revealed that voluntary testing is effective and suitable in South Africa. This dissertation aimed to show that any public health approach that aims to achieve a comprehensive prevention strategy must be consistent with respect for human rights as enshrined in regional and international human rights law. Public health and human rights should, therefore, not be regarded as opposing forces; rather they should be seen as a unified system of protection of human welfare under the Bill of Rights and the Constitution. The solution to the crisis lies not only in testing every single person but also requires a shift of focus to more pressing issues that include gender equality, stigma and discrimination; prioritizing human rights, institutional capacity and resources; and an end to extreme poverty. A human rights-based approach to HIV/AIDS testing, such as the Voluntary Counselling and Testing (VCT) is recommended. Therefore, failure to adhere to the core principles of testing - which are informed consent, counselling and confidentiality of the test result - will only hinder the global fight against HIV/AIDS. The rights of those affected by HIV/AIDS need to be protected in order to address public health imperatives. This can be done through the use of the law as an instrument of social change as well as education and awareness. Key words, HIV/AIDS, mandatory testing, Voluntary Counselling and Testing, public health, human rights-based approach.

Text in English and siSwati / The purpose of this study was to develop support guidelines to assist with disclosure of HIV status to HIV infected children by their parents and caregivers in Swaziland. The study explored parents’ and caregivers’ experiences with disclosure, and described the pattern of disclosure for HIV status to infected children. A qualitative descriptive research was conducted. Data were collected through semi-structured with thirteen (13) parents and caregivers who were purposively selected to participate in the study. Data analysis was done using qualitative content analysis. Three themes emerged which were understanding the general concept of disclosure, the pattern followed by parents and caregivers on disclosure of HIV status to infected children and the experiences of parents and caregivers on HIV status disclosure to their children. Based on the findings, support guidelines were formulated to assist parents and caregivers with disclosure of HIV status to their infected children. The outcome of this study is the description of a clear pattern of when, how and what to be disclosed to HIV infected children; as described by the parents and caregivers of the HIV positive children. / Health Studies / M.A. (Nursing Science)

Health Studies / (M.P.H. (Health Studies))

The primary aim of this study was to determine the effect of an 11-week combined progressive resistance exercise and aerobic exercise programme on the health and well-being of a group of participants sampled from an HIV positive rural population. The study was exploratory and quasi-experimental in nature and utilised quantitative research methods. A total number of 37 participants that met the inclusion criteria were included in the study. The participants were assigned to an experimental group (EG) (n=19) based on their willingness to participate in the exercise intervention and the remainder were assigned to the control group (CG) (n=17). The experimental group participated in an 11-week intervention programme which entailed exercising twice a week for the duration of 60 minutes. The intervention entailed a low cost exercise programme which consisted of aerobic exercises (walking, jogging and stepping) and progressive resistance exercises (own body weight, core exercises and light free weight training). The following variables were measured pre-, mid- and post- intervention, namely: health related fitness components, quality of life, physical activity levels and relevant blood variables. An analysis of data was conducted utilising descriptive and inferential statistics. The outcome of the analyses indicated that the EG did not reveal significantly better post-intervention results than the CG in respect of any of the variables assessed. The CG remained sedentary during the intervention period and revealed either an increase in, or maintenance of the initial scores. The slight variation could have been attributed to the decrease in sample size at mid – and post – testing. At the post-intervention testing phase the majority of the participants available for testing were those who were working and healthy. However, it can be concluded that the overall aims and objectives of the study were achieved despite the attrition of participants during the study and that the subsequent outcome of the study was not expected.

This study aimed at describing and interpreting the changing symbolic meanings of the Acquired Immunodefiency Syndrome (AIDS) which encountering a Human Immunodefiency Virus (HIV)-positive patient introduced into the personal and professional identities of six health care professionals in a subregion of the Eastern Cape. With the exponential increase of HIV/AIDS in South Africa, medical practitioners have become increasingly exposed to HIV infected patients. This study has considered the psychological structures developed by practitioners in an attempt to control and understand their situation in the context of HIV/AIDS. In order to describe these psychological structures the existential phenomenological approaches of L. Binswanger (in Needleman, 1963), A. Giorgi (1975) and F.J.Wertz (1985) were employed. Through these procedures, the structure of the experience of encountering an HIV infected patient was elucidated. This comprised the first goal of this study. The second goal focused on interpreting these descriptions by way of the symbolic meanings and definitions implicit in the structure of this experience. For this latter purpose the approach of symbo1ic interactionism was used, in particu1ar the understandings outlined by H. Blumer (1969). This theory was seen as appropriate in that the encounter between the practitioner and patient was primarily located in interpersonal parameters. The findings were discussed in terms of the two dominant metaphorical frameworks used by the subjects to comprehend the disease - namely the perspectives of society and the biomedical model. These two frameworks were critically evaluated in the context of HIV/AIDS, the needs of HIV infected individuals as well as the needs of the general practitioner. The process of the encounter was found to be very significant for practitioners in terms of their conceptualisations of HIV/AIDS. Old understandings were reinterpreted within the interpersonal context and replaced with more appropriate symbolic metaphors upon which to base practise. This study has revealed these new understandings were limited and constrained with regard to understanding and treating HIV/AIDS in that the subjects were still influenced by the metaphors of the biomedical model. These constraints were examined in the light of both personal and professional meanings and identities. This study concluded by making suggestions for modification of the medical practitioner's role in the context of HIV/AIDS.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-07-04T14:33:32Z No. of bitstreams: 1 glauciahelenaferreiradavid.pdf: 2092999 bytes, checksum: 98b615833a4f91e02529111fc823159e (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-08-08T13:34:55Z (GMT) No. of bitstreams: 1 glauciahelenaferreiradavid.pdf: 2092999 bytes, checksum: 98b615833a4f91e02529111fc823159e (MD5) / Made available in DSpace on 2017-08-08T13:34:55Z (GMT). No. of bitstreams: 1 glauciahelenaferreiradavid.pdf: 2092999 bytes, checksum: 98b615833a4f91e02529111fc823159e (MD5) Previous issue date: 2017-02-21 / Refletir acerca das trajetórias amorosas e sexuais de pessoas soropositivas constitui o objeto principal dessa dissertação. Esta é caracterizada por dois momentos distintos de contato com os participantes. No primeiro momento foi realizado um mapeamento, através da utilização de entrevistas estruturadas, com auxílio do diário de campo, onde foi possível contatar um número maior de participantes, para um olhar mais amplo acerca das principais estratégias utilizadas por essas pessoas para vivenciarem o amor e o sexo a partir da descoberta do diagnóstico positivo para HIV. Na segunda etapa da pesquisa buscou-se uma reflexão mais profunda, com atenção às subjetividades, através de entrevistas em profundidade para história de vida. Foram realizadas quatro entrevistas, com indivíduos de diferentes gêneros, orientação sexual e geração. As narrativas produzidas pelos indivíduos entrevistados nos dois momentos da pesquisa nos indicaram a relevância de uma problematização no contexto da saúde pública, dos discursos que constituem os sujeitos soropositivos e atravessam suas vidas conformando subjetividades, ideais regulatórios, disciplinares e biopolíticos típicos da sociedade moderna ocidental. Nesse sentido, à luz da análise foucauldiana do discurso, é que propomos visibilizar esses sujeitos, impedidos em seus direitos, pela imbricada rede discursiva constituída por relações de saber/poder de forma complexa e multifacetada. Analisando os discursos da aids, do risco, do amor romântico e o desafio relacionado à revelação do diagnóstico positivo para HIV, que emergiram nos diversos relatos, foi possível perceber as inúmeras exclusões, demarcações e impossibilidades geradas por esses discursos. Apoiando-nos nas teorias feministas, buscamos localizar possibilidades de subversão à norma, como forma de resistência e enfrentamento, privilegiando os relatos de nossos interlocutores, como uma provocação construída por inúmeras vozes. / This dissertation aims to reflect about the amorous and sexual trajectories of positive HIV people. This research is characterized by two different periods of contact with participants. The first time, we conducted a mapping, using of structured interviews, with the help of field journal, where it was possible to contact a larger number of participants. It was important for a wider view on the main strategies used by these people to experience the love and sex from the discovery of the positive diagnosis for HIV. In the second stage of the research, we sought a deeper reflection, with attention to subjectivity, through in-depth interviews for life story. Four interviews were conducted with people of different genders, sexual orientation and generation. The narratives produced by individuals interviewed in two moments of research have shown us the importance of a questioning in the context of public health, the discourses that make subjects positions and go through their lives conforming subjectivities, regulatory ideals, disciplinary and biopolitical of modern Western society. Accordingly, in basis of the discourse analysis from Foucault, we propose highlight this subjects, hindered in their rights, by discursive network consisting of relations of know/power so complex and multifaceted. We analyze the discourses of aids, of risk, of romantic love and of the challenge related to the revelation of the positive diagnosis for HIV, which emerged in the various interviews. It was possible to realize the many exclusions, demarcations and impossibilities generated by these discourses. Supporting on the feminist theories, we seek to find possibilities of subversion of the standard, as a form of resistance and confrontation, privileging the Stories of our interlocutors, as a provocation built by many voices.