Thesis (Ph. D.)--Ohio State University, 2007. / Title from first page of PDF file. Includes bibliographical references (p. 114-122).

Magister Artium - MA / The effects of the spread of HIV/AIDS place a great burden on women and children, who will probably suffer most in terms of social and economic deprivation. Since HIV/AIDS is linked to social taboos such as sexuality, drug use and death, there are enormous levels of ignorance, denial, fear and intolerance in most communities. These prejudices lead to the stigmatisation and discrimination of people who are living with HIV/AIDS. Moreover the illness, as it is sexually transmitted, has been conflated with sexual excess, lack of morals, and those already stigmatised such as sex workers with associated discourses of blame, shame and guilt. Generally, responses to HIV and those living with HIV have served to reflect, legitimise and reproduce broader social inequalities on the basis of sexual orientation, gender, race and class. Stigma is the reason why many people who are living with HIV/AIDS, choose not to disclose their status and seek apposite assistance. This study explored the stigma experienced by a group of women who are living with HIV/AIDS and to develop a deeper understanding of whether these experiences are complicated by social responses. / South Africa

M.A. / It is now well known that HIV/AIDS-sufferers face profound psychological, psychiatric and neurological sequelae as the disease progresses. However, studies indicate that women diagnosed with HIV-infection are twice more likely to be depressed, to suffer from PTSD and other psychiatric morbidity than men. Yet very few studies have attempted to investigate the role that gender plays in reacting to the illness. Finding out that one is HIV-infected is one of the most significant discoveries. This is due to the fact that in receiving an HIV-positive diagnosis individuals are exposed to news of prodigious personal consequence. And yet very few studies have focused on how the impact of finding out that one is HIV-positive may affect their adjustment to the illness. Moreover, how men and women are likely to react to such news. It is against this background that the current study was conducted. The aim of the current study was to compare post traumatic symptoms in men and women upon hearing news of their HIV-positive status and to investigate to what extent such reactions may be similar or different and to further assess how their reactions are likely to affect disease progression and adjustment. A total of one hundred participants (38 Male, 63 female) diagnosed with HIV/AIDS participated in the study. These men and women were obtained from support groups in the Gauteng region. The Impact of Event Scale-Revised and Mental Adjustment to HIV-Scale questionnaires were used to collect data over a period of a month. A large majority of 60.2% of the total sample (n = 87) reported experiencing feelings of shock upon hearing about their HIV-positive status, 66.0% of the total sample (n = 94) of those who responded to this item reported trying to remove the issue from their mind. A further 59.6% of the total sample of (n = 94) indicated feeling as though news about their HIV-positive status were not real suggesting that the incident was traumatic. There were no significant gender differences in how both men and women reacted to news of their HIV-positive diagnosis. However, significant differences were found in relation to adjustment. Men were found to be more likely to have more Fighting Spirit which is indicative of adaptive adjustment as compared to women. Women on the other hand were found to be more likely to be Hopeless which is indicative of maladaptive coping.

Background Depression has been found in the literature to be a major problem in people living with HIV/AIDS. Not only does this impact on their daily functioning but has been shown to have negative HIV related outcomes, and result in poorer adherence to antiretroviral medication. The population under study was pregnant at the time of diagnosis. It would seem likely that their risk for depression would be greater than even a general HIV infected population, because of the pregnancy and the fact that they might have concerns around the health and future of the unborn infant. There are a limited number of studies looking at levels of depression over time and possible determinants of this depression even in a general HIV infected population. It was thus felt necessary to establish levels of depression and to establish if there were any factors associated with changes over time in this pregnant population. Method Two hundred and ninety three women were recruited at antenatal clinics in Tshwane from June 2003 and December 2004. They were interviewed at approximately 28 weeks gestational age and were followed for 18 months after the birth. Data included socio demographic variables, a “self efficacy score”, past history of violence, disclosure, CD4 count and knowledge score. Psychological variables included measures of stigma, social support, self esteem and coping. Depression was measured using a modified CES-D (Center for Epidemiological Studies Depression Score) Repeated measures mixed linear analysis was used to assess if there were changes in depression scores over time and if there were factors associated with these changes. Results Two hundred and twenty four women were included in the mixed linear analysis. The mean age of the women was 26.5 years (standard deviation -5.1). Seventy six percent (152) were single with a partner. Seventy six percent (171) had some form of secondary education and 14% (32) had some form of tertiary education. Sixty percent (135) lived in a brick house and 35% (79) had running water in the house. Twenty nine percent (64) had a per capita income below the poverty line. The prevalence of borderline depression (CES-D scores above 12) for this group of women at baseline was 45%. There were significant changes in depression scores over time. This was not a linear relationship (significant quadratic time to interview term p=0.008). This was evidenced by the fall off in scores at 3-9 months followed by a subsequent rise. The factors associated with higher depression scores overall were lower active coping (p=0.004), higher avoidant coping (p=0.003), higher internalised stigma (p=0.001), higher housing scores (0.026), lower self–esteem (0.002), a history of violence (p<0.0001) and having no partner (p=0.005). No factors were associated with changes over time. Conclusion There are significant changes in depression scores over time in this cohort of women Depression scores while falling after the birth of the child as in other cohorts, start to rise again. Although there are no specific factors associated with these changes, overall women who have a history of violence, who have no partner, who live in better housing circumstances, who have poor self esteem, who have high levels of internalized stigma and make use of negative coping strategies are more likely to be depressed. Women who make use of active coping strategies are less likely to be depressed. There are a large number of women at baseline who have scores considered to be diagnostic of borderline depression and because of the potential negative consequences to the woman and child, an intervention aimed at addressing the above issues should be devised. This should start in the antenatal period and carry on beyond this time. Copyright / Dissertation (MSc)--University of Pretoria, 2010. / Clinical Epidemiology / unrestricted

No description available.

Thesis (M Social Work)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: HIV/AIDS is one of the worst pandemics affecting the world today. It cuts across all boundaries and many people are infected as well as affected. The virus has reached all the corners of the globe, but the most hit by it is Africa, especially southern Africa, which carries more than half of the population infected and affected by HIV/AIDS. The top five countries whose populationsare infected with HIV are in southern Africa. Lesotho is amongst the top three on this list and also has problems of poverty and a high unemployment rate. Women and children, who are the target groups that are most affected by poverty, are also those living in rural areas. Thus, being an HIV-positive mother living in the rural areas of Lesotho means one has to deal with poverty, the inaccessibility of services and the psychological impacts of HIV. The aim of the study was to gain a better understanding of the views of health service providers on the need and accessibility of support services for HIV-positive mothers in the rural areas of Lesotho from an ecological perspective. To achieve this aim, the objectives were: to offer an overview of the phenomenon of HIV and describe the psychosocial needs and sociocultural circumstance of HIV-positive mothers in the rural areas of Lesotho, and to discuss the HIV-positive mothers’ need for support services from an ecological perspective. Both quantitative and qualitative research approaches were used. The research utilised exploratory and descriptive design. Purposive sampling was used to select the 30 participants who took part in the study. Data was gathered by means of semi-structured questionnaires that were administered during individual interviews. The questionnaires were formulated on the basis of information retrieved during the literature review. The findings of the study reveal that HIV-positive mothers living in the rural areas of Lesotho have economic, social and cultural circumstance as factors hindering their treatment and prevention of HIV/AIDS. They are also faced with the psychological impacts of HIV, and the findings revealed that disclosure was the key to addressing their problems. The findings also show that most mothers receivedemotional, instrumental, informational and appraisal support from their families at the micro-level of the ecological perspective. The other levels – meso, exo and macro – provided only limited support for the mothers. The recommendations are that these mothers need social support at all levels of the ecological perspective to meet their needs / AFRIKAANSE OPSOMMING: MIV/vigs is een van die ergste pandemies in die moderne wêreld. Dit ken geen grense nie, en vele mense ly hetsy daaraan of daaronder. Die virus het reeds alle uithoeke van die aarde bereik. Tog gaan Afrika, veral Suider-Afrika, die swaarste daaronder gebuk, en word meer as die helfte van die totale populasie wat aan of onder MIV/vigs ly hier aangetref. Die vyf lande met die hoogste MIV-infeksiesyfers ter wêreld is almal in die streek geleë. Lesotho is een van die drie lande boaan hierdie lys, en het terselfdertyd te kampe met die probleme van armoede en ’n hoë werkloosheidsyfer. Vroue en kinders, synde die groepe wat die ergste deur armoede geraak word, woon ook meestal in landelike gebiede. ’n MIV-positiewe moeder in die landelike gebiede van Lesotho moet dus armoede, ontoeganklike dienste sowel as die sielkundige uitwerking van MIV trotseer. Die doel van hierdie studie was om vanuit die ekologiese perspektief ’n beter begrip te vorm van gesondheidsdiensverskaffers se sienings oor die behoefte aan en toeganklikheid van steundienste vir MIV-positiewe moeders in die landelike gebiede van Lesotho. Om hierdie doel te bereik, was die oogmerke om ’n oorsig van die MIV-verskynsel te bied, die psigososiale behoeftes en sosiokulturele omstandighede van MIV-positiewe moeders in die landelike gebiede van Lesotho te beskryf, en die moeders se behoefte aan steundienste vanuit die ekologiese perspektief te bespreek. ’n Kwantitatiewe sowel as ’n kwalitatiewe navorsingsmetode is gevolg, en die navorser het van ’n verkennende en beskrywende ontwerp gebruik gemaak. Doelgerigte steekproefneming is gebruik om die 30 studiedeelnemers te kies. Data is met behulp van semigestruktureerde vraelyste gedurende individuele onderhoude ingesamel. Die vraelyste is opgestel op grond van inligting wat in die literatuuroorsig bekom is. Die studie bevind dat ekonomiese, maatskaplike en kulturele omstandighede MIV/vigs-behandeling en -voorkoming vir MIV-positiewe vroue in die landelike gebiede van Lesotho belemmer. Daarbenewens moet hulle die sielkundige uitwerking van MIV die hoof bied, en die studie dui op openbaarmaking as die sleutel om hul probleme te hanteer. Die bevindinge toon ook dat die meeste moeders emosionele, fisiese, inligting- en bevestigende steun van hul families op die mikrovlak van die ekologiese perspektief ontvang. Die ander vlakke – meso, ekso en makro – bied slegs beperkte steun. Die studie kom tot die gevolgtrekking dat hierdie moeders op alle vlakke van die ekologiese perspektief maatskaplike steun moet ontvang om in hul behoeftes te voorsien.

M.A. / This study explores the experience of pregnancy from the perspective of HIV-positive women. To shed light on this phenomenon, the existing literature was examined and it was found that very few studies have investigated South African women’s experience in this context. Existing findings tend to focus on the day-to-day impact of HIV on a woman’s mothering role rather than on her experience of pregnancy in particular. Pregnancy can be viewed as a process of growth, during which the relationship between the mother and her baby is prepared. For most women, acceptance of pregnancy is associated with the development of an attachment to the foetus. However, the nature of emotional support received during pregnancy can affect the development of the mothers’ attachment to the baby. Moreover, a pregnancy experience is coloured by a complex of personal needs and expectations, health status, as well as emotional, psychosocial and physical circumstances. In this regard, an HIV-positive status may influence an expectant woman’s perception of her health. Generally, being HIV positive and physically healthy is experienced as a complex psychological state, where a chronic sense of uncertainty can precipitate various somatic and psychological symptoms of distress. HIV-positive individuals who experience the most distress tend to have difficulty with initiating contact with sources of support. The focal point of this study was to understand the psychological implications of pregnancy delineated by an HIV-infection, as well as the meanings that these mothers attribute to the experience. Accordingly, a phenomenological framework was adopted to investigate the lived world of the HIV-positive pregnant woman. Phenomenologically informed interviews were conducted with HIV-positive women in the last trimester of their pregnancies, with the aim of obtaining an in-depth account of their experience of pregnancy. These women all knew about their HIV status for at least three years before falling pregnant. The interviews of three of the four participants were transcribed, followed by analyses and descriptions that were guided by phenomenological principles. The findings offer a phenomenological description of themes that form part of the phenomenon of pregnancy in the face of an HIV-positive status for these women. Their experience of pregnancy was characterized by significant emotional distress fuelled by fear of disclosing their status to their children and health care staff, uncertainty about the future, as well as having significant worry about their own and the baby’s health. These mothers adopted a cautious, wait-and-see attitude toward the pregnancy and they coped by distancing themselves from negative affect. Because they did not want to burden their families, they carried much of their emotional distress on their own. HIV-positive pregnant mothers seem to be proactive in looking after their health, possibly as a result of antenatal care. However, they are vigilant about physical changes as well as markers of health, such as CD4 counts, and shifts can be anxiety provoking. Finally, pregnancy intendedness forms a significant part of the overall experience, where a pregnant mother may consider termination of an unexpected pregnancy on the grounds of her HIV-positive status. Negotiating the decision or ability to terminate, can also have an influence on the overall experience of the pregnancy. In conclusion, an overview of the findings leads to tentative recommendations that may alleviate the emotional difficulties experienced by HIV-positive pregnant women. These findings need to be viewed in conjunction with the evaluation of the strengths and limitations. Although this study has yielded some findings that can contribute toward a deeper understanding of HIV-positive women’s experience of their pregnancies, a number of additional issues have arisen as a result of these findings. There is thus a need for further research on the topic and to this end, some suggestions for future research are offered.

<p>The effects of the spread of HIV/AIDS place a great burden on women and children, who will probably suffer most in terms of social and economic deprivation. Since HIV/AIDS is linked to social taboos such as sexuality, drug use and death, there are enormous levels of ignorance, denial, fear and intolerance in most communities. These prejudices lead to the stigmatisation and discrimination of people who are living with HIV/AIDS. Moreover the illness, as it is sexually transmitted, has been conflated with sexual excess, lack of morals, and those already stigmatised such as sex workers with associated discourses of blame, shame and guilt. Generally, responses to HIV and those living with HIV have served to reflect, legitimise and reproduce broader social inequalities on the basis of sexual orientation, gender, race and class. Stigma is the reason why many people who are living with HIV/AIDS, choose not to disclose their status and seek apposite assistance. This study explored the stigma experienced by a group of women who are living with HIV/AIDS and to develop a deeper understanding of whether these experiences are complicated by social responses.</p>

This study focuses on the impact of HIV/AIDS on women in Namibia. Namibia, with a population of only 1.7 million people, is ranked as the seventh highest country in the world in terms of HIV/AIDS infections. The percentage of women living with HIV/AIDS in Namibia accounts for 54% of the total of 68 196 people in the country living with the virus. Women are also diagnosed with the disease at a younger age (30) in comparison to their male counterparts (35 years). Desoite their needs, women living with HIV/AIDS bear a triple burden of caring for those living with HIV/AIDS, caring for themselves and coping with the responses to their infection. There are few focused intervention strategies to support and care for women living with HIV/AIDS in Namibia.

This study focuses on the impact of HIV/AIDS on women in Namibia. Namibia, with a population of only 1.7 million people, is ranked as the seventh highest country in the world in terms of HIV/AIDS infections. The percentage of women living with HIV/AIDS in Namibia accounts for 54% of the total of 68 196 people in the country living with the virus. Women are also diagnosed with the disease at a younger age (30) in comparison to their male counterparts (35 years). Desoite their needs, women living with HIV/AIDS bear a triple burden of caring for those living with HIV/AIDS, caring for themselves and coping with the responses to their infection. There are few focused intervention strategies to support and care for women living with HIV/AIDS in Namibia.