Submitted by Rafael Porto (rafaelluizaguiar@hotmail.com) on 2018-11-06T14:17:10Z No. of bitstreams: 2 Dissertação_Versão FINAL.pdf: 1003916 bytes, checksum: 166c3f04554faa87686d25a2017c2261 (MD5) Carta de Encaminhando de Auto Depósito.pdf: 272057 bytes, checksum: 2f41762157b504a7c8f1e32c99548ced (MD5) / Approved for entry into archive by PPGPSI Psicologia (ppgpsiufam@ufam.edu.br) on 2018-11-06T22:37:17Z (GMT) No. of bitstreams: 2 Dissertação_Versão FINAL.pdf: 1003916 bytes, checksum: 166c3f04554faa87686d25a2017c2261 (MD5) Carta de Encaminhando de Auto Depósito.pdf: 272057 bytes, checksum: 2f41762157b504a7c8f1e32c99548ced (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2018-11-07T12:43:46Z (GMT) No. of bitstreams: 2 Dissertação_Versão FINAL.pdf: 1003916 bytes, checksum: 166c3f04554faa87686d25a2017c2261 (MD5) Carta de Encaminhando de Auto Depósito.pdf: 272057 bytes, checksum: 2f41762157b504a7c8f1e32c99548ced (MD5) / Made available in DSpace on 2018-11-07T12:43:46Z (GMT). No. of bitstreams: 2 Dissertação_Versão FINAL.pdf: 1003916 bytes, checksum: 166c3f04554faa87686d25a2017c2261 (MD5) Carta de Encaminhando de Auto Depósito.pdf: 272057 bytes, checksum: 2f41762157b504a7c8f1e32c99548ced (MD5) Previous issue date: 2018-06-26 / AIDS can already be considered an epidemic, whose illness has different aspects from the psychosocial and mental health point of view. In 2014, the World Health Organization (WHO) has established the concept of key populations, which are populations with the highest prevalence of HIV / AIDS cases: people who use drugs, sex workers, men who have sex with others men (MSM) and transgender people. Being transgender the population with 49 times more chance of infection by HIV virus. By transgender is meant people who were born with a biological sex, but identify with the gender opposite to that attributed at birth. Thus, this master's research aimed to investigate the meanings attributed by transgender women from the diagnosis of HIV / AIDS. It was a research of a qualitative nature and developed from the phenomenological concepts, which has the purpose of making the understanding of what the other brings in his discourse. The method was the phenomenological research in Psychology and the phenomenological interview was used. The data were collected from a guiding question that has unfolded, thus making it possible to identify the meanings of the speeches and the formation of the categories of analysis for the understanding of the data. As results the following categories were obtained: "And the lived-world is expressed from the vulnerability", "And in the silence I hide the pain and the suffering", "From the communication of the diagnosis, another dimension is experienced: the finitude, the limit of the human "," Re-live the moment of contamination "," Being-trans and being-PLHA, double stigma "," Being-with and care. "The interviewees brought as main experiences suffering when diagnosed , the double stigma of being transgender with HIV, and the existential resizing of the being-with. / A AIDS já pode ser considerada uma epidemia, cujo adoecimento ganha contornos diversos do ponto de vista psicossocial e de saúde mental. Em 2014, a Organização Mundial da Saúde (OMS) estabeleceu o conceito de populações chave, que são populações que apresentam maior prevalência de casos de HIV/AIDS, são elas: pessoas que usam drogas, profissionais do sexo, homens que fazem sexo com outros homens (HSH) e pessoas transgênero. Sendo transgênero a população com 49 vezes mais chance de infecção pelo vírus HIV. Por transgênero entende-se pessoas que nasceram com um sexo biológico, mas identificam-se com o gênero oposto ao atribuído no seu nascimento. Sendo assim, essa pesquisa de mestrado teve como objetivo investigar os sentidos atribuídos por mulheres transgênero a partir do diagnóstico de HIV/AIDS. Foi uma pesquisa de natureza qualitativa e se desenvolveu a partir dos conceitos fenomenológicos, que tem por cunho fazer a compreensão do que o outro traz em seu discurso. O método foi o fenomenológico de pesquisa em Psicologia e foi utilizada a entrevista fenomenológica. Os dados foram coletados a partir de uma questão norteadora que sofreu desdobramentos, possibilitando assim identificar os significados dos discursos e a formação das categorias de análise para que seja feita a compreensão dos dados. Como resultados foram obtidas as seguintes categorias: "E o mundo-vivido é expresso a partir da vulnerabilidade”, “E no calar escondo a dor e o sofrimento”, “A partir da comunicação do diagnóstico, outra dimensão é vivenciada: a finitude, o limite do humano”, “Re-viver o momento da contaminação”, “Ser-trans e ser-PVHA, duplo estigma”, “O ser-com e o cuidado”. As entrevistadas trouxeram como vivências principais o sofrimento quando do diagnóstico, o duplo estigma de ser transgênero com HIV e o redimensionamento existencial ao exercer o ser-com.

Magister Public Health - MPH / Being healthy (‘feeling fine’) and health deterioration (‘getting sick’) were key health concerns among PLHIV prior to ART initiation. PLHIV often referred living with HIV as ‘being sick’ and experiencing poor health when already infected with HIV as ‘very sick’ and this perception about sickness and wellness partly determined the need and value placed on accessing HIV services. Motivations for starting treatment included needing to maintain or regain health, encouragement from HCWs, relatives and friends and believing in the effectiveness of ART to improve health. Prevention of HIV transmission to others was not cited to influence uptake. The majority of PLHIV reported stringent adherence to ART; even a half-hour delay in taking treatment was sometimes defined by participants as ‘non-adherence’. Initial reminders for taking ART (setting alarm, placing pills where visible) fell away as daily medication became routine. However, daily uptake of treatment had its own psychosocial and economic consequences which PLHIV had to navigate. With few exceptions, when taking the first line regimen, most PLHIV experienced both temporal (hallucinations, vomiting) and long-term (dizziness and irregular heartbeat) side-effects attributed to ART, which although not considered life threatening, could undermine ART adherence. HIV status disclosure was both limited and selective (mainly to spouses, close relatives, friends and co-workers) and deemed as promoting adherence to treatment and access to HIV services. HIV/AIDS stigma persisted even among relatively healthy PLHIV due to links with ‘promiscuity’, hampering disclosure and access to HIV services. Competing demands on participants’ time, especially livelihood activities, also disrupted accessing services. Good relationships between HCWs and PLHIV promoted access to services.

ABSTRACT Study Aim and Objectives: The aim of the study was to explore what it means to have HIV/AIDS in Gaborone, Botswana. The study describes the demographic and socioeconomic circumstances of the participants. It also elicits and explores the experiences of people living with HIV/AIDS in Gaborone, Botswana. Methods Interviewees were purposely selected from a hospice, an NGO and a church that ministers to PLWHA. In depth interviews were conducted and recorded by audiotape. The interviews were conducted in Setswana and the interviewees responded to a statement, which essentially was, “Tell me about your life since you knew you had HIV/AIDS”. The audio recordings were transcribed into English. Care was taken to carry the Setswana way of speaking directly into English. A thematic analysis of the transcripts was made. A modified cut and paste method was used to gather the information into its various themes. Results There were 15 interviewees. Their average age was 35.3 years and on average, they had 1.6 children each. They were unemployed. The interviewees described a wide range of experiences, which were not necessarily experienced by all. Their narratives described the physical symptoms they suffered. They described stigma and discrimination that they went through. They gave accounts of psychological and emotional turmoil. Psychiatric problems were cited. They were very concerned that they could no longer support their children. They also worried about what would happen to their children when they died. As their disease progressed, they lost their jobs and were reduced to poverty. They could no longer support themselves and their dependents. They depended on relatives, friends, NGOs and government for relief. Relief from friends and relatives was often not available. They suffered hunger, as they could not satisfy their increased appetites after they started ARV drug therapy. Their relationships were disrupted when they got ill. Spouses and friends left and some relatives and friends stigmatised them. Interviewees were taken care of by relatives, friends, health professionals, NGOs, and social workers. In all these categories, there were good and bad care givers except the hospice and church, which were reported as good caregivers. Caregiver fatigue was described. Some interviewees found comfort in God. They believed that He knows what they are going through and will take care of them. The interviewees also found comfort and healing from the companionship of other PLWHA. The interviewees wanted to find jobs and work so that they could support themselves and their dependents. They wished government would train them and find them jobs. Conclusion The study confirmed the psycho-emotional problems and concern for children felt by PLWHA, that the literature revealed. It showed the physical problems they also suffer. The study revealed that interviewees lost jobs and became destitute. They could not satisfy their increased appetites after they started ARV drug therapy. Interviewees’ relationships were disrupted when they got ill. Spouses and friends left and some relatives did not treat them well. There were good and bad care givers in different categories. The African custom of botho/ubuntu seems to be succumbing to the onslaught of HIV/AIDS. The study showed that interviewees found comfort and support from family, friends, NGO’s and the church. They found God and other PLWHA especially valuable support systems. It was encouraging to notice that some interviewees felt that with time, stigmatisation of PLWHA is gradually subsiding.

It is evident from research studies that deaf youth in South Africa have limited knowledge or, rather, are misinformed about issues related to HIV/AIDS (Barnett & Whiteside, 2002). This is not a pure South African problem as Heuttel and Rothstein (2001) note those international studies on differences in HIV/AIDS knowledge between deaf and hearing youth indicates that deaf youth do not have the necessary knowledge about HIV/AIDS. To address this problem the South African government made a commitment to render and strengthen effective HIV/AIDS education to deaf learners (The White Paper 6 on Inclusive Education, 2001). Therefore, this study was aimed at exploring deaf youth’s perceptions about HIV/AIDS, the impact of HIV/AIDS, as well as the role that deaf youth play in the fight against HIV/AIDS in schools. A qualitative research approach was used for this study and a convenience sample of forty participants from two schools for the deaf in the Eastern Cape Province was used. The sample comprised twenty learners from each school, ranging from 14-21 years of age. Interviews were used as a data collection tool. The study has four findings, that is: deaf youth do not have critical knowledge about HIV/AIDS; deaf youth access information through conversations (with peers) and television; life skills teachers put more emphasis on religious education than talking explicitly about HIV/AIDS and discussions about HIV/AIDS are seldom held for fear of stigmatisation and due to various perceptions about HIV transmission. The study concludes that it is imperative for deaf youth to have the right knowledge and skills to reduce their vulnerability to HIV/AIDS therefore; this dissertation recommends that there is a need to address issues related to knowledge improvement, access to information and the social stigma against HIV/AIDS. The study further notes that there is a need to research, reasons why HIV/AIDS is not incorporated in all learning areas; other factors that may be causing teachers not to be able to offer in-depth HIV/AIDS education to deaf youth and to determine the extent to which SLED materials are being put to use by teachers of deaf learners.

Thesis(M Med.(Family Medicine)--University of Limpopo, 2009. / The impact of HIV/AIDS on the health sector and the health professionals that work in it is huge. This impact has contributed to the continuing attrition of health professionals in South Africa. Voluntary Counseling and Testing (VCT) has a central role to play in the response to these problems both at the level of the health sector in general and most especially at the level of the individual health professional. Thus, understanding factors that affect the practice of VCT amongst this group of professionals is crucial in South Africa‟s quest to reverse these negative trends. AIM The aim of this study was to determine the level of knowledge, to access and understand the attitude and practice of VCT for HIV/AIDS amongst the health professionals in a rural district Hospital and to make recommendations in order that appropriate intervention strategies may be instituted. METHODS A descriptive cross-sectional quantitative study design was used in which data was collected using a self-administered questionnaire. The study population included all the health professionals working in the hospital at the time of the study but excluded those who were on leave or absent from duty during the period of data collection. Informed consent was obtained from each participant. Data was captured and analyzed using the SPSS version 15.0 (SPSS Inc, Chicago, Illinois, USA). vi RESULTS There was a very high level of knowledge, a moderately supportive attitude and a moderately high level of practice of VCT amongst the study participants. Divorced/separated respondents to this study had more supportive attitude towards VCT than their single colleagues. Age was found to have a very weak but positive correlation to attitude score. There was no significant difference in knowledge and attitude scores between those who practiced VCT and those who did not. CONCLUSION Health professionals understand the importance of VCT as an HIV preventive behavior but there remains some VCT knowledge, attitude and practice concerns together with other determinants of VCT behavior that needs to be addressed.

Thesis (MSc.(Clinical Psychology))--University of Limpopo, 2009. / HIV/AIDS is increasing at a fast rate. Increasing numbers of women worldwide are being infected with HIV, the virus that causes AIDS. Condoms, abstinence and faithfulness have been suggested to prevent the further spread of HIV infection. The present study adopted a qualitative approach to explore the views and attitudes of female church goers towards HIV/AIDS and its preventative measures. The results indicated that they view HIV/AIDS as a fatal disease which cannot be cured by medical means, and it is caused by unprotected sex when an individual engages in sexual intercourse with someone infected with HIV. They all know that condoms are an effective form of prevention. Despite all their knowledge, however, they feel powerless, unsafe, and hopeless regarding effective HIV control and prevention due to their partners’ resistance in respect of condom usage. Church ministers should be more sensitive to the inequalities that exist in marriages and should be careful in their preaching of submission and obedience of women towards men. Church ministers should present their sermons in a way that fosters equalities and the practice of safe sex. Finally, it is also recommended that the younger generation, both males and females should be educated about gender equality during their Sunday school and youth programmes. These programmes should include teachings about gender equality, practice of safe sex, faithfulness and abstinence. Should this be done effectively the new generation could hopefully operate from a different frame of reference as opposed to the current generation whose value systems and norms are outdated and discriminatory.

The purpose of this qualitative study was to examine the gender differences in the experiences of Kenyan youth living with HIV-AIDS and their decisions in relation to the disease in Kenya. There is need for counselors, educators, related professionals, and other stakeholders to have knowledge and awareness of the gender differences in the experiences of youth living with HIV-AIDS and their decisions in relation to the disease. To capture the distinctive meanings each youth has assigned to his or her experiences and decisions related to the disease, the study used a qualitative Interpretative Phenomenological Approach (IPA). Four focus group interviews were conducted with 33 18-24 year old Kenyan youth (17 female and 16 male) who were living with HIV-AIDS. The youth receive HIV-AIDS support services in the Thika and Kiambu District/County Hospitals' HIV-AIDS Comprehensive Care Centers (CCCs) in Kenya. Five main themes emerged from data analysis including: (a) Self-Portraiture as Youth; (b) Reactions to a Positive HIV-AIDS Diagnosis; (c) HIV-AIDS Contraction Context; (d) Day-to-day Life While HIV-AIDS Positive; and (e) Sexual Behavior While HIV-AIDS Positive - Prevention. Implications for theory, research, and practice are suggested.

Thailand is a nation of some 60 million people, 2 million of whom are estimated to be HIV/AIDS infected and, of those who are infected, 80-90% were infected through heterosexual intercourse and 10-20% are women. In this research, the author discusses the situation in some detail.The experiences of HIV/AIDS infected Thai wives and widows in the rural north of the country are studied.A major contributing factor is the differential constructions of male and female status and sexuality in traditional Thai culture.These constructions are rooted in Theravada Buddhism, ancient mythology and folklore. Data was obtained from 24 participants in Chiangmai Province. The findings of the study revealed several problems with which participants were confronted and the processes they used to address them.It is suggested in the findings that any serious therapeutic interventions and interventionist research studies must be congruent with traditional Thai culture / Doctor of Philosophy (PhD)

This thesis examines aspects of the prevention of sexually transmitted diseases (STDs) in the Australian community, with a particular emphasis on HIV/AIDS in the context of general practice (or primary care settings). The work has four broad aims: i) To describe the primary prevention of sexually transmitted diseases, following from the arrival of the HIV/AIDS pandemic in Australia ii) To describe HIV/STD risk behaviour iii) To summarise previously known evidence of interventions to reduce risk and to raise awareness of HIV and other sexually transmitted diseases iv) To contribute new evidence addressing the potential of the general practitioners' role in HIV/STD prevention The first chapter gives a brief review of the history of HIV/AIDS from its discovery in the United States of America to its appearance in Australia and New Zealand, and discusses the Australian response strategies, both initial and continuing, to confine the epidemic. Specifically, the arrival of HIV/AIDS gave rise to increasing awareness of sexually transmitted diseases, which hitherto, although sometimes chronic, were rarely fatal. The public health risk of HIV necessitated swift government action and led to wider acceptance of publicity about sexual behaviour. Although the thesis does not concentrate solely on HIV, this is still an emphasis. This chapter provides useful background to ensuing chapters. Chapter Two provides an overview of behavioural risk in sexually transmitted diseases. It gives a review of risk factor prevalence studies, and introduces risk behaviour and cognitive models of behaviour change, as applied to STD risk. Sexual behaviour is a complex social interaction, usually involving more than one person, and relying on the personality and behaviour patterns intrinsic to the individuals taking part. It is therefore perhaps more challenging to alter than behaviour which is undertaken alone, being dependent on the behaviour and intentions of both parties. Moreover, comprehensive assessment of sexual risk behaviour requires very detailed information about each incident. Its private nature makes accurate data difficult to obtain, and sexual risk behaviour is, correspondingly, difficult to measure. Chapter Three reviews the effectiveness of interventions tested in primary health care settings to reduce sexual risk behaviour. The candidate uses a replicable method to retrieve and critique studies, comparable with standards now required by the Cochrane Collaboration. From 22 studies discussed, nine health interventions were short, 'one-shot', efforts owing to limited time, resources and other practical constraints. This review demonstrates the scarcity of interventions with people who may be perceived as 'low-risk'. Only four interventions were carried out in community health centres and two in university health clinics. One of the university interventions showed no change in sexual behaviour in any of three arms of the intervention (Wenger, Greenberg et al 1992) while the other showed an increase in condom use in both groups, although the intervention group's self-efficacy and assertiveness also improved (Sikkema, Winett & Lombard 1995). The rationale for the intervention, where given, is described. Chapter Four analyses the content, format and quality of sexual health information brochures available in New South Wales at the time of the candidate's own planning for an interventional study. One of the most effective ways to disseminate information widely is by the use of educational literature, especially when the subject material is potentially sensitive or embarrassing to discuss in person. In this chapter, the candidate reviews the literature available at the time of designing the intervention used in Chapter Five. Readability, attractiveness, clarity and the accurate presentation of facts about sexually transmitted disease risk are examined for each pamphlet. Forty-seven pamphlets were scored according to the Flesch formula, and twenty-four of these scored in the 'fairly' to 'very difficult' range. There was, therefore, a paucity of easy-to-read material on these subjects. Chapter Five evaluates a general practitioner-based counselling intervention to raise awareness of sexually transmitted diseases and to modify HIV/STD risk behaviour. While adults aged 18-25 are less likely than older cohorts to have a regular general practitioner or to visit often, most people visit a general practitioner at least once a year. This could provide an opportunity for the general practitioner to raise preventive health issues, especially with infrequent attendees. As the effectiveness of an opportunistic intervention about sexual risk behaviour was yet to be tested, the candidate designed an innovative randomised controlled trial to raise awareness of risk and increase preventive behaviour. The participation rate was 90% and 76% consented to followup; however the attrition rate meant that overall only 52% of the original participants completed the follow-up questionnaire. The intervention proved easy and acceptable both to GPs and to patients, and risk perception had increased at three months' follow-up; however this occurred in both the control (odds ratio 2.6) and the intervention group, whose risk perception at baseline was higher (odds ratio 1.3). In order to establish some markers of risk in the general population, Chapter Six analyses data resulting from questions on sexual behaviour asked in the Central Sydney section of the NSW Health Survey. The candidate advocated for inclusion of relevant questions to determine some benchmarks of sexual risk behaviour and to provide an indication of condom use among heterosexuals. Although limited in scope as a result of competing priorities for questions in the survey, results demonstrate that, while a small percentage of people were at risk, those with higher levels of partner change or of alcohol use were the most likely to always use condoms. Specifically, 100% of those with more than four new partners in the last 12 months had used condoms with every new partner. In addition, 'heavy' alcohol users were more likely to report condom use every time with new partners (odds ratio 0.34). To furnish data to inform future planning of educational activities for general practitioners, Chapter Seven presents the results of a survey of Central Sydney general practitioners' opinions and current practices in HIV risk reduction with in the broader context of sexually transmitted disease prevention. The general practitioner is in an ideal position to provide information and advice, especially if future research affirms the impact of such advice on STD risk behaviour. General practitioners in this study said they would be slightly more likely to discuss sexual health matters with young patients than with older ones (p=0.091), but this was not significant. The most cited barrier to discussing sexual health was inadequate remuneration for taking time to do so (over 50% gave this reason). The next most cited obstacle was difficulty in raising the subject of STDs or HIV in routine consultations, but this reason was given by less than half the sample. Forty-six percent had participated in continuing medical education programs in STDs, HIV/AIDS, or hepatitis diagnosis or management; 32% of GPs had patients with HIV, and 55% of all GPs indicated they would like more training in management and continuity of care of HIV patients. Approximately half (51%) wanted more training in sexuality issues, including sexual dysfunction. Chapter Eight reviews the whole thesis and discusses future directions for the research agenda.

<p><strong>Introduktion: </strong>Aquired Immunodefficiency Syndrome (AIDS) upptäcktes för första gången 1981 i Afrika, men existerade troligen redan tidigare.<strong> Bakgrund: </strong>Alla människor har rätt till lika vård på lika villkor och alla patienter ska bemötas med positiva attityder. Negativa attityder mot patienter med HIV/AIDS kan påverka vårdkvalitén. <strong>Syfte</strong>: Att belysa sjuksköterskans upplevelser av och attityder till att vårda patienter med HIV/AIDS. <strong>Metod: </strong>Litteraturstudie med 15 artiklar publicerade mellan 1995-2010. Artiklarna har klassificerats och kvalitetsvärderats. Resultaten har analyserats med hjälp av innehållsanalys. <strong>Resultat: </strong>Innehållsanalysen gav fyra kategorier och tolv subkategorier;<strong> </strong><em>upplevelser</em>- ilska/frustration, rädsla, emotionella påfrestningar, positiva upplevelser., <em>attityder-</em> synen på patienter, medkänsla, bemötande, viljan att vårda., <em>relationer-</em> omvårdnadsrelationer, privata relationer., <em>utbildning-</em> behov av utbildning, utbildningens effekt.<strong> Diskussion: </strong>Ett stort behov av utbildning framkom som ett bifynd och utbildning visade sig ha positiva effekter på både upplevelser och attityder<strong>. Slutsats: </strong>För att öka vårdkvalitén för patienterna och trygghetskänslan hos sjuksköterskorna bör det satsas mer på utbildning inom området.</p><p><strong> </strong></p>