Introdução: O cenário da epidemia da AIDS vem se modificando no Brasil e no mundo e o perfil epidemiológico das pessoas vivendo com HIV/AIDS vem sofrendo sucessivas alterações desde a década de 80. Embora os homens representem em números absolutos, o maior número de notificações do total de casos de AIDS, a velocidade de crescimento da epidemia é maior entre as mulheres. O Brasil tem uma resposta à epidemia de DST/AIDS reconhecida internacionalmente, baseada nos princípios do SUS à universalidade, à equidade e à integralidade na assistência. Um dos capítulos desta resposta é a prevenção da transmissão vertical do HIV. O tema que vem ganhando importância na medida em que a AIDS recebe status de doença crônica e as mulheres soropositivas podem fazer as suas escolhas reprodutivas. A prevenção da transmissão vertical do HIV contempla testagem para diagnóstico precoce, terapia antirretroviral durante a gravidez e o parto, terapia antirretroviral para o recém-nascido e a não amamentação. Objetivo- Conhecer como as ações de prevenção e controle da transmissão vertical do Vírus da Imunodeficiência Humana são percebidas pelas gestantes e puérperas atendidas pelo Programa Estadual de DST/AIDS, e sua satisfação, ou insatisfação, em relação à assistência recebida. Método- Nossa amostra foi composta por 14 mulheres, sendo 13 soropositivas para o HIV que engravidaram e tiveram pelo menos um filho no contexto da soropositividade e uma, soronegativa para o HIV e mãe adotiva de uma criança soropositiva. Para a coleta de dados foi utilizada a metodologia qualitativa, com base em entrevistas individuais, semiestruturadas, realizadas em 2010. Resultados - Não houve aconselhamento para a testagem de nenhuma mulher da amostra. As mulheres apresentaram, no geral, uma falta de identificação com o perfil de pessoas que podem se infectar com o HIV, sendo surpreendidas com o diagnóstico. Oito pais apresentaram status sorológico desconhecido, sendo que três negaram-se à testagem. Há dificuldades por parte das mulheres, para promoverem relações sexuais protegidas com o uso do preservativo masculino. Os efeitos adversos dos antirretrovirais são descritos como obstáculo importante à adesão ao tratamento. O alojamento conjunto foi o cenário das piores vivências dentre toda a assistência recebida, destaque dado ao tema aleitamento materno. Há uma lacuna entre as demandas das mulheres em produzir e relatar as suas narrativas e a inexistência de espaços de escuta, seja individualmente na relação com o profissional médico, seja em grupos. Conclusões - A ausência do aconselhamento como espaço de abordagem e esclarecimentos, informações e escolhas, dificulta uma ação mais oportuna para a redução da transmissão vertical do HIV. As mulheres comuns não são atingidas pelas informações sobre HIV/AIDS oferecidas pelas campanhas para prevenção da infecção. O uso do preservativo para evitar a infecção ainda é uma decisão masculina. As mulheres raramente encontram interlocução entre os profissionais, para tirarem suas dúvidas e planejarem sua vida reprodutiva de forma mais segura. Apesar da falta de discussão sobre o planejamento terapêutico, a via de parto e os cuidados com o bebê, as mulheres seguem a prescrição e seguem com seus medos e suas dúvidas / Introduction: The scenario of the AIDS epidemic has been changing in Brazil and worldwide, and epidemiological profile of people living with HIV / AIDS has undergone successive changes since the 80\'s. Although men represent in absolute numbers, the highest number of notifications of all cases of AIDS, the epidemic growth rate is higher among women. Brazil has a response to the epidemic of STD / AIDS internationally recognized principles of the SUS: universality, equity and integrity in service. One of the elements of this response is the prevention of vertical transmission of HIV. The theme that is gaining importance, as AIDS gets the status of chronic disease and HIV positive women can make their own reproductive choices. The prevention of vertical transmission of HIV includes testing for early diagnosis, antiretroviral therapy during pregnancy and delivery, antiretroviral therapy for the newborn and not breastfeeding. Objective -To study how the prevention and control of vertical transmission of human immunodeficiency virus are perceived by pregnant women and new mothers assisted by the State Program of STD / AIDS, and their satisfaction or dissatisfaction in relation to care received. Methods -Our sample consisted of 14 women, 13 HIV-positive pregnant and who had at least one child in the context of being HIV positive and one was seronegative for HIV and an adoptive mother of an HIV positive child. To collect data we used the qualitative methodology, based on individual interviews, semi-structured, conducted in 2010. Results - There was no counseling for the testing of any women in the sample. Women had, overall, a lack of identification with the profile of people who can become infected with HIV, being surprised by the diagnosis. Eight male partners had unknown HIV status, and three refused to be tested. There are difficulties, for women, to promote safe sex with condom use. Adverse effects of antiretroviral drugs are described as barrier to treatment adherence. Rooming-in was the scene of the worst experiences among all the care received, highlighting the theme of breastfeeding. There is a gap between women\'s demands to produce and report their stories and the lack of opportunities to listen, either individually in relation to the medical professional, either in groups. Conclusions - The lack of counseling as a space for dialogue and explanations, information and choices, hampers a more timely action to reduce vertical transmission of HIV. The \"ordinary\" women are not affected by information about HIV / AIDS provided by the campaigns to prevent infection. The use of condoms to prevent infection is still a male decision. Women are rarely have the opportunity to with professionals, to expose their questions and plan their reproductive lives more safely. In this setting of lack ofparticipation on treatment planning, delivery or baby care, women follow the \"prescription\" and move on with their fears and doubts

p. 1-178 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-05-06T18:09:24Z No. of bitstreams: 1 44444444444.pdf: 1267573 bytes, checksum: d19f36de8ef7dc34eafc3b727f404c33 (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-13T13:48:57Z (GMT) No. of bitstreams: 1 44444444444.pdf: 1267573 bytes, checksum: d19f36de8ef7dc34eafc3b727f404c33 (MD5) / Made available in DSpace on 2013-05-13T13:48:57Z (GMT). No. of bitstreams: 1 44444444444.pdf: 1267573 bytes, checksum: d19f36de8ef7dc34eafc3b727f404c33 (MD5) Previous issue date: 2010 / Embora o trabalho de parto não seja o momento adequado para a realização do teste anti-HIV, o Ministério da Saúde considera indispensável disponibilizar o exame e tratamento quimoprofilático para mãe e bebê visando impedir a transmissão do HIV durante a gestação e parto. Assim, está preconizado que o teste rápido anti-HIV seja ofertado mediante aconselhamento em situações consideradas especiais, como em maternidades. Este trabalho teve por objetivo analisar a ação de aconselhamento em DST/AIDS para as parturientes e puérperas que são submetidas ao teste anti- HIV, na admissão para o parto, em Salvador-BA. Foi realizado um estudo qualitativo em uma maternidade com observação participante e entrevistas semi-estruturadas com 20 informantes, sendo 13 puérperas sem diagnóstico prévio para o HIV e 07 profissionais de saúde. Observou-se que a Unidade de saúde pesquisada não desenvolve ações específicas de aconselhamento para a oferta e comunicação do resultado do teste anti-HIV no trabalho de parto, limitando-se a solicitar o exame de forma compulsória e a informar o diagnóstico no pós-teste somente às usuárias, cujos resultados foram positivos para o HIV. A experiência das mulheres na passagem por maternidade de Salvador revela que não há diálogo entre profissional e paciente na triagem pelo teste anti-HIV na admissão para o parto. Muitas nem percebem que foram submetidas a esse tipo de testagem. A significação que permeia um diagnóstico positivo ou negativo para o HIV e o entendimento dos valores e sentidos dados por essas mulheres, principalmente quando se descobrem positivas para o HIV não são abordados pelos profissionais de saúde. Para estes, na dinâmica do hospital não há espaço para a escuta qualificada. Há dificuldade na capacitação desses profissionais para lidar com esse tipo de abordagem no seu cotidiano em que as atitudes e práticas hegemônicas pautada na biomedicina mecanicista e centrada na doença, muitas vezes, se contrapõem as experiências e necessidades dessas mulheres. / Salvador

The purpose of this study was to investigate and compare knowledge and attitudes of directors of athletics and head trainers in the Southwest (Division 1A) and the Southland (Division 1AA) Conferences concerning HIV/AIDS issues related to transmission, prevention, and protection within college athletics programs. The results of this qualitative study provided descriptive data from university administrators within the athletics setting who are responsible for providing adequate student athlete health care services from developed and implemented administrative policies that directly or indirectly affect a student athlete's physiological and psychological well-being.

The demand for circumcision in Swaziland has dramatically increased since it was reported that circumcision ensures 60% protection against HIV infection. The aim of this study was to explore the reasons for, and the motives behind, this increasing interest in undergoing circumcision. A generic qualitative research design was used, in which 17 circumcised men selected by convenience sampling at FLAS Clinic, Mbabane, participated. In-depth unstructured face-to-face interviews were used to collect data. The results showed that the main reasons for circumcision are perceived health, hygiene and sexual benefits, community influences, as well as medical reasons. It was concluded that the major motives underlying circumcision are personal and partner safety and satisfaction during sex. These motives were found to be both promotive and threatening to the interests of public health. After evaluating the risks and benefits, it was recommended that mass circumcision be promoted alongside reinforced and accurate health education on circumcision / Health Studies / M.A. (Public Health)

HIV/AIDS-related stigma and discrimination (S&D), lack of social support, poverty, and gender inequalities have been identified as factors in the increased prevalence rate of HIV transmission in Enugu, Nigeria, especially among women ages 15 to 49 years. Despite the funding of reduction programs, HIV/AIDS-related S&D remain a major driving force in the increased rate of new HIV cases in Enugu. This study addressed a perceived need for behavioral change intervention approaches that span all societal factors to reduce the HIV infection rate in Enugu Nigeria. The study was guided by Goffman's (1963) social S&D theory. The sample was composed of 132 women living with HIV/AIDS WLWHA ages 21 to 54 years, purposefully sampled from the 4 HIV and AIDS comprehensive initiatives care centers in Enugu, Nigeria. Fifteen WLWHA were interviewed and 114 participated in an online survey. The descriptive statistics and a multiple linear regression analysis and comparison revealed a convergent significant relationship between the S&D determinants (social, political, psychological, environmental, and cultural) and HIV/AIDS-related S&D towards WLWHA in Enugu F (4,109) = 45.09, p

No description available.

Antiretroviral drugs were introduced into Uganda during the past decade and have revolutionised the treatment of AIDS. However, in as much as success was recorded, new challenges emerged. One such challenge was the continued use of condoms. This study investigated existing knowledge, attitudes and practices of condom use in a time of highly active antiretroviral therapy in a rural area. A quantitative, cross sectional design, with probability sampling form the general population was utilised. A self-designed questionnaire was used to collect data which was then analysed at the descriptive statistics level. The results indicated that: knowledge of HIV, its transmission, condoms and antiretroviral drugs were high among the respondents; condom acceptance and use were low; and respondents would not intentionally engage in unprotected sexual intercourse because of availability of ARVs. However it was acknowledged that some people taking ARVs have engaged in risky sexual behaviours that would expose others to infection. / Health Studies / M.A. (Public Health)

Objective: Criminal liability for the sexual-transmission of HIV raises complex questions for both clinicians and service-users regarding their responsibilities and legal obligations to disclose information to others. This is the first research study to address the impact of these issues upon everyday clinical and professional management in the UK. The prevalence and incidence of clinical and HIV-legal issues reported by the 107 psychologists sampled are reported. Design: A cross-sectional approach comprising two components was utilised: Firstly, questionnaire survey (Response rate 22%) scoping the experiences of practice issues among psychologists from sexual-health and generic settings. Attitudes towards HIV-prosecutions and various measures of professional self-efficacy were also collected. Secondly, three focus groups (N=15) exploring the impact of practice issues upon clinicians’ likely confidentiality breaking behaviours. Methods: Clinical and legal issues are presented. Further statistical analyses explored the interaction of various demographic, clinical and attitudinal variables upon clinician’s perceived self-efficacy. Focus Group transcripts analysed using Thematic Analysis (Data-driven approach) with eight emergent themes. Results: Although no direct involvements in police investigations reported, two instances of psychology notes being subpoenaed plus multiple ‘near miss’ clinical experiences described. High proportions of sexual-health psychologists experienced HIV-clients disclosing problematic behaviours, including intentional transmission (9%; N=5) and/or ‘reckless’ behaviour (72%). Focus groups expressed high levels of anxiety regarding these scenarios associated to multiple influences (interpersonal, clinician, professional and service factors). Quantitative and qualitative results were triangulated to provide a detailed analysis of how psychologists manage the clinical impact of the issues. Conclusions: Psychologists broadly supported HIV-prosecutions for intentional transmission (81%) but only limited support around ‘reckless’ cases (44%), particularly among those sexual-health experienced. Those ‘critical’ attempted to mitigate the impact of legal issues by proactively raising awareness among HIV-clients and resisting overly-defensive service changes; whereas those ‘less-critical’ were more accepting. Clinical, training and therapeutic implications are briefly considered.

HIV/AIDS continues to pose some of the most significant social, political and legislative challenges globally. This project explicates the text-mediated processes by which many HIV-related laws are becoming created transnationally though the use of omnibus HIV model laws. A model law is a particular kind of regulatory text with a set of relations of use. Model laws are designed to be taken, modified and used by stakeholders in the creation of state laws. Because they are already framed in legislative language, model laws are worded in ways that can be expeditiously activated and translated into state law. The problematic of this inquiry arises from the activities of a constellation of legislative actors including human rights lawyers, policy analysts, academics and activists who have worked to critique aspects of the United States Agency for International Development/Action for West Africa Region (USAID/AWARE) Model Law (2004) and subsequent state laws this text has inspired across West and Central Africa. I argue that mapping the origin and uptake of this omnibus guidance text is optimally achieved through a sustained analytic commentary on the institutional genre of “best practice”. Explicating the coordinating function of this textual genre is central to understanding the rapid spread of HIV/AIDS laws across at least 15 countries in West and Central African between 2005-2010. The work processes of legislative creation, challenge and reform under investigation demand an interrogation of complex ruling apparatuses regulated by text, talk and capital relations. The USAID/AWARE Model Law is rife with contestation: from its name, scope, funding source and process of development, dissemination and domestication to its legislative content and role in protecting or violating women’s rights and public health objectives. Many of the policy actors critiquing this USAID-funded initiative have been engaged in the development of alternative HIV-related model laws and the shaping of a global anti-criminalization discourse to respond to the increasing use of criminal law governance strategies to prosecute HIV-related sexual offenses and the rise in new HIV-specific criminal laws in and beyond sub-Saharan Africa. This study maps relations that rule, and makes processes of power understandable in terms of everyday transnational work activities organized by the language of law. My research method is informed by the critical research strategy of institutional ethnography. This complex legislative process was made visible through participant observation, archival research, textual analysis and informant interviews with national and international stakeholders. This has involved research in Canada, the United States, Switzerland, Austria, South Africa and Senegal (2010-2011). / Graduate

Antiretroviral drugs were introduced into Uganda during the past decade and have revolutionised the treatment of AIDS. However, in as much as success was recorded, new challenges emerged. One such challenge was the continued use of condoms. This study investigated existing knowledge, attitudes and practices of condom use in a time of highly active antiretroviral therapy in a rural area. A quantitative, cross sectional design, with probability sampling form the general population was utilised. A self-designed questionnaire was used to collect data which was then analysed at the descriptive statistics level. The results indicated that: knowledge of HIV, its transmission, condoms and antiretroviral drugs were high among the respondents; condom acceptance and use were low; and respondents would not intentionally engage in unprotected sexual intercourse because of availability of ARVs. However it was acknowledged that some people taking ARVs have engaged in risky sexual behaviours that would expose others to infection. / Health Studies / M.A. (Public Health)