BAKGRUND: År 2009 uppskattade man att över 33 miljoner människor levde med hiv. Personer som lever med hiv omges av fördomar och riskerar att bli stigmatiserade av samhället och av denna anledning är det intressant att undersöka vilka attityder och uppfattningar sjuksköterskor och sjuksköterskestudenter har till dessa personer. SYFTE: Att belysa sjuksköterskors och sjuksköterskestudenters attityder och uppfattningar av personer med hiv/aids och till att vårda dessa personer. METOD: Litteraturstudien baseras på 14 kvalitativa och kvantitativa vetenskapliga artiklar, publicerade mellan år 1991 - 2011. Artiklarna har klassificerats och kvalitetsvärderats. RESULTAT: Resultatet visade att sjuksköterskor och sjuksköterskestudenter hade både positiva och negativa attityder. Positiva attityder visade på empati till patienterna medan negativa attityder ledde till sämre vårdkvalitet och kontaktundvikande av patienterna. Resultatet delades in i fem kategorier; attityder, utbildning, rädsla, empati och värderingar. DISKUSSION: Studien visar att det finns stora kunskapsluckor, vilket leder till rädsla och negativa attityder. Utbildning visade sig ha positiva effekter på attityder. SLUTSATS: För att öka vårdkvalitén hos patienterna så bör det satsas på mer utbildning om hiv/aids till sjuksköterskor och sjuksköterskestudenter.

The present study sought to expand current understandings of how and why participants identify with television characters, as well as how this identification is related to self-efficacy and safe sex intentions regarding HIV prevention. Based on the Entertainment Overcoming Resistance Model, it was expected that when viewers identify with characters in a media program, they would be less likely to counterargue or reject the HIV prevention Hkmessage, but more likely to have greater intentions and self-efficacy in modeling the behaviors shown in the program. This study also sought to understand whether these outcomes may be influenced by the gender of the participant. This study also examined ways of applying the EORM model to African American audiences. The levels of HIV/AIDS among African Americans make the need for prevention strategies for this specific community critical. This study sought a greater understanding of cultural influences, such as medical distrust. Medical distrust has been previously shown to influence responses of African American participants to health information messages. The African American sitcom One on One was chosen to show as a model of HIV prevention discussion and testing. The study included 142 participants. Following a pre-session survey, participants viewed the stimulus and responded to an online survey. Results showed that participants identified with the male and female lead characters in the program. A paired t-test revealed that females were more likely to identify with the female lead than they were with the male lead character. Medical distrust was related to greater counterarguing and lower self-efficacy to perform HIV prevention behaviors. Counterarguing against the message was low overall. Medical distrust did interact with identification in the prediction of counterarguing. However, counterarguing was not associated with less safe sex intentions. Identification with the characters in the program was related to greater self-efficacy for male participants. Self-efficacy was also related to greater safe sex intentions. Although identification was related to counterarguing and self-efficacy, these outcomes are also related to what aspects of the character viewers identify with and how they relate to the content of the media message.

Even though pain is common and often chronic in people living with HIV/AIDS (PLWHA), the management of pain is complicated and frequently woefully inadequate. Many factors influence the way PLWHA experience and communicate their pain. These factors can be categorized as both physiological and emotional. PLWHA often resort to self-care activities to control their pain because of the pervasive lack of adequate pain management by health care providers. The purposes of this study were to increase understanding of the pain management experiences in people living with HIV/AIDS (PLWHA) who report chronic pain and to elucidate the factors that influence this experience. Recruitment was conducted at 3 locations in Central Texas, USA; serving over 3,000 clients/year. A cross-sectional descriptive design and open-ended questions were used to explore PLWHA experiences in reporting chronic pain needs for at least 3 months and to describe pain management choices (self-care and/or seeking care activities) and communication with health care providers. Variables of interest were assessed with paper-pencil surveys (HIV-Self Efficacy Questionnaire, Coping Inventory for Pain in Persons Living with HIV/AIDS and Pain Self-Efficacy Questionnaire) and open-ended questions. Interviews ranged from 7-35 minutes each. One hundred PLWHA participated in the study, 53% African-American, 21% Hispanic and 25% Caucasian. They were primarily male (66%), 34% female, reported a mean age of 48 years and a mean of 13 years living with HIV. 83% of the participants rated their pain as consistently moderate to high levels; 82% rated they are likely to “tolerate the pain.” A majority of the participants (63%) reported they exercise or walk as a way of self-managing their pain. There was a significant association between use of pain management choices (self-care and/or seeking care activities) and confidence in performing life activities (r= 0.344, p<0.05). These findings indicate a need for health care providers to move beyond quantitative measures for this complex problem. Clinicians can use this information to understand the coping strategies used by PLWHA to manage pain. Future implications will be to develop appropriate pain management approaches (behavioral and pharmacological) for health care providers to improve control of chronic pain in PLWHA. Longitudinal studies are needed to explore the causative relationships between pain management choices (self-care and/or seeking care activities) and functional outcomes in PLWHA. / text

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

The message that is being preached on the streets on a daily basis is that HIV/AIDS has no cure and that it is a fatal disease. The AIDS pandemic is a serious problem, everybody's concern and nobody's fault. If not attended to accordingly and not controlled properly, the epidemic poses a serious threat to the whole nation, therefore every individual is faced with an enormous challenge, especially young people, since today's youths are tomorrow's future. The HIV/AIDS pandemic is continuing to rob both parents and their children of an opportunity of reaching their last mile of development which is old age. HIV/AIDS is not regarded to be the same as any other disease. The situation is getting out of hand as the HIV/AIDS victims are facing a double jeopardy of fighting for their lives, while at the same time, suffering from negative societal attitudes. They are being discriminated against, rejected, ill-treated and not treated with love and respect Therefore every individual is faced with the huge task of fighting this monster and creating a caring society. A supportive and enabling environment needs to be created so that HIV/AIDS victims can be treated similarly to any other patients. The aim of the study was to explore learners' knowledge of HIV/AIDS and determine their attitudes regarding people living with HIV/AIDS. From the research findings, it was found that learners are knowledgeable about the general facts on the HIV/AIDS pandemic, but that their knowledge concerning certain aspects is limited to some extent, therefore it is deemed necessary to equip and empower them with more and relevant information. With regard to learners' attitudes, it was found that learners have fair and positive attitudes towards people living with AIDS. It is recommended that these positive attitudes and fair knowledge of learners must be sustained. The most effective way to attain this is though education, and schools are the appropriate places to teach young people about HIV prevention. Here they can receive information and skills. It is further recommended that more HIV/AIDS programmes be developed to increase awareness and knowledge with the intention of educating people to recognize and avoid high-risk behaviour. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2005.

Background: Analyses of the individual-, social- and structural-level factors promoting the transmission of HIV and other blood-borne pathogens have consistently identified exposure to correctional environments, especially for individuals who use injection drugs (IDU), as a risk factor for infection. The objectives of this project were: to review the epidemiologic literature on incarceration and HIV infection among IDU, critically examining evidence presented supporting a causal linkage between imprisonment and infection; to investigate incarceration experiences in a cohort of active IDU; and to assess the possible effects of incarceration on the post-release risk environment of active IDU. Methods: Longitudinal datasets for quantitative analyses were derived from the Vancouver Injection Drug User Study (VIDUS) and the Scientific Evaluation of Supervised Injection (SEOSI), both prospective cohorts of IDU in Vancouver’s Downtown Eastside neighbourhood. In the first analysis, the prevalence and correlates of reporting incarceration in the the previous six months were identified in SEOSI using generalized estimating equations (GEE). In the second analysis, the possible effect of imprisonment on the prevalence of risk factors for HIV infection was estimated in VIDUS using linear growth curve analysis. Results: In the first analysis, 902 individuals interviewed at least once between 1 July 2004 and 30 June 2006 were included. Overall, 423 (46.9%) reported an incarceration event at some point during the study period. In a multivariate GEE model, recent incarceration was independently associated with a number of high-risk factors, including syringe sharing. In the second analysis, 1603 individuals were interviewed at least once between 1 May 1996 and 31 December 2005 and in cluded. Of these, 147 (9.2%) matched the study criteria and were included as cases; 742 (46.3%) were included as matched controls. In linear growth curve analyses adjusted for age, gender and ethnicity, syringe sharing was significantly more common in the incarcerated group (p = 0.03) after incarceration than in the control group. Conclusions: Our findings support the existence of a role for incarceration in continued viral transmission. In response, appropriate harm reduction measures should be expanded within correctional environments and social, political and legal reforms enacted to reduce the incidence of imprisonment for individuals who use illicit drugs.

Youth, the World Bank argues, need to become a constituency for reform in developing countries. This case study responds to this challenge by investigating adolescent students' understanding of the relationship between health literacy, HIV/AIDS, and gender in the context of Uganda. The four questions investigated are: (i) What kind of health literacy, HIV/AIDS, and gender-related information is accessible to Ugandan adolescent secondary school students? (ii) In the students' view, what are the factors contributing to health and HIV/AIDS related challenges faced by young people in Uganda today? (iii) According to these students, what is the impact of the debate on gender equality in the fight against health epidemics including HIV/AIDS? and (iv) What do these students consider to be the way forward for Uganda to achieve better health and improve life chances for all? The theoretical framework includes critical pedagogy and indigenous knowledge systems, as well as integrative gender frameworks. Each contributes a different but complementary understanding of adolescent students' perspectives on the issues under investigation. Data were collected in a qualitative study from January 2005 — May, 2007. The data corpus includes: student journals, reflective reports, artifacts/documents, life history interviews, questionnaires, informal ethnographic conversations, focus group discussions and critical inquiry discussions. In response to each of the research questions, the major findings were as follows: i) The students' understanding of the relationship between health literacy, HIV/AIDS, and gender were in part influenced by the media, and in part their own experiences. ii) Poverty and peer pressure impact young people's health practices. iii) Young people want gender equality debates to have a focus on marginalized males as well as females. iv) Youth suggest that education, fair trade, and better health care services are important in the attainment of the "better health for all" goal in Uganda. The study concludes that marginalized groups, especially youth, need opportunities to develop a united voice and be active participants in reform processes. Further, new analysis frameworks are needed to understand the gender/power relations in Uganda.

Syftet med litteraturstudien var att beskriva sjuksköterskestudenters attityder till hivrelaterad sjukdom och människor som lever med hiv. Ett ytterligare syfte var att granska undersökningsgrupperna utifrån urval och bortfall i de valda artiklarna som ingick i studien. Föreliggande studie har en deskriptiv design och omfattar 13 artiklar med kvantitativ och kvalitativ ansats. Resultatet visade att negativa attityder förekom i varierande utsträckning bland sjuksköterskestudenter i alla världsdelar. Detta trots att majoriteten av deltagarna i studierna var positivt inställda till vårda och behandla människor som lever med hivrelaterad sjukdom. Faktorer som visade sig kunna påverka attityder var ålder, arbetslivserfarenhet, kunskap om hivrelaterad sjukdom och att personligen känna någon som lever med hiv. Det framkom även ett samband mellan land, kultur och sjuksköterskestudenternas attityder. Studenterna visade sig ofta ha negativa attityder vilka grundades på okunskap och rädsla vilket frekvent ledde till stigmatisering av patientgruppen. Det visade sig att det fanns en kunskapsbrist hos studenterna och att få hade tillfredsställande kunskap om hivrelaterad sjukdom och dess smittvägar. Slutsatsen är att sjuksköterskestudenter under sin utbildning ej får tillräcklig kunskap kring hivrelaterad sjukdom vilket kan resultera i negativa attityder, samt svårigheter att möta människor som lever med hiv. Detta kan leda till att den blivande sjuksköterskan kan uppleva otrygghet inför patientmötet. / The purpose of this study was to describe nursing students' attitudes towards HIV- related illness and people living with HIV. A further aim was to examine the study groups on the basis of selection and non-response in the selected articles that were included in the study.  The study has a descriptive design and is based on 13 articles with both quantitative and qualitative approach. The results showed that negative attitudes were present in varying degrees among nursing students in all continents. This result was found, despite the fact that the majority of the participants in the studies were positive to nurse and treat people living with HIV- related illness. Factors that appeared to influence attitudes were age, work experience, knowledge of HIV - related disease and knowing someone living with HIV. There was also a connection between country, culture and nursing students' attitudes. The students were often found to have negative attitudes which were based on lack of awareness and fear which frequently led to stigmatization of the patient group. It turned out that there was a lack of knowledge among the students and that few had adequate knowledge of HIV - related disease and its transmission routes. The conclusion is that nursing students during their training does not get sufficient knowledge about HIV - related illness. This can result in difficulties to meet people living with HIV when the aspiring nurse may experience insecurity in meeting the patient.

The devastation wrought by the HIV/AIDS epidemic in Aboriginal communities is both physical and metaphorical, as the stigmas associated with the virus mediate the way it is both understood and experienced. This thesis examines the role of HIV in Canadian Aboriginal literature, with an eye to the specific ways that these narratives about HIV relate back to real-world understandings of the epidemic. The works of Tomson Highway, Jordan Wheeler, Beth Brandt, and Gregory Scofield demonstrate how HIV/AIDS is frequently tied to colonial histories and personal experiences of disconnect, alienation, and abuse. HIV operates at the boundaries of these texts, drawing connections between otherwise disparate narratives, highlighting stigmas within communities, and focussing on differently marginalized communities of Aboriginal people in Canada. These authors draw from traditional understandings of storytelling, using narrative to incite important discussions about HIV/AIDS, and to work towards greater acceptance and inclusion of HIV-positive people in Aboriginal communities.

In this thesis I explore and evaluate the grounds upon which we can claim that community and activist art makes a difference in peoples’ lives. To do so, I examine an ongoing art project that seeks to transform the lives of American women with HIV/AIDS through artistic creation, the STITCHES Doll Project. To evaluate the efficacy of the Project, I position the Project in relation to the history of HIV/AIDS in America, popular and medical understandings of the illness, connections between HIV/AIDS and oppressive structures, representations of the illness, as well as Western conceptions of embodiment, illness, and identity. Against this history, I provide visual and textual analyses of several of the works produced through the STITCHES Doll Project, in combination with interviews and reports from participants themselves, to determine how these dolls affect these women’s sense of self and agency. This thesis argues that Western understandings of the meaning of HIV/AIDS, combined with its physical, emotional, social, and psychological effects, violently erodes a sense of self for those who contract the illness. Specifically, I argue that because identity in the West is predicated upon self-control, self-containment, mental control, and a repression of embodiment, illness, and death, HIV/AIDS has been experienced at both a personal and cultural level as corrosive of identity. In response to such pain, the STITCHES Doll Project provides an opportunity for HIV+ women to use a variety of strategies to re-establish their identity. Strategies such as sharing the illness or displacing it, when enacted through the Project, can successfully assist in re-affirming identity for participants. I suggest that this is where the value of the Project is best situated, and that this case study provides reason to believe in the value and power of community and activist art. Nevertheless, the Project’s success at individual, social, political, and pedagogical levels is tempered by the challenges posed by cultural codes, discourses, institutions, and practices. In light of this, my research explores how negotiation of these cultural codes, norms and practices helps to both re-build, as well as un-do, identity for participants. / Thesis (Master, Art History) -- Queen's University, 2009-09-29 14:29:09.34