Humant Immunbristvirus (HIV) är ett retrovirus som innebär ett livslångt sjukdomstillstånd. Då HIV-infektionen inte går att bota men är behandlingsbar, kommer de cirka 7000 personer som är drabbade av sjukdomen iSverige någon gång att söka vård.Personer med HIV-infektion blir generellt diskrimineradeoch stigmatiseraderelaterat till sin sjukdom, det är därför av stor vikt att de blir bemötta med respekt och omtanke frånhälso-och sjukvårdspersonal. Syftet med litteraturstudien var att belysa hur personer med HIV-infektion upplever bemötandetfrån hälso-och sjukvården.Enlitteraturstudie utfördes där 14 vetenskapliga studier grundlade resultatet. Vid databearbetningen framkom två huvudteman;Upplevelsen av ett bristfälligt bemötande inom hälso-och sjukvårdenoch Upplevelsen av ett gott bemötande inom hälso-och sjukvården. I litteraturstudiens resultat om ett gott bemötande framkom fem övergripande faktorer som viktiga för personer med HIV-infektion, dessa faktorer var: bemötande, tillit, tid, kunskap och relation. Detta resultat gav upphov till att arbetsredskapetTRO,en vägledning för sjuksköterskan till att skapa en trygg relation inom omvårdnaden, arbetades fram. Trygga relationer motverkarkänslor av diskriminering och stigmatisering för personer med HIV-infektion.Det ärav relevans att mer forskning utförs kring ämnet, personcentrerad vård för personer med HIV-infektion, så att hälso-och sjukvårdspersonal kan utföra omvårdnad utifrån evidensbaserad kunskap.

Bakgrund: Personer med HIV föreligger ökad risk för olika infektioner på grund av deras låga immunförsvar. Omvårdnadsbehov för personer med HIV kan vara munhälsa, nutrition och psykiskt stöd. Det förekommer att vårdpersonal har otrevlig attityd mot personer med HIV och låg kunskapsnivå om sjukdomen. Syfte: Syftet med denna litteraturöversikt var att belysa hur personer med HIV upplever hälso- och sjukvården. Metod: En litteraturöversikt där elva vetenskapliga artiklar har sammanställts. Resultat: Resultatet presenteras i fyra huvudteman: Mötet med vårdpersonal, Stöd och kunskap och Smitta och sekretessbrott, Andra instanser och aspekter som inverkade på upplevelsen av hälso- och sjukvården. Diskussion: Diskussionen belyser hur patienter med HIV upplevde bemötande från vårdpersonalen och hur vårdpersonalens kunskapsnivå kan påverka bemötandet, samt att patienterna upplever att de har en kunskapsbrist om HIV. Resultatet diskuteras med hjälp av vetenskapliga artiklar och Katie Erikssons teori om ansa, leka och lära samt begreppet vårdlidande. Det har betydelse att utföra vårdhandlingar utifrån patientens behov för att minska vårdlidande. / Background: People with HIV has an increased risk of various infections due to their low immune system. Care needs for people with HIV can be a good oral health, nutrition and psychological support. Healthcare professionals can have a bad attitude towards people with HIV and low levels of knowledge about the disease. Aim: The purpose of this literature review was to illuminate how people with HIV experience the healthcare. Method: A literature review with eleven scientific articles have been compiled. Results: The result is presented in four main themes: Meeting with healthcare professionals, Support and knowledge and Contagion and confidentiality, Other instances and aspects that affected the experience of healthcare. Discussion: The discussion illustrates how patients with HIV experienced treatment from the healthcare staff and how the healthcare staff's level of knowledge can affect the treatment, and that patients experience a lack of knowledge about HIV. The key parts of the result were discussed with help of scientific articles and Katie Eriksson´s theory of tending, playing and teaching, as well as the concept of suffering related to care. It is important to carry out health care procedures based on the patient needs to suffering related to care.

Bakgrund: HIV är ett virus som angriper kroppens immunsystem. En välbehandlad HIV smittar inte, trots detta upplever personer med HIV en stigmatisering i samhället. Det finns fortfarande en okunskap och förlegad syn kring HIV och dess smittvägar. Sjuksköterskans arbete bygger på god kommunikation och respekt, särskilt när det gäller utsatta och sårbara grupper. Syfte: Syftet med litteraturöversikten var att belysa hur personer med HIV upplever stigmatisering i mötet med vårdpersonal med fokus på sjuksköterskan. Metod: Litteraturöversikten är en strukturerad litteraturstudie med inslag av den metodologi som används vid systematiska översikter. Resultatet baseras på en analys gjord på femton artiklar. Resultat: Resultatet visade att det förekom en upplevd stigmatisering och diskriminering i vården. Personer med HIV vittnar om ett bristfälligt bemötande där vårdpersonal haft en negativ attityd samt förutfattade meningar. Tre huvudkategorier framkom; rädsla, stöd från vården samt bemötande. Två faktorer som påverkade vårdpersonals bemötande stod ut; rädsla hos vårdpersonal av att själva smittas av HIV samt fördomar gentemot personer med HIV. Slutsats: Personer med HIV har både positiva och negativa upplevelser av vården. I de fall då personer upplever stigmatisering förekommer det överdrivna hygienrutiner, generaliseringar och bristande sekretess från vårdpersonal. Stigmatisering inom vården kan i förlängningen leda till en rädsla och ovilja till att uppsöka vård. / Background: HIV is a virus that attacks the body's immune system. A well-treated HIV is not contagious, but despite this people with HIV experience a stigma in society. There is still an ignorance and outdated view of HIV and its transmission routes. The nurse's work is based on good communication and respect, especially when it comes to vulnerable groups. Aim: The aim of this literature review was to shed light on how people with HIV experience stigma in the meeting with healthcare professionals with focus on the nurse. Method: This literature review is a structured literature study with elements of the methodology used in systematic reviews. The result is based on an analysis made of fifteen articles. Results: The results showed that there was a perceived stigma and discrimination in care. People with HIV testify to an inadequate treatment where care staff had a negative attitude and preconceived notions. Three main categories appeared; fear, support from healthcare professionals and treatment. Two factors that affected the treatment of care staff stood out; fear among healthcare professionals of being infected with HIV and prejudice against people with HIV. Conclusions: People with HIV have both positive and negative experiences of care. In cases where people experience stigma, there is excessive hygiene routines, generalizations and a lack of confidentiality from healthcare professionals. The stigma in healthcare can in the long run lead to fear and reluctance to seek care.

Bakgrund: Human immunodeficiency virus (HIV) är en kronisk sjukdom som successivt försämrar det mänskliga immunförsvaret. Det finns medicinsk behandling som leder till ökad livslängd. Detta innebär att antalet personer med HIV kommer att öka och hälso- och sjukvårdspersonal kommer att kunna möta dessa personer inom flera vårdkontexter än enbart i HIV-specifika sammanhang. HIV har varit en uppmärksammad sjukdom sedan 1980-talet och den diskriminering och stigmatisering som sjukdomen mötte då finns kvar idag, trots nationella och globala lagar och riktlinjer. Syfte: Syftet med denna litteraturöversikt var att beskriva hur personer med HIV upplever hälso- och sjukvårdspersonalens bemötande. Metod: Metoden för denna litteraturöversikt inkluderar tio vetenskapliga artiklar hämtade från databaserna CINAHL och PubMed. Av dessa var två kvantitativa och åtta kvalitativa. Följande sökord användes: nursing, healthcare, HIV, patient, experience, stigma, discrimination och isolation. Artiklarna granskades genom att identifiera meningsbärande begrepp, likheter och olikheter som sedan bildade resultatet. Resultat: Bemötandet av hälso- och sjukvårdspersonalen beskrevs av personer med HIV bestå av fördomar, stigmatisering och diskriminering. Det var inte ovanligt att vårdpersonalen undvek personer med HIV helt och hållet. Personer med HIV uttrycker starka åsikter om vikten av kontinuitet i vården och goda relationer till vårdpersonalen. Diskussion: Resultatet diskuterades utifrån Jean Watsons interaktionsteori samt konsensusbegreppen. I samband med detta jämfördes även hälso- och sjukvårdspersonalens bemötande mot personer med HIV med personer med Hepatit-C. / Background: Human immunodeficiency virus (HIV) is a chronic disease that progressively impairs the human immune system. Today, there are medical treatments that allow people with HIV to live longer than before. This means that the  number of people with HIV will increase and healthcare providers will be able to meet these people in several nursing context than just the HIV-specific context. HIV has been a noted disease since the 1980s and the discrimination and stigma that the disease met remains today, despite national and global laws and guidelines. Aim: The aim of this literature review was to describe how people with HIV are experiencing health care provider’s attitudes. Method: The method of this literature review included ten scientific articles found in the databases CINAHL and PubMed. Following search terms were used: nursing, healthcare, HIV, patient, experience, stigma, discrimination and isolation. Two articles were quantitative and eight were qualitative. These articles were examined by identifying meaningful concepts, similarities and differences that formed the result. Results: According to people with HIV the healthcare providers’ attitudes included prejudice, stigma and discrimination. It was not uncommon for caregivers to avoid people with HIV altogether. People with HIV expressed strong opinions about the importance of continuity of care and good relationships with caregivers. Discussions: The result of the literature review was discussed based on Jean Watson's interaction theory about the centre of caring in the healthcare encounter and the consensus concepts. The healthcare providers’ attitudes towards people with HIV were compared with people with Hepatitis-C.

Esta pesquisa teve como objetivo estudar o cuidado na prática pastoral desenvolvida frente às pessoas com o HIV e AIDS e assim enriquecê-la através da leitura de textos que refletem sobre esta prática. Na leitura buscouse uma abordagem interdisciplinar. O estudo pergunta pela Igreja, considerando que as pessoas com o HIV e AIDS, são parte de seu corpo. Buscando assim, pelo posicionamento das igrejas avaliar a postura que as mesmas deveriam assumir no enfrentamento da epidemia. No confronto com a literatura, numa leitura crítica tenta dar pistas, ser auxílio para o cuidador na sua prática pastoral. Cuidando da vida cuidar de si, cuidar do outro, ser cuidado por Deus, assim termina este primeiro momento. Na descrição da prática pastoral desenvolvida no Hospital Centenário de São Leopoldo-RS, hospital público, é apresentada a formação de visitadores e a organização do serviço de visitação espiritual no hospital. Por fim este estudo quer destacar os desafios que a doença coloca para as igrejas como comunidades de fé, como cristãos pessoas individuais e sociedade. Vê a necessidade da Igreja em redescobrir a si mesma, sua teologia, os meios da palavra que lhe foram concedidas, em como acolher, ouvir, perdoar, tocar, permitir a vida, ser fiel ao seu chamado hoje e permitindo a cura da vida. / This study aimed to reflect the care in the pastoral practice developed with the people who live with HIV/Aids and enrich it with texts that reflect on this practice. In this study an interdisciplinary approach was used. The study also reflects about the church, considering that the people, who live with HIV/Aids, are parts its body. In this perspective the question about the persons position as well as the position of the Church in combating the epidemic was raised. By revising the literature, a critical reading has been done, looking for ways to help the caregiver in his/her pastoral practice. Taking care of life, taking care of himself, taking care of another and be cared by God thats how this first moment envy. The description of the pastoral practice developed at the public hospital Hospital Centenário in São Leopoldo, RS, is introduced with the training of visitors and the organization of the spiritual visitation in the hospital. Lastly, this study intent to show the challenges that the illness (sickness) brings to the Church as a faith community, Christians individual persons and society. There is a need for the Church to reflect about herself, her theology; the ways the Word was conceded, how to care, listen, forgive, touch, and allow life and to be faithful to her call today, allowing the cure of life.

In South Africa, just like in any other country within the African continent, traditional healing remains an integral part of many communities and this is not just restricted to the rural communities only, as is sometimes assumed. The main aim of this research was to explore the approaches of traditional healers in the treatment of HIV/AIDS in the Chris Hani District Municipality, Eastern Cape. The following research objectives were followed regarding the approaches of traditional healers in the treatment of HIV/AIDS: (i) to assess how traditional healers and people living with HIV/AIDS in Tsengiwe village understand HIV/AIDS, (ii) to investigate the reasons people living with HIV/AIDS consult traditional healers in Tsengiwe village, (iii) to assess Tsengiwe village traditional healers’ treatment strategies for HIV/AIDS, (iv) to establish how traditional healers view their role in the treatment of HIV/AIDS in Tsengiwe village. A qualitative research design was utilized, using in-depth interviews with traditional healers and focus group discussions with caregivers and people living with HIV/AIDS respectively. A type of non-probability sampling known as purposive sampling was used. A total of sixteen (16) participants were interviewed. The findings in this research revealed the following themes: (i) HIV/AIDS is incurable and it is understood by symptoms, (ii) belief system entrenched in traditional healing, (iii) cleansing rituals and traditional medicinal remedies and, (iv) strengthening relations between stakeholders. While traditional healers expressed a willingness to work with biomedical professionals in the management of HIV/AIDS, caregivers and people living with HIV/AIDS preferred going to clinics and hospitals for treatment. Furthermore, people living with HIV/AIDS in this research never admitted to consulting traditional healers for their ailments, only saying that they choose to self-medicate.

The aim of the study was to examine the procedures followed by traditional healers treating people living with HIV and AIDS in the Instika Municipality and the challenges faced by them in this endeavour. Using the qualitative research method, in-depth interviews and focus group discussions were conducted with twenty traditional healers. Among the significant findings of this study were the hardships encountered by traditional healers in terms of finance, the transport needed to collect medicinal plants, the shortage of medicinal plants, the lack of co-operation from the formal health care sector and the discrimination and abuse suffered at the hands of members of the community, with Christians and members of the SAPS being among the chief antagonists. It is also acknowledged in this study that traditional healers have been trained by the Department of Health concerning issues of hygiene and that traditional healers have knowledge of the symptoms of HIV and AIDS. It can therefore be concluded that traditional healers have a significant role to play in preventing the spread of HIV and AIDS if they employ preventative measures such as the use of protective gloves and limiting the use of a blade to one patient only. However, traditional healers are not supplied with safety kits or condoms to distribute to patients who consult them for treatment of STIs.

Bakgrund Humant immunbristvirus, Hiv, är en kronisk virusinfektion som utan behandling leder till Acquired Immunodeficiency Syndrome, Aids, vilket är en dödlig sjukdom. Hiv identifierades i början av 1980-talet och då var det främst homosexuella män och missbrukare som drabbades, eftersom Hiv primärt smittar via blod och sexuella kontakter. På grund av dess ursprung finns det föreställningar och fördomar om vilka som drabbas av Hiv. Det har lett till att personer med Hiv utsatts för diskriminering och stigmatisering, både från samhället och hälso- och sjukvårdspersonal. Det har länge funnits behandling som gör risken att föra smittan vidare till någon annan osannolik, men trots det har sjukdomen länge ansetts vara ett av de mest stigmatiserade medicinska tillstånden i världen.   Syfte Syftet var att beskriva hur personer med Hiv upplever och påverkas av bemötandet från hälso- och sjukvårdspersonal. Metod En icke-systematisk litteraturöversikt utfördes och resultatet baserades på 19 kvalitativa vetenskapliga originalartiklar från olika länder. Artiklarna identifierades i databaserna Public Medline och Cumulative Index of Nursing And Allied Health Literature med hjälp indexord och en manuell sökning. Samtliga artiklar som ingick i litteraturöversiktens resultat kvalitetsgranskades och analyserades utifrån en integrerad dataanalys.    Resultat Resultatet visar att personer med Hiv både hade positiva och negativa upplevelser av bemötandet från hälso- och sjukvårdspersonal. Negativa upplevelser förknippades med stigmatisering, överdrivna försiktighetsåtgärder, bristande sekretess, samt bristande kommunikation. Positiva upplevelser identifierades när hälso- och sjukvårdspersonal visade stöd och empati, hade god kommunikativ förmåga, samt när relationen med mellan patient och hälso- och sjukvårdspersonal upplevdes god. Kunskapsbrist och fördomar hos hälso- och sjukvårdspersonal identifierades vara bidragande faktorer till brister i bemötandet, vilket kunde ha negativ inverkan på patienters följsamhet i behandling.  Slutsats Patienter upplevde att kunskapsbrist om Hiv hos hälso- och sjukvårdspersonal var starkt sammankopplat med negativa upplevelser av bemötandet. Negativa upplevelser i form av diskriminering och stigmatisering från hälso- och sjukvårdspersonal kunde leda till en lägre grad av psykisk hälsa. Positiva upplevelser av bemötandet associerades med en hög grad av kunskap bland hälso- och sjukvårdsperonal, vilket kunde öka Hiv-positiva patienters hälsa och välbefinnande. / Background Human immunodeficiency virus, Hiv, is a chronic viral infection that without treatment leads to Acquired Immunodeficiency Syndrome, Aids, which is a deadly disease. Hiv was identified in the early 1980’s and it was mainly gay men and addicts who were affected, as Hiv is primarily transmitted through blood and sexual contact. Due to its origin, there are notions and prejudices about who is affected by Hiv, which has led to people with Hiv being subjected to discrimination and stigmatization, from society and health care professional. There has long been treatment that makes the risk of passing the infection on to someone else unlikely, despite this, the disease has long been considered one of the most stigmatized medical conditions in the world.  Aim The purpose of this literature review was to investigate how people with Hiv experience and are affected by the encounter from health care professionals.  Method A non-systematic literature review was performed and the result was based on 19 qualitative original scientific articles from different countries. The articles were identified in the databases Public Medline and Cumulative Index of Nursing And Allied Health Literature using index words and one manual search. All included articles in the literature review's results were quality reviewed and analyzed through an integrated data analysis.  Results The result shows that people with Hiv had both positive and negative experiences by the encounter from health care professionals. Negative experiences were associated with stigma, excessive precautions, lack of confidentiality, and lack of communication. Positive experiences were identified when health care professionals showed support and empathy, had good communication skills, and when the relationship between patient and provider was experienced as good. Lack of knowledge and prejudices among health care professionals were considered to be contributing factors to shortcomings, which could have a negative impact on patients' treatment adherence.  Conclusions Patients experienced the lack of knowledge about Hiv among health care professionals as strongly linked to negative experiences of the treatment. Negative experiences as discrimination and stigmatization from health care professionals could lead to a lower degree of mental health. Positive experiences from the encounter were associated with a high degree of knowledge among health care workers, which had positive effects on health and well-being of Hiv-positive patients.

偏見不只影響遭受者的身心健康，也違背社會正義，為了改善這樣的狀況，研究者們致力於發展降低偏見的方案。不過這些降低偏見的方案通常針對種族或性別群體，卻甚少關心肥胖者與愛滋感染者。肥胖者、愛滋感染者不僅受研究社群忽視，他們在生活中亦不受重視（如醫療體系），因此本論文著眼降低人們對肥胖者、愛滋感染者的偏見。研究一發展降低偏見方案，透過撰寫支持肥胖者或愛滋感染者的短文，引發人們言行不一的認知失調感，可能進而改變其原本對肥胖者或愛滋感染者的偏見。研究一的結果顯示，只有撰寫愛滋主題的參與者其愛滋偏見分數低於其他組別，也就是說他們的行為違反本身對愛滋感染者的既有態度而產生認知失調，透過降低愛滋偏見來化解認知失調之不適感。不過，撰寫肥胖主題的參與者，其肥胖偏見分數則與各組無異，也就是說這種降低偏見的方案對肥胖者的偏見無影響。預試二發現，相對於愛滋感染者，肥胖者通常被視為較可控制自己身屬於該社會群體的命運（可控制性），且其較需為自己的遭遇負責。為了檢視人們認為肥胖者與愛滋感染者可控制性的差異，是否影響偏見方案的效果，研究二除了改良研究一的降低偏見方案外，更操弄可控制性的高低。研究二發現可控制性會調節降低偏見方案的效果－當人們認為成為愛滋感染者是自己可以控制時，降低偏見方案的效果較弱；反之，若人們認為成為愛滋感染者是自己不能控制的，則降低偏見的效果較強。不過，撰寫肥胖主題文章的參與者則無此效果。這樣的差異或許是因為人們對肥胖者與愛滋感染者的熟悉程度有所不同。相較於愛滋感染者，人們對肥胖者較為熟悉，對其態度不容易改變，不論是接受高可控或低可控的訊息操弄，都無法改變人們對肥胖者的想法。根據本論文結果，認知失調適合降低人們較不熟悉與視其較為不可控的社會群體，如愛滋感染者，不適合應用在人們較熟悉的社會群體，如肥胖者。本論文進一步討論降低偏見方案執行困難的原因，並提出可能的建議與後續的研究方向。 / Prejudice and discrimination may have negative consequences on subordinate group members’ physical and mental health, and prejudice and discrimination also violate social justice. To deal with these problems, researchers have dedicated to develop various interventions to counter prejudice and discrimination. However, most of these interventions focus on racial and gender minorities, and researchers largely ignore people with obesity and people with HIV/AIDS. The purpose of this thesis is to develop an intervention that could reduce prejudice against people with obesity, as well as to reduce prejudice against people with HIV/AIDS. According to cognitive dissonance theory, when people’s attitudes and behavior are inconsistent, they feel uncomfortable and in turn change their attitudes to eliminate the inconsistency (Festinger, 1957). Following the basic ideas in cognitive dissonance theory, in Study 1, I randomly assigned participants to write presumably counter-attitudinal essays, in which they write about people with obesity or people with HIV/AIDS (to advocate allocating more resources to them), or school policy change (a control group). The results showed that after writing about people with HIV/AIDS, participants displayed significantly lower prejudice against people with HIV/AIDS than participants in other conditions. However, after writing about people with obesity, participants’ prejudice against people with obesity remained at similar levels as participants in other conditions. According to findings in the second pilot study, the diverging findings in Study 1 may be due to that people with obesity were considered having more controllability and responsibility than people with HIV/AIDS. To further explore the effects of levels of controllability on intervention, I revised Study 1’s intervention and added a manipulation of controllability on people with obesity or on people with HIV/AIDS. The findings showed that controllability manipulation moderated the intervention effect on people with HIV/AIDS, but had no effect on people with obesity. Because participants were more familiar with people with obesity than with people with HIV/AIDS, it is possible that attitudes toward a familiar social group are more difficult to be changed than the attitudes toward an unfamiliar social group, The results suggested that interventions based on cognitive dissonance principle have effects on unfamiliar social groups, such as people with HIV/AIDS. Obstacles with prejudice reduction interventions were further discussed; suggestions and future research directions were offered.