South Africa bears the largest burden of children living with HIV in Sub-Saharan Africa, with 450 000 of the continent's over 3 million children living with HIV estimated to be in the country (UNAIDS, 2013:87). Children living with HIV have various intrinsic biopsychosocial needs, and the meeting of these needs within drop-in-centres is primarily the responsibility of Social Auxiliary Workers, a ?frontline? category of social welfare workforce whose roles are viewed as critical in enabling the identification and facilitation of provision of health and other services. The study was informed by a concern that, in spite of their envisaged roles, Social Auxiliary Workers have very limited paediatric HIV knowledge, skills and experience. The goal of the study was to explore the perceptions of Social Auxiliary Workers on their role and competencies in addressing biopsychosocial needs of children living with HIV at drop-in-centres. The researcher conducted this study from a qualitative approach. The study was applied in a natural setting and a collective case study design was utilised. The work experiences of a purposive sample of participants that was randomly sampled were gathered by means of semi-structured one-on-one interviews. A total sample of 10 participants was drawn from a pool of 40 Social Auxiliary Workers who were employed in 18 drop-in-centres that are in Sedibeng District Municipality. The study's findings indicate that children living with HIV had many complex biological, psychological and social needs that were exacerbated by stigma, discrimination and non-disclosure of the children's HIV status by parents. This created underlying debilitating barriers for Social Auxiliary Workers to efficiently identify, and get children into treatment, care and social support services. The findings also revealed that Social Auxiliary Workers had limited, non-standardised and highly imperceptible HIV knowledge and skills to competently work with children living with HIV. Furthermore, findings showed that Social Auxiliary Workers face institutional and resource challenges that stem from poverty, insufficient financial resources within drop-in-centres and lack of structured large scale programmes to mobilise and educate communities on children and HIV. The study concluded that many of the biopsychosocial needs that children living with HIV face are not being comprehensively and sustainably addressed as Social Auxiliary Workers are not effective in their role, amongst other things, due to lack of skills and knowledge on how to address factors that contribute to the exclusion; and consequently, disproportionate low access of services by children living with HIV. The study proposes the training and capacitation of Social Auxiliary Workers on paediatric HIV so as to increase the depth and breadth of services rendered to children living with HIV. It is also important that regular and on-going supervision and debriefing opportunities for Social Auxiliary Workers should be strengthened to promote optimal consolidation of skills and knowledge. The provision of simplified practice guidelines and procedures should also be prioritised in order to ensure consistency in understanding amongst Social Auxiliary Workers of their role and obligations. Furthermore, it is recommended that Government and the Department of Social Development should consider scaling-up funding for drop-in-centres as well as implementation of HIV-related stigma and discrimination mitigation programmes in communities. / Mini Dissertation (MSW)--University of Pretoria, 2016. / Social Work and Criminology / MSW / Unrestricted

Certain individual and institutional factors such as knowledge about stigma and discrimination, fear of infection, social judgement, legal and policy environment act as actionable drivers and facilitators of HIV-related stigma and discrimination. These factors may hinder the utilisation and quality of care provided to people living with HIV. Purpose: The purpose of the study was to establish the actionable drivers and facilitators that determine the different forms of HIV-related stigma and discrimination among healthcare professionals at a district hospital in Malawi. Methods: The study used a descriptive correlational study. Data was collected through self-administered questionnaire. Data were analysed using SPPS and STATA 12. Fisher's Exact Test was used to conclude the association and binary logistic regression was used to model the degree of the statistical relationships. Results: The results showed statistically significant relationship between knowledge of stigma and discrimination, social judgement and awareness of workplace policy and HIV-related stigma and discrimination. Recommendations: Interventions aimed at increasing knowledge about HIV-related stigma, reducing social judgement, reinforcing HIV-related workplace policies are needed to reduce HIV-related stigma and discrimination in healthcare settings. / Health Studies / M. Ph. (Health Studies)

People who use illegal drugs all too often experience stigma and discrimination, criminalization and marginalization in Canada. Substance use has both immediate and chronic health consequences that may require healthcare. However, people who use illegal drugs often experience difficulty accessing equitable care, and stigma has been identified as a key barrier to access. This study explores the provision of health care by nurses in an emergency department for people who use illegal drugs, and the impact of hospital policies and procedures on nurses’ capacity to provide care. The study uses data from in-depth interviews with nurses and policy leaders, and analyses policy documents discussed by nurses in the interviews. This study found that neoliberal policies that result in downsizing of social programs means that patients come to emergency departments with a broad set of health and socials needs that extend beyond what nurses can do. The study also uncovered a lack of cultural safety for Aboriginal patients seeking care. Finally, the study discovered the existence of a culture of stigma in the emergency department. The culture of stigma is transmitted and taken up through individual attitudes, relations of power, intake and treatment protocols, critical policy absences and problematic policy. This study concludes with recommendations for policy development and for future research in this area. / Graduate / 0680 / 0573 / 0569 / heyriver@shaw.ca

People who use illegal drugs all too often experience stigma and discrimination, criminalization and marginalization in Canada. Substance use has both immediate and chronic health consequences that may require healthcare. However, people who use illegal drugs often experience difficulty accessing equitable care, and stigma has been identified as a key barrier to access. This study explores the provision of health care by nurses in an emergency department for people who use illegal drugs, and the impact of hospital policies and procedures on nurses’ capacity to provide care. The study uses data from in-depth interviews with nurses and policy leaders, and analyses policy documents discussed by nurses in the interviews. This study found that neoliberal policies that result in downsizing of social programs means that patients come to emergency departments with a broad set of health and socials needs that extend beyond what nurses can do. The study also uncovered a lack of cultural safety for Aboriginal patients seeking care. Finally, the study discovered the existence of a culture of stigma in the emergency department. The culture of stigma is transmitted and taken up through individual attitudes, relations of power, intake and treatment protocols, critical policy absences and problematic policy. This study concludes with recommendations for policy development and for future research in this area. / Graduate / 0680 / 0573 / 0569 / heyriver@shaw.ca

L'obésité est une maladie qui touche près de 15% de la population adulte en France. Elle est susceptible d'entraîner des complications sévères. L'obésité peut être considérée comme un stigmate et les représentations sociales des personnes en obésité sont discriminatoires. Les médecins partagent les représentations sociales communes. Le corps obèse fait rupture avec [l']idéal du corps confondu à la norme, et est une source de discrédit du corps hors normes. Les sujets en obésité subissent l'affichage de l'idéal du corps comme norme de corpulence mais aussi comme norme esthétique et comme signe de distinction morale. Ils sont pris dans un "dispositif" construit autour d'une injonction paradoxale : "consommez, soyez mince". / Obesity is a disease concerning around 15% of the French adult general population. It is usually associated with severe conditions. It can be considered as a sitgma and social views of obese persons are discriminatory. Practitioners do share those common views. The obese body breaks with an ideal body confounded with the standard, and is a cause of disgrace for the out-standard body. Patients with obesity endure the display of an ideal body as a norm of corpulence, but also as an esthetical norm and as a sign of moral distinction. They are caught in a "device" built around the paradox "consume, be thin".

In Canada mental health related concerns are estimated to cost the economy $20-$50 billion annually. 500,000 Canadian each week have to take time off of work because of a mental health disability. This study explores the experiences of people living with a mental health disability in the workplace. The goal is to provide an opportunity to highlight many of the obstacles they face every day. This study relies on qualitative methodologies, using semi-structured interviews to get a more detailed understanding of their experiences. This study not only highlights the perceptions, experience and challenges of people living with a mental health disability, it highlights coping strategies and suggestions for building mentally health workplaces. The participant’s personal narratives can help by providing a chance for a community to build and be used to challenge the stigma and discrimination associated with mental health. / October 2016

Migrant workers in the Deciduous Fruit Industry are part of the marginalised communities in South Africa. They are often voiceless in the communities they find themselves. They are historically displaced, often prone to xenophobia and very vulnerable in terms of HIV. Not only do they have a high infection rate but they also struggle in isolation to carry the burden of HIV and AIDS affection or infection. They will face double jeopardy when a partner becomes ill, in the homeland and they have to continue with employment. The main aim of this research was to reach a holistic understanding through interdisciplinary investigation. The important question that I aim to answer is; “What is the experience of God in the lives of persons affected or infected by HIV and AIDS.” I have looked at Postfoundationalism and the Seven Movements as proposed by Muller to present the research undertaken among migrant workers with HIV and AIDS. The Practical Theology, which I explore, develops out of a very specific praxis, HIV and AIDS. I have also made used of Transversal Rationality as a practical way of doing interdisciplinary work with the stories of my co-researchers affected with HIV AIDS as a case study. I understand that Christian belief has its own integrity, which is exclusive, but if valid, is vital to be able to incorporate the different dimensions of our modern practise to give it the maximum level of meaning and significance. I hope to demonstrate this possibility through my thesis. / Thesis (PhD)--University of Pretoria, 2010. / Practical Theology / unrestricted

Stigmatized obese individuals tend to internalize the pervasive weight stigma which might lead to self-discrimination and increased psychopathology. While explicit and implicit weight stigma can be measured using self-report questionnaires and Implicit Association Tests (IAT), respectively, the assessment of self-discrimination relied solely on self-report. The present study sought to develop an IAT measuring implicit self-discrimination (SD-IAT) in samples of obese individuals with and without binge-eating disorder (BED). Seventy-eight individuals were recruited from the community and individually matched in three groups. Obese participants with BED, obese participants without BED (OB), and a normal weight control group without eating disorder psychopathology (HC) were assessed with the SD-IAT and other measures relevant for convergent and discriminant validation. Results revealed significantly higher implicit self-discrimination in the BED group when compared to both OB and HC. Furthermore, significant correlations were found between the SD-IAT with body mass index, experiences of weight stigma, depressive symptoms, and implicit self-esteem. Finally, implicit self-discrimination predicted eating disorder psychopathology over and above group membership, and experiences of weight stigma. This study provides first evidence of the validity of the SD-IAT. Assessing implicit self-discrimination might further increase understanding of weight stigma and its significance for psychosocial functioning among vulnerable obese individuals.

The purpose of this study was to explore the nature of changes that take place in surviving HIVpositive spouses’ explanations of themselves in relation to their acquired positive status, and in relation to the role that forgiveness may play, all through Hermans’ theory of dialogical self in the self-identity reconstruction process. The interpretive qualitative paradigm was used, along with a phenomenological research design. Research was carried out in a rural area of Gwanda South Constituency in Zimbabwe. Homogenous purposive sampling was used to select five HIVpositive widows and five HIV-positive widowers. In-depth, semi-structured interviews were used and thematic, narrative and interpretive phenomenological analyses were employed to analyse the data. The results showed that the surviving HIV-positive spouses faced a plethora of challenges following the deaths of their partners. Identified key relations to the reconstruction of a new self were found to be: a good knowledge of HIV; being at peace with the past self; forgiveness of self; and reconciliation with what has happened. These were found to be good ingredients for quick recovery and self-identity reconstruction. Significant others play an important role in self-identity reconstruction as they offer an environment that is supportive of HIV disclosure, thereby reducing the occurrence of stigma and discrimination. The study recommends that HIV activists and all education systems that are involved in the HIV campaigns in Gwanda South Constituency incorporate teachings about and awareness of forgiveness, reconciliation, stigma and discrimination at all levels of their education efforts and campaigns. / Psychology / D. Litt. et Phil. (Psychology)

Doctor of Philosophy / Department of Family Studies and Human Services / Karen S. Myers-Bowman / The purpose of this study was to conduct a phenomenological inquiry into the impact HIV/AIDS-related stigma has on People Living with HIV/AIDS (PLHA) and their family members in Ghana and the overall relationship family members have with PLHA. The study explored the concept of stigma in the Ghanaian context, ways in which it is expressed, factors influencing HIV- related stigma and its consequences on both PLHA and their family members. Strategies that PLHA and their family members consider for effective HIV- related stigma prevention were also explored. The study further explored some of the gender- biased nature of HIV- related stigma in Ghana. Data was gathered qualitatively through interviews with five PLHA and their discordant family members. Interviews were transcribed and translated into English, coded and analyzed. After inductively establishing themes and categories, final confirmatory analysis was deductively established, by using the Bronfenbrenner’s ecological model and Symbolic interaction theory to affirm the authenticity and appropriateness of the inductive content analysis. The study found that HIV- related stigma begins with serostatus disclosure. Stigma is manifested in myriad contexts including the family, community, healthcare institutions and gender. The major factors influencing stigma are insufficient knowledge of HIV transmission, fear and misconception of HIV created by the media, cultural and religious factors as well as poverty. Family members experienced similar stigma as PLHA, such as loss of jobs, loss of social network, loss of identity and self stigma. However extreme impacts such as suicidal thoughts were only experienced by PLHA. The impact of HIV- related stigma is worst for women because of beliefs and values relating to gender- role expectations. While women accept and support their husbands when they have HIV/AIDS, women are often neglected and abandoned by their husbands. To address this stigma, participants suggested house to house education, financial support from the government, revision of educational content especially discontinuation of negative images of HIV/AIDS used by the media. Implications for this study in the areas of research, practice and policy are provided.