No abstract available. / Dissertation (LLM)--University of Pretoria, 2013. / gm2014 / Centre for Human Rights / unrestricted

Magister Public Health - MPH / Background-Namibia has a high HIV and malnutrition burden. HIV increases the risk of malnutrition and malnutrition results in rapid progression of the disease and worsening malnutrition. Nutrition plays an important role in the management of an HIV positive child. Optimal nutrition delays disease progression, improves immune function and the effectiveness of antiretroviral drugs thereby improving the quality of life of the child. Early identification of children at risk of malnutrition is therefore essential to prevent malnutrition in HIV positive children. Methodology-The study sought to determine the prevalence and the risk factors for malnutrition in 88 HIV positive children less than 18 months attending Hospital Paediatric ARV Clinic (HPAC). The study used quantitative methods. A questionnaire was administered to the child's caregiver to assess infant, caregiver and socio-economic risk factors for malnutrition after written consent had been obtained. The history of the patient was extracted from the HIV patient care booklet. Nutritional status was assessed using WHO standard growth charts in children and body mass index (BMI) in adults. Results- The study showed that 56.8% of children were wasted (14.8% had severe wasting), 52.3% were stunted (18.2% had severe stunting) and 69.3% underweight (20.5% were severely underweight). This level of malnutrition is much higher than the rates of 8% wasting, 29% stunting and 17% underweight in the general paediatric population. Malnutrition in children was associated with fewer number of working adults per family, frequent illnesses in the child, low level of caregiver education, caregiver unemployment, low household income and lack of adequate food in the family. Children of malnourished caregiver were more likely to be underweight. Conclusions- The results showed a high prevalence of malnutrition (56.8%wasting, 52.3%stunting and 69.3% underweight) among HIV positive infants attending the HPAC. The study showed that poverty and food insecurity were strongly associated with malnutrition in children. This therefore highlights the urgent need to address poverty to reduce malnutrition in the community. Although the study did not show any statistically significant association between feeding practices and malnutrition in children, health workers should encourage HIV positive mothers to breastfeed their infants as per the WHO and Namibian antiretroviral therapy guidelines (2010). Recommendations - There is need to train health workers to identify and manage malnourished children early. Linkages with social services must be improved and strengthened to help reduce poverty in the community. / South Africa

The purpose of this study was to estimate disparities in late human immunodeficiency virus (HIV) diagnosis and all-cause mortality among varying populations of HIV-positive Latinos, and to identify neighborhood-level predictors. Florida HIV surveillance data for years 2000–2011 were merged with 2007–2011 American Community Survey (ACS) data. Multilevel logistic regressions were used to estimate adjusted odds ratios (aOR) for late HIV diagnosis (acquired immunodeficiency syndrome within 3 months of HIV diagnosis). Multilevel weighted Cox regressions were used to estimate adjusted hazard ratios (aHR) for mortality. Of 5522 Latinos diagnosed 2007–2011, males were at increased odds of late diagnosis compared with females (aOR 1.37, 95% confidence interval [CI] 1.13-1.67). Associated factors included residing in the lowest quartile of neighborhood education for females, and in the 3 highest quartiles of unemployment for males. Foreign-born compared with United States (US)-born Latinos were also at risk (aOR 1.24, 95% CI 1.08-1.42). Among foreign-born, residing in areas with

Infection with the human immunodeficiency virus (HIV) in the adolescent/young adult population of the United States is a serious, growing problem. The current HIV risk-reduction strategies for adolescents have been less than effective in stemming the tide of infection. This ineffectiveness can be linked to failure of making developmentally appropriate risk-reduction informational material and reliance on condom-based interventions, which have an unacceptably high failure rate. A critical analysis of current models of HIV-risk reduction should be undertaken to create more developmentally appropriate and effective methods.

Background The development of HIV preventive measures in Thailand has led to a decrease in prevalence in HIV-infected persons. During 2021 there was an estimated number of 520 000 people living with HIV in Thailand amongst adults over 15 years and an estimated number of 2000 children between 0 to 14 years old. Studies have shown that the current obstacles with HIV prevention in Thailand is correlated with HIV-related stigma and therefore being at risk to retrieve the infection. Non-governmental organizations (NGOs) and research groups, are important actors in HIV prevention.  Aim The aim of this study was to examine experiences of HIV preventive work in children, adolescents and young adults among staff in an HIV prevention-oriented organization and a research group in Thailand.  Method A qualitative design was used, and seven semi-structured interviews were conducted with a convenient selected sample. Participants were conveniently recruited from two different population groups, two participants from an HIV prevention-oriented organization and five participants from a research group in a clinical HIV-unit. The interviews were transcribed and analyzed through a content analysis with an inductive approach.  Results Three main categories were identified: Success factors in HIV prevention, Barriers to HIV prevention and Future directions. Eight subcategories were identified: Access to HIV testing, Access to information, Sharing experiences, Collaboration between agencies working with HIV prevention, Decrease in Stigma, Limitations in time and money, Difficulties in adherence to HIV prevention and Stigmatization in HIV. Conclusions HIV prevention needs to be more accessible. Today HIV testing is available for free, however, there are still obstacles to preventive work that ought to be considered, stigmatization and discrimination are such barriers. Future directions in preventive work are increased accessibility to HIV prevention.

Purpose: To recognize and raise awareness about the psychosocial status and health outcomes in older adults living with HIV. Method: A literature search was conducted from the disciplines of nursing and medicine using the CINAHL, PubMed, and Medline databases. Inclusion criteria: articles exploring older adults who are HIV positive and factors related to depression, suicide and available healthcare resources. Exclusion criteria: articles including individuals under the age of 50 infected with HIV/AIDS and articles focused entirely on physiologic principles of HIV/AIDS. Results: In older adults living with HIV/AIDS, the literature review disclosed a comprehensive gap between identifying this age group as 'at risk', lack of communication between health care providers and older adults concerning sexual activity and/or status, and recurring psychosocial components related to lack of resources and standards of care among older adults living with HIV/AIDS. An unbalanced amount of research has focused on the care and prevention of HIV/AIDS among young adult populations, while a limited amount of research is geared toward detection, prevention and interventions for HIV/AIDS in older adults. Findings suggest that HIV/AIDS is a syndrome of bias based on age and/or gender by health care providers. Solutions to this epidemic must begin with an all inclusive plan that investigates the prevention, identification and intervention across the lifespan. Discussion: As the country ages and the population of older adults increase, nurses will encounter an increasing number of older adults living with HIV/AIDS. In order to competently provide quality care to older adults with a positive HIV/AIDS status, further research is needed to bridge the gap of literature connecting psychosocial aspects of care and accompanying health outcomes.

No description available.

No description available.

Bakgrund: Hiv är ett kroniskt virus som angriper immunförsvaret. Det råder stor okunskap kring hiv samt en hel del fördomar och stigmatisering i samhället gällande de som är hiv-positiva. En diagnos medför en stor livsomställning och en transition genomgås. Det ligger i sjuksköterskans profession att bemöta varje person och hjälpa dem i den övergång som sker samt ge information angående hälso- och smittorisker. Syfte: Syftet var att beskriva upplevelsen av att få ett positivt hiv-besked och hur diagnosen hanteras. Metod: Innehållsanalys av biografier används för att belysa personernas subjektiva upplevelser. Resultat: I resultatet framkommer tre teman.  Att få döden som följeslagare; där det framkommer att beskedet är sammankopplat med olika känslor och är unikt för varje person, döden står i centrum.  Att stänga dörren eller komma ut; valet att leva öppet med sin sjukdom eller hålla den hemlig är kopplat till stigmatisering.  Slutet på livet eller början på något nytt; hur personerna hanterar och accepterar situationen så en transition kan genomgås. Slutsats: Med arbetet kan en ökad förståelse för hiv-smittade personer uppnås. Genom att öka kunskapen kring hiv bland vårdpersonal kan en mer individuell vård ges till dessa personer. / Background: Hiv is a chronic illness which attacks the immune system. There is an ignorance around hiv and prejudices and stigmatisation in the community regarding the hiv-positives. A diagnosis brings a life adjustment and the person goes through a transition. The nursing profession contains the meeting with individuals and helps them through the transition and give information about risks of health and infection. Aim: Describe the experience of knowledge about a positive hiv-diagnosis and the management of the diagnosis. Method: A content analysis of biographies uses to illustrate the individuals subjective experiences. Results: Three themes arrives in the result. Death as follower; it reveals that the announcement of the hiv-diagnosis is linked to different feelings and it’s unique for each person, death is crucial. Close the door or come out; the choice to live openly with the disease or keep it as a secret is connected to stigmatization. The end of life or the beginning of something new; how to deal with and accept the situation so a transition can lives through. Conclusion: This study can contribute to an increased comprehension forpeople who lives with hiv.  The knowledge about the diagnosis could contribute to a more individual medical care.

Bakgrund: HIV/AIDS är idag en sjukdom som varit känd för oss i snart tre decennier. Synen på människor som har HIV har förvisso ändrats. Trots förändringar upplever personer med HIV fortfarande negativa attityder, diskriminering och socialt utanförskap både ute i samhället och inom sjukvården. Vid en närmare granskning av litteraturen visar det sig att attityder och rädslor finns kvar mot personer med HIV även hos sjukvårdspersonal. Syfte: Att undersöka sjuksköterskestudenters attityder till personer med HIV. Med frågeställningarna: Hur ser sjuksköterskestudenternas avståndstagande attityder till personer med HIV ut? Hur ser sjuksköterskestudenternas empatiska attityder till personer med HIV ut? Och finns det en önskan att kunna avstå från att vårda personer med HIV. Metod: Studien är deskriptiv kvantitativ med ett frågeformulär baserat på Aids Attitude Scale AAS, ett instrument som mäter avståndstagande och empatiska attityder till personer med HIV. Respondenterna grupperades utifrån ålder, vårderfarenhet och erfarenhet av att vårda patienter med HIV och jämfördes med varandra. Kvalitativa inslag finns i mätinstrumentet i form av möjligheter för respondenten att lämna kommentarer till det sista påståendet om jag gavs valmöjlighet skulle jag avstå från att vårda patienter med HIV. Resultat: Resultatet visar att respondenterna överlag har positiva attityder till personer med HIV. Resultatet visar att respondenterna i de äldre åldersgrupperna, 26- 30 år och 31- 45 år och de som hade tidigare vårderfarenhet, samt de som hade tidigare erfarenhet av vård av personer med HIV uppvisade mindre avståndstagande attityder men också mindre empatiska attityder. Andelen respondenter som ställde sig bakom påståendet om jag gavs valmöjlighet skulle jag avstå från att vårda patienter med HIV, var högre i grupperna där åldern var lägre, gruppen 20- 25 år och hos de som inte hade vårderfarenhet eller erfarenhet av att vårda patienter med HIV. Kunskap och utbildning kan vara av betydelse för att attityderna mot personer med HIV ska kunna ändras. Konklusion: Erfarenhet av att vårda sjuka människor i allmänhet och att vårda sjuka människor med HIV i synnerhet kan leda till lägre avståndstagande attityder mot personer med HIV.