Auswahl der wissenschaftlichen Literatur zum Thema „AIDS (Disease), Social aspects. Namibia“

Research trends in psychosocial aspects of HIV-AIDS are reviewed, exploring the role of psychosocial cofactors in disease progression. This is undertaken within a biopsychosocial model and gives cognisance to the role of psychosocial stress, social support, and emotional adjustment. Research data from a study of biopsychosocial interrelationships in a sample of HIV-positive patients show a significant correlation between social support and emotional adjustment and that social support exerts a mediatory, stress-buffering effect in these patients. Some observations are made on aspects of the social conditions of South Africans with HIV-AIDS.

Background: This study presents an assessment of knowledge and an investigation of specific factors that expose young female student nurses to HIV and AIDS at university of Namibia, Oshakati Campus. The concern over to what young female student nurses are able to control various issues of their sexual lives is critical question for health promotion and the prevention of further HIV infection. Student nurses are believed to have adequate information about HIV and AIDS compared to other young people in the communities.Aim: To assess HIV and AIDS knowledge levels and investigates factors that make young female nurses vulnerable to HIV infection at UNAM, Oshakati CampusMethod: A mixed-method approach was employed to collect the necessary data, a combination of qualitative and quantitative methodology. Qualitative data was collected through a self-administered questionnaire whereas qualitative data was gathered by means of focus group discussions. Quantitative data was analyzed using the Statistical Package for Social Sciences (SPSS) 18, and results from the focus group discussions were grouped into themes and subthemes and analyzed using thematic analysis. Random sampling with replacement technique namely, the fishbowl technique was used to select respondent and participants. This ensures equal and independent chance of being selected each time.Results: Most respondents indicated to have adequate knowledge about HIV and AIDS and had positive attitude necessary to effect behavioral change and implementation of prevention and care strategies. Most respondents were aware of their risk factors and aspects that increased individual vulnerability to HIV and AIDS. While the knowledge and attitude were identified as adequate, the practices of the respondents did not explicit indicate adequate level of responsible behavior among the young female student nurses in the face of HIV and AIDS.Conclusion: Student nurses identified HIV and AIDS as a problem of “others” and continue to report that infection would be an accidental exposure as a result of their profession or perceived powerless over sexual matters and income inequalities. Prevention remains a challenge in planning programs needed to address risky sexual behavior among students due to structural, social, socio-economic dynamics, individual circumstances, gender and biological vulnerability.

In little more than a decade, the AIDS epidemic has exerted a profound effect on morbidity and mortality among young adults and children in many parts of the world. One of the more dramatic aspects of AIDS is that it seems to have arisen almost spontaneously as a new epidemic, spreading rapidly within at-risk populations in a way that is unprecedented for the serious infectious diseases of recent memory. Tuberculosis, on the other hand, had only recently been considered a disease of historical importance but of diminishing relevance to current public health priorities, especially in industrialized countries. Over the past decade, however, and in parallel with the AIDS epidemic, there has been a resurgence of tuberculosis in many of the same populations most affected by HIV infection. This has had important implications for clinical practice, public health, and the development of appropriate health policy. A number of elements have converged to promote the development of HIV-related tuberculosis, including biologic, social, and environmental factors. These will be discussed both to provide a context for understanding the relationship between the two epidemics, and as a basis for suggesting strategies for tuberculosis control in the AIDS era.

The oral research community needs an understanding of the social causes, consequences, and costs of disease in relation to oral health. This workshop concluded that HIV infection constitutes a special dental need requiring specific arrangements to facilitate oral care for infected persons. Oral manifestations of HIV infection affect everyday life, but more evidence is needed on the effects of interventions to alleviate these impacts. Other oral health habits add to the burden of HIV/AIDS-associated oral diseases and compete with them for resources. These problems are most acute where the prevalence of HIV is high and resources are scarce. Effective health promotion is therefore important in these areas. Without data on the utility of oral health care in developing countries, practical approaches are guided by societal and multidisciplinary principles. There are also important ethical considerations

The article provides a brief overview of the literature, which deals with the issues of heroin addiction, its history, prevalence, statistics, clinical characteristics, diagnostics, prevention and countermeasures, as well as programs aimed at social rehabilitation and harm reduction from injecting drug use. Issues such as physiological foundations and features of disease and remission formation, withdrawal, motivational attitudes of drug users, structure users of narcotic substances, the impact of pre-morbid features, socio-demographic, clinical-dynamic, regional and gender aspects of heroin addiction, and also existing approaches to therapeutic and preventive measures are considered in narcology. Medical and social consequences expressed in the form of the spread of hemo-contact infections, such as HIV/AIDS and viral hepatitis; risky behavior and its impact on the growth of sexually transmitted infections; reducing and completely losing social status; suicide-aggressive actions have been studied. The analysis of data on the study of the prognostic value of the socio-demographic and clinical-dynamic characteristics of heroin addiction and its effect is provided on the outcome of the disease. Keywords: Drugs, drug addiction, heroin addiction, opioids, addiction treatment

Our practical experience of anthropology in the field of HIV/AIDS and many researchers’ commitment in such scientific programs showed that social sciences’ approach of chronic disease in African cultural context includes relevant epistemological and methodological issues. The purpose of this article is to give an overview of these issues while showing the contribution of the anthropological approach to the comprehension of the health phenomena related to the AIDS in the African environment. The approach to this was to review the literature on fieldwork already done on HIV / AIDS in the social sciences. The results of our analysis indicate that medical research on HIV / AIDS in African cultural context has mobilized social sciences mainly anthropology in its various specialties which alongside Biology, Epidemiology and Clinic have led to the development of an inclusive approach of the disease. This interactive approach between social sciences and medical sciences allowed fulfilling the limits of medicine’s quantitative approaches and thus to grasp the AIDS pandemic in these epidemiological, behavioral and representational aspects.

OBJECTIVE: To describe the epidemiological aspects of HIV infection and AIDS among indigenous peoples of the state of Mato Grosso do Sul, Brazil. METHODS: This is a descriptive epidemiological study on the occurrence and distribution of HIV infection and AIDS in the indigenous population assisted by the Distrito Sanitário Especial Indígena (Indigenous Special Health District) Mato Grosso do Sul between 2001 and 2014, based on three secondary databases. Annual rates of HIV and AIDS detection and prevalence were calculated, considering case distribution according to village, Health Base Pole and sociodemographic variables. Accumulated rates of detection, mortality and case fatality were calculated by ethnic group and for the Health Base Pole with the highest number of cases. RESULTS: The HIV detection rate fluctuated between 0.0 and 18.0/100 thousand people in the study period. For AIDS, there was no notification before 2007, but in 2012 its rate reached 16.6/100 thousand. HIV prevalence grew between 2001 and 2011, and it continuously grew for AIDS starting from 2007. The highest HIV detection rates occurred among Guarani peoples (167.1/100 thousand) and for AIDS, among the Kaiowá peoples (79.3/100 thousand); mortality and fatality rates were higher among the Kaiowá. Regarding the Dourados Health Base Pole, the AIDS detection rate increased, and the mortality and fatality rates decreased. CONCLUSIONS: HIV infection and AIDS have been increasing among indigenous peoples, with distribution of the disease mainly in the Health Base Poles of the southern region of the state, where greater economic and social vulnerability are also observed. The endemic character of HIV and AIDS can become epidemic in some years given the existence of cases in other villages in the state. Its occurrence among the Guarani and Kaiowá populations indicates the need for expanded diagnosis, access to treatment and prevention measures.

The acquired immune deficiency syndrome (AIDS) is an infectious disease caused by human immunodeficiency virus (HIV). Approximately about 37 million people are infected by this virus with the rate of 1.2 million deaths per year. The mortality rate is high among HIV infected patients in the first 6 months of treatment.1 Immune deficient cases are at the high risk of any opportunistic infection. AIDS has been closely linked with tuberculosis (TB) disease, so almost one third of total mortality is related to this co-infection. In this regard, tuberculosis is used as a diagnostic index for AIDS.2 AIDS is not only associated with high mortality and morbidity, but it affects social life with related stresses and anxieties.3 Considering vast influence of HIV-TB over peoples’ lives, the present study aimed to estimate direct global burden of HIV infection on the patients with TB in a one-year period in 2014.

AIDS, its cause, effect, and possible cure, has become a complex sociopsychological issue with ramifications extending far beyond the purely medical sphere. Spreading rapidly, with a higher incidence rate recorded among young people, the disease transcended the biomedical sphere, presenting sociocultural and psychological ramifications that go beyond its physical impact. With a higher incidence rate among male homosexuals, the epidemic raises morally sensitive questions which further confuse an already clouded picture. Current knowledge on the sexual transmission of AIDS and the role of male homosexuality demonstrates the need for more serious research into the various social and cultural aspects of homosexuality itself. To this end, medical anthropology may provide important information to those dealing with educational and preventive programs for the general population, as well as those in high risk groups for acquiring the disease.

The HIV and AIDS crisis can be presented as a socio-ecological issue, with an ever-increasing impact on both human beings and the environment. Teaching about socio-ecological issues and the consideration of individual capabilities has become crucial within HIV and AIDS education programmes. Issues of deforestation, land degradation and other environmental problems have worsened since the advent of HIV and AIDS, especially in developing countries. The My Future is My Choice (MFMC) programme has been identified as an important HIV and AIDS education initiative that caters for young people in Namibian secondary schools (Grades 8-12). One of the themes within the programme (Facing HIV and AIDS) is highlighted in this study. This study was constituted as a case study of one school in rural Omuthiya, in the Oshikoto region. The study investigated the opportunities for the integration of a focus on socio-ecological issues and risks, within the MFMC education programme. The study also investigated the way in which the program develops learners‟ capabilities to respond to HIV and AIDS related socio-ecological issues and risks/vulnerabilities. The study also presents the constraints and enabling factors influencing the implementation of the programme. This study used a qualitative, interpretive case study methodology. The research methods included the analysis of eight documents and nineteen semi-structured interviews, with the Programme Coordinator, the Programme Facilitator, the School Principal and with the programme participants. The analysis also included two focus group discussions with a group of learners; and two classroom observations; and the learners' submissions (reflection sheets). Convenience sampling was used, and ethical issues were taken into consideration throughout the study. The study revealed the following as key findings:  The aims and objectives of the HIV and AIDS education programme can enhance and constrain the development of capabilities, as well as opportunities and challenges for the integration of a focus on socio-environmental issues and risks as additional learning content.  Teaching and learning methods that are participatory and rooted within the learner centered approach can make the integration of HIV and AIDS inherent socio-environmental issues and risks into the MFMC education programme possible.  The values and beliefs inherent within the MFMC education programme stand as opportunities for the successful development of capabilities in the education programme. The study concluded by recommending that capabilities within the MFMC programme be developed through teaching learners about their rights, respect for human dignity, and the right to health and to living the life free from discriminatory practices, as a moral entitlement of each and every individual. While teaching learners about their right to health and the importance of healthy diets, this study found that the programme could include learning about food production and handling practices for the benefit of those living with HIV and AIDS, while caring for the environment. Another recommendation was that future research should consider actively involving young people in decision-making with regard to the programme, as this will allow them to choose and decide on what knowledge and skills they need and want to acquire. The study further explained that this will promote the programme participants‟ sense of agency, and their freedom to choose what they value being and doing as an important element in enhancing learner capabilities. Ultimately, this will also enable the learners to acquire the necessary skills and knowledge they need in order to respond to the socio-ecological problems they face in their communities.

Thesis (MBA)--Stellenbosch University, 2004.
ENGLISH ABSTRACT: HIV/AIDS is one of the biggest challenges faced by many countries in this century. The rate of infection is rapidly increasing and more and more people are getting ill and dying from AIDS. Of all the people living with AIDS in the world, seven out of ten live in Sub-Saharan Africa. Namibia is one of the top five most HIV/AIDS affected countries in the world. There is therefore no question about the urgent need to accelerate actions to reduce prevalence, expand care and support and extend access to treatment. AIDS is eroding decades of progress made in extending life expectancy; thus hundreds of adults are dying young or in early middle age. The national strategic plan (2004) on HIV/AIDS indicated that the average life expectancy in Namibia is now 42 years, when it could have been 60 without AIDS. A 2003 study on the impact of HIV/AIDS on Windhoek indicated that the antenatal HIV/AIDS prevalence rate in Windhoek for 2002 was 27%, while the national prevalence rate was estimated at 22.3%. The prevalence rate for Windhoek is expected to reach its peak at 38% during 2005. Even though HIV/AIDS will have a diminishing effect on population growth, Windhoek's population is expected to continue growing, particular as a result of inward migration, but at a slower pace. Similarly, HIV/AIDS will have an abating effect on GDP growth as the virus will mainly affect the economic active and available labour force of the population and result in increased labour costs and skilled labour shortages. The impact on the informal sector is potentially more damaging than on the formal economic sector, as the majority of micro- enterprises and informal businesses are build around one individual. As the breadwinner dies, household income and expenditures levels deteriorate and increase poverty levels, because households within the city are very dependent on family structures to support their income levels. Informal settlements are also more volatile to HIV transmission and the majority of HIV infected individuals are likely to be found within these areas as the populations is poorer, crowded, has fewer social services facilities and is more likely migratory compared to those in affluent formal settlements. Considering that the incubation period of HIV/AIDS from infection to death takes about ten years, the real impact of current HIV infections in Windhoek will only be experienced during 2010. Health services will have to attend to a greater demand for curative services as well as to social care and support programs. Social welfare programmes will need to find ways of caring for a large population of HIV/AIDS orphans. Municipalities can playa critically important role in addressing HIV/AIDS at a local level as they are at the interface of community and government. They are ideally placed to playa coordinating and facilitating role that is needed to make sure that partnerships are built to bring prevention and care programmes to every community affected by AIDS. Therefore, in order to succeed in confronting HIV/AIDS, it is important to work closely with all levels of government as well as working with local partners in civil society that are fighting HIV/AIDS at the community level. By taking action against HIV/AIDS, municipalities are securing the future of their towns and communities.
AFRIKAANSE OPSOMMING: MIV/VIGS is een van die grootste uitdagings wat baie lande hierdie eeu in die gesig staar. Die koers van infeksie is vinnig aan die toeneem en al hoe meer mense word siek en sterf as gevolg van VIGS. Van al die mense wat met VIGS lewe in die wêreld, bly sewe uit tien in sub-Sahara Afrika. Namibië is een van die vyf mees MIV/VIGS geaffekteerde lande in die wêreld. Derhalwe is daar geen twyfel rakende die noodsaaklikheid om daadwerklike aksies te bewerkstellig om die voorkoms te verminder, sorg en ondersteuning te verhoog en toegang na behandeling uit te brei. VIGS vernietig dekades van groei behaal in die verlenging van lewensverwagting; dus sterf honderde volwassenes vroeg of gedurende hul middeljare. Die nasionale strategiese plan (2004) rakende MIV/VIGS toon dat die gemiddelde lewensverwagting in Namibië huidiglik 42 jaar is instede van 60 sonder VIGS. 'n Studie onderneem gedurende 2003, rakende die effek van MIV/VIGS in Windhoek, dui aan dat die voorgeboorte MIV/VIGS voorkoms koers 27% vir 2002 was, terwyl die nasionale voorkoms koers slegs 22.3% was. Daar word verwag dat die voorkoms koers vir Windhoek sy maksimum van 38% sal bereik gedurende 2005. Alhoewel MIV/VIGS 'n negatiewe effek op bevolkingsgroei groei gaan het, sal Windhoek se inwoners getalle steeds groei, alhoewel teen 'n stadiger koers, as gevolg van inwaartse migrasie. Terselfdertyd, gaan MIV/VIGS 'n verminderde effek het op die groei van die Bruto Binnelandse Produk (BBP), omdat die virus hoofsaaklik die ekonomiese aktiewe en beskikbare arbeidsmag van die bevolking affekteer wat as gevolg hiervan 'n verhoging in arbeidskoste en tekort aan geskoolde arbeid het. Die effek op die informele sektore is potensieel meer skadelik as op die formele ekonomiese faktore, aangesien die meeste klein en informele besighede rondom een persoon gebou is. lndien die broodwinner sterf, versleg die vlakke van huishoudelike inkomste en uitgawes wat lei tot verhoogde armoede, omdat huishoudings in die stad baie afhanklik is op familie strukture om hulle inkomste te ondersteun. Informele vestigings is meer kwesbaar in die oordrag van MIV en die meerderheid van die MIV geïnfekteerde individue word gewoonlik in hierdie areas aangetref omdat die bevolking armer is, meer persone huisves, minder welsyn dienste fasiliteite het en meer swerwend is in vergelyking met die meer welgestelde formele vestigings. As in ag geneem word dat die ontkiemings periode van MIV/VIGS vanaf infeksie tot en met sterfte omtrent tien jaar neem, sal die werklike effek van die huidige VIGS besmettings in Windhoek slegs ervaar word gedurende 2010. Gesondheidsdienste sal moet aandag skenk aan 'n groter aanvraag vir geneeslike dienste sowel as sosiale sorg en ondersteunings programme. Gemeenskaplike welsyn programme sal maniere moet vind om vir 'n groot populasie van MIV/VIGS weeskinders te sorg. Munisipaliteite kan 'n belangrike rol speel in die aanspreek van die MIV/VIGS epidemie op 'n plaaslike vlak omdat hulle die skakel is tussen die gemeenskap en die regering. Hulle is ideaal geplaas om 'n koordineerende en fasiliterende rol te speel wat nodig is om seker te maak dat vennootskappe gebou word om voorkomings en versorgings programme te lewer aan elke gemeenskap wat deur MIV/VIGS geraak word. Dus, om sukses te behaal in die bekamping van MIV/VIGS , is dit belangrik om nou saam te werk met alle vlakke van die regering sowel as met plaaslike vennote in die gemeenskap wat MIV/VIGS bekamp op gemeenskapsvlak. Deur aksie te neem teen MIV/VIGS , kan munisipaliteite die toekoms van hulle dorpe en gemeenskappe verseker.

This study focuses on the impact of HIV/AIDS on women in Namibia. Namibia, with a population of only 1.7 million people, is ranked as the seventh highest country in the world in terms of HIV/AIDS infections. The percentage of women living with HIV/AIDS in Namibia accounts for 54% of the total of 68 196 people in the country living with the virus. Women are also diagnosed with the disease at a younger age (30) in comparison to their male counterparts (35 years). Desoite their needs, women living with HIV/AIDS bear a triple burden of caring for those living with HIV/AIDS, caring for themselves and coping with the responses to their infection. There are few focused intervention strategies to support and care for women living with HIV/AIDS in Namibia.

HIV and AIDS still challenges the best efforts of public health and medical establishments and continues to ravage communities around the world. While measures have been put in place to preclude it from further spread, recent studies in the field of HIV and AIDS prevention intimate that for more efficacious intervention to be realized, it is critical to understand and address the social and cultural practices which influence sexual behavior, particularly understanding how issues of masculinity plays a role in the perpetuation of these behavior. Relying on Bourdieu’s theory of social practice, this study explores the inherent enduring nature of habitus and its role in the production and maintenance of masculine and sexual identities that predispose young men to HIV and AIDS. The study was conducted in Rundu Urban Constituency in Kavango Region of Namibia to gain insight into male youth’s masculinity and conceptions of risk and vulnerability to HIV and AIDS. The study design was qualitative and interpretive in nature. Data collection strategies included focus group discussions and individual interviews. Twelve male youth aged 17-20 years in two secondary schools (six in each) were selected to participate in the study. Four focus group discussions and fourteen individual interviews were conducted. Institutional ethical clearance from both regional education office and the schools were obtained before undertaking the study. Participants also signed written consent forms before interviews started. The findings of this study revealed that young men from this community were under constant pressure to conform to dominant masculine norms and values. Key in the case of youth in the study was the need to procreate as a dominant marker of one’s masculine and sexual identity because it represented a primary source of a ‘real’ man’s social identity in this community. This masculine and sexual identity seemed in itself to be constructed along paternal lines and cultural beliefs, which youth preserved by not only complying, but also reproducing. The sexual activities they reported that would secure their position as `real` men were often those that put them at risk and made them vulnerable to the epidemic.

This study emerged from the high prevalence rate of HIV and AIDS infection among women in Sub-Saharan Africa, which has no exception to Namibia. Women have been vulnerable to HIV and AIDS let alone on sex related issues since the epidemic emerged, but not research has been done specifically to Okalongo women. The way in which women vulnerable to HIV and AIDS infection were explored by examined social and cultural identities that affect women’s sexual relations in negotiating sex and safe sex. Qualitative study on a sample of fifteen women was conducted in Okalongo. The purpose of this study was to investigate the conceptions and experiences of women in negotiating sex and safe sex with their husband and partners. Feminist theory guided the methodology and analysis of data. I assumed that gender roles andsexuality are socially constructed, shaped by religion, social, political, and economic influences and modified throughout life. Feminist theory assisted in documentary the ways in which the female’s gender and sexuality in Okalongo is shaped by cultural influences and by institutions that disadvantage female and other oppressed groups by silencing their voices. The feminist further guided the discussion of the contradicting messages about women’s sexuality and their experiences, as women complied, conformed and even colluded with their oppression. To address the issue under study, the primary analysis of data from the focus group discussion and individual interview were utilised. The following themes were the heart of analysis: Women Positionality, Normalisation and Compliance, Women Agency and Male Dominance Power, Women Perceptions of Risk, Sex Education in and out of school among Women.In this study the data suggested that women in Okalongo are more vulnerable to their lack of assertiveness, as they have difficult in developing an authoritative voice, they tend to be humble about their achievements and knowledge and to only assertively when concerned about others. The findings supported the literature that women’s vulnerability is strongly influenced and tied by broader forces present in the society. Women’s vulnerability is real and needs to be tackled for any progress to occur in the fight against AIDS. Until factors that constraints and enabling women agency to negotiate sex and safe sex acknowledged and addressed, women will continue to succumb to the HIV pandemic.

Thesis (MA)--Stellenbosch University, 2005.
ENGLISH ABSTRACT: An exploratory study was conducted to determine the psychosocial stressors of women living with HIV/AlDS. The study also included the utilisation of group work by social workers to support HIV positive women. The exploratory study was also conducted to determine HIV positive women's experiences in a support group. The researcher's interest in group work, as well as her involvement with a support group with HIV positive women, is the motivation for the study. The aim of the study is to provide an explanation of the psychosocial stressors that HIV positive women experience and also to capture their experiences regarding the support group they attend. Nine psychosocial stressors, namely anger, fear, loss, grieve, guilt, denial and disclosure, depression, suicidal behaviour and anxiety, were included in the literature study. The advantages, disadvantages and components of group work, as well as comparisons of effective and ineffective groups, were highlighted. The research also focused on planning a group for women with HIV/AlDS, with special attention given to the needs assessment, the purpose of the group, the group composition and the structure of the group. The value of group work with HIV positive women was investigated. The universum was HIV positive women at the Walvis Bay Multi-Purpose Centre. The qualitative research method that was used took the form of structured interviews. The results of this study generally confirmed the findings of the literature study. Recommendations include ways in which social workers can assist HIV positive women not only on an individual basis but also especially in a group setting, and recommendations concerning future research. The importance of future research with HIV positive women was especially recommended.
AFRIKAANSE OPSOMMING: 'n Verkennende studie is onderneem om die psigososiale stresfaktore wat HIV positiewe vroue ondervind, te bepaal. Die studie het ook maatskaplike werkers se gebruik van groepwerk om HIV positiewe vroue te ondersteun, ondersoek. Die navorsing is voorts onderneem om HIV positiewe vroue se ervarings van 'n ondersteunersgroep te bepaal. Die navorser se belangstelling in groepwerk, en haar betrokkenheid by 'n ondersteunersgroep vir HIV positiewe vroue, was die motivering om die studie te onderneem. Die doel met die studie is om die psigososiale stresfaktore wat HIV positiewe vroue ondervind, te beskryf en te verduidelik, en ook om sommige van die ervarings wat sulke vroue in 'n ondersteunersgroep ondervind, te boekstaaf. Nege psigososiale stresfaktore, naamlik woede, vrees, verlies, droefheid, skuldgevoel, ontkenning en onthulling, depressie, selfmoordgedrag en angs, is in die literatuurstudie bestudeer. Die komponente en voor- en nadele van groepwerk, asook 'n vergelyking van effektiewe en oneffektiewe groepe is ook ingesluit. Die beplanning van 'n groep vir HIV positiewe vroue is benadruk, met spesiale verwysing na die behoeftebepaling, en die doel, die samestelling en die struktuur van die groep. Die waarde van groepwerk vir HIV positiewe vroue is ook ondersoek. Die universum is HIV positiewe vroue by die Walvisbaai Multi-Purpose Centre. Die kwalitatiewe navorsingsmetode wat gebruik is, is gestruktureerde onderhoude. Die resultate van die studie het in die algemeen die bevindinge van die literatuurstudie onderskryf. Aanbevelings sluit in wyses waarop maatskaplike werkers HIV positiewe vroue nie alleen op 'n individuele basis nie, maar ook in groepsverband kan ondersteun, asook moontlike gebiede vir verdere navorsing. Die belang van verdere navorsing met HIV positiewe vroue word veraI beklemtoon.

Studies on the impact of HIV/AIDS on health workers conducted in the health sector in different countries in Southern Africa have shown that health workers are affected and infected by HIV/AIDS. This has affected the provision of care rendered by nurses negatively. The high workload emanating from increased numbers of patients contributed to the situation. As a result, a number of nurses suffer from stress related illnesses caused by many factors such as fear of contracting the HIV virus. Low staff morale has also been observed among nurses. The aim of this study was to study nurses perceptions, views and suggestions on the impacts of HIV/AIDS on the provision of health care in terms of increased workload, stress, low morale and fear of contracting HIV/AIDS in two medical wards and a TB ward in one regional hospital in Namibia.

Each year approximately 600 000 infants, most of them in Sub-Saharan Africa are born with HIV infection as a result of mother to child transmission of HIV. Whereas significant progress has been made in reduction of mother to child transmission of HIV in developed countries, the situation remains desperate in developing countries. Progress has been hampered by shortage of staff, facilities, limited access to voluntary counselling and testing and lack of support for women by their partners and communities. The challenge is to increase voluntary counselling and testing uptake during antenatal care. Onandjokwe district in Northern Namibia is currently introducing the Prevention of Mother to Child Transmission Program (PMTCT). It has been found the previous PMTCT programs have failed because they adopted a top down approach where there was no community consultation. This study was conducted to explore the community perceptions, knowledge and attitudes regarding mother to child transmission of HIV through focus group discussions and in-depth interviews of key community members.

Prejudice and discrimination against people infected with Acquired Immune Deficiency Syndrome (AIDS) is widespread. A significant body of research has examined what personality and demographic characteristics appear to be related to discriminatory behavior, in an attempt to suggest who might be more likely to express prejudicial attitudes and discrimination against people with AIDS. This study tested two causal models which attempted to verify existing theories explaining the influences of demographic and attitudinal factors on the evaluation of a person with AIDS. Specifically, these models sought to answer questions related to what personality characteristics and demographic information are most important to AIDS educators and counselors when examining prejudice and discrimination towards persons with AIDS. Three hundred university undergraduates participated in the study. Structural equations modeling was used to analyze the extent to which the models fit the data. Results showed that both models adequately explained the data, with the model establishing a direct causal link between homophobic attitudes and AIDSbased prejudice as the preferred model. Alternative models were also considered in a post-hoc fashion. Implications of the results are discussed, with specific emphasis given to the potential ramifications to further research, counseling practice, and AIDS education.
Department of Counseling Psychology and Guidance Services

This thesis explores the relationship between law and society and various forms of causality: (1) legal change leading to social change; (2) social change leading to legal change; and (3) the interdependent interaction between social change and legal change. It is proposed that a multi-directional approach would be the most useful in examining the moral boundaries exemplified in the law identified with legal and social changes that have resulted in response to the AIDS epidemic.

AbstractAfrica continues to experience the highest infectious disease burden despite an increase in investments. These include investments in malaria, HIV/AIDS, tuberculosis, as well as in communicable diseases. The global targets are to reduce the burden of these diseases through improved surveillance, prevention of outbreaks, effective case management, elimination and eventually, eradication. Achieving these targets, however, is limited by the poor geographic descriptions of the disease burden. Of the big five infectious disease burdens, malaria is the most advanced in terms of mapping its distribution. Malaria cartography has since formed the evidence-base for the design of many national malaria control programmes. This chapter focuses on malaria as an example, demonstrating its geographical descriptions. The availability of georeferenced malaria case data whether based on prevalence or incidence indicators has been used extensively in the mapping of geographical extents at national and sub-national scales. However, routine surveillance data is emerging as a valuable methodology of tracking burden in sub-Saharan Africa. A particular focus of this chapter is the use of routine national health systems surveillance data to describe, at a fine-scale, the distribution of malaria. However, routine data can be applied to the cartographic description of other diseases beyond malaria. The methodological aspects of burden estimation from routine surveillance platforms and cartography are highlighted.

Palliative care of persons with HIV and AIDS has changed over the course of the first three decades of the pandemic. The most radical shifts occurred in the second decade with the introduction of combination antiretroviral therapy and other advances in HIV care. In the United States and throughout the world, progress in prevention of HIV transmission has not kept pace with progress in treatment, thus the population of persons living with AIDS continues to grow. Furthermore, economic, psychiatric, social, and political barriers leave many persons without access to adequate HIV care. As a result, persons who lack access to care may need palliative care for late-stage AIDS while persons with access to AIDS treatments are more likely to need palliative care for multimorbid medical illnesses such as cardiovascular disease, cancer, pulmonary disease, and renal disease. Palliative care of persons with HIV and AIDS cannot be confined to the end of life. We present palliative care on a continuum as part of an effort to alleviate suffering and attend to pain, emotional distress, and existential anxiety during the course of the illness. We will provide guidelines for psychiatric and palliative care and pain management to help persons with AIDS cope better with their illnesses and live their lives to the fullest extent, and minimize pain and suffering for them and their loved ones. This chapter reviews basic concepts and definitions of palliative and spiritual care, as well as the distinct challenges facing clinicians involved in HIV palliative care. Finally, issues such as bereavement, cultural sensitivity, communication, and psychiatric contributions to common physical symptom control are reviewed. The terms palliative care and palliative medicine are often used interchangeably. Modern palliative care has evolved from the hospice movement into a more expansive network of clinical care delivery systems with components of home care and hospital-based services (Butler et al., 1996; Stjernsward and Papallona, 1998). Palliative care must meet the needs of the “whole person,” including the physical, psychological, social, and spiritual aspects of suffering (World Health Organization, 1990).