Articles de revues sur le sujet « AIDS (Disease) – Social aspects – Botswana »

This paper traces the development of policies dealing with HIV/AIDS in Botswana from their beginning in the late 1980s to the current programme to provide population-wide anti-retroviral therapy (ARV). Using a variety of source material, including long-term ethnographic research, it seeks to account for the failure of Western-inspired approaches in dealing with the pandemic. It does this by looking at the cultural and institutional features that have created resistance to the message and inhibited effective implementation. The negative response to the first educational campaign stressing condom use is described and contextualized in terms of Tswana ideas of morality and illness. Nor, as was initially expected, did the introduction of free ARV therapy operate to break the silence and stigma that had developed around the disease. Take-up was very slow, and did not operate to encourage widespread testing. In 2003, key policymakers in Botswana began to argue for a break with the AIDS ‘exceptionalism’ position, with its emphasis on voluntarism, confidentiality and the human rights of patients. This resulted in routine testing being introduced in 2004. This links to a major argument running through the paper which is that the failure of policy cannot be attributed solely to the nature of local populations. Western cultural assumptions about ‘good practice’ also require critical examination.

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.

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.

In the United States, we see three main phases in the construction of the history of AIDS, with each having very different implications for health and social policy. In the first, AIDS was conceived of as an epidemic disease, a “gay plague,” by analogy to the sudden, devastating epidemics of the past. In the second, it was normalized as a chronic disease, similar in many ways to diseases such as cancer. In the third, the authors propose a new historical model of a slow-moving, long-lasting pandemic, a chronic infectious ailment manifested through myriad specific HIV-related diseases. The new paradigm of AIDS incorporates the positive aspects of both earlier conceptions. It emphasizes, like the plague model, the etiology, transmission, and prevention of disease but rejects its assumption of a time-limited crisis. It takes from the chronic disease model an appropriate time frame and concern with the clinical management of protracted illness but insists on the primacy of prevention. The authors criticize both infectious and chronic disease models for their individualistic conceptions of disease and their narrow strategies for disease prevention. They further argue that the traditional distinction between, and approaches to, infectious and chronic diseases need to be rethought for other diseases as well as for AIDS.

Upon its emergence in the western world in the early 1980s, AIDS marked the beginning of a new chapter in the history of communicable disease. In the early stages of the epidemic there was a distinct lack of knowledge about the causation or transmission of the disease, rendering control of the situation a practical impossibility. It was clear that AIDS necessitated a definitive response from several sectors of society. With its apparent associations with then largely marginalised groups of society, namely homosexuals and injecting drug users, virtually no aspects of the response to AIDS were free from the influence of social and political perceptions of the disease and its victims. The US and the UK have strong political and cultural links and in this essay I will compare the responses of these two nations to the AIDS epidemic at a scientific, political and community level and explore the interactions which occurred therein.

Community responses to disease, including non-communicable diseases, are influenced by the socio-cultural system. The system shapes community knowledge and belief on diseases, as well as community attitude and practice towards prevention and treatment. Drawing on the case in West Java Province, this study aims at identifying socio-cultural aspects in preventing non-communicable diseases. This study was conducted by using a qualitative design. The data were collected through in-depth interviews and archival study. This study found four socio-cultural aspects related to disease and the prevention and treatment of disease in West Java: 1) knowledge and practice of medicine covered in a local knowledge system about the prevention and treatment of non-communicable diseases, 2) local institutions, involving social institutions ranging from families, mosque neighborhood groups, and recitation groups, 3) social actors involved, such as ustaz, traditional leaders, and youth groups, 4) local health communication, using visual and audiovisual aids. This study concludes that these four aspects must be considered in designing a socio-cultural-based non-communicable disease prevention strategy, to be effective and in accordance with the socio-cultural context in West Java.

Approach to PLWHA by providing interpersonal counseling is the right thing to do to overcome psychological problems including social, emotional and spiritual aspects of PLWHA. This study aims to look at the effect of interpersonal counseling on social, emotional and spiritual responses in HIV/ AIDS patients. This research is a type of non-experimental research with a cross-sectional approach. The sample is post-test people and tested positive for HIV in the Kediri region, which is 32 with purpossive sampling technique. Data on social, emotional and spiritual responses were obtained based on the results of data recapitulation from the instrument in the form of a questionnaire. The results of the study with the non-parametric Wilcoxon test showed there were differences between social responses of HIV/AIDS patients before and after given interpersonal counseling with p value = 0,000, there were differences between the emotional responses of HIV/AIDS patients before being given interpersonal counseling and after being given counseling with p value = 0,000, and there is a difference between spiritual responses in HIV/AIDS patients before being given interpersonal counseling and after being given interpersonal counseling with p value = 0,000. It can be concluded that interpersonal counseling influences social, emotional and spiritual responses of HIV/AIDS patients. It is recommended that the mentoring of HIV/AIDS patients through interpersonal counseling can continue so as to enhance physiological responses that will have an impact on disease prognosis, prevention of opportunistic infections and reduce mortality rates for HIV patients/ AIDS.

In order to explore the viability of the distinction between overt and covert levels of death fear, 141 individuals (32 HIV positive who had full-blown AIDS, 39 HIV positive without full-blown AIDS, 70 age-matched controls) were administered measures of conscious and unconscious death anxiety as well as a variety of self-report scales assessing life satisfaction, well-being, regrets about one's life, and hopelessness. While results suggested minimal differences to exist between the above groups for measures of conscious death fear, there were substantive, though in some respects, unanticipated differences across groups in aspects of covert fear tapping concerns about the interruption of goals and achievements, isolation from others, and pain, disease, and suffering. Results also suggested that there were both adjustment-related advantages and disadvantages associated with the appearance of symptoms signaling the appearance of full-blown AIDS. Neither gender nor the duration of time one had been living with the diagnosis of either HIV disease or AIDS influenced death fear.

SummaryThough HIV/AIDS poses serious risks to economic security, there is very little economics literature quantifying awareness and knowledge of this disease and their principal socioeconomic determinants. This is what the present study attempts to do in the context of India, which faces a significant threat from HIV/AIDS. The study is based on India's National Family Health Surveys covering the period of economic reforms and beyond. The contribution is both methodological and empirical. The study shows that the recent multi-dimensional deprivation approach to poverty can also be used to measure and analyse awareness and lack of knowledge of HIV/AIDS. The use of decomposable multi-dimensional measures helps in identifying regions, socioeconomic groups and aspects of HIV knowledge that should be targeted in policy interventions. The study identifies the importance of safe sex practices as an area that needs to be targeted in future information campaigns. The study also explores the impact of increased female autonomy in health and economic decision-making on their and their partners' knowledge of the disease, along with a host of other economic and demographic determinants.

The first case of HIV infection was reported in Nigeria in1986. Since then, the prevalence has risen from less than 0.1% in 1987 to 5.8% in 2002, and an estimated 3.6 million Nigerians now live with HIV/AIDS. More than 40 oral manifestations of HIV infection have been recorded and between 70% and 90% of persons with HIV infection will have at least one oral manifestation at sometime during the course of their disease. Oral health-care workers (OHCWS) are expected to play active roles in the prevention and control of HIV/AIDS. In this study, a one-day workshop was organized for 64 oral health workers in Ile-Ife, Nigeria, focusing on the epidemiology of HIV/AIDS, the oral manifestations, control and prevention of HIV in a dental environment, oral care of the infected patient and the ethical, legal and social aspects of HIV/AIDS. Participants' knowledge and practices of infection control were assessed with an infection control checklist administered pre- and post-workshop. Sixty (90.8%) respondents believed that HIV/AIDS was not yet a problem in Nigeria, and 58 (90.6%) believed that drugs have been developed which can cure HIV infection and AIDS. The men complied more with waste disposal regulations than women ( P=0.010). Twenty-nine of 58 (50.0%) did not discard gloves which were torn, cut or punctured. Seven (12.1%) did not change gloves between patients' treatment. Conscious efforts should be made to train OHCWS on all aspects of HIV/AIDS prevention and care. It must never be assumed that adequate information will be acquired through tangential sources.

Botswana, a country in sub-Saharan Africa, has been in the midst of an HIV/AIDs pandemic that has halted its previously lengthening life expectancy trend. However, one group to escape immediate effects on falling life span is the oldest old age group (> 80 years). Their roles in the community due to the pandemic, however, have changed. Place of death is an important consideration in end-of-life care for older adults, and one which has been well studied in the Global North. The purpose of this article is to determine where Botswana's oldest old die (home or hospital), and to see whether cause of death, gender, or residence in a city, town, or rural area is associated with place of death. We use death certificate data from 2005 and 2006 to describe where the oldest old Batswana (the name for the people of Botswana) died, home or hospital. Two-thirds died at home. The mean age at death was 88.46 (± 6.21) years; more were female (56.9%); and of known causes of death, cardiovascular disease was the leading cause (16.8%). Most stated causes of death (62.4%) were listed as “unknown.” Most oldest-old Batswana died in rural areas (70.1%), and in rural areas, proportionally more oldest old died at home compared to cities and towns. On multivariate analysis, being a woman > 80 years of age at death predicted home death. Future longitudinal study needs to determine preferences of place of death and the quality of death of Batswana > 80 years, especially women.

Anthropologists have been involved in the implementation of culturally appropriate HIV/AIDS intervention programs since the advent of the disease. The tradition of applied research in areas like health in "developing" countries and urban "street cultures" (e.g., homeless and low income people, various drug scenes) since the 1950s make it a discipline well-suited to the study of HIV/AIDS, which is often associated with poor and socially marginalized groups. However, the stigma connected to the disease and the lack of political will to initiate structural changes to effectively deal with HIV/AIDS are two key factors prohibiting the establishment of long-term social and policy changes for communities at risk. These conditions have attributed to the growth of HIV/AIDS- related non-government organizations (NGOs), which have been instrumental in dealing with many aspects of the disease. Yet these groups are often faced with the challenge of balancing their clients' needs with program requirements of funding agencies. My involvement with NGOs in a western Canadian city and rural south India exposed some of the tensions these groups experience as they try to meet the demands of clients and funders. Some of these tensions reveal similar problems within NGO environments and others highlight different strategies for sustainability that reflect local constraints as well as strengths. Thus, the comparison of these cases should be of use to a discussion of HIV/AIDS research within applied anthropology and the broader discourse of NGO responses to the epidemic.

HIV/AIDS threatens international health on a scale never before seen in human history. Previous plagues and great epidemics, devastating though they were to imperial China, urbanizing Europe, and the colonizing Americas (McNeill 1998), were regionally contained. More than forty million people worldwide are HIV-positive: about half of them live in sub-Saharan Africa, where it apparently originated and where whole tribes and, indeed, most of the adult population of Botswana may very well die of the disease. (Joint UN/WHO 2004). India has another five million people who are HIV-positive, the largest number outside Africa. AIDS is spreading rapidly in China and devastating Thailand, a regional center for prostitution that spreads it further throughout the Asia-Pacific region. No part of the world is spared. The economic, social, and political impacts of this pandemic have only begun to be felt and to be considered.Modern technological and organizational capacities—jet aircraft and globetrotting business and tourist travelers—turned what would have been, in previous eras, an African regional problem into an international crisis and made AIDS exceedingly difficult to contain. Yet, the human technological and organizational capacity to confront the AIDS pandemic also makes this health crisis different from epidemics in earlier times. Medical science applied by pharmacological research has created drug therapies that can control the disease, that can not only stave off death but make productive life possible for many years. The challenge of AIDS could be met, many in the health community say, if it were not that the life-sustaining drugs are owned by private enterprises (Oxfam 2002). The doctors at Médicins Sans Frontières contend, “Patents are not god-given rights. They are tools invented to benefit society as a whole, not to line the pockets of a handful of multinational pharmaceutical companies” (MSF 2003: 2). “[T]he patent monopoly means that a higher price than necessary has to be paid for patented inventions. This is acceptable if this higher price is merely an inconvenience…. However, if the patented invention is essential (say, if it could prevent your untimely death from disease), then the price is more of a dilemma” (MSF 2003: 5). These and other critics declare that drug makers put profits ahead of people and accuse the governments that grant them patent-intellectual property rights, especially the U.S. government, of contributing to this moral bankruptcy.

Semi-structured interviews were conducted with 40 mine workers on a Johannesburg gold mine, focusing on workers' perceptions of health, HIV/AIDS and sexuality. The paper seeks to highlight a range of factors which might predispose mine workers to high-risk sexual behaviour, despite the fact that they had all attended HIV-education programmes. These factors are presented within a framework that views the process of sexual decision making as a debating process - in which competing facts and beliefs are weighed up against one another - within the context of a range of normative and social parameters. Firstly, attention is given to a number of pre-existing perceptions and doubts which may blunt the force of the facts that HIV educational messages seek to impart to this particular group of people. These include a lack of perceived urgency regarding the treatment of sexually transmitted diseases (STD's), a commitment to ‘flesh-to-flesh’ sex, a dislike of condoms, and faith in the ability of traditional healers to cure a range of STD's and possibly also HIV/AIDS. Secondly, attention is given to the normative context of sexuality, and in particular the way in which norms of masculinity predispose people to high-risk sexual behaviour. Finally, the paper focuses on some aspects of social and occupational life on the mines as the context within which sexual relationships are conducted. These include the phenomenon of single sex hostels, an acceptance of high levels of disease and accidents as the norm, and the use of alcohol. The paper concludes with a discussion of the challenges these findngs pose for a peer education programme which is shortly to be implemented in the mining context.

To distribute social aids during a time of a pandemic, red tapes or unnecessary bureaucratic layers needs to be eliminated because the situations demand flexibility. In fact, during the Covid-19 the Indonesian government struggled to hand the staple needs help due to various problems with the existing social aid system. The purpose of this study is to analyze the social and legal factors that create a red tape that hindered the implementations of distributions. This research uses a qualitative approach with data collection techniques of literature and statutory analysis. The result of this study shows that there is an interplay factor between administrative law on social policies and the bureau pathology(Bureaucratic disease) that infects the bureaucratic system of the Ministry of Social Affairs especially in the aspects of managerial, human resources, and tendencies to conduct unlawful actions aspects. The format of the law has proven to be ineffective to be used in a pandemic setting. Furthermore, there are tendencies of upholding the tight legal mechanism to share the responsibilities in between bottom-up government units which had created ineffective within the systems in times of a pandemic. Nevertheless, it shows that the law has already matured in governing the bureaucratic nature in the Ministry of Social Affairs.

The development and implementation of a culturally and gender sensitive, cognitive behavioral-intervention program aimed at preventing high-risk sexual and drug-use behaviors among culturally diverse women at risk for HIV/AIDS is described. The intervention stressed education, cultural/social barriers to change, and assertiveness/negotiation skill building. Methodological problems and their solutions are presented. The article stresses ways to recruit poor at-risk women, how to reduce attrition using incentives such as providing transportation, having food and child care at the intervention sessions, financial rewards, and a tracking system that includes many friends and family members of the participant. Preliminary findings indicated that the intervention was successful in promoting knowledge about HIV/AIDS. At the end of the six-week intervention protocol, the intervention group compared to the control group showed significant improvements in HIV/AIDS knowledge items dealing with clinical aspects of the disease, transmission knowledge, and partner risk knowledge. Knowledge, along with motivation to reduce risk and negotiation skills are essential in changing behaviors that put one at risk.

Social well-being is an intrinsic part of the current concept of health. In the context of chronic disease, there are many challenges we face in order to provide social well-being to patients and their families, even more if we talk about rare diseases. TransplantChild, a European Reference Network (ERN) in paediatric transplantation, works to improve the quality of life of transplanted children. It is not possible to improve the quality of life if the human and material resources are not available. With this study, we want to identify the economic aids, facilities, services, and financed products that are offered to families in different European centres. We also want to find out who provides these resources and the accessibility to them. We designed an ad hoc survey using the EU Survey software tool. The survey was sent to representatives of the 26 ERN members. In this article we present the results obtained in relation to two of the aspects analysed: long-term financial assistance and drugs, pharmaceuticals and medical devices. Some resources are equally available in all participating centres but there are significant differences in others, such as education aids or parapharmacy product financing. A local analysis of these differences is necessary to find feasible solutions for equal opportunities for all transplanted children in Europe. The experience of centres that already provide certain solutions successfully may facilitate the implementation of these solutions in other hospitals.

HIV/AIDS prevention is very important and absolutely necessary. HIV transmission is now entering a fairly alarming level, in which people with HIV/AIDS in certain subpopulations are emerging. Special steps and resources are thus needed to cope with the condition. There are some phenomena potentially encourage HIV transmissions, such as the increasingly common free sex, homosexuality, the use of unsafe and unsterile syringes in narcotics consumption, commercial sex workers and various high-risk sexual activities. One of the crucial concerns that arises when sending prostitutes back to their hometowns without any coordinated and holistic mechanism is that the prostitutes may cause the spreading of HIV/AIDS in their hometowns. The research objective is to provide the material (input) how the prostitutes themselves may cause the spreading of HIV/AIDS. The research employed descriptive method with a qualitative approach. The results showed that the implementation and the role division in the closure have been highly coordinated and holistic. The leading sector in the role division is the Social Welfare epartment of the Government in Surabaya. In terms of health aspects for the former prostitutes sent back to their hometowns, there has been no policies related to medical screening designed to identify the disease early. Screening is very important for early diagnosis during the post-closure phase. The screening mechanism is that the Provincial Health Department has to optimize the monitoring, coordination, cooperation, agreements and partnerships with stakeholders such as the Local Health Department and the National/Provincial/Distric AIDS Commission, NGOs that are concerned with the problems of HIV-AIDS, international organizations, professional organizations, community leaders, religious leaders and universities.

In the United States, health disparities have been framed by categories of race. Racial health disparities have been documented for cardiovascular disease, cancer, diabetes, HIV/AIDS, and numerous other diseases and measures of health status. Although such disparities can be read as symptoms of disparities in healthcare access, pervasive social and economic inequities, and discrimination, some have suggested that the disparities might be due, at least in part, to biological differences based on race. Or, to be more precise, if race itself has no determined biological meaning, race may nonetheless be a proxy that collects a group of individuals who share certain physiological or genotypic features that affect health.

This article focuses on the elderly patient with a progressive and irreversible dementia, most often of the Alzheimer type. However dementia, the decline in mental function from a previous state, can occur in all ages. For example, if Alzheimer's disease (AD) is the dementia of the elderly, increasingly AIDS is the dementia of many who are relatively young. I will not present the major ethical issues relating to dementia care following the progression of disease from the mild to the severe stages, for I have done this elsewhere. Among the issues included are: presymptomatic testing, both psychological and genetic; responsible diag- nostic disclosure and use of support groups; restrictions on driving and other activities; preemptive assisted suicide; advance directives for research and treatment; quality of life in relation to the use of life-extending technologies; and euthanasia.

Since knowledge about AIDS transmission now appears to be very good, many observers are surprised that more people do not practice behavior, like safer sex, designed to minimize risk of contracting the disease. Still, previous studies have not shown that there is a direct link between knowledge and behavior. New models, based on people's concrete experiences, are therefore needed. The goal of this qualitative research, based on 61 in-depth interviews conducted in France, is to describe how people understand the threat of AIDS and how they face the risk of transmission in their sex lives. In order to understand preventive actions, we must study how information is interpreted and how knowledge is integrated, so that people perceive general or personal risk. We must also specify the way in which people distinguish between aspects of risk perception and vulnerability; feelings of personal control, constructed on the basis of social experiences; characteristics of situations; and finally, the dynamics of action. The proposed risk management model accounts for these diverse factors in elucidating the great diversity of actions reported. This dynamic, non-linear model is designed to capture both the impact of perceptive and cognitive elements on action and vice versa.

Após trinta anos de descoberta da AIDS no mundo, as pessoas infectadas ainda sofrem dos estigmas e preconceitos, não tendo seus direitos garantidos integralmente. Este trabalho tem como objetivo analisar como a literatura tem tratado as questões dos direitos de pessoas com HIV/AIDS e de que forma a terapia ocupacional tem contribuído com a temática. Optou-se por realizar uma pesquisa de base exploratório-descritiva, de abordagem qualitativa, utilizando-se como método a revisão da literatura. A busca pelos artigos completos se deu nas bases de dados da SCIELO, PUBMED e Biblioteca Virtual em Saúde (BVS) com recorte nos períodos de 2006 a 2016. Como resultado, identificamos um número significativo de artigos que tratam sobre a doença, dando ênfase para os aspectos sócio históricos e epidemiológicos de ocorrência. Em relação aos direitos, notou-se um menor número de publicações cuja noção conceitual esteve atrelada ao direito à saúde, desconsiderando a garantia de outros direitos, tão importantes e necessários às pessoas com HIV/AIDS. Ao compreender que os direitos à saúde desta população não se dissociam dos demais direitos que devem ser garantidos, torna-se necessário aos profissionais, dentre os quais, terapeutas ocupacionais, colocar em debate e ampliar o diálogo sobre as ocupações destes sujeitos entendendo esta ocupação como direito a participação social nas diversas esferas da vida social. AbstractAfter thirty years of AIDS discovery around the world, infected people still suffer from stigma and prejudice, and their rights are not fully guaranteed. This study aims to analyze how the literature has dealt with issues of the rights of people with HIV/AIDS and how occupational therapy has contributed to the issue. It was decided to carry out an exploratory-descriptive research, with a qualitative approach, using as a method the literature review. The search for the complete articles was carried out in the SCIELO, PUBMED and Biblioteca Virtual em Saúde (BVS) databases with a cut from 2006 to 2016. As a result, we identified a significant number of articles that deal with the disease, emphasizing the sociohistorical and epidemiological aspects of occurrence. With regard to rights, there was a smaller number of publications whose conceptual notion was tied to the right to health, disregarding the guarantee of other rights, so important and necessary to people with HIV/AIDS. By understanding that the health rights of this population do not dissociate from the other rights that must be guaranteed, it is necessary for professionals, including occupational therapists, to debate and expand the dialogue about the occupations of these subjects, understanding this occupation as social participation in the various spheres of social life. Keywords: Acquired immunodeficiency syndrome; VHI; Occupational therapy; Rights; Social Stigma.

HIV / AIDS is a chronic disease that can affect all aspects of a person's life. Bongas is a sub-district with the highest number of cases compared to other sub-districts in Indramayu Regency. HIV / AIDS is reported to not only cause symptoms and complications but also has a negative impact on quality of life. Quality of life will affect the health condition of people living with HIV, especially in treatment programs. The aim of this study was to determine the quality of life of PLWHA in Bongas. This study used a quantitative research with descriptive approach. The sample amounted to 165 respondents with taking consecutive sampling technique. The results of the study were 118 (71.5%) respondents had a good quality of life in physical domain, 84 (50.9%) respondents had a good quality of life in psychological domain, 124 (75.2%) respondents had a good quality of life in social domain, 93 (56.4%) had a good quality of life in the independence domain, 86 (52.1%) respondents had a good quality of life in the environmental domain, and 86 (52.1%) respondents had a good quality of life in the spiritual domain. The conclusion of this study is that PLWHA in Bongas have a good quality of life. Keywords: Quality of Life, PLWHA

There is a nationwide resurgence of tuberculosis (TB) in the country’s urban centers; New York City stands at the forefront of this resurgence. The root causes are increased homelessness, drug addiction and poverty, all symbols of deteriorating social and economic conditions in the city. The inadequate level of public health resources devoted to TB has also contributed to its spread. Still, even with these factors, it is questionable whether the escalating number of TB cases in this country would have occurred without the reservoir of immunosuppressed persons, who are less resistant to the disease, created by the AIDS epidemic. The fear and urgency of this public health crisis, which has been emerging since the beginning of the last decade, are fueled by the rise of TB strains resistant to the first-line drugs and by the disease’s contagiousness.

The resurgence of tuberculosis in the United States is due, in part, to the dismantling of large-scale treatment systems that were a critical part of the disease control effort for the better part of the twentieth century. As the number of cases grows, clinicians, politicians, public health officials and community advocates have grappled with the difficult problem of building systems to care for infected people that are consonant with current knowledge and beliefs about quality care. As an example, the United Hospital Fund’s 1992 report, The Tuberculosis Revival: Individual and Societal Obligations in a Time of AIDS, discussed policies to guarantee adequate treatment that protects patients’ civil rights, needs for special facilities for care of TB patients, and the special problems faced by infected prisoners. This thoughtful report highlighted many areas of social policy that require further examination.

The purpose of the article is the analysis of the awareness of the Vologda Oblast population about the ways of spreading HIV infection, its manifestations, methods of prevention and treatment, as well as attitudes towards HIV-positive people.The study materials was the next stage of monitoring reproductive potential of the Vologda Oblast population conducted by FSBIS VolRC RAS in 2019.The results of the survey showed that the awareness of the Vologda Oblast population on the problem of HIV infection is differentiated depending on its specific aspects. Residents of the region are most aware of the impact of HIV on the human body and its diagnosis, and the possibility of drug support for the life of patients. However, the population is less aware of the relationship between HIV and AIDS, the ways and biological environments of transmission, and the possibility of having a healthy child with an HIV-positive mother. Women, people aged 20 years and older, and residents from Vologda demonstrated the highest awareness of the main issues of HIV incidence (the nature of the disease, its impact on the body, ways and means of transmission). Men and young people aged 15–19 are less knowledgeable about all aspects, which makes it possible to classify these categories of the population as a «risk group» (i.e. potentially susceptible to HIV infection). In addition, among the residents of the region, social stigmatization of carriers of this disease is widespread, which is expressed in an unjustified fear of contracting HIV infection by household means (sharing dishes, treatment, visiting schools, kindergartens, buying food, etc.).Conclusion. The problem of insufficient awareness of certain aspects of the disease and discrimination against HIV-positive people can be solved by expanding programs aimed at raising awareness of the region’s population on this issue.

Tuberculosis (TB) is treatable but is the leading infectious cause of death worldwide, with men over-represented in some key aspects of the disease burden. Men’s TB epidemiological scenario occurs within a wider public health and historical context, including their prior sidelining in health discussions. Differences are however noticeable in how some Western countries and high TB and HIV burden low and middle-income countries (LMIC) including in Africa have approached the subject(s) of men and health. The former have a comparatively long history of scholarship, and lately are implementing actions targeting men’s health and wellness, both increasingly addressing multilevel social and structural determinants. In contrast, in the latter men have received attention primarily for their sexual practices and role in HIV and AIDS and gender-based violence; moreover, interventions, guided by the public health approach, have stressed short-term, measurable and medical goals. Debates and the limited available empirical literature on men’s engagement with TB-related healthcare are nevertheless indicating need for a shift, within TB work with men in high burden LMICs towards, structural and multicomponent interventions.

Abstract Introduction: More and more children and adolescents suffering from chronic diseases are included in common school education. Unfortunately, teachers do not feel confident enough about how to cope, fulfil and satisfy the needs of these children in the educational, social and emotional spheres. The aim ofp this part of research was to discover how teachers work with chronically ill children of younger school-age. There were three aims. The first aim was to investigate if teachers have basic awareness and knowledge about selected chronic diseases in children of younger school-age. The second aim was to discover what experience and attitudes towards chronically ill children of younger school-age teachers have. The third aim was to discover, how the quality of school care of chronically ill children of younger school-age can be improved. Methods: We used qualitative research methodology. Data were processed and gathered from semi-structured interviews. Interviews were conducted with 12 teachers. Results: Our findings revealed that teachers should be acquainted with the disease itself and its consequences in all aspects. In some cases, teachers must be acquainted also with the practical aspects of a chronic disease, e.g. first aid and application of drugs and aids in order to assist children if necessary. Discussion: The study offers unique insights into primary teachers’ views and experiences with chronically ill children, how teachers work with chronically ill pupils of younger school-age and how the quality of school care of chronically ill children of younger school-age can be improved. Limitations: The research is still being conducted and therefore, it is not possible to provide more detailed results and conclusions. However, our main aim was to draw attention to the very problem from the point of view of teachers themselves and to highlight their vivid experiences. Conclusions: It is necessary to create interconnected networks of experts and families who will cooperate and communicate and who will participate in satisfying needs of a child together. These networks will ensure that children will be integrated into common school life in spite of their disease without serious consequences affecting their development and education.

The HIV epidemic has dramatically changed over the past 30 years; there are now fewer newly infected people (especially children), fewer AIDS-related deaths, and more people with HIV (PWH) receiving treatment. However, the HIV epidemic is far from over. Despite the tremendous advances in anti-retroviral therapies (ART) and the implementation of ART regimens, HIV incidence (number of new infections over a defined period of time) and prevalence (the burden of HIV infection) in certain regions of the world and socio-economic groups are still on the rise. HIV continues to disproportionally affect highly marginalized populations that constitute higher-risk and stigmatized groups, underserved and/or neglected populations. In addition, it is not uncommon for PWH to suffer enhanced debilitating conditions resulting from the synergistic interactions of both communicable diseases (CDs) and non-communicable diseases (NCDs). While research utilizing only a comorbidities framework has advanced our understanding of the biological settings of the co-occurring conditions from a molecular and mechanistic view, harmful interactions between comorbidities are often overlooked, particularly under adverse socio-economical and behavioral circumstances, likely prompting disease clustering in PWH. Synergistic epidemics (syndemics) research aims to capture these understudied interactions: the mainly non-biological aspects that are central to interpret disease clustering in the comorbidities/multi-morbidities only framework. Connecting population-level clustering of social and health problems through syndemic interventions has proved to be a critical knowledge gap that will need to be addressed in order to improve prevention and care strategies and bring us a step closer to ending the HIV epidemic.

The Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections (RCC-ERI) was established in 2005 by the Research Institute for Microbial Diseases (RIMD), Osaka University, in collaboration with the National Institute of Health (NIH), Department of Medical Sciences (DMSc), Ministry of Public Health (MOPH), Thailand. This was initiated based on the recognition that, with today’s highly developed transportation networks including those between Japan and Thailand, infectious disease outbreak and transmission are no longer limited to a single country. Indeed, such diseases are likely to be transmitted immediately to a third country. This makes it essential to cooperate globally in exchanging information fast and often. A dozen Japanese researchers are working regularly at RCC-ERI, where they conduct joint research with Thai researchers on bacterial and viral infectious diseases prevailing in Thailand that could conceivably affect Japan. Examples of such diseases include cholera, meningitis with Streptococcus suis, AIDS, chikungunya fever, and dengue fever. Conducting long-term research in other countries often reveals gaps in perception due to differences in national laws and regulations, in rules and operating customs within research institutions, in economic and cultural backgrounds, and in values and ways of thinking among individual researchers. RCCERI is being operated as fine adjustments are made to achievemaximumproductivity and developing human resources. Some of the many researchers stationed at the Center faced unpredicted situations such as social chaos due to political instability or evacuation due to flooding and had to take emergency response measures. In this article, we cover aspects related to these experiences.

This paper aims to portray the overall picture of poverty in the world and mentions the key solution to overcome poverty from a critical perspective. The data and figures were quoted from a number of researchers and organizations in the field of poverty around the world. Simultaneously, the information strengthens the correlations among poverty and lack of education. Only appropriate philosophies of education can improve the country’s socio-economic conditions and contribute to effective solutions to worldwide poverty. In the 21st century, despite the rapid development of science and technology with a series of inventions brought into the world to make life more comfortable, human poverty remains a global problem, especially in developing countries. Poverty, according to Lister (2004), is reflected by the state of “low living standards and/or inability to participate fully in society because of lack of material resources” (p.7). The impact and serious consequences of poverty on multiple aspects of human life have been realized by different organizations and researchers from different contexts (Fraser, 2000; Lister, 2004; Lipman, 2004; Lister, 2008). This paper will indicate some of the concepts and research results on poverty. Figures and causes of poverty, and some solutions from education as a key breaker to poverty will also be discussed. Creating a universal definition of poverty is not simple (Nyasulu, 2010). There are conflicts among different groups of people defining poverty, based on different views and fields. Some writers, according to Nyasulu, tend to connect poverty with social problems, while others focus on political or other causes. However, the reality of poverty needs to be considered from different sides and ways; for that reason, the diversity of definitions assigned to poverty can help form the basis on which interventions are drawn (Ife and Tesoriero, 2006). For instance, in dealing with poverty issues, it is essential to intervene politically; economic intervention is very necessary to any definition of this matter. A political definition necessitates political interventions in dealing with poverty, and economic definitions inevitably lead to economic interventions. Similarly, Księżopolski (1999) uses several models to show the perspectives on poverty as marginal, motivation and socialist. These models look at poverty and solutions from different angles. Socialists, for example, emphasize the responsibilities of social organization. The state manages the micro levels and distributes the shares of national gross resources, at the same time fighting to maintain the narrow gap among classes. In his book, Księżopolski (1999) also emphasizes the changes and new values of charity funds or financial aid from churches or organizations recognized by the Poor Law. Speaking specifically, in the new stages poverty has been recognized differently, and support is also delivered in limited categories related to more specific and visible objectives, with the aim of helping the poor change their own status for sustainable improvement. Three ways of categorizing the poor and locating them in the appropriate places are (1) the powerless, (2) who is willing to work and (3) who is dodging work. Basically, poverty is determined not to belong to any specific cultures or politics; otherwise, it refers to the situation in which people’s earnings cannot support their minimum living standard (Rowntree, 1910). Human living standard is defined in Alfredsson & Eide’s work (1999) as follows: “Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.” (p. 524). In addition, poverty is measured by Global Hunger Index (GHI), which is calculated by the International Food Policy Institute (IFPRI) every year. The GHI measures hunger not only globally, but also by country and region. To have the figures multi-dimensionally, the GHI is based on three indicators: 1. Undernourishment: the proportion of the undernourished as a percentage of the population (reflecting the share of the population with insufficient calorie intake). 2. Child underweight: the proportion of children under age 5 who are underweight (low weight for their age, reflecting wasting, stunted growth or both), which is one indicator of child under-nutrition. 3. Child mortality: the mortality rate of children under 5 (partially reflecting the fatal synergy of inadequate dietary intake and unhealthy environments). Apart from the individual aspects and the above measurement based on nutrition, which help partly imagine poverty, poverty is more complicated, not just being closely related to human physical life but badly affecting spiritual life. According to Jones and Novak (1999 cited in Lister, 2008), poverty not only characterizes the precarious financial situation but also makes people self-deprecating. Poverty turns itself into the roots of shame, guilt, humiliation and resistance. It leads the poor to the end of the road, and they will never call for help except in the worst situations. Education can help people escape poverty or make it worse. In fact, inequality in education has stolen opportunity for fighting poverty from people in many places around the world, in both developed and developing countries (Lipman, 2004). Lipman confirms: “Students need an education that instills a sense of hope and possibility that they can make a difference in their own family, school, and community and in the broader national and global community while it prepare them for multiple life choices.” (p.181) Bradshaw (2005) synthesizes five main causes of poverty: (1) individual deficiencies, (2) cultural belief systems that support subcultures of poverty, (3) economic, political and social distortions or discrimination, (4) geographical disparities and (5) cumulative and cyclical interdependencies. The researcher suggests the most appropriate solution corresponding with each cause. This reflects the diverse causes of poverty; otherwise, poverty easily happens because of social and political issues. From the literature review, it can be said that poverty comes from complex causes and reasons, and is not a problem of any single individual or country. Poverty has brought about serious consequences and needs to be dealt with by many methods and collective effort of many countries and organizations. This paper will focus on representing some alarming figures on poverty, problems of poverty and then the education as a key breaker to poverty. According to a statistics in 2012 on poverty from the United Nations Development Program (UNDP), nearly half the world's population lives below the poverty line, of which is less than $1.25 a day . In a statistics in 2015, of every 1,000 children, 93 do not live to age 5 , and about 448 million babies are stillborn each year . Poverty in the world is happening alarmingly. According to a World Bank study, the risk of poverty continues to increase on a global scale and, of the 2009 slowdown in economic growth, which led to higher prices for fuel and food, further pushed 53 million people into poverty in addition to almost 155 million in 2008. From 1990 to 2009, the average GHI in the world decreased by nearly one-fifth. Many countries had success in solving the problem of child nutrition; however, the mortality rate of children under 5 and the proportion of undernourished people are still high. From 2011 to 2013, the number of hungry people in the world was estimated at 842 million, down 17 percent compared with the period 1990 to 1992, according to a report released by the Food and Agriculture Organization of the United Nations (FAO) titled “The State of Food Insecurity in the World 2013” . Although poverty in some African countries had been improved in this stage, sub-Saharan Africa still maintained an area with high the highest percentage of hungry people in the world. The consequences and big problems resulting from poverty are terrible in the extreme. The following will illustrate the overall picture under the issues of health, unemployment, education and society and politics ➢ Health issues: According a report by Manos Unidas, a non- government organization (NGO) in Spain , poverty kills more than 30,000 children under age 5 worldwide every day, and 11 million children die each year because of poverty. Currently, 42 million people are living with HIV, 39 million of them in developing countries. The Manos Unidas report also shows that 15 million children globally have been orphaned because of AIDS. Scientists predict that by 2020 a number of African countries will have lost a quarter of their population to this disease. Simultaneously, chronic drought and lack of clean water have not only hindered economic development but also caused disastrous consequences of serious diseases across Africa. In fact, only 58 percent of Africans have access to clean water; as a result, the average life expectancy in Africa is the lowest in the world, just 45 years old (Bui, 2010). ➢ Unemployment issues: According to the United Nations, the youth unemployment rate in Africa is the highest in the world: 25.6 percent in the Middle East and North Africa. Unemployment with growth rates of 10 percent a year is one of the key issues causing poverty in African and negatively affecting programs and development plans. Total African debt amounts to $425 billion (Bui, 2010). In addition, joblessness caused by the global economic downturn pushed more than 140 million people in Asia into extreme poverty in 2009, the International Labor Organization (ILO) warned in a report titled The Fallout in Asia, prepared for the High-Level Regional Forum on Responding to the Economic Crisis in Asia and the Pacific, in Manila from Feb. 18 to 20, 2009 . Surprisingly, this situation also happens in developed countries. About 12.5 million people in the United Kingdom (accounting for 20 percent of the population) are living below the poverty line, and in 2005, 35 million people in the United States could not live without charity. At present, 620 million people in Asia are living on less than $1 per day; half of them are in India and China, two countries whose economies are considered to be growing. ➢ Education issues: Going to school is one of the basic needs of human beings, but poor people cannot achieve it. Globally, 130 million children do not attend school, 55 percent of them girls, and 82 million children have lost their childhoods by marrying too soon (Bui, 2010). Similarly, two-thirds of the 759 million illiterate people in total are women. Specifically, the illiteracy rate in Africa keeps increasing, accounting for about 40 percent of the African population at age 15 and over 50 percent of women at age 25. The number of illiterate people in the six countries with the highest number of illiterate people in the world - China, India, Indonesia, Brazil, Bangladesh and Egypt - reached 510 million, accounting for 70 percent of total global illiteracy. ➢ Social and political issues: Poverty leads to a number of social problems and instability in political systems of countries around the world. Actually, 246 million children are underage labors, including 72 million under age 10. Simultaneously, according to an estimate by the United Nations (UN), about 100 million children worldwide are living on the streets. For years, Africa has suffered a chronic refugee problem, with more than 7 million refugees currently and over 200 million people without homes because of a series of internal conflicts and civil wars. Poverty threatens stability and development; it also directly influences human development. Solving the problems caused by poverty takes a lot of time and resources, but afterward they can focus on developing their societies. Poverty has become a global issue with political significance of particular importance. It is a potential cause of political and social instability, even leading to violence and war not only within a country, but also in the whole world. Poverty and injustice together have raised fierce conflicts in international relations; if these conflicts are not satisfactorily resolved by peaceful means, war will inevitably break out. Obviously, poverty plus lack of understanding lead to disastrous consequences such as population growth, depletion of water resources, energy scarcity, pollution, food shortages and serious diseases (especially HIV/AIDS), which are not easy to control; simultaneously, poverty plus injustice will cause international crimes such as terrorism, drug and human trafficking, and money laundering. Among recognizable four issues above which reflected the serious consequences of poverty, the third ones, education, if being prioritized in intervention over other issues in the fighting against poverty is believed to bring more effectiveness in resolving the problems from the roots. In fact, human being with the possibility of being educated resulted from their distinctive linguistic ability makes them differential from other beings species on the earth (Barrow and Woods 2006, p.22). With education, human can be aware and more critical with their situations, they are aimed with abilities to deal with social problems as well as adversity for a better life; however, inequality in education has stolen opportunity for fighting poverty from unprivileged people (Lipman, 2004). An appropriate education can help increase chances for human to deal with all of the issues related to poverty; simultaneously it can narrow the unexpected side-effect of making poverty worse. A number of philosophies from ancient Greek to contemporary era focus on the aspect of education with their own epistemology, for example, idealism of Plato encouraged students to be truth seekers and pragmatism of Dewey enhanced the individual needs of students (Gutex, 1997). Education, more later on, especially critical pedagogy focuses on developing people independently and critically which is essential for poor people to have ability of being aware of what they are facing and then to have equivalent solutions for their problems. In other words, critical pedagogy helps people emancipate themselves and from that they can contribute to transform the situations or society they live in. In this sense, in his most influential work titled “Pedagogy of the Oppressed” (1972), Paulo Freire carried out his critical pedagogy by building up a community network of peasants- the marginalized and unprivileged party in his context, aiming at awakening their awareness about who they are and their roles in society at that time. To do so, he involved the peasants into a problem-posing education which was different from the traditional model of banking education with the technique of dialogue. Dialogue wasn’t just simply for people to learn about each other; but it was for figuring out the same voice; more importantly, for cooperation to build a social network for changing society. The peasants in such an educational community would be relieved from stressfulness and the feeling of being outsiders when all of them could discuss and exchange ideas with each other about the issues from their “praxis”. Praxis which was derived from what people act and linked to some values in their social lives, was defined by Freire as “reflection and action upon the world in order to transform it” (p.50). Critical pedagogy dialogical approach in Pedagogy of the Oppressed of Freire seems to be one of the helpful ways for solving poverty for its close connection to the nature of equality. It doesn’t require any highly intellectual teachers who lead the process; instead, everything happens naturally and the answers are identified by the emancipation of the learners themselves. It can be said that the effectiveness of this pedagogy for people to escape poverty comes from its direct impact on human critical consciousness; from that, learners would be fully aware of their current situations and self- figure out the appropriate solutions for their own. In addition, equality which was one of the essences making learners in critical pedagogy intellectually emancipate was reflected via the work titled “The Ignorant Schoolmaster” by Jacques Rancière (1991). In this work, the teacher and students seemed to be equal in terms of the knowledge. The explicator- teacher Joseph Jacotot employed the interrogative approach which was discovered to be universal because “he taught what he didn’t know”. Obviously, this teacher taught French to Flemish students while he couldn’t speak his students’ language. The ignorance which was not used in the literal sense but a metaphor showed that learners can absolutely realize their capacity for self-emancipation without the traditional teaching of transmission of knowledge from teachers. Regarding this, Rancière (1991, p.17) stated “that every common person might conceive his human dignity, take the measure of his intellectual capacity, and decide how to use it”. This education is so meaningful for poor people by being able to evoking their courageousness to develop themselves when they always try to stay away from the community due the fact that poverty is the roots of shame, guilt, humiliation and resistance (Novak, 1999). The contribution of critical pedagogy to solving poverty by changing the consciousness of people from their immanence is summarized by Freire’s argument in his “Pedagogy of Indignation” as follows: “It is certain that men and women can change the world for the better, can make it less unjust, but they can do so from starting point of concrete reality they “come upon” in their generation. They cannot do it on the basis of reveries, false dreams, or pure illusion”. (p.31) To sum up, education could be an extremely helpful way of solving poverty regarding the possibilities from the applications of studies in critical pedagogy for educational and social issues. Therefore, among the world issues, poverty could be possibly resolved in accordance with the indigenous people’s understanding of their praxis, their actions, cognitive transformation, and the solutions with emancipation in terms of the following keynotes: First, because the poor are powerless, they usually fall into the states of self-deprecation, shame, guilt and humiliation, as previously mentioned. In other words, they usually build a barrier between themselves and society, or they resist changing their status. Therefore, approaching them is not a simple matter; it requires much time and the contributions of psychologists and sociologists in learning about their aspirations, as well as evoking and nurturing the will and capacities of individuals, then providing people with chances to carry out their own potential for overcoming obstacles in life. Second, poverty happens easily in remote areas not endowed with favorable conditions for development. People there haven’t had a lot of access to modern civilization; nor do they earn a lot of money for a better life. Low literacy, together with the lack of healthy forms of entertainment and despair about life without exit, easily lead people into drug addiction, gambling and alcoholism. In other words, the vicious circle of poverty and powerlessness usually leads the poor to a dead end. Above all, they are lonely and need to be listened to, shared with and led to escape from their states. Community meetings for exchanging ideas, communicating and immediate intervening, along with appropriate forms of entertainment, should be held frequently to meet the expectations of the poor, direct them to appropriate jobs and, step by step, change their favorite habits of entertainment. Last but not least, poor people should be encouraged to participate in social forums where they can both raise their voices about their situations and make valuable suggestions for dealing with their poverty. Children from poor families should be completely exempted from school fees to encourage them to go to school, and curriculum should also focus on raising community awareness of poverty issues through extracurricular and volunteer activities, such as meeting and talking with the community, helping poor people with odd jobs, or simply spending time listening to them. Not a matter of any individual country, poverty has become a major problem, a threat to the survival, stability and development of the world and humanity. Globalization has become a bridge linking countries; for that reason, instability in any country can directly and deeply affect the stability of others. The international community has been joining hands to solve poverty; many anti-poverty organizations, including FAO (Food and Agriculture Organization), BecA (the Biosciences eastern and central Africa), UN-REDD (the United Nations Programme on Reducing Emissions from Deforestation and Forest Degradation), BRAC (Building Resources Across Communities), UNDP (United Nations Development Programme), WHO (World Health Organization) and Manos Unidas, operate both regionally and internationally, making some achievements by reducing the number of hungry people, estimated 842 million in the period 1990 to 1992, by 17 percent in 2011- to 2013 . The diverse methods used to deal with poverty have invested billions of dollars in education, health and healing. The Millennium Development Goals set by UNDP put forward eight solutions for addressing issues related to poverty holistically: 1) Eradicate extreme poverty and hunger. 2) Achieve universal primary education. 3) Promote gender equality and empower women. 4) Reduce child mortality. 5) Improve maternal health. 6) Combat HIV/AIDS, malaria and other diseases. 7) Ensure environmental sustainability. 8) Develop a global partnership for development. Although all of the mentioned solutions carried out directly by countries and organizations not only focus on the roots of poverty but break its circle, it is recognized that the solutions do not emphasize the role of the poor themselves which a critical pedagogy does. More than anyone, the poor should have a sense of their poverty so that they can become responsible for their own fate and actively fight poverty instead of waiting for help. It is not different from the cores of critical theory in solving educational and political issues that the poor should be aware and conscious about their situation and reflected context. It is required a critical transformation from their own praxis which would allow them to go through a process of learning, sharing, solving problems, and leading to social movements. This is similar to the method of giving poor people fish hooks rather than giving them fish. The government and people of any country understand better than anyone else clearly the strengths and characteristics of their homelands. It follows that they can efficiently contribute to causing poverty, preventing the return of poverty, and solving consequences of the poverty in their countries by many ways, especially a critical pedagogy; and indirectly narrow the scale of poverty in the world. In a word, the wars against poverty take time, money, energy and human resources, and they are absolutely not simple to end. Again, the poor and the challenged should be educated to be fully aware of their situation to that they can overcome poverty themselves. They need to be respected and receive sharing from the community. All forms of discrimination should be condemned and excluded from human society. When whole communities join hands in solving this universal problem, the endless circle of poverty can be addressed definitely someday. More importantly, every country should be responsible for finding appropriate ways to overcome poverty before receiving supports from other countries as well as the poor self-conscious responsibilities about themselves before receiving supports from the others, but the methods leading them to emancipation for their own transformation and later the social change.

Through critical reflection on the conspiracy theories told about the origins of HIV by American Indians, we learned that many community members refused the universalized aspects of AIDS prevention, education, and intervention. We found that standard HIV/AIDS-related prevention and treatment programs tend to universalize experiences with and responses to the AIDS epidemic and ignore – or push to the margin – alternative framings and understandings of this disease. Inspired by American Indians’ refusal to synthesize (in the Hegelian dialectical sense) their own experience into national and international AIDS knowledges, in this article we seek to engage with such marginal understandings, as well as their interactions with universal, individual, and community notions of care, AIDS, and health causality. The use of non-standard theories of the origins of AIDS by American Indians, we argue, disrupts the logic that attempts to universalize AIDS and community experiences. By making AIDS a ‘White Man’s disease’, Natives bring the epidemic in line with a history of social and health neglect by the settler state, and refuse to collapse their own, marginalized experiences and understandings of HIV/AIDS into dominant knowledges of the disease.

AbstractThis study evaluates the prevalence of HIV stigma in Spain and analyzes some variables that may affect its existence. In 2008, we conducted a computer-assisted telephone survey of 1607 people, representative of the Spanish population. Two-wave random stratified sampling was performed, first selecting the home and then the person, depending on the rates of age and sex. About 50% of the population feels discomfort about potential contact with people with HIV and tries to avoid it and 20% advocate discriminatory policies involving physical or social segregation of people with HIV. The belief that HIV is easily transmitted through social contact (15%) and blaming people with HIV for their disease (19.3%) are associated with stigmatization. Degree of proximity to people with HIV, political ideology, educational level, and age are also associated with the degree of stigmatization. According to these results, we suggest that, in order to reduce stigma, we need to modify the erroneous beliefs about the transmission pathways, decrease attributions of blame to people with HIV, and increase contact with them. These interventions should particularly target older people, people with a low educational level, and people with a more conservative political ideology.

Studies on the social management of HIV and AIDS have focused on how awareness about HIV and AIDS has been created through organised and interpersonal communication. These studies have not investigated context-constrained language use in the advertisements on the disease despite the wide coverage and potential effectiveness of the public sensitisation about HIV and AIDS. This study, therefore, investigated the pragmatic features of language in selected HIV and AIDS management advertisements with a view to identifying the pragmatic acts of the language. Aspects of pragmatic act theory, noted for negotiability of meaning context based interactional situations was adopted for the research. All the 25 advertisements broadcast between December 2006 and June 2009, to all African countries on both private and government-owned television stations in Nigeria by an International non-governmental agency known as 'it begins with you' (YOU) constituted the data. Fifty–four utterances were generated from the adverts and were subjected to qualitative analysis and reported in simple percentages. Six pragmatic functions manifested in the advertisements: Co-opting and Projecting were realised through inference (INF), shared situational knowledge (SSK) and relevance (REL) to bring the audience into the war against HIV/AIDS. Encouraging and Emboldening were projected through SSK and INF to motivate the audience to go for HIV test and speak openly about the virus. Instigating was done using indirect speech act to empower the female against discrimination and stigmatisation. Advising was achieved through SSK and INF to promote fidelity and safe sexual behaviour. The analysis of YOU advertisements through pragmatic act theory presupposes that pragmatic functions were exploited by the advertisers to sensitise the audience, promote social ties and project into an HIV free generation.

Infection with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) as a complication is now considered a chronic disease and, although mortality and morbidity have been significantly reduced, the psychosocial impact of the disease generates painful consequences in the patient reflected in anxiety and depression. The concept of quality of life is global, multidisciplinary, and involves objective and subjective aspects. Health-related quality of life involves functioning and physical symptoms, psychological factors and social aspects. The interest of this review lies in the social impact of HIV, not only in relation to the economic and political repercussions for treatment and prevention, but also in the identification of variables related to the improvement of the quality of life of people with HIV. There is a great interest in the study of quality of life of patients with HIV / AIDS, and research has shown that there is a relationship between quality of life and psychological variables such as anxiety and depression, as well as biological parameters such as CD4 lymphocyte levels and the viral load that could perhaps be considered in health decisions and in interventions that promote protection and welfare factors. The implementation of interventions aimed at improving the quality of life of patients with HIV / AIDS throughout the evolutionary period of infection is very important.

Abstract Objective: To analyze the way AIDS is configured in the eyes of Indigenous and non-Indigenous women. Method: A descriptive study implementing a mixed approach, conducted in three indigenous villages and in a surrounding municipality. A semi-structured interview script was used, with identification data and questions related to the disease perception, the way of seeing and feeling AIDS. The corpus was processed by IRaMuTeQ software and analyzed by Descending Hierarchical Classification, Content Analysis and Word Cloud. Results: A total of 164 Potiguara indigenous women and 386 non-Indigenous women participated. Three classes were formed: “AIDS and its repercussions”, “Social aspects, spirituality and attributed feelings” and “Transmission modes”. There was a better understanding of the etiology, treatment and AIDS transmission modes among non- Indigenous women, while the content mainly surrounds negative elements such as death, fear, sadness and prejudice among Indigenous women. Conclusion: The knowledge produced in interactions were formed according to the social context and gain its own significance. Such considerations may contribute to the direction of strategic HIV/AIDS control policies focusing on ethnic/cultural specificities.

Abstract Background With high rates of HIV and multiple vulnerable subgroups across diverse settings, there is a need for culturally based, HIV stigma reduction interventions. Pregnant women who are living with HIV are especially in need of services to protect not only their own but also their children’s lives. Uptake of HIV services worldwide is hindered by stigma towards persons living with HIV/AIDS. While cultural context plays a key role in shaping HIV stigma, these insights have not yet been fully integrated into stigma reduction strategies. By utilizing the “What Matters Most” stigma framework, we propose that an intervention to counter culturally salient aspects of HIV stigma will improve treatment adherence and other relevant outcomes. A pragmatic clinical trial in Botswana will evaluate the “Mothers Moving towards Empowerment” (MME) intervention, which seeks to address HIV stigma in Botswana and to specifically engage pregnant mothers so as to promote antiretroviral therapy (ART) adherence in the postpartum period. Methods This study will test MME against treatment as usual (TAU) among pregnant mothers diagnosed with HIV and their infants. Outcomes will be assessed during pregnancy and 16 weeks postpartum. Women who meet eligibility criteria are assigned to MME or TAU. Women assigned to MME are grouped with others with similar estimated delivery dates, completing up to eight intervention group sessions scheduled before week 36 of their pregnancies. Primary outcomes among mothers include (i) reducing self-stigma, which is hypothesized to mediate improvements in (ii) psychological outcomes (quality of life, depression and social functioning), and (iii) adherence to antenatal care and ART. We will also examine a set of follow-up infant birth outcomes (APGAR score, preterm delivery, mortality (at < 16 weeks), birth weight, vaccination record, and HIV status). Discussion Our trial will evaluate MME, a culturally based HIV stigma reduction intervention using the “What Matters Most” framework, to reduce stigma and improve treatment adherence among pregnant women and their infants. This study will help inform further refinement of MME and preparation for a future large-scale, multisite, randomized controlled trial (RCT) in Botswana. Trial registration ClinicalTrials.gov NCT03698981. Registered on October 8, 2018

This article presents acquired immunodeficiency syndrome (AIDS, in Portuguese, or AIDS), when it appeared in the 1980s from an interdisciplinary perspective: on the one hand, signs, symptoms, diagnostic methods and treatment are addressed and are part of the biomedical model that participates in the interpretation of this disease; on the other, the representations of the disease in journalistic articles published in the newspaper O Globo, one of the most important in Brazil. Health and Journalism help to build ideas and understand concepts, prejudices and stigmas that relapse dwell and still fall on the disease that became known as the gay plague, one of several denominations attributed to AIDS when it arose. It is discussed whether it is possible to understand the health-disease process from a plural perspective, which goes beyond the limits of medicine. For this, we analyze texts from the newspaper O Globo, which deal with the HIV/AIDS binomial, paying special attention to the language and lexicography used in the elaboration of them, and taking into account the medical view about the disease in the 1980s. The work allows us to conclude that it is possible and necessary to face the health-disease process using not only biological phenomena, but using social, economic, political and environmental aspects, in front of various disciplinary fields.

Resumen: Introducción: El uso de datos de la Web sobre salud ha demostrado ser útil para evaluar diversos aspectos del comportamiento humano. Objetivo: analizar la tendencia de las búsquedas de información sobre VIH/sida que se realizan, en España, a través de Google. Metodología: Estudio descriptivo. Los datos se obtuvieron mediante acceso online a Google Trends, utilizándose los términos “VIH” y “sida”. Variables estudiadas: consultas relacionadas; hitos; volumen de búsqueda relativo (VBR) y evolución temporal. Fecha de consulta 25 noviembre 2018. Resultados: Se observaron 3 hitos sobre “sida”. El cociente medio entre los dos términos, 1,78 ± 0,13, presentó diferencias significativas (t = 5,29; p < 0,001). El VBR demostró diferencias entre los términos en la 1ª época y la evolución temporal para “sida” fue claramente decreciente (R2 = 0,89; p < 0.001); para “VIH” fue ligeramente creciente (R2 = 0,02; p = 0,087). La relación del VBR entre los términos para el periodo estudiado mostró una relación escasa (R = 0,21; p = 0,005). Conclusiones: La evolución temporal obtenida probablemente se deba a un cambio de preocupación social, del sida al VIH, o a un mayor conocimiento de la enfermedad, que refleja la evolución histórica del VIH y el sida: la infección por el VIH como enfermedad crónica.Palabras clave: Síndrome de Inmunodeficiencia Adquirida; VIH; sida; Acceso a la Información; Google Trends.Abstract: Introduction: The use of health data from the Web has proven useful for evaluating various aspects of human behavior. Objective: to analyze the trend of searches for information on HIV/AIDS carried out in Spain, through Google. Methodology: Descriptive study. The data were obtained through online access to Google Trends, using the terms «HIV» and «AIDS». The variables were: related consultations; milestones; relative search volume (RSV) and temporal evolution. Consultation date 25 November 2018. Results: Users used search terms related to the main terms. There were three milestones in the results of search on «AIDS». The ratio between the two terms, 1.78 ± 0.13, presented significant differences (t = 5.29; p < 0.001). The RSV showed differences between the terms in the first time to study and the time course for ‘AIDS’ was clearly decreasing (R2 = 0.89, p < 0.001), while for ‘HIV’ was slightly increased (R2 = 0.02; p = 0,087). The relation of the RSV, between the two terms, for the entire period studied showed a low relation (R = 0.21, p = 0.005). Conclusions: the temporal evolution obtained is probably due to a change of social concern, from AIDS to HIV, or perhaps to a better understanding of the disease, which reflects the historical evolution of HIV and AIDS: the HIV infection as a chronic disease.Keywords: Acquired Immunodeficiency Syndrome; HIV; AIDS; Access to Information; Google Trends.

: Coronavirus (COVID-19) outbreak was first reported from China in December 2019, and World Health Organization declared the outbreak as a pandemic on 11 March 2020. The number of confirmed cases is rising alarmingly in most countries across all continents over the past few months. The current COVID-19 pandemic has an immense impact on Sexual and reproductive health and rights (SRHR) with disruptions in regular provision of Sexual and reproductive health (SRH) services such as maternal care, safe abortion services, contraception, prevention and treatment of HIV/AIDS and other sexually transmitted diseases. Other aspects that merit attention include probable increase in domestic violence, sexual abuse, and effects of stigma associated with coronavirus infection on SRH clients and health care providers. Furthermore, as the coronavirus infection is relatively new, only minimal data is available to understand the impact of this disease on SRH, including coronavirus infection complicating pregnancies, and in people with STI/HIV-related immunosuppression. There is a serious necessity for the medical fraternity to generate psycho-social and clinico-epidemiological correlations between coronavirus disease and SRHR outcomes. The article reviews the hidden impact of coronavirus pandemic on sexual and reproductive health and rights of women, particularly in India

Background: Adherence in chronic disease conditions is described as the extent to which a person‘s behaviour corresponds to the prescribed medical advice of the healthcare provider. This is not limited to medication intake only but also includes acts such as following instructions regarding dietary or fluid restrictions and taking medicines at the prescribed times and intervals. Although adherence to antiretroviral therapy (ART) is a predictor of good clinical outcome among HIV-infected persons on ART, it is a major challenge and strict adherence is not very common. This article aims to examine the application and relevance of some cognitive-behavioural theories in antiretroviral therapy adherenceMethods: After doing a thorough literature review, contemporary theories of health behaviour at the individual and interpersonal levels referred to as cognitive-behavioural theories were explored. This review highlights some aspects of the cognitive perspective of health behaviour theories as a good theoretical framework that could be used for organising thoughts about adherence and other health behaviours among patients on lifelong treatment such as ART.Results: Key concepts of these theories stipulate that behaviour is mediated by cognition i.e. knowledge and attitude affect the person’s action. In addition, cognitive-behavioural theories recognise knowledge alone as being insufficient to produce behavioural change; a person’s perception, motivation, skills and social environment are all influential in the process of behavioural change.Conclusion: Prediction of medication adherence is complex, and health-related knowledge and beliefs alone are insufficient to achieve behaviour change, especially in chronic conditions such as HIV/AIDS. However, people can control or influence the events affecting their lives by integrating cognitive, social, and behavioural sub-skills related to beliefs of personal efficacy in performing these skills.

This article aims to contribute to the understanding of the social dimensions of the 2020 pandemic, with a particular emphasis on the visual practices of science communication in times of health emergency, by analyzing how the coronavirus disease-2019 (COVID-19) pandemic is being visually represented. It seeks to identify the format and content of images used to illustrate online information about the pandemic, in particular, from websites of policy institutions, research promoters, and media in Portugal and Spain. By examining a sample containing 600 images, it aims to identify the messages being conveyed and the effects these images intend to provoke and to illuminate the differences in representations among the three sources of communication. Differences and similarities with visual images of previous pandemics (influenza, AIDS) are examined. This article ascertains that policy websites aim to be mostly prescriptive, relying on infographics to convey prevention and care instructions to its audiences. On the other hand, science websites rely mostly on stock photos and images from scientific articles to illustrate current research, while newspaper websites are the most diversified in terms of the images they use and the topics they cover. This study concludes that representations of science are still very much based on stereotypical imagery of labs and white coats, that representations of the medical side of the pandemic are focused on images of intensive care that aim to generate fear and stimulate responsible behavior, and that the social aspects of the pandemic are illustrated by images that focus either on pandemic prevention (e.g., washing hands) or on the impacts of the pandemic itself (e.g., empty streets during lockdown).

Abstract Background Critical public health measures implemented to mitigate the spread of the novel coronavirus disease (COVID-19) pandemic have disrupted health research worldwide, including HIV prevention research. While general guidance has been issued for the responsible conduct of research in these challenging circumstances, the contours of the dueling COVID-19 and HIV/AIDS pandemics raise some critical ethical issues for HIV prevention research. In this paper, we use the recently updated HIV Prevention Trials Network (HPTN) Ethics Guidance Document (EGD) to situate and analyze key ethical challenges related to the conduct of HIV prevention research during the COVID-19 pandemic as well as identify potential areas for refinement of the guidance document based on this unprecedented state of affairs. Main body Necessary actions taken for HIV prevention research studies due to the COVID-19 pandemic involve an array of ethical issues including those related to: (1) risk mitigation; (2) behavior change; (3) compounding vulnerability; (4) community engagement; (5) trial reopening; and 6) shifting research priorities. Conclusions In the context of the dueling HIV and COVID-19 global pandemics, research teams and sponsors must be nimble in responding to the rapidly changing environment by being sensitive to the associated ethical issues. The HTPN EGD provides a rich set of tools to help identify, analyze and address many of these issues. At the same time, future refinements of the HPTN EGD and other research ethics guidance could be strengthened by providing explicit advice regarding the ethical issues associated with disrupted research and the reopening of studies. In addition, additional consideration should be given to appropriately balancing domains of risk (e.g., physical versus social), addressing the vulnerability of research staff and community partners, and responding to un-anticipatable ancillary care needs of participants and communities. Appropriately addressing these issues will necessitate conceptual work, which would benefit from the careful documentation of the actual ethical issues encountered in research, the strategies implemented to overcome them, and their success in doing so. Throughout all of these efforts, it is critical to remember that the HIV pandemic not be forgotten in the rush to deal with the COVID-19 pandemic.