The Catholic Church,moral doctrine,and HIV prevention in Recife,Brazil: Negotiating the contradictions between religious belief and the realities of everyday life

Religious beliefs have had a key role in shaping local responses to HIV and AIDS. As the world's largest Catholic country, Brazil is no exception. Yet little research has been conducted to document how religious doctrine is enacted in practice among its lay leaders and followers. In this article, we present ethnographic research from Recife, Brazil, conducted to understand the way in which religious doctrines are interpreted at a local level. Contextualised within the sociology of contemporary Brazilian Catholicism, we draw on interviews with clergy members, lay leaders, and parishioners to discuss how the Catholic Church's vision of sexuality translates into everyday lives of its followers. We explore the disjuncture between the Catholic ideals of fidelity and delaying sex until marriage with the everyday reality of the Church's followers, highlighting the role that gender plays in defining sexual roles and expectations. We conclude by posing questions for future research and HIV prevention strategies considering the formal institutional response of the Brazilian Catholic Church to AIDS on the one hand, and the social and cultural contexts in which Catholics live their daily lives on the other.     

An Evaluation of an HIV/AIDS Prevention Program in a Nigerian Setting

The study examined the success of a group based behavioural intervention with Nigerian youths aimed at reducing the risk of contracting and spreading HIV/AIDS and other sexually transmitted illness (STI). Participants were 147 youths (males=75, females=72, age range 5 to 24 years). The study explored the influence of motivational factors (self efficacy), attitudinal factors (perceived personal risk), knowledge (instrumental knowledge of AIDS) and behavioural factors (refusal of high-risk behaviour) in predicting condom use amongst youth participating in a group-based HIV prevention intervention. Findings indicated that the intervention program reliably predicted participants' attitudinal dispositions to high risk heterosexual behaviour. Instrumental knowledge of HIV/AIDS, perceived self-efficacy, perceived personal risk of HIV/AIDS and refusal of risk behaviour were significant predictors of condom use.     

Portraits of Well-Being: Photography as a Mental Health Support for Women With HIV

Many women living with HIV/AIDS (WL-HIV/AIDS) experience significant mental distress. Although creative arts strategies are well positioned to help support women by inspiring creativity and meaning-making, few arts programs have been implemented and evaluated with this population. The authors conducted a photography project with 30 WL-HIV/AIDS from three United States cities. Participants took pictures to capture their lives with HIV/AIDS and described their photos and stories in group and individual sessions. Using thematic analysis, the authors identified that the project supported women’s mental health in four ways by facilitating empowerment and helping women to express themselves, address their mental health with new tools like photography, and process past traumas. Photography projects may help WL-HIV/AIDS understand and manage their mental health.     

Questions of condom use in the Muslim and Catholic response to HIV and AIDS in Nairobi,Kenya

Religious leaders in Roman Catholic and Sunni Muslim communities in Kenya’s capital city of Nairobi are charged with responding in an official capacity to the pressing concerns facing their respective communities both theologically and practically. However, speaking about sexuality from a religious perspective particularly on the use of condoms in AIDS prevention has been rather troublesome topic many leaders and clergy find problematic discussing openly. This paper offers a comparative analysis of Muslim and Catholic views on sexuality by establishing the parameters within which to consider the presence and activity of Catholic and Muslim leaders in Kenya and the holistic, grassroots approach in responding to the AIDS epidemic in Nairobi regarding condom use.     

Gender as an Obstacle in HIV/AIDS Prevention: Considerations for the Development of HIV/AIDS Prevention Efforts for Male-to-Female Transgenders

SUMMARY

Social discourses regarding gender are responsible for molding people's cognitions, perceptions, behaviors, and interactions with others. Approaching and understanding gender socialization is an important strategy that must be included in the development of HIV/AIDS prevention intervention efforts targeting male-to-female (MTF) transgender people.

This paper represents an effort to identify the influence of gender construction among a group of MTF transgenders in Puerto Rico. Using combined methodology, authors examined results from a questionnaire and in-depth interviews with a convenience sample of MTF transgenders living in the San Juan metropolitan area.

Quantitative analysis demonstrated that this sample is composed of young, unemployed, and undereducated population. Many participated in the sex industry. Participants reported need for basic health and social services and alienation from social networks. Qualitative analysis confirmed their traditional social construction of the “feminine.” Their discourse underlines their need to reinforce their identity by the construction of a female self which undermines their possibilities for negotiating safer sex, as happens to most females in Latino societies.

Social vulnerability, institutional exclusion, and gender construction issues are obstacles for the HIV prevention efforts among these communities.     

Psychosocial Well-being of Children in HIV/AIDS-Affected Families in Southwest China: A Qualitative Study

We investigated the psychosocial well-being of children in HIV/AIDS-affected families in rural China from the child’s and caregiver’s perspectives. Semi-structured interviews were conducted among children living in HIV/AIDS-affected families (n = 16), their caregivers (n = 16) and key community informants (n = 5). Our findings showed that all of the children relied heavily on caregivers and peers to gain psychological support. Children’s psychosocial problems included fear, anxiety, grief, and loss of self-esteem and confidence. Stigma towards children existed, including isolation, ignorance and rejection. Our study illustrates that HIV/AIDS has impacted negatively on the psychosocial well-being of children. These findings can be used as preliminary data supporting more researches to profoundly explore the psychosocial impact of HIV/AIDS on children and appropriately indicate the need for interventions.     

Relations of Power in Different Spaces: An Exploration of the Schooling Experiences of Children in an HIV/AIDS Context

In this article we explore how the concept of relations of power in different spaces plays out in the lives of school children living in an HIV/AIDS context, and how processes of inclusion and exclusion are associated with particular spaces. The article uses Foucault's (2000) identification of four distinct relations of power to argue that within different school spaces we find economic, political, judicial and epistemological relations of power that are embedded in the way children experience reality. The study was conducted in five primary schools, three secondary schools, one early Childhood Education (ECD) centre, a special school and their communities in the province of KwaZulu Natal. Participants were teachers, learners, out of school youth, and members of community organisations working in the district. Data collection methods included individual and focus group interviews. Within the focus group interviews various participatory research techniques were used, including ranking exercises, projective activities, transect walk, body mapping, photo voice. The findings in the study revealed three complex and contradictory schooling spaces: policy space, curriculum space, and safe spaces in which learners' schooling lives are played out. The study showed that space is fundamental in the exercise of power as revealed in the exclusionary and inclusionary ways in which children experienced their schooling lives.     

Saints and Sinners: Training Papua New Guinean (PNG) Christian Clergy to Respond to HIV and AIDS Using a Model of Care

Papua New Guinea has experienced a growing HIV/AIDS epidemic. The Christian Churches have played a vital role in responding to HIV, through community support, encouragement and social change. Strong, effective Church leadership can help create safe environments of care and support for those infected and for prevention of HIV. Method A series of trainings in capacity development for clergy were undertaken by the National AIDS Council Secretariat (NACS)/National HIV/AIDS Support Project (NHASP). Results A model “Church’s Response to HIV and AIDS in a Care Continuum” was developed to assist the training. This paper discusses the model and the lessons learned.

Exploring Perceived Social Support from Peer Facilitators in an HIV Treatment Adherence Intervention for African American Patients: A Content Analysis of Participant Perspectives

HIV treatment adherence interventions increasingly rely on peer facilitators to promote treatment adherence and improve patient retention, yet little is known about how participants perceive the role performed by peer facilitators. The present study examined participant perceptions in terms of the social support from peer facilitators in a hospital‐based intervention in Chicago. Content analysis was conducted with reference to four types of social support (instrumental, informational, emotional and affiliational) on exit interviews with 11 participants enrolled in the intervention that targeted African‐American patients living with HIV/AIDS. We examined how the type of social support perceived by participants was related to their self‐reported behaviours in three domains: adherence, sexual safety and general coping. Our analysis revealed that most participants perceived informational and emotional support from their peer facilitators, followed by instrumental support. Affiliational support was the least frequently perceived type of social support. We found that perceived informational support from peer facilitators with regard to adherence had greater impact and credibility amongst participants than the same type of support from medical providers. Informational support was cited most frequently with regard to influencing adherence and sexual safety behaviours, whereas perceived emotional support was cited primarily with helping participants cope with HIV. Copyright © 2015 John Wiley & Sons, Ltd.     

Gendered adversity and mental health of adolescents orphaned by AIDS in a rural South African community: An exploratory study

This study explored gender differences in adversity and mental health among South African adolescents orphaned by AIDS. Adolescents (N = 121; females = 45.5%; mean age 14.14 years, SD = 2.09) self-reported their childhood adversities and probable mental ill health on the Child Trauma and General Health Questionnaire. Results revealed that female participants orphaned by AIDS were significantly more likely to report childhood adversity at total score level as compared to male participants. However, both male and female participants reported comparable scores on subscales of childhood adversity (emotional abuse, physical abuse, sexual abuse, and physical neglect). Moreover, female participants displayed higher composite mental ill health and all its subscales except for social dysfunction. Our findings suggest that gender-sensitive programmes and policies to address the effect of childhood adversity and mental ill health among adolescents orphaned by AIDS, are urgently needed.     

The Body of Christ has AIDS: The Catholic Church Responding Faithfully to HIV and AIDS in Papua New Guinea

Using the example of the Catholic Church in Papua New Guinea (PNG), I detail how, through praxis, it has brought to life a living theology of HIV and AIDS. In this way, the Catholic Church in PNG is responding faithfully to the epidemic. As a Christian country with a generalised HIV epidemic, where the body of an individual is reconstituted through the liturgical practices of baptism and Eucharist, theologically, in PNG the body of Christ has AIDS. In order to examine the ways in which the Catholic Church in PNG has responded faithfully to the Christian body with AIDS, I do so in relation to the three theological virtues of faith, hope and love.

Effects of cognitive-behavioural therapy on anxiety,depression and condom use in people with HIV in Mexico City: a pilot study

Anxiety and depression in people living with HIV (PLWH) are negatively associated with healthy sexual behaviours. We pilot-tested a Cognitive-Behavioural Therapy (CBT)-based intervention to reduce anxiety and depression, aimed to increase serostatus disclosure to sexual partners, quality of sexual life (QoSL) and condom use. The study had a single-case experimental design (AB) with follow-up measures. Eleven PLWH with moderate/severe anxiety/depression received six-module CBT intervention delivered in ten one-hour individual weekly sessions. Anxiety, depression, consistent/correct condom use and QoSL were measured. Depression and anxiety decreased after the intervention (depression baseline [BL] Mdn = 21, final [F] Mdn = 3, z = -2.934, p = .003; anxiety BL Mdn = 30, F Mdn = 4, z = -2.941, p = .003). QoSL improved (BL Mdn = 28, F Mdn = 13, z = -2.625, p = .009), along with participants’ ability to use condoms (57.14 vs.100, z = -2.937, p = .003). Effect size was large, changes were maintained at follow-up measurements. The CBT intervention had positive effects in reducing anxiety and depression, which could facilitate the acquisition of healthy sexual behaviours. Further studies are important to clarify the benefits of targeting emotional variables to improve wellbeing and prevention behaviours in PLWH.     

A Pandemic of Terror and Terror of a Pandemic: American Cultural Responses to HIV/AIDS and Bioterrorism

Abstract. The cultural construction of American societal responses to the HIV/AIDS pandemic and terrorism is addressed. The use of metaphors of war, survival, extinction, and of those related to God in public narratives is analyzed. Issues of gender, sexuality, money, and power are also discussed within the context of the religion‐science dialogue. Suggestions are made about a possibility for a global ethic of survival based on an ethic of care.     

Psychological Well-Being and Health Related Quality of Life among a Group of Low-Income Women Living with HIV/AIDS in South Africa

This study documented the relationships among biomedical factors, psychosocial factors, health related quality of life (HRQOL) and suicidality in respect of HIV positive women in KwaZulu-Natal. One hundred and thirty three (133) women over the age of 18 years (mean age 32.96 yrs; SD = 7.28) participated in the study. Participants completed a Suicidality Measure (SM: Sheebhan, Janavs, Amorim, Janavs, Weiller, Hergueta, Baker & Dunbar, 1998), Multidimensional Scale of Perceived Social Support (MPSS: Zimet, Dahlem, Zimet & Farley, 1988) and the Health Related Quality of Life Survey—SF-36 (Ware, Kosinski & Dewey, 2002). Information on social/contextual variables including income, marital status, employment status, number of children was obtained. Participants completed two biomedical measures, CD4 count and time since diagnosis information. The findings revealed a compromised level of HRQOL in the participants. After controlling for biomedical factors, psychosocial measures did not explain differences in quality of life. Perceived social support was inversely related to suicidality. Newly diagnosed patients were less likely to think of suicide as an option.     

Using the Theory of Gender and Power to Examine Experiences of Partner Violence,Sexual Negotiation,and Risk of HIV/AIDS Among Economically Disadvantaged Women in Southern India

This article uses the Theory of Gender and Power to examine women's vulnerability to HIV/AIDS in order to: understand the vulnerability of female sex workers/poor women due to poverty and lack of educational resources; explore women's vulnerability in the context of client/partner violence, alcohol use, male partner's high-risk behaviors, and women's lack of control in their intimate relationships; and explore the role of traditional heterosexual gender norms in the outcomes of sexual negotiation. Ethnographic data were collected from 32 women and 38 men in India as part of an ongoing National Institute of Mental Health study. Results highlighted women's vulnerability to HIV/AIDS stemming from partner violence, alcohol use, poverty, dangers of sex work environments, and tacit acceptance of cultural/gender norms.     

Anxiety,depression, and health-related quality of life in aging people living with HIV compared to diabetes patients and patients with minor health conditions: a longitudinal study

HIV infection has evolved from a fatal to a treatable condition, leading to an increase in the rate of elderly People Living with HIV (PLWH). However, little is known about the psychosocial burden of elderly PLWH. Thus, the aim of this longitudinal multi-center cohort study was to investigate whether elderly PLWH experience more anxiety and depression and reduced health related quality of life (HRQOL) compared to elderly patients with other chronic conditions. PLWH were compared to diabetes patients (DM) and patients with minor health conditions (MHC), e.g. patients with hypertension or allergic conditions. All patients were over 50 years old. Anxiety and depression (HADS) as well as HRQOL (SF-36) were assessed at baseline and after 12 months. 218 PLWH, 249 DM and 254 MHC were included. At baseline, the study groups did not differ in anxiety, depression, and physical HRQOL. However, PLWH indicated lower mental HRQOL than DM and MHC patients (p = 0.001). We did not obtain any moderating effects showing a differential effect of patient characteristics on anxiety, depression, and HRQOL in the three patient groups. At follow-up, the level of anxiety, depression, and HRQOL did not change significantly. The prevalence of anxiety ranged between 27 and 35%, and that of depression between 17 and 28%. Thus, the results of our investigation tentatively suggest that the psychosocial adaptation to HIV among elderly PLWH resembles those of other chronic diseases. There may be some subtle impairments, though, as PLWH experienced lower mental HRQOL.