“They're Scared of It”: Intergroup Determinants of Attitudes Toward Children With HIV1

The study used an intergroup perspective to explore teachers’ willingness to teach children with HIV within mainstream education. One hundred thirty‐eight teachers from 13 high schools across the United Kingdom participated in a survey. The results suggest that previous contact with an individual who was HIV positive (whether an adult or a child) was strongly associated with greater willingness to teach a child with HIV. However, this effect disappeared when intergroup anxiety, positive affect, and positive beliefs were included as covariates. There was little evidence that instrumental variables (i.e., relatively pragmatic concerns about infection) were associated with willingness to teach. Participants who had some contact reported lower fear of contagion from a child with HIV, but there was no evidence that this was associated with overall attitudes. The results are interpreted to suggest that interventions to reduce prejudice should not simply concentrate on improving knowledge about HIV transmission.     

Parentification and Maternal HIV Infection: Beneficial Role or Pathological Burden?

Parentification, along with parenting and child adjustment, were examined in 23 9-through 16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were HIV-positive reported to more often engage in parental role behaviors, relative to children of HIV-negative mothers. This difference remained even after controlling for the effects of current drug use, number of adults per child in the household, and marital status. Findings revealed a beneficial relationship between parentification and both child adjustment and parenting, particularly among families affected by maternal HIV infection. When relationships were examined separately by HIV status, the pattern of results suggested that parentification, which involves increased emotional closeness, rather than role-related tasks, which may involve increased responsibility of household maintenance, seems to foster an association with concurrent positive parenting and child adjustment among families coping with HIV/AIDS. Directions for future research, including the need for methodological advances in the field are discussed.     

AIDS and pediatric HIV infection: the problem of the infected mother and her newborn

The number or pediatric AIDS cases in the US was around 2000 in 1990, and children under 13 accounted for about 2% of reported cases. Pediatric cases are increasing as the number of infected women increases. Such cases are concentrated in poor urban populations, aggravating the lack of resources of already overtaxed health services. Ethnic minorities are overrepresented among AIDS cases. In the US, 52% of AIDS cases in adult women are in blacks, 27% in non-Hispanic whites, and 20% in women of Hispanic origin. Among children under 13, 53% are in blacks, 25% in Hispanics, and 22% in whites. The majority of children with AIDS were 5 and were probably infected by vertical transmission. Over 80% were born to mothers with AIDS or at risk of HIV infection, 11% received transfusions of contaminated blood, and 5% received contaminated blood products. Through December 1989, 53% of white, 91% of black, and 85% of Hispanic children with AIDS were infected vertically by their mothers. In the US, over 1/2 of cases of vertical AIDS transmission are due to maternal IV drug abuse and 1/5 to mothers who have sexual relations with IV drug abusers. The rate of infection in children born to seropositive mothers has not been established. Estimates of rates of transmission range from 20% to 50%. The factors causing HIV transmission in 1/3 of infants and protecting the other 2/3 have not been identified. Transmission to the infant may occur during pregnancy or delivery or through breast feeding. There is no evidence that cesarean delivery can protect against infection. The risk of intrauterine infection is probably much greater than that of infection during delivery. Diagnosis of HIV infection in young infants is difficult. There are no physical characteristics distinguishing infected newborns, and laboratory diagnosis is unhelpful because maternal HIV antibodies cross the placental barrier to the fetus. There is as yet no vaccine or curative treatment for HIV infection. Prevention of pediatric HIV infection requires prevention of the infection and the disease in pregnant women. Primary prevention in women depends on their being adequately informed about risks and able to change risk behaviors. Secondary prevention is achieved through use of AZT, which slows the progression of the disease, and prevention or treatment of complications. There is no conclusive evidence as yet that pregnancy hastens the progression of maternal HIV infection. Seropositive mothers should avoid breast feeding if adequate substitute foods are available. The average age at appearance of symptoms in infected children is 8 months. Mortality is higher among children manifesting the disease in the 1st year, with a median survival of 38 months. Full information about HIV infection and voluntary and confidential screening should be available to all women contemplating pregnancy.     

The AIDS epidemic in Cuba

The strategy of the Cuban government to control HIV consists of examining the whole adult population and quarantining all seropositive persons in local institutions. Between 1986 and 1990, a total of 8,832,726 HIV tests were done using domestic ELISA and Western blot methods. 497 persons (362 men and 135 women) were found to be HIV-positive. 122 infections were directly attributed to Cuban intervention in Africa. 150 infected men were homosexuals and bisexuals. Infected blood products caused 9 cases, and neonatal transmission produced 3 infections. 63 AIDS cases were reported since December 1989. Compulsory testing would be more acceptable if HIV infected persons would get zidovudine (AZT) for secondary prevention. It is estimated that this policy has prevented 4000 new infections. The violation of human rights by quarantining people with false positive results is real: 23-53 such people are estimate to be quarantined. Tourists are not examined because of the economic need for more revenue from tourism, thus HIV transmission could continue despite quarantines. The cost of testing is high, although health care already made up 12% of the budget in 1989, increasing from 7.8% in 1983. Tracing sexual contacts requires 450 nurses and 200 epidemiologist. The public education campaign about AIDS involved 30 television programs and several hundred radio programs by groups of experts discussing transmission, AZT treatment, and treatment of opportunistic infections. Since 1988, schools have also included AIDS education from the 5th grade on. Condom use is stressed, but machismo often hinders its acceptance. While AIDS is a menace, the rate of syphilis increased from 7.2/100,000 in 1970 to 84.3/100,000 in 1987. Stressing personal responsibility in preventing HIV infection skirts the need for modification of high risk behavior and lulls the public into a false sense of security because of the belief that full protection from AIDS is provided by the quarantine.     

Determinants of perceived risk for HIV infection among police officers

Police officers often come into contact with persons who are considered members of high risk groups for HIV infection, such as intravenous drug users and prostitutes. The present exploratory study employs field research methodology to observe patrol officers in their work settings in urban and rural locations to investigate contributing factors to their perceived risk of HIV infection. Four notable findings emerged. First, departmental training may not lower fear or perceived risk of HIV infection among police officers. Second, awareness of modes of transmission may increase perceived risk among officers but awareness of and access to protective measures may decrease fear and perceived risk. Third, access to protective measures is not always perceived as enough to ensure safety for officers who are faced with administering first aid to bleeding persons who may be HIV positive. Fourth, “street wisdom” may give police officers an illusion of safety.     

Perceived emotional and life change impact of AIDS on homosexual men in two countries

Abstract

A comprehensive self-administered life event inventory examining both general life stress and stress from events specific to the homosexual and bisexual male population was developed in order to assess the impact of AIDS and HIV infection on homo- and bisexual men. Ranking of questions revealed that while general stressors affected homosexuals similarly to heterosexuals, there were critical stressors affecting homosexuals not measured by conventional inventories. Specifically, emotional distress from receiving an HIV antibody positive result was not significantly different to that caused by a diagnosis of AIDS or ARC, the diagnosis of AIDS in a lover or the death of a lover. A sharp discrepancy in emotional distress between current safer sex behaviour and current unsafe sexual behaviour was also found, and the implications for behavioural modification in this area noted. Those who were HIV antibody positive tended to evaluate the anticipated impact of further AIDS related diagnoses as having a greater emotional impact than those who had tested negative. There would appear to be a closer relationship between emotional distress and life change in homosexual men than in heterosexual samples. The relative emotional impacts and life change assessments of AIDS and HIV infection are discussed.     

Cynical Hostility: A Risk Factor in HIV-1 Infection?1

The aims of this study of HIV-1 positive and HIV-1 negative gay males without disease were (a) to determine whether cynical hostility in these groups (measured by the Cook-Medley Ho scale) is associated with psychosocial deficits that potentially could influence the course of HIV infection; and (b) to examine the construct validity of the sum of three Ho subsets in this sample. Correlational analyses on the full samples, and multivariate analyses of high- and low-hostility groups (formed using Ho scale cutoffs from previous research), examined person variables (traits, coping style), environmental variables (social support, stressors), and affect. In all domains other than stressors (traits, coping styles, social support, and affect), cynical hostility was associated with psychosocial deficits, with results generally stronger for the full Ho scale than for the subset sum. Results support previous research on psychosocial deficits of the cynically hostile, extend findings to HIV-infected gay males, and enlarge our understanding of the trait and coping style correlates of cynical hostility. Implications of these findings for HIV infection are discussed.     

Substance P and Human Immunodeficiency Virus Infection: Psychoneuroimmunology

Effects on the immune system caused by changes in behavioral state or brain activity are mediated, at least in part, through neuroendocrine-immune pathways. Life stress and depression may be associated with altered blood levels of central nervous system-released neuropeptides, including substance P (SP). SP acts as a neuroregulator or neurotransmitter in the conduction of nociceptive stimuli, and is a modulator of neuroimmunoregulation. This review summarizes current knowledge regarding the role of the neuropeptide, SP, in psychoneuroimmunology, in particular as it relates to human immunodeficiency virus infection and acquired immunodeficiency disease syndrome. The association between depression, anxiety, and stress in HIV-disease progression suggests that neurobiologic and neurophysiologic factors play a role in modulating HIV infection and responses to antiretroviral therapy. Individuals with HIV or AIDS may experience stressful life circumstances that can result in increased symptoms of anxiety, stress, and/or depression. Furthermore, psychological and psychiatric symptoms, which occur in individuals with HIV and AIDS, may be related to the progression of AIDS disease. This review presents evidence from the literature, as well as findings from basic investigations conducted in the authors' laboratories, demonstrating that SP may play an important role in HIV pathophysiology. SP can impact the susceptibility of immune cells to HIV infection and modulate immune cell functions in ways that may affect the course of HIV in infected individuals. Moreover, modulation of SP activity and SP receptor is being explored for its potential as a novel therapeutic approach to the treatment of some psychological and psychiatric disorders and to the design of new anti-HIV therapy.     

Information and attitudes about HIV/AIDS in Portuguese adolescents: state of art and changes in a four year period

The incidence of infection with HIV/AIDS among the heterosexual population has been increasing in young adults. The goal of this research was to deepen knowledge of preventive sexual behavior in Portuguese adolescents, including knowledge and attitudes about HIV/AIDS, and assessing whether they changed from 2002 to 2006. Data were collected through a self-administered questionnaire from the Portuguese sample of the Health Behavior in School-aged Children (HBSC), a collaborative WHO study. The study provides national representative data of 7093 Portuguese adolescents, randomly chosen from those attending 8th and 10th grade of high school. Results showed there was an increase in the age of first sexual intercourse and a decrease in the number of teenagers who reported having had sexual intercourse, also in the level of information regarding HIV/AIDS transmission/prevention and in positive attitudes towards people with HIV/AIDS. In general, adolescents have good knowledge about how to protect themselves from becoming infected. However, comparing to 2002, there was a reduction of knowledge and consequent increase in the doubts regarding HIV/AIDS. Given the incipient state of sex education in 2006, the results cannot be attributed to sex education, but they will be relevant for comparison with the 2010 HBSC results.     

Beliefs Contributing to HIV‐related Stigma in African and Afro‐Caribbean Communities in the Netherlands

Thirty years after the first diagnosis, people living with HIV (PLWH) around the world continue to report stigmatizing experiences. In this study, beliefs contributing to HIV‐related stigma in African and Afro‐Caribbean diaspora communities and their cultural context were explored through semi‐structured interviews with HIV‐positive (N = 42) and HIV‐negative (N = 52) African, Antillean and Surinamese diaspora community members in the Netherlands. Beliefs that HIV is highly contagious, that HIV is a very severe disease, and that PLWH are personally responsible for acquiring their HIV infection were found to contribute to HIV‐related stigma, as did the belief that PLWH are HIV‐positive because they engaged in norm‐violating behaviour such as promiscuity, commercial sex work, and, for Afro‐Caribbean diaspora, also homosexuality. These beliefs were found to be exacerbated and perpetuated by cultural taboos on talking about HIV and sexuality. HIV‐related stigma reduction interventions should focus on changing these beliefs and breaking cultural taboos on HIV and sexuality in a manner that is participatory and consistent with the current theory and empirical findings. Copyright © 2011 John Wiley & Sons, Ltd.     

Prediction of Needle Sharing Among Injection Drug Users1

The aim of the present study was to identify the psychosocial factors associated with the intention and behavior of not sharing used needles and syringes among 459 intravenous drug users (IDUs). The intention to not share used needles was positively associated with personal normative beliefs and self‐efficacy; it was negatively related to the proportion of injections with lending used needles and borrowing syringes from sexual partners. Borrowing used needles was negatively associated with intention whereas loaning syringes was positively related to a negative HIV test result. These results suggest that it is only when a direct personal exposure to HIV infection is possible (borrowing) that intention not to borrow is highlighted. Moreover, being HIV positive appears to reduce loaning used syringes.     

HIV infection in the South African construction industry

South Africa has one of the highest HIV prevalences in the world, and compared with other sectors of the national economy, the construction industry is disproportionately adversely affected. Using data collected nationally from more than 57,000 construction workers, HIV infection among South African construction workers was estimated, together with an assessment of the association between worker HIV serostatus and worker characteristics of gender, age, nature of employment, occupation, and HIV testing history. The HIV infection of construction workers was estimated to be lower than that found in a smaller 2008 sample. All worker characteristics are significantly associated with HIV serostatus. In terms of most at-risk categories: females are more at risk of HIV infection than males; workers in the 30–49 year old age group are more at risk than other age groups; workers employed on a less permanent basis are more at risk; as are workers not having recently tested for HIV. Among occupations in the construction industry, general workers, artisans, and operator/drivers are those most at risk. Besides yielding more up-to-date estimated infection statistics, this research also identifies vulnerable sub-groups as valuable pointers for more targeted workplace interventions by construction firms.     

Family Impact Analysis of Section?6 (Sexual Transmission) of the Kenya HIV and AIDS Prevention and Control Act No. 14 of 2006

We have analyzed the impact of Section 6 of The Kenya HIV and AIDS Prevention Act on Kenyan families and especially within marriage. In 2006 Kenya passed two bills into law: The Kenya HIV and AIDS Prevention Act and The Sexual Offences Act. The latter addresses sexual offenses including rape, incest and other acts of sexual violence and relates to the Prevention Act in that HIV infection may be transmitted during a sexual offense. Section 6 of the Prevention Act focuses on the sensitive issue of secondary and tertiary transmission of HIV. Although protection is accorded to individuals living with HIV, this section of the law places responsibility on this group to reduce infections among positive individuals as well as the spread of infection between spouses {when only one partner is positive} by criminalizing recklessness leading to HIV infection. By asking questions proposed in the family impact analysis such as, does the law enhance family stability, and commitment or does it acknowledge diverse family forms, interdependence and target vulnerable groups, the framework allows us to examine the impact of Section 6 of the law on families. Under the FIA framework, the ability of The Prevention Act to enhance family functions, promote wellbeing, marital stability, commitment and responsibility is considered while taking into account the contextual realities in Kenya.     

Responsibility judgments and responses to people living with AIDS in China: testing an attributional perspective

With one in five individuals in the world living in China, there is an urgent need for HIV prevention and understanding HIV/AIDS stigma in China. This study applies an attributional analysis to Chinese students' responses to AIDS, examining effects of attributions of causal controllability for HIV infection on reactions to people living with HIV/AIDS. Students (n = 309) read one of two scenarios describing an AIDS patient and manipulating controllability of AIDS onset. Controllability of AIDS onset contributed to responsibility judgments, less positive affect, and lower desires to personally interact with the patient. Responsibility judgments predicted interaction wishes directly and indirectly through positive affect. Results provide support for Weiner's interpersonal attributional model. Implications for responses to AIDS in China are discussed.     

防艾宣传大学生对艾滋病患者的内隐态度与交往意愿

目的：探讨大学生防艾宣传者对艾滋病患者的内隐态度。方法：采用自编大学生与艾滋病患者交往意愿调查问卷,通过测量获得对艾滋病患者有较高交往意愿的防艾宣传者100名,并随机抽取其中30名作为实验被试,完成了两组内隐联想测验（IAT）。结果：当艾滋病相关词与普通正性词相联以及非艾滋类乙型传染病与普通负性词相联时,其平均反应时低于艾滋病与一般消极性词相联及非艾滋类乙型传染病与普通正性词相联时的反应时;当艾滋病相关词与正性人际词相联以及非艾滋类乙型传染病与负性人际词相联时,其平均反应时与艾滋病和负性人际词相联及非艾滋类乙型传染病与正性人际词相联时的反应时无统计学意义的差异。结论：大学生防艾宣传者对各类传染病患者的内隐交往意愿处于同一水平,但相对于非艾滋类乙型传染病而言,其对艾滋病患者的消极厌恶水平较低。     

Prevalence of suicidal ideation and associated factors among postpartum HIV-positive women in health facilities,South Africa

The goal of this study was to investigate the prevalence of suicidal ideation and its associated factors in postpartum HIV-positive women in South Africa . A cross-sectional survey was carried out on 580 HIV positive postnatal women (M = 28 .5 years; SD = 5 .8) in 48 health facilities in Nkangala district, Mpumalanga, South Africa . Results indicate that 41 .2% of women reported suicidal ideation in the postnatal period . In multivariate analysis, receiving money from the family, having been diagnosed with a sexually transmitted infection (STI) (other than HIV) in the past year, and lack of social support were found to be associated with suicidal ideation . In conclusion, suicidal ideation is common among HIV positive postpartum women, which calls for inclusion of suicidality risk assessment and management protocols in interventions targeting postpartum women living with HIV .     

Mental health correlates of HIV risk behaviour and STIs/HIV infection among university students from 22 low,middle and high income countries

The aim of this study was to determine mental health correlates of HIV risk behaviour and self-reported STIs/HIV infection among university students in 22 low, middle and high income countries. Data on mental health and HIV risk were collected from 16 567 undergraduate university students (mean age 20.9, SD = 2.9) from 23 universities in 22 countries across Asia, Africa and the Americas. Results indicate that overall 16.8% of the students had two or more sexual partners in the past 12 months, and among the sexually active, 73.7% had inconsistently used a condom in the past three months with their primary sexual partner, 3.2% had ever been diagnosed with a sexually transmitted infection (STI) and 0.6% had been diagnosed with HIV. In multivariate logistic regression poorer mental health and child abuse (physical and sexual) were associated with HIV risk behaviour, and child abuse (physical and sexual) was associated with STI and HIV positive diagnoses.     

Ante-natal HIV testing: An observational study of HIV test discussion in maternity care

There has been a vociferous call for ante-natal HIV testing but low uptake persists in the UK despite DOH guidelines. The reasons for this are complex, with many studies examining intention, offer and uptake of HIV test but few observing the process to understand the nature of HIV discussion with pregnant women. A field observational study was undertaken where researchers attended 154 ante-natal consultations. These were selected in rotation during ante-natal visits by women at four London hospital based ante-natal clinics. A standardized checklist was utilized to monitor information on HIV. A mean of 1.73 minutes was spent discussing HIV infection and testing during ante-natal consultations which lasted for a mean of 33.1 minutes. Risk factors for HIV were mentioned infrequently. When mentioned they concentrated on sexual behaviour which was raised in 11.7% of the consultations. Potential interventions to reduce vertical transmission were discussed with no more than one in five women and possible adverse implications of HIV testing with fewer than one in ten, the only exception being the implications of a positive diagnosis for the baby. Discussion of interventions was associated with HIV test uptake, but risk discussion was not. The short time spent on discussing HIV testing, combined with paucity of mention of information relevant to pregnancy are issues for concern and probably help to explain the level of uptake in the UK.     

Family-level impact of the CHAMP Family Program: a community collaborative effort to support urban families and reduce youth HIV risk exposure

This article presents family-level results from an ongoing study examining the impact of the CHAMP (Chicago HIV prevention and Adolescent Mental health Project) Family Program, a family-based HIV preventative intervention meant to reduce the amount of time spent in situations of sexual possibility and delay initiation of sexual activity for urban youth in the 4th and 5th grades living in neighborhoods with high rates of HIV infection. The CHAMP Family Program has been developed, delivered, and overseen by a collaborative partnership, consisting of community parents, school staff, community-based agency representatives, and university-based researchers. Design of the program was informed by input from this collaborative partnership, child developmental theory of sexual risk, and empirical data gathered from the targeted community. This article presents findings that suggest CHAMP Family Program impact on family communication, family decision-making, and family-level influences hypothesized to be related to later adolescent HIV risk. Implications for future family-based HIV prevention research are discussed here.     

HIV infection and drug users: Setting up support groups

The emergence of Human Immunodeficiency Virus (HIV) infection has highlighted the need for the development of risk reduction strategies among drug users. A network of support and self help, whilst fully developed among gay men, has been slow to develop with drug users. Possible reasons for this are examined. Examples of this type of approach in Britain and other countries are reviewed. The positive aspects of encouraging the development of self help groups are discussed. The lesons learned from the first 6 months of a drug users support group are described.