Counseling Caregivers of Families Affected by HIV/AIDS: The Use of Narrative Therapy

This article proposes the use of Narrative Therapy with family caregivers of family members diagnosed with HIV/AIDS. The authors identify the reasons for using Narrative Therapy with African family caregivers who have relocated to the United States of America. The tenets of Narrative Therapy are outlined, and a case illustration is provided to show how Narrative Therapy can be implemented. In this case study, the client moves from a state of helplessness and hopelessness to being able to regain control of her life and improve the care of her sister. She was able to re-write her story: from feeling incompetent to a position of strength. Although Narrative Therapy was used successfully with an African family caregiver within the USA, the authors assert that the interventions have the potential to be used as effectively with those clients living in Africa, provided counselors are sensitive to cultural differences that will affect their practice.     

Child Psychosocial Adjustment and Parenting in Families Affected by Maternal HIV/AIDS

Child adjustment and parenting were examined in twenty-three 9–16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were seropositive reported significantly more externalizing problems. Infected mothers reported less age-appropriate supervision/monitoring relative to non-infected mothers. Better mother-child relationship quality and less impairment in parental supervision/monitoring of age-appropriate youth behaviors were associated with fewer externalizing difficulties among the HIV-positive group only. Similarly, only among HIV-infected mothers was refraining from engaging in inconsistent disciplinary tactics associated with lower reports of internalizing and externalizing problems. These data highlight the promise of programs targeting parenting skills to prevent or ameliorate child difficulties.     

Social Support,Conflict, and Integration Among Women Living With HIV/AIDS1

The relationship between depressive symptoms and perceptions of available social support, social conflict, and subjective social integration were examined as part of a psychosocial study of Puerto Rican, African American, and non‐Hispanic White women living with HIV/AIDS (N= 146) in New York City. Lower levels of subjective social integration and higher levels of social conflict were associated with more depressive symptoms. Perceived availability of social support was not significantly associated with depression in comparison with these other forms of support. No evidence was found for a stress‐buffering or a stress‐amplification effect. Significant ethnic differences in levels of social integration and social conflict also were noted. Results suggest that intervention efforts should go beyond addressing support to further address the conflict and lack, of integration experienced.     

Support Group Needs for People Living with HIV and AIDS (PLWHA) in Communities around Durban,South Africa

The study constructed a participant centred perspective of what members of a support group for people living with HIV and AIDS (PLWHA) desired from their group meetings. The study sample (n = 34) was from three support groups of PLWHA in a province of South Africa (males = 7, female = 27, mean age = 34.2 years, SD = 6.8 years). Participants completed a brief survey and participated in focus group discussion on views on the ideal support group, actual experience with the support group, and solutions for effective support groups. Findings suggest most members of the support group experienced a high degree of stigma at home and needed a so-called ‘safe space’ to escape to and discuss issues with people experiencing similar problems. Respondents wanted to acquire skills to allow them to help themselves and others in the community. They also desired HIV education so that they could properly understand the virus and help the community understand it to reduce stigma.     

Support Needs and Satisfaction in Foster Care: Differences Between Foster Mothers and Foster Fathers

Family foster care is a vulnerable youth care intervention. The recruitment and retention of foster parents causes concerns. Offering support to foster mothers and foster fathers can augment the satisfaction and the intent of continuing fostering. Clearer understanding of the support needs of foster parents and their satisfaction with the foster care placement can lead to the identification of ways to improve the support offered. Although differences between foster mothers and foster fathers regarding their support needs and satisfaction can be expected, knowledge about these differences is nonexistent. Differences in support needs and satisfaction between 86 foster mothers and foster fathers who reported on 120 foster children were examined. No differences between foster mothers and foster fathers were found. Both foster parents had higher support needs regarding dealing with the birth parents compared to support needs in handling problem behavior of the foster child. For both foster mothers and foster fathers satisfaction with collaboration with the foster care worker, satisfaction with recognition experienced and satisfaction with reunification of the foster child, did not differ across these aspects. Satisfaction of foster parents can be increased by keeping in balance the rights and needs of birth parents and those of foster parents. Acknowledging that foster parents are experts on their foster child and consulting them on important decisions will also contribute significantly to their satisfaction.     

Perceived Church-Based Needs and Assets for HIV/AIDS Prevention in an Urban Nigerian Community

Health intervention programs have the potential to use church-based assets to address a wide range of health issues. This study examined the assets Nigerian church members believed their churches needed, including the assets they thought they had to engage in HIV/AIDS prevention activities. Eight hundred and thirty members from 83 churches completed a questionnaire designed from forum focus group data. Respondents were males and females aged 18 years old and above, with primary, secondary, university, or vocational education, and were more likely to be married than single (never married), separated, divorced, widowed or remarried. The data revealed that church members needed access to health promotion assets, including the expertise of members who are health professionals to engage in HIV/AIDS prevention activities. We recommend an intensive HIV/AIDS prevention reorientation-training workshop for church leaders to ensure a sustainable plan to address HIV/AIDS prevention needs.     

Attachment,Social Support,Resilience and Posttraumatic Stress Disorder Symptoms in Chinese Adults Living with HIV/AIDS

The present study aimed to examine the effects of attachment, social support and resilience on posttraumatic stress disorder (PTSD) symptoms in people living with HIV/AIDS. One hundred fifty-two HIV+ adults in China were investigated. The results suggested that attachment anxiety had a significant direct effect on PTSD symptoms and impacted PTSD symptoms indirectly though associations with social support and resilience. Attachment avoidance could also be considered a distal risk factor of PTSD symptoms via the mediation of social support and resilience. The findings highlight the importance of identifying trauma and PTSD symptoms in people affected by HIV/AIDS and suggest that people with attachment anxiety and low social support resources might be at high risk for PTSD.     

The Challenges of HIV/AIDS Counselling in Nigerian Secondary Schools: A Case Study of Kwara State

The study investigated the challenges of HIV/AIDS counselling in Nigerian secondary schools as expressed by school counsellors in Kwara state, Nigeria. The respondents comprised 132 purposively selected counsellors in Kwara state public secondary schools (Male=85; Female=47). Data were collected with the use of a survey instrument and the data were quantitatively analyzed. The study identified the challenges hindering effective implementation of HIV/AIDS counselling in Nigerian secondary schools as ignorance, non-existence of governmental policy on HIV/AIDS counselling in schools and negative attitudes of school administrators, students and teachers to HIV/AIDS. Geographical location and job status had significant influence on the respondents' views of the challenges facing HIV/AIDS counselling in Nigerian secondary schools. The Counselling Association of Nigeria (CASSON) should enlighten Nigerians on the importance of HIV/AIDS counselling in schools.     

Disengagement and Engagement Coping with HIV/AIDS Stigma and Psychological Well-Being of People with HIV/AIDS

The stigma associated with HIV/AIDS poses a psychological challenge to people living with HIV/AIDS. We hypothesized that that the consequences of stigma-related stressors on psychological well-being would depend on how people cope with the stress of HIV/AIDS stigma. Two hundred participants with HIV/AIDS completed a self-report measure of enacted stigma and felt stigma, a measure of how they coped with HIV/AIDS stigma, and measures of depression and anxiety, and self-esteem. In general, increases in felt stigma (concerns with public attitudes, negative self-image, and disclosure concerns) coupled with how participants reported coping with stigma (by disengaging from or engaging with the stigma stressor) predicted self-reported depression, anxiety, and self-esteem. Increases in felt stigma were associated with increases in anxiety and depression among participants who reported relatively high levels of disengagement coping compared to participants who reported relatively low levels of disengagement coping. Increases in felt stigma were associated with decreased self-esteem, but this association was attenuated among participants who reported relatively high levels of engagement control coping. The data also suggested a trend that increases in enacted stigma predicted increases in anxiety, but not depression, among participants who reported using more disengagement coping. Mental health professionals working with people who are HIV positive should consider how their clients cope with HIV/AIDS stigma and consider tailoring current therapies to address the relationship between stigma, coping, and psychological well-being.     

Communicating HIV/AIDS Through African American Churches in North Carolina: Implications and Recommendations for HIV/AIDS Faith-Based Programs

This study explores HIV/AIDS communication strategies among church leaders at predominately African American churches in a metropolitan city and surrounding areas in North Carolina. The church leaders contacted for the study are members of an interfaith-based HIV/AIDS program. The researchers used semi-standardized interviews to explore how church leaders address HIV/AIDS in the church. The findings indicate that the seven church leaders who participated in the study use a variety of communication channels to disseminate HIV/AIDS information for congregants and their surrounding communities, which include both interpersonal and mass media.     

Religio-Biography, Coping, and Meaning-Making Among Persons with HIV/AIDS

Recently, quality of life studies among patients with HIV/AIDS have shown high levels of life satisfaction. Spiritual and religious factors may contribute to these positive outcomes. We interviewed 19 patients with HIV/AIDS in order to understand better the role of religious‐spiritual biographies and orientations in quality of life, and found four patterns to describe the ways in which past experiences with religion/spirituality and religious/spiritual meaning‐making help to explain how patients are currently coping with HIV/AIDS. We illustrate each of these patterns with a prototypic patient: (1) the Deferring Believer (“God allows things to happen for a reason.”); (2) the Collaborating Believer (“This is where I'm supposed to be.”); (3) the Religious/Spiritual Seeker (“I'm trying to get my life together.”); and (4) the Self‐Directing Believer (“What else is new?”). The findings support a previously described theoretical model of meaning‐making in response to adversity, and they suggest the value of life course and narrative approaches to understanding religious coping.     

农村艾滋病人心理支持典型案例分析

艾滋病的防治不仅是药物治疗的问题,还应该重视病人的心理问题.介绍农村地区开展艾滋病人心理支持的三个典型案例,HIV检测确诊阳性后心理支持的案例、需要长期心理支持的案例、心理支持后自强不息的案例,进行案例分析,并探讨艾滋病人心理支持策略,为今后开展类似活动提供参考依据.