Health-related Internet use, coping, social support, and health indicators in people living with HIV/AIDS: preliminary results from a community survey.

Widespread Internet use has revolutionized health information and patient education for persons with chronic illnesses. The authors surveyed 147 HIV-positive persons to examine factors associated with Internet use and associations between Internet use and health. Information, motivation, and behavioral skills associated with using the Internet were related to Internet use. The authors found that health-related Internet use was associated with HIV disease knowledge, active coping, information seeking coping, and social support among persons who were using the Internet. These preliminary findings suggest an association between using the Internet for health-related information and health benefits among people living with HIV/AIDS, supporting the development of interventions to close the digital divide in HIV/AIDS care.     

Social and Cultural Sensitivity in Group-Specific HIV and AIDS Programming

In this article the authors encourage counselors and other human development professionals to provide HIV (human immunodeficiency virus) and AIDS (Acquired Immune Deficiency Syndrome) prevention programming that is sensitive to the social and cultural contexts of the specific group(s) addressed. The focus is on four groups that have been both the target for societal oppression and dramatically affected by the HIV and AIDS epidemic: women, gay and bisexual men, African Americans, and Latinos. First, information is provided to help professionals become more aware of the social and cultural contexts of behavior related to HIV and AIDS prevention in the four groups named. Second, four recommendations are made to assist professionals to sensitively apply that awareness to the planning and implementing of HIV and AIDS prevention programming. Four exemplar programs illustrate the implementation of these recommendations.     

HIV/AIDS and health care workers: contact with patients and attitudes towards them

Data on a range of variables associated with contact with patients with HIV/AIDS and attitudes towards them were collected from 174 Scottish health care workers. Measures of attitudes and contact (overall, social and physical) were derived from the scales devised by Pleck et al. (1988). The measure of overall contact was not significantly related to attitudes, but those with predominantly social contact with patients with HIV/AIDS had more positive attitudes towards them. This relationship was moderated by occupational characteristics, concern about working with people of unknown HIV status and neuroticism. With all these variables controlled, including social contact, those who had not received in-service training relating to HIV/AIDS had more negative attitudes. The results are discussed with regard to the measurement of social contact with patients, salient beliefs, the occupational characteristics associated with attitudes, and in-service education.     

Psychometric properties of the Death Anxiety Scale (DAS) among HIV/AIDS patients

AIDS patients and HIV carriers who are aware of their condition are under multiple kinds of stress with adverse effects on their emotional state and personal and social activity. This paper reports the psychometric properties of the DAS (Death Anxiety Scale) using the Spanish version in the clinical setting. The sample is made up of 148 HIV/AIDS patients (109 men and 39 women). The internal consistency of the scale was .72 and its test-retest reliability was .70. Principal components analysis extracted five factors that jointly accounted for 56.5% of the total variance. As, on the whole, these results are very similar to those reported by other authors, it is concluded that the Spanish DAS is a valid instrument for the assessment of death anxiety in Spanish HIV/AIDS patients.     

Globalization and its discontents: challenges to developmental theory and practice in Africa

The three contributions to this Special Section on Culture and Human Development are summarized and critiqued. In considering the nature of contemporary psychological science, as well as applications to early childhood care and development, education to prevent HIV/AIDS, and formal academic education, the various authors are in general agreement on the limitations of current knowledge as it applies to African populations. There is also a common focus on the promise of scientific procedures that take seriously the importance of local understandings, institutions, and social settings.     

Researching HIV/AIDS,Education & Childhood in the African Context

This article offers a reflective review of 12 articles and 4 brief reports included in this special issue of the International Journal of Psychology in Africa with the theme, ‘HIV/AIDS, education and childhood in the African context’. Muthukrishna and Ramsuran (2007) have emphasised that the consequences of HIV/AIDS can be far-reaching for children and young people resulting in unequal life chances. It is thus fitting that this special issue should be edited by them in KwaZulu-Natal, South Africa, in the country (and province) with the highest levels of incidence of HIV/AIDS in Africa. In this article I offer a commentary on how the interpretive lenses of the authors who are located in various disciplines provide a theorised understanding of what shapes knowledge constructions in situated African contexts.     

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.     

Mapping an HIV/STD prevention curriculum for Zambian in-school settings

HIV/AIDS poses grave risk to human development in sub-Saharan Africa. Evidence-based interventions that are rooted in local culture could help efforts to prevent threats to human development from HIV/AIDS. We used concept mapping (Concept System, 2006 ) to construct the components and content of a locally developed HIV/AIDS curriculum for use by secondary schools in Lusaka, Zambia. Participants were school counsellors (n = 14), youth health program officers (n = 7), and regular education teachers (n = 3) from the education, health, and youth development agencies in Lusaka, Zambia (males = 11; females = 13; mean age 38; SD = 15 years). Concept mapping yielded six statement clusters defining preliminary components of a locally grounded in-school HIV/AIDS prevention curriculum and the content items that define these components: (1) life skills education (18 items), (2) sexuality and reproductive health (10 items), (3) treatment, care and support (13 items), (4) counselling (12 items), (5) basic facts about HIV/AIDS (11 items), and (6) dissemination of information about HIV/AIDS (11 items). Zambian locally constructed constructs for an HIV/STD prevention curriculum overlap those promoted by public health programs in the country and internationally.     

Empathy,Knowledge, and Personal Distress as Correlates of HIV‐/AIDS‐Related Stigmatization and Discrimination

This study investigated the influence of empathy, knowledge, and personal distress on HIV‐/AIDS‐related stigmatization and discrimination in a normal population (N = 346). Participants ranging in age from 18 to 69 years responded to a validated questionnaire. The results showed a significant main and joint influence of empathy, knowledge, and personal distress on stigmatization and discrimination. Stigmatization and discrimination are thus identified as great obstacles in the fight against and prevention of HIV/AIDS. Stakeholders in the HIV/AIDS arena should embark on mass education to increase knowledge of HIV/AIDS; also attitudinal change programs should be initiated, while health institutions should be effectively monitored to ensure best practices.     

HIV/AIDS and immigrant Cape Verdean women: Contextualized perspectives of Cape Verdean community advocates

This research explored Cape Verdean community advocates’ understandings of the structural and social realities that contribute to the increased HIV/AIDS risk of Northeastern U.S.-based immigrant Cape Verdean women. A community perspective informed the analysis of the multi-layered contextual barriers that these advocates identified as limiting the effectiveness of individual-level HIV/AIDS prevention and intervention models. Qualitative content analysis of interviews with nine community advocates revealed several thematic clusters including challenges to (1) perceived institutional and community realities; (2) traditional gender relations; and, (3) traditional ways of thinking. These findings challenge universalist cognitive-behavioral change models of HIV/AIDS prevention and intervention and are critically discussed to better understand the complex realities faced by Cape Verdean immigrant women. A liberatory community psychology perspective framed the research process and contributed to reconceptualizing HIV/AIDS risk as a community problem that requires interventions not simply at the individual and relational levels, but also at the structural level.     

Listening to the Voices of Children in Early Schooling in the South African Context of HIV/AIDS

This study explored how children in early schooling interpreted their social reality to construct vulnerable childhoods in an HIV/AIDS context. Ten males and ten females between the ages of eight and nine years from low-income families in KwaZulu-Natal participated in the study. In order to raise the voices of the children, a listening framework was created through participatory techniques. Focus group interviews, drawings, story telling and projection techniques were used in the study. The study found that children actively interpreted their social reality through engaging with circumstances that surrounded their lives in an HIV/AIDS context. Child activism is important to HIV/AIDS education.     

An Investigation of the Determinants of Stigmatization and Prejudice Toward People Living With HIV/AIDS

The components and determinants of HIV/AIDS stigma and prejudice were investigated in an online‐questionnaire study. The results show that the components of the attitude toward people with HIV/AIDS consist of social distance, demands for political measures, negative stereotypes, and attribution of responsibility to people living with HIV/AIDS. Besides antigay attitudes and false beliefs about ways of infection, the HIV/AIDS attitude is connected to and depends on social dominance orientation (SDO) and right‐wing authoritarianism (RWA). Structural equation modeling indicated that antigay attitudes and false beliefs function as mediator variables for SDO and RWA. Implications of the results are discussed.     

Working class homosexuality and HIV/AIDS prevention some recent research from Sydney,Australia

Abstract

Surveys on gay and bisexual men in Sydney and non-metropolitan New South Wales (NSW) indicate uneven patterns of HIV/AIDS knowledge and sexual behaviour change. As a follow-up action-research study, the Class, Homosexuality and AIDS Prevention (CHAP) project pursued audio-recorded, semistructured interviews with men in western Sydney and Nullangardie, a provincial city in NSW, to investigate the relationship between homosexuality and class.

One-to-one interviews with working-class, homosexually active men revealed particular patterns of homosexual initiation and sexual relationships, and a distinct culture being slowly affected by notions of being “gay” and “gay community”. This impact of modern gay life on western Sydney was different from that in the provincial city. More prominent were the effects of class—unemployment, poor education, poverty, and cultural marginalisation—on the experience and elaboration of homosexuality. Group interviews confirmed an experience of “difference” from prominent gay communities, especially Sydney's “Oxford Street” gay quarter. Working-class men offered a critique of gay community-initiated HIV/AIDS prevention strategies, pointing toward different education initiatives involving local social networks.

Case studies are presented to argue the importance of the relation between sexuality and class, and its consequences for HIV/AIDS education.     

College students and HIV/AIDS: more insights on knowledge, testing, and sexual practices

In this study, the authors confirm and expand previous findings (M. Anastasi, R. G. Sawyer, & P. J. Pinciaro, 1999; J. E. Lewis & R. M. Malow, 1997) concerning college students' knowledge and perceptions about HIV/AIDS. Although students are knowledgeable about HIV/AIDS, they have little personal concern about becoming infected and do not take appropriate safe sex precautions. Findings of the present study show that gender, ethnic background, and knowing someone infected by HIV/AIDS influence students' level of concern about infection. In addition, older students and those who know someone infected by HIV/AIDS are more likely to have been tested. Results are compared with national surveys of other age groups, and the authors suggest specific intervention strategies for college students.     

Opinion on AIDS prevention and education among rural secondary school pupils in the northern province of South Africa

The study investigated perceptions of AIDS prevention and education among 308 Grade 11 pupils (132 boys and 176 girls), secondary school pupils (mainly Northern Sotho and Tsonga) in the Northern Province of South Africa. They were chosen randomly from three rural schools in Mankweng district and were ages 17 to 25 years (M age = 19.1 yr., SD = 2.8). Analysis of ratings given on items of a questionnaire on AIDS prevention and education indicated that 'Isolating people who are HIV positive' and 'How to protect yourself from getting HIV/AIDS' received the highest ratings. Factor analysis extracted three factors on AIDS education explaining 48% of the variance. The items loading strongly on the first factor were use of condoms (.54), giving information (.53), finding a cure (.52), and no sex outside marriage (.42). On AIDS education two factors were extracted accounting for 52% of the variance. The first factor had significant item loadings for 'sexual behaviour and HIV/AIDS' (.75), 'knowledge of self-protection' (.68), 'how AIDS/HIV affects the body' (.66), and 'alcohol and sexual behaviour'. These findings should contribute to the development of health promotion initiatives directed at AIDS/HIV.     

Counseling in the Era of AIDS

The AIDS (Acquired Immune Deficiency Syndrome) crisis is affecting greater numbers of people, and counselors are being called upon to work with this population. Counseling roles have expanded, and counselors have been thrust into the medical, social service, and political spheres. In this article the authors describe the role of the counselor in the era of AIDS; psychological reactions to a chronic, stigmatized, and ultimately fatal illness; and the special needs of specific populations (gay men, families and friends of gay men, gay youth, significant others, people of color, heterosexual women and lesbians, college students, substance abusers, and the “worried well”). The authors also examine the effects of HIV (human immunodeficiency virus) illness and AIDS on the care giver. Counseling interventions are described throughout the article.     

Development of the HIV/AIDS Stress Scale

Development of a self-report measure of stress specific to HIV/AIDS is needed to advance our understanding of the role of stress in adaptation to HIV/AIDS; hence, the aim of this study was the development of the HIV/AIDS Stress Scale. A total of 132 homosexual/bisexual men with HIV/AIDS were interviewed and completed the HIV/AIDS Stress Scale and measures of coping strategies, appraisal, social support and adjustment (global distress, depression, social adjustment, number of HIV symptoms, and subjective health status) at three time points. Thirty-nine primary caregivers were interviewed and completed measures of stress and adjustment. Exploratory factor analyses of the HIV/AIDS Stress Scale items revealed three factors: Social, Instrumental and Emotional/Existential Stress. Factors had adequate internal reliabilities and were stable over 12 months. Construct validation data are consistent with recent stress/coping research that links higher levels of stress with more HIV symptoms, reliance on emotion-focused coping, lower social support, poorer levels of adjustment and higher levels of caregiver stress. Results extend this research by revealing new differential relations between various stress dimensions and stress/coping variables. Convergent validation data suggest that the HIV/AIDS Stress Scale shares conceptual similarity with threat appraisal, and differs from controllability and challenge appraisals. The HIV/AIDS Stress Scale shows potential for the elucidation of the role of stress in coping and adaptation to HIV/AIDS and disease progression in both research and clinical applications.     

Strategies adopted by late middle-age and older adults with HIV/AIDS to explain their physical symptoms

Although the attributions individuals make about what causes their physical symptoms are known to influence their care seeking and self-care behaviours, much less is known about the strategies they use to arrive at these attributions. The strategies employed to understand the causes of their symptoms were investigated using in-depth interviews with 100 late middle-age and older adults with HIV/AIDS in New York City. The data revealed that most participants actively sought to explain their symptoms. The explanatory strategies identified included: relying upon illness or medication representations, lay beliefs about the body and ageing, invoking pre-existing vulnerabilities, engaging in lay experimentation, social comparison processes, considering temporal ordering and consulting authoritative sources. While most of them offered a single cause for their symptoms, some offered more complex multi-causal explanations. These findings provide understanding into the reasons why some older adults with HIV/AIDS misattribute symptoms resulting in delay in care or care over-utilisation, suggesting the need for patient education.     

Subverting Culture: Promoting HIV/AIDS Prevention Among Puerto Rican and Dominican Women

This article discusses the challenges faced by researchers and interventionists when attempting to promote change in social norms and normative beliefs that promote HIV/AIDS risk-related behaviors among Puerto Rican and Dominican women. The article focuses on the role of culture in HIV/AIDS prevention with women by analyzing the sociohistorical context of some cultural beliefs and by illustrating the tension between risk-related and protective cultural beliefs in research conducted by the authors with women in both New York and Puerto Rico. The authors propose that promoting changes in sex-related social norms and normative beliefs might be constructed as a subversive act and present the challenge this analysis poses for community psychology. They conclude that this conceptualization might be construed as subversive because rather than idealizing culture, it promotes changes that respect diversity within the culture and foster participation in the development of new cultural values, beliefs and norms.