HIV/AIDS in scottish prisons: Attitudes of staff and prisoners

Abstract

Prison is commonly regarded as a high risk environment for the transmission of HIV/AIDS. Five hundred and fifty-nine prisoners and 591 prison staff sampled from 8 Scottish prisons completed questionnaires concerning attitudes towards various issues of HIVIAIDS. A majority of prisoners and prison staff expressed liberal attitudes with respect to HIV/AIDS. For both staff and prisoners, the most liberal responses were to items dealing with personal and social contact with people with HIVIAIDS. A majority of prisoners and prison staff expressed conservative attitudes in relation to screening of individuals for HIV. With regard to differences between prisoners and prison staff, prisoners were more supportive than prison staff of the provision of free condoms to homosexuals and free condoms and syringes to intravenous drug users, and the provision of free medical care to both groups in the case of AIDS. Among the prisoner sample, intravenous drug users, in comparison to non-users, were found to be more positive in their attitudes toward HIVIAIDS on a wide range of issues. The implications of the study for health psychology are discussed with regard to prisoner and prison staff educational needs and prisoner management.     

大学生对艾滋病的乐观偏差

研究采用问卷法,以北京6所高校的278名被试为样本,考察了大学生对艾滋病的乐观偏差。结果表明,被试对艾滋病的感染和治愈存在着双重乐观偏差;艾滋病知识掌握程度既与感染艾滋病的乐观偏差无显著相关,也与治愈艾滋病的乐观偏差无显著相关。     

护理扩展培训在艾滋病干预模式中的探讨

新疆艾滋病形势严峻,艾滋病重点疫区的护理人员普遍存在着对艾滋病知识的缺乏,对艾滋病患者持有歧视、恐惧的心理及缺乏基本的防护知识等现状,艾滋病护理扩展培训项目的实施,通过对护理人员进行的艾滋病知识培训,对艾滋病干预模式进行了有益的探索和实践。     

艾滋病揭示的性别不公正

贫困妇女人群中HIV新发感染不成比例上升的现象揭示了社会中的性别不公正,通过美国和肯尼亚的案例说明,预防艾滋病需要认可和促进妇女的人权,减少针对妇女的暴力,并保障妇女的教育,普及艾滋病相关知识.对女性主义进行了重新阐释,并以南非"和平与和解"运动为例指明了新的前进方向.     

对建立我国艾滋病防治督导与评估体系的思考

随着我国艾滋病防治工作的持续深入,定期对艾滋病防治工作进行督导与评估越来越重要。但是,到目前为止,我国尚未建立国家综合协调的艾滋病防治督导与评估体系。通过对建立国家艾滋病防治督导评估体系的必要性、可行性及存在的问题进行分析,围绕如何构建一个统一、综合、有效的督导评估体系提出政策建议。     

艾滋病感染信息配偶告知中的伦理问题探析

艾滋病感染者和病人有将感染信息及时告知配偶的义务,但部分感染者和病人会以隐私保护或告知后可能面临困难为由拒绝履行,这是对避免将疾病传播给他人责任的回避,也会造成维护伦理关系名义下对关系的破坏。因而需要允许保密原则的合理例外,赋予医疗卫生机构告知权限。这一赋权带来的受益大于风险,同时也作为感染者和病人自律的制约与补充,以及信息弱势群体权益的保障。在告知举措上,需要注重伦理管理,完善相关政策措施;回应感染者和病人的生活逻辑,采取人性化告知方式;同时告知与宣传并重,减少歧视感染者和病人的舆论环境。

     

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.     

HIV/AIDS prevention support resourcing with family and peers: University student perspectives

This study explored how students construct family and peers as resources for their HIV prevention. The participants were 20 education students from a South African technology education university (female = 60%, black = 85%; age range = 18 to 24). They completed a semi-structured interview on their access to family and peers talking about HIV/AIDS prevention in the context of perceived cultural influences. The data was thematically analysed using open-coding. Findings suggest that students shared information about HIV/AIDS prevention with peers, and less so with family. They perceived cultural taboos around sex talk to be a barrier to open discussion of HIV/ADS. Students may need to acquire strategies to negotiate HIV/AIDS prevention approaches with family in the context of culture.     

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.     

山西省艾滋病防治政策分析

阐述了艾滋病在山西省流行的现状,探讨了艾滋病引发的社会问题,分析了艾滋病防治条例、四免一关怀政策以及艾滋病自愿咨询与检测制度的执行情况以及在执行过程中所存在的主要问题,研究了山西省艾滋病防治工作相关基金的来源和使用情况,针对山西省在艾滋病防治工作中存在的问题,提出了艾滋病防治工作与社区工作相结合的建议。     

特殊人群艾滋病行为干预的思考

艾滋病直接危害人类的健康,也对社会、政治、经济及人文伦理道德产生重大的负面影响。对艾滋病病人犯罪的监管问题,公安干警的职业暴露问题,都是目前司法实践中遇到的新课题。加强艾滋病患者违法监管,对特殊群体进行行为干预,是司法结构急待解决问题。     

Building contexts that support effective community responses to HIV/AIDS: a South African case study

In this paper we discuss our conceptualisation of a 'health-enabling social environment', and some of the strategies we are currently using to build social contexts most likely to support effective HIV/AIDS management in southern Africa. In developing these ideas, we draw on our on-going collaboration with residents of Entabeni, a remote rural community in South Africa where 43% of pregnant women are HIV positive. The aim of this collaboration is to facilitate contextual changes that will enable more effective community-led HIV/AIDS management in an isolated area where people have little or no access to formal health or welfare support, and where HIV/AIDS is heavily stigmatised. We give an account of the three phases of collaboration to date. These include research; the dissemination of findings and community consultation about the way forward; preliminary project activities (skills training for volunteer health workers; partnership building and a youth rally) as a way of illustrating what we believe are six key strategies for facilitating the development of 'AIDS-competent' communities: building knowledge and basic skills; creating social spaces for dialogue and critical thinking; promoting a sense of local ownership of the problem and incentives for action; emphasising community strengths and resources; mobilising existing formal and informal local networks; and building partnerships between marginalized communities and more powerful outside actors and agencies, locally, nationally and internationally. We discuss some of the triumphs and trials of this work, concluding with a discussion of the need to set realistic goals when working at the community level in highly conservative patriarchal communities to tackle problems which may be shaped by economic and political processes over which local people have little control.     

Boredom in Recovery for Adult Substance Users With HIV/AIDS Attending an Urban Day Treatment Program

This qualitative dissertation study used grounded theory methods to explore the experience of boredom in recovery from substance use disorder with eight adults who also have HIV/AIDS. Boredom is the pervasive perception of nothingness that gives time to reflect. Boredom was revealed to be more than a seemingly harmless phenomenon that persists decades into recovery, even when meaningful occupation outside of substance use is achieved. Boredom becomes less harmful with the achievement of meaningful occupation, but it is still tenacious and deleterious. Boredom can be useful to an adult with HIV/AIDS, however. Implications for the profession's core value of meaningfulness are discussed.     

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.     

Unheard Voices: Experiences of Families Living with HIV/AIDS in India*

This study was aimed at understanding the impact of HIV on the family system in the Indian context. A sample of 20 families caring for a relative living with HIV/AIDS (PLWHAs) was recruited from a HIV counseling clinic at the National Institute for Mental Health and Neuro Sciences and a respite home for PLWHAs in Bangalore City in southern India. Qualitative data were collected from these families using a semi-structured interview guide and recorded in the form of narratives. Analysis of these data revealed the following themes: Stigma and discrimination; disclosure; changes in family functioning; financial difficulties; fears of the family; and helplessness. Each theme was presented in detail and implications for intervention to help these families and their PLWHAs discussed. V.A.S. Krishna, PhD, MPE, Fogarty Funded Post Doctoral Fellow, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63108 (krishnavas@epi.wustl.edu). Ranbir S. Bhatti, PhD, Professor of Family Therapy, Montfort College, Bangalore, Former Professor and Head, Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India 560029 (ranbirbhatti@yahoo.com). Prabha S. Chandra, MD, Additional Professor, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India 560029 (prabhachandra@rediffmail.com). Srilatha Juvva, PhD, Reader, Department of Family and Child Welfare, Tata Institute of Social Sciences (TISS), Mumbai, India 400088 (juvvas@tiss.edu). *The authors would like to thank all the PLWHAs and their family members for volunteering to be part of this study. Post-doctoral Fellowship support for Dr. V.A.S. Krishna from Fogarty Grant—TW05811 (LB Cottler, PI).     

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.     

Illness disclosure and mental health among women with HIV/AIDS

The current study examines two contrasting models of the relationship between illness disclosure and mental health among an ethnically‐diverse group of women with HIV/AIDS. In the first, and commonly accepted model, illness disclosure predicts enhanced mental health status. In the second or alternate model, based on the stigmatization that accompanies HIV/AIDS infection, illness disclosure predicts poorer mental health. We also explore an alternate interpretation for this second model, namely that the mental health status of participants is predictive of their levels of disclosure. A total of 176 women from three major ethnic groups were interviewed and assessed during the baseline visit for a comprehensive longitudinal study. Results showed that these women constituted a highly‐disclosed population; over one‐third of them had disclosed their HIV status to their entire social networks. Contrary to expectation, disclosure was unrelated to mental health among the African‐American (n = 72) and European‐American (n = 47) women. Among the Latina women (n = 57), however, greater disclosure was related to higher levels of depression, psychological distress, and reported pain. Regression analyses controlling for age, education, and illness severity showed that disclosure makes a small but independent contribution to the prediction of mental health status. Thus, among the Latinas, the data were consistent with both the stigma model and the hypothesis that greater distress predicts wider disclosure. General patterns of disclosure are described and possible explanations for the inconsistent relationships found between disclosure and mental health among the three ethnic groups are considered. Copyright © 2000 John Wiley & Sons, Ltd.     

The New Biology and its Impact in Biomedical Strategies Against HIV/AIDS

Abstract. The sequencing of the human genome and the initiation of the structural genomics projects have ushered in a new age of biology that involves multi‐lab, high‐cost projects with broad task‐oriented goals rather than the more conventional hypothesis‐driven approach of the past. The new biology has led to the development of new sets of tools for the scientist to use in the quest to solve mysteries of human disease, biomolecular structure‐function relationships, and other burning biological questions. Nevertheless, the impact of the new biology on the field of AIDS investigation has been minimal, predominantly because many of the tools in the HIV field of study were developed before the full advance of the new biology was felt in the biomedical community. Many of the high‐cost megaprojects that involve large technological advances and are marketed as projects of promise to the biomedical community are not likely to significantly impact the field of HIV/AIDS research and cannot serve as a substitute for direct funding to the HIV/AIDS scientists working for vaccine development, an understanding of mechanisms of disease causation, and new tools for therapeutic intervention.     

Psychological distress and quality of life of people living with HIV/AIDS in a Nigerian teaching hospital

Presence of psychological distress and poor quality of life (QoL) may affect the outcome of HIV/AIDS. One hundred and seventeen consecutive and consenting participants were interviewed using a Socio-demographic questionnaire, Kessler Psychological Distress Scale (K10) and World Health Organization Quality of Life-HIV Bref. Fifty-six (47.9%) participants scored 20 and above on K10 Scale. QoL was significantly higher in married participants, those who perceived their state of health as being good, asymptomatic participants and those who scored well–mild on K10. The older age group scored higher on QoL Scale than the younger age group in the physical health domain while the married participants scored higher in the domains of physical health, psychological health, environment and spiritual/religion. The participants who perceived their state of health as being good scored higher than those who perceived their health as poor in all domains. There is a high level of psychological distress and poor QoL in people living with HIV/AIDS.     

Sex and the Right to HIV/AIDS Education in Early Childhood

This study explored how early childhood teachers (n=5) and young children (n=174) (age range 7 to 8 years; males = 81; females = 93) in two primary schools constructed and interpreted the right to HIV/AIDS education. Data were captured using individual interviews with teachers and group interviews with young children. Analysis of the data showed that teachers viewed young children's right to health information positively but did not consider the right to sexual information. Teachers operated within discourses which upheld the image of the child as innocent requiring protection from sexual knowledge. Children's perceptions of their rights to knowledge of sex in HIV/AIDS education showed ambiguity. Some accepted the right to know whilst others felt that knowledge about HIV/AIDS was inconsistent with childhood innocence.