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.     

Disempowerment and Psychological Distress in the Lives of Young People in Eastern Cape, South Africa

A qualitative study was conducted in Butterworth, in the rural Eastern Cape Province of South Africa, to explore sources of distress for young people. Semi-structured, individual in-depth interviews were conducted with 16 men and 24 women aged 16–22 years. The findings revealed interconnections between structural factors such as death, poverty, unemployment and gender injustices to cause distress. Negative home dynamics such as disinheritance, financial hardships, undisclosed paternal identity, substance abuse, child abuse and unpredictable informal adoption circumstances were worries of the participants. Worries over their inability to complete school dominated the narratives of orphaned participants. Lack of communication and consultation within families on important matters contributed to distress. Distress related to sexual relationships, such as infidelity, an unacknowledged pregnancy, intimate partner violence, transactional sex and sexual orientation were evident only in women’s narratives. Strengthening of families, improving financial security, extension of social grants and no-fee school policies are needed to alleviate distress in young people in this area. These findings are a call for the monitoring of policy delivery imperatives for child protection.     

Psychological Contract in HIV Prevention Clinical Trials in Resource Poor Communities in Africa

The paper explored the application of psychological contract in HIV prevention clinical trials in resource poor communities in Africa. The psychological contract was discussed in relation to practices in New HIV Prevention Technologies in Africa. From this discussion, it would seem risk for exposure to HIV infection is less well articulated in the psychological contract between the promoters of HIV prevention clinical trials and participants in resource poor communities in Africa. The trialing of New HIV Prevention Technologies in Africa should have in-built psychological contract transparency to reduce the risk of participant exposure to HIV infection in clinical trials.     

Undisclosed Paternal Identity in Narratives of Distress Among Young People in Eastern Cape,South Africa

Life trajectories of children with no connections to support from their fathers have received research attention. Within this group is a sub-group who do not know their fathers and no research has attempted to understand their experiences. We present accounts of how young South Africans deal with and seek to uncover undisclosed paternity. Forty young men and women aged 16 to 22 volunteered to participate in a qualitative study on distress that was conducted in the Eastern Cape Province. All interviews were conducted in isiXhosa, following a semi-structured guide. Our findings show that interest in father identity was motivated by harsh circumstances in the maternal home, notably when financial difficulties, exclusion from critical decision making and bullying by non-biological siblings were felt. The search for father identity was pursued in solitude by some participants: their fear of elders’ response restrained them from asking. Some thought that it would be interpreted as being disrespectful and ungrateful to ask ‘such a question’, whilst others worried that they might be victimized or, worse, thrown out by their mothers or maternal guardians. We present accounts of accidental disclosures by strangers and also inadvertent involvement in an incestuous relationship. Open and honest communication with children about their paternal identity should be promoted to prevent the currents of silence, secrecy and anxiety, and avoid unpleasant surprises for the children.     

Formal Employment and Health-Related Quality of Life among People Living with HIV in South Africa

This study examined the link between formal employment and characteristics of the workplace (especially awareness of workplace HIV policies and HIV status disclosure to work colleagues) and health-related quality of life (HRQoL) among people living with HIV (PLHIV). The study analysed medical treatment and employment history since first being diagnosed as HIV-positive among 554 adults, 55 % females, who had been on HIV treatment for at least 2 years in South Africa. Additional cross-sectional data on HRQoL were collected using the Medical Outcomes Study 36-Item Short Form (SF-36) (QualityMetric Incorporated). Two hundred and forty four (44 %) of the study participants (39 % and 49 % among males and females, respectively) were formally employed at the study interview. Formally employed study participants reported higher HRQoL than those not formally employed, as reflected in mean scores in the physical and mental component summaries of the SF-36 instrument. HRQoL was unrelated to study participants’ CD4 count, viral load and duration since HIV diagnosis. Among the formally employed study participants, 27.9 % reported awareness of workplace HIV policies in their organisations, while 50.8 % said they had disclosed their HIV status to work colleagues. The awareness of workplace HIV policies was associated with higher mental component summary scores after controlling for study participants’ socio-demographic characteristics, but had no significant association with the physical component summary scores. The disclosure of HIV status to work colleagues was associated with neither mental nor physical component summary scores. The finding of a positive association between formal employment and HRQoL among PLHIV suggest the need for facilitative interventions for employment entry and continuation among PLHIV for their wellbeing.     

Sexuality,Angelification, and Divine Indwelling: A Contemporary Ethic of Early Christian Asceticism

The monastic movement originated among laity who recognized within themselves the potential to embody the Christian gospel. That a practice so central to early Christians and their Scriptural understanding would undergo such a decline contemporarily gives pause for reconsideration. This article posits that the kind of asceticism at the core of Christian monasticism maintains relevance as a transformative Christian practice in the contemporary world, as well. The argument draws on a tripartite model of spirituality in accord with Gregory of Nyssa’s notion of epektasis. This suggests asceticism’s contemporary appropriation as an ethic of Christian spiritual development oriented toward perpetual ascent. Asceticism will be analyzed as a form of spiritual struggle; that is, physical, emotional, psychological, intellectual, and spiritual exertion aiming to progress in knowledge, similitude, and intimacy with Jesus Christ, for God and for others. The three stages of this ethic of Christian spiritual growth – 1) detachment from fleshly passions, 2) strengthening of the soul, and 3) union with God – find parallels in the three themes at the core of asceticism: sexuality, angelification, and divine indwelling. Situating asceticism within a framework of spiritual struggle creates an opportunity to recover and re-envision a well-established Christian practice in a contemporary context.     

God-language in Public and Private Prayer: A Place for Integrating Gender,Sexuality and Faith

Abstract

Drawing on feminist liturgical critiques of prayer, Audre Lorde's notion of the erotic and Carter Heyward's relational theology, amongst other feminist, Womanist, Black and queer sources, this article proposes that prayer via gendered and erotic images of God and Christ may be a site for the integration of gender, sexuality and faith — not only in the life of the individual but in the wider body politic. The notion of integration is problematized alongside heteropatriarchal practices of prayer, and an eschatological understanding of prayer and identity offered. The article argues for prayer which engages with a multiplicity of embodied, erotic and queer images of God (and particularly Christ), as necessary to the complex work of personal and political integration with which prayer is charged as well as gesturing towards the fullness and mystery of God who both inhabits and transcends the limitations of metaphorical discourse about the divine.     

Cognitive and Behavioral Contributions to Depression Severity,Quality of Life,and Functioning Among People Living With HIV in South Africa

Cognitive-behavioral treatments for depression typically address both behavioral (e.g., activation) and cognitive (e.g., rumination) components, and consequently improve quality of life (QOL) and function in high-resource settings. However, little is known about the cross-cultural applicability and relative contribution of these components to depression symptom severity, QOL, and functional impairment in South Africa and other resource-limited global settings with high HIV prevalence rates.Persons with HIV (N = 274) from a peri-urban community outside Cape Town, South Africa, were administered multiple measures of depression (Hamilton Depression Scale, Centre for Epidemiological Studies Depression Scale, South African Depression Scale), cognitive and behavioral components related to depression (Ruminative Response Scale, Behavioral Activation for Depression Scale), and measures of QOL and functioning (Sheehan Disability Scale, Quality of Life Enjoyment and Satisfaction Scale—Short Form). Multiple linear regression models were fit to assess the relative contribution of behavioral and cognitive components to depression severity, QOL, and functional impairment in this population.Models accounting for age and sex revealed that lower levels of behavioral activation (BA) were significantly associated with all measures of depression, as well as with QOL and functional impairment (all ps < .01). Rumination was associated with all measures of depression (all ps < .01), but not with QOL or functional impairment.The consistent and unique association of BA with depression, QOL, and functional impairment bolsters its importance as a treatment target for this population.     

An Exploration of Spirituality and Sexuality in Men Who Identify as Gay and Were Raised in a Conservative Christian Faith

Abstract

Growing up in a conservative faith can affect the lives of gay men. The influence of early religious training can have an impact on the emotional, sexual, and even physical lives of those who belong to sexual minorities. The messages people hear from religiously employed individuals (i.e. teachers and pastors) can cause deep wounds that last a lifetime. The collision of their sexual and spiritual identities impacts their lives, and can lead to difficulty. Some struggle with their religion, and many struggle to find a community that fully embraces both identities. Researchers sought to explore the process through which seven men navigated the process of identity formation and integration for their sexual and spiritual selves specifically through the lens of being raised Seventh-day Adventist and identifying as gay men. The in-depth interviews provided the data for the study, which is aimed to improve the outcome for the education of counselors who will inevitably work with members of the LGBTQ+?community.     

Increases in Tolerance Within Naturalistic, Intentional Communities: A Randomized, Longitudinal Examination

The authors examine differential changes in values of tolerance among 150 participants discharged from inpatient treatment centers, and randomly assigned to either a self-help-based, communal living setting (i.e., Oxford House), or usual aftercare. Participants were interviewed every 6 months for a 24-month period. Hierarchical linear modeling (HLM) was used to examine the effect of condition (therapeutic communal living versus usual aftercare) on wave trajectories of tolerance (i.e., universality/diversity scores). Over time, residents of the communal living model demonstrated significantly greater values of tolerance than usual aftercare participants. Communal living participants who resided in the house for over 6 months showed the most substantial increases in tolerance. Results support the notion that communal living residents may develop more tolerant attitudes by striving toward superordinate community goals (objectives held by (a) the whole group and (b) which individual members could not achieve alone).     

Gay and Catholic: Accepting My Sexuality,Finding Community,Living My Faith

Abstract

This article considers how the insights of gay and lesbian Christians can be situated in relation to a sex-negative religious tradition. Are they to be seen as anomalous appendages or as integral to the tradition itself? Thinking of the Bible as a ‘faith family photo album’ offers a useful analogy for exploring this methodological issue. The image of a photo album provokes questions as to which characters and primal scenes achieve archival status within religious communities and which are removed from public view. In this frame we can discern that what is received from the past is produced out of messy familial disputes often provoked by radical and subversive practice. The work of disputing which images can be displayed in the family album must continue as it is in the interplay between traditional teachings and transgressive performance that transformative adaptations occur without which Christianity cannot thrive as a living tradition.     

The Social Conditions for Successful Peer Education: A Comparison of Two HIV Prevention Programs Run by Sex Workers in India and South Africa

Peer education is a community-based intervention being implemented worldwide as an approach to HIV prevention. However, its results are inconsistent, with little consensus on why some projects succeed while others fail. Considering peer education as an ‘intervention-in-context’, we systematically compare the context and the implementation of two peer education interventions run by sex workers, one in India and one in South Africa, which produced contrasting outcomes. In so doing, we aim to identify key factors in the projects’ successes or failures that may inform future peer education efforts. The Indian project’s relative success was facilitated (1) by a more stable and supportive social, material and political context, and (2) by a community development ethos which devoted significant resources to sex workers’ involvement, ownership and empowerment, as opposed to a biomedical approach which marginalised sex workers’ concerns. We conclude with lessons learned and implications for current trends in peer education.