HIV Prevalence Areas Research Articles

Psychological needs and HIV/AIDS

AbstractMental Health problems are associated with life‐threatening illnesses generally and Acquired Immune Deficiency Syndrome (AIDS) specifically. This report describes the range and extent of psychological problems and therapeutic input for all patients (n = 258) referred to an HIV clinical psychology service over a one‐year period at a teaching hospital in the area of highest HIV prevalence in the UK. The majority (79%) were HIV positive; of these 92% were gay males, 6.5% heterosexual women and 1.5% heterosexual men. The age range was 15 to 72 years. Referrals were received for patients at all stages of HIV disease and for partners and relatives who were HIV negative but affected by HIV infection in another. The highest rate of referral was for HIV positive patients who were asymptomatic and the greatest intensity of need was for those with AIDS. Suicide (ideation or behaviour) was an issue in referral for 43 patients.Assessment revealed the major problems to include anxiety (48%), relationship problems (31.7%), depression (26.5%), adjustment to HIV status (16.9%), bereavement (12%), employment (11%), sexual issues (10%), isolation and suicide (9% each). Psychological therapy for the majority took the form of short‐term or crisis intervention. Group intervention did not substitute for individual therapy. The needs of patients were examined. They ranged from general interventions addressing adjustment to infection with HIV or an AIDS diagnosis, to specific input for issues such as sexual difficulties or coping with physical illness and bereavement. The data are discussed in terms of the growing demand for psychological services.

Two Views of Risky Sexual Practices Among Northern Thai Males: The Health Belief Model and the Theory of Reasoned Action

We apply the Health Belief Model (HBM) and the Theory of Reasoned Action (TRA) to an analysis of unsafe sexual practices (inconsistent condom use with commercial sex workers) among men living in a high HIV-prevalence area. The empirical analysis is based primarily on a survey of sexual practices that was conducted by the authors during the fall of 1991. The survey sample includes university undergraduates, soldiers, clerks, and laborers living in Chiang Mai, Thailand. There is much overlap between the two theories, and both provide useful frameworks for examining condom use in this population. However, the Bayes Information Criterion (BIC) approach provides very strong evidence that TRA is the more plausible model, given the data. The success of TRA appears to be due to its more adequate incorporation of peer group effects. Other covariates positively associated with consistent condom use in the multivariate models include knowledge about the consequences of HIV infection, knowledge about the benefits of condom use for preventing infection, and positive attitudes about condoms.

Risk factors of HIV-1 infection among female prostitutes in Khon Kaen, Northeast Thailand.

HIV infection has increased to epidemic proportions in Thailand since 1987. There have been separate epidemics among population groups at high risk of infection and significant increases in different localities. The northeast region of Thailand has been affected by the epidemic since early 1989. The purpose of this study was to identify factors associated with HIV transmission among prostitutes during an early phase of the epidemic in the regional center of Khon Kaen. Three hundred and fifty-six prostitutes known to work in the urban area of Khon Kaen (Ampur Muang) in November 1990 were included in the study. Prostitutes were divided into two groups according to the type of place where they worked: direct prostitutes (in brothels, n = 217) and indirect prostitutes (in massage parlors, n = 139). The prevalence of HIV infection was found to be 12% among direct prostitutes and 2% among indirect prostitutes. Four variables were significantly associated with HIV infection after adjusting for confounders by logistic regression analysis: previous work in an area of high HIV prevalence, working in Khon Kaen less than one month, a low price charged for sex and using injectable contraceptives. Follow-up investigations are currently being carried out to explore in detail the association between the use of injectable contraceptives and HIV infection.

AIDS and food production in East and Central Africa: A research outline

There have been very few studies of the impact of AIDS on production, yet it is likely to be severe, especially in Africa. This paper describes the research design which will be adopted by two researchers from the Overseas Development Group of the University of East Anglia, working initially in a high HIV-prevalent area in Uganda.