People With HIV/AIDS Research Articles

Las personas que viven con VIH/SIDA y su vínculo con los antirretrovirales provistos por el Programa Nacional en Argentina

In accordance with the National AIDS Law, the Argentinian State is committed to supply antiretroviral medication (ARV) free of charge. Due to the complexity of the National ARV Program management process, and the fact that people with HIV/AIDS (PLHA) are the beneficiaries of the Program, it is considered relevant to ascertain their opinion. The aim of this work is to examine the supply of ARV by the National HIV/AIDS Program, from the perspective of PLHA, in a public hospital of the city of Rosario, in relation to: 1) value of the Program and the information received from it; 2) waiting times; 3) availability of ARV to continue the treatment. It is a qualitative study with interviews during January and February 2007 consisting of structured questions and patient criteria selection, in the presence of a psychologist. 15 PLHA were interviewed and gave their considered opinion about the Program and its background. They acknowledge difficulties in the continuity of ARV treatment and the consequences with respect to death and quality of life. The Program shows the coexistence between characteristics of a policy guaranteed by the state and others from programs that respond to emergencies. It shows the need to rethink the Program as a genuine health policy, considering ARV as essential medicine.

HIV/AIDS Knowledge, Stigmatizing Attitudes, and Related Behaviors and Factors that Affect Stigmatizing Attitudes against HIV/AIDS among Korean Adolescents

ObjectivesThis study examined the sex differentials for specific aspects of knowledge regarding HIV, stigmatizing attitudes toward people with HIV/AIDS (PWHAs) and sexual behavior. In addition, the factors that affect stigmatizing attitudes toward PWHAs were investigated. MethodsThe population of this study comprised of senior high students in Seoul, Korea. Eight high schools were selected randomly and 1566 adolescents participated in the survey. A total sample of 1548 cases (18 cases were excluded) was used for analysis. A self-administered questionnaire measuring their general and transmission and discriminatory attitudes was used. ResultsThe level of HIV/AIDS knowledge among Korean adolescents was low, as indicated by a correct response rate of 54% (7.0 out of 13). The students answered correctly about HIV transmission by kissing at 50.2%, toilets at 59.4%, cup sharing at 57.4%, and daily school life at 60.5%. The level of discriminatory attitudes towards HIV-infected persons was high. Boys reported a higher proportion of sexual experience (7.0% vs. 2.6%, OR=2.89, p<0.001). Only 39.0% used a condom during their last sexual encounter and more girls (53.3%) than boys (35.3%) reported using a condom. ConclusionsThese findings highlight the need for increasing HIV knowledge, reducing HIV stigma, and providing sex education focusing on safer sex practices.

Assessment of antiretroviral therapy knowledge and willingness of persons with HIV to support its uptake in Uganda.

BackgroundAccess to care and treatment services for human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) are hampered by human resource constraints and knowledge gaps about antiretroviral therapy. Training people with HIV/AIDS (PWA) as educators on antiretroviral therapy may help in the expansion of antiretroviral therapy-related knowledge in Africa. The aim of this study was to assess the antiretroviral therapy-specific knowledge, beliefs, and attitudes of PWA as well as their proactive communication with community members and to explore their willingness to serve as support personnel.MethodsData were obtained from a large randomized trial of PWA. We analyzed qualitative and quantitative data from 524 PWA aged 18 years and over who initiated home-based antiretroviral therapy in 2003. We assessed knowledge and communication of HIV prevention and treatment messages by PWA to communities using structured messages complemented with other knowledge questions and the willingness of PWA to serve as support persons. Descriptive bivariate associations and logistic regression statistical methods were performed. In addition, qualitative data analysis was used.ResultsThe level of knowledge about antiretroviral therapy was high among all PWA on several technical attributes. Overall, 90% of PWA reported that they had been consulted by community members for informed opinions on antiretroviral therapy, 70% felt they were opinion leaders on aspects of antiretroviral therapy within the communities, and approximately 70% were willing to be engaged as community support persons. Those who were classified as opinion leaders reported being approached more regularly by community members for expert advice about antiretroviral therapy compared with nonopinion leaders (odds ratio [OR] 11.7; 95% confidence interval [CI] 7.3–18.6), and opinion leaders were significantly more informed on most technical attributes of antiretroviral therapy, such as “who qualifies for antiretroviral therapy based on CD4 count” (OR 1.6, 95% CI 1.1–2.0) and “the need to be evaluated for antiretroviral therapy” (OR 1.8, 95% CI 1.2–2.0).ConclusionOpinion leaders demonstrated correct knowledge and willingness to provide information on antiretroviral therapy care and treatment issues and were, in turn, consulted more frequently for antiretroviral therapy advice compared with nonopinion leaders. Training opinion leaders to work as community support personnel may increase knowledge about antiretroviral therapy in underserved communities.

Health information behavior in families: Supportive or irritating?

We report preliminary results of a mixed methods study of relationships between family-based information behavior and social support in chronic illness. Twenty-four participants (12 people with HIV/AIDS (PHAs) and 12 people with diabetes) completed surveys, visualized their family-based social support networks, and participated in in-depth, qualitative interviews. Findings revealed that our sample of people with diabetes had significantly larger family support networks than did PHAs. These differences seem linked to greater interpersonal constraints in talking about HIV/AIDS in families. Yet, the two groups did not differ in terms of perceived social support (PSS), frequency of collaborative information behavior (CIB), or use of information obtained collaboratively. However, a surprising relationship between CIB and PSS emerged among diabetics but not PHAs: the greater the frequency of CIB with family members, the less supportive they were perceived to be. This seems rooted in the prevalence of attempted influence and interference by diabetics' family members. Nevertheless, among both PHAs and diabetics, a significant overlap existed between receipt of informational and emotional support. Indeed, information sharing and emotional support could be the same in interactions such as questions of concern, goal attainment, and caring forwards. This study is among the first to document differences in social support and CIB among people with different diseases, pointing to the merit of information services and systems differentiated by disease. The overlap between informational and emotional support suggests the value of organizing, presenting, or rating health information according to emotional valence. Demonstrating that CIB may have negative effects challenges information scientists to reconsider whether receipt of information is always positive. Health information behavior in families therefore appears more complex than has been previously shown.

An Interrupted Time Series Evaluation of a Hepatitis C Intervention for Persons with HIV

Accurate HCV knowledge is lacking among high-risk groups, including people with HIV/AIDS (PLWHA). Liver disease primarily due to HCV has emerged as a serious cause of mortality among PLWHA. We used an Interrupted Time Series design to evaluate a social-ecologically based intervention for PLWHA, where an infectious disease clinic serving a six-county intervention area was monitored before (7 months) and after (17 months) intervention onset. The intervention included education of PLWHA and medical providers, HIV/HCV support groups, and adaptation of the patient chart top sheet to include HCV test information. Clinic-level outcomes were assessed prospectively every other week for 2 years by interviewing patients (n = 259) with clinic appointments on assessment days. Abrupt, gradual and delayed intervention effects were tested. Weighted regression analyses showed higher average HCV knowledge and a higher prevalence of patients reporting HCV discussion with their medical providers after intervention onset. A delayed effect was found for HCV awareness, and a gradually increasing effect was found for knowing one's HCV status. Other communities may consider adopting this intervention. Additional HCV interventions for PLWHA with HIV are needed.

Levels and functions of HIV/AIDS stigma within the Iranian community living in the Sydney metropolitan area

Objective: This study examines the levels of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) related stigma among the Iranian population and the factors that contribute to the formation of stigma within the study population. Design: A quantitative research design was used in this research whereby participants completed a self-administrated questionnaire. A sample of 236 adults aged 20–65 were collected using non-probability sampling techniques. Setting: The study was carried out in the Sydney (Australia) metropolitan area and data were collected in 2007. Method: To obtain a desirable sample size, multivariate techniques including snowball were used. Herek’s (1986) functional approach to attitudes was used to analyze HIV/AIDS stigma in the study population. Results: The findings illustrate that HIV/AIDS-related stigma was dominant among the study population. Overall, participants had negative feelings toward people with HIV/AIDS (PWHA); they were in favour of punitive policies against them and were more likely to avoid having contact with people who had contracted HIV/AIDS. Multiple regression analysis revealed that both instrumental (fear of contamination) and symbolic factors (attitudes towards homosexuals and injecting drug user) independently contributed to HIV/AIDS stigma. Conclusion: The findings suggest that HIV/AIDS stigma has instrumental and symbolic function, and concentrating solely on instrumental (HIV/AIDS transmission routes) factors is less likely to address it properly. Therefore, educational campaigns to reduce HIV/AIDS stigma should also focus on symbolic factors. The findings contribute to the knowledge area of better understanding of HIV/AIDS stigma among ethnic minorities of similar characteristics. The results are valuable for the Iranian community, health service providers, health educators and policy makers.

A multilevel model of HIV/AIDS information/help network development

PurposeThis paper aims to describe the personal information and help networks of people with HIV/AIDS (PHAs) in rural Canada, and to present a research‐based model of how and why these networks developed. This model seeks to consider the roles of PHAs, their family members/friends and formal health systems in network formation.Design/methodology/approachIn‐depth, semi‐structured interviews were conducted with 114 PHAs, their friends/family members (FFs) and formal caregivers in three rural regions of Canada. A network solicitation procedure elicited PHAs' HIV/AIDS information/help networks. Interviews were analyzed qualitatively, and network data were analyzed statistically. Documents describing health systems in each region were also analyzed. Analyses used social capital theory, supplemented by stress/coping and stigma management theories.FindingsPHAs' HIV/AIDS‐related information/help networks emphasized linking and bonding social capital with minimal bridging social capital. This paper presents a model that explains how and why such networks developed. The model shows that networks grew from the actions of PHAs, their FFs and health systems. PHAs experienced considerable stress, which led them to develop information/help networks to cope with HIV/AIDS – both individually and collaboratively. Because of stigmatization, many PHAs disclosed their illness selectively, thus constraining the size and composition of their networks. Health system actors created network‐building opportunities for PHAs by providing them with care, referrals and support programs.Originality/valueThis study describes and explains an understudied type of information behavior: information/help network development at individual, group and institutional levels. As such, it illuminates the complex dynamics that made individual acts of interpersonal information acquisition and sharing possible.

The impact of aging on cancer burden in people with HIV/AIDS

Background People with HIV/AIDS (PWHA) have higher risk of some cancers compared to the general population, with an approximately 2-fold increase for all non-AIDS-defining cancers (NADC). The widespread use of highly active antiretroviral therapy (HAART) has improved life expectancy of PWHA, exposing them to both aging and the prolonged exposure to cancer risk factors. A linkage study was therefore conducted to evaluate the impact of aging on the burden of cancer in this population.

Cancer incidence in people with AIDS in Italy

People with HIV/AIDS (PWHA) have increased risk of some cancers. The introduction of highly active antiretroviral therapies (HAART) has improved their life expectancy, exposing them to the combined consequences of aging and of a prolonged exposure to cancer risk factors. The aim of this study was to estimate incidence rates (IR) in PWHA in Italy, before and after the introduction of HAART, after adjusting for sex and age through direct standardization. An anonymous record linkage between Italian AIDS Registry (21,951 cases) and Cancer Registries (17.3 million, 30% of Italian population) was performed. In PWHA, crude IR, sex- and age-standardized IR and age-specific IR were estimated. The standardized IR for Kaposi sarcoma and non-Hodgkin lymphoma greatly declined in the HAART period. Although the crude IR for all non-AIDS-defining cancers increased in the HAART period, standardized IR did not significantly differ in the 2 periods (352 and 379/100,000, respectively). Increases were seen only for cancer of the liver (IR ratio = 4.6, 95% CI: 1.3-17.0) and lung (IR ratio = 1.8, 95% CI: 1.0-3.2). Age-specific IRs for liver and lung cancers, however, largely overlapped in the 2 periods pointing to the strong influence of the shift in the age distribution of PWHA on the observed upward trends. In conclusion, standardized IRs for non-AIDS-defining cancers have not risen in the HAART period, even if crude IRs of these cancers increased. This scenario calls, however, for the intensification of cancer-prevention strategies, notably smoking cessation and screening programs, in middle-aged HIV-patients.

Existing Analytical Frameworks for Information Behaviour Don’t Fully Explain HIV/AIDS Information Exchange in Rural Communities in Ontario, Canada

A Review of:&#x0D; Veinot, T., Harris, R., Bella, L., Rootman, I., &amp; Krajnak, J. (2006). HIV/AIDS Information exchange in rural communities: Preliminary findings from a three-province study. Canadian Journal of Information and Library Science, 30(3/4), 271-290. &#x0D; &#x0D; Objective –To explore and analyze, against three theoretical frameworks of information behaviours, how people with HIV/AIDS, their friends, and their family living in rural communities find information on HIV/AIDS. &#x0D; &#x0D; Design – Qualitative, individual, in-depth, semi-structured interviews.&#x0D; &#x0D; Setting – Two rural regions in Ontario, Canada.&#x0D; &#x0D; Subjects – Sixteen participants; 10 people with HIV/AIDS (PHAs) and 6 family members or friends.&#x0D; &#x0D; Methods – Participants were recruited through health care providers, social service agencies and through snowball sampling. Semi-structure interviews were conducted focusing on participants’ experience with HIV/AIDS, how they find and use information on HIV/AIDS, networks for information exchange and the effect of technology on information exchange. Interviews were taped, transcribed, analyzed qualitatively using NVivo software. Results were compared to three theoretical frameworks for information behaviour: 1. purposeful information seeking (i.e., the idea that people purposefully seek information to bridge perceived knowledge gaps); 2. non-purposeful or incidental information acquisition (i.e., the idea that people absorb information from going about daily activities); and 3. information gate keeping (i.e., the concept of private individuals who act as community links and filters for information gathering and dissemination).&#x0D; &#x0D; Main Results – Consistent with the theories:&#x0D; • PHAs prefer to receive information from people they have a personal relationship with, particularly their physician and especially other PHAs.&#x0D; • PHAs’ friends and families rely on their friends and family for information, and are particularly reliant upon the PHA in their lives.&#x0D; • Fear of stigma and discrimination cause some to avoid seeking information or to prefer certain sources of information, such as healthcare providers, who are bound by codes of professional conduct.&#x0D; • Emotional support is important in information provision and its presence supersedes the professional role of the provider (social workers and counsellors were identified as key information sources over medical professionals in this instance). Participants responded negatively to the perceived lack of support from providers including doubting the information provided.&#x0D; • PHAs monitor their worlds and keep up to date about HIV/AIDS.&#x0D; &#x0D; Inconsistent with theories:&#x0D; • Reliance on caregivers for information is not solely explained by fear of stigma or exposure. Rather, it is the specialized knowledge and immersion in HIV/AIDS which is valued.&#x0D; • The distinction between peer or kin sources of information and institutional information sources is less clear and relationships with professionals can turn personal over time.&#x0D; • Inter-personal connections include organisations, not just individuals, particularly AIDS Service Organizations and HIV specialist clinics.&#x0D; • Relatively few incidents of finding useful information about HIV/AIDS incidentally were described. The concept of information just being “out there” was not really applicable to rural settings, likely due to the lack of discussion within participant communities and local media. When it was discussed, participants reported being more likely to gain misinformation through their personal networks.&#x0D; • Incidental information acquisition originates mostly from professional and organisational sources. Participants identified posters, leaflets, and, for those who interacted with organisations, information via mail as contributing to current awareness. &#x0D; • The gate keeping concept does not capture all the information sharing activities undertaken by “gate keepers” in rural areas, and neither does it include formal providers of information, yet all PHAs interviewed identified formal providers as key sources.&#x0D; &#x0D; Conclusion – The findings reinforce some of the existing analytical framework theories, particularly the importance of affective components (i.e. emotional supports) of information seeking, the presence of monitoring behaviours, and of interpersonal sources of information. However, alternate theories may need to be explored as the role of institutional information sources in the lives of PHAs doesn’t match the theoretical predication and the “gate keeper” concept doesn’t capture a significant portion of that role in rural HIV/AIDS information exchange.

Interactive acquisition and sharing: Understanding the dynamics of HIV/AIDS information networks

AbstractHIV/AIDS information is an important resource for people affected by the disease, particularly information that they obtain from other people. Although existing studies revealthatpeople with HIV/AIDS (PHAs) rely extensively on personal relationships for HIV/AIDS information, they explain little abouthowthis happens as a social process. To investigate how PHAs and their friends/family members acquire and share network‐mediated HIV/AIDS information, semistructured, in‐depth interviews were conducted in three rural regions of Canada. Interviews were carried out with 114 PHAs, their friends/family members, and health care and service providers. A network solicitation and chain‐referral recruitment procedure was used to delineate HIV/AIDS information networks for participants. Interview data were analyzed qualitatively and compared to Haythornthwaite's (1996) concepts of network‐mediated information processes and Talja and Hansen's (2006) collaborative information behavior framework. Findings revealed that participants obtained HIV/AIDS information from their networks through five interactive processes: joint seeking, tag‐team seeking, exposure, opportunity, and legitimation. The results of this study advance information behavior theory by pointing to the interactive character of information behavior and introducing new concepts to describe everyday life collaborative information behavior. This research also demonstrates the extensive interplay between health information exchange and the sharing of emotional support. The insights emanating from this study suggest that health information practice might benefit from a focus on program strategies such as building information network capacity, developing collaborative information retrieval systems and relationship‐building, in addition to the more traditional library‐related concerns of reference encounters, collections, and institutional Web sites.

Kaposi sarcoma incidence in the Swiss HIV cohort study before and after highly active antiretroviral therapy

Between 1984 and 2006, 12 959 people with HIV/AIDS (PWHA) in the Swiss HIV Cohort Study contributed a total of 73 412 person-years (py) of follow-up, 35 551 of which derived from PWHA treated with highly active antiretroviral therapy (HAART). Five hundred and ninety-seven incident Kaposi sarcoma (KS) cases were identified of whom 52 were among HAART users. Cox regression was used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (CI). Kaposi sarcoma incidence fell abruptly in 1996-1998 to reach a plateau at 1.4 per 1000 py afterwards. Men having sex with men and birth in Africa or the Middle East were associated with KS in both non-users and users of HAART but the risk pattern by CD4 cell count differed. Only very low CD4 cell count (>50 cells microl(-1)) at enrollment or at HAART initiation were significantly associated with KS among HAART users. The HR for KS declined steeply in the first months after HAART initiation and continued to be low 7-10 years afterwards (HR, 0.06; 95% CI, 0.02-0.17). Thirty-three out of 52 (63.5%) KS cases among HAART users arose among PWHA who had stopped treatment or used HAART for less than 6 months.

Challenge and co‐operation: civil society activism for access to HIV treatment in Thailand

Civil society has been a driving force behind efforts to increase access to treatment in Thailand. A focus on HIV medicines brought civil society and non-governmental and government actors together to fight for a single cause, creating a platform for joint action on practical issues to improve care for people with HIV/AIDS (PHA) within the public health system. The Thai Network of People with HIV/AIDS, in partnership with other actors, has provided concrete support for patients and for the health system as a whole; its efforts have contributed significantly to the availability of affordable generic medicines, early treatment for opportunistic infections, and an informed and responsible approach towards antiretroviral treatment that is critical to good adherence and treatment success. This change in perception of PHA from 'passive receiver' to 'co-provider' of health care has led to improved acceptance and support within the healthcare system. Today, most PHA in Thailand can access treatment, and efforts have shifted to supporting care for excluded populations.

“A lot of people didn't have a chance to support us because we never told them” Stigma management, information poverty and HIV/AIDS information/help networks

AbstractBecause of fears of stigmatization, people with HIV/AIDS (PHAs) may avoid health care and refuse illness‐related information and support. However, HIV/AIDS‐related information, especially that which is provided by other people, has also been shown to a vital resource for PHAs and their loved ones. This research examines the role of stigmatization in PHAs' and their friends/family members' efforts to establish personal networks for HIV/AIDS‐related information and help ("information/help networks"). To investigate this question, I draw upon Goffman's (1963) stigma management theory and Chatman's (1996) theory of information poverty. Semi‐structured, in‐depth interviews were conducted with 114 PHAs, their friends/family members, health care and service providers in three rural regions of Canada. Results revealed that the majority of PHAs and friends/family members had relatively small networks for HIV/AIDS information/help. For many participants, the challenges of living with HIV/AIDS led to changes in their personal networks, and stigmatization playing a significant part in such changes. Participants developed information/help networks in a manner consistent with stigma management theory in their decisions to disclose selectively to others, to avoid the topic in conversation, to obtain information/help at a distance or to acquire information/help without disclosing their HIV status. However, in contrast to Chatman's theory, participants did not wholly avoid information from interpersonal sources nor believe that no one was available to help them. These findings suggest that information behaviour theory may need to evolve in order to account for the complexity of self‐protective behaviour.

Kaposi sarcoma incidence in the Swiss HIV Cohort Study before and after highly active antiretroviral therapy.

Between 1984 and 2006, 12 959 people with HIV/AIDS (PWHA) in the Swiss HIV Cohort Study contributed a total of 73 412 person-years (py) of follow-up, 35 551 of which derived from PWHA treated with highly active antiretroviral therapy (HAART). Five hundred and ninety-seven incident Kaposi sarcoma (KS) cases were identified of whom 52 were among HAART users. Cox regression was used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (CI). Kaposi sarcoma incidence fell abruptly in 1996–1998 to reach a plateau at 1.4 per 1000 py afterwards. Men having sex with men and birth in Africa or the Middle East were associated with KS in both non-users and users of HAART but the risk pattern by CD4 cell count differed. Only very low CD4 cell count (<50 cells μl−1) at enrolment or at HAART initiation were significantly associated with KS among HAART users. The HR for KS declined steeply in the first months after HAART initiation and continued to be low 7–10 years afterwards (HR, 0.06; 95% CI, 0.02–0.17). Thirty-three out of 52 (63.5%) KS cases among HAART users arose among PWHA who had stopped treatment or used HAART for less than 6 months.

Underestimation of Relative Risks by Standardized Incidence Ratios for AIDS-Related Cancers

Registry-based studies provide valuable data regarding cancer risk among people with HIV/AIDS (PWHA). Such studies utilize the standardized incidence ratio (SIR) to estimate the relative risk (RR), an etiologically relevant measure. However, SIR may underestimate RR when HIV/AIDS prevalence in the general population or RR is high. We quantified the extent of this underestimation for 3 AIDS-related cancers: Kaposi sarcoma (KS), central nervous system non-Hodgkin lymphoma (CNS NHL) and cervical cancer. We used data on cancer risk among PWHA from the U.S. HIV/AIDS Cancer Match Study. SIRs were compared with RRs estimated using two methods: (1) SIRs calculated using pre-AIDS era (1973-1979) cancer incidence rates (SIRpre-AIDS) and (2) SIRs calculated after subtraction of cancers known to be among PWHA from general population rates (SIRexclusion). For KS and CNS NHL, SIRs (117.8 and 133.9, respectively) calculated using overall general population rates substantially underestimated both SIRpre-AIDS (19,778 and 3,612, respectively) and SIRexclusion (657.7 and 536.4, respectively). In contrast, the extent of underestimation was negligible for cervical cancer (SIR = 4.9 vs. SIRexclusion = 5.1). For KS and CNS NHL, SIRs were higher in females than in males. However, SIRpre-AIDS and SIRexclusion estimates were more similar, indicating that SIR differences artifactually reflect differences in HIV/AIDS prevalence between males and females. For KS and CNS NHL, trends across calendar time were weaker in SIRs than in SIRpre-AIDS and SIRexclusion. For KS and CNS NHL, SIRs substantially underestimate RRs. This underestimation arises from the exceptionally high relative risk of KS and CNS NHL among PWHA. SIRs must be interpreted cautiously when HIV/AIDS prevalence is high or varies across groups of interest.

Examining attribution model of self-stigma on social support and psychological well-being among people with HIV+/AIDS

Among various infectious diseases, HIV/AIDS is considered to be one of the most stigmatizing conditions. Using a prospective design, the present study attempted to test the attributional pathway from perceived control to responsibility to self-blame and finally to self-stigmatization, and to examine the social and psychological sequelae of stigma among a sample of 119 people with HIV/AIDS (PWHA) in Hong Kong. Structural equation modeling findings showed that the model had good fit to the data. Although the linkage between the attributions of control, responsibility, and blame was confirmed, the relationship of blame to self-stigma was not significant. Self-stigma was found to dampen social support and lead to psychological distress half a year later. The present study challenged the adequacy of attributional factors in understanding self-stigmatization and demonstrated the impact of stigma on psychological adjustment among PWHA.

The migratory experiences of people with HIV/AIDS (PWHA) in Wilmington, North Carolina

People with a serious illness such as HIV/AIDS may migrate in order to receive support from family and friends and/or better health care. In this paper, I examine the experiences of people with HIV/AIDS (PWHA) that are initial and return migrants to Wilmington, North Carolina. For the study this paper is based upon, I conducted 63 interviews of service providers, PWHA and community members in Wilmington, North Carolina. Qualitative data analysis reveals that for return migrants, migration networks made the move and getting ‘into the system’ easier while initial migrants struggled through the relocation process and often moved for reasons unrelated to family or friends in the area.

Low HIV infection rates among tuberculosis patients in Dhaka, Bangladesh

The association of tuberculosis (TB) with HIV infection is well established with TB being one of the common manifestations of AIDS. The proportion of TB cases with HIV infection has been rising and the global prevalence of TB/HIV coinfection among adults aged 15–49 years is 0.36%. India has the largest number of co-infected individuals. Bangladesh ranks fifth among the countries with the highest burden of TB but fortunately HIV prevalence in Bangladesh is still low. However recent data from surveillance show that Bangladesh is at the brink of a concentrated epidemic in injecting drug users. The country has 363 people with HIV/AIDS (PHA) identified through passive case reporting as announced by the National AIDS/STD Programme of the Government of Bangladesh on 1 December 2003. Of 67 PHA who visited the Voluntary Counselling and Testing (VCT) Unit of ICDDRB between April 2003 and June 2004 47 had opportunistic infections of whom six had TB (M M Parvez ICDDRB personal communication). (excerpt)

PARENTS' HETEROSEXISM AND CHILDREN'S ATTITUDES TOWARD PEOPLE WITH AIDS

This research examines how parental heterosexism—negative attitudes toward homosexuals and homosexuality—and other family characteristics relate to the development of children's attitudes toward people with HIV/AIDS (PWA). Attention is directed to the overall relationship between parents’ and children's attitudes and to the potential mechanisms through which these linkages are manifested. Based on social learning theories of childhood socialization, a range of mechanisms is considered, focusing on heterosexist attitudes in parents and communication with children about AIDS. Findings indicate that parental attitudes concerning homosexuals influence children's attitudes toward PWA, implying that there can be negative as well as positive consequences of parents’ beliefs on children's attitudes. The possibility of negative parental effects on children's prejudices toward PWA suggests that in-school HIV/AIDS education at younger ages is more important than previously thought.