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 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Kika, a 35-year-old Ugandan mother of five was widowed by AIDS in 1990. After her husband's death, she lost her job and was forced to return to her late father's land and to give some of her children to her mother's care. Soon after she returned, her three-year-old daughter began showing symptoms of HIV infection. In total despair, Kika contacted TASO (The AIDS Support Organization) for help. TASO counselors have helped Kika identify possible income-generating projects which she is trying desperately to realize. This is very difficult because she has no capital to invest in her scheme. Her neighbors and sisters know her status and treat her kindly. Her mother probably suspects that Kira has AIDS but will never discuss it with her. Kika has been celibate since her husband died because she does not want to transmit the disease to another man or to another potential child. Her concern is entirely vested in producing enough income to take care of her children until she dies.
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PMID:"I want to work" -- Kika's story. Special report: women and HIV. 1228 48

Nigeria may be taken to represent countries with an evolving HIV/AIDS epidemic. With particular reference to paediatric HIV, the voluntary testing of young children and their parents may provide an important entry point for the institution of control measures. However, there is a paucity of knowledge about how individuals perceive voluntary testing. This knowledge is important to the development of guidelines for counselling. To reduce this gap, 258 parents of hospitalized children (> 1 month to 15 years of age) were interviewed using a structured questionnaire. In addition, to complement the data, four examples of seropositive mother's responses during post-test counselling are presented and analyzed. In the survey, 223 (86%) parents were HIV/AIDS aware but only 88 (39%) of these parents could describe one or more route(s) of transmission and none described vertical transmission. Among the respondents, 153 (62%) of 248 would consent to the screening of self, and 195 (85%) of 230 to the screening of a hospitalized child if based on his/her clinical condition. Perceptions of good health and lack of exposure, and despair owing to lack of a specific treatment, were the common reasons for refusing consent. These represent some of the issues which would need to be addressed to increase the acceptance of voluntary testing. The fear of a break up of families with seropositive mothers but seronegative fathers was a major concern expressed during post-test counselling. HIV-discordance among couples may be frequent and should be considered in the formulation of policies on counselling and voluntary testing.
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PMID:Perception of voluntary screening for paediatric HIV and response to post-test counselling by Nigerian parents. 1241 18

This small descriptive study investigated the experiences of Ugandan women living with a diagnosis of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), exploring what assisted them to cope and identifying their future concerns. A purposeful sample of seven HIV-positive women was accessed through two indigenous non-governmental organizations in Eastern Uganda. Single semi-structured interviews were conducted on location. Following analysis of the narrative data, three principal aspects of their experiences emerged: loss and adversity, constructive living, and future uncertainties. Loss and adversity encompassed bereavements, multiple psychosocial losses and physical suffering. Constructive living related to the ability to adopt positive living activities, rebuilding shattered lives, sometimes from the brink of despair. Since the participants were all mothers, future concerns focused on child care anxieties. Stress and uncertainty surrounding HIV testing of children was also evident. Despite the cultural contrast, many of the findings were remarkably similar to those documented in Western literature. The women related their experiences with an absence of self-pity or resentment. Resilience, resourcefulness and hope were typically, perhaps instinctively, demonstrated.
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PMID:A study of the experiences of women living with HIV/AIDS in Uganda. 1241 95

Hope is an important protective phenomenon in human life, particularly given that long-lasting despair or hopelessness may threaten human existence. However, previous knowledge on the topic related to people affected by HIV/AIDS is scant. The purpose of this study was to explore the dynamics of hope in significant others of people living with HIV/AIDS and persons living with HIV (PLWH) or AIDS (PLWA) from the perspective of significant others in Finland. Eleven interviews were conducted with six significant others. The data were analyzed using the grounded theory method. The dynamics of hope, as it emerged from the data, is constructed of three main elements: hope, despair, hopelessness, and their reciprocal relationships. An alternating balance between hope, despair, and hopelessness based on the factors contributing to them emerged as central in the dynamics of hope. The dynamics of hope are closely connected to the basic process of searching for one's own way with HIV/AIDS, in becoming HIV-positive, and living with HIV/AIDS. In significant others, the dynamics of hope are closely connected to the basic process of HIV, changing from abstract to concrete in a relationship with a PLWH/PLWA.
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PMID:Dynamics of hope in HIV/AIDS affected people: an exploration of significant others' experiences. 1465 73

HIV vaccine availability does not guarantee uptake. Given suboptimal uptake of highly efficacious and already accessible vaccines in the United States, low vaccine coverage in the developing world, and the expectation that initial HIV vaccines will be only partially efficacious, the public health community will face formidable challenges in disseminating U.S. Food and Drug Administration (FDA)-approved HIV vaccines. HIV/AIDS stigma, fear of vaccine- induced HIV infection, social side effects of testing HIV-positive, and mistrust of government and research present additional obstacles to HIV vaccine dissemination. Increased risk behaviors because of HIV vaccine availability can undermine the effectiveness of partially efficacious vaccines in reducing HIV incidence. HIV vaccine efficacy trials also face significant challenges in recruitment of sufficient volunteers and possible increases in risk behaviors due to trial participation. Planning and designing interventions to facilitate successful recruitment for large-scale phase 3 efficacy trials is a vital step towards U.S. FDA-approved HIV vaccines. Rather than despair in the face of momentous HIV vaccine dissemination challenges, or presume unrealistically that vaccine uptake will ensue automatically and that risk behavior increases will not occur, let us deem the estimated 10-year window to an approved HIV vaccine as an opportunity to investigate and confront these challenges. A consumer research agenda founded on social marketing principles is needed to facilitate the design of empirically-based interventions tailored to the unique needs and preferences of specific segments of consumers. Social marketing interventions may increase future HIV vaccine uptake and clinical trial participation, and mitigate increases in HIV risk behaviors.
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PMID:Challenges for HIV vaccine dissemination and clinical trial recruitment: if we build it, will they come? 1565 80

The challenges of working with medically and mentally ill persons with a paucity of resources, inadequate networks of social support, and multiple stresses and losses maybe daunting to even the most seasoned of caregivers. A psychiatric trainee may be overwhelmed by the despair, sorrow, and desperation en-countered in the day-to-day care of the complex severely ill patient with lethalmedical and lethal psychiatric diagnoses. Individuals who are infected with HIV and hepatitis C, who are polysubstance users, and who are benzodiazepine dependent present with inordinate demands for prescribed substances to use or to sell in the street. The trainee needs to become comfortable with both limit-setting and harm reduction in order to keep the patient engaged in both lifesaving medical and psychiatric care. Nurturing and supportive supervision enables the trainee to integrate skills and work toward an understanding of countertransferences. An ego-supportive psychodynamic approach to supervision in an AIDS psychiatry fellowship facilitates conflict resolution and improves the care of patients with complex and severe medical illness.
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PMID:Preserving a sense of wonder: the integration of an ego-supportive psychodynamic approach to supervision in an AIDS psychiatry fellowship. 1623 73

In Tanzania, women of reproductive age constitute the largest group infected by HIV. This study aimed to explore the lived experiences related to health and sexuality of Tanzanian women who had known their positive serostatus for 1 year. In-depth interviews with 10 women were analyzed using a phenomenological-hermeneutic approach and showed frustration and despair at not having resources to maintain daily life. The women needed regular medical treatment for themselves and for their HIV-positive children. Their sexual desires had declined or vanished, and they had come to view sexuality as a source of transmittable disease. For some women, casual sex was an option to solve urgent financial needs. Happiness was something for their children, not for them. Access to social support from the women's community would help prevent further HIV transmission and enhance survival so the children could grow up with at least one devoted parent.
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PMID:Poverty and devastation of intimate relations: Tanzanian women's experience of living with HIV/AIDS. 1788 20

This is an account of a panel discussion. It focuses on an encounter with the HIV/Aids virus. Such an encounter may result in a descent into despair, hopelessness and ultimately death, or it may offer the opportunity of possible transformation of consciousness to embrace a life lived productively and meaningfully with a chronic but manageable disease. A picture is provided of the dire situation that exists regarding the HIV/Aids pandemic in South Africa. The HI-virus is compared to a malevolent trickster type energy that uses ingenious means to gain access to the host. It is an impersonal agent seeking only its own survival but if left untreated will ultimately result in the death of the host. Reference is made to characters in the musical, The Lion King, to illustrate that it is the willingness to suffer the painful emotions evoked following a diagnosis of being HIV-positive more consciously that allows for a transformation from despair and hopelessness to a life lived productively and meaningfully. Two of the panelists who are HIV-positive share their experiences of this process. One recounts how, living with Aids, his connections with others and human relatedness helped to restore his dignity and self-worth. The other relates how his willingness to state his status publicly allowed him to overcome the stigma and shame that are evoked when diagnosed as HIV-positive. This has allowed him to seek appropriate treatment with ARV's. He now lives with a chronic but manageable infection and leads a creative and significant life. The difficulties encountered regarding the prevention of HIV/Aids when attempting to change potentially destructive sexual behaviours in teenagers are discussed. An inspiring account of work in treating those that live with HIV/Aids under difficult circumstances is also discussed.
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PMID:HIV/Aids: an encounter with death or a journey into life? 1835 50

The global human immunodeficiency virus (HIV) pandemic reached staggering proportions over the past 2 decades, particularly in areas of sub-Saharan Africa and other developing countries. Tremendous increases in donor resources over the past decade have allowed for a rapid scale-up of antiretroviral treatment and greater access to basic care and prevention programs in countries worst affected by HIV infection and AIDS. These programs have had a tremendous impact on the lives of millions of individuals and have also created optimism and hope where previously there was despair. Major challenges remain in combating the current HIV pandemic with regard to access to treatment; efficiency, quality, and sustainability of current programs; and the scale-up of evidence-based, effective prevention strategies. The global health community and political leaders will need to overcome these challenges if a long-term effective response to the HIV pandemic is to be achieved.
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PMID:Setting the stage: current state of affairs and major challenges. 2039 59

In Kenya, as in other countries of sub-Saharan Africa heavily burdened by HIV/ AIDS, orphans and vulnerable children (OV/C) face poverty and despair. There is an urgent need to provide a comprehensive response that supports families and communities in their efforts to care for children and safeguard their rights. The government of Kenya has established a cash transfer program that delivers financial and social support directly to the poorest households containing OV/C, with special concern for those children with or affected by HIV/AIDS. The Kenyan effort builds on lessons drawn from research and program development on cash transfers in Latin America, Asia, and Africa, and the Kenyan program offers an opportunity to examine the challenges faced by Kenya, and its responses in the context of international experiences. This paper-based on observation of and interviews with key actors involved in the origins, development, evaluation, and continued strengthening of Kenyas cash transfer program and on the analysis of technical program documents obtained from those key actors--describes the Kenyan cash transfer program in light of human rights issues as they relate to childrens health. It offers one example of how caring for society's most vulnerable members is a collective responsibility to be shared by a country's government, local citizens, and the international community.
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PMID:Kenya's cash transfer program: protecting the health and human rights of orphans and vulnerable children. 2084 42


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