Cultural competence in HIV prevention and care: different histories, shared future

The Symbolic Meaning of HIV: Understanding Lecturers' Ambivalence over Teaching HIV to Dietetic Students

Responding to the increasing reports of health students and professionals demonstrating stigmatized attitudes toward people living with HIV (PLHIV), this article examined the learning process that takes place during their academic training. Using symbolic interactionism as a theoretical framework, we studied the way lecturers in dietetic schools in Indonesia make meaning of their understanding and experience of HIV in relation to their teaching conduct. We found that the current curriculum does not provide adequate opportunities for students to learn and interact with PLHIV. Participants described HIV discussion is mainly limited to the clinical aspects and essential treatment as they were uncomfortable discussing HIV with the students. The ostensible symbolic meaning of HIV among dietetic lecturers in Indonesia was compounded with limitations and restrictions affecting their teaching practices and attitudes to PLHIV. Future intervention is required to help lecturers recognize their degree of awareness and personal values about HIV.

Services, Stigma, and Discrimination: Perceptions of African Descendant Men Living with HIV/AIDS in Brazil and in the United States

This study aimed to give voice to 13 men of African descent from Salvador, Brazil, and East Texas, United States, living with HIV/AIDS regarding their perceptions on accessibility of services, and the stigma and discrimination they experience. Phenomenological research using in-depth interviews was used as methodology. Five themes emerged from the data analysis: perception of positive health, services and accessibility, not disclosing HIV status is a way to be protected, health professionals untrained in treating people living with HIV/AIDS, being of African descent increases discrimination in both countries, education would decrease stigma and discrimination. This study addresses how stigma and discrimination experienced by these men violate their human rights, and the need of policies to mitigate these practices.

Breaking through the silence: the experience of living with HIV-positive serostatus, and its implications on disclosure

AIDS has reached pandemic proportions and despite advances in medical treatment both the medical and social consequences of HIV-positive serostatus continue to be of concern throughout the world. In countries with greater access to antiretroviral therapy (ARV), HIV/AIDS it is no longer defined as fatal, but rather a chronic disease, thereby this study seeks to understand the experience of individuals living with HIV-positive serostatus, a multifaceted disease, from the time the infection is diagnosed through the four post-diagnosis years, and in particular its implications on the issue of disclosure. A qualitative analysis was conducted, based on 13 in-depth interviews with participants who are HIV-positive and the data was analyzed by inductive content analysis. The results identify six themes, four central elements that compose the experience of living with HIV: the emotional experience, the stigma attached to HIV, the inner dialogue, and disclosure. A three-phase coping process and personality differences were found, all of which will be discussed. The issue of disclosure was found to be cardinal and problematic in its impact on the patient's wellbeing.